COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health System

 

DATE:

April 8, 2009

BOARD MEETING DATE:

June 9, 2009

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

 

TO:

Honorable Board of Supervisors

   

FROM:

Jean S. Fraser, Chief, Health System

 

Nomalee Tilman, Director, Correctional Health Services

   

SUBJECT:

Agreement with Santa Clara County for Acute Inpatient Mental Health Treatment

 

RECOMMENDATION:

Adopt a Resolution:

1)

Waiving the Request for Proposals requirement; and

 

2)

Authorizing the President of the Board to execute an Agreement with Santa Clara County for two beds at the Santa Clara County Main Jail for San Mateo County inmate-patients for the term of July 1, 2009 through June 30, 2011, for a maximum obligation of $2,049,640.

 

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goal 8: Help vulnerable people – the aged, disabled, mentally ill, at-risk youth and others – achieve a better quality of life.

 

The Agreement contributes to this commitment and goal by assuring that critical inpatient mental health care is provided to seriously mentally ill inmates of the San Mateo County jails.

 

Performance Measure:

Measure

FY 2008-09
Estimate

FY 2009-10
Target

Average daily bed use

1.71

1.71

 

BACKGROUND:

From 1997 through June 2009, the Health System has contracted with Santa Clara County to provide beds in their main jail for San Mateo County inmates requiring acute inpatient mental health treatment. On June 3, 2008, by Resolution 69459 your Board approved an Agreement which provided two guaranteed beds at the Santa Clara County Main Jail.

 

DISCUSSION:

The San Mateo County inmate-patient occupancy rate for the Santa Clara County beds averaged 1.71 beds per day last fiscal year, although at any given time as many as four seriously mentally ill inmates have required acute inpatient mental health treatment. Correctional Health Services provides mental health coverage for suicide screening, outpatient treatment and behavior management in County facilities. However, some of the most seriously mentally ill inmates require more intensive and involuntary inpatient treatment. Santa Clara County provides beds in its main jail for inmates requiring acute inpatient mental health treatment. This is the only correctional inpatient psychiatric unit in the Bay Area. The contract also provides that the County will reimburse Santa Clara for 60% of costs for acute medical services at the Santa Clara Valley Medical Center, and 100% of medical costs provided by any other medical facility. Due to the high costs associated with this Agreement staff will continue to examine alternatives, however there are no other options at this time.

 

A waiver of the Request for Proposals requirement is requested as Santa Clara County is the only provider of this service in the Bay Area. It has been providing this service to San Mateo County’s seriously mentally ill inmates since 1997.

 

County Counsel has reviewed and approved the Agreement as to form and content. As required by the contractor, the Agreement is the Santa Clara County standard form agreement and therefore contains hold harmless and non-discrimination language different than that of San Mateo County. The contractor provides equal benefits and complies with the Employee Jury Service Ordinance, though the contract does not include the standard language. The County Manager has approved a waiver of the standard language regarding non-discrimination, employee jury service and equal benefits. Risk Management has reviewed and approved the insurance coverage.

 

FISCAL IMPACT:

The term of the Agreement is July 1, 2009 through June 30, 2011. The Agreement maximum is $2,049,640. The cost of two guaranteed beds for 365 days at a rate of $1,350 per bed per day is $985,500 for the period July 1, 2009 through June 30, 2010. With a 5% COLA in effect for the second year, the cost of two guaranteed beds for 365 days at a rate of $1,418 per bed per day is $1,035,140 for the period of July 1, 2010 to June 30, 2011. The Agreement maximum also includes $14,500 per year for medical expense reimbursement. Costs associated with the Agreement are included in the Correctional Health Services FY 2009-10 Recommended Budget and are funded by reimbursement from Behavioral Health and Recovery Services. Similar arrangements shall be made for FY 2010-11.