COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health System

DATE:

May 11, 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

Lisa Mancini, Director, Aging and Adult Services

Louise Rogers, Director, Behavioral Health and Recovery Services

Brian Zamora, Director, Community Health

SUBJECT:

Agreement with Telecare Corporation for services at Cordilleras Mental Health Center and Garfield Neurobehavioral Center.

RECOMMENDATION:

Adopt a Resolution:

1)

Authorizing the President of the Board to execute an Agreement with Telecare Corporation for mental health services, direct observation therapy services for non-adherent tuberculosis patients and residential rehabilitation and long-term care for clients of the Public Guardian program, for the term July 1, 2009 through June 30, 2010, for a maximum obligation of $7,621,430; and

2)

Authorizing the Chief of the Health System or designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.

VISION ALIGNMENT:

Commitment: To 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.

This Agreement contributes to this commitment and goal through the provision of inpatient and residential psychiatric treatment services, direct observation therapy for non-adherent tuberculosis (TB) patients and residential rehabilitation and long-term care services for Public Guardian program clients at Garfield Neurobehavioral Center (GNC).

Behavioral Health and Recovery Services (BHRS) provides a range of services to promote wellness and recovery and to support consumers remaining in the lowest possible level of care. The provision of locked facility long-term care services is one established level of care. The services provided through this Agreement contribute to this measure.

Performance Measure:

Measure

FY 2008-09
Estimate

FY 2009-10
Target

Clients maintained at current or lower level of care

62%

65%

BACKGROUND:

Telecare Corporation has provided inpatient and residential psychiatric treatment services for San Mateo County residents at Cordilleras Mental Health Center in Redwood City since 1982. Telecare treats up to 110 seriously mentally ill County residents through the operation of a locked Mental Health Rehabilitation Center (MHRC). Residential care services supported by an assertive treatment team and a direct observation therapy program for non-adherent TB patients are also provided at Cordilleras.

Telecare’s focus on increasing the number of admissions and discharges and shortening the average length of stay in its in-county MHRC program reduces administrative days in the San Mateo Medical Center and reduces placements at more costly out-of-county skilled nursing facilities. Telecare was selected to provide these services through a five-year Request for Proposals (RFP) process prior to FY 2005-06. The B-1 Administrative Memorandum does not require a RFP process for the selection of Telecare’s GNC facility to provide care and placement for clients with severe behavioral issues associated with brain damage.

DISCUSSION:

Telecare will provide a total of 110 beds at Cordilleras dedicated to San Mateo County residents, of which 49 are residential beds for clients receiving intensive case management services and 61 beds are part of the facility’s third floor MHRC. In addition, six MHRC beds are reserved for clients of the Veterans Administration and other counties. Telecare also provides peer counseling for clients discharged from Cordilleras. The GNC facility provides additional bed capacity for conserved clients of the Public Guardian program.

The Agreement has been reviewed and approved by County Counsel and Risk Management. Real Property has reviewed and approved the License Agreement for use of the County-owned Cordilleras facility. The contractor has assured compliance with the County's Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

FISCAL IMPACT:

The term of this Agreement is July 1, 2009 through June 30, 2010. The Agreement maximum is $7,621,430. The maximum obligation for BHRS is $7,210,910, which is included in the BHRS FY 2009-10 Recommended Budget. Sales tax through realignment will fund 100% of this amount.

Community Health (CH) will pay $90,520 at a flat rate of $248 per day to reserve the TB bed for a client regardless of whether or not the bed is filled. The State TB Control Branch will award CH $90,520 for FY 2009-10 to cover these costs. Revenue and expenses related to this Agreement are included in the CH FY 2009-10 Recommended Budget. Aging & Adult Services (AAS) will cover $320,000 for the GNC clients. This amount is included in the AAS FY 2009-10 Recommended Budget. The Net County Cost for services provided for AAS through this Agreement is $320,000.