COUNTY OF SAN MATEO
Inter-Departmental Correspondence
Health System

DATE:

October 19, 2009

BOARD MEETING DATE:

November 10, 2009

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Jean S. Fraser, Chief, Health System

Louise Rogers, Director, Behavioral Health & Recovery Services

SUBJECT:

Agreement with Health Plan of San Mateo for Healthy Families, Healthy Kids and HealthWorx program funding

RECOMMENDATION:

Adopt a Resolution:

1) Authorizing the President of the Board to execute a revenue Agreement with the Health Plan of San Mateo for Healthy Families, Healthy Kids and HealthWorx for the term January 1, 2009 through December 31, 2011; 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.

BACKGROUND:

Since March 4, 2003, Behavioral Health and Recovery Services (BHRS), then Mental Health Services, has had an Agreement with the Health Plan of San Mateo (HPSM) for the provision of mental health services for beneficiaries covered by Healthy Families, Healthy Kids and HealthWorx. Under this Agreement BHRS is reimbursed by the HPSM for the provision of mental health services to clients with these insurance coverages.

DISCUSSION:

The HPSM has presented an Agreement for the term January 1, 2009 through December 31, 2011, for the administration of mental health benefits and the provision of mental health services for beneficiaries covered by Healthy Families, Healthy Kids and HealthWorx. BHRS will present to your Board for approval a separate Agreement with HPSM, which shall be a revenue Agreement for the provision of services to clients with Medicare CareAdvantage insurances coverage.

The Agreement has been reviewed and approved by Risk Management and the Agreement and the Resolution have been reviewed and approved by County Counsel. 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. The final Agreement, which included a favorable rate increase for BHRS retroactive to January 1, 2009, was sent to BHRS from the Health Plan of San Mateo in early October, 2009 which caused the delay in the presentation to the Board of Supervisors.

The Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing funding for mental health 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 outpatient mental health services through our provider network is one established level of care. The services funded through this Agreement contribute to this measure. It is anticipated that eighty-seven percent of clients who receive services will be maintained at a current or lower level of care.

Performance Measure:

Measure

FY 2008-09
Actual

FY 2009-10
Projected

Percentage of clients receiving outpatient mental health services maintained at current or lower level of care.

87%

87%

FISCAL IMPACT:

The term of the Agreement is January 1, 2009 through December 31, 2011. Services will be reimbursed on a per-unit basis at rates. It is anticipated that this Agreement will have a neutral effect on current reimbursements. Projected annual revenues from the three programs covered in this Agreement are approximately $ 825,000 and have been included in the BHRS FY 2009-10 Adopted Budget. There is no net County cost associated for services provided through this Agreement.