Inter-Departmental Correspondence
Health System



October 16, 2009


November 10, 2009







Honorable Board of Supervisors



Jean S. Fraser, Chief, Health System


Louise Rogers, Director, Behavioral Health & Recovery Services



Amendment to the Agreement with Veterans Affairs, Palo Alto Health Care System



Adopt a Resolution authorizing the President of the Board to execute an Amendment to the Agreement with Veterans Affairs, Palo Alto Health Care System decreasing the maximum obligation by $204,894, from $968,458 to $763,564, and revising the term end date from February 28, 2011 to December 1, 2010.



Since 2001 the Health System has contracted with the Department of Veterans Affairs, Palo Alto Health Care System (VA) for the use of a building on their Willow Road campus. On June 6, 2006, your Board approved an Agreement for these services for the term March 1, 2006 through February 28, 2007, which included mutual options for four more years, for a maximum obligation of $968,458. Upon receipt of our intention to continue to use the facilities, the VA executed unilateral amendments for the years FY 2007-08, FY 2008-09, and FY 2009-10. Initially the VA facility was used to house the AB2034 supportive / transitional housing program for 40 psychiatrically disabled clients, a program operated through a Behavioral Health & Recovery Services (BHRS) Agreement with Telecare Corporation (Telecare). State AB2034 funding has been discontinued, and clients requiring that intensive level of care now receive services through the contracted Full Services Partnership (FSP) program services provided by Telecare.


Under the current Agreement the VA provides the residential facility, minor maintenance and repair services, external building and property security services, and fire protection services. Daily maintenance of the facility is the responsibility of Telecare.



The VA has recalculated the value of the rental space on their Willow Road campus based upon their actual costs, rather than current market value, which has resulted in a decreased cost for renting the facility. They have presented an Amendment that reflects that decrease, effective January 1, 2009. The annual cost for FY 2009-10 is decreased by $85,338, from $202,320 to $116,982. In addition the term end date is changed from February 28, 2011 to December 1, 2010. The VA has notified us that as of December 1, 2010, this facility will be closed for remodeling. BHRS is in the process of locating another location to house this program. All other terms and conditions of the Agreement remain the same.


The Amendment to the Agreement has been reviewed and approved by Real Property and Risk Management. County Counsel has also approved the Amendment and the Resolution. The VA is in compliance with the County Ordinance with respect to provisions of jury duty pay to employees. The County Manager approved a waiver for the term of the Agreement to extend beyond three years to five years, and a waiver of our County’s Equal Benefits Ordinance requirements.


The amended Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing facilities that house FSP 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 FSP services is one established level of care. This amended Agreement supports the provision of FSP services. It is anticipated that annual hospitalization days for clients who receive FSP services will be reduced by 76 percent.


Performance Measure:


FY 2008-09

    FY 2009-10

Annual reduction in total days of hospitalization for FSP enrollees





The amended Agreement maximum is being decreased by $204,894, from $968,458 to $763,564 for the revised term of March 1, 2006 through December 1, 2010. The maximum cost for FY 2009-10 is reduced by $85,338 from $202,320 to $116,982, which has been included in the BHRS FY 2009-10 Adopted Budget. This amended Agreement is 100% funded by sales tax through realignment revenues. There is no Net County Cost.