Inter-Departmental Correspondence

Health System



May 5, 2010


June 8, 2010







Honorable Board of Supervisors



Jean S. Fraser, Chief, Health System

Louise Rogers, Director, Behavioral Health & Recovery Services



Agreement with Pyramid Alternatives



Adopt a Resolution:

1) Waiving the Request for proposals requirement for mental health and substance abuse treatment; and


2) Authorizing the President of the Board to execute an Agreement with Pyramid Alternatives for the provision of mental health services for the term July 1, 2010 through June 30, 2011, for a maximum obligation of 187,418; and


3) Authorizing the Director of Health or the Director's 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.



Pyramid Alternatives (PA) has a 30 year history providing mental health, substance abuse, and co-occurring treatment for multicultural adults, children and youth. In 2009 PA added the ability to provide supportive group services to older adults in senior centers located in the northern region of San Mateo County. The Senior Supportive Group Services will expand the County’s older adult system of services by using the groups provided by PA to establish a continuum of care.



Because the State has not finalized the budget for FY 2010-2011 and additional cuts to outpatient mental health and drug treatment services are anticipated, a waiver to the RFP process is recommended. Behavioral Health and Recovery Services (BHRS) will continue to accept “any qualified provider” who requests to contract with the County for these services as a means to encourage competition for public contracts. BHRS is accepting the Agreement with Pyramid Alternatives – NCOC for the provision of outreach and engagement of mental health services to youth and underserved populations in the north area of the County. Pyramid Alternatives will provide these services as the lead agency of the North County Outreach Collaborative (NCOC), which includes Asian American Recovery Services (AARS), the Pacifica Collaborative and the Daly City Collaborative.


The Resolution and Agreement have been reviewed and approved by County Counsel. The Agreement has been reviewed by Risk Management. 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.


Subsequent to the final adoption of the State budget it may be necessary to make changes to this contract in order to reflect legislative action. This contract is recommended to your Board at this time in order to provide a continuity of services to the community until final funding levels can be determined. The contract provides that the County may reduce the scope of the contract to reflect any shortfall in funding from State or federal allocations.


The Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing mental health services to seriously emotionally disturbed youth. Behavioral Health and Recovery Services 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 intensive mental health services for youth is one established level of care. The services provided through this Agreement contribute to this measure. It is anticipated that 87% of clients who receive services through this Agreement will be maintained at a current or lower level of care.


Performance Measure(s):


FY 2009-10

FY 2010-11

Percentage of clients maintained at current or lower level of care.





The term of the Agreement is July 1, 2010 through June 30, 2011, for a maximum obligation of $187,418. Of the maximum amount, $15,000 will be funded through Medicare, $83,146 will be funded through federal Medi-Cal, $51,854 will be funded through state Medi-Cal funds, and $37,418 will be funded through the Substance Abuse and Mental Health Services Administration Grant (SAMHSA). There is no Net County Cost. Funds for this Agreement are included in the Behavioral Health and Recovery Services FY 2010-11 Recommended Budget.