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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
Health System
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DATE:
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August 19, 2010
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BOARD MEETING DATE:
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September 14, 2010
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Jean S. Fraser, Chief, Health System
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Brian J. Zamora, Director, Community Health Division
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Lisa Mancini, Director, Aging and Adult Services
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Louise Rogers, Director, Behavior Health and Recovery Services
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SUBJECT:
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Amendment Four to the Agreement with American Medical Response West for Assessment and Transport of Persons With Behavioral Emergencies and for the Prescheduled Transport of Clients for Court Appearances
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RECOMMENDATION:
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Adopt a Resolution authorizing the President of the Board to execute Amendment Four to the Agreement with American Medical Response West for assessment and transport of persons with behavioral emergencies and for the prescheduled transport of Behavioral Health and Recovery Services and Aging and Adult Services clients for court appearances, extending the term from June 30, 2010 through April 30, 2011, and increasing the Agreement maximum obligation by $311,200 from $1,635,000 to a new maximum obligation of $1,946,200.
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BACKGROUND:
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In December 2005 your Board approved a waiver of the Request for Proposals process and a 3-year Agreement with American Medical Response West (AMR) to provide assessment and transport of persons with behavioral emergencies and for the prescheduled transport of Behavioral Health and Recovery Services (BHRS) clients and Aging and Adult Services (AAS) clients for court appearances. The San Mateo County Mental Assessment and Referral Team (SMART) program was developed by the Health System and AMR in which a specially trained paramedic would respond to law enforcement Code 2 requests for individuals having a behavioral emergency.
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Your Board approved Amendment Three on September 29, 2009, to extend the term through June 30, 2010, and increase the maximum obligation to $1,635,000.
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DISCUSSION:
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AMR and County staff have reviewed the services provided under this Agreement and the available funding. Several strategies have been identified to cut costs or continue operating with reduced funding while preserving the most vital services. These include: 1) finding a less expensive transportation alternative for the prescheduled client court appearances for clients not requiring a gurney and a basic life support (BLS) ambulance, 2) continue providing backup to the SMART unit with 911 ambulances rather than non-emergency ambulances, 3) continue staffing the SMART vehicle 12 hours per day for an additional ten months only, and 4) accept donations from the San Mateo County Police Chiefs’ Association, a 501(3)(c) organization, which will be presented at a later date to your Board for approval.
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A review of data relative to the frequency of SMART unit responses showed that the highest volume of calls was between 9 a.m. and 9 p.m. AMR will continue to staff the vehicle seven days a week during these hours. When the SMART unit is unavailable, 911 paramedic-staffed AMR ambulances will respond to behavioral emergency calls.
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Extending the SMART Agreement by ten months through April 30, 2011, will continue the SMART program as long as funding allows. AMR will continue to provide transportation for the prescheduled transport of BHRS clients and AAS clients requiring a gurney and a BLS ambulance for court appearances through the term of this Agreement. This agreement was part of the Continuing Resolution.
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The Amendment and Resolution have been reviewed and approved by County Counsel.
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The County Manager has approved a waiver extending the Agreement beyond three years.
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Approval of this Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by improving emergency services provided to people having behavioral emergencies. It is anticipated that only 24% of behavioral emergency calls will be handled by the SMART vehicle due to funding cuts resulting in service reductions.
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Performance Measure:
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Measure
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FY 2009-10
Actual
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FY 2010-11
Projected
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Percent of EMS responses to behavioral emergencies by AMR “SMART” vehicle.
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32%
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24%
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FISCAL IMPACT:
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The term of the Amendment is December 7, 2005 through April 30, 2011. The maximum obligation is increased by $311,200 from $1,635,000 to a new maximum obligation of $1,946,200. The Net County Cost associated with this Amendment is $95,000, and is included in the Community Health tentatively Adopted FY 2010-11 Budget.
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