Inter-Departmental Correspondence
Health System



April 29, 2011


May 24, 2011







Honorable Board of Supervisors



Jean S. Fraser, Chief, Health System


Stephen Kaplan, Interim Director, Behavioral Health & Recovery Services


Lisa Mancini, Director, Aging and Adult Services



Agreement with the Crestwood Behavioral Health, Inc.



Adopt a Resolution authorizing the:

A) President of the Board to execute an Agreement with Crestwood Behavioral Health, Inc. for residential rehabilitation and long-term care services for the term July 1, 2011 through June 30, 2012, for a maximum obligation of $1,782,000; and


B) 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.



Crestwood Behavioral Health, Inc. is a convalescent care provider of mental health services. The company provides neurobehavioral, psychosocial rehabilitation, adult residential, community, wellness recovery action planning, and health and wellness programs. Services include behavior modification, skilled nursing, life skills training, recreation and rehabilitation, neurobehavioral support, dementia and Alzheimer’s care, behavior intervention, vocational and pre-vocational training, and self-advocacy.


Behavioral Health and Recovery Services (BHRS) has contracted with Crestwood Behavioral Health, Inc. since 1988 to provide long-term care for County residents. Some of these individuals are Lanterman, Petris and Short (LPS) conservatees, and some are conserved under the probate dementia laws.


Under the B-1 Administrative Memorandum, the selection of providers for long-term locked facility services is exempt from the Request for Proposals requirement.



To accommodate specialized treatment care needs and to distinguish between the LPS conserved mentally ill clients and the probate dementia conservatees, this contract has a BHRS Mental Health Services component and an Aging and Adult Services (AAS) component. The Mental Health component provides services to up to 50 clients who are seriously mentally ill and in need of mental health rehabilitation, treatment and long-term care. The AAS component provides services to up to eight clients who are probate dementia conservatees and who require a locked long-term treatment setting. Services provided through this Agreement offer an alternative to the use of more costly hospital emergency services, inpatient hospital admissions and correctional facilities.


The Agreement and Resolution have been reviewed and approved by County Counsel. The Contractor’s insurance has been reviewed and approved 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.


This Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing residential rehabilitation and long-term care for the vulnerable population of adults suffering from serious mental illness. It is anticipated that of the number of clients receiving services, 68% will be maintained at current or lower level of care.


Performance Measure:



FY 2010-11


FY 2011-12


Percentage of clients maintained at current or lower level of care




The term of this Agreement is July 1, 2011 through June 30, 2012, and the maximum obligation is $1,782,000. Of this amount $1,625,000 is for BHRS, which is funded as follows: $825,000 (51%) is from sales tax provided through realignment, and $800,000 (49%) is Net County Cost. These funds are included in the BHRS FY 2011-12 Recommended Budget. Of the maximum obligation $157,000 is for AAS, which will be funded through client reimbursements. These funds are included in the AAS FY 2011-12 Recommended Budget. There is no Net County Cost associated with the AAS component of this Agreement.