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



Agreement with Lena Osher, M.D.



Adopt a Resolution authorizing the:

A) President of the Board to execute an Agreement with Lena Osher, M.D. for the provision of psychiatry services for the term July 1, 2011 through June 30, 2013, for a maximum obligation of $391,620 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.



There has been a shortage of adult and child psychiatrists in California and in the nation for the past several years. Behavioral Health and Recovery Services (BHRS) has found it difficult to fill child psychiatrist positions in San Mateo County due to the high cost of living. Under the Administrative Memorandum B-1, agreements with physicians are exempt from the requirement for a Request for Proposals process. BHRS runs advertisements for specialty psychiatric services on a regular basis in the Northern California Psychiatric Newsletter and other venues as needed. Dr. Osher was selected from candidates who responded to those advertisements in 2003 and has contracted with BHRS since that time.



Dr. Osher will provide psychiatry services for children and youth at Canyon Oaks Youth Center. The services shall include child and youth medication evaluation and treatment, psychotherapy, family consultation, and case consultation to staff.


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.


The Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing psychiatry services. BHRS provides a range of services to children and youth clients of BHRS. The provision of psychiatry services is one established level of care. The services provided through this Agreement contribute to this measure. It is anticipated that 77% of clients who receive services shall rate services as good or better.


Performance Measure:


FY 2010-11

    FY 2011-12

Percentage of clients who rate services received as good or better.





The term of the Agreement is July 1, 2011 through June 30, 2013. The maximum obligation is $391,620 for the two-year term. For FY 2011-12 the budgeted maximum is $195,810. Of that amount, it is anticipated that $87,595 will be funded by Federal Medi-Cal, $3,905 will be funded by Healthy Families, $25,253 will be funded by Healthy Kids, $13,030 will be funded by private insurance, $30,781 will be funded by state general funds for Early Periodic Screening Diagnosis and Treatment, and $35,246 will be funded by sales tax through Realignment. There is no Net County Cost. Funds for these services have been included in the BHRS FY 2011-12 Recommended Budget. A similar arrangement will be in place for FY 2012-13.