Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health, and Recovery Services
Subject: Amendment to the Agreement with BHC Fremont Hospital, Inc. dba Fremont Hospital for Psychiatric Inpatient Hospital Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with BHC Fremont Hospital, Inc. dba Fremont Hospital for psychiatric inpatient hospital services increasing the authorized amount by $2,050,000 to an amount not to exceed $3,800,000, with no change to the term.
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BACKGROUND:
In October 2023, this Board approved an agreement with BHC Fremont Hospital, Inc. dba Fremont Hospital (BHC Fremont) for the term of July 1, 2023 through June 30, 2025, for an amount not to exceed $1,750,000.
DISCUSSION:
Through this amendment, BHC Fremont will continue to provide psychiatric inpatient hospital services for Medi-Cal-covered youth and adults, as well as psychiatric inpatient hospital services for uninsured youth and adults. The reason that it is necessary to increase the amount is because the maximum amount for the contract has remained the same over the years, but the bed rate has increased over time. Additionally, utilization for the first year of this two-year agreement increased by 36% and the number of bed days increased by 31%.
The needs of mental health clients served by hospitals providing inpatient psychiatric services inform the procurement approach that the County has adopted for this contract, and in addition, Administrative Memo B-1 exempts contracts for Psychiatric Inpatient Services from the competitive Request for Proposal process.
The amendment and resolution have been reviewed and approved by the County Attorney as to form.
The resolution contains the County’s standard provisions allowing amendments to the County’s fiscal obligation by a maximum of $25,000 (in aggregate).
It is anticipated that 95% of clients who receive psychiatric inpatient hospital services will not be re-admitted within 30 days of discharge.
PERFORMANCE MEASURES:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Projected |
|
Percentage of clients who receive psychiatric inpatient hospital services that will not be re-admitted within 30 days of discharge |
99% 210 Clients |
95% 201 Clients |
EQUITY IMPACT:
This contract will significantly enhance access to culturally competent and age-appropriate psychiatric inpatient care for Medi-Cal beneficiaries, which are comprised of 44% Latinx, 19% Asian/Pacific Islander, 6% Black, and 13% Mixed Race individuals. Partnering with Fremont Hospital provides youth and adult clients with a critical life-saving resource, offering them a choice of hospitals and access to high-level care. The San Mateo County Health and Quality of Life survey indicates that LGBTQ+ individuals and Native Hawaiian/Pacific Islanders are the most likely to report suicidal thoughts (14.8% and 14.0%, respectively). This contract is for a facility that is out of county, but the closest contract hospital, which is crucial as research highlights the benefits of family and support person visits. Additionally, this contract will facilitate our step-down process, enabling a quicker return to the community for our clients.
FISCAL IMPACT:
The term of the amended agreement is July 1, 2023 through June 30, 2025. The amount of the amended agreement is not to exceed $3,800,000 for the two-year term. This amendment increases the contract amount by $2,050,000. Funds in the amount of $1,900,000 have been included in BHRS FY 2024-25 Recommended Budget. Of the FY 2024-25 amount, it is anticipated that 100% will be funded from 1991 Realignment.