Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Michael del Rosario, Director, Correctional Health Services
Subject: Amendment to the Agreement with Liberty Healthcare Corporation for Acute Inpatient Psychiatric Services
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement with Liberty Healthcare Corporation to continue providing acute inpatient psychiatric services for the term July 1, 2026 through June 30, 2027, in an amount not to exceed $15,120,626.
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BACKGROUND:
In December 2022, Correctional Health Services (CHS) conducted a Request for Proposals, and Liberty Healthcare Corporation (Liberty) was selected as best qualified to operate a 10-bed acute psychiatric unit in the Maguire Correctional Facility. In June 2023, San Mateo County Health entered into an agreement with Liberty for a three-year term from July 1, 2023, to June 30, 2026. An acute inpatient psychiatric unit inside a correctional facility provides beds for incarcerated persons (IP) in need of involuntary psychiatric care to be fully evaluated and treated on-site. IPs who require involuntary psychiatric treatment are given bed priority. Additional beds are filled with IPs transitioning to a sub-acute level of psychiatric care, such as those who no longer meet the criteria for involuntary treatment but still need to stabilize further before being housed in the general population. Once an IP stabilizes to the point where a less intensive setting is appropriate, they are discharged to a less intense level of care, such as the Behavioral Health Unit, which is designed to enhance and expand mental health treatment for IPs.
DISCUSSION:
Liberty has direct experience implementing and operating multiple California county jail-based and State hospital psychiatric forensic units and mental health services. They also have ample experience in providing acute inpatient psychiatric services for adult detainees on both voluntary and involuntary treatment statuses, including the management of acute inpatient psychiatric units designated under the Lanterman-Petris-Short Act (LPS).
Liberty will continue to be responsible for dispensing and administering medications, and conducting all legal proceedings required by the State for an LPS unit. For IPs who have concurrent medical problems, Liberty will continue to work closely with CHS to ensure prompt consultation and referral between medical and mental health providers to facilitate the coordination of mental health care for individuals with complicating medical issues. Liberty has demonstrated successful operations, meeting performance measures, and focusing on psychiatric stabilization with a targeted emphasis on treatment efforts that enable the safe and appropriate discharge into lower-level care as soon as clinically indicated.
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 amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
It is anticipated that less than 10% of incarcerated persons will be discharged from the acute inpatient psychiatric unit to administrative segregation or behavioral health units.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of incarcerated persons discharged from the acute inpatient psychiatric unit to administrative segregation or behavioral health units |
<10% 5 incarcerated persons |
<10% 5 incarcerated persons |
COMMUNITY IMPACT:
Liberty services will positively impact the physical and emotional well-being of incarcerated people who often identify or treat conditions not previously addressed. These services will further reduce unnecessary emergency admissions and inpatient hospitalizations during incarceration. CHS strives to improve individual and public health outcomes by providing medical care in a compassionate, culturally and linguistically appropriate, and timely manner.
FISCAL IMPACT:
The term of the amendment is July 1, 2026 through June 30, 2027 in the amount of $4,180,670, increasing the not-to-exceed amount from $10,939,956 to $15,120,626 for the four-year term. A combination of General funds and CalAIM Medi-Cal reimbursement is included in the FY 2026-27 Recommended Budget. There is no increase in Net County Cost for this amendment.