Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with Diana’s Care Home for Residential Care Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Diana’s Care Home for residential care services for the term of May 1, 2026 through June 30, 2028, in an amount not to exceed $5,547,000.
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BACKGROUND:
Behavioral Health and Recovery Services (BHRS) provides a continuum of residential and community-based services for adults with serious behavioral health needs who require varying levels of support and supervision. Licensed residential care facilities provide an important level of community-based care for clients who require structured residential services and assistance with daily living due to complex behavioral, psychiatric, and/or medical needs.
BHRS has identified a need for dedicated residential care capacity for clients who can be safely served in a licensed residential setting but require a greater level of supervision and support than can be provided through less restrictive housing options.
DISCUSSION:
Diana’s Care Home will provide residential care services to BHRS clients with complex behavioral, psychiatric, and/or medical needs. The agreement which includes a term of May 1, 2026 through June 30, 2028 and a maximum fiscal obligation of $5,547,000, will provide 49 contracted beds across four residential care facilities: Diana’s Care Home, Scott Villa, Arcadian Residential, and Hopkins Manor, offering BHRS additional capacity and flexibility to place clients in an appropriate residential setting based on their individual needs (Agreement).
Services under the Agreement will include 24-hour staffing, meals and snacks, assistance with personal care and daily living activities, medication supervision, housekeeping, structured activities, and transportation as needed. Specialized caregiver services may also be provided when pre-approved by BHRS.
Historically, BHRS utilized an existing Board-approved authorization through the County’s Aging and Disability Services to facilitate payment for residential care services provided to eligible clients. As the responsibility for these services and associated expenditures has transitioned to BHRS, BHRS is bringing this Agreement directly to the Board to establish the appropriate contractual authority for these services.
As set forth above, the proposed Agreement has an effective date of May 1, 2026. The item is being presented to the Board at this time as BHRS completes the transition from the prior Aging and Disability Services payment arrangement and establishes a direct BHRS agreement with Diana’s Care Home. During this period, BHRS has continued to coordinate with Diana’s Care Home to maintain continuity of residential care services for clients.
Pursuant to the B-1 Administrative Memorandum, the selection for the provision of residential services for mental health clients is exempt from the Request for Proposals requirement. This is based on the shortage of available residential services, the limited provider capacity and the need to ensure timely access to services.
The resolution contains the County’s standard provisions allowing amendment of the County’s fiscal obligations by a maximum of $25,000 in aggregate.
The Agreement and resolution have been reviewed and approved by the County Attorney as to form.
It is anticipated that 86% of clients admitted to the facility will not require an acute hospitalization within 14 days of admission.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Actual |
FY 2026-27 Estimated |
|
Percentage of clients admitted to the facility who do not require an acute hospitalization within 14 days of admission |
86% of all clients 49 beds |
86% of all clients 49 beds |
COMMUNITY IMPACT:
This Agreement will positively impact a critically underserved population of behavioral health clients with complex behavioral, psychiatric, and/or medical needs who require residential placement. Residential care providers such as Diana’s Care Home are an important resource for providing structured, community-based care and supporting clients in developing daily living skills and achieving greater independence.
The availability of 49 contracted beds will provide BHRS with additional residential capacity and support appropriate transitions from higher and more costly levels of care to community-based settings.
FISCAL IMPACT:
The amount of the Agreement is not to exceed $5,547,000 for the 26-month term from May 1, 2026 through June 30, 2028. For FY 2026-27, $2,560,000 is included in the BHRS FY 2026-27 Recommended Budget. Of that amount, it is anticipated that 100% will be funded by the 1991 Realignment. Similar arrangements will be made for future years. There is no Net County Cost associated with this Agreement.