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 BHC Fremont Hospital, Inc. dba Fremont Hospital for Psychiatric Inpatient Hospital Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with BHC Fremont Hospital, Inc. dba Fremont Hospital for psychiatric inpatient hospital services for the term of July 1, 2025 through June 30, 2027, in an amount not to exceed $3,800,000.
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BACKGROUND:
Since 2000, the County has contracted with Mills Peninsula Hospital and John Muir Behavioral Health Center for psychiatric inpatient hospital services in the northern part of the County. In order to cover the southern part of the County for emergency admissions and/or when San Mateo Medical Center is full, Behavioral Health and Recovery Services (BHRS) would like to enter into an agreement with BHC Fremont Hospital, Inc. dba Fremont Hospital (BHC Fremont). BHRS has contracted with BHC Fremont for psychiatric inpatient hospital services since 2018.
Under Administrative Memorandum B-1, the selection of providers delivering inpatient psychiatric hospital services for mental health clients is exempt from the Request for Proposals requirement. In order to improve service capacity, BHRS may contract for psychiatric inpatient hospital services with any willing, qualified provider. A waiver request was reviewed by County Procurement, which recommended submission to this Board for approval.
DISCUSSION:
The agreement with BHC Fremont is based on fee-for-service rates, including psychiatric inpatient hospital services for Medi-Cal-covered youth and adults, as well as psychiatric inpatient hospital services for uninsured youth and adults. Administrative day rates, which are set by the State, are also included. Only services authorized by BHRS will be paid.
The resolution contains the County’s standard provisions allowing amendments to the County’s fiscal obligation by a maximum of $25,000 (in aggregate).
The agreement and resolution have been reviewed and approved by the County Attorney as to form.
This agreement is going to this Board late due to prolonged negotiations with the contractor.
It is anticipated that 95% of clients who receive psychiatric inpatient hospital services will not be readmitted within 30 days of discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Actual |
FY 2025-26 Estimated |
|
Percentage of clients receiving psychiatric inpatient hospital services that will not be readmitted within 30 days of discharge |
96% 77 Clients |
96%* 81 Clients |
COMMUNITY IMPACT:
This agreement will significantly enhance access to competent and age-appropriate psychiatric inpatient care for Medi-Cal beneficiaries. Partnering with Fremont Hospital provides youth and adult clients a critical life-saving resource, offering them a choice of hospitals and access to high-level care. Although BHC Fremont is out of county, it is the closest contract hospital, which is crucial as research highlights the benefits of family and support person visits. Additionally, this agreement will facilitate our step-down process, enabling a quicker return to the community for our clients.
FISCAL IMPACT:
The term of the agreement is July 1, 2025 through June 30, 2027. The amount of the agreement is not to exceed $3,800,000 for the two-year term. Funds in the amount of $1,900,000 have been included in the BHRS FY 2025-26 Recommended Budget. Similar arrangements will be made for future years. Of the FY 2025-26 amount, medical costs will be charged to third-party payors, with the remaining balance funded from Realignment estimated at 90% of the cost. There is no Net County Cost.