Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Scott Gilman, Director, Behavioral Health & Recovery Services
Subject: Agreement with Sutter Health on Behalf of Mills-Peninsula Medical Center for Psychiatric Inpatient Hospital Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Sutter Health on behalf of Mills-Peninsula Medical Center for psychiatric inpatient hospital services for the term of July 1, 2020 through June 30, 2022, in an amount not to exceed $3,000,000.
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BACKGROUND:
Since 1995, the County has contracted with Mills-Peninsula Hospital for psychiatric inpatient hospital services. Behavioral Health and Recovery Services (BHRS) has also contracted with John Muir Behavioral Health Center and Fremont Hospital for these services. These services are used to accommodate emergency admissions when San Mateo Medical Center is full. Under the most recent agreement with Mills-Peninsula Hospital, BHRS placed 5 patients and 4 patients in FY 2018-19 and FY 2019-20, respectively. In order to continue this arrangement, BHRS would like to renew the agreement.
Under the B-1 Administrative Memorandum, 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.
DISCUSSION:
The agreement with Mills-Peninsula Hospital is based on fee-for-service rates, which include 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.
Mills-Peninsula Hospital addresses COVID-19 safety through a comprehensive program developed by Sutter Health, by working with local, state, and federal agencies and the numerous guidelines that are available. Mills-Peninsula has extensive experience in infectious diseases, which provides a foundation for their staff, with added training to be prepared, informed, and practiced on the protocols on safety during the pandemic. Specific management positions are dedicated to monitoring, intervening, and correcting staff performance. There is a clear communication plan in which patients, relatives, and partners, such as BHRS, are informed immediately of any COVID-19 related incidents and response; extensive information provided to patients and visitors; and a public facing “Advice Line” helps the public address COVID-19 related medical needs.
Facility safety is a three-pronged approach of before visit, during visit, and post-visit sanitization consisting of pre-visit screening, mandatory mask use, entrance screening, and contactless registration; isolation of patients with symptoms, screening of patients and staff throughout the day, enforced physical distancing; sanitizing surfaces throughout the day; sanitizing equipment between patients and sterilizing procedure rooms, and making hand washing/sanitizer readily available throughout the facility at all times for patients, visitors, and staff.
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 County Counsel as to form. This agreement is late due to prolonged contract negotiations and is on the Continuing Resolution.
It is anticipated that no more than 12% of clients who receive psychiatric inpatient hospital services will be re-admitted within 30 days of discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Actual |
FY 2020-21 Projected |
|
Percentage of clients who are re-admitted within 30 days of discharge |
12% 30 clients |
12% 30 clients |
FISCAL IMPACT:
The term of the agreement is July 1, 2020 through June 30, 2022. The amount of the agreement is not to exceed $3,000,000 for the two-year term. $1,500,000 is included in the BHRS FY 2020-21 Recommended Budget. Of that amount, it is anticipated that $1,461,685 will be funded with 1991 Realignment and $38,315 will be from Net County Cost. Similar arrangements will be made for future years. The payment provisions and levels of services in the agreement are essentially the same as the prior agreement.