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: 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, 2024 through June 30, 2026, in an amount not to exceed $3,000,000.
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BACKGROUND:
Since 1995, the County has contracted with Mills-Peninsula Medical Center (Mills-Peninsula) 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 at capacity. Mills-Peninsula is also an LPS Designated Receiving Facility in the County and is generally responsible for receiving 5150 admissions north of Highway 92. Additionally, Mills-Peninsula is the primary provider within the in-County hospital network for adolescent and youth acute psychiatric inpatient services. In order to continue this arrangement, BHRS would like to renew the agreement.
DISCUSSION:
The agreement with Mills-Peninsula 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.
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. In addition, Administrative Memo B-1 exempts contracts for Psychiatric Inpatient Services from the competitive Request for Proposal process.
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.
This agreement is coming to this Board late due to prolonged contract negotiations.
It is anticipated that no more than 10% of clients who receive psychiatric inpatient hospital services will be re-admitted within 30 days of discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Projected |
|
Percentage of clients who receive psychiatric inpatient hospital services that are re-admitted within 30 days of discharge |
0% 0 clients |
≤10% ≤20 clients |
EQUITY IMPACT:
This contract will enhance access to culturally competent and age-appropriate psychiatric inpatient care for Medi-Cal beneficiaries (44% Latinx, 19% Asian/Pacific Islander, 6% Black, and 13% Mixed Race individuals) as well privately insured individuals who are experiencing acute crisis. This contract ensures closer proximity to clients in North County, which allows for increased family and support person visits. Length of stay for Mills Peninsula clients tend to be shorter on average, due to the staff’s efforts to stabilize and get the clients to a lower level of care.
FISCAL IMPACT:
The term of the agreement is July 1, 2024, through June 30, 2026. The amount of the agreement is not to exceed $3,000,000 for the two-year term. Approximately $1,500,000 is included in the BHRS FY 2024-25 Recommended Budget. Of that amount, it is anticipated that $1,461,685 will be funded with 1991 Realignment and $38,315 will be 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.