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 and Recovery Services
Subject: Agreement with 7th Avenue Center, LLC for Locked Psychiatric Care Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with 7th Avenue Center, LLC for locked psychiatric care services, for the term of July 1, 2020 through June 30, 2023, in an amount not to exceed $5,526,706.
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BACKGROUND:
Mental Health Rehabilitation Centers (MHRC), such as 7th Avenue Center, LLC (7th Avenue), provide locked psychiatric care for adults with serious and persistent mental illnesses. Counties are required by the State Department of Mental Health to pay a “basic rate” for skilled nursing/basic care for adults 18-64 years of age who are housed in MHRC facilities. The basic rates vary by geographic region and are set annually by the State Department of Health Services. Medi-Cal provides basic rate funding for individuals in locked facilities who are age 65 years and older. In addition to the basic rate, selected San Mateo County clients at MHRC facilities may be authorized for supplemental payments, often referred to as “patches” or “enhanced rates” in order to provide augmented services based on the severity of an individual’s illness. 7th Avenue has contracted with Behavioral Health and Recovery Services (BHRS) since 2002.
Under the B-1 Administrative Memorandum, the selection of providers of inpatient psychiatric facilities for mental health clients is exempt from the Request for Proposals requirement.
DISCUSSION:
The agreement with 7th Avenue is for the provision of 10 beds for San Mateo County residents. Efforts over the last several years to decrease the length of stay at Napa State Hospital and at Cordilleras have resulted in an increased use of community placements like 7th Avenue. For severely mentally ill clients, 7th Avenue is a less expensive alternative placement over the Napa State Hospital. 7th Avenue has been willing to work with clients with very difficult behavioral problems who are placed directly from the State Hospital.
The resolution contains the County’s standard provisions allowing amendments of the County’s fiscal obligation by a maximum of $25,000 (in aggregate).
The agreement and resolution have been reviewed and approved by County Counsel as to form.
It is anticipated that 60% of clients who receive locked psychiatric care will be maintained at the current level of care or discharged to a lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Estimated |
FY 2020-21 Projected |
|
Percentage of clients who receive locked psychiatric care that are maintained at the current level of care or discharged to a lower level of care |
60% 12 clients |
60% 12 clients |
FISCAL IMPACT:
The term of the agreement is July 1, 2020 through June 30, 2023.The amount of the agreement is not to exceed $5,526,706 for the three-year term. Funds in the amount of $1,785,996 have been included in BHRS FY 2020-21 Recommended Budget. Of that amount, it is anticipated that $1,607,396 will be funded by sales tax through realignment, and $178,600 will be Net County Cost.