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: Amendment to the Agreement with Telecare Corporation for Full Service Partnership Services - Transitions
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Telecare Corporation for Full Service Partnership services, increasing the amount by $2,623,109 to an amount not to exceed $14,703,217 and extending the term by three months through June 30, 2024.
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BACKGROUND:
The cornerstone of the County's Mental Health Services Act (MHSA) Community Services and Supports plan is the delivery of Full-Service Partnership (FSP) services for its highest-risk clients living with serious mental illness. The FSP service model provides intensive "whatever it takes" behavioral health services to help clients on their path to wellness and recovery and to remain in the community.
FSP programs have been shown to decrease psychiatric emergency services visits, hospitalizations, homelessness, active substance use, and arrests by providing case management, medication management, therapy, social activities, and 24/7 response capability to mitigate evolving situations with FSP clients. Every year, BHRS analyzes FSP program outcomes based on self-reported data from clients for each FSP program, health care utilization data for all FSP programs from BHRS electronic health records, and in-depth client and provider interviews. The following table highlights a few of these client outcomes, comparing one year prior to participation in FSP compared to one year during FSP participation.
|
Telecare Self-Reported Outcomes (N=107) |
Year before |
Year during |
|
Homelessness |
31 (29%) |
9 (8%) |
|
Arrests |
35 (33%) |
13 12%) |
|
Active SUD |
69 (61%) |
35 (33%) |
|
All FSP Hospitalization Outcomes (N = 906) |
Year before |
Year during |
|
% with any hospitalization |
20% |
10% |
|
% with any PES event |
42% |
27% |
In FY 2020-21, a point-in-time analysis showed that Telecare Corporation (Telecare) provided subsidized housing to 83 high-risk consumers who were not eligible for other housing support. Telecare also provided field-based support to an additional 43 clients with permanent supported housing vouchers to remain housed in the community.
In September 2022, this Board approved an agreement with Telecare for FSP services in the amount of $6,902,919 for the term of July 1, 2022, through June 30, 2023.
In May 2023, this Board approved an amendment to the agreement to increase the maximum amount by $5,177,189 for a total amount not to exceed $12,080,108 and extend the term of the agreement by nine months through March 31, 2024.
DISCUSSION:
Telecare will continue to provide FSP and housing support services through this amendment. In addition to serving its highest-risk consumers, this number includes non-violent felons who were released from State prison to County supervision under the Criminal Justice Realignment Act of 2011. FSP enrollees will have services available 24 hours a day, seven days a week. Housing support services will be provided to FSP enrollees to assist them in achieving independence, stability, and overall emotional and physical well-being.
Behavioral Health and Recovery Services (BHRS) requests a three-month extension to allow additional time for the Request for Proposals (RFP) process to be completed. BHRS released the RFP for FSP services in Fall 2023 and is in the process of selecting a provider(s).
The resolution contains the County’s standard provision allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
The amendment and resolution have been reviewed and approved by the County Attorney as to form.
BHRS provides a range of services to promote wellness and recovery and to support consumers remaining in the lowest possible level of care. Providing FSP services for adults and older adults is one established level of care. It is anticipated that 80% of the clients who receive FSP services will be maintained at a current or lower level of care. A client is considered "maintained at the current or lower level of care" if, during the fiscal year, they did not have a new admission to a higher level of care or had one or more new admissions to a program with the same or lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Actual |
FY 2023-24 Estimated |
|
Percentage of FSP clients who receive FSP services that are maintained at a current or lower level of care |
80% 187 of 233 clients |
80% 178 of 223 clients |
FISCAL IMPACT:
The term of the amended agreement is July 1, 2022, through June 30, 2024. The amount of the amended agreement is not to exceed $14,703,217 for the two-year term, and $2,623,109 is included in the BHRS 2023-24 Adopted Budget. Of this amount, MHSA will fund $1,567,771; Federal Financial Participation will fund $666,254; Realignment will fund $115,640, and AB 109 will fund $205,895. The Net County Cost is $67,549.