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: Amendment to the Agreement with the Mental Health Association of Alameda County for Patients’ Rights Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Mental Health Association of Alameda County for patients’ rights services, increasing the amount by $499,000 to an amount not to exceed $699,000 and extending the term of the agreement through June 30, 2028.
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BACKGROUND:
By statute, the County is obligated to provide patients’ rights advocacy services for all recipients of mental health services in San Mateo County. These services include patient hearing representation at Certification and Capacity and/or Meredith Hearings in psychiatric inpatient facilities; complaint investigation and resolution; monitoring of mental health facilities; and outreach and training on advocacy topics for clients and providers. There are inpatient facilities in the County where Capacity and Certification Hearings take place: Mills-Peninsula Hospital, San Mateo Medical Center, Seton’s Geriatric Behavioral Program, Cordilleras Mental Health Center, and Maguire Correctional Facility.
MHA has continuously provided these services for BHRS since 2003. For the last 17 years, through three Request for Proposals and one RFI, MHA has been the only respondent to submit a proposal to provide these services.
In June 2025, the Director of Behavioral Health and Recovery Services (BHRS) approved an agreement with Mental Health Association of Alameda County (MHA Alameda) to provide patients’ rights services in the amount of $200,000 for the term of July 1, 2025 through June 30, 2026.
DISCUSSION:
MHA Alameda will continue to provide patients’ rights services per state and federal statutes for patients in psychiatric inpatient hospital units in San Mateo County. These services include representing patients during involuntary hearings, responding to complaints of patients’ rights violations, and providing information and education to providers, clients, and the community about patients’ rights and psychiatric advanced directives.
Under the B-1 Administrative Memorandum, a waiver of competitive requirements may be granted if sole sourcing and single sourcing are justified and necessary to meet the County’s needs. A waiver request was reviewed by County Procurement, which recommended submission to this Board for approval. This waiver will enable BHRS to ensure patient’s rights services continue uninterrupted for the 2026-2028 fiscal years.
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.
It is anticipated that 100% of clients will be scheduled for Certification and Capacity and/or Meredith Hearing inpatient psychiatric facilities.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of clients scheduled for certification and capacity and/or Meredith hearings in inpatient psychiatric facilities |
95% 1,272 clients |
95% 1,426 clients |
COMMUNITY IMPACT:
New categories of involuntary holds, including involuntary holds for substance use disorder crises, were introduced in San Mateo County in compliance with Prop1 and SB843 on January 1, 2026. Patients’ rights services ensure that patients’ rights are respected and due process of law is followed in all hearings related to Certification, Capacity and/or Meredith Hearings in inpatient psychiatric facilities. The prevention of unnecessary or unnecessarily long hospitalizations results in less traumatic and invasive treatment and restoration to individuals, their families, communities, and social networks.
FISCAL IMPACT:
The term of the amended agreement is July 1, 2025 through June 30, 2028. The amount of the amended agreement is not to exceed $699,000 for the three-year term. Funds in the amount of $233,000 are included in the FY 2025-26 Adopted Budget. Of the FY 2025-26 total amount, it is anticipated that $233,000 will be funded by Realignment funds. There is no Net County Cost. Similar arrangements will be made for future years.