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 The Healthy Teen Project, Inc. for Comprehensive Treatment Services for Clients Diagnosed with Eating Disorders
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement with The Healthy Teen Project, Inc. for comprehensive treatment services for clients diagnosed with eating disorders, extending the term through June 30, 2026, and increasing the amount by $900,000, to an amount not to exceed $1,100,000.
body
BACKGROUND:
As a Mental Health Plan, BHRS is required to provide and cover all medically necessary specialty mental health services for clients diagnosed with eating disorders. BHRS identified that there was a need to fill a service gap for severely mentally ill youth and adolescent clients that were diagnosed with moderate to severe eating disorders, as defined in the Diagnostic and Statistical Manual of Mental Illnesses (5th edition), that required a more specialized and intensive level of treatment. Moreover, no BHRS clinic or program has effectively addressed the comprehensive behavioral, dietary, and medical needs associated with moderate to severe eating disorders. In response to this gap, BHRS reached out to several local providers. HTP, Center for Discovery, and Cielo House were the only providers that met the requirements to provide comprehensive and specialized treatment for mental health clients diagnosed with eating disorders such as anorexia, bulimia, binge eating disorder, and eating disorders not otherwise specified.
In September 2024, BHRS entered into an agreement with HTP for the term of June 1, 2024, through June 30, 2025, for a maximum amount of $200,000.
DISCUSSION:
Since 2018, BHRS has contracted with The Healthy Teen Project, Inc. (HTP) to provide eating disorders services to clients in San Mateo County. Through this amendment, HTP will continue to provide the intensive Outpatient Partial Hospitalization Program, outpatient treatment services, and residential treatment services for Severely Mentally Ill youth clients with moderate to severe eating disorders who need specialized treatment. There is a continued need for these specialized services to support clients with eating disorders in their recovery. Due to additional referrals for intensive outpatient and residential treatment services, an amendment is needed to cover the increase in utilization.
In San Mateo County, BHRS has seen little interest for providers to offer eating disorder treatment services at a reduced rate for the publicly insured, since providers can receive higher reimbursement on a cash basis in the private market, with none of the required paperwork or payment wait times. There are only three in-county providers that provide eating disorder treatment services and BHRS has contracted with each to maintain an adequate provider network. This allows us to provide eating disorder treatment services in the communities in which our clients reside.
BHRS will enter into agreements with any qualified provider for these eating disorder services. Under the B-1 Administrative Memorandum, agreements made with any qualified provider for mental health services are exempt from the solicitation process.
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.
It is anticipated that 75% of clients successfully completing the program will be served at a lower level of care for up to one year after being discharged.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of clients successfully completing the program that are served at a lower level of care for up to one year after being discharged |
75% 3 clients |
75% 3 clients |
EQUITY IMPACT:
The purpose of this contract agreement is to deliver comprehensive behavioral health and medical services to the Medi-Cal population of youth struggling with moderate to severe eating disorders in San Mateo County. The program is to meet the unique needs of underserved populations, emphasizing trauma and culturally informed and evidence-based practices to promote long-term well-being. HTP works to improve the social-emotional development and prevent the long-term trauma effects of marginalized adolescents and families by reducing medical and psychiatric re-hospitalization.
FISCAL IMPACT:
The term of the amended agreement is July 1, 2024, through June 30, 2026. The amount of the amended agreement is not to exceed $1,100,000 for the two-year term. This amendment increases the maximum amount of the agreement by $900,000, where $350,000 is included in the BHRS FY 2024-25 Adopted Budget and $550,000 will be included in the BHRS FY 2025-26 Recommended Budget. Of this amount, 50% or $450,000 will be funded by the Health Plan of San Mateo with an anticipated Memorandum of Understanding and in compliance with a recommendation by Department of Health Care Services Behavioral Health Information Notice 22-009 and the remaining amount will be funded with 1991 Realignment for $450,000. There is no Net County Cost associated with this amendment.