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 Telecare Corporation to Operate a Behavioral Health Crisis Residential Facility
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Telecare Corporation to operate a behavioral health crisis residential facility, for the term of July 1, 2024 through June 30, 2025, in an amount not to exceed $2,751,600.
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BACKGROUND:
In October 2018, Health Rite360 (HR360) began operating Behavioral Health and Recovery Services’ (BHRS) Serenity House Crisis Residential (SHCR), after being selected through the competitive Request for Proposal (RFP) process. In May 2022, BHRS contracted with Telecare Corporation (Telecare) to continue SHCR services on an emergency basis due to the sudden and unexpected contract termination by HR360.
Telecare operates 10 Crisis Residential Treatment (CRT) programs in Alameda, Contra Costa, Orange, Riverside, San Bernardino, San Joaquin, Santa Barbara, and Santa Clara counties, representing a total of 135 beds. In addition to these existing programs, Telecare is partnering with Los Angeles County to open three additional CRT programs this year. Telecare also operates crisis walk-in/mental health urgent care centers throughout Southern California.
Each CRT program run by Telecare is California Department of Health Care Services (DHCS) certified as a Short-Term CRT Facility and Short-Doyle Medi-Cal-certified by their respective County Mental Health Plan. All Telecare CRTs have continuously maintained their DHCS and Medi-Cal certification, as well as their Community Care Licensing as Social Rehabilitation Facilities. Further, all Telecare CRTs are accredited by the Commission on Accreditation of Rehabilitation Facilities International, an independent nonprofit accreditation organization dedicated to advancing the quality of health and human services worldwide.
DISCUSSION:
The BHRS SHCR is designed as an alternative to hospitalization and incarceration for adults experiencing an acute psychiatric episode. The respite stay is short-term, designed to stabilize and return clients to their current living situation if appropriate, or an alternative stable environment. SHCR services are also utilized for clients who are psychiatrically destabilized due to loss of housing, placement, or support system. SHCR services enable San Mateo County residents experiencing a crisis to be diverted from Psychiatric Emergency Services or jail and receive the support they need to work through their crisis.
Through this agreement, Telecare shall continue delivering short term SHCR services for up to 13 adult clients with psychiatric disabilities. Telecare will help its SHCR clients maintain medication management; engage in natural supports; manage mental health symptoms and substance use urges; strengthen acquisition and use of coping skills; and establish or reestablish vital links to services. By providing the latter services, Telecare can keep clients out of more restrictive levels of care and support clients throughout the ongoing process of recovery. Clients’ mental health status will be reassessed regularly, and discharge planning will begin immediately to help clients maintain stability following discharge from SHCR. This will include transporting clients while in the program to doctor appointments, housing, and other community services.
Due to the lack of affordable housing and depletion of licensed Board and Care homes and Room and Board homes in San Mateo County, BHRS has not been able to identify any new housing resources within the County.
SHCR provides short term crisis residential services and is an appropriate model/level of care for many clients with serious mental illnesses to experience life in the community and become de-institutionalized.
Because residential facilities services are limited in the County, under the B-1 Administrative Memorandum, the selection of providers of residential services for mental health clients is exempt from the RFP requirement.
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 agreement and resolution have been reviewed and approved by the County Attorney as to form.
Successful treatment discharge occurs when clients are successfully engaged in the support services they receive to remain in the community. It is anticipated that at least 90% of SHCR clients will be referred/linked/re-established to services in the community following discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Estimated |
FY 2024-25 Projected |
|
Percentage of SHCR clients referred/linked/reestablished to services in the community following discharge |
> 90% 315 clients |
> 90% 315 clients |
EQUITY IMPACT:
This contract will positively impact a critically underserved community of behavioral health clients (25% LatinX, 25% Asian/Pacific Islander, 5% Black, 3% Mixed Race) who have severe mental illness and will benefit from a secured placement to support their stabilization and recovery. Providers such as Telecare are a vital placement resource for such individuals. Having this contract with Telecare affords these individuals an ability to step down from higher acute, more costly levels of care to a placement that can address their behavioral health needs. This provider is committed to serving this population and supporting them with achieving their recovery goals.
FISCAL IMPACT:
The term of the agreement is July 1, 2024, through June 30, 2025. The amount of the agreement is not to exceed $2,751,600 for the one -year term. Approximately $2,751,600 is included in the BHRS FY 2024-25 Recommended Budget. Of that amount, $1,120,039 is funded with 1991 Realignment, and $1,631,561 is funded with Federal Financial Participation and State General Funds. There is no Net County Cost associated with this agreement.