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 Health Plan of San Mateo for Pharmacy Benefits Administration
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with the Health Plan of San Mateo for pharmacy benefits administration, extending the term through December 31, 2025, and increasing the amount by $480,000 to an amount not to exceed $680,000.
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BACKGROUND:
Since 2010, Behavioral Health and Recovery Services (BHRS) has utilized the Health Plan of San Mateo's (HPSM) pharmacy benefits administration services for BHRS clients requiring psychiatric medication. The services are provided to indigent adults and Medi-Cal members carrying a "share of cost," i.e., clients not covered by the Medi-Cal funding structure and for whom BHRS is financially responsible.
On May 23, 2024, the Director of Behavioral Health and Recovery Services approved an agreement with HPSM for the term of January 1, 2024 through December 31, 2024, for BHRS to utilize HPSM's pharmacy benefits administration services for clients requiring psychiatric medication, in an amount not to exceed $200,000.
DISCUSSION:
HPSM will continue to administer the pharmacy benefits provided to BHRS indigent adult clients and Medi-Cal members carrying a share of cost.
It is now necessary to extend the term for an additional year through December 31, 2025, and increase the maximum amount by $480,000 due to an increased use of long-acting second-generation antipsychotics, which improves adherence, and for HPSM to continue to provide the services described above.
The amendment and resolution have been reviewed and approved by County Attorney as to form.
It is anticipated that 84% of clients who receive services will be maintained at curre...
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