Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
David Young, Director, Behavioral Health and Recovery Services
Subject: Memorandum of Understanding with Seton Medical Center for 5150 Services
RECOMMENDATION:
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Adopt a resolution designating Seton Medical Center as a facility designated by the County for evaluation and treatment under Welfare and Institutions Code section 5150 et seq. and simultaneously authorizing a Memorandum of Understanding detailing the 5150 process and procedures with the provider for a term of January 2, 2018 through January 3, 2019.
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BACKGROUND:
The Health System’s Behavioral Health and Recovery Services Division (BHRS) analyzed inpatient data from 2004 through 2017 to establish the current 5150 inpatient demand for persons 60 years of age and older, identifying a monthly demand of 9 admissions. Of these admissions, typically 50% are admitted to the inpatient psychiatric unit at the San Mateo Medical Center (SMMC) and the other 50% are placed and managed across several Bay Area hospitals. In an effort to find placement solutions that will allow clients to remain close to their families and support network, BHRS approached Seton Medical Center (Seton) about partnering to use Seton’s recent addition of 20 licensed acute psychiatric beds serving the population of clients 65 years of age or older.
BHRS assembled a Designated Facility Review Team (consisting of the Medical Director, Assistant Director, and the Quality Manager) to work with Seton staff to establish: the terms of the designation represented in the MOU, training and certification processes to educate staff regarding County involuntary hold policies, and competency regarding patient rights and hearing procedures (led by the Patients’ Rights Advocate Francesca Tennenbaum of the Mental Health Association, Alameda Chapter), as well as the recruitment and hiring of required staffing to operate the unit.
The focus by Seton on the older adult population meets a specific need that is not currently served, through focused treatment that includes a full array of therapeutic programs and service that maximize patient services for this age group. At a minimum, Seton expands the inpatient hospital continuum in the County, keeping older residents in County and close to family; helps meet a growing need in the continuum for level of care capacity; and will ultimately reduce the impact on SMMC as the only in-County facility currently designated and capable of serving older adult inpatient needs.
DISCUSSION:
Through this agreement, BHRS requests your Board to designate Seton as a 5150 facility to receive clients 65 years of age and older that are involuntarily detained; and simultaneously authorize a Memorandum of Understanding detailing the 5150 process and procedures with the provider. The designation allows Seton to receive patients on a 5150 hold that meet Seton’s admissions criteria and are in need of evaluation and treatment at a geropsychology facility. This designation conforms to the requirements of BHRS Policy 90-09: 5150 Designated Facilities, and California Welfare & Institutions Code Section 5150.
The BHRS Designated Facility Review Team will annually review Seton’s performance as a designated 5150 facility, making recommendations for improvement if needed prior to the expiration of the agreement.
The agreement and resolution have been reviewed and approved by County Counsel as to form.
Approval of this agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing 5150 service to older adults, which in turn contributes to the health and safety of communities throughout the County. A successful patient outcome under this agreement is that older adults receive care in a facility providing treatment that specifically addresses their presenting condition and in an environment dedicated to this age population. It is anticipated that 39 clients (65 years of age and older) will be placed at Seton on a 5150 hold in FY 2017-18.
PERFORMANCE MEASURE:
|
Measure |
FY 2017-18 Estimated |
FY 2018-19 Projected |
|
Number of clients (65 years of age and older) placed at Seton on a 5150 hold |
39 clients |
118 clients |
FISCAL IMPACT:
The term of the agreement is January 2, 2018 through January 3, 2019. There is no funding associated with this agreement.