Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, San Mateo County Health
Stephen Kaplan, Director, Behavioral Health and Recovery Services
Subject: Agreement with Optum for After-Hours Phone Coverage Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Optum for after-hours phone coverage services for the term July 1, 2018 through June 30, 2019, in an amount not to exceed $410,138.
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BACKGROUND:
Since 2015, Behavioral Health and Recovery Services (BHRS) has contracted with Optum to provide after-hours phone coverage services for San Mateo County and three other counties (Marin, Sonoma, and Contra Costa).
In March 2015, BHRS issued a Request for Proposals to select a provider for after-hours phone coverage services. Optum submitted a proposal and was selected to provide this service.
DISCUSSION:
Optum provides after-hours phone coverage to the 1-800 numbers that are accessible to residents and Medi-Cal beneficiaries of San Mateo, Marin, Sonoma, and Contra Costa Counties seeking behavioral health services. The agreement covers costs for each of the four participating counties, with BHRS serving as the fiscal representative of these counties. The service and financial arrangements between said counties are defined in a memorandum of understanding.
Each county services their 1-800 number from 8am-5pm, Monday through Friday, except holidays. Optum is responsible for answering calls from 5pm-8am, Monday through Friday, and 24 hours a day on weekends and holidays. Optum provides basic information about the behavioral health benefits for Medi-Cal beneficiaries and transmits the caller’s name, contact information, and a brief description of the presenting problems to the individual county call center by the next business day.
In 2017, the California Department of Health Care Services and the federal government approved the Drug Medi-Cal Organized Delivery System waiver, which has changed state requirements for response time and the screening process for all Health Systems of Care. BHRS is requesting that your Board waive the Request for Proposals process for after-hours phone coverage services for one year, allowing BHRS time to continue to work with Optum and the three counties to fully implement and meet these new state requirements.
The agreement and resolution have been reviewed and approved by County Counsel as to form. This agreement is on the Continuing Resolution. This agreement is late due to the necessary coordination and approval from all four counties included in this agreement.
The resolution contains the County’s standard provisions allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
Approval of this agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by answering client phone calls after hours and providing emergency and basic information about behavioral health benefits of Medi-Cal beneficiaries. BHRS provides a range of services in order to promote wellness and recovery and to support consumers remaining in the lowest possible level of care. The services provided by Optum contribute to this measure. It is anticipated that 95% of calls will be answered within 45 seconds or less.
PERFORMANCE MEASURE:
|
Measure |
FY 2017-18 Actual |
FY 2018-19 Projected |
|
Percentage of calls answered within 45 seconds or less |
95% |
95% |
FISCAL IMPACT:
The term of the agreement is July 1, 2018 through June 30, 2019. The amount of the agreement is not to exceed $410,138. Of that amount, $123,040 will be expended by BHRS. That amount will be funded by Medi-Cal Federal Financial Participation ($30,760) and 1991 Realignment ($92,280). BHRS will receive payment from Contra Costa, Marin, and Sonoma Counties for their costs incurred by these services. BHRS will make payment to this provider on behalf of all participating counties. There is no Net County Cost.