Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lisa Mancini, Director, Aging and Adult Services
Subject: Executing Residential Care Facility Agreements for Aging & Adult Services
RECOMMENDATION:
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Adopt a resolution authorizing:
A) A waiver of the Request for Proposal process; and
B) The Chief of San Mateo County Health or her designee to enter into agreements with Residential Care Facilities for Aging & Adult Services clients and conservatees.
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BACKGROUND:
Aging & Adult Services (AAS) Public Guardian conservatees and Adult Protective Services clients utilize Residential Care Facilities (RCFs). RCFs are licensed by the California Department of Social Services, Community Care Licensing Division. Currently, there are 72 licensed facilities in San Mateo County and 7,372 throughout the entire State. Having RCF access allows AAS to assist Public Guardian conservatees, as well as clients living in the community or transitioning to a lower level of care, with the goal of maintaining placement at the lowest appropriate level of care and preserving the highest and the best quality of life possible.
AAS contracts with RCFs in San Mateo County as well as outside of the County, depending on clients’ needs, available resources, and other factors. In FY 2017-18, AAS spent approximately $1.5 million on RCF placement for approximately 75 clients. Spending for each client and the variation in costs depends on the: duration and length of stay, cost of the RCF, whether the County supplements the cost for the client, level of care the RCF provides, location, services offered, and RCF occupancy type. Appropriations for RCFs are budgeted as part of the AAS services and supplies budget. Historically, most AAS RCF contracts were departmental contracts of $100,000 or less, with a few exceptions that were greater than $100,000, which the Board had approved.
DISCUSSION:
RCF’s are selected for AAS clients based on the individual’s needs and preferences. AAS staff visit RCF-placed conservatees as required by the Probate Code, which is every 90 days (for locally placed clients), to assess, among other factors, whether the RCF placement is adequate and appropriate. If a placement is not appropriate for a client or conservatee, AAS staff intervenes as appropriate to transition the client or conservatee into a more appropriate setting.
The ability of a particular RCF to meet a client or conservatee’s individual needs is a unique performance factor, which makes a competitive procurement process ineffective and inappropriate for the selection of RCFs. To appropriately design a solicitation, AAS would have to tailor the solicitation to the individual needs of clients, which is not feasible and is highly inefficient. Given these circumstances, AAS requests that the Board waive the competitive contract process for selection of any licensed RCF by AAS, consistent with Administrative Memo B-1, which allows the Board of Supervisors to grant non-emergency general exemptions to the competitive contracting process for variety of situations, including if the services have unique performance factors.
In addition, AAS requests that the Board of Supervisors authorize contracting authority to the Chief of San Mateo County Health or her designee to enter into agreements with RCFs.
The resolution has been reviewed and approved by County Counsel as to form, and all agreements will be approved by County Counsel as to form.
Contracting with RCFs contributes to the Shared Vision 2025 outcome of a Healthy Community by allowing AAS conservatees and clients living in the community or those transitioning to a lower level of care in the community to maintain placement at the lowest appropriate level of care and preserve the highest and the best quality of life possible. It is anticipated that 95% of conserved clients will receive at least one face-to-face visit every 90 days per the probate local rules.
PERFORMANCE MEASURE:
|
Measure |
FY 2017-18 Actuals |
FY 2018-19 Projected |
|
Percent of conserved clients who receive at least one face-to-face visit every 90 days per the probate local rules. |
93% 655 out of 705 conserved clients |
95% 655 out of 689 conserved clients |
FISCAL IMPACT:
There is no Net County Cost associated with adopting this resolution. Funds for RCF expenditures are included in the AAS budget under services and supplies. Approximately $2.0M are included in the AAS FY 2018-19 Adopted Budget for RCF expenditures.