Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Scott Gillman, Director, Behavioral Health and Recovery Services
Subject: Agreement with Optum for After Hour Phone Coverage Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Optum for after hour phone coverage services for the term of July 1, 2019 through June 30, 2020, in an amount not to exceed $410,138.
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BACKGROUND:
In March 2015, Behavioral Health and Recovery Services (BHRS) issued a Request for Proposals (RFP) to select a provider for after hour phone coverage services. Optum submitted a proposal and was selected to provide this service.
BHRS has since contracted with Optum for after hour phone coverage services for San Mateo County and three other counties (Marin, Sonoma, and Contra Costa).
DISCUSSION:
Optum shall continue to provide after hours phone coverage services for the 1-800 numbers available to San Mateo, Marin, Sonoma, and Contra Costa County residents and Medi-Cal beneficiaries seeking behavioral health services. The agreement covers the costs for each of the four participating counties, with BHRS serving as the fiscal representative for all participating counties. The service and financial arrangement between the participating counties are defined in a memorandum of understanding.
Each County operates a 1-800 number from 8am-5pm Monday through Friday, except holidays. Optum will be responsible for answering calls from 5pm-8am Monday through Friday, and for answering calls 24 hours a day on weekends and holidays. Optum will provide basic information about the behavioral health benefits for Medi-Cal beneficiaries and transmit the caller’s name, contact information, and brief description of the presenting problems to the individual County call center by the next business day.
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’ care. We are continuing to work with Optum and the other three counties to fully implement and meet these new state requirements. Therefore, BHRS is requesting that the Board waive the RFP process for after hour phone coverage services for one more year, allowing time for BHRS to continue the work that has been initiated with Optum and the other counties. After FY 2019-20, each County will separately determine how they will go about continuing these services. San Mateo County will be issuing its own, single County RFP in FY 2020-21.
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 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).
The 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 contribute to this measure. It is anticipated that 95% of calls will be answered within 45 seconds or less.
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Actual |
FY 2019-20 Projected |
|
Percentage of calls answered within 45 seconds or less. |
95% |
95% |
FISCAL IMPACT:
The term of the agreement is July 1, 2019 through June 30, 2020. The amount of the agreement is not to exceed $410,138 for the one-year-term. Of that amount, $123,040 will be for BHRS. The latter amount will be funded by Medi-Cal Federal Financial Participation ($30,760) and 1991 Realignment ($92,280). There is no Net County Cost. BHRS will receive payment from the County of Contra Costa, Marin, and Sonoma for their respective costs incurred for these services. BHRS will make payment to this provider on behalf of all participating Counties.