Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Scott Gilman, Director, Behavioral Health and Recovery Services
Subject: Amendment to the Agreement with Crestwood Behavioral Health, Inc. for Residential Rehabilitation and Long-Term Care Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Crestwood Behavioral Health, Inc. to provide residential rehabilitation and long-term care services, increasing the amount by $2,376,958 to an amount not to exceed $15,747,958, with no change to the agreement term.
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BACKGROUND:
On October 23, 2018, your Board approved an agreement with Crestwood Behavioral Health, Inc. (Crestwood) to provide mental health services to both Behavioral Health and Recovery Services (BHRS) and Aging and Adult Services (AAS) divisions of San Mateo County’s Health Department for a maximum amount of $13,371,000 for the term of July 1, 2018 through June 30, 2021. The contractor has provided services for San Mateo County residents since 1988.
DISCUSSION:
BHRS recently received notice of rate increases for all Crestwood facilities. Further, BHRS plans to purchase additional beds with Crestwood in response to BHRS’s need for increased beds at this facility. This board resolution is to address the Crestwood rate increase and the purchase of additional beds.
Crestwood provides quality services for clients that have complex medical and behavioral needs. Crestwood’s network of facilities provides up to 58 beds for BHRS clients who are seriously mentally ill and in need of mental health rehabilitation, treatment, and long-term care. Crestwood also provides up to eight skilled nursing facility beds for AAS clients who are probate dementia conservatees of the San Mateo County Public Guardian and who require a long-term care setting. Services provided through this agreement offer an alternative to the use of more costly hospital emergency services, inpatient hospital admissions and correctional facilities.
In addition, BHRS has four dedicated beds at Crestwood’s San Jose Psychiatric Health Facility (PHF), as a less costly alternative to beds with other providers. Purchasing these beds guarantees their availability to the County. These beds will be managed by Psychiatric Emergency Services (PES), as back up to 3A/B at San Mateo Medical Center. Additionally, should PES be able to predict availability, the beds could be transferred to other counties in need of placement, and those counties would be billed the same rates by PHF. BHRS would be credited for the days that other counties use PHF beds.
The resolution contains the County’s standard provision allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
The amendment and resolution have been reviewed and approved by County Counsel as to form.
It is anticipated that 72% of clients will be maintained at a current lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Actual |
FY 2019-20 Projected |
|
Percentage of clients maintained at current or lower level of care |
88% 46 Clients |
72% 42 Clients |
FISCAL IMPACT:
The term of the agreement is July 1, 2018 through June 30, 2021. This amendment increases the contract amount by $2,376,958 to a maximum amount not to exceed $15,747,958 for the term of the agreement. Of this amount, $15,276,958 is allocated to BHRS and $471,000 to AAS.
Of the maximum amount for BHRS, $5,493,388 will be for FY 2019-20 and is funded as follows: $4,944,049 from sales tax provided through Realignment, and $549,339 from Net County Cost. These funds are included in the BHRS FY 2019-20 Adopted Budget.
Of the maximum amount for AAS, $157,000 will be for FY 2019-20 and is Net County Cost. These funds are included in the AAS FY 2019-20 Adopted Budget.
Similar arrangements will be in place for FY 2020-21.