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: Revised Memorandum of Understanding with San Mateo County Sheriff’s Office for Acute Stabilization Unit in Maguire Correctional Facility
RECOMMENDATION:
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Adopt a resolution designation of Maguire Correctional Facility as a facility designated by the County for evaluation and treatment under Welfare and Institutions Code section 5150 et seq. and simultaneously authorizing a revised Memorandum of Understanding detailing the 5150 process and procedures with the provider for the term beginning November 13, 2018 through November 12, 2019, with an annual automatic renewal for a one-year term upon review by Behavior Health and Recovery Services Designated Review Team.
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BACKGROUND:
In the past, the County of San Mateo contracted with the County of Santa Clara for the use of acute psychiatric inpatient beds within their correctional facility for the placement and treatment of San Mateo County Jail inmates experiencing mental illness. When that agreement was terminated by the County of Santa Clara, San Mateo County undertook a few approaches to support the acute mental health needs of inmates, with varying success, for a few years. Liberty Healthcare Corporation was selected through an RFP process and began their contract with Correctional Health Services in May 2018 to operate the Acute Services Unit (ASU) embedded at the County’s Maguire Correctional Facility. In December 2018, your Board approved Maguire as a facility designated by the County for evaluation and treatment under Welfare and Institutions Code section 5150 et seq., and simultaneously authorized and approved the Memorandum of Understanding (MOU) between Behavioral Health and Recovery Services (BHRS) and Maguire detailing the 5150 process and procedures with the provider.
Expanding the inpatient hospital continuum in the County, ASU keeps inmate patients in the County and close to family, helps meet the ongoing need in the continuum for level of care capacity, and significantly reduces the impact on San Mateo Medical Center (SMMC), which was previously providing psychiatric care to County inmates. Since the opening of the ASU, this inmate patient population has remained separate from the public and treatment is kept within the Maguire facility. The ASU has also reduced the number of mental health clients that are in administrative segregation and has made a significant positive impact for clients who were previously non-compliant with medication, which has helped them maintain a consistent level of stabilization. Clients who successfully participate in the ASU treatment program return to either Maguire general population or the community with improved mental health stability. The ASU also provides critically needed linkages to other mental health resources for these clients.
DISCUSSION:
BHRS requests your Board to continue designation of Maguire’s ASU as a 5150 facility. The designation allows the ASU to receive patients on a 5150 hold, provide psychiatric evaluation and treatment of persons on a 5150 hold that can be served by the program, and meet the admissions criteria as determined by the provider. This designation conforms to the requirements of BHRS Policy 90-09: 5150 Designated Facilities, California Welfare & Institutions Code Section 5150. et seq., and California Code of Regulations Title 9, Section 821, et seq.
BHRS also requests your Board to approve and authorize the Revised Memorandum of Understanding between BHRS and Maguire, detailing the 5150 process and procedures with the provider. The revisions reflect annual renewal of the designation and the one-year term of the MOU, upon annual review by the BHRS Designated Review Team.
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 agreement and resolution have been reviewed and approved by County Counsel as to form.
A successful patient outcome under this agreement is that inmates receive care in a facility with a treatment milieu that specifically addresses their presenting condition in an environment dedicated to this population. It is anticipated that 80 inmates will be diverted from PES to Maguire.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Actual |
FY 2020-21 Estimated |
|
Percentage and number of inmates diverted from PES to Maguire |
100% 46 inmates |
100% 80 inmates |
FISCAL IMPACT:
The term of the agreement is November 13, 2018 through November 12, 2019 and will continue to automatically renew annually for a one-year term upon review by the BHRS Designated Facility Review Team. There is no fiscal impact associated with this agreement.