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 & Recovery Services
Lisa Mancini, Director, Aging and Adult Services
Subject: Agreement with Crestwood Behavioral Health for Residential Rehabilitation and Long-Term Care Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Crestwood Behavioral Health for residential rehabilitation and long-term care services, for the term of July 1, 2021 through June 30, 2024, in an amount not to exceed $15,215,790.
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BACKGROUND:
As a provider of mental health services, Crestwood Behavioral Health’s (Crestwood) programs include skilled nursing facilities/neurobehavioral programs, mental health rehabilitation centers (MHRC), adult residential programs, wellness clinics, community programs, residential care facilities for the elderly, and psychiatric health facilities. Crestwood offers a continuum of care and treatment, from traditional psychiatric services to recovery programs, geared towards community reintegration. The contractor has provided services for San Mateo County residents since 1988.
Under the B-1 Administrative Memorandum, the selection of providers for long-term locked facility services is exempt from the Request for Proposals requirement.
DISCUSSION:
Crestwood will continue to provide services to both the Behavioral Health and Recovery Services (BHRS) and Aging and Adult Services (AAS) divisions of San Mateo County Health. Specifically, Crestwood’s network of facilities provides up to 53 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.
BHRS has purchased 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. These beds will be managed by Psychiatric Emergency Services (PES), as back up to 3A/B at San Mateo Medical Center (SMMC). 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 and BHRS would be credited (not charged for those days).
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.
This agreement is coming to your Board late due to prolonged contract negotiations and is on the Continuing Resolution.
It is anticipated that 80% of clients will be maintained at a current lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Actual |
FY 2021-22 Estimated |
|
Percentage of clients maintained at current or lower level of care |
80% 12 Clients* |
80% 12 Clients* |
*This metric is tied to MHRC clients.
FISCAL IMPACT:
The term of the agreement is July 1, 2021 through June 30, 2024. The amount of the agreement is not to exceed $15,215,790 for the three-year term. Of this amount, $14,744,790 is for BHRS and $471,000 is for AAS.
The contract sum will be divided evenly over the three fiscal years. Of the maximum amount for BHRS, $4,914,930 will be for FY 2021-22 and is funded as follows: $4,423,437 (90%) from Realignment, and $491,493 (10%) Net County Cost. These funds are included in the BHRS FY 2021-22 Recommended Budget.
Of the maximum amount for AAS, $157,000 will be for FY 2021-22 and is Net County Cost. These funds are included in the AAS FY 2021-22 Recommended Budget.
The payment provisions in this agreement remain essentially the same as those of the prior agreement. Similar arrangements will be in place for FY 2022-23 and FY 2023-24.