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 $48,660 to an amount not to exceed $15,264,450 with no change to the agreement term.
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BACKGROUND:
On August 3, 2021, 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 for a maximum amount of $15,215,790 for the term of July 1, 2021 through June 30, 2024. Crestwood has provided services for San Mateo County residents since 1988.
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) at San Mateo Medical Center (SMMC), as back up to SMMC’s 3A/B. 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. In this situation, BHRS would be credited for the days that other counties use PHF beds.
DISCUSSION:
BHRS recently received notice that Crestwood’s rate for indigent clients will be increased. As a result, BHRS is requesting an amendment to update the per night rate of a bed for indigent clients from $1,089 to $1,182 and to increase the total maximum amount of the agreement.
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 80% of clients in a locked/Mental Health Rehabilitation Center placement that will be discharged to a less restrictive, more independent level of care or maintained at a current lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Actual |
FY 2021-22 Estimated |
|
Percentage of clients in a locked/ Mental Health Rehabilitation Center placement who are discharged to a less restrictive, more independent level of care or maintained at current level of care |
80% 46 Clients |
80% 46 Clients |
FISCAL IMPACT:
The term of the agreement is July 1, 2021 through June 30, 2024. This amendment increases the contract amount by $48,660 to an amount not to exceed $15,264,450 for the three-year term. Of this amount, $14,793,450 is allocated to BHRS and $471,000 to AAS. Funds in the amount of $48,660 are included in the BHRS FY 2021-22 Adopted Budget. Of the increased amount it is anticipated that 90% or $43,794 will be funded from sales tax provided through Realignment, and 10% or $4,866 is Net County Cost.
Of the maximum amount for BHRS, $4,931,150 will be for FY 2021-22 and is funded as follows: 90% or $4,438,035 from sales tax provided through Realignment, and 10% or $493,115 from Net County Cost. These funds are included in the BHRS FY 2021-22 Adopted 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 Adopted Budget.
Similar arrangements will be in place for FY 2022-23 and FY 2023-24.