Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with Telecare Corporation to Operate a Behavioral Health Crisis Residential Facility
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Telecare Corporation to operate a behavioral health crisis residential facility, for the term of July 1, 2023, through June 30, 2024, in an amount not to exceed $2,751,600.
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BACKGROUND:
In October 2018, Health Rite360 (HR360) began operating Behavioral Health and Recovery Services (BHRS), Serenity House Crisis Residential (SHCR), after being selected through the Request for Proposal (RFP) process. In May 2022, BHRS contracted with Telecare Corporation to continue SHRC services on an emergency basis with the sudden and unexpected contract termination by HR360.
Telecare operates 10 Crisis Residential Treatment (CRT) programs in Alameda, Contra Costa, Orange, Riverside, San Bernardino, San Joaquin, Santa Barbara, and Santa Clara counties, representing a total of 135 beds. In addition to these existing programs, Telecare is partnering with Los Angeles County to open three additional CRT programs this year. Telecare also operates the following crisis walk-in/mental health urgent care centers: the Mental Health Urgent Care Center in Long Beach (Los Angeles County), Mental Health Urgent Care Center in Perris (Riverside County), Ridgecrest CSU (Kern County), Merrill Crisis Walk-In Center (San Bernardino County), and Windsor Crisis Walk-In Center (San Bernardino County).
Each CRT program run by Telecare is California Department of Health Care Services (DHCS) certified as a Short-Term CRT Facility and Short-Doyle Medi-Cal-certified by their respective County Mental Health Plan. All Telecare CRTs have continuously maintained their DHCS and Medi-Cal certification as well as their Community Care Licensing as Social Rehabilitation Facilities. Further, all Telecare CRTs are accredited by the Commission on Accreditation of Rehabilitation Facilities International, an independent nonprofit accreditation organization dedicated to advancing the quality of health and human services worldwide.
DISCUSSION:
The BHRS SHRC is designed as an alternative to hospitalization and incarceration for adults experiencing an acute psychiatric episode. The respite stay is short-term, designed to stabilize and return clients to their current living situation if appropriate or an alternative stable environment. SHRC services are also utilized for clients who are psychiatrically destabilized due to loss of housing, placement, or support system.
Through this agreement, Telecare shall continue to deliver short-term SHRC services for up to 13 adult clients with psychiatric disabilities.
Telecare will help its SHRC clients maintain medication management; engage in natural supports; manage mental health symptoms and substance use urges; strengthen the acquisition and use of coping skills; and establish or reestablish vital links to services. By providing the latter services, Telecare can keep clients out of more restrictive levels of care and support clients throughout the ongoing process of recovery. The clients’ mental health status will be reassessed regularly, and discharge planning will begin immediately to help clients maintain stability following discharge from SHRC. This will include transporting clients while in the program to doctor appointments, housing, and other community services.
Telecare took over the operation of Serenity House and re-opened the doors at the end of September 2022. From September through March 2023, 111 unduplicated clients were served, and 44 clients received services more than once. Clients may have been served more than once by Serenity House as a result of them not having intensive case management after discharge or because they were struggling with substance use issues and were diverted from a substance use treatment program to Serenity House for stabilization before they completed their substance use treatment program.
Current medical revenue generated from September through March 2023 is $368,177 and is projected to be $491,770 after all Medi-Cal claims are processed.
Serenity House services enable San Mateo County residents experiencing a crisis to be diverted from Psychiatric Emergency Services/jail and receive the support they need to work through the crisis.
Under the B-1 Memo Administrative Memorandum, these services were considered to be an emergency with the sudden and unexpected contract termination by the previous service provider. BHRS is in the process of evaluating the first year of these emergency services and will obtain the needed information to release a Request for Proposal for ongoing Crisis Residential Services.
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 the County Attorney as to form.
Successful treatment discharge occurs when clients successfully engage in the support services they receive to remain in the community. It is anticipated that at least 90% of SHCR clients will be referred/linked/reestablished to services in the community following discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Estimated |
FY 2023-24 Projected |
|
Percentage of SHCR clients referred/linked/reestablished to services in the community following discharge |
> 90% 315 clients |
> 90% 315 clients |
FISCAL IMPACT:
The term of the agreement is July 1, 2023, through June 30, 2024. The amount of the agreement is not to exceed $2,751,600 for the one-year term. $2,751,600 is included in the BHRS FY 2023-24 Recommended Budget. Of that amount, $1,202,349 is funded with Measure K, $953,761 is funded with 1991 Realignment, and $595,490 is funded with Federal Financial Participation and State General Funds. There is no Net County Cost associated with this agreement.