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 for Unarmed Mobile Mental Health Crisis Response Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Telecare Corporation for Unarmed Mobile Mental Health Crisis Response Services for the term of January 1, 2024 through June 30, 2025, in an amount not to exceed $4,937,943.
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BACKGROUND:
Behavioral Health and Recovery Services (BHRS) was awarded the State’s Crisis Care Mobile Unit (CCMU) Planning Grant in the winter of 2021 to conduct a thorough mobile crisis response system assessment in San Mateo County for individuals aged 25 and younger. The purpose of this assessment was to determine ways to implement, optimize, and align current mobile crisis practices within San Mateo County to the national best practice standards. Concurrent with the CCMU Planning grant, California’s Department of Health Care Services (DHCS) submitted to the Centers for Medicare and Medicaid Services a State Plan Amendment to establish 24/7/365 community-based mobile crisis intervention services for all ages as a new benefit in the Medi-Cal program.
In June 2023, DHCS issued a Behavioral Health Information Notice (BHIN) 23-025 on this new benefit.
In August 2023, BHRS issued a Request for Proposals (RFP) for San Mateo Mobile Crisis Response (SMMCR).
In November 2023, Telecare was selected to provide these services to develop, operate, and deliver the SMMCR.
DISCUSSION:
Telecare shall provide 24/7/365 SMMCR mobile crisis services to anyone within San Mateo County who is experiencing a behavioral health crisis, as screened to be eligible for an in-person crisis response by the StarVista Crisis Hotline. Telecare shall provide mobile crisis services, which will include a rapid in-person response, individualized crisis assessment, crisis de-escalation, crisis intervention, and community-based stabilization. The latter stabilization shall include a crisis safety plan or completion of a 5150 involuntary hold, as well as necessary transportation to facilitate a warm hand-off to the next appropriate care. In addition, Telecare shall also provide a follow-up within 24 business hours of the initial crisis encounter to support continued resolution of the crisis. Telecare may also provide additional needed clinical interventions and case management support to ensure service/treatment connection and resolution of the crisis episode for the individual and their significant others.
The County of San Mateo derives direct benefit from the implementation of this agreement by increasing its ability to directly respond to community members in mental health crisis; providing Medi-Cal reimbursable services to County clients; enhancing response time for those in need of mental health services and resources; and creating a broader and more effective continuum of care that results in a decrease in psychiatric hospitalizations and justice system contacts.
The resolution contains the County’s standard provision allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
This agreement and resolution have been reviewed and approved by the County Attorney as to form.
This agreement is late due to extended negotiations with Telecare.
It is anticipated that the SMMCR team will respond in-person to provide crisis assessment and crisis evaluation for 100% of calls screened to be eligible for dispatch by the StarVista Crisis Hotline, using the standard Dispatch Screening Tool developed by DHCS. It is also anticipated that 80% of Medi-Cal clients will be provided with at least three documented follow-ups post crisis assessment.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Estimated |
FY 2024-25 Projected |
|
Percentage of calls that SMMCR responds to in-person to provide crisis assessment and evaluation |
100% |
100% |
|
Percentage of Medi-Cal clients that are provided with at least three follow-ups post crisis assessment |
80% |
80% |
FISCAL IMPACT:
The term of the agreement is January 1, 2024 through June 30, 2025. The amount of the agreement is not to exceed $4,937,943 for 18-month term. Funds in the amount of 1,519,827 are included in the BHRS FY 2023-24 Adopted Budget. Of the FY 2023-24 amount, it is anticipated that Realignment will fund $759,895, Medi-Cal FFP will fund $379,984, and Net County Cost will fund $379,948. Similar arrangements will be made for future years.