Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lisa Mancini, Interim Director, Behavioral Health and Recovery Services
Subject: Agreement with El Centro de Libertad for Substance Use Disorder Outpatient Treatment, Contingency Management, and Alcohol and Other Drug Prevention Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with El Centro de Libertad for substance use disorder outpatient treatment, contingency management services, and alcohol and other drug prevention services, increasing the amount by $685,287 to an amount not to exceed $2,404,314 with no change to the agreement term.
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BACKGROUND:
For over 20 years, Behavioral Health and Recovery Services (BHRS) has contracted with El Centro de Libertad (El Centro) for substance use disorder outpatient treatment and recovery services to San Mateo County residents. In April 2016, the California Department of Health Care Services (DHCS) and the Federal Government approved the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver for substance use disorder treatment services. In March 2017, El Centro began providing services under the DMC-ODS waiver, which allowed El Centro and other providers to bill for many more services than they were previously able.
On March 16, 2021, BHRS released a Request for Quotes for Coastside co-occurring
substance use services to provide case management and early intervention services for
the Cariño Project in Half Moon Bay, operated by Ayudando Latinos a Soñar agency.
El Centro was the only agency that submitted a quote and was selected to provide these services.
In November 2021, this Board approved an agreement with El Centro for substance
use disorder outpatient treatment services and Coastside co-occurring substance use
services, for the term of July 1, 2021 through June 30, 2022, in an amount not to
exceed $822,147.
In January 2022, DHCS requested applications for a Contingency Management Pilot Program. San Mateo County responded, and El Centro opted to participate in this pilot to offer Contingency Management services and other evidence-based practices already offered by DMC-ODS providers. Also known as the Recovery Incentive Program, this
pilot consists of a series of incentives for meeting treatment goals, specifically abstinence from stimulants as verified by urine drug tests. This pilot runs from January 1, 2023 to March 31, 2024.
In July 2022, this Board delegated to the Chief of San Mateo County Health or designee authority to amend the agreement to approve a Cost of Living adjustment to the agreement, to increase the amount payable by $896,880, for a total amount not to exceed $1,719,027, and to extend the term through June 30, 2023.
DISCUSSION:
Through the DMC-ODS waiver, El Centro continues to provide substance use disorder outpatient group and individual treatment to adolescent and adult County residents. These services are focused on an individualized outpatient treatment program that includes family group therapy, alcohol and drug testing, relapse prevention, adolescent treatment, and anger management.
BHRS is requesting to amend its current agreement with El Centro to increase the maximum amount payable by $685,287, to an amount not to exceed $2,404,314. The increase is to add staff at the Maple Street Shelter to facilitate increased capacity with the homeless population by providing intake and case management services. These services will continue once the new Navigation Center opens. The goal is to provide maximum treatment services to address substance use disorders and mental illness as the primary factors perpetuating homelessness. The program fits within the County's goals to reduce the unhoused population.
Of the $685,287 request, $34,000 will be used to support start-up costs to hire and train staff, to change billing systems and to invest in hardware and software needed to implement the Contingency Management Pilot/Recovery Incentives Program. Once launched, these pilot client services will be reimbursed in the same manner as all other DMC-ODS client services.
In addition, with Substance Abuse Prevention and Treatment Block Grant (SABG) set-aside funding, BHRS seeks to allow El Centro to provide more comprehensive community services by the provision of support for substance use prevention education. For Fiscal Year 2022-23, BHRS has contracted with El Centro to provide substance use prevention education services to San Mateo County residents.
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 the County Attorney as to form.
Approval of this amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by providing individuals and families with prevention and treatment services to support recovery, which in turn contributes to the health and safety of communities throughout the county. Successful treatment discharge occurs when a program participant completes his/her treatment/recovery plan or when a participant is transferred to the next appropriate level of care. It is anticipated that 77% of participants will achieve a successful treatment discharge. Through substance use prevention education, it is anticipated that 75% of participants will increase in knowledge on the health impacts of alcohol, tobacco, and other drugs.
PERFORMANCE MEASURE:
|
Measure |
FY 2021-22 Actual |
FY 2022-23 Estimated |
|
Percentage of program participants that achieve a successful treatment discharge |
77% 146 of 190 participants |
77% 146 of 190 participants |
|
Percentage of training evaluations that show an increase in knowledge on the health impacts of alcohol, tobacco, and other drugs |
N/A |
75% 75 of 100 participants |
FISCAL IMPACT:
The term of the agreement is July 1, 2021 through June 30, 2023. The amount of the agreement is not to exceed $2,404,314 for the two-year term. Of this amount, $1,557,503 will be included in the BHRS FY 2022-23 Adopted Budget. Of the $685,287 increase, Federal Financial Participation (FFP) will fund $180,228, 2011 Realignment will fund $45,529, AB109 will fund $11,765, Substance Abuse and Prevention Treatment Block (SABG) Grant will fund $42,695, SABG Prevention will fund $91,200 and Net County Cost will be $313,870.