Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with Service League of San Mateo County for Substance Use Disorder Treatment Services and Community Corrections Partnership - Sober Living Environment Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Service League of San Mateo County for substance use disorder treatment services and Community Corrections Partnership - Sober Living Environment services, for the term of June 1, 2025 through June 30, 2027 in an amount not to exceed $2,938,037.
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BACKGROUND:
For over 15 years, Hope House, a program of Service League of San Mateo County (Service League), has provided an intensive residential treatment program for women who have a Substance Use Disorder (SUD). Hope House services include safe and supportive transitional housing coupled with case management. Transitional housing residents must be employed and/or attend school, along with continued recovery-based involvement within the community.
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, Service League began providing services under the DMC-ODS waiver, which allowed Service League and other providers to bill for many more services than they were previously able to.
Under the B-1 Administrative Memorandum, the selection of providers delivering housing and related support services for mental health clients are exempt from the Request for Proposal requirement. In order to improve service capacity, Behavioral Health and Recovery Services (BHRS) may contract for housing and related support services with any willing, qualified provider.
DISCUSSION:
Under this agreement, Service League will provide expanded residential SUD treatment services for adult women, pregnant women, and women with infants; in addition, add Community Corrections Partnership Sober Living Environment/transitional housing 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 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 95% of program participants will achieve a successful treatment discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of program participants that achieve a successful treatment discharge |
95% 45 of 48 participants |
95% 45 of 48 participants |
EQUITY IMPACT:
This contract will positively impact the behavioral health of low-income residents in need of SUD treatment services. Outpatient and residential providers offer bilingual and bicultural substance use treatment services in convenient locations across San Mateo County with the aim of helping residents to achieve long-term wellness and recovery. These SUD providers are essential to assure equitable access to quality care to underserved and vulnerable people in San Mateo County. Most clients have co-occurring mental health needs and other complex needs, including homelessness, justice system involvement, and other physical health conditions.
To advance health equity, improve quality, and help eliminate health disparities, the County requires providers to comply with National Culturally and Linguistically Appropriate Services Standards. Each provider is required to submit an annual cultural competence plan that details current and future efforts to address the diverse needs of clients, families, and the workforce in San Mateo County.
FISCAL IMPACT:
The term of the agreement is June 1, 2025 through June 30, 2027. The amount of the agreement is not to exceed $2,938,037 for the two-year term. For FY 2025-26 the maximum amount is $1,427,387 and will be included in the BHRS FY 2025-26 Recommended Budget. Similar arrangements will be made for future years. Of that amount, it is anticipated that the Medi-Cal reimbursement will fund $889,725, Substance Use Prevention, Treatment, and Recovery Services Block Grant will fund $228,606, the 2011 Realignment will fund $94,655, and the Net County Cost is $214,401.
BHRS is changing the methodology used to pay contracted providers that are currently paid on a 1/12th, monthly advance methodology. For several reasons, BHRS is changing the payment methodology for most contracts to fee-for-service (FFS) and payments will be made in arrears. Additionally, in previous fiscal years, BHRS was granted an exception to pay providers during the accounting “blackout period” in July and August. This practice is no longer available.
To facilitate these changes, BHRS has agreed to one three-month pre-pay for July-September of FY 2025-26 to qualifying providers. This payment will be reconciled in November. This payment must be made in June 2024. To make this payment, an ATR is needed. One ATR for all the impacted contracts will be submitted on the May 6th Board agenda. There will be no pre-pays in subsequent fiscal years.