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: Third Amendment to Agreement with Our Common Ground, Inc. for Substance Use Disorder Treatment Services
RECOMMENDATION:
title
Adopt a resolution authorizing a third amendment to the agreement with Our Common Ground, Inc. for substance use disorder treatment services, for the term June 1, 2025 through June 30, 2027 to an amount not to exceed $23,538,644.
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BACKGROUND:
Behavioral Health and Recovery Services (BHRS) has contracted with Our Common Ground, Inc. (OCG) for over 20 years to provide substance use disorder (SUD) outpatient and residential treatment services to San Mateo County adults with substance abuse and addiction problems.
BHRS is now part of California Advancing and Innovating Medi-Cal (CalAIM), a multi-year initiative by the California Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of our population by implementing a broad delivery system and program and payment reform across the Medi-Cal program. The behavioral health components of CalAIM are designed to support whole-person, integrated care; move the administration of Medi-Cal behavioral health to a more consistent and seamless system by reducing complexity and increasing flexibility; and improve quality outcomes, reduce health disparities, and drive delivery system transformation and innovation through improvements to behavioral health policies and the launch of behavioral health payment reform.
Through the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver and under CalAIM, OCG provides outpatient and residential treatment services to adult County residents. These services encompass a comprehensive approach, including individualized residential and outpatient treatment, family group therapy, alcohol and drug testing, recovery services and relapse prevention, and recovery residence. OCG’s treatment approach is a strength-based Modified Therapeutic Community Model, which values relationships and views the clients in light of their competencies rather than their deficiencies. Success is based upon individual progress in treatment, while concentrating on academic and vocational pursuits.
OCG provides clinically managed residential withdrawal management services, and, provides 24-hour support for moderate withdrawal symptoms that are not manageable in an outpatient setting. BHRS is required to provide these services per the DMC-ODS regulations. Through the Mental Health Diversion Grant Program, OCG also provides residential treatment services to San Mateo County residents who are not eligible for Drug Medi-Cal or other health care insurance but need services. These services include individual therapy, individual counseling, group therapy, anger management, family therapy, and room and board.
In December of 2023, BHRS released a Request for Proposals for the provision of SUD outpatient treatment services. OCG responded and was recommended based on their continued successful treatment program providing services to vulnerable and underserved youth and their established collaboration with community partners. On June 4, 2024, this Board approved an agreement for OCG to provide DMC-ODS services for FY 2024-25.
On May 6, 2025, this Board approved an agreement with OCG to provide DMC-ODS services for the term June 1, 2025 through June 30, 2027. That agreement includes a provision to reconcile service payment amounts for those services according to CalAIM requirements.
On September 1, 2025, under the authority designated by this Board, the Director of BHRS executed a first amendment to this agreement to add CalAIM reconciliation payments for FY 2024-25 payments to the agreement in the amount of $437,064, to a new maximum of $18,989,881, with no change to the agreement term.
On September 10, 2025, BHRS and OCG entered into an amendment by Executive Letter to revise billing rates for FY 2025-26, with no change to the terms or the total amount of the Agreement.
DISCUSSION:
BHRS has transitioned the payment model for provider agreements from 1/12th monthly amounts with a reconciliation to a fee-for-services payment model in accordance with State requirements. The original projected costs for FYs 2025-27 were based on data from FY 2023-24 and the first six months of FY 2024-25.
This agreement is now being amended to add payments for 2025-26 and 2026-27 CalAIM projected DMC-ODS services, in the amount of $4,548,763. This amended increase is based upon current utilization rates data, which are significantly higher than the original projection. There is no change to the services provided or to the term 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 to 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 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of program participants who achieve a successful treatment discharge |
95% 352 of 371 participants |
95% 352 of 371 participants |
COMMUNITY IMPACT:
This contract will positively impact the behavioral health of low-income residents in need of SUD treatment services. OCG offers 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. This provider is essential to assure equitable access to quality care for 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 amended agreement is June 1, 2025 through June 30, 2027. The amount of the agreement is not to exceed $23,538,644 for the 25-month term. For FY 2025-26, the maximum amount is being increased by $2,218,909 to a new maximum of $10,665,976 which is included in the BHRS FY 2025-26 Adopted Budget. Of the increase Federal Financial Participation for Drug Med-Cal will fund $1,678,889, Realignment will fund $296,274, and the Net County Cost is $243,746. For FY 2026-27, the maximum amount is being increased by $2,329,854 to a new maximum of $11,042,590, and the increase will be funded similarly to FY 2025-26.