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 StarVista, for Substance Use Disorder Treatment Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with StarVista for substance use disorder treatment and sober living environment services for the term of June 1, 2025 through June 30, 2027 in an amount not to exceed $1,042,958.
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BACKGROUND:
For over 20 years, Behavioral Health and Recovery Services (BHRS) has contracted with StarVista for substance use disorder (SUD) treatment services. StarVista Insights provides outpatient treatment service to youth ages 12 to 18 in San Mateo County.
BHRS launched the Drug Medi-Cal Organized Delivery System (DMC-ODS) in February 2017, greatly expanding the continuum of care and increasing levels of care targeting substance use disorders. BHRS is now part of 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.
DISCUSSION:
StarVista Insights provides outpatient treatment service to youth ages 12 to 18 in San Mateo County. Youth substance use treatment penetration rates in San Mateo County are about half of the statewide average (0.13% San Mateo County versus 0.25% statewide average).
In December 2023, BHRS released a Request for Proposals for the provision of SUD outpatient treatment services. StarVista was recommended based on their continued successful treatment program providing services to vulnerable and underserved youth and their established collaboration with community partners.
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 their treatment/recovery plan or when a participant is transferred to the next appropriate level of care. It is anticipated that 95% of clients will achieve a successful treatment discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of clients who achieve a successful treatment and sobering station discharge |
95% 285 of 299 clients |
95% 285 of 299 clients |
COMMUNITY IMPACT:
The StarVista contract will positively impact the behavioral health of low-income residents in need of SUD treatment services. StarVista offers bilingual and bicultural outpatient substance use treatment services in convenient locations across San Mateo County with the aim of helping residents to achieve long-term wellness and recovery. StarVista is essential to assure equitable access to quality care for underserved and vulnerable people in San Mateo County. Most of the 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. StarVista 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 $1,042,958 for the 25-month term. For FY 2025-26, the maximum amount is $435,611, which will be included in the BHRS FY 2025-26 Recommended Budget. Of that amount, it is anticipated that the federal Medi-Cal reimbursement will fund $69,550, 2011 Realignment will fund $46,710, and the Net County Cost is $319,351. Similar arrangements will be made for FY 2026-27.
BHRS is changing the methodology used to pay contracted providers that are currently paid on a 1/12th monthly advance. Specifically, BHRS is changing the payment methodology for most contracts to fee-for-service 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 exception will no longer be 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 2025. However, to make this payment, an ATR is needed. One ATR for all the impacted contracts will be submitted on the May 6, 2025 Board agenda. There will be no pre-pays in subsequent fiscal years.
Attachments:
RFP Matrix