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 El Centro de Libertad for Substance Use Disorder Outpatient Treatment, Contingency Management, and Alcohol and Other Drug Prevention Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with El Centro de Libertad for substance use disorder treatment services for the term June 1, 2025 through June 30, 2027, in an amount not to exceed $3,485,549.
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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 for 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.
DISCUSSION:
Through the DMC-ODS waiver, El Centro continues to provide Substance Use Disorder (SUD) outpatient group and individual treatment to adolescent and adult County residents. These services are focused on an individualized outpatient treatment program that includes assessment, care coordination, family therapy, individual and group counseling, alcohol and drug testing, relapse prevention, adolescent treatment, recovery services, and SUD Crisis Intervention Services.
In December 2023, BHRS released a Request for Proposals for the provision of SUD outpatient treatment services. El Centro responded and was selected for their expertise in SUD outpatient group and individual treatment.
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 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 program participants will achieve a successful treatment discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of program participants that will achieve a successful treatment discharge |
95% 200 of 211 participants |
95% 200 of 211 participants |
EQUITY IMPACT:
This contract will positively impact the behavioral health of low-income residents in need of SUD treatment services. El Centro de Libertad 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. El Centro de Libertad is essential to assure equitable access to quality care for underserved and vulnerable people in San Mateo County. Most SUD clients at El Centro 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. El Centro 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 $3,485,549 for the 25-month term. For FY 2025-26 the maximum amount is $1,760,375 and is included in the BHRS Recommended FY 2025-26 Budget. Of this, Federal Financial Participation will fund $750,000, 2011 Realignment will fund $187,500, AB109 will fund $71,507, Substance Use Prevention Treatment, and Recovery Services Block (SUBG) Grant will fund $147,856. SUBG Prevention will fund $26,250 and Net County Cost will be $577,262. 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 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.
Attachment:
RFP Matrix