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 Free at Last for Substance Use Disorder Treatment Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Free at Last for substance use disorder treatment services for the term of June 1, 2025 through June 30, 2027, in an amount not to exceed $1,510,752.
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BACKGROUND:
For over 20 years, Behavioral Health and Recovery Services (BHRS) has contracted with Free at Last for substance use disorder (SUD) treatment and recovery services, serving children, families, adults, and older adults. Services include outpatient and residential treatment services.
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 July 2017, Free at Last began providing services under the DMC-ODS waiver, which allowed Free at Last and other providers to bill for many more services than they were previously able to.
DISCUSSION:
Through the DMC-ODS waiver, Free at Last continues to provide SUD outpatient group and individual treatment to adult County residents. These services are focused on an individualized residential and outpatient treatment program that includes assessment, care coordination, family therapy, individual and group counseling, alcohol and drug testing, relapse prevention, recovery services, and SUD Crisis Intervention Services.
In December 2023, BHRS released a Request for Proposals for the provision of SUD outpatient treatment services. Free at Last responded and was recommended for their expertise in SUD outpatient group services and individual treatment.
Under this agreement, Free at Last will also provide expanded residential SUD treatment services for adult men and women and pregnant women.
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 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% 80 of 84 participants |
95% 80 of 84 participants |
COMMUNITY IMPACT:
This contract will positively impact the behavioral health of low-income residents in need of SUD treatment services. Free at Last 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. Free at Last is essential to assure fair and effective 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 fairness in the healthcare delivery system, 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 $1,510,752 for the two-year term. For FY 2025-26 the maximum amount is $667,465 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 $567,345, Substance Use Prevention, Treatment, and Recovery Services Block Grant will fund $9,172, and the 2011 Realignment will fund $100,120.
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.
Attachment:
RFP Matrix