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: Amendment to the Agreement with StarVista for Mental Health Services and Substance Use Disorder Treatment Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with StarVista for mental health services and substance use disorder treatment services, increasing the amount by $3,838,303 to an amount not to exceed $24,083,378 and extending the term by six months through September 30, 2024.
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BACKGROUND:
For over 20 years, Behavioral Health and Recovery Services (BHRS) has contracted with StarVista for mental health services, Girls’ Juvenile Court services, child abuse treatment services, the Early Childhood Community Team (ECCT), and substance use disorder 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, StarVista began providing services under the DMC-ODS waiver, allowing StarVista and other providers to bill for many more services than they previously could.
In December 2021, this Board approved an agreement with StarVista for mental health services and substance use disorder treatment services, in the amount of $6,920,577, for the term of July 1, 2021, through June 30, 2022.
In July 2022, this Board designated the Chief of San Mateo County Health or designee authority to approve a Cost-of-Living Adjustment (COLA) amendment for FY 2022-2023 and extend the term by one year through June 30, 2023, and increasing the amount by $7,542,045, for a total amount not to exceed $14,462,622.
In April 2023, the Chief of San Mateo County Health approved an amendment to increase the amount by $25,000 for the Health Ambassador Program-Youth, for a total amount not to exceed $14,487,622 with no change to the agreement term.
In June 2023, this Board approved an amendment to the agreement to increase the maximum amount by $5,522,383 for a total amount not to exceed $20,010,005 and to extend the term of the agreement by nine months through March 31, 2024.
In January 2024, this Board designated the Chief of San Mateo County Health or designee authority to approve an amendment to the agreement to provide a 4% COLA for FY 2023-2024, increasing the maximum amount by $235,070 to $5,757,455 for a total amount not to exceed $20,245,075 with no change to the agreement term.
DISCUSSION:
StarVista provides: 1) ECCT services to young children; 2) staffing of the Co-Chair of the Diversity and Equity Council; 3) Trauma-Informed Co-Occurring Prevention for Youth services; 4) texting and social media support through its Crisis Hotline; 5) recruitment of youth ages 16-24 years that have experienced mental health and substance use challenges to participate in Health Ambassador Program-Youth training and community outreach; 6) youth and adult mental health first aid; 7) technology supports for clients and family members that do not have the resources to purchase the technology they need; 8) full implementation of the Youth S.O.S Team for foster youth and caregivers; and 9) the Community Wellness Crisis Response Team for community members experiencing a mental health crisis. Additionally, through the Pride Center, StarVista continues to address the complex and various needs of Lesbian, Gay, Bisexual, Transgender Queer (LGBTQ) persons at high risk for serious mental illness and/or serious emotional disability by providing counseling and crisis intervention, case management, peer support services, and substance use services. Lastly, through the DMC-ODS waiver, StarVista continues to provide expanded substance use disorder treatment services for children, youth, families, adults, and older adults.
DHCS continues to require changes in service delivery and reporting requirements of substance use disorder treatment services through the DMC-ODS waiver. BHRS released a Request for Proposals (RFP) for substance use disorder treatment services and an RFP for the Health Ambassador Program in Fall 2023.
RFPs for trauma-informed and early intervention services, ECCT, and the LGBTQ Pride Center were released in Winter 2023.
The RFPs are at different stages in the procurement process, and a six-month extension to this agreement term will provide additional time for the RFP process to be completed and for BHRS to finalize the implementation of DMC-ODS waiver-related changes to this and all other BHRS substance use-related contracts.
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 and resolution have been reviewed and approved by the County Attorney as to form.
This amendment is late due to negotiations with the provider.
It is anticipated that 99% of clients will be maintained at a current or lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Actual |
FY 2023-24 Estimated |
|
Percentage of clients maintained at a current or lower level of care |
99% 1,462 out of 1,480 clients |
99% 1,462 out of 1,480 clients |
FISCAL IMPACT:
The term of the amended agreement is July 1, 2021, through September 30, 2024. The amount of the amended agreement is not to exceed $24,083,378 for the 39-month term, and $3,838,303 is included in the BHRS FY 2023-24 Adopted Budget. The Mental Health Services Act will fund $1,428,393; 2011 Realignment will fund $1,415,759; Human Services Agency will fund $228,220 for the Family Urgent Response System; Third party billings will fund $301,308, Substance Use and Prevention Treatment Block Grant will fund $167,673; Federal Financial Participation will fund $99,918; and AB109 will fund $3,985. The remaining $193,047 is Net County Cost.