Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
David Young, Director, Behavioral Health and Recovery Services
Subject: Amendment to the Agreement with Project Ninety, Inc. for Substance Use Disorder Treatment Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Project Ninety, Inc. for outpatient and residential substance use disorder treatment services under the Drug Medi-Cal Organized Delivery System, increasing the amount by $1,739,519 to an amount not to exceed $4,589,296, and extending the term of the agreement through June 30, 2018.
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BACKGROUND:
On August 13, 2015, the California Department of Health Care Services (DHCS) announced the approval of its waiver application to the US Center for Medicare and Medicaid Services to implement the Drug Medi-Cal Organized Delivery System (DMC-ODS). The waiver allows any California county to “opt in” to provide for a full continuum of services currently unavailable to Medi-Cal clients. Additionally, the waiver will allow for Federal Financial Participation to offset treatment related costs. San Mateo County - specifically, Behavioral Health and Recovery Services (BHRS) - was the first California county to be approved for the waiver.
On May 24, 2016, your Board approved an agreement with Project Ninety, Inc. (Project Ninety) for residential substance use disorder treatment services, for the term July 1, 2016 through June 30, 2017, in an amount not to exceed $2,849,777.
On August 31, 2016, the Chief of the Health System approved a first amendment to the agreement to include bridge funding, with no change to the maximum amount or term of the agreement.
On October 26, 2016, the Chief of the Health System approved a second amendment to the agreement to extend bridge funding, with no change to the maximum amount or term of the agreement.
DISCUSSION:
Project Ninety will continue to provide residential substance use disorder treatment services to adult male residents of San Mateo County. Through the DMC-ODS waiver, Project Ninety will provide expanded outpatient and intensive outpatient services to adult males residents. This full continuum of services will include safe and supportive transitional housing, case management, and additional services that were not available prior to the waiver. With the DMC-ODS waiver in place, this agreement with the contractor ensures continuous quality improvement in treatment through the development of a quality management program that measures and analyzes both client and system outcomes.
The agreement and resolution have been reviewed and approved by County Counsel as to form. This amendment is late due to prolonged contract negotiations with the provider and is on the Continuing Resolution.
Approval of this amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by providing individuals and families with prevention and treatment services to support recovery, which in turn contributes to the health and safety of communities throughout the County. A 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 57% of clients will achieve a successful treatment discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2016-17 Actual |
FY 2017-18 |
|
Program participants with a successful treatment discharge |
67% * 43 clients |
57% ** 130 clients |
|
* Prior to DMC-ODS, Contractor provided residential services only. |
|
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** Effective 8/1/17, Contractor will provide outpatient and residential services through the DMC-ODS, allowing them to serve more clients |
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FISCAL IMPACT:
The term of the amended agreement is July 1, 2016 through June 30, 2018. The amount of the amended agreement is not to exceed $4,589,296; the amendment increases the contract amount by $1,739,519. The original agreement included shared aggregate amounts among the contracted substance use treatment providers for services funded by AB 109, as well as 2011 Realignment and Unified Reentry. However, beginning in July 2017, services provided under the DMC-ODS waiver will no longer include these shared aggregate funding amounts.
Of the increased amount, Federal Financial Participation - Medi-Cal will fund $123,502, Substance Abuse Prevention and Treatment Federal Block Grant will fund $932,815, State DMC-ODS Allocation will fund $453,719, Mental Health Services Act will fund $63,636, and AB109 will fund $1,075. The remaining $164,772 will be funded by Net County Cost (COLA).