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 Our Common Ground, Inc. for Substance Use Disorder Treatment Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Our Common Ground, Inc. for a cost reconciliation, start-up funds, and additional substance use disorder outpatient and residential treatment services under the Drug Medi-Cal Organized Delivery System, increasing the amount by $452,252 to an amount not to exceed $5,874,469, with no change to the term of the agreement.
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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 federal waiver allows any California county to “opt in” to provide 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 June 7, 2016, your Board approved an agreement with Our Common Ground, Inc. (OCG) for substance use disorder residential treatment services, for the term July 1, 2016 through June 30, 2017, in an amount not to exceed $2,906,592.
On September 15, 2016, the Chief of the Health System approved an amendment to the agreement to include bridge funding through September 30, 2016, with no change to the maximum amount or term of the agreement.
On October 14, 2016, the Chief of the Health System approved an amendment to the agreement to extend bridge funding through December 31, 2016, with no change to the maximum amount or term of the agreement.
On January 24, 2017, your Board approved an amendment to the agreement to provide expanded substance use disorder outpatient and residential treatment services under the DMC-ODS waiver, increasing the contract maximum by $2,515,625 to $5,422,217, and extending the term of the agreement through June 30, 2018.
DISCUSSION:
OCG provides outpatient and residential treatment services to adult residents of the County. Through this agreement, OCG will continue to provide a full continuum of services, including individual therapy, individual counseling, group therapy, anger management, family therapy, room and board and additional services that were not available prior to the waiver.
In addition, OCG has added a specialized wellness component that will treat seriously mental ill adults with a co-occurring substance use disorder. This wellness component is embedded within the existing residential and intensive outpatient program. Additional staff shall provide 24-hour supervision to support client stability within the residential program, a critical service that BHRS does not currently have. As a result, this agreement with OCG will fill a much needed gap.
In April 2017 DHCS conducted an audit on OCG for FY 2014-15. Based upon the findings of that audit, BHRS will make a one-time payment to OCG for an underpayment made in FY 2014-15.
It is now necessary to amend this agreement for the following: 1) additional substance use disorder treatment services under the DMC-ODS; 2) start-up costs incurred prior to the start of DMC-ODS services on February 1, 2017; and 3) a cost reconciliation based upon audit findings by DHCS.
The amendment and resolution have been reviewed and approved by County Counsel as to form.
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 64% of clients will receive a successful treatment discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2016-17 Actual |
FY 2017-18 Projected |
|
Program participants with a successful treatment discharge |
64% 103 clients |
64% 103 clients |
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 $5,874,469; the amendment increases the contract amount by $452,252. Of the increase, 2011 Realignment will fund $40,353, Federal Financial Participation - Medi-Cal will fund $334,254, and the Mental Health Services Act will fund $6,092. The remaining $71,553 will be funded by Net County Cost (COLA).