Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Subject: Agreement with Addiction Research and Treatment, Inc. for narcotic replacement therapy services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Addiction Research and Treatment, Inc. for narcotic replacement therapy services, for the term July 1, 2018 through June 30, 2019, in an amount not to exceed $1,935,299.
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BACKGROUND:
Addiction Research and Treatment, Inc. (ART) provides narcotic replacement therapy (NRT) services for San Mateo County adults with histories of opioid dependency and comorbid health related issues. Specifically, ART provides methadone maintenance, counseling and case management services, primarily to Medi-Cal beneficiaries.
In October 2015, Behavioral Health and Recovery Services (BHRS) requested and was granted approval from your Board to waive the Request for Proposals process for NRT services for two years, pending approval of the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver.
In April 2016, the California Department of Health Care Services and the federal government approved the DMC-ODS waiver. BHRS is in the process of establishing the quantity of services, as well as how the services will be delivered due to the implementation of this waiver.
DISCUSSION:
The demand for Medication Assisted Therapy (which includes NRT services) has nearly doubled since June 2014, due to San Mateo County’s successful implementation of the Affordable Care Act (ACA) and the expansion of Medi-Cal eligibility. More people are covered under ACA and are aware of Medication Assisted Therapy service availability, resulting in a much higher demand for services.
Through this agreement, ART will continue to operate and manage NRT services for San Mateo County adult Medi-Cal clients with complex needs. These services include daily methadone dosing, appropriate Medication Assisted Therapy services, urine screening, addiction education and intervention, aftercare planning, patient follow-up, and follow-up with referring partners. Research has validated the effectiveness of methadone treatment for opiate-dependent patients.
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 Counsel as to form. This agreement is late due to prolonged contract negotiations and is on the Continuing Resolution.
Approval of this agreement 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. Success for services under this agreement is measured by sustained abstinence over a one-year period and is verified by a rigorous regime of testing for alcohol, methadone, methadone metabolites, heroin, opium, other opioids, cocaine, amphetamine, methamphetamine, and other substances. Each patient is randomly tested once a month. It is anticipated that 90 percent of clients requesting methadone services will receive treatment with 24-hours.
PERFORMANCE MEASURE:
|
Measure |
FY 2017-18 Estimated |
FY 2018-2019 Projected |
|
Percentage of clients requesting methadone services that receive treatment within 24 hours |
90% 194 clients |
90% 194 clients |
FISCAL IMPACT:
The term of the agreement is July 1, 2018 through June 30, 2019. The amount of the agreement is not to exceed $1,935,299 and is included in the BHRS FY 2018-19 Recommended Budget. Of this amount, $967,649 will be funded by Federal Financial Participation for Drug Medi-Cal and $967,650 will be funded by 2011 Realignment. There is no Net County Cost. The payment provisions and levels of service remain essentially the same as those of the prior agreement.