Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Scott Gilman, Director, Behavioral Health and Recovery Services
Subject: Measure K: Agreement with StarVista for Mental Health Services and Substance Use Disorder Treatment Services
RECOMMENDATION:
title
Measure K: Adopt a resolution authorizing an agreement with StarVista for mental health services and substance use disorder treatment services, for the term July 1, 2019 through June 30, 2021, in an amount not to exceed $8,821,793.
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BACKGROUND:
For over 20 years, Behavioral Health and Recovery Services (BHRS) has contracted with StarVista for mental health services authorized by the Mental Health Plan (MHP), Girls’ Juvenile Court services, child abuse treatment services, the Early Childhood Community Team, 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, which allowed StarVista and other providers to bill for many more services than they were previously able.
DISCUSSION:
Through this agreement, StarVista continues to provide: (1) mental health services offered through the MHP; (2) Early Childhood Community Team services to young children in the Coastside community; (3) staffing of the Co-Chair of the Diversity and Equity Council; and (4) recruitment of youth ages 16-24 that have experienced mental health and substance use challenges. The latter youth will participate in the Health Ambassador Program for Youth (HAP-Y) training and community outreach, and ultimately graduate as Health Ambassadors. Additionally, through the Lesbian Gay Bisexual Transgender Queer (LGBTQ) Center, StarVista shall continue to address the complex and various needs of 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.
The Seeking Safety curriculum ended June 30, 2019 and was replaced by an alternative curriculum currently under pilot, Mindfulness-Based Substance Abuse Treatment (MBSAT), with a focus on trauma-informed co-occurring prevention. The MBSAT curriculum integrates best practices from the fields of mindfulness, psychotherapy, and substance use reliance treatment in adolescents. StarVista shall provide services under the pilot program through June 30, 2020. BHRS is in the process of releasing an RFP for these services to begin July 1, 2020.
Beginning July 1, 2019, StarVista shall provide texting and social media support through its Crisis Hotline. BHRS is requesting that your Board waive the Request for Proposals (RFP) process for texting and social media services, StarVista operates the only youth crisis hotline in San Mateo County.
Lastly, through the DMC-ODS waiver, StarVista continues to provide expanded services for children, youth, families, adults, and older adults. Services include: intensive day substance abuse treatment to adult women with co-occurring substance abuse and mental health disorders, outpatient substance use treatment and recovery services to formerly incarcerated clients, and a quality management program that analyzes both client and system outcomes.
DHCS continues to impose changes in service delivery and reporting requirements of substance use disorder treatment services through the DMC-ODS waiver. Due to these changes, BHRS is requesting that your Board waive the RFP process for substance use disorder treatment services for two years, allowing BHRS time to finalize the implementation of DMC-ODS waiver-related changes to this and all other BHRS substance use related contracts. In 2020, BHRS will release a RFP for substance use disorder treatment services to start on July 1, 2021.
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 coming to your Board 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 outpatient mental health services, and prevention and treatment services, which in turn contributes to the health and safety of communities throughout the County. It is anticipated that 99 percent of clients will be maintained at a current or lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Actual |
FY 2019-20 Projected |
|
Percentage of clients maintained at a current or lower level of care |
99% 1,462 clients |
99% 1,462 clients |
FISCAL IMPACT:
The term of the agreement is July 1, 2019 through June 30, 2021. The amount of the agreement is not to exceed $8,821,793 for the two-year term. Of this amount, $5,152,372 is included in the BHRS FY 2019-20 Adopted Budget. The Mental Health Services Act will fund $2,083,995, 2011 Realignment will fund $984,769, Measure K will fund $836,495, Substance Abuse and Prevention Treatment Block Grant will fund $307,140, Whole Person Care will fund $228,309, Medicare will fund $167,000, Federal Financial Participation will fund $243,000, Health Plan of San Mateo H-lines will fund $38,000, and AB109 will fund $7,300. The remaining $256,364 is Net County Cost. A similar arrangement will be in place for FY 2020-21.