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: Agreement with Caminar, Inc. for Substance Use Disorder Treatment Services, and Housing and Housing-Related Mental Health Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Caminar, Inc. for substance use disorder treatment services, and housing and housing-related mental health services, for the term of July 1, 2021 through June 30, 2022, in an amount not to exceed $10,381,251.
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BACKGROUND:
Since 1964, the nonprofit organization Caminar, Inc. (Caminar) has provided community-based services to individuals with serious mental illnesses. Caminar’s programs focus on maximizing wellness and recovery opportunities for adults with mental, physical, and developmental disabilities. Caminar provides intensive residential care, transitional and permanent supported housing, supported education and supported employment, individual support services, and life skills training.
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 June 2018, Caminar began providing services under the DMC-ODS waiver, which allowed Caminar and other providers to bill for many more services than they were previously able.
Through the acquisition of Family and Children’s Services on January 1, 2017, Caminar provides outpatient mental health services through the Mental Health Plan. On June 1, 2018, Project Ninety merged with Caminar, to provide outpatient substance use disorder treatment services to adult males under the DMC-ODS.
In January 2020, Behavioral Health and Recovery Services (BHRS) and the Health Plan of San Mateo (HPSM) mutually agreed to de-delegate the outpatient mild to moderate mental health services that BHRS had been responsible for back to HPSM. The de-delegation process was completed on October 1, 2020, terminating mild to moderate mental health services authorized by the Mental Health Plan as of September 30, 2020.
Under the B-1 Administrative Memorandum, housing and housing-related mental health services are exempt from the County Request for Proposals (RFP) process.
DISCUSSION:
Caminar will continue to provide the following: 1) crisis residential treatment; 2) transitional residential treatment; 3) supported housing services (including housing rental subsidies and client transportation costs); 4) case management; 5) rehabilitation services (including supported education, supported employment, and enhanced supported education services for Transition Age Youth); 6) Young Adult Independent Living services; and 7) property management of subsidized housing. Lastly, through the DMC-ODS waiver, Caminar will continue to provide expanded substance use disorder treatment services to adult males. Additional services to be provided are the administration of the San Mateo Contractors’ Association grant funding, and the management of client transportation needs in all contractor-sponsored programs. There were 677 clients served, in FY 2020-21 by the programs in this agreement.
DHCS continues to require 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 your Board to waive the RFP process for substance use disorder treatment services for one year, allowing BHRS time to finalize the implementation of DMC-ODS waiver-related changes to this and all other BHRS substance use related contracts. In late 2021, BHRS will release an RFP for substance use disorder treatment services to start on July 1, 2022.
The resolution contains the County’s standard provisions 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 has been delayed due to prolonged contract negotiations and is on the Continuing Resolution.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Actual |
FY 2021-22 Estimate |
|
Percentage of clients who receive services that are maintained at current or lower level of care |
70% 93 clients |
70% 93 clients |
* Performance Measure data is specific to the DMC-ODS P90 services in this agreement.
FISCAL IMPACT:
The term of the agreement is July 1, 2021 through June 30, 2022. The amount of the agreement is not to exceed $10,381,251, for the one-year term, and is included in the BHRS FY 2021-22 Adopted Budget. It is anticipated that Federal Financial Participation - Medi-Cal will fund $3,400,974, Substance Abuse Prevention and Treatment Federal Block Grant will fund $207,488, 1991 Realignment will fund $3,078,208, Mental Health Services Act will fund $378,321, the SAMHSA Grant will find $124,918, MediCare will fund $84,380, AB 109 will fund $39,892, 2011 Realignment will fund $27,000, and Third-Party uninsured will fund $4,951. The Net County Cost is $3,035,119.