Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health, and Recovery Services
Subject: Amendment to the 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 amendment to the agreement with Caminar, Inc. for Substance Use Disorder Treatment services, and Housing and Housing-Related Mental Health services, extending the term by nine months through March 31, 2024, and increasing the amount by $8,260,099 to an amount not to exceed $29,966,257.
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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 provided outpatient mental health services through the Mental Health Plan. 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.
On June 1, 2018, Project 90 merged with Caminar, to provide outpatient substance use disorder treatment services to adult males under the DMC-ODS.
In December 2021, this Board approved an agreement with Caminar to provide 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.
In June 2022, this Board designated the Chief of San Mateo County Health or designee to approve a Cost-of-Living-Adjustment amendment and extend the term by one year through June 30, 2023, increasing the amount by $11,324,907, to an amount not to exceed $21,706,158,
In October 2022, the Director of BHRS approved an amendment to the agreement removing specific language to be more suitable for Project 90 services to adult-males only, with no change to the amount or term of the agreement.
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. In FY 2021-22, there were 610 clients served 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. BHRS will release a Request for Proposals (RFP) for substance use disorder treatment services in Winter 2023. A nine-month term extension to this agreement will provide additional time for the RFP process to be completed and for BHRS to finalize the implementation of DMC-ODS waiver-related changes to this and all other BHRS substance use related contracts.
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 amendment and resolution have been reviewed and approved by the County Attorney as to form.
It is anticipated that 70% of clients who receive services will be maintained at current or lower level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Actual |
FY 2023-24 Estimated |
|
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 amended agreement is July 1, 2021, through March 31, 2024.
This amendment increases the agreement amount by $8,260,099 to an amount not to exceed $29,966,257 for the 33-month term. Of this increase, Medi-Cal Federal Financial Participation will fund $2,703,775; 1991 Realignment will fund $2,469,483; Mental Health Services Act will fund $301,020; 2011 Realignment (AB 109) will fund $37,393; Substance Abuse Block Grant will fund $165,093; Mental Health Block Grant will fund $99,394; Medicare will fund $71,015 and Net County Cost will fund the remaining $2,412,926.