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 Free at Last for Substance Use Disorder Treatment Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Free at Last for substance use disorder treatment services, increasing the amount by $1,331,337 to an amount not to exceed $4,881,570 and extending the term by nine months through March 31, 2024.
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BACKGROUND:
For over 20 years, Behavioral Health and Recovery Services (BHRS) have contracted with Free At Last (FAL) for substance use disorder treatment and recovery services, serving children, families, adults, and older adults. Services include outpatient and residential recovery 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, FAL began providing services under the DMC-ODS waiver, which allowed FAL and other providers to bill for many more services than they were previously able.
In September 2021, this Board approved an agreement with FAL for substance use disorder treatment services, in the amount of $1,697,945, for the term of July 1, 2021, through June 30, 2022.
In July 2022, this Board delegated to the Chief of San Mateo County Health or designee authority to approve a Cost-of-Living Adjustment amendment, and extend the term through June 30, 2023, increasing the amount by $1,852,288, for a total amount not to exceed $3,550,233.
DISCUSSION:
Through the DMC-ODS waiver, FAL continues to provide expanded substance use disorder treatment services for children, families, adults, and older adults, through outpatient and residential treatment programs. These programs include a recovery-based support system; address legal and medical issues; teach basic life skills such as communication, anger management, and conflict resolution; re-unify families and build parenting skills; assist clients in job training and/or employment; and establish stable housing.
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 Fall 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.
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 70% of clients will achieve a successful treatment discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Estimated |
FY 2023-24 Projected |
|
Percentage of program participants that achieve a successful treatment discharge |
70% 49 out of 70 participants |
70% 49 out of 70 participants |
FISCAL IMPACT:
The term of the amended agreement is July 1, 2021, through March 31, 2024. The amount of the amended agreement is not to exceed $4,881,570 for the 33-month term, and $1,331,337 is included in the BHRS FY 2023-24 Recommended Budget. The Mental Health Services Act will fund $27,480, Federal Financial Participation for Drug Med-Cal will fund $273,156, Substance Abuse and Prevention Treatment Block Grant will fund $173,277, 2011, Realignment will fund $351,988, and AB 109 will fund $29,230. The Net County Cost is $476,206.