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: Measure K: Amendment to the Agreement with HealthRIGHT360 for Substance Use Disorder Prevention and Treatment Services, Medication Assisted Treatment Services, and Outreach and Engagement Services
RECOMMENDATION:
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Measure K: Adopt a resolution authorizing an amendment to the agreement with HealthRIGHT360 for substance use disorder prevention and treatment services, medication assisted treatment services, and outreach and engagement services, increasing the amount by $3,411,448 to an amount not to exceed $12,508,642 and extending the term by nine months through March 31, 2024.
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BACKGROUND:
In 2014, HealthRIGHT 360 (HR360) merged with two community-based organizations that independently contracted with the County: Asian American Recovery Services and Women’s Recovery Association. HR360 services include substance use prevention and treatment services, and the North County Outreach Collaborative (NCOC), which provides outreach, linkage, and case management services to the emotionally disturbed population residing in the northern region of the County.
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, HR360 began providing services under the DMC-ODS waiver, which allowed HR360 and other providers to bill for many more services than they were previously able.
In November 2021, this Board approved an agreement with HR360 for substance use disorder prevention and treatment services, medication-assisted treatment services, and outreach and engagement services, for the term of July 1, 2021, through June 30, 2022, and mental health outreach and vaccine outreach for the term of July 1, 2021, through August 31, 2021, in an amount not to exceed $4,356,068.
In July 2022, this Board designated 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 $4,741,126, for a total amount not to exceed $9,097,194.
DISCUSSION:
Through the DMC-ODS waiver, HR360 continues to provide substance use disorder treatment services to adults, youth, and families, including outpatient and residential treatment, medication-assisted treatment, sober living environments, and case management services. In addition, HR360 has continued to be the fiscal and lead agency for the North County Prevention Partnership (NCPP) by providing culturally appropriate outreach, psychoeducation, screening, referral, and warm hand-off services.
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.
HR360’s substance use disorder (SUD) clients are at a higher acuity level and are some of the most complex SUD cases in the County. Specifically, HR360 clients have severe co-occurring mental health disorders and personality disorders; have physical, sexual and emotional trauma; and may have cognitive impairments that are so significant they cannot benefit from lower levels of residential care. All HR360 SUD clients also have other complex needs including homelessness, a history of criminal involvement, and other health conditions.
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 63% of program participants 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 |
63% 136 out of 216 participants |
63% 136 out of 216 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 $12,508,642 for the 33-month term, and $3,411,448 is included in the BHRS FY 2023-24 Recommended Budget. Measure K will fund $262,829; Mental Health Services Act will fund $329,505; Federal Financial Participation for Drug Med-Cal will fund $1,474,392; Substance Abuse and Prevention Treatment Block Grant will fund $257,981; 2011 Realignment will fund $150,664; and AB109 will fund $90,392. The remaining $845,685 is Net County Cost.