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 El Centro de Libertad for Substance Use Disorder Outpatient Treatment, Contingency Management, and Alcohol and Other Drug Prevention Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with El Centro de Libertad for substance use disorder outpatient treatment services, contingency management services, and alcohol and other drug prevention services, increasing the amount by $901,618 to an amount not to exceed $3,305,932 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 El Centro de Libertad (El Centro) for substance use disorder outpatient treatment and recovery services to San Mateo County residents.
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 March 2017, El Centro began providing services under the DMC-ODS waiver, which allowed El Centro and other providers to bill for many more services than they were previously able.
In March 2021, BHRS released a Request for Quotes for Coastside co-occurring substance use services to provide case management and early intervention services for the Cariño Project in Half Moon Bay, operated by the community-based organization Ayudando Latinos a Soñar. El Centro was the only agency that submitted a quote and was selected to provide these services.
In November 2021, this Board approved an agreement with El Centro for substance use disorder outpatient treatment services and Coastside co-occurring substance use services for the term of July 1, 2021, through June 30, 2022, in an amount not to exceed $822,147.
In January 2022, DHCS requested applications for a Contingency Management Pilot Program. San Mateo County responded, and El Centro opted to participate in this pilot to offer Contingency Management services and other evidence-based practices already offered by DMC-ODS providers. Also known as the Recovery Incentive Program, this pilot consists of a series of incentives for meeting treatment goals, specifically abstinence from stimulants, as verified by urine drug tests. This pilot runs from January 1, 2023, to March 31, 2024.
In June 2022, this Board delegated to the Chief of San Mateo County Health or designee authority to amend the agreement to approve a Cost-of-Living Adjustment and extend the term through June 30, 2023, increasing the amount payable by $896,880, for a total amount not to exceed $1,719,027.
In November 2022, this Board approved a second amendment to add staff at the Maple Street Shelter to facilitate increased capacity with the homeless population by providing intake and case management services, increasing the maximum amount by $685,287 for a total amount not to exceed $2,404,314 with no change to the agreement term.
In March 2023, the Director of Behavioral Health and Recovery Services approved a third amendment through an Executive Letter to add specific language for Coastside co-occurring substance use services, inadvertently removed in Exhibit A2.I, with no change to the agreement term.
DISCUSSION:
Through the DMC-ODS waiver, El Centro continues to provide substance use disorder outpatient group and individual treatment to adolescent and adult County residents. These services are focused on an individualized outpatient treatment program that includes family group therapy, alcohol and drug testing, relapse prevention, adolescent treatment, and anger management.
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 their treatment/recovery plan or when a participant is transferred to the next appropriate level of care. It is anticipated that 77% of program participants will achieve a successful treatment discharge. Through substance use prevention education, it is anticipated that 75% of training evaluations will show increased participant knowledge of the health impacts of alcohol, tobacco, and other drugs.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Estimated |
FY 2023-24 Projected |
|
Percentage of program participants that achieve a successful treatment discharge |
77% 146 of 190 participants |
77% 146 of 190 participants |
|
Percentage of training evaluations that show an increase in participant knowledge on the health impacts of alcohol, tobacco, and other drugs |
75% 75 of 100 evaluations |
75% 75 of 100 evaluations |
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 $3,305,932 for the 33-month term, and $901,618 is included in the BHRS FY 2023-24 Recommended Budget. Of the $901,618 increase, Federal Financial Participation will fund $243,097, 2011 Realignment will fund $73,356, AB109 will fund $18,956, Substance Abuse and Prevention Treatment Block (SABG) Grant will fund $68,790, SABG Prevention will fund $91,200, Healthcare for Homeless grant will fund $60,000, Contingency Management Services grant will fund $34,000, and Net County Cost will be $312,219.