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Health and Human Services Agency, Behavioral Health Division, recommending the Board:
1) Approve and authorize the Chair to sign Agreement for Services 002-S1811 with Progress House, Inc., for the provision of substance use disorder treatment services, for the term July 1, 2017 through June 30, 2020, with a maximum contractual obligation of $2,772,000.00; and
2) Authorize the Purchasing Agent, or designee, to execute further documents relating to Agreement for Services 002-S1811, including amendments which do not increase the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management.
FUNDING: 34% Federal, 37% Realignment, 18% AB 109 funding, 3% fines and penalties, and 8% fund balance.
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DEPARTMENT RECOMMENDATION
Health and Human Services Agency (HHSA) recommending the Board approve and authorize the Chair to sign Agreement for Services 002-S1811 to provide residential and outpatient substance use disorder treatment services for eligible individuals. Approval of this renewal Agreement will allow for the provision of mandated alcohol and drug counseling and treatment services for both existing and future clients.
Additionally, HHSA has determined, in accordance with County Ordinance Section 3.13.030, it is more economical and feasible to engage an independent contractor for substance use disorder treatment services due to the specialized skills and qualifications involved in the performance of the work. The County does not possess the facilities to provide 24 hours per day, seven days per week, substance use disorder treatment services in a residential living setting.
DISCUSSION / BACKGROUND
The Substance Abuse and Mental Health Services Administration (SAMHSA) is a branch of the U.S. Department of Health and Human Services and is charged with improving the quality and availability of prevention, treatment, and rehabilitative services to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illness. SAMHSA offers many grant opportunities, including the Substance Abuse Prevention and Treatment (SAPT) Federal block grant, which is mandated by the U.S. Congress to be used to fund substance abuse and mental health services. In California, the public system of care for the prevention and treatment of Substance Use Disorder (SUD) is overseen by California Department of Health Care Services (DHCS) and is administered by counties. DHCS annually receives SAPT, Medicaid, and State Behavioral Health Realignment funding that it makes available to counties to provide these mandated substance abuse prevention and treatment services.
Progress House, Inc. provides a continuum of care that includes both outpatient counseling services and residential services. In addition to traditional residential treatment, Progress House, Inc. offers withdrawal management (detoxification services) and transitional living services. HHSA is able to refer men, women, and women with children to various facilities. Historically there has been a shortage of residential treatment facilities regionally, and Progress House, Inc. is the only in-county facility that HHSA’s Behavioral Health Division contracts with to provide residential treatment services for men and women. Moreover, Progress House, Inc. has treatment sites scattered throughout El Dorado County, which enables HHSA to place Clients in treatment options that are close to their natural supports, versus out-of-county placement. Clients who remain near their natural support system often have better treatment outcomes.
HHSA has received substance use disorder funding since 2004, first from the California Department of Alcohol and Drug Programs, and later from DHCS. At this time, HHSA has not yet received the renewal funding agreement from DHCS. However, as HHSA consistently receives funding from DHCS, it is anticipated that DHCS will continue to allocate funding to the County to enable continuation of mandated services. If HHSA does not receive funding from DHCS or if the funding is less than anticipated, HHSA will amend or terminate Agreement for Services 002-S1811 accordingly. The Agreement contains both “Fiscal Considerations” and “Termination” language. The maximum contractual obligations are determined based upon financial analysis of historical and projected utilization, service availability, location, and consideration of other factors such as changes in the Drug Medi-Cal services and client Medi-Cal eligibility.
ALTERNATIVES
Disapproval of Agreement for Services 002-S1811 will result in difficulty meeting the service demands of the community, may disrupt the progress and continuity of care for clients currently receiving services from Progress House, and based on current demand, will result in an inability to provide the service levels typically mandated by the funding agreement.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
County Counsel, Risk Management, Human Resources, and Procurement and Contracts.
CAO RECOMMENDATION
It is recommended that the Board approve this item.
FINANCIAL IMPACT
There is no Net County Cost associated with this Agenda item. Sufficient appropriations were included in the fiscal year 2016-17 budget, and will be included in future budgets for the term of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) original Agreements for Services 002-S1811.
2) Clerk of the Board to return one (1) fully executed Agreement to the HHSA Contracts Unit at 3057 Briw Road.
STRATEGIC PLAN COMPONENT
Health and Human Services Agency Strategic Plan Project 3.2, “External/Community Collaboration.”
CONTACT
Patricia Charles-Heathers, Ph.D., Director