REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 9, 2022
FROM
GEORGINA YOSHIOKA, Interim Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Standard Agreement Template for Substance Use Disorder and Recovery Services Residential Treatment and Withdrawal Management Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to the standard agreement template for Substance Use Disorder and Recovery Services Residential Treatment and Withdrawal Management Services, increasing the total aggregate amount by $457,500, from $10,000,000 to $10,457,500, for the period of January 1, 2022 through December 31, 2022.
2. Authorize the Assistant Executive Officer of Department Operations, the Deputy Executive Officer of Human Services, or the Director of the Department of Behavioral Health to execute Amendment No. 1 to the standard agreement template with current individual Substance Use Disorder and Recovery Services Residential Treatment and Withdrawal Management Services providers, on behalf of the County, subject to review by County Counsel.
(Presenter: Georgina Yoshioka, Interim Director, 388-0801)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The total increase of $457,500 is funded through the additional funds provided by the Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA) grant. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2022-23 budget.
BACKGROUND INFORMATION
DBH Substance Use Disorder and Recovery Services (SUDRS) provides a full range of substance use disorder prevention treatment, education, and recovery support services for families and residents of San Bernardino County (County) through contracts with community-based organizations and County-operated clinics with the goal of promoting prevention, recovery, and resiliency. SUDRS Residential Treatment and Withdrawal Management (RT and WM) services provide a 24-hour living support and structure with available trained personnel ranging from high intensity to low intensity services, which include clinical services to address addiction in a therapeutic milieu for adults (ages 18 and over), children (ages 13-17), and perinatal patients, including persons at-risk of or experiencing homelessness. The recommended increase in funding will allow DBH to provide an expansion of SUDRS RT and WM services to eligible clients throughout the County.
On May 10, 2022 (Item No. 18), the Board of Supervisors (Board) accepted the grant award for the CRRSAA supplemental grant, which will increase the capacity and help meet the need for SUDRS RT and WM services.
DBH utilizes a standard agreement template in order to maintain a pool of qualified contract providers for these necessary services. These agencies are currently providing SUDRS RT and WM services to residents through facilities located throughout the County:
• Inland Valley Drug and Alcohol Recovery Services, Inc.
• St. John of God Health Care Services, Inc.
• Social Science Services, Inc. dba Cedar House Life Change Center
• Veteran’s Alcohol Rehabilitation Program, Inc.
• Tarzana Treatment Centers, Inc.
Upon Board approval of the Recommendations, DBH will execute Amendment No. 1 to the standard agreement template with the five current providers who will utilize the increase in funding from the CRRSAA grant which expires on December 31, 2022. Any providers approved in the future will be provided the original standard agreement template and will not utilize this increase in funding from the CRRSAA grant. DBH anticipates that qualified providers for SUDRS RT and WM services will provide approximately 91 additional treatment episodes at an estimated cost per treatment episode of $5,020.
DBH is responsible for providing mental health and/or substance use disorder services to San Bernardino County residents who are experiencing serious mental illness and/or a substance use disorder. An integral part of the service delivery system consists of County operated and contracted service providers delivering an array of treatment and supportive services.
PROCUREMENT
Procurements for SUDRS RT and WM are performed as needed due to change in laws, regulations, and program requirements. Over the past several years, DBH has released County Administrative Office approved Requests for Qualifications for SUDRS RT and WM; one on January 28, 2015, for the period of July 1, 2015 through March 31, 2019, and most recently on August 8, 2018, for the period of April 1, 2019 through December 31, 2021.
As a result of the August 8, 2018 procurement, on March 19, 2019 (Item No. 7), the Board approved the standard agreement template for ongoing SUDRS RT and WM in an aggregate amount not to exceed $30,000,000, for the period of April 1, 2019 through December 31, 2021, with the option to extend two additional one-year periods. The Board further authorized the Assistant Executive Officer of Human Services, Deputy Executive Officer of Human Services, or DBH Director to execute the individual standard agreement templates and amendments, on behalf of the County, subject to review by County Counsel.
On December 7, 2021 (Item No. 13), the Board approved the revised standard agreement template for ongoing SUDRS RT and WM in an aggregate amount not to exceed $10,000,000, for the period of January 1, 2022 through December 31, 2022, exercising the first of two one-year options to extend. The Board further authorized the Assistant Executive Officer of Department Operations, Deputy Executive Officer of Human Services, or DBH Director to make any non-substantive changes, and execute the individual standard agreement templates, on behalf of the County, subject to review by County Counsel.
SUDRS RT and WM is an ongoing procurement, which allows DBH to continuously accept proposals from new providers. Templates are being utilized due to the ongoing need to expedite adding newly accredited facilities to the existing qualified provider pool.
DBH will continue to monitor contractor performance on a regular basis to ensure compliance standards are met. Contract monitoring is inclusive of, but not limited to, site visits and assessments of policy, procedures, process implementation, and service delivery components to ensure compliance with contract and applicable laws and regulations. The fiscal review ensures costs claimed are reasonable, allowable and in compliance with related financial records and procedures. Additionally, as needed and appropriate, a review of Medi-Cal certification, related standards, and chart documentation may be completed.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Contracts Manager, 388-0869) on June 21, 2022; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on June 28, 2022; Finance (John Hallen, Administrative Analyst, 388-0208) on July 6, 2022; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on July 12, 2022.