REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 19, 2023
FROM
GEORGINA YOSHIOKA, 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. 2 to the standard agreement template, effective retroactively from November 1, 2023 through December 31, 2023, for Substance Use Disorder and Recovery Services Residential Treatment and Withdrawal Management Services, increasing the total aggregate amount by $390,457, from $20,129,783 to $20,520,240.
2. Authorize the Assistant Executive Officer, the Deputy Executive Officer of Human Services, or the Director of the Department of Behavioral Health to execute Amendment No. 2 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, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The total increase to the Substance Use Disorder and Recovery Services (SUDRS) Residential Treatment and Withdrawal Management (RT and WM) services in the aggregate amount of $390,457 is funded by Substance Abuse Prevention and Treatment Block Grant, Federal Financial Participation Drug Medi-Cal, California Work Opportunity and Responsibility to Kids, Memorandum of Understanding with Children and Family Services, 2011 Realignment, and Assembly Bill 109 Public Safety Realignment. Adequate appropriation and revenue are included in the Department of Behavioral Health’s (DBH) 2023-24 budget.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and/or substance use disorder services to San Bernardino County (County) residents who are experiencing severe mental illness and/or 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. DBH SUDRS provides a full range of substance use disorder prevention, treatment, education, and recovery support services for families and residents of the County with the goal of promoting prevention, recovery, and resiliency.
SUDRS 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 setting for adults (ages 18 and over), adolescents (ages 12-17), and perinatal patients.
The recommended action will amend the standard agreement template retroactively, increasing the total aggregate amount by $390,457, from $20,129,783 to $20,520,240, for the period of November 1, 2023 through December 31, 2023. DBH utilizes a standard agreement template for this service in order to maintain a pool of qualified contract providers for these necessary services. Through this action, St. John of God Health Care Services, Inc. (SJOG) will be able to continue to provide SUDRS RT and WM services through December 31, 2023.
It was previously anticipated that SJOG would discontinue SUDRS RT and WM services as of October 31, 2023 due to the sale of their facility to the County. Unforeseen delays in the sale of the SJOG facility caused a shortage of available aggregate funds. On September 28, 2023, DBH Fiscal Services began collaborating with SUDRS Administration and SJOG on their allocation of the aggregate funding that would be exhausted as of October 31, 2023. The amended standard agreement template is being processed at this time as this is the first Board of Supervisors (Board) date available following DBH Program, Fiscal, Administrative, and legal reviews.
In addition, DBH is requesting authorization for the Assistant Executive Officer, Deputy Executive Officer of Human Services, or DBH Director to execute the revised standard agreement templates and make any non-substantive changes, on behalf of the County, subject to review by County Counsel.
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.
On March 19, 2019 (Item No. 7), the Board approved the standard agreement template for SUDRS RT and WM services 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 non-substantive amendments, on behalf of the County, subject to review by County Counsel, as well as providing the option for ongoing procurements to be conducted as needed during the original contract period to meet changes in laws, regulations and program requirements.
On December 7, 2021 (Item No. 13), the Board approved the revised standard agreement template for the ongoing SUDRS RT and WM services 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 execute the individual standard agreement templates and make any non-substantive changes, on behalf of the County, subject to review by County Counsel.
On August 9, 2022 (Item No. 15), the Board approved Amendment No. 1 to the revised standard agreement template for ongoing SUDRS RT and WM increasing the total aggregate amount by $457,500, from $10,000,000 to $10,457,500, for the period January 1, 2022 through December 31, 2022. The Board further authorized the Assistant Executive Officer of Department Operations, Deputy Executive Officer of Human Services, or DBH Director to execute Amendment No. 1 to the standard agreement template with current individual SUDR RT and WM services providers, on behalf of the County, subject to review by County Counsel.
On December 22, 2022 (Item No. 26), the Board approved the revised standard agreement template for ongoing SUDRS RT and WM in an aggregate amount not to exceed $20,129,783, upon the effective date signed by both parties through December 31, 2023, exercising the final 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 execute the individual standard agreement templates and make any non-substantive changes, on behalf of the County, subject to review by County Counsel.
PROCUREMENT
SUDRS RT and WM is an ongoing procurement, which allows DBH to continuously accept proposals from new providers to meet changes in laws, regulations and program requirements. Templates are being utilized due to the ongoing need to expedite adding newly accredited facilities to the existing qualified provider pool.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0869) on November 27, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on November 28, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on November 29, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on December 4, 2023.