REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 17, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contracts for Substance Use Disorder and Recovery Services Recovery Residences
End
RECOMMENDATION(S)
Recommendation
Approve amendments to the following contracts for the provision of Substance Use Disorder and Recovery Services Recovery Residences, updating standard contract language, increasing the total amount by $3,979,365, from $1,869,089 to $5,848,454, and extending the term by 15 months, for the total contract period of April 1, 2021, through June 30, 2027:
1. Amendment No. 4 to Contract No. 21-185 with Inland Valley Drug and Alcohol Recovery Services dba Inland Valley Recovery Services, increasing the total contract amount by $973,121 from $822,885 to $1,796,006.
2. Amendment No. 3 to Contract No. 21-186 with New Hope Village, Inc., increasing the total contract amount by $87,600 from $286,179 to $373,779.
3. Amendment No. 4 to Contract No. 21-188 with Veteran’s Alcohol Rehabilitation Program, Inc., increasing the total contract amount by $2,918,644 from $760,025 to $3,678,669.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies.
FINANCIAL IMPACT
Approval of this item does not impact Discretionary General Funding (Net County Cost). The recommended contract increases totaling $3,979,365 for Substance Use Disorder and Recovery Services (SUDRS) Recovery Residences (RR) is funded by the Behavioral Health Bridge Housing (BHBH) Program grant award administered through the California Department of Health Care Services (DHCS); Substance Use Prevention, Treatment and Recovery Services Block Grant Funds; and Assembly Bill 109 Public Safety Realignment. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2024-25 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to county residents experiencing severe mental illness and/or SUD. DBH-SUDRS provides a full range of substance use disorder prevention and treatment services, and education for communities and residents in the county through contracts with community-based organizations and County-operated clinics with the goal of promoting prevention, intervention, recovery and resiliency for individuals and families. SUDRS RR provides a safe, substance-free residence designed to help the client maintain a substance-free lifestyle and transition successfully back into the community, typically, after having received Residential SUD treatment.
SUDRS RR provides county residents with housing units in a sober living environment for adult clients, including those with minor children. The goal of the program is to provide a secure environment for the individual and family while assisting the adult client to transition into permanent housing and integrate back into the community as a productive member, using educational programs, including assistance with employment searches. Attendance in recovery and/or treatment services is mandatory while the client resides in RR.
Clients at the RR are welcome to participate in self-help meetings and any activities. Activities and services at RR facilities are provided within a substance-free environment, overseen by trained staff available 24 hours per day, seven days per week to assist in maintaining a substance-free lifestyle. All facilities must meet the required standards and maintain certification with the California Consortium of Addiction Programs and Professionals, which is an affiliate of the National Alliance of Recovery Residences.
Inland Valley Drug and Alcohol Recovery Services dba Inland Valley Recovery Services (IVRS) and Veteran’s Alcohol Rehabilitation Program, Inc., (VARP) will be receiving BHBH funding to provide additional SUDRS RR beds. New Hope will not add beds but continue to provide approximately 4,380 bed days annually at an estimated cost of $16 per bed day ($70,080 annually over the amended contract term).
IVRS will provide 4,380 additional bed days (9,125 total bed days) annually at an estimated cost of $52 per bed day. The contract increase for additional beds is $888,121 ($228,122 annually for additional beds over the existing contract term and $474,500 annually over the amended contract term). Also included in the contract amendment is $85,000 in BHBH infrastructure funding intended to construct, acquire, and expand RR properties. Infrastructure funding does not impact the provider’s budget for bed days.
VARP will provide 6,570 additional bed days (9,490 total bed days) annually at an estimated cost of $77 per bed day. The contract increase for additional beds is $1,568,644 ($506,694 annually for additional beds over the existing contract term and $730,730 annually over the amended contract term). Also included in the contract amendment is $1,435,000 in BHBH infrastructure funding intended to construct, acquire, and expand RR properties. Infrastructure funding does not impact the provider’s budget for bed days.
On March 9, 2021 (Item No. 9), as the result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 21-185 with IVRS in the amount of $600,000; Contract No. 21-186 with New Hope in the amount of $175,000 and Contract No. 21-188 with VARP in the amount of $422,640 for the provision of SUDR RR, in the total amount of $1,197,640, for the contract period of April 1, 2021, through March 31, 2026.
On August 10, 2021 (Item No. 15), the Board approved Amendment No. 1 to Contract No. 21-185 with IVRS for the substitution of one facility location for a higher quality facility with no change to the contract amount of $600,000, or the contract period of April 1, 2021, through March 31, 2026.
On September 27, 2022 (Item No. 21), the Board approved Amendment No. 2 to Contract No. 21-185 with IVRS, increasing the contract amount by $29,385 from $600,000 to $629,385; Amendment No 1 to Contract No. 21-186 with New Hope, increasing the contract amount by $39,179 from $175,000 to $214,179; and Amendment No. 1 to Contract No. 21-188 with VARP, increasing the contract amount by $29,385 from $422,640 to $452,025, all with no change to the contract periods of April 1, 2021, through March 31, 2026. The contract increases were funded by the Coronavirus Response and Relief Supplemental Appropriations Act supplemental grant.
On August 22, 2023 (Item No. 21), the Board approved Amendment No. 2 to Contract No. 21-188 with VARP, increasing the contract amount by $77,000 from $452,025 to $529,025 with no change to the contract period of April 1, 2021, through March 31, 2026. This increase resulted from an increase to the bed day rate from $58 to $77 per bed day.
On March 12, 2024 (Item No. 16), the Board approved Amendment No. 3 to Contract No. 21-185 with IVRS, increasing the contract amount by $193,500 from $629,385 to $822,885; Amendment No 2 to Contract No. 21-186 with New Hope, increasing the contract amount by $72,000 from $214,179 to $286,179; and Amendment No. 3 to Contract No. 21-188 with VARP, increasing the contract amount by $231,000 from $529,025 to $760,025, all with no change to the contract periods of April 1, 2021, through March 31, 2026. The contract increases allowed IVRS to increase its capacity by six beds, New Hope to increase its capacity by six beds, and VARP to increase its capacity by four beds.
Approval of the recommended amendments will increase funding and extend the contract terms to align with the BHBH grant.
DBH will also implement mechanisms to regularly review 1) client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; 2) applicable reimbursement claims and claims data to ensure fidelity and accuracy of service billing and optimization of Medi-Cal reimbursement in alignment with Contract terms and DHCS billing requirements; and 3) provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Lisa Rivas-Ordaz, Contract Supervisor, 383-3940) on November 21, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on December 3, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on December 10, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on December 11, 2024.