REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 23, 2023
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contracts for Substance Use Disorder and Recovery Services Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to the following contracts for Substance Use Disorder and Recovery Services Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery Services, adding the aggregate amount not to exceed $1,600,000 for clients referred by the Department of Children and Family Services for 2022-23 and 2023-24, with no change to the contract period of July 1, 2022 through June 30, 2027:
a. High Desert Child, Adolescent and Family Services Center, Inc., Contract No. 22-471.
b. Inland Behavioral Health Services, Inc., Contract No. 22-472.
c. Mental Health Systems, Inc., Contract No. 22-474.
d. Social Science Services, Inc. dba, Cedar House Life Change, Contract No. 22-475.
2. Approve Amendment No. 1 to Contract No. 22-473 with Inland Valley Recovery Services for Substance Use Disorder and Recovery Services Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery Services, increasing the total contract amount by $57,000, from $4,769,000 to $4,826,000, and adding the aggregate amount not to exceed $1,600,000 for clients referred by the Department of Children and Family Services for 2022-23 and 2023-24, with no change to the contract period of July 1, 2022 through June 30, 2027.
3. Approve Amendment No. 6 to Contract No. 17-336 with CLARE|MATRIX, for Substance Use Disorder and Recovery Services Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery Services, adding the aggregate amount not to exceed $800,000 for clients referred by the Department of Children and Family Services, with no change to the contract period of July 1, 2017 through June 30, 2023.
4. Authorize the Auditor-Controller/Treasurer/Tax Collector to post adjustments to the Department of Behavioral Health 2022-23 budget, as detailed in the Financial Impact section (Four votes required).
(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). Funding for the increase of $57,000 for Inland Valley Recovery Services is funded by Drug Medi-Cal and 2011 Realignment. The increase of $1,600,000 ($800,000 each for 2022-23 and 2023-24) is an aggregate amount for services by the providers for clients referred by the Department of Children and Family Services (CFS) and will be funded by CFS for Substance Use Disorder and Recovery Services (SUDRS) Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery (EIO IOT) through a Memorandum of Understanding.
The Department of Behavioral Health (DBH) requests the Auditor-Controller/Treasurer/Tax Collector to post the following adjustments to the 2022-23 budget:
|
Fund/Cost Center |
G/L Account |
Description |
Action |
Amount |
|
1018271000 |
52002445 |
Other Professional |
Increase |
$857,000 |
|
1018271000 |
55415013 |
Services & Supplies Transfers In |
Increase |
$857,000 |
Adequate appropriation for the remaining $800,000 will be included in the 2023-24 recommended budget and in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to county residents who are experiencing severe mental illness and/or SUD. SUDRS EIO IOT services provide a full range of SUDRS prevention, treatment services, and education for communities and residents in the county.
Early Intervention services are intended for county youth (ages 12 through 17) and adults (ages 18 through 20) to identify and address potential substance use before it develops into more serious conditions. These services often involve screening, assessment, brief counseling, or psychoeducation to help clients understand the risks and develop healthy coping skills.
Outpatient Treatment is designed for clients with SUDs and provides counseling, therapy, and supportive services without requiring clients to live at a treatment facility. Services typically include individual, group, and family therapy, as well as medication management and psychoeducation.
Intensive Outpatient Treatment is a more structured and time-intensive form of outpatient care, designed for clients with moderate to severe SUDs or co-occurring mental health issues. Clients participate in multiple treatment sessions per week, which may include individual, group, and family therapy, as well as case management and other support services.
Recovery services provide those who have completed treatment with a place to seek support, allowing clients to reconnect with a former treatment provider to assist the client in navigating their recovery journey, when a formal treatment episode is not warranted. These services may include peer support, self-help groups, case management, and ongoing counseling or therapy, with the goal of maintaining abstinence and preventing relapse.
Approval of the Recommendations will allow DBH to extend services to an additional 679 CFS referred clients annually, in addition to the 48 non-CFS referred clients for Inland Valley Recovery Services, at an average cost of $1,178 per client for all services. Recommendation No. 1 provides $1,600,000 in additional funding to be used by the providers on a first come, first served basis for clients referred by CFS; $800,000 each for 2022-23 and 2023-24. Recommendation No. 2 includes Inland Valley Recovery Services in the $1,600,000 additional funding for clients referred by CFS, and also allows for an additional 48 Inland Valley Recovery Services SUDRS EIO OIT clients through the $57,000 increase in funding. Recommendation No. 3 includes CLARE|MATRIX in the additional funding for clients referred by CFS, however, since their contract currently expires on June 30, 2023, they are only eligible to the additional funding of $800,000 for 2022-23.
DBH will continue to monitor contract performance on a regular basis, both quarterly and annually, to ensure services provided follow Federal and State regulations, and DBH contractual requirements and standards of care. The provider invoices will be reviewed and approved by DBH Fiscal for payment and total cost will be verified prior to issuing payment.
PROCUREMENT
Recommendation Nos. 1 and 2
On June 28, 2022 (Item No. 35), as the result of a formal procurement, the Board of Supervisors (Board) approved contracts for SUDRS EIO IOT services with High Desert Child, Adolescent and Family Services Center, Inc., Inland Behavioral and Health Services, Inc., Inland Valley Recovery Services, Mental Health Systems, Inc., and Social Science Services, Inc. dba, Cedar House Life Change, in the amount of $13,429,690 for the period of July 1, 2022 through June 30, 2027.
Recommendation No. 3
On May 23, 2017 (Item No. 43), as a result of a formal procurement, the Board approved the contract with Matrix Institute on Addictions, Inc. (Matrix) (Contract No. 17-336) to provide SUDRS EIO IOT services, in the amount of $933,900, for the period of July 1, 2017 through June 30, 2020.
On June 12, 2018 (Item No. 21), the Board approved Amendment No. 1 to Contract No. 17-336 with Matrix, updating contract language, with no change to the total contract amount or contract period.
On February 12, 2019 (Item No. 14), the Board approved Amendment No. 2 to Contract No. 17-336 with Matrix, reflecting the assignment of the contracts from Matrix to CLARE Foundation, Inc. dba Matrix Institute on Addictions, Inc. formalized as CLARE|MATRIX, with no change to the total contract amount or contract period.
On June 23, 2020 (Item No. 32), the Board approved Amendment No. 3 to Contract No. 17-336 with CLARE|MATRIX, updating standard contract language, increasing the total contract amount by $311,300, from $933,900 to $1,245,200, and exercising the first option to extend the contract through June 30, 2021.
On June 8, 2021 (Item No. 32), the Board approved Amendment No. 4 to Contract No. 17-336 with CLARE|MATRIX, increasing the total contract amount by $311,300 from $1,245,200 to $1,556,500, and exercising a one-year extension option for the total contract period of July 1, 2017 through June 30, 2022.
On June 28, 2022 (Item No. 35), the Board approved Amendment No. 5 to Contract No. 17-336 with CLARE|MATRIX, increasing the total contract amount by $311,300 from $1,556,500 to $1,867,800, and exercising a one-year extension option for the total period of June 1, 2017 through June 30, 2023.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on April 27, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 1, 2023; Auditor-Controller/Treasurer/Tax Collector (Vanessa Doyle, Deputy Chief Controller 382-3195) on May 3, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on May 2, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) May 7, 2023.