REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 21, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contracts for Substance Use Disorder and Recovery Services Non-Residential Drug Court Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendments to the following Contracts, effective January 1, 2024, for the provision of Substance Use Disorder and Recovery Services Non-Residential Drug Court services, expanding the service areas, updating standard contract language, and increasing the combined contract amount by $962,317, from $2,185,817 to $3,148,134, with no change to the total contract period of July 1, 2020 to September 30, 2024:
1. High Desert Child, Adolescent and Family Services Center, Inc., Amendment No. 2 to Contract No. 20-488, increasing the total contract amount by $291,940, from $1,657,559 to $1,949,499.
2. Inland Valley Drug and Alcohol and Recovery Services dba Inland Valley Recovery Services, Inc., Amendment No. 1 to Contract No. 20-489, increasing the total contract amount by $670,377, from $528,258 to $1,198,635.
(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 and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The recommended contract increases totaling $962,317 are funded by 2011 Realignment, Federal Financial Participation Drug Medi-Cal, and Substance Use Prevention, Treatment and Recovery Services Block Grant funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2023-24 budget and will be included in the 2024-25 Recommended Budget.
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 provides a full range of SUD services for residents of the county through contracts with community-based organizations and County-operated clinics with the goal of promoting prevention, intervention, treatment, education, recovery, and resiliency for individuals and families. An integral part of the service delivery system consists of Non-Residential Drug Court services (Drug Court).
DBH has been providing Drug Court through contracted providers since 1994. Drug Court brings multiple sectors of the community together to address criminal offenders’ needs, ensuring consistency in judicial decision making, and enhancing the coordination of agencies and resources. Adult Drug Court employs a program designed to reduce drug relapse and criminal recidivism among defendants and offenders through a risk and needs assessment, judicial interaction, monitoring and supervision, graduated sanctions and incentives, treatment, and various rehabilitation services. Juvenile Drug Court applies a similar approach that is tailored to the needs of youth with substance use disorders. These programs provide youth and their families with counseling, education, and other services to promote immediate intervention, treatment, and structure.
The National Institute of Justice's Multisite Adult Court Evaluation found that Drug Court clients experienced 56 percent less drug use compared to 76 percent among those not in the program. They were also 29 percent less likely to test positive for drug use compared to 46 percent. Additionally, Drug Court clients reported 40 percent less criminal activity compared to 53 percent in the comparison group of non-Drug Court participants, and had 52 percent fewer arrests compared to 62 percent among probationers not in the program.
Upon approval of these amendments, High Desert Child, Adolescent and Family Service Center, Inc. (High Desert Child) will provide Drug Court to approximately 43 additional clients annually at an average estimated cost of $5,643 per client. Inland Valley Drug and Alcohol and Recovery Services, Inc. dba Inland Valley Recovery Services (Inland Valley Recovery) will provide Drug Court to approximately 118 additional clients annually at an average estimated cost of $5,643 per client.
On November 3, 2023, Mental Health Systems, Inc. (MHS) notified DBH that it would terminate its Drug Court contract with the County effective December 31, 2023. DBH program staff met with existing Drug Court providers, communicated the need for service expansion, and directed providers to solicit interest through letters of intent. After the review of the letters of intent, DBH determined that High Desert Child and Inland Valley Recovery would be best able to expand their service areas to include the High Desert, East Valley, West Valley, and Central Valley for the remainder of the contract period. These amendments reflect the expansion of High Desert Child and Inland Valley Recovery in the High Desert, East Valley, West Valley and Central Valley service areas and update standard contract language, adding Executive Order N-6-22 - Russia Sanctions, Campaign Contribution Disclosure Form (SB1439), and update the legal name for Inland Valley Recovery to Inland Valley Drug and Alcohol Recovery Services dba Inland Valley Recovery Services. This commitment by High Desert Child and Inland Valley Recovery to expand their operations has provided a seamless transition and maintained a high standard of continuity in care for the clients currently being served. This proactive approach ensures that the essential services provided to the community will continue without interruption, aligning with DBH’s commitment to delivering consistent and quality care.
In order for High Desert Child and Inland Valley Recovery to rapidly prepare for expansion and ensure that the additional areas served were fully operational by January 1, 2024, DBH agreed that they may invoice up to $101,000 and $99,504, respectively, in additional costs for the retroactive period of January 1, 2024 through June 30, 2024.
DBH will implement mechanisms to regularly review client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contracts are met, review claims for reimbursement to ensure fidelity and accuracy of service billing and optimization of Medi-Cal reimbursement in alignment with contract terms and Department of Health Care Services billing requirements; and review provider invoices to ensure client and/or bed counts are accurate prior to payment processing.
PROCUREMENT
On June 23, 2020 (Item No. 35), as a result of a formal procurement for the provision of Drug Court Services, the Board of Supervisors (Board) approved Contract No. 20-488 with HDCAFSC High Desert Child and Contract No. 20-489 with IVRS Inland Valley Recovery in the total amount of $2,185,817 for the period of July 1, 2020 through September 30, 2024.
On October 26, 2021, (Item No. 21), the Board approved Amendment No. 1 to Contract No. 20-488 with HDCAFSC High Desert Child for the provision of Drug Court services, with no change to the Contract amount of 1,657,559 for the contract period of July 1, 2020 through September 30, 2024..
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on April 23, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on April 19, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on May 3, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on May 6, 2024.