REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
June 8, 2021
FROM
VERONICA KELLEY, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to the Contract for Substance Use Disorder Narcotic Treatment Program Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1, effective June 8, 2021, to Contract No. 19-240 with Aegis Treatment Centers, LLC for the provision of substance use disorder Narcotic Treatment Program services, increasing the total contract amount by $2,124,292, from $17,080,000 to $19,204,292, with no change to the contract period of July 1, 2019 through December 31, 2022.
(Presenter: Veronica Kelley, 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 cost for services in the amount of $2,124,292 will be funded by Drug Medi-Cal and 2011 Realignment funding. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2020-21 budget and will be included in the recommended 2021-22 budget.
BACKGROUND INFORMATION
Aegis Treatment Centers, LLC (Aegis) is licensed by DHCS to provide substance use disorder Narcotic Treatment Program (NTP) services to San Bernardino County residents. Narcotic treatment services are provided in accordance with the requirements of Title 9, the California Code of Regulations, Chapter 4, and Title 22 of the California Code of Regulations and related directives as they pertain to Medi-Cal.
Amendment No. 1 to Contract No. 19-240 to increase funding is being requested due to an increased need for NTP services, which resulted from DBH’s implementation of the Drug Medi-Cal-Organized Delivery System (DMC-ODS) and the increased cost of medications provided in this treatment setting. The DMC-ODS expanded medication assisted treatment with the use of additional Food and Drug Administration (FDA) approved medications now offered in this level of care. Additionally, the focus on the nationwide opioid crisis has placed a spotlight on opioid use disorders where the Narcotic Treatment Centers play a vital role in connecting clients to numerous medications that can help them achieve recovery and re-integrate back into their families and communities. Aegis has facilities located in Ontario and Hesperia, and has recently opened an additional facility located in Redlands in order to accommodate the increase in clients requiring NTP services. Upon approval of the recommended amendment, DBH anticipates approximately 774 additional episodes of NTP treatment will be provided by Aegis countywide, at an approximate cost of $2,734 per episode.
DBH is responsible for providing mental health and substance use disorder services to San Bernardino County residents who are experiencing mental illness and/or substance use disorders. DBH-Substance Use Disorder and Recovery Services provides a full range of substance use disorder prevention, treatment services, and education for communities and residents of San Bernardino 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.
DHCS determines the client capacity and specifies the number of NTP licensed slots based on the recommendation of DBH’s Alcohol and Drug Administrator. DBH monitors contracted NTP providers to ensure they adhere to Drug Medi-Cal regulations and procedures. As a Medi-Cal NTP provider, Aegis delivers services to eligible Medi-Cal beneficiaries at DHCS licensed outpatient clinics. DBH has provided NTP services through contract providers since 2002.
PROCUREMENT
DHCS is responsible for NTP oversight and licensing requirements; therefore, a procurement is not conducted for these substance use disorder services. Aegis and WCHS, Inc. dba Colton Clinical Services (WCHS) are licensed by DHCS to provide substance use disorder treatment services and are the only two agencies within San Bernardino County that provide the required NTP services to residents; WCHS is also contracted by DBH to provide NTP services. The Purchasing Department concurred with the procurement of this non-competitive contract based on a special qualification for these substance use disorder services.
On April 30, 2019 (Item No. 18), the Board of Supervisors approved the contract with Aegis to provide NTP services in the amount of $17,080,000, for the contract period of July 1, 2019 through December 31, 2022.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Administrative Manager, 388-0869) on May 4, 2021; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 4, 2021; Finance (Christopher Lange, Administrative Analyst, 386-8393) on May 21, 2021; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on May 21, 2021.