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 Contracts for Substance Use Disorder and Recovery Services Outpatient Treatment and Intensive Outpatient Treatment Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 4 to Inland Valley Drug and Alcohol Recovery Services, Inc., Contract No 17-335, effective July 1, 2021, for Substance Use Disorder and Recovery Services Outpatient Treatment and Intensive Outpatient Treatment Services provided to Department of Behavioral Health clients increasing the total contract amount by $1,203,867, from $3,815,200 to $5,019,067, which includes an amount of $250,067 for services performed in 2017-18 and 2018-19 and an amount of $953,800 for 2021-22, with no change to the additional aggregate amount not to exceed $891,352 for clients referred by Children and Family Services, and exercising the final one-year extension option, for the total contract period of July 1, 2017 through June 30, 2022.
2. Approve Amendment No. 3 to Mental Health Systems, Inc. Contract No. 17-337 effective June 8, 2021 for Substance Use Disorder and Recovery Services Outpatient Treatment and Intensive Outpatient Treatment Services provided to Department of Behavioral Health clients increasing the total contract amount by $778,959, which includes an amount of $55,559 for 2020-21 and an amount of $723,400 for 2021-22, from $2,893,600 to $3,672,559, with no change to the additional aggregate amount not to exceed $891,352 for clients referred by Children and Family Services, and exercising the final one-year extension option, for the total contract period of July 1, 2017 through June 30, 2022.
3. Approve amendments, effective July 1, 2021, to the following contracts for Substance Use Disorder and Recovery Services Outpatient Treatment and Intensive Outpatient Treatment Services provided to Department of Behavioral Health clients, increasing the total combined contract amount by $1,912,368, from $6,743,277 to $8,655,645, with no change to the additional aggregate amount not to exceed $891,352 for clients referred by Children and Family Services, and exercising the final one-year extension option:
a. CLARE|MATRIX Contract 17-336 A-4, increasing the total contract amount by $311,300, from $1,245,200 to $1,556,500, for the total contract period of July 1, 2017 through June 30, 2022.
b. High Desert Child, Adolescent and Family Services Center, Inc., Contract No. 17-333 A-4, increasing the total contract amount by $458,149, from $1,832,597 to $2,290,746, for the total contract period of July 1, 2017 through June 30, 2022.
c. Inland Behavioral and Health Services, Inc., Contract No. 17-334 A-4, increasing the total contract amount by $337,190, from $1,348,760 to $1,685,950, for the total contract period of July 1, 2017 through June 30, 2022.
d. Social Science Services, Inc. dba Cedar House Life Change Center, Contract No. 17-339 A-4, increasing the total contract amount by $327,649, from $1,002,000 to $1,329,649, for the total contract period of July 1, 2017 through June 30, 2022.
e. St. John of God Health Care Services, to Contract No. 18-682 A-2, increasing the total contract amount by $478,080, from $1,314,720 to $1,792,800, for the total contract period of October 1, 2018 through June 30, 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 total increase in the amount of $3,818,045 ($63,780 for 2017-18, $186,287 for 2018-19, $55,559 for 2020-21 for services rendered, and $3,589,568 for the 2021-22 one-year extension) for Substance Use Disorder and Recovery Services (SUDRS) Outpatient Treatment and Intensive Outpatient Treatment Services (OT/IOT) provided to Department of Behavioral Health (DBH) clients is funded through Substance Abuse Prevention and Treatment Block Grant, Drug Medi-Cal, California Work Opportunity and Responsibility to Kids, and Public Safety Realignment. The aggregate amount not to exceed $891,352 for SUDRS OT/IOT provided to Children and Family Services (CFS) clients remains the same and is funded through a Memorandum of Understanding (MOU) with CFS. Adequate appropriation and revenue has been included in DBH’s 2020-21 budget and will be included in the 2021-22 recommended budget.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and/or substance use disorder services to San Bernardino County residents who are experiencing mental illness and/or substance use disorders. SUDRS provides a full range of substance use disorder prevention, treatment services, and education 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 OT/IOT provides individual and group therapy sessions, assessment and crisis intervention, individual recovery/treatment planning, social/recreational activities, substance use disorder education, and case management. Services are provided to San Bernardino County residents, adults and youth over the age of 12, who have been identified as having substance use disorders. CFS, through a MOU with DBH, refers clients to the providers for SUDRS OT/IOT services.
The recommended amendments to the contracts in the Recommendations will increase the contract amounts and exercise the final option to extend the contracts through June 30, 2022. In addition, the contract amendment for Inland Valley Drug and Alcohol Recovery Services, Inc. includes a funding change affecting prior fiscal years, which is being requested due to CFS clients being Medi-Cal eligible. DBH became aware that the clients were Medi-Cal eligible when reimbursement claims were denied by CFS because the clients were Medi-Cal eligible; the provider was paid using the total amount available in the contract, but because the providers were not fully reimbursed, DBH is requesting an increase to the contract to fully reimburse the providers. Per the MOU between DBH and CFS, the CFS aggregate funding cannot be used when the client is Medi-Cal eligible. Therefore, DBH must utilize Substance Abuse Prevention and Treatment Block Grant, Drug Medi-Cal, California Work Opportunity and Responsibility to Kids, and Public Safety Realignment funding for the services rendered to CFS clients in 2017-18 and 2018-19. In 2021-22, DBH anticipates providing an average of 3,734 substance use disorder treatment episodes at an estimated cost per client of $961. For CFS clients, DBH anticipates providing an average of 574 substance use disorder treatment episodes at an estimated cost per client of $1,552.
PROCUREMENT
On May 23, 2017 (Item No. 43), as a result of a formal procurement, the Board of Supervisors (Board) approved contracts for SUDRS OT/IOT with High Desert Child, Adolescent and Family Services Center, Inc., Inland Behavioral and Health Services, Inc., Inland Valley Drug and Alcohol Recovery Services, Matrix Institute on Addictions, Inc., Mental Health Systems, Inc., MFI Recovery Center, Inc., and Social Science Services, Inc. dba Cedar House Life Change Center, in the combined amount of $8,290,500, for the period of July 1, 2017 through June 30, 2020, with the option to extend for two one-year periods contingent upon funding and contract performance.
On June 12, 2018 (Item No. 21), the Board approved Amendment No. 1 to the contracts with High Desert Child, Adolescent and Family Services Center, Inc., Inland Behavioral and Health Services, Inc., Inland Valley Drug and Alcohol Recovery Services, Inc., Matrix Institute on Addictions, Inc., Mental Health Systems, Inc., MFI Recovery Center, Inc., and Social Science Services, Inc. dba Cedar House Life Change Center, updating standard contract language, with no change to the total contract amount or contract period.
On September 11, 2018 (Item No. 18), as a result of a formal procurement, the Board approved the contract for SUDRS OT/IOT with St. John of God Health Care Services, in the amount of $836,640, for the period of October 1, 2018 through June 30, 2020, with the option to extend for two one-year periods contingent upon funding and contract performance.
On February 12, 2019 (Item No. 14), the Board approved Amendment No. 2 to the contract with Matrix Institute on Addictions, Inc., reflecting the assignment of the contracts from Matrix Institute on Addictions, Inc. 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 April 30, 2019 (Item No. 19), the Board approved Amendment No. 2 to the contracts with High Desert Child, Adolescent and Family Services Center, Inc. and Inland Behavioral and Health Services, Inc., increasing the total combined contract amount by $892,618, from $1,493,400 to $2,386,018, with no change to the contract period.
On January 28, 2020 (Item No. 11), the Board approved Amendment No. 2 to the contracts with Inland Valley Drug and Alcohol Recovery Services, Inc., and Social Science Services, Inc. dba Cedar House Life Change Center, increasing the total combined contract amount by $1,350,000, from $2,262,900 to $3,612,900, with no change to the contract period.
On June 23, 2020 (Item No. 32), the Board approved Amendment No. 3 to CLARE|MATRIX, High Desert Child, Adolescent and Family Services, Inc., Inland Behavioral and Health Services, Inc., Inland Valley Drug and Alcohol Recovery Services, Inc, Mental Health Systems, Inc., Social Science Services, Inc. dba Cedar House Life Change Center, and approved Amendment No. 1 to St. John of God Health Care Services, updating standard contract language, increasing the total combined contract amount by $3,512,419, from $9,939,658 to $13,452,077, and exercising the first option to extend the contracts through June 30, 2021. During the amendment process, MFI Recovery Center, Inc. informed DBH that they will not be extending their contract for SUDRS OT/IOT services and Mental Health Systems, Inc, informed DBH that they will not continue to serve the Big Bear region. The clients from these agencies were transitioned to the other contract providers based on client preference.
The recommended amendments will allow DBH to utilize Substance Abuse Prevention and Treatment Block Grant, Drug Medi-Cal, California Work Opportunity and Responsibility to Kids, and Public Safety Realignment funding for services provided to CFS clients in prior fiscal years and to continue SUDRS OT/IOT services to DBH and CFS clients through June 30, 2022. DBH will continue to monitor contract performance on a regular basis to ensure compliance standards are met.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Contracts Manager, 388-0869) on May 3. 2021; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 13, 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.