COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Human Services Agency

DATE:

November 27, 2001

BOARD MEETING DATE:

December 18, 2001

TO:

Honorable Board of Supervisors

FROM:

Maureen Borland, Director, Human Services Agency
Yvonne Frazier, Administrator, Alcohol and Other Drug Services

SUBJECT:

Acceptance of the Department of Health and Human Services
(DHHS), Center for Substance Abuse Treatment (CSAT) Grant

Recommendation

1.

Adopt a resolution to:

a.

Accept a three-year grant from the DHHS/CSAT to provide substance abuse treatment for the homeless in the amount of $1,734,060 for the period of 9/30/2001 to 9/29/2004; and

b.

Waive the Request for Proposals (RFP) process for the contracted services funded by the grant; and

2.

Adopt a Salary Ordinance Amendment adding one Human Services Analyst II - Unclassified position to provide project coordination as specified in the grant application

Background

In response to a Federal grant funding announcement, interested service providers were invited to participate in a series of planning sessions to design a collaborative effort to provide substance abuse treatment for homeless persons. The Human Services Agency, Alcohol and Other Drug Services (AOD) in collaboration with the Office of Housing, Project Ninety, Inc. (P-90), Service League of San Mateo County (Service League), Clara-Mateo Alliance, Shelter Network, Samaritan House, and Allen/Loeb Associates, submitted an application to the DHHS/CSAT for a three-year grant to provide a spectrum of substance abuse treatment services to persons at the Maple Street (Shelter Network), Safe Harbor (Samaritan House) and Clara-Mateo homeless shelters in San Mateo County. These agencies have a demonstrated ability to provide services to the homeless population and have committed to participate in the implementation of the project.

The total number of unduplicated clients served by these shelters in 1999 was 1,926. Of that number, estimates of those with substance abuse problems range between 35-60%, consistent with statistics published in national literature. Currently there are no substance abuse services available in the shelters and those in need of treatment must be referred to outside agencies. This grant proposes to take treatment to the client rather than send the client to treatment. Clients at shelters will receive a formal assessment, case management, substance abuse treatment, and referral. At the same time, substance abuse treatment services will be linked with shelter services and the Office of Housing to provide access to transitional or permanent housing.

Discussion

On September 28, 2001, the Human Services Agency received notification of grant award in the amount of $1,734,060 for the period September 30, 2001 to September 29, 2004. The grant project will expand services in three critical areas: assessment, case management and treatment capacity. A Human Services Analyst II will act as project coordinator and serve as liaison to the substance abuse treatment providers and the three shelters, supervise and monitor data collection, convene meetings, coordinate follow-up data collection, coordinate with the evaluators, maintain project records, and prepare project reports.

Through contracts with the collaborating treatment providers, (P-90 and Service League), two trained substance abuse counselors will be placed at each of three shelter sites. The counselors will provide assessment, case management, and individual and group substance abuse treatment to a total of 240 homeless men and women per year. Additionally, these provider contracts will include dedicated residential treatment beds that will serve fourteen men and women annually and will provide stipends to enable four working homeless men to receive treatment without sacrificing their employment. Shelter administrative costs related to the grant will be addressed through a Memorandum of Understanding with the Office of Housing.

This award is for a three-year period beginning on October 1, 2001 and ending on September 30, 2004. Additional resources past this funded period have not yet been identified. San Mateo County Alcohol and Other Drug Services will pursue resources in an attempt to sustain services. Possible funding sources may include Local/State/Federal and Foundation. If State Block Grant Funds are increased they may be utilized for sustaining substance abuse treatment services that began under this grant. However, due to the economic decline caused in part by the September 11, 2001 assault on America, these efforts may not result in additional funding. If no additional resources are identified, the program will cease on September 30, 2004.

Performance Measures
Evaluation of the three-year project will be conducted by Allen & Loeb and Associates to assess treatment effectiveness through use of the Addiction Severity Index (ASI), urinalysis results, client retention data, California Alcohol and Drug Data System (CADDS) and CSAT's Government Programs Reporting Act (GPRA) tool.

Performance Measures

Projected Objectives each Fiscal Year

Number of homeless clients receiving treatment

240 individuals

Maximize retention and treatment completion

50% of clients entering treatment will complete program objectives.

Reduce substance abuse and increase abstinence

75% of clients will report abstinence at completion

Improve and maintain physical and mental health social and family functioning, employment and education, and legal status

80% of completing clients will show improved functioning across these domains as measured by ASI at 6 month and 12 month follow-up.

Fiscal Impact

The three-year grant period is September 30, 2001 through September 29, 2004. Funding for FY 2001 - 02 is $506,180, FY 2002 - 03 is $499,491, and FY 2003 - 04 is $502,207. There is no required County match and there is no Net County Cost associated with this transaction. An Appropriation Transfer Request (ATR) to add funding for homeless substance abuse treatment services in the amount of $506,180 from federal DHHS grant funds for FY 2001 - 02 will follow.