COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

August 2, 2002

BOARD MEETING DATE:

August 20, 2002

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Gale Bataille, Director, Mental Health Services

SUBJECT:

Agreement with Women's Recovery Association

Recommendation

Adopt a resolution authorizing the President of the Board:

1. to execute an agreement with Women's Recovery Association (WRA) for the provision of dual diagnosis mental health and drug treatment services for the Mental Health Services Division, and drug treatment services for women with HIV/AIDS for the Health Services Agency AIDS Program, and

2. to authorize the Director of Health Services to execute amendments and minor modifications up to an aggregate of $25,000 for the term of the agreement.

Background

Since 1996, WRA has provided supervised housing and psychiatric rehabilitation services for women who are mentally ill and have drug use problems (dual diagnosis) who are referred by the Mental Health Services Division. In May 2001, a Pre-proposal Survey was issued for a dual diagnosis residential treatment and outpatient program for women. WRA was chosen to provide the services because of their experience in treating dually diagnosed women.

In 1998 the AIDS Program assumed responsibility for overseeing non-residential and residential drug treatment services for people with HIV/AIDS, which were formerly handled by the Mental Health Services Division. In 1998 WRA was awarded $35,000 for the provision of residential drug treatment services and $15,000 for the provision of non-residential drug treatment services for people with HIV/AIDS on a "fee-for-service" basis. All drug programs in good standing with Alcohol and Drug Services of the Human Services Agency are invited to contract with the AIDS Program for these services at the Program Contractor's meetings. A contract does not guarantee client referrals or placements.

Discussion

This renewal assures continued access to residential care for dually diagnosed women in San Mateo County. The services provided by WRA include supervised housing and psychiatric rehabilitation services, allowing these women to be treated in the community and avoiding costly psychiatric hospitalization. WRA will continue to provide residential and outpatient drug services for HIV+ women referred by the AIDS program. The term of this agreement is July 1, 2002, through June 30, 2003.

Performance Measure

2001-02 Objective

2001-02 Actual

2002-03 Objective

Percentage of clients completing the mental health dual diagnosis program who show a reduction in use of acute/sub-acute services six months following discharge

60%

67%

75%

Percentage of all AIDS Program clients who complete the first 90 days of treatment.

75%

67%*

75%

Percentage of AIDS Program clients who remain drug-free through the first 90 days of treatment.

75%

67%*

75%

* 2 out of the 3 clients placed completed the first 90 days of treatment and remained drug free during that time.

Vision Alignment

This agreement with Women's Recovery Association keeps the commitment to Ensure Basic Health and Safety for All and goal number 8: Help vulnerable people-the aged, disabled, mentally ill, at risk youth, and others- achieve a better quality of life. The agreement contributes to this commitment by providing residential, rehabilitation and support services for dually diagnosed women with HIV/AIDS.

Fiscal Impact

The maximum amount of funding for the Mental Health Services section of the agreement is $165,000. Medi-Cal revenues are projected to be $55,787 and sales tax provided through realignment will cover $89,555 of the cost. The remaining $19,658 represents the net County cost for this section of the agreement. Expenditures and revenues for this section of the agreement are included in the FY 2002-03 Mental Health Services budget.

The maximum amount of funding for the AIDS Program section of the agreement is $50,000. There is no net county cost for this section of the agreement as all funding is provided by the Ryan White CARE Act grant. This funding includes reimbursement for administration and monitoring of the agreement to be performed by existing AIDS Program staff. Expenditures and revenue for this section of the agreement are included in the FY 2002-03 AIDS Program budget. The total amount of both sections of this agreement is $215,000.

We request that the Director of Health Services be given signing authority to execute minor amendments and modifications up to an aggregate of $25,000 for the term of the agreement.