COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Human Services Agency

DATE:

December 31, 2002

BOARD MEETING DATE:

January 14, 2003

TO:

Honorable Board of Supervisors

FROM:

Maureen D. Borland, Director, Human Services Agency

Yvonne Frazier, Administrator, Alcohol and Drug Services

SUBJECT:

Flat Rate Alcohol and Drug Treatment Agreements with: 1) Avalon Counseling Services; 2) Family And Community Enrichment Services, Inc.; 3) Horizon Services, Inc.; and 4) Pyramid Alternatives for the Provision of Alcohol and Drug Treatment Services for the Period July 1, 2002 through June 30, 2003.

Recommendation

Adopt a Resolution Authorizing:

1.

The President of the Board of Supervisors to execute flat rate agreements with: 1) Avalon Counseling Services in the amount of $32,853; 2) Family And Community Enrichment Services, Inc. in the amount of $560,049; 3) Horizon Services, Inc. in the amount of $561,474; and 4) Pyramid Alternatives in the amount of $275,321, for the period July 1, 2002 through June 30, 2003; and

2.

The Director of the Human Services Agency to execute amendments and minor modifications during the term of the agreements; however, as to each agreement, such authority is limited to:

a) reducing the County's maximum fiscal obligation in the event there is a commensurate reduction in the funding received by the County;

b) increasing the County's maximum fiscal obligation in the event there is a commensurate increase in funding received by the County; however, said increase shall be limited to a total of $25,000 per agreement; and/or

c) making changes in the types of treatment services provided by the Contractors, as long as the changes have no impact on the County's maximum fiscal obligation.

Background

These are renewal agreements for alcohol and drug treatment services. Avalon Counseling Services, Family And Community Enrichment Services, Inc. and Pyramid Alternatives also have fee-for-service agreements for the provision of similar services for Proposition 36 and Drug Court referred individuals. Those services are provided under separate fee-for-service agreements, which were approved by the Board of Supervisors on October 22, 2002. Payments made under these agreements are intended to pay for services provided to individuals who qualify for alcohol and drug treatment services, and who lack the necessary resources to pay for all, or part, of these treatment services themselves. County payments are not intended to provide the full cost of care for all individuals referred by the County for services. Client fees, paid to the providers, will be used to offset the provider's cost of these services not fully funded by the County.

Discussion

Language contained in these flat rate agreements is the result of extensive negotiations between the County and the Treatment Provider's Coalition. Services provided under these agreements are currently being paid under a continuing Resolution. These agreements contain funding from the following sources: 1) State Negotiated Net Amount (NNA) Combined Drug/Medi-Cal Agreement for State Block Grant and Drug/Medi-Cal funds; 2) State CalWORKs funds; 3) State Aid Public Safety funds; and 4) County funds.

These agreements were delayed pending confirmation of available funding for FY 2002-03 and extensive contract language negotiations. Contract negotiations with the treatment providers have taken place over the past ten months. The process has taken longer than expected due to the difficulty of arriving at a mutually agreeable payment formula that will compensate providers for a combination of two factors - units of service provided and the cost of maintaining availability on a continuous basis. Providers are currently being paid under a continuing Resolution.

The Resolution and agreements have been reviewed and approved as to form by the County Counsel's office.

Performance Measures

Alcohol and Drug Services is in compliance with the Human Services Agency's Outcome Based Management (OBM) Program Plan. Below are the recommended Performance Measures for alcohol and drug treatment services included in the OBM Program Plan

Outcome Based Management Performance Measures

Fiscal Year

2001-02 Data

Projected for

Fiscal Year 2002-03

Number of clients entering treatment (all modalities except methadone services).

4,357

4,100

Percent of clients reducing or abstaining from alcohol and/or other drug use at 3 months and 9 months post-intake.

3 months 78%

9 months 78%

3 months 78%

9 months 78%

Percent of criminal justice involved clients retained in treatment or until completion of program.

50%

50%

Vision Alignment

These flat rate agreements are consistent with 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. These agreements contribute to this commitment and goal by providing individuals admitted for alcohol and drug treatment services with the skills and knowledge necessary to live alcohol and drug free lives, which in turn contributes to the health and safety of the communities in San Mateo County.

Fiscal Impact

A total of $1,429,697 in funding is included in these agreements, and has been included in the FY 2002-03 Budget for Alcohol and Drug Services. Of the $1,429,697, $777,236 is from State Block Grant and Drug/Medi-Cal funds, $370,056 in State CalWORKs funds, $120,000 in State Aid Public Safety funds, and $162,405 is Net County Cost.