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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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Human Services Agency
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DATE:
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March 5, 2003
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BOARD MEETING DATE:
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March 25, 2003
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TO:
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Honorable Board of Supervisors
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FROM:
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Maureen D. Borland, Director, Human Services Agency
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Yvonne Frazier, Administrator, Alcohol and Drug Services
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SUBJECT:
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Flat Rate Alcohol and Drug Treatment Agreements for the Juvenile Drug Court Expansion Project
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Recommendation
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Adopt a Resolution authorizing:
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The President of the Board of Supervisors to execute flat rate Agreements with: Family and Community Enrichment Services, Inc. in the amount of $159,785 and Youth and Family Assistance, Inc. in the amount of $413, 248, for the period of September 30, 2002 through September 29, 2005; and
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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:
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a) reducing the County’s maximum fiscal obligation in the event there is a commensurate reduction in the funding received by the County;
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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
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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.
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Background
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On September 22, 2002, the Human Services Agency’s Division of Alcohol and Other Drug Services (AOD) was awarded a thirty-six month United States Department of Health and Human Services (DHHS) Center for Substance Abuse Treatment (CSAT) grant in the amount of $1,198,572 to fund the Juvenile Drug Court Expansion Project (JDC) in San Mateo County. These Agreements represent the portion of CSAT funding that is dedicated to dual diagnosis nonresidential treatment services. The Board of Supervisors approved the funding award on January 28, 2003 and the Request for Proposals (RFP) process was waived at that time.
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The grant will fund alcohol and drug assessments, referrals, case management and treatment services to multi-recidivist females entering Juvenile Drug Court (JDC) who are at risk of being placed in facilities outside of San Mateo County. There is a strong linkage between mental health, substance abuse, and recidivism. In March 2002, the County AOD Services and the Commission on the Status of Women presented to the Board of Supervisors “Women and Adolescent Girls with Substance Abuse Problems in San Mateo County.” In this report the need for providing services for girls in Juvenile Drug Court was identified.
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Discussion
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The project will expand services in two critical areas: Assessment/case management and treatment services for female juvenile offenders with co-occurring disorders. These Agreements contain dual diagnosis nonresidential treatment services. The Contractors’ were identified through an informational session held prior to the application to CSAT. Three providers attended the informational session and expressed interest in Contracting to provide services for the JDC. Since that time, one of the providers communicated that they were no longer able to Contract for JDC services. JDC services will be provided to a total of sixty (60) female juvenile offenders who are in need of alcohol and drug treatment services as well as mental health treatment. The project is a collaborative effort between the Contractors, County AOD Services, Probation, and Mental Health Services.
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During the initial one to three months, participants will typically be in custody. At this time, there will be nonresidential mental health/substance abuse treatment services. In the next three to nine months, Youth and Family Assistance will provide intensive dual diagnosis nonresidential treatment, education and twelve (12) months of aftercare.
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The program will be evaluated by the University of California San Francisco (UCSF) research center to determine if the outcomes established in the funding proposal to the U.S. Department of Health and Human Services are achieved. A contract with UCSF will be submitted separately.
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The Resolution and Agreements have been reviewed and approved as to form by the County Counsel’s Office. Risk Management has reviewed and approved the insurance information submitted by the Contractors. Submission was delayed pending negotiation of the Agreements.
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Performance Measures
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Evaluation of the three-year project will assess treatment effectiveness and treatment efficiency through use of the Addiction Severity Index (ASI), urinalysis results, reduction in out-of-home placement data and CSAT’s Government Performance Results Act (GPRA) measure. The University of California, San Francisco will conduct the project evaluation.
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Outcome Based Management Performance Measures
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Dependent variable
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Participants will show a reduction in juvenile offending and in the severity of offenses committed during the intervention and for the twelve months subsequent to the intervention.
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• Count of new referrals
• Count of new felonies
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Participants will show a reduction in psychiatric hospitalizations.
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• Count of new placement episodes
• Sum of placement days
• Total costs of placements
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Participants will show reduced substance abuse over the period of their participation in the program.
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90% of participants in the Expanded JDC will show an improvement in the overall ASI score and in a majority of the subscales of the ASI upon follow up.
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80% of participants will show an improvement in life skills as measured by an improvement in overall Child & Family Assessment Scale (CAFAS) score and an improvement in the majority of CAFAS subscales upon follow up.
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Vision Alignment
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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 participants with the interventions, treatment, education, and the skills that are necessary to live productive alcohol and drug free lives. In addition, these program services will provide clients who have been identified to have the need for mental health treatment with appropriate interventions and treatment. These dual diagnosis treatment programs and aftercare services utilize a collaborative approach that contributes to the health and safety of the communities in San Mateo County by addressing the treatment needs of this at-risk population of female offenders.
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Fiscal Impact
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The thirty-six month grant period is September 30, 2002 through September 29, 2005. An appropriation of $143,258.22 will be needed from September 30, 2002 to June 30, 2003 and is included in the FY 2002-03 Human Services Agency Budget. There are no new Net County Costs associated with these Agreements.
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