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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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May 27, 2004
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BOARD MEETING DATE:
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June 29, 2004
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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
Yvonne Frazier, Director, Alcohol and Other Drug Services
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SUBJECT:
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Amendments to the FY 2003-04 Fee-For-Service Agreements
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Recommendation
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Adopt a Resolution authorizing the execution of First Amendments to: Asian American Recovery Services; Avalon Counseling Services; California Detoxification Programs, Inc.; Daytop Village, Inc.; El Centro de Libertad; Free At Last; Horizon Services, Inc.; The Latino Commission; Project Ninety, Inc.; Pyramid Alternatives; Service League of San Mateo County; Sitike Counseling Center; Walden House, Inc.; Women’s Recovery Association; and Youth and Family Enrichment Services.
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The purpose of these Amendments are to increase the aggregate to the Substance Abuse Crime Prevention Act (SACPA)/Proposition 36 amount by $882,068, changing the aggregate amount for these services from $1,204,724 to $2,086,792; adding Ryan White CARE Act funds and services to seven (7) of the Agreements with an aggregate funding amount of $108,925; and adding $181,071 for Center For Substance Abuse Treatment (CSAT) HIV, Door-to-Treatment services changing the CSAT aggregate in nine (9) of the Agreements from $100,000 to $281,071. The term of these Agreements will remain the same, July 1, 2003 through June 30, 2004.
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Background
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On August 5, 2003 the Board of Supervisors authorized the execution of fourteen Fee-For-Service Agreements. These Agreements provide an array of alcohol and drug treatment services including but not limited to: substance abuse; education and early intervention; treatment readiness; outpatient treatment; nonresidential treatment; residential treatment; aftercare; HIV outreach; linkages; and recovery. The services under this Agreement are funded by the following sources: Substance Abuse and Crime Prevention Act- (SACPA)/Proposition 36; Senate Bill (SB) 223, Drug Court Partnership (DCP); Comprehensive Drug Court Implementation Grant (CDCI); and the Center for Substance Abuse Treatment (CSAT) HIV Door-to-Treatment grant. On October 21, 2003, the Board of Supervisors approved an additional Fee-For-Service Agreement with California Detoxification Programs, Inc. to provide methadone detoxification and maintenance services under SACPA/Proposition 36 funding.
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Referrals to alcohol and drug treatment services are made through a variety of sources including the judicial system. County payments made under these Agreements reimburse contractors for providing alcohol and drug treatment services to individuals who qualify for services and who lack the resources to pay for all, or part, of these services. County payments are not intended to provide the full cost of care for all individuals referred for services. Client fees are also paid to providers, on a sliding scale, to offset the costs of services not fully funded by the County.
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Discussion
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The First Amendments to these fifteen Fee-For-Service Agreements increase the aggregate funding amount to cover SACPA/Proposition 36 program costs for FY 2003-04. The original Agreements did not include 100% of the SACPA/Proposition 36 allocation available for treatment in the current year. The increase of $882,068 includes the balance of the available allocation, as well as a $200,000 contingency in the event that program costs exceed the allocation. A redesign of the program was implemented mid-year for purposes of staying within the state allocation. It is not anticipated that the contingency will be utilized and is included only as a year-end safeguard.
Additionally, the First Amendments increase the aggregate funding by $181,071 to cover CSAT HIV Door to Treatment Grant expenditures, and adds Ryan White CARE Act services and $108,925 in funding to the following seven Fee-For-Service Agreements: Daytop Village, Inc.; El Centro de Libertad; Free At Last; The Latino Commission; Project Ninety, Inc.; Service League of San Mateo County and the Women's Recovery Association. These funds provide alcohol and drug treatment services for participants who have been diagnosed with HIV or AIDS.
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County Counsel has reviewed these Amendments and approved them as to form. Risk Management has reviewed and approved insurance for each of the Contractors.
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Performance Measures
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Alcohol and Drug Services is in compliance with the Human Services Agency’s Outcome Based Management (OBM) Program Plan. Performance measures for Ryan White funded services transferred from the Health Services Agency are consistent with expectations for Alcohol and Drug Services treatment and include the following:
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Performance Measures: Ryan White Care Funded Treatment Services:
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Residential:
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Sixty-five percent (65%) of all program participants who complete the first (1st) thirty (30) days of treatment will complete the ninety (90) day program.
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Seventy-five percent (75%) of all program participants surveyed who complete the treatment program shall report total abstinence from, or significant reduction in, alcohol and drug use ninety (90) days after completion.
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Fifty percent (50%) of all program participants surveyed shall continue to access some type of recovery support system one (1) year after completing the first (1st) ninety (90) days of treatment.
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Non-Residential:
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Seventy-five percent (75%) of all program participants referred shall complete the first (1st) ninety (90) days of treatment
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Seventy-five percent (75%) of all program participants shall remain drug-free throughout the first (1st) ninety (90) days of treatment.
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Fifty percent (50%) of all program participants surveyed shall continue to access some type of drug recovery support system ninety (90) days after completing the first (1st) ninety (90) days of treatment.
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Vision Alignment
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The Agreements keep the commitment of: 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 alcohol and drug treatment services to SACPA probationers, parolees and individuals at-risk of HIV who are referred for alcohol and drug treatment services by Human Service Agency, County of San Mateo Alcohol and Other Drug Services.
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Fiscal Impact
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The total funding obligation for these fifteen Agreements is $2,685,060. There are sufficient appropriations in the Agency's FY 2003-04 budget to cover these contracted costs. The increase in funding in SACPA/Proposition 36 is $882,068. Of this amount, $682,068 is funded by the state allocation and $200,000 is a contingency, any portion of which would be 100% Net County Cost if needed to cover program costs in excess of the state allocation. The funding for the Ryan White Care Act of $108,925 is funded through the Health Services Agency's claim process through an agreement with the City of San Francisco. The increase of $181,071 in the CSAT HIV Door-to-Treatment contracts are funded through the Health Services Agency's claim process through the CSAT Door-to-Treatment Grant. There are no additional Net County Costs as a result of these transactions.
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