COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Human Services Agency

DATE:

August 5, 2004

BOARD MEETING DATE:

August 31, 2004

TO:

Honorable Board of Supervisors

FROM:

Maureen D. Borland, Director, Human Services Agency

Yvonne Frazier, Director, Alcohol and Other Drug Services

SUBJECT:

Fee-For-Service Agreements for FY 2004-05

Recommendation

Adopt a Resolution authorizing:

1.

The waiver of the Request for Proposal Process (RFP);

2.

The execution of the Fee-For-Service Agreements with: Asian American Recovery 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. The term of these Agreements is July 1, 2004 through June 30, 2005; and

3.

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

c.

Reallocating funding and units of service between the different contracted modalities as long as the changes have no impact on the County’s maximum fiscal obligation.

Background

These fourteen Agreements will 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 to other resources; recovery support; and methadone detoxification and maintenance service. The contracts include Fee-For-Service payment provision.

Referrals to these providers for such services are made by a variety of sources, including the Adult and Juvenile Courts, Child Welfare Services, Family Self-Sufficiency Teams, Adult and Juvenile Probation, Alcohol and Other Drug Assessors, and others.

Discussion

These Agreements will continue Fee-For-Service alcohol and drug treatment services for FY 2004-05. Seventy-five percent (75%) of the services will be provided through the County’s Substance Abuse Crime Prevention Act (SACPA)/Prop 36 Program. SACPA/Prop 36 was implemented in January, 2001 by providers selected through a Request for Qualifications (RFQ) process. For FY 2001-02, providers were selected through a Request for Proposal (RFP) process.

In FY 03-04, the SACPA/Prop 36 Program as first implemented was extensively redesigned in order to contain program costs within our state funding allocation. That redesign by providers and County staff included the establishment of uniform Fee-For-Service rates for the SACPA/Prop 36 Program.

The remaining twenty-five (25%) of the services provided under these agreements involve four relatively small programs. Of these four programs, three are funded by grants that will expire by the end of FY 04-05. For the fourth program, providers were selected by and are integrated into the HIV services system of the Health Services Agency.

As the preponderance of funds to be expended under these Agreements involve Fee-For-Service rates that were just renegotiated, the Human Services Agency is requesting that the Board of Supervisors waive the RFP process that otherwise would apply. Such waiver will also ensure continuity of service to those clients currently receiving services and provide stability to the network of service providers during what has been a challenging transition to the SACPA/ Prop 36 Program redesign.

County Counsel has reviewed and approved these Agreements as to form. Risk Management has reviewed and approved insurance coverage for each of the Contractors.

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 included in the OBM Program Plan for Alcohol and Other Drug treatment services.
FY 2004-05 is reflecting lower client numbers than FY2003-04 due to the cost containment measures and program redesigning adapted by providers and Alcohol and Other Drug Services.

Outcome Based Management Performance Measures: Treatment

Fiscal Year

2003-04 Data

Projected Fiscal Year 2004-05

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

4,421

4,200

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

3 months 76%

9 months 78%

3 months 70%

9 months 60%

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

49%

56%

Vision Alignment

The Fee-For-Service Agreements keep the commitment of: Ensure basic health and safety for all, and Goal 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/Prop 26 probationers, parolees and individuals at-risk of HIV who are referred for alcohol and drug treatment services.

Fiscal Impact

The term of these Agreements is July 1, 2004 through June 30, 2005. The total funding obligation for these fourteen Agreements is $1,951,834. The services under this Agreement are funded by the following sources:

SACPA/Proposition 36

$1,471,907

SACPA SB 223 Drug Testing

60,607

OCJP Drug Court Partnership Grant

72,236

OCJP Comprehensive Drug Court Imp.Grant

129,705

CSAT HIV Door-to-Treatment Grant

100,000

Ryan White Care Act

117,379

Total Funding Obligations

$1,951,834

Funding for these obligations has been included in the Human Services Agency FY 2004-05 Adopted Budget. There is no Net County Cost.