Inter-Departmental Correspondence

Human Services Agency



November 3, 2004


December 7, 2004



Honorable Board of Supervisors


Maureen D. Borland, Director, Human Services Agency


Yvonne Frazier, Director, Alcohol and Other Drug Services


Acceptance of the Department of Health and Human Services (DHHS), Center for Substance Abuse Treatment (CSAT) Grant Number 1 H79 TI 16683-01




Adopt a resolution:



Accepting a five-year grant from the DHHS/CSAT to provide substance abuse treatment for the homeless in the amount of $1,991,088 for the period from 9/30/2004 to 9/29/2009; and



Waiving the Request for Proposals (RFP) process and authorizing Alcohol and Other Drug Services to initiate five-year contracts with the service providers designated in the grant proposal. It is in the County’s best interest to continue to contract with those service providers designated in the grant proposal in order to provide stability to the network of services provided to the clients.



Authorizing the Human Services Agency Director to execute Agreements/Amendments with the service providers designated in the grant application, and to re-allocate funds within the DHHS/CSAT Grant on behalf of the County of San Mateo. However, as to each Agreement, such authority is limited to:



Reducing the County’s maximum fiscal obligation in the event there is a commensurate reduction in the funding received by the County; and



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



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.



The Human Services Agency, Alcohol and Other Drug Services (AOD) in collaboration with the San Mateo County Office of Housing, Horizon Services, Shelter Network, Samaritan House and Allen/Loeb Associates, submitted an application to the DHHS/CSAT for a five-year grant to provide a spectrum of substance abuse treatment services to persons at the Maple Street (Shelter Network), and Safe Harbor (Samaritan House) shelters in San Mateo County. These agencies have a demonstrated ability to provide services to the homeless population in San Mateo County through prior CSAT Agreements, and have committed to participate in the implementation of this project as they have done in the past. The DHHS has a strong preference for the pre-selecting of service providers with demonstrated ability to provide the proposed services to the target population and a strong history of collaboration with County departments involved in the projects it funds.

The data concerning the sheltered and unsheltered homeless population was collected via a one day count which showed 1,730 homeless persons, of which 575 were unsheltered. Of the 575 unsheltered persons, estimates of those with substance abuse problems ranged between 35-60%, consistent with statistics published in national literature. Basic substance abuse services currently available in the shelters are provided through grant funding that will expire on December 31, 2004.



On September 30, 2004 the Human Services Agency received notification of grant award in the amount of $1,991,088 for the period September 29, 2004 to September 30, 2009. The grant award will allow the County to expand services in the Maple Street (Shelter Network), and Safe Harbor (Samaritan House) shelters, in three critical evidence-based practice areas: Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), and Intensive Outpatient Treatment. Through contracts with the collaborating treatment provider, Horizon Services, trained substance abuse counselors will be placed at the two shelter sites. The counselors will provide formal assessment, case management, and individual and group substance abuse treatment utilizing CBT and MI to a total of 450 homeless men and women over the life of the grant. In addition, services will include linkages and referral of clients to additional treatment and ancillary services including assistance with accessing transitional or permanent housing.

As set forth in the grant application, a Human Services Analyst II will act as project coordinator and serve as liaison to the substance abuse treatment providers and the two shelters, supervise and monitor data collection, convene meetings, coordinate follow-up data collection, coordinate with the evaluators, maintain project records, and prepare project reports. The adoption of a Salary Ordinance Amendment adding one Human Services Analyst II Unclassified position to provide project coordination services as specified in the grant application will be the subject of future proposed resolution submitted to the Board.

Shelter administrative costs related to the grant will be addressed through a Memorandum of Understanding with the Office of Housing.

This award is for a five-year period beginning on September 30, 2004 and ending on September 29, 2009. Additional financial resources for the provision of services beyond September 29, 2009 have not yet been identified. Some training for shelter staff in providing AOD related services is built into the program design. AOD will pursue additional funding in an attempt to sustain services. Possible funding may include local/state/federal funding and foundation grants. If state block grant funds are increased, they may be utilized for sustaining substance abuse treatment services that are initiated under this grant. However, due to economic uncertainties, these efforts may not result in additional funding. If no additional funding is identified, the program will cease on September 29, 2009.

Performance Measures

Evaluation of the five-year project will be conducted by Allen/Loeb Associates to assess treatment effectiveness through use of the Addiction Severity Index (ASI), random urinalysis results, client retention data, California Alcohol and Drug Data System (CADDS) and CSAT’s Government Programs Reporting Act (GPRA) tool.

Performance Measures Projected Objectives each Fiscal Year

Number of homeless clients receiving treatment

450 homeless men and women over the life of the grant.

Maximize retention and treatment completion

80% of clients entering treatment will be retained for at least one month.

Reduce substance abuse and increase abstinence

80% of clients completing treatment will report abstinence or reduced substance intake at six and twelve month follow up.

Improve and maintain physical and mental health, social and family functioning, employment and education, and legal status

80% of clients completing treatment will show improved functioning across these domains as measured by ASI and/or GPRA at 6 month and 12 month follow-up.

Vision Alignment

The services provided under this grant 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 for life. The grant contributes to this commitment and goal by providing homeless individuals in San Mateo County 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

The five-year grant period is September 30, 2004 through September 29, 2009. The total funding for the term of this grant is $1,991,088. The funding available for each federal fiscal year is: FFY2004-05 $396,288; FFY 2005-06 $396,431; FFY 2006-07 $398,947; FFY 2007-08 $399,814 and FFY 2008-09 $399,608. Appropriation needed for FY 2004-05 is $297,216 and an Appropriation Transfer Request (ATR) to add funding for the homeless substance abuse treatment services will follow. There is no required County match and there is no Net County Cost.