Agenda Item
ASR
Control 23-001029 |
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MEETING
DATE: |
02/27/24 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
1,
2, 3, 4 |
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SUBMITTING Agency/Department: |
Health
Care Agency (Approved) |
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Department contact person(s): |
Annette
Mugrditchian (714) 834-5026 |
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Veronica
Kelley (714) 834-7024 |
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Subject: Amendments and Contracts for Adult
Residential Drug Medi-Cal Treatment Services
ceo CONCUR |
County Counsel Review |
Clerk of the Board |
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Concur |
Approved
Agreement to Form |
Discussion |
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3
Votes Board Majority |
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Budgeted: Yes |
Current Year
Cost: $900,000 |
Annual Cost: N/A |
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Staffing Impact: |
No |
# of Positions: |
Sole Source: No |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 5/23/2023 #15, 5/24/2022 #33,
5/11/2021 #18, 12/15/2020 #16 |
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RECOMMENDED
ACTION(S):
1. |
Approve Amendment No. 8 to the Master
Contract with various providers for the provision of Adult Residential Drug
Medi-Cal Substance Use Disorder Treatment Services, increasing aggregate
amount not to exceed by $900,000, effective March 1, 2024, through June 30,
2024, for a revised aggregate cumulative amount not to exceed $41,329,045. |
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2. |
Approve Amendment No. 9 to the
individual Contract with G & C Swan Inc. for Adult Residential Drug
Medi-Cal Substance Use Disorder Treatment Services, effective upon March 1,
2024, through June 30, 2024. |
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3. |
Approve Amendment No. 7 to the
individual Contract with Hope House Corporation for Adult Residential Drug
Medi-Cal Substance Use Disorder Treatment Services, effective March 1, 2024,
through June 30, 2024. |
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4. |
Approve Amendment No. 2 to the
individual Contract with Phoenix House Orange County, Inc. for Adult
Residential Drug Medi-Cal Substance Use Disorder Treatment Services,
effective March 1, 2024, through, June 30, 2024. |
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5. |
Approve Amendment No. 11 to the
individual Contract with Straight Talk Clinic, Inc. for Adult Residential
Drug Medi-Cal Substance Use Disorder Treatment Services, effective March 1,
2024, through June 30, 2024. |
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6. |
Approve Amendment No. 8 to the individual
Contract with The Teen Project, Inc. for Adult Residential Drug Medi-Cal
Substance Use Disorder Treatment Services, effective March 1, 2024, through
June 30, 2024. |
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7. |
Approve Amendment No. 9 to the
individual Contract with Woodglen Recovery Junction, Inc. for Adult
Residential Drug Medi-Cal Substance Use Disorder Treatment Services,
effective March 1, 2024, through June 30, 2024. |
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8. |
Approve the selection of and individual
Contracts with Cactus Gardens Opportunity House, Inc. and Sober Solutions
under existing Master Contract for provision of Adult Residential Drug
Medi-Cal Substance Use Disorder Treatment Services, for the term of April 1,
2024, through June 30, 2024. |
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9. |
Authorize the County Procurement Officer
or Deputized designee to execute Amendment No. 8 to the Master Contract and
the individual Amendments with G & C Swan, Inc., Hope House Corporation,
Phoenix House Orange County, Inc., Straight Talk Clinic, Inc., The Teen
Project, Inc. and Woodglen Recovery Junction, Inc., and execute the
individual Contracts with Cactus Gardens Opportunity House, Inc. and Sober
Solutions, as referenced in the Recommended Actions above. |
SUMMARY:
Approval of the selection of and
individual Contracts with Cactus Gardens Opportunity House, Inc. and Sober
Solutions, and the individual Amendments for the provision of Adult Residential
Drug Medi-Cal Substance Use Disorder Treatment Services will increase options
for Orange County adults seeking residential treatment services.
BACKGROUND
INFORMATION:
On May 21, 2019, your Honorable Board of
Supervisors (Board) approved the Master Contract with various providers for the
provision of Adult Residential Drug Medi-Cal (DMC) Substance Use Disorder (SUD)
Treatment Services and the below additional actions have been executed pursuant
to appropriate authorities. Amendments 1, 2 and 7 to the Master Contract for
administrative revisions were executed under Deputy Purchasing Agent (DPA)
delegated authority. Providers under this Master Contract are paid through a combination
of negotiated rates and actual costs, which draw down from an aggregate
not-to-exceed amount. Prior to contract expiration, the Health Care Agency
(HCA) plans to issue a solicitation to continue services. The Orange County
Preference Policy is not applicable to the Master Contract.
Board Date |
Contract/Amendment |
Action |
Term |
May
21, 2019 |
Master
Contract and Individual Contracts |
Board
Approved Master Contract with Straight Talk Clinic, Inc. and Woodglen
Recovery Junction, Inc. |
July
1, 2019 – June 30, 2022 |
September
24, 2019 |
Contract |
Board
Approved Individual Contract with The Teen Project, Inc. |
October
1, 2019 – June 30, 2022 |
January
28, 2020 |
Contract |
Board
Approved Individual Contract with G & C Swan, Inc. |
March
1, 2020 – June 30, 2022 |
May
5, 2020 |
Contract |
Board
Approved Individual Contracts with Clean Path Recovery, LLC and Hope House
Corporation |
July
1, 2020 – June 30, 2022 |
December
15, 2020 |
Contract |
Board
Approved Individual Contract with Coastal Addiction Center, Inc. |
February
1, 2021 – June 30, 2022 |
May
11, 2021 |
Amendment
No. 4 to Master Contract |
Board
Approved Contract Increase |
July
1, 2021 – June 30, 2022 |
May
24, 2022 |
Amendment
No. 5 to Master Contract |
Board
Approved Term Renewal and Contract Increase |
July
1, 2022 – June 30, 2024 |
May
23, 2023 |
Amendment
No. 6 to Master Contract |
Board
Approved Contract Increase and Approval of Individual Contracts with Phoenix
House Orange County, Inc. and Spencer Recovery Centers Inc. |
July
1, 2023 – June 30, 2024 |
On June 7, 2022, the HCA released a
Request for Applications (RFA) seeking additional, qualified DMC organizations
to provide SUD treatment services for adults. Cactus Gardens Opportunity House,
Inc. (Cactus Gardens) and Sober Solutions submitted applications and were
deemed responsive. Reference letters for Cactus Gardens were completed by
Recover Well, Inc., Laurel Healing Center and PH Wellness with positive
reports. Reference letters for Sober Solutions were completed by Rapid Revenue
Recovery, Northcutt Consulting Services, LLC and The Catholic Worker with
positive reports. Additional funding of $900,000 is being added to the Master
Contract in order to accommodate the two new providers. Existing providers will
be required to sign individual amendments for the Master Contract increase.
The six proposed Amendments with
the current six Contract providers and selection of two new providers are to
ensure that the HCA is in compliance with the California Department of Health
Care Services (DHCS) for the delivery of DMC, Organized Delivery System (ODS)
services and the Substance Use Prevention Treatment, and Recovery Services
Block Grant guidelines and standards for delivering non-DMC services.
Scope
of Services
The goal of Adult Residential DMC
SUD Treatment Services is to provide residential treatment to adults 18 years
and older who have a substance use diagnosis and meet the American Society of
Addiction Medicine criteria. Clients are referred from the Beneficiary Access
Line, OC Links, the Assessment and Referral to Treatment Team (ART), or from
the clinics where they are currently receiving services. All clients have an
assessment and must be authorized to receive this level of service. Providers
must transition clients to the appropriate level of care as medical necessity
dictates.
In the residential treatment
environment, there is a daily regimen of structured activities that are
intended to build positive behavioral patterns within a community. Residential
Treatment Services provide client-centered treatment, which is based on
mutually agreed upon goals/objectives between the clinician and client.
Services include intake, treatment planning, individual and group counseling,
educational sessions, collateral services, relapse prevention and case
management. Common issues that are addressed at the beginning of treatment
include: planning and preparing for housing, a safe living environment,
education, and employment so clients have a specific plan at the time of
discharge. With the addition of the two new providers, HCA will have the
capacity for 182 licensed beds that will be utilized.
Performance
Outcomes
Program
performance is assessed through two measures: At least 70 percent exit the
program making satisfactory progress (i.e., Completion Rate) and at least 30
percent of those who exit the program attend at least one treatment service
within 30 days of exiting the program (i.e., Linkage Rate). The linkage rate
target was met during both reporting periods and there has been an increase in
successful completions during the first quarter of FY 2023-24. No vendor fell
substantially under the average. HCA will continue to monitor target rate
trends as additional years of data are analyzed and identify strategies to help
clients successfully complete residential treatment services. The table below
represents the average for all providers for the 2022-23 Fiscal Year as well as
Fiscal Year 2023-24 through October 2023.
|
Goals for Providers |
FY 2022-23 |
FY 2023-24 Through October 2023 |
Completion
Rates |
>70% |
64% |
67% |
Linkage
Rates |
>30% |
60% |
55% |
These contracts, due to the nature of the
services, could require the addition of subcontractors. In order to add
subcontractor(s) to the contract, the Contractor must seek express consent from
HCA. Should the addition of a subcontractor affect the scope of work and/or
contract amount, HCA will bring the item back to the Board of Supervisors for
approval. See Attachment J for the Contract Summary Form.
HCA has developed a Good Neighbor Policy
that is included in Residential Program contracts wherein Contractors provide
services to County residents and the services may have a potential impact on
the surrounding neighborhood(s) including but not limited to environment,
safety and congregation. HCA has not received any negative feedback from the
community and will continue to work with Contractors and the community to
ensure positive community relations.
Contractor |
Facility Location |
Cactus
Gardens |
Garden
Grove |
G
& C Swan, Inc. |
Colton,
Upland |
Hope
House Corporation |
Anaheim |
Phoenix
House Orange County, Inc. |
Santa
Ana |
Sober
Solutions |
Huntington
Beach |
Straight
Talk Clinic, Inc. |
Santa
Ana |
The
Teen Project, Inc. |
Trabuco
Canyon |
Woodglen
Recovery Junction, Inc. |
Fullerton |
HCA requests that the Board approve the
Amendments with G & C Swan, Inc., Hope House Corporation, Phoenix House
Orange County, Inc., Straight Talk Clinic, Inc., The Teen Project, Inc. and
Woodglen Recovery Junction, Inc. and the individual Contracts with Cactus
Gardens and Sober Solutions for the provision of Adult Residential DMC SUD
Treatment Services, as referenced in the Recommended Actions.
FINANCIAL
IMPACT:
Appropriations for these Contracts
are included in Budget Control 042 FY 2023-24 Budget.
The Contracts include provisions
allowing HCA to terminate the Contract, reduce the level of services, and/or
renegotiate the levels of services provided, as necessary. This includes a
notice that allows HCA adequate time to transition or terminate services to
clients, if necessary.
Funding
Sources:
Fed: 20% (Substance Use Prevention,
Treatment, and Recovery Services Block Grant)
Fees/Other: 40% (Federal Financial
Participation Drug Medi-Cal)
State: 40% (Drug Medi-Cal State,
General Fund and Realignment)
STAFFING
IMPACT:
N/A
ATTACHMENT(S):
Attachment
A – Amendment No. 8 to Master Contract MA-042-20010248 for Adult Residential
Drug Medi-Cal Substance Use Disorder Treatment Services
Attachment B – Amendment No. 9 to Contract MA-042-20010248 for Adult
Residential Drug Medi-Cal Substance Use Disorder Treatment Services with G
& C Swan, Inc.
Attachment C – Amendment No. 7 to Contract MA-042-20010248 for Adult
Residential Drug Medi-Cal Substance Use Disorder Treatment Services with Hope
House Corporation
Attachment D – Amendment No. 2 to Contract MA-042-20010248 for Adult
Residential Drug Medi-Cal Substance Use Disorder Treatment Services with
Phoenix House Orange County, Inc.
Attachment E – Amendment No. 11 to Contract MA-042-20010248 for Adult
Residential Drug Medi-Cal Substance Use Disorder Treatment Services with
Straight Talk Clinic, Inc.
Attachment F – Amendment No. 8 to Contract MA-042-20010248 for Adult
Residential Drug Medi-Cal Substance Use Disorder Treatment Services with The
Teen Project, Inc.
Attachment G – Amendment No. 9 to Contract MA-042-20010248 for Adult
Residential Drug Medi-Cal Substance Use Disorder Treatment Services with
Woodglen Recovery Junction, Inc.
Attachment H – Contract MA-042-20010248 for Adult Residential Drug Medi-Cal
Substance Use Disorder Treatment Services with Cactus Gardens Opportunity
House, Inc.
Attachment I - Contract MA-042-20010248 for Adult Residential Drug Medi-Cal
Substance Use Disorder Treatment Services with Sober Solutions
Attachment J - Contract Summary Form
Attachment K – Redline to Attachment A
Attachment L – Redline to Attachment B
Attachment M – Redline to Attachment C
Attachment N – Redline to Attachment D
Attachment O – Redline to Attachment E
Attachment P – Redline to Attachment F
Attachment Q – Redline to Attachment G