AGENDA STAFF REPORT

Agenda Item AGENDA STAFF REPORT ASR Control 21-000841
MEETING DATE:	12/07/21
legal entity taking action:	Board of Supervisors
board of supervisors district(s):	3
SUBMITTING Agency/Department:	Health Care Agency (Approved)
Department contact person(s):	Annette Mugrditchian (714) 834-5026
	Jeff Nagel (714) 834-7024

Subject: Contract for Adolescent Residential Drug Medi-Cal and Withdrawal Management

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

3 Votes Board Majority

Budgeted: Yes

Current Year Cost: $500,000

Annual Cost: FY 2022-23 $1,000,000
FY 2023-24 $1,000,000

Staffing Impact:

# of Positions:

Sole Source: No

Current Fiscal Year Revenue: N/A

Funding Source: See Financial Impact Section	County Audit in last 3 years: No

Prior Board Action: N/A

RECOMMENDED ACTION(S):

Approve the selection of and Contract with The Teen Project, Inc. DBA Sanctuary Recovery Center, for provision of Adolescent Residential Drug Medi-Cal and Withdrawal Management Services, effective January 7, 2022, through June 30, 2024, in an amount not to exceed $2,500,000, renewable for an additional two-year term.

Pursuant to Contract Policy Manual Section 3.4-114, authorize the County Procurement Officer or authorized Deputy to exercise a contingency contract cost increase in an amount not to exceed 10 percent of the contract amount for the first year of the Contract, for the entire term of the Contract, including renewals, and within the scope of work set forth in the Contract. The use of this contingency contract cost increase is subject to approval requirements established by the County Procurement Officer.

Authorize the County Procurement Officer or authorized Deputy, to execute the Contract with The Teen Project, Inc. DBA Sanctuary Recovery Center, as referenced in the Recommended Actions above.

SUMMARY:

Approval of the selection of and Contract with The Teen Project, Inc. DBA Sanctuary Recovery Center for provision of Adolescent Residential Drug Medi-Cal and Withdrawal Management Services will fulfill mandated services for adolescent females ages 12 through 17 years old as required under the Drug Medi-Cal Organized Delivery System.

BACKGROUND INFORMATION:

The Drug Medi-Cal (DMC) Organized Delivery System (DMC-ODS) requires DMC Residential Treatment and Withdrawal Management Services for adolescents ages 12 through 17 years old. Currently, there are no adolescent residential providers within the Health Care Agency (HCA) DMC-ODS. HCA previously had Contracts with two adolescent DMC residential providers, but the Contracts were terminated due to one facility closing in October 2019 and another facility closed in June 2020. Since June 29, 2020, adolescents in need of residential treatment for substance use disorders have been placed with an out-of-network provider in a neighboring county through Letter of Agreement (LOA). Adolescents are placed out of county because there are currently no DMC certified residential providers who are licensed to serve adolescents in Orange County.

On June 23, 2021, HCA released a Request for Application (RFA) for qualified DMC organizations to provide Substance Use Disorder (SUD) Residential Treatment Services for adolescents, including Medication Assisted Treatment (MAT). On July 1, 2021, HCA released a RFA for qualified DMC organizations to provide SUD Residential Withdrawal Management Services for adolescents, including MAT. The Teen Project, Inc. DBA Sanctuary Recovery Center (The Teen Project, Inc.) was the only applicant for both RFAs and will provide both DMC Residential Treatment Services and Withdrawal Management Services for adolescent females 12 through 17 years old in their Sanctuary Recovery Center program using the same beds, staffing and facility. The Teen Project, Inc. anticipates expanding their population in the future to serve adolescent males. In the meantime, adolescent males in need of residential treatment will continue to be placed with an out-of-network provider in a neighboring county through LOA. The Teen Project, Inc. currently contracts with HCA to provide adult DMC Residential Treatment Services at their Trabuco Canyon facility. Adolescent DMC Residential Treatment Services will be at the same facility, in a separate building. Services with The Teen Project, Inc. can be accessed through OC Links, the Beneficiary Access Line (BAL), DMC outpatient providers, and by directly contacting The Teen Project, Inc. The Teen Project, Inc. will accept self-referrals as well as referrals from the community. HCA has conducted due diligence on the vendor. The Teen Project, Inc. was deemed qualified, and reference checks were satisfactory and completed with Los Angeles County, California Youth Opioid Response and McMillen Family Foundation regarding similar projects.

Scope of Services

In the DMC-ODS, the American Society of Addiction Medicine categorizes residential treatment in distinct levels of care identified as Level 3.1 Clinically Managed Low-Intensity Residential Services, 3.2 Clinically Managed Residential Withdrawal Management, 3.3 Clinically Managed Population-Specific High-Intensity Residential Services and Level 3.5 Clinically Managed High-Intensity Residential Services. The Teen Project, Inc., will be providing 3.1 through 3.5 levels of care, including MAT services within each level of care, for adolescent females 12 through 17 years old who are Medi-Cal beneficiaries residing in Orange County. There will be six beds at the facility and services will be provided 24 hours a day, seven days a week and 365 days a year.

Residential Treatment Services and Withdrawal Management Services will include intake, treatment planning, individual counseling, family counseling, group counseling, substance use related educational sessions, collateral services, education, structured therapeutic activities, case management, crisis intervention services, MAT, drug testing, discharge planning services and transportation services. Additionally, Withdrawal Management Services include frequent observation and physical checks for as long as withdrawal signs and symptoms warrant.

Performance Outcomes

The following are required performance objectives:

All levels of care:

Demonstrate provision of effective Residential Treatment Services and Withdrawal Management Services as measured by satisfactory treatment progress at discharge.	>50%
Provide linkage to the lower level of care for clients within seven days of discharge	>75%

Residential 3.1, 3.3, and 3.5 only:

Demonstrate provision of effective Residential Treatment Services as measured by retention rates (at least 30 days in services).	>50%
Demonstrate provision of effective Residential Treatment Services as measured by completion rates.	>50%
Demonstrate provision of effective Residential Treatment Services as measured by satisfactory treatment progress at discharge.	>50%
Clients who complete a satisfaction survey will agree or strongly agree that they are “overall satisfied with the services received” and will agree or strongly agree that they would recommend the program to someone they know.	>90%

The Teen Project, Inc. has an existing Good Neighbor policy in place. To date, HCA has not received any negative feedback from the Trabuco Canyon community.

HCA has verified there are no concerns to address with respect to the provider’s ownership/name, litigation status or conflicts with County interests. The proposed Contract with The Teen Project, Inc. will have subcontractors. See Attachment B for information regarding subcontractor and Contract Summary Form.

HCA requests that the Board of Supervisors (Board) authorize, pursuant to Contract Policy Manual Section 3.4-114, the County Procurement Officer or authorized Deputy to exercise a contingency contract cost increase in an amount not to exceed 10 percent of the Contract amount for the first year of the Contract, for the entire term of the Contract, including renewals, and within the scope of work set forth in the Contract. The contingency provision would be exercised in the event there is an increase in the projected services needed for the clients being served. The use of this contingency contract cost increase is subject to approval requirements established by the County Procurement Officer.

HCA requests that the Board approve the Contract with The Teen Project, Inc. for provision of Drug Medi-Cal Adolescent Residential Treatment and Withdrawal Management Services as referenced in the Recommended Actions.

FINANCIAL IMPACT:

Appropriations for this Contract are included in Budget Control 042 FY 2021-22 Budget and will be included in the budgeting process for future years.

Funding Sources:

FED: 33% (Substance Abuse Prevention and Treatment Block Grant)

State: 33% (Drug Medi-Cal State General Funds)

Fees/Other: 34% (Federal Financial Participation Drug Medi-Cal)

Should services need to be reduced or terminated due to lack of funding, the Contract contains language that allows HCA to give a 30-day notice to either terminate or renegotiate the level of services to be provided. The notice will allow HCA adequate time to transition or terminate services to clients, if necessary.

STAFFING IMPACT:

N/A

ATTACHMENT(S):

Attachment A - Contract MA-042-22010617 for Adolescent Residential Drug Medi-Cal and Withdrawal Management Services with The Teen Project, Inc.
Attachment B - Contract Summary Form