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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
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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:
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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):
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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.
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Board Date |
Contract/Amendment |
Action |
Term |
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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 |
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September 24,
2019 |
Contract |
Board Approved
Individual Contract with The Teen Project, Inc. |
October 1, 2019
– June 30, 2022 |
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January 28, 2020 |
Contract |
Board Approved
Individual Contract with G & C Swan, Inc. |
March 1, 2020 –
June 30, 2022 |
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May 5, 2020 |
Contract |
Board Approved
Individual Contracts with Clean Path Recovery, LLC and Hope House Corporation |
July 1, 2020 –
June 30, 2022 |
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December 15,
2020 |
Contract |
Board Approved
Individual Contract with Coastal Addiction Center, Inc. |
February 1, 2021
– June 30, 2022 |
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May 11, 2021 |
Amendment No. 4
to Master Contract |
Board Approved
Contract Increase |
July 1, 2021 –
June 30, 2022 |
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May 24, 2022 |
Amendment No. 5
to Master Contract |
Board Approved
Term Renewal and Contract Increase |
July 1, 2022 –
June 30, 2024 |
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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.
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Goals for Providers |
FY 2022-23 |
FY 2023-24 Through October 2023 |
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Completion Rates |
>70% |
64% |
67% |
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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.
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Contractor |
Facility Location |
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Cactus Gardens |
Garden Grove |
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G & C Swan,
Inc. |
Colton, Upland |
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Hope House
Corporation |
Anaheim |
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Phoenix House
Orange County, Inc. |
Santa Ana |
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Sober Solutions |
Huntington Beach |
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Straight Talk
Clinic, Inc. |
Santa Ana |
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The Teen
Project, Inc. |
Trabuco Canyon |
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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