Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  22-000947

 

MEETING DATE:

05/23/23

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Annette Mugrditchian (714) 834-5026 

 

 

Veronica Kelley (714) 834-7024

 

 

Subject:  Amendments and Contracts for Adult Residential Drug Medi-Cal Treatment Services

 

      ceo CONCUR

County Counsel Review

Clerk of the Board

          Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: N/A

Current Year Cost:   N/A

Annual Cost: FY 2023-24 $2,000,000

 

 

 

    Staffing Impact:

No

# of Positions:            

Sole Source:   No

    Current Fiscal Year Revenue: N/A

   Funding Source:     See Financial Impact Section

County Audit in last 3 years: No

   Levine Act Review Completed: Yes

 

    Prior Board Action:         5/24/2022 #33, 5/11/2021 #18, 12/15/2020 #16, 5/5/2020 #5

 

RECOMMENDED ACTION(S):

 

 

1.

Approve Amendment No. 6 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 $2,000,000 for the term of July 1, 2023, through June 30, 2024, for a revised aggregate cumulative total amount not to exceed $40,429,045.

 

 

2.

Approve Amendment No. 6 to the individual Amendment with G & C Swan, Inc. for Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services for the term of July 1, 2023, through June 30, 2024.

 

 

3.

Approve Amendment No. 5 to the individual Amendment with Hope House Corporation for Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services for the term of July 1, 2023, through June 30, 2024.

 

 

4.

Approve Amendment No. 8 to the individual Amendment with Straight Talk Clinic, Inc. for Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services for the term of July 1, 2023, through June 30, 2024.


 

 

 

5.

Approve Amendment No. 6 to the individual Amendment with The Teen Project, Inc. for Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services for the term of July 1, 2023, through June 30, 2024.

 

 

6.

Approve Amendment No. 6 to the individual Amendment with Woodglen Recovery Junction, Inc. for Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services for the term of July 1, 2023, through June 30, 2024.

 

 

7.

Approve the selection of and individual Contract with Phoenix House Orange County, Inc. under existing Master Contract for provision of Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services for the term of July 1, 2023, through June 30, 2024.

 

 

8.

Approve the selection of and individual Contract with Spencer Recovery Centers Inc. under existing Master Contract for provision of Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services for the term of July 1, 2023, through June 30, 2024.

 

 

9.

Authorize the County Procurement Officer or Deputized designee to execute the individual Amendments with G & C Swan, Inc., Hope House Corporation, Straight Talk Clinic, Inc., The Teen Project, Inc., and Woodglen Recovery Junction, Inc., and individual Contracts with Phoenix House Orange County, Inc. and Spencer Recovery Centers Inc., as referenced in the Recommended Actions above.

 

 

 

 

SUMMARY:

 

Approval of the selection of and individual Contracts with Phoenix House Orange County, Inc. and Spencer Recovery Centers Inc. 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 and 2 to the Master Agreement for administrative revisions were executed under Deputy Purchasing Agent (DPA) 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. 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 and Two Individual Contracts

July 1, 2019 - June 30, 2022

 

September 24, 2019

N/A

Board Approved Individual Contract with The Teen Project, Inc.

October 1, 2019 - June 30, 2022

 

 

January 28, 2020

N/A

Board Approved Individual Contract with G & C Swan, Inc.

March 1, 2020 - June 30, 2022

 

 

May 5, 2020

N/A

Board Approved Individual Contracts with Clean Path Recovery, LLC and Hope House Corporation

July 1, 2020 - June 30, 2022

 

 

December 15, 2020

N/A

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

 

On June 7, 2022, the Health Care Agency (HCA) released a Request for Applications (RFA) seeking additional, qualified DMC organizations to provide SUD treatment services for adults. Phoenix House Orange County, Inc. (Phoenix House) and Spencer Recovery Centers Inc. (Spencer) submitted applications and were deemed responsive. Reference letters for Phoenix House were completed by State of California Division of Rehabilitative Programs and County of Los Angeles Public Health Department with positive reports. Reference letters for Spencer were completed by Warriors Heart and Dr. Kenneth Gheysar from the American Board of Addiction Medicine with positive reports. Additional funding of $2 million is being added to the Master Contract’s aggregate amount not to exceed in order to accommodate the two new providers. Existing contracts are being amended to reflect the Master Contract increase.

 

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 or from the clinics where they are currently receiving services.  Providers will directly admit individuals that use drugs intravenously and/or are pregnant. All clients have an assessment and must be authorized to receive this level of service.  For adults, the length of residential services for all levels will be 90-days maximum, unless medical necessity authorizes a one-time extension of up to 30 days. 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. Components 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 and education and employment so that clients have a specific plan at the time of discharge.

 

Performance Outcomes

Providers are required to meet the following performance objective for Residential Treatment:

 

            Fifty percent of clients will complete residential treatment program.

 

            Twenty percent of clients who have discharged will be linked with a lower level of care within seven days.

 

Program

Completion Rate

FY 2021-22

>50%

Completion Rate

FY 2022-23 (To February) >50%

Linkage Rate (2022-23*)

>20%

G & C Swan, Inc.

52%

72%

48%

Hope House Corporation

62%

98%

32%

Straight Talk

58%

61%

68%

Teen Project, Inc.

59%

100%

50%

Woodglen Recovery Junction, Inc.

47%

70%

56%

Phoenix House

50%

49%

52%

* Linkage Rates were not tracked prior to 2022.

 

In FY 2021-22, all providers either met or exceeded the performance objective, with one provider, missing the performance objective by three percent but is on track to exceed the performance objective this fiscal year.  In addition, all other providers are on track for meeting or exceeding performance objectives this year.  Spencer Recovery is a new provider, therefore there are no rates to report at this time.  Phoenix House currently provides these services under an individual contract, which is in the fifth and final year and expires June 30, 2023.  Phoenix House applied under the RFA to join the Master Agreement.

 

Contractors' performance has been confirmed as satisfactory with no identified issues. HCA has verified there are no concerns that must be addressed with respect to Contractors' ownership/name litigation status or conflicts with County interests.

 

This contract, due to the nature of the services, could require the addition of subcontractors. In order to add subcontractor(s) to the contract, the provider/contractor must seek express consent from the department. Should the addition of a subcontractor affect the scope of work and/or contract amount, the department will bring the item back to the Board of Supervisors for approval. In the past (if there is information available), subcontractor(s) have/have not been used for this contract. See Attachment I 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. The Good Neighbor Policy can be found in Exhibit D of the contract.

 

 

Contractor

Facility Location

G & C Swan, Inc.

Colton, Upland

Hope House Corporation

Anaheim

Phoenix House Orange County, Inc.

Santa Ana

Spencer Recovery Centers Inc.

Laguna 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, Straight Talk Clinic, Inc., The Teen Project, Inc. and Woodglen Recovery Junction, Inc. and the individual Contracts with Phoenix House Orange County, Inc. and Spencer Recovery Centers Inc. for the provision of Adult Residential DMC SUD Treatment Services as reference in the Recommended Actions.

 

 

 

FINANCIAL IMPACT:

 

Appropriations for the Contracts will be 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 service to clients, if necessary.

 

Funding Sources:

 

Fed: 20% (Substance Abuse Prevention and Treatment 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. 6 to Master Contract MA-042-20010248 for Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services
Attachment B – Amendment No. 6 to Contract MA-042-20010248 with G & C Swan, Inc.
Attachment C – Amendment No. 5 to Contract MA-042-20010248 with Hope House Corporation
Attachment D – Amendment No. 8 to Contract MA-042-20010248 with Straight Talk Clinic, Inc.
Attachment E – Amendment No. 6 to Contract MA-042-20010248 with The Teen Project, Inc.
Attachment F – Amendment No. 6 to Contract MA-042-20010248 with Woodglen Recovery Junction, Inc.
Attachment G – Contract MA-042-20010248 for Provision of Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services with Phoenix House Orange County, Inc.
Attachment H - Contract MA-042-20010248 for Provision of Adult Residential Drug Medi-Cal Substance Use Disorder Treatment Services with Spencer Recovery Centers Inc.
Attachment I - Contract Summary Form