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DATE: |
October 19, 2021 |
17 |
SUBJECT
Title
AUTHORIZE COMPETITIVE SOLICITATION FOR SUBSTANCE USE RESIDENTIAL SERVICES (DISTRICTS: ALL)
Body
OVERVIEW
The County of San Diego (County) Health and Human Services Agency (HHSA), Behavioral Health Services (BHS) department provides a comprehensive array of community-based mental health and substance use disorder services.
Approval of today’s recommended action authorizes competitive solicitation of substance use residential treatment and withdrawal management services, to include withdrawal management that will be available to eligible adults regionwide, to further support access to critical capacity within the County’s Drug Medi-Cal Organized Delivery System. Substance use residential treatment provides 24-hour, non-medical clinically managed substance use treatment, recovery and ancillary services to adults aged 18 years and above with substance use issues, including co-occurring mental health conditions. Clients receive assessment, individual, group, educational and recovery support services, delivered with an approach that is person-centered; outcomes-driven; culturally responsive; trauma-informed; and inclusive of evidence-based practices.
Today’s action aligns with the County’s strategic approach to strengthening service delivery through practices that are comprehensive and outcomes oriented, ensuring the best services lead to optimal outcomes for all San Diegans. This item also aligns with the County’s Live Well San Diego vision by supporting access to services that promote the health and well-being of San Diegans with behavioral health needs.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. In accordance with Section 401, Article XXIII of the County Administrative Code, authorize the Director, Department of Purchasing and Contracting, to issue competitive solicitations for substance use residential and withdrawal management services, and upon successful negotiations and determination of a fair and reasonable price, award contracts for an initial term of up to one year, with four one-year options, and up to an additional six months, if needed; and to amend the contracts to reflect changes in program funding or service requirements, subject to the availability of funds and the approval of the Agency Director, Health and Human Services Agency.
EQUITY IMPACT STATEMENT
The County of San Diego (County) Health and Human Services Agency, Behavioral Health Services (BHS) department serves as the specialty mental health plan for Medi-Cal eligible residents within San Diego County with serious mental illness, and the service delivery system for Medi-Cal eligible residents with substance use care needs. These individuals and families often struggle disproportionately with social and economic factors that may negatively impact their behavioral health. These factors, referred to as the social determinants of health, are rooted in inequitable distribution of resources.
As a steward of public health for the region, BHS must ensure that the services offered through County-operated and contracted programs address the social determinants of health by being accessible, capable of meeting the linguistic and cultural needs of a diverse population, and equitably distributed to the individuals, families, and communities most in need. BHS utilizes a population health approach, including evidence-based practices, robust data analysis, and stakeholder input from consumers, community-based providers, healthcare organizations and others to identify need and design services that are impactful, equitable, and yield meaningful outcomes for clients.
If approved, today's action will authorize the procurement of services that improve access to treatment and care for some of the region’s most vulnerable, under-served, and under-resourced populations.
FISCAL IMPACT
Funds for this request are included in the Fiscal Year 2021-23 Operational Plan in the Health and Human Services Agency. If approved, today’s recommendation will result in approximate costs and revenue of $2,800,000 in Fiscal Year 2021-22 and $8,400,000 in Fiscal Year 2022-23. The funding sources will be Drug Medi-Cal, Realignment, and Substance Abuse Prevention and Treatment Block Grant. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
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Details
ADVISORY BOARD STATEMENT
This Board Letter will be presented as an informational item at the Behavioral Health Advisory Board meeting on November 4, 2021.
BACKGROUND
The County of San Diego Health and Human Services Agency, Behavioral Health Services (BHS) department provides a comprehensive array of community-based mental health and substance use disorder services through contracts with local public and private agencies.
Approval of today’s recommended action authorizes competitive solicitation of substance use residential treatment and withdrawal management services, that will be available to eligible adults regionwide. Services will be delivered with an approach that is person-centered; outcomes-driven; culturally-responsive; trauma-informed; and inclusive of evidence-based practices.
The services that will be procured include the following:
• Residential Treatment Services: Clinically Managed Residential Treatment Services are non-institutional, 24-hour, non-medical, short-term services to support clients in their efforts to restore, maintain, and apply interpersonal and independent living skills, and access community support systems. The components of Residential Treatment Services include intake/admission, treatment planning, individual and group counseling, family therapy, patient education, safeguarding medications, crisis intervention services, transportation services, and discharge services.
• Residential Withdrawal Management Services: Clinically Managed Residential Withdrawal Management is delivered by trained staff who provide 24-hour supervision, observation, and support for individuals who are intoxicated or experiencing physical withdrawal from alcohol or other drugs. This level of care is characterized by its emphasis on peer and social support; and provides services for clients with moderate to severe intoxication/withdrawal signs and symptoms that require 24-hour structure and support. Withdrawal Management support systems include the availability of specialized clinical consultation and supervision for biomedical, emotional, behavioral, and cognitive needs.
The recommended action supports the continuation of critical work to advance the transformation of the Behavioral Health Continuum of Care, including substance use service delivery within San Diego County’s Drug Medi-Cal Organized Delivery System. All contracts are contingent upon the availability of funding, successful negotiations, and determination of a fair and reasonable price.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the Building Better Health and Living Safely Initiatives in the County of San Diego’s (County) 2021-2026 Strategic Plan as well as the County’s Live Well San Diego vision, by ensuring that vulnerable populations of individuals with behavioral health needs continue to have access to a comprehensive continuum of behavioral health services administered through accessible behavioral health programs.
Respectfully submitted,
HELEN N. ROBBINS-MEYER
Chief Administrative Officer
ATTACHMENT(S)
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