The County of Santa Clara
California

Agreement/Amendment
67499

Consider recommendations relating to Fiscal Year 2013-2014 Contract Amendment for substance use disorder services with State Alcohol and Drug Programs (ADP) and State Department of Health Care Services (DHCS).

Information

Department:Department of Alcohol and Drug ServicesSponsors:
Category:Agreement

Attachments

  1. NNA Contract Amendment Letter
  2. Third Amendment to NNA Contract
  3. Second Amendment for NNA Contract
  4. First Amendment to NNA Contract
  5. NNA Contract
  6. F85 (This file has not yet been converted to a viewable format)
  7. Revised F-85

Multiple Recommendations

Possible action:
a. Approve Appropriation Modification No. 182 - $11,131 decreasing revenue and expenditures in the Department of Alcohol and Drug Services budget. (Roll Call Vote)
b. Approve Third Amendment to Agreement with ADP as the primary State agency and DHCS as the secondary State agency relating to providing prevention and substance use treatment services increasing the maximum contract amount by $13,022,325 from $41,642,757 to $54,665,082, and extending the term for a 12-month period through June 30, 2014, that has been reviewed and approved by County Counsel as to form and legality.

Body

FISCAL IMPLICATIONS

On April 8, 2010, ADP issued a multi-year Combined Negotiated Net Amount/Drug Medi-Cal (NNA/DMC) contract to the County for FY 2011 through FY 2013 to be effective July 1, 2010 and ending June 30, 2013. In FY 2012-13, the NNA/DMC contract is now known as the Agreement for Substance Use Disorder (SUD) Services. On May 3, 2013, ADP issued a contract amendment to the Agreement for SUD Services to reflect the following: (1) extend the contract period to end June 30, 2014; (2) decrease contract amount for FY 2013; (3) add new funding for FY 2014; and (4) implements a Contingency Assignment of Agreement from ADP to DHCS if the FY 2014 Budget Act is enacted to eliminate the ADP and transfer of the “Non Drug Medi-Cal” Program to DHCS with regard to the “Non Drug Medi-Cal” program portions of this agreement.

The amounts for the multi-year contract are shown in the table below.

Year

Fiscal Year

Amount

1

2010/2011

$15,603,969

2

2011/2012

$12,862,773

3

2012/2013

$13,099,170

4

2013/2014

$13,099,170

Total

 

$54,665,082

Related to the transfer of the Non Drug Medi-Cal Program to DHCS, this change was the transfer of Drug Medi-Cal (DMC) functions and associated staff from ADP to DHCS.  Secondly was the establishment of the local Behavioral Health Trust fund that moved State funds into a county realignment sub-account that includes funds for the Mental Health Department. This transmittal will formally recognize the organization changes reflected in AB 1474.

CONTRACT HISTORY

ADP established the NNA/DMC contract in FY1995. The Board approved the first year of the NNA/DMC contract in December 1994. The intent of the NNA/DMC multi-year contract was to provide a three-year contract to counties in subsequent years. The contract amendment reflects a change from NNA/DMC to SUD Services for FY2013-14.

The SUD Services portion of the Agreement is performance-based that means reimbursement of state and federal funds are based on the provision of negotiated units of service. Services provided under this contract include support, prevention, non-residential, residential, narcotic treatment, and ancillary services.

The Drug Medi-Cal portion of the Agreement makes available substance abuse treatment services to Medi-Cal beneficiaries. The DMC Agreement represents an allocation of State General Fund for match and projected Federal Drug Medi-Cal and is required to be able to receive federal Medicaid reimbursement. Services covered under this contract include non-residential and narcotic treatment services.

REASONS FOR RECOMMENDATION

The multi-year NNA/DMC contract must be executed and returned to ADP by close of business on June 14, 2013, to ensure continuous funding of State and Federal funding and to receive Federal DMC reimbursement. Until this contract is executed, the County will not receive funding for the NNA/DMC reimbursable services.

The Department of Alcohol and Drug Services would like to recognize the following changes in the FY2013 and FY 2014 budget:

Type

Amount

Substance Abuse Prevention and Treatment (SAPT) Discretionary             

($17,641)

SAPT Adolescent Treatment

$98

SAPT Prevention Set-Aside

($8,431)

SAPT HIV Set-Aside

$33,057

Federal Regular DMC

($22,497)

Federal Perinatal DMC

$4,283

Total             

($11,131)

ADP is requesting that each of the three original amendments to be signed by the County and returned to ADP to execute the amendment.  This is a non-standard process for the County.

CHILD IMPACT

The recommended action will have no/neutral impact on children and youth.

SENIOR IMPACT

The recommended action will have no/neutral impact on seniors.

SUSTAINABILITY IMPLICATIONS

The recommended action will have no/neutral impact on sustainability.

BACKGROUND

The Governor proposed elimination of ADP on July1, 2012, as part of his final budget recommendation.  This was put on hold for one year after the Legislature approved and the Governor signed a budget trailer bill requiring a detailed plan for reorganization and transfer of administrative and programmatic functions from ADP to DHCS. The Legislature’s intent in AB 1474 (Section 81) was to transfer ADP’s functions to other departments effective July 1, 2013, and required the California Health and Human Services Agency (CHHS) in consultation with stakeholders and affected departments to provide a plan that ensure the transfer achieves the following goals:

·        Improve access to alcohol and drug treatment services for consumers, including a focus on recovery and rehabilitative services,

·        Effectively integrate the implementation and financing of services,

·        Ensure appropriate state and county accountability through oversight and outcome measure strategies,

·        Provide focused, high-level leadership within state government for alcohol and drug treatment services.

ADP annually allocates funding to counties for substance abuse prevention, treatment and recovery services through the management of the following funding sources, and this funding is included in the FY 2013-14 SUD Services contract amendment.

These funding sources are described below:

Parolee Services Network – Implemented in FY1991-92, PSN provides community treatment and recovery services to parolees in six Bay Area counties. Funded by the California State Department of Corrections (CDC), the counties work through an Interagency Agreement with ADP’s Parolee Services Network.

SAPT Federal Block Grant Funds – Block Grant funds are used for a wide range of activities to prevent and treat substance abuse and dealing with the abuse of alcohol, the use or abuse of illicit drugs, the abuse of licit drugs, and the use or abuse of tobacco products. Federal law requires that at least 20% of the total Block Grant must be expended on prevention services. Federal law also requires that five percent of the Block Grant be expended on HIV Early Intervention services. Any unspent portion of SAPT funds allocated in a given year can be rolled over to the following fiscal year on a one-time basis.

Federal Drug Medi-Cal Funds – Services covered under DMC include outpatient, day treatment and narcotic treatment program (NTP) services, also known as methadone maintenance.

This reimbursement amount of $13,099,170 in the FY 2014 is based on the Governor’s Budget allocation for FY 2014.

CONSEQUENCES OF NEGATIVE ACTION

Failure to approve the recommended actions would result in the loss of enhanced services and revenue to the County.

STEPS FOLLOWING APPROVAL

Obtain the President’s and Clerk’s signatures on each of the three original amendments to the Agreement and forward to DADS to return to ADP.

 

Meeting History

Jun 4, 2013 9:00 AM Video Board of Supervisors Regular Meeting
RESULT:APPROVED [UNANIMOUS]
MOVER:S. Joseph Simitian, Supervisor
SECONDER:Dave Cortese, Supervisor
AYES:Mike Wasserman, Dave Cortese, Ken Yeager, S. Joseph Simitian