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Approve a contract with Hilltop Recovery Services to provide residential substance use disorder treatment services from February 1, 2019 to June 30, 2020, equal to the aggregate dollar value of the Service Authorization Letters to be executed between Solano County and Hilltop within budgeted appropriations; Delegate authority to the County Administrator to execute contract amendments that are within budgeted appropriations; and Authorize the Director of Health and Social Services to execute any amendments which are technical or administrative in nature and have no fiscal impact.
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Published Notice Required? Yes ___ No X
Public Hearing Required? Yes ___ No X
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS) recommends that the Board of Supervisors approve a contract with Hilltop Recovery Services to provide residential substance use disorder treatment services from February 1, 2019 to June 30, 2020, equal to the aggregate dollar value of the Service Authorization Letters to be executed between Solano County and Hilltop within budgeted appropriations; Delegate authority to the County Administrator, to execute contract amendments that are within budgeted appropriations; and Authorize the Director of Health and Social Services to execute any amendments which are technical or administrative in nature and have no fiscal impact.
SUMMARY:
H&SS budgets annually for 36 residential substance use disorder treatment beds per day across several providers that are located both in and out of Solano County. In the past few months, H&SS has been unable to place clients at several residential providers because other counties are paying much higher bed per day rates, more than twice Solano’s daily rate. In order to maintain the needed number of treatment beds, H&SS has sought out other qualified contractors in the Bay Area. This contract with Hilltop Recovery Services gives the County access to a provider with a day rate similar to what Solano currently pays and helps to solve the shortage and will help relieve the waiting list for residential drug treatment.
DISCUSSION:
In 2017 H&SS issued a Request for Qualifications (RFQ) to acquire residential, detox, and outpatient treatment services for substance use disorders. Two of the successful residential bidders were in Contra Costa County. Those providers were selected on the basis of their proposals and have a long-term history of providing services to Solano County. However, Contra Costa County has recently opted into the Drug Medi-Cal waiver program which enables Contra Costa to draw down federal funds for this service and pay a much higher day rate ($240/day) for residential services, whereas last year Solano increased the daily rate to $100/day.
The bed availability problem is further exacerbated by the fact that counties bordering Solano have all begun operation under the Drug Medi-Cal waiver, where the higher rate and higher local utilization result in less availability for Solano referrals. The Department of Probation refers individuals to residential care under H&SS contracts. Hilltop Recovery Services is located in Lake County which currently has not opted into the Drug Medi-Cal waiver. Upon visiting the facility, H&SS staff believed the quality of the program to be strong. The Behavioral Health Division of H&SS has contracted with this provider for the last few years.
FINANCIAL IMPACT:
Costs associated with this contract are included in the FY2019/20 budget. Substance Abuse Block Grant (SABG) and 2011 Realignment will provide funding for the agreement. The costs associated with preparing the agenda item are nominal and absorbed by the department’s FY2018/19 Adopted Budget.
ALTERNATIVES:
The Board could choose not to approve the contract. This is not recommended because it will reduce the number of treatment beds available to county residents who need substance use disorder treatment.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed the contract for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION