Download Resolution - Napa County

RESOLUTION NO. 2017-36
A RESOLUTION OF THE BOARD OF SUPERVISORS OF NAPA COUNTY,
STATE OF CALIFORNIA, TO INCREASE, DECREASE AND ESTABLISH
NEW FEES FOR SERVICES PROVIDED BY THE COUNTY’S ALCOHOL
AND DRUG SERVICES DEPARTMENT
WHEREAS, there is a need to increase, decrease and establish new fees charged by Napa
County to recover the costs of services provided by the Alcohol and Drug Services Department; and
WHEREAS, Chapter 12.5 of Part 1 of Division 2 of Title 5 of the California Government Code
(commencing with Section 54985) and Chapter 8 of Division 1 of Title 7 of the California Government
Code (commencing with section 66016) authorize the County to establish and increase fees to recover
the reasonable cost of providing services; and
WHEREAS, Section 96.137 (a)(2) of Title 45 of the Code of Federal Regulations (45 CFR
96.137(a)(2)) requires that entities that receive federal Substance Abuse Prevention and Treatment
(SAPT) block grant funding secure from patients or clients payments for services in accordance with
their ability to pay; and
WHEREAS, California Health and Safety Code section 11852.5 requires that charges be
established for the care and treatment of each client receiving service under a county plan, negotiated
net amount contract, and Drug Medi-Cal contract; and
WHEREAS, at least fourteen days prior to the date this resolution is to be considered, notice
was mailed to those persons who had requested same; and
WHEREAS, at least ten days prior to the date this resolution is to be considered, data was
made available to the public indicating the amount of cost, or estimated cost, required to provide the
service for which the fee or service charge is levied and the revenue sources anticipated to provide the
service, including general fund revenues; and
WHEREAS, notice of the hearing of the proposed fees was published twice in the manner set
forth in section 6062a as required by section 66018, subdivision (a), of the Government Code; and
NOW, THEREFORE, BE IT RESOLVED by the Board of Supervisors of Napa County as
follows:
1.
The Board hereby increases those fees shown on Exhibit “A”, attached hereto and incorporated
by reference herein.
2.
The Board hereby directs the Clerk of the Board of Supervisors of the County of Napa to
incorporate the changes presented in Exhibit A into Section III, Part 120.300 of the Napa
County Policy Manual, “Fees for Services Provided by County Departments and Agencies.”
3.
The Board finds this Resolution is statutorily exempt from the California Environmental
Quality Act pursuant to Title 14, California Code of Regulations, section 15273(a)(1) and (2) in
that the proposed fees are for the purpose, and do not exceed the reasonable cost to the County,
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of operating expenses and/or the purchasing of supplies, equipment and materials to provide the
services and supplies noted.
4.
The increase of fees authorized by this Resolution shall become effective upon adoption.
THE FOREGOING RESOLUTION WAS DULY AND REGULARLY ADOPTED by the
Board of Supervisors of the County of Napa, State of California, at a regular meeting of said Board
held on the 28th day of February, 2017, by the following vote:
AYES:
SUPERVISORS
WAGENKNECHT, GREGORY, RAMOS
and PEDROZA
NOES:
SUPERVISORS
NONE
ABSTAIN:
SUPERVISORS
NONE
ABSENT:
SUPERVISORS
DILLON
NAPA COUNTY, a political subdivision of the
State of California
By: ________________________________________
ALFREDO PEDROZA, Chair of the
Board of Supervisors
APPROVED AS TO FORM
Office of County Counsel
APPROVED BY THE NAPA COUNTY
BOARD OF SUPERVISORS
By: Dylan Roy
Deputy County Counsel
Date: February 28, 2017
Processed By:
Date: January 27, 2017
_______________________________
Deputy Clerk of the Board
DOCS/HHS/ALC & DRUGS/ADSClientFeeResolutio2017.doc
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ATTEST: GLADYS I. COIL
Clerk of the Board of Supervisors
By: ___________________________
EXHIBIT A
Alcohol and Drug Services Fees. The fees for alcohol and drug services are as follows:
Service Types
Current Rates
Description
$116.00 per
50-minute session
A face-to-face contact between a therapist or counselor and a beneficiary
in crisis. Services shall focus on alleviating crisis problems. “Crisis”
means an actual relapse or unforeseen event or circumstance, which
presents to the beneficiary an imminent threat of relapse. Crisis
Intervention services shall be limited to the stabilization of the
beneficiary’s emergency situation.
Individual Intake/Assessment
$116.00 per
50-minute session
A face-to-face contact between a beneficiary and therapist or counselor..
The process of admitting a beneficiary into a substance abuse treatment
program. Includes the evaluation or analysis of cause or nature of mental,
emotional, psychological, behavioral, and substance abuse disorders; the
diagnosis of substance abuse disorders, utilizing the DSM-IV; and the
assessment of treatment needs to provide medically necessary treatment
services by a physician licensed to practice medicine in the State of
California. Intake may include a physical examination and laboratory
testing (e.g., body specimen screening) necessary for substance abuse
treatment and evaluation conducted by staff lawfully authorized to provide
such services and/or order laboratory testing within the scope of their
practice or licensure.
Individual –
Treatment Planning
$ 116.00 per
50-minute session
Individual –
Crisis Intervention
Collaborative session between program staff and beneficiary to identify
problems, goals, action steps and target dates.
$116.00 per 50-minute
session
A face-to-face contact between beneficiary and therapist or counselor
to therapeutically address behavioral manifestations of a client's
ambivalence about change and/or enhance a client's motivation for
change and /or addressing beneficiaries need for mental health or
physical health
Individual –
Collateral Services
$116.00 per
50-minute session
Face-to-face sessions with therapists or counselors and significant
persons in the life of a beneficiary, focusing on the treatment needs of the
beneficiary in terms of supporting the achievement of the beneficiary’s
treatment goals. Significant persons are individuals who have a personal,
not professional or official, relationship with the beneficiary.
Individual –
Discharge Planning
$116.00 per
50-minute session
Face-to-face final collaborative session between program staff and
beneficiary to reinforce newly developed recovery skills and to develop a
plan to maintain those skills upon conclusion of treatment.
$34.74 per
90-minute session
Face-to-face contact in which one or more therapists or counselors treat
two or more clients at the same time, focusing on the needs of the
individuals served. Sessions shall focus on short-term personal, family,
job/school, and other problems and their relationship to substance abuse
or a return to substance abuse. Each beneficiary shall receive at least
two sessions per month.
Group – Early Recovery
$34.74 per 90-minute
session
Face-to-face contact in which one or more therapists or counselors treat
two or more clients at the same time focusing on the needs of the
individuals served. Sessions shall focus on teaching clients cognitive
tools for managing cravings and emphasize time management, and the
groups assist clients in connecting with community support services.
Group – Education
$34.74 per 90-minute
session
Face-to-face group sessions designed to educate participants on the
impact of drug and alcohol abuse on their health, wellbeing, relationships,
and community resources available to address these effects with the goal
of decreasing risk and reducing harm.
Individual
Counseling
Group Counseling
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Group – Criminal
Thinking
$34.74 per 90-minute
session
Case Management
$108.00 per 50-minute
session
Family Counseling
Services
$116.00 per 50-minute
session
Urinalysis Testing
$23.20 per 10-minute
session
Recovery Services
$129.60 per hour
Face-to-face contact in which one or more therapists or counselors
provide group services to two or more beneficiaries at the same time.
Outpatient treatment group for clients involved in the Criminal Justice
System that incorporates and addresses the client’s criminogenic needs.
This group focuses on the connection between addiction and criminal
behavior.
Face-to-face, telephone or telehealth contact in which one or more
therapists or counselors or case managers provide individuals with
linkage, referral and service coordination with other agencies and/ or
community resources that help address issues that could be barriers to
the client’s ability to sustain ongoing recovery. Case Management
services may be provided anywhere in the community. Services can
include:
A. Comprehensive assessment and periodic reassessment of
individual needs to determine the need for continuation of case
management services;
B. Transition to a higher or lower level SUD of care;
C. Development and periodic revision of a client plan that included
service activities;
D. Communication, coordination, referral and related activities;
E. Monitoring service delivery to ensure beneficiary access to service
and the service delivery system;
F. Monitoring the beneficiary’s progress;
G. Patient advocacy, linkages to physical and mental health care,
transportation and retention in primary care services
Only the Family Unit or Significant Other will participate, not the member,
The session(s) will focus on understanding the roles a family plays in the
addicts life, understanding the elements of enabling, establishing
strategies of how to work with the addict and referrals to supportive
services, such as Ala-non.
Face-to-face contact in which one or more therapists or counselors or
case managers do urine collection, testing and recording of results of
urine drug screens, as a part of treatment. Brief contact with the
beneficiary may take place, as positive test results are disclosed. **A
therapeutic intervention may take place and be coded/documented as a
separate individual contact.
Beneficiaries may access recovery services after completing their
course of treatment whether they are triggered, have relapsed or as a
preventative measure to prevent relapse. Recovery services may be
provided face-to-face, by telephone, or by telehealth with the
beneficiary and may be provided anywhere in the community. The
components of Recovery Services are:
A. Outpatient counseling services in the form of individual or group
counseling to stabilize the beneficiary and then reassess if the
beneficiary needs further care;
B. Recovery Monitoring: Recovery coaching, monitoring via
telephone and internet;
C. Substance Abuse Assistance: Peer-to-peer services and relapse
prevention;
D. Education and Job Skills: Linkages to life skills, employment
services, job training, and education services;
E. Family Support: Linkages to childcare, parent education, child
development support services, family/marriage education;
F. Support Groups: Linkages to self-help and support, spiritual and
faith-based support;
G. Ancillary Services: Linkages to housing assistance, transportation,
case management, individual services coordination.
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Physician Consulting
$130.00 per hour
Medication Assisted
Treatment
$130.00 per hour
Withdraw-Management
Level 1
Withdraw-Management
Level 3.2
Residential Level 3.1
Physician consultations services are not with the DMC-ODS
beneficiaries; rather, they are designed to assist the Medical Director
when seeking expert advice on complex client cases and designing
the treatment plan in such areas as: medication selection, dosing, side
effect management, adherence, drug interactions, or level of care
considerations.
Beneficiaries meeting medical necessity through an identified
diagnosis for opiate and/or alcohol dependence. Includes the ordering,
prescribing, administering and monitoring of all medications.
(Medications to be included in the services will be Buprenorphine
(Suboxone), Vivitrol and Disulfiram)
$194.40 per day
Ambulatory withdrawal management without extended on-site
monitoring. Beneficiaries may have mild withdrawal with daily or less
than daily outpatient supervision. Medically necessary services will be
provided with an individualized treatment plan prescribed by a
licensed physician or LPHA. Supportive services to include:
A. Availability of specialized psychological and supervision for
biomedical, emotional, behavioral, and cognitive problems as
indicated
B. Obtain a comprehensive medical history and physical examination
of the patient at admission
C. Affiliation with other levels of care, including other levels of
specialty addiction treatment, for additional problems identified
through a comprehensive biopsychosocial assessment
D. Conduct and/or arrange for appropriate laboratory and toxicology
tests, which can be point-of-care testing
E. 24-hour access to emergency medical consultation services should
such services become indicated
F. Provide or assist in accessing transportation services for patients
who lack safe transportation
$243.00 per day
Beneficiaries have moderate withdrawal and need 24-hour support to
complete withdrawal management and increase likelihood of
continuing treatment or recovery. Supportive services to include:
A. Availability of specialized clinical consultation and supervision for
bio-medical, emotional, behavioral, and cognitive problems
B. WM 3.2 is managed by clinicians, not medical or nursing staff and
protocols are in place should a patient’s condition deteriorate and
appear to need medical or nursing interventions
C. Affiliation with others levels of care
D. Ability to arrange for appropriate laboratory and toxicology tests
$130.00 per day
Clinically Managed Low-Intensity Residential Services with 24-hour
structure offering at least 5 hours of clinical services weekly while
preparing for outpatient treatment.
The treatment servers are focused on improving the individual’s
readiness to change and/or functioning and coping skills. Services
may include individual, group, and family therapy; medication
management and medication education; mental health evaluation and
treatment; vocational rehabilitation and job placement; and either
introductory or remedial life skills workshops.
The structured recovery residence environment provides sufficient
stability to prevent or minimize relapse or continued use and continue
problem potential. Interpersonal and group living skills generally are
promoted through the use of community or house meetings of
residents and staff.
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Residential Level 3.5
$162.50 per day
Clinically Managed High-Intensity Residential Services with 24-hour
support to complete withdrawal management and increase likelihood
of continuing treatment or recovery. Goals of treatment are to
promote abstinence of substance use, arrest, and other addictive
and/or antisocial behaviors, and effect change in participants;
lifestyles, attitudes and values. Focus is on stabilization of dangerous
addiction signs and symptoms, initiation or restoration of a recovery
process and preparation for ongoing recovery. Necessary support
systems include:
1. Telephone or in-person consolation with a physician and
emergency services availability 24/7.
2. Direct affiliations with other levels of care or close coordination
through referral to more and less intensive levels
3. Arranged medical, psychiatric, psychological, laboratory, and
toxicology services, as appropriate to the severity and urgency of the
patient’s condition.
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