The County has renewed a contract with a private firm to provide medial treatment for people addicted to opioids approving a new, 3-year pact that projected to be a moneymaker for the County.
County Supervisors on July 7 were asked by Director of Behavioral Health, Dana McEwen, to retroactively approve a contract with Aegis Treatment Centers, LLC, to continue to provide drug addiction care under the State’s “Drug Medi-Cal Organized Delivery System” or DMC-ODS program through the 2028-29 fiscal year. Contract costs are $4.02 million per year.
The treatment program is run under the California Department of Health Care Services, with County Behavioral Health acting as the administrator and Aegis delivering actual services under the “Narcotics Treatment Program” or NTP.
SLO County “contracted Narcotic Treatment Program provider and delivers the required component of DMC-ODS continuum of care,” reads McEwen’s report. “The current contract with Aegis expired on June 30, 2026.
The County’s renewal contract was still being finalized, McEwen said, but the State said to go ahead and renew contracts and it would allow the reimbursements to be applied retroactively.
Aegis runs two drug treatment clinics in SLO County and a third in Santa Maria. Though the Southern Border is now mostly closed, and smuggling of illegal drugs like heroin, fentanyl and methamphetamine have slowed considerably, SLO County continues to have a drug problem.
“San Luis Obispo County continues to experience the impacts of the opioid epidemic,” the report said, “making access to evidence-based treatment for opioid use disorder a critical component of the County’s behavioral health system.
“Aegis provides outpatient medication-assisted treatment, including methadone and buprenorphine, drug testing, and individual and group counseling at licensed treatment centers in Atascadero, San Luis Obispo, and Santa Maria.
“Aegis also coordinates with the County’s Drug and Alcohol Services Division and County Jail to support continuity of care for individuals entering and leaving custody.”
The County needs to continue this contract to help people who seek to break their addictions. “Medication-assisted treatment [MAT] provided through Aegis improves access to outpatient substance use disorder treatment, promotes long-term recovery, and reduces the risk of overdose while helping individuals remain engaged in care.
“The partnership also strengthens coordination across the behavioral health continuum by supporting collaboration between community providers, Drug and Alcohol Services, and the County Jail to ensure continuity of treatment during transitions into and out of custody.”
The contract and this treatment program are also called for in the Department of Behavioral Health’s 2024-2029 Strategic Plan.
“Maintaining these services supports the Strategic Plan’s vision of expanding access to high-quality behavioral health care, strengthening community partnerships, and improving health outcomes for San Luis Obispo County residents.”
McEwen said the State’s reimbursements will likely cover the entirety of the contract and not require the County to pay into it, as has been needed in the past.
In a chart included in the report, Aegis charged $2.5 million in FY 2023-24; $3.186M in 2024-25; and is projected to bill $3.6M in 2026-27.
Under revenues, the County lists $2.14M from Medi-Cal for 2023-24 with the County putting in an additional $496,000. For FY 2024-25 Medi-Cal’s portion was $3.66M and the County’s $519,000l and in FY 2025-26 Medi-Cal’s part is projected at $3.72M and the County’s share is zero.
With the new contract, the County is being projected to make money from the program. For FYs 2025-26 through 2028-29 revenue from Medi-Cal is listed as $4.72M but expenses are $4.02M giving the County $704,000 extra each year.
“Approval of this contract,” the report said, “will not increase the level of General Fund support required by the Department of Behavioral Health. Projected DMC revenue associated with these services is expected to exceed contract expenditure, resulting in a positive net fiscal impact to the County.”
Aegis’ program works fairly well in some regards, but not so good in others.
“Aegis has the capacity to assist 325 eligible Medi-Cal beneficiaries at a given time,” McEwen’s report said, “with an average enrollment of 236 patients per month since the beginning of 2020. Aegis’ attrition (drop-out rate) was 9%, which met the target of achieving no more than 20% attrition.”
The numbers aren’t as good when it comes to relapses. “Aegis’ opiate relapse rate was 17.11%, which did not meet the 15% target.” But whether or not someone relapses into drug use varies for several reasons.
“Targets on relapse rate may not be met each year for a variety of complex reasons,” McEwen said, “including the retention of the clients may affect the relapse rates as clients are more likely to relapse in the first 90 days, so if the program has admitted an unusual high rate of new clients, which is a good thing, the relapse rate may be higher.
“Relapse rates can also depend upon the drug testing procedures, the frequency of drug testing, and the regular and consistent attendance of the clients.”
The new contract includes some performance goals to improve success rates.
“Performance measures in this renewal contract,” the report said, “require Aegis to strive to continue to improve these rates by at least one percentage point annually:
• Attrition: Aegis attrition rate (drop-out rate) shall be no more than 20% among patients during the first 90 days of treatment.
• Relapse Rate: Aegis illicit opiate relapse rate shall be no more than 15% (excluding the first 90 days of treatment) and no more than 25% for all illicit drug relapse rates.”
Aegis runs drug treatment clinics throughout California and is a division of Pinnacle Treatment Centers, a nationwide drug treatment company.
If readers need help fighting an opioid addiction the Aegis Center in SLO is at 1551 Bishop St., Suite 520. Call 805-208-3300. In Atascadero they’re at 6500 Morro Rd., Suites C & O. Call 805-461-5212.
