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Health and Human Services Agency recommending the Board:
1) Approve and authorize the Purchasing Agent to sign Agreement for Services 3792 with C.O.R.E. Medical Clinic, Inc., for the provision of Drug Medi-Cal Organized Delivery System (DMC-ODS), Narcotic Treatment Program (NTP) services in the amount of $69,877, with an effective date retroactive to April 1, 2019, through December 31, 2020;
2) Find in accordance with County Ordinance Section 3.13.030 it is more economical and feasible to engage an independent contractor for DMC-ODS and NTP services; and
3) Authorize the Purchasing Agent, or designee, to execute further documents relating to Agreement for Services 3792, including amendments which do not increase the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management. (Est. Time: 5 Min.)
FUNDING: 47% Federal, 11% State, 26% Realignment, 16% Other, and 0% General Fund. Medi-Cal (including Federal Financial Participation and State funding); and Behavioral Health Realignment.
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DISCUSSION / BACKGROUND
On July 28, 2017, the California Department of Health Care Services (DHCS) released Mental Health Substance Use Disorder Services (MHSUDS) Information Notice (IN) No. 17-036 which obligates all Counties to provide Drug Medi-Cal (DMC) State Plan services to all beneficiaries who reside in that county per Section 2: Covered Services of Exhibit A, Attachment 1 of the “State/County” DMC contract and Government Code 30026.5 (e)(5). The Information Notice clarified that Counties are expected to establish contractual arrangements to ensure that the county of residence is financially responsible to pay for any DMC entitlement services being provided to its residents by another county. Historically, pursuant to HHSA’s current Agreement #220-F1811 with DHCS, HHSA’s clients receiving narcotic treatment program (NTP) services were only available in neighboring counties of Sacramento or Placer and were paid for by those counties.
However, according to IN 17-036, El Dorado County became the county of responsibility for those non-Federal Financial Participation (the Federal portion of Medicaid) costs starting in fiscal year 2016-17.
In January 2019, HHSA began processing the documents to develop an agreement with the service provider. The start date of this agreement is retroactive to April 1, 2019, a date identified by the service provider as the date they began to incur NTP costs for El Dorado County residents.
NTP services provide outpatient medication assisted treatment and patient-centered substance abuse counseling. Treatment is provided by physicians, clinic and caseload managers and counselors, medical assistants, nurse practitioners, physician assistants, vocational nurses and psychiatric technicians.
C.O.R.E. Medical Clinic, Inc. has the necessary expertise to provide NTP services, and since the need for services in any given fiscal year is difficult to anticipate, HHSA plans to contract with multiple vendors in order to provide sufficient availability of NTP services.
ALTERNATIVES
Disapproval of Agreement for Services #3792 will limit HHSA’s ability to provide narcotic treatment services, place HHSA out of compliance with State regulations, and may disrupt continuity of care for clients currently receiving services.
PRIOR BOARD ACTION
Similar agreements dealing with Information Notice No. 17-036.
1) 10/09/19, 18-1348, BAART Behavior Health Services #3320
2) 10/09/18, 18-1210, MedMark Treatment Centers #3284
3) 07/17/18, 18-0233, HHSA Aegis Treatment Center #2454
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
CAO RECOMMENDATION
It is recommended that the Board approve this item.
FINANCIAL IMPACT
There is no Net County Cost associated with this Agenda item. Sufficient appropriations have been included in the Fiscal Year 2018-19 budget, and will be included in future budgets for the term of the Agreement. The Behavioral Health Department has significant savings as a result of staff vacancies; therefore, those savings will be used to fund this Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Obtain signature of Purchasing Agent on two (2) originals of Agreement for Services #3792.
2) Forward one (1) fully executed document of the Agreement to HHSA-Contracts Unit, 3057 Briw Road, Placerville for further processing.
STRATEGIC PLAN COMPONENT
County strategic plan goal #5 - Healthy Communities - “Improved health, well-being, and self-sufficiency of El Dorado County communities, residents, and visitors.”
CONTACT
Don Semon, Director, Health and Human Services Agency