Title
Health and Human Services Agency recommending the Board:
1) Make findings in accordance with County Ordinance 3.13.030 that it is appropriate to contract with Granite Wellness Centers for the provision of Drug Medi-Cal Organized Delivery System Services provided under Agreement 5398 because (B) “Specialty skills and qualifications not expressly identified in classifications are involved in the performance of the work;”
2) Approve and authorize the Chair to sign Agreement 5398 with Granite Wellness Centers, for the term of July 1, 2021 through June 30, 2023, with a maximum obligation of $1,644,038; and
3) Authorize the Health and Human Services Agency Director, or designee, contingent upon County Counsel and Risk Management approval, to execute further documents relating to Agreement 5398 including amendments which do not increase the maximum dollar amount or term of the Agreement.
FUNDING: 70% Federal Medi-Cal, 8% State Medi-Cal, 7% 2011 Realignment, and 15% Substance Abuse Prevention and Treatment Block Grant.
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DISCUSSION / BACKGROUND:
The Drug Medi-Cal Organized Delivery System (DMC-ODS) provides a continuum of care modeled after the American Society of Addiction Medicine Criteria for substance use disorder treatment services, enables more local control and accountability, provides greater administrative oversight, creates utilization controls to improve care and efficient use of resources, implements evidenced based practices in substance abuse treatment, and coordinates with other systems of care. This approach provides the beneficiary receiving services with access to the care and system interaction needed in order to achieve sustainable recovery. DMC-ODS and its organized substance use disorder care increases the success of DMC beneficiaries while decreasing other system health care costs.
On May 23, 2017, the Board authorized the County to “opt in” to the Federal 1115 Waiver for a Drug Medi-Cal Organized Delivery System (DMC-ODS). On April 30, 2019, the Board approved Funding Agreement #18-95146 with California Department of Health Care Services, which allowed the County to move forward with the DMC-ODS Waiver plan and begin contracting with Drug Medi-Cal (DMC)-certified service providers. By opting in to participate in this program, the County is obligated to establish sufficient capacity through maintaining "network adequacy" for services in order to meet the needs of the target population. More specifically, in accordance the DMC-ODS funding Agreement, the County must comply with 42 Code of Federal Regulations (CFR) Section 438.207 while maintaining a network of providers that is sufficient in number, mix, and geographic distribution to meet the needs of the anticipated number of beneficiaries in the service area.
Prior to the DMC-ODS, Drug Medi-Cal benefits included:
1) Outpatient services
2) Intensive outpatient services
3) Narcotic Treatment Program services
4) Residential treatment services for perinatal population
Additional benefits available from the DMC-ODS Waiver:
1) Residential Treatment services for eligible Medi-Cal beneficiaries of all ages with multiple levels of care.
2) Withdrawal Management services.
3) Recovery Services, Case Management, Physician Consultation, Additional Medication-Assisted Treatment, and Partial Hospitalization.
HHSA initiated Request for Qualifications (RFQ) 19-918-004, which closed on March 26, 2021, to ensure standardized service agreements for DMC-ODS providers that meet the requirements of the DMC-ODS funding and to meet network adequacy requirements. This proposed Agreement with Granite Wellness Centers is a renewal of Agreement #4341 approved by the Board on July 23, 2019 (File 19-0811, Item 14) to provide residential and outpatient services to El Dorado County beneficiaries. The proposed Agreement would ensure compliance with all Federal and State requirements and will continue to uphold parameters such as consistency in service delivery expectations, performance measures and outcomes, productivity, and funding.
ALTERNATIVES:
Should the Board decline to approve this Agreement, HHSA would be out of compliance with the Intergovernmental Funding Agreement for DMC-ODS services.
PRIOR BOARD ACTION:
1) 05/23/17, 17-0525, Approved participation in the DMC-ODS Waiver plan.
2) 04/30/19, 19-0525, Approved DMC-ODS Interdepartmental Funding Agreement
3) 07/23/19, 19-0811, Approved Agreement #4341
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, and Risk Management.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
Federal Medi-Cal with matched funding from 2011 Behavioral Health Realignment and State General Fund for Residential and Outpatient Intensive Treatment services for the expanded population, and Substance Abuse Prevention and Treatment Block Grant (SABG) for Recovery Residences and Room and Board. Sufficient appropriations were included in the Fiscal Year 2021-22 budget, and will be included in future budgets for the term of the Agreement. HHSA has confirmed appropriate internal controls are in place to ensure Medi-Cal revenues are realized in order to prevent additional pressures on the Behavioral Health budget.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) original Agreements to Agreement for Services #5398; and
2) Clerk of the Board to return one (1) fully executed Agreement to HHSA Contracts Unit at 3057 Briw Rd, Suite B.
STRATEGIC PLAN COMPONENT:
Goal #1: “Public Safety: Protects the community, prevents crime, enforces the law, administers justice, provides rehabilitative services, and promptly responds to emergency and calls for service.”
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