Title
Health and Human Services Agency, Mental Health Division, recommending the Board consider the following:
1) Approve and authorize the Chair to sign retroactive revenue Agreement 284-F1511 (DHCS 14-90055) with the California Department of Health Care Services, for the provision of alcohol and drug counseling services with a term that began July 1, 2014 through June 30, 2017, in the amount of $3,845,280;
2) Approve and authorize the Chief Administrative Officer, or their designee, to execute additional documents or amendments related to Agreement 284-F1511 that do not affect the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management; and
3) Approve and authorize the Director of the Health and Human Services Agency, or successor, to continue to administer Agreement 284-F1511 and authorize the Director or the Chief Fiscal Officer to execute any required fiscal and programmatic reports.
FUNDING: Federal (Substance Abuse Prevention and Treatment Block Grant, and Medicaid), State Behavioral Health Realignment Funds, and State General Fund (Drug Medi-Cal) Funds, administered by the California Department of Health Care Services.
Body
Budget Summary: |
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Total Estimated Cost (3 years)
. |
$3,845,280 |
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Budget: FY 2014-15
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$1,281,760 |
Budget: FY 2015-16
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$1,281,760 |
Budget: FY 2016-17
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$1,281,760 |
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Total Funding Available
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$3,845,280 |
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Change To Net County Cost |
$0 |
Fiscal Impact/Change to Net County Cost
There is no Net County Cost associated with this revenue-generating Agreement. Sufficient appropriations are included in Fiscal Year (FY) 2014-15 and will be included in future budgets for the term of the Agreement.
Background
The mission of the Health and Human Services Agency (HHSA), Mental Health Division, Alcohol and Drug Program (ADP) is to provide an array of evidence-based services designed to prevent and reduce alcoholism and drug addiction. HHSA's Alcohol and Drug Programs accomplish this mission through education, prevention, treatment, and counseling services offered directly through County of El Dorado Mental Health and through contracts with community agencies.
For over 20 years, HHSA has successfully implemented and coordinated the problem solving specialty courts, including the Drug Dependency Court, the Proposition 36 Drug Court, Adult Felony Court, DUI Court, and the Behavioral Health Court. The client completion rates in the problem solving specialty Courts in El Dorado County are higher than the Statewide averages.
Further, HHSA provides evidence-based substance use disorder (SUD) treatment services within the Placerville and South Lake Tahoe jails, and in both Mental Health Outpatient clinics in Placerville and South Lake Tahoe. HHSA has contracts with multiple specialty treatment providers regionally to meet the needs of adults and youth for SUD treatment. HHSA's prevention programs operate in partnership with four well-organized and established Community Drug Free Coalitions in South Lake Tahoe, Georgetown, Placerville, and El Dorado Hills.
Funding for these valuable services has varied over the years; however, since at least 1990, the County of El Dorado's ADP has received State and Federal funding via an agreement with the State of California to provide SUD treatment services and prevention programs. Further, Title 45 of the Code of Federal Regulations Part 96 (45 CRF Part 96), Substance Abuse Prevention and Treatment Block Grants (SAPT) provides the authority for Agreement 284-F1511. Federal funding from the SAPT has included six (6) funding streams, including Adolescent/Youth, Prevention Set-Aside, Friday Night Live/Club Live, HIV Set-Aside, Perinatal, and Discretionary funding streams. County of El Dorado offers all of these direct services.
SUD services provided to Medi-Cal beneficiaries are known as Drug Medi-Cal (DMC), and may be accessed by beneficiaries through treatment providers whom DHCS has certified to provide DMC services. State funding for DMC services was historically provided via the State General Fund. This funding was realigned in the Governor's budget in 2011, and since 2011 it has been provided via State Behavioral Health Realignment funds. A portion of the DMC funding for FY 2014-15 continues to be allocated through Realignment funds.
Passage and implementation of the federal Affordable Care Act (ACA) necessitated a change to the State Medi-Cal plan. The ACA required that health insurance plans be made available to more citizens, mandated that SUD services be included as an essential health benefit on all health insurance plans, and increased the number of Californians eligible to receive Medi-Cal as their health plan. To accommodate this anticipated increase in DMC services, the State has incorporated additional DMC funding from the State General Fund. These funds are intended to be used for expanded services in the form of Intensive Outpatient Treatment service specific to the Medi-Cal population. The HHSA Substance Use Disorder Program is in the process of developing protocols for Intensive Outpatient Treatment services.
The DHCS issued Agreement 284-F1511 on October 14, 2014 with a due date of December 15, 2014. Staff immediately began processing the documents for the Board's review and approval; however, changes in funding required the ADP program to obtain clarification from the State on a variety of modifications prior to submitting the item for Board approval.
Reason for Recommendation
HHSA recommends approval of funding Agreement 284-F1511 for the provision of SUD treatment and prevention services provided through the County's Alcohol and Drug Program. If this funding is not accepted, the County would no longer be able to provide SUD treatment services for those residents in need of assistance. Further, failure to approve this Agreement could jeopardize future funding for these services.
Clerk of the Board Follow Up Actions
1. Clerk of the Board to obtain the Chair's signature on three (3) original Agreement 284-F1511.
2. Clerk of the Board to obtain the Chair's signature on two (2) each of the Contractor Certification Clauses (CCC-307) and Certification Regarding Lobbying.
3. Clerk of the Board to provide two (2) Certified Minute Orders.
2. Clerk of the Board to return all documents to HHSA at 3057 Briw Road, Suite A.
Contact
Don Ashton, M.P.A., Director
Concurrences
County Counsel and Risk Management