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Health and Human Services Agency (HHSA) recommending the Board:
1) Award Request for Proposal 22-952-009 to the proposal identified as appropriate by the evaluation panel, Shamanic Living Center, dba Recovery In Action (RIA), to provide Drug Medi-Cal Organized Delivery System Level 1.0 Outpatient and 2.1 Intensive Outpatient Services for adults in El Dorado County; and
2) Authorize HHSA to negotiate a three (3) year Agreement for Services with RIA, for an estimated budget not to exceed $1,500,000 for the term of the Agreement, for Fiscal Years 2022-23, 2023-24, and 2024-25, and return to the Board for approval of the agreement upon completion of the negotiations.
FUNDING: Federal Medicaid, Federal Substance Abuse Prevention and Treatment Block Grant (SABG), 2011 Realignment Drug Medi-Cal Organized Delivery System (DMC-ODS), State General Fund, and California Assembly Bill (AB) 109 Treatment funds available pursuant to Title XIX of the Social Security Act and Medicaid State Plan.
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DISCUSSION / BACKGROUND:
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) (File ID: 17-0525). Since that time, the Health and Human Services Agency (HHSA) has developed service agreements with providers to provide substance use disorder (SUD) services for County clients in accordance with the terms and conditions of the DMC-ODS agreement between the State and County of El Dorado (County).
The County’s DMC-ODS is a managed care plan as defined under 42 Code of Federal Regulations (CFR) Section 438.2 as a Prepaid Inpatient Health Plan (PIHP). As a PIHP delivering Medicaid services, the County and its network of contracted providers, must adhere to Medi-Cal Managed Care laws and regulations governed by the Center for Medicare & Medicaid Services. These regulations include many requirements designed to ensure that DMC eligible adults and adolescents residing in the County receive h...
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