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Health and Human Services Agency recommending the Board:
1) Approve and authorize the Chair to sign Non-Financial Agreement for Services 4604 with Assurex Health Inc., doing business as (dba) Myriad Neuroscience, for the provision of genetic testing to support medication choices, for a perpetual term that commences upon execution;
2) Approve and authorize the Chair to sign Agreement for Services 4483 with Assurex Health Inc., doing business as (dba) Myriad Neuroscience, for the provision of genetic testing to support medication choices, with a maximum contractual obligation of $100,000, and for a term effective upon execution through June 30, 2023;
3) Make findings in accordance with County Ordinance 3.13.030 that (B) “Specialty skills and qualifications not expressly identified in County classifications are involved in the performance of the work.” Therefore, it is appropriate to contract with Myriad Neuroscience for services provided under these Agreements 4604 and 4483; and
4) Authorize the Purchasing Agent, or designee, to execute further documents relating to Agreement for Services 4604 and 4483, including amendments which do not change the term or increase the maximum dollar amount, and contingent upon approval by County Counsel and Risk Management.
FUNDING: Contract 4604 - Non-Financial. Contract 4483 - 100% Mental Health Services Act Funding.
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DISCUSSION / BACKGROUND:
California voters passed Proposition 63 (MHSA), in November 2004 and MHSA was enacted into law January 1, 2005. MHSA imposes a one percent (1%) tax on personal income above $1,000,000. The funds are distributed to the counties throughout the State and are intended to transform the mental health system into one that is focused on wellness, recovery, and resiliency.
Under MHSA, each county is required to develop a Three-Year Program and Expenditure Plan (Plan), followed by two subsequent years of Annual Updates to the original Plan. The purpose of the Annual Update is to review existing projects and to make deletions, modifications, or additions to the original Plan. Therefore, planning, implementing, and updating each Plan and Annual Update is an ongoing, annual process.
On June 9, 2020 the Board adopted and authorized implementation of the MHSA Fiscal Year (FY) 2020-21 through FY 2022-23 Three-Year Program and Expenditure Plan (MHSA Plan, File 20-0446, Item #55).
The MHSA Plan includes a program in the Community Services and Support (CSS) component, for the provision of pharmacogenomics testing to provide insight into an individual’s possible drug response to certain psychiatric medications for more appropriate drug prescribing and dosing. The contractor chosen to provide this service is Assurex Health, Inc., dba Myriad Neuroscience (Myriad), whose trademarked test is called GeneSight.
Agreement 4604 for the GeneSight test is specifically designated for mental health clients who have Medi-Cal insurance. Myriad will bill Medi-Cal for the Medi-Cal covered testing services and will not bill the County. This is a perpetual contract that allows the County psychiatry team members to refer clients for GeneSight testing.
Agreement 4483 for the GeneSight test is designated for mental health clients that do not have Medi-Cal insurance, for whom GeneSight testing is not a covered benefit, or for whom GeneSight testing would require an out-of-pocket cost. Myriad will bill the County for the testing services, which will be paid for with MHSA funding. This Agreement will expire on June 30, 2023.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA will be unable to provide this innovative and effective service to its mental health clients, and will be out of compliance with the MHSA Plan.
PRIOR BOARD ACTION:
06/09/20, 20-0446, HHSA Mental Health Services Act Plan FY 2020/21 - 2022/23
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, and Risk Management.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
As a non-financial agreement, there is no cost associated with Agreement 4604. Additionally there is no Net County Cost associated with Agreement 4483, as this is fully paid for with MHSA funding; sufficient appropriations have been included in the Fiscal Year 2020-21 budget and will be included in future budgets for the duration of this Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) original Agreements for Services 4604, and two original Agreements for Services 4483.
2) Clerk of the Board to return two (2) fully executed Agreements, one for 4604 and the other for 4483, to the HHSA Contract Unit at 3057 Briw Rd.
STRATEGIC PLAN COMPONENT:
County of El Dorado Strategic Plan Project - Healthy Communities; Improved health, well-being, and self-sufficiency of El Dorado County communities, residents, and visitors.
CONTACT
Don Semon, Director