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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 Aegis Treatment Centers, LLC for the provision of Drug Medi-Cal Organized Delivery System Services under Agreement 5348 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 for Services 5348 with Aegis Treatment Centers, LLC, for the term of July 1, 2021 through June 30, 2023, with a maximum obligation of $860,000 for the term of the Agreement; 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 for Services 5348, including amendments which do not increase the maximum dollar amount or term of the Agreement.
FUNDING: 70% Federal Medi-Cal, 23% 2011 Behavioral Health Realignment, and 7% State General Fund for Narcotic Treatment Program services.
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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).
On April 30, 2019, the Board approved Funding Agreement 18-95146 with the California Department of Health Care Services (DHCS), 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 to meet the needs of the target population. In accordance with the requirements of the DMC-ODS funding Agreement, the County must comply with 42 Code of Federal Regulations (CFR) Section 438.207 and maintain 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 through DMC-ODS; and
3) Recovery Services, Case Management, Physician Consultation, Additional Medication-Assisted Treatment, and Partial Hospitalization benefits are provided through DMC-ODS.
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 Aegis Treatment Centers, LLC (Aegis) is a renewal of Agreement 4300 approved by the Board on July 23, 2019 (File 19-0811, Item 14) and its Amendment I approved by the Board on April 20, 2021 (File 21-0205, Item 12). The Agreement will continue to provide Narcotic Treatment Program services to El Dorado County beneficiaries. Aegis has the professional staff necessary to disperse medication as part of a narcotic treatment program. The County currently does not have a classification structure that supports the distribution of medication as part of a narcotic treatment program. 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 4300
4) 04/20/21, 21-0205, Approved Amendment I to Agreement 4300
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, and Risk Management. The Auditor-Controller was notified.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
The agreement is funded by Federal Medi-Cal with matched funding from 2011 Behavioral Health Realignment and State General Fund for Narcotic Treatment Program services. 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 5348; 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