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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings that the provision of Drug Medi-Cal Organized Delivery System services provided by Shamanic Living Center, Inc., doing business as Recovery In Action, are in the public’s best interest and that there are specialty skills and qualifications not expressly identified in classifications involved in the performance of the work in accordance with El Dorado County Ordinance Code 3.13.030(B), Chapter 3.13.030(B), El Dorado County Charter Section 210(b)(6), and/or Government Code Section 31000;
2) Approve and authorize the Chair to sign Agreement for Services 6527 with Shamanic Living Center, Inc., doing business as Recovery In Action, with a not-to-exceed amount of $235,000, and for the term of one (1) year, effective upon execution through June 30, 2023; and
3) Authorize the HHSA Director or Behavioral Health Director to execute further documents relating to Agreement 6527, contingent upon approval by County Counsel and Risk Management, including amendments which do not increase the maximum dollar amount or term of the Agreement.
FUNDING: 74% Drug Medi-Cal with Federal Financial Participation and Behavioral Health or Child Welfare Services Realignment, 13% Substance Abuse Prevention and Treatment Block Grant (SABG), and 13% Public Safety Realignment (AB109) Funding.
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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 high quality services without barriers to access.
In adherence with the DMC-ODS Agreement, the County is required to develop 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. Outpatient treatment services are intended to treat clients experiencing alcohol and/or drug use disorders by helping them: Reduce substance abuse usage and/or achieve a substance-free life; Maximize multiple aspects of life functioning; Prevent or reduce the frequency and severity of drug and alcohol relapse; and improve their overall quality of life. SUD outpatient treatment providers must have and maintain an active DMC certification for the facility where services are provided, issued by the Department of Health Care Services (DHCS) of a substance abuse treatment program for the contracted American Society of Addiction Medicine (ASAM) Level of Care.
In order to solicit DMC-certified outpatient service providers for youth and adult clients in the County, the Chief Administrative Office (CAO) Procurement and Contracts Division, released Request for Proposal (RFP) 22-952-009 on October 29, 2021, for ASAM Level 1.0 Outpatient and 2.1 Intensive Outpatient Services. One single proposal was received by Shamanic Living Center, doing business as (dba) Recovery In Action (RIA), that met the requirements of the RFP for adult outpatient services, and this proposal was evaluated by a panel of three (3) evaluators with knowledge of HHSA’s DMC-ODS outpatient treatment needs. As a result of the RFP evaluative process, HHSA requested and the Board approved the award of this RFP to the qualified proposer, RIA, to provide DMC-certified outpatient treatment services in the County. RIA is a DMC-certified outpatient treatment provider established in Diamond Springs specializing in clinic/center (rehabilitation, substance use disorder). The Board approved the award on April 19, 2022 (File ID 22-0553).
This proposed Agreement 6527 with Shamanic Living Center, Inc., dba Recovery In Action will provide Adult and Youth Level Outpatient drug treatment 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 the Agreement with RIA, HHSA would continue to provide services through existing contracts; however, it could result in difficulty meeting the needs of the community and could result in HHSA being out-of-compliance with the DMC-ODS Waiver Plan authorized by the Board in 2017.
PRIOR BOARD ACTION:
1) 05/23/17, 17-0525, HHSA Federal 1115 Waiver for DMC-ODS
2) 04/19/22, 22-0553, HHSA Request to Award RFP No. 22-952-009, DMC-ODS Outpatient Treatment Services
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, Procurement and Contracts, and Risk Management. Auditor Controller notified per Board Policy B-12.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with Agreement 6527. Services provided under the DMC-ODS program will be funded by Medicaid Federal Financial Participation (FFP) funds that will be matched with Behavioral Health Realignment, Child Welfare Services Realignment and AB-109 funds. Since many of the individuals in need of these services are Medi-Cal beneficiaries, it is estimated that 90-95% of the services provided will be covered by Drug Medi-Cal and the remainder would be paid out of the appropriate Realignment funds. Sufficient appropriations for Federal Medicaid, Behavioral Health Realignment, and State General Funds are included in the Fiscal Year 2022-23 Budget.
CLERK OF THE BOARD FOLLOW UP ACTIONS Agreement for
Clerk of the Board to obtain signature of Chair on one (1) original Agreement for Services 6527.
STRATEGIC PLAN COMPONENT:
County Strategic Plan: “Healthy Communities, Improved Health, Well-being, and Self-sufficiency of El Dorado County communities, residents, and visitors.”
CONTACT
Daniel Del Monte, Interim Director, Health and Human Services Agency