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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings in accordance with El Dorado County Ordinance Code, Chapter 3.13.030(B) and El Dorado County Charter, Section 210(b)(6) that the provision of Drug Medi-Cal Organized Delivery System services provided by Recover Medical Group P.C. include specialty skills and qualifications not expressly identified in County classifications;
2) Approve and authorize the Chair to sign Agreement for Services 7107 with Recover Medical Group P.C., with a not-to-exceed amount of $300,000 and for the term of two years effective upon execution; and
3) Authorize the HHSA Director or Behavioral Health Director to execute further documents relating to Agreement 7107, 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:85% Drug Medi-Cal Federal Financial Participation/State General Fund and 15% Behavioral Health Realignment.
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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...
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