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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 (RIA), are in the public’s best interest and that there are specialty skills and qualifications not expressly identified in County classifications involved in the performance of the work in accordance with El Dorado County Ordinance Code 3.13.030(B);
2) Approve and authorize the Chair to sign Amendment I to Agreement for Services 6527 with RIA, increasing the not-to-exceed amount of $235,000 by $50,000, for a new not-to-exceed amount of $285,000, revising the contractor responsibilities, and extending the term by one (1) year, effective upon execution through June 30, 2024; 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, 4% Substance Abuse Prevention and Treatment Block Grant (SABG) - Adolescent and Youth, 9% SABG Discretionary, and 13% AB109 Funding.
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DISCUSSION / BACKGROUND:
On May 23, 2017 (File ID: 17-0525), 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 (File ID: 19-0525), the Board of Supervisors (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. Subsequently, on September 21, 2021 (File ID 21-1360), the Board approved the renewal of this funding under Funding Agreement 21-10027 with DHCS for the provision of DMC-ODS services, which included the same terms and requirements as DHCS Funding Agreement 18-95146.
On April 19, 2022, (File ID: 22-0553), the Board approved the award of Request for Proposal (RFP) 22-952-009 to Shamanic Living Center, dba Recovery In Action (RIA), to provide DMC-certified outpatient treatment services to adult beneficiaries in the County. Thereafter, on July 26, 2022, as a result of the competitive RFP award, the Board executed Agreement for Services 6527 with RIA to provide DMC-ODS outpatient treatment services to adult El Dorado County beneficiaries, for the maximum obligation of $235,000 for the term of July 26, 2022, through June 30, 2023 (File ID: 22-0976).
This Amendment I to Agreement for Services 6527 with RIA is necessary to add in the provision of Recovery Services, as the County does not have staffing that can provide these mandated services, increase the compensation by $50,000 for the maximum obligation of $285,000 for anticipated services over the term of the Agreement, and to extend the term through by one (1) year through June 30, 2024 with no change to the rates.
The Amendment will ensure compliance with all Federal and State requirements and will allow HHSA to continue to uphold the DMC-ODS parameters such as consistency in service delivery expectations, performance measures, outcomes, productivity, and funding.
ALTERNATIVES:
Should the Board decline to approve the Amendment I to Agreement 6527 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) 07/26/22, 22-0976, Approved HHSA Recovery In Action 6527
2) 04/19/22, 22-0553, Approved HHSA Request to Award RFP No. 22-952-009, DMC-ODS Outpatient Treatment Services
3) 04/30/19, 19-0525, Approved DMC-ODS Interdepartmental Funding Agreement
4) 05/23/17, 17-0525, Approved HHSA Federal 1115 Waiver for DMC-ODS
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, 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 Amendment I to 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 are included in the Fiscal Year 2023-24 Recommended Budget request.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on one (1) Amendment I to Agreement 6527; and
2) Clerk of the Board to return one (1) fully executed Agreement to HHSA Contracts Unit via email to hhsa-contracts@edcgov.us.
STRATEGIC PLAN COMPONENT:
Healthy Communities, Improved Health, Well-being, and Self-sufficiency of El Dorado County communities, residents, and visitors
CONTACT
Olivia Byron-Cooper, MPH, Interim Director, Health and Human Services