To: Board of Supervisors
From: Behavioral Health
Meeting Date: August 29, 2023
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Department Contact: |
Jenine Miller, Psy. D. |
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707-472-2341 |
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Item Type: Consent Agenda |
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Time Allocated for Item: N/A |
Agenda Title:
title
Approval of Second Amendment to Agreement No. BOS-20-060 with Partnership Health Plan of California (PHC), in the Amount of $17,034,638, for a New Total Amount of $21,000,000, to Allow PHC to Administer Drug Medi-Cal Organized Delivery System (DMC-ODS) Services on Behalf of Mendocino County to Medi-Cal Beneficiaries Through the Utilization of Federal, State, and County Realignment Funds Available for Reimbursable Covered Services Rendered by Certified DMC-ODS Providers, Effective July 1, 2020 through December 31, 2023
End
Recommended Action/Motion:
recommendation
Approve second amendment to Agreement No. BOS-20-060 with Partnership HealthPlan of California (PHC) in the amount of $17,034,638, for a new total amount of $21,000,000, to allow PHC to administer Drug Medi-Cal Organized Delivery System (DMC-ODS) services on behalf of Mendocino County to Medi-Cal beneficiaries through the utilization of federal, state, and county realignment funds available for reimbursable covered services rendered by certified DMC-ODS providers, effective July 1, 2020 through December 31, 2023; authorize the Behavioral Health and Recovery Services Director or designee to sign any amendments that do not increase the maximum amount; and authorize Chair to sign same.
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Previous Board/Board Committee Actions:
May 19, 2020, Item No. 5c), BOS Approval of Agreement No. 20-060.
July 1, 2021, first Amendment No. MH-21-032, executed by the Behavioral Health and Recovery Services Director
Summary of Request:
In 2015, the California Department of Health Care Services (DHCS) implemented a new substance use disorder benefit and delivery system called the Drug Medi-Cal Organized Delivery System (DMC-ODS) as part of an amendment to DHCS 1115 waiver. DMC-ODS provides a continuum of care modeled after the American Society of Addiction Medicine Criteria to enable more appropriate delivery of services and treatment, provide more local control and accountability, and provide greater administrative oversight of services for Medi-Cal beneficiaries.
Counties had the choice of opting into the waiver to expand services or maintaining their current state plans. Opting into DMC-ODS was phased in, starting with the bay area counties. On July 2020, Mendocino County Behavioral Health and Recovery Services (BHRS) opted in and began administering the DMC-ODS waiver program locally, providing and arranging for substance use disorder treatment for Medi-Cal beneficiaries.
Partnership HealthPlan of California (PHC) proposed a regional model approach for delivery of DMC-ODS services. Under this approach, PHC administers the DMC-ODS substance use treatment services on behalf of the county. This model allows DMC-ODS services to be provided to beneficiaries across county lines, so that individuals can access services not offered within their home county.
The proposed second Amendment to BOS Agreement No. BOS-20-060 authorizes PHC to continue to administer DMC-ODS services on behalf of Mendocino County for an additional six months, and increases the dollar amount to $21,000,000, as DHCS determined there was a billing and reimbursement discrepancy related to PHC billing for Indian Health Care Provider (IHCP) services. DHCS is in the process of processing payments to BHRS for reimbursement owed for the IHCP services provided by PHC providers.
Alternative Action/Motion:
Return to staff for alternative handling.
Does This Item Support the General Plan? Yes
Strategic Plan Priority Designation: A Safe and Healthy County
Supervisorial District: All
vote requirement: Majority
Supplemental Information Available Online At: n/a
Fiscal Details:
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source of funding: Medi-Cal, Realignment, and SABG |
budgeted in current f/y: No |
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current f/y cost: $21,000,000 for the term of the Agreement. |
if no, please describe: Unanticipated funds |
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annual recurring cost: varies |
revenue agreement: Yes |
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budget clarification: Up to $21,000,000 for July 1, 2020 through December 31, 2023 |
Agreement/Resolution/Ordinance Approved by County Counsel: Yes
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CEO Liaison: Executive Office |
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CEO Review: Yes |
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CEO Comments:
FOR COB USE ONLY
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Executed By: Atlas Pearson, Senior Deputy Clerk |
Final Status: Approved |
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Date: August 29, 2023 |
Executed Item Type: Interim Agreement Number: *20-060-A1 |
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