Title
a. Approve and authorize the Director of Health Services or designee to execute a service agreement between the County of Monterey and Close Grover Medical Corporation for the provision of technical medical services as the Chief Substance Use Navigator (SUN) for the County of Monterey Buprenorphine Program retroactive to March 1, 2023, through April 15, 2024, for an amount not to exceed $61,497 contingent on availability of grant funds; and
b. Authorize the Director of Health Services or designee to execute up to three (3) future amendments to this Agreement where each amendment does not exceed 10% ($6,149) of the original Agreement amount and does not significantly alter the scope of the services.
c. Approve and authorize the Director of Health Services or designee to execute a Business Associate Agreement (BAA) between the County of Monterey and Close Grover Medical Corporation to comply with privacy and protection of patient health information shared with Close Grover Medical Corporation during the provision of technical medical services as the Chief Substance Use Navigator (SUN) for the County of Monterey Buprenorphine Program retroactive to March 1, 2023, to February 28, 2027.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health Services or designee to execute a service agreement between the County of Monterey and Close Grover Medical Corporation for the provision of technical medical services as the Chief Substance Use Navigator (SUN) for the County of Monterey Buprenorphine Program retroactive to March 1, 2023, through April 15, 2024, for an amount not to exceed $61,497 contingent on availability of grant funds; and
b. Authorize the Director of Health Services or designee to execute up to three (3) future amendments to this Agreement where each amendment does not exceed 10% ($6,149) of the original Agreement amount and does not significantly alter the scope of the services.
c. Approve and authorize the Director of Health Services or designee to execute a Business Associate Agreement (BAA) between the County of Monterey and Close Grover Medical Corporation to comply with privacy and protection of patient health information shared with Close Grover Medical Corporation during the provision of technical medical services as the Chief Substance Use Navigator (SUN) for the County of Monterey Buprenorphine Program retroactive to March 1, 2023, to February 28, 2027.
SUMMARY/DISCUSSION:
Pursuant to California Health and Safety Code, Section 1797 et seq., the County of Monterey EMS Agency is responsible for EMS system coordination, medical oversight, and coordination of the delivery of EMS by provider organizations in Monterey County.
In 2022, the County of Monterey EMS Agency entered into a three-county collaborative with the County of Santa Cruz and the County of San Benito to support the ongoing efforts to address substance use disorder (SUD) as a treatable emergency condition. Through the Buprenorphine program, paramedics responding to medical emergency calls will be able to identify and treat patients who may benefit from medication-assisted treatment (MAT).
In 2023, the Department of Health Care Services (DHCS) informed the three counties of funding available for this program. The total grant amount of $375,000 was allocated among the participating three counties based on population percentage. This grant will support overall program and grant management costs related to the administration of buprenorphine to patients in opioid withdrawal or following a near-fatal opioid overdose and linking these patients to needed services.
Dr. Reb Close, of Close Grover Medical Corporation, has an expanded knowledge and expertise in addressing the opioid epidemic in the County of Monterey, Santa Cruz, and San Benito, thus she possesses intimate knowledge of the Buprenorphine program in the three counties. She is currently the Clinical Champion and Implementation Leader for the California Bridge Project. Santa Cruz and San Benito Counties are already in the process of contracting with Dr. Close to provide the services needed. Having a single physician act as the Chief SUN will provide the program the consistency it needs.
EMS is seeking approval retroactive to March 1, 2023, because the grant award documents were not received until August 2023. It took time to meet with the grantor to clarify grant requirements before the subcontract agreement could be approved by the Board. Without the subcontract agreement being fully executed, the EMS Agency could not begin to execute an agreement with Close Grover Medical Corporation. The BAA is needed to comply with privacy and protection of patient health information shared with Close Grover Medical Corporation during the provision of technical medical services as the Chief Substance Use Navigator (SUN) for the County of Monterey Buprenorphine Program. Given that the services provided by Close Grover Medical Corporation will continue after the term of the grant, the BAA must remain in place after the term of the grant.
This work supports the Monterey County Health Department 2018-2024 Strategic Plan Goal 2 (Enhance public health and safety through prevention) and Goal 4 (Engage Health Department workforce and improve operational functions to meet current and developing population health needs). It also supports the following of the ten essential public health services, specifically, (Monitor health status to identify and solve community health problems; Mobilize community partnerships and action to identify and solve health problems; and Link people to needed personal health services and assure the provision of health care when otherwise unavailable).
OTHER AGENCY INVOLVEMENT:
The Office of the County Counsel has reviewed and approved the Agreement as to legal form. Auditor-Controller has reviewed and approved the Agreement as to fiscal provisions.
FINANCING:
There are no General Fund Impacts resulting from this Board action. There are sufficient appropriations and revenues in FY 2024 adopted budget 001-4000-8109-HEA006. The County of Monterey will compensate vendor from the Public Health Institute.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐ Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐ Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒ Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐ Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐ Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Teresa Rios, EMS Director, 783-7082
Approved by:
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Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Service Agreement is on file with the Clerk of the Board
Business Associate Agreement on file with the Clerk of the Board