Title
a. Accept and approve the updated Substance Use Disorder Services Agreement (“Agreement”) boilerplate containing County of Monterey’s standard risk provisions of insurance and indemnification, for the provision of substance use disorder (“SUD”) treatment services to clients with SUDs by County of Monterey service providers;
b. Approve and authorize the Director of Health or Assistant Director of Health to execute the standard template agreement with the following SUD providers, effective July 1, 2023, through June 30, 2024, and each in the following not to exceed contract amounts:
i. Community Human Services (CHS) for a total maximum amount not to exceed $5,083,737;
ii. Door to Hope (DTH) for a total maximum amount not to exceed $1,685,477;
iii. Sun Street Centers (SSC) for a total maximum amount not to exceed $7,036,462; and
iv. Valley Health Associates (VHA) for a total maximum amount not to exceed $1,241,886.
c. Approve and authorize the Director of Health or Assistant Director of Health to execute a standard template agreement with additional providers for SUD treatment and related services, during FY 2023-24, where the contract amount for each agreement with each additional provider does not exceed $200,000 and where the aggregate for all contracts with additional providers does not exceed $2,000,000; and
d. Approve and authorize the Director of Health or Assistant Director of Health to execute up to three future amendments for each Agreement listed in paragraph (b) above, which in the aggregate does not exceed 10% of the original contract amount and does not significantly change the scope of services, total not to exceed maximum of $10,812,188.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
a. Accept and approve the updated Substance Use Disorder Services Agreement (“Agreement”) boilerplate containing County of Monterey’s standard risk provisions of insurance and indemnification, for the provision of substance use disorder (“SUD”) treatment services to clients with SUDs by County of Monterey service providers;
b. Approve and authorize the Director of Health or Assistant Director of Health to execute the standard template agreement with the following SUD providers, effective July 1, 2023, through June 30, 2024, and each in the following not to exceed contract amounts:
i. Community Human Services (CHS) for a total maximum amount not to exceed $5,083,737;
ii. Door to Hope (DTH) for a total maximum amount not to exceed $1,685,477;
iii. Sun Street Centers (SSC) for a total maximum amount not to exceed $7,036,462; and
iv. Valley Health Associates (VHA) for a total maximum amount not to exceed $1,241,886.
c. Approve and authorize the Director of Health or Assistant Director of Health to execute a standard template agreement with additional providers for SUD treatment and related services, during FY 2023-24, where the contract amount for each agreement with each additional provider does not exceed $200,000 and where the aggregate for all contracts with additional providers does not exceed $2,000,000; and
d. Approve and authorize the Director of Health or Assistant Director of Health to execute up to three future amendments for each Agreement listed in paragraph (b) above, which in the aggregate does not exceed 10% of the original contract amount and does not significantly change the scope of services, total not to exceed maximum of $10,812,188.
SUMMARY/DISCUSSION:
The County of Monterey Health Department, Behavioral Health Bureau (BHB), currently utilizes a Board-approved SUD Services Agreement (“Agreement”) boilerplate to contract with providers providing SUD services to eligible Monterey County Medi-Cal beneficiaries.
Behavioral Health seeks Board approval of a revised and updated standard boilerplate agreement drafted in accordance with the requirements for contract payment reimbursement and cost and revenue reporting of the California Advancing and Innovating Medi-Cal (CalAIM) program, a multi-year California Department of Health Care Services (DHCS) initiative to improve the quality of life and health outcomes of our population by implementing a broad delivery system, program, and payment reform across the Medi-Cal program. Additionally, as part of BHB’s Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver services, BHB updated the Agreement’s boilerplate language and payment provisions in Exhibit B and Exhibit I to reflect language in the State/County DMC-ODS Contract and CalAIM payment reform. This updated SUD standard boilerplate agreement removes cost report reconciliation language and adds payment reform language to Exhibit B and reformats the current Agreement language which will be used for new agreements that begin July 1, 2023.
The County of Monterey currently has two-year SUD Agreements, which will expire June 30, 2023, with the following local providers:
• Agreement A-15296 with CHS for a current contracted dollar amount of $9,233,716: CHS provides residential services for adults, outpatient group, and individual therapy for adults, including case management and Medication Assisted Treatment (MAT). In addition to narcotic treatment services, such as methadone dosing. CHS also provides Buprenorphine, Disulfiram, and Narcan.
• Agreement A-15297 with DTH for a current contracted dollar amount of $2,871,401: DTH provides residential services for adults, outpatient group, and individual therapy for adults, including case management and recovery services.
• Agreement A-15451 with SSC for a current contracted dollar amount of $12,899,025: SSC provides residential services for adults, outpatient group, and individual therapy for youth and adults, including case management and recovery services. SSC also provides prevention services for youth, parents, and caretakers.
• Agreement A-15266 with VHA for a current contracted dollar amount of $2,391,478: VHA provides outpatient group and individual therapy for adults and youth, including case management and MAT. In addition to narcotic treatment services, such as methadone dosing, VHA also provides Buprenorphine, Disulfiram, and Narcan.
Both the current Agreement template and the new standard agreement template incorporates the County of Monterey standard risk provisions for insurance and indemnification.
To ensure continuity in the provision of SUD services to eligible residents in Monterey County, the Department seeks authorization to execute SUD Agreements with CHS, DTH, SSC, and VHA effective July 1, 2023, utilizing the updated SUD standard agreement boilerplate subject to further review and approval of County Counsel, County Risk Manager, and County Auditor Controller.
Behavioral Health is submitting this comprehensive board report to enhance contracting efficiency by allowing the Director of Health or Assistant Director of Health to execute agreements for SUD services without having to request separate Board approval for each agreement. Behavioral Health seeks to enter into new agreements with contractors that historically have provided quality SUD treatment services to County residents for many years. The four providers listed in the Title Section, paragraph (b) have agreed to the County’s standard boilerplate insurance and indemnification provisions. The Department will continue to secure Board approval for amendments to any agreements that significantly change the scope of services and exceed in total the 10% of original agreement amount.
This work supports the County of Monterey Health Department 2018-22 Strategic Plan Goal: 3) Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports one of the ten essential public health services, specifically: 7) Link people to needed personal health services and assure the provisions of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel, Risk Management, and Auditor-Controller have reviewed and approved the revised County of SUD Services Agreement template (“standard template agreement”) as to legal form and fiscal provisions, respectively and are supportive of request to authorize the Director of Health or Assistant Director of Health to execute agreements with identified providers and others meeting County of Monterey standard agreement requirements.
FINANCING:
The funds for these agreements are included in the Health Department Behavioral Health (HEA012, Unit 8410) FY 2023-24 Adopted Budget. Approval of this action has no impact on the County General Fund.
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: Rose Moreno, Management Analyst III, 755-4716
Approved by:
_______________________________ Date ___________________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachments:
Board Report
Agreement (Boilerplate)