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Consent-Health & Human Services # 23.
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| Board of Supervisors |
Adult & Aging |
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| Subject |
Approve agreement with Yolo Wayfarer Center (dba Fourth and Hope) to provide Case Management, Physician Consultation, Low-Intensity Residential Treatment, High-Intensity Residential Treatment, and Recovery Residences/Transitional Living Services in the amount of $1,437,648 for the period July 1, 2018 through June 30, 2020. (No general fund impact) (Larsen)
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| Recommended Action |
- Approve agreement with Yolo Wayfarer Center (dba Fourth and Hope) to provide Case Management, Physician Consultation, Low-Intensity Residential Treatment, High-Intensity Residential Treatment, and Recovery Residences/Transitional Living Services in the amount of $1,437,648 for the period July 1, 2018 through June 30, 2020; and
- Delegate authority to the Director of Health and Human Services Agency and/or her/his designee to sign and execute any additional forms, documents and/or amendments as necessary relating to this agreement, provided there are no significant programmatic changes or increases in funding.
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| Strategic Plan Goal(s) |
Operational Excellence
Thriving Residents
Safe Communities |
| Reason for Recommended Action/Background |
In 2015, the Federal government approved a 5-year pilot project to expand substance use services that could be billed to Medi-Cal. This pilot project is called the Drug Medi-Cal Organized Delivery System (DMC-ODS).
Under the DMC-ODS waiver, current Drug Medi-Cal eligible services will continue alongside expanded services eligible to be billed to Drug Medi-Cal. These increased services will be available to anyone eligible for Medi-Cal and will include Residential Treatment, Intensive Outpatient Treatment, Withdrawal Management (Detoxification), Case Management, Physician Consultation, and Recovery Services. The system will provide a coordinated entry for clients either through multiple in-person access points or a 1-800 screening number available 24/7. All providers within the system will utilize the same screening tool allowing for consistency and appropriate client placement based on medical necessity.
On May 8, 2018, the Board of Supervisors approved an agreement with Department of Health Care Services to receive funding in the amount of $13,943,284 for the Drug Medi-Cal Organized Delivery System Intergovernmental Agreement No. 17-94092 for Substance Use Disorder Services for the period June 30, 2018 through June 30, 2020.
The DMC-ODS waiver created opportunity for the Yolo County Health and Human Services Agency (HHSA) to further its integration efforts by examining the Adult substance use system of care and various funding streams that have been fragmented in the past. So, in addition to Drug Medi-Cal funding, all Adult substance use Agreements with a Drug Medi-Cal certified provider, beginning July 1, 2018 may have blended funding streams including: CalWORKs, Child Welfare Services, AB109, 2011 Realignment, Substance Abuse Block Grant (SABG), and Stathum Funds.
Approval of this Agreement will allow Yolo Wayfarer Center to provide a range of adult substance use services, including Case Management, Physician Consultation, Low-Intensity Residential Treatment, High-Intensity Residential Treatment, and Recovery Residences/Transitional Living Services. These services are part of the Adult Substance Use Disorder Continuum of Care.
- Case Management Services support beneficiaries as they move through the DMC-ODS continuum of care from initial engagement and early intervention, through treatment, to recovery supports.
- Physician Consultation Services include DMC provider physicians consulting with addiction medicine physicians, addiction psychiatrists, or clinical pharmacists. Physician Consultation Services are designed to assist DMC provider physicians with seeking expert advice on designing treatment plans and supporting DMC providers with complex cases.
- Residential Treatment Services are a 24-hour, non-institutional, non-medical, short-term service that provides residential rehabilitation services to beneficiaries with a substance use disorder diagnosis when determined by a Medical Director or LPHA as medically necessary and in accordance with an individualized treatment plan. Residential Treatment Services are provided in DMC-certified facilities designated (and licensed as necessary) by DHCS as capable of delivering care consistent with level needed (i.e. low-intensity or high-intensity).
- Recovery Residences (RR) are available for beneficiaries who require housing assistance in order to support their health, wellness, and recovery. There is no formal treatment provided at these facilities, however, residents are required to actively participate in outpatient treatment and/or recovery supports during their stay.
The performance measures included in this agreement are as follows:
HHSA will use a Results-Based Accountability model to measure progress towards the following objectives. Each of the project components will complete tracking and reporting on objectives in the RBA.
| PM1: How much did we do? |
| 1.1 |
Bi-Annually Reported
# of clients
Demographics:
# age
# gender
# Race/Ethnicity
# disability
# Culture |
| 1.2 |
Bi-Annually Reported
# type and quantity of services provided |
| 1.3 |
Bi-Annually Reported
# of referrals/coordination for other services and referral disposition |
| 1.4 |
Bi-Annually Reported
# of referrals/coordination to/ with other substance use disorder providers for continued care |
| 1.5 |
Bi-Annually Reported
# total beneficiaries who completed their treatment episode |
| PM2: How well did we do it? |
| 2.1 |
Bi-Annually Reported
# of beneficiaries satisfied with services provided
% of beneficiaries satisfied with services provided
(as collected by questions 1-3 on the Consumer Perception Survey)
- I like the services that I received here
- If I had other choices, I would still get services from this agency
- I would recommend this agency to a friend or family member
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| 2.2 |
Annually Reported
# of beneficiaries satisfied with access and services provided based on Drug Medi-Cal Organized Delivery System (DMC-ODS) Treatment Perception Survey (TPS)
% of beneficiaries satisfied with access and services provided based on Drug Medi-Cal Organized Delivery System (DMC-ODS) Treatment Perception Survey (TPS) |
| 2.3 |
Bi-Annually Reported
Initiation rate:
# of beneficiaries who receive at least 1 service (individual, group, collateral, or case management) within 14 days of a diagnosis being established by your facility
% of beneficiaries who receive at least 1 service (individual, group, collateral, or case management) within 14 days of a diagnosis being established by your facility |
| 2.4 |
Bi-Annually Reported
Engagement rate:
# of beneficiaries who receive at least two or more services (individual, group, collateral, or case management) within 30 days of a diagnosis being established by your facility
% of beneficiaries who receive at least 2 or more services (individual, group, collateral, or case management) within 30 days of a diagnosis being established by your facility |
| 2.5 |
Bi-Annually Reported
Retention rate:
# of beneficiaries who stayed for a minimum of two weeks that completed their entire treatment episode
% of beneficiaries who stayed for a minimum of two weeks that completed their entire treatment episode |
| 2.6 |
Bi-Annually Reported
# of beneficiaries who were satisfied with access to services
% of beneficiaries who were satisfied with access to services
(as collected by questions 4-8 on the Consumer Perception Survey)
- The location of service was convenient (parking, public transportation, distance, etc)
- Staff were willing to see me as often as I felt it was necessary
- Staff returned my calls within 24 hours
- Services were available at times that were good for me
- I was able to get all the services I thought I needed
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PM3: Is anyone better off? |
| 3.1 |
Bi-Annually Reported
# of beneficiaries reporting a reduction in substance use at completion of the program, and
% of beneficiaries reporting a reduction in substance use at completion of the program |
| 3.2 |
Bi-Annually Reported
# of beneficiaries reporting a reduction in days incarcerated while in treatment, compared to the previous 6 months
% of beneficiaries reporting a reduction in days incarcerated while in treatment, compared to the previous 6 months |
| 3.3 |
Bi-Annually Reported
% reduction of days incarcerated during treatment (1 – days incarcerated in treatment/days incarcerated 6 months prior to treatment) |
| 3.4 |
Bi-Annually Reported
% of clients reporting an improvement in outcomes as a result of receiving these services (as collected by questions 21-28 on the Consumer Perception Survey):
- I deal more effectively with daily problems
- I am better able to control my life
- I am better able to deal with crisis
- I am getting along better with my family
- I do better in social situations
- I do better in school and/or work
- My housing situation has improved
- My symptoms are not bothering me as much
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| Collaborations (including Board advisory groups and external partner agencies) |
County Counsel has approved this Agreement as to form.
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| Competitive Bid Process |
On February 26, 2018, HHSA issued a Request for Proposal (RFP) seeking contractors to provide Substance Use Disorder (SUD) Adult Continuum of Care services to eligible Yolo County residents.
HHSA received eight proposals from this solicitation. Below is a table of all providers who submitted proposals. HHSA formed a review committee that included HHSA staff, representatives from other County departments and subject matter experts from other California counties. All proposals were evaluated and the following proposals were determined to meet all the required qualifications necessary to successfully provide these services: CommuniCare, Turning Point, Progress House, Community Recovery Resources, Yolo Wayfarer Center, BayMark, and CORE. Because these proposals were considered to be of high quality, they will be offered a contract to provide these identified services. Separate agreements for the other bids chosen will be submitted to the Board for approval. Heritage Oaks was the only bid received that will not be awarded a contract.
Request for Proposals (RFP) Service Requested:
Substance Use Disorder Adult Continuum of Care
Evaluation Criteria Included in RFP
- General company information (20 points)
- Experience and past performance (100 points)
- For contractors bidding on residential treatment services (6 points)
- Preferred qualifications (20 points)
- Responsiveness/responsibility (20 points)
- Pricing requirements (40 points)
- Proposer’s approach to project (100 points)
- Quality assurance and oversight (20 points)
- Outputs and outcomes measures (50 points)
- Financial information (pass/fail)
- Quality and completeness of submitted proposal (pass/fail)
Bids Received
| Bidder |
Scopes included in Bid |
Bid |
CommuniCare Health Center
Turning Point Community Programs
Progress House
Community Recovery Resources
Yolo Wayfarer Center dba Fourth and Hope
Heritage Oaks
BayMark Health Centers (MedMark, Fairfield; MedMark, Sacramento;
Bi-Valley Medical Clinic)
CORE Medical Clinic, Inc. |
Intensive Outpatient, Outpatient, Case Management, Physician Consultation, Recovery Services, In-Person Screening/Referral
Intensive Outpatient, Outpatient, Case Management, Physician Consultation
Low-Intensity Residential, Case Management, Physician Consultation
Low-Intensity Residential, High-Intensity Residential, Case Management, Physician Consultation, Withdrawal Management, Intensive Outpatient, Transitional Living
Low-Intensity Residential, , High-Intensity Residential, Transitional, Case Management, Physician Consultation
Intensive Outpatient, Outpatient, Case Management, Physician Consultation
Opioid (Narcotic) Treatment Program, Case Management, Physician Consultation
Opioid (Narcotic) Treatment Program, Case Management, Physician Consultation |
$1,583,952
$278,388
$500,000
*
$1,001,950
$785,929
$1,181,581**
$2,000,000** |
* Community Recovery Resources declined to submit a bid amount. The entire program cost $3,823,974 was included in their proposal and expected to be funded by different sources.
** BayMark and CORE requested funding for two years. All other bids shown denote an annual budget. |
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| Fiscal Impact |
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| Source of Funds for this Expenditure |
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Explanation (Expenditure and/or Revenue) |
| Further explanation as needed: |
No general funds are required by this action. These services will be funded by Department of Health Care Services funds received from the State. The amount of $718,824 is included in the HHSA adopted budget for FY18-19. The related funding will be included in the requested budget process for future fiscal years.
The following is the breakdown of funding for this agreement.
Services |
FY 2018-19
July 1, 2018
through
June 30, 2019 |
FY 2019-20
July 1, 2019
through
June 30, 2020 |
Total |
| Case Management, Physician Consultation, Low-Intensity Residential Treatment, High-Intensity Residential Treatment, and Recovery Residences/Transitional Living Services |
$718,824 |
$718,824 |
$1,437,648 |
| Total |
$718,824 |
$718,824 |
$1,437,648 |
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