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Consent-Health & Human Services # 16.
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| Board of Supervisors |
Adult & Aging |
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| Subject |
| Approve agreement with CORE Medical Clinic, Inc. to provide Opioid (Narcotic) Treatment Program services in Narcotic Treatment Program licensed facilities in the amount of $2,000,000 for the period July 1, 2018 through June 30, 2020. (No general fund impact) (Larsen) |
| Recommended Action |
- Approve agreement with CORE Medical Clinic, Inc. to provide Opioid (Narcotic) Treatment Program (OTP/NTP) services in Narcotic Treatment Program (NTP) licensed facilities in the amount of $2,000,000 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 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, CWS, AB109, 2011 Realignment, SABG, Stathum Funds, etc.
Approval of this Agreement will allow CORE Medical Clinic, Inc. to provide OTP/NTP services in NTP licensed facilities as determined to be medically necessary with an individualized treatment plan determined by a licensed physician or licensed prescriber and approved and authorized according to State of California requirements. These services will be provided to any eligible Yolo County adult Medi-Cal resident referred through an access point established by Yolo County. The purpose of providing OTP/NTP services is to provide an additional treatment option for beneficiaries struggling with opioid or alcohol use. Among other services CORE Medical Clinic, Inc. will be responsible for the following: intake and assessment, individual and group counseling, patient education, medication services, collateral services, crisis intervention services, treatment planning, medical psychotherapy (counseling services consisting of face-to-face discussion conducted by the Medical Director of the NTP/OTP on a one-on-one basis with the beneficiary), and discharge services.
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. |
| 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, BayMark Health Services and CORE Medical Clinic, Inc. were the only providers that responded to the OTP/NTP service scopes. Both proposals were evaluated and determined to meet all the required qualifications necessary to successfully provide these services. Because both proposals met all required qualifications and were of high quality both BayMark Health Services and CORE Medical, Clinic, Inc. will be offered contracts to provide these identified services. A separate agreement with BayMark Health Services will be submitted to the Board for approval.
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 |
Bid |
BayMark Health Services (Bi-Valley Medical Clinic, MedMark-Fairfield and MedMark-Sacramento)*
CORE Medical Clinic, Inc.* |
$1,181,581
$1,000,000 |
*Baymark’s proposal included two years of service for 75 clients with additional services of case management and physician consultation and CORE’s proposal was for one year of service for 130-140 clients. |
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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 $1,000,000 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 |
| OTP/NTP |
$1,000,000 |
$1,000,000 |
$2,000,000 |
| Total |
$1,000,000 |
$1,000,000 |
$2,000,000 |
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