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  Consent-Health & Human Services   # 16.       
Board of Supervisors Adult & Aging  
Meeting Date: 09/01/2020  
Brief Title:    Third Amendment to Agreement 18-155 with C.O.R.E. Medical
From: Karen Larsen, Director, Health and Human Services Agency
Staff Contact: Ian Evans, Adult and Aging Branch Director, Health and Human Services Agency, x8297
Supervisorial District Impact:
Subject
Approve third amendment to Agreement No. 18-155 with C.O.R.E Medical Clinic, Inc., to extend the term of the agreement through June 30, 2021; add funding in the amount of $1,000,000 for 2020-21, for a new contract maximum of $3,000,000; and revise and clarify contract language. (No general fund impact) (Larsen)
Recommended Action
  1. Approve third amendment to Agreement No. 18-155 with C.O.R.E Medical Clinic, Inc., to extend the term of the agreement through June 30, 2021; add funding in the amount of $1,000,000 for fiscal year 2020-21, for a new contract maximum of $3,000,000; and revise and clarify contract language; and
     
  2. Delegate authority to the Director of the Yolo County Health and Human Services Agency or her/his designee to: 1) exercise optional year extensions up to $1,000,000 per fiscal year, for fiscal years 2021-22 and 2022-23; and 2) issue related option year notices. Please see Section 1. of Att. A. Third Amendment as it amends section III. of Agreement No. 18-155.
Strategic Plan Goal(s)
Thriving Residents
Reason for Recommended Action/Background
On May 8, 2018, the Board of Supervisors approved an agreement with Department of Health Care Services (DHCS) to receive funding in the amount of $13,943,284 for the Drug Medi-Cal Organized Delivery System.
 
Yolo County completed a formal competitive selection process (see Competitive Selection details below) and C.O.R.E. Medical Clinic, Inc. was selected to provide Opioid (Narcotic) Treatment Program services in Narcotic Treatment Program licensed facilities.
 
On June 26, 2018, the County entered into Agreement No. 18-155 with C.O.R.E. Medical Clinic, Inc. for the provision of these services for the period July 1, 2018 through June 30, 2020, in the amount of $2,000,000.
 
At that time, it was the intention of the Yolo County Health and Human Services Agency (HHSA) to include language allowing the HHSA Director to exercise option years and issue related option year notices for three additional fiscal years. Based on guidance at that time, HHSA included the following language in Agreement No. 18-155:

"This Agreement may be extended upon written agreement of the Yolo County Health and Human Services Agency Director, and/or her/his designee, and an authorized representative of Contractor for three (3) additional twelve (12) month periods on the same terms and conditions as set forth in this Agreement."
 
Since this agreement was executed, HHSA received new guidance from the Yolo County Procurement Manager regarding the sufficiency of this language and a request for increased transparency to this Board regarding costs of future option years. Thus, HHSA is amending Agreement No. 18-155 to add language to specify the additional option year amounts. Please see section 1. of this Third Amendment which revises Section III. Compensation and Payment Terms of Agreement No. 18-155, by adding paragraph B.2. to that section.

Here is a breakdown of the potential costs associated with the option years.
 
 
Option Year/ Fiscal Year		 Maximum Agreement Term Extension Per Option Year/
Fiscal Year		 Increased Funding Amount Per Option Year/
Fiscal Year		 Revised Agreement
Lifetime Maximum
 
Second/
(FY 2021-22)		 On or before
June 30, 2022		 Less than or equal to $1,000,000 Less than or equal to $4,000,000
Third/
(FY 2022-23)		 On or before
June 30, 2023		 Less than or equal to $1,000,000 Less than or equal to $5,000,000

Further, this third amendment clarifies the language regarding the delegated authority for the HHSA Director to exercise the options and to issue related notices. Please see section 2. of this Third Amendment which revises Section IV. of Agreement No. 18-155.
 
Finally, this third amendment adds language regarding special terms and conditions for agreements funded by federal monies and revises and clarifies other boilerplate language.

Staff recommends the approval of this agreement for C.O.R.E. Medical Clinic, Inc to continue to provide the vital services and to clarify provisions for the ease of future contract administration.

Performance measures were included in Agreement No. 18-155 and are not being changed by this third amendment.
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, two of which offered Opiod (Narcotic) Treatment Program services - BayMark Health Services and C.O.R.E. Medical Clinic, Inc. 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 C.O.R.E. Medical, Clinic, Inc. were offered contracts to provide these identified services. During contract negotiations it was discovered that BayMark Health Services, a parent company, has three separate entities that HHSA will be contracting with for these services; Bi-Valley Medical Clinic, Inc., MedMark Treatment Centers-Fairfield and MedMark Treatment Centers-Sacramento.  These three agreements and C.O.R.E. Medical Clinic, Inc. were submitted separately to the Board for approval.

Additional information regarding the Competitive Bid Process is provided below, including a summary of the RFP evaluation criteria.

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)*
C.O.R.E. 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 C.O.R.E.’s proposal was for one year of service for 130-140 clients.
Fiscal Impact
Fiscal impact (see budgetary detail below)
Fiscal Impact (Expenditure)
Total cost of recommended action:    $   1,000,000
Amount budgeted for expenditure:    $   1,000,000
Additional expenditure authority needed:    $  
On-going commitment (annual cost):    $   1,000,000
Source of Funds for this Expenditure
$1,000,000
Explanation (Expenditure and/or Revenue)
Further explanation as needed:

This action increases the contract maximum by $1,000,000 for a total of $3,000,000 for the period of July 1, 2018 through June 30, 2021. No general funds are required by this action. These services will be funded by ODS Medi-Cal FFP. The amount of $1,000,000 is included in the HHSA proposed budget for fiscal year 2020-21. 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.

Scope of Service Fiscal Year 2018-19
July 1, 2018
through
June 30, 2019		 Fiscal Year 2019-20 July 1, 2019
through
June 30, 2020		 Fiscal Year 2020-21 July 1, 2020
through
June 30, 2021		 Total
OTP/NTP $1,000,000 $1,000,000 $1,000,000 $3,000,000


The agreement also includes two (2) one-year optional extensions for fiscal year 2021-22 (July 1, 2021 through June 30, 2022) and fiscal year 2022-23 (July 1, 2022 through June 30, 2023) in an amount less than or equal to $1,000,000 per fiscal year, as follows:

 
Option Year/
Fiscal Year		 Maximum Agreement Term Extension Per Option Year/Fiscal Year Maximum Increased Funding Amount Per
Option Year/
Fiscal Year		 Revised Maximum Payment Obligation including Option Year Increase
 
First/
(FY 2021-22)		 On or before
June 30, 2022		 Less than or equal
to $1,000,000		 Less than or equal
to $4,000,000
Second /
(FY 2022-23)		 On or before
June 30, 2023		 Less than or equal
to $1,000,000		 Less than or equal
to $5,000,000


In no event shall the term of the Agreement extend beyond June 30, 2023 nor shall the total contract maximum exceed the amount of FIVE MILLION DOLLARS ($5,000,000), unless otherwise agreed to in writing by the parties and in conformity with the then-current Yolo County Procurement Policy approved by the Yolo County Board of Supervisors.
Attachments
Att. A. Third Amendment
Form Review
Inbox Reviewed By Date
Financial Services mqader 08/17/2020 01:01 PM
County Counsel Hope Welton 08/17/2020 01:16 PM
Form Started By: Kimberly Mayfield Started On: 05/13/2020 11:21 AM
Final Approval Date: 08/18/2020

    

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