DATE: April 11, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendments to Non-Drug Medi-Cal Master Agreements
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment I to Master Agreement with providers of non-Drug Medi-Cal Outpatient Services to update state-mandated requirements, effective upon execution, with no change to the term of July 1, 2022 through June 30, 2027, or compensation maximum of $11,362,380;
2. Approve and authorize the Chairman to execute Amendment I to Master Agreement with providers of non-Drug Medi-Cal Residential Treatment and Withdrawal Management Services to update state-mandated requirements, effective upon execution, with no change to the term of July 1, 2022 through June 30, 2027, or compensation maximum of $13,231,565;
3. Approve and authorize the Chairman to execute Amendment I to Master Agreement with non-Drug Medi-Cal Residential Room and Board providers for reimbursement of room and board costs to update state-mandated requirements, effective upon execution, with no change to the term of July 1, 2022 through June 30, 2027, or compensation maximum of $25,367,740; and,
4. Approve and authorize the Chairman to execute Amendment II to the Youth Treatment Services Master Agreement No. 18-694 with providers of non-Drug Medi-Cal Outpatient services to update state-mandated requirements, effective upon execution, with no change to the term of January 1, 2019 through June 30, 2023, or compensation maximum of $5,536,611.
REPORT
Approval of recommended actions will allow the Department of Behavioral Health to update the Non-Drug Medi-Cal (DMC) master agreements with contract language from the California Department of Health Care Services (DHCS). The recommended amendments would allow the County to comply with various state-mandated requirements and continue receiving State funds through the California Department of Health Care Services (DHCS) to finance County substance use disorder (SUD) treatment services, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
If your Board does not approve the recommended actions, the Department will be out of compliance with several state-county contract requirements, jeopardizing State, Federal, and Behavioral Health Realignment revenues for the provision of substance use disorder treatment services and programs during the specified contract period.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum compensation amounts of the recommended agreements, combined total of $55,498,296 [Non-Drug Medi-Cal Outpatient Services ($11,362,380), Residential Treatment and Withdrawal Management Services ($13,231,565), Residential Treatment and Withdrawal Management Room and Board ($25,367,740), and Youth Treatment Service ($5,536,611)], will be fully funded by the Behavioral Health Realignment and the Substance Abuse Block Grant (SABG). Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2022-23 Adopted Budget and will be included in subsequent budget requests for the duration of the term.
DISCUSSION:
December 11, 2018, the Board approved Master Agreement No. 18-694 with Non-Drug Medi-Cal Youth Treatment Service vendors to provide outpatient alcohol and substance use disorder treatment services to Fresno County minors between the ages of 12 and 17 years old.
On June 4, 2019, the Board approved Amendment I to Agreement No. 18-694 to reallocate underutilized funds assigned to the youth outpatient substance use disorder (SUD) treatment program to the SUD treatment for justice-involved youth program under Agreement No.18-622.
On May 3, 2022, your Board approved Non-Drug Medi-Cal Outpatient Master Agreement No. 22-177, Non-Drug Medi-Cal Residential Master Agreement No. 22-178, and Room and Board Master Agreement No. 22-179. These agreements enable the County to contract with qualified local providers to offer substance use disorder treatment services to residents who do not qualify for Drug Medi-Cal (DMC) and have no alternative payment options and allows the County to pay for room and board costs for Drug Medi-Cal and non-Drug Medi-Cal person served. These agreements allow the Department to continue contractual arrangements with treatment providers through several Master Agreements.
As part of DHCS’s efforts to implement the California Advancing and Innovating Medi-Cal (CalAIM), guidance has been received from the state that adds, removes, and/or updates various State requirements within the state-county agreement. Due to these ongoing implementation efforts, the Department anticipates future changes to the Non-Drug Medi-Cal master agreements in order to remain in compliance with changing state requirements.
The recommended amendments would bring the Department into compliance with multiple DHCS requirements. These amendments also update insurance requirements to meet current County standards. All other terms remain unchanged.
REFERENCE MATERIAL:
BAI #34, May 3, 2022
BAI #45, June 4, 2019
BAI #34, December 11, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Non-Drug Medi-Cal Outpatient Master Agreement
On file with Clerk - Amendment I to Non-Drug Medi-Cal Residential Master Agreement
On file with Clerk - Amendment I to Residential Room and Board Master Agreement
On file with Clerk - Amendment II to Youth Treatment Services Master Agreement
CAO ANALYST:
Ronald Alexander