DATE: May 7, 2019
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Amendment I to Agreement 17-265 with Turning Point of Central California, Inc.
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment I to Agreement No. 17-265 with Turning Point of Central California, Inc. to provide specialty mental health services and substance use disorder outpatient treatment services, effective upon execution with no change in term to June 30, 2022 and decreasing the maximum by $1,191,108 to a total of $12,433,797.
REPORT
Approval of the recommended action will allow for the hiring of additional staff to meet Drug Medi-Cal Organized Delivery System (DMC ODS) service requirements and remove Substance Abuse Prevention and Treatment (SAPT) Block Grant Funds from this agreement, which will be allocated by the Department to other DMC ODS service modalities. The services are funded with Short/Doyle Medi-Cal Federal Financial Participation (FFP), Drug Medi-Cal, 2011 Public Safety Realignment, and Mental Health Services Act (MHSA) Community Service & Supports (CSS) funds with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
If the recommended action is not approved, Turning Point of Central California, Inc. will not be able to hire additional staff to provided new services available under the DMC ODS. Additionally, the Department will not be able to reallocate funds to other necessary DMC ODS service modalities.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum amount of the amendment ($12,433,797) will be fully offset by Short/Doyle Medi-Cal FFP, Drug Medi-Cal, 2011 Public Safety Realignment, and MHSA CSS funds as approved in the MHSA FY 2017-18 Annual Update for the AB109 - Outpatient Mental Health & Substance Services program. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2018-19 Adopted Budget and will be included in subsequent requested budgets for the duration of the agreement.
DISCUSSION:
On June 20, 2017, the Board of Supervisors approved Agreement 17-265 with Turning Point of Central California, Inc. (Turning Point) for the provision of specialty mental health and Substance Use Disorder (SUD) services to adult population transfers as set forth in AB 109. The Department has opted in to the Drug Medi-Cal Organized Delivery System (DMC ODS), a pilot program to test a new paradigm for the organized delivery of health care services for Medi-Cal eligible individuals with substance use disorders. Critical elements of the DMC ODS include providing a continuum of care modeled after the American Society of Addiction Medicine (ASAM) Criteria for SUD treatment services, increased local control and accountability, greater administrative oversight, creates utilization controls to improve care and efficient use of resources, evidence based practices in substance abuse treatment, and increased coordination with other systems of care. The recommended amendment will allow Turning Point to hire an additional 2.0 Full-time Equivalent (FTE) Licensed Clinicians and 2.0 FTE case managers to provide SUD services in accordance with DMC ODS requirements. Funding for the additional staff will be provided by reallocating existing 2011 Public Safety Realignment funds, which were previously dedicated to SUD residential treatment. SUD residential treatment is DMC reimbursable under the DMC ODS reducing the need for dedicated 2011 Public Safety Realignment funds. The Community Corrections Partnership (CCP), which administers 2011 Public Safety funds, was informed of the actions included in this agreement at their March 12, 2018 meeting. The recommended amendment will also allow the Department to remove $200,000 of Substance Abuse Prevention and Treatment Block Grant funds annually and reallocate those funds to other needed SUD services as part of the larger DMC ODS implementation plan. Estimated Medi-Cal revenues for mental health services have also been reduced to align with current program service volumes.
The recommended amendment provides for termination due to non-allocation of funds upon giving 30-days advance written notice to the contractor and provides for termination without cause by the contractor, the county, or the Department Director, or designee, upon giving 60-days advance written notice to terminate.
REFERENCE MATERIAL:
BAI #42, June 20, 2017
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Agreement 17-265
CAO ANALYST:
Ronald Alexander