TO: Board of Supervisors
FROM: Jennifer Yasumoto, Director of Health and Human Services Agency
REPORT BY: Gaby Angeles, Staff Services Analyst II
SUBJECT: Revenue Agreement No. 240177B with Department of Health Care Services (Drug Medi-Cal Organized Delivery System)
RECOMMENDATION
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Director of Health and Human Services Agency (HHSA) requests approval of and authorization for the Chair to sign Revenue Agreement No. 240177B with Department of Health Care Services (DHCS) for a maximum of $38,502,000 for the term Fiscal Year 2023-2024 through Fiscal Year 2026-2027 for the State and Federal funding for alcohol and drug programs approved in the Napa County Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver.
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EXECUTIVE SUMMARY
Approval of today’s action will allow the County to enter into an intergovernmental agreement with DHCS to identify and provide covered DMC-ODS services for substance use disorder (SUD) services for Napa County Medi-Cal beneficiaries through utilization of federal and state funds.
FISCAL & STRATEGIC PLAN IMPACT
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Is there a Fiscal Impact? |
Yes |
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Is it currently budgeted? |
Yes |
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Where is it budgeted? |
Health and Human Services Agency, Behavioral Health division |
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Is it Mandatory or Discretionary? |
Mandatory |
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Is the general fund affected? |
No |
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Future fiscal impact: |
This Agreement terminates on June 30, 2027. Appropriations have been included in the approved Fiscal Year 2023-2024 budget and future fiscal years will be budgeted accordingly. |
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Consequences if not approved: |
If this agreement is not approved, HHSA will be unable to be reimbursed for providing expanded substance use services at our negotiated rate based on estimated and actual program costs. |
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County Strategic Plan pillar addressed: |
Healthy, Safe, and Welcoming Place to Live, Work, and Visit |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by 14 California Code of Regulations 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.
BACKGROUND AND DISCUSSION
The DMC-ODS is a Medi-Cal benefit and delivery system in counties that choose to opt into and implement the waiver. The DMC-ODS allows counties to selectively contract with providers in a managed care environment to deliver a full array of services consistent with the American Society of Addiction Medicine (ASAM) Treatment Criteria, including recovery supports and services. Napa County opted into participating in the DMC-ODS waiver in December 2017 to address the prior limitations on California’s Drug-Medi-Cal funded (DMC) services. By continuing to participate in the waiver, Napa County beneficiaries have a full continuum of evidence-based substance use disorder treatment services to increase the likelihood of achieving and sustaining long-term recovery.
DHCS has instituted several improvements to the DMC-ODS program through the California Advancing and Innovating Med-Cal (CalAIM) initiative. There are many significant changes to the DMC-ODS program including reimbursement for treatment services during the assessment period while a diagnosis is being formed. Additionally, ASAM level .50 (early intervention services) are now reimbursable for youth. Also, people leaving correctional settings with a known SUD are now immediately eligible at release for recovery services. Lastly, the most impactful change associated with the launch of CalAIM for DMC-ODS counties is that residential treatment episodes are no longer capped at a two stay maximum per calendar year. This change is specifically impactful to women who often leave residential treatment due to childcare issues. People will now have access to life saving residential care when needed.