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Agenda Item
ASR
Control 24-000521 |
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MEETING
DATE: |
04/22/25 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
All
Districts |
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SUBMITTING Agency/Department: |
Health
Care Agency (Approved) |
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Department contact person(s): |
Veronica
Kelley (714) 834-7024 |
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Ian
Kemmer (714) 834-2160 |
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Subject: Renewal of Drug Medi-Cal Adult
& Adolescent Outpatient Services
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ceo CONCUR |
County Counsel Review |
Clerk of the Board |
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Concur |
Approved
Agreement to Form |
Discussion |
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3
Votes Board Majority |
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Budgeted: N/A |
Current Year
Cost: N/A |
Annual Cost: FY 2025-26 $14,271,314 |
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Staffing Impact: |
No |
# of Positions: |
Sole Source: No |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 8/2/2022 #12, 11/29/2022 #35 |
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RECOMMENDED
ACTION(S):
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1. |
Approve
Amendment No. 3 to renew the Master Contract with various providers for the
provision of Drug Medi-Cal Adolescent Outpatient and Intensive Outpatient
Services, for the term of July 1, 2025, through June 30, 2027, for an
aggregate amount not to exceed $3,093,948, for a revised cumulative aggregate
total amount not to exceed $7,477,041. |
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2. |
Approve
Amendment No. 3 to renew the Master Contract with various providers for the
provision of Drug Medi-Cal Adult Outpatient and Intensive Outpatient Services,
for the term of July 1, 2025, through June 30, 2027, for an aggregate amount
not to exceed $25,448,680, for a revised cumulative aggregate total amount
not to exceed $49,012,273. |
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3. |
Authorize the
County Procurement Officer or Deputized designee to execute the Amendment No.
3 to the Master Contract and individual amendments with various providers for
Drug Medi-Cal Adolescent Outpatient and Intensive Outpatient Services and to
execute the Amendment No. 3 to the Master Contract and individual amendments
with various providers for Drug Medi-Cal Adult Outpatient and Intensive
Outpatient Services, as referenced in the Recommended Actions above. |
SUMMARY:
Approval of Amendments to renew the
Master Contract and individual Amendments with various providers for the
provision of Drug Medi-Cal Adolescent and Adult Outpatient and Intensive
Outpatient Services, including Medications for Assisted Treatment, will fulfill
mandated services for adults and adolescents as required under the Drug
Medi-Cal Organized Delivery System.
BACKGROUND
INFORMATION:
Your Honorable Board of Supervisors
(Board) approved the Master Contract with various providers for provision of
Drug Medi-Cal (DMC) Adolescent Outpatient and Intensive Outpatient Services.
The below actions were executed pursuant to appropriate authorities. Prior to
contract expiration, the Health Care Agency (HCA) plans to issue a solicitation
to continue services. The Orange County Preference Policy is not applicable to
these Amendments.
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Board
Date |
Contract/Amendment |
Action |
Term |
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August 2, 2022 |
Contract |
Board Approved Contract |
September 9, 2022-June
30, 2025 |
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November 29, 2022 |
Contract |
Board Approved Contract |
January 1, 2023-June 30
2025 |
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N/A |
Amendments No. 1 Amendment No. 2 |
DPA Administrative
Amendments |
August 1, 2023- June
30, 2025 May 24, 2024-June 30,
2025 |
The proposed Master Contracts for
adolescents and adults with the recommended providers are needed to fulfill
mandated services required under the Drug Medi-Cal Organized Delivery System
(DMC-ODS) for both adolescents twelve through seventeen years and adults
eighteen or older who are Medi-Cal eligible residents of the County of Orange.
Scope
of Services
DMC-ODS Outpatient Substance Use Disorder
(SUD) treatment is a required service for DMC. These treatment programs include
outpatient and intensive outpatient services to adolescent individuals ages 12
through 17 and adults 18 or older who are Medi-Cal eligible residents of the
County. Through these contracts, providers will continue to offer Intensive
Outpatient Treatment (IOT) and Outpatient Drug Free (ODF) treatment, as well as
Recovery Services (RS) for clients who have already completed a SUD treatment
program and require continued support.
Outpatient treatment services shall be
recovery-based and have an individualized approach, which will address their
specific needs and impairments.
Adolescent outpatient treatment services will utilize the Adolescent SUD
Best Practices Guide as established by the California Department of Health Care
Services (DHCS). This guide ensures services address the unique and complex
developmental needs of this population while recommending family and/or
supportive adult participation in the adolescent’s treatment. Adolescents and
adults will be assessed and referred for the appropriate level of care based on
their eligibility as determined by utilizing the American Society of Addiction
Medicine (ASAM) assessment tool. Services will include assessment, individual
and group counseling, patient education, treatment planning, assessment and
care coordination for family needs, case management, crisis intervention,
discharge planning, referral for ancillary needs, and linkage to ongoing
support and continuity of care.
Phoenix House of Orange County, Inc. will
continue to provide Medications for Addiction Treatment (MAT) services for
adolescents with an opioid use disorder and/or alcohol use disorder, while
Genesis New Beginning and PES-ebs., Inc. will continue to provide these same
services for adults.
Performance
Outcomes
The Performance Outcomes for DMC
Adolescent and Adult Outpatient and Intensive Outpatient Services are listed
below:
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Effective outpatient
services will be measured by provider retention rates of 50 percent or
higher, where retention is defined as client engagement in services for at
least 30 days. |
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Effective outpatient
services will also be measured by satisfactory treatment progress rates of 50
percent or higher for each provider, where satisfactory treatment progress is
defined as significant progress being made towards client treatment plan
goals at the time of discharge. |
Adolescent Performance Outcomes:
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FY 2023-24 July 1, 2023, to June 30, 2024 Total number of clients served: 323 |
FY 2024-25 July 1, 2024, to December 31, 2024 Total number of clients served: 162 |
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Contractor |
Retention Rate (Goal >50%) |
Completion Rate (Goal >50%) |
Retention Rate (Goal >50%) |
Completion Rate (Goal >50%) |
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Twin Town Treatment
Center, Inc. |
65% |
63% |
91% |
70% |
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Wel Mor Psychology
Group, Inc. |
63% |
73% |
100% |
92% |
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Phoenix House of Orange
County, Inc. |
100% |
67% |
*** |
*** |
***For FY 2024-25, the numbers served were
very low. As such, reliable percentages could not be calculated.
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FY 2023-24 July 1, 2023, to June 30, 2024 Total number of clients served: 2453 |
FY 2024-25 July 1, 2024, to December 31, 2024 Total number of clients served: 1698 |
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Contractor |
Retention Rate (Goal >50%) |
Completion Rate (Goal >50%) |
Retention Rate (Goal >50%) |
Completion Rate (Goal >50%) |
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Twin Town Treatment Center, Inc. |
69% |
64% |
77% |
75% |
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Wel Mor Psychology Group, Inc. |
73% |
80% |
67% |
84% |
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PES-ebs., Inc. |
69% |
29% |
68% |
45% |
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Genesis New Beginning |
91% |
13% |
98% |
80% |
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The Teen Project, Inc. |
77% |
49% |
89% |
59% |
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DMS Services, dba DMS Options |
N/A |
N/A |
0% |
0% |
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Phoenix House of Orange County, Inc. |
80% |
55% |
88% |
67% |
In FY 2023-24, one provider (DMS Services)
experienced a significant delay in launching services due to issues securing a
DMC-approved location, hiring staff, and completing the extensive onboarding
process. In addition, three providers (PES-ebs, Genesis, DMS Services) were not
accurately entering data into the outcomes system, resulting in inaccurately
low calculated rates. County systematically reviewed their data entry practices
and provided technical assistance and training, resulting in improved rates during
the first half of FY 2024-25 for two of the providers. County will continue to
work closely with providers to ensure prompt and precise entry, and provide
training support, as necessary. In FY ’24-’25, Phoenix House Adolescent Program
faced significant staffing challenges, specifically related to hiring and
retention.
The individual Contracts have subcontracts
with various providers. See Attachment C for information regarding
subcontractors and Contract Summary Form.
The contractors’ performance has been
confirmed as satisfactory. HCA has verified there are no concerns that must be
addressed with respect to Contractors’ ownership/name, litigation status or
conflicts with County interests.
HCA requests the Board approve Amendments
No. 3 to the Master Contract and individual amendments with various providers
for the provision of Drug Medi-Cal Adolescent and Adult Outpatient and
Intensive Outpatient Services as referenced in the Recommended Actions above.
FINANCIAL
IMPACT:
Appropriations for the Contracts will be included in
Budget Control 042 FY 2025-26 and in the budgeting process for future years.
The Contracts include provisions allowing
HCA to terminate the Contracts, reduce the level of services, and/or
renegotiate the levels of services provided, as necessary. This includes a
notice that allows HCA adequate time to transition or terminate services, if
necessary.
STAFFING
IMPACT:
N/A
ATTACHMENT(S):
Attachment
A- Amendment No. 3 to MA-042-22011841 for provision of Drug Medi-Cal Adolescent
Outpatient and Intensive Outpatient Services
Attachment B - Amendment No. 3 to MA-042-23010409 for provision of Drug
Medi-Cal Adult Outpatient and Intensive Outpatient Services
Attachment C - Contract Summary Forms