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Agenda Item
ASR
Control 21-000923 |
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MEETING DATE: |
12/07/21 |
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legal entity taking action: |
Board of Supervisors |
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board of supervisors
district(s): |
2, 4, 5 |
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SUBMITTING
Agency/Department: |
Health Care Agency
(Approved) |
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Department contact
person(s): |
Annette Mugrditchian (714) 834-5026 |
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Jeff Nagel (714) 834-7024 |
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Subject: Amendments for Narcotic
Replacement Therapy Treatment Services
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ceo CONCUR |
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Clerk of the Board |
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Concur |
Approved Agreement to Form |
Consent Calendar |
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3 Votes Board Majority |
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Budgeted: N/A |
Current Year Cost:
N/A |
Annual Cost:
N/A |
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Staffing Impact: |
No |
# of Positions:
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Sole Source:
Yes |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 03/23/2021
#23, 10/06/2020 #3, 06/02/2020 #11, 04/23/2019 #26 |
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RECOMMENDED ACTION(S):
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1. |
Approve Amendment No. 7 to expand the scope of work for the Contract with Western Pacific Med-Corp, Inc. for provision of Drug Medi-Cal Narcotic Replacement Therapy Treatment Services for the effective date of January 7, 2022, through June 30, 2022. |
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2. |
Approve Amendment No. 4 to expand the scope of work for the Contract with Western Pacific Re-Hab for provision of Drug Medi-Cal Narcotic Replacement Therapy Treatment Services for the effective date of January 7, 2022, through June 30, 2023. |
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3. |
Approve Amendment No. 6 to expand the scope of work in the Sole Source Contract with Western Pacific Re-Hab, for provision of Narcotic Replacement Therapy Treatment Services for the effective date of January 7, 2022, through June 30, 2022. |
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4. |
Authorize the County Procurement Officer or authorized Deputy to execute the Amendments with Western Pacific Med-Corp, Inc. and Western Pacific Re-Hab, as referenced in the Recommended Actions above. |
SUMMARY:
Approval of the Amendments with Western Pacific Med-Corp, Inc., and Western Pacific Re-Hab. for Drug Medi-Cal and non-Drug Medi-Cal Narcotic Replacement Therapy Treatment Services will allow the County to expand the provision of narcotic replacement maintenance therapy and detoxification from serving only adults to serving adolescents with opiate withdrawal symptoms as well.
BACKGROUND INFORMATION:
In 2016, Health Care Agency (HCA) submitted a plan to the Department of Health Care Services (DHCS) to provide a continuum of Substance Use Disorder (SUD) services, reimbursable under Drug Medi-Cal (DMC), for residents of Orange County. On May 8, 2018, your Honorable Board of Supervisors (Board) approved this plan. After a competitive solicitation, HCA executed contracts with various DMC and non-DMC certified treatment providers in Orange County. Implementation of this new benefit and services for Orange County Medi-Cal beneficiaries is directly addressing the opioid crisis.
On March 28, 2017, the Board approved a Contract with Western Pacific Re-Hab for provision of Narcotic Replacement Therapy (NRT) Treatment Services. On May 22, 2018, the Board approved the Contract with Western Pacific Med-Corp, Inc. for provision of DMC NRT Treatment Services and the below additional actions have been executed pursuant to appropriate authorities.
Non-DMC and DMC NRT Board Actions
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Board Date |
Contract/Amendment |
Action |
Term |
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April 23, 2019 |
Amendment No.3 |
Board Approved Increase Amount for Non-DMC NRT Amendment with Western Pacific Re-Hab |
July 1, 2017 - June 30, 2020 |
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June 02, 2020 |
Amendment No. 2 and Amendment No. 4 |
Board Approved DMC and Non-DMC NRT Amendments with Western Pacific Med-Corp. Inc. and Western Pacific Re-Hab respectively |
July 1, 2020 - June 30, 2021 |
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October 06, 2020 |
Contract |
Board Approved DMC NRT Contract with Western Pacific Re-Hab |
November 6, 2020 - June 30, 2023 |
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March 23, 2021 |
Amendments No. 5 |
Board Approved DMC and Non-DMC NRT Amendments with Western Pacific Med-Corp. Inc. and Western Pacific Re-Hab respectively |
July 1, 2021 - June 30, 2022 |
The proposed Amendments are needed to fulfill DHCS mandated services for adolescent Medi-Cal beneficiaries ages 12 through 17 years old as required under the DMC Organized Delivery System (DMC-ODS). The Amendments will expand services from serving only adults to serving also adolescents ages 12 through 17 years old without insurance. These will be HCA’s first contracts with a DMC and non-DMC NRT provider serving adolescents. The expanded scope of work to include minors as a population served under the contracts was not included in the competitive solicitation for the DMC and non-DMC-NRT services as required by Contract Policy Manual Section 3.4-115 and therefore requires Board approval.
Scope of Work
Both DMC and non-DMC NRT Treatment Services include: Medication Assisted Treatment (MAT), assessment and evaluation, counseling, co-occurring disorder treatment, both individual and group counseling services, case management, relapse prevention and linkage with ancillary services. MAT is provided to clients suffering from opioid addiction. MAT works to reduce cravings, block the effects of opioids and stabilize clients and is considered part of the best practice for treatment of clients with opioid disorders. MAT helps clients to stay off the opioid narcotics, which reduces the serious and sometimes deadly side effects of withdrawal and/or overdose. MAT takes a whole patient approach to treatment that focuses on alleviating both the physical and behavioral aspects of addiction to opiates. MAT services under the Contracts are provided to Medi-Cal eligible residents of Orange County and to residents of Orange County who have no insurance and are at or below 200 percent of the federal poverty level. The target population for these services is being expanded via the Amendments to include adolescents ages 12 through 17 years old.
DMC Services
MAT services under the Contracts with Western Pacific Med-Corp. Inc., and Western Pacific Re-Hab, are provided to Medi-Cal eligible residents of Orange County. The provider has four sites for the provision of these services in Costa Mesa, Fullerton, Stanton and Mission Viejo. These Amendments will allow DMC NRT services to be offered to adolescents ages 12 through 17 years old. .
Non-DMC Services
MAT services under the Contract with Western Pacific Re-Hab are provided to residents of Orange County who have no insurance and are at or below 200 percent of the federal poverty level. The provider has three sites for the provision of these services in Costa Mesa, Fullerton and Stanton. This Amendment will allow non-DMC NRT services to be offered to adolescents ages 12 through 17 years old.
Collectively, Western Pacific Med-Corp, Inc., and Western Pacific Re-Hab, have the capacity to serve 1675 clients annually.
Services are accessible for both DMC and Non DMC Clients through self-referral, or by being referred through SUD programs, hospitals, correctional facilities and other community partners.
Performance Outcomes:
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Goal for DMC and Non-DMC NRT |
FY 2019-20 DMC NRT |
FY 2019-20 Non-DMC NRT |
FY 2020-21 DMC NRT |
FY 2020-21 Non-DMC NRT |
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Compliance with MAT |
> 80% |
90% |
97% |
96% |
98% |
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Abstinence from Substances |
> 50% |
56% |
84% |
67% |
69% |
Performance Outcomes are reported back to HCA monthly by the provider through their client method tracking reports
The Contract with Western Pacific Re-Hab for non DMC NRT Treatment Services is a sole source because the Substance Abuse Prevention and Treatment Block Grant funding does not allow for contracts with for-profit organizations. Also, the County must utilize state-certified NRTs to provide these services. Western Pacific Re-Hab is the only non-profit vendor that is state-certified and is geographically accessible to the target population. HCA has confirmed with the state that as of October 22, 2021, no new non-profit providers have been licensed to provide these services in Orange County. This Contract was approved as a sole source Agreement by the County Procurement Office on February 10, 2020, and the completed Sole Source Request Form is attached to this Agenda Staff Report as Attachment H.
The Contractors' performances have been confirmed as satisfactory. HCA has verified there are no concerns that must be addressed with respect to Contractors' ownerships/names, litigation status or conflicts with County interests.
The proposed Amendments do not currently include subcontractors or pass through to other providers. See Attachment D for Contract Summary Form.
HCA requests that the Board approve Amendment No. 7 with Western Pacific Med-Corp, Inc., and Amendments No. 4 with Western Pacific Re-Hab and No. 6 with Western Pacific Re-Hab,as referenced in the Recommended Actions.
FINANCIAL IMPACT:
Appropriations for these Contracts are included in Budget Control 042 for FY 2021-22 as approved by the Board of Supervisors on March 23, 2021, for a total of $9,158,670 annually.
Should services need to be reduced or terminated due to lack of funding, these contracts contain language that allows HCA to give 30-day notice to either terminate or renegotiate the level of services provided. The notice will allow HCA adequate time to transition or terminate services to clients, if necessary.
STAFFING IMPACT:
N/A
ATTACHMENT(S):
Attachment A - Amendment No. 7 to Contract MA-042-19010230
with Western Pacific Med-Corp, Inc.
Attachment B - Amendment No. 4 to Contract MA-042-21010263 with Western Pacific
Re-Hab
Attachment C - Amendment No. 6 to Contract MA-042-18010277 with Western Pacific
Re-Hab
Attachment D - Contract Summary Form
Attachment E - Redline to Attachment A
Attachment F - Redline to Attachment B
Attachment G - Redline to Attachment C
Attachment H - Sole Source Justification to Attachment C