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Agenda Item
ASR
Control 22-001102 |
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MEETING
DATE: |
03/28/23 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
2,
3, 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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Veronica
Kelley (714) 834-7024 |
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Subject: Contracts for Drug Medi-Cal
Narcotic Replacement Therapy Treatment 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: Yes |
Current Year
Cost: $700,000 |
Annual Cost: FY 2023-24 $9,900,000 |
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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: 5/10/2022 #30, 12/7/2021 #2, 6/22/2021
#S71I, 3/23/2021 #23 |
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RECOMMENDED
ACTION(S):
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1. |
Approve the selection of and Contract
with California Treatment Services, LLC dba Recovery Solutions of Santa Ana
for provision of Drug Medi-Cal Narcotic Replacement Therapy Treatment
Services, for the term of July 1, 2023, through June 30, 2025, for an amount
not to exceed $7,000,000, renewable for an additional two-year term. |
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2. |
Approve the selection of and Contract
with Western Pacific Med-Corp for provision of Drug Medi-Cal Narcotic
Replacement Therapy Treatment Services for the term of July 1, 2023, through
June 30, 2025, for an amount not to exceed $11,000,000, renewable for an
additional two-year term. |
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3. |
Pursuant to Contract Policy Manual
Section 3.4-114, authorize the County Procurement Officer or or Deputized
designee to exercise a contingency contract cost increase in an amount not to
exceed 10 percent of the first year of funding for the Contract with
California Treatment Services, LLC dba Recovery Solutions of Santa Ana and
Western Pacific Med-Corp for the entire term of the contract, including
renewals, and within the scope of work set forth in the Contract. The use of
this contingency contract cost increase is subject to approval requirements
established by the County Procurement Officer. |
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4. |
Approve Amendment No. 11 to the Contract
with California Treatment Services, LLC dba Recovery Solutions of Santa Ana
for provision of Drug Medi-Cal Narcotic Replacement Therapy Treatment
Services, to increase the contract amount by $300,000, for the term of May 1,
2023, through June 30, 2023, for a revised cumulative contract total amount
not to exceed $16,725,111. |
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5. |
Approve Amendment No. 7 to the Contract
with Western Pacific ReHab for provision of Drug Medi-Cal Narcotic
Replacement Therapy Treatment Services, to increase the contract amount by
$400,000, for the term of May 1, 2023, through June 30, 2023, and to renew
the Contract for the term of July, 1, 2023, through June 30, 2025, for an
amount not to exceed $1,800,000, for a revised cumulative contract total
amount not to exceed $3,733,333. |
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6. |
Authorize the County Procurement Officer
or Deputized designee to execute the Contracts California Treatment Services,
LLC dba Recovery Solutions of Santa Ana and Western Pacific Med-Corp and
Amendments with California Treatment Services, LLC dba Recovery Solutions of
Santa Ana and Western Pacific Rehab, as referenced in the Recommended Actions
above. |
SUMMARY:
Approval of Contracts and
Amendments with California Treatment Services, LLC dba Recovery Solutions of
Santa Ana, Western Pacific Med-Corp, and Western Pacific Rehab for Drug
Medi-Cal Narcotic Replacement Therapy Treatment Services will provide narcotic replacement
maintenance therapy and detoxification for adults and adolescents with opiate
withdrawal symptoms.
BACKGROUND
INFORMATION:
On
November 22, 2022, the Health Care Agency (HCA) released a Request for
Application (RFA) for qualified Drug Medi-Cal (DMC) Narcotic Replacement
Therapy (NRT) Treatment providers to provide narcotic replacement maintenance
therapy and detoxification for adults and adolescents with opiate withdrawal
symptoms. There were two respondents to the RFA. The applications were reviewed
by HCA representatives for responsiveness and California Treatment Services,
LLC dba Recovery Solutions of Santa Ana and Western Pacific Med-Corp were
recommended for contract award.
HCA staff conducted due diligence on the
contractors. Reference checks were satisfactory and completed with Riverside
University Health System – Behavioral Health, Harm Reduction Institute and
Mercy House for California Treatment Services, LLC dba Recovery Solutions of
Santa Ana; and College Hospital Costa Mesa, Woodglen Recovery Junction, Inc.
and Roque Center, Inc. for Western Pacific Med-Corp regarding similar projects.
Additionally, on October 6, 2020, your
Honorable Board of Supervisors (Board) approved the Contract with Western
Pacific Re-Hab for the term of November 6, 2020 - June 30, 2023, renewable for
two additional one year terms. Prior to contract expiration, HCA plans to issue
a solicitation to continue services.
The services provided under the Contracts
with California Treatment Services, LLC dba Recovery Solutions of Santa Ana,
Western Pacific Med-Corp, and Western Pacific Re-Hab would be provided in
compliance with the continued intergovernmental agreement between the HCA and
the California Department of Health Care Services (DHCS) for the implementation
and delivery of DMC, Organized Delivery System (ODS) services.
An increase in the current approved
contract amounts is requested for the two current providers of DMC NRT
Treatment Services, California Treatment Services, LLC dba Recovery Solutions
of Santa Ana and Western Pacific Re-Hab for the remaining term through June 30,
2023, to compensate them for dually insured beneficiaries now covered through
federal legislation changes.
The table below summarizes the prior Board
actions as it pertains to the current DMC funded NRT Treatment Services.
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Board
Date |
Contract/Amendment |
Action |
Term |
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May 22, 2018 |
Contracts with California Treatment
Services, LLC dba Recovery Solutions of Santa Ana (Recovery Solutions) and
Western Pacific Med-Corp |
Board Approved DMC NRT Contracts |
July 1, 2018 - June 30, 2020 |
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June 2, 2020 |
Amendment No. 2 to DMC – NRT Contract
with Western Pacific Med-Corp, Amendment No. 3 to DMC-NRT Contract with
Recovery Solutions |
Board Approved DMC NRT Contract Renewal
Amendments |
July 1, 2020 - June 30, 2021 |
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October 6, 2020 |
Contract with Western Pacific ReHab |
Board Approved DMC - NRT Contract |
November 6, 2020 - June 30, 2023 |
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March 23, 2021 |
Amendments No. 5 to DMC – NRT Contract
with Western Pacific Med-Corp and Amendment No. 6 to DMC - NRT Contract with
Recovery Solutions |
Board Approved Contract Increase |
July 1, 2021 - June 30, 2022 |
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June 22, 2021 |
Amendment No. 7 to DMC - NRT Contract
with Recovery Solutions |
Board Approved Contract Increase |
July 1, 2021 - June 30, 2022 |
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December 7, 2021 |
Amendment No. 4 to DMC - NRT Contract
with Western Pacific Re-Hab and Amendment No. 7 to DMC – NRT Contract with
Western Pacific Med-Corp |
Board Approved Contract for Scope of
Work Expansion |
January 7, 2022 – June 30, 2022 |
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May 10, 2022 |
Amendment No. 9 to DMC - NRT Contract
with Recovery Solutions Amendment No. 8 to DMC - NRT Contract with Western
Pacific Med-Corp, Amendment No. 5 to DMC - NRT Contract with Western Pacific
Re-Hab |
Board Approved Contract Renewal |
July 1, 2022 - June 30, 2023 |
All other amendments were executed under
Deputy Purchasing Agent authority.
The proposed Contracts and Amendments with
the recommended providers are needed to fulfill mandated services required
under the DMC-ODS for both adolescents and adults ages 12 years and older, and
clients who now present with both Medicare and Medi-cal benefits.
Scope
of Services
DMC NRT Treatment Services include:
Medication Assisted Treatment (MAT), substance use disorder related treatment
including assessment and evaluation, individual and group counseling services,
case management, relapse prevention and linkage to additional services. MAT is
provided to clients with opioid use disorder. MAT works to reduce cravings,
block the effects of opioids and help clients to stabilize, and is considered
part of the best practice for treatment of clients with opioid disorders. MAT
helps clients to refrain from using 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.
DMC
Services
MAT services under the Contracts with
California Treatment Services, LLC dba Recovery Solutions of Santa Ana and Western
Pacific Med-Corp will be provided to Medi-Cal eligible residents in Orange
County. Clients of these programs are referred by Beneficiary Access Line,
Correctional Health Services, community providers, self-referred and by various
providers providing substand use disorder services within the network of care.
Some clients may be experiencing homelessness, newly discharged from being
incarcerated and/or released from hospital. These programs have the capacity to
serve over 2,100 clients at any given time throughout the year. Western Pacific
Med-Corp has a total of four clinic sites and California Treatment Services,
LLC dba Recovery Solutions of Santa Ana has one clinic site. These clinic sites
allow for clients who are affected by opioid use disorders throughout Orange
County to access this needed service. The target population for California
Treatment Services, LLC dba Recovery Solutions includes adults, ages 18 years
and older, while the target population for Western Pacific Med-Corp and Western
Pacific Re-Hab include adolescents and adults, ages 12 years and older. The
expansion to providing adolescent services helps fulfill access and capacity
requirements mandated by DHCS through the DMC-ODS. DMC NRT, including MAT
services, are offered in Costa Mesa, Fullerton, Mission Viejo, Santa Ana and
Stanton.
Performance
Outcomes
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Goal
for DMC |
FY
2021-22 DMC
NRT |
FY
2022-23 DMC
NRT (July-Dec) |
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Compliance
with MAT |
> 80% |
93% |
93% |
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Abstinence
from Substances |
> 50% |
59% |
56% |
Performance Outcomes are collected after
clients are in treatment for 90 days. This is to allow clients to stabilize in
treatment to support more accurate performance outcome data.
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.
Orange County Preference Policy is not
applicable to these Contracts and Amendments.
The Contracts and Amendments do not
currently include subcontractors or pass through to other providers. See
Attachments E for Contract Summary Forms.
HCA requests that the Board approve the
selection of and Contracts with California Treatment Services, LLC dba Recovery
Solutions of Santa Ana and Western Pacific Med-Corp, Amendment No. 11 with
California Treatment Services, LLC dba Recovery Solutions of Santa Ana, and Amendment
No. 7 with Western Pacific Re-Hab, as referenced in the Recommended Actions
above.
FINANCIAL
IMPACT:
Appropriations for these Contracts
are included in Budget Control 042 FY 2022-23 Budget and will be included in
the Budgeting process for future years.
The proposed Contract includes provisions
allowing HCA to terminate the Contract, 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 to
clients, if necessary.
Funding
Sources:
FED: 3% (Substance Abuse Block
Grant)
Fees/Other: 47% (Federal Financial
Participation Drug Medi-Cal)
State: 47% (Drug Medi-Cal State
General Fund, 2011 Realignment/AB 109 Realignment)
GF: 3% (Net County Cost)
STAFFING
IMPACT:
N/A
ATTACHMENT(S):
Attachment
A - Contract MA-042-23010943 for Drug Medi-Cal Narcotic Replacement Therapy
Treatment Services with California Treatment Services, LLC dba Recovery
Solutions of Santa Ana
Attachment B - Contract MA-042-23010944 for Drug Medi-Cal Narcotic Replacement
Therapy Treatment Services with Western Pacific Med-Corp
Attachment C - Amendment No. 11 to Contract MA-042-19010241 for Drug Medi-Cal
Narcotic Replacement Therapy Treatment Services with California Treatment
Services, LLC dba Recovery Solutions of Santa Ana
Attachment D – Amendment No. 7 to Contract MA-042-21010263 for Drug Medi-Cal
Narcotic Replacement Therapy Treatment Services with Western Pacific Rehab
Attachment E – Contract Summary Forms
Attachment F - Redline to Attachment C
Attachment G - Redline to Attachment D