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Agenda Item
ASR
Control 21-000699 |
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MEETING DATE: |
09/14/21 |
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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): |
Joanne Lim (714) 834-55 |
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Erin Winger (714) 647-4510 |
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Subject: Approve Agreement Increase
Amount of Sublocade Agreement
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ceo CONCUR |
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Clerk of the Board |
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Concur |
No Legal Objection |
Discussion |
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3 Votes Board Majority |
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Budgeted: Yes |
Current Year Cost:
$1,666,667 |
Annual Cost:
FY 2022-23 $333,333 |
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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: N/A
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RECOMMENDED ACTION(S):
Authorize the County Procurement Officer or authorized Deputy to increase the agreement amount of Sublocade Agreement with AmerisourceBergen Drug Corporation dba ASD Specialty Healthcare, LLC Besse Medical, in an amount not to exceed $1,000,000 effective upon Board of Supervisors approval through November 1, 2021, and in an amount not to exceed $1,000,000 effective November 2, 2021, through November 1, 2022, for a new cumulative total amount not to exceed $2,250,000.
SUMMARY:
Approval to increase the agreement amount of Sublocade Agreement with AmerisourceBergen Drug Corporation dba ASD Specialty Healthcare, LLC Besse Medical will allow the Health Care Agency's Correctional Health Services to support current coronavirus mitigation strategies, as well as expand upon continuity of care goals and address patient diversion opportunities.
BACKGROUND INFORMATION:
On November 2, 2020, the Health Care Agency (HCA) signed a sole source commodities agreement for Sublocade with AmerisourceBergen Drug Corporation dba ASD Specialty Healthcare, LLC Besse Medical. Sublocade is a proprietary, long-acting, injectable form of buprenorphine used to treat opioid use disorder. HCA committed to make no more than $250,000 in Sublocade purchases under the agreement. However, the Correctional Health Services (CHS) Program has an expanded need for Sublocade and is bringing this item in front of your Honorable Board of Supervisors (Board) for approval of an increase in the amount purchased under this commodities agreement. CHS is requesting to augment the existing agreement to include Sublocade in order to support current coronavirus mitigation strategies, as well as expand upon continuity of care goals and address patient diversion opportunities.
The County of Orange is mandated to provide medical care to persons in the County's custody pursuant to State of California Penal Code Sections 4011 and 4015 and Government Code Section 29602. HCA's CHS division is the designated provider of health care to adult persons in-custody on behalf of the Orange County Sheriff's Department (OCSD) and on behalf of the Probation Department for juveniles. Over the course of the past several years, CHS has augmented existing substance use disorder (SUD) treatment protocols to incorporate enhanced medication-assisted treatment (MAT). MAT is an evidence-based approach that utilizes medications, in combination with other therapy modalities, to provide for a “whole-person” methodology to the treatment of SUD. MAT is primarily used for the treatment of addiction to opioids, with prescribed medication normalizing brain chemistry and blocking physiological cravings. MAT medications can be delivered in a daily oral or a monthly injectable form.
The current process for medication delivery in the Orange County Jail system primarily involves daily dispensing of oral MAT doses to individual patients. This process requires both health care personnel for medication administration and custody personnel for access and security. Near the beginning of the pandemic in 2020, CHS collaborated with OCSD on coronavirus mitigation strategies throughout the facilities to address staff and patient safety, including modification of medication delivery to reduce staff and patient face-to-face encounters, where applicable. Both CHS and OCSD experienced increased efficiencies when extending time from daily to weekly medication administration. Through grant opportunities, CHS has been able to fund the purchase of monthly injectable MAT medications to substitute daily oral administration and incorporate this medication delivery process on a more limited scope, where applicable. Through this method, CHS has identified opportunities to maximize patient care by decreasing treatment disruptions through a reduction in inmate misuse of the medication while realigning personnel obligations. While price per dose may appear more cost effective for the oral form, the ancillary costs associated with medication delivery, including general operational efficiency improvements, argue in favor of incorporating once monthly injectables into a larger scope of the MAT program. Providing a monthly injectable medication to patients prior to release from custody supports continuity of care and is in line with County’s OC Cares goals, ensuring patients are receiving sustained treatment while engaging services in the community post-release and allowing for potential delays due to the impact of the coronavirus within the health care delivery system in the community.
HCA tried to contract directly with Indivior, Inc, the manufacturer of Sublocade, but were unable to come to an agreement and were directed to contract with their distributor, AmeriSourceBergen Drug Corporation dba ASD Speciality Healthcare, LLC Besse Medical. As this is a proprietary drug, this is the only source available to provide Sublocade and thus HCA proceeded as a sole source agreement. The proposed agreement is a sole source agreement and a completed Sole Source Request Form is attached to this Agenda Staff Report. See Attachment B for a completed Sole Source Request Form.
This agreement does not currently include subcontractors or pass through to other providers. See Attachment C for Contract Summary Form.
The Contractor's performance has been confirmed as at least satisfactory. HCA has verified there are no concerns that must be addressed with respect to Contractor's ownership/name, litigation status or conflicts with County interests. The Orange County Preference Policy is not applicable to this sole source agreement.
HCA requests that the Board authorize the County Procurement Officer or authorized Deputy to increase the agreement amount of Sublocade Agreement with AmerisourceBergen Drug Corporation dba ASD Specialty Healthcare, LLC Besse Medical, as referenced in the Recommended Action.
FINANCIAL IMPACT:
Appropriations for this agreement are included in Budget Control 042 FY 2021-22 Budget and will be included in the budgeting process for future years.
STAFFING IMPACT:
N/A
ATTACHMENT(S):
Attachment A -– Sublocade AgreementContract No.
MA-042-21010912 with AmerisourceBergen Drug Corporation dba ASD Specialty
Healthcare, LLC Besse
Attachment B - Sole Source Justification Form
Attachment C - Contract Summary Form
Attachment D - State of California Penal Code Sections 4011 and 4015 and
Government Code Section 29602