REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 19, 2023
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Revenue Agreement with the California Department of Health Care Services for the Substance Use Disorder and Recovery Services Drug Medi-Cal Organized Delivery System
End
RECOMMENDATION(S)
Recommendation
Approve Revenue Agreement with the California Department of Health Care Services (State Agreement No. 23-30118) for the Substance Use Disorder and Recovery Services Drug Medi-Cal Organized Delivery System in the amount of $260,750,000, effective July 1, 2023 through June 30, 2027.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The Revenue Agreement (Agreement) with the California Department of Health Care Services (DHCS) for the Substance Use Disorder and Recovery Services (SUDRS) Drug Medi-Cal Organized Delivery System (DMC-ODS) in the amount of $260,750,000, is funded by State General Funds and Federal Financial Participation Drug Medi-Cal. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to county residents experiencing severe mental illnesses and/or SUD. Through its SUDRS division, DBH offers a comprehensive range of SUD services through contracts with community-based organizations and County-operated clinics which provide services inclusive of prevention, treatment, wellness and recovery for individuals and families.
In August 2015, DHCS implemented the DMC-ODS pilot program designed to test a new model for the organized delivery system of health care services for Medi-Cal eligible individuals with SUDs.
On March 1, 2018, DBH opted into the DMC-ODS program and launched the DMC-ODS Plan for county residents. Benefits offered through the DMC-ODS program include providing a continuum of care modeled after the American Society of Addiction Medicine Criteria® for SUD treatment services which also includes increased local control and accountability, greater administrative oversight, utilization controls to improve care and efficient use of resources, evidence-based practices in SUD treatment, and increased coordination with other systems of care.
In 2021, DHCS received reauthorization from the Centers for Medicare & Medicare Services through California’s prior Section 1115 demonstration to continue the DMC-ODS program through December 31, 2026. This Agreement will continue to the approved DMC-ODS program through June 30, 2027.
In 2022-23, the DBH-SUDRS comprehensive SUD continuum of treatment programs provided SUD treatment to 5,358 clients. Of the clients treated, 22% had a co-occurring disorder and received concurrent mental health and SUD treatment. A total of 7,945 treatment episodes were provided consisting of 512,950 service components.
DBH-SUDRS uses and will continue to use DMC-ODS funds to provide Withdrawal Management (also known as Detoxification), Outpatient, Intensive Outpatient, Residential Treatment (also known as Live-In Rehabilitation) to adults and adolescents suffering from SUDs through 22 contracts with 13 community-based organizations. Funding is also used to provide preventative treatment to adolescents with a higher risk of developing a SUD. Supplemental services such as Recovery Services are also provided to clients during and post treatment to support them in their sober journey.
DBH is requesting retroactive approval of the recommended Agreement with DHCS. The Agreement was received on September 20, 2023, and required extensive fiscal review to ensure the fiscal provisions and standard agreement language and requirements could be met. This is the first date available after the required DBH program, fiscal, administrative, and legal reviews. Approval of this item will allow DBH to continue providing services under DMC-ODS.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Manager, 388-0858) on November 20, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on November 20, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on November 28, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on December 4, 2023.