REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
January 5, 2021
FROM
VERONICA KELLEY, Director, Department of Behavioral Health
SUBJECT
Title v
Revenue Agreement with the State of California for the Substance Use Disorder Drug Medi-Cal Organized Delivery System
End
RECOMMENDATION(S)
Recommendation
Approve Revenue Agreement with the State of California Department of Health Care Services (State Agreement No. 20-10193), for the Substance Use Disorder Drug Medi-Cal Organized Delivery System, in the amount of $147,928,527, for the period of July 1, 2020 through June 30, 2023.
(Presenter: Veronica Kelley, Director, 388-0801)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The Revenue Agreement with the State of California Department of Health Care Services (DHCS) for the Substance Use Disorder (SUD) Drug Medi-Cal Organized Delivery System (DMC-ODS) in the amount of $147,928,527 includes Drug Medi-Cal State General Funds and Drug Medi-Cal Federal Share funding. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2020-21 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and SUD services to San Bernardino County residents who are experiencing major mental illness and/or substance use disorders. DBH provides a full range of SUD prevention, treatment services and education for communities and residents of San Bernardino County through contracts with community-based organizations and county-operated clinics with the goal of promoting prevention, intervention, recovery and resiliency for individuals and families. In 2019-20, the DBH SUD comprehensive continuum of treatment programs provided 5,994 unduplicated clients SUD treatment. Of the clients treated, 22% had a co-occurring disorder and received concurrent mental health treatment. A total of 9,197 treatment episodes were provided which consists of 669,576 service components at over 3 million service hours.
The DMC-ODS is a component of the 1115 Bridge to Reform demonstration waiver project implemented by DHCS. The DMC-ODS is a pilot program to test a new paradigm for the organized delivery of health care services for Medi-Cal eligible individuals with substance use disorders. DBH opted into the DMC-ODS on March 1, 2018 and launched the DMC-ODS Plan for San Bernardino County residents. Benefits offered through the DMC-ODS are modeled after the nationally recognized guidelines from the American Society of Addiction Medicine (ASAM) known as the ASAM Criteria; whereas clients are screened and placed in the most appropriate level of care to best suit their needs. Services provided under the DMC-ODS are significantly more comprehensive than the limited set of services provided under the standard Drug Medi-Cal program. The DMC-ODS plan builds on the standard program by expanding services to include case management, multiple levels of residential SUD treatment, withdrawal management, recovery services with a provision for DMC billable peer services, physician consultation, and the option to provide medication-assisted treatment.
On November 10, 2020, DBH received the agreement for DMC-ODS services for 2020-21 through 2022-23 from DHCS. The item is being presented at this time as it is the first date available following the required operational, fiscal, and legal reviews. Approval by the Board of Supervisors at this time will not impact DBH services or activities.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Contracts Manager, 388-0869) on December 8, 2020; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on December 9, 2020; Finance (Christopher Lange, Administrative Analyst, 386-8393) on December 9, 2020; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on December 9, 2020