REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  May  19, 2020
CATEGORY:  Consent - Health and Human Services-6.

SUBJECT:

Agreements with Partnership HealthCare of California for Drug Medi-Cal Organized Delivery System Services

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Paige Greene, Branch Director, HHSA Adult Services, (530) 225-5900

STAFF REPORT APPROVED BY:  Donnell Ewert, Director, Health and Human Services Agency

RECOMMENDATION

Approve the following evergreen agreements with Partnership HealthCare of California (PHC) for the provision of a Drug Medi-Cal Organized Delivery System:  (1) Master Administration Services expenditure agreement to ensure availability and accessibility to Drug Medi-Cal services for Medi-Cal beneficiaries effective July 1, 2020, including: (a) Master Administration Services Exhibit D, Memorandum of Understanding, with no compensation to specify Substance Use Services delivery and coordination responsibilities effective date of signing; and (b) Master Administration Services agreement Exhibit E, Business Associate Agreement; and (2) Substance Use Services revenue agreement at rates listed on Exhibit D with no maximum compensation for the delegation of, arrangement for, and provision of Medi-Cal covered substance use treatment services for Medi-Cal beneficiaries assigned to PHC as Members effective date of signing, including the Substance Use Services Business Associate Agreement.

DISCUSSION

The Health and Human Services Agency – Adult Services Branch (HHSA) provides outpatient substance use disorder (SUD) treatment services to assist individuals who are experiencing substance use problems that are impacting their physical health, interpersonal relationships, or causing employment or legal issues. If an individual needs other services, such as residential treatment, detox services, or other types of counseling, the individual is referred to an appropriate, available local treatment program. Individuals are assessed to ensure they meet medical criteria for treatment.

Shasta County, as a part of a seven-county north-state region, with PHC, submitted a joint regional plan to the State Department of Health Care Services and Federal Centers for Medicaid Services to opt-in to the Drug Medi-Cal Organized Delivery System (DMC-ODS). The DMC-ODS will allow Medi-Cal patients to access a greater scope of SUD services than is currently available in the state-plan Medi-Cal program and will increase federal dollars available to fund the expanded system of care.

The Master Administration Services Agreement assigns the functions of the State’s DMC-ODS agreement from the County to PHC. Services provided through this agreement by PHC are billed to County on a fee-for-service basis. This agreement is also the County’s commitment to monitoring Partnership’s provision of the services and functions contained in the Department of Health Care Services DMC-ODS agreement. 

The Substance Use Services agreement represents a revenue agreement which will allow HHSA to be a provider in the DMC-ODS and to bill the Medi-Cal health plan (PHC) for SUD treatment services. On submission of approved claims, HHSA will be compensated for SUD outpatient services provided to Medi-Cal beneficiaries. There is no maximum amount reimbursable under this agreement.

ALTERNATIVES

The Board could choose not to approve the recommendation, defer consideration to a future date, or provide alternate direction to staff.

OTHER AGENCY INVOLVEMENT

County Counsel has approved the agreements as to form.  Risk Management has reviewed and approved the agreements. This recommendation has been reviewed by the County Administrative Office.

FISCAL IMPACT

Associated revenue and expenditures are on a fee-for-service basis.  Due to the timing of receipt of the agreements, the rates included in this agreement, and budget submission, the current Health and Human Services Agency’s FY 2020-21 Requested Budget does not fully include appropriation authority for the activities described in these agreements.  A budget amendment will be presented after the Board’s approval of the FY 2020-21 Requested Budget to accommodate any necessary changes.  Sufficient appropriation authority will be included in future year budget submittals.