Authorize six-month extensions of the procurement for the seven Adult Drug Medi-Cal Organized Delivery System agreements for Substance Use Disorder treatment and delegate signing authority for four of the resulting renewal agreements to the Yolo County Procurement Manager, for the period for the period of July 1, 2023 through December 31, 2023. (No general fund impact) (Sullivan)

Authorize six-month extensions of the procurement for the seven Adult Drug Medi-Cal Organized Delivery System (DMC-ODS) agreements for Substance Use Disorder treatment (SUD) and delegate signing authority for five of the resulting agreements to the Yolo County Procurement Manager, for the period for the period of July 1, 2023 through December 31, 2023, as follows:

The County entered into an agreement with the California Department of Health Care Services (DHCS) to provide Drug Medi-Cal Organized Delivery System (DMC-ODS) Substance Use Disorder (SUD) treatment services to eligible clients. DMC-ODS is a program for organized SUD services to Medi-Cal eligible individuals with SUD residing in a county that has elected to participate in the DMC-ODS. The program provides beneficiaries with access to care and system interaction needed to achieve sustainable recovery. The County also receives funding from a variety of other federal and state funding streams that assist the County in provided SUD treatment services to various client populations, including but not limited to: Substance Abuse Prevention and Treatment (SABG) Block Grant Funds; Substance Abuse and Mental Health Services Administration (SAMHSA); CalWORKS and CWS funding; 2011 Realignment, and Intergovernmental Transfer (IGT) Funds.

California Advancing and Innovating Medi-Cal (CalAIM) Initiative
In January 2022, DHCS rolled out the CalAIM initiative that aims to provide broad delivery system program and payment reform across the Medi-Cal system. The goal is transformation of the Medi-Cal delivery system, moving it towards a population health approach that prioritizes prevention and whole person care. Focus shifts from compliance to quality and performance metrics. DMC-ODS requirements and policies pursuant to CalAIM initiative were updated as a result of these updates the County is required to revise the terms and conditions in the provider agreements for these services.  In preparation for this system-wide change, the County has been working closely with CalMHSA who has been providing the County and other DMC-ODS/Special Mental Health Services (SMHS) Medi-Cal counties with technical assistance around the CalAIM initiative.

The County has received new boilerplate templates from CalMHSA for both DMC/SUD treatment services and SMHS Medi-Cal services that include updated programmatic regulatory requirements and updated billing/claiming requirements. County is working on finalizing a new Yolo County DMC/SUD boilerplate that is in compliance with these changes, a draft of which is attached hereto as Att. A. Draft Yolo County DMC/SUD boilerplate. The renewal agreements requested in this staff report will be drafted and executed on the finalized Yolo County DMC/SUD boilerplate. County Counsel and the Procurement Division are participating in the review and finalization of the Yolo County DMC/SUD boilerplate. However, due to the timeliness in which the County has been receiving information from DHCS, especially regarding rates, we do not have final boilerplate language at this time.  Approval of these requests herein will enable HHSA to expedite processing and approval of the DMC-ODS agreements for SUD providers to minimize any lapse in services once we have all of the information from DHCS and have negotiated final rates with our providers.

Contract Requests
On or about February 26, 2018, Yolo County issued a formal request for proposal (2018 RFP) to solicit providers for the Yolo County SUD Treatment Adult Continuum of Care (details below) and awarded several agreements. On or about February 17, 2021, the Yolo County Procurement Manager approved a sole source procurement with Wellspace Health to add a residential detoxification provider (WM3.2).

On or about October 7, 2022 Yolo County Procurement Manager approved a sole source procurement with Granite Wellness Centers due to the termination of the agreement with Progress House which created an urgent need for residential services in the Adult SUD Continuum of Care. Community Recovery Resources which one of the original awarded providers from the 2018 RFP is now operating under Granite Wellness Centers.

On or about March 3, 2023, Yolo County issued a formal request for proposal (2023 RFP) to solicit providers for the Yolo County Substance Use Disorder (“SUD”) Adult Continuum of Care services. The 2023 RFP closed on May 12, 2023 and is in process with a target to have newly awarded contracts in place on or before January 1, 2024. However, to allow time to finalize the award and contract negotiation process, HHSA requests short-term renewal agreements as provided below.

On July 10, 2018, the BOS approved Agreement No. 18-55 with C.O.R.E Medical Clinic, for the provision of providing Opioid/Narcotic Treatment Program (NTP) services with an initial term of July 1, 2018 through June 30, 2022, with three optional extensions through FY 22-23. The County has taken all of its optional extensions. HHSA now requests BOS approval of a six-month extension of the procurement for the short-term renewal agreement with C.O.R.E Medical Clinic, Inc. for NTP services in an amount not to exceed $450,000 for the period of July 1, 2023 through December 31, 2023, and delegate signing authority to the Yolo County Procurement Manager to assist with expediting execution of the renewal agreement.

On July 10, 2018, the BOS approved Agreement No. 22-282 with CommuniCare Health Center, for the provision of outpatient SUD treatment services with an initial term of July 1, 2018 through June 30, 2022, with three optional extensions through FY 22-23. The County has taken all of its optional extensions.  HHSA now requests BOS approval of a six-month extension of the procurement for the short-term renewal agreement with CommuniCare Health Center, for the provision of outpatient SUD treatment services in an amount not to exceed $592,000 for the period of July 1, 2023 through December 31, 2023, and delegate signing authority to the Yolo County Procurement Manager to assist with expediting execution of the renewal agreement.

On June 26, 2018, the BOS approved Agreement No. 18-132 with Yolo Wayfarer Center, for the provision of providing SUD residential treatment services with an initial term of July 1, 2018 through June 30, 2022, with three optional extensions through FY 22-23. The County has taken all of its optional extensions.  HHSA now requests BOS approval of a six-month extension of the procurement for the short-term renewal agreement with Yolo Wayfarer Center, for the provision of providing SUD residential treatment services not to exceed $750,000 for the period of July 1, 2023 through December 31, 2023, and delegate signing authority to the Yolo County Procurement Manager to assist with expediting execution of the renewal agreement.

On June 26, 2018 the BOS approved Agreement No. 18-133 with Bi-Valley Medical Clinic, Inc. for the provision of for the provision of NTP services with an initial term of July 1, 2018 through June 30, 2020, with three optional extensions through FY 22-23. The County has taken all of its optional extensions. HHSA now requests BOS approval of a six-month extension of the procurement for the short-term renewal agreement with Bi-Valley Medical Clinic for NTP services in an amount not to exceed $85,000 for the period of July 1, 2023 through December 31, 2023 and affirm the Procurement Manager’s signing authority for this agreement under standard County policy.

On June 4, 2021, the Yolo County Procurement Manager approved Agreement No. PO 3950 with Wellspace Health for the provision of withdrawal management SUD treatment services with an initial term of March 1, 2021 through June 30, 2022, with one optional extension for FY22-23. The County has taken all of its optional extensions. HHSA now requests BOS approval of a six-month extension of the procurement for the short-term renewal agreement with Wellspace Health for the provision of withdrawal management SUD treatment services in an amount not to exceed $65,000 for the period of July 1, 2023 through December 31, 2023 and affirm the Procurement Manager’s signing authority for this agreement under standard County policy.

On December 06, 2022, the BOS delegated signing authority to the Yolo County Procurement Manager to execute Agreement No. 22-282 with CommuniCare Health Centers for the provision of in-custody SUD treatment services with an initial term of September 30, 2022 through June 30, 2023, with one optional year for FY 23-24 in the amount of $187,500. However, due to significant regulatory and claiming changes driven by the CalAIM initiative, the current agreement cannot be extended on the same terms and conditions and must be replaced by a renewal agreement. HHSA now requests BOS approval of a six-month extension of the procurement for the short-term renewal agreement with CommuniCare Health Center, for the provision of in-custody SUD treatment services in an amount not to exceed $187,500 for the period of July 1, 2023 through December 31, 2023, and delegate signing authority to the Yolo County Procurement Manager to assist with expediting execution of the renewal agreement.

On December 6, 2022, the BOS delegated signing authority to the Yolo County Procurement Manager to execute Agreement No. 22-284 with Granite Wellness Centers for the provision of 24-hour non-institutional SUD treatment services in an amount not to exceed $474,000, for the period of October 1, 2022 through June 30, 2023, with one 6-month optional extension through December 31, 2023. However, due to significant regulatory and claiming changes driven by the CalAIM initiative, the current agreement cannot be extended on the same terms and conditions and must be replaced by a new agreement with underlying procurement approval. HHSA now requests BOS approval of a sixth month extension of the procurement for the short-term renewal agreement Granite Wellness Centers for the provision of 24-hour non-institutional treatment services in an amount not to exceed $237,500 for the period of July 1, 2023 through December 31, 2023, and delegate signing authority to the Yolo County Procurement Manager to assist with expediting execution of the renewal agreement.

Performance Measures included in this Agreement are as follows:
Performance Measures are included in the current agreements and will be included in the resulting agreements.

County Counsel will review and approve as to form the Yolo County DMC/SUD boilerplate and resulting renewal agreements.
CalMHSA will provide technical assistance with CalAIM Initiative.
Procurement Division of the Department of General Services 

On or about March 3, 2023, Yolo County issued a formal request for proposal (2023 RFP) to solicit providers for the Yolo County Substance Use Disorder (“SUD”) Adult Continuum of Care services. The 2023 RFP closed on May 12, ,2023 and is in process with a target to have newly awarded contracts in place on or before January 1, 2024.

On April 27, 2022, under guidance from Yolo County Procurement Manager, HHSA sent an informal request to its current substance use disorder providers soliciting their interest in contracting for a 10-bed in custody SUD treatment program for individuals who are in-custody for 90 days or longer. CommuniCare Health Centers was the only provider who responded with interest in providing these services. 

On or about October 7, 2022, the Yolo County Procurement Manager approved a sole source procurement with Granite Wellness Centers. Due to the termination of the agreement with Progress House Inc. therefore there was an urgent need for residential services in the SUD Adult Continuum of Care. Community Recovery Resources which one of the original awarded providers from the 2018 RFP is now operating under name Granite Wellness Centers.

On or about February 17, 2021, the Yolo County Procurement Manager approved a sole source procurement with Wellspace to add a residential detoxification provider (WM3.2).

On or about February 26, 2018, Yolo County issued a formal request for proposal (2018 RFP) to solicit providers for the Yolo County Substance Use Disorder (“SUD”) Adult Continuum of Care services to eligible Yolo County residents. As a result of the 2018 RFP contracts were awarded to 7 providers: Baymark Health Centers, CommuniCare Health Centers, Community Recovery Resources, C.O.R.E Medical Clinic, Progress House, Turning Point Community Programs, and Yolo Wayfarer Center dba Fourth Hope.

Additional information regarding the 2018 RFP is provided below, including a summary of the solicitation evaluation criteria.

Evaluation Criteria Included in RFP

*  Community Recovery Resources declined to submit a bid amount. The entire program cost $3,823,974 was included in their proposal and expected to be funded by different sources.
** BayMark and CORE requested funding for two years. All other bids shown denote an annual budget