THE HUMAN SERVICES DEPARTMENT, THE BROWARD ADDICTION RECOVERY CENTER DIVISION, AND THE ELDERLY AND VETERANS SERVICES DIVISION RECOMMEND APPROVAL OF THE ABOVE ACTION.
This action supports the Commission's Value of "Approaching human services collaboratively and compassionately, with special emphasis on the most vulnerable," and the Goal to "Effectively advocate for and acquire municipal, state and federal financial support to equitably address health and human services needs of the entire community, through a truly coordinated system of care."
Retroactive approval of the Concordia LOA is being requested as a result of protracted negotiations between Broward County and Concordia (Exhibit 2).
Broward County has managed programs for adult substance abuse treatment and mental health services for decades. BARC has served adult individuals with substance abuse disorders for over 40 years and currently provides a full array of comprehensive substance abuse detoxification and treatment services in residential and community-based settings. EVSD has been providing adult mental health services to elders residing in Broward County for over 40 years, specializing in case management services to elders meeting the State of Florida priority definition of Severe and Persistent Mental Illness.
For many years, the State of Florida Department of Children and Families (DCF) contracted directly with Broward County to provide grant funds for the adult substance abuse treatment and mental health services. In 2011, the Florida Legislature, per Section 394.9082(4)(a), Florida Statutes, authorized DCF to contract with the Broward Behavioral Health Coalition (BBHC), a single private community-based managing entity, for the purchase of substance abuse and mental health services in Broward County.
As part of this reform to the State's healthcare system, the Florida Legislature created Part IV of Chapter 409, Florida Statutes, directing the Agency on Health Care Administration to create the Statewide Medicaid Managed Care (SMMC) program. One key subcomponent is the Managed Medical Assistance (MMA) program. Medicaid recipients must enroll in the SMMC-MMA Program to receive services delivered by subcontractors of authorized providers such as Concordia.
Contract 34381-17 with BBHC is Broward County’s grant-funded agreement of more than $2.8 million for the provision of adult substance abuse treatment and mental health services. Through this contract, BARC provides residential detoxification; intensive residential treatment; non-residential day treatment; and outpatient individual and group counseling services. EVSD provides screening; comprehensive assessment; targeted mental health case management; in-home/on-site counseling; recovery support; coordination of resources; and information and referral for elders with mental health disorders, including clients with forensic involvement.
This grant-funded contract with BBHC requires that any provider receiving more than $500,000 in funding and meeting SMMC-MMA provider criteria enroll as a SMMC-MMA provider. This obligation can only be achieved by becoming a subcontractor member of an authorized managed care organization's network, one of which is Concordia. Pursuant to this requirement, BARC and EVSD initiated the enrollment process and have been involved in protracted negotiations (see Exhibit 2) for an agreement with Concordia.
This LOA between Concordia and Broward County sets forth the general terms and conditions under which BARC and EVSD may provide substance adult substance abuse treatment and mental health services to clients who are members of a health care benefit plan offered or sponsored by Concordia, effective retroactively to February 1, 2016, and continuing until a provider agreement between the County and Concordia is executed.
This is a contracted rate agreement of a transitional nature to ensure continued provision of services to Broward County residents. There are two different time frames (20 days and 90 days) in the LOA for claims payment. The 20-day time frame applies to approved claims; the 90-day time frame applies to claims for which Concordia has requested additional information or documentation.
The estimated reimbursement amount is $60,000 per year (EVSD and BARC combined). BARC has been billing Concordia since 2015 for services provided, when a first interim agreement was in place. BARC also served 78 clients with Concordia coverage for a total revenue of $42,086.
The County Attorney's Office has reviewed and approved this LOA as to form, requesting disclosure of scrivener’s discrepancies and clarifications (Exhibit 2). The LOA is in Concordia’s format and Concordia will sign last, following approval by the Board of County Commissioners.
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