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Health and Human Services Agency (HHSA) recommending the Board:
1) Authorize the Chair to execute Intergovernmental Agreement 25-50128 (Fenix 9782) with Department of Health Care Services (DHCS), a reimbursement-based revenue agreement with a “zero-dollar” maximum obligation, allowing the County as the Mental Health Plan (MHP) provider to not be limited to a specified reimbursement amount for Medi-Cal covered specialty mental health services (SMHS), for the retroactive term effective July 1, 2025, through December 31, 2026, along with the accompanying Contractor Certification Clause, which is required to be returned to DHCS with the Agreement;
2) Authorize the HHSA Director, or Chief Assistant Director to execute amendments to Agreement 9782 which does not increase Net County Cost; and
3) Authorize the HHSA Director, Chief Assistant Director, or Chief Financial Officer (as applicable) to execute programmatic, administrative and financial documents relating to the Agreement 9782.
FUNDING: SMHS are funded through federal Medi-Cal, with match funding from State General Fund, Mental Health Services Fund and 2011 Behavioral Health Realignment.
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DISCUSSION / BACKGROUND:
DHCS requires a MHP provider in each county to be responsible for providing or arranging for the provision of mandated services for Medi-Cal beneficiaries in their County, including but not limited to, inpatient and residential mental health treatment, as well as outpatient SMHS.
To meet this requirement, HHSA contracts with DHCS to serve as the MHP provider in El Dorado County, in accordance with the requirements of California Welfare and Institutions Code (WIC) Section 14680 through Section 14727. SMHS for adults are provided by County staff; however, SMHS for children have been provided by contracted Community Based Organization (CBO) providers since Fiscal Year (FY) 2006-07, in conjunction with support and oversight by HHSA Behavioral Health staff, which include, but is not limited to, psychiatric medication support services and after-hours crisis intervention coverage.
On November 15, 2022, the Board approved Intergovernmental Agreement 22-20100 (6967) with DHCS to confirm the County as the MHP provider and to formalize the provision of state reimbursement of SMHS for Medi-Cal eligible County residents, for the term of July 1, 2022, through June 30, 2027 (Legistar file 22-1818). On April 10, 2025, the County received notice of cancellation of Agreement 22-20100 (6967) effective June 30, 2025, from the state and were informed a renewal agreement would be coming and would be retroactive. This non-financial Agreement 9782 (25-50128) is that renewal of Agreement 6967 to further confirm the County as the MHP provider, for a retroactive start date of July 1, 2025, through December 31, 2026. While there remains authority for the County to bill for Medi-Cal services, the instrument itself is this non-financial agreement.
HHSA received this agreement from DHCS on July 15, 2025, which was after the retroactive agreement’s term start date, and brought this agreement before the Board at its earliest opportunity. HHSA recommends Board approval of the retroactive agreement to prevent the denial of SMHS reimbursement to the County for services provided to Medi-Cal eligible clients.
ALTERNATIVES:
In the event the Board declines to approve this agenda item, HHSA’s Behavioral Health Division would not receive Medi-Cal and other state/federal funding reimbursement from DHCS for Medi-Cal covered services.
PRIOR BOARD ACTION:
11/15/2022, 22-1818, HHSA DHCS Agreement 6967 (22-20100) Mental Health Plan
08/14/2018, 18-1110, 08/14/18 HHSA DHCS Agreement 3190 (17-94580) Mental Health Plan
04/23/2013, 13-0330, HHSA 4-23-13 Agmt with CA DHCS for Mental Health Plan
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with this agenda item. Services provided under the Agreement will be funded by Federal Financial Participation funds that will be matched with State General Fund, Mental/Behavioral Health Services Act funding, 1991 and 2011 Realignment funds, and private insurance with a small portion of client fees. Sufficient appropriations were included in the Fiscal Year 2025-26 Budget and will be included in future budgets for the years applicable to the agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
1) Clerk of the Board to obtain signatures of Chair on two originals of Agreement 9782;
2) Clerk of the Board to return the Chair signed agreements to HHSA Contracts Unit at 3057 Briw Rd, Suite B.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency