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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings pursuant to Section 3.13.030 (B) of the El Dorado County Ordinance Chapter 3.13, Contracting Out, that the Health Information Data Sharing services provided by Manifest MedEx (Manifest) requires specialty skills and qualifications not expressly identified in County classifications are involved in the performance of the work;
2) Make findings in accordance with Procurement Policy C-17 Section 3.4(3) exempting the competitive bidding process, with Purchasing Agent concurrence, as “competitive bidding would produce no economic benefit to the County” due to Manifest being certified by the State to help county Mental Health Plans (MHPs) administer the secure exchange of health and social services information required under the State’s Data Exchange Framework grant program;
3) Approve and authorize the Chair to sign Participation Agreement 9086 with Manifest, in the amount of $205,000 and for the term of three years upon final execution;
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 9086, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum dollar amount or term of the Agreement; and
5) Authorize the HHSA Director, or the Chief Assistant Director, to execute programmatic, administrative, and fiscal documents relating to Agreement 9086.
FUNDING: 50% State Grant Funding from Managed Care Plans and 50% Mental Health Service Act (MHSA) funding.
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DISCUSSION / BACKGROUND:
The Department of Health Care Services (DHCS) is enhancing health information exchange to improve care for Medi-Cal members as California shifts to data-driven, value-based healthcare. Effective data sharing is crucial for care coordination and supports whole-person care programs such as Enhanced Care Management and Community Supports. As part of DHCS Medi-Cal reforms made under the California Advancing and Innovating Medi-Cal (CalAIM) initiative (2021), county MHPs are required to provide a more comprehensive level of care for a whole person care approach. Pursuant to California Health and Safety Code (HSC) § 130290, the California Health and Human Services (CalHHS) Data Exchange Framework (DxF) requires certain data sharing requirements and Memorandums of Understandings (MOUs) with Managed Care Plans be implemented among healthcare entities. California HSC § 130290 also encourages the inclusion of county health, public benefit, and social services programs participate in the Data Exchange Framework.
In May 2023, in support of the CalAIM reforms, the CalHHS Center for Data Insights and Innovation (CDII) launched the Data Exchange Framework (DxF) Grant Program, consisting of two types of grant programs: (1) The DxF Educational Initiative Grant Program; and (2) The Data Sharing Agreement (DSA) Signatory Grant Program, available in three rounds. CDII allocated up to $47 million for DSA Signatory Grants to fund activities for individual Signatories to meet their DSA requirements. Additionally, the DSA Signatory Grant Program was broken out into the Technical Assistant Grant and the Qualified Health Information Organization (QHIO) Onboarding Grant, both designed to provide direct support to DSA Signatories to subsidize their data exchange implementation efforts.
On December 8, 2023, HHSA Behavioral Health Division (BHD) applied for the QHIO Onboarding Grant Round 3. In that grant application, Manifest, being approved by CalHHS and certified by CDII as a DxF QHIO to help county MHPs and health and human service providers meet their CalAIM required state-wide data sharing requirements, was selected by HHSA to serve as their QHIO. On February 27, 2024, the Board authorized the HHSA Director to accept the DxF QHIO Onboarding Grant Round 3 in the estimated amount of $50,000, for the performance period of two years (Legistar file 24-0089).
Manifest, as the largest nonprofit health data network and QHIO in California, is an integral part of the state’s health data infrastructure, combining and delivering crucial health information for more than 38 million Californians across most counties throughout the state. Manifest integrates and shares vital health information statewide and connects nationally, facilitating data exchange across a broad healthcare ecosystem via a web-based portal. Manifest, through its data network, collaborates with health providers, hospitals, and county MCPs to address health equity and advance population health initiatives, supporting all Data Exchange participants in achieving CalAIM and DxF goals to enhance efficiency and patient outcomes.
Through proposed Agreement 9086, Manifest will provide County Medi-Cal beneficiaries a secure web-based portal that enables beneficiaries to access their current health/treatment records and will allow data sharing between county MCPs and health and social service providers to enable proactive responses to health crises. HHSA recommends the Board to approve this new Agreement with Manifest to ensure HHSA BHD, as the County MHP, meets requirements of its state contracts with DHCS for the Mental Health Plan and Drug Medi-Cal Organized Delivery System, supporting HHSA’s CalAIM and DxF objectives.
In accordance with Board of Supervisors Procurement Policy C-17, HHSA recommends this participation agreement be exempt from competitive bidding, with Purchasing Agent concurrence, as “competitive bidding would produce no economic benefit to the County”; as Manifest, being approved by CalHHS and certified by CDII as a DxF QHIO, helps county MHPs and health and human service providers in California meet their CalAIM required state-wide data sharing requirements. Further, as Manifest was selected by HHSA to serve as its QHIO with their application submission of the department’s awarded QHIO Onboarding grant, Manifest is the County’s QHIO of record with DHCS.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA as the County MHP would not meet its obligations required by the State for the Data Exchange Framework and would not meets its data sharing requirements under the County’s executed State contracts with DHCS for the Mental Health Plan and Drug Medi-Cal Organized Delivery System.
PRIOR BOARD ACTION:
02/27/24, 24-0089, HHSA Data Exchange Framework Grant
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, Human Resources, Information Technologies, and Risk Management. The Auditor Controller has been notified per Policy B-12.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with this agenda item. Sufficient appropriations were included in the Fiscal Year 2024-25 Budget and the 2025-26 Budget request and will be included in future budgets for the term of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
Clerk of the Board to obtain signature of Chair on one original Participation Agreement 9086
STRATEGIC PLAN COMPONENT:
Area of Focus: Safe and Healthy Communities
Priority: Achieve CalAIM requirements and maximize opportunities for service delivery
Action Item: Implement CalAIM payment reform within the Behavioral Health Division
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency