Title
Mental Health Department recommending Chairman be authorized to sign Amendment I to Agreement 094-S0711 (State Agreement Number 06-76019-000) with the State Department of Mental Health specifying funding in the amount of $809,011 for Fiscal Year 2007-2008 to provide services to mentally disordered clients who are Medi-Cal beneficiaries.
RECOMMENDED ACTION: Approve.
FUNDING: State Department of Mental Health.
Body
BUDGET SUMMARY: |
|
|
Total Estimated Cost |
Amendment: |
$809,011 |
|
|
|
Funding |
|
|
Budgeted |
$809,011 |
|
New Funding |
$ |
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Savings |
$ |
|
Other |
$ |
|
Total Funding Available |
$809,011 |
|
Change To Net County Cost |
|
$0 |
Fiscal Impact/Change to Net County Cost: This is a three year funding agreement for FY2006-07 through FY2008-09. Funding for FY2006-07 was $787,845 and funding for FY2007-08 is $809,011 for a current total of $1,596,856. FY2007-08 funding was received from the State in September 2007. Notification of the funding amount for FY2008-09 is pending from the State and will be processed as a second amendment to the agreement.
Background: This agreement with State Department of Mental Health (DMH) defines the amounts payable to the County and the responsibilities of the County in delivering services. This is the agreement under which the Mental Health Department operates to provide medically necessary specialty mental health services to mentally disordered clients who are Medi-Cal beneficiaries. It further identifies the State and Federal requirements associated with Quality Improvement and Utilization Management activities and identifies the County's responsibilities in the areas of reporting and data collection.
Under this agreement EDC Mental Health selects and credentials their provider network, negotiates rates, authorizes services and provides payment for services rendered by specialty mental health service providers in accordance with statewide criteria. Medi-Cal beneficiaries must receive Medi-Cal reimbursed specialty mental health services through the County Mental Health Department.
Coverage of a specialty mental health service requires that several criteria be met. The beneficiary must meet the medical necessity criteria for specialty mental health services, which consists of a clearly identified set of diagnoses, functional impairments, and intervention criteria. The services must be delivered by or under the direction of a specialist in the mental health field, for example, a psychiatrist, a psychologist, a Licensed Clinical Social Worker, or Marriage, Family and Child Counselor. The service must also be a mental health service, for example, medication management of psychotropic medications, individual therapy, and psychological testing. A distinction is made between specialty mental health care (those services requiring the services of a specialist in mental health) and general mental health care needs (those needs which could be met by a general health care practitioner). General mental health care needs for Medi-Cal beneficiaries remain under the purview of Department of Human Services (DHS) either through their managed care plans or through the Fee for Service Medi-Cal (FFS/MC) system.
Reason for Recommendation: This agreement is for a three year period beginning with FY2006-07. The amendment specifies the funding amount for the period July 1, 2007 through June 30, 2008. The amendment was not received from the State DMH until June 15, 2008 and was processed as quickly as possible by the Department for approval by the Board. Amendment I incorporates the actual funding already received from the State in September 2007. The State has indicated that the funding amount for FY2008-09 will be provided in the near future and the Department will return to the Board for approval of a second amendment to incorporate the FY2008-09 amount.
Action to be taken following Board approval:
1) Chairman to sign two original Amendments.
2) Board Clerk's Office to return two original signed Amendments to the Department
3) Department will obtain State Department of Mental Health signatures and return a fully executed copy of the Amendment to the Board Clerk's Office.
Contact: John Bachman, Mental Health
Concurrences: This amendment has been approved by County Counsel and Risk Management and a copy is on file in the Board Clerk's Office.