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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings pursuant to Section 3.13.030 (E) of the El Dorado County Ordinance Chapter 3.13, Contracting Out, that the provision of Psychiatric Inpatient Concurrent Review is appropriate to be performed by California Mental Health Services Authority (CalMHSA) as they are another governmental entity or agency;
2) Approve and authorize the Chair to sign Participation Agreement 9677 with CalMHSA, in the amount of $75,600, and for the retroactive term of one year from July 1, 2025, through June 30, 2026;
3) Authorize the Purchasing Agent to execute amendments relating to Participation Agreement 9677, contingent upon approval by County Counsel and Risk Management, which do not exceed Purchasing Agent signature authority or increase the term of the Agreement beyond three years; and
4) Authorize the HHSA Director, or the Chief Assistant Director, to execute programmatic, administrative, and fiscal documents relating to Participation Agreement 9677.
FUNDING: 100% State Behavioral Health Realignment.
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DISCUSSION / BACKGROUND:
HHSA contracts with California Department of Health Care Services (DHCS) to serve as the Mental Health Plan (MHP) for El Dorado County (County). As the MHP, HHSA is responsible for conducting concurrent review and treatment authorization for all psychiatric inpatient hospital and psychiatric health facility services.
On May 31, 2019, DHCS issued Behavioral Health Information Notice (BHIN) 19-026, which requires county MHPs to ensure medical necessity and compliance with Title 9, California Code of Regulations, Section 1820.205, for Medi-Cal reimbursement of psychiatric inpatient services. MHPs must approve, modify, or deny authorization requests during inpatient care and provide written notification to both the treating providers and the beneficiary in the case of adverse decisions.
BHIN 22-017, issued on April 15, 2022, allows MHPs to either directly manage or delega...
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