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Health and Human Services Agency (HHSA) recommending the Board:
1) Accept the State of California Department of Health Care Services (DHCS) Behavioral Health Quality Improvement Program (BH-QIP) allocation in the estimated amount of $444,823 for the California Advancing & Innovating Medi-Cal implementation plan incentive payments, available after submission of a DHCS approved implementation plan through the term of June 30, 2024;
2) Delegate authority to the HHSA Behavioral Health Director or the Director of HHSA to sign and submit the required DHCS BH-QIP Program Funding Claiming Forms for said funding; and
3) Authorize the HHSA Behavioral Health Director, or designee, to execute and administer any subsequent administrative documents related to said allocation, contingent upon County Counsel and Risk Management approval, including any extension(s) or amendment(s) that do not increase the amount or term of the agreement, and required fiscal or programmatic reports.
FUNDING: 100% State General Fund revenue from the Department of Health Care Services Behavioral Health Quality Improvement Program. No matching funds are required.
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DISCUSSION / BACKGROUND:
The Department of Health Care Services (DHCS) has created the Behavioral Health Quality Improvement Program (BH-QIP) to incentivize counties to prepare for changes under the California Advancing & Innovating Medi-Cal (CalAIM) initiative, as well as future programs requiring counties to build out new infrastructure and capacity. CalAIM focuses on implementation of payment reform, behavioral health policy changes, and bi-directional data exchange between systems of care for the purpose of improving quality and behavioral health outcomes and care coordination for Medi-Cal beneficiaries.
The BH-QIP is structured as an incentive program, requiring counties to achieve certain CalAIM implementation milestones to earn incentive payments in the following two steps:
1. Start-up funding amount of $250,000 that was made available to each county in the first and second quarter of Fiscal Year (FY) 2021-22; and
2. Incentive payments, available after January 2022, following a county’s submission of a DHCS approved implementation plan and the subsequent completion of CalAIM implementation milestones, which must be designed to support a county’s ability to implement the following CalAIM goals:
a. Payment Reform;
b. Implementation of CalAIM Behavioral Health Policy Changes, including Medical Necessity, Eligibility Criteria, and Documentation Redesign;
c. Multi-system (e.g. Managed Care, Dental, Behavioral Health) Data Exchange and Care Coordination.
On August 31, 2021 (File ID 21-1313), the Board authorized submission of the Initial Funding Request and Certification form to DHCS for the $250,000 in BH-QIP Start-Up funds, for the purposes of fulfilling CalAIM start-up requirements. The DHCS initial BH-QIP Startup Funding Claim Form and Certification was signed by the County Behavioral Health Director, certifying that all claiming information sent to DHCS is accurate and complete and in accordance with law. The form was also signed by the County Auditor-Controller, certifying that claims are based on expenditures necessary for claiming BH-QIP funding pursuant to all applicable requirements of the program.
On December 10, 2021, DHCS released BHIN 21-074, providing CalAIM BH-QIP implementation guidelines, funding allocation methodology for incentive payments, and county claiming process. DHCS has allocated a total of $694,823 to the County of El Dorado, which includes the $250,000 for start-up funding and $444,823 in additional Implementation Plan incentive funding available after submission of a DHCS approved implementation plan and claim form, through the term of June 30, 2024. The required BH-QIP Program Funding Claiming Form for the completion of the first BH-QIP milestone is due to DHCS by March 31, 2022, in order to be eligible for the initial incentive payment of $104,718 for the County of El Dorado. The required form requests the signature of “the official responsible for administration of the County Behavioral Health Program”, so HHSA is requesting the Board delegate authority to the County Behavioral Health Director to sign the form.
Upon Board approval, the Program Funding Claim form will be signed by the County Behavioral Health Director to certify that all claiming information is accurate and complete and in accordance with the law, and by the County Auditor-Controller to certify that all claims submitted to DHCS are based on activities necessary for claiming BH-QIP funding pursuant to the applicable requirements of the program.
ALTERNATIVES:
Should the Board decline to accept the requested funding or decline to authorize the HHSA Behavioral Health Director to sign and submit the required DHCS BH-QIP Program Funding Claiming Forms, the County would not receive the $444,823 in BH-QIP incentive funding to respond and prepare for changes under the CalAIM initiative.
PRIOR BOARD ACTION:
1) 08/31/2021, #21-1313 HHSA DHCS BHIN 21-044 CalAIM
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel and Risk Management. Auditor-Controller signature and certification is required by DHCS on all BH-QIP Program Funding Claiming Forms.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with these revenue allocations. HHSA has included this allocation in HHSA’s Fiscal Year 2021-22 Budget, and will be included in future budgets for the term of the BH-QIP funding allocation.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to return one (1) signed Certified Minute Order of the agenda item to Health and Human Services Agency, Contracts Unit, 3057 Briw Road.
STRATEGIC PLAN COMPONENT:
County Strategic Plan, Healthy Communities
CONTACT
Don Semon, Director, Health and Human Services Agency