Title
Health and Human Services Agency (HHSA) recommending the Board:
1) Approve and authorize the Chair to sign non-financial Agreement 6967 (Standard Agreement 22-20100), with the State of California, Department of Health Care Services, thereby continuing to confirm the County as the Mental Health Plan to allow provision of specialty mental health services provided for Medi-Cal eligible County residents, for a retroactive effective date for the five-year term of July 1, 2022, through June 30, 2027; and
2) Authorize the HHSA Director, or Chief Assistant Director, to execute further documents relating to Agreement 6967 (Standard Agreement 22-20100), contingent upon approval by County Counsel and Risk Management, including amendments which do not increase the compensation or term of the Agreement.
FUNDING: The Mental Health Plan is funded with 48% Federal Medi-Cal, 2% State Medi-Cal, 17% Mental Health Services Act (MHSA), 32% 1991 and 2011 realignment, as well as 1% private insurance and client fees.
Body
DISCUSSION / BACKGROUND:
The State of California Department of Health Care Services (DHCS) requires a Mental Health Plan 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 Specialty Mental Health Services (SMHS).
To meet this requirement, the Health and Human Services Agency (HHSA) contracts with DHCS as the Mental Health Plan (MHP) provider for the County of El Dorado, in accordance with the requirements of 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 Behavioral Health staff, which include, but is not limited to, psychiatric medication support services and after-hours crisis intervention coverage.
On April 23, 2013 (File ID: 13-0330), the Board approved Standard Agreement 456-F1311 (12-89361) with DHCS to confirm the County as the MHP provider to allow for reimbursement of SMHS for Medi-Cal eligible County residents for the term of May 1, 2013, through June 30, 2018. This agreement was renewed on August 14, 2018 (File ID: 18-1110), when the Board approved Standard Agreement 3190 (17-94580) with DHCS to continue to confirm the County as the MHP provider for the retroactive term of July 1, 2017, through June 30, 2022.
This non-financial Standard Agreement 6967 (22-20100) is a renewal of Agreement 3190 to further confirm the County as the MHP provider for El Dorado County, for a retroactive start date of July 1, 2022, through June 30, 2027. While there remains authority for the County to bill for Medi-Cal services, the instrument itself is a non-financial agreement.
HHSA received the request to process this agreement on July 19, 2022, which was after the retroactive start date of July 1, 2022. HHSA staff reviewed the agreement for processing and submission to County Counsel for review. HHSA recommends approval of the retroactive start date to prevent the denial of services provided during the gap that would be created if this is not approved with the retroactive start date.
ALTERNATIVES:
In the event the Board declines to execute Agreement 6967 (22-20100) with DHCS, DHCS may designate another qualified entity to be the Mental Health Plan for the County of El Dorado (California Code of Regulations, Section 1810.305 (b)). In that event, HHSA would no longer be designated as the MHP, would no longer be obligated to provide Medi-Cal Managed Care services to the mental health population, and could no longer be reimbursed for mental health services through Medi-Cal.
PRIOR BOARD ACTION:
1) 08/14/2018, File ID 18-1110, 08/14/18 HHSA DHCS Agreement 3190 (17-94580) Mental Health Plan
2) 04/23/2013, File ID 13-0330, HHSA 4-23-13 Agmt with CA DHCS for Mental Health Plan
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Information Technologies, and Risk Management.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
This Agreement for Services is a renewal of a prior multi-year agreement. Agreement 6967 is a non-financial agreement; overall the Mental Health Plan continues to be funded with Federal and State Medi-Cal reimbursement for SMHS services, MHSA, 1991 and 2011 Realignment, and private insurance with a small portion of client fees. Sufficient appropriations are budgeted for FY 2022-23 and will be for the years applicable to the agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Obtain the Chair’s signature on Agreement 6967.
STRATEGIC PLAN COMPONENT:
Healthy Communities
CONTACT
Evelyn Schaeffer, Director, Health and Human Services Agency