REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
July 23, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Mental Health Plan Contract with the California Department of Health Care Services for the Provision of Specialty Mental Health Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Contract No. 22-1094 (State Agreement No. 22-20127), effective July 1, 2024, with the California Department of Health Care Services, for the provision of Specialty Mental Health Services, updating contract language to include California Advancing and Innovating Medi-Cal directives and requirements, terms and conditions for the provision of specialty mental health services and reimbursement of expenditures, with no change to the contract period of July 1, 2022 through June 30, 2027.
2. Authorize the Director of the Department of Behavioral Health, as the County Mental Health Director, to execute all documents, including any subsequent non-substantive amendments in relation to the Mental Health Plan Contract No. 22-1094 (State Agreement No. 22-20127), as required by the California Department of Health Care Services, for the period of July 1, 2022 through June 30, 2027, on behalf of the County, subject to County Counsel review.
3. Direct the Director of the Department of Behavioral Health to transmit any non-substantive amendments in relation to the Mental Health Plan Contract No. 22-1094 (State Agreement No. 22-20127) to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Operate in a Fiscally-Responsible and Business-Like Manner.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost) as the Mental Health Plan (MHP) Contract No. 22-1094 (State Agreement No. 22-20127) (Contract) with the California Department of Health Care Services (DHCS). The Contract outlines the terms and conditions to obtain Federal Financial Participation reimbursement of expenditures for eligible Specialty Mental Health Services (SMHS) provided to eligible Medi-Cal members with the remaining funding provided through State 1991 and 2011 Realignment. The Department of Behavioral Health (DBH) has budgeted for approximately $203,788,952 in reimbursement. Adequate appropriation and revenue have been included in the DBH 2024-25 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to San Bernardino County (County) residents experiencing severe mental illness and/or SUD. DBH accomplishes this through a continuum of care of utilizing County operated clinics, fee-for-service providers, hospitals, and other contracted service providers.
In accordance with Title 9, Section 1810.226 of the California Code of Regulations, a MHP is an entity that enters into a contract with DHCS to directly provide or arrange and pay for SMHS to Medi-Cal members in a county. A MHP may be a county, counties acting jointly, or another governmental or non-governmental entity.
The MHP Contract allows DBH to provide SMHS to eligible members of the community; submit claims for reimbursement of services rendered by the County-operated clinics, fee-for-service providers, hospitals, and contracted service providers; ensure network adequacy; and meet and demonstrate compliance with all MHP requirements and mandates. DBH has been the administrator of the MHP for the County since 1998. DHCS updates the MHP Contract as necessary to account for changes in the delivery of services, requirements, and/or regulations. The updated MHP Contract is then submitted by DBH to the Board of Supervisors (Board) for approval.
As the MHP Administrator, DBH is required to contract with DHCS for SMHS. This MHP Contract with DHCS is in accordance with California Welfare and Institutions Code (WIC) Sections 14680 through 14727. WIC Section 14712 directs DHCS to implement and administer Managed Mental Health Care for Medi-Cal eligible residents of California through contracts with MHPs. With Amendment No. 1 (Amendment), DBH agrees to continue to operate the MHP for the County and to adhere to DHCS’ contractual requirements.
During 2022-23, DBH served 43,893 unduplicated clients of which 35,412 were Medi-Cal beneficiaries. The number of clients served is expected to continue increasing in future fiscal years in alignment with historical service data.
On November 15, 2022 (Item No. 23), the Board approved the Contract with the DHCS for the provision of SMHS and reimbursement of expenditures, for the period of July 1, 2022 through June 30, 2027.
On March 14, 2024, DHCS notified DBH of the release of the Amendment, but it was sent through the wrong channels. On May 20, 2024, DHCS contacted DBH to follow up on the status of the Amendment. This item is being presented at this time as this is the first date available following the required extensive program, fiscal, administrative, and legal reviews. Approval at this time will have no impact on DBH SMHS.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Ellayna Hoatson, Contract Supervisor, 388-0858) on July 2, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 2, 2024; Finance (Christopher Lange, Deputy Director, 386-8393) on July 2, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on July 8, 2024.