REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 13, 2023
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Mental Health Services Act Progressive Integrated Care Collaborative Innovation Plan 2023
End
RECOMMENDATION(S)
Recommendation
1. Approve the Mental Health Services Act Progressive Integrated Care Collaborative Innovation Plan 2023, in an expenditure amount not to exceed $16,557,576, for the period of July 1, 2023 through June 30, 2028.
2. Authorize the Director of the Department of Behavioral Health, as the County Mental Health Director, to sign the Mental Health Services Act County Compliance Certification form, as required by the California Department of Health Care Services, for the Mental Health Services Act Progressive Integrated Care Collaborative Innovation Plan 2023, on behalf of the County.
3. Authorize the Director of the Department of Behavioral Health, as the County Mental Health Director, and the Auditor-Controller/Treasurer/Tax Collector to sign the Mental Health Services Act County Fiscal Accountability Certification form, as required by the California Department of Health Care Services, for the Mental Health Services Act Progressive Integrated Care Collaborative Innovation Plan 2023, on behalf of the County.
4. Authorize the Director of the Department of Behavioral Health, as the County Mental Health Director, to submit the Mental Health Services Act Progressive Integrated Care Collaborative Innovation Plan 2023 documents and any subsequent non-substantive amendments necessary, as required by the California Department of Health Care Services, to the California Department of Health Care Services, Mental Health Oversight and Accountability Commission, on behalf of the County, subject to review by County Counsel.
5. Direct the Director of the Department of Behavioral Health, as the County Mental Health Director, to transmit Mental Health Services Act Progressive Integrated Care Collaborative Innovation Plan 2023 documents and amendments 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
Provide for the Safety, Health and Social Service Needs of County Residents.
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). The submission and approval of the Mental Health Services Act (MHSA) Progressive Integrated Care Collaborative (PICC) Innovation Plan 2023 (Plan) is required by the California Department of Health Care Services (DHCS), Mental Health Services Oversight Accountability Commission (MHSOAC) in order to expend State funds. Expenditures will not exceed $16,557,576 for the project period of July 1, 2023 through June 30, 2028, for these services and will be funded 100% by MHSA. Adequate appropriation and revenue will be included in the Department of Behavioral Health’s (DBH) 2023-24 recommended budget and future recommended budgets.
BACKGROUND INFORMATION
MHSA Innovative projects are unique as they are intended to test the implementation of novel, creative, and/or ingenious mental health practices that contribute to learning for integration into the mental health system. DBH developed the PICC project to deliver integrated behavioral and physical health services to Medi-Cal enrollees at pilot clinic sites. The project will benefit these individuals through the delivery, coordination, and payment for care related to the full continuum of their physical and behavioral health needs.
The proposed project will incorporate a full range of outpatient mental health and substance use disorder services alongside primary care services that will:
• Share access to medical information (with appropriate permissions);
• Meet and confer about individual cases; and
• Develop procedures and practices to ensure the delivery of all needed care.
Five areas have been identified, based on experiences with other projects and recommendations from system learning, where the development of procedures and practices will have immediate benefits for DBH consumers. Those areas are:
• Laboratory Studies - Onsite laboratory services will increase compliance and improve patient safety.
• Electrocardiograms Studies - Will assist in ensuring patient safety for clients who are prescribed psychotropic medications.
• Data Sharing - Will explore read-only access and universal release of information to facilitate bidirectional exchange of information between physical health, mental health and substance use disorder treatment, with appropriate approvals.
• Physical Health Specialist Consultation and Referrals - Will allow for the utilization of an existing network of medical specialists to address medical concerns beyond the scope of primary care.
• Billing - Will work toward developing a cost model for integrated care including mental health, physical health, and substance use.
In accordance with Welfare and Institutions Code Section 5848, a public hearing was held on May 11, 2023, by the San Bernardino County Behavioral Health Commission, and no substantive recommendations or changes to the PICC Plan were suggested. Non-substantive text edits were identified and updated during the stakeholder process. The PICC Plan was reviewed and approved by MHSOAC on May 25, 2023. In addition, on today’s agenda, there is a companion item for the Board of Supervisors (Board) to approve the MHSA Three-Year Integrated Plan Fiscal Years 2023-24 through 2025-26. Upon approval of the PICC Plan by the Board, it will become part of the MHSA Three-Year Integrated Plan Fiscal Years 2023-24 through 2025-26.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Contracts Manager, 388-0869) on May 23, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 24, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on May 23, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on May 25, 2023.