REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 8, 2023
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Participation Agreement for the Medi-Cal Peer Support Specialist Certification Program with the California Mental Health Services Authority
End
RECOMMENDATION(S)
Recommendation
1. Approve Participation Agreement (Agreement No. 3866-PEERS-2023-SBR) with the California Mental Health Services Authority for the Medi-Cal Peer Support Specialist Certification Program in an amount not to exceed $44,375, retroactively effective January 1, 2023 through December 31, 2024.
2. Authorize the Director of the Department of Behavioral Health, as the County Mental Health Director, to sign and submit the Participation Agreement referenced in Recommendation No. 1, and any subsequent non-substantive amendments, as required by the California Mental Health Services Authority, on behalf of the County, subject to review by County Counsel.
3. Direct the Director of the Department of Behavioral Health, as the County Mental Health Director, to transmit the executed Participation Agreement, referenced in Recommendation No. 1, and any subsequent non-substantive 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
Ensure Development of a Well-Planned, Balanced, and Sustainable County.
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 County’s portion of the Participate Agreement (Agreement) with California Mental Health Services Authority (CalMHSA) in the amount of $44,375, which includes a 15% Administration Fee, is funded by the Mental Health Services Act (MHSA). Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2023-24 budget and will be included in the 2024-25 recommended budget.
BACKGROUND INFORMATION
CalMHSA is a Joint Powers Authority (JPA) comprised of California Mental Health Plans that provide administrative and fiscal services in order for member counties to maximize resources related to coordination for implementation of statewide or multi-county projects, such as the statewide Suicide Prevention and Stigma and Discrimination Reduction campaigns.
The California Behavioral Health Directors Association (CBHDA) sponsored the formation of a Joint Powers Authority to facilitate joint county mental health programs. Through the JPA, resources can be maximized for the most efficient use of purchasing products, developing requests for proposals, and contracting with providers to accomplish the agreed upon goals. The CalMHSA JPA brings together 50 member counties to act jointly for the development and implementation of behavioral health programs. CalMHSA recently requested member counties to process a participation agreement, the Agreement in the Recommendation section, between CalMHSA and the individual counties’ behavioral health department, which acts as an addendum to the current JPA contract, Agreement No. 08-1173 between CalMHSA and the County.
DBH has been a member of the CalMHSA JPA since November 2008. On November 18, 2008 (Item No. 90), the Board of Supervisors (Board) approved Agreement No. 08-1173 with CalMHSA to create and participate in the California Counties’ Mental Health Services Authority to jointly develop and fund mental health services and education programs as determined on a regional, statewide, or other basis.
On August 24, 2010 (Item No. 20), the Board approved Amendment No. 1 to Agreement No. 08-1173, updating membership voting and funding language. On May 7, 2013 (Item No. 25), the Board approved Amendment No. 2 to Agreement No. 08-1173, to broaden the breadth of programs to include all mental and/or behavioral health programs, as requested by the CalMHSA member counties and the CBHDA.
Senate Bill (SB) 803, Mental Health Services: Peer Support Specialist Certification, chaptered in 2020, authorized the Department of Health Care Services (DHCS) to seek federal approvals to add Peer Support Specialists (Peers) as a Medi-Cal provider type and peer support services as a distinct service type in counties opting to participate in this program. DHCS through SB 803, acknowledges the role that Peers play in California’s behavioral health systems, and recognizes that Peers have long acted as a part of the prevention, early intervention, treatment, and recovery process for individuals living with Mental Health (MH) conditions and Substance Use Disorders (SUD). As individuals with lived experience, or as the parents, caregivers and family members of individuals living with MH and/or SUD conditions, Peers personally understand the experience of the individuals they serve and can help clarify the most effective set of services for each individual’s recovery needs. DHCS has received federal approvals through the Medicaid waiver and State Plan Amendment processes as of July 1, 2022, as required by SB 803.
SB 803 also directed DHCS to develop state standards for Medi-Cal Peer Support Specialist Certification Programs (Program) that may be implemented by counties, or county contracted entities, who opt in to provide these programs. This certification is required for Medi-Cal reimbursement. DBH currently does not have the infrastructure or staffing to meet state standards to opt in to provide a Program and seeks to continue to contract with CalMHSA to implement a DHCS approved Program for San Bernardino County. Peers who receive certification through this Program will be permitted to provide services that may then be billed to Medi-Cal, thus allowing the County to bring in additional Medi-Cal reimbursements.
DBH is requesting retroactive approval of the recommended Agreement. The Agreement was received on April 24, 2023, and required extensive fiscal and programmatic reviews to ensure the fiscal provisions and standard agreement language could be met. Approval of this item will allow the Director of DBH, as the County Mental Health Director, to sign and submit the Agreement and subsequent non-substantive amendments, as required by CalMHSA, to continue to represent San Bernardino County in the administration of all components of the Program to support consistency statewide. DBH Peer and Family Advocate staff will become certified as (Medi-Cal) Peers , by CalMHSA, which are recognized as a Medi-Cal Provider type and therefore permitted to provide Medi-Cal eligible services reimbursable to the Medi-Cal certified program through this Agreement.
DBH will transmit the related Agreement documents and any subsequent non-substantive amendments to the Clerk of the Board of Supervisors within 30 days of execution.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on July 10, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 19, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on July 19, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on July 24, 2023.