REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 25, 2025
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendments to the Memoranda of Understanding with Inland Empire Health Plan and Molina Healthcare of California, Inc. for Managed Care Plans
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 2 to the Memorandum of Understanding, Contract No. 23-1362, with Inland Empire Health Plan, updating contract language to add Exhibit C Data Elements, which outlines Protected Health Information that will be shared between both parties, with no changes to the contract amount of $3,181,818 or the period of January 1, 2024 through December 31, 2026.
2. Approve Amendment No. 1 to the Memorandum of Understanding, Contract No. 23-1363, with Molina Healthcare of California, Inc., updating contract language to add Exhibit C Data Elements, which outlines Protected Health Information that will be shared between both parties, with no changes to the contract not to exceed amount of $381,818, or the period of January 1, 2024 through December 31, 2026.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
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
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost), as it is non-financial in nature. The amendments to the Memorandum of Understandings (MOU) are non-financial and only delineate responsibilities between the Department of Behavioral Health (DBH), Inland Empire Health Plan (IEHP) and Molina Healthcare of California, Inc. (Molina), for eligible services provided to Medi-Cal beneficiaries.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to county residents experiencing severe mental illness and/or SUD. DBH, as the County’s Mental Health Plan (MHP) and Drug Medi-Cal Organized Delivery System (DMC-ODS), is required by regulation (Title 9 of the California Code of Regulations Section 1810.370) and its Specialty Mental Health Services (SMHS) contract with the State Department of Health Care Services to enter into MOUs with any Medi-Cal Managed Care Plan (MCP) operating within the county.
DBH currently has MOUs with two MCPs, IEHP and Molina. DBH has had MOUs with these MCPs for over 20 years, with the purpose of ensuring that physical health, SMHS and DMC-ODS services delivered to Medi-Cal clients are coordinated. The MHP and MCPs develop and sustain a collaborative partnership for the coordination of SMHS and DMC-ODS services to MCPs’ members who meet a medical necessity requirement with DBH. The MCPs provide non-SMHS while DBH provides SMHS and DMC-ODS services through its network of care, which includes County clinics, Community Based Organizations, and fee for service providers.
On December 19, 2023 (Item No. 29), the Board of Supervisors (Board) approved MOU No. 23-1362 with IEHP for the provision of coordination of benefits of Medi-Cal Mental Health and SUD services for Medi-Cal eligible individuals, for the period of January 1, 2024 through December 31, 2026; and MOU No. 23-1363 with Molina for the MCP, for the provision of coordination of benefits of Medi-Cal Mental Health and SUD services for Medi-Cal eligible individuals and if applicable, for treatment services for individuals with eating disorders, in a total amount not to exceed $381,818, for the period of January 1, 2024 through December 31, 2026. The MOU clarifies roles and responsibilities between the MHP and MCP, supports local engagement, facilitates care coordination and the exchange of information necessary to improve care coordination, and improves referral processes between the parties.
On August 20, 2024 (Item No. 29), the Board approved Amendment No. 1 (Amendment) to MOU No. 23-1362 with IEHP for the provision of coordination of benefits of Medi-Cal Mental Health and SUD services for Medi-Cal eligible individuals, and increase the total amount to $3,181,818, from $0, with no change to the contract period of January 1, 2024, through December 31, 2026. The Amendment added the provision of eating disorder treatment services for Medi-Cal eligible clients.
The recommended amendments to the MOUs with IEHP and Molina will update the MOU to add Exhibit C to the contracts and add language clarifying which Protected Health Information (PHI) data elements will be shared between both parties at a minimum. Paragraph 11 of the MOU currently requires both parties to share PHI for coordination of medical and behavioral health care. A sentence was added to Paragraph 11 referencing Exhibit C which contains the PHI data elements that will be shared between the County and IEHP and the County and Molina.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Michael Shin, Contracts Manager, 388-0899) on March 3, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 3, 2025; Finance (Paul Garcia, Administrative Analyst, 386-8392) on March 7, 2025; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0332) on March 10, 2025.