REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
March 10, 2020
FROM
VERONICA KELLEY, Director Department of Behavioral Health
SUBJECT
Title v
Amendment to Memorandum of Understanding with Inland Empire Health Plan for the Coordinated Medi-Cal Mental Health Managed Care Plans
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2, effective March 10, 2020, to Memorandum of Understanding No. 18-78 with Inland Empire Health Plan for the provision of health care services to eligible San Bernardino County residents, updating agreement language and terms, with no change to the contract period of February 13, 2018 through December 31, 2020.
(Presenter: Veronica Kelley, Director, 388-0801)
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.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). Expenditures for these services are funded through reimbursements by Inland Empire Health Plan and Health Access (IEHP). Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2019-20 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
As the San Bernardino County Mental Health Plan, DBH is responsible for a collaborative partnership with Medi-Cal Managed Care Plans for coordination of Medi-Cal specialty mental health and Substance Use Disorder Recovery for San Bernardino County Medi-Cal beneficiaries who have Medicare/Medi-Cal coverage. DBH has partnered and maintained a MOU with IEHP since 2002 to provide and arrange health care services for eligible residents. The recommended MOU amendment with IEHP will allow for additional clinic sites and funding information to better address the needs of beneficiaries that require specialty mental health services.
IEHP HHP Program Background
DBH has been participating in a pilot project, Behavioral Health Integration Complex Care Initiative (BHICCI), with IEHP since April 2016 in preparation for transition to IEHP’s Health Homes Program (HHP). In March 2018, the BHICCI pilot site underwent a Case Rate Readiness evaluation by the IEHP Leadership Team and was deemed to meet the criteria set by IEHP for transition to the HHP. The California Department of Health Care Services scheduled HHP to be implemented on July 1, 2019.
The IEHP HHP is a clinical service delivery model that focuses on providing individualized complex care management delivered by an integrated care team, known as the Community Based Care Management Entity. This team works closely with the beneficiary’s Primary Care Provider and all other network providers, providing an intensive set of services for a small subset of Medi-Cal members who have chronic conditions requiring coordination of care at the highest levels. HHP focuses on whole-person, complex care management, which includes changing behaviors and patterns of health care with the goal of reducing avoidable, high cost interventions and increasing the use of appropriate, timely interventions, along with improved self-care management. It is estimated that approximately 8,000 IEHP beneficiaries are currently receiving specialty mental health services in DBH clinics who will meet the criteria to be enrolled in the HHP. DBH estimates that approximately 2,000, or 25%, will enroll and receive HHP complex care management services.
On February 13, 2018 (Item No. 19), the Board of Supervisors (Board) approved MOU No. 18-78 with IEHP for the provision of coordinating the delivery of health care services to Medi-Cal beneficiaries, for the period of February 13, 2018 through December 31, 2020, with authorization for a maximum of two successive one-year extensions, subject to review by County Counsel.
On June 11, 2019 (Item No. 20), the Board approved Amendment No. 1 to MOU No. 18-78 with IEHP to provide coordination of benefits with Medi-Cal Mental Health Managed Care Plans and Substance Use Disorder and Recovery Services for Medi-Cal eligible individuals for participation in the Health Homes Program, with no change to the contract period of February 13, 2018 through December 31, 2020.
Amendment No. 2 to the MOU with IEHP is required to update contract language and terms to better address the needs of beneficiaries who require specialty mental health services.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on January 15, 2020; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on January 17, 2020; Finance (Christopher Lange, Administrative Analyst, 386-8393) on February 14, 2020, and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on February 19, 2020.