REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
August 6, 2019
FROM
VERONICA KELLEY, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Memorandum of Understanding with Molina Healthcare of California Partner Plan, Inc. for Coordinated Medi-Cal Mental Health Managed Care Plan
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1, effective August 6, 2019, to Memorandum of Understanding No. 18-79 with Molina Healthcare of California Partner Plan, Inc. to add Addendum I addressing sharing of protected health information in order to provide coordination of benefits with Medi-Cal Mental Health Managed Care Plan 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.
(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). The Memorandum of Understanding (MOU) delineates areas of understanding and agreement for the Department of Behavioral Health (DBH) to submit claims for reimbursement to Molina Healthcare of California Partner Plan, Inc. (Molina) for eligible services provided to beneficiaries.
BACKGROUND INFORMATION
DBH serves as the San Bernardino County Mental Health Plan and is responsible for developing and sustaining a collaborative partnership with Medi-Cal Managed Care Plans for coordination of Medi-Cal Specialty Mental Health and Substance Use Disorder Recovery Services to referred clients, including care coordination and service delivery benefits for San Bernardino County Medi-Cal beneficiaries. DBH has partnered and maintained a MOU with Molina since 2004 to provide and arrange health care services for eligible residents. The recommended amendment with Molina will incorporate the Health Homes Program (HHP) to address the needs of beneficiaries that require specialty mental health services.
Molina’s HHP is a service delivery model that focuses on providing individualized, whole-person care by a trained, integrated care coordination team that works in close connection with the member’s Primary Care Provider and all other network providers. This integrated care coordination team, known as the Community-Based Care Management Entity (CB-CME) provides an intensive set of services for a subset of Medi-Cal members who have chronic conditions and/or severe mental illness, with a certain level of acuity and who require coordination of care at the highest levels. The goal of HHP is to coordinate the full range of physical health, behavioral health, and community-based long-term services and supports needed by Medi-Cal beneficiaries with chronic conditions. Molina participates in the HHP as a Managed Care Plan; the County participates in the HHP as a CB-CME through its network providers.
HHP, created by the Department of Health Care (DHCS), focuses on whole-person, complex care management, which includes changing behaviors and patterns of health care among both providers and members. The service delivery model encompasses a person-centered, comprehensive approach to addressing the member’s goals for improvement and management of behavioral and physical health, acute care, long term services and supports, and social needs. The CB-CMEs will address the members’ health needs through the provision of HHP core services, which may include, but is not limited to, delivering various medical and behavioral health care services, coordinating with Primary Care and other network provider teams, coordinating with community-based organizations and housing agencies, and/or referrals to other resources within the community.
On February 13, 2018 (Item No. 19), the Board of Supervisors approved the MOU with Molina for the purpose of coordinating the delivery of health care services to Medi-Cal beneficiaries, for the period of February 13, 2018 through December 31, 2020, with the option of a maximum of two successive one-year extensions.
The amendment to the MOU with Molina is required by DHCS to delineate Molina’s and DBH’s responsibilities with respect to HHP, allowing them to work collaboratively to address the needs of beneficiaries who require specialty mental health services.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on July 8, 2019; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 15, 2019; Finance (Christopher Lange, Administrative Analyst, 386-8393) on July 18, 2019; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on July 18, 2019.