REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 5, 2021
FROM
VERONICA KELLEY, Director, Department of Behavioral Health
SUBJECT
Title
Non-Financial Mandated County Performance Contract with the California Department of Health Care Services
End
RECOMMENDATION(S)
Recommendation
Approve non-financial Mandated County Performance Contract (State Agreement No. 21-10106) with the California Department of Health Care Services outlining conditions and requirements for funding for the period of July 1, 2021 through June 30, 2024.
(Presenter: Veronica Kelley, Director, 388-0801)
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
The County Performance Contract is non-financial in nature; therefore, approval of this item does not impact Discretionary General Funding (Net County Cost).
BACKGROUND INFORMATION
The Department of Behavioral Health (DBH) is the administrator of the Managed Care Medi-Cal Mental Health Plan (MHP) for the County and is required to enter into a Mandated County Performance Contract with the California Department of Health Care Services (DHCS) for the delivery of mental health services provided with realignment funds to the residents of the County. The County Performance Contract specifies the State and Federal codes and regulations required to operate, maintain, or receive reimbursement for programs such as those funded under the Mental Health Services Act (MHSA), Lanterman-Petris-Short (LPS) Act, Projects for Assistance in Transition from Homelessness (PATH), Community Mental Health Services Block Grant (MHBG), Crisis Counseling Assistance and Training Program, Children's System of Care, Substance Abuse Treatment and Prevention Block Grant (SABG) programs, and housing and homeless programs, as well as outlining DHCS’ oversight provisions of the County’s community mental health services pursuant to the Bronzan-McCorquodale Act.
In order to receive funding, DBH must comply with the conditions and requirements outlined in the County Performance Contract for quality assurance, the scope of work and program standards, budget requirements, and accountability measures for local mental health programs. Pursuant to Welfare and Institutions (W&I) Code 5650(a), DHCS requires each County Governing Body or Board to approve and sign the County Performance Contract. Upon Board of Supervisors’ (Board) approval, DBH will submit the approved County Performance Contract to DHCS.
DBH is the local MHP responsible for providing certain mental health services, including Tier III, Specialty Mental Health Services, to San Bernardino County residents. Tier levels (I, II, and III) indicate the level of DBH service intensity with Tier level III services provided to residents requiring significant behavioral health supportive services. DBH contracts with partners such as Inland Empire Health Plan (IEHP) and Molina in the administration of Medi-Cal behavioral health benefits for individuals experiencing severe and persistent mental illness and suffering from substance use disorders. Additionally, through the use of MHSA funding, DBH provides outreach, supportive services, and community education to those who are unserved, underserved or inappropriately served, which includes prevention and early intervention, crisis services, and recovery based services that are provided through an extensive continuum of care of County operated clinics, fee-for-service, and contracted DBH service providers.
DHCS administers MHSA, LPS, PATH, and MHBG programs and oversees the County provision of community mental health services provided by realignment funds. The County must meet certain conditions and requirements to receive funding for these programs and community mental health services and acts as the local MHP.
Pursuant to W&I Code 5604.2, the San Bernardino County Behavioral Health Commission (BHC) is required to review the County Performance Contract prior to the Board’s approval. The BHC is appointed by the Board and provides the Board with recommendations on local mental health programs that will strengthen and improve services to County residents. The County Performance Contract was reviewed by the BHC at the meeting held on September 2, 2021.
On June 17, 2021, DBH received the County Performance Contract from DHCS outlining the requirements for quality assurance, scope of work, program standards, budgeting, and accountability measures for local mental health programs, for the period of July 1, 2021 through June 30, 2024, with an initial deadline of September 20, 2021. As the BHC is required to review and there was not a meeting in August, a new deadline of November 1, 2021, was requested from DHCS and approved. DHCS and DBH are currently operating under the existing agreement, which was approved by the Board on November 19, 2019 (Item No. 12), until the new agreement for 2021-24 is in place. The item is being presented at this time, as this is the first date available following the required operational, fiscal, and legal reviews. Approval by the Board at this time will have no impact on these services and activities.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Contracts Manager, 388-0869) on September 14, 2021; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on September 14, 2021; Finance (Christopher Lange, Administrative Analyst, 386-8393) on September 14, 2021; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on September 15, 2021.