REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 16, 2021
FROM
VERONICA KELLEY, Director, Department of Behavioral Health
SUBJECT
Title
Department of Behavioral Health’s Short-Doyle/Medi-Cal Specialty Mental Health Services Published Charges
End
RECOMMENDATION(S)
Recommendation
Approve Department of Behavioral Health’s Short-Doyle/Medi-Cal specialty mental health services Published Charges for Federal reimbursement, effective July 1, 2021 through June 30, 2022.
(Presenter: Veronica Kelley, Director, 388-0801)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The Department of Behavioral Health’s (DBH) Published Charges apply to all Short-Doyle/Medi-Cal (SD/MC) eligible specialty mental health services and represent the allowable interim rates that DBH may claim for federal reimbursement from the California Department of Health Care Services (DHCS).
BACKGROUND INFORMATION
DHCS provides annual updates to its county interim rates and requires DBH to obtain Board of Supervisors’ (Board) approval of DBH’s Published Charges for SD/MC specialty mental health services. The proposed 2021-22 Published Charges will be uniformly applied in DBH’s Electronic Health Records system to all insurers, patients and Medi-Cal payers, and will be utilized to claim for the allowable interim reimbursement for services provided beginning July 1, 2021.
In 1957, the Short-Doyle Act was passed by California legislation requiring counties to ensure the delivery of mental health services utilizing a system of county operating contract providers. Through the SD/MC expansion, expenses for certain specialty mental health services incurred by the County are eligible to receive federal reimbursement. SD/MC specialty mental health services are provided to San Bernardino County eligible residents by both County operated clinics and DBH contracted service providers. The SD/MC claims processing system enables California county Mental Health Plans (MHP) to obtain reimbursement from DHCS for medically necessary specialty mental health services provided to Medi-Cal eligible beneficiaries diagnosed as seriously mentally ill adults and emotionally disturbed children. Obtaining reimbursement for services provided to clients allows DBH, the MHP for the County, to continually provide necessary services.
On July 19, 2021, DHCS provided DBH with county interim rates for 2021-22, based on DBH’s most recently filed cost report trended forward using a cost-of-living index. The proposed Published Charges for SD/MC specialty mental health services noted below are effective July 1, 2021 through June 30, 2022, and are based on the current or prior County interim rates that best represent actual costs.
|
SD/MC Specialty Mental Health Service |
2020-21 Published Charge Rates |
2021-22 DHCS Interim Rates |
2021-22 Proposed Published Charge Rates |
|
Crisis Stabilization Emergency Room Rate Per Hour |
$92.15 |
$93.48 |
$93.48 |
|
Crisis Stabilization Urgent Care Rate Per Hour |
$92.15 |
$93.48 |
$93.48 |
|
Day Treatment Intensive Services Rate Per Half Day |
$196.89 |
$199.73 |
$199.73 |
|
Day Treatment Intensive Services Rate Per Full Day |
$276.53 |
$280.53 |
$280.53 |
|
Day Treatment Rehabilitation Rate Per Half Day |
$114.86 |
$116.52 |
$116.52 |
|
Day Treatment Rehabilitation Rate Per Full Day |
$647.79 |
$657.15 |
$657.15 |
|
Case Management Rate Per Minute |
$4.55 |
$4.61 |
$4.61 |
|
Intensive Care Coordination Per Minute |
$4.55 |
$4.61 |
$4.61 |
|
Mental Health Services Rate Per Minute |
$4.71 |
$4.78 |
$3.72 |
|
Intensive Home-Based Services Per Minute |
$4.71 |
$4.78 |
$3.72 |
|
Therapeutic Behavioral Services Rate Per Minute |
$4.71 |
$4.78 |
$4.78 |
|
Medication Support Services Rate Per Minute |
$9.84 |
$9.98 |
$7.79 |
|
Crisis Intervention Services Rate Per Minute |
$11.84 |
$12.01 |
$12.01 |
|
Hospital Inpatient Day |
$1,598.14 |
$1,623.18 |
$1,623.18 |
|
Hospital Administrative Day |
$569.54 |
$626.60 |
$626.60 |
|
Psychiatric Health Facility |
$737.36 |
$748.43 |
$748.43 |
|
Adult Crisis Residential |
$416.03 |
$422.05 |
$422.05 |
|
Adult Residential |
$202.92 |
$205.85 |
$205.85 |
|
Therapeutic Foster Care |
$87.40 |
$87.40 |
$87.40 |
This item is being presented at this time as this is the first Board date available for presentation following the extensive research that included comparisons of the DHCS provided interim rate for each service type against the rate based on cumulative actual costs of county clinics and contracted providers from the most recently filed cost report and required operational, fiscal, and administrative reviews. Approval of the proposed Published Charges after the effective date of July 1, 2021, will have no impact on DBH’s services or activities and will allow DBH to claim for federal reimbursement from DHCS.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on October 8, 2021; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on October 19, 2021; Finance (Christopher Lange, Administrative Analyst, 386-8393) on October 22, 2021; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on October 26, 2021.