REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 15, 2022
FROM
GEORGINA YOSHIOKA, Interim Director, Department of Behavioral Health
SUBJECT
Title
Mental Health Plan Contract with the California Department of Health Care Services for the Provision of Specialty Mental Health Services
End
RECOMMENDATION(S)
Recommendation
1. Approve the Mental Health Plan contract (State Agreement No. 22-20127) with the California Department of Health Care Services, for the terms and conditions for the provision of specialty mental health services and reimbursement of expenditures, for the period of July 1, 2022 through June 30, 2027.
2. Authorize the Director of the Department of Behavioral Health, as the County Mental Health Director, to execute all documents, including any subsequent non-substantive amendments in relation to the Mental Health Plan contract (State Agreement No. 22-20127) as required by the California Department of Health Care Services, for the period of July 1, 2022 through June 30, 2027, on behalf of the County, subject to County Counsel review.
3. Direct the Director of the Department of Behavioral Health to transmit all documents and amendments in relation to the Mental Health Plan Contract (State Agreement No. 22-20127) to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Georgina Yoshioka, Interim Director, 388-0801)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Improve County Government Operations.
Operate in a Fiscally-Responsible and Business-Like Manner
Provide for the Safety, Health and Social Services Needs of County Residents
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The Mental Health Plan (MHP) contract (State Agreement No. 22-20127) with the California Department of Health Care Services (DHCS) outlines the terms and conditions to obtain Federal Financial Participation (FFP) reimbursement of expenditures for eligible specialty mental health services (SMHS) provided to eligible Medi-Cal beneficiaries. The Department of Behavioral Health (DBH) has budgeted for approximately $175,000,000 in reimbursement. Adequate appropriation and revenue have been included in the DBH 2022-23 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder treatment services to San Bernardino County residents who are experiencing severe and persistent mental illness, substance use, and other addictions. DBH accomplishes this through a continuum of care of County operated clinics, fee-for-service providers, and contracted service providers.
In accordance with Title 9, Section 1810.226 of the California Code of Regulations, a MHP is an entity that enters into a contract with DHCS to directly provide or arrange and pay for specialty mental health services to Medi-Cal beneficiaries in a county. A MHP may be a county, counties acting jointly, or another governmental or non-governmental entity.
DBH has been the administrator of the MHP for the County since 1998. Due to changes in the delivery of services, requirements and regulations, the MHP contract is updated as necessary by DHCS, then submitted to the Board of Supervisors for approval. The provision of the MHP contract allows DBH to provide SMHS to eligible members of the community; submit claims for reimbursement of services rendered by the county operated clinics and fee-for-service and contracted service providers; ensure network adequacy; and meet and demonstrate compliance with all MHP requirements and mandates.
As the MHP Administrator, DBH is required to contract with DHCS for SMHS. This MHP contract with DHCS is in accordance with California Welfare and Institutions Code (WIC) Sections 14680 through 14727. WIC Section 14712 directs DHCS to implement and administer Managed Mental Health Care for Medi-Cal eligible residents of California through contracts with MHPs. With this contract, DBH agrees to continue to operate the MHP for the County and to adhere to DHCS’ contractual requirements.
During 2021-22, DBH served 39,900 unduplicated clients; 31,513 were Medi-Cal beneficiaries. The number of clients served is expected to continue increasing in future fiscal years in alignment with historical service data, as well as with the revision of the asset limits for certain Non-Modified Adjusted Gross Income (non-MAGI) Medi-Cal populations.
On July 26, 2022, DBH received the MHP contract (State Agreement No. 22-20127) from DHCS for the provision of SMHS, for the period of July 1, 2022 through June 30, 2027. From the receipt of the contract through September 6, 2022, as there would be no impact to services, DBH staff focused on a high priority project affecting client services.
This item is being presented at this time as this is the first date available following the required extensive program, fiscal, administrative, and legal reviews. DBH will prioritize appropriate resources to bring forth Board items in a timely manner. Approval at this time will have no impact on DBH SMHS as costs are reimbursed by DHCS.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on October 19, 2022; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on October 21, 2022; Finance (Christopher Lange, Administrative Analyst, 386-8393) on October 24, 2022; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) October 25, 2022.