DATE: November 17, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 1 to Participation Agreement with the California Mental
Health Services Authority for the Quality Measures and Performance
Improvement Program
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment No. 1 to Participation Agreement with the California Mental Health Services Authority for the Quality Measures and Performance Improvement Program to update the terms of service for Measurement Year 2026/Reporting Year 2027 and revise Exhibit A, effective upon execution with no change to the term of November 18, 2025, through December 31, 2029, and increasing the maximum compensation by $115,830 to a total of $169,830.
REPORT
Approval of the recommended action will amend Agreement No. A-25-587 to provide updated terms of service and costs associated with Measurement Year 2026/Reporting Year 2027 for the California Mental Health Services Authority (CalMHSA) to provide program management and oversight of the Quality Measures and Performance Improvement Program. The program supports the County in meeting the Healthcare Effectiveness Data and Information Set (HEDIS) reporting requirements for Measurement Year 2026/Reporting Year 2027. The services are funded by Quality Management administrative funds, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the County will not receive any support in meeting the HEDIS reporting requirements for Measurement Year 2026/Reporting Year 2027. The County would be out of compliance and may face administrative and/or monetary sanctions from the Department of Health Care Services (DHCS).
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum amount of the agreement ($169,830) will be funded with Quality Management administrative funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2026-27 Adopted Budget.
DISCUSSION:
On September 14, 2010, the Board approved Agreement No. 10-489 with CalMHSA, authorizing the Department to join the CalMHSA Joint Powers Authority (JPA), to develop, implement, administer and provide fiscal oversight of Mental Health Services Act (MHSA) projects.
On June 18, 2013, the Board approved Amendment No. 10-489-1 with CalMHSA, broadening the stated purpose for the JPA to allow CalMHSA to perform additional services for Behavioral Health Departments acting alone or in collaboration with other Departments, which includes but is not limited to data management, research, and development.
Improving quality outcomes, reducing health disparities, and driving delivery system transformation and innovation through value-based initiatives, modernization of systems, and payment reform is one of the goals of the California Advancing and Innovating Medi-Cal (CalAIM) Act. Additionally, the Medicaid and Children's Health Insurance Program Managed Care Final Rule (42 CFR, 438.340) requires each state Medicaid agency to produce a written quality strategy to assess and improve the quality of health care and services provided by all Medicaid managed care entities in that state.
On December 29, 2023, DHCS released Behavioral Health Information Notice No: 24-004 which clarifies requirements for county behavioral health plans to establish Quality Improvement Systems and to collect and submit performance measurement data required. DHCS has identified measures that county Behavioral Health Plans shall report to DHCS as a part of their Quality Improvement Systems. These measures are to be reported to DHCS on an annual basis.
On November 18, 2025, your Board approved Agreement No. A-25-587 with CalMHSA for the provision of program management and oversight of the Quality Measures and Performance Improvement Program, to provide support for the County to meet the Healthcare Effectiveness Data and Information Set (“HEDIS”) reporting requirements for Measurement Year 2025. These services help the County remain in compliance with state reporting requirements.
The recommended Amendment No. 1 to the Participation Agreement will grant CalMHSA authority to provide program management and oversight of the Quality Measures and Performance Improvement Program for participating counties through December 31, 2029. The program ensures the County remains in compliance with DHCS reporting requirements for Measurement Year 2026.
Under the previous agreement, the County selected the Simple Bundle at an annual cost of $54,000. For Measurement Year 2026/Reporting Year 2027, the Department is requesting transition from the Simple Bundle to the Enhanced Bundle ($89,100) and has additionally requested to opt in for the Behavioral Health Plan Data Sharing Enhanced Bundle ($26,730), resulting in a total compensation of $115,830 for this year. CalMHSA will utilize data provided by the Department to calculate the required Behavioral Health Plan measures. Revised Exhibit A also authorizes CalMHSA to obtain Managed Care Plan medical and pharmacy claims data on the County’s behalf for the necessary HEDIS calculations required for Measurement Year 2026 reporting. The Enhanced Bundle provides additional program management, data analysis, and quality improvement support on a quarterly basis that is necessary to meet the County’s reporting and performance requirements. Funding for subsequent years may vary based on the service bundle requested by the Department and will be brought annually as an amendment to the Board for review and approval.
The Amendment varies from standard County template as it was drafted by CalMHSA. The template is utilized by CalMHSA to execute amendments to Participation Agreements with different counties and is consistent statewide.
Assembly Bill 339 noticing has occurred, and the Human Resources Department approved execution of the recommended amendment.
Approval of the recommended amendment will update the terms and services to align with the Enhanced Bundle for Measurement Year 2026, revise Exhibit A to authorize CalMHSA to obtain required claims data for the required reporting and increase the maximum compensation by $115,830 to a total of $169,830.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board will be notified of the recommended Amendment during the November 2026 meeting.
REFERENCE MATERIAL:
BAI #39, November 18, 2025
BAI #57, June 13, 2013
BAI #39, September 14, 2010
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 1 to Agreement with CalMHSA
CAO ANALYST:
Ronald Alexander Jr.