DATE: June 20, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Agreement with Kings View to include State Mandated CalAIM Requirements
RECOMMENDED ACTION(S):
TITLE
Approve and Authorize the Chairman to execute an Agreement with Kings View for Rural Crisis Intervention Team (CIT) Services to include California Advancing and Innovating Medi-Cal requirement updates effective July 1, 2023 through June 30, 2025, which includes an optional one-year extension, total not to exceed $5,830,549.
REPORT
Approval of the recommended action will allow the Department of Behavioral Health (DBH) to adhere to new Department of Health Care Services (DHCS) implemented California Advancing and Innovating Medi-Cal (CalAIM) regulations affecting the Behavioral Health System of Care, specifically regarding the existing Agreement Nos. 22-266 and 22-422 with Kings View for Rural CIT Services. The agreement will become effective on July 1, 2023, with no increase in Net County Cost. This item is county-wide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended action, contracted Rural CIT services will be out of compliance with the new CalAIM regulations from the State, effective July 1, 2023.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The total contract maximum will be $5,830,549 for the two-year contract term. The recommended Agreement is fully funded by Medi-Cal Federal Financial Participation, Mental Health Services Act-Prevention and Early Intervention funds ($2,193,508 each FY), and Crisis Care Mobile Unit (CCMU) grant funds. Sufficient appropriations and estimated revenues are included in the DBH’s Org 5630 FY 2023-24 Recommended Budget and will be included in subsequent budget requests.
DISCUSSION:
CalAIM is a long-term commitment to transform and strengthen Medi-Cal, offering Californians a more equitable, coordinated, and person-centered approach to maximizing their health and life trajectory. The three goals of CalAIM are: 1) identify and manage comprehensive needs through whole person care approaches and social drivers or health, 2) improve quality outcomes, reduced health disparities, and transform the delivery system through value-based initiatives, modernization, and payment reform, and 3) make Medi-Cal a more consistent and seamless system for enrollees to navigate by reducing complexity and increasing flexibility. Under the CalAIM transformation effort, the County is required to update contracts with new language to include the new CalAIM related requirements to ensure compliance.
On June 21, 2022, your Board approved Agreement No. 22-266 with Kings View to continue providing CIT services to individuals experiencing a behavioral health crisis in rural areas of Fresno County. On September 20, 2022, your Board approved Amendment No. 22-422 to incorporate CCMU grant funds for case management staff to provide post-crisis follow-up services.
The recommended Agreement is necessary due to the DHCS’ implementation of CalAIM and shall replace, restate, and supersede the existing agreements in their entirety, which includes updated contract language that ensures compliance with the new CalAIM requirements and will maintain the current service levels provided to the individuals served throughout the Behavioral Health System of Care. The modification clause of the recommended Agreement delegates the Board’s authority to the DBH Director or designee to make certain changes to the agreement during the term of the agreement, as further described in the modification clause of the agreement. The requested Agreement will become effective July 1, 2023.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of this agenda item at the May 17, 2023 meeting.
REFERENCE MATERIAL:
BAI #26, September 20, 2022
BAI #46, June 21, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Kings View
CAO ANALYST:
Ronald Alexander