DATE: June 20, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 1 to Master Agreement for Individual and Group Providers for the Fresno County Mental Health Plan
RECOMMENDED ACTIONS:
TITLE
Approve and authorize the Chairman to execute Amendment No. 1 to Master Agreement adding Erene Soliman Psychologist Incorporated, Esperanza Family Counseling, and Healing Hope, Inc. to the agreement, and to include new contract language and billing structure based on the California Advancing and Innovating Medi-Cal initiative as required by the State of California Department of Health Care Services, extending the term by 12 months from July 1, 2023 to June 30, 2024 with no change to the compensation maximum of $22,741,629.
REPORT
There is no additional Net County Cost associated with the recommended action. Approval of the recommended action will add three vendors to the master agreement and update contract language and the billing structure and extend the term by 12 months to allow the Department of Behavioral Health (DBH) to maintain and increase its provider capacity and continue to provide Medi-Cal beneficiaries medically necessary specialty mental health services. This item is countywide.
ALTERNATIVE ACTIONS:
There are no viable alternative actions. If your Board does not approve the recommended action, the current master agreement will not include the necessary contract language and billing structure as required by the State of California Department of Health Care Services (DHCS) and DBH will not be able to increase its network of providers, possibly leading to longer wait time and potentially causing DBH to be out of compliance for providing timely service. In addition, if the master agreement is not extended for an additional twelve-month period (July 1, 2023 - June 30, 2024), DBH will need to transition the beneficiaries to other contracted providers.
FISCAL IMPACT:
There is no Net County Cost associated with the recommended action. Services are financed with Short/Doyle Medi-Cal Federal Financial Participation and Behavioral Realignment funds. The new billing structure and addition of four providers will not change the maximum cost of $22,741,629. Actual cost will be determined by actual services provided. Sufficient appropriations and estimated revenues are included within the Department’s Org 5630 FY 2023-24 Recommended Budget.
DISCUSSION:
The California Advancing and Innovating Medi-Cal (CalAIM) initiative is a comprehensive initiative launched by DHCS in January 2019, with the goal of improving the quality of care and health outcomes for Medi-Cal beneficiaries while also containing costs.
The CalAIM initiative aims to transform Medi-Cal by implementing a range of changes across five key areas: whole person care, behavioral health, continuity of care, population health management, and value-based payments. Some of the specific goals of the initiative include:
o Improving access to and coordination of care for Medi-Cal beneficiaries, particularly those with complex medical and behavioral health needs
o Addressing social determinants of health, such as housing instability and food insecurity, that can impact health outcomes
o Expanding the use of telehealth and other technology to improve access to care and reduce costs
o Moving towards a value-based payment system that rewards providers for achieving better health outcomes and reducing costs
Additionally, in December 2022, County Counsel informed all County Departments that only the Board can add and delete vendors from master agreements. Amendment No.1 will allow DBH to add the additional providers. Amendment No. 1 will also include the necessary CalAIM initiative language such as reporting requirements, documentation standards, and auditing requirements. The rate structure will also change from a per minute rate based on the provider and service type to a flat per minute rate based on the provider type.
REFERENCE MATERIAL:
BAI #33, June 23, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment 1 to Master Agreement
CAO ANALYST:
Ron Alexander