DATE: April 9, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment to Agreement with the State Department of Health Care Services for the Medi-Cal Managed Care Mental Health Plan for Fresno County
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment 1 to Agreement No. 22-452 (State Agreement #22-20101) with the California Department of Health Care Services for the Medi-Cal Managed Care Mental Health Plan for Fresno County to modify the terms and conditions of the Agreement to comply with the updated Managed Care Final Rule, effective upon execution with no change to term of July 1, 2022 through June 30, 2027 ($0).
REPORT
The Department receives funding from the California Department of Health Care Services (DHCS) for the provision of specialty mental health services under the Fresno County Mental Health Plan (FCMHP) to Fresno County Medi-Cal members with mental health conditions and substance use disorders as mandated by the California Code of Regulations Title 9, Chapter 11 commencing with Section 1810.100, Welfare and Institutions Code Division 5, and Title 42 Code of Federal Regulations. Approval of the recommended action amends the agreement to remove cost reporting requirements, modernize certain language, and refine service requirements to advance quality, equity, access, accountability and transparency with no Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department’s ability to collect revenues from DHCS for specialty mental health services provided to County Medi-Cal members with mental health conditions and substance use disorders would be limited.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The Department will be reimbursed on a fee-for-service basis for actual services rendered to persons served. Federal Financial Participation (FFP) reimbursement for FY 2023-24 is estimated at $71,932,533. Sufficient appropriations and estimated revenues are included in the Departments Org 5630 FY 2023-24 Adopted Budget and will be included in subsequent budgets for the remainder of the contract term.
DISCUSSION:
On September 11, 2018, the Board authorized the previous DHCS agreement 18-525 (State agreement #17-94581) to operate the Fresno County Mental Health Plan (FCMHP) in accordance with all applicable Federal and State laws. It is the responsibility of the FCMHP to ensure Fresno County Medi-Cal members who meet criteria for medical necessity of a mental health condition receive specialty mental health services that are within the scope of the agreement. The Board approved Amendment 18-525-1 on March 22, 2022. Said agreement expired on June 30, 2022.
On October 11, 2022, your Board approved the current DHCS Agreement 22-452 (State agreement #22-20101) for the FCMHP. The recommended amendment removes requirements for Fiscal year end Cost Reporting, previously required for DHCS reimbursement of County; replaces all references to “beneficiary” and “beneficiaries” with “member” and “members” respectively; adds Community-Based Mobile Crisis Intervention Services as a required specialty mental health service; updates, removes and or adds references to Code of Federal Regulations, Government Code, Welfare & Institutions Code, California Code of Regulations, Behavioral Health Information Notices (BHIN), All Plan Letters (APL), State Plan amendments, federal waivers, federal Medicaid laws and CalAIM Special Terms and Conditions.
Specialty mental health services that will continue to be funded by the recommended Amendment and provided by the FCMHP include the following services: mental health services, medication support services, day treatment intensive, day rehabilitation, crisis intervention, crisis stabilization, adult residential treatment, crisis residential treatment, psychiatric health facility services, intensive care coordination, intensive home-based services, therapeutic behavioral services, therapeutic foster care, psychiatric inpatient hospital services, targeted case management, and peer support services. Community-based mobile crisis intervention services will also be added via the recommended Amendment.
With approval of this recommended action, County agrees to indemnify DHCS for any intellectual property claims.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was made aware of the recommended amendment at its March 20, 2024, meeting.
REFERENCE MATERIAL:
BAI #23, October 11, 2022
BAI #42, March 22, 2022
BAI #34, September 11, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment 1 to A-22-452 with DHCS #22-20101-A1
CAO ANALYST:
Ronald Alexander