DATE: September 27, 2016
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Retroactive Confidentiality Agreement with Department of Health Care Services
RECOMMENDED ACTIONS:
TITLE
1. Retroactively approve and authorize the Director of the Department of Behavioral Health to execute a Confidentiality Agreement with the California Department of Health Care Services to disclose confidential information about the temporary suspension or payment suspension of certified Drug Medi-Cal providers that are or were in contract with the County Department of Behavioral Health, effective October 12, 2015.($0)
2. Delegate authority to the Director of the Department of Behavioral Health to approve and execute subsequent amendments to the Confidentiality Agreement.
REPORT
Approval of the first recommended action will allow the Department of Health Care Services (DHCS) to enter into a confidentiality agreement with the County Department of Behavioral Health (DBH). It is essential that DHCS share this confidential information with DBH in its capacity as a Drug Medi-Cal (DMC) contractor because neither DHCS nor its contractors can pay claims submitted by a provider during a period of temporary suspension or payment suspension.
ALTERNATIVE ACTION(S):
If the first recommended action is not approved, DBH would not be able to receive confidential information from DHCS regarding DMC certified providers on temporary suspension or payment suspension with DHCS. If the second recommended action is not approved, DBH would have to return to your Board with amendments and revisions which may impact the timely submission of documents requested with urgency by the State.
RETROACTIVE AGREEMENT:
The recommended Confidentiality Agreement was emailed to the Department on October 12, 2015 from DHCS, seeking to enter into an agreement with the County effective that date. Due to an administrative oversight, the email went unattended and was not forwarded to the DBH -Contracts Division until August 12, 2016, prompting the retroactive Agreement. From October 12, 2015 to present, there have been no negative impacts with disclosure or sharing of information as a result of the delay; this Agreement serves to legally bind said information between the two agencies.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action.
DISCUSSION:
The State contracts with the County to provide drug and alcohol treatment and prevention program services financed with both Federal and State funding, including DMC. With these funds, the County contracts with local service providers to perform community substance abuse prevention and treatment services. DHCS may place DMC certified providers on temporary suspension or payment suspension due to non-compliance with Title 22, in which case, DMC reimbursement will not be paid for services rendered and billed. In order for the DHCS to provide DBH with confidential information regarding the status of a provider, a confidentiality agreement with DHCS must be executed.
Confidential information includes:
• provider name;
• legal entity name;
• National Provider Identifier number;
• State DMC number;
• the status of temporary suspension or payment suspension; and,
• the date the temporary suspension or payment suspension began.
This information will be used only to cease payments to suspended providers during the period of suspension and to make client referral decisions.
With your Board’s approval of the recommended actions, the Director of DBH will be able to execute the Confidentiality Agreement, retroactive to October 12, 2015, and approve and execute subsequent amendments.
REFERENCE MATERIAL:
BAI #19, December 9, 2014
BAI #31, August 6, 2013
BAI #36, June 8, 2010
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Confidentiality Agreement with the Department of Health Care Services
CAO ANALYST:
Sonia De La Rosa