DATE: February 6, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Participation Agreement with California Mental Health Services Authority for CalMHSA Interoperability Program (CalMHSA Connex) and Data Archive Solution
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a Participation Agreement with the California Mental Health Services Authority for Interoperability Solution services, effective February 6, 2024 through December 31, 2026, total not to exceed $581,013; and
2. Approve and authorize the Chairman to execute a Participation Agreement with the California Mental Health Services Authority for Data Archive Solution, effective February 6, 2024 through December 31, 2026, total not to exceed $58,704.
REPORT
Approval of the first recommended action will assign funding to the California Mental Health Services Authority (CalMHSA) for FY 2023-24 through FY 2026-27 to act as the fiscal intermediary and provide program management and oversight for the CalMHSA Connex, a managed Interoperability Software as a Service solution. Approval of the second recommended action will assign funding to CalMHSA for FY 2023-24 through FY 2026-27 to act as the fiscal intermediary and to provide support services to assist with archiving legal Electronic Medical Record (EMR) databases to a secure Cloud environment. These services are funded with Mental Health Services Act (MHSA) Capital Facilities and Technology Needs (CFTN) fund, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the first recommended action, the Department would be out of compliance with Welfare and Institutions Code (W&I) § 14184.100, et seq., and Health and Safety Code § 130290 to implement the California Health and Human Services Interoperability Rule and may be subject to temporary withhold of funds, monetary sanctions, and or temporary suspension or termination of MHP personnel or contractors as specified in W&I § 14197.7(g). If the second recommended action is not approved, the Department would need to explore alternative archive solutions to host EMR data from January 1, 2016, standardize bulk data to meet United States Core Data for Interoperability (USCDI) version 4 format, and maintain interoperability workflow.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The cost for all services will be funded with MHSA CFTN fund. The total cost for the recommended agreements with CalMHSA will not exceed $639,717. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2023-24 Adopted Budget.
DISCUSSION:
On December 27, 2022, the Department of Health Care Services (DHCS) releases Behavioral Health Information Notice (BHIN) No. 22-068 to notify Mental Health Plans (MHPs) about the Interoperability and Patient Access final rule. The Interoperability Rule requires MHPs to implement and maintain a secure, standards-based Patient Access Application Programming Interface (API) and a publicly accessible, standards-based Provider Directory API that can connect to mobile applications, and be available through a public-facing digital endpoint on each MPH’s website.
On November 29, 2023, CalMHSA reached out to MHPs surveying counties’ interest in participating in CalMHSA Connex and Data Archive. The CalMHSA Connex is CalMHSA Interoperability Program which would provide oversight and maintenance of API and Provider Directory API in accordance with BHIN No. 22-068. CalMHSA Data Archive provides technical assistance in migrating over and standardizing EMR data from January 1, 2016 in accordance with USCDI version 4 for use within CalMHSA Connex.
The recommended Participation Agreements will grant CalMHSA authority to provide implementation of interoperability services including but not limited to project management, set-up and configuration, and validation; manage operational availability of connections to include interoperability infrastructure, security, HIPAA compliance, maintenance of real-time bi-directional data exchange process; provide training and support for interoperability services; provide oversight and maintenance of interoperability services and data archive solutions.
The Agreement varies from standard County template as it was drafted by CalMHSA. The template is utilized by CalMHSA to execute Participation Agreements with different Counties and is consistent statewide. Risk Management recommended the inclusion of standard County insurance requirements and indemnity language. These were not incorporated as CalMHSA will include these provisions in the Agreements with the chosen researcher. The Department believes that the benefits of the recommended Agreement outweigh any potential risks and recommends approval of the agreement.
The recommended Participation Agreements are a three-year contract with the option for early termination in which the Department of Behavioral Health may withdraw from the program upon a six-month written notice. Upon cancellation, termination or other conclusions of this contract, any County funds remaining undisbursed after CalMHSA satisfies all obligations arising from the services of the program shall be returned to the County.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CalMHSA Connex
On file with Clerk - Agreement with CalMHSA Data Archive Solution
CAO ANALYST:
Ronald Alexander