DATE: December 17, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment I to Participation Agreement with the California Mental Health Services Authority for Quality Measures and Performance Improvement Program
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment I to Participation Agreement with the California Mental Health Services Authority, to extend the term of existing Participation Agreement for Quality Measures and Performance Improvement Program by one year from December 31, 2024 to December 31, 2025 with no change to the compensation maximum of $31,000; and
2. Approve and authorize the Department of Behavioral Health Director, or designee, to be the signatory and act as the Fresno County representative on behalf of the Board of Supervisors on associated California Mental Health Services Authority Quality Measures and Performance Improvement related reports and forms, without modifying the maximum compensation.
REPORT
Approval of the first recommended action will allow amendment to extend the term of the Participation Agreement with the California Mental Health Services Authority for Quality Measures and Performance Improvement Program (QMPIP) for one year, through December 31, 2025 and approve of language regarding data retention and destruction as shown in Exhibit A of the Amendment. California Mental Health Services Authority (CalMHSA) will continue to provide project management and oversight for state required quality metrics and performance improvement projects related to Healthcare Effectiveness Data and Information Set (“HEDIS”) reporting requirements for Measurement Year 2023. Approval of the second recommended action will continue to allow the Department of Behavioral Health Director, or designee, to sign related reports and forms, without modifying the maximum compensation, and act as a representative of the County. The services are funded with Mental Health Services Act (MHSA) Community Services & Supports (CSS) funds, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the County will not receive support in meeting the QMPIP HEDIS reporting requirements for Measurement Year 2023 through the original term of December 31, 2024, and not have plans in place for data retention and destruction which could pose a risk to Department data. The County would be out of compliance and may face administrative and/or monetary sanctions from the Department of Health Care Services (DHCS).
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. There is no modification to maximum compensation ($31,000) for this amendment. Services are fully funded with MHSA Community Services & Supports funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2024-25 Adopted Budget.
DISCUSSION:
On September 14, 2010, the Board executed Agreement No. 10-489 with CalMHSA, authorizing the Department to join the CalMHSA Joint Powers Authority (JPA), to develop, implement, administer and provide fiscal oversight of MHSA projects.
On June 18, 2013, the Board approved Amendment No. 10-489-1 with CalMHSA, broadening the stated purpose for the JPA to allow CalMHSA to perform additional services for Behavioral Health Departments acting alone or in collaboration with other Departments, which includes but is not limited to data management, research, and development.
Improving quality outcomes, reducing health disparities, and driving delivery system transformation and innovation through value-based initiatives, modernization of systems, and payment reform is one of the goals of the California Advancing and Innovating Medi-Cal (CalAIM) Act. Additionally, the Medicaid and Children's Health Insurance Program Managed Care Final Rule (42 CFR, 438.340) requires each state Medicaid agency to produce a written quality strategy to assess and improve the quality of health care and services provided by all Medicaid managed care entities in that state.
On December 29, 2023, DHCS released Behavioral Health Information Notice No. 24-004 which clarifies requirements for county behavioral health plans to establish Quality Improvement Systems and to collect and submit performance measurement data required. DHCS has identified key measures that county BHPs shall report to DHCS as a part of their Quality Improvement Systems. These measures are to be reported to DHCS on an annual basis, starting for Measurement Year (MY) 2023 (January through December).
On May 21, 2024, the Board approved the Participation Agreement to grant CalMHSA authority to provide program management and oversight of the Quality Measures and Performance Improvement Program for participating counties. The program provided data science expertise to ensure counties are in compliance with DHCS reporting requirements for MY 2023. CalMHSA utilized data provided by the County to calculate the required Mental Health Plan and Drug Medi-Cal Organized Delivery System measures.
Approval of Amendment I to the Participation Agreement will extend the project term from December 31, 2024, to December 31, 2025, with no modification to maximum compensation. The Amendment’s Exhibit A also adds language regarding the data retention and destruction to put safeguards in place for the Department’s data.
The recommended Amendment I to Participation Agreement is effective upon execution through December 31, 2025. The County may withdraw from the Program and terminate the Agreement upon six (6) months' written notice to CalMHSA. Upon cancellation, termination or other conclusions of this contract, any County funds remaining undisbursed after CalMHSA satisfies all obligations arising from the administration of the program shall be returned to the County.
REFERENCE MATERIAL:
BAI #28, May 21, 2024
BAI #57, June 18, 2013
BAI #39, September 14, 2010
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Agreement with CalMHSA
CAO ANALYST:
Ron Alexander