DATE: May 19, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 1 to Participation Agreement 24-067 with the California Mental Health Services Authority
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment No. 1 to the Participation Agreement No. 24-067 with the California Mental Health Services Authority to purchase the Connex Admission, Discharge, Transfer Dashboard and Closed Loop Referral and Prior Authorization Module, effective upon execution, with no change to the term of February 6, 2024 through December 31, 2026, and increasing the maximum by $213,792 to a total of $794,805.
REPORT
There is no increase in Net County Cost associated with the recommended action. Approval of the recommended action will assign funding to the California Mental Health Services Authority (CalMHSA) for FY 2025-26 through FY 2026-2027 to act as the fiscal intermediary and provide the Admission, Discharge, Transfer (ADT) Dashboard and Closed Loop Referral (CLR) and Prior Authorization (PA) Module of CalMHSA Connex, a managed Interoperability Software as a Service solution, to the Department. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended action, the Department would be unable to support real-time ADT notifications between behavioral health, physical health, and care coordination entities and support bi-directional data exchange to support closed-loop referrals between behavioral health, physical health, and social service providers. These are new Department of Health Care Services (DHCS) requirements taking effect this year. If we do not proceed with the recommended actions, the County will be unable to comply with DHCS’ requirements, and may be subject to fines, fees, and sanctions, including termination of Department personnel or contractors, by DHCS.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. Approval of the recommended action will increase total compensation by $213,792 to $794,805 for the recommended Agreement. The recommended Amendment No. 1 will be funded with Proposition 30. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2025-2026 Adopted Budget and will be included in future budget requests.
DISCUSSION:
On December 27, 2022, DHCS released 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. CalMHSA Connex is CalMHSA’s Interoperability Program which would provide oversight and maintenance of a Patient Access API and a Provider Directory API in accordance with BHIN No. 22-06.
On February 6, 2024, the Board approved Participation Agreement No. 24-067 with CalMHSA to allow the County to participate with CalMHSA to utilize CalMHSA Connex. The Department has since implemented the Connex Interoperability Program. The original Participation Agreement was a three-year base contract with no options for extension, effective February 6, 2024, through December 31, 2026, with a maximum compensation of $581,013.
The recommended Amendment No. 1 will enable the Department to add functionality to the Connex Interoperability Program, by purchasing the ADT Dashboard and CLR/PA Module. The ADT Dashboard enables the Department to view and act on timely admission, discharge, and transfer data to support care coordination and operational decision-making. The CLR/PA Module will enable the Department to manage end-to-end referral and authorization workflows electronically and improve care coordination through an interoperable, Fast Healthcare Interoperability Resources based infrastructure compliant with federal and state interoperability requirements.
The recommended Amendment No. 1 varies from the standard county template as it was drafted by CalMHSA, is utilized by CalMHSA to execute Participation Agreements with different counties and is consistent statewide.
AB339 noticing has occurred and the Human Resources Department approved execution of the recommended amendment.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was made aware of the recommended Amendment No. 1 during the April 2026 meeting.
REFERENCE MATERIAL:
BAI #22, February 6, 2024
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 1 to Participation Agreement 24-067 with CalMHSA
CAO ANALYST:
Ronald Alexander