DATE: July 9, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment II to Agreement with Mental Health Systems, Inc. dba
TURN Behavioral Health Services for Specialty Mental Health Services Maximum Compensation Increase
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute retroactive Amendment II to agreement with Mental Health Systems, Inc. dba TURN Behavioral Health Services (MHS), effective April 1, 2024 with no change to the term of January 1, 2020 to June 30, 2025 and increasing the maximum by $1,588,174 to a total of $7,981,892.
REPORT
There is no additional Net County Cost associated with the recommended action. MHS has been providing more billable services than expected. Approval of the recommended action will increase the Agreement maximum compensation allowing MHS to increase Medi-Cal billing, thus maximizing specialty mental health services. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended action, the program will not be able to provide the amount of specialty mental health services they are capable of providing due to their current maximum compensation for specialty mental health services being nearly fully expensed.
RETROACTIVE AGREEMENT:
This proposed Amendment II is retroactive to April 1, 2024 due to the program providing more specialty mental health services than expected and being at risk for going over their maximum compensation.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum cost of the recommended Agreement for the entire contract period, $7,981,892, will be funded with Mental Health Services Act Community Services and Supports (MHSA CSS) funds as well as Medi-Cal Federal Financial Participation (FFP) funds. Sufficient appropriations and estimated revenues are included in DBH’s Org 5630 FY 2023-24 Adopted Budget and will be included in future budget requests.
DISCUSSION:
On January 7, 2020, your Board approved retroactive Agreement number 20-014 which allowed for MHS to operate a recovery-oriented program for Co-Occurring Disorders Program Full-Service Partnership services for adults and older adults with active co-occurring disorders and symptoms.
On June 20, 2023, your Board approved a Superseding Agreement (No. 23-284), which ensured compliance with CalAIM requirements.
On November 7, 2023, your Board approved Amendment I (23-597) to the agreement which updated the program’s Scope of Work.
Approval of the recommended Amendment II will increase the maximum compensation for specialty mental health services, allowing the program to bill for more specialty mental health services. Estimated units of Medi-Cal billable services were included in the program’s proposed budget during CalAIM payment reform; however, the program is trending to exceed the maximum compensation allowable for specialty mental health services outlined in the current agreement.
Specific Services provided by MHS include innovative interventions, comprehensive services, integrated behavioral health and substance abuse treatment services, and housing services to support the individual in recovery and self-sufficiency. In addition, residential treatment beds are provided for individuals at any given time. The target population served under this Agreement is adult and older adult individuals with active co-occurring disorders (COD) of severe mental illness (SMI) and substance use disorder (SUD) who are frequent users of crisis services, emergency rooms, detoxification services, jails, hospitals and as needed.
OTHER REVIEWING AGENCIES:
The Mental Health Board has been made aware of the recommended Amendment.
REFERENCE MATERIAL:
BAI #47, November 7, 2023
BAI #44, June 20, 2023
BAI #22, January 7, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment II to Agreement with MHS
CAO ANALYST:
Ron Alexander