DATE: March 5, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: CalMHSA Presumptive Transfer Program
RECOMMENDED ACTION:
TITLE
1. Approve and authorize the Chairman to execute a retroactive Agreement with the California Mental Health Services Authority for the Presumptive Transfer Program, to supersede existing Participation Agreement (State No. 421-2018-PT-FC-A1) with a new Participation Agreement (State No. 4928-PT-2023-FC), effective July 1, 2023 to June 30, 2025, total not to exceed $1,184,325.
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 Presumptive Transfer Program related reports and forms, without modifying the maximum compensation.
REPORT
Approval of the recommended actions will allow the Department of Behavioral Health to continue participating in the California Mental Health Services Authority (CalMHSA) Presumptive Transfer Program (Program). The Program operates a banking pool and acts as a fiscal agent for participating counties to make and receive transfer payments for specialty mental health services (SMHS) reimbursed through Federal Financial Participation (FFP). CalMHSA has developed a member portal allowing counties to issue requests for fund transfers for services rendered to Foster Children from another jurisdiction and in reviewing and verifying requests for transfers to allow for timely payments. Approval of the recommended action will allow the Department to continue local program activities through June 30, 2025. The agreement will be funded with Realignment funds, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION:
There are no viable alternative actions. Should your Board not approve the recommended actions, the Department would not be able to participate in the inter-member transfer payment program to facilitate prompt payments between counties as required by Welfare and Institutions Code (W&IC), section 14717.1.
RETROACTIVE AGREEMENT:
Due to the later addition of the member portal, the final recommended agreement was received from CalMHSA on November 22, 2023 and is retroactive to July 1, 2023.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The agreement will be fully offset with Realignment funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2023-24 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
On March 12, 2019, your Board approved Agreement No. 19-113 with CalMHSA authorizing the Department to join in the Presumptive Transfer Program. Counties who provide foster youth SMHS are reimbursed through FFP and county match through Medi-Cal billing. CalMHSA operates a banking pool and acts as a fiscal agent for participating counties to make and receive inter-member transfer payments. Each participating county has a separate financial ledger account and receives periodic statements of year-to-date balance, payments to other counties, and payments from other counties, administration costs and interest earned. Required future funding is based on the projection of actual expenses in order to make funding continuously available for the program. CalMHSA will transfer funds back to the participating counties that have more funding than deemed necessary for the program.
On May 3, 2022, your Board approved the extension of Participation Agreement (State No. 421-2018-PT-FC-A1) through June 30, 2025. Approval of the recommended actions allows foster children who are placed outside of the County to access SMHS in a timely manner. It also allows the County to be reimbursed timely for SMHS provided to foster children placed in this county. Under the W&IC, section 14717.1, responsibility for providing or arranging for SMHS shall promptly transfer from the county of original jurisdiction to the county in which a foster child resides, subject to any exceptions established pursuant to that section. As additional background information, due to the agreement being drafted and utilized by CalMHSA, it varies from the standard county template. The agreement with CalMHSA includes a mutual indemnification clause, a limitation on liability, and does not include the County’s standard insurance requirements. The department believes that the benefit of the contract as written outweighs any potential risks and recommends approval of the agreement.
Upon approval by your Board, the previously approved Participation Agreement (State No. 421-2018-PT-FC-A1) will be superseded by Participation Agreement (State No. 4928-PT-2023-FC) effective July 1, 2023 through June 30, 2025. The new agreement includes language concerning CalMHSA’s newly developed member’s portal that allows counties to issue requests for fund transfers for services rendered to Foster Children from another jurisdiction, on top of reviewing and verifying requests for transfers to allow for timely payments.
REFERENCE MATERIAL:
BAI #31, May 3, 2022
BAI #29, March 12, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CalMHSA
CAO ANALYST:
Ron Alexander