DATE: December 17, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Retroactive Amendment No. 5 to Master Agreement 20-236 for Individual and Group Providers for the Fresno County Mental Health Plan
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive Amendment No. 5 to Master Agreement for Individual and Group Providers for the Fresno County Mental Health Plan, reflecting the name change of Karina Cisneros to Karina Baca, effective July 1, 2023 with no change to the term of July 1, 2020 through June 30, 2025 and increasing the maximum by $1,500,000 to a total of $28,739,838.
REPORT
There is no additional Net County Cost associated with approval of the recommended action, which will increase the maximum compensation for the agreement retroactive to July 1, 2023. The increase in compensation will address the increase in reimbursable services rendered by providers on the master agreement. The recommended action will also reflect the name change of an individual provider from Karina Cisneros to Karina Baca. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department would not be able to reimburse all services rendered by providers for FY 2023-24. The County would not be able to bill Medi-Cal for those services.
RETROACTIVE AGREEMENT:
The recommended amendment is retroactive to July 1, 2023. The Department implemented CalAIM in FY 2023-24 which changed the method by which providers are reimbursed under the Master Agreement. The Department did not have sufficient historical information to estimate the total reimbursable services which were rendered for this master agreement resulting in the maximum compensation being exceeded.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The combined increase of $1,500,000 for FY 2023-24 and 2024-25 increases the total maximum compensation to $28,739,838 for all providers for the total contract term. Specialty Mental Health Services under this agreement are funded in part by Medi-Cal Federal Financial Participation (FFP) and Realignment funds. Sufficient appropriations and estimated revenues are included in the Department’s Behavioral Health Org 5630 FY 2024-25 Adopted Budget.
DISCUSSION:
On June 23, 2020, the Board approved Master Agreement No. 20-236 with licensed and registered Individual and Group Providers for mental health services to be delivered through a broad base of providers including psychiatrists, psychologists, licensed clinical social workers, licensed professional clinical counselors, and licensed marriage and family therapists to Medi-Cal eligible persons.
On June 20, 2023, the Board approved Amendment 1 (No. 23-271) to Master Agreement No. 20-236 to update rates to comply with the California Advancing and Innovating Medi-Cal (CalAIM) initiative set forth by the Department of Health Care Services (DHCS).
On January 9, 2024, the Board approved Amendment No. 2 (No. 24-021) to add additional providers to the Master Agreement.
On May 21, 2024, the Board approved Amendment No. 3 (No. 24-217) to revise billing rates, remove a provider, add additional providers, and increase the maximum compensation to the Master Agreement.
On November 5, 2024, the Board approved Amendment No. 4 (No. 24-574) to add additional providers to the Master Agreement.
The CalAIM initiative increased reimbursements for services provided and the Department did not have sufficient historical information to project costs accurately. With the increased reimbursements, the Department estimates the FY 2023-24 funds to be exhausted prior to all services being reimbursed.
Approval of the recommended Amendment No. 5 will increase the maximum compensation for specialty mental health services provided under this Master Agreement and account for an individual provider’s name change from Karina Cisneros to Karina Baca.
REFERENCE MATERIAL:
BAI #41 November 5, 2024
BAI #27 May 21, 2024
BAI #32 January 9, 2024
BAI #43 June 20, 2023
BAI #33 June 23, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 5 to Master Agreement
CAO ANALYST:
Ron Alexander