DATE: April 22, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: 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 a Participation Agreement with the California Mental Health Services Authority for Quality Measures and Performance Improvement Program, effective upon execution through December 31, 2025, total not to exceed $36,000.
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 assign funding to the California Mental Health Services Authority (CalMHSA) to provide program management and oversight of the Quality Measures and Performance Improvement Program. The program will support the County in meeting the Healthcare Effectiveness Data and Information Set (“HEDIS”) reporting requirements for Measurement Year 2024. Approval of the second recommended action will 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 any support in meeting the HEDIS reporting requirements for Measurement Year 2024. 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. Services ($36,000) 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 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).
The recommended Participation Agreement will grant CalMHSA authority to provide program management and oversight of the Quality Measures and Performance Improvement Program for participating counties. The program ensures Counties are in compliance with DHCS reporting requirements for Measurement Year 2024. CalMHSA will utilize data provided by the County to calculate the required Mental Health Plan and Drug Medi-Cal Organized Delivery System measures.
The Agreement varies from standard County template as it was drafted by CalMHSA. The template is utilized by CalMHSA to execute Participation Agreements with different Counties and is consistent statewide. The agreement includes a limitation of liability to funds paid to CalMHSA and a mutual indemnification clause. However, the Department believes that the benefit of the contract as written outweighs any potential risks and recommends approval of the agreement.
The recommended 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 #57, June 13, 2013
BAI #39, September 14, 2010
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CalMHSA
CAO ANALYST:
Ronald Alexander