DATE: June 24, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Participation Agreement with California Mental Health Services Authority for Psychiatric Inpatient Concurrent Review Program
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a Participation Agreement with the California Mental Health Services Authority for Psychiatric Inpatient Concurrent Review, effective July 1, 2025, through June 30, 2026, total not to exceed $1,223,880.
REPORT
There is no additional Net County Cost associated with the recommended action which will allow the Department of Behavioral Health to continue participation in the Psychiatric Inpatient Concurrent Review Program (Program) which includes utilizing a technology-assisted concurrent review process compliant with Behavioral Health Information Notice (BHIN) 19-026. This item is countywide.
ALTERNATIVE ACTION(S):
Should the Board not approve of the recommended action the Department would need to rely on internal personnel, which may redirect them from current responsibilities and significantly deplete resources. The Department would also need to develop a process for inpatient hospitalization review and educate the inpatient psychiatric hospitals on how to submit reviews, further straining resources for both the Department and the hospitals.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum amount of the agreement ($1,223,880) will be fully offset with Realignment funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2025-26 Recommended Budget and will be included in subsequent budget requests.
DISCUSSION:
Per the Department of Health Care Services Behavioral Health Information Notice 19-026 and 22-017, Mental Health Plans (MHP) are required to conduct concurrent review and authorization for all psychiatric inpatient hospital services and psychiatric health facility services. By utilizing a technology-assisted concurrent review process, a consistent and efficient review process will support MHP compliance with Behavioral Health Information Notices and the Parity in Mental Health and Substance Use Disorder Services Final Rule.
On May 17, 2022, the Board approved Agreement A-22-204 with CalMHSA allowing the Department to participate in Psychiatric Inpatient Concurrent Review program with a total budget of $918,223. The Agreement allowed Acentra Health, formerly Keystone Peer Review Organization under the oversight of CalMHSA to conduct concurrent review and authorization of inpatient psychiatric services on behalf of the Department.
On December 3, 2024, the Board Approved Amendment I to Agreement A-22-204 extending the agreement to June 30, 2025, and increasing the maximum budget by $446,777 for a total of $1,365,000.
The recommended agreement continues the Psychiatric Inpatient Concurrent Review Program administered by CalMHSA for one year. CalMHSA has an agreement with Acentra Health to provide the County a web-enabled utilization review platform and clinical services to carry out psychiatric inpatient concurrent review and authorization services on behalf of multiple California county MHPs.
The agreement varies from the standard county template as it was drafted by CalMHSA and is utilized by CalMHSA to execute Participation Agreements with different counties and is consistent statewide.
REFERENCE MATERIAL:
BAI #42, December 3, 2024
BAI #37, May 17, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Participation Agreement with CalMHSA
CAO ANALYST:
Ronald Alexander