DATE: May 6, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 4 to Mental Health Systems, Inc. dba Turn Behavioral Health Co-Occurring Full-Service Partnership Agreement
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a Fourth Amendment to Agreement No. 23-284 with Mental Health Systems, Inc. dba Turn Behavioral Health for specialty mental health services, effective upon execution with no change to the term of January 1, 2020 through June 30, 2025 and increasing the maximum by $750,000 to a total of $8,761,666.
REPORT
There is no additional Net County Cost associated with the recommended action. Mental Health Systems Inc. (MHS) has been providing more billable specialty mental health services than originally projected for their Co-Occurring Full-Service Partnership (FSP) program. Approval of the recommended action will increase the agreement maximum compensation, allowing MHS to continue providing and receiving reimbursement for Medi-Cal billable services, thus maximizing County person served access to specialty mental health services. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, MHS will not be reimbursed for specialty mental health Medi-Cal billable services once the annual contract maximum has been exceeded for FY 2024-25 for services rendered under the full-service partnership program. Additionally, County persons served participating in this program would experience a decrease in specialty mental health services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The new maximum amount of the agreement ($8,761,666) will be fully offset with Mental Health Services Act (MHSA), Medi-Cal Federal Financial Participation (FFP), and Realignment funds. Sufficient appropriations and estimated revenues are included in DBH’s Org 5630 FY 2024-25 Adopted Budget.
DISCUSSION:
On January 7, 2020, the Board approved retroactive Agreement No. 20-014 which allowed MHS to operate a recovery-oriented program for co-occurring full-service partnership services for adults and older adults with active co-occurring disorders and symptoms.
On June 20, 2023, the Board approved a Superseding Agreement (No. 23-284), to incorporate California Advancing and Innovating Medi-Cal (CalAIM) required updates including payment structure changes.
On November 7, 2023, the Board approved First Amendment to Master Agreement No. 23-284 which updated the program’s Scope of Work and replaced the rate sheet to include Supplemental/Add On service codes that were previously added by the DBH Director through her authority in Article 25 of the agreement to accommodate State mandated rate increases.
On July 9, 2024, the Board approved Second Amendment to Master Agreement No. 23-284 to increase the specialty mental health maximum compensation of the agreement.
On January 28, 2025, your Board approved Third Amendment to Master Agreement No. 23-284 to increase the MHSA maximum compensation to increase client housing support funds.
Services provided by MHS’s co-occurring disorders program include community-based outpatient specialty mental health services, innovative interventions, comprehensive services, integrated behavioral health and substance abuse treatment services, and housing services to support the individual in recovery and self-sufficiency. 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, and hospitals.
Approval of the recommended action will increase the maximum compensation for specialty mental health services, allowing the program to bill for more specialty mental health services as the program is trending to exceed the maximum compensation allowable for specialty mental health services outlined in the current agreement.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of this agreement at the May 2025 meeting.
REFERENCE MATERIAL:
BAI # 34 January 28, 2025
BAI # 29 July 9, 2024
BAI # 47 November 7, 2023
BAI # 45 June 20, 2023
BAI # 22 January 7, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 4 to Master Agreement No. A-23-284
CAO ANALYST:
Ron Alexander