DATE: February 25, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment I to Memorandum of Understanding with Medi-Cal
Managed Care plans
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment I to Memorandum of Understanding (MOU) No. 24-365 with Blue Cross of California Partnership Plan, Inc. dba Anthem (Anthem), Fresno-Kings-Madera Regional Health Authority dba CalViva Health (CalViva Health), and Kaiser Foundation Health Plan, Inc. (Kaiser), to add the names and titles of the Drug Medi-Cal Organized Delivery System and Mental Health Plan designated person and the Managed Care Plans designated person, with no change to the term of unlimited 12-month auto-renewals unless terminated by either party, or maximum compensation ($0).
REPORT
Approval of the recommended action will allow the Department of Behavioral Health (Department) to fulfill the Department of Health Care Services’ (DHCS) requirement of including the names and titles of the designated persons. The designated persons act as liaisons between the Managed Care Plan and the Mental Health Plan. Approval will also allow the Department to continue to coordinate care with Medi-Cal Managed Care Plans (MCPs) for Medi-Cal beneficiaries who are identified as needing specialty mental health and substance use disorder services. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. If the recommended action is not approved, the Department will be out of compliance with DCHS and Medi-Cal beneficiaries may not be able to access specialty mental health services and substance use disorder treatment services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. All services delivered will continue to be billed to Medi-Cal.
DISCUSSION:
On October 12, 2023, the DHCS released Behavioral Health Information Notices (BHINs) 23-056 and 23-057. The BHINs updated requirements to the MOU’s between the County and Medi-Cal MCPs due to new California Advancing and Innovating Medi-Cal (CalAIM) regulations. Additionally, the BHINS clarified and reiterated responsibilities, oversight, compliance and DHCS reporting requirements between the County and the MCPs.
On July 9, 2024, your Board approved an agreement with three MCPs: Blue Cross of California Partnership Plan, Inc. (dba Anthem), Fresno-Kings-Madera Regional Health Authority (dba CalViva Health), and Kaiser Foundation Health Plan, Inc. This agreement is required by DHCS to ensure coordinated services for Medi-Cal members. At the time of approval, the names of all designated individuals for the Drug Medi-Cal Organized Delivery System/Mental Health Plan (DMC-ODS/MHP) and MCPs were not yet known.
The Department submitted the approved MOU to DHCS, who subsequently requested that the Department add the specific titles of designated individuals to the MOU and list both names and titles in the necessary exhibit.
REFERENCE MATERIAL:
BAI #25, July 9, 2024
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to MOU
CAO ANALYST:
Ron Alexander