DATE: April 9, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment II to California Mental Health Services Authority Participation Agreement
RECOMMENDED ACTION(S):
TITLE
Approve and authorize Chairman to execute Amendment II to Participation Agreement with California Mental Health Services Authority (CalMHSA) to modify the Fiscal Provisions related to the administrative fee during the project period, effective upon execution, with no change to the term of August 9, 2022 through June 30, 2024 or compensation maximum of $200,590.
REPORT
There is no additional Net County Cost associated with the recommended action. Approval of the recommended action will allow Department of Behavioral Health (DBH) to specify in the agreement that only funding for services that have been rendered and paid from the Flexible Spending Account (FSA) will be subject to a 15% administrative fee and any unused funds will be fully reimbursed at the end of the project period as defined in the initial Participation Agreement 22-343 and Agreement 23-239. The agreement will only require a correction in language and will have no impact on current funds or payments.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, DBH would be subject to a 15% administrative fee for refunds and any new service costs added to the flexible spending account on this Participation Agreement.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum amount allocated for this agreement shall not exceed $200,590 and will be fully offset with Realignment funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2023-2024 Adopted Budget and will be included in future budget requests.
DISCUSSION:
On September 14, 2010, the Board approved Agreement No. 10-489 with California Mental Health Services Authority (CalMHSA) authorizing the Department to join the CalMHSA Joint Powers Authority (JPA), to develop, implement, administer, and provide fiscal oversight of Mental Health Services Act (MHSA).
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, which included but was not limited to data management, research, and development.
On August 9, 2022, the board approved Agreement 22-343 with California Mental Health Services Authority to provide support in developing Behavioral Health Quality Improvement Program projects. The Department works with CalMHSA to develop and implement strategies required to meet DHCS milestones in the BQHIP, which will be governed by CalMHSA Agreement and Bylaws. CalMHSA’s primary responsibilities will be to develop these projects to support counties in meeting required BHQIP deliverables and implementing the CalAIM transformation. The projects are identified in the following categories:
• Payment Reform, Policy Changes, and Data Exchange categories. • Project 1 (Payment Reform) - CalMHSA will work with the Department to draft updated subcontracted provider boilerplate language to incorporate new code sets and claiming requirements in order to meet the Milestone 1a(iii) requirement.
• Project 2 (Policy Changes) - CalMHSA will conduct a landscape analysis of documentation audit practices and draft an updated Utilization Management protocol to comply with best practices and updated document audit standards to meet the Milestone 2d(iv) requirement.
• Project 3 (Data Exchange) - CalMHSA will collaborate with the Department to receive and analyze Managed Care Plan data for the July 2022/July 2023 measurement period and analyze the data to establish Department baseline performance to meet the Milestone 3d(i) requirement.
• Project 4 (Optional Data Exchange Services) - CalMHSA will support the Department in developing and implementing Performance Improvement Project (identifying, implementing, and tracking interventions to improve performance related to measures indicated under Milestone 3d(i) to meet Milestones 3d(i), 3d(ii), 3d(iii) requirements.
Additional Professional Services (project management clinical training and policy changes implementation support) will be used to further assist in developing communication strategies for the entire network of care and training resources.
Selecting to participate in all four (4) Projects will ensure each Milestone deadline is met.
Upon approval by the Board, the recommended Amendment will be effective upon execution through June 30, 2024. The recommended Agreement amends language that clarifies that only funds disbursed from the total flexible spending account are subject to a 15% administrative fee. Additionally, it removes a sentence from Fiscal Provisions, Item G to eliminate the administrative fee for refunds so that any unused funds at the end of the Agreement period are fully refunded. All terms and provisions not altered by this Amendment in the initial BHQIP Agreement No. 22-343 and Amendment I Agreement No. 23-239 will remain valid and enforceable.
REFERENCE MATERIAL:
BAI #26, June 6, 2023
BAI #34, August 9, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment II to CalMHSA Participation Agreement No. 22-343
CAO ANALYST:
Ron Alexander