DATE: June 4, 2019
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director of Behavioral Health
SUBJECT: Department of Behavioral Health Budget Resolutions
RECOMMENDED ACTION(S):
TITLE
1. Adopt Budget Resolution increasing the FY 2018-19 appropriations in the 1991 Realign-Behavioral Health Org 5245 in the amount of $9,000,000 (4/5 vote).
2. Adopt Budget Resolution increasing the FY 2018-19 appropriations in the Mental Health (EPSDT) Org 5637 in the amount of $4,000,000 (4/5 vote).
3. Adopt Budget Resolution increasing the FY 2018-19 appropriations and estimated revenues in the Behavioral Health Org 56302007 in the amount of $13,000,000 (4/5 vote).
4. Adopt Budget Resolution increasing the FY 2018-19 appropriations in the Mental Health (Managed Care) Org 5636 in the amount of $3,000,000 (4/5 vote).
5. Adopt Budget Resolution increasing the FY 2018-19 appropriations and estimated revenues in the Behavioral Health Org 56302666 in the amount of $3,000,000 (4/5 vote).
6. Adopt Budget Resolution increasing the FY 2018-19 appropriations in the Prop 36 Org 1060 in the amount of $75.57 (4/5 vote).
7. Adopt Budget Resolution increasing the FY 2018-19 appropriations in the Drug Medi-Cal County Admin Org 1064 in the amount of $15.72 (4/5 vote).
8. Adopt Budget Resolution increasing the FY 2018-19 appropriations and estimated revenues in the Behavioral Health Org 56302080 in the amount of $91.29 (4/5) vote).
REPORT
Approval of recommended actions one through five will allow the Department of Behavioral Health to continue funding various Substance Use Disorder (SUD), Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, and specialty mental health services to eligible Medi-Cal beneficiaries. Approval of recommended actions six through eight will allow the Department to expend remaining Prop 36 and Drug Medi-Cal County Admin revenue funds.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. If the recommended actions are not approved, the Department will not have sufficient appropriations to continue funding State and Federal mandated services through the end of the fiscal year.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions.
Recommended actions one, two, and three will increase FY 2018-19 appropriations in the 1991 Realign-Behavioral Health Org 5245 ($9,000,000) using fund balance from the Health and Welfare Trust Fund and in the Mental Health (EPSDT) Org 5637 ($4,000,000) using fund balance from the 2011 Special Revenue Fund and increase FY 2018-19 appropriations and estimated revenues in the Contracted Services-MH Org 56302007 in the amount of $13,000,000 by operating transfers in from Orgs 5245 and 5637.
Recommended actions four and five will increase FY 2018-19 appropriations in the Mental Health (Managed Care) Org 5636 using fund balance from the 2011 Special Revenue Fund and increase FY 2018-19 appropriations and estimated revenue in the Contracted Services - MH Org 56302666 in the amount of $3,000,000 by an operating transfer in from Org 5636.
Recommended actions six, seven, and eight will increase FY 2018-19 appropriations in the Prop 36 Org 1060 and Drug Medi-Cal County Admin Org 1064 using fund balance from the Special Revenue fund and increase FY 2018-19 appropriations and estimated revenue in the SUD Planning and Support Org 56302080 in the amount of $91.29 by operating transfers in from Orgs 1060 ($75.57) and 1064 ($15.72).
DISCUSSION:
The Fresno County Mental Health Plan provides specialty mental health services to Medi-Cal beneficiaries in Fresno County through a contract with the California Department of Health Care Services (DHCS), including Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services to Medi-Cal clients aged 0-21. Additionally, the Department opted in to the Drug Medi-Cal Organized Delivery System (DMC-ODS) that expands SUD services providing access to a full continuum of SUD benefits, which was approved by DHCS and implemented on January 1, 2019.
The need for additional funding is due to delays in Medi-Cal reimbursements and higher than anticipated expenditures. Additionally, longer than anticipated testing and implementation of the DMC-ODS billing system has resulted in delays in Drug Medi-Cal billing. The recommended Budget Resolutions one through five will increase realignment appropriations to offset delayed Medi-Cal revenue needed to cover costs of Federal and State mandated specialty mental health and SUD services already rendered and allow for continued funding of these services through the end of the fiscal year.
Proposition 36 established the Substance Abuse and Crime Prevention Act (SACPA) of 2000 to track and monitor client fines, fees, and interest. With the sunsetting of Prop 36 in 2005, allocations were discontinued and State allocations to the Drug Medi-Cal County Admin fund were realigned as part of 2011 Realignment. Approval of Recommended Actions six, seven, and eight will allow the Department to expend the remaining balances in the respective Special Revenue Funds.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended budget resolutions at its April 17, 2019 Board Meeting.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Budget Resolution 5245
On file with Clerk - Budget Resolution 5637
On file with Clerk - Budget Resolution 56302007
On file with Clerk - Budget Resolution 5636
On file with Clerk - Budget Resolution 56302666
On file with Clerk - Budget Resolution 1060
On file with Clerk - Budget Resolution 1064
On file with Clerk - Budget Resolution 56302080
CAO ANALYST:
Ron Alexander