DATE: May 17, 2022
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Participation Agreement with California Mental Health Services Authority for the Psychiatric Inpatient Concurrent Review Program
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a Participation Agreement with the California Mental Health Services Authority for the Psychiatric Inpatient Concurrent Review Program, effective upon execution through December 31, 2024, total not to exceed $918,223; and,
2. Approve and authorize the Department of Behavioral Health Director, or designee, to be the signatory and act as the Fresno County representative on behalf of the Board of Supervisors on associated California Mental Health Services Authority Psychiatric Inpatient Concurrent Review Program related reports and forms, without modifying the maximum compensation.
REPORT
Approval of the recommended actions will allow the Department of Behavioral Health to participate in the Psychiatric Inpatient Concurrent Review Program (Program) which will include utilizing a technology-assisted concurrent review process compliant with Behavioral Health Information Notice (BHIN) 19-026 and Substance Use Disorder Services Final Rule (Parity Rule: Title 42 of the CFR, part 438.910). Approval of the recommended actions will allow the Department Director to sign related reports and forms without modifying the maximum compensation, and act as a representative of the County. The agreement will be fully funded with Realignment funds, with no increase in Net County Cost. The item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the Department would be unable to participate in the implementation of the newly approved State Program developed by California Mental Health Services Authority. Concurrent reviews and authorization of psychiatric inpatient hospital services are State mandates as identified in BHIN 19-026. Without concurrent reviews and authorization for psychiatric inpatient hospitalization services, the County will be out of compliance which may result in County cost.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum amount of the agreement $918,223 will be fully offset with Realignment funds. Sufficient appropriations and estimated revenues will be included in the Department’s Org 5630 FY 2021-22 Recommended Budget and in subsequent budget requests.
DISCUSSION:
On September 14, 2010, the Board approved Agreement No. 10-489 with the 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 with other departments, which included but was not limited to data management, research and development.
Per the BHIN 19-026, Mental Health Plans (MHPs) are required to conduct concurrent review and authorization for all psychiatric inpatient hospital services and psychiatric health facility services. CalMHSA was tasked to develop a technology-assisted concurrent review process that will support MHP to meet compliance with California Department of Health Care Services (DHCS). Upon execution, CalMHSA will provide oversight of Keystone Peer Review Organization (KEPRO) who will conduct concurrent review and authorization of inpatient psychiatric services on behalf of the County. The program will include web-enabled technology for hosting, supporting, and maintaining a psychiatric inpatient concurrent review and authorization system. CalMHSA has selected and contracted with KEPRO to provide direct deliverable services, concurrent reviews, and authorization for psychiatric inpatient hospitalizations. KEPRO has been providing innovative solutions to government sponsored healthcare programs such as care management, quality oversight and assessments, eligibility and enrollment.
The recommended 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. The Department believes that the benefits of the recommended agreement outweigh any potential risks and recommends approval of the agreement. As written, Agreement with CalMHSA requires a six-month advance written notice for termination. Approval of the recommended actions will result in concurrent reviews and authorizations for psychiatric inpatient hospital services to begin 30-days following execution of agreement with CalMHSA.
REFERENCE MATERIAL:
BAI #57, June 18, 2013
BAI #39, September 14, 2010
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CalMHSA
CAO ANALYST:
Sonia M. De La Rosa