To: Board of Supervisors
From: DHHS: Behavioral Health
Agenda Section: Consent
Vote Requirement: Majority
SUBJECT:
title
Signature Authorization for Residential Treatment Services Agreements with Licensed Psychiatric Health Facilities Regarding the Provision of Psychiatric Inpatient Services to Eligible Medi-Cal Beneficiaries Residing in Humboldt County
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve the attached residential treatment services agreement template regarding the provision of psychiatric inpatient services to eligible Medi-Cal beneficiaries residing in Humboldt County;
2. Authorize the Department of Health and Human Services - Behavioral Health Director, or a designee thereof, to execute residential treatment services agreements that are substantially similar to the attached residential treatment services agreement template, and any and all subsequent amendments thereto, after review and approval by County Counsel, Risk Management and the County Administrative Office; and
3. Direct the Clerk of the Board to provide the Department of Health and Human Services - Contract Unit with one (1) fully executed certified copy of the Board order related to this item.
Body
SOURCE OF FUNDING:
Behavioral Health Fund (1170-424)
DISCUSSION:
The Board of Supervisors has authorized the Department of Health and Human Services - Behavioral Health (“DHHS - Behavioral Health”) to operate the County of Humboldt’s Mental Health Plan. The provision of specialty mental health services to all Medi-Cal beneficiaries residing in Humboldt County that meet necessary criteria is, and will remain, the responsibility of DHHS - Behavioral Health. Therefore, since April 1998, DHHS - Behavioral Health has contracted with qualified specialty mental health providers, who have historically served Medi-Cal beneficiaries residing in Humboldt County. DHHS - Behavioral Health has established a provider network with in-county as well as out-of-county providers for referrals of Medi-Cal beneficiaries residing in Humboldt County to ensure that such beneficiaries have a choice of appropriate providers.
Psychiatric health facilities offer an alternative to repeated psychiatric hospitalization. Adults placed at these facilities are stabilized, treated and transitioned to a variety of less restrictive placements as part of each individual’s long-term permanency plan. The facilities DHHS - Behavioral Health contracts with for these services are inpatient acute care treatment facilities that provide multi-disciplinary evaluation, treatment, rapid stabilization and coordinated discharge planning services to individuals who are unable to safely function at home or in the community. When an initial placement in a psychiatric health facility occurs, the client is stabilized and transitional plans are put into place and reviewed on a regular basis in order to transition the client to community living as soon as may be clinically appropriate.
The State of California recently began implementation of the California Advancing and Innovating Medi-Cal (“CalAIM”) initiative in an effort to make Medi-Cal services more accessible, equitable and person-centered. Part of CalAIM’s objectives is to “align funding, data reporting, quality and infrastructure to mobilize and incentivize progress toward common goals.” This has resulted in the state requiring changes to the payment structure of DHHS - Behavioral Health’s residential treatment services agreements with licensed psychiatric health facilities. However, while counties are required to update their residential treatment services agreements by July 1, 2023, the state has not yet completed their instructions delineating all of the changes that will need to be made or how such changes are to be implemented.
DHHS - Behavioral Health has developed the attached residential treatment services agreement template based on the direction that has been received by the state, and intends to use this template with all licensed psychiatric health facilities that currently contract with the County of Humboldt for the period of July 1, 2023 through June 30, 2025. As further clarification and direction is received by the state, DHHS - Behavioral Health will amend its residential treatment services agreements with licensed psychiatric health facilities, as needed.
Accordingly, DHHS - Behavioral Health recommends that the Board approve, and authorize the DHHS - Behavioral Health director, or their designee, to execute residential treatment services agreements substantially similar to, the attached residential treatment services template regarding the provision of psychiatric inpatient services to eligible Medi-Cal beneficiaries residing in Humboldt County, and any and all amendments thereto, after review and approval by County Counsel, Risk Management and the County Administrative Office.
FINANCIAL IMPACT:
|
Expenditures (1170-424) |
FY23-24 Projected |
FY24-25 Projected |
|
Budgeted Expenses |
$1,308,000 |
$1,308,000 |
|
Total Expenditures |
$1,308,000 |
$1,308,000 |
|
Funding Sources (1170-424) |
FY23-24 Projected* |
FY24-25 Projected* |
|
State/Federal Funds |
$1,308,000 |
$1,308,000 |
|
Total Funding Sources |
$1,308,000 |
$1,308,000 |
*Projected amounts are estimates and are subject to change.
Expenditure appropriations for the provision of psychiatric inpatient services in the amount of One Million Three Hundred Eight Thousand Dollars ($1,308,000.00) have been included in proposed fiscal year 2023-2024 budget for DHHS - Behavioral health Administration budget unit 1170-424. Psychiatric inpatient services provided pursuant to the terms and conditions of residential treatment services agreements with licensed psychiatric health facilities will be billed to Medi-Cal and reimbursed. DHHS - Behavioral Health covers the match portion of any billings not covered through the reimbursement process.
STAFFING IMPACT:
Approval of the attached professional services agreement template will not impact current staffing levels.
STRATEGIC FRAMEWORK:
The recommended actions support the Board of Supervisors’ Strategic Framework by protecting vulnerable populations, creating opportunities for improved safety and health and providing community-appropriate levels of service.
OTHER AGENCY INVOLVEMENT:
None
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose not to approve, or authorize DHHS - Behavioral Health Director, or a designee thereof, to execute residential treatment services agreements that are substantially similar to, the attached residential treatment services agreement template regarding the provision of psychiatric inpatient services to eligible Medi-Cal beneficiaries residing in Humboldt County. However, this alternative is not recommended since it will severely limit DHHS - Behavioral Health’s ability to comply with applicable CalAIM requirements.
ATTACHMENTS:
1. Residential Treatment Services Agreement Regarding the Provision of Psychiatric Inpatient Services to Eligible Medi-Cal Beneficiaries Residing in Humboldt County
PREVIOUS ACTION/REFERRAL:
Board Order No.: C-10; D-15
Meeting of: 06/02/2020; 08/10/2021
File No.: 20-635; 21-941