To: Board of Supervisors
From: DHHS: Behavioral Health
Agenda Section: Consent
Vote Requirement: 4/5th
SUBJECT:
title
Behavioral Health Fiscal Year 2023-2024 Substance Use Disorder Supplemental Budget (Requires 4/5 Vote)
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve the attached supplemental budget in the amount of $1,833,324 for Fiscal Year 2023-2024, Department of health and Human Services - Behavioral Health Fund 1180, Substance Use Disorder Budget Unit 425 (Requires 4/5 Vote).
Body
STRATEGIC PLAN:
This action supports the following areas of your Board’s Strategic Plan.
Area of Focus: Safe & Healthy Communities
Strategic Plan Category: 1002- Remove barriers to quality healthcare
DISCUSSION:
The Substance Use Disorder (SUD) division is committed to providing recovery-oriented services so program participants can develop the skills needed to live free from the harmful use of substances. Services include assessment, referral, treatment, case management and care coordination for adolescents and adults with SUD treatment needs in Humboldt County.
In August 2015, the Center for Medicaid Services approved a waiver of certain requirements set forth in Section 1115 of the United States Social Security Act which allowed the State of California to implement the Drug Medi-Cal Organized Delivery System (DMC-ODS) Pilot Program in order to
expand, improve and reorganize its processes for treating people with substance use disorders.
Participation in the DMC-ODS Pilot Program requires that counties provide access to a full continuum of substance use disorder treatment services modeled after the American Society of Addiction Medicine criteria.
In November 2017, Partnership HealthPlan of California (PHC), the County of Humboldt and seven
other northern California counties submitted a DMC-ODS Pilot Program Implementation Plan, now known as the Wellness and Recovery Program Regional Model, regarding the identification and provision of covered DMC-ODS services to eligible beneficiaries in each county under the oversight of PHC. In June 2019, the County of Humboldt and PHC entered into a data sharing agreement to allow the Humboldt County Department of Health and Human Services - Behavioral Health (DHHS - Behavioral Health) and PHC to exchange Medi-Cal data needed to develop and test processes for eligibility maintenance, claims payment and reporting mechanisms required to implement the Wellness and Recovery Program.
On April 28, 2020, your Board approved the resolution authorizing the Humboldt County Department of Health and Human Services to participate in the California Department of Health
Care Services’ Drug Medi-Cal Organized Delivery System pilot program.
On Dec. 3, 2020, California Department of Health Care Services issued Behavioral Health Information Notice number 20-065 regarding obligations related to Indian Health Care Providers (IHCP) in DMC-ODS counties. PHC notified Regional Model counties of process for paying all-inclusive rate for IHCP claims on Sept. 13, 2023.
Due to ongoing expansion of Wellness and Recovery Program services to Humboldt County Medi-Cal beneficiaries and the obligations related to IHCP all-inclusive rate payments, DHHS-Behavioral expenditures are projected to exceed current approved budget of $6,001,047 in the category of Support and Care of Persons by $1,833,324. DHHS-Behavioral Health recommends approval of the attached supplemental budget in the amount of $1,833,324 for Fiscal Year 2023-2024.
SOURCE OF FUNDING:
State Drug Medi-Cal, Federal Drug Medi-Cal and Patient Revenue. Revenues are recorded within the Substance Use Disorder Fund (1180-513073, 513074, 514088)
FINANCIAL IMPACT:
|
Expenditures (1180425) |
FY23-24 |
FY24-25 Proposed* |
FY25-26 Projected* |
|
Budgeted Expenses |
9,201,113.00 |
10,199,832.00 |
11,219,815.00 |
|
Additional Appropriation Requested |
1,833,324.00 |
|
|
|
Total Expenditures |
11,034,437.00 |
10,199,832.00 |
11,219,815.00 |
*Projected amounts are estimates and are subject to change.
|
Funding Sources (1180425) |
FY23-24 |
FY24-25 Projected* |
FY25-26 Projected* |
|
State/Federal Funds |
11,034,437.00 |
10,199,832.00 |
11,219,815.00 |
|
Total Funding Sources |
11,034,437.00 |
10,199,832.00 |
11,219,815.00 |
*Projected amounts are estimates and are subject to change.
Narrative Explanation of Financial Impact:
Year-end projections for DHHS-Behavioral Health SUD budget unit 1180425 include a recommendation for supplemental budget to increase appropriation of Support and Care of Persons in the amount of $1,833,324.00 due to increases in Per Utilizer/Per Month (PU/PM) payments to Partnership Healthcare for SUD Regional Model and Tribal Healthcare Providers. Offsetting revenues include State Drug Medi-Cal $255,140.00, Federal Drug Medi-Cal $1,445,790 and Patient Revenue $132,394.00
STAFFING IMPACT:
Narrative Explanation of Staffing Impact:
There is no staffing impact related to this supplement budget recommendation.
OTHER AGENCY INVOLVEMENT:
N/A
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose not to approve this supplemental budget request; however, this alternative is not recommended as it would impact DHHS-Behavioral Health’s ability to accurately represent DHHS-Behavioral Health’s SUD budget.
ATTACHMENTS:
1. 1180425 DHHS-SUD Supplemental Budget Fiscal Year 2023-2024
2. DMC-ODS Regional Counties: Process for paying Office of Management and Budgets (OMB) all-inclusive rate for IHCP claims.
PREVIOUS ACTION/REFERRAL:
Meeting of: 4/28/2020
File No.: 20-456