To: Board of Supervisors
From: DHHS: Mental Health
Agenda Section: Consent
SUBJECT:
title
Revise Mental Health Charge Rate Schedule effective January 1, 2020
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve and adopt the proposed charge rate schedule for the Department of Health and Human Services - Behavioral Health (Attachment 1) as required by the State Department of Health Care Services. This schedule shall be effective January 1, 2020 until amended.
Body
SOURCE OF FUNDING:
Behavioral Health Fund
DISCUSSION:
Medi-Cal and Medicare regulations require the establishment of fees for services based on ability to pay, but not to exceed the actual costs incurred, as well as to ensure that a uniform rate is established for government and private payers. It also requires entities that receive this funding to establish systems for eligibility determination, billing, and collection. Both of these regulatory funding sources make payment to DHHS-Behavioral Health based on interim rates, which are ultimately settled to cost in the cost report and audit processes.
The Mental Health charge rates for Specialty Mental Health Services are based on the estimated and historical cost per unit of providing services to clients. Billing rates are further governed by Certified Public Expenditure (CPE) and the Uniform Method of Determining Ability to Pay (UMDAP) Schedule (Attachment 2) for the billing of clients.
DHHS-Behavioral Health has conducted a financial review of the impact of staffing costs, including salary and benefit costs and operating expense costs, professional & special services and medication costs. These costs have been compared to units of service for the provision of Specialty Mental Health services. Significant changes that have impacted cost per unit in this rate setting period include the implementation of an electronic health record and a restructure of DHHS-Behavioral Health medical staffing components. C...
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