HomeMy WebLinkAboutDBH BAI - Granicus File 22-0167 - 3-22-2022 Board Date.pdf COZj���C
Board Agenda Item 42
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DATE: March 22, 2022
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Interim Director, Department of Behavioral Health
SUBJECT: Revenue Amendment with the State Department of Health Care Services for the
Medi-Cal Managed Care Mental Health Plan
RECOMMENDED ACTION(S):
Approve and authorize the Chairman to execute a revenue Amendment No. 1 (State Agreement
#17-94581 A01)with the California Department of Health Care Services for the Medi-Cal Managed
Care Mental Health Plan for Fresno County to comply with the updated Managed Care Final Rule,
effective upon execution with no change to the term of July 1, 2017 through June 30, 2022 ($0).
Approval of the recommended action will provide continued funding from the California Department of Health
Care Services (DHCS)for specialty mental health services under the Fresno County Mental Health Plan
(FCMHP)to Fresno County Medi-Cal beneficiaries with mental health conditions with no Net County Cost.
These services are mandated by California Code of Regulations Title 9, Chapter 11 commencing with
Section 1810.100, Welfare and Institutions Code Division 5, and Title 42 Code of Federal Regulations.
Approval of the recommended amendment will address a change to remain in compliance with the updated
Final Rule requirements for MHPs. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department of Behavioral Health's ability to
collect revenue from DHCS for specialty mental health services provided to County Medi-Cal beneficiaries
with mental health conditions and substance use disorders would be limited.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. There is no cost
associated with the recommended amendment. The Department will be reimbursed based upon actual
services rendered to individuals served and the certified public expenditures reported on the fiscal year-end
cost reports. In FY 2020-21, these costs were $113,406,493.71. Sufficient appropriations and estimated
revenues are included in the Department's Org 5630 FY 2021-22 Adopted Budget.
DISCUSSION:
On September 11, 2018, your Board approved the State Agreement#17-94581 with the California
Department of Health Care Services for the provision of specialty mental health services to Fresno County
residents. It is the responsibility of the FCMHP to ensure County Medi-Cal beneficiaries who meet criteria for
medical necessity of a serious mental illness (SMI)or serious emotional disturbance (SED) receive
specialty mental health services that are within the scope of the recommended agreement.
County of Fresno page 1 File Number.22-0167
File Number:22-0167
Specialty mental health services include mental health services, medication support services, day treatment
intensive, day rehabilitation, crisis intervention, crisis stabilization, adult residential treatment, crisis
residential treatment, psychiatric health facility services, intensive care coordination, intensive home-based
services, therapeutic behavioral services, therapeutic foster care, psychiatric inpatient hospital services, and
targeted case management.
With your Board's approval of the recommended amendment, new changes and responsibilities for the
FCMHP under the Final Rule will include access to care, network adequacy, timeliness to service,
processing of grievances and disputes, integrity requirements, compliance, termination clauses, out of
county placement documentation, and HIPAA requirements.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was made aware of the recommended amendment at its March 22, 2022,
meeting.
REFERENCE MATERIAL:
BAI #34, September 11, 2018
BAI #46, May 21, 2013
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Amendment with DHCS#17-94581 AO
CAO ANALYST:
Sonia M. De La Rosa
County of Fresno Page 2 File Number.22-0167