HomeMy WebLinkAboutIGT Agreement A-25-233 with DHCS.pdf Agreement No. 25-233
CONTRACT# 24-40134
INTERGOVERNMENTAL AGREEMENT REGARDING
TRANSFER OF PUBLIC FUNDS
This Agreement is entered into between the CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES ("DHCS") and the COUNTY OF FRESNO
("Governmental Funding Entity")with respect to the matters set forth below.
The parties agree as follows:
AGREEMENT
1. Transfer of Public Funds.
1.1 The Governmental Funding Entity authorizes DHCS to instruct the State
Controller's Office to offset from the accounts and in the amounts identified in Section 1.2,subject
to the limitations identified in Section 1.3 and as modified by the provisions in Section 1.4 for the
purposes described in Section 3.
1.2 The Governmental Funding Entity authorizes DHCS to instruct the State Controller's
Office to withhold 10.5 %of the Governmental Funding Entity's monthly distribution from the Behavioral
Health Subaccount in the Local Revenue Fund 2011 (Fund 3217); 0.00 % of the Governmental Funding
Entity's monthly distribution from the Mental Health Subaccount of the Sales Tax Account of the Local
Revenue Fund(Fund 0351); and 10.00 %of the Governmental Funding Entity's monthly distribution from the
Mental Health Services Fund (Fund 3085). In accordance with Subdivision(e)of Section 14184.403 of the
Welfare and Institutions Code, the Governmental Funding Entity authorizes DHCS to instruct
the State Controller's Office to transfer the funds withheld into the Medi-Cal County Behavioral
Health Fund(Fund 3420).
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1.3 DHCS shall instruct the State Controller's Office to stop withholding
funds pursuant to Section 1.2 when the ending amount in the County Funds Accounting (CFA)
report issued pursuant to Section 2 exceeds five times the monthly average county share of Drug
Medi-Cal claims approved for payment during the prior fiscal year. The Governmental Funding
Entity authorizes DHCS to instruct the State Controller's Office to resume withholding funds
pursuant to Section 1.2 once the ending amount in the CFA report issued pursuant to Section 2 is
equal to or less than three times the monthly average county share of approved claims during the
prior fiscal year.
1.4 The Governmental Funding Entity authorizes DHCS to instruct the State
Controller's Office to adjust the percentages for withholding funds specified in Section 1.2 if the
ending amount in the CFA report issued pursuant to Section 2 is equal to or less than one and
one-half times the monthly average county share of Drug Medi-Cal claims approved for payment
during the prior fiscal year. The adjustment will be an increase of five percent from each funding
source identified in Section 1.2 and shall remain in effect until the ending amount in the CFA
report exceeds three times the monthly average county share of Drug Medi-Cal claims approved
for payment during the prior fiscal year, at which time the percentages will revert to the amounts
specified in Section 1.2.
1.5 In any month in which the Drug Medi-Cal CFA balance is less than the
amount necessary to fund the county nonfederal share of approved claims in that claim file,the
Governmental Funding Entity agrees to transfer funds in an amount necessary to fund the county
nonfederal share of approved claims. "CFA balance" is defined as the real time balance in the
Governmental Funding Entity's CFA account. DHCS will withhold payment of claims for any
month triggering this provision until the necessary funds are received. Upon receipt of these
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funds,DHCS will credit the funds to the Governmental Funding Entity's CFA and release the
applicable claim file for payment.
1.6 The Government Funding Entity may transfer funds to DHCS to deposit
into the Medi-Cal County Behavioral Health Fund at any time during the course of this
agreement through a wire transfer, Automated Clearing House, or physical check.
1.7 If, at the end of the Service Period, the CFA balance reflects an excess of
funds transferred that was necessary to fund the county nonfederal share of approved claims with
dates of service during the Service Period, DHCS agrees to return the unexpended funds to the
Governmental Funding Entity. If mutually agreed to by the parties, amounts due to or owed by
the Governmental Funding Entity may be offset against future transfers. Actual approved claims
and the associated county nonfederal share amounts will be considered final [two years after] the
end of the Service Period.
1.8 The Governmental Funding Entity certifies that any funds transferred
pursuant to this Agreement qualify for federal financial participation pursuant to Section 433.51
of Title 42 of the Code of Federal Regulations, any other applicable federal Medicaid laws,and
the CalAIM Terms and Conditions, and are not derived from impermissible sources such as
recycled Medicaid payments, Federal money excluded from use as State match, impermissible
taxes, and non-bona fide provider-related donations. Impermissible sources do not include
patient care or other revenue received from federal healthcare programs to the extent that the
program revenue is not obligated to the State as the source of funding.
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1.9 The funds transferred pursuant to this Agreement represent a voluntary
contribution to the non-federal share of Medi-Cal expenditures for purposes of all state and
federal laws, including but not limited to section 14184.403 of the Welfare and Institutions Code
and 42 U.S.C. § 1396d(cc).
1.10 The Governmental Funding Entity agrees that failure to timely transfer
funds in accordance with this Agreement constitutes a failure to perform functions of a program
funded by the Behavioral Health Subaccount that may place federal Medicaid funds at risk such
that DHCS may take the steps and issue the notifications set forth in section 30027.10 of the
California Government Code. In the event of a disallowance or deferral of federal funds related
to the allowability of funds transferred pursuant to this Agreement, DHCS shall be held harmless
from any such deferral or disallowance of federal funds, and associated federally-imposed
interest, if applicable. If, after conferring with the Governmental Funding Entity, DHCS
determines that the disallowances and deferral cannot be cured through the provision of alternate
public funds,the Governmental Funding Entity shall be responsible for refunding the federal
portion of that disallowance or deferral to DHCS. DHCS shall recoup the disallowed federal
funding already paid to the Governmental Funding Entity for such purpose. The Governmental
Funding Entity shall retain the county nonfederal share of such recouped payments.
1.11 The Governmental Funding Entity must, in accordance with applicable
federal regulations, maintain all documentation necessary to verify that the funds transferred
meet the requirements of Section 1.8. This documentation must include any records required for
Medi-Cal field audits.
2. County Funds Accounting_Report
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2.1 DHCS shall provide the Governmental Funding Entity a CFA report on
the 151h of every month. The CFA report shall include information for the prior calendar month.
The CFA report shall include the Governmental Funding Entity's starting CFA amount, which is
the ending amount from the prior month, an itemized list of all transactions that increased and
decreased the CFA aggregate amount during the reporting month, including but not limited to all
approved claims and amounts transferred, as applicable,pursuant to this Agreement, the CFA
ending amount based on the listed transactions, and the recommended amount the Government
Funding Entity should transfer to meet the account threshold described in Section 1.5.
Transaction details will include the transaction identifier or warrant number, the transaction date,
a description of the transaction,the amount of the transaction, and the CFA balance after the
transaction.
3. Authorized Use of Transferred Funds
3.1 DHCS shall exercise its authority under section 14184.403 of the Welfare
and Institutions Code to accept funds transferred by the Governmental Funding Entity pursuant
to this Agreement as public funds, to use for the purpose set forth in Section 3.2.
3.2 The funds transferred by the Governmental Funding Entity pursuant to
this Agreement shall be used exclusively to fund the county's nonfederal share of Medi-Cal
payments associated with the provision of Drug Medi-Cal services section 14184.403 of the
Welfare and Institutions Code. The funds transferred that constitute the county nonfederal share,
together with the applicable federal financial participation and State funds, shall be paid by
DHCS to the Medi-Cal behavioral health delivery system associated with the Governmental
Funding Entity, consistent with the applicable state and federal requirements for the applicable
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CONTRACT#
ut r All
service periods from July 1, 2023 through December 31, 2026, in accordance with section
14184.403 of the Welfare and Institutions Code.
3.3 DHCS shall seek Federal Financial Participation for the Medi-Cal
payments specified in Section 3.2 to the full extent permitted by federal law. The total
intergovernmental transfer-funded payment amount, which includes the federal and nonfederal
share,paid to a Medi-Cal behavioral health delivery system shall be for the support of behavioral
health-related services and activities that benefit patients served by the Medi-Cal behavioral
health delivery system, consistent with federal law. The Drug Medi-Cal health system associated
with the Governmental Funding Entity,that receives payments pursuant to Section 3.2, will
retain 100%of those payments to use to meet the costs of furnishing such services and activities
which may include the Governmental Funding Entity's payment to its subcontract providers.
Nothing in this agreement shall be construed to direct the manner, including type or amount, in
which the Drug Medi-Cal System shall meet such costs.
4. Dispute Resolution Process.
4.1 In the event of a dispute arising under this Agreement, including but not
limited to, disputes related to the CFA report, the Governmental Funding Entity must submit an
appeal letter to DHCS. Such appeal letter must be submitted within 120 calendar days of receipt
of the CFA report or other relevant documentation. The dispute letter must set forth the relevant
facts and explanation of the dispute.
4.2 Within 60 calendar days of receipt of the appeal letter,DHCS will issue a
final decision to the Governmental Funding Entity. The 60-day time period may be extended if
the Governmental Funding Entity and DHCS agree in writing on an extension of time to evaluate
and resolve the dispute.
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CONTRACT# 24-40134
5. Amendments.
5.1 No amendment or modification to this Agreement shall be binding on
either party unless made in writing and executed by both parties.
5.2 The parties shall negotiate in good faith to amend this Agreement as
necessary and appropriate to implement the requirements set forth in Section 3 of this
Agreement.
6. Notices. Any and all notices required, permitted, or desired to be given hereunder
by one party to the other shall either be sent via secure email to the below stated contacts or in
writing and delivered to the other party personally or by United States First Class, Certified or
Registered mail with postage prepaid, addressed to the other party at the address set forth below:
To the Governmental Funding Entity:
COUNTY of FRESNO Department of Behavioral Health
Insert Contact Info as Identified by Funding Entity:
P.O. Box 712
Fresno, CA 93712-0712
With copies to:
Sean Patterson
spatterson@fresnocountyca.gov
Maryann Le
mle@fresnocountyca.gov
To DHCS:
Kenneth Rhodes,Fiscal Section
California Department of Health Care Services Local Government Finance
Division
1501 Capitol Ave.,MS 4413
Sacramento,CA 95814
BH-IGT@dhcs.ca. ov
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CONTRACT#
7. Other Provisions.
7.1 This Agreement contains the entire Agreement between the parties with
respect to the County's nonfederal share of payments associated with the Governmental Funding
Entity's Medi-Cal behavioral health delivery system that are voluntarily funded by the
Governmental Funding Entity, and supersedes any previous or contemporaneous oral or written
proposals, statements, discussions, negotiations or other agreements between the Governmental
Funding Entity and DHCS relating to the subject matter of this Agreement. This Agreement is
not, however, intended to be the sole agreement between the parties on matters relating to the
funding and administration of the Medi-Cal program. This Agreement shall not modify the terms
of any other agreement, existing or entered into in the future, between the parties.
7.2 The non-enforcement or other waiver of any provision of this Agreement
shall not be construed as a continuing waiver or as a waiver of any other provision of this
Agreement.
7.3 Section 2 of this Agreement shall remain in effect for 15 months after the
expiration or termination of this Agreement.
7.4 Nothing in this Agreement is intended to confer any rights or remedies on
any third party, any third party provider(s) or groups of providers, or any right to medical
services for any individual(s) or groups of individuals. Accordingly, there shall be no third party
beneficiary of this Agreement.
7.5 Time is of the essence in this Agreement.
7.6 Each party hereby represents that the person(s) executing this Agreement
on its behalf is duly authorized to do so.
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7.7 For purposes of this Agreement, "approved claims" shall mean Drug
Medi-Cal claims submitted to the Short-Doyle Medi-Cal claiming system submitted by and
approved for payment to the Governmental Funding Entity.
8. State Authority. Except as expressly provided herein, nothing in this Agreement
shall be construed to limit, restrict, or modify the DHCS' powers, authorities, and duties under
Federal and State law and regulations.
9. Approval. This Agreement is of no force and effect until signed by the parties.
10. Term. This Agreement shall be effective as of July 1, 2023 and shall expire as of
December 31,2026 unless terminated earlier by mutual agreement of the parties.
11. The parties hereto have mutually agreed that upon execution of this IGT
Agreement,the previous IGT Agreement and all amendments thereto shall automatically
terminate, with the effect of such termination retroactive to ,and this IGT
Agreement shall supersede the previous IGT Agreement in its entirety.
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Docusign Envelope ID:A7EC36A0-3FA4-42A3-816B-130A366F1A313
CONTRACT# 24-40134
SIGNATURES
IN WITNESS WHEREOF,the parties hereto have executed this Agreement, on
the date of the last signature below.
THE Co FRSIQ ;
By: Date: to -26
Ernest Buddy Mendes
Chairman of the Board of Supervisors of the County
of Fresno
Attest:
Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State of California.
By: y . .DCjou74)V,
THE STATE OF CALIFORNIA,DEPARTMENT OF HEALTH CARE SERVICES:
Signed by:
By. CayI'S Qvukx� Date: June 13, 2025
Charles Anders
[DHCS SIGNATORY]
4856-9198-7279.1
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