REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  November  14, 2017
CATEGORY:  Consent - Health and Human Services-10.

SUBJECT:

California Department of Health Care Services Performance Agreement for Fiscal Year 2017-18

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Donnell Ewert, Director, Health and Human Services Agency, (530) 225-5899

STAFF REPORT APPROVED BY:  Donnell Ewert, Director, Health and Human Services Agency

RECOMMENDATION

Approve and authorize the Health and Human Services Agency Director to sign: (1) Retroactive renewal agreement, No. 17-94556, with the California Department of Health Care Services at no compensation to establish performance criteria for Shasta County in the provision of mental health services and to allow access to certain federal and state resources and local realignment funds to support mental health care delivery for the period July 1, 2017 through June 30, 2018; (2) the Contractor Certification Clauses Form CCC-307; and (3) amendments, including retroactive, that do not result in a substantial or functional change to the original intent of the agreement and that otherwise comply with Shasta County Administrative Policy 6-101, Shasta County Contracts Manual.

SUMMARY

This is a renewal agreement with the California Department of Health Care Services (DHCS).  This agreement establishes performance expectations for Shasta County, through its Health and Human Services Agency (HHSA), as the community specialty mental health services provider for Shasta County.  In addition, provisions in this agreement assure that HHSA continues to receive access to State and Federal funding, along with local realignment funds to support mental health care.

DISCUSSION

Realignment legislation adopted in 1991, delineated the Mental Health service expectations for local jurisdictions, and changed the primary State funding sources for these services from State General Fund to vehicle license fees and sales tax revenues. Subsequently, Welfare and Institutions Code Section 5650 establishes the requirement for counties to adopt and submit an annual performance agreement to DCHS that stipulates the conditions, general assurances and program principles that HHSA must adhere to as the community mental health provider. In general, the agreement establishes HHSA as the provider of community mental health services in Shasta County to ensure access to mental health services within available resources for persons experiencing severe and disabling mental illnesses and children with serious emotional disturbances. HHSA received the retroactive agreement from DHCS on October 23, 2017. The Board of Supervisors approved the Fiscal Year (FY) 2016-17 DHCS Performance Agreement No. 16-93146 on August 16, 2016.

Although this agreement contains no direct reimbursement, it describes the provisions that must be adhered to in order for the County to receive 1991 and 2011 realignment revenue, Mental Health Services Act (MHSA) funding, Projects for Assistance in Transition from Homelessness (PATH) Program funding, and Federal Community Mental Health Block grant funding.  These five revenue streams, particularly 1991 and 2011 realignment (budgeted in FY 2017-18 at $12.3 million), and MHSA (budgeted at approximately $8.2 million in FY 2017-18), make up a significant portion of HHSA’s annual revenue allocated to the provision of community mental health services. In addition, this agreement stipulates the local Mental Health Alcohol Drug Advisory Board review of subcontractor provisions, cultural competence, a complaint and civil rights hearing procedure, Health Insurance Portability and Accountability Act (HIPAA) compliance, information confidentiality and security, data reporting, cost reporting, and cost settlement processes. 

ALTERNATIVES

The Board could choose not to approve the agreement.

OTHER AGENCY INVOLVEMENT

County Counsel has approved the agreement as to form.  Risk Management has reviewed and approved the agreement.  The Information Technology Department has reviewed the agreement.  The Shasta County Mental Health, Alcohol and Drug Advisory Board reviewed the agreement at its meeting on November 1, 2017.  This recommendation has been reviewed by the County Administrative Office.

FINANCING

Although this agreement does not reference a specific dollar amount, it provides the mechanism and general assurances by which certain funding streams and allocations flow to HHSA.  This agreement also upholds the County’s General Fund Maintenance of Effort (MOE) match at $276,788 in exchange for the receipt of over $5.1 million in annual sales tax and vehicle license fee 1991 realignment funding.  This agreement is consistent with the Mental health FY 2017-18 Adopted Budget.  There is no additional County General Fund impact associated with the approval of this recommendation.