REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  February  28, 2023
CATEGORY:  Consent - Health and Human Services-9.

SUBJECT:

Adopt a resolution regarding the California Department of Health Care Services (DHCS) Mental Health Plan (MHP) agreement which: (1) approves a retroactive renewal revenue agreement (No. 22-20136) with DHCS for the MHP in Shasta County; (2) delegates signature authority to the HHSA Director or their designee, to sign retroactive revenue renewal Agreement No. 22-20136, and accompanying certification documents, including retroactive, with DHCS for Medi-Cal covered specialty mental health services through the MHP for the period July 1, 2022, through June 30, 2027, provided they otherwise comply with Administrative Policy 6-101, Shasta County Contracts Manual; and (3) delegates signature authority for amendments and other subsequent related documents, including retroactive, to the HHSA Director or their designee that do not result in a functional or substantial change, provided they otherwise comply with Administrative Policy 6-101, Shasta County Contracts Manual.

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Laura Burch, Director, Health and Human Services Agency, 530-245-6269

STAFF REPORT APPROVED BY:  Laura Burch, Director, Health and Human Services Agency

RECOMMENDATION

Adopt a resolution regarding the California Department of Health Care Services (DHCS) Mental Health Plan (MHP) agreement which: (a) approves a retroactive renewal revenue agreement (No. 22-20136) with DHCS for the MHP in Shasta County; (b) delegates signature authority to the HHSA Director or designee, to sign retroactive revenue renewal Agreement No. 22-20136, and accompanying certification documents, including retroactive, with DHCS for Medi-Cal covered specialty mental health services through the MHP for the period July 1, 2022 through June 30, 2027, provided they otherwise comply with Administrative Policy 6-101, Shasta County Contracts Manual; and (c) delegates signature authority for amendments and other subsequent related documents, including retroactive, to the HHSA Director or designee that do not result in a functional or substantial change, provided they otherwise comply with Administrative Policy 6-101, Shasta County Contracts Manual.

DISCUSSION

This agreement is retroactive due to the department not receiving renewal documents until August 2022 (after the expiration of the previous agreement).

As the single state Medicaid agency, the California Department of Health Care Services (DHCS) administers California’s Medicaid “Medi-Cal” Program. Medi-Cal is a federal/state partnership providing comprehensive health care, including the Specialty Mental Health Services Program, to individuals and families who meet defined eligibility requirements. DHCS contracts with California’s 56 Mental Health Plans (MHPs), including the County of Shasta, for the provision of Medi-Cal Specialty Mental Health Services. This agreement is called Mental Health Plan Contract and is required by state laws and regulations (Welfare and Institutions Code Sections 14680-14726, and Title 9, California Code of Regulations, Sections 1810.100 and 1810.110). The Mental Health Plan Contract sets forth comprehensive requirements for MHPs to provide or arrange for the provision of SMHS to beneficiaries in their counties that meet medical necessity criteria, consistent with the beneficiaries' mental health treatment needs and goals.

Shasta County has provided mental health services to Medi-Cal recipients through its Shasta County MHP since January 1997. As many of the requirements in the Medicaid Managed Care regulations became effective and applicable on July 1, 2022, DHCS is retroactively aligning the proposed Mental Health Plan Contract with the July 1, 2022 date. Execution of this contract is required for the County to receive Medi-Cal reimbursement funds.

Approximately $15 million per fiscal year is received through this contract. This reimburses the County for services provided to Medi-Cal beneficiaries.

ALTERNATIVES

DHCS has indicated that there is no ability for counties to modify the terms of the Mental Health Plan Contract. The Board could choose not to approve some or all of the recommendations. If the Mental Health Plan Contract is not approved, it would result in a loss of significant amounts of realignment funding to the County and/or the state administration of the County’s mental health program. If the delegating signature authority to the HHSA Director is not approved, it may result in a decrease of efficiency in contract maintenance during the five-year term of the agreement as items needing signatures would need to return to the Board for review and approval.

OTHER AGENCY INVOLVEMENT

County Counsel has approved the agreement as to form. Risk Management and County Information Technology have reviewed and approved the agreement. The recommendation has been reviewed by the County Administrative Office.

FISCAL IMPACT

Compensation payable to Shasta County by the federal Medicaid funding is realized over the agreement term through expenditure of 1991 and 2011 mental health realignment and a County General Fund contribution as match. Federal reimbursement is contingent on certified public expenditures made by Shasta County and then claimed through the Medi-Cal billing process. The agreement will allow for the continued pass-through of approximately $15 million in federal Medicaid funds annually to Shasta County. Payment to Shasta County is processed as claims are made for mental health services provided by the HHSA as well as through contractors. A cost reporting/reconciliation process takes place after the close of the fiscal year and any differences between the billed costs and the cost of providing services are paid to or recouped from Shasta County’s Mental Health Fund. Matching funds are provided through a combination of 1991 and 2011 realignment as well as a County General Fund contribution of $276,778. There is no additional General Fund impact.