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COUNTY OF SAN MATEO
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Inter-Departmental Correspondence
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Health Department
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DATE:
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March 20, 2006
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BOARD MEETING DATE:
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April 4, 2006
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Charlene A. Silva, Director, Health Department
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Gale Bataille, Director of Mental Health Services
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SUBJECT:
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Amendment to the Agreement with the State Department of Mental Health for Managed Care Services
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RECOMMENDATION:
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Adopt a resolution authorizing the President of the Board to execute an Amendment to the Agreement with the State Department of Mental Health for Managed Care services for the term July 1, 2005 through June 30, 2006, increasing the Agreement maximum by $97,954 to a new maximum of $9,251,816.
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VISION ALIGNMENT:
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Commitment: To ensure basic health and safety for all.
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Goal 8: Help vulnerable people-the aged, disabled, mentally ill, at risk youth, and others- achieve a better quality of life.
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This Agreement contributes to this commitment and goal by providing funding for managed care mental health services.
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BACKGROUND:
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In April 1995, under a 1915(b) waiver granted to the State Department of Health Services (DHS) by the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA), San Mateo was the first California county to implement a managed mental health care system for Medi-Cal beneficiaries. At the end of the initial two-year waiver period, the San Mateo Mental Health Services Division worked with DHS and the State Department of Mental Health (DMH) to submit a second federal waiver request, which was approved effective July 1, 1998, and was extended through October 31, 2001. Since that time Mental Health Services has applied for and received waivers allowing the continued operation of our managed care mental health system. Our annual DMH Managed Care Agreements have authorized the San Mateo County Mental Health Plan to provide mental health services under the conditions of these federal waivers to Medi-Cal eligible clients and provide State General Fund revenue to support managed care and other specified services. Effective July 1, 2005, San Mateo County is folded into the non-1915(b) waiver operated by DMH for all California counties.
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DISCUSSION:
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On January 31, 2006, the Board of Supervisors, by Resolution Number 067794, approved an Agreement with DMH for Medi-Cal managed care services providing $9,153,862 for the term July 1, 2005 through June 30, 2006. DMH is now amending this Agreement by increasing the maximum by $97,954 to reflect the amount included in the approved State budget for FY 2005-06.
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The amended Agreement defines the requirements for quality improvement, record keeping, client rights, availability and accessibility of services, utilization management, provider certification, fee-for-service reimbursement, responsibility for medications prescribed by psychiatrists, and laboratory services. It also establishes requirements for Day Treatment Services, Therapeutic Behavioral Services (TBS), certification of program integrity, the Health Insurance Portability and Accountability Act (HIPAA), and other program requirements.
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The term of this amended Agreement remains July 1, 2005 through June 30, 2006.
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FISCAL IMPACT:
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The amended Agreement maximum is $9,251,816 for FY 2005-06. This includes $6,482,000 as the state share of Medi-Cal expenses for pharmacy and related laboratory services. The balance of $2,769,816 is the state share of Medi-Cal expenses for other managed care activities and services. The FY 2005-06 budget for Mental Health Services includes the amended amount of this agreement.
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In addition to the state allocation, Mental Health Services bills the State separately for the federal financial participation (FFP) of Medi-Cal. State and federal revenues are included in the adopted FY 2005-06 budget for Mental Health Services.
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