title
Delegate authority to the Director of Health and Social Services, or designee, to negotiate, sign, and execute master agreements, with County Counsel concurrence, with other mental health plans within the State for the provision of out-of-county placement of clients to facilitate payments for mental health services provided by out-of-county providers/facilities; and Delegate authority to the Director of Health and Social Services, or designee, to negotiate, sign, and execute temporary single-use agreements, with County Counsel concurrence, with various mental health providers that are not currently contracted with Solano County for the provision of as needed treatments for foster youth placement in community treatment facilities
body
Published Notice Required? Yes ___ No _X _
Public Hearing Required? Yes ___ No _X _
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS) recommends that the Board of Supervisors delegate authority to the Director of Health and Social Services, or designee, to negotiate, sign, and execute master agreements, with County Counsel concurrence, with other mental health plans within the State for the provision of out-of-county placement of clients to facilitate payments for mental health services provided by out-of-county providers/facilities; and delegate authority to the Director of Health and Social Services, or designee, to negotiate, sign, and execute temporary single-use agreements, with County Counsel concurrence, with various mental health providers that are not currently contracted with Solano County for the provision of as needed treatments for foster youth placement in community treatment facilities.
SUMMARY:
Assembly Bill (AB) 1051 (Bennett, Chapter 402, Statutes of 2022), amended various sections of the Welfare and Institutions Code concerning specialty mental health services (SMHS) for foster children and presumptive transfer requirements. Effective July 1, 2024, when a child or youth is placed outside of their county of origin into a community treatment facility, group home, or short-term residential therapeutic program or admitted to a children’s crisis residential program, the responsibility to provide or arrange and pay for specialty mental health services shall remain with the Mental Health Plan in the county of original jurisdiction of a child or youth. Expedited agreements and payments will be required to ensure adherence to this requirement per the Department of Health Care Services’ Behavioral Health Information Notice (BHIN) 24-025 (Attachment A).
To expedite placement of foster children/youth in treatment through master agreements between Health and Social Services, Behavioral Health Division, and out-of-county residential facilities requires sufficient signing authority to implement the required payment mechanism within 30-days of placement. Granting this authority to the director of H&SS or designee, with County Counsel concurrence, provides for the efficient administration of Solano County’s obligations under AB 1051, including the execution and submittal of all client care single case agreements and amendments.
FINANCIAL IMPACT:
2011 Realignment and Medi-Cal revenues will fund the specialty mental health services for youth in these facilities. Appropriations for out-of-county youth placements have been included in the Department’s FY2024/25 Working Budget; however, if the cost of placements exceed existing appropriations, the Department will request a budget adjustment at a later date.
The costs of preparing the agenda item are nominal and absorbed by the Department’s FY2024/25 Working Budget. There is no additional impact on the County General Fund.
DISCUSSION:
AB 1299, effective July 1, 2017, added Welfare and Institutions Code (WIC) section 14717.1, which established presumptive transfer, requiring that when a child or youth in foster care is placed outside of their county of original jurisdiction, the responsibility to provide or arrange and pay for that child or youth’s specialty mental health services (SMHS) transfers from the Mental Health Plan (MHP) in the county of original jurisdiction to the MHP in the county where the child or youth resides (also referred to as the “county of residence”). AB 1051 amended county conditions and requirements for presumptive transfer when a child or youth in foster care is placed in a specific out-of-county residential setting, requiring an expedited placement and payment process.
AB 1051, effective July 1, 2024, changes the responsibility to provide, arrange, and pay for SMHS for youth placed in designated facilities to the county of jurisdiction’s MHP. These changes significantly impact Solano County Behavioral Health, Child Welfare Services, and the Probation Department’s Juvenile Division, who need immediate access to services and placements for youth with complex and intense mental health needs. Solano County Behavioral Health may need agreements with any of the other 57 California counties and 350+ treatment facilities in California. To expedite the process and reduce the time it takes to execute those agreements and contracts, H&SS is recommending the Board delegate signatory authority to the H&SS Director or designee.
AB 1051 intends to reduce unnecessarily long lengths of stay in facilities since many are intended to be short-term and time-limited based on medical necessity. Collaborating facilities could include any of the following: community treatment facilities, group homes, children’s crisis residential programs, short-term residential treatment programs, and other types of residential treatment as required under Behavioral Health.
The Department of Health and Social Services (H&SS) is recommending that the Board delegate signing authority to Director of H&SS, with County Counsel concurrence, for the following situations:
• For dependents and wards from other counties who are placed at a facility within Solano County with which the Solano County Mental Health Plan has an existing contract, a Letter of Agreement will be generated and sent to the other county stating the Solano County facility will bill for SMHS through the Solano County Mental Health Plan. Solano County MHP will claim the services to the DHCS and will invoice the other county’s MHP. Attachment B is a sample of a Letter of Agreement.
• For Solano County dependents and wards placed at facilities in other counties, a Letter of Agreement will be generated and sent stating the facility will bill SMHS through the other county’s MHP, which will claim the services to DHCS and invoice Solano County MHP. If an agreement with another county MHP cannot be reached, because of the emergency nature of the needed treatment and placements for youth, the process would entail the creation of an Admission Agreement (Attachment C) directly with each facility. A Master Agreement for each youth in that facility will be executed between the parties subsequently within a mutually agreeable timeframe. The Master Agreement will detail the specific services needed for each youth and any other contractual arrangements not provided for in the Admission Agreement.
ALTERNATIVES:
The Board could choose not to approve delegating signatory authority to the Director of H&SS or the use of the sample Letter of Agreement template and sample Standard Admission Agreement template. This is not recommended as the County is mandated to expedite the process for contracting with residential facilities and creating agreements with other county mental health plans within 30 days, per the timelines mandated in the AB 1051.
OTHER AGENCY INVOLVEMENT:
Solano County Child Welfare Services and Probation Department’s Juvenile Division are active partners with Solano County Behavioral Health in placing and treating children and youth in foster care, both in-county and out-of-county. County Counsel was consulted on the development of the sample Letter of Agreement template and the sample Standard Admission Agreement template.
Behavioral Health Administration works concurrently with County Counsel, H&SS Contracts Bureau, H&SS Fiscal, and other counties to develop expedited policies and procedures.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION