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Approve the joint partnership agreement between the Solano County Behavioral Health Department and the California Mental Health Services Authority (CalMHSA) to initiate and receive inter-county fund transfers for behavioral health youth presumptively transferred to Solano County, and from Solano County, for FY2020/21 through FY2024/25; and Authorize the County Administrator to sign the agreement and authorize the initial deposit of $115,160 to CalMHSA for inter-member transfers, as well as all subsequent deposits for associated client placement costs that are within budgeted appropriations (4/5 vote required)
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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 approve the joint partnership agreement between the Solano County Behavioral Health Department and the California Mental Health Services Authority (CalMHSA) to initiate and receive inter-county fund transfers for behavioral health youth presumptively transferred to Solano County, and from Solano County, for FY2020/21 through FY2024/25; and authorize the County Administrator to sign the agreement and authorize the initial deposit of $115,160 to CalMHSA for inter-member transfers, as well as all subsequent deposits for associated client placement costs that are within budgeted appropriations (4/5 vote required).
SUMMARY:
Continuum of Care Reform (AB403, 2015) modified Welfare and Institution Code § 14717.1 to read that the responsibility for providing or arranging for specialty mental health services shall promptly transfer (“presumptive transfer”) from the county of original jurisdiction (i.e., placing county) to the county in which a foster youth resides, subject to any exceptions established pursuant to that section. The proposed inter-member agreement enables the transfer of funds between counties to reimburse for specialty mental health services provided in a county that is receiving a foster youth or probation youth for placement. Transfer to the County Mental Health Plan of residence is intended to promote timely access to mental health care. A county that elects not to presumptively transfer a youth and arrange directly for their mental health care may do so only under prescribed circumstances and must demonstrate an ability to enter into a contract with a receiving mental health provider within 30 days to assure both timely access to care and timely reimbursement to service providers.
The county of original jurisdiction remains responsible for reimbursing the receiving county for specialty mental health services provided or arranged by the receiving county. Implementation of this statute requires a system for counties to make prompt payments to each other. Under this program, CalMHSA acts as a fiscal agent for participating counties to make and receive transfer payments, preventing the need for counties to develop multiple contracts with other counties. The initial deposit of $115,160 will be offset by funds received by other counties. County Mental Health Plans review and authorize payments for appropriateness before funds are transferred to a county of residence.
DISCUSSION:
County Mental Health Plans provide specialty mental health services to foster youth and probation youth in placement and are reimbursed through Short/Doyle Medi-Cal billing for these services. Whether placing or receiving youth, this inter-member transfer program allows for timely reimbursement by the county of financial responsibility.
Solano County is a member of the California Mental Health Services Authority (CalMHSA), a joint powers authority created to perform administrative and fiscal services on behalf of its members and each county’s Behavioral Health Director is a board member. The proposed agreement is a model to be used for future requirements necessitating intercounty transfer of funds. CalMHSA will operate a banking pool, where each participating member county will have separate financial ledger account and will receive periodic statements of year to date balance, payments to other counties, payments from other counties, administration costs and interest earned. The initial amount required is estimated to be the first quarter of expenditures but will be reconciled as actual expenses are made. Required future funding will be based on the projection of actual expenses in order to make funding continuously available for program. CalMHSA will transfer funds back to the participating counties that have a more funding than deemed necessary for the program.
FINANCIAL IMPACT:
Costs for care to these Solano County youth covered by the proposed agreement are included in the Department’s FY2020/21 Preliminary Recommended Budget as the County is responsible for the payment of these services. The proposed presumptive transfer, inter-county agreement process will minimize administrative burdens associated with developing contracts to transfer funds from county to county. Realignment funds in the amount of $115,160 will be placed in a CalMHSA account and transferred to receiving counties as appropriate. The administrative charge by CalMHSA to operate this agreement is minimal compared to the administrative burdens of swiftly entering into intercounty contracts. Approval of this agreement has no impact on County General Fund. The cost associated with preparing the agenda item is nominal and absorbed by the Department’s FY2020/21 Preliminary Budget.
ALTERNATIVES:
The Board could choose not to approve this joint partnership agreement. This is not recommended as this intercounty model enables timely transfer of funds to and from Solano County for specialty mental health care provided in the county where the youth is residing, and these transfers of funds are required in the Welfare and Institution Code.
OTHER AGENCY INVOLVEMENT:
There are no other agencies involved in this agreement. County Counsel has reviewed the agreement for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION