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Approve a first contract amendment for $210,000 with Behavioral Health Industry News, dba OPEN MINDS, for a total contract amount of $280,000, to provide consultation and technical assistance with the California Advancing and Innovating Medi-Cal (CalAIM) behavioral health initiative for the current period through June 30, 2025; and Delegate authority to the County Administrator to execute the contract amendment and any subsequent amendments, pending County Counsel concurrence, up to an aggregate of $74,999
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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 a first contract amendment for $210,000 with Behavioral Health Industry News, dba OPEN MINDS, for a total contract amount of $280,000 to provide consultation and technical assistance with the California Advancing and Innovating Medi-Cal (CalAIM) behavioral health initiative for the current period through June 30, 2025; and Delegate authority to the County Administrator to execute the contract amendment and any subsequent amendments, pending County Counsel concurrence, up to an aggregate of $74,999
SUMMARY:
The California State Department of Health Care Services (DHCS) launched a system redesign plan in January 2022 called California Advancing and Innovating Medi-Cal (CalAIM) after receiving an approved Medicaid Waiver from the federal Center for Medicaid and Medicare Services. CalAIM intends to improve quality of life and health outcomes by implementing a statewide person-centered approach to providing services and payment reform for the Medi-Cal program.
OPEN MINDS provides Solano County Behavioral Health with consultation and technical assistance in implementing the mandated DHCS CalAIM requirements. Services support the County’s Mental Health Plan (MHP) and Drug Medi-Cal Organized Delivery System (DMC-ODS) changes needed for various milestones including, but not limited to, integration of value-based care contracting and other activities in compliance with the rules and regulations set by CalAIM’s Behavioral Health Quality Improvement Program (BHQIP), the Medi-Cal transformation initiatives, and related DHCS Behavioral Health Information Notices (BHINs).
CalAIM initiatives span a multi-year period, with the first reforms implemented in January 2022 and additional reforms phased in through 2027. The contract amendment extends the contract by one year, through June 30, 2025, for OPEN MINDS’ continued support and technical assistance to implement these mandated requirements.
FINANCIAL IMPACT:
Appropriations are available in the FY2023/24 Working Budget for anticipated expenses in this fiscal year and are funded with Federal Quality Assurance/Utilization Review revenues and 2011 Realignment. There is no additional impact to the County General Fund. The costs associated with preparing the agenda item are nominal and absorbed by the Department’s FY2023/24 Working Budget.
DISCUSSION:
The behavioral health components of CalAIM are designed to support whole-person integrated care; move the administration of Medi-Cal behavioral health to a more consistent and seamless system by reducing complexity and increasing flexibility; improve quality outcomes; reduce health disparities; drive delivery system transformation and innovation through improvements to behavioral health policies; launch behavioral health payment reform; integrate substance use and mental health systems of care; and implement justice-involved initiatives and population management and capacity and infrastructure changes. While the majority of these policy changes were launched in 2022, implementation continues through 2027.
Solano County Behavioral Health currently contracts with OPEN MINDS to assist in a variety of initiatives, including mandates under CalAIM’s Behavioral Health Quality Improvement Program (BHQIP), such as payment reform and the transition to fee-for-service and performance-based contracting. These required changes focus on optimizing and improving revenue cycle management efficiency, productivity metrics, the provider reimbursement/claims system, the redesign of contracts to value-based deliverables for behavioral health services, administrative reporting systems, data exchange, and reimbursement and incentive payment processes. The current contract is for $70,000 for the period of April 1, 2023 through June 30, 2024. This first contract amendment extends the contract through June 30, 2025 and increases the contract by $210,000 for a new total amount of $280,000.
This first contract amendment will provide for ongoing assistance as requirements, changes to regulations, or other forms of policy change continue to be received from DHCS. It is anticipated that through 2027, Solano County Behavioral Health will continue to adapt to new regulatory mandates and make the signification shift of its administrative oversight and management under a Department of Health Care Services (DHCS) contract to a County Mental Health Professional (MHP), also known as a Prepaid Inpatient Health Plans (PIHPs), subject to applicable Medi-Cal Managed Care laws and regulations governed by the Centers for Medicare and Medicaid Services (CMS). These new requirements and additional behavioral health reform initiatives are directed through DHCS. This ongoing contract is integral to overall successful implementation.
ALTERNATIVES:
The Board may choose not to approve the contract amendment. This is not recommended as it would result in Solano County Behavioral Health not having the ability to comply with California Advancing and Innovating Medi-Cal (CalAIM) mandated requirements.
OTHER AGENCY INVOLVEMENT:
The contract was reviewed as to form by County Counsel.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION