Agenda

Return

C. 69

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	July 28, 2020

Contra

Costa

County

Subject:

Approval of Amendments to Multiple Behavioral Health Contracts

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 07/28/2020

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Suzanne Tavano, 925-957-5212
cc:	Marcy Wilhelm

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: July 28, 2020
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County, Amendment Agreements with the community based behavioral health Children Service providers specified on the attached list with no change in the original monthly payment limits of $4,441,000 and to continue the increased per minute billing rates due to COVID-19, from July 1, 2020 through December 31, 2020.

Per minute billing rates: Mental Health Services $6.37; Case Management, Brokerage $4.89; Medication Support $11.68; Crisis Intervention $9.43; Intensive Care Coordination $4.90; In-Home Behavioral Health $6.35; Therapeutic Behavioral Services $4.68, $4.86, and $6.36.

FISCAL IMPACT:

The recommended contract amendments recognize the on-going service interruption faced by the Community Based Organizations (CBO) contracted to provide Specialty Mental Health Services (SMHS) to youth diagnosed with Serious Emotional Disturbance and eligible for Early Periodic Screening, Diagnosis and Treatment (EPSDT) services. The rate adjustments will ensure CBO’s have sufficient revenues to maintain staff to continue provision of mandated services to eligible youth in our community without a change to the contract payment limit. The contracts partially are funded with State “2011 Realignment” dollars. In the final State adopted budget the 2011 Realignment Funds were reduced by $7.9 million annually. The Department has identified $4 million in one-time non-recurring revenue that will finance the six month period July 1, 2020 through December 31, 2020. It is the Department’s intent to meet with these CBO’s over the next six months to develop a new value-based contract structured on performance, deliverables and available funding.

BACKGROUND:

COVID-19 is having continued negative impact on contracted providers’ ability to deliver necessary behavioral health services to Contra Costa County youth who are Medi-Cal beneficiaries eligible for entitlement services. Shelter-in-place orders have required a transition from in-person services, to remote delivery of care through use of tele-health. Since many behavioral health services to youth are school-based, the current suspension of in-person classes continues to require more outreach and engagement of children and their families in the community. While the transition to tele-health occurred fairly rapidly there are continued challenges to operations of these non-profit organizations that provide critical services to vulnerable residents of Contra Costa County. The on-going social distancing requirements to prevent disease transmission are essential but do make delivery of critical services extremely challenging and at times not possible.

On April 28, 2020, the Board of Supervisors approved increased per minute billing rates for certain CBO’s due to the COVID-19 pandemic. Approval of these Amendments will allow the rate increases to continue through December 31, 2020 to provide cash flow and budget predictability to the CBO’s.

CONSEQUENCE OF NEGATIVE ACTION:

If these Amendment Agreements are not approved the residents of Contra Costa County may experience reduced or discontinued behavioral health services.