Title
a. Approve and authorize the Director of Health or the Assistant Director of Health to sign a Letter of Agreement with The Santa Cruz-Monterey-Merced Managed Care Commission, dba Central California Alliance for Health (CCAH), for the provision by CCAH of funding in the amount of $2,321,000 through the CalAIM Incentive Payment Program to the Monterey County Health Department, (MCHD), to facilitate the implementation of the Enhanced Care Management (ECM) and community supports program, for a term from date of the agreement’s execution by the parties through March 31, 2023; and
b. Approve and authorize the Director of Health or the Assistant Director of Health to sign up to three (3) future amendments to this Agreement where the amendments do not significantly change the scope of work and do not cause an increase of more than ten percent (10%) ($232,100) of the original Agreement amount.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health or the Assistant Director of Health to sign a Letter of Agreement with The Santa Cruz-Monterey-Merced Managed Care Commission, dba Central California Alliance for Health (CCAH), for the provision by CCAH of funding in the amount of $2,321,000 through the CalAIM Incentive Payment Program to the Monterey County Health Department, (MCHD), to facilitate the implementation of the Enhanced Care Management (ECM) and community supports program, for a term from date of the agreement’s execution by the parties through March 31, 2023; and
b. Approve and authorize the Director of Health or the Assistant Director of Health to sign up to three (3) future amendments to this Agreement where the amendments do not significantly change the scope of work and do not cause an increase of more than ten percent (10%) ($232,100) of the original Agreement amount.
SUMMARY/DISCUSSION:
California Department of Healthcare Services (DHCS) launched CalAIM on January 1, 2022. CalAIM is a multi-year DHCS initiative to improve the quality of life and health outcomes of the Medi-Cal managed care population through the implementation of broad delivery system, program and payment reform across the Medi-Cal program. DHCS is contracting directly with counties for some elements of CalAIM, but primarily with Local Managed Care Plans (LMP) which are in turn expected to contract with local agencies and community-based organzations to implement many of the programs and components of CalAIM, including CalAIM’s Enhanced Care Managed (ECM) and Community Supports programs.
While elements of the prior six year DHCS Medi-Cal 2020 Section 1115 Demonstration pilot Whole Person Care (WPC) program for high utilizers of the healthcare system have been incorporated into both ECM and Community Supports programs, DHCS and the MCPs recognize there will still need to be significant investments in care management capabilities, ECM and Community Supports infrastructure, information technology (IT) and data exchange, and workforce capacity as part of expected start-up costs not covered by the per member per month payment model of both programs.
Monterey County Health Department (MCHD) entered into a contract with the Santa Cruz-Monterey-Merced Managed Care Commission, dba Central California Alliance for Health (CCAH) in March of 2022 to be an ECM provider. This current proposed agreement is for the additional funding of $2,321,000 to be administered by CCAH to MCHD for the term of date of the agreement’s execution by the parties through March 31, 2023 to support MCHD with start-up costs to fully implement ECM. CCAH and MCHD determined together that additional supports for ECM program implementation were needed in the areas of rapid expansion of staffing capacity, development of program workflows and policies, staff training in new procedures, information technology infrastructure for reporting and interfacing with other patient case management software, and staff office equipment.
This work supports the Monterey County Health Department Strategic Plan Goal: 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports five of the ten essential public health services, specifically: 9. Inform, educate, and empower people about health issues; 4. Mobilize community partnerships and action to identify and solve health problems; 5. Develop policies and plans that support individual and community health efforts; 6. Enforce laws and regulations that protect health and ensure safety; and 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
The Office of the County Counsel and the Auditor-Controller have reviewed and approved this Agreement as to legal form and fiscal provisions, respectively.
FINANCING:
There will be no fiscal impact to the Health Department’s Fiscal Year (FY) 2021-21 Adopted Budget and FY 2022-23 Recommended Budget from approval of this Agreement. There are sufficient appropriations in the Health Department’s (8438-HEA014) FY 2021-22 Adopted Budget to cover Recommended action and will be included in the FY 2022-23 and FY 2023-24 Requested Budgets. The additional funding supplied through this Agreement will reduce program costs and the use of local funds.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐ Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐ Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability, and transparency.
☒ Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐ Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐ Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Krista Hanni, Program Manager II, 755-4586
Approved by:
______________________________Date:_____________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachment:
Letter of Agreement