Title
a. Approve and authorize the Director of Health Services or designee to execute a no cost Memorandum of Understanding with the Santa Cruz-Monterey-Merced-San Benito-Mariposa Medical Managed Care Commission, dba Central California Alliance for Health (CCAH), the County of Monterey, on behalf of the County of Monterey Health Department, Behavioral Health Division, and Carelon Behavioral Health of California, delineating the roles and responsibilities of each party for the delivery and coordination of covered mental health and medical services to Medi-Cal beneficiaries for a retroactive term starting January 1, 2024 through February 28, 2027; and
b. Approve and authorize the Director of Health Services or designee to execute a no cost Memorandum of Understanding with the Santa Cruz-Monterey-Merced-San Benito-Mariposa Medical Managed Care Commission, dba Central California Alliance for Health (CCAH), the County of Monterey, on behalf of the County of Monterey Health Department, Behavioral Health Division, and Carelon Behavioral Health of California, delineating the roles and responsibilities of each party for the delivery and coordination of covered substance use and medical services to Medi-Cal beneficiaries for a retroactive term starting January 1, 2024 through February 28, 2027; and
c. Authorize the Director of Health Services or designee to execute up to three (3) amendments that do not significantly alter the scopes of work or encompass payment.
Report
RECOMMENDATION
It is recommended that the County of Monterey Board of Supervisors:
a. Approve and authorize the Director of Health Services or designee to execute a no cost Memorandum of Understanding with the Santa Cruz-Monterey-Merced-San Benito-Mariposa Medical Managed Care Commission, dba Central California Alliance for Health (CCAH), the County of Monterey, on behalf of the County of Monterey Health Department, Behavioral Health Division, and Carelon Behavioral Health of California, delineating the roles and responsibilities of each party for the delivery and coordination of covered mental health and medical services to Medi-Cal beneficiaries for a retroactive term starting January 1, 2024 through February 28, 2027; and
b. Approve and authorize the Director of Health Services or designee to execute a no cost Memorandum of Understanding with the Santa Cruz-Monterey-Merced-San Benito-Mariposa Medical Managed Care Commission, dba Central California Alliance for Health (CCAH), the County of Monterey, on behalf of the County of Monterey Health Department, Behavioral Health Division, and Carelon Behavioral Health of California, delineating the roles and responsibilities of each party for the delivery and coordination of covered substance use and medical services to Medi-Cal beneficiaries for a retroactive term starting January 1, 2024 through February 28, 2027; and
c. Authorize the Director of Health Services or designee to execute up to three (3) amendments that do not significantly alter the scopes of work or encompass payment.
SUMMARY/DISCUSSION
Within the Medi-Cal program, the Department of Health Care Services (DHCS) assigns responsibility for the delivery of certain services to different entities. Responsibility for Specialty Mental Health (SMH) and Substance Use Disorder (SUD) services fall under the counties, while responsibility for Medical and Non-Specialty Mental Health (NSMH) services fall under the Managed Care Plans (MCPs). In Monterey County, SMH services are provided through the Mental Health Plan (MHP) while SUD services are provided through the Drug Medi-Cal Organized Delivery System (DMC-ODS), both within the Behavioral Health division of the County Health Department.
In January of 2022, the California Department of Health Care Services (DHCS) launched the California Advancing and Innovating Medi-Cal (CalAIM) initiative, a multi-year effort to improve the quality of life and health outcomes of Medi-Cal beneficiaries by implementing a broad delivery system, program, and payment reform across the Medi-Cal program.
As a component of CalAIM, DHCS issued Behavioral Health Information Notices 23-056 and 23-057 in October of 2023 which require, and provide a template for, the establishment of Memorandums of Understanding (MOUs) between MCPs and MHPs and between MCPs and DMC-ODS. The requirement for MOUs to be in place falls under the MHP/DHCS Contract and the DMC-ODS/DHCS Intergovernmental Agreement. DHCS issued companion notices and the templates for the MOU requirements to the MCP plans. The local MCP, Central California Alliance for Health, delegates responsibility for the provision of NSMH services to a third party, Carelon Behavioral Health of California, so Carelon is also a signatory to the MOUs.
The intent of the MOUs is to ensure the various entities responsible for the provision of services to Medi-Cal beneficiaries collaborate, share information and coordinate care for the individuals and families they serve to provide whole person care. The MOUs clarify roles and responsibilities between the parties, support local engagement, facilitate care coordination and the exchange of information necessary to improve referral processes between the parties. They set forth the obligations of each party as it relates to service and care delivery and improve transparency and accountability. These MOUs will replace the current MOU between the MCP and the MHP.
As this is not a service agreement, the County’s insurance and indemnification requirements do not apply.
This Agreement is retroactive to January 1, 2024, due to the short timeframe the department has had from receipt of the templates from DHCS and the need for both the county and the managed care plan to review and discuss them.
This work supports the following County of Monterey Health Department 2018-2024 Strategic Plan Goal: 3) Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services.
OTHER AGENCY INVOLVEMENT
The Office of County Counsel has reviewed and approved these Agreements as to legal form.
FINANCING
These are no cost Agreements. There are no General Fund impacts resulting from this recommended Board action.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiative(s):
☐ 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 gene
Prepared by: Jan Wolf, Management Analyst lll, 755-4735
Approved by:
__________________________________________________
Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
MOU (MHP) is on file with Clerk of the Board.
MOU (DMC-ODS) is on file with Clerk of the Board.