Title
a. Approve and authorize the Director of Health Services or designee to execute renewal and amendment No. 1 to Agreement No. A-15818 with The Santa Cruz-Monterey-Merced Managed Medical Care Commission, dba Central California Alliance for Health (CCAH), for the provision by CCAH funding through California Advancing and Innovating Medi-Cal (CalAIM) Incentive Payment Program to the County of Monterey, Health Department (MCHD) to facilitate the implementation of Enhanced Care Management (ECM) and community supports program, revising the scope of work, extending the Agreement term by seventeen (17) months for a new Agreement term of January 1, 2022 to December 31, 2024, with no change to the total Agreement amount of $2,321,000; and
b. Approve and authorize the Director of Health Services or designee to execute up to two (2) future amendments to this Agreement where the amendments do not significantly change the scope of work, do not cause an increase of more than 10% ($232,100) of the original Agreement amount, and total Agreement amount not to exceed revised maximum of $2,553,100.
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 renewal and amendment No. 1 to Agreement No. A-15818 with The Santa Cruz-Monterey-Merced Managed Medical Care Commission, dba Central California Alliance for Health (CCAH), for the provision by CCAH funding through California Advancing and Innovating Medi-Cal (CalAIM) Incentive Payment Program to the County of Monterey, Health Department (MCHD) to facilitate the implementation of Enhanced Care Management (ECM) and community supports program, revising the scope of work, extending the Agreement term by seventeen (17) months for a new Agreement term of January 1, 2022 to December 31, 2024, with no change to the total Agreement amount of $2,321,000; and
b. Approve and authorize the Director of Health Services or designee to execute up to two (2) future amendments to this Agreement where the amendments do not significantly change the scope of work, do not cause an increase of more than 10% ($232,100) of the original Agreement amount, and total Agreement amount not to exceed revised maximum of $2,553,100.
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 organizations 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 Managed Care Plans (MCP) 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.
This Amendment No. 1 revises milestones and will continue funding eight (8) full-time staff positions hired within the CCAH/MCHD contract that ended on April 30, 2023, to deliver direct ECM contracted services through December 31, 2024 and assign two (2) staff positions to provide ECM program supervision and program management. This Amendment was delayed in being presented to the County of Monterey Board of Supervisors due to the delays with the DHCS confirming the milestones and term extension period.
This work supports the County of Monterey’s Health Department’s 2018-2024 Strategic Plan Goals: 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 FY 2024-25 Adopted Budget from approval of this Agreement. 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: Patricia Alcocer, Management Analyst II, 755-4583
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Amendment No. 1
Board Order
Agreement