Title
a. Approve and authorize the Director of the Department of Social Services or designee to sign an agreement with The Health Co-Lab, LLC dba The Last Mile RCM for an Enhanced Care Management (ECM) Billing Platform to bill reimbursements for Medi-Cal ECM services for the period of July 1, 2026 through June 30 , 2028, in the amount of $60,000 including nonstandard indemnification and liability provisions; and
b. Authorize the Director of the Department of Social Services or designee to sign up to three amendments to this Agreement where the total amendments do not exceed 10% ($6,000) of the amended contract amount, do not significantly change the scope of work, and do not exceed the maximum aggregate amount of $66,000.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of the Department of Social Services or designee to sign an agreement with The Health Co-Lab, LLC dba The Last Mile RCM for an Enhanced Care Management (ECM) Billing Platform to bill reimbursements for Medi-Cal ECM services for the period of July 1, 2026 through June 30 , 2028, in the amount of $60,000 including nonstandard indemnification and liability provisions; and
b. Authorize the Director of the Department of Social Services or designee to sign up to three amendments to this Agreement where the total amendments do not exceed 10% ($6,000) of the amended contract amount, do not significantly change the scope of work, and do not exceed the maximum aggregate amount of $66,000.
SUMMARY:
Social Services is finalizing the planning phase of becoming an Enhanced Care Management (ECM) provider and is seeking a billing platform that will facilitate billing the county’s Managed Care Plan, Central California Alliance for Health (CCAH), for reimbursement of California Advancing and Innovating Medi-Cal (CalAIM) Enhanced Care Management services provided to CalWORKs customers.
DISCUSSION:
Social Services’ case managers, services and programs provide, or make referrals to, many of the social supports endorsed by CalAIM’s whole person care approach but, until recently, the department has not formally integrated Medi-Cal’s Enhanced Care Management or Community Supports into its core programs. Social Services is becoming an ECM provider to enhance services for customers and to generate revenue to support staff capacity. The department’s plan is to integrate ECM into our core programs in alignment with our current workflows.
OTHER AGENCY INVOLVEMENT/COMMITTEE ACTIONS:
The Health Department’s program and IT staff served as a resource in navigating Medi-Cal and CCAH’s ECM credentialling, billing and systems requirements. The County Administrative Office assisted in amending CCAH’s ECM contract, originally with the Health Department, to establish the County as the ECM provider under which county departments can establish ECM programs. The Office of County Counsel has reviewed and approved the Agreements as to form, as has the Auditor-Controller’s Office as to financial provisions.
FINANCING:
This agreement is funded with revenue generated by the Medi-Cal ECM reimbursements. Sufficient appropriations and estimated revenues for SOC005 are included in the FY 2026-27 Recommended Budget. The annual fee for Client's use of the Last Mile RCM platform shall not exceed $30,000 per contract year, based on current volume estimates for the Monterey County Department of Social Services ECM program.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
This agreement supports Social Services’ ability to become an ECM provider and conforms to prescribed billing requirements to receive reimbursements for services provided to customers as a CalAIM Enhanced Care Management provider. Integrating Medi-Cal ECM into Social Services core programs will enhance services for customers by embracing CalAIM’s whole person care approach to health and social well-being. The billing platform will assist the department in achieving workflow alignment, administrative efficiencies, and revenue generation via Medi-Cal reimbursements.
Mark a check to the related Board of Supervisors Strategic Plan Goals [Include one or two sentences referencing the Ordinance, Code, Board Order/Resolution, etc. in relation to this selection]:
_X__Well-Being and Quality of Life
_X__Sustainable Infrastructure for the Present and Future
____ Safe and Resilient Communities
____ Diverse and Thriving Economy
____ Dynamic Organization and Employer of Choice
_X__Administrative
Prepared by: Denise R. Vienne, Management Analyst III, x4484
Approved by: Roderick W. Franks, Director, x4430
Attachments: Agreement
The proposed agreement is on file with Clerk of the Board as an attachment to this Board Report.