Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health, and Recovery Services
Subject: Participation Agreement with California Mental Health Services Authority for Psychiatric Inpatient Concurrent Review Program for Youth and Adults
RECOMMENDATION:
title
Adopt a resolution to enter into a Participation Agreement with California Mental Health Services Authority to provide Concurrent Review Services, for the term of January 1, 2024 through December 31, 2024, in an amount not to exceed $576,464.
body
BACKGROUND:
The California Mental Health Services Authority (CalMHSA) administers the Psychiatric Inpatient Concurrent Review program with the primary purpose of conducting concurrent review and authorization for all psychiatric inpatient hospital and psychiatric health facility services on behalf of participating California County Mental Health Plans (MHP). Behavioral Health and Recovery Services (BHRS) is the MHP for San Mateo County.
A concurrent review occurs while treatment is in progress and usually starts within 24-72 hours of admission to a hospital. The main focuses of the review are to track the utilization of resources and the patient's progress, to ensure the patient receives the proper care, and to reduce denials of coverage after the treatment is complete.
By utilizing a technology-assisted concurrent review process, the CalMHSA will ensure a consistent and efficient review process across participating counties and will support MHP compliance with California Department of Health Care Services (DHCS) Behavioral Health Information Notice (BHIN) 19-026 (or any BHIN released by DHCS that supersedes BHIN 19- 026), and the Parity in Mental Health and Substance Use Disorder Services Final Rule (Parity Rule; Title 42 of the CFR, part 438.910).
A DHCS audit of BHRS found the County out of compliance for n...
Click here for full text