Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with the State of California Department Health Care Services for Medi-Cal Managed Care and Specialty Mental Health services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement an agreement and/or subsequent amendments with the State of California Department of Health Care Services for Medi-Cal Managed Care and Specialty Mental Health services for the term of July 1, 2025 through December 31, 2026, for a zero-dollar amount, and authorizing and directing the Chief of San Mateo County Health to execute the agreement on behalf of County.
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BACKGROUND:
The State of California requires County Mental Health Plans to enter into an agreement with the Department of Health Care Services (DHCS) for the delivery of Specialty Mental Health Services and corresponding activities that are similar to the administration of a health plan (managed care). The agreement is the instrument by which Behavioral Health & Recovery Services (BHRS) exists and the mechanism by which Medi-Cal beneficiaries with severe and complex mental health needs receive treatment. BHRS delivers substance use treatment services through a similar agreement with the state for DMC-ODS. BHRS delivers Medicare services through a contract with the Health Plan of San Mateo.
The agreement specifies the services to be provided; various administrative activities such as contract requirements, conflict of interest requirements, and delegation limitations; access criteria, staffing requirements, data system requirements, quality improvement, utilization management, service authorizations, network adequacy, timely access standards, provider requirements, care coordination, client notification requirements, language and interpretation standards, ...
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