Special Notice / Hearing: 4/5ths__
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: Appropriation Transfer Request to Allow a Three-month Payment in Advance of Expenditure for Mental Health and Substance Use Disorder Contracted Providers to Allow a Transition from Payment in Advance of Expenditure to Payment in Arrears Methodology and a Final Transition from an Exception for Payments During the Fiscal "Blackout" Period in July and August
RECOMMENDATION:
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Approve an Appropriation Transfer Request (ATR) accepting unanticipated Intergovernmental Revenue ($20,112,756) and increasing Service and Supplies ($13,485,727) and Other Charges ($6,627,029) to allow a three-month payment in advance of expenditure for Mental Health and Substance Use Disorder contracted providers.
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BACKGROUND:
Behavioral Health and Recovery Services (BHRS) has paid many of its Mental Health (MH) and Substance Use Disorder (SUD) providers using a 1/12th, payment in advance of expenditure methodology. This methodology provided easily budgeted cash flow for providers that do not have large reserves. With the implementation of CalAIM, the California Department of Health Care Services transformation of the Medi-Cal system, counties are now required to reimburse for delivered services in arrears. During FY 2024-25, BHRS has continued to pay providers using a 1/12th methodology with a quarterly reconciliation to actual fee-for-service units. To aid in the final transition to fee-for-service and payments for non-Medi-Cal services to payment in arrears, BHRS has offered a one-time, final three-month payment in advance of expenditure. The payment will take place in June 2025.
The contract maximum obligations for FY 2025-26 were developed based on anticipated FY 2024-25 Medi-Cal fee-for-service units and other non-Medi-Cal services a...
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