Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Stephen Kaplan, Director, Behavioral Health & Recovery Services
Subject: Agreement with Health Plan of San Mateo to Deliver Expanded Medi-Cal Benefits for Mental Health
RECOMMENDATION:
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Adopt a resolution authorizing a revenue agreement with the Health Plan of San Mateo to provide expanded Medi-Cal benefits to members with mild to moderate mental health conditions for the term of January 1, 2017 through June 30, 2018, for an estimated total of $4,500,000.
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BACKGROUND:
Specialty outpatient mental health services for individuals with serious and persistent mental illness have long been a Medi-Cal benefit, managed and provided by Behavioral Health and Recovery Services (BHRS). However, Medi-Cal members with mild to moderate mental health conditions that did not meet specialty mental health medical necessity criteria have had limited access to outpatient mental health services.
In June 2013, the Governor approved California Senate Bill X1-1, adding mental health services and substance use disorder services to the schedule of Medi-Cal benefits provided by Medi-Cal managed care plans. As of January 1, 2014, the expanded mental health services provide assessment and treatment to health plan members with mild to moderate mental health diagnoses. Services include:
1. Individual and group mental health evaluation and treatment;
2. Psychological testing when clinically indicated to evaluate a mental health condition;
3. Psychiatric consultation for medication management;
4. Screening and brief intervention for alcohol use disorder;
5. Outpatient laboratory, supplies and supplements; and
6. Medications
DISCUSSION:
BHRS currently partners with the Health Plan of San Mateo (HPSM) to deliver behavioral health care services to HPSM members in the CareAdvantage, HealthWorx and Healthy Kids programs. HPSM ha...
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