Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lizelle Lirio de Luna, Director, Family Health Services
Subject: Enhanced Care Management Services for Health Plan of San Mateo California Children's Services Clients
RECOMMENDATION:
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Adopt a resolution authorizing Family Health Services to enter into an agreement with the San Mateo Health Commission dba Health Plan of San Mateo to provide Enhanced Care Management services for California Children's Services clients for the term of July 1, 2023, through June 30, 2024, and automatically renewing for subsequent terms of one year for payment to the County in an amount estimated at $399,835 annually, and authorizing the Chief of San Mateo County Health or their designee to execute any and all amendments related to the agreement.
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BACKGROUND:
The California Department of Health Care Services (DHCS), through the California Advancing and Innovating Medi-Cal (CalAIM) initiative, seeks to move Medi-Cal services toward a population health approach that prioritizes prevention and whole-person care. The program is designed to extend support and assistance beyond hospitals and healthcare settings directly into California communities.
As part of CalAIM, based in part, upon the successes of the Whole Person Care pilots, DHCS established a new statewide benefit entitled Enhanced Care Management (ECM). ECM provides a whole-person approach to care that addresses the clinical and non-clinical circumstances of high-need Medi-Cal recipients. The goals of ECM are: 1) improving care coordination; 2) integrating services; 3) facilitating community resources; 4) improving health outcomes; 5) addressing social determinants of health; and 6) decreasing inappropriate utilization. ECM is intended for the highest-risk, highest-cost Medi-Cal managed care members with the most complex medical and social needs.
EC...
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