Agenda

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Consent-Health & Human Services # 18.

Board of Supervisors

Child, Youth & Family

Meeting Date:	10/25/2016
Brief Title: HHSA Funding Shift-Contracts
From:	Karen Larsen, Director, Health and Human Services Agency
Staff Contact:	Mary Kirlin, Integration Branch Director, Health and Human Services Agency, x2795

Subject

Approve one new contract and six amendments to contracts funding health and behavioral health services for clients of Child Welfare Services and CalWorks from Social Services funds to Behavioral Health funds. (No general fund impact) (Larsen)

Recommended Action

Strategic Plan Goal(s)

Operational Excellence
Thriving Residents
Safe Communities

Reason for Recommended Action/Background

Since May 2016, HHSA has been working to identify ways to live within its budget, especially in the Social Services area. At the same time, Integration has encouraged the Agency to look across program lines to best leverage funding to provide services. These seven (7) items make changes to enhance federal funding, helping with the Social Services budget shortfall.

The seven (7) actions all change contract terms with existing vendors so that services can be billed to Medi-Cal or other state and federal sources rather than being paid for exclusively with Social Services funds.

Many of the shifts are to accommodate changes in Medi-Cal eligibility. Historically, vendors might have multiple contracts with HHSA for a similar service. The difference would be whether the client had Medi-Cal or not. If they did not have Medi-Cal, any number of funding streams could have been used to pay for the service, each under a separate contract. Under the Affordable Care Act, the vast majority of clients in the Child Welfare and CalWorks systems now have Medi-Cal. Thus, needed services can now be billed to Medi-Cal and the County can recoup a portion of the cost. At this point nearly all eligible individuals are on Medi-Cal so the shifts can occur, reducing pressure on the Social Services budget.

In this group of contracts there are also vendors providing drug treatment services that can be partially reimbursed by state or federal sources. This will also reduce pressure on the Social Services budget.

In total, HHSA is amending eleven (11) contracts and creating three (3) new contracts affecting eight (8) vendors. Only seven (7) of these shifts require Board action, as listed below:

Bridges Professional Treatment Services-CalWORKs Amendment #3
CommuniCare Health Centers-EPSDT-WRAP Amendment #3
CommuniCare Health Centers-MIOCR Amendment #2
CommuniCare Health Centers-Perinatal/Other Drug Medi-Cal & CWS Amendment #2
CommuniCare Health Centers-CWS & CalWORKs
Progress House, Inc.-CalWORKs Amendment #3
Yolo Family Services Agency-CalWORKs Amendment #4

Most shifts are within a single vendor. In a few cases, HHSA re-distributed resources between vendors. With the one exception noted below, the total budget has stayed the same.

In addition to shifting funds between types of accounts, HHSA has taken the opportunity to augment the CommuniCare contract by $108,300 for child psychiatry services through EPSDT.

Collaborations (including Board advisory groups and external partner agencies)

County Counsel has approved all documents as to form.

Fiscal Impact

Fiscal Impact (Expenditure)
Fiscal impact (see budgetary detail below)
Total cost of recommended action:		$ 108,300
Amount budgeted for expenditure:		$ 0
Additional expenditure authority needed:		$ 0
On-going commitment (annual cost):	$

Source of Funds for this Expenditure

$108,300

Explanation (Expenditure and/or Revenue)

Further explanation as needed:

This Board action does not require additional appropriation authority. HHSA has sufficient appropriations based on the September approval of the HHSA budget.

Attachments
Att. A. Amendment-Bridges
Att. B. Amendment-CCare EPSDT-WRAP
Att. C. Amendment-CommuniCare MIOCR
Att. D. Amendment-CCare Peri DMC CWS
Att. E. Agreement-CCare CW CWS
Att. F. Amendment - Progress House
Att. G. Amendment-YFSA CalWorks

Form Review

Inbox	Reviewed By	Date
Financial Services	dolander	10/19/2016 09:39 AM
County Counsel	Hope Welton	10/19/2016 09:40 AM
Form Started By: ccontreras		Started On: 10/06/2016 08:15 AM
Final Approval Date: 10/19/2016