An increase of $45,000 is needed to pay for an outstanding claim for services provided in fiscal year (FY) 19-20.

California state law mandates the County to provide psychiatric inpatient hospital services to eligible Medi-Cal and non-Medi-Cal mental health consumers.  Woodland Memorial Hospital is the designated and responsible hospital to provide these services to Yolo County residents, that are adults (age 18 or older), who meet California Welfare and Institutions Code criteria and/or who are a danger to self, others or are gravely disabled and require inpatient acute psychiatric services.

When no adult bed space is available at Woodland Memorial Hospital, or when a child or adolescent is in need of services, the patient must be treated by another qualified psychiatric hospital facility in the surrounding area.  BHC Heritage Oaks Hospital, being such a facility, is equipped to provide appropriate services to meet our clients’ needs.

The County is responsible for serving all Yolo Medi-Cal beneficiaries regardless of age.  The Contractor is not certified to bill Medi-Cal for services provided to Yolo Medi-Cal beneficiaries whose age is between 21 and 64 years of age. Thus, federal financial participation (FFP) is not available for these services. The stated contract amount is to be used for funding the services related to this particular group.

For services provided to Yolo Medi-Cal beneficiaries whose age is either 20 or younger, or 65 or older, the payment to the Contractor for this population is not paid directly via the County.  The Contractor bills Medi-Cal directly to receive funding via FFP and the County’s mental health realignment funds.  The State then reduces the amount used for this purpose from the monthly realignment apportionment to the County. 

All services described above require approval of the County via the Health and Human Services Agency (HHSA).  The contract details the approval process and method of payment.  HHSA monitors the use of the services regardless of the patient’s age.  The HHSA budget includes the estimated funding need for all services.

Additionally, when the agreement was initially approved by this Board, the Director of the Yolo County Health and Human Services Agency (HHSA Director) or her/his designee was delegated authority to exercise optional year extensions in an amount not to exceed $540,000 per FY, for a 5-year maximum payment obligation “not to exceed $2,700,000.” However, since then several amendments have been processed to increase or decrease the FY budgets, so the 5-year maximum payment obligation “not to exceed amount” of $2,700,000, is no longer reflected in the Agreement. Now, the Agreement provides for optional year extensions in the amount of $500,000 for FY22-23 and 23-24 and the not to exceed amount is $2,776,812.  Staff requests the Board reaffirm the HHSA Director’s authority to exercise the optional year extensions in an amount not to exceed $500,000 for FY2022-2023 and 2023-2024, without indicating a 5-year maximum payment amount. This will allow for future amendments to be processed that may increase and decrease FY contract budgets without having to revisit this delegated authority. The HHSA Director will not be able to increase the contract maximum beyond the $500,000 amount for FY 2022-23 and 2023-2024 without an amendment being approved by the County Board of Supervisors. All contract budget amendments will also be approved in accordance with County Procurement Policy.

Performance measures were included in Agreement No. 20-04 and are not being changed by this amendment.