To: Board of Supervisors
Department or Agency Name(s): Human Services
Staff Name and Phone Number: Angela Struckmann, 707-565-5800, Sara Avery, 707-565-5900
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Human Services Department Contract with Partnership HealthPlan for California Advancing and Innovating Medi-Cal Enhanced Case Management Services
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Recommended Action:
Recommended action
A) Authorize the Director of the Human Services Department to execute a funding agreement with Partnership HealthPlan to provide California Advancing and Innovating Medi-Cal Enhanced Care Management services.
B) Adopt a Budget Resolution adjusting the Fiscal Year 2025-2026 budget to increase appropriations in the amount of $160,000. (4/5th Vote Required)
end
Executive Summary:
The Human Services Department is requesting that the Board authorize the Director of the Human Services Department to execute the Partnership HealthPlan Agreement #AA-PHC-ECM-2599 to provide reimbursement-based California Advancing and Innovating Medi-Cal Enhanced Care Management services and accept $160,000 in new revenue for Fiscal Year 2025-2026. Enhanced Care Management is a Medi-Cal benefit designed to provide intensive, person-centered care coordination for individuals with complex health and social needs.
Discussion:
The Human Services Department (HSD) will enter into a new reimbursement-based services agreement with Partnership HealthPlan for California Advancing and Innovating Medi-Cal (CalAIM) to deliver Enhanced Care Management (ECM) services to eligible Medi-Cal beneficiaries. ECM is a statewide Medi-Cal initiative under CalAIM that provides comprehensive care coordination, including care planning, service navigation, and coordination of medical, behavioral health, and social services for individuals with high needs.
Under the reimbursement-based services model, HSD will receive reimbursement based on services delivered to eligible participants. The anticipated revenue for FY 2025-2026 is $160,000. These funds will support existing staff and operational capacity to deliver ECM services and will allow HSD to expand access to coordinated care for vulnerable populations served by the department. ECM is a Medi-Cal benefit that provides person-centered care coordination that connects individuals to the right services for their unique needs. Service plans may include medical coordination, support transitioning from hospital to home, referrals to services and benefits, and support to sustaining stable housing. Social workers will be making home visits to the individuals to ensure that the services are effective in keeping them living safely at home.
The CalAIM ECM program at Adult and Aging will focus on Medi-Cal beneficiaries who are high utilizers of emergency department services, individuals transitioning from hospital to home, and adults at risk of institutional placement. These populations align with clients currently served through the Adult and Aging Linkages program. CalAIM ECM will allow HSD to draw down reimbursement revenue for services provided to older adults and people with disabilities.
Because this is a new contract and associated revenue was not included in the FY 2025-2026 adopted budget, a budget adjustment is required to increase both appropriations and revenue. Approval of this item will enable HSD to implement CalAIM ECM services to eligible Partnership HealthPlan Medi-Cal recipients.
Strategic Plan:
Not applicable.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY25-26 Adopted |
FY26-27 Projected |
FY27-28 Projected |
|
Budgeted Expenses |
|
|
|
|
Additional Appropriation Requested |
$160,000 |
|
|
|
Total Expenditures |
$160,000 |
|
|
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$160,000 |
|
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$160,000 |
|
|
Narrative Explanation of Fiscal Impacts:
The $160,000 in new reimbursement-based revenue from Partnership HealthPlan for CalAIM ECM services were not included in the Fiscal Year 2025-26 adopted budget.
The Human Services Department is requesting to increase appropriations in the amount of $160,000 for Fiscal Year 2025-26. There is no impact to the General Fund.
STAFFING IMPACTS:
Narrative Explanation of Staffing Impacts (If Required):
No new positions are requested. ECM services will be delivered using existing staff and resources.
Attachments:
1. Partnership HealthPlan Agreement #AA-PHC-ECM-2599
2. Budget Resolution
Related Items “On File” with the Clerk of the Board:
None