To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera, 707-565-4774
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Partnership HealthPlan of California CalAIM Grant Program Agreement
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute a grant agreement with Partnership HealthPlan of California to receive $52,000 in revenue to support California Advancing and Innovating Medi-Cal implementation in Sonoma County through December 31, 2023.
B) Adopt a budget resolution authorizing budgetary adjustments to the fiscal year 2022-2023 adopted budget to reflect additional revenues and expenditures supporting the implementation of California Advancing and Innovating Medi-Cal in the amount of $52,000 within the Department of Health Services. (4/5th Vote Required)
end
Executive Summary:
The California Advancing and Innovating Medi-Cal (CalAIM) Enhanced Care Management and Community Supports programs launched on January 1, 2022. These programs require significant new investments in care management capabilities, program infrastructure, information technology and data exchange, and workforce capacity across Managed Care Plans, city and county agencies, providers, and community-based organizations. In order to support and expand upon Enhanced Care Management and Community Supports programs, the California Department of Health Care Services implemented the CalAIM Incentive Payment Program.
Utilizing the CalAIM Incentive Payment Program funding, Partnership HealthPlan of California (PHC) developed the PHC CalAIM Grant Program to invest in Enhanced Care Management and Community Supports provider capacity and delivery system infrastructure to support the launch of these important programs. Funding was specifically available to implement certified Electronic Health Record technology or a care management documentation system that is able to generate and manage a patient care plan.
The Department of Health Services (“DHS” or “the Department”) applied for and received a grant from PHC for upgrades to the Department’s current Electronic Health Record system to support implementation of Enhanced Care Management and Community Supports. This item requests approval to execute the PHC CalAIM Grant Program Agreement.
This item also includes a request for approval of a budget adjustment to the fiscal year 2022-2023 adopted budget to increase revenues and expenditures associated with the PHC Grant Program agreement by $52,000 in the Department of Health Services.
Discussion:
California Department of Health Care Services introduced CalAIM to change the broad-based delivery system, program, and payment process across the Medi-Cal program. California Department of Health Care Services is utilizing this process to leverage Medi-Cal funding to support challenges facing California’s vulnerable populations, including homelessness, behavioral healthcare access, children with complex medical conditions, justice involved populations who have significant clinical needs, and the aging population.
CalAIM’s Enhanced Care Management and Community Supports programs launched on January 1, 2022. These programs require significant new investments in care management capabilities, program infrastructure, information technology and data exchange, and workforce capacity across Managed Care Plans, city and county agencies, providers, and community-based organizations. In order to support and expand upon Enhanced Care Management and Community Supports programs, California Department of Health Care Services implemented the CalAIM Incentive Payment Program.
Utilizing the CalAIM Incentive Payment Program funding, PHC developed the PHC CalAIM Grant Program to invest in Enhanced Care Management and Community Supports provider capacity and delivery system infrastructure to support the launch of these important programs. Funding was specifically available to implement certified Electronic Health Record technology or a care management documentation system that is able to generate and manage a patient care plan.
An Electronic Health Record (EHR) is an electronic, real-time version of a client’s treatment history that is available instantly and securely to authorized users. Electronic Health Records improve client care, care coordination, diagnostics and outcomes, as well as increase practice efficiencies and cost savings. The Department contracts with Netsmart for the Electronic Health Record program Avatar, a cloud-based, web-accessible Electronic Health Record system.
In March 2022 the Department applied for $52,000 to fund modifications to Avatar, the Department’s Electronic Health Record system, to meet the needs of Enhanced Care Management and Community Supports for CalAIM. On May 6, 2022, funds were awarded to DHS in the amount requested. This item requests approval to execute the PHC CalAIM Grant Program Agreement.
Through the existing contract, Netsmart will be tasked with making upgrades to the Avatar system, including adding Enhanced Care Management screening forms and assessments. Department staff will work directly with Netsmart to complete the new forms and reporting requests. The current contract can accommodate the required professional services related to the CalAIM upgrades without modification.
As detailed in a separate agenda item going to the Board, titled “California Mental Health Services Authority Semi-Statewide Enterprise Health Record,” DHS will be moving to a new Electronic Health Record system over the next 1-2 years. This shared system will simplify the administrative and regulatory systems governing Medi-Cal documentation and billing in a manner that makes it possible to create new Electronic Health Records that can maximize DHS functions. Because that new system will not be in operation for 1-2 years, and this grant opportunity was made only available for Enhanced Care Management providers for upgrades needed now, DHS is able to make necessary changes to Avatar now in order to run this program immediately.
This item includes a request for approval of a budget adjustment to the fiscal year 2022-2023 adopted budget to increase revenues and expenditures associated with the PHC Grant Program agreement by $52,000 in the Department of Health Services.
Strategic Plan:
N/A
Prior Board Actions:
On November 16, 2021 the Board A) received a report on the California Advancing and Innovating Medi-Cal (CalAIM) multi-year initiative; B) approved the County’s participation as an Enhanced Care Management (ECM) provider and authorize the Health Services Interim Director, or designee, to enter into an agreement with Partnership HealthPlan of California (PHC) to provide ECM services to PHC referred members at the Per Enrollee Per Month (PEPM) contract rates; C) adopted a personnel resolution amending the Department of Health Services allocation list, adding a 1.00 time-limited full-time equivalent Program Planning and Evaluation Analyst position and a 1.00 time-limited full-time equivalent Department Analyst position, effective November 16, 2021; and D) adopted a resolution authorizing budgetary adjustments to the fiscal year 2021-2022 adopted budget by increasing revenues and expenditures in the Department of Health Services by $266,980 to support additional position allocations for the remainder of the fiscal year.
On August 4, 2020 the Board approved agreements for behavioral health services including an agreement with Netsmart Technologies, Inc. for a software license and services agreement to provide an integrated information system with clinical decision support for behavioral health services for a term beginning July 1, 2020 and ending no later than June 30, 2023, for a not to exceed amount of up to $1,032,034 annually.
Fiscal Summary
|
Expenditures |
FY 22-23 Adopted |
FY 23-24 Projected |
FY 24-25 Projected |
|
Budgeted Expenses |
|
|
|
|
Additional Appropriation Requested |
$52,000 |
|
|
|
Total Expenditures |
$52,000 |
0 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
|
|
|
|
Fees/Other |
$52,000 |
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$52,000 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
Appropriations associated with the proposed grant agreement with PHC will be added to the DHS FY 22-23 budget via the attached budget resolution.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - PHC CalAIM Grant Program Agreement
Attachment 2 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None