TO: Board of Supervisors
FROM: Ryan J. Alsop, County Executive Officer
REPORT BY: Jennifer Palmer, Director of Housing & Community Services
SUBJECT: Amendment No. 4 to Agreement No. 220376B with Partnership Health Plan for the extension of certain Community Supports under the California Advancing Innovating Medi-Cal Program known as “CalAIM”
RECOMMENDATION
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Approve and authorize Amendment No. 4 to Master Services Agreement No. 220376B with Partnership Health Plan for the County to provide Community Supports to certain Medi-Cal participants through December 2025 generating approximately $1,000,000 in annual revenue (Fiscal Impact: $1,000,000 Revenue, Housing & Community Services Fund, Budgeted, Discretionary).
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BACKGROUND
CalAIM is a Medi-Cal Waiver program designed to build a whole system, person-centered approach to care, in which clinical and social services are integrated to support people’s health and wellbeing throughout their lives. As a statewide population health initiative, CalAIM will reach all Medi-Cal members while focusing particularly on advancing health equity by expanding resources available to populations and communities that have been historically under-resourced and under-served.
The first stage of CalAIM implementation has included scaling impactful services from this and other initiatives statewide through Enhanced Care Management (ECM) and Community Supports (California’s nomenclature for the proposed list of state approved In Lieu of Services/ILOS). ECM is designed to address the clinical and non-clinical needs of the highest-need enrollees through intensive coordination of health and health-related services. Its goal is to connect to beneficiaries on the street, in a shelter, in their doctor's office, or at home by providing a single Lead Care Manager to coordinate care and services among the physical, behavioral, dental, developmental, and social services delivery systems, making it easier for beneficiaries to get the right care at the right time.
Community Supports are services intended to be cost effective alternatives to traditional medical services or settings. Community Supports address the social drivers of health - the factors in people's lives that influence their overall health outcomes, such as housing, medical respite, assisted living, and medically tailored meals. A total of 14 services are approved under CalAIM:
• Housing Transition Navigation Services
• Housing Deposits
• Housing Tenancy and Sustaining Services
• Short-Term Post-Hospitalization Housing
• Recuperative Care (Medical Respite)
• Day Habilitation Programs
• Caregiver Respite Services
• Nursing Facility Transition/Diversion to Assisted Living Facilities
• Community Transition Services/Nursing Facility Transition to a Home
• Personal Care and Homemaker Services
• Environmental Accessibility Adaptations (Home Modifications)
• Medically Supportive Food/Meals/Medically Tailored Meals
• Asthma Remediation
The structure of CalAIM allows the Medi-Cal managed care plans, locally Partnership Health Plan, to identify which Community Supports it wants to offer and contract for those services directly with providers. Locally, Napa County Department of Housing & Community Services (HCS) is the delegate administrative entity (DAE) for three Community Supports: Housing Navigation, Housing Deposits and Housing Tenancy & Sustaining Services. HCS is eligible to receive payment in exchange for the direct provision or sub-contracted provision of services to CalAIM beneficiaries through a Master Service Agreement with Partnership Health Plan.
Today’s action amends Agreement No 220376B for reimbursement for the fee-for service costs for the provision of Housing Transition Navigation Services, Housing Deposits and Housing Tenancy and Sustaining Services to include all applicable Exhibits and Attachments and an expiration date extension through December 2025 for approximately $1,000,000 in estimated annual revenues.
Requested Action:
Approve and authorize Amendment No. 4 to Master Services Agreement No. 220376B with Partnership Health Plan for the County to provide Community Supports to certain Medi-Cal participants through December 2025 generating approximately $1,000,000 in annual revenue
FISCAL & STRATEGIC PLAN IMPACT
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Is there a Fiscal Impact? |
Yes |
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Is it currently budgeted? |
Yes |
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Where is it budgeted? |
Fund 2030 |
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Is it Mandatory or Discretionary? |
Discretionary |
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Discretionary Justification: |
The agreement provides revenues to support expansion of important housing services to assist individuals and families experiencing homelessness with obtaining and maintaining permanent housing. |
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Is the general fund affected? |
No |
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Future fiscal impact: |
CalAIM funds will be utilized to expand housing services in current and future fiscal years. |
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Consequences if not approved: |
Napa County will be unable to receive reimbursement for specific housing activities without the contract. |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by 14 California Code of Regulations 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.