TO: Board of Supervisors
FROM: Jennifer Palmer, Director of Housing & Community Services
REPORT BY: Brandee Freitas, Staff Services Manager Housing & Community Services
SUBJECT: Amendment No. 5 to Agreement No. 220376B with Partnership Health Plan
RECOMMENDATION
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Approve and authorize Amendment No. 5 to Master Services Agreement No. 220376B with Partnership Health Plan for the County to provide Community Supports to certain Medi-Cal participants through December 2026. (No Fiscal Impact)
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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.
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 enrollees determined to have the highest needs 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 15 services are approved under CalAIM:
• Transitional Rent
• 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
• Sobering Centers
• Asthma Remediation
The structure of CalAIM allows the Medi-Cal managed care plans, locally Partnership Health Plan, to identify which Community Supports it offers 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 Transition Navigation Services, Housing Deposits and Housing Tenancy and 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 2026.
Requested Action:
Approve and authorize the Chair to sign Amendment No. 5 to Master Services Agreement No. 220376B with Partnership Health Plan for the County to provide Community Supports to certain Medi-Cal participants through December 2026.
FISCAL & STRATEGIC PLAN IMPACT
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Is there a Fiscal Impact? |
No |
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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 supporting delivery 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 deliver qualifying housing services through December 2026. |
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Consequences if not approved: |
Napa County will be unable to receive reimbursement for certain housing activities without the contract and will need to determine whether services will continue through provision of local funding. |
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.