To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract Amendment #77-761-1 with Bay Area Doctors Inc.
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Amendment #77-761-1 with Bay Area Doctors Inc., a corporation, effective July 1, 2026, to amend Contract #77-761, to include the Dual Eligible Special Needs Plan (D-SNP) obligations and requirements, authorizing the Contractor to provide specialized care to beneficiaries who are dually eligible for Medicare and Medi-Cal and to offer care coordination and wrap around services, with no change in the payment limit of $450,000 or term ending in May 31, 2028.
FISCAL IMPACT:
Approval of this Contract Amendment will have no additional fiscal impact and will remain budgeted by the department and funded 100% by Contra Costa Health Plan (CCHP) Enterprise Fund II. (No rate increase)
BACKGROUND:
In January 2022, the Department of Health Care Services (DHCS) implemented its California Advancing and Innovating Medi-Cal (CalAIM) initiative, part of which requires all Medi-Cal Managed Care Plans to have a D-SNP line of business as of January 1, 2026, unless determined otherwise by the DHCS exemption process. D-SNPs are Medicare Advantage (MA) plans that provide specialized care to beneficiaries dually eligible for Medicare and Medi-Cal and offer care coordination and wrap-around services. To comply with the DHCS mandate to implement a D-SNP line of business, CCHP is required to achieve network adequacy of its provider network.
On May 13, 2025, the Board of Supervisors approved Contract #77-761 with Bay Area Doctors Inc., in an amount not to exceed $450,000, for the provision of behavioral health therapy services for CCHP members and County recipients, for the period June 1, 2025 through May 31, 2028.
Approval of Contract Amendment #77-761-1 will allow the Contractor to continue providing behavioral health therapy services to CCHP members who are dually eligible for Medicare and Medi-Cal and will support CCHP’s compliance with DHCS mandates and CMS network adequacy standards through May 31, 2028.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract Amendment is not approved, CCHP not be compliant with DHCS and beneficiaries dually eligible for Medicare and Medi-Cal will not receive additional services.