To: Board of Supervisors
From: Dr. Ori Tzvieli, Interim Health Services Director
Report Title: Application for CalAIM PATH 4 Funding Grant for CalAIM Justice-Involved Initiatives
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Interim Health Services Director, or designee, to submit an applocation for funding in an amount to be determined based on the proposal submitted and approved by the California Department of Health Care Services (DHCS) for the California Advancing and Innovating Medi-Cal (CalAIM) Justice-Involved (JI) PATH Round 4 grant program; and APPROVE and AUTHORIZE the Interim Health Services Director, or designee, to execute the grant agreement and all related certifications, subject to County Counsel approval.
FISCAL IMPACT:
Funds requested from DHCS will support compliance with the State’s mandate to implement pre-release Medi-Cal enrollment under CalAIM for eligible justice-involved individuals. No additional County funds are required.
BACKGROUND:
As part of California’s CalAIM initiative, counties are required to implement a comprehensive set of pre-release services for justice-involved individuals by October 2026, in alignment with the Section 1115 Medicaid Demonstration Waiver approved by the Centers for Medicare and Medicaid Services (CMS). These services aim to improve care continuity and health outcomes by establishing clinical and care coordination supports that begin during incarceration and continue post-release. Pre-release services include physical and behavioral health care coordination, Medi-Cal eligibility support, clinical consultation, substance use disorder treatment, medication-assisted treatment (MAT), and the provision of durable medical equipment (DME) and medications upon release.
In addition, under AB 133 (Chapter 143, Statutes of 2021), all counties were required to implement pre-release Medi-Cal application and enrollment processes by January 1, 2023, to ensure that eligible individuals are enrolled and able to access covered services immediately upon release from custody.
Contra Costa Health (CCH) has previously applied for and received funding under earlier PATH JI grant rounds to support this work:
PATH JI Round 1 Planning Grant ($175,000) to conduct collaborative planning and identify necessary workflows, protocols, and IT system modifications to implement pre-release enrollment and suspension processes.
PATH JI Round 2 Implementation Grant ($2,350,000) to implement the plans developed during Round 1.
PATH JI Round 3 Capacity and Implementation Grant ($9,405,038) to support the planning and delivery of targeted pre-release Medi-Cal services for eligible individuals in county jails, juvenile facilities, and state prisons, in accordance with the CalAIM Section 1115 Demonstration approval. This funding also supports CCH’s Behavioral Health Services Division (BHSD) in building capacity to provide behavioral health linkages as required under AB 133.
PATH funds may be used for investments in personnel, IT infrastructure, and collaborative implementation activities and are distributed based on achieving performance milestones.
The Contra Costa County Probation Department, Sheriff’s Office, Employment and Human Services Department (EHSD), and County’s BHSD previously delegated responsibility to CCH to lead the PATH Round 1, 2, and 3 applications on their behalf. CCH will pursue the same approach and serve as the delegated entity to submit a single PATH Round 4 application on behalf of the County to simplify grant administration and project implementation activities. All eligible agencies for PATH Round 4 will collaborate to identify funding needs and develop comprehensive proposals.
All agencies collaborate through the CalAIM Justice-Involved Executive Leadership Committee and the CalAIM JI Pre-Release Workgroup, both facilitated by CCH’s Detention Health Services Division and have been meeting regularly since Summer 2022.
CONSEQUENCE OF NEGATIVE ACTION:
Failure to apply for this funding opportunity will result in loss of allocated funding for this new initiative and non-compliance with mandated state law.