To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Accept CalAIM PATH Round 3 Funding Awarded for CalAIM Justice-Involved Initiatives
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director to accept allocated PATH 3 funding in the amount of $9,405,038; and
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute three terms and conditions along with the necessary certifications and assurances required by the California Department of Health Care Services (DHCS).
FISCAL IMPACT:
The funds requested of DHCS are essential in helping the County meet the State’s mandate for pre-release Medi-Cal enrollment under CalAIM for eligible justice-involved individuals. No additional County funds required.
BACKGROUND:
California statute (AB-133 Health; Chapter 143) mandates all counties implement pre-release Medi-Cal enrollment processes by January 1, 2023. Establishing pre-release Medi-Cal enrollment processes is part of the State's vision to enhance the Medi-Cal health care delivery system for justice-involved populations. Implementation of pre-release enrollment and suspension processes will help ensure Medi-Cal coverage upon reentry into the community to facilitate access to needed Medi-Cal covered services. This process for screening and supporting Medi-Cal Applications is already in place in state prison facilities.
Contra Costa Health previous applied for and was successfully awarded planning and implementation grants during the earlier PATH Round 1 and Round 2 application periods to support collaborative planning and implementation activities for processes, protocols, and IT system modifications necessary to support mandated Medi-Cal application enrollment and suspension processes prior to release.
Contra Costa Health, in coordination with the Office of the Sheriff, Probation Department, and Employment and Human Services Department (EHSD) will utilize PATH Round 3 funds to support the planning and implementation of CalAIM Pre-Release Services for incarcerated persons. PATH Round 3 funds are intended to provide funding to support the planning and implementation of the provision of targeted pre-release Medi-Cal services to individuals in state prisons, county jails, and youth correctional facilities who meet the eligibility criteria as outlined in the CalAIM Section 1115 Demonstration approval. This funding will also support County Behavioral Health Agencies to implement behavioral health linkages as required by AB 133. PATH funds will be available to support investments in personnel, capacity, and/or IT systems that are needed for collaborative planning and implementation to effectuate prerelease service processes. These PATH capacity building funds are available to qualified entities and will be distributed based on meeting certain performance milestones.
The Contra Costa County Probation Department, Sheriff’s Office, and EHSD previously delegated to Contra Costa Health to apply for funding on their behalf during the Rounds 1 and 2 applications. The PATH Round 3 grant introduces County Behavioral Health agencies as permissible applicants in addition to the Probation and Sheriff’s Departments. Contra Costa Health will pursue the same approach and serve as the delegated entity to submit a single PATH Round 3 application on behalf of the County to simplify grant administration and project implementation activities. The grant’s terms and conditions require the County to hold harmless the third-party administrator, Public Consulting Group LLC, from any and all liability arising from or relating to the receipt of grant funds.
All agencies serve as key stakeholders in the collaborative Contra Costa County CalAIM Justice-Involved Pre-Release Workgroup to support workflow development and implementation. Members of the workgroup include representatives from the following County agencies: Contra Costa Health (CCH) Office of the Director, Behavioral Health, Detention Health, Public Health, EHSD, Sheriff’s Office, Probation Department, Juvenile Hall Health Services, CCH Office of Informatics and Technology, and the Contra Costa Health Plan. The committee has been meeting monthly since Summer 2022.
Approval to apply for the PATH 3 funding grant was provided by the Board of Supervisors on 7/18/2023 with the expectation that the department would return to the Board once the allocation amounts were known. CCH received notice of awarded allocation on September 14, 2023 in the following amounts: Behavioral Health: $1,905,038; Sheriff’s Office: $5,000,000; Probation Department: $2,500,000. This total of $9,405,038 will be distributed to the County in multiple phases and tied to milestone-based activities. The grant terms and conditions require the County to complete and submit an implementation plan identifying how funding will be used between April 1, 2024 and March 31, 2026. CCH will coordinate the development of a detailed Implementation Plan to document how the PATH funding will be used to implement each operational criteria required with the CalAIM Justice-Involved Pre-Release Services initiative. This implementation plan is due to DHCS within 180 days of initial application approval.
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.