To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Letter of Agreement #78-095 with Fresno County
☒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 Letter of Agreement #78-095 with Fresno County, a government agency, to facilitate Specialty Mental Health Services (SMHS) at out-of-county Community Treatment Facility (CTF), Group Home (GH), and Short-Term Residential Therapeutic Program (STRTP) services for Medi-Cal eligible foster child or youth under twenty-one (21) years of age, for the period May 1, 2025 through June 30, 2027.
FISCAL IMPACT:
Approval of this Letter of Agreement will result in reimbursement of Local Share of Medi-Cal claims necessitated by Assembly Bill (AB) 1051. Fresno County will bill County for the amount of the County’s local match (Intergovernmental Transfer) as indicated on the Department of Healthcare Services (DHCS) 835 file (DCHS Payment and Explanation of Benefits file) for the provision of SMHS related services to the Medi-Cal eligible foster child or youth under 21 years of age. (Local Match required).
BACKGROUND:
The California legislature recognizes the need to ensure that foster children overcome barriers to care that may result when responsibility for providing or arranging for youth who are placed outside of their county of original jurisdiction, are able to access specialty mental health services in a timely manner, as mandated by AB 1051.The goal is to establish responsibility for providing or arranging for SMHS, shall promptly transfer from the county of original jurisdiction (“County of Jurisdiction”) to the county in which the foster child resides (“County of Residence”). This agreement will facilitate the need to have the ability to quickly place foster children and youth in Placement Facilities outside of the county of original jurisdiction when necessary. Contra Costa County and Fresno County, through their respective Departments of Behavioral Health, are contracted with Placement Facilities in their respective Counties to facilitate treatment. To address the short timeframes in which payments must be made in accordance with AB 1051, the county of residence will provide SMHS to the foster children and youth who are placed in their county via their local contracted Placement Facilities provider.
Engaging in this County-to-County Agreement will minimize duplication and maximize coordination, by preventing the need for Contra Costa Behavioral Health (CCBH) to directly contract with numerous STRTPs in Fresno County, which is a lengthy and effort-intensive endeavor. This Agreement shall allow CCBH to quickly access timely placements of youth requiring SMHS.
Approval of new Letter of Agreement #78-095 will allow for the timely provision of services to the foster children and youth and the subsequent payment for services rendered and comply with specifications per AB 1051 through June 30, 2027. This Agreement includes mutual indemnification, and the County agreeing to indemnify the Contractor for any claims arising out of the performance or failure to perform by either party under this Agreement. This Agreement is late due to a delay in negotiating language between the Contractor, Division and County Counsel.
CONSEQUENCE OF NEGATIVE ACTION:
If this Letter of Agreement is not approved, services for foster children and youth and the subsequent payment for services will be delayed.
CHILDREN’S IMPACT STATEMENT:
The recommendation supports the following children's outcome(s):” and then include whichever of the following apply; Children Ready for and Succeeding in School; Children and Youth Healthy and Preparing for Productive Adulthood; and Communities that are Safe and Provide a High Quality of Life for Children and Families.