Memorandum
Date: February 27, 2024
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director Lake County Behavioral Health Services
Subject: Approve Memorandum of Understanding between Partnership HealthPlan of California and Lake County Behavioral Health Services and Authorize the Behavioral Health Director to Sign.
Executive Summary:
Medi-Cal Managed Care Plans (MCPs) Contract with the Department of Health Care Services (DHCS) to provide high quality, accessible, and cost-effective health care through managed care delivery systems. The MCP Contract requires MCPs to build partnerships with the following Third Party Entities to ensure Member care is coordinated and Members have access to community-based resources in order to support whole-person care:
• Local Health Departments;
• Local Educational and governmental agencies, such as county behavioral health departments for Specialty Mental Health Care and Substance Use Disorder (SUD) Treatment Services; and
• Other local programs and services, including
• Social services;
• Child Welfare Departments;
• Continuums of Care programs;
• First 5 programs and providers;
• Regional Centers;
• Area Agencies on Aging;
• Caregiver Resource Centers;
• Women, Infants and Children Supplemental Nutrition Programs;
• Home and Community-Based Services (HCBS) waiver agencies and providers; and justice departments.
The MOUs are intended to be effective tools to clarify roles and responsibilities between MCPs and Third Parties, support local engagement, and facilitate care coordination and the exchange of information necessary to enable care coordination and improve the referral processes between MCPs and Third Party Entities. The MOUs are also intended to improve transparency and accountability by setting forth certain existing requirements for each party as it relates to service or care delivery and coordination so that the parties to the MOU are aware of each other’s obligations.
The purpose of the MOU is to:
• List the minimum MOU components required by the MCP Contract;
• Clarify roles and responsibilities for coordination of the delivery of care and services of all Members, particularly across MCP carved out services, which may be provided by the Third Party Entity;
• Establish negotiated and agreed upon processes for how MCPs and Third Party Entities will collaborate and coordinate on population health and/or other programs and initiatives;
• Memorialize what data will be shared between MCPs and Third Party Entities and how the data will be shared to support care coordination and enable monitoring;
• Provide public transparency into relationships and roles/responsibilities between MCPs and Third Party Entities; and
• Provide mechanisms for the parties to resolve disputes and ensure overall oversight and accountability under the MOU.
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Recommended Action: Approve Memorandum of Understanding between Partnership HealthPlan of California and Lake County Behavioral Health Services and Authorize the Behavioral Health Director to Sign.