Memorandum
Date: March 19, 2024
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director Lake County Behavioral Health Services
Subject: Consideration of General Fund Loan Request of $3,000,000 and Loan of $1,000,000 from Department of Social Services Realignment Fund.
Executive Summary:
Lake Behavioral Health Services Department is currently in a budget deficit due to issues processing Medi-Cal reimbursement. The cause of this deficit is a lack of timely reimbursement for Medi-Cal eligible services due to billing code error issues in our new Electronic Health Record (E.H.R.), SmartCare. These billing code error issues were outside of County staff control. The E.H.R. is contracted directly with the California Mental Health Services Authority (CalMHSA) who was the entity responsible for the migration of data into SmartCare. Unfortunately, migration and set-up errors have precluded effective billing.
As the Board is aware, LCBHS migrated to a new E.H.R. in March 2023 as a Pilot County. Our previous E.H.R, Anasazi, had been scheduled to sunset at the end of 2023. Thus, a transition to a new E.H.R. vendor was unavoidable. After a thorough review of available options, we joined the Semi-Statewide Electronic Health Record Enterprise called SmartCare through CalMHSA. To date, there are 23 other California counties using this system.
There have been challenges processing claims for Behavioral Health services out of the new E.H.R. since it went live in March 2023. As stated above, these were the result of billing code error issues that were outside of County staff control. We have continued to work diligently with CalMHSA to resolve these billing error issues. We are not the only County experiencing these issues. As of March 12, 2024 CalMHSA reported $1.5B approved claims in SmartCare, but only $451.9M of those claims, or 30.1%, have been paid to Counties. There is also a total of $150.5M denied claims. A request for disaggregated County-sp...
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