TITLE
Recommendation to authorize City Manager or designee, to execute an agreement, and all necessary documents or subsequent amendments, including amending the award amount, with the California Department of Health Care Services Capacity and Infrastructure Transition Expansion and Development (CITED) Program, under the Providing Access and Transforming Health (PATH) Initiative (PATH-CITED), to accept and expend grant funding in the amount of $554,323 for the transition, expansion, and development of Enhanced Care Management (ECM) and Community Supports capacity and infrastructure, under the California Advancing and Innovating Medi-Cal (CalAIM) initiative, for a period of eighteen (18) months, with the option to extend the agreement for an additional one-year period, at the discretion of the City Manager; and
Increase appropriations in the Health Fund Group in the Health and Human Services Department by $554,323 offset by grant revenue. (Citywide)
DISCUSSION
California Advancing and Innovating Medi-Cal (CalAIM) is a new initiative by the California Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal members by implementing broad delivery system, program, and payment reform across the Medi-Cal program. CalAIM seeks to: establish a population-health management framework to address social determinants of health and improve health equity statewide; focus on an Enhanced Care Management (ECM) approach; and fund Community Supports (CS), which will serve as cost-effective alternatives to covered services in the Medi-Cal managed care delivery system.
CalAIM is comprised of interdisciplinary approaches to care that address the clinical and non-clinical needs of high-cost and/or high-need populations (populations of focus) in Medi-Cal through a systematic coordination of services and comprehensive, community-based care management. Populations of focus are defined as high-utilizers of emergency services, people experiencing homelessness, and adults with serious mental illness or substance use disorder who are impacted by complex social factors. CalAIM provides an enhanced focus and the incorporation of services that address the social determinants of health among high-risk and high-need populations.
PATH-CITED funds support the assessment of current software for the population health management functionality needed to serve high-risk and high-need populations. Funding also supports the assessment of billing capacity, reporting functions, and interoperability. Software upgrades to meet these required areas are also covered by the funds. Funds will also be used for hiring staff with the comprehensive technical knowledge and understanding of billing reporting, data, workflows, and other aspects essential to meet CalAIM’s requirements.
This capacity building funding is being leveraged with prior funding received for CalAIM infrastructure development to better understand opportunities to align electronic records for improved population health data monitoring, track health management, and develop appropriate reporting and billing capabilities for long-term program sustainability and funding.
Future rounds of capacity building funding will be pursued to support the subsequent phases involved in launching the CalAIM initiative in Long Beach.
This matter was reviewed by Deputy City Attorney Taylor M. Anderson on February 17, 2023 and by Budget Analysis Officer Greg Sorensen on March 3, 2023.
TIMING CONSIDERATIONS
City Council action is requested on March 21, 2023, to provide program services without interruption.
FISCAL IMPACT
The City will receive grant funding in the amount of $554,323 for a period of 18 months. An appropriation increase is requested in the amount of $554,323 in the Health Fund Group in the Health and Human Services Department, offset by grant revenue. This grant has no required match or in-kind service mandate. This recommendation has minimal staffing impacts beyond the normal budgeted scope of duties and is consistent with existing City Council priorities. Grant revenues will offset the cost of two full-time employees required to meet the scope of work outlined by the grant.
SUGGESTED ACTION
Approve recommendation.
Respectfully Submitted,
KELLY COLOPY
DIRECTOR
HEALTH AND HUMAN SERVICES
APPROVED:
THOMAS B. MODICA
CITY MANAGER