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Welcome to the December CalAIM Corner!

Issue #12 | December 2024

Updates

• The CalAIM assessment, designed to support the delivery of whole-person care, is now live in AVATAR! This tool will help us better identify and address the needs of our clients in alignment with the CalAIM initiative. 
• QM will be hosting Assessment Workshops for BHRS Staff and Contract Agencies who use BHRS Avatar for Mental Health Documentation. These workshops are optional but are available to any staff who would like additional support and guidance regarding how to complete the new CalAIM Assessment and how to access PreCalAIM Assessments. The workshops will review important training and support information and will do a live walkthrough of the assessment form, diagnosis form and reports.
  
  • Workshop dates:
    • December 27, 2024, 10-11am
    • January 9, 2025, 10-11am
    • January 15, 2025, 1-2pm
    • January 22, 2025, 11-12pm
    • January 27, 2025, 3:30-4:30pm
  • Invites to the sessions have been sent via Teams. Please RSVP so QM can anticipate attendance. Workshops with no accepted invited will be cancelled.
  • For more information, email hs_bhrs_ask_qm@smcgov.org. 

Year in Review - CalAIM Implementation

In the past year, BHRS has made significant progress in the implementation of CalAIM. This newsletter covers a brief explanation of each implementation milestone and its current status. This is just a summary, each implementation milestone, in blue, includes many tasks. A more in depth explanation of each milestone will be discussed at the BHRS All Staff meeting on February 12, 2025!

Check out the current breakdown of CalAIM Implementation - 69% of tasks have been completed as of December 2024!

Payment Reform

The three components of Payment Reform are Provider Billing, Reimbursement Structure and the Financing Mechanism, which have all been implemented as of July 2024.

• Under Provider Billing, BHRS providers switched from Common Procedure Coding System (HICPICs) to Current Procedural Terminology (CPT) coding system.
• The Reimbursement Structure transitioned from a cost based reimbursement, a flat fee, to a fee-for-service system for contractors.
• The new Financing Mechanism, called Intergovernmental Transfers, is a way for public agencies to move funds between or within levels of government.

Screening Tool 

The Screening Tool is a series of questions that the Access Call Center uses when they receive calls. It determines which system the beneficiary qualifies for, including either a Managed Care Plan (MCP), which would be Health Plan of San Mateo or Kaiser, OR the Mental Health Plan (MHP) which is us, BHRS. 

Transition Tool

The Transition Tool is used when completing a transition of services to the other delivery system (MCP or MHP) or when adding a service from the other delivery system to their existing mental health treatment. Dates for training to be determined. 

CalAIM Trainings for Contractors/BHRS Staff

BHRS Quality Management has hosted many trainings this year to support CalAIM implementation. To revisit a training, BHRS staff can visit LMS via Okta. Contracted providers can access here: https://sanmateocounty.csod.com. 

CalAIM Updates to Avatar

Updates must be made in Avatar NX to reflect the changes by CalAIM. A workgroup, made up of staff across departments, has been created to develop and implement solutions for Avatar NX barriers to CalAIM implementations. 

Drug Medi-Cal Organized Delivery System (DMC-ODS) 

The AOD team has made significant progress in implementing DMC-ODS CalAIM initiatives, including Early Intervention Services, Evidence Based Practice requirements, Recovery Incentive Program, Medications for Medicated Assisted Treatment Expansion and more! We covered these a few months ago - see the August newsletter for a breakdown of AOD specific implementation milestones.

Behavioral Health Administrative Integration

CalAIM is requiring that Medi-Cal Specialty Mental Health (SMH) and substance use disorder (SUD) treatment services are combined into one, integrated specialty behavioral health program by January 1, 2027. The primary goals of  Administrative Integration are to improve health care outcomes and the experience of care for Medi-Cal members—particularly those living with co-occurring mental health and SUD issues—by reducing administrative burden for members, counties, providers and the state. Read more here. BHRS is already set up for this integration, for example, our Access Call Center has one phone number for SUD and MH, whereas other counties have separate phone numbers for each. We've also integrated our MH and SUD Standard of Care practices, which refer to the established guidelines and best practices that BHRS providers follow when delivering mental health treatment. 

Justice Involved Initiative

The CalAIM Justice Involved Initiative aims to support the health and well-being of justice-involved individuals - those who are incarcerated or who have recently been released from jail or prison. The initiative provides a targeted set of services provided by Correctional Health Services (CHS) 90 days prior to release including enrollment in Medi-Cal, appointments with BHRS and Enhanced Care Management services. BHRS's role is to collaborate with CHS to get newly released adults and youth into MH and SUD services as quickly as possible. 

Contractor Incentive Program

The Contractor Incentive Program is not a DHCS CalAIM Initiative, but was implemented by BHRS as a way to support our contracted providers transition to CalAIM. This program is funded by MHSA.

Thanks for Reading!

Be sure to check out the QM lightbulb which comes out the Friday before the Leadership meeting, which occurs on the third Wednesday of the month.

Please email Caprice Scott, CalAIM Project Manager, at cscott1@smcgov.org for any CalAIM questions.

For questions, feedback or to join this mailing list and receive this newsletter, please email Audrey Davis, BHRS Communication Specialist, at adavis2@smcgov.org.