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San Francisco supervisors hear plan to reclaim Medi‑Cal funds for children’s mental‑health services
Summary
Supervisors and city staff on March 25 heard presentations outlining steps to increase Medi‑Cal reimbursements for children’s behavioral‑health services, including time‑tracking at family resource centers and contract adjustments that analysts estimate could recover millions annually.
Supervisor Myrna Melgar convened a March 25 hearing of the Public Safety and Neighborhood Services Committee to examine how San Francisco can maximize state and federal Medi‑Cal funding for children’s mental‑health services.
Alex Briscoe, principal of the California Children’s Trust, told the committee that the trust and city partners identified four projects — family resource centers, a children’s health‑center billing benefit, expanded school district claiming and administrative‑activity claims — that together could generate additional federal revenue for local programs. Briscoe said 26 family resource centers will begin time tracking April 1 and that initial work already identified more than $15 million of local, non‑federal spending the city can use to draw down federal matching funds. “Every dollar we leave unclaimed is a dollar we have less to reinvest in impactful support for our children and youth,” Briscoe said.
Drew Morrell, who spoke for the Department of Public Health’s behavioral‑health team, outlined technical barriers the department faces, especially a 2016 state implementation that introduced continuous time‑study requirements for certain Mental Health Medi‑Cal (MH‑MA) claims. Morrell said the department is pursuing two approaches: direct‑charge claims for staff or contractors who are 100% dedicated to a qualified MH‑MA activity (which avoids time‑study), and targeted time studies for other activities while managing long audit windows. “We’re exploring opportunities to claim administrative activities without imposing double time studies on clinical staff,” Morrell said.
Fred Brusseau of the Budget and Legislative Analyst’s office presented conservative estimates from the departmental cost report and his office’s review: about $3.2 million could be recovered by capturing eligible costs now exceeding the 15% general‑administration cap, and contractor shifts or partial time studies could translate into roughly $7 million more in reimbursable costs under some scenarios. Brusseau recommended the department report back to the board in about six months on implementation and results.
Department staff and advocates described concrete next steps. Briscoe said a new Medi‑Cal benefit for caregiver mental‑health services, approved in July, could generate $1 million–$3 million annually and that San Francisco could be viewed as a statewide early adopter. Farah Faramond of DPH asked the board to consider investments in crisis residential beds and expanded substance‑use treatment capacity for youth, estimating roughly $1.1 million and $2 million price points respectively for initial bed and program investments.
Public comment included Asha Renick of the Family Resource Center Alliance, who said 70 FTEs across five organizations will start time tracking April 1 and called the effort a sustainable new revenue stream that supplements existing funding.
The committee did not take a final funding vote; Chair Maher moved — and the committee approved — to continue the item to the call of the chair so the department can proceed with the analysis and report back.
