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Solano approves CalAIM plan to let jails bill Medi‑Cal for 90‑day pre‑release services
Summary
The board approved a CalAIM implementation plan that uses one‑time readiness funds to build billing and EHR systems and hires project staff so the sheriff’s office can bill Medi‑Cal for pre‑release medical and behavioral health services starting with a phased launch and an expected 9/30/2026 program date.
The Solano County Board of Supervisors voted to adopt an implementation plan and budget to deliver Medi‑Cal‑reimbursable 90‑day pre‑release medical services to people housed in county jails. The plan, approved unanimously, uses a PATH Round 3 grant to stand up billing systems, hire project staff and expand vendor contracts so the jail can eventually bill Medi‑Cal for services provided before release.
Sheriff’s Office presenters said state mandate requires counties to implement CalAIM pre‑release services and that funding is available to build necessary infrastructure. "We are mandated," said Renee Smith, grants/services manager at the Sheriff’s Office, explaining the legal requirement and the county’s decision to apply for readiness funds rather than leave the mandate unfunded.
The board reviewed a multi‑bucket readiness budget: about $1.8 million was shown for electronic health record (EHR) and billing infrastructure and third‑party administrator setup; roughly $450,000 for enhanced care‑management vendor support and reentry case management, and additional amounts for staffing, medication‑assisted treatment (MAT) coordination and oversight. Staff told the board PATH Round 3 funds (~$3.5 million) are intended to stand up operations ahead of Medi‑Cal billing, which would be a permanent funding stream once billing readiness is achieved.
Staff described three new position requests tied to the grant: a CalAIM project manager/coordinator to run billing and QA, a billing assistant, and a correctional officer to support increased MAT workloads. The sheriff’s office said providers and managed‑care plans must be integrated and that significant electronic data‑sharing work will be required to transmit claims and protected health information to DHCS.
County leaders framed the plan as a way to improve continuity of care and reduce recidivism. "If we get really good at billing and documentation, in the long run the more the merrier," said one supervisor during discussion; presenters cautioned that Medi‑Cal will reimburse eligible services but that county workloads will increase during implementation.
What’s next: staff will proceed with readiness planning, contract amendments and technology work to meet a readiness deliverable date 6 months before their planned launch (readiness due ~03/31/2026; target launch 09/30/2026).
