Title
Public Health Department recommending Chairman be authorized to sign Budget Transfers for reimbursement to California Forensic Medical Group (CFMG) and payment to other medical professionals and facilities for emergency medical services provided to County Inmates; and recommending funding in the amount of $41,667 for excess insurance coverage and an adjustment in the amount of $23,298 to Probation's Juvenile Hall budget. (4/5 vote required)
RECOMMENDED ACTION: Approve.
FUNDING: General Fund.
Body
BUDGET SUMMARY: |
|
|
Total Estimated Cost |
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$305,103 |
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|
|
Funding |
|
|
Budgeted |
$ |
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New Funding |
$ |
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Savings |
$ |
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Other - GF Contingency |
$305,103 |
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Total Funding Available |
$305,103 |
|
Change To Net County Cost |
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$0 |
Fiscal Impact/Change to Net County Cost: $240,138 will be paid to CFMG and other medical professionals reimbursing them for costs incurred in treating County inmates. $41,667 will be used to pay for an insurance premium to cover costs of inmate hospitalization which exceed the contracted cap amount between County and CFMG. $23,298 is an increase to the Juvenile Hall budget to account for medical, dental, and lab services; this budget modification is due to an increase in the Medical Consumer Price Index (CPI), which was not accounted for during the normal budget process. The total of $305,103 is coming from the General Fund Contingency account.
Background: The current agreement between the County and CFMG, which designates CFMG as the administrator of healthcare needs for County inmates, holds CFMG liable for inpatient care up to $15,000 per person per episode. However, there were two incidents where the cost for emergency and specialty inpatient care exceeded that amount. Those occurrences required services which were provided by a number of medical professionals and facilities listed below:
Anthony Field, M.D.
Barton Healthcare System
Barton Hospital - Facility Fees
Carson Surgical Group Carson Tahoe Pathology
Carson Tahoe Radiation Oncology Associates
Carson Tahoe Regional Healthcare - Facility Fees
CFMG - reimburse for overcap of $15,000
El Dorado County Ambulance
Gastroenterology Consultants
Jorge Perez, M.D.
Raymond L. Swartz, M.D.
Reno Heart Physicians
Sierra Nevada Cardiology Associates
Tahoe Carson Valley Medical Center - Professional Fees
Timothy Doyle, M.D.
U. C. Davis Medical Center - Facility Fees
U. C. Davis Medical Center - Professional Fees
El Dorado Pathology Medical Group
Marshall Medical Center - Facility Fees
On February 13, 2007, the Board of Supervisors approved, and the Public Health Department subsequently obtained, a Catastrophic Insurance policy to mitigate the costs of these occurrences. However, cases which pre-dated the effective date of the policy are excluded from coverage, and this exclusion applies to the cases cited in this request.
Reason for Recommendation: The current agreement with CFMG does not account for contingencies such as this, and, as a result, CFMG temporarily shouldered some of the cost of these emergency services. The providers, noted above, invoiced the County at discounted rates. The County is obligated to cover these expenses. Therefore, the Department recommends the Board authorize the reimbursement to CFMG and payment of the related outstanding invoices.
Regarding the aforementioned Catastrophic Insurance policy, which will cover costs of inmate hospitalization exceeding the contracted cap amount of $15,000 per inmate/incident between County and CFMG, the attached Budget Transfer makes funds available for the payment of the policy premium through the end of the fiscal year.
Lastly, the Juvenile Hall budget must be increased due to an increase in the Medical Consumer Price Index (CPI). CPI data was available during the County's regular budget adoption period; however, it mistakenly was not applied to the Juvenile Hall budget at that time. The CPI is the standard by which prices are based for applicable services provided for minors in County custody, including medical, dental, and lab work.
Action to be taken following Board approval: Chair to sign attached budget transfer moving funds from the General Fund Contingency; Department to work with Auditor to process invoices for payment; Board Clerk's Office to forward signed Budget Transfers to Auditor's Office for posting.
Contact: Dan Buffalo
Concurrences: