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Health and Human Services Agency (HHSA), in conjunction with the El Dorado County Sheriff’s Office (EDSO), recommending the Board:
1) Adopt and authorize the Chair to sign Resolution 142-2024, to replace and supersede Resolution 182-2019, delegating authority to the Sheriff, or Undersheriff to execute and administer agreements, and amendments by and between the California Department of Health Care Services (DHCS) and the County, for the Medi-Cal County Inmate Program (MCIP), contingent upon approval by County Counsel and Risk Management, if applicable; and
2) Delegate authority to the Sheriff, Undersheriff, or Agency Chief Fiscal Officer of EDSO to execute any required fiscal and programmatic reports related to DHCS MCIP.
FUNDING: Federal (Medicaid); County share of cost for the non-federal portion is based on usage.
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DISCUSSION / BACKGROUND:
DHCS oversees the California Medical Assistance Program, known as Medi-Cal, which is the State’s Medicaid program intended to provide needed health care services for low-income individuals. Federal law generally prohibits claiming Medicaid funds for healthcare services provided to inmates in correctional facilities. However, there is an exception: if an inmate requires inpatient services at an offsite medical facility for an anticipated stay of more than 24 hours and has completed the application process and been deemed eligible for the MCIP, they can receive Medicaid funding.
Historically, counties have absorbed the full cost of healthcare for county inmates. The MCIP helps alleviate this burden by offsetting costs for inmates who qualify for Medi-Cal. Eligible inmates are billed at Medi-Cal rates, with the county covering only the non-federal portion. Consequently, participating in MCIP can result in budgetary savings for the county.
For eligible inmates or juvenile wards who receive Medi-Cal covered services offsite, the county can submit claims to DHCS. DHCS reimburses the Medi-Cal provider at the applicable Medi-Cal rate, subject to federal financial participation. The county is then responsible for any remaining balance owed to the Medi-Cal provider. Additionally, the county must reimburse DHCS for the non-federal share of administrative costs associated with administering the MCIP. These administrative costs include, but are not limited to, providing the county with a paid claim analysis report and conducting legal research and analysis related to the MCIP.
On November 5, 2019, the Board approved Resolution 182-2019, delegating authority to the Director of HHSA to execute future agreements and amendments with DHCS for participation in the MCIP (Legistar file 19-1526). This delegation of authority aimed to reduce delays in the execution of these agreements/amendments.
HHSA and EDSO have identified the need to transition the administration of the MCIP to EDSO to better align with the program's goals. As part of this transition, HHSA and EDSO recommend that the Board replace and supersede Resolution 182-2019, which changes the signature authority delegation from the Director of HHSA to the Sheriff or Undersheriff to execute and administer agreements and amendments between DHCS and the County for the MCIP.
ALTERNATIVES:
Should the Board decline to approve this recommendation, the Director of HHSA would continue to have signature authority for MCIP agreements/amendments through Resolution 182-2019.
PRIOR BOARD ACTION:
1) 02/07/17, 17-0105, HHSA DHCS MCIP Agreement Q4 FY 2016-17
2) 02/07/17, 17-0106, HHSA DHCS MCIP Agreement
3) 05/22/18, 18-0739, HHSA Agreement 2479 with CA Dept. of Health Care Services - Medi-Cal Inmate Program (MCIP)
4) 11/02/19, 19-1526, HHSA DHCS Agreement 4259 and Signature Authority Resolution
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
El Dorado County Sheriff’s Office and County Counsel
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
The resolution for the transition of the MCIP has no financial impact as the institutional medical care account had transferred to EDSO in Fiscal Year 2022-23.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one original Resolution.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency
Undersheriff Bryan Golmitz, El Dorado County Sheriff’s Office