Title
Health and Human Services Agency recommending the Board consider the following:
1) Approve the following non-financial Memoranda of Understanding with California Health and Wellness Plan for a term effective upon signature and continuing until terminated by one of the parties thereto. These Memoranda of Understanding establish the roles and responsibilities of specific divisions of the Health and Human Services Agency in the provision of services for the beneficiaries of the Medi-Cal Managed Care program administered by California Health and Wellness Plan:
a) Memorandum of Understanding 109-M1410 with the Public Health Division;
b) Memorandum of Understanding 270-M1411 with the Mental Health Division; and
2) Authorize the Chief Administrative Officer to execute further documents relating to the above noted Agreement, including amendments thereto, contingent upon approval by County Counsel, and further authorize the Director of the Health and Human Services Agency, or designee, to execute any administrative documents relating to said Agreement including required fiscal and programmatic reports.
FUNDING: Medi-Cal Managed Care (State and Federal).
Body
Fiscal Impact/Change to Net County Cost
There is no Net County Cost associated with these non-financial Memoranda of Understanding.
Background
In June 2013, the Governor's Budget expanded managed health care into rural areas that had previously been Fee-For-Service (FFS) only. This expansion provides beneficiaries throughout the state with care through an organized delivery system, and the County of El Dorado is one of the 28, primarily rural, FFS counties being transitioned to Medi-Cal Managed Care in this process. Medi-Cal Managed Care Rural Expansion is the result of State Assembly Bill (AB) 1467, which added Article 2.82 (commencing with Section 14087.98) to the Welfare and Institutions Code; Section 14087.98 includes a procedure for the transition to a Medi-Cal Managed Care Plan (MCMCP). This procedure required the State establish a methodology for selecting vendors to administer MCMCP, and the state utilized a Request for Application (RFA) process that resulted in the State selection of vendors to administer MCMCP in the counties. The State selected two vendors, California Health and Wellness Plan and Anthem Blue Cross, to administer the MCMCP in a group of 18 counties, including the County of El Dorado.
As of November 1, 2013, Medi-Cal recipients have been required to enroll either in one of the Medi-Cal Managed Care Plans (California Health and Wellness Plan or Anthem Blue Cross), or to access other insurance opportunities through the Covered California Insurance Exchange.
Both MOUs are non-financial agreements; however, each one establishes certain roles and responsibilities regarding the provision of services to beneficiaries of California Health and Wellness Plan (CHWP):
A. MOU 109-M1410 establishes Public Health Division activities specific to the Maternal, Child and Adolescent Health (MCAH) program, California Children's Services (CCS) program, Child Health and Disability Prevention (CHDP) program, and direct observation of tuberculosis therapy.
B. MOU 270-M1411 establishes Mental Health Division activities specific to the provision of mental health services for beneficiaries of CHWP. The majority of the activities defined in MOU 270-M1411 are also included in the Agreement with the State Department of Health Care Services that establishes the County as the Mental Health Plan for the residents of El Dorado.
Reason for Recommendation
The Health and Human Services Agency (HHSA) Divisions of Mental Health and Public Health have statutory requirements for access and service delivery assurance to the disenfranchised population generically addressed under Welfare and Institutions Code 17000. Failure to execute said MOU's will result in the inability of Public Health and Mental Health to effectively carry out the legally required activities as identified in statute and procedurally could result in program default jeopardizing both State and Federal funding to those programs. Approval of MOU 109-M1410 and MOU 270-M1411 with California Health and Wellness Plan will ensure compliance with AB 1467 and the various statutes amended by AB 1467 to expand Medi-Cal Managed Care within the State of California.
Clerk of the Board Follow Up Actions
1. Chair to sign two (2) original MOU 109-M1410, and two (2) original MOU 270-M1411.
2. Clerk of the Board to return all signed documents to HHSA at 3057 Briw Road.
Contact
Don Ashton, M.P.A., Director
Concurrences
County Counsel