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Health and Human Services Agency (HHSA) recommending the Board adopt and authorize the Chair to sign Resolution 117-2026, authorizing the HHSA Director, or Chief Assistant Director, to execute six non-financial Memoranda of Understanding (MOUs) with local Managed Care Plans, including Blue Cross of California Partnership Plan, Inc., Kaiser Foundation Health Plan, Inc, and San Joaquin County Health Commission doing business as Health Plan of San Joaquin and Mountain Valley Health Plan, which are required by the Department of Health Care Services for the purpose of documenting processes for coordinating care and exchanging health information for Medi-Cal services, including amendments thereto, for a term of each MOU effective upon final execution and continuing annually thereafter unless terminated earlier by one of the parties, subject to final County Counsel and Risk Management approval, as applicable.
FUNDING: N/A
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DISCUSSION / BACKGROUND
Medi-Cal is California’s Medicaid program, providing free or low-cost health coverage to eligible low-income residents. On January 1, 2022, DHCS launched the California Advancing and Innovating Medi-Cal (CalAIM) Initiative with the goal of making Medi-Cal more equitable, coordinated, and person-centered to Medi-Cal members. On October 11, 2023, as part of the Cal-AIM Initiative, DHCS issued All Plan Letter (APL) 23-029 requiring MCPs that contract with DHCS under Medi-Cal Managed Care Contracts (MCP Contracts) to deliver medically necessary services to Medi-Cal members, to establish MOUs with Third Party Entities, including local health departments, governmental agencies, and other local programs and services, for the purpose of documenting processes for coordinating care and exchanging health information.
In El Dorado County, the three local MCPs are Blue Cross of California Partnership Plan, Inc. (“Anthem”), Kaiser Foundation Health Plan, Inc. (“Kaiser”), and San Joaquin County Health Commission doing business as Health Plan of San Joaquin and Mountain Valley Health Plan (“SJMVHP”). These local MCPs have engaged and collaborated with HHSA’s Behavioral Health, Public Health, and Social Services, Protective Services divisions to establish non-financial MOUs which clarify the roles and responsibilities of each party for the coordination of delivery of care and services, exchange of private health information, and referral process for Medi-Cal members residing in El Dorado County.
The MOUs set forth by the respective HHSA programs are as follows:
(1) HHSA’s Behavioral Health Division is establishing two MOUs with these MCPs, which align with the County’s Drug Medi-Cal Mental Health Plan (MHP) and Organized Delivery System (DMC-ODS) agreements with the State of California, to ensure that Medi-Cal members receive MHP and DMC-ODS services in a coordinated manner to include Specialty Mental Health Services (SMHS) and Substance Use Disorder (SUD) services.
(2) HHSA’s Public Health Division, as the County’s Local Health Department (LHD) and Women, Infants, and Children (WIC) Local Agency, is establishing two MOUs with these MCPs, to ensure that Medi-Cal members receive coordinated care for LHD services and WIC Local Agency services.
(3) HHSA’s Social Services Division, Protective Services is establishing two MOUs with these MCPs, to ensure that Medi-Cal members receive coordinated care for In-Home Supportive Services (IHSS) and Child Welfare Services (CWS).
Each of these HHSA divisions have been working closely with the MCPs to finalize these MOUs utilizing DHCS’ provided templates since early 2024, in which County Counsel has been actively involved in performing legal reviews, however, each of the MOUs are in various stages. Final MOUs must be provided to DHCS as soon as possible, with an initial requested date of January 1, 2025, which was later extended due to the complexity in the development process.
HHSA is seeking the Board grant signature authority to the HHSA Director, or Chief Assistant Director, for these MOUs to ensure that the finalized MCP MOUs can be executed timely and provided to DHCS as soon as possible, contingent upon final County Counsel and Risk Management approval.
ALTERNATIVES
Should the Board decline to approve this Resolution, HHSA will bring each finalized MOU before the Board on differing agenda items/dates, however, this will result in further delays in the provision of these required MOUs to DHCS.
PRIOR BOARD ACTION
N/A
OTHER DEPARTMENT / AGENCY INVOLVEMENT
County Counsel
CAO RECOMMENDATION
Approve as recommended.
FINANCIAL IMPACT
There is no financial impact associated with this agenda item.
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