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Health and Human Services Agency (HHSA) recommending the Board:
1) Accept and approve the use of funding from County Medi-Cal Managed Care Plans (MCP), including Kaiser Foundation Health Plan, Inc. (Kaiser), Blue Cross of California Partnership Plan, Inc. (Anthem), and Health Plan of San Joaquin/Mountain Valley Health Plan (HPSJ/MVHP), for the Community Health Assessment (CHA) and Community Health Improvement Plan (CHIP) processes;
2) Authorize the HHSA Director to execute the finalized Funding In Agreement 9375 with Kaiser, similar in form and scope to the CHA/CHIP sample agreement template attached (Attachment A) which has been County Counsel and Risk Management approved, subject to minor modifications on the finalized agreement contingent upon approval by County Counsel and Risk Management, for the term of July 1, 2025 through June 30, 2028, in the amount of $38,570 for Fiscal Year (FY) 2025-26, and future FYs to be determined upon mutual agreement between the parties;
3) Authorize the HHSA Director to execute the finalized Funding In Agreement 9410 with Anthem, similar in form and scope to the CHA/CHIP sample agreement template attached (Attachment B) which has been County Counsel and Risk Management approved, subject to minor modifications on the finalized agreement, contingent upon approval by County Counsel and Risk Management, for the term of July 1, 2025 through June 30, 2028, in the amount of $52,828 for FY 2025-26, and future FYs to be determined upon mutual agreement between the parties;
4) Authorize the HHSA Director to execute the finalized Funding In Agreement 9427 with the HPSJ/MVHP, similar in form and scope to the CHA/CHIP sample agreement template attached (Attachment C) which has been County Counsel and Risk Management approved, subject to minor modifications on the finalized agreement, contingent upon approval by County Counsel and Risk Management, for the term of July 1, 2025 through June 30, 2028, in the amount of $83,060 for FY 2025-26, and future FYs to be determined upon mutual agreement between the parties;
5) Delegate authority to the HHSA Director or Chief Assistant Director to execute future amendments that do not increase Net County Cost, contingent upon County Counsel and Risk Management approval as applicable, and subsequent administrative documents or required fiscal or programmatic reports.
FUNDING: 100% MCP funding granted to County.
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DISCUSSION / BACKGROUND:
In January 2023, DHCS launched the implementation of the Population Health Management (PHM) Program, which requires participation from all MCPs. The PHM Program aims to ensure that all members have access to a comprehensive range of services tailored to their needs and preferences across the continuum of care, ultimately supporting longer, healthier, and more fulfilling lives, improving outcomes, and advancing health. The County currently partners with three MCPs: Kaiser, Anthem, and HPSJ/MVHP.
As part of the PHM Program, MCPs meet their Population Needs Assessment (PNA) obligations by actively participating in the CHA and CHIP processes conducted by Local Health Jurisdictions (LHJs). The PNA process aims to initiate or strengthen collaboration among MCPs, LHJs, and community stakeholders, promoting a deeper understanding of the health and social needs of members and the communities they live in through cross-sector partnerships. This collaboration is intended to reduce siloed approaches to population health management and enhance the ability of MCPs and community partners to identify community needs and strengths, ultimately leading to more effective improvements in the health and well-being of members.
The purpose of the CHA and CHIP funding granted by the MCPs to the County, is to support the County, a LHJ, in the development, implementation and evaluation of its CHA and CHIP by providing meaningful contributions that support improving the quality of life and health outcomes of County’s residents, including the Medi-Cal managed care population, through population health management efforts identified in the CHA and CHIP.
HHSA’s Public Health Division has collaborated with the MCPs to determine the amounts for meaningful contributions to meet the MCPs PNA obligations through Funding In Agreements 9375, 9410, and 9427. Funding in amounts have been determined and agreed upon by the MCPs for FY 2025-26. The MCPs and HHSA have mutually agreed to discuss the award amounts for FY 2026-27 and FY 2027-28 at least sixty calendar days prior to June 30 of the current fiscal year to be in effect for July 1 of next fiscal year. These allocations will be based on budget availably by each MCP, with the funding amounts for subsequent FY to be incorporated into the Agreements via a Notice to Party letter, without the need for an Amendment, to be effective immediately following said notice.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would continue to provide services using discretionary funding, however, would miss out on the opportunity to receive grant funding from the three MCPs over the scheduled three-year period.
PRIOR BOARD ACTION:
N/A
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel and Risk Management
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with this agenda item. Sufficient appropriations were included in the FY 2025-26 budget and will be included in future budgets for the term of the Agreements.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
N/A
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency