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Health and Human Services Agency (HHSA) recommending the Board approve and authorize the HHSA Director, or Director of Public Health to sign the Letter of Intent with the Health Plan of San Joaquin for mutual intent to negotiate and develop a Medical Services Agreement.
FUNDING: N/A
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DISCUSSION / BACKGROUND:
California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation. Insuring almost one-third of California’s residents, Medi-Cal is a key source of health coverage for low-income children, adults, and people with disabilities. The San Joaquin County Health Commission (Commission), a multi-county commission, contracts with the California Department of Health Care Services (DHCS) to provide a managed health care plan for people receiving Medi-Cal. Through this managed health care plan, referred to as the Health Plan of San Joaquin (HPSJ) Local Initiative Two-Plan Medi-Cal Managed Care Plan Model, the Commission has successfully improved health care access for its members and increased reimbursement rates for health care providers.
The HPSJ is a non-profit Health Maintenance Organization (HMO) that has been providing healthcare services to the Central Valley community for over two decades. It is publicly sponsored and collaborates with the Medi-Cal Managed Care Division of the DHCS to deliver healthcare to Medi-Cal members. HPSJ prioritizes primary and preventive care through organized systems of care networks, aiming to provide quality healthcare, improve accessibility, and reduce costs.
Beginning in 2021, the DHCS began expanding the Commission’s managed health care plan to rural counties, to allow participating counties to have greater local influence and control over their managed care medical system. On August 31, 2021, the County of El Dorado (County) Board of Supervisors (Board) approved in concept to transition the County to the HPSJ Managed Care Plan Model (21-1362). Subsequently, on December 14, 2021, the Bo...
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