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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 a...
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