Title
Health and Human Services Agency, Mental Health Division, recommending the Board authorize the Chair to sign Agreement for Services 118-F1310 with Blue Cross of California, acting as fiscal intermediary for County Medical Services Program, to reimburse the County for the provision of mental health services to clients eligible for CMSP sponsored "Path2Health" insurance, with a term to be effective upon execution and with no end term (perpetual).
FUNDING: County Medical Services Program (CMSP) and Path2Health, a low-income health program sponsored by CMSP.
Body
Fiscal Impact/Change to Net County Cost
There is no Net County Cost associated with this funding Agreement. Blue Cross, on behalf of CMSP, reimburses the Health and Human Services Agency, Mental Health Division ("HHSA/MHD") for the cost of services provided under the terms and conditions contained in Agreement for Services 118-F1310.
Compensation for Services
Payments are made to County within 60 days of receipt and approval of invoices; invoices must be submitted within 150 days of service for actual services performed and documented per contract requirements.
Contract Termination
This Agreement includes a provision for either party to terminate without cause upon ninety (90) days written notice.
Background
The El Dorado County Mental Health Plan ("MHP") mandates that the County Health and Human Services Agency, Mental Health Division provide mental health services to individuals in need of service, regardless of their ability to pay.
On November 2, 2010, the Federal government approved California's five-year $10 billion "Bridge to Reform" waiver of Section 1115 of the Social Security Act that allows the federal government to grant Medicaid (Medi-Cal in California) waivers. This waiver allows California to enhance its Medi-Cal program, thereby allowing the state to transition to the Federal reforms ("Affordable Care Act") that will take effect in January 2014. The Section 1115 Waiver allows counties the opportunity to expand coverage to childless adults through participation in Low Income Health Programs ("LIHP"). Participation may be on an individual county basis or through a county consortium.
The County of El Dorado is a member of the CMSP, a consortium of thirty-five primarily rural California counties, which provides health coverage for low-income, indigent adults. Path2Health is a CMSP sponsored LIHP that became effective January 1, 2012, is authorized under California's Section 1115 Waiver, allows early implementation of the Affordable Care Act and, in addition to medical coverage, provides mental health services for eligible clients. All thirty-five CMSP counties participate in Path2Health.
Reason for Recommendation
Agreement for Services 118-F1310 with Blue Cross will allow the County to receive reimbursement for services provided to those clients who are eligible for the Path2Health program, will become effective upon execution, and will automatically renew for successive one-year terms unless terminated pursuant to terms and conditions contained therein.
Action(s) to be taken following Board approval
1. Chair to sign three (3) original Agreements 118-F1310.
2. Clerk of the Board to return all signed original Agreements to HHSA/MHD at 3057 Briw Road, Suite A.
3. HHSA/MHD to return all Agreements 118-F1310 to Blue Cross for final execution.
4. HHSA/MHD will return one fully executed Agreement to the Board Clerk's Office upon receipt.
Contact
Daniel Nielson, M.P.A., Director
Concurrences
County Counsel and Risk Management