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Health and Human Services Agency (HHSA) recommending the Board:
1) Approve and authorize the Chair to sign Agreement 4993 with the County of Santa Cruz acting as the Host Entity for the Medi-Cal Administrative Activities (MAA) and Targeted Case Management (TCM) program. Execution of this Agreement 4993 will enable the County of El Dorado to continue to participate in and receive federal revenues for MAA/TCM, with a retroactive effective date starting July 1, 2019 through June 30, 2022, for an estimated contractual obligation of $30,000;
2) Authorize the HHSA Director, or designee, to execute any further documents related to Agreement 4993 including required fiscal and programmatic reports, and amendments which do not increase the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management.
FUNDING: 100% Federal funding for Medi-Cal Administrative Activities.
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DISCUSSION / BACKGROUND:
The California Department of Health Care Services (DHCS) is responsible for administering the California Medi-Cal Assistance Program, of which Medi-Cal Administrative Activities (MAA) and Targeted Case Management (TCM) are components. The State enters into cooperative arrangements with Local Government Agencies (LGAs) to ensure the appropriate administration of MAA/TCM with the objective to assist eligible Medi-Cal recipients in gaining access to needed medical, social, educational, and other services. This Agreement allows various County departments to receive federal reimbursement for qualifying MAA/TCM services.
The LGA (County of El Dorado) may claim federal Medicaid matching funds for assisting the State in the proper and efficient administration of the Medi-Cal Program. The Health and Human Services Agency acts as the liaison for receipt of MAA revenues for the County and has been participating in MAA since 1998.
Pursuant to Welfare and Institutions Code Section 14132.47(m), LGAs participating in MAA are required to pay an annual participation fee through a mechanism agreed to by the State and the LGA Consortium. The current agreed-to mechanism assigns administrative and fiscal intermediary duties between the State and all participating LGAs to a Host Entity county. The MAA and TCM participation fees are determined annually based on the percentage of revenue received by each program.
Retroactive Term:
Previously, the County of Plumas was the designated MAA Host Entity for the period of July 1, 2014 through June 30, 2019. The Host Entity designation transferred to County of Santa Cruz effective July 1, 2019; however, Santa Cruz County did not issue the retroactive participation agreement until May 28, 2020, at which time HHSA staff immediately began processing the agreement for submission to the Board at the next available Agenda date.
ALTERNATIVES:
Agreement 4993 is required for the County’s continued participation in MAA, and the annual LGA participation fee is a requirement to participate in the MAA program. Should the Board decline to approve this Agreement, approximately $60,000 in potential revenue would be lost for programs participating in MAA.
PRIOR BOARD ACTION:
1) 08/30/2016, 14-1657, HHSA County of Plumas Agmt 240-M1510
2) 08/29/2018, 17-0847, HHSA County of Plumas Agmt 161-F1811
3) 12/04/2018, 18-1773, HHSA Plumas County Agreement 3492
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, 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 Fiscal Year 2019-2020 Budget and in the Fiscal Year 2020-2021 Budget. The Public Guardian program and Community Services Division are participants in the MAA program which brings in Federal Medi-Cal Administrative revenues. Not participating in MAA through this Agreement will increase the General Fund cost of the Public Guardian Program.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain the Chair’s signature on two (2) originals of Agreement 4993.
2) Clerk of the Board to return all documents to Health and Human Services Agency, Contracts Unit, to obtain final signature from the County of Santa Cruz.
STRATEGIC PLAN COMPONENT:
Good Governance
CONTACT
Don Semon, Health and Human Services Agency Director