Title
Health and Human Services Agency recommending the Board provide conceptual approval, pursuant to Board Policy A-3, of the development of a new County Ordinance to satisfy the requirements to join the Health Plan of San Joaquin Medi-Cal Managed Care plan.
FUNDING: N/A
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DISCUSSION / BACKGROUND:
Board Policy A-3 "Ordinances - New or Amended" requires new ordinances to be presented to the Board of Supervisors for review and conceptual authorization to prepare the ordinance.
California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation. Providing insurance for almost one-third of California’s roughly 40 million residents, Medi-Cal is a key source of health coverage for low-income children, adults, and people with disabilities, while also providing wrap-around coverage for many elderly Medicare beneficiaries. California was the first state to pilot managed care in Medicaid, beginning in the early 1970s, and from that the Medi-Cal Managed Care (MMC) program has developed a unique structure that grew out of the different health care delivery and financing systems in different counties across the state. Over time, California has transitioned progressively more Medi-Cal beneficiaries into MMC, and through this Medi-Cal providers who wish to provide services to managed care enrollees must participate in the managed care plan’s provider network.
Working directly with Barton Health, Marshall Medical, El Dorado Community Health Center, Alpine County, and the Health and Human Services Agency (HHSA) of El Dorado County, it was determined that the best model for Medi-Cal Managed Care in the County would be to adopt a two-plan public/commercial model, one plan being available to residents through a private provider and the other through a Public Plan. The Health Plan of San Joaquin (HPSJ) was selected as this plan due to their geographic proximity to El Dorado County as well as their impressive statistics in regards to putting...
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