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Health and Human Services Agency recommending the Board Approve the Final Passage (Second Reading) of revised and updated Ordinance 5149 that allows participation in the Health Plan of San Joaquin Local Initiative Two-Plan public/commercial Medi-Cal Managed Care Plan Model, which has been updated to correct the effective date of the county plan model change to January 1, 2024. (Cont. 12/7/2021, Item 48)
FUNDING: There are no funding requirements related to County operations or associated activities.
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DISCUSSION / BACKGROUND:
On December 7, 2021, the Board approved the Introduction (First Reading) of Ordinance 5149 and Continued it to February 14, 2021 for Final Passage (Second Reading).
On April 13, 2021, the Board of Supervisors approved and authorized the Chair to sign a Letter of Intent to transition to the Health Plan of San Joaquin (HPSJ) Local Initiative Two-Plan public/commercial Medi-Cal Managed Care Plan Model.
On August 25, 2021, the Summary Ordinance 5149 was submitted to the Mt. Democrat for public notice to be included in the September 17, 2021 edition.
On August 31, 2021, the Board of Supervisors approved in concept the transition to the Health Plan of San Joaquin (HPSJ) Local Initiative Two-Plan public/commercial Medical Managed Care (MMC) Plan Model.
On October 12, 2021, the Board of Supervisors approved the Introduction (First Reading) of Ordinance 5149 to allow participation in the HPSJ MMC Plan, and waived the full reading of the Ordinance for Final Passage, continuing the matter to October 19, 2021.
On October 19, 2021, the Board of Supervisors approved the Final Passage (Second Reading) of Ordinance 5149, which was a new Ordinance to allow participation in the Health Plan of San Joaquin Local Initiative Two-Plan public/commercial Medi-Cal Managed Care Plan Model. (Cont. 10/12/2021, Item 25).
Subsequent to October 19, 2021, the State Department of Health Care Services (DHCS) contacted HHSA and advised the agency that Ordinance 5149 would require one additional statement, referencing an effective date of January 1, 2024 as the day for the transition to HPSJ as a local, public plan option. HHSA was asked to provide the revised ordinance back to DHCS by December 31, 2021.
Attached please find a redline version of the approved Ordinance 5149, as well as a revised version for approval by the Board of Supervisors.
ALTERNATIVES:
Should the Board decline to approve this recommendation, the County would be unable to participate in the new MMC plan through HPSJ and would continue with the current model. The new MMC plan through HPSJ is supported and endorsed by Barton Health, Marshall Medical Center, El Dorado Community Health Centers, Alpine County, and El Dorado HHSA.
PRIOR BOARD ACTION:
April 13, 2021, File ID 21-0278, Agenda No. 24, “HHSA - Letter of Intent for MMC”
August 31, 2021, File ID 21-1362, Agenda No. 14; “Approval in Concept”
October 12, 2021, File ID 21-1422, Agenda No. 25; “First Reading of New HPSJ Ordinance.”
October 19, 2021, File ID 21-1422, Version 2, Agenda No. 12; “Second Reading of New HPSJ Ordinance.”
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no cost associated with this Agenda Item, and therefore no impact to the General Fund.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to return one (1) certified Ordinance 5149 as revised and approved on December 14, 2021.
STRATEGIC PLAN COMPONENT:
Healthy Communities
CONTACT
Don Semon, Director, Health and Human Services Agency