Title
Health Services Department recommending the Board approve and authorize the Chair to sign Agreement 032-125-P-E2010 (074-S1111) with the County Medical Services Program Governing Board for a term through July 1, 2010 until terminated by either party, to provide health care services to indigent adults pursuant to California Welfare and Institutions Code Section 16809 et seq.
FUNDING: Realignment (sales tax and vehicle license fees).
Body
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BUDGET SUMMARY: |
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Total Estimated Cost |
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$3,768,780 |
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Funding |
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Budgeted |
$3,535,288 |
FY 2010-11 Health Care pymt |
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New Funding |
$233,492 |
County Participation Fee |
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Savings |
$ |
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Other |
$ |
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Total Funding Available |
$3,768,780 |
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Change To Net County Cost |
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$0 |
Fiscal Impact/Change to Net County Cost: The County of El Dorado payment for health care services to indigent adults ($3,535,288) is taken from the County’s Health Realignment funds prior to realignment being transferred to the County. The County participation fee ($233,492) is specified in California Welfare and Institution Code 16809.5 (d), which notes that the participation fee payments "shall not be paid for with funds from the health account of the local health and welfare trust fund established pursuant to Section 17600.10." Accordingly, County General Funds are used to support payment of the County's participation fee. This payment is recorded in Health Services Department Index 406100; County General Funds are transferred to Index 406100 via Subobject 2020, Operating Transfer In.
Background: Pursuant to the California Welfare and Institution Code Section 17000, “every county and every city and county shall relieve and support all incompetent, poor, indigent persons, and those incapacitated by age, disease, or accident, lawfully resident therein, when such persons are not supported and relieved by their relatives or friends, by their own means, or by state hospitals or other state or private institutions.”
"In 1982, California law was amended to eliminate the medically indigent adult (MIA) category of Medi-Cal eligibility and this population became the responsibility of counties under California Welfare and Institutions Code (“WIC”) Section 17000. The County Medical Services Program (CMSP) was established in 1983 to assist counties with populations below 300,000 to address the health care needs of medically indigent adults. Currently, thirty-four (34) counties participate in CMSP. Counties entered into a County Participation Agreement with the State Department of Health Services (State DHS) to participate in CMSP. County representatives provided advice on the CMSP program through participation on the Small County Advisory Committee, which was established by State DHS.
In 1995, the CMSP Governing Board (Governing Board) was established by California law to govern CMSP. The Governing Board replaced the Small County Advisory Committee and assumed overall policy and fiscal responsibility for CMSP, including setting CMSP beneficiary eligibility standards, covered benefits, and health care provider payment rates. The Governing Board is composed of eleven (11) members; ten (10) are county officials elected by the CMSP counties and one is an ex-officio, non-voting representative of the California Health and Human Services Agency Secretary.” (Background information provided by CMSP - attached)
The County of El Dorado has participated in the CMSP program since 1995 and has found it to be a cost effective method for providing health coverage for low-income, indigent adult residents in the County. While the Health Services Department manages the Agreement with CMSP, the Department of Human Services provides eligibility determination and processing for the eligible residents of the County of El Dorado.
Over the past several months, CMSP has worked collaboratively with the participating counties to revise and update the Participating County Contract. The Department now presents this Amended and Restated Participating County contract, to be effective July 1, 2010.
Reason for Recommendation: Approval of this Agreement will enable the County to continue meeting its obligations under Welfare and Institutions Code Section 17000 to ensure health care services for low-income, indigent adults in the County of El Dorado.
Action to be taken following Board approval:
1. Chair to sign three (3) original Agreements 032-125-P-E2010.
2. Board Clerk’s Office to return three (3) signed original documents to Department to meet submission deadline of June 11, 2010.
3. Board Clerk’s Office to provide a certified copy of Board minutes authorizing Chair signature on Agreement.
4. Department to submit one (1) certified copy of Board minutes and three (3) signed Agreements to CMSP Governing Board for final execution.
5. Upon receipt of a fully executed Agreement from CMSP, Department to return one (1) original to Board Clerk’s Office.
Contact: Kathy Lang
Concurrences: County Counsel