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Health Services Department, Mental Health Division, recommending the Board authorize the Chair to sign Agreement 038-S1011 with Blue Cross of California for the term August 15, 2010 through June 30, 2011 to provide reimbursement to the county for CMSP-eligible patients receiving treatment in the Psychiatric Health Facility.
FUNDING: Payments from Blue Cross for services provided.
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Fiscal Impact/Change to Net County Cost: This is a revenue generating agreement. There is no Net County Cost associated with this Agreement.
Contract Termination: This Agreement includes a provision for either party to terminate the Agreement without cause in ninety (90) days upon written notice.
Reason for Recommendation: 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. CMSP is funded by realignment revenue (motor vehicle license fees and sales tax). County General Funds are used to support payment of the County’s participation fee in CMSP (budgeted at $233,492 for FY 2010-11).
The Governing Board of CMSP is in the process of implementing agreements with selected Psychiatric Health Facilities (PHFs) to provide inpatient mental health services to CMSP eligible members. Without this agreement, CMSP will not reimburse the County for PHF services provided to otherwise eligible CMSP patients. CMSP eligible individuals are ages 21 through 64 who reside in a participating county, have incomes at or below 200% of the federal poverty level, and are not eligible for Medi-Cal benefits.
Blue Cross of California is acting as third party administra...
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