Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Srija Srinivasan, Director, Family Health Services and Health Coverage Unit
Subject: Correction to a Resolution for the County Children’s Health Initiative Program
RECOMMENDATION:
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Adopt a resolution replacing Resolution Number 075471 and authorizing an agreement with the California Department of Health Care Services to provide funding for the County Children’s Health Initiative Program for the term of July 1, 2015 through September 30, 2019, in the amount of $16,410,038.
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BACKGROUND:
Since 2005, as part of our county’s efforts to sustain universal health insurance for children, your Board executed agreements with the State of California to enable a portion of the local Healthy Kids (HK) children’s insurance program to receive federal reimbursement. The County Children's Health Insurance Program (C-CHIP) is a collaboration between the State and San Mateo County to provide federal funding for children's health insurance that meets federal and state requirements. San Mateo, San Francisco, and Santa Clara counties are the only three California counties that pursued such an arrangement to support our local children’s health insurance programs. The State of California changed the administration of this program as part of larger changes that unified children’s coverage within the State Medicaid program, Medi-Cal, and to comply with an Affordable Care Act (ACA) provision that required insurance programs preceding the ACA to be maintained in the manner that existed before the ACA.
Your Board executed an agreement with the State in February 2015 that aligned with this “maintenance of effort” provision with the State bearing the financial responsibility for the non-Federal costs of the program; the term of that agreement was from January 1, 2014 through June 30, 2015.
Your Board adopted a Resolution authorizing the Health System Chief to execute an agreement with the State on September 26, 2017 to administer this program for the period July 1, 2015 through September 30, 2019.
DISCUSSION:
The packet prepared for the September 26, 2017 action by your Board required the submission of the memorandum and resolution document prior to when we received the Agreement from the State. We estimated the fiscal impact based on the data available to us at the time, without information about the State’s fiscal projection methodology. This sequencing was necessary to facilitate processing of the State-required contract document by September 30, 2017, which was a deadline for State payment of invoices for the July 1 through September 30, 2015 time period.
The State requires a corrected Resolution, with an amended total of $16,410,038 in estimated revenues, to meet its fiscal and contractual responsibilities. To minimize any further delay, the Health Coverage Unit (HCU) is seeking authorization for the Health System Chief to sign the agreement in lieu of your Board.
The Health System also requests that your Board authorize the Chief of the Health System or designee to execute contract amendments which modify the County’s maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.
The Resolution has been reviewed and approved by County Counsel as to form.
Approval of this agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing affordable health insurance to children who are not eligible for full scope Medi-Cal or a subsidized insurance plan through Covered California. We anticipate 1,100 of our 1,300 Healthy Kids enrollees to be enrolled in CCHIP.
PERFORMANCE MEASURE:
|
Measure |
FY 2016-17 Actual |
FY 2017-18 Projected |
|
Number of children enrolled in Healthy Kids to be enrolled in CCHIP |
1,000 |
1,100 |
FISCAL IMPACT:
There is no fiscal impact to this Resolution correction, as the estimated fiscal impact to the County remains unchanged.
The term of this agreement is July 1, 2015 to September 30, 2019. The amount of the agreement is $16,410,038 for a 51-month term. The amount claimed each year is dependent on the number of children enrolled; funds in an amount of $1,927,800 are included in the HCU FY 2017-18 Adopted Budget. Similar arrangements will be made in future HCU budgets. Since the County is receiving this funding, there is no Net County Cost.