Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, Health System
Carlos Morales, Director, Correctional Health
Subject: Resolution Authorizing the Controller to Pay Non-Contract Medical Service Providers at Non-County Facilities to Provide Services to County Inmates
RECOMMENDATION:
title
Adopt a resolution authorizing the Controller to pay non-contract medical service providers at non-County facilities to provide services to County inmates not available at a County site for the term July 1, 2018 through to June 30, 2023, in an amount not to exceed $2,500,000.
body
BACKGROUND:
Since 1980, your Board has authorized the Controller to pay non-contract medical service providers at non-County facilities to provide services to County inmates when San Mateo Medical Center (SMMC) or a contracted medical care provider is unable to provide the necessary level of care.
Specific to Correctional Health Services (CHS), California Assembly Bill 658 (AB658) (enacted July 16, 2015) authorizes hospitals that do not contract with the county sheriffs, police chief, or other public agency to provide emergency health care services to local law enforcement patients at a rate equal to 110 percent of the hospital’s actual costs, according to the most recent Hospital Annual Financial Data report issued by the Office of Statewide Health Planning and Development, as calculated using a cost-to-charge ratio.
DISCUSSION:
As a result of criminal justice realignment and changes in sentencing laws, inmates are staying in the correctional facilities longer, requiring more medical care for which the County is financially responsible. Additionally, due to similar factors, we are seeing an increase in patient acuity, e.g. oncology treatment, stroke, and neurological cases. As SMMC is not a stroke designated center, first responders either transport the inmates directly to a stroke certified center or SMMC sends these patients out upon evaluation.
Due to the trending medical needs of the inmate population that are serving longer sentences at the County jail and in accordance with AB658 billing rates, CHS’ outside hospital costs have averaged $500,000 per year during the last 3 years. While the Medi-Cal County Inmate Program has allowed outside providers to claim Medi-Cal reimbursement for inpatient costs (i.e. lowering the responsible amount for CHS), outpatient costs are still not reimbursable and continue to increase.
CHS requests that your Board adopt this Resolution for a five-year term, effective through June 30, 2023. The longer term and resolution has been approved by County Counsel as to form.
The agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by addressing the need for highly specialized medical services to County patients. It is anticipated that less than 25% of County patients will be referred to non-contract medical service providers for specialty care services.
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Estimated |
FY 2019-20 Projected |
|
Percentage of patients referred to non-contract medical services providers for specialty care services |
<20% 200 patients |
<25% 250 patients |
FISCAL IMPACT:
Total authorized expenditure under the Resolution is not to exceed $2,500,000 for the period of July 1, 2018 through June 30, 2023. Inmate medical costs are funded by a combination of Health Realignment funds and Net County Costs. The cost of outside hospital costs will be included the CHS FY Recommended 2018-19 Budget and future Recommended Budget years.