Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Ccenter
Subject: Approve an Appropriation Transfer Request for the FY 18-19 Close
RECOMMENDATION:
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Approve an Appropriation Transfer Request (ATR) accepting unanticipated revenue from the Whole Person Care Program within Intergovernmental Revenue and transferring appropriation savings from Other Charges to Services and Supplies.
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BACKGROUND:
California’s 1115 Waiver Renewal, called Medi-Cal 2020 was approved by the Centers for Medicare and Medicaid Services (CMS) on December 30, 2015. One component of the Medi-Cal 2020 is the establishment of the Whole Person Care Pilots, a five-year (calendar years 2016-2020) initiative that seeks to provide a coordinated, efficient and effective delivery of care to San Mateo County’s highest-risk and vulnerable populations. Each Lead Entity implementing WPC including San Mateo County Health combines non-federal and federal share of expenditures in equal proportions to meet program goals.
Each Lead Entity receives their WPC funding by advancing non-federal funds through an intergovernmental transfer (IGT) in order to draw down an equal amount of federal financial participation (FFP) funds. The Department of Health Care Services (DHCS) notifies Lead Entities of the IGT and FFP amounts, as well as the due dates and payment dates. IGTs are due within 7 days of DHCS notification. If the IGTs are made within the requested timeframe, the IGT funds are matched by the federal government and the gross payment to the Lead Entity will made within 14 days of the IGT.
DISCUSSION:
Based on a calendar year budget of $33,073,542, San Mateo County Health is required to provide an annual IGT payment $16,536,771. Calendar year 2017 (second half of FY16-17& first half of 17-18) was a startup year for the pilot and several programs were slowly ramping up. The pilot therefore only drew down $11,581,604 and $4,955,167 had to rollover to calendar year 2018 (FY18-19). Because of the rollover funds, the IGT request was of a larger amount than originally anticipated. The State approved the use of the rollover funds and sent the most recent IGT notice in May 17, 2019 for the amount that exceeds SMMC’s spending authority by $1.05M.
Additionally, our year-end assessments of expenses projections for contract services necessitates an increase of spending authority of $1M. These projections are consistent with financials reported at the Hospital Board meetings.
FISCAL IMPACT:
There is no change to Net County Cost and in the County Contribution as the result of this ATR.