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 Center
Subject: Agreement with San Mateo Health Commission dba the Health Plan of San Mateo to Provide Medi-Cal Dental Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with San Mateo Health Commission dba the Health Plan of San Mateo to provide Medi-Cal dental services for Health Plan of San Mateo members for the term of January 1, 2022 through December 31, 2022.
body
BACKGROUND:
Senate Bill (SB) 849 (Chapter 47, Statutes of 2018), authorizes the Department of Health Care Services (DHCS) to establish a dental integration program in San Mateo County to test the provision of Medi-Cal dental services as a covered benefit of the Health Plan of San Mateo (HPSM). Medi-Cal beneficiaries in San Mateo County, with limited exceptions, will receive their dental care through HPSM beginning January 1, 2022. Beneficiaries will thereby be accessing both medical and dental benefits through one entity - HPSM. The purpose of this effort is to test the impact on oral care access, quality, utilization, and medical costs by delivering covered dental services as a Medi-Cal managed care benefit.
DISCUSSION:
As a result of the dental integration program enacted by DHCS, HPSM desires to enter into a provider agreement with San Mateo Medical Center (SMMC) to enable SMMC to continue to provide Medi-Cal dental services and receive reimbursement from HPSM for services provided to HPSM members.
County Counsel has reviewed and approved the resolution and agreement as to form.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
It is anticipated that dental revenue will increase to by 1.5%.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Actual |
FY 2021-22 Estimated |
|
Increase in dental revenue |
$4,950,757 |
$5,025,018 (1.5% year-on-year increase) |
FISCAL IMPACT:
The initial term of the agreement is January 1, 2022 through December 31, 2022.
Pursuant to its terms, the agreement automatically renews for successive twelve-month periods with the same terms and conditions, subject to any subsequent amendments.
This agreement has no fiscal impact over the FY 2021-22 Adopted and FY 2022-23 Recommended budgets.
There is no Net County Cost associated with this agreement.