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
Carlos Morales, Director, Correctional Health Services
Subject: Addendum to the Participation Agreement with Department of Health Care Services in the Medi-Cal County Inmate Program
RECOMMENDATION:
title
Adopt a resolution authorizing an addendum to the participation agreement with the State of California Department of Health Care Services in the Medi-Cal County Inmate Program for the term of July 1, 2020 to June 30, 2023.
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BACKGROUND:
In June 2014, this Board designated Correctional Health Services (CHS) as the entity to assist county jail inmates with their applications for health insurance affordability programs in accordance with Assembly Bill (AB) 720, Chapter 646, as part of California’s implementation of the Affordable Care Act. This effort was also implemented in order to leverage savings in preparation of the California Department of Health Care Services (DHCS) Medi-Cal County Inmate Program (MCIP), which consists of the following three programs:
• Adult County Inmate Program, authorized in AB1628 and added in Welfare and Institutions Code section 14503.7, provides Medi-Cal coverage to eligible adult county inmates for inpatient hospital services provided off the grounds of the correctional institutions. Claims eligible for this program are retroactive from November 1, 2010.
• Juvenile County Ward Program, authorized in AB396 and Senate Bill (SB) 695, and added in Welfare and Institutions Code section 14053.8, provides Medi-Cal coverage to eligible juvenile county wards for inpatient hospital and inpatient mental health services provided off the grounds of the correctional institutions. Claims eligible for this program are retroactive from January 1, 2012.
• County Compassionate Release Program and County Medical Probation Program, authorized in SB1462 and added in Government Code sections 26605.6, 26605.7, and 26605.8, permits county sheriffs to grant medical release or medical probation in lieu of jail time if certain conditions are met.
On June 10, 2020, DHCS released the fiscal year 2020-23 participation and administrative services agreement for Counties choosing to voluntarily participate in the fee-for service MCIP. In March 2022, DHCS incorporated the Alternative Formatting addendum (Addendum) into our existing participation agreement. The Addendum assures the state that the County complies with the Americans with Disabilities Act prohibiting discrimination on the basis of disability, as well as section 508 of the Rehabilitation Act of 1973. Specifically, electronic and printed documents intended as public communications are produced to ensure the visual-impaired, hearing-impaired, and other special needs audiences are provided material information in the formats needed to provide the most assistance, to make informed choices.
DISCUSSION:
It is now necessary to amend this agreement to incorporate the Addendum, in order to continue participating in the MCIP. Without the MCIP, CHS would be responsible for paying the cost of medical care of its inmates provided outside the correctional facilities. DHCS, as the state agency administering the MCIP, can draw federal funds for allowable services, such as inpatient hospital, psychiatric stays and physician services during the inpatient stay.
Non-contract Medi-Cal providers will directly bill DHCS for MCIP services, which DHCS will reimburse at the applicable Medi-Cal rate. DHCS will then seek and retain federal financial participation claimed for MCIP services and the County will reimburse DHCS for the nonfederal share of claims paid by DHCS to the Medi-Cal provider for MCIP services. When the medical services are provided by a Designated Public Hospital (DPH), such as the San Mateo Medical Center, the financial federal participation resulting from expenditures for the MCIP services will be claimed by the DPH under a certified public expenditure process. The County will also reimburse DHCS its apportioned share of the non-federal share for administrative costs incurred for the MCIP.
The addendum and resolution delegating signature authority for future amendments have been reviewed and approved by County Counsel as to form.
It is anticipated that CHS will complete Medi-Cal applications for 100% of those inmates requiring hospitalization.
PERFORMANCE MEASURE:
|
Measure |
FY 2021-22 Estimated |
FY 2022-23 Projected |
|
Percentage of Medi-Cal applications completed by CHS for inmates requiring hospitalization |
100% 96 inmates |
100% 96 inmates |
FISCAL IMPACT:
The term of the participating agreement remains July 1, 2020 to June 30, 2023. There is no Net County Cost associated with the addendum.