Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Gina Wilson, Chief Financial Officer, San Mateo County Health
Subject: Participant Agreement Between the Department of Health Care Services and the County of San Mateo
RECOMMENDATION:
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Adopt a resolution authorizing the execution of a participant agreement with the Department of Health Care Services to permit the Local Governmental Agency to participate in the County-Based Medi-Cal Administrative Activities program effective July 1, 2022, with no termination date and/or dollar obligation.
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BACKGROUND:
The County-Based Medi-Cal Administrative Activities (CMAA) program became a Medi-Cal program on January 1, 1995, pursuant to Welfare and Institutions Code § 14132.47. This program allows local governmental agencies to receive federal reimbursement for the cost of performing administrative activities that directly support efforts to identify and enroll potential eligible individuals into Medi-Cal.
Through the CMAA program, the Department of Health Care Services (DHCS) and individual county agencies promote access to healthcare for clients in the county public health system, minimize healthcare costs and long-term healthcare needs for at-risk populations, and coordinate client healthcare needs with other healthcare providers. CMAA activities include but are not limited to conducting Medi-Cal outreach, facilitating Medi-Cal eligibility determinations, Medi-Cal program planning, and Medi-Cal contract administration.
San Mateo County Health has participated in this program for many years. Past agreements were time-limited and signed by the Chief of County Health.
The current agreement has a termination date of June 30, 2025. Upon execution of this participant agreement, both Local Governmental Agency and DHCS agree to abandon and terminate the current agreement.
DISCUSSION:
The program has been stable for many years with minimal changes to the agreement. As such, the State has decided to move to an “evergreen” format in which the agreement with the County would never expire. Should circumstances change, there is a 30-day termination clause if needed.
County Health’s participation in this program currently consists of 13 claiming plans across County Health divisions as well as County Probation.
The resolution contains the County’s standard provision allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
It is anticipated that the net revenue generated by participation in the CMAA program will be $14,724,010. County Health expects a slight decline in revenue as the State implements a new technology system that will more precisely determine eligibility percentages, reducing reimbursement.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Actual |
FY 2022-23 Estimated |
|
Net revenue generated by participation in the CMAA program |
$15,299,138 |
$14,724,010 |
FISCAL IMPACT:
This is an “evergreen” agreement with no end date. Claiming for this program is done in arrears. For the most fully complete claiming period, FY 2020-21, total expenses used in the CMAA claims were $77,100,000, with a return of $15,300,000 in CMAA revenue. Of the $77,100,000 in expenses, Net County Cost funded $50,500,000 of those expenses. These funds were included in the prior budget periods, and similar arrangements will be made for future years.