Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  18-000283

 

MEETING DATE:

05/08/18

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Anna Peters (714) 834-5150 

 

 

Richard Sanchez (714) 834-2830

 

 

Subject:  Medi-Cal Administrative Activities and Targeted Case Management Agreements

 

      ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: N/A

Current Year Cost: N/A

Annual Cost: FY 2018-19 $1,750,000
FY 2019-20 $1,750,000

 

 

 

    Staffing Impact:

No

# of Positions:

Sole Source: No

    Current Fiscal Year Revenue: N/A

  Funding Source: FED: 100% (MAA/TCM)

County Audit in last 3 years: No

 

 

    Prior Board Action: 6/2/2015 #29

 

RECOMMENDED ACTION(S):

 

 

1.

Approve the Master Agreement for Provision of Medi-Cal Administrative Activities for the period of July 1, 2018, through June 30, 2020.

 

2.

Approve the Master Agreement for Provision of Targeted Case Management Services for the period of July 1, 2018, through June 30, 2020.

 

3.

Authorize the Health Care Agency Director, or designee to execute the individual Agreements for Medi-Cal Administrative Activities and Targeted Case Management Services as referenced in the Recommended Actions above.

 

 

 

 

SUMMARY:

 

Approval of the Master Agreements for Medi-Cal Administrative Activities and Targeted Case Management Services between the County and various participating community based organizations will improve the availability and accessibility of needed medical, social, educational, and other services to Medi-Cal eligible and potentially eligible individuals served by those organizations.

 

 

 

BACKGROUND INFORMATION:

 

The proposed Master Agreements for provision of Medi-Cal Administrative Activities (MAA) and Targeted Case Management (TCM) Services were prepared in recognition that community-based agencies are uniquely qualified to assist the County to improve the availability and accessibility of needed medical, social, educational, and other services to Medi-Cal eligible and potentially eligible individuals served by those agencies. Under these Agreements, the Health Care Agency (HCA) will contract with qualified individual community-based organizations for provision of MAA and/or TCM services they provide. Each community-based organization has entered into a separate agreement with the Orange County Children and Families Commission to provide said services and Commission is responsible for monitoring outcomes. HCA is designated as the Local Government Agency for this program and responsible for submitting all claims on behalf of the community-based organizations who have current service contracts with the Commission.  Therefore, MAA TCM Agreements are not solicited through the RFP process.  On June 2, 2015, your Honorable Board approved the Master Agreements for the provision of Medi-Cal Administrative Activities and Targeted Case Management Services for the period of July 1, 2015, through June 30, 2018.

 

MAA activities include outreach to potentially eligible Medi-Cal individuals about available Medi-Cal services; assistance to individuals in accessing and enrolling in Medi-Cal/Healthy Families programs; arranging transportation for Medi-Cal eligible individuals to Medi-Cal services; and participation in countywide efforts in program planning and policy development related to the expansion of Medi-Cal services. TCM services are case management services that assist Medi-Cal eligible individuals in defined target groups to gain access to needed medical, social, educational and other services.

 

Agencies that participate in MAA and TCM have benefited the community by developing strategies to increase system capacity, close service gaps, promote inter-agency coordination, and increased overall fiscal stability as well as allowing flexibility and responsiveness of community-based agencies during fluctuating economic conditions. As a result, children and their families have increased access to community health prevention and medical services. Services and outcomes are monitored by the Children and Families Commission of Orange County.

The Federal government provides reimbursement of expenditures for MAA and TCM as authorized by Title XIX; local programs are administered by the Department of Health Care Services through HCA, as the Local Governmental Agency.  It is anticipated that the following providers will participate in the MAA/TCM program under these master agreements as these providers have agreements with the Children and Families Commission of Orange County, whose State Prop 10 funding is used as certified public expenditures to claim Federal MAA/TCM funds.

 

MAA Providers

Location

Anaheim Regional Medical Centers

Anaheim

Anaheim Global Medical Center

Anaheim

Family Support Network

Placentia

Fountain Valley Regional Hospital and Medical Center

Fountain Valley

Garden Grove Hospital and Medical Center

Garden Grove

Community Health Initiative of Orange County

Santa Ana

Children and Families Commission of Orange County

Santa Ana

St. Joseph Hospital of Orange

Orange

Mission Hospital Regional Medical Center

Mission Viejo

Orange County Global Medical Center

Santa Ana

South Coast Global Medical Center

Santa Ana

 

TCM Providers

 

Location

Children's Bureau of Southern California

Anaheim

Orange County Child Abuse Prevention Center, Inc.

Orange

 

The proposed Agreements will be executed between the County and various Orange County community-based organizations which will enable the County to distribute approximately $1,750,000 annually of revenue received to the providers for MAA/TCM activities.  Funds disbursed as a result of these Agreements are intended to support health access and related services, including MAA/TCM activities.  

 

This contract does not include subcontractors or pass through to other providers, See Attachments C &D for contract summaries.

 

The Health Care Agency requests your Honorable Board to approve the master Agreements for Provision of Medi-Cal Administrative Activities and Targeted Case Management Services as referenced in the Recommended Actions.

 

 

 

FINANCIAL IMPACT:

 

Appropriations and revenues are included in the FY 2018-19 Budget and will be included in the budgeting processes for future years.

 

 

STAFFING IMPACT:

 

N/A

 

ATTACHMENT(S):

 

Attachment A - Agreement for Provision of Medi-Cal Administrative Activities
Attachment B - Agreement for Provision of Targeted Case Management Services
Attachment C - Contract Summary to Attachment A
Attachment D - Contract Summary to Attachment B