|
Agenda Item
ASR
Control 20-000475 |
||
|
MEETING DATE: |
06/23/20 |
|
|
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): |
Cheryl Meronk (714) 834-4099 |
|
|
|
Steve Thronson (714) 834-4418 |
|
Subject: Amendment 6 to Coordination
and Provision of Public Health Care Services
|
ceo CONCUR |
|
Clerk of the Board |
||||||||
|
Concur |
Approved Agreement to Form |
Consent Calendar |
||||||||
|
|
|
3 Votes Board Majority |
||||||||
|
|
|
|
||||||||
|
Budgeted: N/A |
Current Year Cost:
N/A |
Annual Cost:
N/A |
||||||||
|
|
|
|
||||||||
|
Staffing Impact: |
No |
# of Positions:
|
Sole Source:
N/A |
|||||||
|
Current Fiscal Year Revenue: N/A
|
||||||||||
|
Prior Board Action: 9/24/2019
#9, 2/26/2019 #20, 6/26/2018 #16, 5/21/2013 #17 |
||||||||||
RECOMMENDED ACTION(S):
|
1. |
Approve Amendment 6 to the Coordination and Provision of Public Health Care Services Contract between the County of Orange and Orange County Health Authority, a Public Agency, dba CalOptima, effective July 1, 2020. |
|
2. |
Authorize the Health Care Agency Director, or designee, to execute the Contract as referenced in the Recommended Action above. |
SUMMARY:
Approval of Amendment 6 to the Contract for Coordination and Provision of Public Health Care Services with Orange County Health Authority, a Public Agency, dba CalOptima will improve coordination of care for Whole Person Care Pilot clients who are enrolled in the CalOptima Health Homes Program.
BACKGROUND INFORMATION:
The Orange County Health Authority, a Public Agency, dba CalOptima (CalOptima) has a current contract with the State of California, Department of Health Care Services to arrange and pay for the provision of health care services to Medi-Cal eligible beneficiaries in Orange County.
On May 21, 2013, your Honorable Board of Supervisors (Board) approved the original contract effective June 1, 2013. The agreement authorized reimbursement to the Health Care Agency (HCA) for services to CalOptima beneficiaries. These services include pulmonary disease services, HIV services, sexually transmitted disease services and medical assistance pursuant to the Child Health and Disability Prevention/Early and Periodic Screening, Detection and Treatment program, family planning services, perinatal services, medical services to eligible clients under the California Children's Services and medical services to minors residing at the Orangewood Children's Home.
The First Amendment to the contract, effective July 1, 2015, incorporated Targeted Case Management services into the agreement.
The Second Amendment to the contract, approved by the Board on June 26, 2018, extended the contract through December 31, 2018, with the same terms and conditions.
On February 26, 2019, your Board ratified and approved the Third Amendment to the contract, effective January 1, 2019, which extended the contract through December 31, 2023, and updated contract language to address programmatic and regulatory changes.
The Fourth Amendment to the contract, effective August 1, 2019, was to reflect changes related to the Whole Child Model program.
On September 24, 2019, your Board approved the Fifth Amendment to the contract, effective July 1, 2019, which updated contract language to comply with the Department of Health Care Services subcontracting requirements as well as incorporated Medical Respite Care program services for CalOptima beneficiaries enrolled in the Whole Person Care (WPC) Program.
The Sixth Amendment proposes to add WPC/Health Homes Program (HHP) Crossover services to the Coordination and Provision of Public Health Care Services Contract and associated compensation to County for coordination and provision of these services, inclusive of associated administrative costs. It also includes a minor update to the Compensation attachment in order to clarify Vaccine For Children administration fees financial responsibility for members assigned to a Health Network. This portion is not related to WPC or HHP Crossover services.
The Amendment is being submitted for Board approval less than 30 days prior to the start of the contract because CalOptima and HCA were not in agreement on the WPC and HHP clients to be covered under this arrangement. The amendment only covers those clients that are enrolled in the CalOptima Direct/CalOptima Community Network. HCA and CalOptima will continue to work together regarding those clients that are enrolled in the other CalOptima networks.
HCA requests that the Board approve the Amendment 6 to the Coordination and Provision of Public Health Care Services Contract with CalOptima as referenced in the Recommended Actions.
FINANCIAL IMPACT:
Revenue for this Contract will be absorbed in Budget Control 042 FY 2020-21 Budget and will be included in the budgeting process for future years.
It is estimated that funding for these services represents less than ten percent of the contractor's total annual operating budget. Should services need to be reduced or terminated due to lack of funding, this contract contains language that allows HCA to give 30 days' notice to either terminate or renegotiate the level of services to be provided. The notice will allow HCA adequate time to transition or terminate services to clients, if necessary. HCA staff has reviewed the contractor’s financial documentation, including their most recent financial statements. At this time, there appears to be no issues that would impact the contractor’s ability to perform the services.
STAFFING IMPACT:
N/A
ATTACHMENT(S):
Attachment A - Amendment 6 to Coordination and Provision
of Public Health Care Services Contract between County of Orange and Orange
County Health Authority, dba CalOptima
Attachment B - Contract Summary Form
Attachment C - Redline Version to Attachment A