Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  12-000379

 

MEETING DATE:

04/17/12

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):

Kim Engelby (714) 834-5264 

 

 

 

 

 

Subject:  Amendment: for Medi-Cal Administrative Activities - Agreement

 

      ceo Concur

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: Yes

Current Year Cost: N/A

Annual Cost: N/A

 

 

 

    Staffing Impact: No

# of Positions:

Sole Source: N/A

    Current Fiscal Year Revenue: FY 2011-12: $6,500,000

    Funding Source: FED: 100%

 

    Prior Board Action: 6/2/2009 #50

 

RECOMMENDED ACTION(S):

 

 

1.

Approve the Amendment to the Standard Agreement No. 09-86031 with the State Department of Health Care Services in an annual amount not to exceed $6,500,000 for two additional fiscal years for the total amount of $32,500,000 during the period of July 1, 2009 through June 30, 2014.

 

2.

Authorize the Health Care Agency Director, or designee, on behalf of the Board of Supervisors, to execute Standard Agreement No. 09-86031-A01 and its exhibits.

 

3.

Authorize the Health Care Agency Director, or designee, on behalf of the Board of Supervisors, to execute the Contractor's Release form upon submission of the final invoice to the State Department of Health Care Services.

 

4.

Authorize the Health Care Agency Director, or designee, on behalf of the Board of Supervisors, to execute the LGA Consortium Participation Agreement and its exhibits in conjunction with and as a requirement of this agreement.

 

 

 

 

SUMMARY:

 

The Health Care Agency requests approval of Standard Agreement No. 09-86031-A01 (an extension of the prior board approved Standard Agreement no. 09-86031) with the State Department of Health Care Services for claiming reimbursement for allowable Medi-Cal Administrative Activities.

 

 

 

BACKGROUND INFORMATION:

 

The federal government provides reimbursement for Medi-Cal Administrative Activities (MAA) as authorized by Title XIX of the Social Security Act.  MAA are services and activities that assist Medi-Cal eligible individuals and their families in gaining access to health care, such as outreach and facilitating application.  The State Department of Health Care Services requires approval of an agreement, which establishes the terms and conditions under which the County of Orange could claim federal reimbursement for allowable MAA during the period of July 1, 2009 to June 30, 2014.

 

The Health Care Agency recently received the final version of the Extension Standard Agreement from the State.  The previous MAA agreement ends on June 30, 2012.  The actual revenue received will be based on quarterly claims submitted to the Department of Health Care Services.  The total maximum amount of the agreement is $32,500,000, broken down annually as follows:

 

 

FY 2009-10:

$6,500,000

 

FY 2010-11:

$6,500,000

 

FY 2011-12:

$6,500,000

 

FY 2012-13:

$6,500,000

 

FY 2013-14:

$6,500,000

 

In this agreement the indemnification provision differs from the County standard.  The State requires the County to indemnify them in order to receive funding.  CEO/Risk Management reviewed the State’s sole indemnification clause and found the risk to be acceptable to obtain funding.

 

This Standard Agreement contains the Contractor’s Release Form, which is submitted with the final invoice to the State after the contract term end. The form releases the State from further contract obligations and liability once final payment is received. Prior to submission, all contract-related services and accounting will be finalized by agency staff.  Delegation of authority for the Health Care Agency Director, or designee, to execute the Contractor's Release Form is requested.

 

As stated in Exhibit B Paragraph 5, as a condition of participating in the Medi-Cal Administrative Claiming Process, the Standard Agreement requires the County of Orange to pay an annual participation fee which is accomplished by way of entering into an agreement with the “Host” County designated by the State of California LGA Consortium.  All counties are required to be part of the consortium in order to bill MAA.  The rate of the participation fee is based on the proportional claiming volume by Orange County. This agreement, the LGA Consortium Participation Agreement, has been submitted to the Honorable Board and approved on a separate ASR in the past. 

 

The Health Care Agency requests that your Board approve the Standard Agreement with the State Department of Health Care Services and authorize the Health Care Agency Director, or designee, to execute the agreements, as referenced in the Recommended Actions.

 

 

 

FINANCIAL IMPACT:

 

This Agreement is included in the Health Care Agency's FY 2012-13 Requested Budget and will be included in the budgeting process for FY 2013-14.

 

 

 

STAFFING IMPACT:

 

N/A

 

ATTACHMENT(S):

 

A. Amendment to Agreement 09-86031-A01 with the Department of Health Care Services
B. Redline Version to Attachment A