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Agenda Item
ASR
Control 11-001539 |
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MEETING DATE: |
10/04/11 |
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legal entity taking action: |
Board of Supervisors |
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board of supervisors
district(s): |
All Districts |
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SUBMITTING
Agency/Department: |
County Counsel
(Approved) |
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Department contact
person(s): |
Paul Albarian (714) 834-3309 |
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Subject:
OC Health Authority Ordinance
Amendments
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ceo Concur |
County
Counsel Review |
Clerk of the Board |
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Concur |
Approved Ordinance to Form |
Discussion |
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3 Votes Board Majority |
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Budgeted: N/A |
Current Year Cost:
N/A |
Annual Cost:
N/A |
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Staffing Impact: No |
# of Positions:
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Sole Source:
N/A |
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Current Fiscal Year Revenue: N/A |
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Funding Source: N/A |
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Prior Board Action: 4/19/11
#33: 5/3/11 #47 |
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RECOMMENDED ACTION(S):
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1. |
Read title of Ordinance: “An Ordinance of the County of Orange amending Sections 4-11-11, 4-11-12 and 4-11-16 to the Codified Ordinances of the County of Orange Regarding the Orange County Health Authority.” |
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2. |
Order that further reading of the Ordinance be waived |
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3. |
Consider the matter |
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4. |
Direct that the Ordinance be placed on agenda of the next regularly scheduled Board meeting for adoption. |
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5. |
At the set time, consider the matter and adopt the Ordinance. |
SUMMARY:
Request to amend Sections 4-11-11, 4-11-12 and 4-11-16 of Article 3 of Division 11 of Title 4, and modify the selection and qualification requirements for members of the CalOPTIMA Board of Directors and to establish the staggering of CalOPTIMA Board of Director term expirations and appointments to ensure that no more than 50% of the terms of the Board of Directors expire at the same time.
BACKGROUND INFORMATION:
The County of Orange created CalOPTIMA as a health care delivery system by Ordinance No. 3896 in 1993. The statutory purpose of CalOPTIMA is to “negotiate exclusive contracts with the California Medical Assistance commission and to arrange for the provision of health care services to qualifying individuals who lack sufficient annual income to meet the cost of healthcare, and whose other assets are so limited that their application toward the cost of health care would jeopardize the person's or family's future minimum self-maintenance and security.” (Codified Ordinances, Section 4-11-2(a)).
The Ordinance creating CalOPTIMA directs that it is to design a program that performs a number of different functions, including: (1) incorporating managed care concepts and providing prevention, education and early intervention services; (2) creating mechanisms for access to health care services for culturally and linguistically diverse populations; (3) involving the health care institutions; (4) providing a system for recipients to select a primary care provider; (5) including special care management components; (6) incorporating a plan of service delivery and implementing reimbursement mechanisms that will assure the long-term viability of a locally operated Medi-Cal system; and (7) implementing a financial plan that includes the creation and maintenance of a prudent reserve, expansion of access, improvement of benefits, and augmentation of provider reimbursement.
In short, CalOPTIMA is a complex health insurance managed care company.
As designed by the Ordinance, the governing body of CalOPTIMA is a Board of Directors, consisting of nine (9) voting members who are legal residents of Orange County and who “shall be generally representative of the diverse backgrounds, interests and demography of persons residing in the County.” Furthermore, members of the Board of Directors “shall have a commitment to a health care system which seeks to improve access to high-quality health care” and “which in fact delivers high-quality care and is financially viable. Members of the Board of Directors shall possess the requisite skills and knowledge necessary to design and operate a quality publicly assisted health care delivery system.” (Codified Ordinances, Section 4-11-11(b)).
On December 16, 2008, the Board of Supervisors approved an amendment to Section 4-11-11 and created a five (5) member Selection Panel for the Board of Directors appointment process. The currently proposed changes seek to ensure an independent and well qualified CalOPTIMA Board of Directors to effectively provide leadership and direction to CalOPTIMA. These changes also reduce the potential for conflicts of interest, which will further enhance CalOPTIMA Board of Director leadership. Moreover, by staggering the expiration and appointment of Board of Director members, these changes serve to ensure that no more than 50% of the Board of Directors terms expire at the same time.
FINANCIAL IMPACT:
N/A
STAFFING IMPACT:
N/A
ATTACHMENT(S):
Attachment 1:
Redlined Amendment of Codified Ordinances Sections 4-11-11, 4-11-12 and
4-11-16 in regard to the Orange County Health Authority.
Attachment 2: Final Proposed Amendments to Ordinance