Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  23-000965

 

MEETING DATE:

01/09/24

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):

Regina ChinsioKwong (714) 834-2729 

 

 

Debra Baetz (714) 834-2830

 

 

Subject:  Approve Intergovernmental Transfer Agreement with CalOptima Health

 

      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:   No

    Current Fiscal Year Revenue: N/A

   Funding Source:     N/A

County Audit in last 3 years: No

   Levine Act Review Completed: N/A

 

    Prior Board Action:         12/5/2023 #7

 

RECOMMENDED ACTION(S):

 

 

1.

Approve the Intergovernmental Transfer Agreement with the Orange County Health Authority dba CalOptima Health for participation in an Intergovernmental Transfer to obtain federal reimbursement for uncompensated care provided to their patients January 1, 2022, through December 31, 2022.

 

2.

Authorize the Health Care Agency Director or Deputized designee to execute the Agreement referenced in Recommended Action above.

 

 

 

 

SUMMARY:

 

Approve to participate in an Intergovernmental Transfer will result in the reimbursement for uncompensated health care provided to Medi-Cal patients.

 

 

 

BACKGROUND INFORMATION:

 

Rate range Intergovernmental Transfers (IGT) began statewide in 2006 and have been used by other counties in California to offset the cost of uncompensated health care provided by county health departments, public hospitals and other local care providers. The Federal Centers for Medicare & Medicaid Services (CMS) provides a rate range for Medi-Cal managed care services, but the actual reimbursement rates that plans receive are set by the California Department of Health Care Services (DHCS). The difference between the federal allowable rate and state actual rate represents the potential amount of federal reimbursement that counties can claim through a rate range IGT. The Health Care Agency (HCA) was invited by the Orange County Health Authority dba CalOptima Health (CalOptima) to participate in an IGT to obtain federal reimbursement for uncompensated health care provided to their patients during the period of January 1, 2022, through December 31, 2022. The reimbursement by CMS is a dollar-for-dollar match of non-federal funds, which combined covers the cost of eligible healthcare expenditures incurred. In this instance, the net proceeds are shared between CalOptima and HCA.

 

CalOptima, in collaboration with the University of California, Irvine Medical Center, has participated in IGTs since FY 2010-11. To optimize Orange County's drawdown of federal funds, CalOptima extended the IGT opportunity to HCA beginning with FY 2014-15. On December 5, 2023, your Honorable Board of Supervisors (Board) approved HCA’s IGT Agreement with DHCS, which authorized HCA to transfer approximately $4 million to the state. Approval of this Agreement with CalOptima will allow CalOptima to transfer to HCA the estimated $7 million in federal matching funds for a total return of approximately $11 million, as specified in the Agreement with DHCS approved by the Board on December 5, 2023. The state Agreement was brought to the Board on December 5, 2023, to meet the December 8, 2023, deadline required by DHCS. The CalOptima Agreement referenced in the recommended action was not received in time to include with the state Agreement approved on December 5, 2023.

 

Because this federal funding is intended to offset Public Health expenditures, all funds received will be used to support Public Health initiatives in Orange County. Funds received by HCA will offset net County costs to support Public Health Services that promote health and prevent the spread of communicable diseases.

 

The term of this Agreement is January 1, 2022, through June 30, 2025, and the IGT payment represents compensation for covered services rendered to Medi-Cal Plan members between January 1, 2022, and December 31, 2022. No funds will be transferred from CalOptima to HCA until this Agreement is fully executed.

 

The Agreement with CalOptima contains a mutual indemnification provision, which varies from the County's standard of sole indemnification, thereby obligating both parties to indemnify, defend and hold harmless each other from all third-party claims and liabilities arising from the parties' performance of the IGT Agreement. CEO/Office of Risk Management has reviewed and approved this provision and determined the risk to be acceptable for the County's obligations under the Agreement.

 

HCA requests approval of the IGT Agreement with CalOptima and associated actions referenced in the Recommended Actions.

 

 

 

 

FINANCIAL IMPACT:

 

 

N/A

 

 

 

STAFFING IMPACT:

 

N/A

 

 

 

ATTACHMENT(S):

 

Attachment A - Intergovernmental Transfer Agreement with the Orange County Health Authority dba CalOptima
Attachment B - Risk Assessment Form