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Receive a presentation from Partnership HealthPlan of California (PHC), Solano County’s managed care plan that administers Medi-Cal benefits through local care providers to ensure members have access to high-quality, comprehensive, cost-effective health care
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Published Notice Required? Yes _____ No __X__
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health & Social Services (H&SS) recommends that the Board receive a presentation from Partnership HealthPlan of California (PHC), Solano County’s managed care plan that administers Medi-Cal benefits through local care providers to ensure members have access to high-quality, comprehensive, cost-effective health care.
SUMMARY/DISCUSSION:
Partnership HealthPlan of California (PHC) is a non-profit community-based health care organization that contracts with the State to administer Medi-Cal benefits through local care providers ensuring Medi-Cal recipients have access to comprehensive, cost-effective health care. In 1994, the Solano Health Partnership (the predecessor of Partnership HealthPlan) began serving residents in Solano as a County Organized Health System. The Solano Coalition for Better Health, a community stakeholder group, founded Partnership HealthPlan. In 1998, the Solano Health Partnership expanded into Napa County and changed its name to Partnership Health Plan of California. PHC has further expanded and now services fourteen (14) Northern California counties: Del Norte, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Shasta, Siskiyou, Solano, Sonoma, Trinity, and Yolo.
As a County Organized Health System (COHS), the goals of PHC are to improve access, quality, and efficiency and provides health care to over 549,7000 Medi-Cal members. PHC has invested $4.9 million toward increasing access to housing, $250,000 through the Social Determinants of Health Grant for La Clinica transitional housing and has participated in four (4) community outreach events. Through the PHC Quality Improvement Program, over $11 million has gone to improving outcomes for Medi-Cal members through various projects for physicians, primary care providers, and specialists. The PHC Quality and Performance Improvement Program provides a systematic process to monitor clinical and service aspects of health care delivery. It includes a structured framework to review activities to identify opportunities to improve the quality of health care services, promote efficient and effective use of health plan financial resources, and to improve health outcomes.
Partnership HealthPlan of California Priorities
• Wellness and Recovery Benefit - provides the full continuum of substance use care for Medi-Cal members. The benefit will go beyond the current network of limited outpatient; intensive outpatient, and narcotic treatment (methadone) programs to include withdrawal management, medication-assisted treatment, residential care and case management services.
• Transition to Whole Child Model - a program developed by the State of California for California Children Services (CCS). Members who have been receiving CCS care will get these services through PHC Whole Child Model program in which a child care’s needs will be coordinated, approved, and paid by one organization.
• Public Charge - PHC’s mission is to help members and communities be healthy and continues to express opposition towards the proposed federal change that would allow non-cash benefits to be considered in determining whether an individual is a public charge and thus prevent an individual from adjusting immigration status.
• The Healthcare Effectiveness Data and Inormation Set (HEDIS) - a tool created by the National Committee for Quality Assurance (NCQA) to measure the performance of health plans on the quality of care and services provided to members. HEDIS allows PHC to identify best practice areas and where to focus improvement efforts.
• National Committee for Quality Assurance (NCQA) - nonprofit organization that works to improve health care quality through the administration of evidence-based standards, programs, and accreditation. PHC would maintain or improve its accreditation status rating
FINANCIAL IMPACT:
The costs associated with preparing the staff report are included in the Department’s FY2018/19 Adopted Budget. There is no additional financial impact to the County General Fund.
ALTERNATIVES:
The Board may choose not to receive this presentation. This is not recommended as this is an opportunity to provide an update from Partnership HealthPlan of California
OTHER AGENCY INVOLVEMENT:
The Department of Health & Social Services and Partnership HealthPlan of California worked collaboratively on this Board item.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION