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Approve an agreement with the California Department of Health Care Services effective July 1, 2026 to participate in the Medi-Cal County Inmate Program; Approve a separate administrative services agreement with the California Department of Health Care Services for the period July 1, 2026 through June 30, 2029; Authorize the County Administrator to execute both agreements and any amendments including changes to terms and conditions and scope of services, with County Counsel concurrence; and Authorize the Sheriff or his designee to execute the 2029 County Participation Form to inform the California Department of Health Care Services of the County’s intent to continue participation in the program for the subsequent State fiscal years
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Published Notice Required? Yes ____ No _X _
Public Hearing Required? Yes ____ No _X _
DEPARTMENTAL RECOMMENDATION:
The Sheriff’s Office recommends that the Board of Supervisors:
1. Approve agreement number 26-MCIPSOLANO-48 with the California Department of Health Care Services effective July 1, 2026, to participate in the Medi-Cal County Inmate Program;
2. Approve a separate administrative services agreement with the California Department of Health Care Services for the period July 1, 2026, through June 30, 2029;
3. Authorize the County Administrator to execute both agreements and any amendments including changes to terms and conditions and scope of services, with County Counsel concurrence; and
4. Authorize the Sheriff or his designee to execute the 2029 County Participation Form to inform the California Department of Health Care Services of the County’s intent to continue participation in the program for the subsequent State fiscal years.
SUMMARY:
The Medi-Cal County Inmate Program (MCIP) is a voluntary, fee-for-service only program administered by the California Department of Health Care Services (DHCS) that allows counties or medical providers to draw down federal Medicaid funding for inmates who are treated for more than 24 hours at medical facilities that are offsite or separate from county jails. The MCIP consequently creates budgetary savings for the County for the medical care provided to its Medi-Cal eligible inmates.
Solano County has participated in MCIP since April 2017 and in May 2026, the County submitted a County Participation Form for State Fiscal Years 2026 - 2029 which indicated that the County was interested in voluntarily participating in the MCIP from July 1, 2026, through June 30, 2029. Continued participation requires the Board of Supervisors to approve the MCIP agreement and return the signed agreement and a meeting minute order indicating Board approval to DHCS. Additionally, the Board of Supervisors is required to approve a separate agreement for administrative services provided by DHCS.
FINANCIAL IMPACT:
Under MCIP, the County's inmate medical provider, California Forensic Medical Group (CFMG) otherwise known as Wellpath, realizes savings for inpatient hospitalization or medical care costs they would have otherwise paid. CFMG pays the County the quarterly non-federal share invoiced by DHCS and 85% of the Medi-Cal payment made to Northbay, retaining the remaining amount for CFMG’s administrative costs. In order to participate in the MCIP program, the County is charged a 5% state administrative fee which is entirely offset by CFMG reimbursement.
Board approval will not impact the County General Fund; however, non-approval will negatively impact County General Fund as the Sheriff's FY2026/27 Requested Budget includes $150,000 in revenue from CFMG for inmates covered under MCIP.
To date, Solano County has received $1,343,764 from CFMG for participation in the MCIP program through May 18, 2026, for inmates who received inpatient medical treatment. Additionally, there is $385,425 due in payments from CFMG for the period July 1, 2020, through June 30, 2024. The claims reimbursement process can be lengthy, given that a Medi-Cal provider only submits claims after all eligible costs have been determined, and the State’s release of funds is predicated on the review and appeals process.
The costs associated with preparing this agenda item are nominal and absorbed by the department’s FY2026/27 Working Budget.
DISCUSSION:
The MCIP is a voluntary, fee-for-service only program administered by the DHCS that allows counties or medical providers to draw down federal Medicaid funding for inmates who are treated for more than 24 hours at medical facilities that are offsite or separate from county jails. The MCIP consequently creates budgetary savings for the County for the medical care provided to its Medi-Cal eligible inmates.
Since FY2016/17, with Board approval, the County has participated in the Adult County Inmate Program under the MCIP. The current contract with CFMG, the County’s contract inmate medical provider, is a full cost model, under which CFMG is required to pay for inpatient medical treatment if they approve the treatment. Under MCIP, instead of billing CFMG for treatment, NorthBay seeks reimbursement from the State under Medi-Cal, enabling CFMG to realize savings. Since CFMG benefits from lower inmate medical costs resulting from accepted MCIP claims, CFMG pays the County the quarterly non-federal share invoiced by DHCS and 85% of the Medi-Cal payment made to Northbay, retaining the remaining amount for CFMG’s administrative costs. The retention by CFMG is a standard administrative fee for MCIP in all their contracts with other counties. In order to participate in the MCIP program, the County is charged a 5% state administrative fee which is entirely offset by CFMG reimbursement.
Working in collaboration with CFMG and NorthBay, County Health and Social Services (H&SS) and the Sheriff’s Office are responsible for identifying inmates admitted for covered inpatient off-site hospital or medical services; obtaining appropriate authorized representative forms from inmates; working with inmates to complete and sign Medi-Cal application documents; and enroll the inmates by submitting completed Medi-Cal applications and support documentation to the DHCS.
ALTERNATIVES:
The Board of Supervisors could choose not to approve the agreements; however, this alternative is not recommended as it would exclude the State, the County's inmate medical provider CFMG, and the County from benefiting from the MCIP for inpatient hospitalizations of Solano County inmates. Moreover, non-approval is not fiscally prudent, as this revenue stream aids in reducing General Fund costs associated with inmate medical expenses.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved the agreements as to form.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION