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Authorize the Department of Health and Social Services to pursue an Intergovernmental Transfer with the California Department of Health Care Services for approximately $2,000,000 for the twelve month period from January 1, 2023 to December 31, 2023 in order to leverage additional federal Medicaid funds for the provision of healthcare services; Authorize payment of a State administrative fee equal to twenty percent of the transfer amount estimated at $400,000; and Delegate authority to the County Administrator to execute the necessary agreements with the State of California and Partnership HealthPlan of California
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Published Notice Required? Yes ____ No _X _
Public Hearing Required? Yes ____ No _X _
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS) recommends that the Board of Supervisors authorize H&SS to pursue an Intergovernmental Transfer (IGT) with the California Department of Health Care Services (DHCS) for approximately $2,000,000 for the twelve month period from January 1, 2023 to December 31, 2023 in order to leverage additional federal Medicaid funds for the provision of healthcare services; authorize payment of a State administrative fee equal to twenty percent of the transfer amount estimated at $400,000; and delegate authority to the County Administrator to execute the necessary agreements with the State of California and Partnership HealthPlan of California.
SUMMARY:
The Board approved Intergovernmental Transfer (IGT) agreements for fiscal year funding cycles FY2013/14 through FY2018/19, bridge IGT funding for the eighteen-month period of July 1, 2019 to December 31, 2020 when the funding cycle shifted from fiscal year to calendar year, and for calendar years (CY) 2021 and 2022 authorizing the transfer of local funds to the California Department of Health Care Services (DHCS). These IGT agreements allow Solano County to leverage additional federal Medicaid funds for the provision of healthcare services used to promote the well-being of Partnership HealthPlan of California and Solano County Medi-Cal beneficiaries by maintaining and/or improving current services in certain public health programs. Under the IGT, Solano County executes agreements to transfer funds to DHCS, including payment of a State administrative fee equal to twenty percent of the transfer amount.
DHCS submits the IGT to the Centers for Medicare and Medicaid Services (CMS), and upon approval, the federal matching funds are paid to the State. DHCS then increases the amount of its Medi-Cal contract with Partnership HealthPlan of California (PHC), Solano County’s Medi-Cal Managed Care Organization, in the amount of the transferred funds plus the federal matching, less the administrative fee charged by the State. Finally, PHC pays the resulting net transferred funds to the County. Under the proposed agreement, the County will transfer approximately $2,000,000 in local funds plus a twenty percent State administrative fee estimated at $400,000.
FINANCIAL IMPACT:
The source of funding for this transfer and payment will be 1991 Public Health Realignment funds currently allocated to H&SS. The Department’s FY2024/25 Working Budget includes the IGT funds and administrative fee. There is no additional impact on the County General Fund.
With Board and CMS approval, H&SS will transfer up to approximately $2,000,000 for CY2023. Additionally, H&SS will make a payment estimated at $400,000 to DHCS as California Welfare and Institutions Code §14301.4 authorizes the State to assess a twenty percent non-refundable assessment fee on the non-federal share of an IGT to cover the administrative costs of operating the IGT program and to support the Medi-Cal program. H&SS anticipates receiving an estimated $4,000,000 in IGT funds, which has historically, been received within 28-69 days after the funds transfer.
The cost of preparing this agenda item is nominal and is included in the Department’s FY2024/25 Working Budget.
DISCUSSION:
California counties participating in Medi-Cal Managed Care, including Partnership HealthPlan of California, may enter into prospective payment IGT agreements with the California Department of Health Care Services (DHCS). The resulting amended Health Plan Agreement between PHC and the County provides for an increase in the Medi-Cal Managed Care payment to transfer the IGT funds for services specified in the IGT spending plan. H&SS will use these funds to promote the well-being of PHC Medi-Cal beneficiaries by maintaining and/or improving current services, increasing access to services, and expanding existing services or health programs.
H&SS has worked closely with PHC and other community partners to strategically utilize IGT funds to maintain critical services and improve the overall quality of care in the County’s health system. The IGT funds previously approved by the Board have been used by H&SS to maintain sexually transmitted disease (STD) and tuberculosis (TB) control and case management services, support public health nursing home visiting and care management services for high-risk families, support continued implementation of the Baby First/Healthy Families America program, and support provision of mental health services to severely and persistently mentally ill residents at the County’s Integrated Care Clinics.
The current IGT funding request will be used to support California Children's Services Program services not otherwise covered by PHC or the State; Child Health and Disability Prevention services; care management services, including home visiting through multiple programs, including Nurse-Family Partnership (focusing on first-time mothers), Impact Nursing (focusing on distressed and at-risk families with infants and young children), Black Infant Health (focusing on distressed and at-risk African-American/Black pregnant women and families with infants), and Healthy Families America (focusing on families with infants and young children at risk for abuse and other related risk factors); and Tuberculosis Control (focusing on TB medical services and care management).
ALTERNATIVES:
The Board may choose not to approve H&SS pursuing IGT funds with the California Department of Health Care Services and delegation of authority to the County Administrator to sign the IGT agreements. This is not recommended because the additional IGT funds will increase health services and sustain current health services for Solano County residents.
OTHER AGENCY INVOLVEMENT:
H&SS worked with Partnership HealthPlan of California, the California DHCS, and County Counsel to secure the IGT funds.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION