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Approve a first amendment to an Engagement Letter with Wipfli LLP for $163,000 for a total contract amount of $237,999 to prepare Medi-Cal Change in Scope of Services Requests, a Medi-Cal Home Office Report and related services for the Health and Social Services, Family Health Services primary care and dental clinics for the fiscal year ending June 30, 2025; and Delegate authority to the County Administrator to sign the amendment, with County Counsel concurrence, once signed by the vendor
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Published Notice Required? Yes ____ No _X _
Public Hearing Required? Yes ____ No _X _
DEPARTMENTAL RECOMMENDATION:
The County Administrator’s Office recommends that the Board of Supervisors approve a first amendment to an Engagement Letter with Wipfli LLP for $163,000 for a total contract amount of $237,999 to prepare Medi-Cal Change in Scope of Services Requests, a Medi-Cal Home Office Report and related services for the Health and Social Services, Family Health Services primary care and dental clinics for the fiscal year ending June 30, 2025; and Delegate authority to the County Administrator to sign the amendment, with County Counsel concurrence, once signed by the vendor.
SUMMARY/DISCUSSION:
The Health and Social Services, Family Health Services primary care and dental clinics in Vallejo, Fairfield and Vacaville operate as Federally Qualified Health Centers through the Healthcare for the Homeless grant administered by the Health Resources and Services Administration (HRSA). The clinics are primarily reimbursed by the Prospective Payment System (PPS) which is a predetermined, fixed rate per patient per visit. The payment structure is designed to cover the reasonable costs for providing services as defined by federal regulations. The California Department of Health Care Services (DHCS) has established permanent rates for all FHS sites. These rates were established at each clinic between FY2010/11 and FY2016/17 with only minimal annual increases, well below inflationary costs.
Family Health Services is currently undergoing a process to submit for PPS rate adjustments at each location through a Change in Scope of Service Request (CSOSR) process. Initiated in FY2024/25, this effort includes the addition of chiropractic services for adults and licensed marriage and family therapy services for pediatrics. The CSOSR process, as outlined by DHCS, requires detailed cost reporting and compliance with specific guidelines to adjust the PPS rate properly. Specialized expertise is needed in the submission process to ensure compliance with DHCS guidelines. In FY2024/25, the County Administrator, under delegated authority, entered into an engagement letter with Wipfli LLP, a consultant with specialized FQHC knowledge and experience, for $74,999 to initiate the first activities in the CSOSR process. These necessary activities were successfully completed and the recommendation is to amend the engagement letter with Wipfli LLP for $163,000 to prepare the CSOSRs and Medi-Cal Home Office Report, including assisting FHS with necessary accounting and financial support, developing a productivity exemption request based on the clinics’ large volume of clients experiencing homelessness, and provide ongoing project management and administrative support.
FINANCIAL IMPACT:
The cost of the first amendment is $163,000 and is included in the County Administrator’s Office FY2025/26 Recommended Budget. The cost associated with preparing the agenda item is nominal and absorbed by the department’s FY2024/25 Working Budget.
ALTERNATIVES:
The Board could choose not to approve the first amendment to the Engagement Letter; however, the current PPS rates at each clinic do not cover encounter costs, and this is an opportunity to submit updated costs with the goal of obtaining increased rate reimbursements.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION