To: Board of Supervisors
From: DHHS: Administration
Agenda Section: Departmental
Vote Requirement: Majority
SUBJECT:
title
Introduction of an Ordinance of the Board of Supervisors of the County of Humboldt Amending Sections 591-1, 591-3 and 591-5, Relating to Membership of Partnership HealthPlan of California Commission, of Title V of the Humboldt County Code
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RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Introduce the attached ordinance of the Humboldt County Board of Supervisors amending Sections 591-1, 591-3 and 591-5, relating to membership of Partnership HealthPlan of California Commission, of Title V of the Humboldt County Code;
2. Set the attached ordinance for adoption on January 23, 2024 or at least one (1) week away from the date of the Board of Supervisors at which the ordinance is first introduced;
3. Direct the Clerk of the Board of Supervisors to publish the pre-adoption summary of the attached ordinance and to post a certified copy of the full text of the ordinance in the office of the Clerk of the Board of Supervisors at least five (5) days prior to the Board of Supervisors meeting at which the ordinance will be adopted [California Government Code Section 25124(b)(1))]; and
4. Direct the Clerk of the Board of Supervisors, within Fifteen (15) days after adoption of the attached ordinance, to publish a post-adoption summary of the ordinance with the names of the Supervisors voting for and against the ordinance, and to post in the office of the Clerk of the Board of Supervisors a certified copy of the full text of the adopted ordinance and amendments along with the names of those Supervisors voting for and against the ordinance [California Government Code Section 25124(b)(1)].
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SOURCE OF FUNDING:
Federal and State Medi-Cal dollars
DISCUSSION:
As part of the Fiscal Year 2012-13 state budget, the State of California authorized expansion of Medi-Cal managed care into the 28 rural counties that had provided Medi-Cal benefits on a fee-for-service basis only. On February 27, 2013, the California Department of Health Care Services announced that Medi-Cal benefits in Humboldt County would be provided by Partnership HealthPlan of California (PHC), an existing county organized health system model of Medi-Cal managed care.
On May 14, 2013, the Board of Supervisors (Board) adopted Ordinance No. 2501 adding Chapter 1 (Partnership HealthPlan of California Commission), Title V (Health and Safety), Division 9 (Health Care), to the Humboldt County Code (Attachment 1). Ordinance 2501 authorizes the County of Humboldt to implement a county-organized health system and join the Partnership HealthPlan Commission.
On April 19, 2016, the Board adopted Ordinance No. 2548 amending the original ordinance to accommodate changes in Partnership HealthPlan Commission representation.
Partnership HealthPlan is set to expand to ten (10) additional counties on or about January 1, 2024, through a contract with the California Department of Health Care Services. This expansion necessitates additional amendments to the county ordinance.
On August 23, 2023, in preparation for the expansion, the Partnership HealthPlan Commission adopted changes (Attachment 2) to the Commission bylaws as follows:
1. Modify the Commission representation formula using the following equation: 0-45,000 Medi-Cal Partnership members = 1 seat; 45,000-60,000 =2 seats; 60,001+ = 3 seats.
2. Allow for seats lost due to the implementation of the updated representation formula to be depleted using the process of attrition, which allows a lost seat to be vacated 1 year after the adoption of the updated formula or on the seat’s natural expiration date, whichever occurs first.
3. Add language stating the provider types that Partnership encourages representation from, to align with the Department of Health Care Services 2024 contract.
4. Add language stating special efforts will be made to select candidates who reflect the diversity of the community and regions that Partnership serves, including, but not limited to: race, age ethnicity, language, disability status, and sexual orientation.
The attached ordinance will amend Sections 591-1, 591-3 and 591-5 of the Humboldt County Code to reflect the Partnership HealthPlan Board of Commissioners action.
It is important to note that this change reduces the number of Commissioners allocated to Humboldt County from three (3) to two (2). Nine (9) of Partnership’s fourteen (14) current counties will see a similar reduction in the number of seats allocated to them on the commission as a result of the changes in the health plan’s bylaws. This will accommodate representation from Partnership’s ten (10) new counties while maintaining a functional size governing commission. Absent further action from the Board, Commissioner Tory Starr will complete his four-year term on April 22, 2024. That vacancy will not be filled, leaving two Commissioners to represent Humboldt County on the Partnership HealthPlan Commission into the future.
FINANCIAL IMPACT:
There are no direct costs associated with the changes to the county ordinance except for staff time. The amendments to county ordinance to change the number of Humboldt County Commissioners that are represented on the Partnership HealthPlan Board will not impact the county budget as Partnership HealthPlan reimburses Commissioners for travel and time spent representing Humboldt County. There is no impact to Humboldt County General Fund.
STAFFING IMPACT:
No new positions are required.
STRATEGIC FRAMEWORK:
The recommended actions support the following areas of the Board of Supervisors’ Strategic Framework:
Core Roles: Create opportunities for improved safety and health
New Initiatives: N/A
Strategic Plan: N/A
OTHER AGENCY INVOLVEMENT:
Partnership HealthPlan of California; California Department of Health Care Services
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose not to approve the proposed changes to the Humboldt County Code. This alternative is not recommended as continued representation on the Partnership HealthPlan Commission is necessary to ensure participation in the county organized health system.
ATTACHMENTS:
1. Ordinance of the Board of Supervisors of the County of Humboldt Amending Sections 591-1, 591-3 and 591-5, Relating to Membership of Partnership HealthPlan of California Commission, of Title V of the Humboldt County Code
2. Resolution of the Partnership HealthPlan Board of Commissioners adopting changes to Governance Bylaws
3. Pre-adoption Summary
4. Post-adoption Summary
PREVIOUS ACTION/REFERRAL:
Board Order No.: H2, D8
Meeting of: 04/23/13, 4/19/16
File No.: N/A, 16-2258