To: Board of Supervisors
From: DHHS: Administration
Agenda Section: Consent
SUBJECT:
title
Agreements with the California Department of Health Care Services Regarding Implementation of the Medi-Cal County Inmate Program in Humboldt County
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve, and authorize the Chair of the Board to execute, the attached participation agreement with the California Department of Health Care Services regarding implementation of the Medi-Cal County Inmate Program in Humboldt County for the period of July 1, 2021 through June 30, 2023;
2. Approve, and authorize the Chair of the Board to execute, the attached administrative services agreement with the California Department of Health Care Services regarding implementation of the Medi-Cal County Inmate Program in Humboldt County for the period of July 1, 2021 through June 30, 2023;
3. Authorize the Assistant Department of Health and Human Services Director and the Humboldt County Sherriff, or designees thereof, to execute any and all subsequent amendments to the attached agreements with the California Department of Health Care Services, after review and approval by County Counsel, Risk Management and the County Administrative Office; and
4. Direct the Clerk of the Board to return one (1) fully executed original copy of the attached participation agreement, and two (2) fully executed original copies of the attached administrative services agreement, to the Department of Health and Human Services - Contract Unit for submittal to the California Department of Health Care Services.
Body
SOURCE OF FUNDING:
General Fund (1100)
DISCUSSION:
Pursuant to California Penal Code and Title 15 of the California Code of Regulations - Minimum Standards for Local Detention Facilities, counties are mandated to provide emergency and basic medical services to all inmates housed in county correctional and detention facilities. The County of Humboldt currently contracts with Wellpath, previously California Forensic Medical Group for onsite medical services. The cost of offsite, inpatient services for inmates is the responsibility of the County of Humboldt.
Federal law prohibits claiming Medicaid funds for healthcare services provided to inmates residing in correctional facilities. There is an exception to this federal prohibition when a Medi-Cal eligible inmate receives inpatient services at an offsite medical facility for an expected stay of more than 24 hours.
The California Department of Health Care Services (DHCS) administers the Medi-Cal County Inmate Program which allows for Medi-Cal billing of allowable inpatient hospital services, including, without limitation, inpatient psychiatric services and physician services provided during inpatient hospital stays, for Medi-Cal eligible inmates.
The Medi-Cal County Inmate Program is voluntary and counties have the option to participate in the program by entering into an agreement with DHCS. Once enrolled, any Medi-Cal eligible inpatient services will be billed directly to Medi-Cal by the provider. DHCS will invoice the county for the non-federal share of the charges on a quarterly basis. Counties participating in the Medi-Cal County Inmate Program will be responsible for an annual administrative fee, which covers a small portion of DHCS’s administrative costs in administering the program. Per legislation, there is to be no General Fund impact under the Medi-Cal County Inmate Program. However, if a county does not participate in the Medi-Cal County Inmate Program, the county remains responsible for paying for the full expense of inpatient, offsite services for inmates. As such services are not currently reimbursable, participation in the Medi-Cal County Inmate Program will result in savings to the General Fund.
Accordingly, the Humboldt County Department of Health and Human Services (DHHS) recommends that the Board approve, and authorize the Chair of the Board to execute, the attached agreements with DHCS regarding implementation of the Medi-Cal County Inmate Program in Humboldt County for the period of July 1, 2021 through June 30, 2023. It is also recommended that the Board authorize the Assistant DHHS Director and the Humboldt County Sherriff, or designees thereof, to execute any and all subsequent amendments to the attached agreements with DHCS, after review and approval by County Counsel, Risk Management and the County Administrative Office, in order to avoid any unnecessary delays in implementation of the Medi-Cal County Inmate Program. It should be noted that the attached agreements with DHCS come to the Board after the start date thereof due to inadvertent delays that occurred during the contract development process.
FINANCIAL IMPACT:
The administrative fees associated with participation in the Medi-Cal County Inmate Program is $2,955.98 for fiscal year 2021-2022 and $3,103.77 for fiscal year 2022-2023. Such fees were not included in the approved budget for fiscal year 2021-2022. However, inpatient medical care costs were included in the approved fiscal year 2021-22 budget for budget unit 1100-490, Medical Care. The savings incurred by participating in the Medi-Cal County Inmate Program will exceed these administrative fees. As a result, the attached agreements with DHCS will reduce the cost burden of inpatient medical care costs for inmate services on the General Fund.
The savings that participation in the Medi-Cal County Inmate Program will generate is dependent on the number of inmates eligible for Medi-Cal who experience health issues that require offsite/inpatient medical services exceeding 24 hours and the extent and nature of those services and associated costs. As the County of Humboldt has not participated in the Medi-Cal County Inmate Program, an estimate of savings is currently not known.
STRATEGIC FRAMEWORK:
The recommended actions support the Board of Supervisors’ Strategic Framework by managing community resources to ensure sustainability of services.
OTHER AGENCY INVOLVEMENT:
None
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose not to approve the attached agreements with DHCS regarding implementation of the Medi-Cal County Inmate Program in Humboldt County. However, this alternative is not recommended as it will result in a loss of potential savings from participation in the Medi-Cal County Inmate Program.
ATTACHMENTS:
1. Participation Agreement with the California Department of Health Care Services Regarding Implementation of the Medi-Cal County Inmate Program in Humboldt County
2. Administrative Services Agreement with the California Department of Health Care Services Regarding Implementation of the Medi-Cal County Inmate Program in Humboldt County
PREVIOUS ACTION/REFERRAL:
Board Order No.: N/A
Meeting of: N/A
File No.: N/A