To: Board of Supervisors
From: Sheriff
Agenda Section: Consent
Vote Requirement: Majority
SUBJECT:
title
Renewal of Agreements with Department of Health Care Services (DHCS) for the Medi-Cal County Inmate Program (MCIP) covering Fiscal Years 2023-2024, 2024-2025 and 2025-2026
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve and authorize the Chair of the Board to execute one original copy of the MCIP Participation Agreement # 23-MCIPHUMBOLDT-12 and two original copies of the MCIP Agreement for Administrative Services # 23-30022;
2. Authorize the Sheriff, Correctional Captain or Deputy Director of Financial & Support Services to approve and execute any amendments related to these agreements upon review and approval by County Counsel, Risk Management and the County Administrative Office; and
3. Direct the Clerk of the Board to return all original, executed copies of the agreements to the Correctional Captain for forwarding to DHCS.
Body
SOURCE OF FUNDING:
General Fund 1100, Medical Care Budget 490
DISCUSSION:
Pursuant to California Penal Code and Title 15 to 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 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.
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 an inmate receives inpatient services at a medical facility located off the grounds of the correctional facility for an expected stay of more than 24 hours, and the inmate is found to be Medi-Cal eligible.
The California Department of Health Care Services (DHCS) administers a Medi-Cal County Inmate Program (MCIP) that allows for Medi-Cal billing of Medi-Cal allowable inpatient hospital services, including inpatient psychiatric services and physician services provided during inpatient hospital stays, for inmates who are determined eligible for Medi-Cal.
MCIP 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. To participate in MCIP, the county will be responsible for an annual administrative fee to participate in the program, which covers a small portion of DHCS’s administrative costs in administering the MCIP. Per legislation, there is to be no General Fund impact under MCIP. However, if a county does not participate in MCIP, the county remains responsible for paying for the full expense of inpatient, offsite services for inmates. As none of such services are currently reimbursable and full responsibility of the county, participation in MCIP will result in savings to the General Fund.
Approval of the MCIP Participation Agreement #23-MCIPHUMBOLDT-12 with DHCS will allow the county to continue to participate in MCIP upon execution of the documents until terminated by either party.
Approval of the MCIP Agreement for Administrative Services #23-30022 defines the administrative fees the county is responsible for in Fiscal Years 2023-2024, 2024-2025 and 2025-2026.
FINANCIAL IMPACT:
|
Expenditures (1100, 490) |
FY23-24 Adopted |
FY24-25 Projected |
FY25-26 Projected |
|
Budgeted Expenses |
$3,170.04 |
$3,423.64 |
$3,697.59 |
|
Total Expenditures |
$3,170.04 |
$3,423.64 |
$3,697.59 |
|
Funding Sources (1100, 490) |
FY23-24 Adopted |
FY24-25 Projected* |
FY25-26 Projected* |
|
General Fund |
$3,170.04 |
$3,423.64 |
$3,697.59 |
|
Total Funding Sources |
$3,170.04 |
$3,423.64 |
$3,697.59 |
*Projected amounts are estimates and are subject to change.
Narrative Explanation of Financial Impact:
The administrative fee for Fiscal Year (FY) 2023-2024 is not to exceed $3,170.04, the administrative fee for FY 2024-2025 is not to exceed $3,423.64, and the administrative fee for FY 2025-2026 is $3,697.59, for a total not to exceed $10,291.27. These fees would be paid out of Fund 1100, Budget Unit 490, Medical Care. The savings incurred by participating in MCIP will exceed these administrative fees; therefore, these agreements will reduce the cost burden of inpatient medical care costs for inmate services on the General Fund. The savings that participation in the MCIP 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. For comparison, to date the county has saved approximately $76,000 this fiscal year compared to the same date last fiscal year.
STAFFING IMPACT:
Enrollment of qualifying individuals into MCIP is a contracted service provided by Wellpath under our current Professional Services Agreement effective through FY 2024-2025, therefore, there will be no staffing impact on the county.
STRATEGIC FRAMEWORK:
This action supports your Board’s Strategic Framework priority of managing our resources to ensure sustainability of services.
OTHER AGENCY INVOLVEMENT:
N/A
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose to not to renew the agreements for the Medi-Cal County Inmate Program; however that is not recommended as it could result in loss of potential savings from participation in the program.
ATTACHMENTS:
1. MCIP Participation Agreement #23-MCIPHUMBOLDT-12
2. MCIP Agreement for Administrative Services #23-30022
PREVIOUS ACTION/REFERRAL:
Board Order No.: D-11
Meeting of: 1/4/2022
File No.: 21-1860