To: Board of Supervisors
From: DHHS: Administration
SUBJECT:
title
Approval of Intergovernmental Transfer between Humboldt County Department of Health and Human Services and California Department of Health Care Services
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RECOMMENDATION(S):
Recommendation
That the Board of Supervisors approve the attached Intergovernmental Transfer agreement between the Humboldt County Department of Health and Human Services and the California Department of Health Care Services; authorize the Director of the Department of Health and Human Services to sign and execute the attached Intergovernmental Transfer agreement; authorize the Department of Health and Human Services to transfer $1,976,535 (including a 20% California Department of Health Care Services administrative fee) to the California Department of Health Care Services; and authorize the Director of the Department of Health and Human Services to execute future amendments and/or documents related to the attached Intergovernmental Transfer agreement after review and approval by County Counsel and Risk Management.
Body
SOURCE OF FUNDING:
Federal and State Medi-Cal dollars; County Health Realignment
DISCUSSION:
As part of the 2012/13 state budget, the State of Califomia authorized expansion of Medi-Cal managed care into counties that had previously provided Medi-Cal benefits on a fee-for-service basis only. On May 14,
2013, the Board of Supervisors adopted Ordinance 2501 authorizing the County of Humboldt to join the
Partnership HealthPIan of California (PHC), a regional County Organized Health System model of Medi-
Cal managed care. PHC began administering Medi-Cal managed care in Humboldt County on September 1, 2013.
Welfare and Institutions Code, sections 14164 and 14301.4 provides for a voluntary Intergovernmental Transfer (IGT) program. California counties participating in Medi-Cal managed care, including Humboldt as a member of PHC, qualify for additional federal Medicaid funds for health services if they enter into IGT agreements with the California Department of Health Care Services (DHCS).
The Humboldt County Department of Health and Human Services is eligible to participate in an IGT that draws down additional federal funds for Medi-Cal services in the county. The State and DHHS have existing contracts with PHC for Fiscal Year 2017/18 which makes DHHS eligible for IGT funds for Fiscal Year 2017/18. DHHS has participated in the IGT program for each of the previous four fiscal years.
Overview of the IGT Process:
1. DHHS will transfer up to approximately $1,976,535 in local funds to DHCS. This includes $1,647,112 in county IGT funds and a $329,422 state DHCS administrative fee. The source of the funding for this transfer will be 1991 and 2011 realignment flmds. The projected date for this transfer is on or about November 9, 2018.
2. Upon receipt of the transferred funds, the State will increase PHC rate payments for FY 17/18. The new payments will be made up of local transferred funds & new federal funds. After the 20% State administrative fee in the amount of $329,422 is deducted, PHC will receive the dollars.
3. PHC will distribute the funds (approximately $3,294,224) to DHHS, as their contracted medical provider. The process will result in approximately $1,647,112 in net new funds to provide additional health services to Medi-Cal patients.
Next steps/timeline:
• County will execute final agreements with the DHCS by July 31, 2018
• State will receive federal approval by October 29, 2018
• County will wire funds to the State by November 9, 2018
• PHC will receive capitation payments by March, 2019
• PHC will pay providers by April, 2019
FINANCIAL IMPACT:
There is no impact to the County General Fund associated with the recommendation before your board. The source of funding for this transfer will be 1991 and 2011 realignment funds held in Trust Fund 3443 and 3742 respectively. There are sufficient funds to accommodate the transfer required by the contract in order to draw down additional dollars. The projected date of the IGT transfer is on or about November 9, 2018. Upon receipt of payment from Partnership HealthPIan, $1,647,112 will be deposited into Social Services Operating fond 1160, budget unit 511, and revenue line 585810 which was included in the proposed county budget for fiscal year 2018-19. The balance of the revenue will be deposited back into Trust Fund 3443 - 1991 realignment and/or 3742 - 2011 realignment.
This action supports the board's strategic framework by protecting vulnerable populations and creating opportunities for improved safety and health.
OTHER AGENCY INVOLVEMENT:
Partnership HealthPlan of California
California Department of Health Care Services
Federal Centers for Medicare and Medicaid Services
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The board could choose not to approve the attached Intergovernmental Transfer agreement; however, staff does not recommend this alternative. Without the Intergovernmental Transfer agreement, the Department of Health and Human Services would be unable to receive additional federal funds for health programs and services associated with the Medi-Cal managed care health plan.
ATTACHMENTS:
Intergovernmental Agreement Regarding Transfer of Public Funds
PREVIOUS ACTION/REFERRAL:
Board Order No.: C-8
Meeting of: 5/14/13