To: Board of Supervisors
From: DHHS: Administration
Agenda Section: Consent
SUBJECT:
title
Intergovernmental Agreement with the California Department of Health Care Services Regarding the Transfer of Public Funds
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Waive the requirements of the Humboldt County Nuclear-Free Ordinance with regard to the attached intergovernmental agreement with the California Department of Health Care Services;
2. Approve, and authorize the Department of Health and Human Services Director, or a designee thereof, to execute the attached intergovernmental agreement with the California Department of Health Care Services regarding the transfer of public funds;
3. Authorize the Department of Health and Human Services, or a designee thereof, to execute any subsequent amendments to, and other documents regarding, the attached intergovernmental agreement with the California Department of Health Care Services, after review and approval by County Counsel, Risk Management and the County Administrative Office;
4. Authorize the Department of Health and Human Services to transfer up to $2,442,683 to the California Department of Health Care Services in the first quarter of calendar year 2021; and
5. Authorize the Department of Health and Human Services to transfer up to $1,312,294 to the California Department of Health Care Services in the second or third quarter of calendar year 2021, as directed by the California Department of Health Care Services.
Body
SOURCE OF FUNDING:
Federal and State Medi-Cal; County Health Realignment; Trust Funds 3443, 3444 and 3742
DISCUSSION:
As part of the fiscal year 2012-2013 state budget, the State of California 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 Humboldt County Board of Supervisors adopted Ordinance 2501 authorizing the County of Humboldt to join the Partnership HealthPlan 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 Sept. 1, 2013.
California 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 the County of 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 (DHHS) is eligible to participate in an IGT that draws down additional federal funds for the provision of Medi-Cal services in Humboldt County. The State of California and DHHS have existing contracts with PHC for fiscal year 2019-2020 which makes DHHS eligible for IGT funds for fiscal years 2019-2020 and 2020-2021. DHHS has participated in the IGT program for each of the previous 6 fiscal years.
Pursuant to the terms and conditions of the attached intergovernmental agreement with DHCS, DHHS will be required to transfer up to $2,442,683 in local funds, which includes $2,035,569 in Humboldt County IGT funds and a 20% state administrative fee of $407,114, to DHCS in the first quarter of calendar year 2021. DHHS will also be required to transfer up to $1,312,294 in local funds, which includes $1,093,578 in Humboldt County IGT funds and a 20% state administrative fee of $218,716, to DHCS in the second or third quarter of calendar year 2021, as directed by DHCS. The required transfers will be funded with realignment revenues received by DHHS.
Upon receipt of the transferred funds, the State of California will increase PHC rate payments for fiscal years 2019-2020 and 2020-2021. The new payments will be made up of local transferred funds and new federal funds. After the above-referenced state administrative fees are deducted, PHC will receive the funds. PHC will deduct a 3% administrative fee and will distribute the remaining funds, which are estimated to total approximately $6,070,545 to DHHS, as their contracted medical provider, for fiscal years 2019-2020 and 2020-2021. The transfer process will result in approximately $2,315,568 in new funds to provide additional health services to Medi-Cal beneficiaries residing in Humboldt County.
FINANCIAL IMPACT:
As noted above, the attached intergovernmental agreement with DHCS will require DHHS to transfer up to a total of $3,754,977 in local realignment funds to DHCS. There are sufficient funds in Trust Funds 3443, 3444 and 3742 to accommodate the required transfers. Upon receipt of payment from PHC, approximately $2,315,568 will be deposited into DHHS - Social Services budget unit 1160-511, at revenue line 585810, which has been included in the approved fiscal year 2020-2021 budget. The remaining revenue will be deposited back into Trust Funds 3443, 3444 and/or 3742 via the same budget unit. In the event the second transfer does not occur in fiscal year 2020-2021, DHHS will include the second transfer in the proposed fiscal year 2021-2022 budget. Approval of the attached intergovernmental agreement with DHCS will not impact the Humboldt County General Fund.
STRATEGIC FRAMEWORK:
The recommended actions support the Board of Supervisors’ Strategic Framework by protecting vulnerable populations, creating opportunities for improved safety and health and providing community-appropriate levels of services.
OTHER AGENCY INVOLVEMENT:
Partnership HealthPlan of California; Federal Centers for Medicare and Medicaid Services
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The board could choose not to approve the attached intergovernmental agreement with DHCS regarding the transfer of public funds. However, this alternative is not recommended since it will not allow DHHS to receive additional federal funds for health programs and services associated with the Medi-Cal managed care health plan.
ATTACHMENTS:
1. Intergovernmental Agreement with the California Department of Health Care Services Regarding the Transfer of Public Funds
PREVIOUS ACTION/REFERRAL:
Board Order No.: H-2
Meeting of: 04/23/13
File No.: 20-1196