TITLE
Recommendation to authorize City Manager, or designee, to execute all documents necessary to enter into an agreement, including any necessary amendments, with the County of Santa Cruz, host entity for the County-based Medi-Cal Administrative Activities and Targeted Case Management Programs, for a three-year period, July 1, 2019 through June 30, 2022, with the option to extend the agreement for two additional one-year periods, at the discretion of the City Manager. (Citywide)
DISCUSSION
The City of Long Beach Department of Health and Human Services (Health Department) participates in the County-based Medi-Cal Administrative Activities (CMAA) and Targeted Case Management (TCM) Programs. The CMAA Program provides specific services within a larger program referred to as the Medi-Cal Administrative Activities (MAA) Program. Reimbursement revenue received from these programs total approximately $300,000 annually.
CMAA are services the Health Department performs to ensure that Medi-Cal-eligible individuals are enrolled in, and assisted in navigating, the Medi-Cal system. The program also works to ensure programs and policies assist in removing any barriers to Medi-Cal enrollment and Medi-Cal-covered health care services. Administrative activities include outreach, facilitating Medi-Cal applications, program planning, and policy development.
The TCM Program assists defined targeted groups in accessing medical, social, educational, and other needed services. TCM service components include: comprehensive assessment and periodic reassessment of client status, development of Individual Services Plans (ISP) for each beneficiary, referral and related activities, and monitoring with follow up activities. There are five defined targeted groups for the TCM Program: children under the age of 14, medically fragile individuals, individuals at risk of institutionalization, individuals in jeopardy of negative health or psycho-social outcomes, and individuals with communicable diseases.
California AB 2377 (Chapter 147, amended in June 1994), requires Local Governmental Agencies (LGA) participating in the MAA and TCM claiming process to pay the State of California Department of Health Care Services (State) a participation fee, to cover the State’s costs of administering the programs.
By legislation, the State is not to incur any administrative costs. To minimize administrative costs, a consortium of counties developed a mechanism that designates one jurisdiction as the “Host Entity” to prepare and transmit invoices on behalf of county health jurisdictions. On behalf of all county health jurisdictions, the host entity also reimburses the State and the California State Association of Counties for any administrative costs.
The County of Santa Cruz has been selected as the host entity for both the MAA and TCM Programs from July 1, 2019 through June 30, 2022. For the performance of this service, the host entity receives an annual budgeted compensation amount of $71,000, which is derived proportionately from participating municipalities. Participating municipalities are invoiced annual participation fees to cover administrative costs of the programs, including costs incurred by the host entity. The host entity prepares and transmits MAA and TCM claims to the State and federal agencies on behalf of all county health jurisdictions.
This matter was reviewed by Deputy City Attorney Taylor M. Anderson on March 3, 2020 and by Budget Analysis Officer Julissa José-Murray on March 9, 2020.
TIMING CONSIDERATIONS
City Council action is requested on April 14, 2020, to continue to provide these services without interruption. Delays at the State level prevented this item from being executed earlier.
FISCAL IMPACT
Cost to the City for this agreement includes a membership fee of $500 and an annual participation fee paid to the Host Entity. Annual participation fees were under $9,000 in FY 18 and FY 19 and are expected to remain in the same range. There is sufficient appropriation budgeted in the Health Fund Group in the Health and Human Services Department to support this agreement. This recommendation has no staffing impact beyond the normal budgeted scope of duties and is consistent with existing City Council priorities. No match or in-kind service mandate is required and there is no local job impact associated with this recommendation.
SUGGESTED ACTION
Approve recommendation.
Respectfully Submitted,
KELLY COLOPY
DIRECTOR
HEALTH AND HUMAN SERVICES
APPROVED:
THOMAS B. MODICA
ACTING CITY MANAGER