TITLE
Recommendation to authorize City Manager, or designee, to execute all documents necessary to enter into a Memorandum of Understanding, including any subsequent amendments, with Health Net Community Solutions, Inc., for the coordinated provision of Targeted Case Management Services to eligible Medi-Cal beneficiaries, for the period of July 1, 2020 through July 1, 2025, with the option to extend for one additional five-year period, at the discretion of the City Manager. (Citywide)
DISCUSSION
Since 1997, the Health and Human Services Department (Health Department) has provided Targeted Case Management (TCM) services to both eligible Medi-Cal and non-Medi-Cal beneficiaries under an agreement with the State of California Department of Health Care Services (State).
On February 5, 2019, the City Council approved the current agreement with the State, which became effective on July 1, 2019 and continues in full force and effect until terminated by either party. Under this agreement, Health Department staff assists eligible clients with significant health needs with accessing critical medical, social, educational, and other services. This year, over 400 individuals received case management services through TCM from the Health Department, the beneficiaries being mostly children and medically fragile individuals.
Health Net Community Solutions, Inc. (Health Net), a Managed Care Health Plan provider for Medi-Cal beneficiaries in Los Angeles County, has been providing TCM Services to the Health Department since 2015. The current Memorandum of Understanding (MOU) with Health Net began on July 1, 2015 and expires on July 1, 2020. The State is requiring the Health Department to enter into a renewal MOU with Health Net to ensure there is no duplication of services between the Health Department’s TCM Program and the medical case management services provided by Health Net. The term of this MOU will be for a five-year period; however, the MOU may be terminated by eit...
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