TO: Board of Supervisors
FROM: Jennifer Yasumoto, Director of Health and Human Services Agency
REPORT BY: Jennifer Ivancie, Staff Services Analyst I
SUBJECT: Agreements for Medi-Cal Administrative Activities for Fiscal Year 2023-2024
RECOMMENDATION
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Approve and authorize Agreement No. 240217B with Cope Family Center; Agreement No. 240219B with Puertas Abiertas Community Resource Center; Agreement No. 240220B with Parents Child Advocacy Network; and Agreement No. 240218B with Up Valley Family Centers of Napa Valley for Fiscal Year (FY) 2023-2024 to provide outreach and linkage to the Medi-Cal program and services and facilitate the Medi-Cal application process. (Fiscal Impact: $96,513; Health and Human Services Agency Fund 2000; Public Health Subdivision 20001; Budgeted; Discretionary).
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BACKGROUND
Medi-Cal Administrative Activities (MAA), provided for in the Medi-Cal State Plan and implemented through the 1995 Medi-Cal Administrative Claiming (MAC) agreement, are activities that support the overall Medi-Cal system such as connecting potential individuals to eligibility and services, planning related to system capacity, and general administration. The Medi-Cal State Plan identifies the Department of Health Care Services (DHCS) as the single state agency responsible for administering the federal Medicaid program (Medi-Cal in California) and lays out the eligibility criteria for beneficiaries and services that can be provided. Essentially, every activity and service that is to be claimed for Federal Financial Participation (FFP) must be covered in the State Plan. The Local Government Agency (LGA), or the designated entity responsible for administering MAA locally, is Health and Human Services Agency (HHSA). The LGA may subcontract with Community Based Organizations (CBOs) and other local agencies to perform MAA.
CBOs are often the first doors that low-income individuals and families enter for services, information, referrals, and facilitation of applications for public assistance. Services such as these may be reimbursable under the MAA program. The CBO's represented in these agreements are well regarded by the communities they serve and are very accessible to the target populations, making them the perfect vehicle to have a positive, proactive impact in reaching the uninsured. These agreements are funded with MAA reimbursements that HHSA claims based on MAA claimable activities performed by these CBO's. For HHSA to claim FFP, it must expend up-front Certified Public Expenditures (CPE) to pay for services. HHSA’s CPE is funded by county contributions, Tobacco Master Settlement Agreement funds (MSA), and Mental Health Services Act (MHSA) grants. The contract maximums represent the costs of providing the services and enable the CBOs to continue their Medi-Cal outreach and enrollment efforts.
These agreements are being presented to the Board at this time because the timing for identifying available CPE is not ready until the end of the calendar year. The funds used to support the work include MSA, MHSA, and reimbursement received from DHCS for the prior year’s MAA expenditure. All agreements are with local vendors.
Requested Actions:
Approve and authorize the Chair to sign the following agreements:
1. Agreement No. 240217B with Cope Family Center, Inc., for a maximum of $32,532;
2. Agreement No. 240219B with Puertas Abiertas Community Resource Center, for a maximum of $24,828;
3. Agreement No. 240220B with Parents Child Advocacy Network for a maximum of $25,009; and
4. Agreement No. 240218B with Up Valley Family Centers of Napa Valley, Inc., for a maximum of $14,144.
FISCAL & STRATEGIC PLAN IMPACT
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Is there a Fiscal Impact? |
Yes |
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Is it currently budgeted? |
Yes |
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Where is it budgeted? |
Health & Human Services Public Health Division |
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Is it Mandatory or Discretionary? |
Discretionary |
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Discretionary Justification: |
While there is no mandate to contract with these providers, these agreements will allow HHSA to continue to support a community-wide effort for outreach and enroll uninsured and potentially eligible residents in Medi-Cal coverage and link them to needed health and behavioral health services. |
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Is the general fund affected? |
No |
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Future fiscal impact: |
None, these Agreements terminate on June 30, 2024, and are included in the approved Fiscal Year 2023-2024 budget. |
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Consequences if not approved: |
Contractors will be unable to be reimbursed for additional outreach and facilitation of application activities performed in the community and HHSA will be unable to claim the providers’ portions from the agreements that provide outreach and facilitation of application activities, which are reimbursable by Medi-Cal Administrative Activities. |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by 14 California Code of Regulations 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.