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Consent-Health & Human Services # 14.
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| Board of Supervisors |
Health |
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| Subject |
| Approve the Health Department's pursuit of an Intergovernmental Transfer for FY 2011-12 in the amount of $4.7 million with the State Department of Health Care Services to secure federal matching funds that can be used to provide additional health services for Medi-Cal beneficiaries in Yolo County, and authorize the County Administrator to sign all related agreements. (No general fund impact) (Cook) |
| Recommended Action |
- Approve the Health Department to participate in an Intergovernmental Transfer (IGT) for FY 11-12 to secure matching Federal funds
- Authorize the County Administrator to process and sign all related FY 11-12 IGT agreements on behalf of Yolo County
- Approve FY 11-12 IGT funding plan
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| Strategic Plan Goal(s) |
Champion job creation and economic opportunities
Collaborate to maximize success
Enhance and sustain the safety net
Preserve and ensure safe and crime free communities
Provide fiscally sound, dynamic and responsive services |
| Reason for Recommended Action/Background |
History and Background:
For many years, California Counties with public hospitals have had the opportunity to secure federal matching funds for their local expenditures in support of County hospitals via the Medi-Cal program. The format for securing federal funds frequently involved an Intergovernmental Transfer (IGT), whereby the County transfers funds to the State Department of Health Care Services (DHCS) which then uses them to increase Medi-Cal payments (within federally allowed levels) to that County's Hospital. This results in the County Hospital getting back the transferred funds, along with the matching federal funds that are contained in Medi-Cal expenditures. With the advent of Medi-Cal Managed Care, Counties have entered into IGTs with DHCS that help to finance increased State payments to the Medi-Cal Health Plan (again within specified federal limits). The Plan then makes special payments to its contracted medical providers. As a result of being a Medi-Cal Managed Care County, Yolo County was eligible to participate in an IGT for FY 2010-2011 that drew down $2.7 million in additional federal funds for Medi-Cal services in the County.
Actions to Date:
In January 2013 we submitted a letter of intent to the Department of Health Care Services to pursue an IGT for FY 2011-12. In February 2013 we submitted draft agreements with DHCS and a Health Plan Provider Agreement Amendment for approval (ATTACHMENT A, B, C, & D) and presented a preliminary proposal to PHC for the use of the funds (ATTACHMENT E) in order to meet the recently established State time line for processing of FY 2011-12 IGTs.
Overview of Proposed IGT:
The following provides a summary of the IGT and the proposed transfer for funds.
- IGT Transfer: The IGT transfer will consist of a $2.2 million dollar transfer of funds from the County to the State. The source of funding for this transfer will be realignment and or general funds currently allocated to the Health Department. The projected date of the IGT transfer is on or about May 2013.
- Enhanced State Payment to Partnership Health Plan of California: Upon receipt of the IGT funds, the State will increase PHCs rate payments for FY 2011-12 by $4.7 million. The new payments will be made up of $2.2 million local transferred funds and $2.3 million in new federal match. After the 20% State administrative fee ($447,000), PHC will receive $4.6 million. (See Attachment F: Summary Chart of FY 1112 Financial Estimates)
- Partnership Health Plan of California Increased Payment to Contracted Medical Providers: After payment to the State of approximately $117,000 in Managed Care Organization taxes, PHC will distribute $4.6 million to the Health Department, as their contracted medical provider to provide additional health services to Medi-Cal patients in the following priority areas: (1) Mental Health (2) Substance Abuse (3) Care Coordination (4) Access to Specialty Care. The Health Department will be required to develop specific plans for expending the augmented funds. These plans will be approved by PHC and the Department of Health Care Services. The proposed use of the funding includes: $407,000 to the Alcohol, Drug and Mental Health Department (ADMH) for case management and care coordination; $655,000 for public health programs & services; $181,000 for Planning, Policy, Development & Evaluation in the Health Department; and $641,000 in a Health Sustainability Reserve fund. (See Attachment E: Project Funding Proposal)
Next Steps:
DHCS will return the approved contract documents in March 2013. Counties will have 30 days to execute the agreements. DHCS expects to receive formal approval from CMS in May 2013. Counties will receive instructions from DHCS to wire funds to the State's account in May 2013. PHC will receive the capitation payments by June 30, 2013. PHC will pay providers as specified in the Plan/Provider Amendments by July 30, 2013. |
| Other Agency Involvement |
| The Department has worked closely with Partnership Health Plan of California to secure this funding. We have also worked with County Counsel, the Auditors Office, Alcohol Drug and Mental Health Department and have sought input from various stakeholders on the use of the funds, including: Health Council, Maternal, Child and Adolescent Health Advisory Board, Local Mental Health Board, ADMH Provider Stakeholder Group, Communicare Health Centers, Woodland Health Care, and Board and Care Mental Health Treatment Providers. |
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| Fiscal Impact |
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| Source of Funds for this Expenditure |
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Explanation (Expenditure and/or Revenue) |
| Further explanation as needed: |
| There is no net county cost at this time in the request to pursue the IGT funds. The Department's contribution to the IGT will be funded from existing General Fund and/or Health Realignment revenues within Indigent Health, which will be offset by a corresponding receivable to the expense account being used to record the expected refund. There is no additional contribution from the county General Fund. The new Federal Funds will arrive during the new fiscal year 2013-14 and will be included in the upcoming budget development process. |
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