COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

June 14, 2007

BOARD MEETING DATE:

June 26, 2007

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Srija Srinivasan, Director, Health Policy, Planning, and Promotion

SUBJECT:

Amendment to the Agreement with the State of California Managed Risk Medical Insurance Board (MRMIB)

RECOMMENDATION:

Adopt a Resolution:

1.

Authorizing the President of the Board to execute a First Amendment to Agreement Number 067753 with the State of California Managed Risk Medical Insurance Board at a new rate not to exceed $165.63 per-member per-month for a child less than one year of age and $75.64 per-member per-month for a child one through eighteen years of age effective July 1, 2006, with no change to the term of the Agreement; and

2.

Authorizing the Director of Health or the Director's designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate) and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goal 5: Residents have access to healthcare and preventive care.

This Amendment contributes to this commitment and goal by providing funds to pay for health coverage for children residing in San Mateo County whose family incomes range from 250% to 300% of the Federal Poverty Level.

Performance Measures:

Measure

FY 2005-2006
Actual

FY 2006-2007
Projected

Medi-Cal membership for children

24,058

26,005

Healthy Families membership

8,585

8,750

Healthy Kids membership

6,073

6,768

BACKGROUND:

In December 2005 your Board executed an Agreement by Resolution Number 067753 with the State of California Managed Risk Medical Insurance Board (MRMIB) establishing San Mateo County as the administrator of the County Children’s Health Initiative Program (C-CHIP), thereby giving the County access to federal funding through the County Health Initiative Matching Fund created through AB 495 (Diaz 2001). AB 495 authorizes local governments to seek and obtain federal matching funds to provide comprehensive health insurance to children whose family incomes range from 250% to 300% of the Federal Poverty Level and who do not qualify for Medi-Cal or Healthy Families. The San Mateo County Healthy Kids program was established in 2003 as the local C-CHIP Program.

DISCUSSION:

The C-CHIP program rates are adjusted by MRMIB on an annual basis. After deducting the costs of the non-federally funded support services, the FY 2006-07 rates for San Mateo County were modified from $165.35 to $165.63 per-member per-month for a child less than one year of age and from $75.39 to $75.64 per-member per-month for a child one through eighteen years of age. These rates are effective July 1, 2006 through June 30, 2007. The Amendment was delayed for approval because the initial amendment request dated September 11, 2006, was not received by the County, and MRMIB staff did not relay this amendment request until April 2, 2007.

San Mateo County Children’s Health Initiative (CHI) currently has 400 children enrolled in the Healthy Kids program meeting eligibility criteria for C-CHIP funds. The anticipated County revenue is approximately $200,000 per year in federal matching funds. This estimate is lower than the original projected amount of $400,000, reflecting experience gained in coordinating this funding stream with another federal funding source, as well as developing a more accurate estimate of the number of children who fall within the eligible income range.

This Amendment, Board Memo, and Resolution have been reviewed and approved by County Counsel.

FISCAL IMPACT:

This Amendment to the Agreement does not change the maximum obligation of $897,379 in funding for the County, nor the original term of July 1, 2005 to June 30, 2007. Due to the lower than anticipated enrollments of eligible C-CHIP children, there will be no increase in the maximum State obligation. The FY 2006-07 approved budget for CHI reflects the initial C-CHIP projected annual revenue of $400,000. Revenue from a combination of sources, including First 5 San Mateo County, Peninsula and Sequoia Healthcare Districts, foundations, and other state programs fund the remaining costs of CHI. Approval of this Amendment has no Net County Cost impact.