20080226_m

COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

February 15, 2008

BOARD MEETING DATE:

February 26, 2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Srija Srinivasan, Special Assistant, County Manager’s Office

SUBJECT:

Second Amendment to the Agreement with the State of California Managed Risk Medical Insurance Board

RECOMMENDATION:

Adopt a Resolution authorizing the President of the Board to execute a Second Amendment to the Agreement with the State of California Managed Risk Medical Insurance Board to: increase the coverage rate amount by $.03 for a total revised rate of $75.67 per-member per-month for a child one through eighteen years of age effective June 29, 2007; establish new administrative policies in Exhibits B and D of the Agreement; extend the term of the Agreement from July 1, 2005 through June 30, 2007 to July 1, 2005 through June 30, 2008; and increase the contract amount by $481,260, for a total obligation of $1,378,639.

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. Eligible children must reside in San Mateo County and their family’s income must fall within 250% and 300% of the Federal Poverty Level.

Performance Measures:

Measure

FY 2007-08
Estimated

FY 2008-09
Projected

Medi-Cal (MC) membership for children

13,500

14,000

Healthy Families (HF) membership

9,300

9,500

Healthy Kids (HK) membership

6,400

6,800

BACKGROUND:

In December 2005 your Board executed an Agreement 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). These matching federal funds allow local governments to provide comprehensive health insurance to children in families with incomes ranging 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. In June 2007 your Board approved the first Amendment to this Agreement to increase the established per-member per-month (PMPM) rates for the program.

DISCUSSION:

C-CHIP rates are adjusted by MRMIB on an annual basis. After deducting the costs of the non-federally funded support services, the FY 2007-08 rate for San Mateo County was modified from $75.64 to $75.67 PMPM for a child one through eighteen years of age. This rate is effective June 29, 2007. In addition, this Amendment extends the current Agreement term one year to June 30, 2008, and increases the amount by $481,260. The Amendment also includes new administrative policies in Exhibits B and D of the Agreement. These new policies state that the Agreement is contingent upon the availability of federal funds and is subject to federal program restrictions enacted at any given time. Furthermore, modifications were made to better define the policies on the disclosure of program records. The Children’s Health Initiative (CHI) received this Amendment in December 2007. Therefore, this Amendment will not be executed as of its start date of June 29, 2007.

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

FISCAL IMPACT:

The maximum obligation for this Agreement is increased by $481,260, from $897,379, to a new maximum of $1,378,639. This Amendment also extends the original term from July 1, 2005 through June 30, 2007, to July 1, 2005 through June 30, 2008. CHI is funded by contributions from First 5 San Mateo County, Peninsula and Sequoia Healthcare Districts, the County’s Solid Waste Fund ($1.5 million) and the County’s General fund ($1.2 million). Approval of this Amendment has no Net County Cost impact.



COUNTY OF SAN MATEO Inter-Departmental Correspondence
Health Department

DATE:		February 15, 2008
BOARD MEETING DATE:		February 26, 2008
SPECIAL NOTICE/HEARING:		None
VOTE REQUIRED:		Majority

TO:	Honorable Board of Supervisors
FROM:	Charlene A. Silva, Director, Health Department Srija Srinivasan, Special Assistant, County Manager’s Office
SUBJECT:	Second Amendment to the Agreement with the State of California Managed Risk Medical Insurance Board
RECOMMENDATION:
Adopt a Resolution authorizing the President of the Board to execute a Second Amendment to the Agreement with the State of California Managed Risk Medical Insurance Board to: increase the coverage rate amount by $.03 for a total revised rate of $75.67 per-member per-month for a child one through eighteen years of age effective June 29, 2007; establish new administrative policies in Exhibits B and D of the Agreement; extend the term of the Agreement from July 1, 2005 through June 30, 2007 to July 1, 2005 through June 30, 2008; and increase the contract amount by $481,260, for a total obligation of $1,378,639.

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. Eligible children must reside in San Mateo County and their family’s income must fall within 250% and 300% of the Federal Poverty Level.


Performance Measures:
Measure	FY 2007-08 Estimated	FY 2008-09 Projected
Medi-Cal (MC) membership for children	13,500	14,000
Healthy Families (HF) membership	9,300	9,500
Healthy Kids (HK) membership	6,400	6,800

BACKGROUND:
In December 2005 your Board executed an Agreement 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). These matching federal funds allow local governments to provide comprehensive health insurance to children in families with incomes ranging 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. In June 2007 your Board approved the first Amendment to this Agreement to increase the established per-member per-month (PMPM) rates for the program.

DISCUSSION:
C-CHIP rates are adjusted by MRMIB on an annual basis. After deducting the costs of the non-federally funded support services, the FY 2007-08 rate for San Mateo County was modified from $75.64 to $75.67 PMPM for a child one through eighteen years of age. This rate is effective June 29, 2007. In addition, this Amendment extends the current Agreement term one year to June 30, 2008, and increases the amount by $481,260. The Amendment also includes new administrative policies in Exhibits B and D of the Agreement. These new policies state that the Agreement is contingent upon the availability of federal funds and is subject to federal program restrictions enacted at any given time. Furthermore, modifications were made to better define the policies on the disclosure of program records. The Children’s Health Initiative (CHI) received this Amendment in December 2007. Therefore, this Amendment will not be executed as of its start date of June 29, 2007. This Amendment and Resolution have been reviewed and approved by County Counsel.

FISCAL IMPACT:
The maximum obligation for this Agreement is increased by $481,260, from $897,379, to a new maximum of $1,378,639. This Amendment also extends the original term from July 1, 2005 through June 30, 2007, to July 1, 2005 through June 30, 2008. CHI is funded by contributions from First 5 San Mateo County, Peninsula and Sequoia Healthcare Districts, the County’s Solid Waste Fund ($1.5 million) and the County’s General fund ($1.2 million). Approval of this Amendment has no Net County Cost impact.