COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

July 22, 2008

BOARD MEETING DATE:

August 12, 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:

Third 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 Third Amendment to the Agreement with the State of California Managed Risk Medical Insurance Board to: establish new administrative policies in Exhibits A and B of the Agreement; extend the term of the Agreement from July 1, 2005 through June 30, 2008 to July 1, 2005 through June 30, 2009; and increase the funding amount by $354,586, for a new maximum of $1,733,225.

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

14,300

Healthy Families (HF) membership

9,400

9,600

Healthy Kids (HK) membership

6,500

6,550

BACKGROUND:

In December 2005 your Board executed an Agreement with the State of California’s 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 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 February 2008 your Board approved the Second Amendment to this Agreement to extend the term and to increase the established per-member per-month (PMPM) rates for the program in addition to other administrative policy changes.

DISCUSSION:

This Amendment includes new administrative policies in Exhibits A and B of the Agreement. These new policies state that the County must adhere to the new monthly and quarterly financial and enrollment reporting requirements, which include modified submission deadlines and more comprehensive documentation. In addition, this Amendment states that the County must abide by the federal Health Insurance Portability and Accountability Act (HIPAA) regulations when submitting the program enrollment files, as well as the Agreement being contingent upon the availability of federal and state funds for the 2008-09 State fiscal year. The Children’s Health Initiative (CHI) received this Amendment in June 2008, therefore, it will not be executed as of its start date of July 1, 2008.

.

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

FISCAL IMPACT:

This Amendment extends the original term from July 1, 2005 through June 30, 2008, to July 1, 2005 through June 30, 2009. The maximum funding provided by MRMIB for this Agreement is increased by $354,586, from $1,378,639 to a new maximum of $1,733,225. Although the contract is for the maximum possible amount, MRMIB only has a federal funding commitment until March 2009, therefore the CHI FY 08-09 tentatively Adopted Budget only includes revenue of $100,000 for this program.  Should additional revenue be received, an Appropriation Transfer Request will be submitted. CHI is funded by contributions from First 5 San Mateo County, Peninsula and Sequoia Healthcare Districts, and the County’s General Fund ($2.7 million). Approval of this Amendment has no Net County Cost.