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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
Health System
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DATE:
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November 9, 2010
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BOARD MEETING DATE:
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December 7, 2010
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Jean S. Fraser, Chief, Health System
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SUBJECT:
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Amendment to the Agreement with the Health Plan of San Mateo to participate in the county-based Medi-Cal Administrative Activities Federal Financial Participation Program
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RECOMMENDATION:
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Adopt a Resolution authorizing the:
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President of the Board to execute an Amendment to the Agreement with the San Mateo County Health Commission, doing business as the Health Plan of San Mateo, to participate in county-based Medi-Cal Administrative Activities, increasing the total amount payable by $1,500,000 for a maximum amount not to exceed $2,500,000 and extending the participation period to FY 2007-08 through FY 2012-13, with no change to the term; and
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Chief of the Health System or designee to execute contract amendments which modify the total amount payable 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.
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BACKGROUND:
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On June 29, 2010, your Board approved an Agreement with the Health Plan of San Mateo (HPSM) to participate in county-based Medi-Cal Administrative Activities (CMAA), a federal reimbursement program. On June 30, 2010, the California Department of Health Care Services (DHCS) announced proposed changes to the CMAA program per federal requirements revising the time survey methodology used for claims. These changes would permit increased HPSM staff participation in CMAA.
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DISCUSSION:
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This Amendment would allow for increased revenue for HPSM based on proposed programmatic changes by DHCS and based on fiscal changes to cost allocation by HPSM. DHCS has not indicated when the new policy will be finalized, although implementation would apply retroactively effective July 1, 2010. In addition, changes in administrative cost allocation by HPSM would increase the allowable match, or certified public expenditure, for claims. The total CMAA claims fluctuate based on the percentage of time staff spend performing the claimable activities. This Amendment ensures HPSM may claim the maximum amount upon finalization of the changes by DHCS. This Amendment corrects a clerical error in the Exhibit B of the original Agreement whereby the years of participation in the program were designated as being FY 2008-09 through FY 2012-13 rather than FY 2007-08 through FY 2012-13. Authorization by the Chief of the Health System to execute service changes ensures flexibility in complying with future state regulations.
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San Mateo County will continue to act as a pass through for the federal dollars and retain a five percent administrative fee.
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County Counsel has reviewed and approved the Amendment and Resolution as to form.
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The Amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by supporting efforts at optimizing the reimbursements to local government. It is anticipated that the 99% of all time studies will be completed accurately and on time. This measure is an indicator of securing revenue.
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Performance Measure(s):
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Measure
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FY 2009-10
Actual
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FY 2010-11
Projected
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Percent of time studies completed accurately and on time.
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100%*
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99%
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*Higher than anticipated results.
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FISCAL IMPACT
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The term of the Amendment is July 1, 2010 through June 30, 2013. The maximum payable amount is increased by $1,500,000 for an amount not to exceed $2,500,000. All funds are paid by federal monies received and will result in no increased Net County Cost. The administrative fee for this contract has been included in the Health Administration FY 2010-11 Adopted Budget. The increased administrative fee as a result of this Amendment will not be realized until FY 2011-12 and will be included in future budget requests.
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