HomeMy WebLinkAboutMINUTES - 01172012 - C.16RECOMMENDATION(S):
Adopt Position Adjustment Resolution #21039 to add one Health Plan Director of Provider
Relations & Credentialing position (VRGD) at salary level ZA5 ($7307.57 - $8882.40) in
the Health Services Department.
FISCAL IMPACT:
Upon approval, this action will result in an annual cost of approximately $170,839,
including pension costs of $37,839, and will be funded with health plan member premiums.
BACKGROUND:
The Contra Costa Health Plan (CCHP) has been without a position in this classification for
approximately two years. However, during that time, membership of the health plan has
increased from 85,000 to approximately 106,000 and will continue to grow.
The State of California now requires Seniors and Persons with Disabilities (SPD) to join a
managed care plan. Since June 2011, these SPD's are being added at the rate of
approximately 1000 new lives per month. Because of this huge influx of Medi-Cal
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 01/17/2012 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I
Supervisor
Gayle B. Uilkema, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
Federal D. Glover, District V
Supervisor
Contact: Terrina C. Manor,
957-5248
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board
of Supervisors on the date shown.
ATTESTED: January 17, 2012
David Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc: Gladys Reid, Roxana Mendoza, Debbie Cho
C.16
To:Board of Supervisors
From:Ted Cwiek, Human Resources Director
Date:January 17, 2012
Contra
Costa
County
Subject:Add one Health Plan Director of Provider Relations and Credentialing position in the Health Services
Department.
BACKGROUND: (CONT'D)
patients and a severe access problem for new members using Contra Costa Regional
Medical Facility (CCRM) facilities, CCHP has had to recruit and credential many new
primary care providers in the community in order to care for the new members. This
process is ongoing and expected to continue as the needs for more providers increase with
member enrollment.
In addition to adding more that a 1000 extra new SPD members monthly, CCHP's
Medi-Cal line of business has exploded due to the poor economy, increasing the number
of Medi-Cal members over 20% in the past 2 years. This calls for additional recruitment
and credentialing of all types of medical providers such as Durable Medical Equipment
vendors, Oxygen vendors, Skilled Nursing Facilities, Home Health, Hospice, dialysis,
and non emergency transportation.
Further, because of patient access difficulties at CCRMC, the health plan is charged with
the recruitment of many new hospitals and specialty care providers. The unit has already
recruited and credentialed more than 97 new specialists to care for the increased patient
demands and the the need will continue.
The Provider Relations and Credentialing unit has played a much bigger role in
overseeing contracts generated for the Health Plan. With the addition of the SPD's, the
unit must process an additional 20-25 contracts per month based upon continuity of care
if the member had been receiving services from a provider not currently in the CCHP
network.
Due to the increasing size of CCHP's membership, additional reporting requirements,
ongoing recruiting and training of providers, and increases in contracts, the ability to
appropriately handle provider issues and complaints and the ability to ensure a stable
network is critical. A Director level position is needed to run this unit.
CONSEQUENCE OF NEGATIVE ACTION:
If this action is not approved, the Health Plan will not have a position in the appropriate
classification to perform the required job duties.
CHILDREN'S IMPACT STATEMENT:
N/A
ATTACHMENTS
P-300 #21039