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HomeMy WebLinkAboutMINUTES - 02111992 - 1.35 1 - 35 ` TO: BOARD OF SUPERVISORS s _ Contra FROM: Phil Batchelor, County Administrator o! Costa is �g.•. .�:;..::- ._ o�t County DATE: February 3, 1992 "°r>----- SUBJECT: LEGISLATION: AB 2354 (Campbell) SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: Acknowledge that the Board of Supervisors is the SPONSOR of AB 2354 by Assemblyman Campbell, which would make changes to legislation sponsored by the Board of Supervisors in 1990 in order to qualify a pilot project for the Contra Costa Health Plan for federal approval . BACKGROUND: In 1990, the Board of Supervisors sponsored AB 3223 by Assemblyman Campbell . AB 3223 authorizes not more than two pilot projects, one of which is to be a prepaid health plan. The projects will be allowed to require an enrollee who is pregnant at the time she enrolls or who becomes pregnant while enrolled, to remain enrolled in the prepaid health plan for the balance of her pregnancy and for a six month period thereafter. The baby would likewise be enrolled in the prepaid health plan for the first six months of life if the mother chose to enroll the baby. Thereafter, the mother could determine whether she wishes to remain enrolled in the prepaid health plan or return to the Medi-Cal fee-for-service system. In addition, eligibility to Medi-Cal would be guaranteed for the period of the pilot project, even if the woman's circumstances changed so markedly that she would no longer be eligible for Medi-Cal except for the pilot project. This legislation was passed by the Legislature and signed into law by the Governor. CONTINUED ON ATTACHMENT: YES SIGNATURE: IAX� . - RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S): ��j&ee�6 1 .6 ACTION OF BOARD ON February , APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE 4—UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. CC: ATTESTED County Administrator Health Services Director PHIL BATCHELOR,CLERK O THE BOARD OF Director of Planning, CCHP SUPERVISORS AND COUNTY ADMINISTRATOR Les Spahnn, SRJ. Jackson, Barisli & Associated, M382 (70/88) BY ,DEPUTY -2- Unfortunately, we were unaware at the time that the federal government limits pilot projects involving "guaranteed eligibility" and "lock-in" , as these provisions are called, to a six month period. Since AB 3223, as enacted, would provide the mother perhaps as much as 12 -14 months of guaranteed eligibility and lock-in (through the balance of pregnancy and for six months thereafter) , the federal government would not approve the project. It is, therefore, necessary to amend AB 3223 to strictly limit the period of lock-in and guaranteed eligibility to six months . AB 2354 has been introduced by Assemblyman Campbell for this purpose. AB 2354, as introduced, will limit the mother to six months of lock-in and guaranteed eligibility and will also and separately limit the baby to six months of lock-in and guaranteed eligibility. What this may, unfortunately, do is to terminate the mother' s period of lock-in and eligibility just before or just after the birth of the baby. The baby would be locked-in and guaranteed . eligibility for the first six months of life in any case, if the mother so chose. Hopefully, after six months of appropriate prenatal care, the Contra Costa Health Plan (CCHP) marketing staff will be able to convince the mother that membership in the CCHP is the best way to obtain her medical care so she will voluntarily remain in the CCHP. The potential for termination of guaranteed eligibility is not judged to be a major factor since it is most unlikely that a pregnant Medi-Cal recipient' s economic and domestic circumstances will change so dramatically that she will become ineligible to Medi-Cal during her pregnancy and shortly thereafter. What the entire pilot project does is to provide an opportunity for the CCHP to prove to a mother that they can provide high quality prenatal and postnatal care to her and her baby and that the continuum of care is valuable to the mother, baby and the entire community. The pilot project already has built in evaluation criteria which must be met in order to test the validity of the thesis that early and continuous prenatal and postnatal care actually results in longterm savings to the community and improved health to mother and child. AB 2354 still requires some technical amendments to clarify the period of the baby' s eligibility, but otherwise we believe that this legislation is what is required by the federal government. In view of the fact that this legislation is included in the Board' s 1992 Legislative Program, it is appropriate for the Board to acknowledge that AB 2354 is sponsored by the Board.