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Home My WebLink AboutMINUTES - 01141997 - C100 -s1'- BOARD OF SUPERVISORS TO: — = °— Contra Costa FROM: William Walker, M.D. Count osrq cd4N` y Health Services Director DATE: December 16, 1996 SUBJECT: Status Report on the Local Initiative for Medi-Cal in Contra Costa County SPECIFIC REQUEST(S) OR RECOMMENDATION(S) &BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: Accept the Status Report on the Local Initiative for Medi-Cal in Contra Costa County as requested by Supervisor Gayle Bishop at the Board of Supervisors meeting on November 19, 1996. II. FINANCIAL IMPACT: The November 19, 1996 approval of Contract#29-772, with the State Department of Health Services (DOHS), will result in a maximum payable amount of$26,661,430 for fiscal year 1996-97 to reimburse the County for the services and costs of the Medi-Cal Local Initiative (LI) Health Plan. III. REASONS FOR RECOMMENDATIONS/BACKGROUND: The State of California has given Contra Costa County Health Plan LI a confirmed conditional start date of February 1, 1997. The Standard Agreement#29-772 will supersede the prepaid health plan contract for Medi-Cal beneficiaries. CONTINUED ON ATTACHMENT: X YES _NO SIGNATURE: W 4Z / RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S)' ACTION OF BOARD ON January 14, 1997 APPROVED AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE X 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. Contact Person:Milt Camhi(313-6004) ATTESTED January 14, 1997 CC: Health Services Director Contra Costa Health Plan(CCHP) PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS�ND COUNTY ADMINISTRATOR BY Contra Costa County The Board of Supervisors HEALTH SERVICES DEPARTMENT OFFICE OF THE DIRECTOR Jim Rogers, 1st District SE. L William B.Walker, M.D. Jeff Smith,2nd District Director&Health Officer Gayle Bishop,3rd District `' Mark DeSaulnier,4th District 20 Allen Street,rj�� Tom Torlakson,5th Districtp� ? Martinez,California 94553-3191 z \��; c (510) 370-5003 County Administrator >.� FAX(510)370-5099 Phil Batchelor �SrA coii�`�' County Administrator Interoffice Memorandum To: Board of Supervisors Date: December 9, 1996 From: William B.Walker,M.D. Subject: Status Report on the Local Initiative for Medi-Cal in Contra Costa County As requested by Supervisor Gayle Bishop,the following is a status reportto the Board of Supervisors on the Local Initiative for Medi-Cal in Contra Costa County. The State Department of Health Services has approved Contra Costa Health Plan as the Local Initiative in Contra Costa County. On November 6,1996 the State Department of Health Services gave Contra Costa Health Plan(CCHP)a targeted start date of February 1,1997. In his letter notifying CCHP of this target implementation date,Joseph A.Kelly,Chiefofthe Medi-Cal Managed Care Division,said,"I want to congratulate you and your staffon this achievement....We are very pleased at the progress that has been made in the development ofthe Detailed Design Application and we look forward to implementation ofthe Local Initiative in Contra Costa County." The development ofthe Local Initiative has been amassive effort involving all divisions ofthe Health Services Department. The application,whichthe State accurately termed a Detailed Design Application, consists of over 20 large volumes of narrative,policies,procedures,manuals,draft provider contracts,and member informational materials. We submitted and the State has reviewed at least 10,000 written pages. Although Contra Costa Health Plan has successfully gone through the State's rigorous examination,Foun- dation(the Commercial Plan for Contra Costa County)has not yet been given the go ahead from the State and does not have atargeted start date. Until Foundation is approved by the State,Medi-Cal beneficia- ries in Contra Costa County will have a choice of an expanded CCHP called Health Partners or fee-for- service Medi-Cal. After Foundation has started,then over 60,000 Medi-Cal beneficiaries in our county will have a choice of an expanded CCHP,which includes Kaiser and community MDs,along with Mer- rithew providers,or Foundation Health Plan. Merrithew Memorial Hospital&Health Centers • Public Health • Mental Health • Substance Abuse • Environmental Health Contra Costa Health Plan • Emergency Medical Services • Home Health Agency • Geriatrics A-345 (1/96) Page 2 12/9/96 Board of Supervisors A maj or component ofCCHP's preparation to become the Local Initiative was the development of its Health Partners concept. CCHP has been a staffmodel HMO utilizing primarily Merrithew Memorial Hospital&Health Centers as its facilities and the Merrithew medical staff as its core providers. Under the Local Initiative,CCHP will now consist ofits current Merrithew facilities and providersplus Kaiser Perma- nente and community physicians and hospitals. A Medi-Cal beneficiary who oins the CCHP Local Initia- tive will be able to choose either a Kaiser provider,a community MD or a Merrithew MD as the primary care provider. This is an extensive expansion ofinember choice and access. Among other changes which enhance memberaccess is the implementation of anew appointment system in the County's ambulatory care system called Patients'Choice. This new system helps ensure that members can get same day appointments when they ask for them. We have also increased the number of County health centers for Health Plan members. Contra Costa Health Plan members can now be seen in Bay Point andAntioch. As part ofthe reorganization for Medi-Cal,CCHP has developed anew Quality Management Plan which covers the expanded network. This proposed plan includes anew body,called the CCHP Joint Confer- ence Committee. Two members ofthe Board of Supervisors are to be members ofthis Joint Conference Committee. We will bring this proposed plan to the Board of Supervisors early next year. The Managed Care Commission,which was established over a year ago by the Board of Supervisors to provide oversight for CCHP,has endorsed the goals,objectives and structures ofthe Quality Management Plan and the annual Quality Management workplan at its November 1996 meeting. To summarize the status ofthe Local Initiative in Contra Costa County it is important first of all to note that Merrithew and Contra Costa Health Plan are already taking care ofthe Medi-Cal population. Merrithew Memorial Hospital&Health Centers is the largest fee-for-service provider to Medi-Cal patients and Contra Costa Health Plan,with a quarter century ofMedi-Cal experience,has the largest prepaid Medi- Cal market share in the County. And for the next phase in its development,Contra Costa Health Plan has successfully managed a most detailed and rigorous application process,met the State's deadlines,ex- panded our provider network,and made some internal changes and now will make the transition into an operational Local Initiative in Contra Costa County. We are confident we will successfully compete in this fast changing,cost competitive,service and quality driven healthcare marketplace while maintaining our core values. WBW:b:km k\mscmem.pm5 The Old CCHP Contra Costa Health Plan Staff Model HMO Merrithew Memorial Health Centers Other County Providers Hospital • Brentwood e.g., Mental Health • Concord Public Health • Martinez Substance Abuse • Pittsburg • Richmond k\rn 1209.pm5 Contra Costa Health Plan's Health Partners for Medi-Cal County Health Kaiser CommunityProviders Services Dept. Permanente MMH Health Care Other County Traditional & Other Community Centers Providers Safety Net Providers Providers A long tradition of serving Medi-Cal. Now together as Health Partners. k\rn1209.pm5 Contra Costa Health Plan's HEALTH PARTNERS Serving Medi-Cal in Contra Costa County C W. a 1=800=211=8040 Call today for information about joining ✓Expanded Choice ' YES,I am interested in receiving material about Contra Costa ' Choose from one of our doctor groups Health Partners,a program for Medi-CaI members of Contra Costa for your health care Health Plan • Contra Costa Health Services Name ' • Kaiser Permanente Address • Community Physicians Network i City Zip Phone ,/Expanded Health Services i Call HCO 1-8004304263 to enroll • Doctors you know Mail to: Contra Costa Health Partners,595 Center Avenue,Suite 100 i • Hospitals near you Martinez,California 94553 • Advice Nurses 24 hours a day L--------------------J