Loading...
HomeMy WebLinkAboutMINUTES - 12141999 - C139 TO: BOARD OF SUPERVISORS ` CONTRA COSTA COUNTY FROM: William Walker, MD Health Services Director DATE: December 3,1999 SUBJECT: Modify Structure of Managed Care Commission(MDC) SPECIPIC REQUESTIS)OR RECO MBNDAInON{S}&BACKGROUND AND JUSTIFICATION Recommendation: RESCIND the May 4, 1995, Board Carder which established the Managed Care Commission(MCC) and APPROVE the attached document. The document simplifies the committee structure and authorizes the payment of $25 stipend for attendance at any MCC meeting by a commission member occupying the designated Medi-Cal member seat(not to exceed 12 meetings per year). B c gr : A. The Board of Supervisors, in establishing the MCC in 1995, specified six standing committees of the MCC. After four years of operation, the members of the Commission decided the structure was too complex to be efficient and at its November 17, 1999, meeting, voted to recommend the new structure to the Board of Supervisors. B. In order to recruit and retain a Commission member to fill the designated Medi-Cal member seat, the Commission members voted at its November 17, 1999, meeting to recommend to the Board of Supervisors that they authorize the payment of a $25 stipend to such a member. 'There is precedent in the County for paying a stipend to Commission members. For example, in 1946, the Board of Supervisors authorized paying all members of the Human Relations Commission $10 per meeting not to exceed four meetings per month. Additionally, Local Initiatives in neighboring counties which have instituted stipends for Medi-Cal members of their commissions and boards,have found that they were able to recruit and retain such members. Bscal Impatt: A maximum of$300 per year for stipend. k CONTINUED ON ATTACHMENT: Yes SIGNATURE RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(4): ACTION OF BOARD ON December 14, 1999 APPROVED AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS {ABSENT AND CORRECT COPY OF AN ACTION TAKEN _ AND ENTERED ON THE MINUTES OF THE BOARD AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: Contact Person: Bobbi Baron,CCHP 313.6CO4 ATTESTED December 14, 1999 CC: Bobbi Baron,CCHP PHIL BATCHELOR,CLERK OF THE BOARD OF Health Services Director(HSD) SUPERV RS AND CO NTY ADMINISTRATOR BY; DEPUTY CONTRA COSTA COUNTY MANAGED CARE COMMISSION QYERVZW The Managed Care Commission(MCC)is a 15-member Advisory Body appointed by the Board of Supervisors to act as the guidance mechanism of CCHP. The MCC replaces the CCHP Advisory Board and the MAPC and takes on the functions of both bodies. Meetings of the MCC and its committees are open to the public, consistent with the Ralph M. Brown Act and County statutes. Work of the committees, once accepted by the MCC,would be the basis for MCC advice to relevant bodies including the Board of Supervisors, the State Department of Health Services,the Federal Health Care Financing Administration, among other agencies. FUNOCIONS AND DUDES Fundi ns arid„duties of e MCC w U'u dude: Cover the health care concerns for the Medi-Cal, Medicare, Commercial, and Medically Indigent persons served by the County. Assure provider, consumer, and community, as well as gender, ethnic, cultural, and geographically diverse population input to deliberations and decision-making. (The Board of Supervisors does this by its requirements for membership on the MCC and the MCC does likewise by its appointments to its committees.) Do long-range planning and policy formulation and make recommendations to:Board of Supervisors, County HSD Director and Chief Executive Officer of CCHP/Local Initiative. Study and make recommendations to the Chief Executive Officer of CCHP on operational objectives,policies and procedures and recommend changes as well as revised service, product development, marketing, and data gathering priorities. Assure'effectiveness, quality (including good outcomes), efficiency, access, acceptability of CCHP services by ongoing as well as periodic formal reviews of information produced by an up-to-date Management Information System and other sources. Regularly review the CCHP operational budget and amendments thereto. Review, analyze, and advise the Board of Supervisors, HSD Director, and Chief Executive Officer ofCCHP of the overall progress, constraining, or threatening needs and special problems of CCHP. Encourage public understanding of CCHP and provide support throughout the County for its development. Prioritize and assign to appropriate committees. 2 COMMITTEE STRUCTURE, MEMBERSHIP, AND FUNCTIONS There will be an Executive Committee of the MCC with at least one member who is a member of CCHP. There will be three standing and three special committees of the MCC with names and functions as follows: STANDING COMMITTEES Health Care Study health care delivery approaches, centralization versus regionalization issues, and new, alternative, or improved modes of treatment. Review quality assurance studies and utilization.trends. Analyze member and consumer issues including geographic, gender, ethnic, and other facets of consumer concerns. Review availability, acceptability, and member satisfaction with services. Review grievance trends. Make recommendations to MCC. Finance Study plan budgets, expenditures, and cost trends. Make recommendations to MCC. Marketing and Health Promotion Study needs of current and potential subscribers for scope of services, scope of benefits, and price. Examine patterns of enrollments and disenrollments of CCHP members and of competitors. Review outreach,health education, and health promotion activities. Make recommendations to MCC. SPECIAL COMMITTEES Community Advisory Committee This committee is required by State mandate for the Local Initiative and is charged with providing input on CCBP's Cultural and Linguistic Services Plan.. Make recommendations to the MCC. Governance Recommend structural and governance changes of the Managed Care Commission and its standing and special committees and annually recommend a slate of officers. Make recommendations to MCC. 3 y Public Policy Study impending federal, state, and county program changes and their relationship to CCHP. Monitor and make recommendations on county, state, and federal legislation and regulatory matters. Make recommendations to MCC. There may be Ad Hoc Committees of the MCC. These will be created by the MCC for special issues or concerns that do not fit into the work of the standing committees or that may involve several of them. The assignment, membership, and duration will be set by the MCC. Committee chairs must be members of the MCC. Committee members need not be members of the MCC. In addition to the 15 Commission members, any individual or organization may attend and participate on any appropriate committee that is established. MCC committee chairs are appointed by the MCC chair. MCC MEMBERSHIP,APPOINTMENTS,AND TRANSITION PROCEDURES The Board.of Supervisors as a whole shall make the appointments to the.MCC. There will be 15 appointed members of the MCC: No less than one Medi-Cal subscriber;one Medicare subscriber,one commercial subscriber;one person sensitive to medically indigent health care needs;one physician,non-contracting;one other provider,non-contracting;; and no less than nine at-large members,non-contracting. The Board of Supervisors` appointments reflect the County's ethnic, cultural, gender, and geographic diversity. The Board of Supervisors will appoint members of the MCC who are dedicated,health-care interested, capable,public-spirited individuals who want to make CCHP an outstanding health care plan. The Board of Supervisors will not select individuals because they fit any specific skill or area of expertise. However, a list of desirable capacities appears below to be used in making the choices for the members to be appointed. These are in no way prerequisites for a position on the MCC but do bring valuable areas of experience to the MCC when present in a suitable candidate. Ambulatory care Business interests Consumer advocacy Evaluation of outcomes Finance Health care law Health issues: children,women,elderly,cultural,ethnic,linguistic,disabled HM0 administration Labor Marketing Nursing administration and practice Nutrition education and services Personnel Public health and prevention 4 They are voluntary positions and, except for the Medi-Cal position,unpaid,but actual and necessary expenses are to be reimbursed as per County practice. The commission member occupying the designated Medi-Cal member seat shall receive a 25 stipend for attendance at any MCC meeting(not to exceed 12 meetings per year). MIALAMINTIMENTS In the first round of MCC appointments,the Board willl endeavor to appoint a majority from current members of the HMO Advisory Board and.MAPC bodies if there is sufficient interest and expertise among the current eligible membership. Terms of office are for three years. Persons who are involved as contractors with CCHP cannot be members of the MCC, nor can Health Services Department employees. Once selected by the Board of Supervisors,the 15 initial appointees will be choses by lottery: 1/3 for one-year term, 1/3 for two-year terra, and 1/3 for three-year term. Reappointment can be made to a maximum of two consecutive full three-year terms. Subsequently, after an absence of one year, a former MCC member can be appointed for a full term. Initially the current chairs of the MAPC and HMO Advisory Board will be appointed to the MCC as part of the majority who are drawn from the current MAPC and Advisory Board. They will serve as interim co-chairs of the MCC for a period not to exceed four months. They will appoint the initial committee chairs and members of the MCC standing committees. The MCC will elect its chair once the co-chair term is over. A special recommendation committee of two members each from the MAPC and the Advisory Board, and CCHP Chief Executive Officer or his designee(s),will recruit widely for MCC applicants, assure that all applications including those of current eligible HMO Advisory Board and MAPC members are forwarded to the Board of Supervisors and recommend to the Board initial members for the MCC. The Director of Health Services is an ex-officio,non-voting member. The Chief Executive Officer of CCHP is an ex-officio,non-voting member. The:Board of Supervisors fum.ction as ex-officio, non-voting members. BY LAWS The MCC shall establish By Laws which include officers;member absence policies;rules of procedures; conduct of business; and establishment of rules for a quorum. -CONN ICT OF al aEREST Boar Po y for M d. e!Co ss Even though persons who are involved as contractors with CCHP cannot be members of the MCC, in the course of MCC business, issues or events may arise that could possibly constitute a conflict of interest for members. Therefore, MCC members must file an initial 5 and annual conflict of interest statement. failure to file such a statement may result in the member's removal. Members may participate on issues in all discussions including those having'a direct financial impact on the members and/or an issue in which the member and/or the member's organization or his/her immediate family member(s)has a direct financial conflict of interest. STAFFING The MCC and its committees will be staffed.by Contra Costa Health plan and County Health Services Department administrative stab. 6