HomeMy WebLinkAboutRESOLUTIONS - 01012002 - 2002-312 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Order on may 14, 2002 , by the following vote :
AYES : SUP'ERV'ISORS UILKEMA, GERBER, DeSAULNIER, GLOVER ANIS GIOIA
NOES : NONE
ABSENT: NONE
ABSTAIN: NONE
SUBJECT: Standards for Administration )
of Indigent Health Care ) RESOLUTION 2002/ _ 3_U
(Basic Health Care Program) )
WHEREAS the County is responsible under Welfare and
Institutions Code Section 17000 for the health care of persons
qualified as indigent for its General Assistance program; and
WHEREAS the County established the Basic Adult Care
Program by Resolution No. 82/1486, superseded by Resolution No. 83/191
as amended by Resolution No. 83/1025; superseded these Resolutions by
Resolution No. 85/35 as amended by Resolution No. 85/114 ; and
thereafter superceded these Resolutions by Resolution No. 85/376;
WHEREAS the Basic Adult Care Program was transferred out
of the Contra Costa Health Plan by Resolution No. 92/760;
WHEREAS the County desires to change the name of the Basic
Adult Care Program to the Basic Health Care Program and to otherwise
update the administrative elements of the program;
The Contra Costa County Board of Supervisors hereby adopts
the following standards for the provision of health care services to
eligible indigents, effective May 1, 2002:
I. BASIC HEALTH CARE PROGRAM
The Basic Adult Care Program (BAC) is hereby replaced by the
Basic Health Care (BHC) Program as the county health care
program for the General Assistance and medically indigent
eligibles described herein.
II. ELIGIBILITY
A. The following persons are eligible for the Basic
Health Care Program:
1 . Residents of Contra Costa County who are
medically indigent as determined by the income and
resources criteria established by regulation by the
Health Services Director and who are not eligible for
any other health insurance program, including, but
not limited to, the California Medi--Cal program and
employer-sponsored health programs .
2 . Persons eligible for Contra Costa County General
Assistance as determined by the Department of
Employment and Human Services under those Resolutions
of the Board of Supervisors governing General
Assistance eligibility pursuant to Welfare and
Institutions Code section 17000 .
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RESOLUTION NO. 2002/ 312
B. Eligibility Determination:
Medically indigent eligibility will be determined, and
General Assistance eligibility will be verified, by the
Health Services Department .
III. TERM OF ELIGIBILITY
A. The Health Services Director, by regulation, shall
determine and may modify the term of eligibility of
persons entitled to receive BHC Program benefits . A
determination that a person is eligible for the BHC
Program shall be effective for not less than five calendar
months, including the month during which application is
made, provided that at all times during such period such
person meets the eligibility requirements set forth in.
Section II .A. and fulfills the Health Partnership
obligation, if any, set forth in Section VII .B. The
Health Services Director may, by regulation, establish the
terms and conditions under which persons enrolled in the
BHC Program may be re-enrolled for consecutive eligibility
periods .
B. Upon termination of eligibility, the person must
reapply and his or her eligibility must be redetermined.
Neither an initial application for enrollment nor an
application for re-enrollment after termination may be
made, nor may eligibility be determined for a person not
then enrolled, until the applicant needs health care
services under the BHC Program and applies at a Contra
Costa County Health Services Department facility.
C. An applicant is entitled to receive medically
necessary services at a Contra Costa County Health
Services Department facility before eligibility has been
determined. If the applicant who has received medical
services is determined to be ineligible for the BHC
Program, the Health Services Department shall bill the
recipient for the services rendered.
IST. ENROLLMENT IN BASIC HEALTH CARE PROGRAM
Eligible persons who are enrolled in the Basic Health Care
(BHC) Program are subject to termination as follows :
A. Termination for Cause . If, after reasonable efforts,
any BHC member, hospital, or medical staff member is
unable to establish and maintain a satisfactory hospital-
patient or physician-patient relationship with any BHC
member, then the rights of the BHC member may be
terminated after the mailing of written notice of
termination to the BHC member, at least 15 days before the
proposed effective date, specifying the reasons for
termination, and providing the BHC member with 10 days to
respond (orally or in writing) to the BHC Program
Grievance Coordinator, who shall make a written
recommendation to the BHC Program for or against
termination.
B. Loss of Eligibility. If a BHC members ' eligibility
ceases for any reason, including failure to pay a Health
Partnership fee, such loss of eligibility shall result in
an automatic loss of benefits concurrent with the loss of
eligibility. Services received after the effective date
of termination will be billed directly to the recipient .
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RESOLUTION NO. 2002/ 312
C. Ay
.]2eals on Termination, A BHC member may appeal a
termination for cause to the Contra Costa County Health
Services Director.
V. SERVICES PROVIDED
The services provided by the BHC Program are limited to those
set forth in Attachment A, attached hereto. The County of
Contra Costa is not responsible for unauthorized medical
services rendered by non-County facilities .
VI. PROGRAM CHANGES
Nothing in this Resolution shall preclude the County of Contra
Costa from modifying, reducing, or eliminating any or all of
the services provided by the BHC Program or from terminating
the BHC Program at any time.
VII . HEALTH PARTNERSHIP PAYMENTS
A. Hgalth Partnership obligation.•
Individuals otherwise qualified under Sect'ion II .A. for
the BHC Program who are determined by the Health Services
Department to be able, based on income and resources, to
contribute to the cost of their health care, will be
required as a condition of eligibility to pay a
proportionate share of their Health Plan monthly cost .
Said proportionate share shall be based on each eligible ' s
gross income, resources, and family size .
B. Payment of the Health Partnershi-o Obligation
1 . Persons subject to a Health Partnership
obligation will be enrolled in the BHC Program,
advised of their financial obligation, and asked to
pay for not less than the minimum five, (5) month
eligibility period upon approval of their
application.
2 . Persons who do not pay the entire amount of the
five month Health Partnership Obligation in advance,
must pay the balance due by the first day of the
following month, and must pay any further obligation
as directed by the Health Services Director.
3 . Persons who fail to make timely payment of their
Health Partnership Obligation are subject to
disenrollment from the BHC Program effective as of
the date of eligibility after notice and the
opportunity for an appeal to the Enrollment
Supervisor of the Contra Costa Health Plan.
4 . Persons with an unpaid Health Partnership
Obligation under the BHC Program are ineligible for
re-enrollment upon the expiration of their
eligibility period.
VIII. CHOICE OF PROGRAM
Eligible persons who choose not to participate in the County' s
BHC Program will not be enrolled in the Program and will be
treated by the County as private pay fee-for-service patients .
The County will not pay for care provided to such fee-for-
service patients at non-County facilities .
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RESOLUTION NO. 2002/312
IX. REGULATIONS
The County Health Services Director is empowered to adopt
written regulations and procedures consistent with this
Resolution for the operation of the Basic Health Care Program.
Resolution No. 85/375 is hereby superseded.
Contact: William Walker, M.D. (370-5003)
cc: County Administrator
Health Services Director
Contra Costa Health Plan Director
County Counsel
Auditor-Controller
VLD: Id
H:\Hoard Actiona\HaaiC Adult Care\2002 Draft #2 Reaolution.wpd
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RESOLUTION NO. 2002/312
ADDENDUM TO ITEM SD.2
May 14, 2002
On this day, the Board was scheduled to consider adopting a policy regarding Basic Health Care Program for
Indigent Adults and Children.
The Chair invited the public to comment. The following person presented testimony:
Aimee Chitayat, from Community Clinic Consortium of Contra Costa, 13925 San Pablo Avenue#207, San
Pablo,
Following discussion, the Board took the following actions:
ADOPTED Resolution No. 2002/312 and approved Administration of Indigent Health Care and
authorized the Health Services Director to establish Basic Health Care Program regulations
including a sliding fee schedule for indigents with incomes up to 300% of Federal Poverty
Guidelines; and DIRECTED the Health Services Director to return to the Board within six
months to a year with a status of the program.
1
ATTACHMENT A
BASIC HEALTH CARE PROGRAM
COVERED BENEFITS, LIMITATIONS, AND EXCLUSIONS
Abortions Not covered (pregnancy is covered
by Medical)
Acupuncture Not Covered
Advice Nurse Covered
Allergy Injections and Allergy Covered
Testing —
Alcohol Abuse Not covered (covered by other
programs administered by the health
Services Department)
Biofeedback Not covered
Blood Covered, except self donation is not
covered
Chi ro ractic Care Not covered
Contact Lenses Not covered, except for implants
following cataract surgery or for
Aphakia or Keratocomas
Cosmetic Surgery ^ Not covered
ATTACHMENT A
(PAGE 1 of 5 PAGES)
Custodial Care Not covered
Dental Care Not covered, except for emergency
dental services limited to dental x-
rays, dental examinations, and
extractions, only.
Children ages 5 through 14,
inclusive, are limited to the
following covered services:
1. Emergency dental services
2. Dental examinations
3. Dental x-rays
4. Dental fillings
5. Extractions
i 6. Preventive dental care that
includes teeth cleaning, sealants, and
fluoride applications.
Diabetic Supplies Covered
Diabetic Testing Covered
Drug Abuse Not covered (covered by other
programs administered by the Health
Services Department)
Durable Medical Equipment Covered
Emergency and Urgent Care Covered
Eye Glasses Not covered
ATTACHMENT A
(PAGE 2 of 5 PAGES)
_Experimental Treatment Not covered
Family Planning Covered
i..Hearing Aids & Batteries Not covered
Hearin Tests Audiolo ) Covered
Hemodial sis Acute Covered
Hemodialysis -- Chronic Not covered
Home Health Services Not covered
Hospitalization Covered
Hospice Not covered
Hypnotherapy Not covered
Immunizations and Inoculations Covered, except travel inoculations
and medications are not covered.
..Infertility Services Not covered
Long Term. Care at Skilled Nursing Not covered
Facility
Maternity Care Not covered covered by Medical
ATTACHMENT A
(PAGE 3 of 5 PAGES)
Mental Health Services Not covered (covered by other
programs administered by the Health
Services Department)
tNewbomcovers e Not covered (covered by Medical)
Or an Trans lant Not covered
Ortho tic (eye trainin Not covered
k.Outpatient Visits Covered, but some visits require
prior authorization
j
Over the Counter Drugs Only those drags listed on the
Preferred Drug List, as periodically
amended by the Pharmaceuticals and
Therapeutics Committee, are
covered.
Personal & Comfort Items Not covered
Physical Examinations Not covered, except back-to-work
ro rams are covered
Prescription Drugs, Outpatient Only those drugs listed on the
(legally require a prescription) Preferred Drug List, as periodically
amended by the Pharmaceuticals and
Therapeutics Committee, are
covered.
Prosthetic devices, corrective appliances & Not covered
artificial aids
ATTACHMENT A
(PAGE 4 of 5 PAGES)
Radial Keratotomy Not covered
Refraction Covered
Skilled Nursing Facility Not covered
Sterilization Covered
i
Su lies, dis osable Covered
Therapy: outpatient, physical, speech and Covered only in cases of expected
occupational short term improvement (2 month
maximum)
TMJ Treatment Not covered
LTransportation Not covered _
NOTE: All covered services are provided only at Contra Costa County facilities
unless referred and preauthorized by Contra Costa County.
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ATTACHMENT A
(PAGE 5 of 5 PAGES)