HomeMy WebLinkAboutMINUTES - 06251985 - 1.58 TO: BOARD OF SUPERVISORS
Phil Batchelor, County Administrator `�-'�tra
FROM: f OZACI
l
DATE; June 17, 1985 cwgy
SUBJECT: LEGISLATION - AB 2170 (MARGOLIN)
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) 4 BACKGROUND AND JUSTIFICATION
RECOMMENDATION•
Adopt a position of support for AB 2170 by Assemblyman Margolin which would
allow individuals eligible for Medi-Cal to enroll in an HMO and be
guaranteed coverage for six months.
BACKGROUND:
Under current law, a welfare recipient is only eligible for Medi-Cal in
those months he/she is eligible for welfare. There are a variety of
technical reasons -which can cause a recipient not to be eligible for a
given month, thereby also terminating Medi-Cal for that month. This causes
an enormous administrative problem for HMOs like the Contra Costa Health
Plan. A recipient may, for instance, fail ;to submit an earnings report on
time. This can cause a suspension of AFDC to
and thereby Medi-Cal.
When the recipient is in the Contra Costa Health Plan, this means the
recipient must be disenrolled and reenrolled the following month. During
the period of disenrollment, the Health Plan gets no reimbursement and
cannot provide medical care to the individual. However, the individual can
probably come into a county outpatient clinic and get care anyway on a
fee-for-service basis which the individual may not be able to pay for.
This costs the county money in care provided for free and lost revenue from
the state. In cases where the individual is undergoing ongoing treatment,
the treatment must be interrupted during the period of disenrollment.
After the paperwork is- straightened out with the Social Services
Department, the individual generally gets his/her AFDC payment reinstated.
However, the recipient cannot be reenrolled in the Health Plan during that
same month.
AB 2170 would eliminate this unnecessary and unproductive administrative
paperwork and interruption in the continuity of medical care by allowing a
Medi-Cal recipient to enroll in the Health Plan and be guaranteed six
months of coverage as is provided for by federal law. During this
six-month period, the individual could not disenroll from the Health Plan
except for "good cause" .
CONTINUED ON ATTACHMENT: X YES SIGNATURE:
_ X RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
_....X APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON _._.Selma 25.19 APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT __ ) 1 HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
County Administrator OF SUPERVISORS ON THE DATE SHOWN.
CC: Health Services Director ESTED
Executive Director, Contra Costa eal th p%
Assemblyman Margolin i PHIJ BATCHELOR, CLERK OF THE BOARD OF
Assemblymen Baker, gates, Campbell & Isenberg SUPERVISORS AND COUNTY ADMINISTRATOR
CSAC (Roger King) ,
M382/7-83 BY �� , DEPUTY
Page 2
Since AB 2170 would eliminate unnecessary administrative paperwork and
expense, would improve revenue to the Health Plan, reduce uncompensated
care provided by the Health Services Department and improve the continuity
of medical care, the bill deserves the support of the Board of Supervisors.
The Health Services Director recommends that the Board support AB 2170, and
this office concurs in that recommendation.
AB 2170 will be heard in the next few days in the Assembly Ways and Means
Committee. The bill passed the Assembly Health Committee May 7 by a vote
of 9:0.