HomeMy WebLinkAboutMINUTES - 05081990 - 2.5 TO: BOARD Of SUPERVISORS
57
FROM: Phil Batchelor, County Administrator Cwtr
Mark Finucane, Director �nf
Health Services Department Costa
DATE: WLn
May 4, 1990
SUBJECT:
SB-1255 Medi-Cal Contract
SPEC 1 F i C REQUEST(S) OR RECOUNIE DATION(S j A BAC WROUND AAD JUSTIFICATION
I . RECOMMENDED ACTION:
1 . Authorize the Health Services Director to provide, by May
10, 1990, written notification to the California Medical
Assistance Commission of the County's intent to enter
into SB-1255 negotiations .
2. Authorize the Health Services Director to transfer a
maximum of $4,000,000 to the State of California as
authorized under SB-1255 .
3 . Instruct staff to report back to your Board, the results
of the SB-1255 Medi-Cal contract negotiations by July 1,
1990 .
II. FINANCIAL IMPACT:
Merrithew Memorial Hospital will be eligible for a maximum of
$4 . 0 million in matching Federal funds . See background
information for full discussion.
III. BACKGROUND:
Federal grants to the States for the Medicaid program (Medi-
Cal in California) are authorized under Title XIX of the
Social Security Act to provide medical assistance to certain
persons with low income. These Medicaid programs are jointly
financed by the Federal and State governments and administered
by the States . State Medicaid agencies conduct their programs
according to the Medicaid State plan approved by the
Administrator of the Health Care Financing Administration
(HCFA) . To carry out the Medicaid program, the State agency
pays providers for medical care and services provided to
eligible Medicaid recipients .
The Federal government pays its share of Medicaid program
expenses to the State on a quarterly basis according to a
formula. The State share of Medicaid program expenses is paid-
from "State funds" , that is, those funds over which the State
legislature has unrestricted power of appropriati In
California, the program "split" is 50% Federal finan g, 50%
State financing.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY AOMINISTRATORRECOMME/OATION OF BOAR COMMITTEE
APPROVE OTHER
IGNJ►1'URE 5 1
ACTION OF BOARD ON APPROVED AS RECOMMENOCO < OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
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 SHDWN.
County Admin s-trator ATTESTED MAY 81990
Health. Services
PHIL BATCHELOR. CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
M382 7-83 BY .DEPUTY
-2-
SB-1255 (Chapter 996, Statutes of 1989 ) added Section 14085 . 6
to the Welfare and Institutions Code and established a program
whereby certain voluntary transfers and donations will be
utilized by the State to provide funds to disproportionate
share hospitals to assist them in enhancing or maintaining
access for Medi-Cal beneficiaries . This program is similar
in nature to those established in Tennessee and other states .
These voluntary transfers would be used to match Federal
dollars under the Medi-Cal program, thereby increasing the
total revenue base available for distribution (i.e. , $1
donation will generate $1 in Federal funding back to the
disproportionate hospitals) .
Merrithew Memorial Hospital is one of the forty-one (41)
disproportionate hospitals eligible for reimbursement under
this program.
The California Medical Assistance Commission (CMAC) is
responsible for administration of SB-1255 . The Commission
will solicit the donations and distribute the funds collected
through the Medi-Cal contracting processing.
Facilities which voluntarily donate funds by May 17th will be
eligible for a Medi-Cal contract rate increase by June 30th
of this year, retroactive to January 1 � i990.
ISSUES
Issues 1: The State SB-1255 Plan may be disallowed at the
Federal level.
Discussion: If a disallowance were to occur, some part of
the "increased" Federal share might be required
to be reimbursed.
Issue 2: Facilities which make a "voluntary" donation are not
guaranteed of a return of either the matching
Federal funds or the donation itself .
Discussion: SB-1255 is intended to provide a workable
program. If the most "needy" facilities in the
State make donations and do not receive-back,
at a minimum, $1 .50 for each $1 . 00 in donation,
the program will fail. While, because of
Federal restrictions, the State cannot
guarantee the return of the transferred funds,
it is the intent of the program that no
"donating" facility will be disadvantaged.
Los Angeles, San Bernardino, San Francisco, and Santa Clara
counties will be participating in the initial transfer and
negotiation phase of the SB-1255 program.
The Health Services Director has discussed the viability of the
program at length with the Administrator of the Health Care
Financing Administration. The Auditor-Controller, County Counsel,
Health Services Director, and County Administrator, coupled with
input from the law firm of Weissburg and Aronson have actively
participated in the review and risk assessment of this program and
are in concurrence regarding the recommendations .
In addition, advise and counsel was sought from the Director of the
State Department of Finance, and the Los Angeles County
Administrator who assured the County that the recommended action
was an acceptable business decision.