HomeMy WebLinkAboutMINUTES - 06251991 - 1.93 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
Adopted this order on June 25 , 1991 , by the following vote:
AYES: Supervisors Fanden, Schroder, McPeak, Torlakson, Powers
NOES: None
ABSENT: None
ABSTAIN: None
In the Matter of: ) 408 #9
Support for SB 855 } Resolution 91/
(Robbins ) )
WHEREAS, State Senator Alan Robbins has introduced Senate Bill
855 regarding certain intergovernmental transfers in
support of the Medi-Cal Program and regarding a payment
adjustment program for Medi-Cal inpatient hospital
services rendered by disproportionate share hospitals;
and
WHEREAS, SB 855 is designed to maintain and enhance the access
available for Medi-Cal beneficiaries to receive
inpatient hospital services in Contra Costa County and
throughout California; and
WHEREAS, it is anticipated that Contra Costa County, through its
hospital facility, will receive more revenues under SB
855 on an annual basis than the amount of
intergovernmental transfers required from Contra Costa
County on an annual basis, including projections of an
intergovernmental transfer of $4,448, 657 for the
1991-92 fiscal year contrasted to projected revenues of
$8, 174,662 for the same fiscal year;
NOW THEREFORE, BE IT BY THE BOARD OF SUPERVISORS OF THE COUNTY OF
CONTRA COSTA RESOLVED:
that with specific reference to Government Code Section
17556( a) , the Board of Supervisors hereby requests the
enactment of, and states its support for, SB 855 . This
action is conditioned on the financial structure of SB
855 including substantially the same in concept as the
June 19, 1991 version which was approved by the Senate
Appropriations Committee on June 17, 1991.
IT IS FURTHER ORDERED THAT:
the Chairman is authorized to sign letters on behalf of
the Board of Supervisors for the purpose of
transmitting this Resolution to the Governor of
California, Senate President Pro Tempore David Roberti,
Assembly Speaker Willie Brown, Jr. , Senator Alan
Robbins and members of this County' s legislative
delegation.
I hereby certify that this is a true and correct copy of
an action taken and entered on the minutes of the
Board of Superviseon the date shown.
ATTESTED: —.
PHIL BA HELOR.Clerk of the Board
of Supervisors and County Administrator
gy . dy .Deputy
RESOLUTION NO. 91/408. /9
i
-Y W x. 93
TO: BOARD OF SUPERVISORS Contra
FROM: Phil Batchelor, County Administrator
Costa
Count
DATE: June 241 19 91
SUBJECT:
LEGISLATION: SB 855 (Robbins)
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOM3NDATIONS:
1 . Adopt a position in SUPPORT of SB 855 by Senator Robbins
which would provide additional federal revenue for
disproportionate share hospitals.
2 . Adopt the attached Resolution indicating the Board' s support
for SB 855 and specifically requesting passage of SB 855,
thus waiving any future potential SB 90 claims.
3 . Authorize the Chairman to send copies of the Resolution to
Governor Pete Wilson, Senate President Pro Tempore David
Roberti, Assembly Speaker Willie Brown, Jr. , Senator Alan
Robbins and members of this County' s legislative delegation.
BACKGROUND:
As the Board of Supervisors is aware, the Medi-Cal Program has
never adequately financed health care through direct payments for
services rendered. However, federal medicaid policy recognizes
the need to maintain the fiscal viability of so-called
"disproportionate share" providers. As a result, under federal
medicaid law, "payment adjustments" tied to inpatient hospital
services rendered by disproportionate share providers are a
favored category. Amendments included in Section 4703 of the
Omnibus Reconciliation Act of 1990 confirm that states have
substantial flexibility in structuring payment adjustments for
inpatient services provided by such hospitals.
CONTINUED ON ATTACHMENT: X YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON Jme 25, 1991 APPROVED AS RECOMMENDED 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 SHOWN. �/ Q
cc: See Page 2 ATTESTED
PHIL ATCHELOR,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
BY DEPUTY
M382 (10/88)
-2-
California now operates a small payment adjustment program
(pursuant to AB 4563 , Chapter 981, Statutes of 1988 ) due, in
part, to limitations on State matching funds. By taking
advantage of other federal statutes, which permit local. transfers
to serve as the state match, it is proposed that there be a
substantial increase in statewide medicaid payment adjustments.
A program in the magnitude of $1. 2 billion is possible because
there is no federal limit to the amount of payment adjustments
which may be made to disproportionate share hospitals for
inpatient services.
Each month, counties, university hospitals, and hospital
districts eligible to participate would make an intergovernmental
transfer of 1/12 of a predetermined annual amount to a special
fund in the state treasury. The State would obtain an equal
amount of federal matching funds and distribute the total funds
each month to eligible disproportionate share county, university,
district and private hospitals in the form of "payment
adjustments" on Medi-Cal days of service. The amount of a public
entity' s intergovernmental transfer to the state and the amount
of payment adjustments distributed would be based on statutory
formulas. The program has been designed so that counties and
other public entities should receive about $1.83 of payment
adjustments for each $1. 00 they transfer to the state.
This system, sponsored by Los Angeles County and supported by
CSAC, is embodied in legislation which is being carried by
Senator Alan Robbins, SB 855 . SB 855 is on the Third Reading
file on the Senate Floor, but must still go through the Assembly
before being considered by the Governor. In order to avoid any
possible Gann Limit, Proposition 98 or federal maintenance of
effort requirements on the state, the program has been designed
in such a- way that each county must transfer funds to the state
and then receive them back from the state, along with the payment
adjustment. Because the program also required federal approval,
it is likely that only partial year benefits will be available
for fiscal year 1991-92.
To avoid any possible SB 90 claims in the future related to this
program, the Administration is requesting that each eligible
county' s Board of Supervisors adopt a Resolution in support of
the bill with language which has been incorporated in the
attached Resolution.
On a statewide basis, the program would require transfers of $636
million. The resulting payment adjustments would total $1. 2
billion. In Contra Costa County' s case, the transfer would total
$4, 448,657, for which the County would receive a payment
adjustment of $8, 174,662, for a net benefit to the County of
$3,726 , 005.
In view of the substantial potential benefit to the County from
this program, it is recommended that the Board of Supervisors
approve the above recommendations.
cc: County Administrator
Health Services Director
County Counsel
Auditor-Controller