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Home My WebLink AboutMINUTES - 05101994 - 1.35 TO: BOARD OF SUPERVISORS FROM: Mark Finucane Contra Health Services Director Cx)sta DATE: May 6, 1994 , Goirly SUBJECT: Local Initiative Workplan Timetable SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDATION Approve the Local Initiative Workplan Timeline for the Medi-Cal Local Initiative and authorize the Chair, Board of Supervisors, to submit the Workplan Timeline to the State. II. FINANCIAL IMPACT Receipt of$541,000 in planning funds from the SDOHS is contingent upon the Board of Supervisors' submission of a Workplan Timeline. III. REASONS FOR RECOMMENDATION / BACKGROUND The State of California is making planning funds available to Counties to assist them in developing their Local Initiative. The SDOHS has informed us that Contra Costa County's share of the initial planning funds will amount to $541,000. To receive this fixed fee planning grant, the Board of Supervisors must submit an outline of a Workplan Timeline. The County may modify the Timeline at any stage in the development of the Local Initiative. The Medi-Cal Advisory Planning Commission approved the Workplan Timeline at its May 5, 1994, meeting. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S): J ACTION OF BOARD ON �YYI� I D 9 q T APPROVED AS RECOMMENDED OTHER VOTE OF SUPERV19ORS 1 HEREBY CERTIFY THAT THIS IS A TRUE _V-/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. CC: ATTESTED PHIL BAT HELOR. CLERK OF THE BOARD OF CCS: Milt Camhi SUPERVISORS AND COUNTY ADMINISTRATOR Bobbi Baron . BY_j �� D DEPUTY M382/7-83 The Board of Supervisors Contra thetchelor and County Administration Building Costa Coun A(510)646-2371dministrator 651 Pine St., Room 106 County Martinez, California 94553 Tom Powers,1st District Jett Smith,2nd District sE L Gayle Bishop,3rd District ? °" Sunne Wright McPeak,4th District y, Tom Todakson,5th District S "a rrA POU1'i"� May 10, 1994 Ms Sandra Carol Pierce Chief Contract Development Section California Department of Health Services 714 P Street, Room 1400 Sacramento, CA 95814 Dear Ms Pierce: Enclosed is the Local Initiative Workplan Timeline that was approved by the Contra Costa County Board of Supervisors at its meeting today, May 10, 1994. Sincerely, Tom Powers, Chair ccs: Mark Finucane, Health Services Director Milt S. Camhi, CCHP Executive Director r } CONTRA COSTA COUNTY LOCAL INITIATIVE WORKPLAN TIlViELINE MILESTONE TARGET DUE DATE COMMENTS 1. Planning Process 1.1 Letter of Interest Submitted 6/30/93 1.2 Letter of Intent Submitted 9/28/93 & 11/9/93 1.3 Planning Body B/S appointed MAPC 12/14/93 1.4 Planning Contract When issued by SHOHS 2. Establish Local Initiative 2.1 Legal Authority Established Section 25209.6 of Government Code (Stats 1980 80,C.388 #1) gives B/S authority to participate as an HMO 2.2 Legal Status Established 1851 Contra Costa County is a general law county as established by State legislature 2.3 Local Initiative In place B/S is transitional governing body Governance Structure 2.4 Articles of Established 1851 See 2.2 above Incorporation 3. Financial Analysis 3.1 Demographic Data Ongoing Initial analysis was completed January 1994. Will be updated as new information is received 3.2 Utilization Data Ongoing We are using a combination of State data and CCHP specific data 3.3 Knox-Keene License In place County holds a Knox-Keene Business Plan license for CCHP UP NMESTONE TARGET DUE DATE COMMENTS 3.4 Regulatory Reporting In place CCHP already meets Knox-Keene Requirements and PHP requirements 3.5 Capitalization Plan In place CCHP already meets Knox-Keene requirements 3.6 Financial Assumptions October 1994 Will utilize existing CCHP financial data 3.7 Cost Analysis of November 1994 Will utilize existing CCHP cost Administration and analyses Operational Issues 4. Scope of Services /Benefit November 1994 Package 5. Development & QMrational Funding 5.1 Development Uncertain State delayed issuance of Contract development contract 5.2 Funding for Planning ► Fixed fee funding July 1994 ► Invoice reimbursed Ongoing from July 1994 funding 6. Administrative & QMrational Design 6.1 Determine Operational Completed The Local Initiative will use an Components expanded CCHP combining staff model and community providers 6.2 Determine Completed Local Initiative will use CCHP Administrative administrative components Components including fiscal, MIS, case management, member services, and provider relations 2 o NULESTONE TARGET DUE DATE COMMENTS 7. Delivery System 7.1 Access (time and July 1994 The Access Standards Special distance standards) Committee of the MAPC is to give its report at the June MAPC Meeting. MAPC is to report to B/S in July 1994. 7.2 System Integration December 1994 CCHP is already part of an integrated Health Services Department. It will expand through a combination of community and staff model providers 7.3 Identify Existing Completed Kaiser and CCHP are current Managed Care Systems PHP Contractors. PacifiCare is due to start Summer 1994 7.4 Provider Participation December 1994 The Provider Affairs Committee Standards of MAPC will work on this 7.5 Quality Standards December 1994 MAPC is working on outcomes 7.6 Cultural, Ethnic, & January 1995 There is a special MAPC Linguistic subcommittee dealing with Requirements cultural, linguistic, and ethnic accessibility 7.7 Access for Physically January 1995 There is a special MAPC Disabled Subcommittee dealing with issues of the disabled 7.8 Inpatient Access February 1995 There is a Hospital Subcommittee of MAPC 7.9 Access Enhancements In place CCHP recently expanded its 24- hour telephone advice nurse, urgent care, and member services MILESTONE TARGET DUE DATE COA' MTMS 7.10 Provider Manual February 1995 Will be reviewed by MAPC 7.11 Public Health In place CCHP is part of an integrated Linkage Health Services Department which includes public health services 8. Management Information Systems 8.1 Billing & Claims In place CCHP already has billing and Processing claims capability 8.2 Cost Analysis Preliminary analysis completed 8.3 Referral and Missed In Place for Community providers will be AppointmentFollow-up Staff Model required to have referral and missed appointment system 8.4 State Mandates Will be met 9. Provider Relations 9.1 Provider Recruitment Recruitment will be started in July 1994 9.2 Provider Contracting January 1995 9.3 Provider Orientation February to March 1995 9.4 Ongoing Provider Ongoing Ongoing after implementation Communications 10. S t a t e M a n d a t e d On or before State's due date Deliverables 10.1 Knox-Keene In Place B/S holds an unrestricted Knox- License Keene License for CCHP 4 MILESTONE TARGET DUE DATE COMMENTS 11. MarketingStrategies trategies 11.1 Enrollment Plan February 1995 11.2 Enrollment Material February 1995 12. Quality Assurance Program 12.1 QAIP / PR December 1994 12.2 QA Committees December 1994 12.3 Case Management In Place CCHP has a special Targeted Case Management Program initially funded through a SDOHS pilot project grant 12.4 Beneficiary 6 months after implementation and Satisfaction yearly thereafter Surveys 12.5 Beneficiary Grievance In Place CCHP has State approved complaint and grievance system 12.6 Medical In Place CCHP has a Medical Director Administration who is responsible for authorizations, case management, advice nurse program, etc. 12.7 UR In Place CCHP will expand on its current State approved UR system 13. Public Relations 13.1 Public Information & January 1995 onwards Education 13.2 Member Education January 1995 onwards 5 MILESTONE TARGET DUE DATE C0NVVIENTS 13.3 Member Services In Place CCHP has a Member Services Program Department 13.4 Health Education In Place On going 14. erational Contract with On or Before April 1, 1995. SDOHS BB:smp 52:BT April 26, 1994