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Home My WebLink AboutMINUTES - 05101994 - 1.52 TO: BOARD OF SUPERVISORS FROM : Mark Finucane Contra Health Services Director eN--L DATE: May 6, 1994 l./ougy SUBJECT: Draft Solicitation for Response for Dental Managed Care SPECIFIC REQUEST(S) OR RECOWENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDATION Approve the report from MAPC containing its comments on the draft Solicitation for Response for Dental Managed Care and authorize the Chair, Board of Supervisors, to submit the report to the State. II. FINANCIAL IMPACT Medi-Cal fee for service payments for dental care to Contra Costa County Medi-Cal beneficiaries amounts to over $3.5-million annually. Additionally, CCHP provides dental care on a prepaid basis. The State is intending to "carve out" Medi-Cal dental services and provide these services through a limited number of managed care contracts. This will impact both the County's fee for service Medi-Cal revenues and the CCHP capitation payments for dental services. III. REASONS FOR RECOMMENDATION / BACKGROUND On April 1, 1994, the California Department of Health Services Dental Managed Care Procurement (DMCP) Unit released its draft Solicitation for Response (SFR) for the implementation, operation, and maintenance of Dental Managed Care Contracts. At its May 5th Meeting, MAPC approved the attached report commenting on the draft document and requested that the Board of Supervisors endorse the report and forward it to the SDOHS. CONTINUED ON ATTACHMENT; _ YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATUREISI: / ACTION OF BOARD ON _ APPROVED AS RECOMMENDED W 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: 1 OF SUPERVISORS ON THE DATE SHOWN. cc: ATTESTED PHIL BAT ELOR, CLERK OF THE BOARD OF CCS: Milt Camhi SUPERVISORS AND COUNTY ADMINISTRATOR Bobbi Baron M382-7-83 OAA,,�BY A DEPUTY The Board of Supervisors Contra Clerk'ofthehBoard and County Administration Building Costa County Administrator 651 Pine St., Room 106 (510)646-2371 Martinez, California 94553 County Tom Powers.1st District Jeff Smith.2nd District E,•. oA Gayle Bishop.3rd District Sunne Wright McPeak,4th District ;:• Tom Torlakson.5th District _ Tt covs May 10, 1994 Patrick Rodriguez, Chief Dental Managed Care Unit State Department of Health Services P.O. Box 942732 Sacramento CA 95814-7320 Dear Mr. Rodriguez: The Board of Supervisors today voted to approve the attached report from the Medi-Cal Advisory Planning Commission (MAPC) and to submit this report to the State as Contra Costa County's comments on the Draft Solicitation for Response for Dental Managed Care. Sincerely, T Powers, Chair Board of Supervisors TP:BB/lmb Attachments: MAPC Report and Board Order L33:BA MOPC Medi-Cal Advisory Planning Commission 595 Center Avenue,Suite 100 Martinez,California 94553 (510)313-6004 FAX (510) 313-6002 COMMISSIONERS Welby W.Bigelow,Jr.,M.D. Margaret Dowling Heather Saunders Estes, M.S.W. Memo to: Board of Supervisors Mary Lavender Fujii,M.S.R.D. l� Claudette Garner,M.Ed. From: Michael G. Hams,"Chair Michael G. Harris,O.D.,J.D.,M.S. Date: May 6, 1994 Paul Katz Subject: Solicitation for Response for Dental Managed Care Joan Lauten6crger, R.N. Michael P. Lawson Viola Lujan The California Department of Health Services (DHS) Dental Managed Suzanne MacDonald Care Procurement (DMCP) Unit released on April 1, 1994, a draft copy Jack McGervey of a Solicitation for Response (SFR) for the implementation, operation, and maintenance of Dental Managed Care projects in regions throughout Stephen Heisler. M.D. the State. The DSH requested comments and suggestions concerning this Bessanderson McNeil, M.P.H. document prior to the issuance of the final SFR. The DHS will not Cynthia Miller consider any comments received after May 23, 1994. Tony Paap At the May 5, 1994 meeting, the MAPC reviewed and approved the Evelyn Rinzler,M.A. attached report and voted to send it to the Board of Supervisors along with a recommendation that the Board of Supervisors endorse the report and Dolores Sanchez,L.C.S.W.,M.P.H.,Ed.D. forward it to the DHS. Raymond L.Smart Gregg S.Sorensen,M.D.,M.P.H. MH:BB/Imb Linda Stephenson,F.N.P.,M.H.S. Terry Tanner,D.D.S. Attachment: Draft Report Rev.Curtis A.Timmons,B.A.,Th-D. BOARD OF SUPERVISORS LIAISONS Tom Powers Tom Torlakson L33:DM Contra Costa County Comments and Recommendations on Draft Solicitation for Response for Dental Managed Care The State's Request The State in asking for comments and recommendations on its draft Solicitation for Response (SFR) for Dental Managed Care has highlighted three issues for particular attention: 1. Price Bid: one price bid for two years with negotiations for three extension years. 2. Implementation Period of not more than three months. 3. Seven Geographic Regions: Contra Costa County is now part of a region which also includes Alameda, San Francisco, San Mateo, Santa Clara and Santa Cruz Counties. FINDINGS: The draft Solicitation for Response is an extraordinarily complex and lengthy document with requirements that will eliminate all but a few of the largest current third party dental carriers. The extensive requirements go far beyond that now expected of plans who are providing Medi- Cal dental prepaid managed care services. Contra Costa Health Plan has included dental services in its Medi-Cal contract with the State since it started its Medi-Cal PHP operations in the mid-1970s. An expanded CCHP utilizing current dentists, traditional Medi-Cal providers, community dentists, and CHDP dentists may be an appropriate vehicle for delivering prepaid dental care in Contra Costa County. However, the requirements for MIS reporting alone would make it practically impossible for CCHP to apply even if Contra Costa County were to be separated from the rest of its region. For the CCHP or any other smaller dental contractor to be in a position to submit a bid, the State would have to modify its requirements as follows: 1. Reduce the extent and complexity of the requirements to allow the participation of smaller plans with a proven successful history of providing prepaid managed dental care to Medi-Cal beneficiaries. Make it feasible for the current contractors who already serve a large proportion of the Medi-Cal population to compete under the new program. -2- 2. Create smaller geographic regions in those areas where there is an interest expressed by current Denti-Cal managed care providers or allowing these potential contractors to submit a bid for one county in the region. 3. Increase the implementation period to at least six months to allow time for such activities as training and credentialling of dentists, and getting the MIS on line. 4. Clarify negotiation process for three year extension period. Are the three years negotiated as a block or is each of the three years negotiated separately? 5. Additionally, we believe the State should not contract with a provider owned organization to administer the dental managed care contracts. 52:DP May 2, 1994