HomeMy WebLinkAboutMINUTES - 02071995 - 1.54 1.54
THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Order on February 7, 1995 by the following vote:
AYES: Supervisors Rogers, Smith, DeSaulnier, Torlakson and Bishop
NOES: None
ABSENT: None
ABSTAIN: None
SUBJECT: 1994 Annual Report of the Medi-Cal Advisory Planning
Commission
IT IS BY THE BOARD ORDERED that the 1994 Annual Report of
the Medi-Cal Advisory Planning Commission is ACCEPTED.
I hereby certify that this is a true and correct copy of
an action taken and entered on the minutes of the
Board of Superv'so, on the date shown.
ATTESTED: 1
PHIL BATCHELOR, I rk of the Board
o Supervi and n dministrator
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APPENDIX
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A* APC Members and MAPC -staff
S. Contra Costa County Board of Supervisors Board: Order
Authorizing Composition of and Appointments to MAPC and
Overview Establishing the Functions, Membership Categories,
Community Participation, Of ficers and Rules of Procedure,
SC of f ing and Sunset Clause for MAPC
C. XA.PCAgendas and Minutes.-*
January 6, 1994 MAPC Meeting
February. 3, 1994 MA.PC Meeting
March 3, 1994 MAPC Meeting
Apr i1 6, 1994 MAPC Meeting and Public Hearing
May 5, 1994 MAPC .Meeting.
June 1, 1994 MAPC Meeting and Public Hearing
July 7 19.94 DMPC Meeting
September 7, 19 94 MAPC Meeting and Public Hearing
f.
October 6, 1994 MAPC Meeting
November 3, 19.94 MAPC Meeting
D MAPC Rxecu tive Committee Agendas and Minutes:.
May 10, 1994 Meeting
June 231 1994 Meeting
September 3 0', 1994 Meeting
October 241: 1994 Meeting
December 1, - 1994 Meeting
L. XAPC Recommenda tions Adopted.,by the Board of Su ervisons and
Forwarded to the State:
Dental Managed Care ' Recommendations
Mainstream Plan Requirements
Comments on. S tate. Department of 'Health. Servi.ces Draf t RFA
County Specific Criteria for Private .Plans in Contra Costa
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MEDI-CAL ADVISORY.,PLANNING.. COMMISSION MAPC)
MEMBERS
,(* indicates current.membership 1/95)
Public/Beneficiary Representatives
Medi..Cal Beneficiary Representatives/Members at Large:
*Margaret Dowling
Beneficiary Representative
*Rosalind Love
Beneficiary. Representative
*Evelyn E. Rinzler
Contra Costa Legal'Services
Member,MAPC Executive Committee
*Dolores SancheD.
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Educator/Counselor
Jose Samaniego
Linda Stephenson
Joyce White
Community Based Organizations:
*Claudette Garner
East Bay Perinatal Council
*Viola Lujan
United Council of Spanish-Speaking Organizations
*Mary.Lavendar Fujii
-County Food & Nutrition Policy.Consortium
Member,MAPC Executive Committee
Health Service Department Advisory,Boards;
*Reverend Curtis A. Timmons, B.A., Thd.D.
Substance Abuse Advisory Board
MAPC Vice(:hair& Member, M Executive Committee
*Suzanne MacDonald
Maternal and Child and Adolescent Health
*Cynthia Miller
Mental..Health commission
*Bessanderson McNeil, M.P.H.
Public and Environmental Health Advisory Board
*Paul Katz
contra costa Health Plan Advisory Board
*Jack McCervey
Contra, costa Health Plan Advisory Board
Provider Reptesentatives
Physician Representatives:
*Stephen Heisler, M.D.
Gregg. Sorensen, M.D.
Welby W. Bigelow, Jr., M.D.
Pauline.Wills, M.D.
Kathryn Bennet, M.D.
Community Based ProviWer .Organization:
*Heather Saunders Estes
Planned Parenthood
Member, MAPC-Executive Conunittee
Community Hospital Representatives;
*Michael Lawson
Brookside Hospital
*Janiece Nolan, M.P.H.., PhD.
John Muir Medical Center
*Antonie W Paap
C
hildref' Hospital of Oakland
Eileen Lynette
John Midr Medical Center
Other Provider Representatives:
*Michael G. Harris, O-D , J.D., M.S.
I
Other Provider
APC:Chair, &Chair, MAK.Executive Committee
*Joan o. Lautenberger, R.N.
Nurse
*,Raymond,L. Smart
Pharmacist..
Terry Tanner, D.D.S.
Dentist
Board of Supervisors Liaisons:
.,
*Jim Rodgers
*Tom Torlakson
Tom Powers
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la!lutsr CWOSSTION OT AND APPOINTMENTS IQ TU M=I-C" ADnS=r
PUMINO COMMISSION
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i. AClC19OWLEXT that because of a potential conflict of taterest,
supervisor smith declined to participate in the discussion of
this item and did not participate in the decision makiag
regarding the composition of the Commission, or the functions:
sembership categories or other issues related to this Item and
does not Join in s►aking the following recoutmendatioas.
_. .APPROVE the attached document ostablishinq the functions, •
aembership categories, community participation, officers and
rules of procedure, staffing and sunset clause for the Medi-
Cal Advisory Planning Commission (MAPC), except as hereinafter*`.-
supplemented or amended.
3. APPROVE the attached guidelines for XAPC sombership.
4. APPOINT the followlaq individuals who have been nominated by .
the entities indicated in the attached document entitled
"Members and Romivating. UtIties" . for the following
categoriest
V Physicians
Gregg Sorensen, N.D.
53 A Manor Drive
« Pittsburg, CA 9456.5
Pauline Mills, M.D.
3023 Vale Road, Suite 103
San Pablo, CA 94606
tow ISAM o«mJewl.n: -VU e>4K•+vRl:
,�.�ucar"erawe+aw or+tourm aor"raaw+troa �..�nlaMoeamanor a eaeo eo"mrret
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e„ .aewen
tileen Lynette, txecutive Director of tang less and
Rehabilitation Care
John Muir Medical Center
1601 Ignacio Vallty Road
Walnut Creek, CA !4396
f. APPOINT the following individual for the "tegury entitleds `
"Other Providera"s
r' Michael warria, O.D., J.D., X.S.I.optometrist
S Senedita Placa
Xoraga, CA 96336 .
7. APPOINT, the following five individuals for the category
entitieds "Beneficiaries and Members at targe"s
If Margaret Dowling, Bast County benetietarr
P.O. Box 783
Pittsburg, CA 94563
if Jose Samaniego, Central County beneficiary
P.O. Box 464
Concord, CA 94522
if Joyce White
648 S. 15th Street
Richmond, CA 94909
tvelyn T. Rinzler, Contra Costa Legal services
3523 Freeman Road
Walnut Creek, CA ..
of Dolores Sanchez, M.D., LducatorlCounsslor
1033 Carquinez Street
tl Cerrito, G 94330
S. APPOINT the following three individuals for the category
entitled: "Community-Based Organizations"s
4f Mary Tujii, County Tood i Nutrition Polley Consortium
1136 Lindell Drive
Walnut Creek, CA 94596
viola Lujan, United Council of Spanish-Speaking
Organisations
3810 Crestview Drive
Pittsburg, CA 94565
Claudette Garner, test Bay Perinatal emmell
362 S. 37th Street
Richmond, CA 94804
!» SPECIr! that all of the above appointments are effective
December 14, 1993 and are for a two-year term ending December
13, 1995. .The Commission itself will Ceara to exist effective
September 1, 1996 unless the Board of Supervisors takes action
prior to that date to continue the Commission.
20. MOTE that so mental bealth providers or community-based
organizations are recommended for membership on the Commission
because a parallel Mental Health Planning effort is being
undertaken by the Mental Health Director, which will provide
a process and forum for mental health providers and community-
based organizations to participate in planning for the Medi-
Cal Managed Care System. DIRECT that representatives from
-test Say Hospital and the Mental Health Contractors' Alliance
be members cf this mental health planning process.
il. 2STABLISH a special Committee of the Board of Supervisors,
Consisting of two members of the board, to serve as liaison to
„r, the Medi-CalAdvisory Planning Commission, including
i ` f monitoring the activities of the Commission, Meeting with the
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xathryn BintfOtte Not.
3994 Canyon Way
Martinez, CA $4333
J Dentist
Terry Tanner, D.D.P.
265 16th street
Richmond, CA 94801
1 9Tusse .
Joan 0. Lautenberger, R.s,
3979 S. Peardale Drive
Lafayette, CA 94349
J Pharmacist
Raymond L. Smart
1158 Panoramic Drive
Kartinez, CA 94353
J Community-Based Provider Organization
Heather Saunders gates
147 Cross Road
Danville, CA 94526
♦ Substance Abuse Representative
The Rev. Curtis A. Timmons, P.A., Th.D.
P.O. Sox 8213
Pittsburg, CA 94565
♦ !!ental Health Representative
Cynthia Miller
308 Jose Lane
Kartinez, CA 94353
4F Public i Lnvironmental Health Representative
Sessanderson McNeil, K.P.S.
694 Wilson Avenue
Richmond, CA 94805-1867
./ Katernal i Child i Adolescent Health Representative
Suzanne MacDonald
250S Wright Avenue
Pinole, CA 94864 .
♦ Contra Costs Health Pian Representatives
Paul Utz
2104 Holbrook Drive
Concord, CA 94519
Jack McGarvey
23 Marlee Road
Pleasant Sill, CA 94523
S. APpoiwT the following three individuals for the category
entitled: "Co=unity Hospital Representatives"s
V . Kichael Lawson, CEO, Brookside Hospital
4835 Reno Lane
Richmond, CA 04803
Antonio, H. Papp, CEO, Children's Hospital of Oakland
244 Lakeside Drive, f16
Oakland, CA 94612
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Commission, being provided copies of all documents and sweeting
notices which are provided to &embers of the Commission and
providing the Commission with the position of the board of
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3. Quality: The Commission will review and make recommendations on quality of care
issues.
4. nefits: The Commission will review the scope of benefits and services offered by the
County sponsored system and make recommendations for modifications.
5. Consumer Satisfaction: The Commission will review and make recommendations
on mechanisms for monitoring consumer satisfaction, grievances, and complaints.
6. Provider Relationshi,Rs: The Commission will review mechanisms for provider
satisfaction.
7. Community Health Related Needs: The Commission will review unmet health related
needs,in the community and make recommendations how managed care systems can
address these problems.
8. Governance: The Commission will review and make recommendations on Local Initiative
governance options..
MEMBERSHIP
The 25 members of MAPC.shall be appointed by the CCC Board of Supervisors for a two year
term and shall include:
1 i
Pet , Benef cjary�epre;s�.�rlati� ry
6 Advisory Board Representatives -
I Substance Abuse.Advisory Board
1 Maternal & Child Health Advisory Board
1 Mental Health Commission
1 Public & Environmental Health Advisory Board
2 Contra Costa Health Plan Advisory Board
Current Chair of CCHP Advisory Board
Immediate Past Chair of CCHP Advisory Board
3 Community Based Organizations' Representatives
j 5 Current or Past Medi-Cal Beneficiaries and/or members at large
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I Registered Nurse - nominated by North Bay Coastal Region IX, CNA
3 Physicians - nominated by the ACCMA:
1 from West County
1 from East County
1 from any region of the County
3 Community Hospitals' Representatives
(Hospitals must include non-County facilities who have historically
demonstrated a loyalty and competence in serving the special needs of Medi-Cal
beneficiaries.)
1 Community Based Provider Organization Representative - Planned Parenthood
1 Dentist nominated by the Contra Costa Dental Society
1 Pharmacist nominated by the Contra Costa Pharmacists' Association
1 other community provider
C,QMMUNITY PARTICIPATION
To assure that all provide-s. beneficiaries, and members of the public have the opportunity to
participate in the planning for and implementation of the County sponsored Medi-Cal managed
care program, the Commission shall:
1. Have regular open meetings conducted at least quarterly and in accordance with the
Ralph M. Brown Act (Gov. Code 54950 et seq.)
2. Annually hold regional hearings in East, Central, and West Contra Costa County to elicit
broad community input.
3. Establish such special committees on an ongoing or limited term basis as necessary to
conduct its work. In addition to the 25 Commission members any individual or
organization may attend and participate on any appropriate special committee that is
established. The Commission Chair shall appoint the Chair of any special subcommittee.
Examples of the types of special committees the Commission may establish are:
committee on issues of the physically disabled; committee on cultural, linguistic, and
ethnic accessibility of services; contract provider committee.
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Committee meetings shall be regarded as open "workshops" designed to elicit broad
public participation.
OFFICERS & RULES OF PROCEDURE
'.The initial meeting of MAPC will be called to order by the Chair of the Contra Costa,
Health Plan Advisory Board. The Commission shall subsequently elect a Chairperson
and a Vice-Chairperson for terms of one calendar year. The Chairperson and Vice-Chairperson
may serve two consecutive terms of one year each.
The Commission shall conduct its business according to the following rules and by laws and
other organizational rules. It shall consider and adopt other such by laws and organizational rules
it deems necessary to carry out its functions.
CONDUCT OF BUSINESS
1. Meetings. Meetings shall be conducted pursuant to the Ralph M. Brown Act. (Gov.
Code, § 54950 et seq.)
2. Chairperson. The chairperson shall be responsible for:
A. Conducting all meetings of the Commission.
B. Reviewing and approving Commission agendas.
C. Selecting Commission members for standing and ad hoc committees.
3. Ouorum. Business shall be conducted by the Commission only when a quorum is present.
A majority shall constitute a quorum. During periods when one or more seats on the
Medi-Cal Advisory Planning Commission is vacant, the vacant positions shall not be
considered for determining whether a quorum is present. A seat is vacant when there is
no commissioner appointed to serve in that capacity.
CONFLICT OF INTEREST
1. General Board Policy. Pursuant to Resolution No. 82/574, the Board of Supervisors has
adopted a policy for Board appointees concerning conflicts of interest. Resolution No.
82/574 applies to the Commission and requires as follows:
A. Statutes on Conflicts. Officials, Commissioners, and Committee members
appointed by the Board shall adhere to the principles and rules of the Political
Reform Act of 1974 (Gov. Code, §.816000 et seq.), including the following:
1. Local government should serve the needs and respond to the wishes of all
citizens equally, without regard to their wealth. (Gov. Code, § 81001(b))
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2. Public officials should perform their duties in an impartial manner, free
from bias caused by financial interests of themselves or their supporters.
(Gov. Code, § 81002[b])
3. Public officials should disclose assets and income which may be materially
affected by their official actions, and in appropriate circumstances they
should be disqualified from acting, in order to avoid conflicts of interest.
(Gov. Code, §. 81002[d])
B. Common Law Policy on Conflicts. All officials should so conduct the public
business as to avoid even any appearance of conflict of interest. (See, e.g.,
Kimura vs. Roberts [1979] 89 Cal.App.3d 871)
2. Board Policy for Medi-Cal Advisory Planning Commission
A. All members must file an initial and annual conflict of interest statement. Failure
to file such a statement may result in the member's removal.
B. Members may participate on issues in all discussions including those having a
direct financial impact on the members and/or their institutions. However, no
member may vote on an issue in which the member and/or the member's
institution has a direct financial conflict of interest.
ABSENCES
The Commission considers it imperative that members who vote on matters before the
Commission are informed and knowledgeable as to such matters. Therefore if a member fails
to attend three consecutive meetings, such member will be ineligible to vote at the next meeting
attended. Prolonged absences may result in the member's removal.
WORKPLAN
It shall adopt a work plan which includes mission, goals, and principles.
In developing its work plan it shall consider and prioritize the following issues:
Beneficiary Issues:
♦ Client education, rights, responsibilities
♦ Grievance procedures
♦ Needs of special populations, e.g. foster children, children with special needs, ethnic or
cultural groups, mentally disabled, HIV/AIDs, homeless, undocumented
♦ Accessibility issues
Provider & System Issues:
♦ Roles.of traditional providers
♦ Public/private linkages
♦ Integrated service networks
♦ Management of specialized services in regional and central locations
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♦ Health professionals' training, e.g. in serving a culturally diverse population
♦ Episodic care/emergency care/urgent care
Community Issues:
♦ Community wide prevention programs
Governance Issues:
♦ Governing body options
STAFFING
The Commission and its special committees will be staffed by Contra Costa Health Plan and
County Health Services Department administrative staff.
SUNSET CLAUSE
The Commission will assist in the planning for all phases of the County sponsored Medi-Cal
managed care program. MAPC will be dissolved on September 1, 1996, unless the Board of
Supervisors determines prior to that date that the Commission is still needed to provide ongoing
planning, direction, and advice to the Board of Supervisors.
L28:MAC 1
MAPC Members
Guidelines for Membership
By Category
1. M.D., R.N. DDS, Pharmacist: nominated by appropriate professional organization
2. Hospitals: DSH provider or traditional provider
3. Other providers: ✓discipline not already represented on MAPC
✓traditional or safety net provider
4. CBO: ✓ensure geographic distribution
✓applicant has history of commitment to Medi-Cal
population; especially AFDC & MIC
✓CBO represents special populations, needs
5. Beneficiaries: ✓ensure geographic distribution
Overall
1. Ethnic, cultural, geographic diversity and gender balance
2. Knowledge and experience in meeting special needs of vulnerable populations
3. Demonstrated commitment to the community the applicant will represent
4. Demonstrated credibility within the represented community
5. Demonstrated interest in health care issues for low income communities and knowledge
of the Health First proposal
6. Ability to make the necessary time commitment to participate
I31:CA 12/1/93
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Medi-Cal Advisory Plannin Commission
Organization Chart
Contra Costa County
Board of Supervisors
Health Services �►�
Depar=ent
Director — Medi-Cal Advisory
Planning
---- Gor=ission
Contra Costa
Health Plan Planning y
(CCHP) for All Phases
Advisory Board cf county
Reviews All Sponsored
CCHP Programs: Medi-Cal Managed
M' Medi•C&I Care Program
or Medicare
or Basic Adult Care
Cr Commercial
Cmdi»dual,
=all group,
Iarge group
b" MajorRisk
Medicallas=ce
Progmm
or Am .�
Medi-Cal Advisory Planning Commission (MAPA Meeting
t
Thursday: January 6; 1994
4-6 p.m.
George Gordon Center
$40 Court Street, Martinez (Training Institute)
AGENDA
4:00- 4:15 Welcome and introductions Paul Katz, Chair
HMO Advisory Board
4:15 - 4:30 Public/Private Partnership in. Mark Finucane
the Local Initiative Health Se=rvices Director
4:30 - 4:45 State Pian Timeline for Expanding Milt Camhi
Medi-Cal Managed Care & National Executive Director
Health Care Reform Contra Costa Health Plan
4:45 - 5:15 Review of MAPC Functions, MAPC Members
Membership, Organization,
Officers, and Rules of Procedure
5:15 - 5:35 Local initiative Governance Issues Staff Presentation and
MAPC Members Discussion
5:35 5:45 Discussion and Schedule MAPC Members
of Future Meetings, Hearings,
Special Committees
5:45 . 6:00 Public Comment Public
6:00 Adjourn
131:MA
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C01,WSSIONFRS PRESENT:
pawl Katz, Chair Michael Lawaon Jose Samaniego
Margaret Dowling V101a Ltian Raymond Smut
Heather Saunders Faun Eileen Lynette Gregg Sorensen
Mary Fujii Susanne MacDonald Terry Tacna
Claudette Garner Jack McGervey partis Timmons
Michael Harris Antonie Paan Joyce White
Joan Lautenberger Evelyn Rimier Tom Torlakson,BIS Liaison
COMMISSIONERS Bessanderson McNeil,Cynthia Miller,Dolores Sanchez
ABSENT. Tom Powers, BIS Liaison
STAFF PRESENT: Bobbi Baron,Lorna Bastian,Linda Brun,Bill Bun,Milt Camhi, Vickie Dawes,Mark Finucane, Mary
Foran, Paz Godley, Frank Puglisi,
MBERS OF THE Ken Anderson, Alan Elnick,Yale Ferguson, Lynne Godsey,Barbara Goodhart,Bill Guertin, Stephen
.VuBLIC PRESENT: Heisler, Mike Jee, Larry Lucero,Norma Martin,Karen Nelson,Hamid Rezapour, Vickie Smith,Linda
Stephenson,Lisa Tanaka
ITEM NUMBER DISCUSSIONS '; < . ACTION WHO
.00 Call to Paul Katz, Acting Chairman, called the Commission to
Order order at 4:07 p.m.
1.00 Paul welcomed the Commission and introductions were
made.
Supervisor Tom Torlakson outlined the eight areas that
the Commission will review,monitor, and make
recommendations on (outcome measures, accessibility,
quality, benefits, consumer satisfaction,provider
relationships, community health related needs,
and governance).
Mark Finucane commented on the private/public
partnership in the local initiative and his desire to expand
CCHP to include community providers.
Ua&-Cal Advismy Planning C =DiW=1lde06g
J 46q 6. 1994
2
1<I'EM NtJMBBRISCttSSIONS < L ' <` 't 41.+C'iION
k
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Milt Camhi's presentation covered the u us of Medi-Cal Provide glossaries of ltm
managed care in Contra Costa County and the time Une, minsged care, health Camhi
for implementing the two-plan model. He examined the bmulm and health
relationship of the State Plan with national health are care finance tams to
reform. Commission members
who request Inch
Bobbi Baron presented an overview of the factors that
will need to be considered when the MAPC discusses
governance options. '
Paul Katz asked that Commissioners advise staff of any Advise gaff of MAPC
special needs they may have in order to participate in the special needs
meetings.
Bobbi Baron reported that Conflict of Interest Code Put on February's Bobbi
will be on the agenda at the February meeting; Once agenda Baron
adopted, it will go to the Board of Supervisors for
approval. Commissioners will then have 30 days to
complete their forms. t1
Paul Katz requested the Commission indicate on the .Provide preference MAPC
preference form their choices for day and time of future for day and time of
regular meetings. To meet the state time table, it will future meetings.
probably be necessary for the Commission to meet on a .Use preferences to Staff
monthly basis. prepare a schedule
for 1994.
Paul reported that by the February meeting there should Indicate on MAPC
be a full board and at that time a committee could be preference form
chosen to nominate a chair and vice-chair. Various interest in the eight
standing committees and/or task forces will be organized function area to be
later. reviewed
Gregg Sorensen, M.D. asked for a count of Medi-Cal Prepare data for Bobbi
populations in Santa Barbara, San Mateo, Fresno, ad February meeting Baron
Contra Costa Counties.
Reverend Timmons asked that a summary of Knox- Provide summary of Bobbi
Keene licensure requirements be available next meeting. Knox-Keens Baron
Regional public hearings will be held in W,West, do
Central County during the year. Zbese will be in
addition to the regular monthly meetings. Reverend
Timmons requested that these regional hearings be held
at a time,and place to accommodate working people.
Medi-Cal Advisory Planning Commission Meeting
January 6, 1994
3
ITEM NUM$ER DISCUSSIONS
ACTT
,. aN
re being no further business to discuss, the meeting
as adjourned at •00 p.m.
/ (Dated)(Signed)
LC:MACWN
Medi-Cal Advisory Planning Commission 04APQ Meeting
Thursday, February 3, 1994.
1-3 p.m.
11BEW Han
530 Contra Costa Boulevard, Pleasant Hill
(North of Sunvalley)
AGENDA
1:00- 1:05 1.0 Call to Order Paul Katz, Acting Chair
Introduction of New Members
1:05 - 1:15 ...* 2.0 Approval of Minutes of MAPC Members
January 6 Meeting
1:15 - 1:30 3.0 Priority Areas of Interest MAPC Members
Discussion
1:30 - 1:45 ...* 4.0 Proposed Principles for Medi-Cal MAPC Discussion
Managed Care and Adoption
i .
1:45 - 2:00 5.0 Mainstream Plan and Local Initiative Staff Presentation
2:00- 2:25 6.0 Governance Issues:
6.1 ./Factors Staff Presentation
6.2 ./options Staff Presentation
...* 6.3 ✓Workplan MAPC Members Discussion
and Adoption
2:25 - 2:40 ...* 7.1 */Schedule of Future MAPC Members Discussion
Meetings and Hearings and Adoption
7.2 /Nominating.Committee
2:40 - 2:45 8.0 Responses to MAPC Requested Information Staff
2:45 - 3:00 9.0 Public Comment
3:00 10.0 Adjourn
Note: ...* Indicates an Action Item ULMA
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COMMISSIONERS PRESENT:
Paul Katz. Ch* Michael Lawson Evelyn Rinder
Margaret Dowling Viols Lojan Jose Samaniego
Heather Saunders Estes Eileen Lynette Dolores Sanchez
Mary Fujii Jack McGavey Tem Talnaer
Michael Harris Bessanderson McNeil Curtis Timmons
Stephen Heisler Cynthia Miller
Joan Lautenberger Antonie Paap
COMMISSIONERS Welby Bigelow,Jr,, Claudette Garner, Suzanne MacDonald, Raymond Smart, Gregg Sorensen,
ABSENT: Joyce White,Tom Powers and Tom Torlakson, B/S Liaisons
STAFF PRESENT: Bobbi Baron, Linda Brun, Milt Camhi, Pat Godley
J
XMBERS OF THE Richard Baker,Yale Ferguson,.Karen Nelson, Hamid Rezapour, Linda Stephenson, LuGene Taylor,
a-tIBLIC PRESENT: Janet Wasko
DISCUSSIONS
ITEM NUMBER
..
ACTION . . '-WH
1.0 Call to Order Paul Katz, Acting Chairman, called the Commission to order
at 1:12 ptm,
2.0 Minutes of the January meeting were approved.
.3.0 Staff presented a schedule of subject areas to be discussed at
suture meetings. The Commission added "Benefits'as the
subject arae to be discussed at the September meeting.
4.0 Proposed principles for Medi-Cal Managed Gare were
discussed. It was MIS/C to approve the principles as written
and then to expand them as necessary.
5.0 Maimtrrsas Plan and Lod Initiative ,
Bobbi Ram presented an analysis of the State Plan's
nquinements for the Local Initiative and the Mainstream,Plan
describing where the requirements were similar and where
they differed.
In response to Supervisor Torlakson's commr,.ats at the fust Study issue and report Main-
commission meeting about the need for a'level playing field', to N11 Commission in' stream
Paul Katz appointed a special committee of Heather Saunders April Plan
Fates (Chair), Viola Lujan and Jack McGervey to further study Coni-
the issue and report back to the full Commission at the April Stec
meeting their recommendations.
144o&-U Advimy Planning Commission Meettgg ..,.;. .
February 3. 1994
t
frEM'itilaUMBfiR DISCUSSECNS ACTIOI�I '1i�H0 ;:
6.0 Milt Camhi pt ted information m governance 6ctaes. Amend list soocrdbgh Staff
options.and workplan. Commission members suggested
sodding two additional considerations to do 'Facims to be
Considered in Evaluating Law Initiative Governaaoe
Options'.Nua►ber 13 ('provider comdina$�hips'
and Number 14 'nee of surpluaea.'
Various governance options for the Last Initiative wens Schedule speakers Staff
explained. Commission asked that appropriate speakers be sad prepare analyse
invited to address the Commission and that staff prepare sa
analysis of the governance options using the boors as 69
basis of the analysis.
It was M/S/C to adopt the Proposed MAPC GoverwU m
Options Workplan with the following correction: All dates
should be 1994.
.7.1 Schedule of To s000mmodate as many members as possY'ble,it was MISIC
Meetings that the following meeting schedule be adopted:
Thursday, Much 3...................4:00.6:00 p.m
Wednesday, April 6..................bearing 5:30.7:00 P.M.
y meeting 7:00-8:30 p.m
71hursday, May 5......................1:00.3:00p.m
Wednesday, June I...................hearing 5:30.7:00 p.m
meeting 7:00-8:30 p.m
Thursday,July 7 or
August 4................................4:00+6:00p.m
Wednesday. September 7.............hearing 5:30.7:00
Meeting 7:00-8:30 p.m
7.2 Nominating Paul Katz appointed a nominating committee consisting of
Committee Evelyn R.inrler, Chau;cynthia Miller; and Stephen Heisler,
wbo will recommend nominees for Chair and Vx*C hw at ebe
Much meeting. If any of the commiacion are interested in Submit names and Commi-
serving as Chair or Vice-Chair, they dwWd submit their background to Evelyn scion
names and background to Evelyn Riarkx clo Milt Camhi. Ia Rinner c%Milt Cambi Members
addition nominations may be made from the floor at the Mach
$A Responses to Commission requested that map/directions('including telephone Provide directions to Staff
MAPC number of the meeting site)be included in the regular meeting meeting sites
Requested packets-
Info/Other
Business
Regional Hearings
Commissioners made suggestions for publicizing the bearings Design and distribute Staff
and volunteered to help in getting the information bark to their flyers
constituencies.
Medi-Cal.Advisory Planning Commission Meeting
February 3, 1994
3
:TTEWNUMBER DISCUS5lt3I+1S ; ACTit3N WHO
.:.:..: ::::.:.....::
It was recommended that: flyers be widely distributed, Get approval for Viola
community access cable televise the bearings, UCSSO vans transporting Lujan
might be used to transport beneficiaries, written comments be beneficiaries
encouraged and suitable accommodations be made to ensure
accessibility.
Commission asked to be kept apprised as the state makes
dental and mental health carveouts information available. The
commissioners expressed an interest in working.with groups
involved in planning for other aspects of Medi-Cal managed
care.
MAPC letterhead was distributed. Commission to indicate any Provide corrections Commi-
changes to be made to their to Bobbi Baron ssion
Members
The first MAPC Report was distributed. Commission to Provide
provide Bobbi Baron with names and addresses of those who names/addresses for Commi-
should be on the mailing list for future monthly issues. mailing list ssion
Members
9.0 Public There was no public comment.
Comment
There being no further business to discuss, the meeting was
adjourned at 3:00 p.m.
(Signed)__,� (Dated)
LC:MACMIN
Contra Costa County
Medi-Cal,Advisory Planning Commission OJAPQ Meeting
Thursday, March 3, 1994
4-6 p.m.
AGENDA
4:00 - 4:05 1.0 Call to Order Paul Katz, Acting Chair
4:05 - 4:10 ...* 2.0 Approval of Minutes of MAPC Members
February 3 Meeting
4:10 - 4:25 3.1 Federal, State and Local Access Steve Tremain, M.D.
Standards Presentation
4:25 - 4:40 ...* 3.2 Local Initiative Access Standards MAPC Discussion
and Adoption
4:40 - 5:15 4.0 Governance: County Government Option Staff Presentation
4.1 1Factor Analysis and MAPC Discussion
4.2 VExamples of County Government Option
5:15 - 5:25 5.0 Conflict of Interest Code Stmt Presentation
and MAPC Discussion
5:25 - 5:30 6.0 Other Business:
6.1 Commission Schedule Information Only
6.2 Proposed Committee Structure Information Only
6.3 April Hearing MAPC Discussion
5:30 - 5:40 ...* 7.0 Report of Nominating Committee MAPC Action
and Election of Officers
.5:40 - 5:55 8.0 Public Comment and Hearings
8.1 Hearing on Conflict of Interest Code
8.2 Other Public Comment
5:55 - 6:00 ...* 9.0 Adoption of Conflict of Interest Code MAPC Adoption
6:00 10.0 Adjourn
Note: ...* Indicates an Action Item
LCUA
unty
Contra Costa Co
Medi-Cal Advisory Planning Commission Meeting
March 39 1994
Minutes
COMMISSIONERS PRESENT:
Pain Katz, Chair Stephen Heisler Tony Pup
Welby Bigelow,Jr. Joan Lautenberger Evelyn Rimier
Margaret Dowling Eileen Lynette Dolores Sanchez
Heather Estes Suzanne MacDonald Raymond Smut
Mary Fujii Jack McGervey Gregg Sorensen
Claudette Garner Bessanderson McNeil :, Terry Tanner
Michael Harris Cynthia Miller Curtis Timmons
COMMISSIONERS Michael Lawson, Viola Lujan, Jose Samaniego;Tom Powers and Tom Torlakson, BIS Liaisons
ABSENT:
STAFF PRESENT: Joseph Barger, Bobbi Baron; Linda Brun, Milt Canthi, Mark Finucane, Steve Tremain
MEMBERS OF THE Richard Baker, Gary Hamilton, Elliot Nipomnick, Linda Stephenson, Janet Wasko, Joyce White
7BL.IC PRESENT:
Item Number Discussions Action Who
3.0 Call to Paul Kau, Acting Chairman, called the Commission to order.
Order at 4:10 P.M.
'2.0 Approval Minutes of the February meeting were approved.
of
Minutes
3.1 Federal, Steve Tremain, M.D., presented federal and Aute
State and requirements and suggested areas for Local Initiative access
Local standards.
Access
Standards
Present-
ations;
3.2 Local The Chair called for an Access Standards Special Committee
Initiative to be foraged. At the Juae.meeting, this committee would
Actress make its report to the Commission on proposed Local Report to MAPC special
Standards Initiative access standards. Tau committee will include Viola at June Meeting Committee
Lujan, Gregg Sorensen, Bessanderson McNeil, Maggie
Dowling. Joan Uutenberger, and Steve Tremain, M.D.
(resource). It was M/S/C to adopt the proposal for organizing
the Access Standard Special Committee.
Medi-Cal Advisory Planning Commission Meeting
March 3. 1994
2
TTT:M NUMBER DISCUSSIONS ACTION VRO
1
A,4 Govern- Milt Camhi presented an analysis on the county government
mace option as a form of Local Initiative governance using the
Commission's 14 factors as the basis of his analysis.
5.4 Conflict Questions were taken regarding the proposal Conflict of.
of Interest Inwea.
6.0 Other
Business
6.2 Proposed The MAPC Committee structure will be discussed at the April
Comm, meeting.
ittee
Structure
6.3 April Plans for publicity of the April hearing includes posters in
Hearing Spanish and flyers which include availability of interpreter
services or other reasonable accommodations. Both were }
distributed. In future flyers, the appropriate symbols will be Appropriate Staff
used to indicate wheelchair accessibility and availability of Symbols to be
hearing impairment equipment. Commission members are to Used
publicist the hearing with.grwgn in the community.
7.0 Report of Paul Katz stressed the impotence of organizing a membership
Nomin screening committee that will recruit candidates for future
sting vacancies on the Commission.
Comm-
ittee! The nominating committee consisting of Evelyn Rinzler,
Election Chair, Stephen Heisler, and Cynthia Miller recommended
of Michael Harris for Chair and Curtis Timmons for Vice-Chair.
Officers There wen no nominations from the floor. It was M/SIC that
the nominations be closed and that the report of the
nominating committee be accepted.
8.0 Public Then were no public comments. -
Comment
and
Hearings
8.1 Hearing Then were so comments:
on .
Conflict
of Interest
Medi-Cat Advisory Planning Commission Meeting
March 3, 1994
3
ITEIvf NUMI3ER DISCUSSIONS ACTION 'WHO
_=
8.2 Other Request made to Chair Michael Harris that liquid Arrange for Staff
Public refreshments be available for future meetings. refreshments
Comment
Info/ Request made that copies of CCHP's member satisfaction Send survey Staff
Other survey be included in the April agenda packet.
Business
Question raised about adoption of the proposed committee Add Membership Staff
structure chart. Staff will add both the membership screening Screening
committee and the.access standards committee to the chart, Committee&
and final draft will be included in the April agenda packet. Access Standards
Committee/
Include in April
Packet
9.0 Adoption It was M/S/C that the Commission adopt the Conflict-of Forward Code to Staff
Of Interest Code. Board of
Conflict Supervisors for
of Interest Approval
Code
10.0 Adjourn There being no further business to discuss, the meeting was
adjourned at 6:00 p.m.
(Signed) ate / !�
Contra Costa County
Medi-Cal Advisory Planning Commission (MAPA Meeting
• Wednesday, April 6, 1994
7:30 - 8:30 p.m.
AGENDA
7:30- 7:40 1.0 Call to Order and Remarks of the Chair Michael Harris, Chair
1.5 Public Comment
7:40- 7:45 •* 2.0 Approval of Minutes of :. MAPC Members
March 3, 1994 Meeting
7:45 - 8:00 3.0 Onsumer Satisfaction
3.P. Contra Costa Health Plan
Member Relations Activities Staff
3.2 Member Satisfaction Survey Results Staff
3.3 DUcussion of Consumer Satisfaction MAPC Members Y
8:00 . 8:20 4.0 Mainstream Klan Committee
4.1 Report of Committee Heather Saunders Estes
** 4.2 Adoption of Committee Report MAPC Members
8:20 - 8:25 5.0 MAPC Committees
"* 5.1 Adoption of Cominittee Structure MAPC Members
5.2 Appointment of ScrWing Committee MAPC Chair
8:25 - 8:30 ** 6.0 Adoption of Commission Calendar. MAPC Members
8:30 7.0 Adjourn Michael Harris, Chair
** Action Item u:w►A 31"1%
_ { s
i
} �h
tont costa_County
Medi-Cal Advisory 'lalnning CommissionVIeet'uig }
::.
:i
�iprii fib, X994
{
Mtrlutes
t
COMMISSIONERS PRESENT:
:Michael Harris, Chair Suzanne MacDonald Gregg Sorensen
Margaret Dowling Bessanderson McNeil Curtis Ti rmmons
Heather Estes Cynthia Miller Tom Powers,B/S Liaison
Paul Katz Evelyn Rinzler
Joan Lautenberger Dolores Sanchez
-.Michael Lawson Raymond Smart
COMMISSIONERS Welby Bigelow, Mary Fujii, Claudette Garner, Stephen Heisler,Viola Lujan, Eileen Lynette,Jack
ABSENT: McGervey, Antonie Paap, Terry Tanner; Tom Torlakson,BJS Liaison
.STAFF PRESENT: Bobbi Baron, Linda Brun, Milt Camhi, Elissa Leidy
FIBERS OF THE Karen Nelson, Larry Lucero
PUBLIC PRESENT:
: .Item Number Discussions
lcttono =;
3.0 Call to Michael Harris, Chair, called the Commission to order at
Order 7:43 p.m.
1.5 Public None
Comment
2.0 Approval Minutes of the March meeting were approved.
of
Minutes
3.0 Consumer
Suis. 3.1 Contra Costa Health Plan Member Relations Activities
fiction Bobbi Baron described member relations activities of
CCH?and of the Health Services Department.
3.2 Member Satisfaction Survey Results
Bobbi Baron presented results of CCHP Member
Satisfaction Survey.
3.3 Discussion of C nsumer Satisfaction
` . When CCHP contracts with additional community '
providers as part of its Local Initiative expansion, it will
share the results of the member satisfaction surveys with
these providers.
-
Medi-Cal Advisory Planning Commission Meeting
April 6, 1994
2
ITEM NUMBER DISCUSSIONS yip
r
4.0 Main-
stream
Plan
Comm- 4.1 Report of Committee
ittee Heather Saunders Estes, Chair, presented the
Mainstream Plan Committee report. She asked for
approval and that it be.forwarded to the Board of
Supervisors for their consideration and subsequent
forwarding to the State Department of Health Services.
4.2 Adoption of Committee Report
It was M/S/C that the committee report be approved Revise report Staff
with one revision: eliminate the word "rating" and accordingly and
substitute `results of survey". The Board of Supervisors, forward to Board
after their endorsement, is to forward the report to the of Supervisors
State.
5.0 MAPC
Comm- 5.1 Adot tion of Committee Structure
ittees It was M/S/C that the chart be adopted with the Revise chart Staff
following revision: "Other Providers" be added under accordingly
"Provider Affairs Committee". Commissioners were
urged to indicate interest in specific committees to staff
by April 15, 1994.
5.2 Appointment of Screenin, Committee
Bessanderson McNeil,Joan Lautenberger, and Curtis,
Timmons (Chair) were appointed to screen applicants for
various MAPC positions.
6.0 Adoption
of Comm- It was MISIC that the Commission adopt the Commission
ission Calendar for 1994.
Calendar
7.0 Adjourn
There being no further business to discuss, the meeting was
adjourned at 9 p.m.
(Signed) (Date)
Public Hearing
on
Medi-wCal Managed HCare ,
Contra Costa County
If you have an interest in learning more about
managed care for Medi-Cal recipients or would like your
views to be heard, come to the hearing hosted by the
Medi-Cal Advisory Planning Commission
Brookside Hospital
April 69 1994
5:30 p.m. - 7:00 p.m.
Li Wort'
=e Imenc i
ROWtcetis�rnia �os�wsQ Brookside Hospital
Con W. ANed$ -. 2000 Vale Road
;_ g
.+ Ysatia IM
Garvin
Q McBryde Richmond
Ws
Garvin i t
�anis
..'a 8ur�at
! Richm nd ��;° For transportation
ntw information call
''"°""° -�— �nr'rTh icfin►e,lQ �yeh (510) 724-3.1-11
►• � r-a� ._ ��� _. Are'„:—�:. ��1!! ?�U_��](I
sMnowe -
Contra Costa County
Medi-Cal Advisory Planning Commission OJAPC) Regional Hearing
Wednesday, April 6, 1994 )�
3:30 - 7:00 p.m.
Brookside Hospital
2000 Vale Road, San Pablo
AGENDA
5:30 - 5:35 1.0 *Opening the Hearing Michael Harris, Chair
*Introductory Remarks
*Introduction of Commissioners
5:35 - 5:44 2.0 Welcome Supervisor Tom Powers,
Board of Supervisors Liaison
}1
5:40 - 5:50 3.0 Overview of State Plan Milt Camhi,
for Medi-Cal Managed Care Executive Director
Contra Costa Health Plan
5:50 - 7:00 4.0 Comments from the Public
7:00 5.0 Closing the Hearing Michael Harris, Chair
}
LCAA 3/24M
CONTRA COSTA COUNTY
MEDI-CAL ADVISORY PLANNING COMMISSION
- ' HEARING - April 6, 1994.-MINUTES
Commission sent- Michael Lawson Dolores Sanchez
Michael Harris, Chair Suzanne MacDonald Raymond Smart
Margaret Dowling Bessanderson McNeil Gregg Sorensen
Heather Estes Cynthia Miller Curtis Timmons
Paul Katt Evelyn Rinzler Tom Powers, BIS Liaison
Joan Lautenberger
Commissioners Absent:
Welby Bigelow Stephen Heisler Jack McGervey
Mary Lavender Fujii Viola Lujan ' Antonio Paap
Claudette Garner Eileen Lynette Terry Tanner
Tom Torlakson, BIS Liaison
Staff Present: Linda Brun Elissa Leidy
Bobbi Baron Milt Camhi
lbers of Ae Public:
awth Fontana Tangela M Hunter Karen Nelson
Barbara Emison Gaffield Otis E Rounds, MD Larry Lucero
Denise M Lara Kevin Geraghty, MD Carlota Dunhower
Kimberly Duir, MD Clementine Wilson MaryAnne Burtman
Kemp Hazzard Veora Timmons Janet Jue
Oly Timmons Luz Pardini Henry Linker,OD
Joyce White Ann Marzett, PHN
TMI NUMBER
DISCUSSION
1.0 Open Michael Harris, Chair, opened the hearing at 5.45 p.m.
2.0 Welcome Supervisor Tom Powers,Board of Supervisors Liaison to the MAPC,
thanked the Commission and the members of the public who were .
present for their participation in the Local Initiative planning process,
Overview Milt Camhi, Executive Director, CCHP, gave an overview of the
State Plan for Medi-Cal Managed Care.
4.0 Comments from the Public The following members of the public spoke:
}
[a] Ruth Fontana on issues concerning individuals with
environmental illness. She also submitted written testimony.
[b] Barbara Emison Gaffield on the importance of nutrition
services. She also submitted written testimony.
[c] Denise M Lara on the benefits of a nutrition program her
daughter attended (Weight Shapers).
[d] Tangela M Hunter on problems with the Medi-Cal system and
obtaining needed services.
[e] Otis E Rounds, MD, on governance and use of'community
physicians.
[f1 Kevin Geraghty, MD, on Brookside Hospital's interest in the
Local Initiative.
5.0 Close There being no further comments from the public,the Hearing was
closed at ? p.m.
(signed) (dated)
L33:HN4
Contra Costa County
Medi-Cal Advisory Planning Commission (MAPC) Meeting
Thursday, May 5, 1994
• 13 pm.
Local 1 Hall
5034 Blum Road, Martinez
AGENDA
1:00- 1:10 1.0 Call to Order and Remarks of the Chair Michael G. Harris, Chau
1:10- 1:20 2.0 Public Comment
1:20 . 1:28 ...• 3.0 Approval of Minutes of April 6, 1994 Meeting MAPC Members
4.0 Governance Alternatives
1:25 - 2:00 4.1 Presentation Mark Windisch
2:00 - 2:10 4.2 Discussion MAPC Members
2:10 - 220 5.0 Committees
5.1 Establishment of Benefits Committee MAPC Members
...' 5.2 Establishment of Executive Committee and MAPC Members
Election of Members
5.3 Appointment of Committee Chairs Michael G. Harris, Chair
2:20- 2:25 6.0 Comments on Mainstream Plan RFA &
'W'ork Group Decisions
6.1 Staff Report
6.2 Discussion & Approval MAPC Members
2:25 - 235 7.0 Dental Carve Out RFP
7.1 Report of Dental Committee Terry Tanner, DDS
...'
72 Discussion and Approval of Report
2:35 - 2:40 8.0 Outcome Measures - Referral to Committees Michael G. Harris, Chair
2:40 - 2:50 9.0 Approval of Local Initiative Workplan Timeline MAPC Members
2:50 - 3:00 10.0 Hearing on June 6 Staff Presentation and.
MAPC Discussion
3:00 11.0 Adjourn
Note: ... Indicates an Action Item M.MA 4/2s/94
Contra Costa County
Medi-Cat Advisory Planning Commission Meeting )
May So L994
Minutes
CONMOSSION'ERS PRESENT:
Michael Harris, Chair Michael LAW300 Dolores Sanchez
J► &Uie DowlittS Viols Lujaa Raymond Smart
Mary Lavender Fuji Suzan"MacLktmald Linda Stepbenson
Claudette Garner Cynthia Miler Terry Tanner
Steve Heisler Tony Paap •. Curtis Timmons
Paul Katz Evelyn Rintlear
Joan La utenberSer
COMMISSIONERS Welby Bigelow,Heather Saunders Estes,Jack McGervey, Bessunderson McNeil,
ABSENT. Grey& Sorenson;Tota Torlalwa and Tom Powers,B1S Liaisons
STAFF PRESENT: Bobbi Baron, Linda Brun, Milt Camhi
MEMBERS OF THE Karen Nelson,Luny Lucero, Sandra Persyn, Mark Windisch
PUBLIC PRESENT.
L Item Number Discussions Action Who
2.0 Call to,. Michael Harris,Chair,called the CommWim to order at
order 1:10 p.m.
2.0 Public Larry Luoem reported that bawftts are cootaiaed is&merits Provide copies to Staff
Camment Section of Tide 22. Camavtwooers
on taquiwt
3.0 approval Commissioner Titnmams requeated that the April 6 areews
M minutes be amended to iwhde''nw ima of a quorum was
Minutes raised under 4.1 Rcvort of Mainstream Plan�Committes.Olt
was MtSlC dw both miautas of the April 6 public beariq
and the reswar Com aluiam meatus a amended be
approved. There was we abwiaiap vote(Dowling).
4.1 Pxanlatis�
4.0 Govern- )AAA wiadisch,attorney with wei"burS ad Armwoo,
Sacs Inc., discussed Soveraance options for local Initiativas.
Alter- The models examined included CONS look-alike,county
atiativet taxa-profit,joint power, privau soon-profit corporations, }
Wadi-Cal Advisory Plaaaing C41unissiae Meetize
Ms;S. 1994
2
I '
TW NUMBER DISCUSSIONS ACTION WHO
and s for-profit Model.The lactose wed in rsysaa► Sssod Warsaw Iia'f
these models ars:: Cammissicearr
.0awtory et 6wity . of Section
.consistency with !kite pin 1090
.00aftict of interest imm
.inti-(snit and business ooQtpWdat
.fraud and abuse in refsr:sl
.federal leen regarding 7=5 asrollmeat rwpitavisseb
.county exposure to hab ty
.initial funding of toew business
.Brown Act
-enroll.inS non-Medi-Cil ttorsnbets
.federal bealtb nefortm
There are currently no more COHS :lots avail"in fsed Staff
t.alifw=(currently COBS modes!are operatinS in San c4mmis6oders
Mateo, Sants Barbara, and Sohmo and in development in copies of bills
Santa Cruz and Orange Counties).7bere are bills for aatbotstinS
individual counties to engage in COBS *kx*- WW* COHS look-
governance. Staff to pet copies of these biiit Mod make alikes an request
avinlable to Commission. Sera Diego County is purtatiAg state
legislation to eliminate two-plan model for their arae.
In response to s request from the Chair,Mr.WindirA stated
that Contra Costs County would be prime candidate for
county model a they art already run", S a cosmty HMO.
CORS took alike model requires state legislation.
5.0 Comm-
Woes
ommWoes 5.1 tab •shment of Benefits CammiU=
Comminee to be esublished to look at benefits made
available to members of Local Initiative.It was M/M
that benefits committee be established.
5.2 Fitablishment of Executive Committee and Election of
Offi
For special situations when=tire Commiadaa Nomiaatiag Nominating
cameo be called toSetha,a five-member executive I"an so Committee
committee will meet cc aocasice to unwise pmv*t lMcam owd one
ism that cannot wait till next regularly schis6iled or lessee
comausaoc meems. Committee to include Chair.Viae- members; for
Committee Chair,Provider Affairs Metcobrr-at-
Committee Chair, and an okcW Member-01wil .The large of
4a,i,t�t„o,, Nominating Commivae will propose one or nacre shone&*
Commissioners for Member-al•Ltrge at the hens oammtM e
maetieS. In addition, Commiaaiocterss may self nominate.
It was M/S/C Chu the Executive Committee be
established. There was nae abstaining vote(Dowling).
Mali-Cal Advisory Planning Commission meeting
May S. 1944
3
ITEM NUMBER DISCUSSIONS ACtiONWH(
5.3 Amintmeat of Commi"m Chair%
All committee chairs have beam appointed by the MAPC Notify Bobbi Comtaissiomrs
Chair and have asread to ked their p rticular 341roo of but"
conUnitsees. Anyone interesting in metvint an 6m is serving oa
committees should all Bobbi Sam.Theme oomamideea oounitmtros
will probably int now mots om am a mooch. Rageast
saabe that gaff ammpe for minuses to be tokan. Re*" Codex Staff
Made that staff take into ooasiderariae 6e Comotssiattesre
Commissiooers'individual availability wben wbWW g ecbedWas wbm
taoetinys. Question raised if thane Committees an mbject Whadm1*1
to Brown Act. Staff to determine. Commit ms may be mmetinps
supported by gaff if requested by the chairs. Question .7
raised about charge for eacb committee. Staff will Provide each Staff
provide each with draft specific chaw. comtmttae with
draft Charge
Research
applicability of Staff
Draft Act to
ooa�oUse
araxingi
6.0 Comm-
sats on 6.I Suff Rmort on Mainstream Plan RFA and W,gkQrm
main- Staff report was distributed. Since this response has to
stream be seat to the stats by May la,it was placed an the
Pian RFA Board of Supervisor agenda for May 10. Staff asked that
gad Work Commission vote on adoption today.
Group
Decisions
6.2 Discussion and Annroval
Mary Lavender Fujii reported the Contra Casts County Schedule and Staff
Food and Nutrition Policies Coaaortium has developed publicize
specific recommendation retarding this RFA ad Exemitive
wanted this included in the MAPC raptxt. It was M/S/C Cammiume
that original Board Order be pulled from abs May 10 matins
agenda so that the Executive Committee has time:to
most and consider the Nutritional Policies Cma-m bum's
mommeodation.
Revised Board Order to be placed cm May 17 agands. It
was M/S/C that staff's response be approved and that
the Executive Committee consider bow Commissiam
Fttjii's comments could be incorporated. At the request
of the chair, it was determined there were 12 members
Present at this point of the meeting.
7.0 Dental
Carve 7.1 $trort of Dental Committee t
Out RFP Terry Tanner, D.D.S. Chair of the Dental Subcommittee
,submitted a report for review.
Medi-Cal Advisory Planning Commission Meeting
May 5, 1994
4
NVHO:
I ;TEM NUMBER DISCUSSIONS
CTI13N
7.2 Discussion and Approval
It was M/S/C that the Dental Committee report be Forward report Staff
approved and forwarded to Board of Supervisors. to B/S
9.0 Approval ` It was M/SIC that Local Initiative Workplan Timeline be Forward report Staff
of Localapproved and forwarded to Board of Supervisors.There was to B/S
Initiative one abstaining vote(Dowling).
Workplan
Timeline
10.0 Hearing Bobbi Baron reminded Commissioners that Hearing flyers
on June 1 were available in both English and Spanish..
11.0 Adjourn There being no further business to discuss, the meeting was
adjourned at 3:15 p.m.
(Signed) (D )
ic:w►c►sn+
Contra Costa County
Medi-Cal Advisory Planning Commission (MAPC} Meeting
Wednesday, June 1, 1994
7:30 - 8:30 p.m.
Pittsburg Preschool Coordinating Council..
1760 Chester Drive, Pittsburg
AGENDA
7:30- 7:45 1.1 Call to Order and Remarks of the Chair Rev. Curtis Timmons,
Vice-Chair
1.2 Commissioners' Comments MAPC Members
1.3 Public Comment
7:45- 8:00 *' 2.1 Approval of Minutes of MAPC Members
May 5, 1994 Meeting
*• 2.2 Approval of Minutes of MAPC Member
May 10, 1994 Executive Committee Meeting
*' 2.3 Ratification of Executive Committee's MAPC Members
Approval of Amended RFA Comments Report
8:00 - 8:10 3.0 Progress Report of Access Committee Bessanderson McNeil
8:101- 8:15 4.0 Brown Act Requirements . Staff Presentation
8:15 - 8:20 *' 5:0 Election of Executive Committee MAPC Members
8:20 - 8:30 6.0 Progress Report of Screening Committee Rev. Curtis Timmons,
Vice Chair
8:30 - 8:40 *' 7.0 local Initiative Development Contract Staff Presentation
MAPC Discussion
8:40 - 8:45 8.0 Membership of MAPC Committees Staff Presentation
MAPC Discussion
8:45 - 8:55 9.0 Discussion of Governance Alternatives Matrix MAPC Members
8:55 - 9:00 10.0 Executive Committee Mating information Only - Staff
Agenda for June 23, 1994
• 9:00 . 11.0 Adjourn
*' Action Item uI"x SWS4
` y v - n �.. 'Tye cgf. ta, .`�2� '�';t,Asow �21'{vb xA'`• >nr..cy.as w \
n.��-.7�
'�•. v2. n�'.. a K f 5. 4 '.:x d"c Jw __ <
�•�.a ' r { >st rY hrvly 1, v
n ontra �Co.a un�3' 1
r
Advisory 'taru>ing �ommiss n 1Vi w F N r{
v.
. >yY r r rw S t � ���/I-� Y. .y�� R\s�x +!•roC tf, arE q. Y r
r hi"�" t : bac _ > , > '"R• ">A
. utes .G
C01jNUSSIONERS PRESENT:
Cttrtis Timmoat,Vice-Calc Viola Lnjan
Maggie Dowling Stuaane MacDonald
Mary Lavender Fuju Ba"Werson McNeD
.Steve Heisler Evelyn Riaaler
Paul Katz Raymond Smart
Joan Lautenberger Gregg Sorensen
Linda Stepbenson
Claudette Garner, Michael Barris, Michael Lswsoa,Jack
COMMISSIONERS Welby Bigelow,Heather Saunders Estes, chez,Terry Ta=er;Tom Powers and
ABSENT. McGervey, Cynthia Miller,Tony Paap,Dolores San
Tom Torlakson,BIS Liaisons
1
STAFF PRESENT: Bobbi Baron,Linda Brun, Milt Cambi
MEMBERS OF THE Ruth Fontana,Tangela Hunter,Rosalind Love, Larry Lucero, Andrea ORtz,Hamid Rezapour
PUBLIC PRESENT:
.. Action
ltttn Numbs "
Dismssions Who
l.i Call to Curtis Timmons,Vice-chair ailed the Commission to order
Order at 7:57 p.m.
. Commissioner Dowling asked for a Dopy of the video tape bvextigate Staff
1.2 Comma- avu7ability of
sidams' of tonight's meesiag.
Comm-
asked that&V written taetimmy of Aumb wtittan S�
. Commissiooa Timmons eomments to
fooigbt's bearing be made available to Commi.dopers.
swintttes
. Commi"jocer Timmons &anked Frances O me for
boating tonigbt's bearing a<Pittsburg Preschool
Coordinating Cotmeil.
Commissioner Fujii thanked the Commisdoa far atheduliag `
the Executive Committee w bear ba pros-loo avisims to
the Drag RFA. naked that Staff
. Commissioner Timmons the MAPC kdabead be Modify
revised to identify the Executive Committee.
ktterbead
• Commission Dowling requested that each page in theStaff
-
packets be numbered in the future. Number pages of
agenda packet
Medi4U Advisory Planning Cotamistdon MeefaS
limo 3. 1994
2
.J0 NLTM BIL �` i,TSC US.QONS ,
4 ,
O
is Pubtio Now
ccantamt .
2.1 Approval ' Bobbi Sum requefW drat dx May S meeting minow be
of aareaded as follows: On page 2 u nda 5.2 Establithmettt..stf Amend mimdn S
Minutes zxwytive comn+tree and Ele:tioe of Officers the words
of May S *benefits Comauttee Cbair• be ebanged to*5wefidw7 Iaataes
Meetins Committee Chair.'It was M/S/C that dao sniaw�t be
approved as &mood*&
2.2 Approval It was MIS/C that the nsioutsa of die May 20 Ru"dive .
of Commitwc meeting be approved.
Minutes
of
F.ttecutive
Comm-
iaee
2.3 Rauf- Vice-Chair Titumons read a Setter from CatamiWCWw
ioation of Dowling regardinS ber eoacerm that the public Learing bad ad Address the Eseartive
Exec. been • ticed properly.' Sino this subject was No of the DOwling� Committee
Quan.- &Send&, it will be referred to the EI*MWve Cammiw+e. inose
inn's
Approval It was M/S/C that the report be ratified.Tbere was este
Of abstainiag vats(Dowiiag).
Amended
RFA
Cotata-
eats a
Report
3.0 progress C =missions McNal reported than the e+ommittee bas met to
Report of work out iasvcs ac access. Anotber meeting is pbuwed.The
Access committee will report back to the CM—; an in fitly.
Catam-
laee
4.0 Brcwa Sobbi$arca foportsd dsat the Coatmiaaoe*a Eseeutivs
Act Commitwe meetings have to follow the Brown Act
Require- requireamts. 'this does not apply to subcomtaittees tmleas a
ttnmts majorityof Cotamiassioaert<attend s aubcommitsae meeting.
S.0 Election The Nominating Coa nittee asked dw Member-et-Large
of . candidates to briefly stale their Credentials to nerve cc
Ezeawve Executive C unittee. Secret ballot vote was taken,and Mary
Contra;- FuJii was elected by suiority vote.
t tttee
Medi-Cal Advisory Planning Commission Meeting
June 1, 1934
3
ITEM NUMBER !DISCUSSIONS t)
won=
ICTQN WH
6.0 Progress The Screening Committee will interview Commissioner Put on July 7 Staff
Report of applicants for the two vacancies on June 3 and report their agenda
Screening recommendations at the July 7 MAPC meeting.
Comm-
ittee
7.0 Local Bobbi Baron reported that the State Department of Health
Initiative Services sent the final contract for reimbursing the Local
Develop- Initative for the costs of development. It will go to the Board
ment of Supervisors for their signature.
Contract
8.0 Member- Based on requests made by Commissioners, the Committee
ship of Structure continues to be revised. Commissioners may still
MAPC notify Bobbi if they wish to serve on any of the committees.
Comm- The public is welcome to serve on any of these committees.
ittees
9.0 Disc- It was M/S/C to table the governance discussion until after
ussion of the third public hearing.
Govern-
ance
Altern-
atives
Matrix
10.0 Executive Meeting has been scheduled on June 23 from 9-12 a.m. at
Comm- 595 Center Avenue, Martinez to discuss various procedural
ittee matters. Any recommendations will be brought back to the
Meeting Commission in July.
Agenda
11.0 Adjourn There being no further business to discuss, the meeting was
adjourned.at 9:05 p.m.
(Signed) ` . (Date)
Contra Costs County
Medi-Cal Advisory Planning Commission (MAPA Regional Hearing
Wednesday, June 1, 1994
5:30 - 7:00 p.m.
Pittsburg Preschool Coordinating Council
1760 Chester Drive, Pittsburg
AGENDA
5:30 - 5:35 1.0 .Opening the Hearing Rev. Curtis Timmons
.Introductory Remarks Vice-Chair
.Introduction of Commissioners
5:35 - 5:40 2.0 Welcome Supervisor Tom Torlakson
Board of Supervisors Liaison
5:40 - 5:50 3.0 Overview of State Plan Milt Camhi,
for Medi-Cal Managed Care Executive Director
Contra Costa Health Plan
5:50.- 7:00 4.0 Comments from the Public
7:00 5.8 Closing the Hearing Rev. Curtis Timmons,
Vice-Chair
ICAA 51WW
4
Public Hearing 7
on
Medi-CalManaged Health Care
in
Contra.Costa County
if you have an interest in learning more about
managed care for Medi-Cal recipients or would like your
views to be heard, come to the hearing hosted by the
Medi-Cal Advisory Planning Commission
Pittsburg Preschool Coordinating Council
.1760 Chester
June 1, 1994-5:30 p.m,,- 7:00 p.m.
�`Pittsbur
�t Pittsburg Preschool
Coordinating Council.
. Ch
b ary •. (wheel chair accessibility)
t l8ii�s r - G•C �e r•.
4`
For free transportation
Directions:Highway 4 to Pittsburg.Take Railroad Avenue Fant information call
Turn left on Railroad Avenue.Turn right on California. Maggie Dowling at:
Turn left on Harbor.Turn Right on School Street (510) 427-1219
At first 4-way stop turn right on Chester into parking lot at end of Chester.
For more information call Bobbi Baron 313-6404
MRPC
Medi-Cal Advisory PL Laing Caaai:dofs
595 Center Avenue,Suke 100
Martine:,CaUtornia 94SS3
(5 10)31144 Notice Of Public Hearing
FAX 010),311"')
, OMMISS,oNM .The MAPC Commissioners would I&e to invite residents of
ivsn,v.siii...Ja x.D. East county to a Public Hearing on managed care.
Melvin Doorli'4 The State of California has proposed iplan'for the implementa-
Hasshe* foes.M.LTM tion of managed care for certain Medi-Cal recipients. AFDC
Navy LawmArt Ni4 M.S.LD. Medi-Cal beneficiaries will choose between a private HMO or the
County's Local Initiative (Contra Costa Health Plan)to be their
Midmd G.Hamis.C.D.J.D.M.S. health care provider.
NIJ Kota To help in the transition to managed care,the Medi-Cal Advisory
Lass bMn R.N. Planning Commission 04APC)was appointed by the County
Mick.er P.Limmm Board of Supervisors. The Commissioners,several of whom live
via,Laos or work in East County,were appointed because of their interest
Suzaim UncDonala in the community and their expertise in the health care field.
t '
'Ot` e"Heisler. N.V. ou are encouraged to make your views on managed care known
mey
s"pk"'H` to the Medi-Cal Advisory Planning Commission. Come to the
stsmaAelso►McNeil.M.P.H. Public Hearing in your area,or you may send your written com-
eruk,e Mater ments to Medi-Cal Advisory Planning Commission; 595 Center
T*"P•o Avenue, Suite 100; Martinez, CA 94553.
swiss,Rintrer.M.A. If you require an interpreter or other reasonable accommodations,
Worts 5~6q.L.C.S.VV..M.P.H..UD. please contact Bobbi Baron at 313-6004 at least three days prior
Rer"a L Sao" to this hearing. Please help us accommodate individuals with EU
e..M S.Ssnmsen.M.D..M.P.H. MCS and refrain from wearing scented products to this Hearing.
Lived.Ssar NUM F.N.R.
If you would like to help us advertise the Public Hearing in your
Terq'T.wwr..D.D.S. community,you may post the flyer on the reverse side.
Am Canis a Timmons.R.&.7LD.
DOOM of sunRv2SORs LWSONs Pittsburg Preschool Coordinating Council
Too Pow" 1760 Chester,Pittsburg
TimTogelsw, Wednesday,June 1, 1994
5:30 p.m- 7:00 p.m.
t
/V r
coXi n r
aCosta . unty.
Medial dnso "Planru COn1II1MOn
-C . A r3'
fast Cflun Public Hear' (Pittsbur
. .�
dune
Minutes
COMNIISSIONERS PRESENT: Viola Lujan
Curtis Timmons, Vic 43Wr Suzanne MacDonald
Maggie Dowling Bessanderson McNeil
Mary Lavender Fujii Evelyn Rinner
Steve Heisler Gregg Sorensen
Paul Katz Linda Stephenson
Joan Lautenberger Tom Torlabon,B/S Liaison
COMMISSIONERS ABSENT: Welby Bigelow, Heather Saunders Esus, Claudette Garner, Michael Harris,
Michael Lawson,Jack McGervey,Cynthia Miller,Tony Paap,Dolores Sanchez,
Raymond Smart, Terry Tanner;Tom Powers, B/S Liaison
STAFF PRESENT: Bobbi Baron,Linda Brun, Milt Cambi, Elissa Leidy
MEMBERS OF THE Randy Adkins, Nobemi Beltzel, Maria Camaclio, Arlene Dutro, Ruth Font_ .�
PUBLIC PRESENT: Bud Getty,Doris Glasper, Frances Greene, Vivian Herman, Tangela Hunter.
William Lee, Maria Lopez, Rosalind Love, Larry Lucero, Sarah Maxwell,
Stephanie Michaels,Sandra Nieves,Janiece Nolan,Andrea Ortiz,Michael Parnell,
Charlotte Perry,Lee Peterson,Judy Rasmusson(sent in written comments),Frank
Selkik,Connie Tolleson,Veronica Vale,Carta Walker,Jackie Walton,Yolanda
Whitney
1.0 Curtis Timmons, Vice-Chair, called the bearing to order at 5:45 p.m.
2.0 Supervisor Tom Torlakson, Board of Supervisors Liaison to the MAPC, thanked the Commission and the members of
the public who worc present for thew participation in the Local Initiative planning process. He spoke briefly on the Los
Medanos Community Hospital closure issue.
3.0 Milt Camthi reported that the State has reversed bow much Medi-U private HMOs can enroll.
4.0 Comments from the Public
4.1 Judy Rasmusson's testimony was read by Ruth Fontana.Ms.Rasmusson was concerned that if SSI recipients are
brought into Medi-Cal, she may be faced with unsafe access, inadequate ambulance service and environmental
precautions.
4.2 Lee Peterson of the California Council of the Blind had requested that public bearing materials be in altern;,•'
format for the visually impaired. He suggested CCHP should have a staff person who can deal with the n
disabled.
4.3 Doris Glasper had concerns regarding a family member having less benefits when covered by both an HMO and
Medi-Cal.
-2-
Medi-Cal Advisory Planning Commission
East County Public Hearing (Pittsburg)
June 1, 1994
7.
J
4.4 Connie Tollison voiced her concerns regarding the need to schedule appointments in a timely manner for her and
her handicapped child and not to be rushed through during the appointment.
4.5 Ruth Fontana spoke on the lack of care available at Merrithew for her chemical sensitivity. She wondered what
the difference in quality of care would be between the present county health services care and CCHP managed
care.
4.6 Tangela Hunter addressed the commission regarding the state's billing process and the fact that the state persists
in discontinuing her medications. ,
4.7 Yolanda Whitney reported that she had been very satisfied with care at LMCH. In addition, she does not want to
lose her Medi-Cal.
4.8 Arlene Dutro, a benefits counselor for Pittsburg Preschool Coordinating Council, was concerned with case
management. She believes social services has been overlooked as a segment of the state managed care plan. Ms.
Dutro stressed the importance that Medi-Cal forms be simplified.
4.9 Sandra Yvez spoke in behalf of illegal immigrants and the rude manner in which they are treated in the health
system. She questioned what the new Medi-Cal program will offer these people.
4.10 Andrea Ortez conveyed her concern for the uninsured, like her 19-year-old son whose two part-time jobs do not
include health care benefits, and since he is employed he cannot be covered under her Medi-Cal plan. She is
anxious about her 73-year-old neighbor, who has share of cost coverage, and must cut her grocery expenses in
order to pay medical bills and buy prescriptions.
4.11 Tom Torlakson asked how staff plans to respond to the issues presented tonight. Mr. Camhi said CCHP will follow
up on any issues raised by its members..
(Signed) (Date)
tc:rOWULm
Contra Costa County
Medi-Cal Advisory Planning Commission 04A,PQ Meeting
Thursday, July 7, 1994.
4-6 p.m.
Local 1 Hall
5034 Blum Road, Martinez
AGENDA
4:00-4:20 I.1 Cali to Order and Remarks of the Chair J&chael G. Harris, Chair
1.2 Commissioners Comments MAPC Members
1.3 Public Comment
4:20- 4X ...* 2.1 Approval of Minutes of June 1, 1994 Hearing MAPC Members
...* 2.2 Approval of Minutes of June 1, 1994 Meeting MAPC Members
4:25 - 5:00 3.0 Executive Committee Meeting
of June 23, 1994
3.1 Report of tate Meeting Michael G. Harris, Chair
3.2 Charge to the Committees Michael G. Harris, Chair
31.3 Request for Commissioners' Input Michael G. Harris, Chair
in Beneficiary Nexis
...* 3.4 Approval of Minutes. MAPC Members
5:00 -5:10 4.1 Report of Screening Committee , Rev. Curtis Timmons
...* 4.2 Discussion and Decision MAPC Members
5:10.5:20 5.1 Report of Ataoess Committee Btssandtrson McNeil, Chair
3:20-5:5Q 6.0 Mental Health Carve Out Lorna Bastian, Meatal Health Director
Alan Stein, Mental Health Planning Director
5:50- 6:00 7.0 Local Initiative Update Staff
6:00 8.0 Adjourn
Note: ...* Indicates an Action Item
Y
sr:w►irn,p+ _
p. v y av th t?a 2G.
i .-�.. \t. � i t yw:> .'� � �.. ty >.tc� :'^<<•a.ra ��s o•\ < �a <k 1�yiY S\ � �- < Y >xi
on"tT8.C4S'�8 COIilI!
> Medi-Cal•Adviso PIco:C
�,,�,���/�
Y O a
���j�� ommiss
- s >. -Y h: a $ ,• si 3 .�✓ iya�""—a--O.
• �.n 6 s - t '.. n > rro )> a<. a.. - ,C C'$u�.. )>. r' Ys ,.♦ a.
w
..0 x c� ice\ � a .w`•. n < \ <>
99
-. as „•. > a y .. � a r .3 n � � - a.• w s >< \
COINSSIONERS PRESENT:
Michael Farris, Chair Paul Bats Dolores Sanchez.
Curtis Timmons,Vice-Chair Joan Lautenbager Ray Smart
Maggie Dowling Michael Lawson Litlda Stepbton
Heather Saunders Esus Suzanne MacDonald Terry Tanner
Mary Lavender Fujii Jack McGervey -
Claudette Garner Bessanderson McNee
Stephen Heisler Tony Paap
COMMISSIONERS Welby Bigelow,Viola Lujan, Cynthia Miller.Evelyn Rinzler, Gregg Sorensen;Tom Power's and
ABSENT: Tom Torlakson,BIS Liaisons
STAFF PRESENT: Bobbi Baron,Linda Brun, Milt Cambi
•• `MEMBERS OF THE Richard Baker,Jacques Barber,David Joslin,Rosalind Love,Jeffrey Sprague, Sarah Stewart
.UBL1C PRESENT:
Disssions
Item Numbercu
1.1 Call to Michael Harris, Chair,called the Commission to order at
Order. 4:10 p.m.
yer in
1.2 ami. Single Pa
itiative has qualified for the ballot.What Put angle payer Staff
adoaerc'
will be the impact of this legislation an our Loaf initiative m
Comm- Initiative?Staff reported that this is ctrrremay ander September
ons: ataady;will have an analysis.for MAPC September Stan&
mfg updates be,
Commissioner requested that oomminee
included at the regional hearings(of P9hAP Pvvide
minutes of Committee meetings).
Copies of videotape:of the first and seioond bearings are
now available. Commissioners should Contact Bobbi
SStaff to to pmter�in��ung ealeadar which .
includes 1995.
Beneficiary Concerns: Michael Harris reminded
Commissioners of the tared to provide a brief atmmary
based on their c1perieaoe tad Imowledge of beoefiriary
issues. If possible,members to Provide mmtaary by
tnid-August. Send notices to Staff -
Benefits Committee is scheduled to meet at 2 p.m. m Commission
August iS.
Provider Committee is scheduled to meet at 1 P.M. on,
August 30.
'Medi-Cal Advisory Planting Commitian MeetinS
July 7. 1994
.2
't1EM NUMI31~1t (DISCUSSIONS ACTIONi0
19 Public None
Comment
2.1 Approval It was M/S/C that the minutes of the Jane I Reeria=be
Of approved.
Idimta
of lune 1
Hearing
2.2 Approval It was M/S!C that the minutes of the June 1 meetiap be
of approved.
Minutes
Of June 1
Meeting
3.3 Request It was IM/StC that Commission Rules cad Prooedures as
for ztei'lectad is the Executive Committee minutes be approved.
Commi-
issionew
Input in
Bene-
ficiary
Needs
3.4 Approval It was MIST by the members of the Executive Committee
of that the minutes of the June 23 Executive Committee meeting
Minutes be approved.
of
June 23
Executive
Commi-
#ttee
hdeating
4.1 Report of The Screening Committee recommended Jawaoe Nolan,to AD
Screening the bospital vacancy on the Commissiom cad Rosalind Lova as
Gummi- member-at-large.
tax
4.2 Discuss- It was M!S/C dw the two nominees be noommeaded to the Send Staff
ion and Board of Supervisors for their wr orval. r+, -mmendation
Decision to bard of
&;Perviaors
5.1 Report of Mw Acorn Committee will make its fmommeadatioas in a
the written report at the September meeting. Copies of the Put Access Staff
Acow amended charge to the committee will be included in the Committee
Commi• report. report on
nee September
&sea" f
Medi-Cal Advisory Planning Commission Meeting.
July 7, 1994
3
_.
ITEM NUMBER DISCUSSIONS O
6.0 Mental The presentation by the Mental Health Division was tabled
Health until the October meeting. Members of the Mental Health
Carve Commission are invited to participate in MAPC committees.
Out
7.0 Local The State is delaying the release of the Mainstream Plan
Initiative Request for Application. Implementation of the two-plan
Update model is being revised with a new target date of
December 1, 1995. There will be a State public forum
in Sacramento on September 16. .
It was M!S!C that the Commission forward to Board of
Supervisors its concern that the rights of beneficiaries in
Such areas as access in having opportunities to health
cane card for meaningful input be protected in whatever
Mainstream Plan or Plans are chosen by the State
Department of Health Services.
Contract to receive Local Initiative development funds
from the State Department of Health Services will be on
July 12 Board of Supervisors agenda.
Heaa Blum will be requested to provide written report .
on different government models at the October meeting.
8.0 Adjourn There being no further business to discuss,the meeting was
adjourned at 5:10 p.m.
` f
9- �- e4' �
(Signed) (Date)
LCMACLM
CONTRA COSTA COUNTY
MEDI-CAL ADVISORY PLANNING COMMISSION(MAPC)MEETING
Wednesday, September 7, 1994
7:30-9:00 P.M.
Contra Costa Cosmty
Board of Supervisors Chambers
651 Pine Street, Martinez, CA
130 1.0 Call to Order and Remarks of Chair Michael Harris, Chair
1.1 Introduction of Staff
1.2 Commissioner's Comments MAPC Members
1.3 Public Comment
7:50 * 2»0 Approval of Minutes
of July 7, 1994 Meeting (pp. 3-5) MAPC Members
7:55 3.0 Interim Report of Access Committee (pp. 6-15) Bessanderson McNeil, Chair
' 3.1 Discussion and Derision MAPC Members
8:10 4.0 Draft 1995 Schedule of Meetings & Hearings Staff
(PP. 16)
4.1 Discussion and Decision MAPC Members
8:15 5.0 Revised Workplan Timeline Staff
* 5.1 Discussion and Decision MAPC Members
8:20 6.0 Update of Provider Affairs Committee Heather Saunders Estes, Chair
5:25 7.0 Update of Cultural, Linguistic, Ethnic Dolores Sanchez, Chair
Access Committee
8:30 8.0 Update of Benefits Committee lack McGervey, Chair
8:35 9.0 Commissioner's Input: Beneficiary Needs (pp. 26-33) Michael Harris, Chair
8:40 10.0 Local Initiative Update (pp. 34-35) Staff
8:45 11.0 Analysis of Single Payer Initiative Staff
8:58 12.0 Notice of Brown Act Workshop (pp. 36-42) Michael Harris, Chair
9:00 13.0 Adjourn
Note: ...*indicates an Action Item
If you are unable to attend, please call Jackie Lacy at 313.6024. .
it+�.yd
f
Ems-
contra Cosa Coulnty
r
>
�' Medl Cal Advisory Planningommiss><on Meeting
y s
R k
t
{�' y - 1VilnIIteS }S C Y
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iCONMUSSIONERS PRESENT:
Michael Harris, Chair Paul Katz Bessanderson McNeil
Curtis Timmons, Vice-Chair Joan Lauteabager Evelyn Ringer
Welby Bigelow Michael Lawson Dolores Sanchez
Maggie Dowling Viola Lujan Ray Smart
Heather Saunders Estes Suzanne MacDonald : Gregg Sorensen
mmy Lavender Fujii Jack McGervey
COMMISSIONERS Claudette Garner, Stephen Heisler,Cynthia Miller,Tony Paap, Linda Stephenson,Terry Tanner;Tom
ABSENT: Powers and Tom Torlakson, B/S Liaisons
STAFF PRESENT: Bobbi Baron, Linda Brun, Milt Camhi, Jackie Lacy, Elissa Leidy,Lynn Morris
MEMBERS OF THE Jacques Barber, Kelly Dunn, Rosalind Love,Janiece Nolan, Robert Polacchi
PUBLIC PRESENT;
Item Number Discussions !►coon Who
1.0 Call to Michael Harris, Chair,called the Commission to order at
Order 7:49 p.m.
1.T Introd- Lynn Morris, CCHP Assistant Director of Planning and a
notion of new MAPC staff member, was introduced.,
Staff
.1.2 Commi- Commissioner asked that vote be taken an changing the
asioners, hours of future meetings.
Comm- Commissioner asked that a onel*ge calendar indicating
eats scheduled committee meetings be issued each month
Three Commissioners wished to discuss.County Hospital
issue but it could not be addressed since it was not Will address Executive
included in the agenda• Committee
Commissioner stressed need to address why there is not
more attendance from the public at the bearings.
• Commissioner requested to be on mailing list for Send minutes to Staff
minutes from all committees. those interested
Commissioner suggested that in the future,information fi .
should be sent out one mouth in advance when any vote
must be taken. �
Commissioner requested that Mark Finucane be invited
to next Commission meeting.
Medi-Cal Advisory Planning Commission sting
Sqpt=ber 7.1994
2
.TEM 2�1JMBfiR ,DISCUSSIOI�iS f } ti C �iriC'iiON its
}
2.3 Public Kelly Dunn, Attorney with The Hawkins Curter for dw Send bill to Bobbi•Barco
Comment Disabled, spoke about the new kgiala =(HR4277)which Evelyn Rkudw
was signed into effect August 15. 1994.This legislation will
require that SSI recipients with•primary diagnosis of
druglalcobol addictions will be dropped from SSI after 36
months. Staff clarified that their Medi-Cal and Medicare
benefits will continue.
2.0 Approval It was M/S/C that the minutes of the July 7 meeting be
of approved.
Minutes
of July 7
Meeting
3.0 Interim Bessanderson McNeil, Access Committee Chair, indicated
Report of that this is an interim report and read the committee's
Access recommendations. It was asked that in the next Aeneas
Comm- Committee report confidentiality as an access barrier be
jum included. Dr. Henrik Blum,wbo addressed the Aeneas
Committee, may be invited to a future MAPC meeting to
_discuss access issues.
a.I Discuss- It was M/S/C that the interim report be approved.
ion and
Decision
4.0 Diaft Two versions of the draft 1995 meeting and hearing schedules Poll MAPC as to Lynn Morris
1995 were distributed. dicir preferences
Schedule re meetings
of
Meetings
and
Hearings
4.1 Discuss- Discussion was tabled until October meeting.
ion and
Decision .
S.0 Revised In order to obtain planning funds from the state, the
Workplan Commission was required to update the workplan timeline,
Timeline All changes were underlined. These can be changed as needed
in the future.
There was a discussion.about the extended hours in the
Richmond and Pittsburg Clinic and the additional bus
tmasportation in the updated workplan.
Medi-Cal Advisory Planning Commission M..,mg .
September 7, 1994
3 n
ITEM NUMBER DISCUSSI024S s ►CTtON R'HC
Concern was expressed that the disabled are unable to utilise
this bus transportation because them am so Wks.
Executive Committee will further discuss the implementation Put on Execadve Staff
of the workplan at its September maeting. Committee
Age
3.1 Discuss- It M/S/C that the Workplan Timeline be approved and
ion and forwarded to the state.
Decision
t.0 Update of Heather Saunders Estes, Chair, reported the committee had
Provider not met but were attempting to ad a date.
Affairs
Comm-
ivae
7.0 Update of Chair Dolores Sanchez reported that the committee has met
Cultural, once, reviewed the.State Department of Health Services'
Linguis- proposal and didn't believe it was strong enough. Dr. Miriam
tic, Warner (anthropologist)and Dr. Kim Duir(Richmond Health
Ethnic: _Center physician)will be invited to share their expertise at
Access future meetings.
Acss
}
ittae
8.0 Update of Chair Jack McGervey reported that this committee had
Benefits completed a comparison of Medi-Cal vs. CCHP benefits and
Comm- came up with five recommendations. Prevention services were
ittee emphasized. Results will be forwarded to the full Beneficiary
Affairs Committee before being submitted to the MAPC.
9.0 Comm- Michael Harris reminded Commissioners that they should
iissionew submit their brief statements based on their knowledge and
Input: experience on beneficiaries' needslemcft s.
Benef-
unary
Needs
113:0 Local Inc County Board of Supervisors has communicated with the
Initiative State regarding their need to be consulted in the State's
Update decision to modify the two plan model for Medi-Cal.The
Board has concerns that the safety net's ability to serve the
indigent be kept intact.
Commission members brought up the role of the MAPC and Put on Staff
its relationship with the Board of Supervisors txnaerning September
aisums such as the two plan vs. a multiple plan model. Executive
• 3 Committee i
Agenda
-4- '
Medi-Cal Advisory Planning Commission Meeting
September 7, 1994
4
ITEM NUMBER DISCUSSIONS
ACTT
_ _ I
__ ON
I
11.0 Analysis It was M/S/C that this item be tabled until the October !
of Single meeting.
Payer
Initiative
12.0 Notice of Michael Harris urged interested Commissioners to attend the
Brown county workshop 'Complying with the Brown Act' on
Act September 29, 1994. `
Workshop
13.0 Adjourn There being no further business to discuss, the meetingl,was
adjourned at 9:20 p.m.
i
I o
I
ate
(Signed)--
(Date)
I
u:w,e►+ma
r
Contra Costa County
Medi-Cat Advisory Planning Commission (MAPA Regional Hearing
Wednesday, September 7. 1994
3:30-7:00PJL
Board of Supervisors Chambers.
651 Pine Street
Martinez, California
AGENDA .
5:30 5:35 1.0 Opening the Hearing Michael Harris,
Chair
Introductory Remarks
Introduction of Commissioners
3:35-5:40 2.0 Welcome Supervisor Jeff Smith,
Board of Supervisors
5:40- 5:50 3.0 Overview of the State Plan Milt Camhi,
for Medi-Cal Managed Care Executive Director,
Contra Costa Health Plan
5:50- 6:40 4.0 Comments from the Public
6:40 -7:00 Comments from the Public
(Call in Available Via Telephone 6464W)
7:00 5.0 Closing the Hearing Michael Harris
Chair
NOTE: If you require an interpreter or other reasonable accommodations, please contact Lynn Morris at
510-313-6024 by Thursday, September 1, 1994. Please help us accommodate individuals with E IMCS and
refrain from wearing scented products to this Hearing.
For home-bound individuals unable to attend the hearing and wishing to participate, a public'comment
telephone tine will be available from 6:40 to 7:00 P.M. The number is 510-646-4440. Please limit
comments to 3 minutes. If the line is busy when you call, please hang up and try the call again during the
allocated time period. For more information, call Lynn Morris at 510-313-6024.
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CONMSSIONERS PRESENT: Michael Lawson
Michael Harris, Chair Viola Lujan
Curtis Timmons, Vice-Chair Suzanne MacDonald
Welby Bigelow Jack McO my
Maggie Dowling Evelyn Rimier
Heather Estes Dolores Sanchez
Mary Lavender Fujii Raymond Smart
Paul.Katz Gregg Sorensen
Joan Lautenberger
COMMISSIONERS ABSENT: Claudette Garner,Stephen Heisler,Bessanderson McNeil,Cynthia Miller,Tony
Paap, Linda Stephenson,TerryTanner; Tom Powers and Tom Torlakson,B/S
Liaisons
STAFF PRESENT: Bobbi Baron,Linda Brun, Milt Camhi,Jackie Lacy,Elissa Leidy,Lynn Morris
MEMBERS OF THE PUBLIC Jacques Barber,Rita Barouch,Jim Beaver,Brenda Blasingame,Frank Camargo,
PRESENT: , Eugene Draper,Kelly Duna,Aaron Jones,Bill Kehoe, Claudia Lopes,Ros
Love, Barbara Nash,Janiece Nolan, Luz Pardini,Joyce Routson,Jan Schih.4,
Jeff Smith, Rhonda Stephens,Ernest Takeuchi, Cate Teuten, Inda Ureta, Gene
Zimmerman, Rosalie Zollars
1.0 Curtis Timmons, Vice-Chair, called the hearing to order at 5:43 p.m.
2.0 Supervisor Jeff Smith thanked the Commission and the members of the public who were present for their participation
in the Local Initiative planning process.
3.0 Milt Camhi reported that the state is proposing to include in its plan for Medi-Cal managed care multiple HMOs rather
than the two plan model.Two thirds of Medi-Cal eligibles must be in an HMO;the other third can be in fee-for-service.
.4.0 Comments from the Public
4.1 Luz Pardini asked if community providers will have access to the county services, i.e. the nutrition department.
plan.
care ed
4.2 Rhonda Stephens, county dietician, stressed importance of including medical nutrition in the maaag p
4.3 Inda Ureta, home economist with WIC program, stressed importance of county including.nutritional services for
children of all ages.
4.4 Bill Keough gave an account of his son's(Patrick)genetic condition(PKU).The family depends on dietary services
for Patrick's care.
4.5 Utilizing the public comment telephone line, Ruth Fontana called in to report that although Milt Camhi, Contra
Costa Health Plan Executive Director, and Commissioner Evelyn Rinzler offered their assistance in April,she is
unable to obtain approval from Medi-Cal for the doctor-prescribed treatment for her EUMCS condition. A
Commissioner asked staff to prepare an analysis of Medi-Cal vs.FFS benefits and also a comparison of the ct R
grievance procedures. This will be made available at the October meeting. In addition, Ruth urged the county to
consider carefully the building materials to be used in the hospital replacement project. Chair Michael Harris
asked that Ruth forward to the MAPC a written copy of her testimony.
Medi-Cal Advisory Planning Commission _6
Central County Public Hearing (Martinez)
September 7, 1994
2
1
4.6 Utilizing the public comment telephone line, Norma Townsend suggested home medical services be included in
the managed care plans.
4.7 Dr. Gene Zimmerman, a physician in Antioch, wanted to describe what private providers will be up against if
managed care is allowed to expand. He reported that private providers like himself have historically treated Medi-
Cal patients as a public service. He felt that with private insurers reducing payments and HMOs taking over,it
is impossible to treat patients and make any profit;and he believes FFS is the best approach for Medi-Cal patients.
4.8 Brenda Blasingham spoke on Contra Costa County Health Services Tobacco Prevention Project which promotes
community level intervention.
There being no further business, the hearing was closed at 7;07 p.m.
{
(Signed) / !G (Date)
ic:Rearmin
Contra Costa County
Kedi-Cal Advisory Planning COMmission (NAPC) Keeting
�- Thursday, October 6, 1994
1:00 - 3:00 P*K.
Local 1 Hall
5034 Blum Road, Kartines
f .
AG ENDA
1:00 1.0 Call to Order and Remarks of Chair Harris
1:00 2.0 Commissioner"s Comments MAPC
1:10 3.0 Staff Progress Report Camhi
1:15 4.0 Public Comment
1:30 5.0 ** Approval of Minutes of September 7, 1994 Meeting
and Hearing (pp.1-6)
1:35 6.0 Presentation by Dr. Henrik Blum: "Local Governance:
- what it Means for Beneficiaries" (pp.7-17)
Questions and Answers
2:15 7.0 Report and Recommendations Harris
i.
of the Executive Committee
** Discussion and Decision
2:25 8.0 Draft 1995 Schedule Harris
of Meetings and Hearings
** Discussion and Decision
2:30 9.0 Local Initiative Camhi
Information Update (pp. 16-35)
Question and Answers
2:40 10.0 Potential Impact Morris
of Single Payer Initiative
on Local .Initiative (pp. 36-39)
2:50 11.0 Update of Mainstream Plan Committee Estes
2:55 12.0 Update of Cultural, Linguistic, Sanchez
Ethnic Access Committee
3:00 13.0 Adjourn Harris
**' indicates action item
Pi.EASE . CALL JACKIE LACY AT (510) .313-6024 IF YOU CANNOT ATTEND.
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. Minutes:
C01,WSSIONERS PRESENT:
Michael Harris, Chair Viola.Lnjan
Curtis Timmons,Vice-Chair Jack McGervey
Maggie Dowling Bessanderson McNell
Mary Lavender Fujii Evelyn Rinner
Gaudette Garner Ray Smart
Stephen Heisler
COMMISSIONERS Welby Bigelow,Heather Saunders Estes,Paul Katz, Joan Lautenberger, Michael Lawson, Suzanne
ABS ': MacDonald, Cynthia Miller, Tony Paap, Dolores Sanchez, Gregg Sorensen, Linda Stephenson,Terry
Tanner; Tom Powers and Tom Torlakson,BIS Liaisons
STAFF PRESENT: Linda Brun, Milt Camhi, Lynn Morris
MEMBERS OF THE Henrik Blum, Regina Dozier,David Knoll, Claudia Lopez,Rosalind Love,Edith Lowenstein,Rol
PUBLIC PRESENT: Polacchi, Diane Ryland, Janet Wasko
hem Number 'Discussions a�►cbon Who
1.0 Call to Michael Harris, Chair, called the Commission to order at
Order 1:30 p.m. without a quorum present.
Reverend Timmons,Vice Chair, clarified that without a.
quorum present the meeting was informational only,with no
action possible.
2.0 Commi- Commissioner asked that members be notified of Lord
lwlclltl�w Initiative meetings so that they may amend and/or
Comm- arrange transportation for the public to amend.
�s Commissioner asked if members will be given the
opportunity to review the Local Initiative RFA.Milt
Camhi clarified that the RFA he bad just reoeived was
for the private HMO. Copies may be requested by
calling the State DHS at 91W7-0977.The Local
Initiative RFA has not yet been received.
. Commissioner requested that an overview be sonde
available of who will be eligible for Local Initiative,
aince currently some employed people receive Medi-Cal
benefits. Milt Camhi explained that these were Medi-Cal '
eligibility issues and not part of the Local Initiative.
Commissioners would certainly have the opportunity to
comment an the Loral Initiative RFA as it is MAPC's
role to do so..
Mediu Advisory Planning C.... fdeetia ...)
October 60 1994
Z •
at?EM NVMBER DISCUSSIONS
x
rl!!1CCION 'R�iO
4
• Commissioner.asked if we could aped the private
Wmstsram)HMO to adhere to the same sweat
standards, at. that we have written for Local Initiative.
Milt reported that the state specific$the$aunty can bot
designate any of the private HMO(Mainstream Plan's)
Btu"and that it would be a conflict of interest to do
so.
Commissioner asked that the monthly meeting calendar Include calendar Staff
be not with meeting agenda packet each moa&. in meeting
Packet
3.0 Staff Milt Camhi reported that the Board of Supervisors is meeting
Progress on October 7 regarding bospital contracts and the Local
Report Initiative.
4.0 Public Edith Lowenstein,M.D. reported that she was attending Send Dr. Staff
Comment today's meeting in Suzanne MwDoaald's absence and that she Lowenstein
was relocating. Dr. Lowenstein said that abe would be tasrtiag application info
application for The VWAI d position.
3.0 Approval
Of Sint there was no quorum present, the minutes of the
Minutes, September 7, 1994 Meeting and Hearing could not be
of Sept- approved.
ember.7
Meeting
and
Hearing
6.0 Present-
ation by Dr. Bti m dmnibed the five governance alternatives and bow
Henrik they might impact beneficiaries. He encouraged the
Blum, C anwiissikm to review his study.He suggested that the county
M.D. should be a strong presence in whatever form is need sad
sbould keep control by contracts if not by direct operations
and be able to introduce changes.
Dr. Harris and members thanked Dr. Blum for his excellent
pr+earatadon.
7.0 Report
and Dr. Harris reported that the Executive Committee met on
Recomm- September 30. MAPC members were polled on their meeting
ndations time preferences. Ile Executive Committee;noommends:
of the Continue rotating meeting times: 1-3 p.m.,4.6 p.m..
Executive and 74:30 p.m.
Comm Official committee minutes will be action minutes. At
ittee committee meetings, they easy select one of the
committee members to take mem detailed minutes.
Committee meetings may be tape recorded as long as
participants arc notified, Recomm- Dr. Harris
Beneficiary Committee will study methods for soliciting esxdstions will be,
community input.- made at
Commissioner asked that Beneficiary Affairs also look at November 3 .
this matter. meeting
Medi-Cal Advisory Planning Commission U.,etaiag _) Y
October 6. 1994
3
ITEM sumsER DISCUSSIONS ;°�
�; .ACTION. "WIIO
2.0 Draft Lyng Morris reported the outoome of the poll of 1995 draft Staff
199S Commissioners regarding meeting prefe ranow revealed the achedttle
Schedule majority of members are satisfied with the meeting tjmcluding sites)
Of days/times.The 1995 schedule will be adapted st the to be proposed at
Meetings November meeting. November 3
and Commissioner stated that presebeduling the hearing =ado
Hearings topica was inappropriate.
Commissioner questioned why 1995 hearings couldn't be
held in new locations,i.e. Brentwood. Staff reported
sites were determined according to svallsbility,access to
the disabled, food service, etc. Commissioner stated the
City of Brentwood facility,has wheelchair access, public Send Morris site Commissioner
transportation availability,and signing in the area. information
.. Commissioners should notify Lynn Morris of availability
of sites where all facility needs may be me4.
Commissioner requested that she be ant a lint of groups
who should receive hearing flyers.
9.0 Local Milt Camhi encouraged Commissioners to review the drag
Initiative summary and be swarm of the standards the state has now
Info established.
Update
10. Potential Lynn Morris a%plainesd Proposition 166,which promises to
Impact of provide comprehensive health cue for all California legal
Single residents. This proposition would increase payroll taxes.
Payer individual state taxes and tobacco taxes. HMOs would
Initiative probably cense to exist. An elected Health Commissioner
on Local would sex all physician, drug, and hospital prim and would
Initiative determine what medical procedures are appropriate.The
impact on the Local Initiative would be to eliminate the need
for it.Private insurance would be replaced by the single payer
government system.
11.0 Update of The Mainstream Plan Committee recently met with a
Main- representative from Tower Health Plan.The comrpittee will
tRream interview any new health plans coming into the county.
Plan Health Net,Kaiser, and PacifiCare have bean reconsidering
Comm- applying for Mainstream Plan;Blue Cmas and Tower are still
Wee intereated.
12.0 Update of Evelyn Rinrler gave a state:report on Cultural.Linguistic.
Cultural. Ethnic Access Committee.Dr. Miriam Werner spoke at a
Ling- recent meeting regarding cultural diversity. She gave aha
tristic.
committee specifics on bow to turn knowledge into action.
Ethnic 1
Access
Comm-
ittee
Medi-Cal Advisory Planning Commission Meeting
October 6, 1994
4
s
TEEM NUMBER DISCUS§IONS '
i�CTIUId
O
13.0 Adjourn There being no further business to discuss, the meeting was
adjourned at 2:55 p.m.
(Signed) (Dole)
;z
' CONTRA COSTA COUNTY 1
MEDI-CAL ADVISORY PLANNING COMMISSION QAAPC)MEMWO
Tbursday, November 3, 1994 .4:U0-6:W P.W.
Local 1 Hall•$034 Blum Road, Martinez
AGENDA
4:00 1.0 Call to Order and Remarks of Chair RuTis
4:05 2.0 Commissioner's Comments Members
4:10 3.0 Staff Progress Report Staff
4:15 4.0 Public Comment
4:25 5.0 •* Approval of Minutes of September 7. 1994
Meeting and Hearing and Informational
Minutes of October 60 1994 Meeting (pp. 1-10) Members
4:35 6.0 Presentation by Alan Stein,Director of Planning,
HSD Mental Health Services • *Mental Health Carve Out"
4:50 7.0 Presentation by Dr, Wendel Brunner, ESD Public
Health Durectm • *Role of DHS Public Health in
Relationn to the Mainstream (Private)EMO"
5:05 8.1 Report of the Executive Committee Harris
(sent under separate cover)
8.2 ** Recommendations of the Executive Committee (pp. 11)
Discussion and Decisions
A. Meeting Schedule, Commissioner Attendance,
and Meeting/Heaft Sites
B. Annual Report, Internal WorkplanMtndine.
and M,aeting with Board of Supervisors
C. Revision in Charge to Access Committee
3:40 9.0 ** Report and Recommendations of the
Beneficiary Issues Committer (pp. 12-13) Rinner
Discussion and Decision
5:50 10.0 Report of the Cultural,Linguistic,
Wadc Access Committee Sanchez
r 5:55 11.0 Report of the Provider Affairs Committee Estes
6:00 12.0 Adjourn - Harris
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?contra Costa oo .
n
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z Medi-CaT Advisory 'Iru�ing ommisSion 'Ieeting Y
f November , X994
��U.nutes• � : t
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COM WSSIONERS PRESENT:
Michael Harris, Chair Viola Lujan Evelyn Rinzler
Curtis Timmons,,Vice-Chair Suzanne MacDonald Gregg Sorensen
Heather Saunders Estes Jack McGervey Linda-Stephenson
Claudette Garner Cynthia Millar
Paul Katz Tony raw
COMMISSIONERS Welby Bigelow,Maggie Dowling, Mary Lavender Fujii,`Stepben Heisler,loan Lautenberger,
ABSENT: Michael Lawson, Rosalind Love, Bessanderson McNeil,Janiece Nolan, Dolores Sanchez,Ray
Smart, Terry Tanner; Tom Powers and Tom Torlakson,B/S Lialsons
STAFF PRESENT: Bobbi Baron,Linda Brun,Wendel Brunner,Milt Camhl,Lynn Morris,Jerry Nichols,Alan Stein
MEMBERS OF THE. Jacques Batter, Claudia Lopez, Robert Polacchi, Diane Ryland, Rosalie Zollas
PUBLIC PRESENT:
Item Number Discussions Action Who
1.0 Call to Michael Harris, Chair, called the Commission to order at
Order 4:22 p.at.-witbout a quorum present The quorum was
established at 5:00 p.m. at which time the.Commission was
2.0 C mmi- able to take acd n.
Isioners,
Comm- Michael Harris reported that since Lindy Stephenson has
ants taken &temporary job with the county,and in light of
the MAPC conflict of interest policy,she will abstain
from voting while,sbe is so employed.
Michael Harris thanked Evelyn Rinsler for speaking an
the County Specific Requirements for DHS consideration
at the November ist Board of Supervisors meeting.
Curtis Timmons suggested gaff might reach
beneficiaries by directly**Wdog support from
community clergy who aright puuiohcize the work of the
Commission to their congregations.Commissioner
Tunmca,will provide clergy names to staff. Provide am" Curtis Timmooa
9.0 Staff The Board of Supervisors has asked for a worlubop to discuss
Progress what is happening with nanaged cam in general,what is
Report happening with CCHP, and specifically with Medi-Cat and
the MAPC. This will provide an opportunity for MAPC to
meet with the new Board of Supervisors. Staff
will schedule early in 1495 after the new Board is seated.
4.0 Public None f
Comment
Schedule Staff
>YledrCal Adv�.wry�g Coe
Noveanl a 3.1104
s -
I=N, _}; /4etioa iVbo
5.0 AppMVW Jack McGervoy requested that theSeptember 7 matin
o! minutes,be amended AS follows: U (Update
Minutss Benefits Committee)the word 'completed'should be rapbmd
of Sept- with the word 'conducted'.It was M/SIC that the minutes be :
ember 7 approved as amended Amend Staff
Meeting =blow
3.1 Approval It was MIS/C that the September 7 bearing minutes be
of Sept- approved.
enobcr 7
Haring
3.2 Approval It was MIS/C dud the October 6 meeting record was a tree
of reflection of what happened even though that was too
October 6 quorum.
Meeting
6.0 Present- Alan Stein, Director of Planning for Meatal Health Services
ation by Department, spoke to the Commission on the mortal be"
Also •carve out'and the necessity of managing meaW bealth
- Stein servicaa. The current Medi-U dual systems consisting of
Short-Doyle County_Programs and the Fee-for-Service Private
Providers will be consolidated under Meatal Health Services
Division and will begin managed care services for inpatients
on January Ist.The outpatient consolidation is wlWulad to
begin July I. Under full capitation the Division can use funds
for any type of services that benefit tUeats and act Jost for
Medi-Cal reimbursable services. Meatal Health Service
Division is correctly working with CCHP to oollaborstively
develop authorisation prmm that would allow Meatal Health
to build.on CCHP's experience.
7.0 Pi t- Wendel Brunner, M.D.,Public Health Director, reported cm .
Won by the role of public bealth in relationship to do Local Initiative
Wendel and Private Plea.Dr. Brunoer considers the key issues(i.e.,
Brunner prenatal care, immunizations,etc.)could be dealt with in
managed care. Public Health is proposing that the Local
Wtistive eater into a contract with Public Health Division and
this noodel contract be used with the Private PLa. CCHP
members already receive Public Health services; the same
services sbould be available to the Private Flea members.
Both MAPC and PEHAB will be involved in the devdopasr�t
of this 'M OU' {Memorandwo of Undeatanding)before it is
presented to the Board of Supexvitsart.
it OS-GI A&UM PAM=$Com ussioo
November 3.IM _
hem Number Disarssioas Action Who
f-I Report of Staff is still in the prones:of finaUzint the meeting sod
the beuinS sites portion of the 1995 meetinS schedule.
Eu cutive Attendance records revealed that participation drops at ie 1.3
Com: p.m. meetings, so Michael Harris suggested all regular
ittee meetiass should be from 46 p.m. It was M/S/C that the 1995
schedule of meeting dates be approved. Regular meetings wM
be held the first Thursday of the month from 4-6 p.m.
Commissioners have been contacted regarding suandaaoa
It was M/S/C that the MAPC prepare an Internal
Workplan/Timeline for use next year. Michael Harris urged
Commissioners to send staff say suggestions they may have Submit Commissioners
or to call him. suggestions
A revision was made in the Charge to Across Committee to
have it look,at access to hospital services. It was M/SIC that
the revision be approved.
9.0 Report It was M/S/C that the report be accepted.
and
Recomm-
endstions ?
of the
Bewfi-
cisry
Issues
Commi-
ttet
10.0 Report of The chair of this committee, Dolores Sanchez,was absent so
the this item was,tabled until the January meeting. Include in Staff
Cultural. January AS=&
ungui-
stic.
&hnic
Acoass
Commi- '
ttee .
I I.0 Report of Staff has bees unable to put together a mw4nS due to
lite conflicts in the Commissioners schedules. In response to
Provider Gregg Sormsea's tetter and suggestions,Michael Harris
Affairs reported: 1)The MAPC encourages beneficiary involvement
Commi- on each committee. 2)The Provider Affairs Committee may
ttee consolidate the four sub-committees if they so decide. 3)It is
current practice to devote a portion of each meeting to
committee reports.
ted',-W Advisory Pkanittx Cammissios
Kovaabet 3,1!94
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!tea►NMd.. iV6o
Michael Harris thanked Dr. Soremea for his input and asked
that other Gommitsiooers express digit views as weU.
lu Adjourn There beiag to further business to discuss, The maria=wm
s4oumed&15:43 p.m
(Siped) (Date)
j
f
a
Medi -Cal Advisory Planning Commission
Executive Committee Meeting
May 10 , 1994
AGENDA
To Review Comments on the State Draft RFA
•
Contra,Costa County
Medi-Cal Advisory Planning Commission
Executive Committee Meeting
May 10, L994
Minutes
EXECUTIVE COIvOMWEE:
Michael Harris, Chair
Curtis,Timmons,Via-Chair
Heather Estes
Evelyn Rinzler
OTHER COMMISSIONERS Mary Lavender Fujii
PRESENT:
STAFF PRESENT: Bobbi Baron,Linda Brun
PUBLIC PRESENT: Frances swseu
Michael Harris, Chair, called the Executive Committee to order at 8:36 a.m.
The purpose of the meeting was to review the Contra Costa County Food and Nutrition Policy
Consortium's written comments regarding the Stare Draft RFA. Mary Lavender Fujii,a MAPC member
who represents the consortium, explained the consortium is concerned that there is the potential for
misinterpretation and that legal and binding contracts will be based on these drafts.
After much discussion, thelxecutive Committee MISIC that the following language be added to the
earlier approved comments on Draft RFA and that the amended document be forwarded to the Board of
Supervisors for their endorsement.
The MAPC utilized the attached document from the Contra Cosa Food and Nutrition
Policy Consortium as the basis for its following statements of principles concerning
perinatal 4ad nutrition services.
MAPC reaffirms the impotence of comprehensive perinatal services mad recommends
that the state be clear that all current CPSP standards will be required of the Local
Initiatives and the private plans.
MAPC reaffirms that comprehensive nutritional services including medically necessary
therapies are essential components of health care. MAPC recommends that the state
ensures that nutritional services comparable to CPSP standards for nutritional
service clearly defined.documented benefits which are well publicized to a
es at all Medi-
Cal beneficiaries.
j The MAPC utilized the attached document from the Contra Costa Food and Nutrition Policy
Consortium as the basis for its following statements of painciples Concerning perinatal and
nutrition services.
MAPC reaffirms the importance of comprehensive perinatal services and recommends that the
state be clear that all current.CPSP standards will be required of the Local Initiatives and the
Private plans.
MAPC reaffirms that comprehensive nutritional services including medicany McCessary tlfenpies
are essential components of health cam. MAPC recommends .that the state ensures that
nutritional services comparable to CPSP standards for nutritional services are clearly defined.
documented benefits which are well publicized to all Medi-CaI beneficiaries.
CONFORMANCE W'IT'H CORE REOVIRFM=
1. Plan's uperience with low incornt nroljeis:
The draft RFA asks for a description of the applicant's experience in providing managed
health care services to Medi-Cal, medically indigent, and low income populations. The
weighting the state will give to this experience is unknown at this time.
2. Plan eroviders' ex;sijence witb low-income enrollees:
The draft RFA calls for a listing of plan medical practitioners to include information
about each provider's qualifications. However, there does not appear to be any request
i for information about the provider's experience with low income enrollees.
3. &=Sements for *X=ial =ulations":
V Linguistic
The cultural and linguistic requirements may need some further definition. For
example it may be desirable to have bilingual capability in certain regions or
facilities in which there is a concentration of a specific limited/non-English
speaking population even though that population does not account for S% of all
Medi-Cal managed care eligibles in a County.
We support the establishment of a community advisory group as recommended
by the state and recommend that the. functions of such a group be expanded to
include input into all facets of the plan's Mali-Cal operations and not just
linguistic access.
Again the draft RFA says that proposal will be scored on a plan's ability to
provide culturally appropriate services but the weighting or scoring will not be
available until the final RFA is published.
V Disabilitie
The state says that its contract language prohibiting discrimination which is
consistent with Tide VI of the Civil Rights Act ensures equal access and
appropriate can for persons with disabilities. We believe, e state should require
plans to describe their arrangements for these members.
of Mental Health/Substance Abuse
The RFA does not address the relationships between the Local Initiative or.
private HMOs and the county mental health managed care system.
4. Relationships with gublic health services
?here"are provisions for a MOU between the local health department and the Local
Initiative or private HMO. Plans are asked to make 'every reasonable effort` to sign the
MQU which delineates local health department and plan responsibilities. The suggested
MQU seems to address the relationship issues satisfactorily. It would be preferable,
however, if the state would define what it considers 'every reasonable effort.'
S. Contracts with traditional ozMdders
While private plans are 'encouraged' to contract with traditional providers the points
given for such contracts is not known at this time.
6. Contracts with safety net providers
White private plans are 'encouraged' to contact with safety net providers the points
given for such contracts is not known as this time.
7.. Communily su22grt and involvemen
Private plans should be required to have community advisory groups for all issues and
not.just for linguistic access.
S. Ongoing member input
There should be a requirement for private plans to develop mechanisms for providing
Medi-Cal member input in a meaningful way.
Q. Community prevention and promotion activities
The workgroup decision gives the local health department the responsibility for public
information and education programs. We believe the private plans should also sponsor,
prevention and health promotion"activities aimed at the general community.
10. Commitment to enrollingMedi-Cal
The RFA requirements ensure that only those plans with a commitment to enrolling
Medi-Cal will take part in the application process.
Attachment: Contra Costa County Food and Nutrition.Policy Consortium Document
Medi-Cal Advisory Planning Commission
Executive Committee Meeting
June 23, 1994
AGENDA TOPICS
1. Focus of Commission
✓Mandatory vs. Voluntary Enrollees
✓Low Income Women and Children
2. Focus of Committees
✓Draft Charge to Committees
3. Commission Rules and Procedures
✓Minutes
✓Agendas
VRoberts Rules of Order
✓Meeting Length
✓Meeting Time and Day
✓Absences
4. Legislative Requirements
✓Brown Act • notices of meetings, hearings
VADA - reasonable accommodations
LP AT
Contra Costa"County
o
1
Niedl-Cal Advisory:�lann>ing �o n
Executive Cominl Meeting
. tee .
1
;dune 23, X994
Minutes
EXEC;UITVE COND&TTEE:
Michael Harris, Chair
Curtis Timmons, Vice-chair
Heather Estes
Mary Lavender Fujii
Evelyn Rinzler
OTHER COMNIISSIONERS Delores Sanchez and Linda Stepbettson
PRESENT:
STAFF PRESENT: Bobbi Baron, Linda Brun, Milt Camhi
PUBLIC PRESENT: None
Michael Harris, Chair, called the Executive Committee to order at 9:08 a.m.
1. Focus of Commission
Since AFDC related and hGC beneficiaries will be mandated into managed care while SSI related and aged
beneficiaries will retain afee-for-service option,the focus of the commission needs to be concentrated on low
income women and children. The Commission wants more input from these mandated groups. Specific topics.
or questions the commission would like the public to address at the public bearings are to be highlighted in
MAPC Reports and meeting notices (e.g. OB and prenatal concerns).
Michael Harris will request that each Commissioner put together a brief statement based on their knowledge
and experience on beneficiaries' needsfconcerns and what is working right with regard to Medi-Cal managed
care. The request will be included in the July agenda. Staff to prepare an outline of areas to be explored.
Staff to compile responses and distribute at September meeting.
2. Focus of Committees
,A copy of current committee structure chart will be Included in July packet.
.MAPC Report will announce that the public is welcome to serve on
subcommittees but will not have voting privileges.
,Commissioners are to be notified of all scheduled committee meetings one week before. Committee chairs to
give staff at least two weeks notice before any meeting.
.Executive Committee approved the revised 'Charge to Commitues`.
3. Commission Rules and Procedures
Minutes: }
_.Written testimony.is to be attached to the bearing minutes.
.Since minutes are recorded in action format, a motion must be made, and seconded in order that a
Commissioner's concern be included in the minutes.
Medi-Cat Advisory Planning C acn iasion
Executive Comunittat Meeting
June 23. 1994
The April bearings videotape will be purchased ad made available for viewing by individual
Commissioners.
.The original audio tapes of umd4s and bearings are to be duplicated when Commissioners rawest.
Agendas:
.Commissioners can suggest topics for agendas. h was decided that an outside expert In bealth care issues
present s report on tovernance alternatives.Henrik Blum, M.D., MPH, Professor Emeritus-Health Policy
ad Planning, U.C. Berkeley will be asked
to address the Commission at At October anedCiag on bow various governance Structures will affect
beneficiaries.
.In the phrase 'Discussion and Approval',the word 'Approval" will be substituted with the word 'Decision".
.Action item will be scheduled towso the beginning of the nwetings.
Roberts Rules of Ord
.Reverend 'Timmons to provide to staff`a copy of aunty counsel's directive to Substance Abuse
Advisory Board regarding quorum.
.Chair arcked that Commissioners wait for recognition before speaking. '
meeting Length:
.Commission meetings will be beld to a two-bour length.
Chair will follow time lines indicated on agenda but asked for Commissioners' assistance.
• Meeting Times and Days-
This
ys:This will remain the same.
Absences:
.Chair to speak to Commissioners who are absent three or more times. Chair to address this at July meeting.
4. Legislative Requirements
Brows, a
.Adequate notice of the June hearing was given; it is not necessary to post notice in newspapers.
.Staff to prepare reply to Commissioner Dowling's letter for chair's signature.
ADA:
.ADA reasonable accommodations requirements were described.
Next meeting will be Friday, September 16, 1994 from 9 - 11 in CCHP conference room.
"There being no further busiauss,the meeting was adjourned at 12 noon.
(Signed) (Date)
MAPC
Medi-Cal Advisory Planning Commission
. SCenter anue, 100
_ainez.Caiasaia 94553 Executive Committee
'Telephone(510)313-ODOO{510)313- Meeting
Fox 6002
COMMISSIONERS September 30, 1994
B*law,)r.,M.D. 9 11 A.M.
Contra Costa Healtb Plan Conference Room
595 Center Avenue, Suite 100
Claudcuor 64"W,M.E4 Martinez
Swphen Neut",Ma
,Paul Katz AGENDA
Joan L u&c%&cgrr,RN.
9:00 1.0 Call to Order and Introductions
Michael P.1AW"a
9:05 2.0 ** Recommendation: 1995 MAPC Meeting
Schedule
a. Review of Poll Results
Suzanne MacDonald
9:20 3.0 ** Recommendation: MAPC Meeting
�atx MCG*"" 9:20
ande»an McNeil,M.P.H.
Cynthia Miller 9'30 4.0 Review of DRAFT MAPC September 7..
1994 Hearing and Meeting Minutes
7anieu Nelda
Tony Paap 9:40 5.0 Consideration of Alternative Methods for
Soliciting Community Input
Dolores Sanriux,LC.S.Rr.,M.P.H.UD.
8arnond L Stuart 9:50 6.0 Consideration of an Internal MAPC
Workplan/Timeline
Gni S.Sonrnun,MA.M.P.H.
Liz&SwpMuan,F.N.P.,M.H.S. 10:10 7.0 Consideration of an Annual Report on
Terry Test.".D.D.S. MAPC Accomplishments
DtECUTTVE COMMITTEE 10:20 , 8.0 Consideration of MAPC Rale in Decisions
Michael G.Harris,a.n..r.D.,M.s. Re: Medi-Cal Managed Care vs. Indigent
Care
iter.curd,A.Timmons,B.A..TA.D. a. Delineation of CCHP as the Local
�Ieaci�sr Saunders E us,M.S.W. Initiative
b. Role of MAPC and Board of
Alyn Rimier,M.lt Supervisors
Mary Lavender Fujii,M.S.R.D. C. Revising the Access Committee
"kRD OF SUPERVISORS UAiSONS Charge
5 am Pewen
Tom Torlalcson
Executive Committee Agenda
September 30, 1994
PageTwo,
wo,
10:40 9.0 Consideration of"A Healthy Perspective
on Health Care Reform; The Chronic
Disease Prevention Dividend" (Report
Submitted for Review)
10:45 10.0 Update on Mainstream Committee
Interview with Tower Health Services
10:50 11.0 Discussion Re: the Potential Impact of the
Singh Payer Initiative on the Local
Initiatrve
11:00 12.0 Adjourn
*'� indicates action item
Contra Costa County
Meth-Cal Advisory Planning Commission
Executive Committee Meeting
September 30, 1994
9:00. 11:00 A.M.
Contra Costa County Health Plan
Martinez, CA
MINUTES
EXECUTIVE COMMITTEE MEMBERS PRESENT:
Michael Barris, Chair
Curtis Timmons, Vice-Chair
Heathen Saunders Estes
Mary Lavender Fuiji
Evelyn Rinzlts
OTHER MAPC MEMBERS PRESENT:
Linda Stephenson
STAFF PRESENT: Milt Camhi, Lynn Morris
1.0 Michael Harris, Chair, called the meeting to order at 9:05 A.M.
2.0 The Committee reviewed result from the poll which was sent to MAPC members regarding
their meeting.time preferences. As previously, no one time was preferred.by the majority of
members and, indeed, the three times (4•6 pm, 1.3 pm, 6:30-8:30 pm) rated relatively close.
Therefore, it. was decided that we would continue to rotate the times on the meeting schedule.
A draft will be prepared for adoption at the October MAPC meeting.
3.0 Recordkeeping was discussed. It is recommended that action minutes be taken by staff at
committee meetings. The chair of the committee will sign the action minutes and they will
constitute the formal record of the, meeting. In addition, each committee can at its own
_ discretion appoint a member of it committee to take more extensive minutes should the
committee so desire.
The Committee also recommended there be a *Commissioner's Column* in the MAPC Report.
This would allow each member to express their viewpoints in their own words. The column
would be 200.300 words and begin with those commissioners who have not yet been profiled.
A lottery to select the order will be utilized.
There was a review of the draft September 7, 1994 hearing and meeting minutes. There was
a question regarding the Benefit Committee Report which will be discussed with. Jack
McGervey, Benefits Committee Chair, if available before the October b, 1994 MAPC maetinl
Lynn Morns will check the notes and tape of the meeting for clarification. The minutes of the
public hearing were corrected to reflect Michael Harris calling the hearing to order.
s
t
_0 There was a review of the poll results and discussion regarding alternative methods for soliciting .
community input. The Committee recommended:
I) Use a variety of methods.
2) Annual regional hearings while they have not been as effective in all parts of the county
as is desired, are required by-the Board of Supervisors.
3) Focus groups should be explored.
4) Consider the feasibility of interviews at clincis and other facilities where Medi-Cal
beneficiaries am available.
S) Interview or survey beneficiaries as part of health fairs or community events. Look at
ways to provide incentives(i.e. services such as blood pressure screenings,refreshments,
etc.) to those participating in the interviews.
6) Formulate a survey to be handed to beneficiaries or sent to them in the mail.
7) Solicit provider input. Staff to develop a proposal.
It was decided the Beneficiary Committee should take this on as a project with assistance from
staff.
6.0 It.was recommended that MAPC develop an internal workplan/timeline with projects and dates
for completion. Each committee should formulate their goals, tasks, workplan/timeline. Staff
will then incorporate the committee`s workplans into one document.
l a It was recommended that the MAPC develop an annual report summarizing its accomplishments
for the year and that MAPC meet with the Board of Supervisors to discuss the report and.its
future goals and activities. Each committee requested to provide input.
If the MAPC approves this recommendation, Michael Harris will contact Supervisors Torlakson
and Powers (liaisons to MAPC) to request such a meeting, and follow up with a formal letter
to the Board with copies to Internal Operations.
8.0 MAPC's role as an advisory,body was discussed. The role of CCHP as the designated Local
Initiative was clarified. There was consensus that MAPC's efforts should be to provide insight
into how the Focal Initiative can best serve the needs of all.
The question of access to hospital services was.discussed and there was consensus that the
Access Committee should be.charged to evaluate whether beneficiaries are getting the services
they need. This assessment should include a profile of Medi-Cal beneficiaries (i.e.what services
they use most) and their ability to access those services.
9.0 It was recommended that reports and speakers on particular issues be directed to the appropriate
committees for consideration and possible recommendation for future action.
It was recommended that Lary Cohen, Prevention Program Director, be invited to present "A
Healthy Perspective on Health Care Reform; The Chronic Disease Prevention Dividend" at a
Benefits Committee meeting. .
,i—
t
10.0 Lynn Morris presented a brief summary of the Mainstream Committee's meeting with Tow& �
Health Pian. The report will be presented to the MAPC at its October 6, 1994 meeting.
11.0 There was discussion regarding how the Single Payer Initiative should be addressed by the
MAPC at its October 6, 1994 meeting. It was recommended that it be discussed in the
framework of how the success or failure of the measure would.impact the County Local
Initiative .
12.0 The meeting was adjourned at 11;05 A.M.
(signed by Chair) (date)
ti
3
MEDI-CAL ADVISORY PUNNING COMMISSION
EXECUTIVE COMMITTEE MEETING
OCTOBER 24* 1994
50:30 A.M. - 12t30 P.K.
CONTRA COSTA HEALTH PLAN CONFERENCE ROOM
595 CENTER AYE, SUITE 200
MARTINEZ, CA
AGENDA
10:30 1.0 Call to Order Harris
10:30 2.0 ** Approval of September 30, 1994
Executive Committee Minutes (Pp.2-4) Members
50:35 3.0 ** Recommendation Re: Meeting Schedule
and Commissioner Attendance (pp-5-6)
Harris
30:45 4.0 Review of Alternative Meeting
Formats Dowling
20:55 5.0 ** Recommendation Re: Alternative
Sites for Regional Bearings Morris
11:10 6.0 ** Recommendation Re: Annual Report
and Meeting with Board of
Supervisors Timmons
51:25 7.0 * Recommendation Re: Review of the
State RFA for Private HMO and
Potential Response
(County-Specific Requirements for
-DRS Consideration) (pp.7-9) ruiji
51:40 8.0 Discussion Re: Beneficiary Harris
Involvement in MAPC Committees (pp.9-1i) (for Sorensen)
11:55 9.0 Consideration of MAPC Committee Barris
Consolidation (pp.12) (for Sorensen)
12:05 10.0 Consideration of Structure of Harris
Committee Reports at (for Sorensen)
MAPC Meetings (pp-9-11)
12:15 11.0 ** November 3 Agenda Priorities (pp.13-14) Members
12:25 12.0 ** Determination of Neat Meeting Members
12:30 13.0 Adjourn Harris
**indicates action item
Executive Committee Members: Please call Jackie Lacy at (510) 313-6024 if
you are unable to attend..
Contra Costa County
Medi-Cal Advisory Planning Commission
Executive Committee Meeting
October 24, 1994
10:30 am. - 12:30 p.m.
Contra Costa County Health Plan
Martinez, CA
NOSTUTl~'S
EXECUTIVE COMN3I= MEMBERS PRESENT:
Michael Harris, Chair .
Mary Lavender Fujii
Evelyn Rimier
OTHER MAPC MEMBERS PRESENT:
Maggie Dowling
STAFF PRESENT: Bobbi Baron, Linda Brun, Milt Camhi, Lynn Morris
1.0 Michael Harris, Chair, called the meeting to order at 10:40 am.
2.0 Approval of. September 30, 1994 Executive Committee Minutes: It was M/S/C that the
minutes be approved. .
3.0 Recommendation Re: Meeting Schedule and Commissioner Attendance:The census shows
that the meetings wit'hthe last attendance during 1994 were those scheduled from 1-3 p.m. The
Committee will bring back to the full Commission in November a recommendation that the
regular meetings be held from 4-6 p.m.with the three regional hearings and associated meetings
to remain as previously scheduled (5-7 p.m. and 7:30-9 p.m.). Mazy Fujii was opposed to this
recommendation.
4.0 Review of Alternate Meeting Formats: After discussion of alternate meeting formats such as:
A. the possibility of holding more infrequent, longer Commission meetings
combined with twice monthly Executive Committee meetings and
B. Commission retreats; the Chair directed staff to poll commissioners to determine if there
is an interest in alternative meeting formats and if they would be willing to fund their
participation in a retreat. ^ .
Concern was expressed over lack of commissioner attendance at meetings. Staff will also poll
commissioners who have missed a number of meetings and ask about their commitment to attend
future meetings.
Michael Harris will write a letter to commissioners asking for input on what they feel should
be MAPC priorities.
' z
3.0 Recommendation Re: Alternative Sites for MeetingslHearings: Staff reported on possibilities 0
for alternative sites and were directed to firm up commitments.
b.0 Recommendation Re:Annual Report and Meeting With Board of Supervisors:-It'vvas WSIC
that the Commission will present to the Board of Supervisors a written annual report on what
has been accomplished in its first year and its future goals. This report would be presented at
a special muting with the Board of Supervisors. Michael Harris will discuss the meeting with
the Board liaisons to MAPC, Supervisor Powers and Supervisor Torlalcson.
7.0 Recommendation Re: Review of the State RFA for Private HMO and Potential Response
(County-SpeciCc Requirements for DHS Consideration): Commissioner Fujii presented the
draft county specific requirements. After discussion it was M/S/C to amend the requirements
by adding X16 Marketing Practices. It was further M/S/C to approve the amended requirements
and forward tbem to the Board of Supervisors with a recommendation that the Board approve
the requirements and convey them to the State Department of Health Services by the November
4, 1994 deadline.
2.0 Discussion Re: Beneficiary Involvement in MAPC Committees: Greg Sorensen's letter was
discussed (see attached). Michael Harris expressed appreciation for the input and will request
again at the November 3 meeting that Commissioners submit in writing their concerns. It was
agreed that current practice allows for such involvement.
+ 9.0 Consideration of MAPC Committee Consolidation: Possible consolidation of MAPC
Committees as suggested in Gregg Sorensen's letter is on the Provider Affairs Committee agenda
for consideration at its October 27 meeting.
10.0 Consideration of Structure of Committee Reports at MAPC Meetings:It was agreed that this
is current practice.
11.0 November 3 Agenda Priorities: Ttie Executive Committee discussed the draft agenda for the
November 3 MAPC meeting and agreed to consider Governance Alternatives at the am .
Executive Committee muting and then to bring the Executive Committee recommendations to
the full Commission. Staff was directed to invite Dr. Henrik Blum to the Executive Committee
meeting. Governance Alternatives will be on the agenda of the MAPC January 1995 meeting.
After further discussion the Executive Committee MIS/C to approve an amended agenda.
12.0 Commissioner Requests: At the request of Commissioner Dowling for Commission documents
in alternate formats, Chair Michael Harris requested that staff further discuss with Ken Metz of
the Council of the Blind regarding any needs for individual accommodation for visually
handicapped individuals. The Chair also requested that, if it is reasonable, staff will provide
agenda packet documents in disk format to commissioners who request them. It was also noted
that not all documents are available to be transferred to this format. Commissioner Dowling
requested the material be given to her on disk and offered to provide the diskettes.
13.0 Determination of Next Meeting: The next Executive Committee meeting will be December 1
1994 from 9 am. to 11 a.m. in the CCHF conference room. Executive Committee members
should let Lynn Morris know of any items that they wish put on the agenda for that meeting.
14.0 Adjournment: The meeting was adjourned at 11:05 am.
t:
(signed by C (dge)
M
MEDI-CAL ADVISORY PLANNING COMMISSION
EXECUTIVE COMMITTEE MEETING
DECEMBER 1. 1994, THURSDAY
1:00 to 3:00 P.M.
CONTRA COSTA HEALTH PLAN CONFERENCE ROOM
595 CENTER AVE. SUITE 100
MARTINEZ, CA
AGENDA
1:00 1.0 Call to Order Harris
1:00 2.0 Approval of October 24, 1994
Executive Committee Minutes (pp. 1-3 Members
1:05 3.0 ** Consideration of Meeting.Sites
and Hearing Date Change (p.4) Staff
1:10 4:0 ** Consideration of Executive Committee
1995 Meeting Schedule (p5) Staff
1:15 S.0 ** Consideration of MAPC January Meeting
Agenda (p.6) Harris
1:20 6.0 Discussion with Henrik Blum, M.D. on
"Governance Alternatives for
Local Initiative" (pp.ms) BIum
** Determination of Recommendation Members
r
2:00 7.0 Update on Board of Supervisors
February 7, 1995
Workshop and Meeting Harris/Staff
2:10 8.0 Update on Commissioner Column
in MAPC Report Staff
2:20 9.0 Update on Poll re: Alternative Meeting
Formats and Suggestions-for Workplan Harris
2:25 10.0 Annual Report Outline (p.lq) Staff
2:30 11,0 Update on Local Initiative Staff
2:45 12.0 Update on Conw-ttees Members/Staff
3:00 13.0 Adjourn Harris
_ t
Contra Costa Ctxmty
Medi-Cal Advisory Planning Commission }
Executive Committee Meeting
December 1, 1994
1 p.m. -3 p.m.
Contra Costa Health Plan
Martinez„ CA
MINUTES
: 01HER C JOEMBERS PRES -
Michael Harris, Chair Mola Lujan
Heather Saunders Estes
Mary Lavender Fujii GUESTS PRESENT:
Evelyn Rinzler Henrik Blum
Rev. Curtis A. Timmons Gene Draper
STAFF PRESENT: Bobbi Baron, Milt Camhi, Kathy McNutt, Lynn Morris
1.0 Michael Harris, Chair, called the meeting to order at 1:22 p.m.
2.0 It was MSC that the October 34, 1994 Executive Committee Minutes be
approved.
3.0 Consideration of Meeting Site& Hearing Date Change: It was agreed
that if possible the Commission should hold one meeting in far East County
(Brentwood) in addition to the hearing scheduled in Antioch. Lynn Morris
was directed to coordinate with Rev. Timmons on a site and on a Central
County hearing date change to September 3 or 7.
4.0 Executive Committee 1995 Meeting Schedule was adopted as written.
5.0 The MAPC January Meeting Agenda was approved. A discussion on where
to discuss the suggested Marketing Code of Ethics format resulted in a request for
the Beneficiary Issues Committee to review the submitted copy at their December
15 meeting, along with samples from other organizations.
6.0 Governance Alternatives for the Decal Initiative: Dr. Blum explained his
ideas on evolving model for CCHP governance and provider structure. He
recommended,that the CCHP remain under the Board of Supervisors at this time
and that consideration be given to an eventual consolidation of the MAPC and
HMO advisory boards into one oversight body with some members from each.
Dr. Blum was asked to attend the full MAPC meeting on January S for further
discussion. The Committee would like to see how other counties are operating
and requested,speakers for the meetings after January S. MAPC to discuss
governance at the Board of Supervisors February 7 workshop.
7.0 Update on Board of Supervisors February.7. 1995,Workshop: The t
Medi-Cal Advisory Planning Commission will present its annual report and
governance options to the Board of Supervisors at the February 7 Workshop.
Staff was directed to prepare a timed formatlagenda for MAPC's portion of the
workshop to be reviewed at the January 5 meeting. A memo is to be sant
immediately to the MAPC members informing them of the place, date and time
of the workshop.
8.0 Update on Commissioner Column: Staff reported that Michael Harris had drawn
the names for the column. Each Commissioner will have the option of writing
his or her own column or of being interviewed.
9.0 Alternative Meeting Format & Suggestions for Workplan: The results
so far on the poll for alternative meeting formats show a lack of interest by the
Commissioners in a retreat. Staff reiterated its availability to assist the committees
with workplan development.
10.0 Ile Annual Report outline was reviewed and it was agreed that the MAPC be
given a first draft at the January 3 meeting, that individual Commissioners provide
staff with their comments after they have had an opportunity to review the draft,
and that the MAPC be asked to give the Executive Committee thi authority`to
review and approve the report at its January 19 meeting. A final report is to be
given to the MAPC and to the Board of Supervisors in time for the February S
workshop.
11.0 Update on Local Initiative: Milt Camhi's update to the Committee included that
the state has delayed the commercial plan filing date to 3130195 and it appears the
2-plan model will not be operational until at least March of 1996.
12.0 Update on Committees: The Beneficiary Issues, Access and Provider Affairs
Committees will meet in December.
13.0 'AdUournment: The meeting was adjourned at 3 p.m.
(signed by Chair) (date)
{11} .
The Board of SupervisorsContra �ft Gwrd
aw
County Administration Buildingcoufft Waft" r
K 1551 Pint St, Room 106 Costae,o>a6-2371
Martinez. California 94553 County
f �rawus,la a.a;et
i ..2 s+�z<+a 11it�riet
&W,M""M ac stn o"Vt Y
'leh iaelokoen,f!�Q�fiCt
.4
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
So rd of Supervisors
TP:BB/lmb
Attachments: MAPC Report and board Order
L33:Bn
*OARD Or SUPERVISORS _
r
. : Mark Fsnucan Contra
&Wth stsviom MUM
costa
*ATI: twy 6,1994 C=rty
mart solicitation tar Rrspaatae fa DOW Managed Car,:' a
9MCtrIC FAUAaT(f1 at MCCMAMMAT10m(s) i BACKCiOWND AND &ISTI•ICAT/CN
L
Approve 169 report from MAPC aontaininS lU oomme nts on the draft Saddtatioa for
Rrsponst for Dental Manned Can ad aut s in t69 Chair,Board of SupwNioN to
submit the report 10 tllt Sass.
3I. MA_NMAI-D"ACT '
Medi-Cal far i'ar service payments for dental Gatti lo Contra Cm a County Modi-09I
beneficiaries amounts to am S3.5-mIIlion wmu9Ily. Afttionatly, CCS pao4ft
dvual ane an a prtpaid basis. TAt State is snten&&to•snot out'Mali-Cat dental
Strvieu and provide thaw=TV! s through s limited dumber of Managed cars contracts.
Ws will impact both the County's for for service Midi-Cit reV9rtues and t69 CCHP
capitation psymenu for dental seiv�oet.
M. REASONS FOR R_& M7►=AnON f llACKGROL
On April 1,1994,dee Catiforak Department of Reath Services Daatal Managed Care
Procurement (DMCP) Unit released its draft Solicitation for Reponse (SFR) for the
implementation,operation,and mainterAr4e of Dental Mined Cart Contracu. At its
May Sth MeetinS, MAPC approved the &trached report L oomnratting on *4 draft
document and requested that the Board of Supervisors andors9 the report and forward it
to the SDORS.
ketO,r'►iMV7lC M •TT�LAMCrR! �,� R! C/fM�TY*!: -
*CCO ORMDAT19% p COVI/TT aOMIM/lTO&V" MCCOm 9ND&TION K 40DA*O CONN II I-
t
aCt 10.1 M =Me* w awtwvs>P a! a<IIt07rAlAbRp *TMC.
%on or supcWra ws
• a lyM rT c"I I rallT "Olt T • to A "%M
—e~to%* JANSEN, AND CO CC? CC" CW AN ACTION TAMN
YO 9WERM ON TW Y I ftn j or TK ADARD
ANSTA I N: Q MLXM V i WAS ON Thi OAT% SHMN.
ATTIlT9e �
CCs: Milt Canthi PFUI, OAT ELolt CL OX or TME DOARD or
SUMERVMORS AND COUNTT A0IA,NIiTAA'r0*
DOW$iron
A • R�
Contra Costa County
Comments and Recommendations on
Dm ft 5oiicitatjon JQr Response for
Dental Managed Care
The S# .BcQuest
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. ,- evenVigra hp is Regions: Contra Costa County is now part of a region which.also
includes Alameda, San Francisco, San Mateo, Santa Clara and Santa Cruz Counties.
FIND?NGS:
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 iti region.
For the CCH? 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 when 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 thrix years
negotiated as a block or is each of the three years negotiated separately?
S. Additionally, we believe the State should not contract with a provider owned organization
to administer the dental managed care contracts.
52.DP
May 12, 2944
- BOARD OF SUPERVISORS
IM: Mark Finucane4tP *Zt' v0rAra
Health Services Director C09ta
April 19, 1994 @ Cou*
aratccT:
Approval of Medi-Cal Advisory Planning Commission (*MAPC") Mainstream Plan Report
Pzc I r i c RSO ANT I s) CIR RLCOW 04DAT i ON(s) t awcWAaurc AM JUST t F t CAT I av
I. RECONNIENDA77ON:
Approve the report from MAPC including criteria the Commission recommends the State
Department of Health Services (*State*)use in deciding which private HMOs to contract
with in Contra Costa County and the results of a preliminary survey of private HMOs,
and authorize the Chair, Board of Supervisors, to submit the report to the State.
II. F'ANCIAL 51PACT:
Fee for service revenue to providers in Contra Costa County, including Merrithew
Memorial Hospital & Clinics, for services given to AFDC linked Medi-Cal eligibles
amounts to over$36-million annually. As the State moves to managed care, this fee for
service revenue will be transferred into capitation payments to the CCHP Local Initiative
and private HMO Mainstream Plan. The core requirements as set forth by the MAPC,
should help to ensure a level playing field for the Local Initiative and Mainstream Plan.
III. REASONS FOR RECO1WN Eh,1►ATIQNS & BACKGROUND
(See attached MAPC Mainstream Plan report.)
Tht MAPC established a Mainstream PIan Committee in response to Supervisor Tom
Torlakson's call at the first Commission Meeting for a level playing field for both the
Local Initiative and the Mainstream Plan. The Commission approved the report of the
Committee which contains ten core requirements and results of their initial survey of
potential Mainstream PIan contractors. Of more immediate impact, one plan -
PacifiCare - has put in an application for a Medi-Cal Contract in Contra Costa County
to be implemented this Summer, and the State has asked the County to communicate any
concerns it has with this.
The enclosed Mainstream Plan report addresses the issues the County has regarding the
Mainstream Plan expansion, and also responds to the State's request for County input on
the PacifiCare application.
mmT/NYlD cw ATTACMIMENT: YEt 1•tiNATYRl;
RECOUNICHDATION OP COUXTY ADMINtiTltATOM mccom aNDATION OF •OARO Cams"l l iz
51 GNATLRE 1$1:'
4CT/ON OV HOARD oN April 19 . 1994 ` wrPROYEO Ai RtColwcNOttO �� oTNER �„�,
'DTS OF SUlmm l»tS
'I HMEBY CERTIFY THAT THIS IS A TRUE
UNANIMMM (ABSENT } AM CORRECT COPY OF AN ACTION TAMN
AYES: 4,5,3 NMS: - AND ENTERED ON TW M I NUTES OF THE •BARD
AWENT; 1 ABSTAIN: 2 OF SUPERV I SORB ON TIM DATE SHOWN.
"milt S. Camhi, CCHP
x: Bobbi Aaron, CCHP ATTESTED April 19, 1994
SS1:BO PHIL BATCHELOR, CLERK OF THE BOARD OF
SUPE VISORS AND COUNTY ADMINISTRATOR
a
4382/7-83 BY .DEPUTY
MAPC
Medi-Cal Advisory Planning Commission
395 Center Avenue,Suite 100
Martinez,California 94553
(510)3136004
FAX(5 10)3136002. Memo to: Board of Supervisors
From: Michael G. Harris, Chair
COMMISSIONERS Medi-Cal Advisory Planning Commission
Welby W.Bigelow,Jr.,M.D.
Date: April 13, 1994
Margaret Dowling
Heather Saunders Esus, M.S.W. Subject: Mainstream Plan Report
Mary Lavender Fuji,M.S. R.D.
Claudette Garner, M.Ed. RECOMMENDATION:
Michael G.Harris, O.D-J.D..M.S. The Medi-Cal Advisory Planning Commission at its April 6, 1994 meeting
voted to recommend to the Board of Supervisors that you endorse this
Paul Katz Mainstream Plan report including criteria for evaluating Mainstream Plans
Joan Lousenberger. R.N. in Contra Costa County and the preliminary results of the Commission's
survey of interested HMOs. Furthermore, it is requested you forward this
Michael P.Losf+son initial report to the State Department of Health Services.
Viola Lujan
Eileen Lynette,R.N. BACKGROUND:
The Medi-Cal Advisory Planning Commission established the Mainstream
Suzanne MacDonald Plan Committee, consisting of Heather Saunders Estes, Chair, Viola
Jack McGenvy Lujan, and Jack McGervey at its February 3, 1994 meeting and charged
them with ascertaining:
Stephen Heisler, M.D.
Bessandcrson McNeil. M.P.H. 1. Willingness and capability of potential Mainstream Plan contractors
to serve the special needs of Medi-Cal enrollees and
-nthia Miller
Tony Poop 2. .Their plans for relating to safety net and traditional providers
Evelyn Rin;lcr,M.A.
The Commission in setting up the special Mainstream Plan Committee was
Dolores Sonche;.L.C.S.W.,M.P.H..LLD. responding to Supervisor Torlakson's call at the first Commission meeting
Raymond L Smarr for a level playing field for both the Local Initiative and the Mainstream
Plan. The Commission requested that at the April 6, 1994 meeting the
Gregg S.Sorensen.M.D..M.P.H. committee report its recommendations on requirements for ensuring a
Terry Tanner,D.D.S. level playing field and its analysis as to how well each Mainstream Plan
Rev.Cutis A. Timmons. B.A.,Th.D. meets these requirements.
BOARD OF SUPERVISORS LIAISONS Workplan:
Tour Powers The committee developed a set of uniform questions for potential
Mainstream Plan contractors. It then wrote to eleven health plans who
Toni Torlakson were either currently operating in .Contra Costa County or who had
previously expressed an interest in Medi-Cal contracting.
Two plans (Kaiser-Permanente and PacifiCare) responded with requests
for interviews and two plans (Blue Cross/California Care and Health Net)
sent in written responses to the questions. The committee interviewed
representatives of Kaiser and PacifiCare and reviewed the Blue Cross and
Health Net written responses.
The committee decided to examine each responding plan against 10 core
requirements which measure a plan's willingness and ability to serve
Medi-Cal enrollees. The core requirements and the results of the
committee's surveys are attached.
The committee presented its report at the April 6 meeting which was
approved by the commission and incorporated into this Mainstream Plan
report.
RESULTS:
The MAPC notes that there still are many uncertainties about the
responding plans and charges the Mainstream Plan Committee with
reviewing any PHP contract applications in the interim period and any
Mainstream Plan applications subsequently filed: The Mainstream Plan
Committee will use the ten core requirements as the basis of this further
review.
From the information gathered so far, the Commission expressed concerns
about the ability of individual private HMOs to serve the wide range of
needs of Medi-Cal patients,particularly those of the disabled beneficiaries.
The commission also notes that both Kaiser and PacifiCare were willing
to take a portion of the Mainstream Plan enrollment but were uneasy with
the prospect of being responsible for the entire amount. The commission
agrees that the current "two plan model" has serious flaws and should be
reconsidered by the SDOHS. The commission believes that multiple
Mainstream Plans would better serve the Medi-Cal recipients. Further, we
question the capacity of most plans to handle the entire "Mainstream" Plan
enrollments.
The commission recommends that the Board of Supervisors communicate
our concerns to the State Department of Health Services.
BB/lmb
Attachments:
1. Committee's Charge
2. Letter Sent to Plans
3. Core Requirements
4. Results of Survey of Mainstream Plans
133:FR R 1 4:13,94
Contra Costa County
Medi-Cal Advisory Planning Commission
Mainstream Plan Committee
In response to Supervisors Tom Torlakson's call for a level playing field for both the Local
Initiative and the Mainstream Plan, the MAPC wishes to ascertain the wil_.ngness and capability
of potential Mainstream Plan contractors to serve the special needs of 1ti::::ii-Cal enrollees. The
MAPC also wishes to understand how the Mainstream Plan will relate to the safety net and
traditional providers who have historically served Medi-Cal patients.
The MAPC set up the Special Mainstream Plan Committee to obtain from potential contractors
in Contra Costa County their plans for serving Medi-Cal managed care eligibles both in the
interim period (before the two-plan model is implemented) and once the two-plan model is in
operation.
The committee is to develop a set of uniform questions to ask the plans and to request that the
plans at their discretion either submit written responses or agree to be interviewed by the
committee.
At the April MAPC meeting, the committee will report its recommendations on requirements
for ensuring a level playing field and its analysis as to how well each Mainstream Plan meets
these requirements.
L32 MPC 2;16'W
-/ av-4z
'MROC
Medi-C&1 Advisory Planning C.ammissiaa
59S Center Avenue,Suite 100
Martinez,Califomis 94553
(5 10)3134OD4
FAX(510) 3136002 February 23, 1994
coMMlssiorl>Rs Cynthia Suzuki
W.11ry W.&VIM,jr,M.D. Foundation Health Plan
3400 Data Drive
Mat:artit Do•utitg Rancho Cordova CA 95670
Header S,auaden Esse,M.S.W.
Marl lAwrader Fuji,M.S.R.D. Dear Ms. Suzukd:
elartiette Garnet..M.Ed. The Contra Costa County Board of Supervisors has created a 25-member
Michael G.Harris,o.D.a.D..M.s. Medi-Cal Advisory Planning Commission to assure provider, consumer,
and community input into the planning for Contra Costa's implementation
Paul Katt of the State Plan For Expanded Managed Care.
Joan j.artenbNjer. RX
The Commission will be making recommendations directly to the Board
Michael lswnan of Supervisors on the county's managed care system with a special
Viola Luis" emphasis on the Local Initiative. However, the Commission recogni=ing
Eilern Lynette,R.N. that up to 40% of the county's managed care eligibles will be served by
a Mainstream Plan wishes to kern bow potential Mainstream Plan
Suzanne MacDonald contractors will offer the same protections to beneficiaries that the Local
Jack McGen't) initiative is required to provide.
Stephen Heisler.M.D. At its last meeting the Commission set up a special Mainstream Plan
&ssandttson McNeil.M.P.H. Committee to ascertain the willingness and capability of potential
Mainstream Plan contractors to serve the special needs of Medi-Cal
Cynthia Miller enrollees and to learn how the Mainstream Plan will relate to the safety
Antonio H.Poop net and traditional providers who Have historically served Medi-Cal
Ewlyn Rin,let M.A. patients.,The committee is to report its findings and recommendations at
the Commission's April 6 meeting.
Jose Samanieto
Dolms;Satschm LC.s.w..M.P.H.,Ed.D. The Commission has asked the Mainstream Plan Committee to obtain
from potential contractors in Contra Costa County their plans for serving
Raymond L smart Medi-Cal managed cane eligibles both in the interim period (before the
Gru S.Sorensen,M.D..M.P.H. two-plan model is 'implemented) and once the two-plan model is in
operation.
Terry Tanner,D.D.S.
Rea.Canis A.Timmons.B.A..T11-1). The Mainstream Plan Committee as partof its fact-finding proms has
ire a, u developed the attached set of questions to ask of each potential contractor.
If you are considering the possibility of becoming a Mainstream Plan in
BOAV Of SUPERVISORS 11AJSONS
Tom Pawns
Tom Torlalkson
Contra Costa County,we ask that you either provide written responses by
Wednesday, March 9 or that you participate in an interview with the
committee Deter in the month. Of course, if you wish you may provide
both written comments and agree to be interviewed.
Please send your replies to. Bobbi Baron, Medi-Cal Advisory Planning
Commission, 595 Center Avenue, Suite 100, Martinez, CA 94553. You
can tall her at 510-313-6044 if you want more information or wish to
schedule an interview.We are looking forward to Itarning from you about
your plans for Medi-Cal managed cam in our county.
Sincerely,
J McGervey
Mainstream Plan Committee
TM:BB/lmb
Enclosures:
1. Questions
2. Medi-Cal Advisory Planning Commission Roster
cc: Larry Lucero, SDOHS
Milt Camhi
Bobbi .Baron
Contra Costa County
Medi-Cal Advisory Planning Commission
Questions for Xainstream Plans
Administration and Qperat12ns:
1. Whicb model are you planning for: single mainstream;
"consortium" of mainstreams; other? Nov would you modify
this if single payor or alliance health reform was enacted?
2. How many Medi-Cal eligibles do you plan. to enroll in the
interim period? What is your proposed contract limit after
the interim period?
3. Which Medi-Cal aid (AFDC, ATD, AB, etc.) categories will you
.include in the interim period? After implementation of the
State's two-plan model?
4. Will your Contra Costa Medi-Cal service area be countywide
or in specified sub areas of the county? If in selected
areas, Which ones?
S. How do you propose to respond under the two-plan model if
the Mainstream Plan enrollment appears to be approaching the
state limit of 40% of the managed care eligibles in Contra
Costa County?
Capabilities and Experience in Serving Medi-Cal and Othgr Low-
Income Groups
6. What is your health plan's experience in enrolling low-
income individuals?
7. Will the provider groups you use in Contra Costa County have
experience in caring for low-income individuals?
S. What arrangements will you make to take care of "special
populations", e.g. people who can't, speak English; those
with disabilities (mobility, hearing, sight, etc) ; those
requiring mental health or substance abuse services?
Traditional and Safety Net Providers:
9= How do you plan to relate to the county's public health
services, (e.g. CHDP services, iumunization and well baby
clinics, expanded perinatal services?
10. Do you intend to contract with safety net providers (Board
of supervisors definition on next page) ; with traditional
providers. If a Clinton type health reform is passed,. what's
your position on contracting with essential community
providers?
Contra Costa County Medi-Cal Advisory Planning Commission
„Questions for Mainstream Plans"
Page Two
Communications and Community Support:
11. What will you do to provide evidence of broad community
support for your health plants efforts in Medi-Cal managed
care? Would you be willing to sponsor and hold regional
hearings in Contra Costa County on your health plants
mainstream proposal?
12. What are your mechanisms for providing ongoing Medi-Cal
member input at a policy level?
Community Health Issues:
13. The Local Initiative has committed itself to reinvesting a
portion of any surplus from its Medi-Cal program into
community health programs operating in Contra Costa County.
Would you do the same? If so, how much and for what kinds of
programs?
14 . What community prevention and promotion activities do you
plan to conduct targeted at the Medi-Cal population?
15. To help reduce Medi-Cal turnover problems, would you support
guaranteed eligibility for selected groups (e.g. children)
and/or lock-in?
The Board of Supervisors defines safety net providers as:
those cUn.ical providers who over time have continually provided a
substantial amount of comprehensive primary care or acute hospital
inpatient services to a signif cant number of medically indigent and
Medi-Cal patients. Such safety net providers are the main,if not
sole, source of care for Medi-Cal beneficiaries and medically indigent
persons.
The Contra Costa County Board of Supervisors has identified such safety net providers
as those who have traditionally shown a loyalty and competence in serving special .
vulnerable populations. ?be State and Federal governments have designated Federally
Qualified Health Centers and institutions receiving DSH payments as safety net/essential
community providers.
132:P 2rtane
Cynthia Suzuki
Foundation Health Plan
3400 Data Drive
Rancho Cordova CA 95670
Jackie Anderson
Blue Cross
2155 Oxnard Street
. Woodland Hills CA 91367
Carol Rhodes
PacifiCare
5701 Katella Avenue
Cypress CA 90630
Sean O'Brien
Health Net
P.O. Box 9103
Van Nuys CA 91409-9103
Bob Eisenman
Kaiser-Permanente
1950 .Franklin - Third Floor
Oakland CA 94612
Paul Swenson
Aetna Health Plans of Northern California
1111 Bayhill Drive 1300
San Bruno CA 94066
Max Brown
CaliforniaCare
P.O. Box 4089
Woodland Hills CA 91365-4089
William Caswell
Maxicare California
1149 S. Broadway Street 0819
Los Angeles CA 90015
Karen Jansen
PruCare of California, Northern California
177 Bovet Road 1400
San Mateo CA 94402
R. Judd Jessup
TakeCare Health Plan, Inc.
2300 Clayton Road 11000
Concord CA 94520-2100
Howard Davis
universal Care
1600 .East Hill Street
Signal hill CA 90806
LMAPMW
CORE REQUIREMENTS •
1. Plan's Experience with Low Income Enrollees
Does the plan have Medi-Cal contracts in Contra Costa County or in other areas of the state? Has the plan
taken pan in any state programs for low income individuals?Does the plan have its own program for low`
income (non-Medi-Cal) individuals?
2. Plan Providers' Experience with Low Income Enrollees
Does the plan now have providers in Contra Costa County who have a significant number of low income
patients?
3. Arrangements for Special Populations
Has the plan and its providers made arrangements to accommodate members with mobility problems; who
do not speak English, who require special mental health and/or substance abuse services? Are these
arrangements adequate?
4. Relationships with Public Health Services
Will the plan utilize public health services such as CHDP and CPSP or will it duplicate these services
through its own providers?
5.. Contracts with Traditional Providers
Will the plan contract with many community providers whose caseloads include a significant number of
Medi-Cal eligibles?
6. Contracts with Safety Net Providers.
Will the plan contract with safety net providers such as community clinics and acute care hospitals who
have continually over time provided a substantial amount of care to a significant number of Medi-Cal and
indigent patients?
7. Community Support and Involvement
Will the plan sponsor forums, hearings and/or other means of obtaining community input into its planning
for Medi-Cal in Contra Costa County?
S. Ongoing Member Input
Does the plan have mechanisms for providing Medi-Cal member input in a meaningful way?
9. Community Prevention and Promotion Activities
What is the plan's record in sponsoring and/or running various prevention and health promotion activities
aimed at the general community and not targeted just for its members?
10. Commitment to Enrolling Medi-Cal
Has the plan expressed a firm commitment to enrolling a significant segment of the Medi-Cal population?
Will the plan's Medi-Cal enrollment.be a significant portion of its overall enrollment?
Has the plan made operational adjustments to accommodate Medi-Cal members?
Has the plan invested significant time and staff into the planning for a Medi-Cal contract?
L':FRR 1 3:,W -
RESULTS OF SURVEY OF MAINSTREAM PLANS
Core Requirement Blue Cross Kaiser PacifiCare Health Net
1. Plan'.s experience with low income 0 + 0
enrollees
2. Plan providers' experience with low 0 + -- --
income enrollees
3. Arrangements for.".special 0 0 0 -
populations" -
✓linguistic
./disabilities
./mental health/substance abuse
4. Relationships with public health - - 0 0
services
5. Contracts with traditional providers 0 -- 0 0
6. Contracts with safety net providers 0 -- 0 -
7. Community support and 0 -- - --
involvement
8. Ongoing member input - + + 0
9. Community prevention and - ++ 0 --
promotion activities
10. Commitment to enrolling Medi-Cal ++ 0 ++ 0
Rating Scale:
++ Definitely meets core requirement
+ Somewhat meets core requirement
0 Uncertain
- Probably does not meet core requirement
-- Definitely does not meet core requirement
The committee has not at this time assigned weightings to specific core,requirements
132:FRR 1 411 U94
The Board of Supervisors
phi it•1dsNa
Contra C ;.1 ward
.d
County Administration Buildingcw"'Y"°"°"""*W
651 Pine St, Room 106
Costa 010»-2371
Martinez,California 94553 County
TM►e,..m� to DsV+cf 1
,be$ffAK 2nd Devoe
CWYW wneo,"DOM
Sumo VftM WP"k.ft D*VO '
'team t�rMlup►51l+Dapria
May 17, 1994
Department of Health Services
Medi-Cal Managed Care Division
Ms. Sandra Carol Pierce, Chief
Contract Development Section
714 P Street, Room 1400
Sacramento CA 95814
Dear Ms. Pierce:
At its meeting today, the Board of Supervisors approved the
attached report from the Medi-Cal Advisory Planning Commission
containing its comments on the Draft RFA and the Summary of
Workgroup Decisions and voted to transmit the approved report to
the State Department of Health Services.
Sincerely,
Tom Powers, Chair
Board of Supervisors
TP:BB/lmb
Attachment:
MAPC. Comments on Draft RFA
and Summary of Workgroup Decisions
MAO
' Kark Tinucane, w+"+
Health Services Director Costa
t DAM Kay 11, 1994 Coity
y
SLWtCT:
Approval of Kedi-Cal Advisory Planning Commission (KAPC)
Comments on Draft RTA
WMCI►IC Xt=XST{f) CIR RtCt;*MCNDATlON(ey a a.CoCPKIUND AND JUST1►IC:ATION
*. uconcmmn Irrsern
APPROVE the report from KIAPC commenting on the state
Department of Health Services Draft RFA for Mainstream
Plans incorporating the statels.vorkgroup decisions
and authorise the Chair, board of Supervisors, to
submit the report to the state.
22. TIlQ►NeXI L Z1CpRl.T .
Tee for service revenue to providers in Contra Costa
County, including Merrithew Kemorial Hospital and
Clinics, for services given to AlDC linked Medi-Cal
eligibles amounts to over $36-million annually. As the
state moves to managed care, this fee for service .
revenue will be transferred into capitation payments
to the Contra Costa Health Plan Local Initiative and
private RX0 Mainstream Plan. .The Draft RFA, which
contains requirements for both Local Initiatives and
the private NMOs affects how Contra Costa Health Plan
(Contra Costas vehicle for the Local Initiative) will
be able to manage revenue and expanses-
III. 11"ONS ?OR ANDOOOMAiTIONSIsACKaROMCD
(See attached KAPC report)
The State Department of Health Services has issued a
Draft RFA for potential private plans and has asked
for comments on the documant with a deadline of
Wednesday, Kay la, 1994.
At its April 19 seeting the board of Supervisors
approved a set of care requirements for Private Plans
as recommended by the XAPC. The commission has taken
these core requirements into consideration in its
review of the Draft Private Plan RFA.
The KAPC executive Committee approved the report at
Its May 9. 1994 setting and requested that the board
of Supervisors endorse the report and submit it to the
State Department of Health Services.
tOMTIMyRD OM ATTACMM[MT7 We e1ONATURR:
NRCO...IRMPATION O. COVMTT AW INIiT'l1ATOR �,,,� •RCOIf/R/OAT/0N p OOAwO COYMIITTRR +
#►.Neva ._. e*mRN
I�
ACTION OF eeANO ON ir.RevtttM #tt t/RC4rrR1ORD eTMRN
V= Of 06910W i ecce
1 "=BY Cf:RT I Ir TfiRT TM 1 e i t A TItLIE
t atAti l MOuf l Aeatrn ) AM CORRECT CW W of AN ACTION TAIMMM
DYES: i�DEi: AM CWM*= CN TW M I MMS O► TME t>n14ttD
AaSE►t!;�_ AWTA i N: or lILWWWV 1 eOt S ON TME DATE $MOM'► .
tC: ATT IRM .
0441L SATC•4CLOA. CLERK OF TPIE BOARD CW
Milt Camhi, CC" SUPERVISORS AND COUNTV ADMINISTRATOR
Ccpvry
0382 7-e3
Contra Costa County
Medi-Cal Advisory Planning,Commission
Comments on Draft RFA
BACKGROUND
On March 7, 1994 the California Department of Health Services issued a draft Request for
Application(RFA)for potential private plans in the 13 target counties, and on April 4. 1994 also
issued the summary of decisions of its managed cart work groups. Since these decisions will be
incorporated in the final RFA, the Medi-Cal Advisory Planning Commission (MAPC) has
combined its comments on both documents in this report. The DOHS has just extended the
deadline for submitting comments to Wednesday, May 18.
At its April 19 meeting the Board of Supervisors approved a set of core requirements for private
plans as recommended by the MAPC. We have taken these core requirements into consideration
in this review of the draft private-plan RFA.
GENERAL COMW-M
The MAPC is pleased that the private plan and Local Initiative will be acquired to meet most
of the same requirements. We are still distressed, however, that while the Local Initiative is
required to contact with safety net providers and to provide participation. standards for
` traditional providers, the private,plans are only "encouraged" to do so.
The draft RFA is missing certain elements which will be included in the final document. For
example, since the numerical evaluation scoring system is not included, the MAPC is still in the
dark as to how much weight will be given to contracts with traditional or safety net providers.
The MAPC also notes that the draft RFA is missing the Implementation Plan section and is
concerned that there be provision for an orderly transfer to a two plan managed care model.
We question an inconsistency with the State Pian for Expanding Medi-Cal Managed Care: Foster
children are included as "mandatory* eligibles in the draft RFA (page 24) yet the State Plan
(page 22) clearly states that, 'inclusion of Medi-Cal eligible foster children as covered
beneficiaries will be discussed with each county and evaluated on a county by county basis."
We are unaware of any such discussions and wish to understand the process the state used to
determine that foster children in AU 13 counties would be mandated into a managed care plan.
We are concerned that an inadvertent oversight may become a state requirement if it is not
corrected. The providerlbeneficiary ratios on page 78 of the draft RFA now call for more
referral specialists than for primary care physicians. We understand from discussion with DORS
staff that this was not the intention and that the final RFA will contain a conwdon.
The MAPC is concerned' that the state's requirement for encounter levet data will be
unnecessarily burdensome for both the Local Initiatives and private HMOs. We recommend that
the state concentrate on well defined outcome measures instead of the massive data requirements.
2
The MAPC utilized the attached document from the Contra Costa Food and Nutrition Policy
Consortium as the basis for its following statements of principles ooncerning'perinatal and
4 nutrition services.
MAPC reaffirms the importance of comprehensive perinatal services and recommends that the
state be clear that all current CPSP standards will be required of the Local Initiatives and the
private plans.
MAPC reaffirms that comprehensive nutritional services including medically necessary therapies.
are essential components of health cane. MAPC recommends that the state ensures that
nutritional services comparable to CPSP standards for nutritional services are clearly defined,
documented benefits which are well publicized to all Medi-Cal beneficiaries.
CONFORMANCE WITH CORE R Q=MENTS
1. Plan's experience Mjth low income enrollees.
The draft RFA asks for a description of the applicant's experience in providing managed
health care services to Medi-Cal, medically indigent, and low income populations. The
weighting the state will give to this experience is unknown at this time.
2, Plan providers' expCrrience with low income enrollees:
The draft RFA calls for a listing of plan medical practitioners to include information
about each provider's qualifications. However, there does not appear to be any request
for information about the provider's experience with low income enrollees.
- 3, Arraneements for 's=i L ;ula8ons":
Unguistic
The cultural and linguistic requirements may need some further definition. For
example it may be desirable to have bilingual capability in certain regions or
facilities in which there is a concentration of a specific limited/non-English
speaking population even though that population does not account for 5.% of all
Medi-Cal managed care eligibles in a county.
We support the establishment of a community advisory group as recommended
by the state and recommend that the functions of such a group be expanded to
include input into all facets of the plan's Medi-Cal operations and not just
linguistic access.
Again the draft FIFA says that proposal will be scored on a plan's ability to
provide culturally appropriate services but the weighting or scoring will not be
available.until the final RFA is published,
V Qui
The state says that its contract language prohibiting discrimination which is
consistent with Title VI of the Civil Rights Act ensures equal access and
appropriate care for persons with disabilities. We believe the state should require -
plans to describe their arrangements,for these members.
./ Mental Health/Substance, Abuse
The RFA does not address the relationships between the Local Initiative or
y
private HMOs and the county mental health managed care system.
4. Relations i s-with public healthseryices
There are provisions for a MOU between the focal health department and the Local
Initiative or private IIM . Plans am asked to make 'every reasonable effort' to sign the
MOU which delineates lOocal health department and plan responsibilities. The suggested
1M 07J seems to address the relationship issues satisfactorily. It would be preferable,
however, if the state would define what it considers 'every reasonable effort."
S. Contracts with traditional„pr Aders
While private plans am 'encouraged' to contract with traditional providers the points
given for such contracts is not]mown.at this time.
6. Contracts with safely net prQviders
White private plans are "encouraged" to contract with,safety net providers the points
given for such contracts is not known as this time.
7. Community suFe and involvement
Private.plans should be required to have community advisory groups for all issues and
not just for linguistic access.
S. Ongoing member input
There should be a requirement for private plans to develop mechanisms for providing
Medi-Cal member input in a meaningful way.
9. Community prevention and oromdon activities
The workgroup decision gives the local health department the responsibility for public
information and education programs. We believe the private plans should also sponsor
prevention and health promotion activities aimed at the general community.
10. Commitment to enrolling Medi-Cal
The RFA requirements ensure that only those plans with a commitment to enrolling
Medi-Cal will take part in the application process.
Attachment: Contra Costa County Food and Nutrition Policy Consortium Document
L32:90R S/I7194
�. DATE: May 10, 1994
TO The Medi-Cal Advisory Planning Commission
Centro Costa bounty
Michael Harris, Chair
f OOD & NUTRITION FROM: Managed Care Subcommittee:
Policy Consortium Mary Lavender Fujii
wonting so mdum chronic dispose i Frances Sturgess
prompts good heohb 1w Contra Costo
Corny rrr,idenN by ossu►ing access to Lux Pardini
atisqunse ord+w+riaars food.
RE: Attachment for the MAPC Response to Department of Health
Services Request for Comment
Nentber organizations
Aworicon Cancer Society
Contra Costa unit ?hank you for the consideration given to our concerns with the Department
American Moon Association of Health Services request for comment on the ."Executive Summary of
Contra Casio Chapter
Head Sian Recommendations for Medi-Cal Managed Care" and the Draft RFA at the
Contra Costa Child Core Council last MAPC meeting and the Executive Committee meeting today. As
Contra Costa Food Bank
Costa Board of Supervisors requested,the following is the itemized list that the Food and Nutrition Policy
Centra cotta Health coalition Consortium's managed care subcommittee had drafted for review.
Lonna Costa Munger Task Force,
Contra Costa Covny
Nutrition Counc+l In sum, the standards for CPSP services described in Title 22.for quality of
Contra Costa County
Wittiness Program care,care.delivery,qualifications of personnel,documentation,and evaluation
Diablo volley Dietetic Association are specific and need to be preserved for managed care to maintain the
CMt?P-child Health and
Disability Prevention Program quality of program outcomes. The legislation specifically exempts capitated
Nvemion Program or managed care programs from these standards, and the RFA and the DHS
se;o_Teenage Prr Nutrition ogram ram response indicate only a partial adoption of these standards. This is contrary
WIC-women,Infants d Children to the recommendations of several of the Work Groups,as documented in our
Supplementol Food Program attachment.
Public Employees Union,Local One
Public end Environmental
Health Advisory Board Nutrition services outside of CPSP are acknowledged as important but the
Dopo ierd of social Services tanpage of the DHS response and the absence of indices in the RFA for
food Stamp Program Standards for these services do not provide for appropriate quality assurance.
University of Colifonio Coop
fxsension,Expanded Food and Also,a significant access issue is that Benefit Statements for nutrition services
Nutrition Education Program in medically necessary therapies and health education have been unclear to
the point where clients in the past have been denied reimbursable services.
We wish to see these corrected and we address the details in the attached
77 comments list.
cc: Milton Camhi, Contra Costa County Health Pian
✓Bobbi Baron, Contra Costa County Health Plan
Contto Costo County
Heolth Services Dept. -
75 Santo Barboro Rd.
fleosoni Hill, CA 94523
(5 t 0) 646.651 1
$:AV It.tni A,AA ACln
Comments on Medi-Cal Managed Care.Work Group Recommendations and RFA re:
Comprehensive Perinatal Services Standards and Access
Medically Necessary Nutrition TMerapy Standards and Access
Thank you for providing the opportunity to comment on the Draft RFA and the Executive
Summary of Recommendations for Medi-Cal Managed Care. The effort expended is
obvious,and its scope addresses many important issues. Although there are issues that need
clarification, the format and presentation are very clean, which is helpful for its teview. If
some.of the attached concerns seem intensely specific. it is because of the potential for
misinterpretation and the fact that legal and binding contracts will be based on these drafts. Q,
Section: Future of Public Health Subgroup .
p.7 B. CPSP as standards for pregnant women
DHS Response:
'Plans will also be required to provide CPSP interventions for pregnant women WHO
MEET CPSP CRITERIA as a result of the screening—interventions must be consistent with
requirements in Title 22, CCR, S. 51348 & 513481.
Concern: Under current CPSP criteria,all pregnant women who are Medi Cal qualified.and
who desire to participate are eligible for CPSP services, including screening, assessment,
participation in care plan development,interventions,reassessment,and other interventions.
The DHS decision appears to place limits on who can be served and the extent of the
services rendered. ' This is confusing and needs to be rephrased to affirm original
recommendations.
Section: Benefits Package Subgroup
p.14 4 . B Pregnancy services.
In this and the Section above, the recommendations of each work group asked for specific
standards to be followed for CPSP. The DHS decisions acknowledged the AGOG
Standards (although 51348.1 lists the 6th ed, not the 7th as recommended, and this needs
to be restated for current editions and updates). However,"Modify" appears to disregard
1. the Welfare and. Institutions Code S. 14134.5 which defines Comprehensive Perinatal
Services and mandates the establishment of standards, including minimum standards for a
CAPITATED OR GLOBAL fee structure by DHS and CCLHO.
2.Title 22 sections 51179 et seq.,which specifies standards for application review, including
capacity, qualifications of staff, and quality of care.IF the standards for application in the
RFA were equal to or more stringent than these, well and good, but as they are not, loss
of quality of care and scope of perinatal services as compared to the original OB Access
program. will-be lost.particularly as it relates to practitioners listed. '
f
sss Page 2 sss
3.Title 22 51348 is referenced as'Interventions"to be provided,which if"interventions"is
restated as to be DEFINED as assessment,reassessment etc as stated in S 1348,that is good.
However, the LANGUAGE 'in 51348.b specifically EXEMPTS capitated health system
contracts and unless specifically rewritten "b"may provide a LOOPHOLE by which these
minimum standards do not apply. ,
4. Recommend DHS response be changed to original recommendation.
Section: Future of PH Subgrp/Additional Recommendations "
P..8 Rec:. The requirement for nutritional counseling should be rephrased to nutritional
assessment and appropriate intervention.
DHS response: "Appropriate nutritional interventions" are already covered.
Concern: "Interventions"needs to be defined as being based on assessments and standards
of care. It can be unclear to what extent "Appropriate" is to be interpreted. Recommend
DHS revise response.
Section: Subgroup: Benefits Package
P. 10 B) Recommend screening all beneficiaries for nutrition risk and offer nutr. ed., "
provide medical nutr therapy services by a dietitian and include as a benefit listing.
DHS Response This is current policy. Screening....guidelines.
• Concern: Restate DHS response as originally recommended.
L Medical nutrition therapies and availability of covered, in-plan referrals to nutrition
professionals/Registered Dietitians is often inferred but not clearly stated as a benefit in
many plans,with the result that access is denied to clients even when they ask. (Often the
providers and the benefits office staff are ignorant of the extent of services available unless
it is unequivocally and clearly listed in the benefits)
2. USPSTF Guidelines are not substantive enough to assure access to quality care.
Recommend use of language provided in Calif;.DHS booklet"Expanding MediCal Managed
Care" Aug. 31, '93, Recommended Core Preventive Svcs p 7, 8 but with specification of
"Nutrition assessment and intervention" rather than solely "nutrition counseling".
Section: Program Admin. Standards Subgroup
Key Issues p, 16 1. Referral to non covered services B.
Comment: No mention of Prenatal Care Guidance or other Perinatal Outreach Support in
DHS decision statement. These are valuable resources to plans to maintain access and
continuity of care and deserve mention,
p. 17 Referral to Family Planning Services: DHS response: "Modify..
sss Page 3 sss
Concern: Family planning referral should be required as recommended, and in such a way
as not to conflict with Federal Regulations--Le. the SPECTRUM OF AVAILABLE
CHOICE should be a mandate as specified in the Recommendations "{Family Planning
Agencies(if client prefers to receive services outside the Plan)}"butte limited to a referral
:o any specific group.
p. 19 4) Pediatric Sub-specialists: Recommendation lists 'Gastrointestinal/Clinical
Nutrition"
Concern: RFA/Attachment "Recommended Managed Care Provider Network" lists this
only as"Gastrointestinal"without reference or linkage to the specialty of Clinical Nutrition
or necessary nutrition services. Although this may seem a statement of the obvious, the
obvious bas often been under-utilized.
Section: Cultural and Linguistic Requirements Subgroup
p. 25 1. The 5% threshold for all plans.
Concern: This would appear to guamtee that no plan could presume to exclude
monolingual clients by not providing bilingual services (and in effect select them out to
other plans that do)which is great. On a practical level this may be difficult to implement,
if for instance the geographic concentration of a given language group is outside the
jurisdiction of a given provider, but that provider is required to maintain bilingual capacity.
Or,if there is less than 5%countywide but a significant concentration of monolingual clients
reside in a given service area, these clients would not be accounted for.
Section: Managed Care QA and Evaluation Workgroup Subgroup
p. 35 2 Home care vs "Home Health."
Concern: No mention of the need for reimbursement of nutrition therapies bas been
specified. It would be helpful if the definition of reimbursable services would include those
rendered by staff recognized as certified to provide such by the State of California(see Bsns
and Professions Code 2585/2586, Qualifications/Registered Dietitian, Title act and
authority)
p. 36 6. Redommendation_of addition to contract "nutrition counseling shall be available
when prescribed by a physician and the Plan must have a mechanism in place to provide
nutriijonal services."
sa Page 4 sss
DHS response Agraes.
Concern: However,RFA does not delineate nutrition counseling as a covered service nor
ask to specify the mechanism the Plan has to provide these services,nor specify in the audit
the use of the mechanism,nor qualifications of staff to provide these.This is a serious gap
in OA and provision of seMces.
Section: Education/Patient Satisfaction Subgroup
The efforts in this area are to be applauded. The concern and desire to set standards and
provide,guide lines are commendable. Recognizing Health Education as a major force in
chronic disease and disability prevention is critical to improved outcome and controlled cost,
but we must be vigilant that the focus be outcome and counseling oriented and not merely
the presentation of information. To increase the assurance that this;Will happen,we submit
the following comments.
p. 43 ]. Patient Ed Recommendations
Concern: While all Health Ed.services need not necessarily be provided by a Masters level
Health Educator, oversight of services should be done by a staff Health Educator, not
merely by a consultant, especially given the prospective size of the Loral or Mainstream
Plans in a given county.
p. 44 F See RFA Matrix attachment #3 comments.
G; DHS Response States policy is reflected in '11".
Concern: As H specifies only "offering and outcome of referrals" it is unclear how this
general statement can possibly agree with the very specific statement of the recommendation
in "G" of documenting the "process in terms of clearly stated education intervention goals,
objectives, agreed upon activities and follow through on what the PATIENT did"
p. 45 I Documenting effective coordination:
Concern: DHS Response states it agrees, BUT refers to F to confirm. F addresses
CONTENT of program, not documentation. This is not the same as including the
recommendations.
p.45 2. Provider Education Recommendations: A. Clearinghouse on managed care health
ed. resources.
Concern: DHS decision appears to agree but does not mention already established
clearinghouses such as Education Program Associates, instead refers only to informal
networking. Does this mean EPA will no longer exist?
s*: Page 5 sss
p. 46 F Health Ed. activities and incentives—
Comment: Neither the recommendation nor the DHS decision is clear and both appear to
be at cross purposes. It appears the recommendation is for DHS to reimburse providers for
doing or preparing Health Ed, and DHS is saying the Plan should provide its own
incentives—whether to heir own providers or to clients for participation is unclear. Please
clarify.
p. 51-53 Implementation Plan for Health Ed. in Managed We ;
Title 10.Title 17, CHDP, EPSDT and Title 22 are referenced. If indeed the plan complies
with ALL of Title 22, that would be great But it is unclear if it refers only to the Health
Ed portion. This could use clarification.
Work Group Description looks good. How will it be assembled?` By invitation?
Section: Attachment 2- Referral matrix
Comment: As noted before, no nutrition /clinical nutrition specialty listed.
Section: Attachment 3-Health Ed. Matrix
Comment: It does include nutrition etc. but where is this in the RFA?
Also important to specify in clinical preventive services lactation counseling, breastfeeding
promotion and intent to participate in the Baby Friendly Hospital Initiative of WHO. This
is consistent with the intent of MCH to establish the Breastfeeding Task Force for
promotion of breastfeeding in California.
For the Patient Ed. and Clinical counseling list medical nutrition therapies sbould be
included/specified. Some nationally known insurance plans do. not reimburse for services
of a Registered Dietitian even in such obvious,categories as Diabetes. Plans need to know
that Medi-Cal does approve and cover these services when given by an RD and that they
will be expected to follow suit. 'Further examples of medical nutrition therapy categories
would include cardiovascular,digestive,renal,liver,substance abuse,eating disorder,cancer,
weight management, pediatric growth and development, and nutrition support modalities
such as tube feeding, stroke rehab, and intravenous/parenteral nutrition at home or in the
hospital, to name a few.
DRAFT RFA DOCUMENT; COMMENTS AND CONCERNS
p. 81 Anciillal):health services documentation should specifically include Registered
Dietitians, as providers do subcontract with these as important members of the chronic
disease and disability prevention and medical nutrition therapies team. Their services have
been documented to significantly manage costs, and a plan that does not provide for their
inclusion- is at higher risk; of higher cost outcomes.
sa Page 6 ss:
The fact that an affiliated hospital may be named as providing R.D. services is insufficient
without documentation of patient access standards and agreements.
p. 86 Marketing: Any Benefits statement must be dear as to average.
(See Concern re:Benefits Package Subgroup p 10 part B and Managed Care OA and Eval
p36 part 6)
Attachment 8: PHP Standards Review need to be modified.
p. 9 of 37 section 52 .Uctmurcj rtification: no entry is noted for Nutrition personnel/
Registered Dietitians,whose certification is recognized in Business and Professional Codes
2585/2586 and who are authorized to provide medically necessary nutrition therapies as
ordered by a physician.
p. 14 of 37 section 9.1 b Ambulatoa care_services (Outpatient Hospital): no entry is noted
for Registered Dietitian under "plan employs orbas contfacted with appropriate licensed
or certified:..."
p. 18 of 37 section 12.3 Effc�tive Health cation: as noted in comments on the Draft
Work Group Summary,at this level of care Health Education Specialist should be a)Masters
Level and b) Staff, not just a consultant.
Attachment 9: Addendum to Policy better no.93-03 Attachment A Primary Care Facility
Identification Form: also, Facility Checklist referencing T22: again, certification of and
access to nutritionists is not addressed,although in the second document,Health Education
is.
Again, thank you for your consideration.
Managed Care Subcommittee
Contra Costa County Food and Nutrition Policy Consortium
(a:81:2k%dOFCW/n+MAY 10.199+
as Page 7 s*:
The Board of Supervisors Contra C*k co ft&Md
County Administration Building C"
851 pine St,Room 106
tartinez,Coldomia 94553 C3urlty
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November 20 1994
Department of Health Services
Medi-Cal Managed Care Procurement Project
Attention: Ms. Sandra Carol Pierce
P.O. Box 942732
Sacramento CA 94234-7320
Dear Ms. Pierce:
In response to the State Department of Health Services' request for
County input enclosed are Contra Costa County's specific criteria
for private plans with Medi-Cal contracts in our County.
.These criteria .were recommended by the Medi-Cal Advisory Planning
Commission's Executive Committee and unanimously approved by the
Board of Supervisors at our meeting on Tuesday, November 1, 1994.
We wish to stress the importance of these criteria in assuring all
Medi-Cal beneficiaries in our County ieceive access to the highest
quality comprehensive health care services. Finally, we need to
emphasize Contra Costa's desire that these criteria not merely be
a consideration but carry substantial weight in the State
Department of Health's evaluation and scoring of .the private plans'
applications.
We expect to see the evaluation portion of the RFA incorporate
Contra Costa County's concerns in a meaningful way. And we look
forward to working cooperatively together with the state, the
private HMO and our own Local Initiative.
Sincerely,
Tom Powers, Chair
Board of Supervisors
TP:BB/lmb
Enclosure
Kark Tinucane,VNKO 1' ,,
Health Services Director
October 25, 1994 i,OC)Ljry
01m.
County Specific Raquiresents for Nadi-Cal Kanagsd Care
a+scnc+�cowtA�oR*+�i+m+tto«ut��wxaowo a+re w�snrumo«
�. APPI Pi the attached Count
Xanaged Cars, end TORWARD thee�rrequirements toethe State di-Cal
Department of Health Services.,
ZZ. Z'Zx]lxC2AL TMPAeT
tea-for-sarvice revenue to providers in Contra Costa County,
Including Kerrithev Kemoris2 Hospital and Clinics, for services
given to AFDC linked Kedi-Cal eligibles amounts to over g36-
million w%nually. As the State moves to managed cars, this tee-
for-sarvice revenue will be transferred into capitation payments
to the Contra Costa Health Plan Local Initiative and private
HMO. The County Specific Requirements as rocommanded by the
Medi-Cal Advisory Planning Commission, should bolp to ensure a
level playing field for the Local Initiative and Commercial Plan
In Contra Costa County.
• 211. AUSQH3 yOR RECDVI+lE M&XION jsA„ CROMM
The State Department of Health Services issued its Nadi-Cal
Kanaged Care RFA for Commercial Plans on September 30, 1994. On
October 13, 1994, it sent a letter. to the chairperson of the
Board of Supervisors in each of the 12 affected torgat counties
soliciting rocammendations for county specific requirements for
Commercial Plans. The deadline for submitting such
recommendations is friday, November 4, 1994.
Since the full Nadi-Cal Advisory Planning cc—lesion regularly
scheduled meeting is being held too late to seat the State's
deadline, the Nadi-Cal Advisory Plan Co=ission Executive
Committee at its Konday, 00 bar 24, 4 *a ti q, ovieved and
Co++'twu[o or arratw:,rr: ,�� e+eK+nwt:
ea oow99"?Wft W 9.0k*M aawa rr W= �. ftoorltxo+tto_W6 aorr+rt�z
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cart er sun.+�+aeru
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Nilt Camhi, 2xecutive Director November 1994
Contra Costa Health Plan a 00TW90AMor
• su�ooes iwc oau�r�ow�'n►�*a
- +ort te�f
approved the attached County Specific Requirements and
recommended that the board of Supervisors approve thsss
requirements and forvard than to the Stats Department of Sealth
Services before the Noveaber 4, 1994 4 p.s. deadline. The
County Specific Requirements build on the cors rsquiraaants tow
Commercial Plans as rsconmended by the Nodi-Cal Advisory
Planning Commission and approved by the board of Supervisors on
April 19, 1994.
9
r
City S2tlfls Criteria for Privalc Plans in pntm Costa County
Approved by Medi-Cal Advisory Planning Commission Executive Committee
on October 24, 1994
i. Public Overslebt
* Agrees to conduct 3 regional public hearings prior to March 31, 1995, and
annually thereafter using the same protocols as used by the MAPC in its public
hearings about the Local Initiative. Hearings to include issues of both mandatory
and voluntary enrollees.
* Agrees to establish a community advisory group to provide input for use in its
planning and implementation of its program for mandatory and voluntary
enrollees.
2. Ongoing Member Input
* In addition to state required annual surveys, has mechanisms for providing Medi-
Cal member input in a meaningful way.
3. Dietetic Services
* Agrees to include a nutritional assessment form approved by the American
Dietetics Association or the California Dietetics Association in the initial health
assessment performed on all adults and children.
* Agrees to have in place appropriate mechanisms for follow up dietetic services
either by referral or performed directly by the physician.
* Agrees to solicit provider letters of intent from Registered Dieticians prior to-
March 31, 1995.
* To ensure compliance with above requirements, State agrees to put a registered
dietician on the State Medical Audit Team.
4. Provision of Comnreben ivs a Nutritional and Perinatal SerPices
7
* Provides comprehensive nutritional-and perinatal services equivalent to current
CPSP standards and ensures those benefits, as well as immunization and other
prevention services, are well publicized to all Medi-Cal beneficiaries and
providers.
Z
3. Provider Education
* As part of Provider education, clarifies and emphasizes prevention services as a
benefit and makes providers aware of social support services, encouraging them
to make mfearrals to these services and follow up afterward.
6. CQm munityPrevenljon and Promotion Activities
* Has a good record in sponsoring and/or running various prevention and health
promotion activities aimed at the general community and not targeted just for its
members. Agrees to work with community groups and the local public health
department in designing and carrying out prevention programs.
* Agrees to reinvest a portion of any surplus from its Medi-Cal program into
community health programs operating in Contra Costa County.
7. Acct Standards
* In addition to state's access standards, agrees to abide by acoess standards
recommended by MAPC and approved by Board of Supervisors for the Local
Initiative. These may include time and distance requirements and support
services such as transportation and patient education.
* Has mechanism to monitor compliance with Iocal access standards and ensures
an acceptable level of compliance to these standards.
8. Arrangements for Suecial Populations
* Has arrangements to accommodate members with mobility problems; those who
do not speak English; those who require spacial mental health and/or substance
abuse services equivalent to standards recommended by the MAPC and approved
by Board of Supervisors for the Local Initiative.
9. pi's 'Exucrien_ce with tow Income Enrollees
* Has existing Medi-Cal contracts either in Contra Costa County or in other areas
of the state.
* Takes part in state programs for low income individuals. (e.g. AIM)
* Has its own health insurance program for low income(non-Medi-Cal)individuals.
14. Contra Costa County Plan's Providers' F mrience wftb ax beome Enrollees
* Has traditional primary and specialty providers in those regions of Contra Costa
County with the most number of Medi-Cal patients.
* Has or will contract with at least one safety net provider in.Contra Costa County.
11. Suety Net Providers
* Agrees to anter into negotiations with Merrithew Memorial Hospital and clinics
for specified inpatient and outpatient services.
12. Voluntary Efli,Ibles
* Agrees to enroll "voluntary' eligibles up to an auvilment limit agreeable to the
Board of Supervisors.
13. Implementation Timing
* Agrees to concurrent implementation with the Local Initiative unless the Local .
Initiative petitions to the state for an earlier start date.
14. jock-In
* Is a federally qualified HMO and agrees to lock in.
15. Area Cflverag& .
* Has a provider network in areas of the county such as south central county which
are not currently serviced by the Health Services Department.
16. Marketing Practices
* Agrees to abide by the Marketing Guidelines and Code of Ethics adopted by the
Medi-Cal Advisory Planning Commission and approved by Board of Supervisors
for the Local Initiative: Guidelines/Code of Ethics to, be based on GHAA
Marketing Guidelines.
aa�
WA:c