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HomeMy WebLinkAboutMINUTES - 04251995 - 1.77 TO: BOARD OF SUPERVISORS Jt FROM: Mark Finucane, Health Services Director Contra, t Costa DATE: April 7, 1995 County SUBJECT: Approval of Standard Agreement (Amendment) #29-609-42 with the State Department of Health Services SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: Approve and authorize the Chair, Board of Supervisors, to execute on behalf of the County, Standard Agreement (Amendment) #29-609-42 (State #93-18608 A-01) with the State Department of Health Services, effective January 1, 1995, to amend Standard Agreement #29-609-41, for prepaid health services for Medi-Cal beneficiaries. This amendment increases the FY 1994-95 contract payment limit by $1,474,797, from $16,265,808 to a new fiscal year total of $17,740,605, and extends the term of the agreement through December 31, 1997. II. FINANCIAL IMPACT: Approval of this amendment will increase the State's funding encumbrance for FY 1994-95 by $1,474,797, for a new total of $16,265,808. However, the net effect of this increase on Health Plan revenues is dependent upon enrollment levels. III. REASONS FOR RECOMMENDATIONS/BACKGROUND: On January 11, 1994, the Board approved Standard Agreement #29-609-41 with the State Department of Health Services, for prepaid health services for Medi-Cal beneficiaries, for the period from January 1, 1994 through December 31, 1995. Standard Agreement (Amendment) #29-609-42 extends the term of the agreement through December 31, 1997 and sets new per capita rates of payment, effective October 1, 1994, as as follows: Medically Needy Public Assistance No Share of Cost Aged $ 111.47 Aged $ 160.56 AFDC $ 91.89 AFDC $ 134.47 Disabled/Blind $ 187.63 Disabled/Blind $ 882.20 AIDS $1,906.90 MI Children $ 178.00 MI Adults $ 609.00 AIDS $1,906.90 Other Paid Category Refugee $ 174.87 The Board Chair should sign ten copies of the agreement. Nine copies of the agreement and three sealed/certified copies of this Board Order should be returned to the Contracts and Grants Unit for submission to the State Depar ent of Health Services. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact: Milt Camhi (313-5604) CC: Health Services (Contracts) ATTESTED State Dept. of Health Services Phil Batchelor, Clerk of the Board of Su�ecrlisats aadGaunt� �� M3e2/7-e3 BY DEPUTY STATE OFCXIFORNIA { a5 q5 1717 - APPROVED BY THE CONTRACT NUMBER AM.NO. STANDARD AGREEMENT ATTORNEY GENERAL 93-18608 A01 STD.2(REV.5-91) TAXPAYER'S FEDERAL EMPLOYER IDENTIFICATION NUMBER THIS AGREEMENT,made and entered into this 1St day of January , 1995. 94-6000509 in the State of California,by and between State of California,through its duly elected or appointed,qualified and acting TITLE OF OFFICER ACTING FOR STATE AGENCY Chief, Program Support Branch Department of Health Services hereafter called the State,and w CONTRACTOR'S NAME � The County of Contra Costa hereafter called the Contractor. WITNESSETH: That the Contractor for and in consideration of the covenants,conditions,agreements,and stipulations of the State hereinafter expressed, does hereby agree to furnish to the State services and materials as follows: (Set forth service to be rendered by Contractor,amount to be paid Contractor, time for performance or completion,and attach plans and specifications,if any.) Amendment A-01 to Contract Number 93-18608 BETWEEN Contra Costa Health Plan AND THE STATE OF CALIFORNIA; WHEREAS, the State of California and Contra Costa Health Plan entered into a contract for prepaid health care services dated January 1, 1994 ; and NOW THEREFORE, this contract is amended as follows: APPROVED De rtmen t A T'i�,E��fc,e CONTINUED ON _ _6 SHEETS, EACH BEARING NAME OF CONTRACTOR AND CONTRACT MBER. Budget Div:isiOri The provisions on the reverse side hereof constitute a part of this agreement. IN WITNESS WHEREOF,this agreement has been executed by the parties hereto,upon the date first above written. STATE OF CALIFORNIA CONTRACTOR AGENCY CONTRACTOR(It other than an individual,state whether a corporation,partnership,etc.) Department of Health Services The County of Contra Costa BY(AUTHOZEDSIGNATURE) VPRIN ORIAAND URE) D PRINTED NAME SIGNING NXME OF PERSON SIGNIPO Edward E. Stahlberg Chair, Board of Supervisors TITLE ADDRESS Chief, Program Support Branch 651 Pine Street, Martinez, CA 94553 AMOUNT ENCUMBERED BY THIS PROGRAM/CATEGORY(CODE AND TITLE) FUND TITLE Department of General Services DOCUMENT Loc_Asst_Sect. 14147 W&I Code � Hlth Care De-posi use only $ 1,474,797 (OPTIONAL USE) 50% Fed 50% State THIS CONTRACT ENCUMBERED FOR Fed.Cat.No. 93778 4260-101-001 & 890 THIS CONTRACT $24,903,&)8 ITEM CHAPTER STATUTE FISCAL YEAR TOTAL AMOUNT ENCUMBERED TO 4260-601-92 139 1994 994_95 Exempt from PCC DATE OBJECT OF EXPENDITURE(CODE AND TITLE) per W & I Code $26,378,605 NJA Section 14204 (b) I hereby certify upon my own personal knowledge that budgeted funds T.B.A.NO. are available for the period and purpose of the expenditure stated above- SIGNA OF C TING OFFICER DATE 1995 MAY D JUL 9 4. tM El CONTRACTOR STATE AGENCY DEPT.OF GEN.SER. F1 CONTROLLER The County of Contra Costa 93-18608-A01 1. ARTICLE II - DEFINITIONS, Paragraph F, Covered Services, is amended to read as follows: F. "Covered Services" means those services set forth in Title 22, CCR, Division 3, Subdivision 1, Chapter 4, Article 3, Section 53210. Covered Services do not include: 1. Services for chronic renal dialysis and ,major organ transplants. 2 . Services in any federal or state government hospital. 3 . Services in any county hospital for the treatment of tuberculosis, or chronic medically uncomplicated narcotism or alcoholism. 4. Serviceh rendered to members who have been institutionalized for more than one full calendar month in a skilled nursing or an intermediate care facility. 5. Laboratory services provided under the State serum alpha feto protein testing program administered by the Genetic Disease Branch of the Department of Health Services. 6 . The facility or per diem charge component of services rendered to covered beneficiaries 64 years of age and institutionalized in a non-joint Commission on Accreditation of Healthcare Organizations (JCAHO) accredited facility designated by HHS as an Institution for Mental Disease (IMD) , or services rendered to covered beneficiaries 21 to 64 years of age institutionalized in a JCADO accredited facility designated by HHS as an IMD (except for covered beneficiaries who were receiving such services before turning 21 years of age and who may continue to require and receive such services in which case: (a) coverage may be extended until the beneficary' s twenty-second (22) birthday and (b) the Contractor will be liable for such services subject to subpart 4 above) . 7 . Short-Doyle/Medi-Cal Services 2 The County of Contra Costa 93-18608-A01 8. Local Educations Agency (LEA) assessment services as described in Title 22, CCR, Section 51360 (b) (1) provided to a member who qualifies for LEA services based on Title 22, CCR, Section 51190.1 (a) . 9 . Any LEA services described in Title 22, CCR, Section 51360 provided pursuant to an Individualized Education Plan (IEP) as set forth in Education Code, Section 56340 et seq. , or an Individualized Family Service Plan (IFSP) as set forth in Government Section 95020. " 2 . ARTICLE II - DEFINITIONS, Paragraph K, Eligible Beneficiary, is amended to read as follows: K. "Eligible Beneficiary" means any Medi-Cal beneficiary with one of the following aid codes: Aid to Families with Dependent Children (AFDC) - aid codes 30, 32, 33, 34, 35, 38, 39, 40, 42, 46,54, 59, 77, 78; Aid to the Blind (AB) -aid codtes 20, 24, 26; Aged Supplemental Security Income/State Supplementary Payment (SSI/SSP) -aid codes 10, 14, 16; Aid to Disabled (ATD) -aid codes 36, 60, 64, 66; Medically Indigent Children - aid code 82; Medically Indigent Pregnant Women - aid code 86; and Refugees - aid codes 1, 2, 8. " 3 . ARTICLE IV - TERM AND TERMINATION, Paragraph A, Term of Contract, is amended to read as follows: A. Term of Contract "This contract will become effective on January 1, 1994 and will continue in full force and effect through December 31, 1997 subject to the provisions of Article IX, Sections A and H, because the State has currently appropriated and available for encumbrance only funds to cover costs through June 30, 1994. " 4 . ARTICLE IV - TERM AND TERMINATION, Local Initiative - Termination, Paragraph F, is amended to read as follows: "F. Local Initiative/Mainstream Plan Termination The Director, will have good cause for termination of this contract pursuant to Section B of this Article when the Local Initiative or Mainstream managed care plan begins operation in the services area pursuant to the Department' s plan for Expanding Medi-Cal Managed Care. The Director will have good cause for requesting termination of any dental subcontracts when a contracted 3 The County of Contra Costa 93-18608-A01 dental managed care plan contract is awarded and begins operation in the service area pursuant to the Department' s plan for Expanding Medi-Cal Managed Care. " 5. ARTICLE VI - DUTIES OF THE STATE, Paragraph L, Risk Limitation, is amended to read as follows: L. Risk Limitation "Terminate the Contractor' s financial liability to provide covered services to a member on a risk basis in those situations where, during the 12-month period beginning July 1, 1993 and ending June 30, 1994 or any succeeding 12-month period commencing July 1st, and ending the following June 30th, the member has received medically necessary covered services, as determined by the Department, from the Contractor in an amount in excess of $100, 000, based upon Medi-Cal schedules of reimbursement, and exclusive of payments recovered by Contractor from third-party payors. Affected members will not.be disenrolled because of their need of services in excess of $100, 000, and the Contractor will be responsible to provide or arrange and pay for, medically necessary covered services for members. Contractor will be reimbursed for such continuing care in excess of $100, 000 by the Department, based on Medi-Cal schedules of reimbursement or the Contractor' s costs, whichever is lower, and exclusive of payments recovered by the Contractor from third-party payors, as determined by the Department upon Contractor submission to the Department of appropriately documented claims for services provided during the 12-month period specified above. The dates set forth in this paragraph only serve to establish the beginning and ending dates of the risk limitation period and will not be construed to extend the Contractor' s responsibility to render services under this contract nor the Department' responsibility to pay for services rendered beyond the date on which this contract terminates. The establishment of a risk limitation period that extends beyond the term of the current contract contemplates the possibility of (but does not bind the parties ' to) renewal of the contract for an additional term. In the event the contract is terminated or not renewed, therisk limitation period will terminate upon termination of the contract. " 4 The County of Contra Costa 93-18608-A01 6. ARTICLE VII - ELIGIBILITY AND ENROLLMENT, Paragraph C, Enrollment Totals, is amended to read as follows: C. Enrollment Totals "Total enrollment under this contract will not exceed 15, 000 members. " 7 . ARTICLE IX - PAYMENT, Paragraph A, Amounts Payable, is amended to read as follows: "A. Amounts Payable The maximum amount payable for the 1993-94 Fiscal Year ending June 30, 1994 will not exceed $8, 638, 000. "o the 1994-95 Fiscal Year ending June 30, 1995 will not exceed . . . . . . . . . . . . . . . . . . . . . . . . . . .$17,740, 605; Any requirement by the Department and the Contractor for the period of the contract subsequent to June 30, 1995 will be dependent upon the availability of future appropriations by the Legislature for the purpose of this contract. If funds become available for purposes of this contract from future appropriations by the Legislature, the maximum amount payable under this contract for: o the 1995-96 Fiscal Year ending June 30, 1996 will not exceed. . . . . . . . . . . . . . . . . . . . . . . . . . . . $18,232,204; o the 1996-97 Fiscal Year ending June 30, 1997 will not exceed. . . . . . . . . . . . . . . . . . . . . . . . . . .$9,116, 102; o The maximum amount payable under this contract will not exceed. . . . . . . . . . $53,726, 911. 11 8. ARTICLE IX - PAYMENT, Section B, Capitation Rates, is amended to read as follows: "B. Capitation Rates The State will remit to the Contractor a capitation payment for each member, for each month in which such member is eligible for Medi-Cal benefits and appears on the approved list of members supplied to the Contractor by the Department. Capitation payments will be made in accordance with the following schedule of capitation payment rates: 5 The County of Contra Costa 93-18608-A01 1 Capitation rates include coverage for Medi-Cal Dental benefits. Public Assistance Aged $ 111.47 AFDC $ 91. 89 Blind/Disabled $ 187 . 63 AIDS $1906.90 Medically Needy - No Share of Cost Aged $ 160.56 AFDC $ 134 .47 Blind/Disabled $ 882 .20 AIDS $1906.90 Medically Indigent - No Share of Cost Children $ 178. 00 Adults $ 609 .00 Other Paid Category Refugee t. $ 174.87 9 . ARTICLE IX - PAYMENT, Section C, Rates Constitute Payment in Full, is amended as follows: "C. Rates Constitute Payment in Full The capitation payment constitutes payment in full by the Department on behalf of a member for all covered services required by such member, subject to the provisions of Article VI, Section L and for all administrative costs incurred by the Contractor in providing or arranging for such services, but does not include payment for the recoupment of current or previous losses incurred by the Contractor. The basis for the determination of the capitation payment rates is outlined in. Attachment II (consisting of 14 pages) . " 10. The effective date of this rate change is October 1, 1994. 11. The effective date of this amendment is January 1, 1995. 12 . This Amendment Increases the amount payable for Fiscal Year 1994-95 by $1,474,797 . 13 . All rights, duties, obligations, and liabilities of the parties hereto otherwise remain unchanged. 6 1 ATTACHMENT Il -D October 1 , 1994 PREPAID HEALTH PLANS t- RATE DEVELOPMENT FISCAL YEAR 1994-95 ' Part B . OVERVIEW OF THE RATE CALCULATION PROCESS AND WORKSHEET The purpose of the rate calculation process, as explained in this manual, is to develop a monthly rate per eligible Medi-Cal beneficiary for a time period in the future called the Rate Period. This year' s rate period is October 1 , 1994 to September 30, 1995 This process can be seen as a two step process with some miscellaneous adjustments . The first step in evaluating a' given plan is to calculate what rates would have been paid in some past period. This must take into consideration all the specific contract requirements, particularly as they differ from the entire fee-for-service (FFS) group. It must consider all the demographic aspects of the population being served, including aid code, sex, age, and geographic area. The second step is to project this rate into the future . There are two major considerations here : legislative changes and trend. The first of these relates to bills that have been passed or are expected to be enacted. The latter of these is a conglomerate of changes in physician practices, changes in Medi-Cal beneficiary practices, changes in hospital practices, and anything else which might affect the cost of medical care. Adjustments are then made for Child Health and Disability Prevention (CHDP) , Short/Doyle, health insurance recoveries, stop loss reinsurance, administration and denial . The Capitation- Rate Worksheet, on page 7, shows how a single capitation rate is calculated. A short line-by-line description of this process follows . Each line number also refers to a section in Part C which gives, a more detailed explanation of the adjustment . At the top right of the worksheet , the Base Period and Rate Period are shown. The base period refers to the first step i.nthe process, that is, calculating the monthly cost per eligible for a given period in the past . The rate period refers to the period for which capitation payments will be made . Note that rates are calculated for specific aid code groupings and each of sixdifferent types of services, or vendor -code , groupings . The general methodology is to start with a dollar number and multiply it by a series of factors, each of which is rounded to three decimal places ., The Contract`Cost and the Projected Cost are each rounded to cents . Each numbered line is defined as follows : 2 1 . Base Cost - These are the cost per person per eligible month (CPPM) figures for each of six vendor code groupings . CPPM figures are calculated on other worksheets for each of the four geographic regions, and nine aid code groupings . 2 . Area Adjustments - This factor adjusts the base costs to specific counties or to specific plans that operate in Los Angeles county. There are no adjustments on this line for counties other than Los Angeles, Alameda, Contra Costa, Orange, Riverside, San Bernardino, San Diego, San Francisco, and Santa Clara. No adjustment means that a factor of 1. 000 appears on the worksheet . For example $6 . 23 x 1 . 000 = $6 .23 : 3 . Age/Sex Adjustments - These adjustments are all specific to the plan which is being rated. Based on age/sex factors calculated for the entire State, a plan' s age/sex mix in a given aid code grouping is used to calculate ' its specific age/sex factors . There is no adjustment if a plan averaged less that 100 eligibles per month in an aid code grouping during the most recent available past year of data. t. 4 . Contract Adjustments - In many cases, a particular- plan will contractually' exclude coverage of certain medical services . These services will then be paid through the fee-for-service (FFS) system, and the plan will therefore not be capitated for these potential costs . Note that no factors on this line are greater than 1 . 000 . This is because reduced services imply a reduction in the capitation rate . 5 . Eligibility Adjustments - This section represents adjustments to the base cost because the distribution of eligible months by aid code in a plan (within an aid code grouping) differs from the statewide FFS distribution. 6 . Interest Offset - This adjustment relates to the way the State pays out funds . On the average, it takes three to four months before all the bills relating to a single service are paid under Medi-Cal FFS . Because money is paid out earlier to capitated plans, the State loses interest . This adjustment intends to make up for this loss by reducing the capitation payment . 7 . Legislative Adjustments - This section evaluates the financial impact of legislative changes on the FFS program. In some instances, laws have already been passed, and only the financial affect must be estimated. In other cases legislation is only expected to occur, and in these cases the expected financial impact may be tempered. Only changes which are included in the May 1991 Medi-Cal Estimate are considered. S . Trend - This adjustment predicts the affect of all other changes that may take place in the Medi-Cal population and in 3 the medical services area, including fee-for-service (FFS) rate increases not covered by legislative adjustments . 9 . Medical Cost Adjustments - An additional amount is added to the rate if a plan will cover services generally provided by the Child Health and Disability Prevention (CHDP) or Short/Doyle Mental Health (SDMH) programs . If a plan is expected to recover amounts from a Medi-Cal beneficiary' s private health coverage, then an amount is subtracted from the rate for other health insurance . 10 Stop Loss Reinsurance - 'After the FFS Medical Cost is determined, a further adjustment is made for stop loss reinsurance . This means the State will pay costs for claims from a single beneficiary once they exceed a certain amount during the Rate Period. Since these are costs which the plan will not have to pay, the rate must be- reduced. 11 . Administration Allowance - A flat dollar amount is allowed for administrative expenses for each Medi-Cal eligible per month, depending on the aid code grouping. Aid code groupings which are expected; to have higher claim costs receive greater allowances . These amounts differ for PHPs and PCCMs because the State continues to handle certain claims under the PCCM arrangement. 12 . Percent of Fee-for-Service Equivalent Cost Payable - The total FFS Equivalent Cost is multiplied by a percentage to get the Initial Capitation Rate . This year the percentage has been set at 97o for the PHPs and 95o for the PCCMs . 13 . Dental Coverage - This adjustment is made only when a plan elects to cover dental services . The amount covers these services plus an administrative component . CAPITATION RATE WORKSHEET Date: 9/28/1994 Base Period: FY 88/89 Aid Group: Public Assistance Aged Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =____> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $7.03 $23.13 $34.79 $7.52 $40.34 $5.07 $117.88 2. Area Adjustments .962 1.151 .933 1.247 .976 .898 3. Age/Sex Adjustments .998 1.019 1.015 1.002 1.107 1.025 4. Contract"Adjustments a. Hemo, Maj Org, LTC .998 1.000 1.000 1.000 .278 1.000 b. AIDS 1.000 1.000 1.000 1.000 1.000 1.000 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.002 .988 .998 .996 .997 .963 b. Medicare 1.052 .997 1.042 1.000 1.005 1.012 6. Interest Offset .982 .992 .968 .975 .989 983 CONTRACT COST FY 88/89 $6.97 $26.51 $33.16 $9.12 $12.01 $4.47 $92.24 7. Legislative Adjustments a. Fees 30/89 1.000 1.000 1.000 1.000 1.000 1.000 40/89 1.000 1.000 1.000 1.000 1.000 1.000 10/90 1.000 1.000 1.000 1.000 1.000 1.000 20/90 1.000 1.000 1.000 1.000 1.000 1.000 30/90 1.000 1.000 1.000 1.000 1.072 1.000 40/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 20/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 30/89 .998 .996 1.023 1.033 .998 .998 40/89 1.015 .995 1.000 1.000 1.000 1.000 10/90 1.000 1.000 1.000 1.000 1.004 1.038 20/90 1.000 1.000 1.000 1.000 1.000 1.000 30/90 1.000 1.000 1.004 1.014 1.000 .957 40/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 20/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 .974 1.238 1.143 .251 1.075 1.875 PROJECTED COST FY 90/91 $6.88 $32.52 $38.93 $2.41 $13.87 $8.37 $102.98 9. Medical Cost Adjustments a. CHDP .00 b. Health Insurance Recoveries "(.31) FEE-FOR-SERVICE MEDICAL COST $102.67 10. Stop Loss Reinsurance at $100,000 is .1% (.09) FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $102.58 11. Administration Allowance 4.62 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $107.20 12. Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $102.38 13. Dental Coverage $ 9.09 FINAL CAPITATION RATE - Including Dental Coverage $111.47 CAPITATION RATE WORKSHEET Date: 9/28/1994 Base Period: FY 88/89 Aid Group: Public Assistance Disabled Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =____> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $23.40 $34.66 $100.24 $15.78 $32.86 $18.81 $225.75 2. Area Adjustments .907 1.036 .887 1.098 .549 .991 3. Age/Sex Adjustments .956 1.077 .898 .993 1.001 .898 4. Contract Adjustments a. Hemo, Maj Org, LTC .992 1.000 1.000 .999 .140 1.000 b. AIDS .989 .976 .966 .958 .999 .991 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.008 .995 1.010 1.001 .998 .985 b. Medicare .920 1.008 .916 .973 .960 .970 6. Interest Offset .982 .991 .976 .979 .990 .981 CONTRACT COST FY 88/89 $18.13 $37.52 $69.64 $15.70 $2.40 $15.55 $158.94 7. Legislative Adjustments a. Fees 3Q/89 1.000 t., 1.000 1.000 1.000 1.000 1.000 40/89 1.000 1.000 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000. 1.000 1.000 1.000 1.000 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.000 1.000 1.072 1.000 4Q/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 3Q/89 .998 .996 1.023 1.033 .998 .998 4Q/89 1.015 .995 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.004 1.038 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.004 1.014 1.000 .957 40/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 20/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 1.009 1.200 1.165 .841 1.142 1.302 PROJECTED COST FY 90/91 $18.53 $44.62 $83.33 $13.93 $2.94 $20.21 $183.56 9. Medical Cost Adjustments a. CHDP .06 b. Health Insurance Recoveries (.54) FEE-FOR-SERVICE MEDICAL COST $183.08 10. Stop Loss Reinsurance at $100,000 is 1.6% (2.89) FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $180.19 11. Administration Allowance 6.76 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $186.95 12. Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $178.54 13. Dental Coverage $ 9.09 FINAL CAPITATION RATE - Including Dental Coverage $187.63 CAPITATION RATE WORKSHEET Dote: 9/28/1994 Base Period: FY 88/89 Aid Group: Public Assistance Family Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =____> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $13.93 $4.29 $32.30 $7.52 $.04 $4.05 $62.13 2. Area Adjustments 1.052 .980 1.046 1.131 1.000 .999 3. Age/Sex Adjustments 1.043 .975 1.032 1.027 1.000 1.011 4. Contract.Adjustments a. Hemo, Maj Org, LTC .999 1.000 1.000 1.000 .580 1.000 b. AIDS 1.000 1.000 1.000 1.000 1.000 1.000 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.006 .982 1.026 1.022 1.000 .954 b. Medicare 1.000 1.000 1.000 1.000 1.000 1.000 6. Interest Offset .985 .992 .980 .985 .990 .985 CONTRACT COST FY 88/89 $15.13 $3.99 $35.06 $8.79 $.02 $3.84 $66.83 7. Legislative Adjustments a. Fees 30/89 1.000 ! 1.000 1.000 1.000 1.000 1.000 4Q/89 1.000 1.000 1.000 1.000 1.000 1.000 10/90 1.000 1.000 1.000 1.000 1.000 1.000 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.000 1.000 1.072 1.000 40/90 1.000 1.000 1.000 1.000 1.000 1.000 1Q/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 3Q/89 1.048 .996 1.023 1.085 .998 .998 4Q/89 1.015 .995 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.004 1.038 20/90 1.000 1:000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.004 1.014 1.000 .957 4Q/90 1.000 1.000 1.000 1.000 1.000 1.000 1Q/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 1.053 1.118 1.215 1.131 1.000 1.604 PROJECTED COST FY 90/91 $16.95 $4.42 $43.75 $11.01 $.02 $6.15 $82.30 9. Medical Cost Adjustments a. CHDP 2.02 b. Health Insurance Recoveries (.04) FEE-FOR-SERVICE MEDICAL COST S84.28 10. Stop Loss Reinsurance at $100,000 is .8% (.66) FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $83.62 11. Administration Allowance 3.08 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $86.70 12. Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $82.80 13. Dental Coverage $ 9.09 FINAL CAPITATION RATE - Including Dental Coverago $ 91.89 CAPITATION RATE WORKSHEET Date: 9/28/1994 Base Period: FY 88/89 Aid Group: Medically Needy No Share Aged Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =____> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $16.14 $17.79 $69.96 $12.09 $26.16 $12.87 $155.01 2. Area Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 3. Age/Sex Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 4. Contract-Adjustments a. Nemo, Maj Org, LTC .991 1.000 1.000 .999 .482 1.000 b. AIDs 1.000 1.000 1.000 1.000 1.000 1.000 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.000 1.000 1.000 1.000 1.000 1.000 b. Medicare 1.000 1.000 1.000 1.000 1.000 1.000 6. Interest Offset .969 .991 .963 .967 .986 .975 CONTRACT COST FY 88/89 $15.50 $17.63 $67.37 $11.68 $12.43 $12.55 $137.16 7. Legislative Adjustments a. Fees 3Q/89 1.000 t, 1.000 1.000 1.000 1.000 1.000 4Q/89 J.000 1.000 1.000 1.000 1.000. 1.000 1Q/90 1.000 1.000 1.000 1.000 1.000 1.000 20/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.000 1.000 1.072 1.000 40/90 1.000 1.000 1.000 1.000 1.000 1.000 1Q/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 30/89 .998 .996 1.023 1.033 .998 .998 40/89 1.015 .995 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.004 1.038 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.004 1.014 1.000 .957 40/90 1.000 1.000 1.000 1.000 1.000 1.000 1Q/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 .981 1.233 1.143 .592 1.049 1.339 . PROJECTED COST FY 90/91 $15.40 $21.54 $79.09 $7.29 $14.01 $16.78 $154.11 9. Medical Cost Adjustments a. CHDP .00 b. Health Insurance Recoveries (.67) FEE-FOR-SERVICE MEDICAL COST .$153.44 10. Stop Loss Reinsurance at $100,000 is .0% .00 FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $153.44 11. Administration Allowance 5.17 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $158.61 12. Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $151.47 13. Dental Coverage $ 9.09 FINAL CAPITATION BATE - Including Dental Coverage $160.56 CAPITATION RATE WORKSHEET Date: 9/28/1994 Base Period: FY 88/89 Aid Group: Medically Needy No Share Disabl Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =____> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $50.77 $41.01 $637.53 $43.09 $26.17 $36.64 $835.21 2. Area Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 3. Age/Sex Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 4. Contract.Adjustments a. Hemo, Maj Org, LTC .969 , 1.000 1.000 .998 .491 1.000 b. AIDs .978 .741 .919 .828 .979 1.004 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.000 1.000 .999 .999 1:000 1.001 b. Medicare 1.000 1.000 1.000 1.000 1.000 1.000 6. Interest Offset .968 .985 .958 .971 .985 .973 CONTRACT COST FY 88/89 $46.57 $29.93 $560.72 $34.54 $12.39 $35.83 $719.98 7. Legislative Adjustments a. Fees 3Q/89 1.000 t 1.000 1.000 1.000 1.000 1.000 40/89 1.000 1.000 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.000 1.000 20/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.000 1.000 1.072 1.000 40/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1..000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 30/89 .998 .996 1.023 1.033 .998 .998 40/89 1.015 .995 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.004 1.038 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 30/90 1.000 1.000 1.004 1.014 1.000 .957 40/90 1.000 1.000 1.000 1.000 1.000 1.000 1Q/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 1.048 1.204 1.273 1.042 1.209 _ 1.161 PROJECTED COST FY 90/91 $49.44 $35.71 $733.13 $37.96 $16.09 $41.53 $913.86 9. Medical Cost Adjustments a. CHOP .01 b. Health Insurance Recoveries (1.76) FEE-FOR-SERVICE MEDICAL COST $912.11 10. Stop Loss Reinsurance at $100,000 is 1.6% (14.36) FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $897.75 11. Administration Allowance 16.50 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $914.25 12. Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $873.11 13. Dental Coverage $ 9.09 FINAL CAPITATION RATE - Including Dental Coverage $882.20 CAPITATION RATE WORKSHEET Date: 9/28/1994 Base Period: FY 88/89 Aid Group: Medically Needy No Share Family Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =_=__> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $21.35 54.62 $73.57 - $12.31 $.31 $8.36 $120.52 2. Area Adjustments 1.028 1.068 ,898 1.190 1.000 1.121 3. Age/Sex Adjustments .914 .961 .891 .942 1.000 .950 4. Contract. Adjustments a. Nemo, Maj Org, LTC .998 1.000 1.000 1.000 .491 1.000 b. AIDs 1.000 1.000 1.000 1.000 1.000 1.000 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.000 1.000 1.000 1.000 1.000 1.000 b. Medicare 1.000 1.000 1.000 1.000 1.000 1.000 6. Interest Offset .980 ,990 .970 .978 .985 .982 CONTRACT COST FY 88/89 $19.62 $4.69 $57.10 $13.50 $.15 $8.74 $103.80 7. Legislative Adjustments a. Fees 3Q/89 1.000 1 1.000 1.000 1.000 1.000 1.000 40/89 1.000 1.000 1.000 1.000 1.000 1.000 10/90 1.000 1.000 1.000 1.000 1.000 1.000 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.000 1.000 1.072 1.000 40/90 1.000 1.000 1.000 1.000 1.000 1.000 1Q/91 1.000 1.000 1.000 1.000 1,000 1.000 2Q/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 3Q/89 1.048 .996 1.023 1.085 .998 .998 4Q/89 1.015 .995 1.000 1.000 1.000 1.000 10/90 1.000 1.000 1.000 1.000 1.004 1.038 20/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.004 1.014 1.000 .957 40/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 20/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 1.032 1.146 1.252 1.066 1.000 1.174 PROJECTED COST FY 90/91 $21.54 $5.33 $73.43 $15.94 $.16 $10.24 $126.64 9. Medical Cost Adjustments a. CHDP 1.82 b. Health Insurance Recoveries (.21) FEE-FOR-SERVICE MEDICAL COST .$128.25 10. Stop Loss Reinsurance at $100,000 is .8% (1.01) FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $127.24 11. Administration Allowance 4.05 TOTAL FEE-FOR-SERVICE EQUIVALENT COST, $131.29 12- Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning,of month $125.38 13. Dental Coverage $ 9.09 FINAL CAPITATION RATE - including Dental Coverage $134.47 CAPITATION RATE WORKSHEET Date: 9/28/1994 Base Period: FY 88/89 Aid Group: , Medically Indigent Children Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =__=_> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $16.18 $3.04 $101.40 $10.13 $.63 $5.16 $136.54 2. Area Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 3. Age/Sex Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 4. Contract Adjustments a.,: Hemo, Maj Org, LTC .997 1.000 1.000 .999 .292 1.000 b. AIDS 1.000 1.000 1.000 1.000 1.000 1.000 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.009 .945 1.023 1.026 1.000 .893 b. Medicare 1.000 1.000 1.000 1.000 1.000 1.000 6. Interest Offset .979 .988 .969 .976 .985 .980 CONTRACT COST FY 88/89 $15.93 $2.84 $100.52 $10.13 $.18 $4.52 $134.12 7. Legislative Adjustments a. Fees 3x/89 1.000 1-- 1.000 1.000 1.000 1.000 1.000 44/89 _1.000 1.000 1.000 1.000 1.000 1.000 1x/90 1.000 1.000 1.000 1.000 1.000 1.000 20/90 1.000 1.000 1.000 1.000 1.000 1.000 30/90 1.000 1.000 1.000 1.000 1.072 1.000 40/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 20/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 30/89 .998 .996 1.023 1.033 .998 .998 40/89 1.015 .995 1.000 1.000 1.000 1.000 10/90 1.000 1.000 1.000 1.000 1.004 1.038 20/90 1.000 1.000 1.000 1.000 1.000 1.000 30/90 1.000 1.000 1.004 1.014 1.000 .957 4x/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 20/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 .972 1.061 1.339 1.086 1.000 1.167 PROJECTED COST FY 90/91 $15.68 $2.99 $138,24 $11.60 $.19 $5,27 $173.97 9. Medical Cost Adjustments a. CHDP 3.19 b. Health Insurance Recoveries . (.13) FEE-FOR-SERVICE MEDICAL COST $177.03 10. Stop Loss Reinsurance at $100,000 is 2.2% (3.82) FEE-FOR•SERVICE MEDICAL AFTER REINSURANCE $173.21 11. Administration Allowance 3.66 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $176.87 12. Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $168.91 13. Dental Coverage $ 9.09 FINAL CAPITATION BATE - Including Dental Coverage $178.00 CAPITATION RATE WORKSHEET Dote: 9/28/1994 Bose Period: FY 88/89 Aid Group: Medically Indigent Adults Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =____> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $100.72 $3.25 $325.74 $41.21 $.00 $29.77 $500.69 2. Area Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 3. Age/Sex Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 4. Contract Adjustments a. Hemo, Maj Org, LTC 1.000 1.000 1.000 1.000 .999 1.000 b. AIDs 1.000 1.000 1.000 1.000 1.000 1.000 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.000 1.000 - 1.000 1.000 1.000 1.000 b. Medicare 1.000 1.000 1.000 1.000 1.000 1.000 6. Interest Offset .977 .988 .972 .971 .985 .980 CONTRACT COST FY 88/89 $98.40 $3.21 $316.62 $40.01 $.00 $29.17 $487.41 7. Legislative Adjustments a. Fees 30/89 1.000 1.000 1.000 1.000 1.000 1.000 4Q/89 ,.000 1.000 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.000 1.000 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.000 1.000 1.072 1.000 4Q/90 1.000 1.000 1.000 1.000 1.000 1.000 1Q/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 3Q/89 1.048 .996 1.023 1.085 .998 .998 4Q/89 1.015 .995 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.004 1.038 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.004 1.014 1.000 .957 4Q/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 1.081 1.272 1.267 1.085 1.000 1.370 PROJECTED COST FY 90/91 $113.15 $4.05 $412.03 $48.09 $.00 $39.90 $617.22 9. Medical Cost Adjustments a. CHDP 1.56 b. Health Insurance Recoveries (.93) FEE-FOR-SERVICE MEDICAL COST $617.85 10. Stop Loss Reinsurance at $100,000 is .1% (,62) FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $617.23 11. Administration Allowance 10.95 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $628.18 12. Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $599.91 13. Dental Coverage $ 9.09 FINAL CAPITATION RATE - Including Dental Coverage $609.00 CAPITATION RATE WORKSHEET Date: 9/28/1996 Base Period: FY 88/89 Aid Group: Refugees Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =____> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $19.57 $9.32 $19.61 $13.56 $.00 $16.08 $78.14 2. Area Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 3." Age/Sex Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 4. Contract. Adjustments a. Hemo, Maj Org, LTC .998 1.000 1.000 .999 .527 1.000 b. AIDs 1.000 1.000 1.000 1.000 1.000 1.000 c: Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.000 1.000 1.000 1.000 1".000 1.000 b. Medicare 1.000 1.000 1.000 1.000 1.000 1.000 6. Interest Offset .985 .992 .976 .980 .990 .986 CONTRACT COST FY 88/89 $19.24 $9.25 $19.14 $13.28 $.00 $15.85 $76.76 7. Legislative Adjustments a. Fees 3Q/89 1.000 1 1.000 1.000 1.000 1.000 1.000 4Q/89 1.000 1.000 1.000 1.000 1.000 1.000 1Q/90 .1.000 1.000 1.000 1.000 1.000 1.000 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.000 1.000 1.072 1.000 40/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 3Q/89 .998 .996 1.023 1.033 .998 .998 4Q/89 1.015 .995 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.004 1.038 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.004 1.014 1.000 .957 40/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 20/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 1.053 1.118 1.215 1.131 1.000 1.604 PROJECTED COST FY 90/91 $20.52 $10.25 $23.89 $15.84 $.00 $25.38 $95.88 9. Medical Cost Adjustments a. CHDP .53 b. Health Insurance Recoveries (.01) FEE-FOR-SERVICE MEDICAL COST $96.40 10. Stop Loss Reinsurance at $100,000 is .0Y .00 FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $96.40 11. Administration Allowance 3.08 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $99.48 12. Percent of Fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $95.00 13. Dental Coverage $ 79.87 FINAL CAPITATION RATE - Including Dental Coverage $174.87 CAPITATION RATE WORKSHEET Date: 9/28/1994 ' Base Period: FY 88/89 Aid Group: AIDS Rate Period: 10/94 - 9/95 County: Contra Costa Base: North Counties Contract: Contra Costa 45 Services =__=_> Phys Pharm HIP HOP LTC Other TOTAL 1. Base Cost $83.59 $316.78 $1,478.16 $140.68 $14.81 $82.39 $2,116.41 2. Area Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 3. Age/Sex Adjustments 1.000 1.000 1.000 1.000 1.000 1.000 4. Contract Adjustments a. Nemo, Maj Org, LTC 1.000 1.000 1.000 1.000 $.14 1.000 b. AIDs 1.000 1.000 1.000 1.000 1.000 1.000 c. Procedures 1.000 1.000 1.000 1.000 1.000 1.000 5. Eligibility Adjustments a. Aid Codes 1.000 1.000 1.000 1.000 1.000 1.000 b. Medicare 1.000 1.000 1.000 1.000 1.000 1.000 6. Interest Offset .975 .978 .966 .973 .982 .972 CONTRACT COST FY 88/89 $81.50 $309.81 $1,427.90 $136.88 $2.04 $80.08 $2,038.21 7. Legislative Adjustments a. Fees 3Q/89 1.000 l 1.000 1.000 1.000 1.000 1.000 4Q/89 1.000 1.000 1.000 1.000 1.000 1.000 1Q/90 1.000 1.000 1.000 1.000 1.000 1.000 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 3Q/90 1.000 1.000 1.000 1.000 1.072 1.000 4Q/90 1.000 1.000 1.000 1.000 1.000 1.000 10/91 1.000 1.000 1.000 1.000 1.000 1.000 2Q/91 , 1.000 1.000 1.000 1.000 1.000 1.000 b. Benefits 3Q/89 .998 .996 1.023 1.033 .998 .998 40/89 1.015 .987 1.000 1.000 1.000 1.000 10/90 1.000 1.000 1.000 1.000 1.004 1.000 2Q/90 1.000 1.000 1.000 1.000 1.000 1.000 30/90 1.000 1.000 1.000 1.000 1.000 1.000 4Q/90 1.000 1.000 1.000 1.000 1.000 1.000 1Q/91 1.000 1.000 1.000 1.000 1.000 1.000 20/91 1.000 1.000 1.000 1.007 1.000 1.007 8. Trend 1/89-1/91 .855 1.320 .855 1.102 1.000 1.155 PROJECTED COST FY 90/91 $70.59 $402.02 $1,248.93 $156.91 $2.19 $92.95 $1,973.59 9. Medical Cost Adjustments a. CHDP .00 b. Health Insurance Recoveries (.54) FEE-FOR-SERVICE MEDICAL COST $1,973.05 10. Stop Loss Reinsurance at $100,000 is 7% (13.80) FEE-FOR-SERVICE MEDICAL AFTER REINSURANCE $1,959.25 11. Administration Allowance 27.99 TOTAL FEE-FOR-SERVICE EQUIVALENT COST $1,987.24 12. Percent of fee-for-Service Equivalent Cost Payable 95.5% FINAL CAPITATION RATE - Capitation payments at beginning of month $1,897.81 13. Dental Coverage $ 4.09 irngAL CAPITATION RATE - Including Dental Coverage $1,906.90 TO: BOARD OF SUPERVISORS FROM: Mark Finucane, Health Services Director Contra Costa DATE: April 7, 1995 County SUBJECT: Approval of Standard Agreement (Amendment) #29-609-42 with the State Department of Health Services SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: Approve and authorize the Chair, Board of Supervisors, to execute on behalf of the County, Standard Agreement (Amendment) #29-609-42 (State #93-18608 A-01) with the State Department of Health Services, effective January 1, 1995, to amend Standard Agreement #29-609-41, for prepaid health services for Medi-Cal beneficiaries. This amendment increases the FY 1994-95 contract payment limit by $1,474,797, from $16,265,808 to a new fiscal year total of $17,740,605, and extends the term of the agreement through December 31, 1997. II. FINANCIAL IMPACT: Approval of this amendment will increase the State's funding encumbrance for FY 1994-95 by $1,474,797, for a new total of $16,265,808. However, the net effect of this increase on Health Plan revenues is dependent upon enrollment levels. III. REASONS FOR RECOMMENDATIONS/BACKGROUND: On January 11, 1994, the Board approved Standard Agreement #29-609-41 with the State Department of Health Services, for prepaid health services for Medi-Cal beneficiaries, for the period from January 1, 1994 through December 31, 1995. Standard Agreement (Amendment) #29-609-42 extends the term of the agreement through December 31, 1997 and sets new per capita rates of payment, effective October 1, 1994, as as follows: Medically Needy Public Assistance No Share of Cost Aged $ 111.47 Aged $ 160.56 AFDC $ 91.89 AFDC $ 134.47 Disabled/Blind $ 187.63 Disabled/Blind $ 882.20 AIDS $1,906.90 MI Children $ 178.00 MI Adults $ 609.00 AIDS $1,906.90 Other Paid Category Refugee $ 174.87 The Board Chair should sign ten copies of the agreement. Nine copies of the agreement and three sealed/certified copies of this Board Order should be returned to the Contracts and Grants Unit for submission to the State Depar ment of Health Services. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT CO?Y CSF AN ACT!0N TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact: Milt Camhi (313-5604) CC: Health Services (Contracts) ATTESTED �1�C 5�. State Dept. of Health Services Phil Batchelor,Clerk of the Board of Supecy=vd County Adman Wator M3e2/7-e3 BY �"nr DEPUTY IM6