HomeMy WebLinkAboutMINUTES - 03121996 - C30 To: BOARD OF SUPERVISORS
FROM: William Walker, M.D. =/F� Contra
Health Services Director Costa
DATE: March 3, 1996 County
sUBJECI. SB-1255 Medi-Cal Contract
SPECIFIC REQUESTS)OR RECONINI ENDATION(S)&BACKGROUND AND jUgrMCATION
RECOMMENDATION:
Authorize the Health Services Director to transfer a maximum of $8,000,000 to the State of California as
authorized under SB-1255.
FISCAL IMPACT•
Merrithew Memorial Hospital will be eligible for a maximum of$8.0 million in matching Federal funds. See
background information for full discussion.
BACKGROUND:
On March 3, 1995 the Board approved the transfer of $10,000,000 to the State of California as authorized
under SB-1255.
Federal grants to the States for Medicaid program (Medi-Cal in California) are authorized under Title XIX
of the Social Security Act to provide medical assistance to certain persons with low income. These Medicaid
programs are jointly financed by the Federal and State governments and administered by the States. State
Medicaid agencies conduct their programs according to the Medicaid State plan approved by the
Administrator of the Health Care Financing Administration (HCFA). To carry out the Medicaid program,
the State agency pays providers for medical care and services provided to eligible Medicaid recipients.
The Federal government pays its share of Medicaid program expenses to the State on a quarterly basis
according to a formula. The State share of Medicaid program expenses is paid from "State funds", that is,
those funds over which the State legislature has unrestricted power of appropriation. In California, the
program "split" is 50% Federal financing, 50% State financing.
SB-1255 (Chapter 996, Statutes of 1989) added Section 14085.6 to the Welfare and Institutions Code and
established a program whereby certain voluntary transfers and donations will be utilized by the State to
provide funds to disproportionate share hospitals to assist them in enhancing or maintaining access for Medi-
Cal beneficiaries. This program is similar in nature to those established in Tennessee and other states.
These voluntary transfers would be used to match Federal dollars under the Medi-Cal program, thereby
increasing.the total revenue base available for distribution (i.e., $1 donation will generate $1 in Federal
funding back to the disproportionate hospitals).
Merrithew Memorial Hospital is one of the ninety eight (98) disproportionate hospitals eligible for
reimbursement under this program. /J
CONTINUED ON ATTACHMENT: YES xx NO SIGNATURE ��
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE _OTHER
SIGNATURE(S):
ACTION OF BOARD ON March 12, 1996 APPROVED AS RECOMMENDED X OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
X UNANIMOUS (ABSENT III ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
Contact Person: Patrick Godley 370-5007
CC: CAO ATTESTED March 12. 1996
Office of the Director (HSD) PHIL BATCHELOR,CLERK OF THE BOARD OF
Chief Financial Officer (HSD) SUPERVISORS AND COUNTY ADMINISTRATOR
BY �, DEPUTY
2
The California Medical Assistance Commission (CMAC) is responsible for administration of SB-1255. The
Commission solicits the donations and distributes the funds collected through the Medi-Cal contracting
processing.
ISSUES
Issue 1: The State SB-1255 Plan may be disallowed at the Federal level.
Discussion: If a disallowance were to occur, some part of the "increased" Federal share might be required
to be reimbursed.
Issue 2: Facilities which make a 'voluntary" donation are not guaranteed of a return of either the
matching Federal funds or the donation itself.
Discussion: SB-1255 is intended to provide a workable program. If the most "needy" facilities in the State
make donations and do not receive back, at a minimum, $1.50 for each $1.00 in donation, the
program will fail. While,because of Federal restrictions,the State cannot guarantee the return
of the transferred funds, it is the intent of the program that no "donating" facility will be
disadvantaged.
To date, the Medi-Cal Commission has held eight rounds of voluntary donations and supplemental contract
negotiations. Merrithew has voluntarily contributed a total of$17,750,000; supplemental Medi-Cal contract
payments have been $30,100,000.