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HomeMy WebLinkAboutMINUTES - 06161998 - C52-C56 _........ ......... ......... ......... ...... _ . . .._........ _.......... ......... ......... ......... .._...... ......... .............. _.. __ _ _ ......... ......... ......... ......... ......... .......... . .............................................................................. TO: BOARD OF SUPERVISORS FROM: William Walker, M.D. , Health Services Di ector .', t�- By: Ginger Marieiro, Contracts Administrator '� Costa DATE: June 3, 1998 County SUBJECT: Approval of Contract #27-384 with John Milano, D.C. SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION I . RECOMMENDED ACTION: Approve and authorize the Health Services Director, or his designee (Milt Camhi) , to execute on behalf of the County, Contract #27-384 with John Milano, D.C. , for the period from May 1, 1998 through April 30, 1999, for the provision of chiropractic services for Contra Costa Health Plan members, to be paid as follows : 30 per member, per visit, not to exceed 10 visits per member, per year. II . FINANCIAL IMPACT: This Contract is funded by Contra Costa Health Plan member premiums . Costs depend upon utilization. As appropriate,'' patients and/or third party payors will be billed for services . ` III . REASONS FOR-RECOMMENDATIONS/BACKGROUND: The Health Plan has an obligation to provide certain specialized' professional health care services for its members under the terms' of their Individual and Group Health Plan membership contracts with the County. Under Contract #27-384 the Contractor will provide chiropractic` services to Health Plan members through April 30, 1999 . CONTINUED ON ATTACHMENT: YE§ SEG ATUR : RECOMMENDATION OF COUNTY ADMINISTRATOR � RECOMMENDATION OF BOARD COMMITTEE ,AY APPROVE OTHER SIGNATUR M; 2f ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (ABSENT } AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED_ t�u s f 1221, PHIL BA HELOR,CLEKK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact Person: Milt Camhi (31.3-6004) CC: Health Services(Contracts) Risk Management Auditor Controller BY DEPUTY Contractor t# RVCS FROM: William Walker, M.D. , Health Services Director • ''`_-� ' Contra By: Ginger Marieiro, Contracts Administrator Gusto DATE: June 3, 1998 County SUBJECT: Approval of Contract #24-939-80 with Lee Embrey, Ph.D. SPECIFIC REQUEST(S)OR RECOMMENDATION(5)&BACKGROUND AND JUSTIFICATION I . RECOI #ENLED-ACTION: Approve and authorize: the Health Services Director, or his designee (Donna Wigand) , to execute on behalf of the County, Contract ##24-939--80 with Lee Embrey, Ph.D. , for the period. from April 1, 1998 through June 30, 1999, to provide Medi-Cal mental health specialty services, to be paid in accordance with the rates set forth in the attached fee schedule. II . FICIAL IMPACT: This Contract is funded by State and Federal FFP Meda.-Cal Funds . III . REASONS FOR RECCtMM�DA"I10NSIBA.CKGR0UND: On January 14, 1997, the Board of Supervisors adopted Resolution ##97/17, authorizing the Health Services Director or his designee (Donna Wigand, LCSW) to contract with the State Department of Mental Health to assume responsibility for Medi-Cal specialty mental health services as of July 1, 1997 . The implementation date has since been changed to April 1, 1998 . Responsibility for outpatient specialty mental health services involves contracts with individual, group and organizational providers to deliver these services. Approval of Contract ##24-939--80 will allow the Contractor to provide mental health specialty services through tune 30, 1999 . CQNIINUM ON AT 1ACHMENT: S XX, S G ATUR RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER �� y ACTION OF BOARD C!N APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (ASSENT__-----j AND CORRECT COPY OF AN ACTION'TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ASSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED 19i:s--- PHIL B CHELOR,C ARK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact Person: Donna Wigand (313-6411) CC: Health SerAces(Cc nffacts) RISS{Management Auditor Controller BY ' t,h t , �& ;A y,2 DEPUTY Contractor Board Order page two (2) .CCM"P OUTPATIENT SPECIALTY MENTAL HEALTH SERVICES FEE SCHEDULE--Revised 4213!97. CPT CODE PROCEDURE M.D Ph.D L.C.S.W. M.F.C.C. Level 4Codes 90830 Test Administration- I hour max 6 $30 94987 Test Scoring- lhour max 2 $30 90843 Individual Ps chothera 112 hour $30 110844 Individual Ps ebothera - 1 flour $60 $30 $30 $30 90846 Family Thera -wi bout patient $30 $30 $30 90847 Family Thew -conjoint $30 $30 $30 80853 Group Therapy-per person-per visit-I 1l21rr max $12 $12 $12 50852 Pharmacological management $30 80870 ECT-Single Seizure $60 X5544 Case Conference- 112 hour $30 $15 $15 $15 X9546 Case Conference- 1 hour $60 $30 $30 $30 Hospital lopt.Service 99221 Hospital Care Visit-In€tial-30 minutes $30 98222 Hospital Care Visit-Initial-50 minutes w- 99232 Hospital Gare Visit-Subsequent-313 minutes $30 Outpatient Consults 99242 Office Consultation New Patient-30 minutes $30 99244 Office Consultation New Patient-60 ininutes $60 Inpatient Consults 99261 Inpatient Consultation New Patient-30 minutes $30 99253 Inpatient Consultation New Patient-613 minutes $60 Nursing Fac Assess 99301 Evaluation and Mana ernent-30 minutes $30 93303 Evaluation and Mana ernent-60 minutes $60 98341 Subsequent Nursing Facility Care-15 minutes $15 93313 Subsequent Nursing Facility Gare-30 minutes $30 Rest Name et At Svc. 95329 Evaluation of New Patient $60 _ 99333 Evaluation of Established Patient $30 Home Services 99341 Evaluation of New Patient $60 99353 Evaluation of Established Patient $30 •"*'these are the only outpatient services which CCMHP will authorize and the only C* for which providers will be reimbursed. TO: PRD F FROM: William Walker, M.D. , Health Services Director '`_ Contra By: Ginger Marieiro, Contracts Administrator Costa DATE: June 3, 1998 County SUBJECT: Approval of Contract #27-395 with Phuong Dui Dang;, M.D. SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION I . RECQMME=Ea AC'T'I : Approve and authorize the Health Services Director, or his designee (Milt Camhi) , to execute on behalf of the County, Contract #27-395 with Phuong Dui Dang, M.D. , for the period from June 1, 1998 through December 31, 1999, for provision professional primary care services for Contra Costa Health Plan members, to be paid as follows : payment #1 - County will pay Physicians for covered services, at the rates set forth in the Medi-Cal Schedule of Maximum Allowances and Relative Value Study in effect at the time services are rendered; Payment #a - County will pay a quarterly case management fee to those Physicians who over a three-month period have met County's quality standards as determined by County in its sole discretion. Quality case management fee payment levels are set forth in the "Primary Care Compensation Plan, Details and Examples"; and Payment #3 - County will pay an annual incentive bonus to those Physicians who have achieved the County's quality standards as determined by County in its sole discretion. Said payments will be paid from the Incentive/Bonus Pool, accumulated from surplus funds after all budget pools have been made whole. The quality standard and incentive bonus calculations are set forth in the "Primary Care Compensation Plan, Details and. Examples". I I . FINA—KCIAL IMPACT: This Contract is funded by Contra Costa Health Plan member premiums . Costs depend upon utilization. As appropriate, patients and/or third party payors will be billed for services . III . REASONS FOR RECQ_M)Mj �A'TI0X /MC_X%R_0UND: On February 1, 1997 the Local Initiative for Medi-Cal managed care in Contra Costa County was implemented. Local Initiatives are required to include traditional Medi-Cal providers from the community in their provider networks . This Contract is necessary to meet State mandates to expand the number of community providers for the Local Initiative, along with a recent Department of Corporations audit finding that requires formal contracts with low volume providers . Approval of this Contract will allow the Contractor to provide professional primary care services to Health Plan members through December 31, 1999 . CONTINLJED O A N • Y SIGNATURE RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVEOTHER SIGNATUBE0113/W,44 4�z ACTION OF BOARD ON APPROVED AS RECOMMENDED Y OTHER VOTEOF SUPERVISORS #HEREBY CERTIFY THAT THIS IS A T€ttfE UNANIMOUS (ASSENT______j AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES : --- ------ AND ENTERED ON THE M#NUTES OF THE BOARD ABSENT: ABSTAIN -_ OF SUPERVISORS ON THE DATE SHOWN. ATTESTED t,�.A I, 119 9 - PHIL BA HELOR,CLERIk OF THE BOARD Of SUPERVI ORS AND COUNTY ADMINISTRATOR Contact Person:Milt Camhi (313-6004) CC: Health Services(Contracts) Risk Management > Auditor Controller BY \) LA. Art f . . DEPUTY Contractor TO: fOARD OF SUPQRVISORS FROM: William Walker, M , Health Services Director Contra By: Ginger Marieiro, Contracts Administrator Costa DATE: June 3, 1998 County SUBJECT: Approval of Contract #24-939-74 with Joanne Middleton, Ph.D. SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION I . RECOMMENDED ACTION.- Approve and authorize the Health Services Director,) or his designee (Donna Wigand) , to execute on behalf of the County, Contract #24-939-74 with Joanne Middleton, Ph.D. , for the period from April 1, 1998 through June 30, 1999, to provide Medi-Cal mental health specialty services, to be paid in accordance with the rates set forth in the attached fee schedule. II . FINANCIAL IMPACT This Contract is funded by State and Federal FFP Medi-Cal Funds. ' III . REASONS FOR REC0bIML=AT1QjXS/BACKGR0UI+'CI►: On January 14, 1997, the Board of Supervisors adopted Resolution #97/17, authorizing the Health Services Director or his designee (Donna Wigand, LCSW) to contract with the State Department of Mental Health to assume responsibility for Medi-Cal specialty mental health services as of July 1, 1997. The implementation date has since been changed. to April 1, 1998 . Responsibility for outpatient specialty mental health services involves contracts with individual, group and organizational providers to deliver these services. Approval of Contract #24- 939-74 will allow the Contractor to provide mental health specialty services through June 30, 1999. CONTINUED ON T A ' N : YES yX SIQNAT + -x RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVEOTHER SIGNATU F.01: ACTION OF BOARD ONO. APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (AEIS£NT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DA'Z'E SHOWN. ATTESTED w # 1 t E PHIL BA CHELOR,CLE OF THE BOARD OF SUPER SCORS AND COUNTY ADMINISTRATOR Contact Verson: Donna Wi and (313-6411) CC: Health Services(Contras) Risk Management ; Auditor Controller BY DEPUTY Contractor Board Order page two (2) CCMHP OUTPATIENT SPECIALTY MENTAL HEALTH SERVICES FEE SCHE521.1--Revised 12/9!97. CPT CODE PROCEDURE M.D Ph.I7 L.C.S.W. M.F.C.C. Level 1Codes 90830 Test Administration- 1 hour rnax 6 $30 9oee7 Test Scoria 1 1hour max 2 $30 90843 Individual Psychotherapy- 1/2 tiour $30 90844 individual Ps cbothera - 1 hour $60 $30 $30 $30 90845 family Thera -wittrout patient $30 $30 $30 90847 Family Therapy-conjoint. $30 $30 $30 90853 GrouI2 Therapy-per person-per visit-1 1/2hr max $12 $12 $12 90862 Pharmacological management- $30 90870 ECT-Single Seizure $60 X9544 Case Conference- 1/2 hour $30 $15 $15 $15 X9548 Case Conference- !hour $60 $30 $30 $30 Hospital In t.Service 99221 Hos ftaf Care Visit-Initial-30 minutes $30 99222 Hospital Gare Visit-lnitiat-50 minutes $60 99232 Hospital Care Visit-Subsequent-30 minutes $30 dUtpatient Consults 99242 Office Consultation New Patient-30 minutes $30 89244 office Consultation New Patient-60 minutes $60 Inpatient Consults 99251 Inpatient Consultation New Patient-30 minutes $30 _ 99253 Inpatient Consultation New Patient-60 minutes $60 Nursing Fac Assess 99301 Evaluation and Management-30 minutes $30 99303 Evaluation and Management-60 minutes $60 99311 Subsequent Nursing Facility Care-15 minutes $15 99313 Subsequent Nursing Facility Care-30 minutes $3{1 /test Home et At Svc. 99323 Evaluation of New Patient $60 99333 Evaluation of Establislied Patient $30 Home services 8934! Evaluation of New Pallent $60 99353 Evaluation of Established Patient $30 "* These are the only outpatient services which CCMHP will authorize and the only knolicodes for which eroviders will be reimbursed. ......................................................................................................-........11.1.111,111,... .............................................................................................................................................................................................. ...................................................... Tt::: > 'BOARD OF SUPERVISORS FROM: William Walk Health Services Director Contra By: Ginger Marieiro, Contracts Administrator Costa DATE: June 3, 1998 County SUBJECT: Approval of Contract #24-939-82 with James Kenshalo, L.C.S.W. SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION I . RECOMMENDED ACTION: Approve and authorize the Health Services Director, or his designee (Donna Wigand) , to execute on behalf of the County, Contract #24-939-82 with James Kenshalo, L.C.S.W. , for the period from April 1, 1998 through June 30, 1999, to provide Medi-Cal mental health specialty services, to be paid in accordance with the rates set forth in the attached fee schedule. II . FINANCIAL IMPACT: This Contract is funded by State and Federal FFP Medi-Cal Funds . III . REASONS FOR RECOMME .-MATIONS/BACKGROUND: On January 14 , 1997, the Board of Supervisors adopted Resolution #97/17, authorizing the Health Services Director or his designee (Donna Wigand, LCSW) to contract with the State Department of Mental Health to assume responsibility for Medi-Cal specialty mental health services as of July 1, 1997 . The implementation date has since been changed to April 1, 1998 . Responsibility for outpatient specialty mental health services involves contracts with individual, group and organizational providers to deliver these services. Approval of Contract #24-939-82 will allow the Contractor to provide mental health specialty services through June 30, 1999. el CONTINUED ON-ATTACH-MENT:- YES XX SIGNATURd ea ARECOMMENDATION Of COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE 7x— APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON --------- R APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ASSENT I HEREBY CERTIFY THAT THIS IS A TRUE 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. ATTESTED. �i M i ?3Q_: 1 11,9?S PHIL BAHELOR,CLF-RK OF THE BOARD OF ContactPerson.- Donna Wigand (313-6411) SUPERVISORS AND COUNTY ADMINISTRATOR CC: Health Services(Contracts) Risk Management Auditor Controller 13 Q-w DEPUTY Contractor ................. Board order page two (2) CCM14P OUTPATIENT SPECIALTY MENTAL HEALTH SERVICES FEE SCHEDULE--Revised 1219197. CPT CODE PROCEDURE WD, Ph.D L.C.S.W. M.F.C.C. Level 1Codes 90830 Test Administration- 1 hour max 6 $30 90887 Test Scoria 1hour max 2 $30 90843 Individual Ps cltothera - 112 hour $30 90944 Individual Ps chothera t hour $60 $30 $30 $30 90846 Family Thera without patient $30 $30 $30 90847 Family Thera -con oint $30 $30 $30 901353 Group Therm . r erson- er visit-1 112hr max $12 $12 $12 9086:2.Pharmacological management $30 90810 ECT-Single Seizure $60 X9544 Case Conference- 112 hour $30 $15 $15 $15 X9546 Case Conference- !hour $60 $30< $30 $30 Hospital Inpt,Service 99221 Hospital Gare Visit-Initial-30 minutes $30 99222 Hospital Care Visit-Initial-50 minutes $60 99232 Hospital Care Visit-Subsequent-30 minutes $30 Outpatient Consults 992_42 office Consultation New Patient-30 minutes $30 _ 99244 Office Consultation New Patient-60 minutes $60 Inpatient Consults 99251 Inpatient Consultation New Patient-30 minutes $30 99253 Inpatient Consultation NNew Patient-60 minutes $60 Nursing Fac Assess 99301 Evaluation and Management-30 minutes $30 993€3 Evaluation and Management-60 minutes $60 99341 Subsequent Nursing Facility Care-15 minutes $15 99313 Subsequent Nursing Facility Care-30 minutes $30 Rest Home et Al Svc. 99323 Evaluation of New Patient $60 99333Evaluation of Established Patient $30 Home Services 99344 Evaluation of New Patient $60 99353 Evaluation of Established Patient $30 MENThese are the only outpatient services which CCNIHP will authorize and the only codes for which providers will be reirnbursed.