HomeMy WebLinkAboutMINUTES - 03231999 - C98 TO: BOARD OF SUPERVISORS l
> CONTRA COSTA
COUNTY
FROW William B.Walker, M.D.
Health Services Director
DATE: March 8, 1999
SUBJECT:
SS-1255 Medi-Cal Contract
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
Recommendation:
Authorize the Health Services Director to transfer a maximum of$10,000,000 to
the State of California as authorized under SS-1255.
Fiscal Impact:
Contra Costa Regional Medical Center (CCRMC) will be eligible for a maximum
of$10.0 million in matching Federal funds. See background information for full
discussion.
Federal grants to the State of the 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, these funds over which the
State legislature has unrestricted power of appropriation. In California, the
program "split" is 50% Federal financing, 50% State financing.
SS-1255 (Chapter 996, Statutes of 1989) added Section 14085.5 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.
CONTINUED ON ATTACHMENT:
SIGNATURE � �`
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
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
AND ENTERED ON THE MINUTES OF THE BOARD
AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN.
ABSENT: ABSTAIN:
ContactPemon: Patrick Godley/370 .5075 #
CC:
ATTESTED i� 1
Office of the Director/ 20 Allen St . PHIL BAT CHELO ,CLERK OFTH BOARD OF
Patrick Godley/ 20 Allen St . SUP VISOR COUNTY ADMINISTRATOR
Sara Hoffman
BY: DEPUTY
Ski-1255I Medi-Cad. Contract
-2-
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).
CCRMC is a disproportionate hospital eligible for reimbursement under this
program.
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 14 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
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 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 eleven rounds of voluntary
Donations and supplemental contract negotiations. CCRMC has voluntarily
contributed a total of$31,250,000; supplemental Medi-Cal contract
payments have been $53,300,000.