HomeMy WebLinkAboutMINUTES - 05162000 - C86-C95 TO: BOARD OF SUPERVISORS
FROM: William Walker, M.D. , Health Services Director Contra
By: Ginger Marieiro, Contracts Administrator
DATE: May 2, 2000 COSta
__. County
SUBJECT: Approval of Contract #24-949-29 (1) with Sunny Hills Children' s
Services
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)a BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee
(Donna Wigand) , to execute on behalf of the County, Contract #24-949-
29 (1) with Sunny Hills Children' s Services, for the period from July 1,
1999 through June 30, 2000, to provide Medi-Cal mental health specialty
services, to be paid in accordance with the rates set forth in the
attached fee schedule .
FISCAL IMPACT:
This Contract is funded by Federal Financial Participation and State
Medi-Cal Consolidation.
BACKGROUND/REASON(S) FOR RECOMMENDATION(S) :
On January 14, 1997, the Board of Supervisors adopted Resolution #97/17,
authorizing the Health Services Department to contract with the State
Department of Mental Health to assume responsibility for Medi-Cal mental
health specialty services . Responsibility for outpatient mental health
specialty services involves contracts with individual, group and
organizational providers to deliver these services .
On October 13 , 1998, the Board of Supervisors approved Contract #24-949-
29 with Sunny Hills Children' s Services, for the period from June 1, 1998
through June 30, 1999, for Medi-Cal mental health specialty services .
Approval of Contract #24-949-29 (1) will allow the Contractor to continue
providing services, through June 30, 2000 .
CONTINUED1 T
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATUREUM:
ACTION OF BOARD ON 000 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 12 Iloo
PHIL BATCHELOR,L.OR,CLERK OF THE BOARD OF
Contact person: Donna Wigand (313-6411) SUPERVISORS AND COUNTY ADMINISTRATOR
CC: Health Servicer(Contracts)
Risk Management } � �
Auditor Controller BY DEPUTY
Contractor
....................
BOARD ORDER
PAGE -2
ATTACHMEN'T A
Out of County
PHYSICIAN REIMBURSEMENT TABLE
LEVEL CPT CODE PROCEDURE TIME RATE
LEVEL t CODES 99204 Initial Outpatient Psychiatric Assessment 60 min. $60
90862 Medication Management 30 min. I $30
99242 Child Consultation 30 min. $30
99244 Child Consultation 60 min. $60
EMERGENCY DEPARTMENT 99284 1 Emergency Department Mental Health Services 45 min. $45
HOSPITAL INPATIENT 99222 Hospital Care-Initial 60 min. $60
SERVICES 99232 Hospital Care-Subsequent 30 min. $30
99233 Hospital Care-Subsequent 60 min. $60
NURSING FACILITY 99301 Evaluation and Management 30 min. $30
ASSESSMENT 99303 Evaluation avd Management 60 min. $60
99311 Subsequent Nursing Facility Care 15 min. $15
99313 Subsequent Nursing Facility Care 30 min. $30
REST HOME 99323 Evaluation of New Patient 60 min. $60
1
99333 Evaluation of Established Patient 30 min, $30
HOME SERVICES 99344 Evaluation of New Patient 60 min. $60
99348 Evaluation of Established Patient 40 min. $40
PhD REIMBURSEMENT TABLE — �
LEVEL CPT CODE PROCEDURE TIME RATE
LEVEL I CODES X9514 Test Administration(max 6 hours) 60 min. $30
X9532 Test Scoring(max 2 hours) 60 min, 4 $30
X9538 Test Report Writing(max 2 hours) 80 min. $30
X9502 individual Psychotherapy-Inpatient Setting 60 min. I� $30
99205 Outpatient Assessment Visit-New Patient 60 min. i $30
90812 Individual Psychotherapy 60 min. $30
X9508 Family Therapy 60 min. $30
90853 Group Therapy-per person/per visit 90 min. $12
X9544 Case Conference 30 min. $15
X9546 Case Conference 60 min. $30
EMERGENCY DEPARTMENT 99284 Emergency Department Mental Health Services 45 min. $22.50
INPATIENT CONSULTS 99251 Inpatient Consultation New Patient 30 min. $15
99253 Inpatient Consultation New Patient 80 min. $30
MFCC REIMBURSEMENT TABLE
LEVEL CPT CODE PROCEDURE TIME RATE
LEVEL I CODES 99205 Outpatient Assessment Visit-Now Patient 60 min. $30
90812 Individual Psychotherapy 60 min. ( $30
X9.508 Family Therapy 60 min. $30
90853 Group Therapy-per persontper visit 90 min. $12,
X9544 Case Conference 30 min $15
X9546 Case Conference 60 min. j $30
LCSW REIMBURSEMENT TABLE
LEVEL CPT CODE PROCEDURE TIME RATE
LEVEL I CODES 99205 Outpatient Assessment Visit-New Patient 60 min. $30
90812 Individual Psychotherapy 60 min. $30
X9508 Family Therapy 60 min, , $30
i
90853 Group Therapy-per person/per visit 90 min, $12
X9544 Case Conference 30 min. $15
X9546 Case Conference i 60 min. j $30
25816 'EPSDT Supplemental Services delivered by an LCSW t_ j $30
EMERGENCY DEPARTMENT 99284 1 Emergency Department Mental Health Services 45 min. .: $22.50
I
TO: BOARD OF SUPERVISORS 0
FROM: William Walker, . M.D. , Health Services Director .�
By: Ginger Marieiro, Contracts Administrator Contra
DATE: May 2, 2000 Costa
County
SUBJECT: Approval of Contract #27-436-1 with Florence Chan, R.N.
SPECIFIC REQUEST(S)OR RECOMMENDATIONIS)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee (Milt
Camhi) , to execute on behalf of the County, Contract #27-436-1 with
Florence Chan, R.N. , for the period from June 1, 2000 through May 31, 2001,
in the amount of $65, 480, for consultation and technical assistance to the
Contra Costa Health Plan (Health Plan) with regard to the Authorization and
Utilization Units .
FISCAL IMPACT
This Contract is funded by Health. Plan member premiums .
BACKGROUND/REASON(S) FOR RECOMMENDATION(S):
On June 15, 1999, the Board of Supervisors approved Contract #27-436 with
Florence Chan, R.N. , for the period from June 1, 1999 through May 31, 2000,
to provide consultation and technical assistance to the Health Plan with
regard to Authorizations and Utilization Management Units .
Approval of Contract #27-436-1, will allow the Contractor to continue to
provide consultation and technical assistance to the Health Plan' s
Authorization and Utilization Units including, but not limited to,
coordinating activities of unit staff, making recommendations with regard
to authorization of medical procedures and participating in the Health
Plan' s formal grievance process, through May 31, 2001 .
CONTINU9P ON ATT SIG A U
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
ACTION OF BOARD Ot?f ' /G^ ct'�tl� 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._/ / 457 A1#04 c. ['
PHIL BATCHELOR,CLERK OF THE BOARD OF
Contact Person:
Milt Camhi (313-6004) SUPERVISORS AND COUNTY ADMINISTRATOR
CC: Health Services(Contracts)
Risk Management
Auditor Controller BYDEPUTY
Contractor
Cis
TO: BOARD OF SUPERVISORS
FROM: William Walker, M.D. , Health Services Director •�, ;
By: Ginger Marieiro, Contracts Administrator `�' Contra
DATE: May 2, 2000 Costa
County
SUBJECT: Approval of Contract #27-422-3 with Gene Loney
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)✓E BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee (Milt
Camhi) , to execute on behalf of the County, Contract #27-422-3 with Gene
Money, for the period from June 1, 2000 through May 31, 2001, in the amount
of $59, 000, for consultation and technical assistance to the Contra Costa
Health Plan with regard to custom software applications .
FISCAL IMPACT:
This Contract is funded in the Department' s Budget by Contra Costa Health
Plan (Health Plan) member premiums .
BACKGROUND/REASON(S) FOR RECOMMENDATION(S) :
On April 20, 1999, the Board of Supervisors approved Contract #27-422-1 (as
amended by Contract Amendment Agreement #27--422-2) with Gene Roney, for the
period from June 1, 1999 through May 31, 2000, for consultation and
technical assistance to the Health Plan with regard to custom software
applications.
Approval of Contract #27-422-3 will allow Gene Roney to continue providing
services to the Health Plan through May 31, 2001 .
CObITINUED ON AIJACHMENT,` S A U `
i-'�RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
ACTION OF BOARD Op4 t -�4 0 06 APPROVED AS RECOMMENDED . X 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/ j I t 5Wt')14
PHIL BATCHELOR,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: Milt Camhi ..(313-6004)
CC: Health Services(Contracts)
Risk Management
Auditor Controller By-j", Cvr ,DEPUTY
Contractor
ON
TO: BOARD OF SUPERVISORS ���
William Walker, M. Health Services Director
e ! ! i
FROM: By: Ginger Marieiro, Contracts Administrator 'r Contra
Costa
DATE: May 2, 2000 County
SUBJECT: Approval of Contract #27-366 with Raja 'Poke, M.D.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee (Milt Camhi) ,
to execute on behalf of the County, Contract #27-366 with Raja Toke, M.D. , for the
period from May 1, 2000 through April 30, 2002 , for provision of professional
primary care services for Contra Costa Health Plan members, to be paid as follows :
1. For Medi-Cal Beneficiaries:
a. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in effect on.August 1, 1998 plus
5%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan capitated payment,
County will thereafter increase the rates County pays to Contractor accordingly.
b. County will pay a quarterly case management fee,as follows:
Panel Size* Quarterly Fee
1 to 499 $3.00 per beneficiary per quarter
500 to 999 $3.25 per beneficiary per quarter
1000 or more $3.50 per beneficiary per quarter
*Panel Size is the number of Medi-Cal beneficiaries receiving treatment by Contractor during each quarter as specified in the "CCHP's Community
Provider Network Primary Care Providers Compensation Plan".
2. For Healthy Family Program Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances
in effect on August 1, 1998 plus 10%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
3. For Plan B Commercial Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in
effect on August 1, 1998 plus 20%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
FISCAL 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 .
BACKGROUND/REASON(S) FOR RECOMMENDATION(S) :
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 Department of Corporations audit finding
that requires formal contracts with low volume providers .
Under Contract #27--366, the Contractor will provide professional primary care
services to Health Plan members through April 30, 2002 .
CONTINUER.ON A SIgNATUR
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
w'~ APPROVE OTHER
SIGNMREM: .L- 46e,,
a
ACTION OF BOARD O A/, 000) APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS (ABSENT ,L! ) 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 Z�W� 11a,- c f eOO
PHIL BATCHELOR,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: Milt: Camh (313-6004)
CC: Health Services(Contracts)
Risk Management
Auditor Controller BY 2DEPUTY
Contractor
" t
TO: BOARD OF SUPERVISORS
FROM: William Walker, M.D. , Health Services Director f ;
By: Ginger Marieiro, Contracts Administrator Contra
Costa
DATE: May 2, 2000 County
SUBJECT: Approval of Contract #27-189-1 with Sam Sundar, M.D.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee (Milt Camhi.) ,
to execute on behalf of the County, Contract #27-189-1 with Sam Sundar, M.D. , for
the period from May 1, 2000 through April 30, 2002, for provision of professional
primary care services for Contra Costa Health Plan members, to be paid as follows :
1. For Medi-Cal Beneficiaries:
a. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in effect on August 1, 1998 plus
5%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan capitated payment,
County will thereafter increase the rates County pays to Contractor accordingly.
b. County will pay a quarterly case management fee,as follows:
Panel Size* Quarterly Fee
1 to 499 $3.00 per beneficiary per quarter
500 to 999 $3.25 per beneficiary per quarter
1000 or more $3.50 per beneficiary per quarter
*Panel Size is the number of Medi-Cal beneficiaries receiving treatment by Contractor during each quarter as specified in the "CCHP's Community
Provider Network Primary Care Providers Compensation Plan".
2. For Healthy Family Program Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances
in effect on August 1, 1998 plus 10%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
3. For Plan B Commercial Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in
effect on August 1, 1998 plus 20%. In the event rate increases are subsequently approved by the Stare of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
FISCAL 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 .
BACKGROUND/REASON(S) FOR RECOMMENDATION(S) :
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 Department of Corporations audit finding
that requires formal contracts with low volume providers .
Linder Contract#27-189-1, the Contractor will provide professional primary care
services to Health Plan members through April 30, 2002 .
CONTINU A T: YifrSIG AT
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
r•
SIGNATUR (S):
ACTION OF BOARD Q ' 4 at"!?/Jb APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
X�/ 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_ o
PHIL BATCHELOR,CLERK OF THE BOARD OF
Contact Person: Milt Camhi (313-6004) SUPERVISORS AND COUNTY ADMINISTRATOR
CC: Health Services(Contracts)
Risk Management
Auditor Controller BY �CC-1�[-' DEPUTY
Contractor
TO: BOARD OF SUPERVISORS���
FROM: William Walker, M.D. , Heap Ser-17Y *f++'`Director "f
By: Ginger Marieiro, Contracts Administrator
�� ��
BATE: may 2, 2000 Costa
COUnty
SUBJECT: Approval of Contract #27-425-1 with Hilltop Pediatric Group
SPECIFIC REQUEST(S)OR RECOMMENDATION($)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee (Milt Camhi) ,
to execute on behalf of the County, Contract #27-425-1 with Hilltop Pediatric
Group, for the period from January 1, 2000 through December 31, 2001, for
provision of primary care services for Contra Costa Health Plan members, to be
paid as follows :
I. For Medi-Cal Beneficiaries:
a. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in effect on August 1, 1998 plus
5%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan capitated payment,
County will thereafter increase the rates County pays to Contractor accordingly.
b. County will pay a quarterly case management fee,as follows:
Panel Size* Quarterly Fee
I to 499 $3.00 per beneficiary per quarter
500 to 999 $3.25 per beneficiary per quarter
1000 or more $3.50 per beneficiary per quarter
*Panel Size is the number of Medi-Cal beneficiaries receiving treatment by Contractor during each quarter as specified in the "CCHP's Community
Provider Network Primary Care Providers Compensation Plan".
2. For Healthy Family Program Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances
in effect on August 1, 1998 plus 10%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
3. For Plan B Commercial Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in
effect on August 1, 1998 plus 20%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
FISCAL IMPACT:
This Contract is funded by Contra Costa Health Plan member premiums . Costs depend
upon utilization.
BACKGROUND/REASON(S) FOR RECOMMENDATION(3) :
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 .
On April 20, 1999, the Board of Supervisors approved Contract #27-426 with Hilltop
Pediatric Group, for the period from June 1, 1999 through December 31, 1999, for
provision of primary care services .
Approval of Contract #27-426-1 will allow the Contractor to provide services to
Health Plan members, through December 31, 2001 .
CONTINUEQ ON ATTACHMEUT: yar SIGNAIURE 10)
t/RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
rs' APPROVE OTHER
ACTION OF BOARD C3N` / � + �
APPROVED AS RECOMMENDED h 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.
ATTESTEDl�
_ 9 r` , G't!0
PHIL BATCH LOR,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Cantact'Person: Milt Camhi 1313-6004):,
CC: Health Services(Contracts)
Risk Management
Auditor Controller By L -
,DEPUTY
Contractor
TO: BOARD OF SUPERVISORS
FROM: William Walker, M.D. , Health Services Director •,� 'ti
By: Ginger Marieiro, Contracts Administrator Contra
DATE: May 2, 2000 Costa
County
SUBJECT. Approval of Contract #27-355-1 with Anh Trung Do, M.D.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee (Milt Camhi) ,
to execute on behalf of the County, Contract #27-355-1 with Anh Trung Do, M.D. ,
for the period from April 1, 2000 through March 31, 2001, for provision
professional primary care services for Contra Costa Health Plan members, to be
paid as follows :
1. For Medl-Cal Beneficiaries:
a. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in effect on August 1, 1998 plus
5%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan capitated payment,
County will thereafter increase the rates County pays to Contractor accordingly.
b. County will pay a quarterly case management fee,as follows:
Panel Size* Quarterly Fee
1 to to 499 $3.00 per beneficiary per quarter
500 to 999 $3.25 per beneficiary per quarter
1000 or more $3.50 per beneficiary per quarter
*Panel Size is the number of Medi-Cal beneficiaries receiving treatment by Contractor during each quarter as specified in the "CCHP's Community
Provider Network Primary Care Providers Compensation Plan".
2. For Heahbv Family Program Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances
in effect on August 1, 1998 plus 10%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
3. For Plan B Commercial Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in
effect on August 1, 1998 plus 20%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
FISCAL 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 .
BACKGROUND/REASON(S) FOR RECOMMENDATION(5) :
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 Department of Corporations audit finding
that requires formal contracts with low volume providers .
Under Contract #27-355-1, the Contractor will provide professional primary care
services to Health Plan members, through March 31, 2001 .
CONJINQEDC SI
rs, RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
_4::::-APPROVE _OTHER
ACTON OF BOARD Oht' l J rIGI 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
PHIL BATCHE OR,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: Milt Camhi (.313-6004)
CC: Health Services(Contracts)
Risk Management
Auditor Controller BY /� ' CGC t�
Contractor DEPUTY
To: BOARD OF SUPERVISORS � y„�
FROM: William Walker, . M. Health Ser C s Director ;
By: Ginger Marieiro, Contracts Administrator `�` Contra
DATE: May 2, 2000 Costa
County
SUBJECT: Approval of Contract #27-437-1 with Dominic Biunno, Jr.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee (Milt
Camhi) , to execute on behalf of the County, Contract #27-437-1 with Dominic
Biunno, Jr. , for the period from June 1, 2000 through May 31, 2001, in the
amount of $54, 920, for consultation and technical assistance to Department
with regard Contra Costa Health Plan (Health Plan) provider contracts .
FISCAL IMPACT:
This Contract is funded by Health Plan member premiums .
BACKGROUND/REASON(S) FOR RECOMMENDATION(S) :
On May 25, 1999, the Board of Supervisors approved Contract #27-437 with
Dominic Biunno, Jr. , for the period from June 1, 1999 to May 31, 2000, for
provision of consultation and technical assistance with regard to Health
Plan provider contracts .
Approval of Contract #27-437-1 will allow the Contractor to continue
providing consultation and technical assistance with regard Health Plan
provider contracts, including but not limited to, developing requests for
proposals, negotiating with prospective contractors, developing measurable
outcome-oriented objectives, and monitoring regulatory requirements and
Health Plan compliance, through May 31, 2001 .
CONTINUED A C SIGNATUr 1Xri
i___"RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEN ATION OF BOARD COMMITTEE
4`APPROVE OTHER
ACTION OF BOARD Ohl`' y .� -_2eo'1 APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
KI 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 1 tX
PHIL BATCHELOR,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: Milt Camhi (31.36004)
CC: Health Services(Contracts)
Risk Management �7
Auditor Controller BY _IJ22-r . ti--
DEPUTY
Contractor
V rq+
TO: BOARD OF SUPERVISORS `
FROM: William Walker, M.D. , Health Servicesirector
a
By: Ginger Marieiro, Contracts AdministratorContra
DATE: May 2, 2000 Costa
County
SUBJECT: Approval of Contract #27-172-1 with John Yu, M.D.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee (Milt Camhi) ,
to execute on behalf of the County, Contract #27-172-1 with John Yu, M.D. , for the
period from January 1, 2000 through December 31, 2001, for provision of primary
care services for Contra Costa Health Plan members, to be paid as follows :
1. For Medi-Cal Beneficiaries:
a. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in effect on August 1, 1998 plus
5%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan capitated payment,
County will thereafter increase the rates County pays to Contractor accordingly.
b. County will pay a quarterly case management fee,as follows:
Panel Size* Quarterly Fee
I to 499 $3.00 per beneficiary per quarter
500 to 999 $3.25 per beneficiary per quarter
1000 or more $3.50 per beneficiary per quarter
*Panel Size is the number of Medi-Cal beneficiaries receiving treatment by Contractor during each quarter as specified in the "CCHP's Community
Provider Network Primary Care Providers Compensation Plan".
2. For Healthy Family Program Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances
in effect on August 1, 1998 plus 10%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
3. For Plan B Commercial Members. County will pay Physicians for covered services,those rates set forth in the Medi-Cal Schedule of Maximum Allowances in
effect on August 1, 1998 plus 20%. In the event rate increases are subsequently approved by the State of California and are included in the County's Health Plan
capitated payment,County will thereafter increase the rates County pays to Contractor accordingly.
FISCAL IMPACT:
This Contract is funded by Contra Costa Health Plan member premiums . Costs depend
upon utilization.
BACKGROUND/REASON(S) FOR RECOMMENDATION(S) :
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 .
On January 28, 1997, the Board of Supervisors approved Contract #27-172 with John
Yu, M.D. , for the period from February 1, 1997 through December 31, 1999, for
provision of primary care services .
Approval of Contract #27-172-1 will allow the Contractor to provide services to
Health Plan members, through December 31, 2001 .
CONTINUEDA U
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
1--APPROVE OTHER
SIGNATUREML— ` u
ACTION OF BOARD ON aid 0v 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 G?e r o
PHIL BATCHELOR,CLERK OF THE BOARD OF
Contact Berson:
Malt Camhi (313-6004) SUPERVISORS AND COUNTY ADMINISTRATOR
CC: Health Services(Contracts)
Risk Management
Auditor Controller BY ��• _ DEPUTY
Contractor
TO: BOARD OF SUPERVISORS
FROM. William Walker, M.D. Hea t r-Vije�S 'rirector
By: Linger Marieiro, Contracts Administrator
a
Contra
DATE: May 1, 2000COSta
County
SUBJECT: Approval of Contract #26-964-1 with V. Arek Keledjian, M.D.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION(S) :
Approve and authorize the Health Services Director, or his designee,
(Frank Puglisi, Jr. ) to execute on behalf of the County, Contract
#26-964-1 with V. Arek Keledjian, M.D. (specialty: Endoscopy -
Internal Medicine) , for the period from June 1, 2000 through May 31,
2003 , to be paid in accordance with the attached fee schedule .
FISCAL IMPACT:
Cost to the County depends upon utilization. As appropriate, patients
and/or third party payors will be billed for services .
BACKGROUND/REASON(S) FOR RECOMMENDATION(S) :
For a number of years the County has contracted with Medical and
Dental Specialists to provide specialized professional services which
are not otherwise available in its hospital and clinics .
On August 3 , 1999, the Board of Supervisors approved Contract #26-964
with V. Arek Keledjian, M.D. , for the period from June 1, 1999 through
May 31, 2000, to provide Endoscopy services, including on-call and
clinical coverage services for Contra Costa Regional Medical Center
and Contra Costa Health Centers .
Approval of Contract #26-964-1 will allow Contractor to continue
providing services through May 31, 2003 .
-c
_4eL RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
_1ZXPPROVE OTHER
ACTION OF BOARDi3h}�f / e2 i ,�G ad�o 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
PHIL BATCHELOR,CLERK OF THE BOARD OF
Contact Person: Frank Puglisi, Jr. (370-5100) SUPERVISORS AND COUNTY ADMINISTRATOR
CC: Health Services(Contracts)
Risk Management
Auditor Controller BY . -
DEPUTY
Contractor
Board Order
Page 2
#26-964-1
For Endoscopy services,:
a. gkOO per four-hour Endoscopy clinic coverage;
b. $500 per each Endoscopic (ERCP) procedure performed at
Contra Costa Regional Medical Center [CCRMC] (excluding
those procedures performed during Contractor' s
regularly scheduled four-hour Endoscopy clinic coverage
services, set forth in subparagraph a, above) ;
C . j2_00 per occurrence when Contractor is required to come to
the CCRMC during on-call hours, at the direction of the
Health Services Director or his designee (Chief of
Surgery) to perform an Endoscopic procedure;
d. $100 per weekday evening on-call duty period from 5 : 00 p.m.
to 8 : 00 a.m. ; and
e . A159 per weekend day and holiday on-call duty period from
8 : 00 a.m. to 8 : 00 a.m.