Title
a. Approve and authorize the Director of Health Services or designee to execute a non-standard Memorandum of Understanding (MOU) with Kaiser Foundation Health Plan, Inc. (KFHP), to coordinate public health-related Medi-Cal services for members enrolled in the KFHP Medi-Cal Managed Care Plan, effective January 1, 2027 through December 31, 2031 with no exchange of funds;
b. Approve non-standard liability provisions as recommended by the Director of Health Services; and
c. Approve and authorize the Director of Health Services or designee to sign up to three (3) future amendments to the MOU, provided that these amendments do not substantially change the Scope of Services, do not add funds to the MOU, and are approved by the Office of the County Counsel.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health Services or designee to execute a non-standard Memorandum of Understanding (MOU) with Kaiser Foundation Health Plan, Inc. (KFHP), to coordinate public health-related Medi-Cal services for members enrolled in the KFHP Medi-Cal Managed Care Plan, effective January 1, 2027 through December 31, 2031 with no exchange of funds;
b. Approve non-standard liability provisions as recommended by the Director of Health Services; and
c. Approve and authorize the Director of Health Services or designee to sign up to three (3) future amendments to the MOU, provided that these amendments do not substantially change the Scope of Services, do not add funds to the MOU, and are approved by the Office of the County Counsel.
SUMMARY:
Kaiser Foundation Health Plan, Inc. (KFHP) began providing services to Monterey County residents in January 2025. KFHP will operate as a Medi-Cal managed care plan in Monterey County beginning January 1, 2027. The requested MOU assists with coordinating services between KFHP and the Health Department for KFHP Medi-Cal Managed Care Plan (MCP) members who reside in Monterey County. The MOU also supports local implementation of the California DHCS CalAIM Population Health Management Program.
DISCUSSION:
In January 2023, the California Department of Health Care Services (DHCS) launched the Population Health Management (PHM) Program, which is a cornerstone of California Advancing and Innovating Medi-Cal (CalAIM). To support the success of the PHM Program and broader health care transformation efforts, Medi-Cal Managed Care Plans (MCPs) must meaningfully collaborate with local health jurisdictions on their Community Health Assessments (CHAs) and/or Community Health Improvement Plans (CHIPs). MCPs must also build partnerships with local health jurisdictions to ensure Medi-Cal MCP member care is coordinated and that members have access to community-based resources in order to support whole person care.
The Health Department requests a new MOU with KFHP to clarify roles and responsibilities related to the PHM Program, support local engagement, and facilitate care coordination and exchange of information. The MOU will also improve the referral process and promote transparency and accountability by setting forth certain existing requirements for each party as they relate to service of care delivery and coordination so that the parties are aware of each other’s obligations. Areas covered by the MOU include the Health Department’s CHIP and CHA as well as the Public Health Bureau services of childhood lead poisoning prevention, maternal, child, and adolescent health; and prevention and control of vaccine preventable diseases, sexually transmitted infections, and tuberculosis.
This work supports the County of Monterey Health Department 2025-2028 Strategic Plan Goals:
1. Build Community Power and Partners’ Capacity to Increase Equity and Improve Health, and 2. Provide Exceptional Person-Centered Care through Accessible, Community-Focused Health Services. It also supports four of the ten essential public health services, specifically: 1. Monitor health status to identify and solve community health problems; 2. Diagnose and investigate health problems and health hazards in the community; 4. Mobilize community partnerships and action to identify and solve health problems; and 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
OTHER AGENCY INVOLVEMENT/COMMITTEE ACTIONS:
The Office of the County Counsel and Auditor-Controller have reviewed and approved this MOU as to legal form and fiscal provisions, respectively.
FINANCING:
There is no exchange of funds between the County of Monterey and Kaiser Foundation Health Plan, Inc.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
This MOU aligns with the Strategic Plan Goal of Well-Being and Quality of Life by promoting care coordination and increased access to health and public health services for members enrolled in the KPHF Medi-Cal Managed Care Plan.
_X_ Well-Being and Quality of Life
____ Sustainable Infrastructure for the Present and Future
____ Safe and Resilient Communities
____ Diverse and Thriving Economy
____ Dynamic Organization and Employer of Choice
Prepared by: Patricia Velarde, Management Analyst II, 796-1377
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Memorandum of Understanding