Title
a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the Enhanced Care Management Services Agreement with The Santa Cruz-Monterey-Merced -San Benito Mariposa Managed Medical Care Commission, dba Central California Alliance for Health (CCAH), in substantially the same form as that which has been presented to the Board, without significant change to their content, for the provision of Enhanced Care Management Program services to CCAH members, for a term of January 1, 2025 to December 31, 2025, subject to one-year automatic renewals, with 120 days prior written notice termination without cause; and
b. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the CalAIM Incentive Payment Program Letter of Agreement with The Santa Cruz-Monterey-Merced-San Benito Mariposa Managed Medical Care Commission, dba Central California Alliance for Health (CCAH), in substantially the same form as that which has been presented to the Board, without significant change to their content, in the amount of $850,000 to facilitate the implementation of the Enhanced Care Management Program, for a term date January 1, 2025 through January 31, 2026; and
c. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute up to three (3) future amendments to these Agreements where the amendments do not significantly alter the scope of work, and do not exceed a revised maximum amount of $935,000.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the Enhanced Care Management Services Agreement with The Santa Cruz-Monterey-Merced -San Benito Mariposa Managed Medical Care Commission, dba Central California Alliance for Health (CCAH), in substantially the same form as that which has been presented to the Board, without significant change to their content, for the provision of Enhanced Care Management Program services to CCAH members, for a term of January 1, 2025 to December 31, 2025, subject to one-year automatic renewals, with 120 days prior written notice termination without cause; and
b. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the CalAIM Incentive Payment Program Letter of Agreement with The Santa Cruz-Monterey-Merced-San Benito Mariposa Managed Medical Care Commission, dba Central California Alliance for Health (CCAH), in substantially the same form as that which has been presented to the Board, without significant change to their content, in the amount of $850,000 to facilitate the implementation of the Enhanced Care Management Program, for a term date January 1, 2025 through January 31, 2026; and
c. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute up to three (3) future amendments to these Agreements where the amendments do not significantly alter the scope of work, and do not exceed a revised maximum amount of $935,000.
SUMMARY/DISCUSSION:
The California Department of Healthcare Services (DHCS) implemented CalAIM in January, 2022. CalAIM is a multi-year DHCS initiative to improve the quality of life and health outcomes of the Medi-Cal managed care population. DHCS has contracted with the Central California Alliance for Health to contract with local agencies and community-based organizations to implement CalAIM Enhanced Care Managed programs. Natividad Medical Center is negotiating with CCAH to provide ECM services to the youth population transitioning from incarceration.
The CCAH Enhanced Care Management Services Agreement will be effective January 1, 2025 for one year with automatic renewal unless either party terminates the agreement. Through this agreement CCAH will make per member per month payments to NMC to provide case management services to authorized CCAH members. NMC will assess, monitor and direct specific CCAH members to necessary services and resources to improve their quality of life, health and well-being.
The CalAIM Incentive Payment Program Letter of Agreement will be effective January 1, 2025 and terminate January 31, 2026. The current proposed agreement is to fund start-up costs to fully implement ECM for the youth population transitioning from incarceration. As NMC reaches milestones, specific payments will be made to NMC, up to the total eligible amount of $850,000. The start-up costs include developing office space, purchasing furniture, purchasing equipment and staffing.
OTHER AGENCY INVOLVEMENT:
County Counsel reviewed and approved these Agreements as to legal form, and the Auditor-Controller reviewed and approved as to payment provisions. The amendments were reviewed and approved by NMC’s Finance Committee and Board of Trustees on November 8, 2024.
FINANCING:
The estimated costs for these agreements will be covered by anticipated reimbursements from CCAH and are included in the Fiscal Year 2024 - 2025 Adopted Budget. Funding will be provided from NMC’s Enterprise Fund 451-9600-6312.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
These agreements are for the provision of services to the at-risk youth population transitioning from incarceration to improve their health and quality of life through programs and services.
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Prepared by: Nancy Majewski, Managed Care Operations Manager, 783-2385
Approved by: Charles R. Harris, M.D., Chief Executive Officer, 783-2504
Attachments:
Central California Alliance for Health Enhanced Care Management Services Agreement
Central California Alliance for Health CalAIM Incentive Payment Program Letter of Agreement
Attachments on file with the Clerk of the Board