Title
a. Delegate authority to the Director of Health or his designee to sign and execute a Letter of Intent for the purpose of entering into an agreement with Beacon Health Strategies/College Health IPA, a California medical professional corporation, effective January 1, 2014, until a formal agreement is executed or until the Letter of Intent is terminated by either party; and
b. Delegate authority to the Director of Health to negotiate, sign, and execute an agreement with Beacon Health Strategies/College Health IPA, a California medical professional corporation, to allow the County Health Department to serve as a network provider of mild to moderate mental health services for eligible Central California Alliance for Health Medi-Cal managed care beneficiaries in Monterey County ("Beacon Agreement"), subject to County Counsel, County Risk Manager, and County Auditor-Controller review and approval, with terms effective no sooner than upon your Board's approval continuing through no later than December 31, 2019; the Director of Health shall notify your Board and the County Administrative Officer ("CAO") in writing within ten days of execution of the Beacon Agreement; and
c. Delegate authority to the Director of Health to sign up to three (3) future Amendments to the Beacon Agreement that do not materially change the scope of work or the anticipated revenues; the Director of Health shall notify your Board and the CAO in writing within ten days of execution of each amendment.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Delegate authority to the Director of Health or his designee to sign and execute a Letter of Intent for the purpose of entering into an agreement with Beacon Health Strategies/College Health IPA, a California medical professional corporation, effective January 1, 2014, until a formal agreement is executed or until the Letter of Intent is terminated by either party; and
b. Delegate authority to the Director of Health to negotiate, sign, and execute an agreement with Beacon Health Strategies/College Health IPA, a California medical professional corporation, to allow the County Health Department to serve as a network provider of mild to moderate mental health services for eligible Central California Alliance for Health Medi-Cal managed care beneficiaries in Monterey County ("Beacon Agreement"), subject to County Counsel, County Risk Manager, and County Auditor-Controller review and approval, with terms effective no sooner than upon your Board's approval continuing through no later than December 31, 2019; the Director of Health shall notify your Board, and the County Administrative Officer ("CAO") in writing within ten days of execution of the Beacon Agreement; and
c. Delegate authority to the Director of Health to sign up to three (3) future Amendments to the Beacon Agreement that do not materially change the scope of work or the anticipated revenues; the Director of Health shall notify your Board and the CAO in writing within ten days of execution of each amendment.
SUMMARY/DISCUSSION:
Under the Affordable Care Act, Medi-Cal expanded coverage to include eligible adults who are at or below 138% of the federal poverty guidelines. The State of California, effective January 1, 2014, assigned coverage of mild to moderate mental health benefits to the Managed Care Medi-Cal Plans. In Monterey County, that responsibility went to Central California Alliance for Health.
Central California Alliance for Health, the managed care Medi-Cal organization in Monterey County, entered into an agreement with Beacon Health Strategies/College Health IPA to manage and administer mild to moderate mental health services. As a contracted provider with Central California Alliance for Health, the Health Department/Clinic Services Bureau has provided these expanded mental health services to eligible beneficiaries.
The Health Department/Clinic Services Bureau was notified of the need to participate with Beacon Health Strategies/College Health IPA as a network provider of outpatient mental health services for individuals with mild to moderate mental health issues. Negotiations to enter into an agreement were initiated in January, however due to the complexity and lengthy process of contract negotiations, to date an agreement has not been finalized. The proposed Letter of Intent will allow the Health Department/Clinic Services Bureau to provide the expanded services to individuals seeking care while ensuring that payment will be made for services rendered until an agreement is finalized. Authorization is also requested to enter into a formal agreement, once finalized.
This work supports the Monterey County Health Department 2011-2015 strategic plan initiative: 3) Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services.
It also supports one of the ten essential public health services, specifically: 7) Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
County Counsel, County Risk Manager, and County Auditor-Controller concur with this recommendation. Letter of Intent is on file with the Clerk of the Board
FINANCING:
A Letter of Intent to enter into an agreement has been proposed to expedite the processing and payment of claims for Fiscal Years 2013-14 and 2014-15. With implementation of the Affordable Care Act, services have been rendered beginning February 1, 2014. Claims for services provided are subject to a potential discount penalty of 25% if they are not submitted within six months of date of service with higher penalties accumulating monthly with a maximum penalty of 100%. Authorization is requested to sign the Letter of Intent with Beacon Health Strategies/College Health IPA to maximize potential for reimbursement of 100% of the approximately $240,000 in outstanding claims for services provided in Fiscal Year 2013-14. The estimated amount of reimbursement in Fiscal Year 2014-15 is $500,000.
Prepared by: Robin Kimball, 1344
Approved by: Ray Bullick, Director of Health, 4526
Attachments:
Letter of Intent is on file with the Clerk of the Board