Title
Approve for final adoption the By-Laws of the Santa Cruz-Monterey-Merced-San Benito-Mariposa Managed Medical Care Commission (“SCMMSBMMMCC”), as amended by the SCMMSBMMMCC Board on December 6, 2023.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
Approve for final adoption the By-Laws of the Santa Cruz-Monterey-Merced-San Benito-Mariposa Managed Medical Care Commission (“SCMMSBMMMCC”), as amended by the SCMMSBMMMCC Board on December 6, 2023.
SUMMARY:
Welfare and Institutions Code §14087.54 provides that County Board(s) of Supervisors (BOS) may, by ordinance, establish a commission with the authority to contract and arrange for the provision of health care services and may enter into contracts for the provision of health care services to persons who are eligible to receive medical benefits under a publicly supported program.
The BOS of Santa Cruz, Monterey, Merced, San Benito and Mariposa counties adopted mirrored ordinances establishing the Santa Cruz - Monterey - Merced - San Benito -Mariposa Managed Medical Care Commission (“SCMMSBMMMCC” or “Commission”) for the purpose of contracting with the Department of Health Care Services and to arrange for the provision of health care services to qualifying individuals in the respective counties who lack sufficient annual income to meet the cost of health care and whose other assets are so limited that their application toward the cost of health care would jeopardize future minimum self-maintenance and security.
The county ordinances set forth certain requirements and standards of conduct for the Commission. Further, the ordinances require the Commission to adopt Bylaws outlining procedures for the conduct of business not otherwise specified in the ordinance, including a provision for the creation of standing committees of the Commission. Upon adoption by the Commission, the Bylaws are to be submitted to the BOS of each county for final approval.
Commission Staff reviewed the Bylaws adopted by the predecessor Commission, the Santa Cruz - Monterey - Merced Managed Medical Care Commission. Commission Staff updated the Bylaws to reflect the following revisions necessary to properly reflect the SCMMSBMMMCC Board’s conduct of business:
• To incorporate Board of Supervisors of San Benito County and Mariposa County to the Commission.
• To increase the count of voting members from 21 Commissioners to 25 Commissioners.
• To revise the method of appointing members, determined by a formula linked to the count of Medi-Cal beneficiaries in each county, with a cap of 5 members per county.
• The subsections regarding Qualifications were eliminated.
• To clarify and modify provisions in the Compensation section.
• To amend the provisions regarding Regular and Special Meetings, removing the provision for a special meeting convened by call of the Chairperson or eleven (11) members, transferring this authority to the Chairperson or a majority of appointed Commissioners.
• To change the provision regarding a Quorum, specifying that any Commission action shall require a roll call vote if requested by another attending member.
• To update the Voting formula for eligible votes, requiring a positive majority for approval.
The draft Bylaws were submitted by Commission Staff to the Department of Managed Health Care and were approved as part of the required Notice of Material Modification to the Alliance’s Knox-Keene license.
DISCUSSION
At its October 25, 2023, meeting, the SCMMSBMMMCC Board adopted the bylaws of the Commission, outlining the conduct of business of the Board and as recommended by Commission Staff. Further, the Board directed staff to return to the Board with revisions to the bylaws to reflect concerns expressed by the Board regarding the provisions outlining the qualifications of the Board seat(s) designated for public representation. The Board stated its desire that the bylaws require that at least one of the individuals from the public representing the population of beneficiaries to be served by the Alliance be either a past or present Medi-Cal beneficiary or the parent or guardian of a past or present Medi-Cal beneficiary.
At its December 6, 2023, meeting the SCMMSBMMMCC Board considered Commission Staff’s revisions codifying the Board’s commitment to having a public representative seat on the Commission specifically dedicated for a past or present Medi-Cal beneficiary or parent/guardian and remains consistent with the composition of the current Board. The SCMMSBMMMCC Board voted unanimously to adopt the Bylaws, as revised, and to submit the Bylaws, as revised, to each county’s Board of Supervisors for final approval.
This work supports one of County of Monterey Health Department’s 2018-2024 Strategic Plan Goals; 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. While this work is not directly in support of a Health Department strategic initiative, it is in support of one or more 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:
The Board of Supervisors appoints five of the now 25-member Commission. The Director of Health Services and a member of the Board of Supervisors constitute two of the five appointed Commissioners.
FINANCING:
The recommended action has no impact on the County budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Juanita Sanders, Management Analyst II, 755-5494
Approved by:
______________________________ Date_______________________
Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Final By-Laws