Title
a. Approve delegation of authority to the Director of Health to execute a Memorandum of Understanding (“MOU”) with the Santa Cruz-Monterey-Merced Managed Medical Care Commission dba Central California Alliance for Health (“CCAH”) and Local County Child Health and Disability Prevention (“CHDP”) Programs, to delineate responsibilities in the provision of pediatric preventive services to all Medi-Cal enrollees under age 21, effective as of the date of execution and shall renew automatically for subsequent terms of two (2) years each unless earlier terminated or amended; and
b. Approve delegation of authority to the Director of Health amend or terminate the MOU, following approval by County Counsel as to form and legality. Delegation of authority shall expire on June 30, 2020.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve delegation of authority to the Director of Health to execute a Memorandum of Understanding (“MOU”) with the Santa Cruz-Monterey-Merced Managed Medical Care Commission dba Central California Alliance for Health (“CCAH”) and Local County Child Health and Disability Prevention (“CHDP”) Programs, to delineate responsibilities in the provision of pediatric preventive services to all Medi-Cal enrollees under age 21, effective as of the date of execution and shall renew automatically for subsequent terms of two (2) years each unless earlier terminated or amended; and
b. Approve delegation of authority to the Director of Health amend or terminate the MOU, following approval by County Counsel as to form and legality. Delegation of authority shall expire on June 30, 2020.
SUMMARY/DISCUSSION:
This MOU between the CCAH and CHDP Programs in Santa Cruz, Merced, and Monterey counties documents the ways the organizations work together in the provision of pediatric preventive services to all Medi-Cal enrollees under the age of 21. The coordination of care outlined in the MOU will help assure that Medi-Cal Managed Care enrollees under age 21 receive timely and appropriate preventive health assessments, including anticipatory guidance, referral to diagnosis and treatment services, and assuring continuity of care and follow-up.
To meet the federal regulations for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program services, California enacted the CHDP program in 1973. CHDP established care standards and preventive health services for low income children and youth in California. In CHDP, Medi-Cal enrollees under age 21 are eligible for all services under EPSDT. With the establishment of Alliance in each of the three counties, Medi-Cal enrollees enroll in Alliance and are linked to a primary provider who is responsible for managing the EPSDT services. In CHDP, income-eligible, non-Medi-Cal enrollees under age 19 are eligible for early and periodic screening.
Each county CHDP program implements the State and Federal regulations mandating CHDP activities at the local level. Activities include: intensive informing of Medi-Cal beneficiaries about CHDP services; assisting Medi-Cal beneficiaries to gain and maintain access to preventive and curative health services; developing and implementing on-going strategies to outreach the eligible population; recruiting, training, enrolling, assisting, and monitoring a network of community medical providers offering CHDP services; providing supplemental care coordination; and assessing compliance with program standards. Alliance implements the Federal and State requirements for providing EPSDT services to their Medi-Cal enrollees under the age of 21.
CHDP programs in Monterey, Santa Cruz, and Merced Counties are encouraged to have an MOU with the County’s managed care plan. The CHDP and Alliance activities are the same for each county, thus the development of the single MOU that outlines the provision and coordination of care for Medi-Cal children and youth as required by federal and state statutes. This MOU is not a service agreement and no funds are exchanged between the entities for services provided.
This work supports the Monterey County Health Department 2011-2015 Strategic Plan Initiative(s): empower the community to improve health through programs, policies, and activities; enhance community health and safety by emphasizing prevention; ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports one or more of the ten essential public health services, specifically: inform, educate, and empower people about health issues; mobilize community partnerships and action to identify and solve health problems; develop policies and plans that support individual and community health efforts; link people to needed personal health services and assure the provision of health care when otherwise unavailable; assure competent public and personal health care workforce; and evaluate effectiveness, accessibility, and quality of personal and population-based health services.
OTHER AGENCY INVOLVEMENT:
County Counsel reviewed and approved the MOU. Risk Management and the Auditor-Controller have reviewed the MOU as to risk, and fiscal provisions, respectively. The MOU does not include the County’s insurance and indemnification provisions as it outlines legal responsibilities under applicable state regulations and is not a service agreement. A copy of the MOU is on file with the Clerk of the Board.
FINANCING:
There are no fiscal provisions included in this MOU. Approval of this MOU will have no impact on the Health Department’s (HEA003-8124) Adopted Budget for Fiscal Year 2014-15.
Prepared by: Patricia McFadden, MAII, 4726
Approved by: Ray Bullick, Director of Health, 4526
Attachment:
MOU is on file with Clerk of the Board