File #: RES 24-088    Name: Clinic Services Bureau Appropriations Increase
Type: BoS Resolution Status: Passed
File created: 5/1/2024 In control: Board of Supervisors
On agenda: 6/25/2024 Final action: 6/25/2024
Title: Adopt Resolution to: a. Amend the Health Department's Fiscal Year (FY) 2023-24 Adopted Budget to increase appropriations in the Clinic Services Bureau (001-4000-8592-HEA007) by $7,847,000 financed by assigned fund balance (001-3043-FQHC) (4/5ths vote required); and b. Authorize and direct the Auditor-Controller, and the County Administrative Office to incorporate the appropriations changes in the FY 2023-24 Health Department's Clinic Services Bureau Adopted Budget (001-4000-8592-HEA007).
Attachments: 1. Board Report, 2. Resolution, 3. Completed Board Order Item No. 28, 4. Completed Resolution Item No. 28
Title
Adopt Resolution to:
a. Amend the Health Department's Fiscal Year (FY) 2023-24 Adopted Budget to increase appropriations in the Clinic Services Bureau (001-4000-8592-HEA007) by $7,847,000 financed by assigned fund balance (001-3043-FQHC) (4/5ths vote required); and
b. Authorize and direct the Auditor-Controller, and the County Administrative Office to incorporate the appropriations changes in the FY 2023-24 Health Department's Clinic Services Bureau Adopted Budget (001-4000-8592-HEA007).
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors Adopt a Resolution to:
a. Amend the Health Department's Fiscal Year (FY) 2023-24 Adopted Budget to increase appropriations in the Clinic Services Bureau (001-4000-8592-HEA007) by $7,847,000 financed by assigned fund balance (001-3043-FQHC) (4/5ths vote required); and
b. Authorize and direct the Auditor-Controller, and the County Administrative Office to incorporate the appropriations changes in the FY 2023-24 Health Department's Clinic Services Bureau Adopted Budget (001-4000-8592-HEA007).

SUMMARY/DISCUSSION:
The Clinic Services Bureau requires increased appropriations to process payments to the State, which result from the annual Medi-Cal PPS Reconciliation process. Until this FY, the repayment period lagged about one or two FYs; however, the State has transitioned to an electronic Medi-Cal PPS Reconciliation filing, which has expedited the processing and repayment timelines. Accordingly, repayments anticipated to occur in future FYs will be incurred in FY 2023-24 and will be financed with funds set aside for this purpose.

The Clinic Services Bureau provides primary healthcare services to County residents, and bills Medi-Cal for all reimbursable services. Patient encounters are billed and reimbursed at the wrap rate, which is lower than the Prospective Payment System (PPS) rate established by the state. This is supplemented by per-member per-month (PMPM) payments and other payments tied to the Medi-...

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