Title
a. Ratify Memorandum of Understanding (“MOU”), executed by the Director of Health, with the Santa Cruz-Monterey-Merced Managed Medical Care Commission dba Central California Alliance for Health (“CCAH”) and Monterey County Health Department (“MCHD”) as the designated Targeted Case Management Local Governmental Agency, to implement a collaborative approach to offering the broadest care possible to mutually served members/ clients and to assure non-duplication of Targeted Case Management and CCAH claims, 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 and authorize execution of up to three (3) amendments to MOU that do not significantly change the Scope of Work; and
c. Approve and authorize execution of any notice of termination of MOU. Delegation of authority shall expire on June 30, 2020.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Ratify Memorandum of Understanding (“MOU”), executed by the Director of Health, with the Santa Cruz-Monterey-Merced Managed Medical Care Commission dba Central California Alliance for Health (“CCAH”) and Monterey County Health Department (“MCHD”) as the designated Targeted Case Management Local Governmental Agency, to implement a collaborative approach to offering the broadest care possible to mutually served members/clients and to assure non-duplication of Targeted Case Management and CCAH claims, 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 and authorize execution of up to three (3) amendments to MOU that do not significantly change the Scope of Work; and
c. Approve and authorize execution of any notice of termination of MOU. Delegation of authority shall expire on June 30, 2020.
SUMMARY/DISCUSSION:
California’s “Bridge to Reform”, Section 1115 Medicaid Demonstration Waiver and the related Medi-Cal Managed Care Expansion requires broader Managed Care Health Plan (MCP) responsibility for care coordination and case management services for beneficiaries, including coordination and referral of resources for client social support issues. MCHD’s Targeted Case Management (TCM) programs provide case management for Medi-Cal beneficiaries, including coordination and referral for resources for client medical, social, educational and other support issues. California’s Department of Health Care Services has developed protocols for case management coordination between TCM programs and MCPs that ensure non-duplicative claims to Medi-Cal, and has required LGAs and MCPs to enter into Memorandum of Understanding (MOUs).
This MOU between the CCAH and MCHD documents the required coordination interfaces and corresponding protocols related to each agency’s mutually exclusive case management activities. The case management coordination outlined in the MOU will offer the broadest array of health care and social support services for our concurrently served members/clients. Additionally, this MOU serves to define the respective responsibilities and necessary coordination between MCHD and CCAH, to assure that claims for TCM do not duplicate claims for Medi-Cal Managed Care under CCAH.
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; 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; 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.
OTHER AGENCY INVOLVEMENT:
County Counsel reviewed and approved the MOU. The Auditor-Controller has reviewed the MOU as to fiscal provisions. 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 2015-16.
Prepared by: Dyan Apostolos, Assistant Bureau Chief, 8972
Approved by: Ray Bullick, Director of Health, 4526
Attachment:
MOU is on file with Clerk of the Board