Title
a. Approve and authorize the Director of Health or Assistant Director of Health to sign and execute a non-exclusive Referral Agreement with Community Hospital of the Monterey Peninsula (CHOMP) for the provision of the following referral services; diagnostic radiology diagnostic laboratory, and obstetrical care (labor and delivery, post-partum care) for Monterey County Health Department patients as referred, with an initial term of May 8, 2018 to May 7, 2020, in substantially the same form as that which has been presented to the Board, without material change to its content;
b. Accept the recommendations of the Director of Health or Assistant Director of Health regarding the following non-standard provisions in the Referral Agreement: indemnification and insurance; and
c. Approve and authorize the Director of Health or Assistant Director of Health to sign up to three (3) future amendments to this Agreement where the amendments do not significantly change the scope of work.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and Authorize the Director of Health or Assistant Director of Health to sign and execute a non-exclusive Referral Agreement with Community Hospital of the Monterey Peninsula (CHOMP) for the provision of the following referral services; diagnostic radiology diagnostic laboratory, and obstetrical care (labor and delivery, post-partum care) for Monterey County Health Department patients as referred, with an initial term of May 8, 2018 to May 7, 2020, in substantially the same form as that which has been presented to the Board, without material change to its content; and
b. Accept the recommendations of the Director of Health or Assistant Director of Health regarding the following non-standard provisions in the Referral Agreement: indemnification and insurance; and
c. Approve and authorize the Director of Health or Assistant Director of Health to sign up to three (3) future amendments to this Agreement where the amendments do not significantly change the scope of work.
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Clinic Services) operates nine community clinic sites designated as Federally Qualified Health Center Look-Alikes (FQHC-LA), which provide preventative, primary, and specialty medical care services. FQHC-LA clinic sites are governed and regulated by the Health Resources and Services Administration (HRSA) to provide primary health services to all patients regardless of ability to pay.
Required and additional services within the clinics HRSA approved scope of project that are not directly provided by the clinic must be made available to patients through a formal written referral arrangement. Required services that must be referred due to the clinics either not having the appropriate equipment or staff, are diagnostic radiology, diagnostic laboratory and obstetrical care services (labor and delivery and post-partum care). This is a non-exclusive Agreement. As stated in the Agreement, Clinic Services has the right to contract and refer to other entities for the same or similar services.
FQHCs are required by HRSA, as defined by the federal Section 330 of the Public Health Service Act statute, to establish a Sliding Fee Discount that outlines a fee schedule for its services that is consistent with locally prevailing rates and reflects the clinic’s reasonable costs of providing services. For services provided via formal referral arrangements, the referred to entity shall make available a discount to eligible patients who are at or below 200% of the Federal Poverty Level that meets or exceeds the Sliding Fee Discount requirements set by HRSA to assist with the costs of their care.
This work supports the Monterey County Health Department 2011-2015 Strategic Plan Initiatives: 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 and the Auditor-Controller have reviewed and concur with this recommendation. Risk Management has not reviewed and approved the non-standard provisions including indemnification and insurance. The Health Department recommends moving forward as it is a licensure requirement from HRSA to have formal written arrangements.
FINANCING:
There are no fiscal provisions within this Agreement.
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: Sheena Morales, Management Analyst III, x1393
Approved by: Elsa Jimenez, Director of Health, x4526
Attachment:
Agreement is on file with the Clerk of the Board