Title
a. Approve and Authorize the Sheriff or Undersheriff to sign the Agreement with the California State Department of Health Care Services (DHCS), July 1, 2020 to June 30, 2023, for reimbursement of eligible inpatient medical expenses for inmates at the Monterey County Jail through the Medi-Cal for Inmate Program (MCIP); and
b. Approve and Authorize the Sheriff or Undersheriff to sign the Administrative Agreement with the California State Department of Health Care Services (DHCS), July 1, 2020 to June 30, 2023, for reimbursement of administrative costs associated with the Medi-Cal for Inmate Program (MCIP).
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and Authorize the Sheriff or Undersheriff to sign the Agreement with the California State Department of Health Care Services (DHCS), July 1, 2020 to June 30, 2023, for reimbursement of eligible inpatient medical expenses for inmates at the Monterey County Jail through the Medi-Cal for Inmate Program (MCIP); and
b. Approve and Authorize the Sheriff or Undersheriff to sign the Administrative Agreement with the California State Department of Health Care Services (DHCS), July 1, 2020 to June 30, 2023, for reimbursement of administrative costs associated with the Medi-Cal for Inmate Program (MCIP).
SUMMARY/DISCUSSION:
The Monterey County Sheriff’s Office request approval of this agreement.
On October 8, 2013 California assembly Bill No. 720, Chapter 646 was passed, adding Section 4011.11 to the Penal Code and amending Section 14011.10 of the Welfare and Institutions Code relating to inmates. These legislative actions created the Medi-Cal for Inmates program (MCIP), with a start date of January 1, 2014. Prior to the creation of this program, all medical care costs of inmates were borne by the County where inmate was incarcerated.
The program has three sections covering Adults, Juvenile Wards and the compassionate release of terminally ill inmates. Adult prisoners meeting Medi-Cal eligibility guidelines are eligible to have inpatient hospital stays, in a non-correctional care facility, of 24 hours or more covered by Medi-Cal. The Adult eligibility piece of the program serves as the main focus of this board report, as Probation has had very few claims in recent history.
On September 16, 2014, a Board Order passed authorizing inpatient prisoners be enrolled into Medi-Cal. The Board Order delineated that the Department of Social Services would designate staff members to complete applications and to determine eligibility for inmates and designated the Sheriff’s Office authorized representative status to sign a Medi-Cal application for an inmate only if the inmate was unwilling or unable to sign the application.
Since that time, the strategic partners in this plan (Department of Social Services, MCSO, Probation, Natividad, CAO and Health) have coordinated on a regular basis to evaluate enrollment strategies, based on the MCIP program language disseminated in 2014.
Prior to implementation of this program, MCSO reimbursed Natividad Medical Center (NMC) and Salinas Valley Memorial Hospital (SVMH) and other hospitals at their Medicare Cost to Charge Ratio, plus ten percent (10%) as a maximum cap cost for hospitalizations. Even at this discounted rate, there were years MCSO paid out over a million dollars a year in inpatient medical costs.
The previous agreements with DHCS have called for the County through the MCSO to pay a quarterly prorated administrative fee and pay 5% or 50% (the Non-Federal Share) of the amount of each paid claim. However, until DHCS sends out the Administrative agreement, we are unsure what our cost will be. No matter what the cost is, it will be less than the County having to pay 100% of the cost.
OTHER AGENCY INVOLVEMENT:
Department staff involved in working through this state reimbursement process includes the MCSO, Probation, Department of Social Services, Natividad, Health and the CAO.
FINANCING:
The cost of this contract was included in the FY 2019-20 approved budget, and the proposed FY 2020-21 budget. There will be no increase in General Fund Contribution resulting from this Board action.
Prepared by: Arthur Curtright, Management Analyst II, Ext #3708
Approved by: Steve Bernal, Sheriff/Coroner, Ext #3750
Attachments: Attachment A - DHCS MCIP Evergreen Agreement for FY 2020-2023
Attachment B - Exhibit X - Business Associate Addendum