Title
a. Ratify execution by the Director of Health or Assistant Director of Health of a Medi-Cal Point of Service (POS) Network/Internet Agreement, with a retroactive effective date of July 1, 2020, authorizing the NIDO Clinic to perform Medi-Cal eligibility verification during the patient intake process; and
b. Authorize the Director of Health or Assistant Director of Health or their designees through June 30, 2025 to sign and execute future Medi-Cal Point of Service (POS) Network/Internet Agreements and amendments thereto for clinic sites operated by the Monterey County Health Department Clinic Services Bureau.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Ratify execution by the Director of Health or Assistant Director of Health of a Medi-Cal Point of Service (POS) Network/Internet Agreement, with a retroactive effective date of July 1, 2020, authorizing the NIDO Clinic to perform Medi-Cal eligibility verification during the patient intake process; and
b. Authorize the Director of Health or Assistant Director of Health or their designees through June 30, 2025 to sign and execute future Medi-Cal Point of Service (POS) Network/Internet Agreements and amendments thereto for clinic sites operated by the Monterey County Health Department Clinic Services Bureau.
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Clinic Services) operates ten community clinic sites designated as Federally Qualified Health Centers (FQHCs) which provide preventive, primary, and specialty medical care services
The Monterey County Health Department assumed management of the NIDO Clinic in January of 2020 and as part of the process to transition the clinic to a primary care site, a Medi-Cal Point of Service Network/Internet Agreement (POS Agreement) was required to verify patient eligibility.
The California Department of Health Care Services (DHCS) requires that Medi-Cal patient eligibility verification be conducted through the Medi-Cal website utilizing the POS Network portal. In order to access the portal, DHCS requires a signed POS Agreement on file. The Health Department executed the POS Agreement prior to Board of Supervisors approval to allow immediate portal access for NIDO staff to complete the required Medi-Cal eligibility verification process. Verification of Medi-Cal eligibly is a key part of the patient intake workflow and is vital to operations. It is key to ensure that patients are covered by Medi-Cal for services to be rendered to protect the patient from high out of pocket costs and ensure Clinic Services reimbursement. Clinic Services currently has POS Agreements on file for each existing clinic site.
Ratification of the executed POS Agreement will allow Clinic Services to continue to utilize the Medi-Cal portal for patient eligibility verification. Authorization of the Director of Health or Assistant Director of Health or their designees to sign and execute future Medi-Cal Point of Service (POS) Network/Internet Agreements and amendments for clinic sites operated by Clinic Services will prevent delays in patient eligibility verification and disruption to operational workflows.
This work supports the Monterey County Health Department 2018-2022 Strategic Plan Initiatives: 1. 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: 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
County Counsel and Health Department IT have reviewed as to form.
FINANCING:
There are no fiscal provisions to 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: Alanna Mack, Management Analyst I, 755-1385
Approved by:
______________________Date:_________
Elsa Jimenez, Director of Health, 755-4526
Attachment:
Agreement is on file with Clerk of the Board