REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
February 11, 2020
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment No. 1 to the Hospital Services Agreement with L.A. Care Health Plan
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Agreement No. 18-878 with Local Initiative Health Authority of Los Angeles County operating and doing business as L.A. Care Health Plan, an independent public entity, for provider participation and reimbursement for health care services provided to L.A. Care Health Plan members at Arrowhead Regional Medical Center, amending the Medi-Cal Managed Care Program compensation rates, updating certain terms to comply with California Department of Health Care Services requirements, and extending the termination date from June 30, 2019 to June 30, 2024.
2. Direct the Clerk of the Board to maintain confidentiality of the Agreement pursuant to Health and Safety Code section 1457(c)(1).
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of these recommendations will not result in the use of Discretionary General Funding (Net County Cost). Expenditures for medical services provided under this contract by Arrowhead Regional Medical Center (ARMC) are reimbursed by L.A. Care Health Plan (LA Care) for health care services provided to LA Care Med-Cal Managed Care members based on the agreed upon rates. Sufficient appropriation and revenue is included in the ARMC 2019-20 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
The Board of Supervisors (Board) approved Hospital Services Agreement No. 18-878 with LA Care on December 18, 2018 (Item No. 9) to designate ARMC as a participating provider and allow health plan members to access services at ARMC. This agreement allows ARMC to provide culturally sensitive and linguistically competent quality health care services, promote health and disease prevention, and continuously improve the knowledge and effectiveness of the provider community for the benefit of LA Care members.
Approval of this Amendment No. 1 will allow ARMC to continue to provide services to LA Care members retroactively to July 1, 2019, through June 30, 2024. This amendment also revises the Medi-Cal Managed Care Program compensation rates and updates certain terms to comply with California Department of Health Care Services requirements. Hospital Services Agreement No. 18-878 will continue to provide for the safety, health, and social service needs of County residents, as well as supporting fiscally-responsible and business-like operations by ensuring provision of patient care services to LA Care members at agreed upon reimbursement rates.
This Amendment No. 1 is a retroactive amendment due to the fact that LA Care provided a draft to ARMC on November 22, 2018, and negotiations were necessary to ensure continued reimbursement for care given to members of LA Care. In addition, in August 2019, DHS required an amendment to all contracts updating terms. ARMC was already in compliance with the specified terms, and continued to negotiate the rates for services. This is the first available Board Meeting following all necessary reviews of the amendment.
Pursuant to Health and Safety Code section 1457(c)(1), specific terms related to the rates of payment for health care services are not immediately subject to laws related to public records; therefore, the Clerk of the Board is directed to maintain confidentiality of this agreement.
PROCUREMENT
Not Applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Scott Runyan, Deputy County Counsel, 387-5455) on December 18, 2019; Finance (Amanda Trussell, Principal Administrative Analyst, 387-4773) on January 27, 2020; and County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on January 28, 2020.