REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 26, 2023
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Amendment to Revenue Contract with Inland Empire Health Plan and IEHP Health Access for Specialty Care Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Revenue Contract No. 16-714 with the Inland Empire Health Plan and IEHP Health Access, updating Addendum A to expand specialty care services to include the Covered California line of business, with no change to the contract period beginning November 1, 2016 and automatically renewing until the contract is terminated by either party.
2. Direct the Clerk of the Board of Supervisors to maintain confidentiality of the Contract pursuant to California Health and Safety Code section 1457(c)(1).
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The Inland Empire Health Plan and IEHP Health Access (IEHP) has a capitation agreement with the Department of Public Health (DPH), where it will pay a fixed rate for each enrolled IEHP member. The revenue generated is based on actual fees for service utilization, estimated to be $4,201,000 for 2023-24. The total revenue earned under this agreement will vary with the number of enrollees and the medical services those enrollees receive. The DPH budget includes estimates of the additional revenue to be generated and other expenditures to be incurred due to making health care services available to Covered California members. Adequate appropriation and revenue have been included in DPH’s 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DPH currently is a participating provider in the IEHP Medi-Cal network for the provision of specialty care services, including Obstetrics/Gynecology (OB/GYN) and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS). Services are provided at the Federally Qualified Health Centers located in Adelanto, Hesperia, Ontario, and San Bernardino. This Amendment will allow DPH to continue as an IEHP network provider and allow DPH to participate in the healthcare service product expansion of the Covered California network. It is IEHP’s expectation that Medi-Cal will shift to the Covered California program as the State conducts annual reviews to determine whether applicants continue to meet Medi-Cal eligibility requirements.
IEHP is one of two entities that have been chosen as a preferred County-managed care plan for San Bernardino and Riverside Counties.
Either party may terminate the Revenue Agreement without cause with 90 days’ written notice.
Pursuant to California Health and Safety Code section 1457(c)(1), specific terms related to the rates of payment for health care services in a county medical facility are not immediately subject to laws related to public records; therefore, the Clerk of the Board of Supervisors is directed to maintain confidentiality of this Revenue Agreement.
On April 19, 2016 (Item No. 41), the Board of Supervisors (Board) approved Revenue Letter of Agreement No. 16-168 with IEHP to provide and bill for the specialty care services, for the period of April 20, 2016 through December 31, 2016, pending approval of a formal contract.
On September 13, 2016 (Item No. 55), the Board approved Revenue Contract No. 16-714 with IEHP for DPH to provide specialty care services, for the period of November 1, 2016 through October 31, 2021, with automatic renewals thereafter.
On August 4, 2023, DPH received Amendment No. 1 to Revenue Contract No. 16-714 with IEHP, updating Addendum A to expand specialty care services to include the Covered California line of business, with no change to the contract term.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on September 6, 2023; Finance (Paul Garcia, Administrative Analyst, 386-8392) on September 7, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) September 11, 2023.