REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 5, 2026
FROM
SHARON NEVINS, Director, Department of Aging and Adult Services
SUBJECT
Title
Non-Financial Memorandum of Understanding with Kaiser Foundation Health Plan, Inc. to Provide Coordinated Care for In-Home Supportive Services
End
RECOMMENDATION(S)
Recommendation
1. Approve non-financial Memorandum of Understanding, as required by the California Department of Health Care Services, including non-standard terms, with Kaiser Foundation Health Plan, Inc., to provide coordinated care for In-Home Supportive Services, effective May 5, 2026 through May 5, 2029.
2. Authorize the Director of the Department of Aging and Adult Services to execute this Memorandum of Understanding and any subsequent, non-substantive amendments in relation to the Memorandum of Understanding on behalf of the County, subject to review by County Counsel.
3. Direct the Director of the Department of Aging and Adult Services to transmit the Memorandum of Understanding and subsequent non-substantive amendments in relation to the Memorandum of Understanding to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Sharon Nevins, Director, 891-3917)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote and Fulfill the Countywide Vision.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
The Memorandum of Understanding (MOU) is non-financial in nature and will not impact Discretionary General Funding (Net County Cost).
BACKGROUND INFORMATION
Under the 2024 Medi-Cal Managed Care Plan (MCP) contract with the State of California Department of Health Care Services (DHCS), MCPs are required to build partnerships with third-party entities, such as In-Home Supportive Services (IHSS), to ensure coordinated member care and to connect members with community-based resources to support whole system and person-centered care. MCP contracts with the State now require an MOU with counties and third-party entities. On October 11, 2023, DHCS issued All Plan Letter 23-029 outlining the requirements for MCPs and third-party entities to begin using a standardized MOU template. DCHS developed an MOU template for MCPs and third-party entities to utilize, which will ensure contract provisions are captured and provide standardization in reporting.
The DHCS-required MOU template will set the minimum requirements for key contract provisions, including data sharing and training. It will clarify each party’s roles and responsibilities in coordinating the delivery of care and services, outline formal processes for collaboration on population health programs, establish data-sharing pathways, and provide mechanisms for oversight and accountability. In addition, the MOU template will ensure transparency regarding the roles and responsibilities of all parties involved.
On May 21, 2024 (Item No. 7), the Board of Supervisors (Board) approved Contract No. 24-397 with Inland Empire Health Plan and Contract No. 24-398 with Molina Healthcare of California. These MOUs were approved using the DHCS required template with standardized language. Kaiser Foundation Health Plan, Inc (Kaiser) was originally scheduled for the same Board date but was removed from the agenda due to delays in finalizing coordination and negotiation.
The MOU with Kaiser includes the following terms that differ from the standard County contract terms:
1. The MOU does not require Kaiser to meet the County’s insurance standards as required by pursuant to County Policy 11-07.
• County policy requires contractors to carry appropriate insurance at limits and under conditions determined by the County’s Risk Management Department and as set forth in the County policy.
• Potential Impact: The contract does not include any of the County’s standard insurance requirements. This means that the County has no assurances that Kaiser will be financially responsible for claims that arise from this agreement, which could result in an expense to the County.
2. The County is required to indemnify Kaiser against all claims and losses.
• The County standard contract does not include any indemnification or defense by the County of a Contractor.
• Potential Impact: By agreeing to indemnify Kaiser, the County could be contractually waiving the protection of sovereign immunity. Claims that may otherwise be barred against the County, time-limited, or expense-limited could be brought against Kaiser without such limitations and the County would be responsible to defend and reimburse Kaiser for costs, expenses, and damages, which could result in an expense to the County.
The Department of Aging and Adult Services recommends approval of this item, including the non-standard terms, as it meets the DHCS requirements and allows continued collaboration with Kaiser for coordinated care associated with IHSS. This collaboration allows elderly and dependent adults to remain in their homes for a longer period.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Human Services (Lisa Rivas-Ordaz, Contracts Manager, 388-0222) on April 13, 2026; County Counsel (Jacqueline Carey-Wilson, Deputy County Counsel, 387-5455) on April 9, 2026; Risk Management (Stephanie Pacheco, 386-9039) on April 14, 2026; and County Finance and Administration (John Hallen, Principal Administrative Analyst, 386-8392) on April 15, 2026.