REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 13, 2023
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Data Sharing Agreement with Department of Health Care Services for the Global Payment Program
End
RECOMMENDATION(S)
Recommendation
1. Approve the Data Sharing Agreement with the Department of Health Care Services for the provision of monthly data from the previous year to identify services that may qualify for additional reimbursement through the Global Payment Program, effective for the one-year reimbursement period beginning November 1, 2022.
2. Authorize the Director of Arrowhead Regional Medical Center to execute future non-financial Data Sharing Agreements with the State, subject to review and approval by County Counsel, for a period of five years from June 13, 2023, through June 12, 2028.
(Presenter: William L. Gilbert, Hospital 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 this item will not result in the use of Discretionary General Funding (Net County Cost). This item will allow the sharing of certain information between Arrowhead Regional Medical Center (ARMC) and the Department of Health Care Services (DHCS) relating to services provided to the uninsured population, which would enable ARMC to obtain additional reimbursements for such care.
BACKGROUND INFORMATION
The Global Payment Program (GPP) is a Medi-Cal waiver program that provides funding to public health care systems for services provided to the uninsured population. Hospitals participating in the GPP receive value-based payment for qualifying services provided to the uninsured and state-only populations. State-only population is a Medi-Cal recipient category with no federal matching funds. GPP hospitals are required to provide encounter data to the GPP team each year to certify these qualifying services. The recommended Data Sharing Agreement (Agreement) is for ARMC to obtain a list of individuals qualifying for state-only reimbursement, by calendar year and month, for assistance in identifying GPP-qualifying encounters from DHCS.
Recommendation No. 1 will approve the Agreement for data sharing, allowing ARMC to receive information from DHCS for uninsured individuals qualifying for state-only reimbursement. The State GPP is a retroactive data review. The reimbursement period is always based on the prior calendar year. This Agreement is effective for the one-year reimbursement period beginning November 1, 2022, as DHCS will be providing data from the month of November 2022 for one year in order for ARMC to receive reimbursements. Information is provided by DHCS for comparison by ARMC to patients served during that specific period. This will help in identifying those services provided by ARMC that may qualify for reimbursement by DHCS through the GPP.
Recommendation No. 2 will allow the ARMC Hospital Director, upon approval by County Counsel to execute future Data Sharing Agreements with the State. A new Data Sharing Agreement is required annually. These agreements are also requested anytime that the State wants to share information regarding qualified individuals receiving state services.
Approval of these recommendations will allow ARMC to operate in a fiscally-responsible and business-like manner, while providing for the safety, health and social service needs of County residents by ensuring that ARMC qualifies for all revenues available from the State.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on May 22, 2023; Finance (Chen Wu, Budget and Finance Officer, 580-3165) on May 22, 2023; Finance (Jenny Yang, Administrative Analyst, 387-4884) on May 24, 2023; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on May 24, 2023.