REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 12, 2023
FROM
GILBERT RAMOS, Director, Transitional Assistance Department
SUBJECT
Title
Amendment to Non-Financial Memorandum of Understanding with Inland Empire Health Plan for Data Sharing
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to non-financial Contract No. 21-106 (Memorandum of Understanding) with Inland Empire Health Plan for the exchange of information regarding mutual customers to promote retention and successful renewals for Medi-Cal coverage, updating language to report County file exchanges for disenrolled/discontinued members, with no change to the contract term of December 6, 2020, through December 5, 2025.
(Presenter: James LoCurto, Assistant Director, 388-0245)
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 Memorandum of Understanding (MOU) is non-financial; therefore, it does not impact Discretionary General Funding (Net County Cost).
BACKGROUND INFORMATION
Under the terms of the recommended amendment to the MOU (Contract No. 21-106), Inland Empire Health Plan (IEHP) will provide the Transitional Assistance Department (TAD) with a complete list of San Bernardino County IEHP members (Members) on a monthly basis. TAD will provide IEHP with weekly lists of mutual customers of IEHP and TAD who require an Annual Redetermination for continued Medi-Cal coverage, monthly lists of Members that were discontinued the previous month, and monthly lists of Members whose cases are set to disenroll within 10 business days. The recommended amendment requires weekly notification of customers that are due for an Annual Redetermination of eligibility and provides a more comprehensive list of customer demographics and information regarding customer status of enrollment/disenrollment requirements, including outlining a specified format in which this information is to be exchanged between IEHP and TAD, thus ensuring the web-based interface is uploaded correctly.
TAD administers the public assistance programs in San Bernardino County, including Medi-Cal, California’s Medicaid program serving low-income individuals. Eligibility for Medi-Cal must be reevaluated on an annual basis. Failure to complete and return an Annual Redetermination to TAD results in loss of benefits for individuals and families.
IEHP is a Local Initiative Health Plan formed pursuant to Welfare and Institutions Code section 14000, et seq., through a Joint Powers Agreement between the Counties of Riverside and San Bernardino. IEHP operates in compliance with the Knox-Keene Health Care Services Act of 1975 and arranges and pays for the provision of covered Medi-Cal services to eligible Medi-Cal members residing in San Bernardino County.
IEHP will encourage their members whose eligibility is being redetermined to complete and return redetermination packets by contacting Members by mail, phone, or in person; assisting Members with completing their redetermination, as needed; referring questions or reschedules to the TAD Customer Service Center; and keeping track of Members who indicate they do not wish to renew their Medi-Cal coverage.
On February 9, 2021 (Item No. 59), the Board of Supervisors approved an MOU (Contract No. 21-106) between IEHP and TAD for the exchange of information regarding mutual customers to promote retention and successful renewals for the contract period of December 6, 2020, through December 5, 2025. Under the terms of this MOU, IEHP provides TAD with a complete list of Members on a monthly basis, and TAD provides IEHP with lists of those mutual customers who require an Annual Redetermination for continued Medi-Cal coverage.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Human Services Contracts (Patty Steven, Contracts Manager, 388-0241) on June 8, 2023; County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on July 24, 2023; Finance (John Hallen, Administrative Analyst, 388-0208) on August 3, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on August 7, 2023.