REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 29, 2022
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
JOSH DUGAS, Director, Department of Public Health
SUPRIYA BARROWS, Deputy Executive Officer, Community Revitalization
SUBJECT
Title
Amendment to Revenue Enhanced Care Management Provider Agreement with Inland Empire Health Plan and IEHP Health Access for the Establishment of the California Advancing and Innovating Medi-Cal Program
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1, retroactively effective January 1, 2022, to Revenue Enhanced Care Management Provider Agreement No. 21-983 with Inland Empire Health Plan and IEHP Health Access, to increase reimbursement rates to the County for Community Supports Services, with no change to the contract term of January 1, 2022 through June 30, 2024.
2. Direct the Clerk of the Board of Supervisors to maintain confidentiality of the Amendment No. 1 to Agreement No. 21-983 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
Improve County Government Operations.
Operate in a Fiscally-Responsible and Business-Like Manner.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
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 result in additional revenue to the Department of Public Health (DPH) and the Office of Homeless Services (OHS) based on a capitation system that uses a value-based methodology for Community Supports services. At this time, budget adjustments are not requested but will be included on a future quarterly countywide budget report presented to the Board of Supervisors (Board) for approval and will be included in applicable departments’ future recommended budgets.
BACKGROUND INFORMATION
On January 1, 2022, the California Department of Health Care Services (DHCS) established a new, statewide Enhanced Care Management and Community Supports Program called California Advancing and Innovating Medi-Cal (CalAIM), which provides for a whole-person care approach to address the medical and non-medical circumstances of high-need Medi-Cal beneficiaries at their County medical location of preference. High-need Medi-Cal beneficiaries include individuals who are homeless and/or have serious mental illnesses, children with complex medical conditions, justice-involved populations with significant clinical needs, and the growing aging population.
On December 14, 2021 (Item No. 17), the Board approved Revenue Enhanced Care Management Provider Agreement No. 21-983 with Inland Empire Health Plan and IEHP Health Access (collectively, “IEHP”), that established capitation payment rates and set the parameters for the County departments, including Arrowhead Regional Medical Center (ARMC), Department of Behavioral Health (DBH), DPH, and OHS (the “County Departments”), to receive incentive funding for providing enhanced care management and community supports services to certain IEHP members under CalAIM.
Following approval of Agreement No. 21-983 in December of 2021, IEHP and the County were able to negotiate higher capitation rates that will be paid by IEHP to the County for providing community support services. In order to be effective for the full term of the new Enhanced Care Management and Community Supports Program, the rates presented in the recommended amendment require retroactive approval to January 1, 2022. The County Departments recommend approval of this amendment as it will enable the County to optimize a whole person care approach, increase funding to the County to address the medical and non-clinical needs of Medi-Cal beneficiaries, and address a critical County goal to provide for the safety, health and social service needs of County residents.
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 of Supervisors is directed to maintain confidentiality of the amendment.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Adam Ebright, Dawn Martin, and Suzanne Bryant, Deputy County Counsels, 387-5455) on February 28, 2022; Behavioral Health (Georgina Yoshioka, Director, 252-5142) on February 18, 2022; Public Health (Joshua Dugas, Director, 387-6222) on February 15, 2022; Office of Homeless Services (Supriya Barrows, Deputy Executive Officer, 387-4717) on February 5, 2022; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on March 10, 2022; Finance (Christopher Lange, Administrative Analyst, 386-8393, and Paul Garcia, Administrative Analyst, 386-8392) on March 4, 2022; and County Finance and Administration (Diana Atkeson, Deputy Executive Officer, 387-5423, and Cheryl Adams, Deputy Executive Officer, 388-0238) on March 20, 2022.