REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
August 6, 2019
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Memorandum of Agreement for Definitive Medical Care with the National Disaster Medical System
End
RECOMMENDATION(S)
Recommendation
Approve Memorandum of Agreement for Definitive Medical Care with the National Disaster Medical System for the provision of health services to victims of a public health emergency for a period not to exceed five years effective upon execution.
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of the Memorandum of Agreement for Definitive Medical Care (MOA) with the National Disaster Medical System (NDMS) will not result in the use of Discretionary General Funding (Net County Cost). Arrowhead Regional Medical Center (ARMC) may receive reimbursement from Federal Medicare, private insurances, TRICARE (a military health program), and the NDMS for services provided to victims of a public health emergency, subject to availability of NDMS appropriations. The intent in the case of a national disaster is for NDMS to reimburse ARMC up to 110%, which includes a 10% administration fee.
BACKGROUND INFORMATION
In a federally declared national disaster, the NDMS statute provides that the NDMS shall be a collaboration between NDMS Federal Partners, working in conjunction with the states and other appropriate public or private entities, to provide the following services as medically indicated: health services, health-related social services, other human and auxiliary services to respond to the needs of victims of a public health emergency, and presence at locations for limited periods of time, when such locations are at risk of a public health emergency during the time specified. The recommended MOA will enable ARMC to continue as a NDMS Federal Partner and to plan jointly for the admission, treatment, and discharge of all patients transferred to ARMC under NDMS.
Upon activation by NDMS, ARMC will continue to provide, as required under the existing MOA, a maximum of 140 beds for patients to be admitted as a consequence of a federally declared national disaster. In the event of a federally declared national disaster, services related to this MOA will only be utilized after all local resources (for example, city, county, and state) have been completely exhausted.
NDMS reimburses ARMC for the services ARMC provides during the federal declared national disaster. However, the reimbursement is subject to the availability of funds and only after ARMC has exhausted all other means of reimbursement such as third-party billing, including health insurance companies and TRICARE. NDMS will reimburse ARMC for uninsured or Medi-Cal patients at 110% of the current Medicare rate. For patients with insurance and/or TRICARE, the reimbursement will be for the difference between the payment received and the cost of the services provided. The MOA shall be effective upon execution by both parties, and shall remain in effect for a period not to exceed five years.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Scott Runyan, Deputy County Counsel, 387-5455) on July 10, 2019; Finance (Amanda Trussell, Principal Administrative Analyst, 387-4773 on July 23, 2019; and County Finance and Administration (Katrina Turturro, Deputy Executive Officer, 387-5423) on July 23, 2019.