REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 15, 2022
FROM
LEONARD X. HERNANDEZ, Chief Executive Officer, County Administrative Office
SUBJECT
Title
Amendment to Master Employment Agreement for Enhanced Care Management
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to the Master Employment Agreement No. 22-1082, effective November 15, 2022, for the Enhanced Care Management program to retain program staff as part of the new California Advancing and Innovating Medi-Cal Program, updating employment terms and benefits, through June 30, 2024.
2. Delegate authority to the Chief Executive Officer, or the designated Department Director, to execute individual Employment Agreements and amendments for the California Advancing and Innovating Medi-Cal Program, effective through June 30, 2024, with the option to extend the term for a maximum of three, successive one-year periods.
(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.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost) as the program expenses are funded by the California Department of Health Care Services (DHCS) and reimbursed to San Bernardino County (County) on behalf of Arrowhead Regional Medical Center (ARMC), Department of Behavioral Health (DBH), Department of Public Health (DPH), and Office of Homeless Services (OHS), through the Inland Empire Health Plan and IEHP Health Access (collectively referred to as “IEHP”) based on a capitation (healthcare payment) system that uses a value-based methodology.
BACKGROUND INFORMATION
Effective January 1, 2022, the County implemented a new initiative from DHCS, called Enhanced Care Management (ECM) and Community Supports (CS) as part of the California Advancing and Innovating Medi-Cal (CalAIM) Program. Through ECM and CS, the County seeks to meet the medical and non-medical circumstances of high-need Medi-Cal beneficiaries at the individual’s County medical location of preference. High-need Medi-Cal beneficiaries include individuals who are homeless and/or have serious mental illness, adults and children with complex medical conditions, justice-involved populations with significant clinical needs, and the growing aging population. ECM and CS were implemented collaboratively as a multi-departmental endeavor with ARMC, DPH, and DBH leading the ECM program, and OHS leading CS services.
On January 11, 2022 (Item No. 12), the Board of Supervisors (Board) approved Master Employment Agreement No. 22-1082 to hire ECM program staff and Master Employment Agreement No. 22-1083 to hire CS program staff effective January 1, 2022 through June 30, 2024, with the option to extend the term for a maximum of three, successive one-year periods in the event that the Board approves an extension beyond June 30, 2024, to the term of Agreement No. 21-983 between IEHP and the County, on behalf of ARMC, DBH, DPH, and OHS. The Board also delegated authority to the Chief Executive Officer, or the designated Department Director, to execute individual Employment Agreements for the implementation of ECM and CS.
A similar delegation of authority is now requested for execution of individual Employment Agreements and amendments to expedite this process, given the high volume of program staff. The County or contract staff may terminate the Agreements at any time without cause with a 14-day prior written notice to the other party. The Agreements may be terminated for just cause immediately by the Director of the applicable department. Contract staff shall serve at the pleasure of the Director of the applicable department, or their designee, who shall have the full authority and discretion to exercise County rights.
The rates for family medical coverage for ECM staff, as well as life insurance benefits for ECM Drug and Alcohol Counselors have been updated in the amendment to align with the current Memorandum of Understanding. The amendment will be effective on November 15, 2022.
The ARMC, DBH, and DPH recommend approval of this amendment for the safety, health, and social service needs of County residents through the continued implementation of ECM by providing full benefits to retain ECM staff.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Cynthia O’Neill, Principal Assistant County Counsel, and Deputy County Counsels, Charles Phan, Suzanne Bryant, Adam Ebright and Dawn Martin, 387-5455) on October 3, 2022; Arrowhead Regional Medical Center (William L. Gilbert, Director, 580-6150) on September 14, 2022; Behavioral Health (Georgina Yoshioka, Interim Director, 252-5142) on October 3, 2022; Public Health (Joshua Dugas, Director, 387-9146) on October 3, 2022; Office of Homeless Services (Martha Zepeda, Deputy Executive Officer, 387-4351) on October 3, 2022; Human Resources (Diane Rundles, Director, 387-5570, and Gina King, Deputy Director, 387-5571) on September 23, 2022; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on October 6, 2022; Finance (Administrative Analysts, Jenny Yang, 387-4884, Christopher Lange, 386-8393 and Paul Garcia, 386-8392) on October 7, 2022; and County Finance and Administration (Diana Atkeson, Deputy Executive Officer, 387-5423) on October 7, 2022.