REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  December  12, 2017
CATEGORY:  Consent - Health and Human Services-10.

SUBJECT:

Agreement with County Medical Services Program Administered by Advanced Medical Management, Inc.

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Dean True, Branch Director, Health and Human Services Agency - Adult Services (530)225-5900

STAFF REPORT APPROVED BY:  Dean True, Branch Director, Health and Human Services Agency - Adult Services

RECOMMENDATION

Approve and authorize the Chairman to sign an evergreen revenue agreement, effective date of signing, with the County Medical Services Program (CMSP) Governing Board at rates listed in Exhibit B to the agreement to authorize the Health and Human Services Agency medical providers to receive reimbursement for outpatient mental health and substance abuse services provided to Shasta County CMSP clients. 

SUMMARY

In June 2015, the CMSP Governing Board held a Strategic Planning Meeting to create a two-year pilot project which became effective May 1, 2016 to expand covered primary and specialty care services to eligible CMSP beneficiaries. CMSP provides limited-term health coverage for uninsured low-income, indigent adults (ages 21-64) that are not otherwise eligible for other publicly funded health programs. Advanced Medical Management, Inc. is the third-party administrator for payment of CMSP claims, and in order for the Health and Human Services Agency (HHSA) to receive reimbursement for the services performed by HHSA staff, a new medical provider agreement with CMSP must be approved.

DISCUSSION

In 1983, California law was enacted that established the County Medical Services Program (CMSP) as a program within the State Department of Health Care Services (DHCS). CMSP provides health coverage for low-income, indigent adults in 35 rural California counties. In April 1995, California law was amended to establish the CMSP Governing Board charging them with overall program and fiscal responsibility. As of September 2005, Anthem Blue Cross Life & Health Insurance Company became the third-party administrator for CMSP, followed by Advanced Medical Management, Inc. (AMM) beginning in April 2015. As the current third-party administrator for CMSP, AMM continues to provide for the healthcare needs of low-income, indigent adults in rural California counties.

This agreement will allow the Health and Human Services Agency to remain a network provider for those served through CMSP. As of September 30, 2017, there are 17 Shasta County residents enrolled in CMSP. As an approved network provider, HHSA will be eligible to receive reimbursement for non-emergency services provided to CMSP clients. Furthermore, HHSA will be able to participate in a loan forgiveness program through the California Office of Statewide Health Planning and Development and the CMSP Governing Board for medical professionals providing services through CMSP network providers.

ALTERNATIVES

The Board could choose not to approve the agreement.

OTHER AGENCY INVOLVEMENT

County Counsel has approved the agreement as to form. Risk Management has reviewed and approved the agreement. This recommendation has been reviewed by the County Administrative Office.

FINANCING

HHSA's FY 2017-18 Adopted Budget includes sufficient appropriation authority for the activities described in this agreement. There is no additional General Fund impact from the recommended action.