SHERIFF'S OFFICE - D. THOMPSON

Approve agreement with California Department of Health Care Services for the Medi-Cal County Inmate Program for the period of July 1, 2018 through June 30, 2019, in an amount not to exceed $2,447.76; adopt Resolution authorizing the execution of the agreements with California Department of Health Care Services.

SBC FILE NUMBER: 110

RESOLUTION NO: 2018-23

Section 1905(a)(29)(A) of the Social Security Act prohibits Medi-Caid/Medi-Cal funds for healthcare services to inmates residing in correctional facilities. This federal prohibition does not apply when an inmate receives inpatient services at a medical facility located off the grounds of the correctional facility for an expected stay of more than 24 hours providing that the inmate is Medi-Cal eligible.  Historically, counties absorb 100% of the health care costs associated with county inmates.

For the past few years, the Department of Health Care Services (DHCS) has been evaluating how to implement a Medi-Cal County Inmate Program (MCIP) that would allow eligible claims for services provided to inmates to be submitted and paid by the Medi-Cal program.  The Health Care Agency has participated in these discussions through the California State Sheriff's Association and the County Health Executive Association of California. 

On December 21, 2016, DHCS issued its final policy letter regarding the ability for counties to participate in the MCIP.  The MCIP is voluntary and the County has the option to participate in this program by entering into an agreement with DHSC.  The County currently contracts with California Forensic Medical Group (CFMG) for the provision of medical services for inmates, including a provision to cover the cost of services for inpatient hospitalization up to $15,000 per inmate per incident.  Inpatient medical costs exceeding the $15,000 limit become the responsibiity of the County. While the County has not incurred any costs outside of the contracted payments, CFMG has paid medical providers $131,176 between July 2016 and March 2018.  The contract before you is a proactive step toward mitigating that one instance that could cause a financial hardship for the County.

The County will be responsible for reimbursing DHCS for its non-federal share of DHCS' administrative costs associated with administering MCIP.  These costs include, but are not limited to, providing County with paid claim analysis reports, collecting the non-federal share of expenditures for MCIP services, analyzing provider reports, and legal research and analysis related to MCIP.   For FY 2018-19 cost sharing will be based on 1). 30% of the total administrative costs distributed evenly to participating counties over 50,000 in population; and 2). 70% of the total administative costs allocated to participating counties pro-rated based on population.  The County cost for FY 2018-19 will not exceed $2,447.76.

The Sheriff's Office will return to your Board with an agreement between the County and CFMG to support the participation in the Medi-Cal program.   At this time it is unknown how or if this agreement will affect the annual cost of the CFMG contract as the number of inmates who are Medi-Cal eligible is unknown.  

1).  Adopt Resolution approving Agreement No. 18-95057 with the California Department of Health Care Services for participation in the Medi-Cal County Inmate Program in the maximum amount of $2,447.76 for the period of July 1, 2018 - June 30, 2019, and authorizing the Sheriff to execute and implement it; and

2).  Authorize the Sheriff or his designee to submit the Medi-Cal County Inmate Program Agreement, and sign the Agreement including any nonmonetary changes, modifications, amendments, or termination.