SHERIFF'S DEPARTMENT-  D. THOMPSON

Approve Agreement Number 20-10236 with California Department of Public Health Services for administrative services associated with the Medi-Cal County Inmate Program for the period July 1, 2020 through June 30, 2023 in an amount not to exceed $7,853.36; adopt Resolution authorizing the execution of the Agreement.

SBC FILE NUMBER: 110

RESOLUTION NUMBER: 2020-55

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. 

The Department of Health Care Services (DHCS) has worked 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. 

The MCIP is voluntary and the County has has chosen to participate in this program by entering into an agreement DHCS. The County currently contracts with Wellpath for medical services to inmates, which includes 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 responsibility of the County.  While the County has not incurred any costs outside of the contracted payments, Wellpath has paid medical providers in excess of $140,000 over the past four years.  The contract before you is proactive toward mitigating that one instance that could cause the County financial hardship. 

The County will be responsible for reimbursing DHCS for the non-federal share of DHCS's administrative costs associated with administering the 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.  Based on the methodology specified in Addendum 'A', payment under this Agreement shall not exceed $7,853.36.  The fiscal year breakdown of this amount is as follows:

$2,491.15 July 1, 2020 - June 30, 2021

$2,615.71 July 1, 2021 - June 30, 2022  

$2,146.50 July 1, 2022 - June 30, 2023  

1).  Adopt Resolution approving Agreement No. 20-10236 with the California Department of Public Health Care Services for administrative services while participating in the Medi-Cal Inmate Program in the amount not to exceed $7,853.36 for a period of July 1, 2020 - June 30, 2023; and

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