Agenda

Return

C. 40

To:	Board of Supervisors
From:	Anna Roth, Health Services
Date:	January 11, 2022

Contra

Costa

County

Subject:

Add Eight (8) Positions for CalAIM Initiatives in the Contra Costa Health Plan of the Health Services Department

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 01/11/2022

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	MaryJane DeJesus-Sapharn, (925) 957-5240
cc:	Jo-Anne Linares MJ De Jesus Sharron Mackey Lauren Jimenez

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: January 11, 2022
Monica Nino, County Administrator

BY:	, Deputy

RECOMMENDATION(S):

ADOPT Position Adjustment Resolution No. 25866 to add one (1) Deputy Executive Director, Contra Costa Health Plan- Exempt (VCD2) at salary plan and grade B85-2030 ($10,116.43 - $12,296.58); one (1) part-time (32/40) Medical Director – Exempt (VCA2) position at salary plan and grade B85-2645 ($30,332.31); one (1) Medical Social Worker II (X4VH) position at salary plan and grade 255-1590 ($6,764.93 - $8,222.82) (represented); one (1) Administrative Services Assistant III (APTA) position at salary plan and grade ZB5-1631 ($6,812.18 - $ 8,280.25); two (2) Registered Nurse (VWXG) positions at salary plan and grade L32-1880 ($10,398.09 - $12,985.79); one (1) Health Plan Authorization Representative (VRTA) position at salary plan and grade 3RX-1119 ($4,092.57 - $5,226.38); and one (1) Clerk-Senior Level (JWXC) position at salary plan and grade 3RX -1033 ($3,758.50 - $4,799.76) in the Health Services Department. (Unrepresented and represented)

FISCAL IMPACT:

This action will incur an approximate annual cost of $1,768,432, including $685,798 in pension cost. The Deputy Executive Director, Contra Costa Health Plan- Exempt will be funded 100% by member premiums. All other positions will be funded by Contra Costa Health Plan revenues related to the new Enhanced Care Management (ECM) Medi-Cal benefit (50%) and the CalAIM 5-year initiative funding (50%).

BACKGROUND:

In 2016, the Contra Costa Health Plan (CCHP) cancelled the former Deputy Executive Director, Contra Costa Health Plan- Exempt position and added a Chief Operations Officer-Exempt position. This executive management change was needed due to the evolved operational complexities of CCHP. At that time, CCHP determined that it had a much greater operational need for a high-level executive to direct the operational management of all aspects of CCHP and have full responsibility in designing, implementing and analyzing operational systems within the Health Plan.

With the California Advancing and Innovating Medi-Cal (CalAIM) expanding all facets of CCHP services and responsibilities, CCHP now has an operational business need to revive the Deputy Executive Director, Contra Costa Health Plan- Exempt to focus on managing a variety of administrative and operational functions including contracts and personnel administration, line management of business services, and operational and clinical units on special projects.

CalAIM leverages Medi-Cal as a tool to help address many of the complex challenges facing California’s most vulnerable residents and takes a person-centered approach that targets the social determinants of health and reduces health disparities and inequities.

As the Medi-Cal Managed Care Plan (MCP), and with CalAIM’s first reforms rolled out in January 2022 and continuing through 2027, CCHP needs to develop a dedicated and specialized oversight unit for CalAIM implementations. CCHP’s current operating structure cannot support a bodacious paradigm shift for oversight for a large delivery system change. CalAIM includes the social determinants of health with a large emphasis on the merger of physical and behavioral health. An oversight unit is required to monitor the implementation and governance structure for a brand-new provider type that includes Public Health/Behavioral Health and Community-Based Organization.

This specialized expertise is required for a CCHP CalAIM Oversight Unit that will have jurisdiction for program management over Enhanced Care Management (ECM), Community Support Services, Student Behavioral Health Initiative, Population Health, Dual Eligible Special Needs Plans (DSNP), and Social Justice Reentry Program. It is critical to have the right talent to supervise this huge transformation of our Medi-Cal delivery system in Contra Costa County.

The CalAIM Oversight Unit will consist of staffing which includes a Medical Director, Medical Social Worker II, two (2) Registered Nurses, Administrative Services Assistant III, Health Plan Authorization Representative, and Clerk-Senior Level.

CONSEQUENCE OF NEGATIVE ACTION:

If the addition of these positions is not approved, CCHP will lack the managerial and operational structure it needs to respond effectively to business changes stemming from CalAIM. Contra Costa Health Services will not be able to fulfill the requirements of the Enhanced Care Management program and would not be able to provide care management services to the highest need Medi-Cal enrollees.