Agenda

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C. 33

To:	Board of Supervisors
From:	William Walker, M.D., Health Services Director
Date:	December 8, 2015

Contra

Costa

County

Subject:

Approve Memorandum of Understanding #28-881 with Anthem Blue Cross Health Plan

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 12/08/2015

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Mary N. Piepho, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Daniel Peddycord, 313-6712
cc:	T Scott Jpigg M Wilhelm

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: December 8, 2015
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

Approve and authorize the Health Services Director, or his designee, to execute, on behalf of the County, a Memorandum of Understanding #28-881 with Anthem Blue Cross Managed Care Plan (MCP), for the purpose of coordinating services between Anthem Blue Cross MCP and the County’s Targeted Case Management (TCM) program for Anthem Blue Cross MCP Medi-Cal patients for the period from July 1, 2015 through June 30, 2020.

FISCAL IMPACT:

None. This non-financial agreement will allow the County to continue to receive funds to provide Targeted Case Management services for Medi-Cal patients enrolled in the Anthem Blue Cross Managed Care Plan No additional County match is required.

BACKGROUND:

Since 1997, the Department of Health Care Services has funded many local governmental agencies to provide TCM services. The TCM program is a federal program funding comprehensive case management services to individuals within a specified target group. Public Health Nursing provides TCM services. Due to California’s “Bridge to Reform”, Section 1115 Medicaid demonstration waiver and the related Medi-Cal managed care expansion, the new TCM policies require a current TCM provider Memorandum of Understanding with participating counties. This Memorandum of Understanding defines protocols for coordination of care to assure non-duplication of services for Anthem Blue Cross Medi-Cal patients who receive TCM comprehensive case management services by the County’s Public Health Nurses.

Approval of Memorandum of Understanding #28-881 allows the County and Anthem Blue Cross Managed Care Plan to adhere to state and federal policies and procedures ensuring coordination and non-duplication of services through June 30, 2020. This agreement includes mutual indemnification.

CONSEQUENCE OF NEGATIVE ACTION:

If this agreement is not approved, the County will not have funds accessible to continue the Targeted Case Management Services.

CHILDREN'S IMPACT STATEMENT:

Not applicable.