Agenda

Return

C. 16

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	April 27, 2021

Contra

Costa

County

Subject:

County Organized Health System Letter of Intent

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 04/27/2021

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:	Patrick Godley, 925-957-5405
cc:	Jackie Peterson Marcy 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: April 27, 2021
Monica Nino, County Administrator

BY:	, Deputy

RECOMMENDATION(S):

ACCEPT the concept introduced by the Contra Costa Health Plan at the March 12, 2021 Joint Conference Committee Meeting to convert CCHP from a Medi-Cal two plan model to a single plan model known as a County Organized Health System (COHS), and AUTHORIZE the Chair of the Board and the Contra Costa Health Plan (CCHP) CEO to sign a non-binding letter of intent to the State of California.

FISCAL IMPACT:

Conversion to a single plan model will increase CCHP’s Medi-Cal membership from 200,000 to approximately 238,000. The net income impact is expected to be positive and in the range of 2% to 4% of gross revenue.

BACKGROUND:

On March 12, 2021 the Contra Costa Health Plan Joint Conference Committee received and reviewed the option for a CCHP conversion to a single plan model. Supervisors Andersen and Glover are voting members on the Committee, which approved the concept and recommended forwarding the submission to the full County Board for approval.

BACKGROUND: (CONT'D)

The State Department of Health Care Services (DHCS) is beginning the procurement process for Commercial Medi-Cal Managed Care plans. As part of the procurement process counties now have the option to request a change in the local plan model.

The Contra Costa Health Plan (CCHP) currently operates in a “Two-Plan Model” county. The two plans are CCHP and Anthem Blue Cross. Currently CCHP has approximately 84% of the Medi-Cal membership and Anthem has approximately 16%.

An option for CCHP is to convert to a single plan model known as a County Organized Health System (COHS). The COHS model provides a number of benefits: (a) enhances the probability of success in the State’s CalAIM initiatives (b) provides the pathway for full Medi-Cal population health initiatives (c) opens possibilities for better management for those transitioning out of incarceration (d) allows for consideration of a fully integrated model inclusive of behavioral health, dental and long-term care and (e) the single plan structure is a cost effective alternative.

The County Board is currently the governing body of CCHP. Conversion to a COHS has no impact on the current governance or organizational structure.

Conversion from a two plan to a single plan model requires the State Department of Health Care Services (DHCS) approval, a new County Ordinance, possible State legislative action, and Federal approval of a section 1115 Waiver for the creation a new COHS.
The State timeline for model conversion consideration is as follows:
a) Letter of intent approved by the County Board of Supervisors by April 30, 2021.
b) County Ordinance adoption by October 1, 2021 (the substance of the Ordinance is currently under review).
c) State legislative action, if needed, by September 10, 2021 (this appears to be unlikely at this time)
d) After October 19, 2021 Final Commercial Plan RFP release.
e) 2021-2022 DHCS will work with federal Centers for Medicare and Medicaid Services (CMS) for necessary waiver amendments.
f) January 2024 new contracts and plans begin.

Submission of the County letter of intent (LOI) is the first step in the process. The LOI is non-binding and does not guarantee State approval but without the submission by the April 30, 2021 deadline CCHP would be excluded from future consideration. The LOI is intended to (a) demonstrate understanding of the obligations of the new plan (b) describe county engagement and (c) outline the necessary steps to meet the requirements. See attachment A for the Letter of Intent.

CONSEQUENCE OF NEGATIVE ACTION:

Failure to file a letter of intent will eliminate CCHP from model conversion consideration.