The goals of the Contra Costa Health Plan (CCHP), a Health Maintenance Organization (HMO), are to be responsive to the health insurance needs of the people of Contra Costa County and to encourage the promotion and awareness of Contra Costa Health Plan (CCHP) to the general public, particularly those most medically vulnerable. In order for Contra Costa Health Plan's (CCHP) Membership Services unit to meet its goals, the unit requests to add one PFT Administrative Services Assistant II position that will assist with tasks that have strict deadlines, assist in the preparation and maintenance of procedures manuals, analyze data and prepare reports on organizational, procedural and technical projects, facilitate and ensure the delivery of messages to the County’s members in a compliant manner, monitor the outcomes of all communication to Health Plan members, and represent the unit on specific administrative matters. The unit must also advocate and deliver messages within a certain time frame to Health Plan members as they promote health campaigns that have a fiscal impact. Also, communication must be provided to members in the County’s threshold languages as well as providing alternative formats such as large print, audio, and braille.  

  
In addition, Health Services Finance management identified a need to add additional supervisory positions to the Contra Costa Health Plan (CCHP) finance unit. The present organizational structure is unsustainable as four (4) Accountants, one (1) Accounting Technician, and one (1) Account Clerk report directly to the manager, who also directly performs key reporting duties. On January 1, 2022, the State required Health Plans to submit a new Quarterly Financial Report to the Department of Health Care Services (DHCS) State oversight agency. New State mandates also require Medi-Cal Managed Care Health Plans to report information related to plan members who have Other Health Care Coverage (OHC), and account for refunds due from providers for medical claim overpayments. The unit must also address the additional work created by California Advancing and Innovating Medi-Cal (CalAIM) initiative and the additional work associated with a proposal to convert the Contra Costa Health Plan (CCHP) from a Medi-Cal Two-Plan Model to a Single-Plan County Organized Health System Model. The unit plans to add additional accounting staff to absorb these new mandates and reporting requirements. Management determined the addition of a Health Services Accountant and a Supervising Accountant will provide the appropriate level of management to bring on new staff, provide appropriate training and cross-training to staff, and carve out some of the routine monthly and quarterly work to enable the unit to address the new State reporting requirements in a timely manner, which is critical to the proposal to convert Contra Costa Health Plan (CCHP) to a Single-Plan Model. These additional positions will enable the unit manager to manage the unit and focus on the review of quarterly financial reporting that will become the primary responsibility of other staff. There are also increased State and Federal reporting obligations for the Community Health Plan. This plan includes commercial coverage for County employees and retirees, and the State-sponsored coverage available to in-home supportive service providers in Contra Costa County. Supervisory oversight is needed to manage the process of setting premium rates and monitoring Pharmacy costs.