DATE: August 6, 2024
TO: Board of Supervisors
SUBMITTED BY: Sanja Bugay, Director, Department of Social Services
SUBJECT: Termination of Master Agreement for Medi-Cal Health Enrollment Navigators
RECOMMENDED ACTION(S):
TITLE
1. Retroactively approve and authorize the Director of the Department of Social Services’ (DSS) previously submitted 30-day written notice to contracted Community Based Organizations within Master Agreement No. A-23-509 terminating the Agreement effective June 30, 2024, pursuant to the Non-Allocation of Funds provision of the Agreement, as required by the May 29, 2024, Termination Notice issued by the Department of Health Care Services (DHCS); and
2. Approve and authorize the Director of the Department of Social Services, and/or designee, subject to approval by County Counsel as to legal form, to execute any documents or certifications necessary to affect the termination of Agreement No. A-23-509.
REPORT
There is no Net County Cost associated with approval of the recommended actions, which will allow for the termination of the Medi-Cal Health Enrollment Navigators Project (SB 154) Master Agreement pursuant to the Non-Allocation of Funding provisions of the Agreement. On May 29, 2024, the Department of Health Care Services (DHCS) issued a termination notice notifying the Department that DHCS is terminating the associated allocation agreement effective June 30, 2024, resulting from the Governor’s projected FY 2024-25 deficit. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Per the “Stop Work Notice” issued by DHCS on May 21, 2024, and the formal termination notice issued on May 29, 2024, all work efforts for the Medi-Cal Health Enrollment Navigators Project are to cease June 30, 2024. If the recommended action is not approved, contracted Community Base Organizations (CBO) will continue work efforts without sufficient funding from DHCS to reimburse the Department for services provided.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The Department was allocated $1,282,250 from DHCS and has expended $281,262.47 through June 30, 2024.
DISCUSSION:
On September 9, 2023, the Board approved a Master Agreement for the Medi-Cal Health Enrollment Navigators Project. The Department received an allocation in the amount of $1,282,250 from DHCS to conduct outreach, enrollment, and renewal services for targeted populations with limited access to Medi-Cal services. The Department subcontracted with seven CBOs to aid with these core services. $1,223,650 was allocated to the CBOs and $58,600 was allocated to the Department for administrative costs.
CBOs began outreach effective October 2023 and were able to consistently provide direct outreach and enrollment services to clients. Trainings and monthly meetings were provided to ensure success of the project.
On May 16, 2024, during a partner DHCS meeting, and on May 21, 2024 within a “Stop Work Notice,” all Project Partners were notified that the Medi-Cal Health Enrollment Navigators Project will be terminating June 30, 2024 due to State budget cuts. All Project Partners were informed to take necessary administrative measures to close-out all activities, with due haste, to ensure that no costs and expenditures for providing services are incurred past June 30, 2024.
On May 29, 2024, DHCS issued a formal letter that “serves as the official termination notice of the Health Enrollment Navigators Project pursuant to section 32 of the Federal Terms and Conditions of the Allocation Agreement. Project Partners must provide any notification and notices to their subcontractors as required by the Allocation Agreement and their individual subcontracts. All Health Navigators Project participants are directed to stop implementation effective immediately. During this noticing period, Project Partners should begin immediately ending all implementation activities with all possible haste, and shift work efforts to close-out activities.”
Approval of the recommended action will allow the Director of the Department of Social Services, and/or designee, to terminate the Medi-Cal Health Enrollment Navigators Project Master Agreement No. 23-509 and cease all further work efforts for outreach, enrollment and/or renewal services by the seven CBOs by June 30, 2024. The Department issued 30-day written notice to all seven CBOs to not incur any other expenses after June 30, 2024. Any activity performed after June 30, 2024, will not be subject to reimbursement.
REFERENCE MATERIAL:
BAI #60, September 19, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - May 21, 2024 Work Stop Notice; Bulletin 2024-001
On file with Clerk - May 29, 2024 Medi-Cal Health Navigators Termination Letter
On file with Clerk - 30-Day Termination Letters Sent to the CBOs
CAO ANALYST:
Ronald Alexander