DATE: July 14, 2026
TO: Board of Supervisors
SUBMITTED BY: Paul Nerland, County Administrative Officer
SUBJECT: Budget Resolutions and Revenue Agreements with Anthem BlueCross and Kaiser Permanente
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute an Agreement with Anthem BlueCross for Medi-Cal Grant Funding, effective upon execution through December 31, 2027, total not to exceed $146,317;
2. Approve and authorize the Chairman to execute an Agreement with Kaiser Permanente for Medi-Cal Grant Funding, effective upon execution through June 1, 2027, total not to exceed $15,136;
3. Adopt Budget Resolution increasing appropriations and estimated revenues for the FY 2026-27 Medi-Cal - HHIP & IPP Org 0129 in the amount of $161,453 (4/5 vote); and
4. Adopt Budget Resolution increasing appropriations and estimated revenues for FY 2026-27 Office of Housing and Homelessness Org 5428 in the amount of $161,453 (4/5 vote)
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the first and second recommended actions will authorize the Chairman to execute agreements with Anthem BlueCross (Anthem) and Kaiser Permanente (Kaiser) which will provide funding to support administrative and operational costs needed to initiate the Department’s Flexible Housing Subsidy Pool (Flex Pool) project. Approval of the third and fourth recommended actions will increase appropriations and estimated revenues in FY 2026-27 to administer Medi-Cal grant funding in support of homelessness response activities. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board elect not to approve the recommended actions, the County would forfeit $161,453 in grant funds that would be used to support homelessness response in Fresno County.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended agreements will provide a combined $161,453 in grant funds from Anthem ($146,317) and Kaiser ($15,136). Approval of the third and fourth recommended actions will increase appropriations and estimated revenues for the Medi-Cal - HHIP & IPP Org 0129 in the amount of $161,453 and increase appropriations and estimated revenues for the Office of Housing and Homelessness Org 5428 in the amount of $161,453.
DISCUSSION:
Anthem, Kaiser, and CalViva Health (CalViva) are licensed health plans that provide services to Medi‐Cal enrollees throughout California including to Fresno and Madera counties. CalViva Health contracts with HealthNet Community Solutions, Inc. to provide and arrange for Medi-Cal network services.
On December 9, 2025, your Board approved agreements with the local Managed Care Plans for CalAIM Transitional Rent and Housing Deposit Community Supports. The County, through the Office of Housing and Homelessness and the Department of Behavioral Health, has opted to be a Transitional Rent and Housing Deposit Community Supports provider. To administer Transitional Rent benefits and other Community Supports, the County intends to adopt a Flex Pool model to provide faster access to housing, improve health outcomes, and seamlessly braid funding sources to support permanent housing subsidies for people exiting homelessness.
On February 23, 2026, the Department submitted a Letter of Interest to the local Managed Care Plans, which includes CalViva, Anthem Blue Cross, and Kaiser Permanente, and was awarded the entire requested amount of $504,542.
On April 21, 2026, your Board approved an agreement with CalViva Health for $343,089 (68%) of the total request of $504,542. The funding was split proportionately by the Managed Care Plan membership within the jurisdiction. The recommended agreements will provide the remaining $161,453 from Anthem ($146,317) and Kaiser ($15,136). These funds are provided through the California Department of Health Care Services (DHCS) Medi-Cal Incentive Payment Program (IPP) and the Housing and Homelessness Incentive Program (HHIP). These DCHS programs are intended to provide support for addressing homelessness and increasing access and engagement with Medi-Cal services to improve health outcomes for Medi-Cal members.
The grant funds provided through the recommended agreements will be used to support Flex Pool administrative and operational costs needed to initiate year one of the project, including landlord engagement and incentives, as well as case management and rental assistance costs not covered by other CalAIM Community Supports benefits. The Department anticipates releasing a request for proposals for Flex Pool Administrator services later this year, with services anticipated to begin in October of 2026.
Grant funds will also be used to support the County’s role as the Collaborative Applicant for the Fresno Madera Continuum of Care (CoC), including costs to conduct the local competitive process and submit project applications for the 2025 U.S. Department of Housing and Urban Development CoC Notice of Funding Opportunity competition, and costs associated with the 2026 Point-in-Time Count conducted on January 27th - 28th, 2026.
REFERENCE MATERIAL:
BAI #38, April 21, 2026
BAI #48, December 9, 2025
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Anthem BlueCross
On file with Clerk - Agreement with Kaiser Permanente
On file with Clerk - Budget Resolution (0129)
On file with Clerk - Budget Resolution (5428)
CAO ANALYST:
Dylan McCully