DATE: November 24, 2020
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Memorandum of Understanding with Saint Agnes Medical Center whereby Saint Agnes Commits to Provide Health Care Services to Low Income Fresno County Residents
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive Memorandum of Understanding (MOU) with Saint Agnes Medical Center whereby Saint Agnes commits to provide health care services to uninsured, underinsured, indigent, and low-income residents of Fresno County, effective September 1, 2020 ($0).
REPORT
Approval of the recommended action will allow Saint Agnes Medical Center (SAMC) to continue its participation in the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) 340B Drug Pricing Program, with no Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, SAMC could seek to pursue an MOU with another local government agency in order to meet the HRSA 340B Drug Pricing Program requirements for participation or SAMC could forgo participation in the 340B Drug Pricing Program.
RETROACTIVE AGREEMENT:
The recommended MOU is retroactive to September 1, 2020. The County received this MOU request from SAMC on September 28, 2020. This will align the MOU start date with the HRSA 340B recertification period for 2020.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action and there is no monetary compensation or reimbursement exchange under the recommended MOU.
DISCUSSION:
SAMC has requested that the County enter into the recommended MOU in order to allow them to recertify their participation in the HRSA 340B Drug Pricing Program (Program). One of the eligibility requirements for Program recertification is that SAMC enter into an MOU with a local government agency whereby the agency attests to SAMC’s commitment to low-income, indigent, uninsured and underinsured residents of Fresno County.
Section 340B of the Public Health Service Act requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to health care organizations that care for uninsured and low-income patients. These organizations include community health centers, critical access hospitals, and public and nonprofit disproportionate share hospitals (DSH) that serve low-income and indigent populations. The Program benchmark requirement for certification is that >11.75% of the patients seen and treated by DSH’s meet this requirement. SAMC states they meet the requirement by providing >28% of their services to this population.
The savings for these drugs are passed on to consumers through SAMC’s Community Benefit Program, which combats numerous health issues in Fresno County communities including diabetes and other chronic conditions. The savings from the 340B Program also helps SAMC maintain a Social Care Health Hub where Community Health Workers actively connect patients to primary care, mental health, substance use, and social service programs to reduce emergency department visits.
Although the County does not currently have a health care services agreement with SAMC to provide services to uninsured, underinsured, indigent, and low-income county residents, the Department supports and encourages SAMC’s ongoing efforts to provide services to this population. Therefore, the Department believes that SAMC’s continued eligibility and participation in the 340B Drug Pricing Program provides significant savings which will allow SAMC to continue to provide services to this population through their Community Benefit Program.
With your Board’s approval, the recommended MOU will commence retroactively to September 1, 2020. The MOU shall continue until terminated by either party without cause upon issuance of not less than a 60-day written notice of termination to the other party.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Memorandum of Understanding with Saint Agnes Medical Center
CAO ANALYST:
Raul Guerra