DATE: April 27, 2021
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Budget Resolutions Increasing Appropriations and Revenues for County Medical Services
RECOMMENDED ACTION(S):
TITLE
1. Adopt Budget Resolution increasing FY 2020-21 appropriations and estimated revenues for County Medical Services Org 5240 in the amount of $320,000 to allow for continued funding of indigent medical services (4/5 vote); and
2. Adopt Budget Resolution increasing FY 2020-21 appropriations for the Local Health and Welfare Fund 0135, subclass 10000, Health Org 52430301 in the amount of $320,000 (4/5 vote).
REPORT
There is no Net County Cost associated with the recommended actions. Approval of the recommended actions will provide funding for the County to continue to meet its obligation under Welfare and Institutions Code, Section 17000 et seq., for the provision of certain non-emergency specialty medical care services for residents who do not qualify for Medi-Cal. Cost is 100% offset with 1991 Realignment Health account through the Local Health and Welfare Fund. This item is countywide.
ALTERNATIVE ACTION(S):
There is no alternative action. Should your Board choose not to approve the recommended actions, the County would not have the spending authority to continue issuing claim payments to existing contractors for medical services provided to indigent Fresno County residents under the Medically Indigent Services and Non-Resident Specialty Care services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. Approval of the first recommended action will increase the FY 2020-21 appropriations and estimated revenues in the Department’s County Medical Services Org 5240 in the amount of $320,000 to offset costs related to an increase in Non-Resident Specialty Care services claims. Approval of the second recommended action will increase appropriations in the Department’s 1991 Realignment Health Org 52430301 to recognize the Operating Transfer Out to the Department’s Org 5240. Sufficient fund balance exists in the 1991 Realignment Health account, Org 52430301
DISCUSSION:
On March 24, 2020, the Board approved Agreement No. 20-122 with Advantek Benefit Administrators to provide eligibility determination for certain non-emergency specialty care medical services provided to medically indigent Fresno County residents who do not qualify for full-scope Medi-Cal or other health care options. Additionally, Advantek manages, adjudicates claims and makes payments for Non-Resident Specialty Care services rendered.
The agreement allows approved medical specialty providers within Fresno County to claim costs of services provided to eligible beneficiaries using Medi-Cal rates. Claim amounts can vary depending on the preapproved specialties utilized, the severity of the medical condition, and the length of medical treatment provided. One recent claim was outside of the normal trended cost which has been consistent for the last two years. Due to this unforeseen higher than normal claim, the Department requires an additional $320,000 in spending authority. Approval of the recommended actions increases appropriations within the Department’s Orgs 5240 and 52430301 to meet expenditures associated with the unexpected increase in claim costs.
The County continues to be obligated under Welfare and Institutions Code section 17000 et seq. to provide medical services to indigent Fresno County residents.
REFERENCE MATERIAL
BAI #40, March 24, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Resolution (Org 5240)
On file with Clerk - Resolution (Org 52430301)
CAO ANALYST:
Ronald Alexander