Contra Costa County Municipal Code Ch. 40-4 One Local Health Plan Model of Medi-Cal Managed Care

To protect the health, welfare and safety of the people of Contra Costa County, it is necessary to ensure that the County Health Services Department maintains its flexibility to serve Medi-Cal managed care enrollees in the most effective manner, including but not limited to serving enrollees through a single local plan model.

(Ord. No. 2021-31, § 1, 9-14-21; Ord. No. 2021-42, § 1, 12-14-21)

The board of supervisors finds and declares as follows:

(a) Residents of Contra Costa County who are Medi-Cal beneficiaries are currently served under the two-plan model of Medi-Cal managed care that was established by the California Department of Health Care Services.

(b) Contra Costa Health Plan, which is directly owned and operated by the county, currently serves as the local initiative plan under the existing two-plan model.

(c) The California Department of Health Care Services has offered counties the opportunity to transition to a single local plan model of Medi-Cal managed care.

(d) The county operates Contra Costa Health Plan within the county health services department, as authorized by Government Code Section 25209.6, which imposes no limitations on the contracting models available to the county-operated health plan.

(e) A single local plan allows for enrollment in one local public health plan, making entry into the health care system and managing care for members more effective and efficient.

(f) Contra Costa Health Plan is well-positioned to become the single local Medi-Cal managed care plan because it serves more than eighty percent of the local Medi-Cal population, contracts with most health care providers who furnish services to Medi-Cal enrollees in the county, and has a demonstrated record of success in arranging and providing Medi-cal services through managed care.

(g) It is in the best interests of the county to maintain its flexibility to operate in a manner that best serves the county's Medi-Cal managed care population.

(Ord. No. 2021-31, § 2, 9-14-21; Ord. No. 2021-42, § 2, 12-14-21)

Contra Costa Health Plan is authorized to serve as the single local plan for Medi-Cal managed care enrollees in the county, upon approval of the California Department of Health Care Services. The effective date of this authorization is January 1, 2024, unless the California Department of Health Care Services approves and authorizes a different date.

(Ord. No. 2021-31, § 3, 9-14-21; Ord. No. 2021-42, § 3, 12-14-21)

Nothing in this chapter precludes the county from continuing to operate under the two-plan model or from opting into any other Medi-Cal managed care contracting model the state makes available.

(Ord. No. 2021-31, § 4, 9-14-21; Ord. No. 2021-42, § 4, 12-14-21)