Imperial County Municipal Code Ch. 8.03 Imperial County Health Authority

Pursuant to California Welfare and Institutions Code Section 14087.38, there will be created the Imperial County Health Authority ("Health Authority"). Upon the establishment of the health authority, all of the rights, duties, privileges, and immunities vested in Imperial County pursuant to Article 2.7 of Chapter 7 of Part 3 of Division 9 of the California Welfare and Institutions Code shall be vested in the health authority and shall continue to be so vested until Imperial County formally terminates its participation in the health authority.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

A. The purpose of the health authority is to advise and ensure that qualified residents of Imperial County are provided health care services pursuant to Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code.

B. The health authority is specifically authorized to seek licensure under the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 3 of the Health and Safety Code) to enter into a contractual relationship with the California Department of health care services to provide a "Medi-Cal Managed Care Program" ("program") and to arrange for the provision of health care services to qualifying individuals under such program in Imperial County pursuant to Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code.

C. Until the health authority obtains Knox-Keene Licensure, the health authority shall work in partnership with the local initiative health plan selected by the Imperial County Board of Supervisors, so long as that plan maintains its status as the local initiative health plan, to:

1. Improve access to primary care and related specialty and ancillary services for enrolled Medi-Cal recipients;

2. Promote the long-term viability of "safety net" providers; and

3. To increase prevention, education, and early intervention services for enrolled recipients.

D. Upon obtaining Knox-Keene Licensure, the health authority shall design and operate a program or programs that:

1. Delivers primary care via a contracted provider network which significantly improves access to primary care and related specialty and ancillary services for enrolled Medi-Cal recipients;

2. Includes mechanisms for assuring that health authority financed medical care services meet appropriate quality of care standards;

3. Incorporates a plan of service delivery and implements reimbursement mechanisms which will promote the long-term viability of a locally operated Medi-Cal managed care system and participating "safety net" providers herein defined as Medi-Cal disproportionate share hospitals, county clinics, and licensed community and rural clinics;

4. Implements a financial plan which includes the creation of a prudent reserve within three years of commencing operations and which provides that if additional surplus funds accrue, they shall be used to expand access, improve benefits, and augment provider reimbursement;

5. Gives a high priority to increasing prevention, education, and early intervention services for enrolled recipients;

6. Ensures that all statutory, contractual, or other program obligations shall be the obligations solely of the health authority and shall not be the obligations of county or the state; and

7. Implements programs and procedures to ensure that a high level of member satisfaction is maintained.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

A. All rights, powers, privileges and immunities vested in Imperial County pursuant to Article 2.7 of Chapter 7 of Part 3 of Division 9 of the California Welfare and Institutions Code shall be vested in the health authority.

B. The health authority may negotiate and enter into contracts authorized by Section 14087.3 and also may enter into contracts for the provisions of healthcare services to individuals and groups including, but not limited to, those covered under Subchapter XVIII (commencing with Section 1395) of Chapter 7 of Title 42 of the United States Code, those entitled to coverage under other publicly supported programs, those employed by public agencies or private businesses, uninsured or indigent individuals, and any other persons.

C. The health authority may acquire, possess and dispose of real or personal property as necessary for the performance of its functions, may employ personnel, may contract for services required to meet its obligations, and may sue or be sued.

D. The health authority may borrow from the county and the county may lend the health authority funds or issue revenue anticipation notes to obtain those funds necessary to commence operations. The health authority shall be deemed a unit of local government for purposes of all grant programs and other funding and loan guarantee programs.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

The health authority shall be governed by a health authority commission ("commission"), which shall be comprised of members and appointed as hereinafter designated.

A. The board of supervisors shall appoint the commission consisting of thirteen (13) voting members representing the interests of the county, the general public, beneficiaries, physicians, hospitals, clinics, and other non-physician healthcare providers. The commission shall be generally representative of the diverse skills, backgrounds, interests, and demography of persons residing in the county. The commission members serve at the pleasure of the board. Members of the commission shall either be residents of Imperial County or practice medicine within Imperial County.

B. Qualifications. Each member of the commission shall have a commitment to a healthcare system which seeks to improve access to high quality healthcare for all persons, regardless of their economic circumstances, delivers high quality care, and is financially viable. Members of the commission shall likewise have an abiding commitment to and interest in a quality publicly assisted healthcare delivery system.

C. The thirteen (13) voting members shall include:

1. One member representing the interests of the general public, demonstrating awareness and knowledge of the healthcare system and representative of the interests of Imperial County residents and businesses;

2. One member of the Imperial County Board of Supervisors;

3. The Imperial County - County Executive Officer, or his designee;

4. Two physicians representing providers of Medi-Cal services and the practice of medicine;

5. One person representative of the interests of non-physician providers of Medi-Cal covered healthcare services, healthcare consumers, community representatives or community clinics;

6. Two chief executive officers of hospitals located in Imperial County. In the event there ceases to be two hospitals in Imperial County, then the chief executive officer of a hospital located in Imperial County and person designated by him/her;

7. One chief executive officer of the federally qualified health clinic or an administrator of a health clinic serving the largest proportion of Medi-Cal beneficiaries and the un- and under-insured;

8. One medical director of the federally qualified health clinic or a health clinic serving the largest proportion of Medi-Cal beneficiaries and the un- and under-insured;

9. One person representing the interests of Medi-Cal beneficiaries, demonstrating sensitivity and awareness of the concerns and issues encountered by Medi-Cal beneficiaries;

10. The Imperial County Director of Behavioral Health Services, or his designee; and

11. The Imperial County Director of Social Services.

D. Nominations. The board of supervisors shall appoint commissioners from a list of nominated persons which will be created in the following manner:

1. For the positions listed in Subdivisions (C)(l), (4), (5), and (9), nominations shall be provided in accordance with Subdivisions (D)(4) and (5) below by the following entities:

a. The member representing the interests of the general public (Subdivision (C)(1)) is to be nominated by the joint chamber of commerce;

b. The two physicians representing providers of Medi-Cal services and the practice of medicine (Subdivision (C)(4)) are to be nominated by the Imperial County Medical Society;

c. The person representative of the interests of non-physician providers of Medi-Cal covered healthcare services, healthcare consumers, community representatives or community clinics (Subdivision (C)(5)) is to be nominated by the director of the department of public health of Imperial County;

d. The Medi-Cal beneficiary (Subdivision (C)(9)) is to be nominated by the director of the department of social services of Imperial County.

2. For the position listed in Subdivision (C)(2), the board of supervisors shall select one supervisor to be a voting member.

3. The positions listed in Subdivisions (C)(3), (6), (7), (8), (10), and (11) are ex officio voting members.

4. Nominations. Nominations for the appointment of commissioners shall be assembled by the Imperial County Clerk of the board of supervisors. Each designated entity listed in Subdivision (D)(l) shall in accordance with any applicable laws and regulations nominate qualified individuals for the position for which they are designated to the board of supervisors for consideration. The board of supervisors has the right to reject any nominations and require new nominations to be submitted.

E. Persons nominated by the processes specified in Subdivision (D) shall be appointed by majority vote of the board of supervisors in accordance with all applicable laws. Any commission member so appointed may be removed without cause from office by a majority vote of the board of supervisors.

F. Commission Terms. The term for the ex officio voting members listed in Subdivisions (C)(3), (6), (7), (8), (10), and (11) shall be coterminous with their county or official position unless the board of supervisors replaces such member on its own motion. Members, except those members designated by virtue of holding another office, shall be appointed to three-year terms, and the initial terms shall be staggered by lot as follows: Two original, non-ex officio voting members shall initially serve a one-year term. Two original, non-ex officio voting members shall initially serve a two-year term. Two original, non-ex officio voting members shall serve a three-year term.

G. Commission Officers.

1. Chairperson. The board of supervisors shall appoint the initial chairperson of the commission. The commission shall establish bylaws which shall set forth the procedures for electing future chairpersons, the term of the chair, and the duties of the chairperson.

2. Other officers. The commission bylaws shall establish other officers, their terms, and duties.

H. Vacancies. Vacancies occurring on the commission shall be filled by the board of supervisors for the remainder of the unexpired term only. Such appointment need not adhere to the nomination process outlined in Subdivision (D), however the requirements of the position contained in Subdivisions (B) and (C) must be met.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

A. Procedures for the conduct of business not otherwise specified in this chapter, including, but not limited to, provisions for the creation of standing committees and meeting schedule and procedure, shall be contained in the bylaws prepared by the commission.

B. The commission shall prepare and amend bylaws, which shall become effective upon approval by a quorum of the commission.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

A majority of current members of the commission shall constitute a quorum and no act of the commission shall be valid unless a majority of a quorum votes in favor thereof. Vacant seats shall not count as a "current member". Any act of the commission shall be accomplished by a roll call vote when such a vote is requested by any member in attendance.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

Under Welfare and Institutions Code Section 14087.38, the health authority shall be a separate entity from the county. Any contractual or other obligations of the health authority shall be the obligations solely of the health authority and shall not be the obligations of the county.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

Official minutes, recording motions entertained and actions taken at each meeting of the commission, shall be prepared and submitted to the clerk of the board.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

County may advance to the health authority financial and/or in-kind support for reasonable costs associated with planning, development, programs, and/or administration provided that the health authority agrees to reimburse county according to an express schedule of repayment.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

The commission shall authorize all purchases except that the commission's chair may make purchases for budgeted items not to exceed an amount per item purchased as determined by the commission and provided for in its by-laws. Alternatively, the chair may request the county purchasing agent to purchase budgeted items within the county purchasing agent's expenditure limit.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

The commission shall prepare and approve an annual budget containing projections of expenditures and revenues for the budget year. The budget shall conform to timing requirements set forth in the county's annual budget process. Upon approval, the commission shall submit a copy to the board of supervisors.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

Should the commission require the following services, it shall utilize them as set forth in this section.

A. Personnel Services. The commission shall follow county requirements and practices in recruitment, retention and employment of personnel. With approval of the director of human resources and risk management, the commission may establish and operate an independent personnel office. Salary ranges may be different than the county salary ranges.

B. Auditor-Controller. The commission may organize and operate an independent financial system and appoint a chief financial officer with the consent of the county auditor-controller. The auditor-controller shall sign all commission checks from the county treasury unless the auditor-controller approves other methods.

C. Treasurer. The county treasurer shall be the custodian of the commission's funds. The treasurer shall invest commission funds as directed by the commission under guidelines agreed to between the commission and treasurer. The funds shall be invested in the same manner as local public funds may be invested under law and the county's investment policy.

D. Other Services. The commission is authorized, but not required, to use other county services such as purchasing, communications, data processing and motor pool.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

A. On or before January 31st of each year, the commission shall submit an annual report to clerk of the board. The report shall highlight the activities, accomplishments, and future goals of the health authority.

B. The board of supervisors may request the commission to submit progress reports and recommendations from time to time. The commission shall respond to such requests within a reasonable period of time.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

The health authority shall continue until the board of supervisors takes action to terminate the health authority. Any termination shall comply with applicable provisions of Welfare and Institutions Code Section 14087.38.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)

If any section, subsection, paragraph, sentence, clause, phrase, or portion of this Chapter 8.03 of the County of Imperial Codified Ordinances is, for any reason, held to be invalid or unconstitutional by any court of law with proper jurisdiction, such decision shall not affect the validity of the remaining portions of this chapter. The board of supervisors hereby declares that it would have adopted this chapter, and each section, subsection, paragraph, sentence, clause, phrase, or portion thereof, irrespective of the fact that any one or more sections, subsections, paragraph, sentences, clauses, phrases, or portion thereof be declared invalid or unconstitutional.

(Ord. No. 1496, § 1, 6-10-14; Ord. No. 1513, § 1, 12-15-15)