Lake County Municipal Code Art. XXVII Partnership Healthplan of California Commission

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Editor's note— Ord. No. 2990, adopted July 16, 2013, set out provisions for use herein as art. XXVI, §§ 2-188—2-196. To prevent duplication of section numbers, those provisions were included as art. XXVII, §§ 2-193—2-201. Subsequent to the adoption of those provisions, Ord. No. 3014, § 1, adopted October 21, 2014, repealed art. XXVII, §§ 2-193—2-201, in its entirety, and enacted a new art. XXVII to read as set out herein. Former art. XXVII pertained to similar subject matter and was derived from Ord. No. 2990, adopted July 16, 2013.

The Partnership HealthPlan of California Commission ("The Commission") is a multi-county commission that has created a managed health care plan for Medi-Cal recipients. The purpose of this chapter is to authorize the County of Lake to join the existing Commission. This will allow the implementation of a county organized health system in Lake County as authorized by Welfare and Institutions Code § 14087.54.

The Commission has a proven record of improving health care access to its members, who are Medi-Cal recipients, and improving Medi-Cal reimbursement rates to health care providers. The Commission links each member with a primary care provider and has been successful in reducing inappropriate use of emergency rooms, providing appropriate levels of inpatient care for its members, developing innovative case management programs and arranging for the provision of an enhanced level of local health care services.

The Commission will negotiate an exclusive contract with the California Department of Health Care Services authorizing the expansion of the Partnership HealthPlan of California into Lake County. This expansion is expected to occur on or about September 1, 2013.

(Ord. No. 3014, § 2, 10-21-2014)

Pursuant to Welfare and Institutions Code § 14087.54, the Lake County Board of Supervisors hereby authorizes the County of Lake to join the Commission.

(Ord. No. 3014, § 2, 10-21-2014)

Commission representation shall be based on the number of Medi-Cal beneficiaries enrolled in the HealthPlan in that county as follows: one (1) commissioner per zero (0) to forty-five thousand (45,000) beneficiaries; two (2) commissioners per forty-five thousand (45,000) and one (1) to sixty thousand (60,000) beneficiaries; three (3) commissioners per more than sixty thousand (60,000) and one (1) beneficiaries.

The members appointed by the County of Lake Board of Supervisors shall serve at the pleasure of the board and shall be selected as follows:

The members will be nominated by local health care providers that serve MediCal beneficiaries such as hospitals, physicians, community clinics and health centers and the County Department of Health Services. The Director of Health Services or his/her designee may make recommendations to the Board of Supervisors based on the Partnership HealthPlan of California Commission's "Guiding Principles" and the following criteria:

(1) Knowledge of the community's health care needs.

(2) Medical background.

(3) Business experience.

(4) Political experience.

(5) Finance experience.

(6) Experience as a consumer.

(Ord. No. 3014, § 2, 10-21-2014; Ord. No. 3138, § 2, 4-9-2024)

The initial term and all terms thereafter for the Commissioners shall be for four-year periods. Nothing herein shall prohibit a person from serving more than one (1) term. Each Commission member shall remain in office at the conclusion of that member's term until a successor member has been selected and installed into office. An office shall become vacant if a board member discontinues to function in the area from which appointed, or fails to attend three (3) meetings in a row of the Commission.

(Ord. No. 3014, § 2, 10-21-2014; Ord. No. 3138, § 1, 4-9-2024)

Pursuant to the provisions of Section 14087.54 of the Welfare and Institutions Code as it exists on the date of adoption of the ordinance from which this section is derived, the Commission shall:

A. Have the power to negotiate the exclusive contract with the California State Department of Health Care Services as specified in Section 14087.5 of the Welfare and Institutions Code, and to arrange for the provision of health care services provided under Chapter 7, Part 3, Division 9 of the Welfare and Institutions Code;

B. Be considered an entity separate from the County of Lake;

C. File the statement required by Section 53051 of the Government Code;

D. Have the power to acquire, possess, and dispose of real or personal property, as may be necessary for the performance of its functions, to employ personnel and contract for services required to meet its obligations, and to sue or be sued; and

E. Have all the rights, powers, duties, privileges, and immunities conferred by Article 2.8 of Chapter 7, Part 3, Division 9 of the Welfare and Institutions Code in addition to those previously specified in this section.

(Ord. No. 3014, § 2, 10-21-2014)

Pursuant to the provisions of Section 14087.54(d) of the Welfare and Institutions Code as it exists on the date of adoption of the ordinance codified in this chapter, any obligations of the Commission, statutory, contractual, or otherwise, shall be the obligations solely of the Commission and shall not be the obligations of the County of Lake. The Commission shall do business as the Partnership HealthPlan of California.

(Ord. No. 3014, § 2, 10-21-2014)

The Commission may establish advisory committees from time to time for any purpose that will be beneficial in accomplishing the work of the Commission.

(Ord. No. 3014, § 2, 10-21-2014)

The Commission shall continue to represent Lake County until such time as the Lake County Board of Supervisors terminates the representation. To terminate the representation, the Lake County Board of Supervisors or its designee shall provide ninety (90) day notice to other participating counties and the state Department of Health Care Services, as specified in Welfare and Institutions Code Section 14087.54(g).

(Ord. No. 3014, § 2, 10-21-2014)