Modoc County Municipal Code Ch. 8.80 Partnership Healthplan of California Commission

A. Partnership Healthplan of California Commission ("commission") is a multi-county commission that has created a managed healthcare plan for Medi-Cal recipients. The purpose of this chapter is to update the terms of the County of Modoc's participation in the commission. This will allow the implementation of a county-organized health system in Modoc County as authorized by Welfare and Institutions Code § 14087.54.

B. The commission has a proven record of improving healthcare access to its members, who are Medi-Cal recipients, and improving Medi-Cal reimbursement rates to healthcare 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.

C. The commission negotiated a contract with the California Department of Health Care Services, as specified in Welfare and Institutions Code § 14087.5, to arrange for the provision of health care services provided under Welfare and Institutions Code Ch. 7, Pt. 3, Div. 9. The commission is authorized to negotiate a contract with the California Department of Health Care Services to expand the commission into additional member counties. This expansion is expected to occur on or about January 1, 2024.

(Ord. of 7-23-2013, § I; Ord. No. 350-A, § I, 12-12-2023)

Pursuant to Welfare and Institutions Code § 14087.54, the county board of supervisors hereby authorizes the County of Modoc to continue participation in the commission under the terms set forth in this chapter.

(Ord. of 7-23-2013, § I; Ord. No. 350-A, § I, 12-12-2023)

A. The commission shall be comprised of commissioners appointed by the board of supervisors of each member county. Unless and until the commission, by formal action, establishes a different formula or system of membership, commission representation for each member county shall be based on the number of Medi-Cal beneficiaries enrolled in the commission's health care plan in each county according to the following formula:

1. Zero to forty-five thousand Medi-Cal beneficiaries within the county equals one commission seat.

2. Forty-five thousand and one to sixty thousand Medi-Cal beneficiaries within the county equals two commission seats.

3. Sixty thousand and one and up Medi-Cal beneficiaries within the county equals three commission seats.

B. The persons appointed to the commission by the Modoc County Board of Supervisors shall serve at the pleasure of the board of supervisors.

C. The county board of supervisors shall follow its own commissioner selection criteria set forth in this section but also acknowledges that the commission encourages member counties to consider selecting commissioners from the following settings: safety net providers (including providers at federally qualified health centers), behavioral health providers, regional center providers, local education authorities, dental providers, Indian Health Service facility providers, and hospital providers with special efforts to select candidates, as opportunity allows, who reflect the diversity of the community and regions (including, but not limited to race, ethnicity, language, and disability status).

D. The clerk of the board shall receive applications. The applications shall be reviewed by the chair of the board and a recommendation made to the board of supervisors.

(Ord. of 7-23-2013, § I; Ord. No. 350-A, § I, 12-12-2023)

The term for the commissioners shall be for four-year periods. Nothing herein shall prohibit a person from serving more than one 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 commissioner ceases functioning in the area from which appointed or fails to attend three Commission meetings in a row.

(Ord. of 7-23-2013, § I; Ord. No. 350-A, § I, 12-12-2023)

Pursuant to the provisions of the Welfare and Institutions Code § 14087.54 as it exists on the date of adoption of the ordinance from which this chapter 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 Welfare and Institutions Code § 14087.5, and to arrange for the provision of health care services provided under the Welfare and Institutions Code Ch. 7, Pt. 3, Div. 9;

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

C. File the statement required by Government Code § 53051;

D. Have the power to acquire, possess, and dispose of real or personal property, including creating and/or acquiring affiliated or supporting entities, as may be necessary for the performance of its functions; to employ personnel, including health care providers in accordance with California law; to 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 of the Welfare and Institutions Code Art. 2.8 of Ch. 7, Pt. 3, Div. 9 in addition to those previously specified in this section.

(Ord. of 7-23-2013, § I; Ord. No. 350-A, § I, 12-12-2023)

Pursuant to the provisions of Welfare and Institutions Code § 14087.54(d) 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 Modoc. The commission shall do business as the Partnership Healthplan of California.

(Ord. of 7-23-2013, § I; Ord. No. 350-A, § I, 12-12-2023)

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. of 7-23-2013, § I; Ord. No. 350-A, § I, 12-12-2023)

The commission shall continue to represent the County of Modoc until such time as the Modoc County Board of Supervisors terminates the representation. To terminate the representation, the county board of supervisors, or its designee, shall provide a ninety-day notice to other member counties and the California Department of Health Care Services, as specified in Welfare and Institutions Code § 14087.54(g).

(Ord. of 7-23-2013, § I; Ord. No. 350-A, § I, 12-12-2023)