Sonoma County Municipal Code Ch. 34 County Organized Health System

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Editor's note— Ord. No. 6461, § I, adopted Jan. 9, 2024, amended Ch. 34 in its entirety to read as herein set out. Former Ch. 34, §§ 34-1—34-7, pertained to similar subject matter and derived from Ord. No. 5849, § I, adopted Sep. 1, 2009; Ord. No. 5927, § I, adopted April 5, 2011; Ord. No. 5966, § I, adopted Feb. 7, 2012; Ord. No. 6043, § 1, adopted July 30, 2013; Ord. No. 6099, § I, adopted April 21, 2015; and Ord. No. 6137, § I, adopted Nov. 10, 2015.

Partnership HealthPlan of California Commission ("commission") is a multicounty commission that has created a managed health care plan for Medi-Cal recipients. The purpose of this chapter is to authorize the county of Sonoma to join the existing commission. This will allow the implementation of a county organized health system in Sonoma County as authorized by Welfare and Institutions Code Section 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 negotiated a contract with the California Department of Health Care Services, as specified in Welfare and Institutions Code Section 14087.5, to arrange for the provision of health care services provided under Welfare and Institutions Code Chapter 7, Part 3, Division 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. No. 6461, § I, 1-9-2024)

Pursuant to Welfare and Institutions Code Section 14087.54, the Sonoma County Board of Supervisors hereby authorizes the county of Sonoma to continue participation in the commission under the terms set forth in this ordinance.

(Ord. No. 6461, § I, 1-9-2024)

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 plan in each county according to the following formula:

(1) 0-45,000 Medi-Cal beneficiaries within the county equals one (1) commission seat.

(2) 45,001-60,000 Medi-Cal beneficiaries within the county equals two (2) commission seats.

(3) 60,001+ Medi-Cal beneficiaries within the county equals three (3) commission seats.

Any deletion of commissioners will be achieved through attrition, with a maximum of one (1) year to come into compliance.

Persons appointed to the commission by the Sonoma County Board of Supervisors shall serve at the pleasure of the board.

The Sonoma 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).

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

(1) One (1) member shall be a community clinic representative identified by the Redwood Community Health Coalition (clinic representative).

(2) One (1) member shall be the Director of the Sonoma County Department of Health Services or designee (county official).

(3) One (1) member from the community ("public representative"). The Sonoma County Department of Health Services may make recommendations based on the following criteria:

(a) Legal resident of Sonoma County;

(b) Knowledge of the healthcare needs of children, the aged, and disabled;

(c) Business experience;

(d) Political experience; and

(e) Finance experience.

(Ord. No. 6461, § I, 1-9-2024)

Members of the commission shall serve four-year terms of office. Nothing herein shall prohibit a person from serving more than one (1) term. Vacancies shall be filled in accordance with the procedures set forth in Section 34-3. 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 (3) commission meetings in a row.

(Ord. No. 6461, § I, 1-9-2024)

Pursuant to the provisions of Section 14087.54 of the Welfare and Institutions Code, the commission shall:

(1) Have the power to negotiate the exclusive contract with the California 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;

(2) Be considered an entity separate from the county of Sonoma;

(3) File the statement required by Section 53051 of the Government Code;

(4) 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

(5) 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. 6461, § I, 1-9-2024)

Pursuant to the provisions of Section 14087.54(d) of the Welfare and Institutions Code, 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 Sonoma. The commission shall do business as Partnership HealthPlan of California.

(Ord. No. 6461, § I, 1-9-2024)

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

At a minimum, two (2) standing advisory committees shall be established:

(1) The physicians advisory committee, and

(2) The consumers' advisory committee.

(Ord. No. 6461, § I, 1-9-2024)

The commission shall continue to represent the county of Sonoma until such time as the Sonoma County Board of Supervisors terminates the representation. To terminate the representation, the Sonoma County Board of Supervisors or its designee shall provide ninety (90)-days' notice to other member counties and the California Department of Health Care Services, as specified in Welfare and Institutions Code § 14087.54(g).

(Ord. No. 6461, § I, 1-9-2024)