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HomeMy WebLinkAboutAgreementA-20-263withDHCS-AdministrativeServices.pdf1. Agreement No. 20-263 County of Fresno 20-10217 MEDI-CAL COUNTY INMATE PROGRAM AGREEMENT FOR ADMINISTRATIVE SERVICES Intent of Agreement This Reimbursement for Administrative Costs for the Medi-Cal Inmate Program (MCIP) Agreement (Agreement) is intended to reimburse the California Department of Health Care Services (DHCS) for its administrative costs associated with the MCIP as further detailed below and in Schedule A attached hereto . 2 . Parties The parties to this Agreement are DHCS and the County of Fresno (County). 3. Authority A. DHCS is the single state agency responsible for administering the California Medical Assistance Program (Medi-Cal), including MCIP , pursuant to Welfare and Institutions Code section 14100.1 . B . This Agreement is authorized by Welfare and Institutions Code sections 14053.7 and 14053 .8 and Penal Code section 5072. 4. Term of the Agreement The term of this Agreement shall be from July 1, 2020 through and including June 30 , 2023 . 5 . Definitions . A. The term "Certified Public Expenditure Process " or "CPE Process " means the process establ ished for Medi-Cal under state law (including but not limited to Welfare and Institutions Code section 14166 .1, et seq .), the California Medi - Cal State Plan , and approved Medicaid demonstration projects and waivers through wh ich public Medi-Cal providers claim Federal Financial Participation (FFP) for allowable expenditures . B. The term "days" as used in this Agreement shall mean calendar days unless specified otherwise . C . The term "Demonstration Project" means the Californ ia Medi-Cal 2020 Demon- stration , Number 11-W-00193/9, as approved by CMS effective beginning De- cember 30 , 2015 and any successor demonstration projects. Page 1 of 13 County of Fresno 20-10217 Page 2 of 13 D.The term “Designated Public Hospital” is defined as set forth in the Demonstra- tion Project, and codified in state law at Welfare and Institutions Code section 14184.10, subdivision (f) pursuant to SB 815 (2016), and may be modified from time to time. E.The term “Inmate” as used in this Agreement includes persons identified in Welfare and Institutions Code sections 14053.7(e)(2)(A) and 14053.8(k) “Juve- nile Inmate,” and Government Code sections 26605.6(a) “Prisoner,” 26605.7(a) “Prisoner” and (d)(1) “Probationer,” and 26605.8 “Prisoner” and “Probationer.” F.The term “MCIP” or “Medi-Cal County Inmate Program” contains the following three components: the Adult County Inmate Program (ACIP), as authorized in state law pursuant to Welfare and Institutions Code section 14053.7 and Penal Code section 5072, the Juvenile County Ward Program (JCWP), as authorized in Welfare and Institutions Code section 14053.8, and the County Compassion- ate Release Program (CCRP) and County Medical Probation Program (CMPP), as authorized by Government Code sections 26605.6, 26605.7, and 26605.8. G.“MCIP Administrative Services” means the administrative services provided by DHCS personnel for the administration of MCIP. H.“Medi-Cal provider” means, any individual, partnership, group association, cor- poration, institution, or entity and the officer, directors, owners, managing em- ployees or agents of any partnership, group association, corporation, institu- tion, or entity that provides services, goods, supplies, or merchandise, directly or indirectly, to a Medi-Cal beneficiary, and that has been enrolled in the Medi- Cal program. I.The State Fiscal Year (SFY) begins on July 1st of each calendar year and ends on June 30th in the subsequent calendar year. 6.Maximum Payable Amount The amount that the County shall be obligated to pay for MCIP administrative services rendered under this Agreement shall not exceed its share of the nonfederal share of DHCS administrative costs. The maximum payable amount the County shall be obligated to pay for services rendered under this Agreement shall not exceed $23,430.87 which shall be based on a methodology specified in Addendum A. A.The maximum payable amount shall be further subject to the allocated State Fiscal Year’s (SFY’s) annual limits not to exceed: $7,432.47 for July 1, 2020, through and including June 30, 2021 $7,804.10 for July 1, 2021, through and including June 30, 2022 $8,194.30 for July 1, 2022, through and including June 30, 2023 County of Fresno 20-10217 Page 3 of 13 For future contract periods not covered under this Agreement, the maximum payable amount shall be determined through a new Agreement or an amend- ment to this Agreement. 7.Contact Persons Any notice, request, demand, or other communication required or permitted hereunder, shall be deemed to be properly given when furnished in writing to the following: A.In the case of the County to: David Pomaville, Director, Department of Public Health County of Fresno P.O. Box 11867 Fresno, CA 93775 Or to such person or address as the County may furnish in writing to DHCS. B.In the case of DHCS to: California Department of Health Care Services Local Governmental Financing Division County Based Claiming & Inmate Services Section Attn: Inmate Medi-Cal Claiming Unit 1501 Capitol Avenue, MS 4603 P.O. Box 997436 Sacramento, CA 95899-7436 Or to such person or address as DHCS may, from time to time, furnish in writing or to the County. 8.Payment Terms and Invoicing A.General Terms 1.DHCS shall submit a quarterly invoice to the County for the County’s appor- tioned share of the nonfederal share of the MCIP administrative services for the period billed. 2.The County shall pay DHCS for the County’s apportioned share of the non- federal share of MCIP administrative services which shall be based on a methodology specified in Addendum A within 60 days of receipt of an in- voice. 3.Failure by the County to timely pay DHCS shall constitute a material breach of this Agreement, which at DHCS’ discretion, may result in termination of County of Fresno 20-10217 Page 4 of 13 both this Agreement and the MCIP Evergreen Provider Agreement (PA) by DHCS. The County may cure such breach by rendering payment of the amount owed to DHCS three days prior to the termination of this Agreement or the PA. 4.The County shall not make payments for any invoice or portion thereof ex- ceeding the respective maximum payable amount. Payment for any MCIP administrative services rendered by DHCS exceeding the respective maxi- mum payable amount shall require an amendment. If the County fails to execute a retroactive amendment to the maximum payable amount under this Agreement, DHCS shall terminate both the Agreement and the PA. 5.Payments shall be sent to DHCS at the following address, or such other address as DHCS may specify in writing: California Department of Health Care Services Local Governmental Financing Division County Based Claiming & Inmate Services Section Attn: Inmate Medi-Cal Claiming Unit 1501 Capitol Avenue, MS 4603 P.O. Box 997436 Sacramento, CA 95899-7436 9.DHCS Responsibilities A.MCIP Administrative Services 1.DHCS shall administer MCIP and this Agreement for the purpose of claim- ing federal reimbursement for MCIP services. It is understood by both par- ties that other administrative activities remain the responsibility of the County. 2.DHCS shall maintain accounting records for personnel services at a level of detail as described in Schedule A. Additionally, these records must iden- tify any equipment and all related operating expenses. 3.DHCS shall submit to the County a quarterly invoice for the County’s appor- tioned share of the nonfederal share of MCIP administrative services based on Addendum A. The quarterly invoice for reimbursement shall identify the following summarized categories of DHCS’ costs for the allocated SFY pe- riod billed: salary, benefits, operating expenses, and total costs. Costs shall be multiplied by one minus the Federal Medical Assistance Percentage (FMAP) applicable to such administrative costs subject to the limit on the amount reimbursable by the County. The maximum payable amount shall not exceed the County’s apportioned share, which shall be based on a methodology specified in Addendum A. County of Fresno 20-10217 Page 5 of 13 B. General Responsibilities 1. Should the scope of work for this Agreement conflict with DHCS’ responsi- bilities under federal Medicaid law, those responsibilities shall take prece- dence. 2. DHCS’ cessation of any activities due to federal Medicaid responsibilities does not relinquish the obligation of the County to reimburse DHCS for ad- ministrative costs incurred by DHCS in connection with this Agreement for periods in which the County participated in MCIP. 3. DHCS agrees to provide to the County, or any federal or state department with monitoring or reviewing authority, access and the right to examine its applicable records and documents for compliance with relevant federal and state statutes, regulations, and this Agreement. 10. County Responsibilities A. MCIP Administrative Services 1. As a condition of participation, the County accepts responsibility for reim- bursing DHCS for the County’s apportioned share of the nonfederal share of costs of MCIP administrative services based on Addendum A. 2. The County shall reimburse DHCS its allotted portion of the nonfederal share of funding allocated for compensation, associated operating ex- penses, equipment, and travel costs for no more than 3.50 full-time equiva- lent (FTE) positions composed of: one-half (0.50) FTE Staff Service Man- ager I, one (1) FTE Health Program Specialist I, one (1) FTE Staff Services Analyst/Associate Governmental Program Analyst, one-half (0.50) FTE At- torney, and one-half (0.50) FTE Accounting Officer, to be established and housed at DHCS, to support the reported expenditures submission process for obtaining federal reimbursement under this Agreement. 3. If a County does not participate in MCIP or does not abide by the terms of this Agreement, the County remains responsible for arranging for and pay- ing for medical care for its MCIP eligible beneficiaries. B. General Responsibilities 1. Upon compliance with all applicable provisions of this Agreement and ap- plicable laws, the County may send its MCIP eligible beneficiaries to Medi- Cal providers to receive MCIP services. County of Fresno 20-10217 Page 6 of 13 2.The County shall reimburse DHCS pursuant to Paragraph A with funds from the County’s General Fund, or from any other funds allowed under federal law and regulation. 3.In the event of a federal deferral or disallowance applicable to MCIP ex- penditures, the County shall provide all documents requested by DHCS within fourteen days. 11.Amendments Amendments to this Agreement shall be in writing signed by the parties to this Agreement, and, if required by state law, by approval of the California Department of General Ser- vices. Notwithstanding the previous sentence, any changes made to the contact persons identified in Article 5 may be made by written communication, e-mail to the other contact person or persons and without formal amendment. 12.Termination and Agreement Disputes A.This Agreement may be terminated by either party upon written notice given at least 30 days prior to the termination date. Notice shall be addressed to the respective parties as identified in Article 5. The County shall remain obligated after the termination date to pay for all MCIP administrative costs incurred by DHCS for periods in which the County participated in the MCIP. B.This Agreement shall terminate upon cessation of the MCIP. The County shall remain obligated after the termination date to pay for all of the County’s appor- tioned share of MCIP administrative costs incurred by DHCS for periods in which the County participated in MCIP C.Termination of this Agreement will automatically terminate the County’s MCIP Evergreen PA. 13.General Provisions A.Indemnification. It is agreed that the County shall defend, hold harmless, and indemnify DHCS, its officers, employees, and agents from any and all reported expenditures, liability, loss, or expense (including reasonable attorney fees) for injuries or damage to any person, any property, or both which arise out of the terms and conditions of this Agreement and the negligent or intentional acts or omissions of the County, its officers, employees, or agents. B.Severability. If any term, condition, or provision of this Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remain- ing provisions will nevertheless continue in full force and effect, and shall not be affected, impaired or invalidated in any way. Notwithstanding the previous sentence, if a decision by a court of competent jurisdiction invalidates, voids, County of Fresno 20-10217 Page 7 of 13 or renders unenforceable a term, condition, or provision in this Agreement that is included in the purpose of this Agreement then the parties to this Agreement shall either amend this Agreement pursuant to Article 9, or it shall be terminated pursuant to Article 10. C.Records. DHCS and the County shall maintain and preserve all records relating to this Agreement for a period of three years from DHCS’ receipt of the last payment of FFP, or until three years after all audit findings are resolved, which- ever is later. This does not limit any responsibilities of DHCS or the County provided for elsewhere in this Agreement, or in state or federal law. D.Compliance with Applicable Laws. All parties performance under this Agree- ment shall be in accordance with all applicable federal and state laws, includ- ing, but not limited to: 1.The Americans with Disabilities Act of 1990, as amended; 2.Section 504 of the Rehabilitation Act of 1973, as amended; 3.Title XIX of the Social Security Act; 4.Welfare and Institutions Code section 14000 et seq.; 5.Government Code section 53060; 6.The California Medicaid State Plan; 7.Applicable laws and regulations related to licensure, certification, confi- dentiality of records, quality assurance, and nondiscrimination; 8.The Policy and Procedure Letters, and similar instructions, published with regulatory authority; 9.Government Code sections 26605.6, 26605.7, and 26605.8; 10.Penal Code section 5072; 11.42 Code of Federal Regulations; and, 12.Applicable sections of the California Code of Regulations. E.Controlling Law and Venue. The validity of this Agreement and its terms or provisions, as well as the rights and duties of the parties hereunder, the inter- pretation and performance of this Agreement shall be governed by the laws of the State of California. Venue for any action brought concerning this Agreement shall be in any county in which the Attorney General maintains an office. County of Fresno 20-10217 Page 8 of 13 F.Integration Clause. 1. This Agreement and any exhibits and addendums attached hereto shall constitute the entire Agreement among the parties to it pertaining to the implementation of MCIP and supersedes any prior or contemporaneous un- derstanding or agreement with respect to the subject matter of this Agree- ment. 2.Notwithstanding Subparagraph G.1., DHCS Form 9098 or DHCS Form 6208 (whichever is applicable) is incorporated by reference into this Agree- ment if the County has a DHCS Form 9098 or DHCS Form 6208 on record. Notwithstanding Subparagraph G.1., the terms of the DHCS Form 9098 or DHCS Form 6208 control to the extent there is a conflict with this Agree- ment, except for Article 10 of this Agreement. If the DHCS Form 9098 or DHCS Form 6208 does not address a matter addressed by this Agreement, then this Agreement controls. G.Conformance Clause. Any provision of this Agreement in conflict with present or future governing authorities is hereby amended to conform to those author- ities and such amended provisions supersede any conflicting provisions in this Agreement. The governing authorities include, but are not limited to the author- ities listed in Article 11.E. H.Waiver. No covenant, condition, duty, obligation, or undertaking made a part of this Agreement shall be waived except by amendment of the Agreement by the parties hereto, and forbearance or indulgence in any other form or manner by either party in any regard whatsoever shall not constitute a waiver of the cove- nant, condition, duty, obligation, or undertaking to be kept, performed, or dis- charged by the other party to which the same may apply; and, until performance or satisfaction of all covenants, duties, obligations, or undertakings is complete, the party shall have the right to invoke any remedy available under this Agree- ment, or under law, notwithstanding such forbearance or indulgence. I.Third Party Benefit. None of the provisions of this Agreement are or shall be construed as for the benefit of, or enforceable by, any person not a party to this Agreement. J.Conflict of Interest. The County is subject to the Medi-Cal Conflict of Interest Law, as applicable and set forth in Welfare and Institutions Code section 14022 and Article 1.1 (commencing with Welfare and Institutions Code section 14047), and implemented pursuant to 22 California Code of Regulations, sec- tion 51466. K.Budget Contingency Clause. If funding associated with MCIP for any SFY is reduced by the State Budget Act DHCS shall have the option to cancel this Agreement, with no liability occurring to the State. County of Fresno 20-10217 Page 9 of 13 L.Confidentiality. The County shall comply with the applicable confidentiality re- quirements as specified in Section 1902(a)(7) of the Social Security Act; 42 Code of Federal Regulations, part 431.300; Welfare and Institutions Code sec- tion 14100.2; and 22 California Code of Regulations, section 51009; and, the Business Associates Agreement attached and hereby incorporated by refer- ence. County of Fresno 20-10217 Page 11 of 13 SCHEDULE A SCOPE OF WORK CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (DHCS) DHCS agrees to: 1.Calculate the actual costs for administrative accounting, policy development, and data processing maintenance activities, including the indirect costs related to the MCIP program provided by its staff, which is in accordance with the provisions of Section 1903(w) of the Social Security Act and 42 Code of Federal Regulations, part 433, subpart B. 2.Lead the development, implementation, and administration for the MCIP. 3.Submit claims for Federal Financial Participation (FFP) based on Certified Public Ex- penditures (CPE) from participating MCIP counties. 4.On an annual basis, submit any necessary materials to the federal government to provide assurances that claims for FFP will include only those expenditures that are allowable under federal law. 5.Maintain accounting records to a level of detail that identifies the actual expenditures incurred for personnel services including salary or wages, benefits, and overhead costs for DHCS’ staff. Additionally, these records will identify any equipment and all related operating expenses applicable to these positions. Records should include, but not be limited to general expense, rent and supplies for identified staff and managerial staff working specifically on activities or assignments directly related to the MCIP. 6.Ensure that an appropriate audit trail exists within DHCS’ records and accounting sys- tem and maintain expenditure data as indicated in this Agreement. 7.Designate a person to act as liaison with the County for issues arising from this Agree- ment. This person shall be identified to the County’s contact person for this Agree- ment. 8. Provide a written response to the County’s contact person within 30 days of receiving a written request for information related to the MCIP. 9. Provide the County with accounting, program technical assistance, and training re- lated to the MCIP. 10.Maintain an invoice tracking system for MCIP and provide a report on a quarterly basis. County of Fresno 20-10217 Page 12 of 13 11. Establish an annual MCIP administrative cost based on Addendum A. 12. Invoice the County on a quarterly basis for administrative costs. County of Fresno 20-10217 Page 13 of 13 ADDENDUM A: MCIP Administrative Costs The MCIP Administrative Contract is a three-year contract. At the beginning of each cal- endar year, counties have the opportunity to inform DHCS of their intent to continue par- ticipation in MCIP for the upcoming State Fiscal Year (SFY) by completing the MCIP Let- ter of Intent (LOI). The methodology for calculating each county’s nonfederal share of administrative costs was developed by DHCS in consultation with the California State Association of Counties, County Health Executives Association of California, California Association of Public Hos- pitals and Health Systems, and the California State Sheriffs’ Association. The nonfederal share of administrative costs allocated to each county is based on the following: 1)30% of the total administrative costs will be distributed evenly to participating counties over 50,000 in population. * 2)70% of the total administrative costs will be allocated to participating counties pro-rata based on population. * *Population data will be obtained from the California Department of Finance, De- mographic Estimates To account for a cost of living adjustment on a yearly basis after the initial SFY of the current Agreement, DHCS will include a year over year growth factor of 5% to the maxi- mum payable amount of the annual administrative cost for each subsequent SFY. DHCS will invoice participating counties for the nonfederal share of administrative costs quarterly after the close of the previous quarter based on actual administrative costs per the meth- odology above. California Department of Health Care Services Name/No.: Medi-Cal County Inmate Program (MCIP) Administrative Services Agreement (No. 20-10217) Fund/Subclass: 0001/10000 Organization #: 56201683 Revenue Account #: 7295