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Home My WebLink About08.22.21 Letter of Support from Senator Nielsen and also Response from DHCS about Model Options From:York, Danette To:Alpert, Bruce;Bennett, Robin;Clerk of the Board;Connelly, Bill;Cook, Holly;Cook, Robin;Hironimus, Patrizia; Kimmelshue, Tod;Lucero, Debra;Paulsen, Shaina;Pickett, Andy;Reaster, Kayla;Ring, Brian;Ritter, Tami; Sweeney, Kathleen;Teeter, Doug Cc:Kim, Sang;Andrew Miller;Alpert, Bruce Subject:Letter of Support from Senator Nielsen and also Response from DHCS about Model Options Date:Sunday, August 22, 2021 5:28:54 PM Attachments:COHS_Ordinance_Butte_SUP.pdf Misconceptions of Feasibility of Imperial County-like Model - Public.pptx DHCS" Response Regarding Model Options.docx On the upcoming agenda is consideration of the ordinance required by DHCS to change Medi-Cal Managed Care models. California Health and Wellness (CHW) has been reaching out to individual board members throughout the ten counties that plan to move from the regional 2 plan model to the COHS model joining Partnership. Attached, you will find the following: a copy of a letter of support to make the change from Senator Nielsen’s office (each of you may have already received a copy of this) a presentation that provides information regarding some misinformation CHW is giving clarification from DHCS on the only options available for Yuba County – these options are the same for Butte County. Respectfully, Danette York Public Health Director BUTTE COUNTY PUBLIC HEALTH 202 Mira Loma Drive | Oroville, CA 95965 T:530.552.3820 | F: 530.538.2164 COVID-19 Call Center: 530.552.3050 Open 8 am-5 pm, everyday FACEBOOK | TWITTER COUNTY OF BUTTE E-MAIL DISCLAIMER: This e-mail and any attachment thereto may contain private, confidential, and privileged material for the sole use of the intended recipient. 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From: Luu, Phuong <pluu@CO.YUBA.CA.US> Sent: Friday, August 20, 2021 3:27 PM To: York, Danette <DYork@buttecounty.net>; Andrew Miller <Andrew.Miller@enloe.org>; Elizabeth.Kelly@colusadhhs.org; Benriquez@countyofglenn.net; Christine Zoppi <CZoppi@countyofglenn.net>; NDiLouie@countyofglenn.net; jgarrison@countyofglenn.net; Phebe.Bell@co.nevada.ca.us; jobijobi@comcast.net; Ryan.Gruver@co.nevada.ca.us; jarsenith@placer.ca.gov; Robert Oldham <roldham@placer.ca.gov>; DanaLoomis@countyofplumas.com; thobson@pcbh.services; Sierra Vickie <vclark@sierracounty.ca.gov>; Jamie Franceschini <jfranceschini@sierracounty.ca.gov>; Nancy OHara <nohara@co.sutter.ca.us>; Rick Bingham <RBingham@co.sutter.ca.us>; Leah Northrop <LNorthrop@co.sutter.ca.us>; Sarah Eberhardt-Rios <SEberhardt-Rios@co.sutter.ca.us>; Tehama County Public Health <Valerie.Lucero@tchsa.net>; 'Jayme Bottke' <Jayme.Bottke@tchsa.net>; Tehama Health Officer <Jennifer.Brown@tchsa.net>; Vasquez, Jennifer <jvasquez@CO.YUBA.CA.US>; Marshall, Meghan <mmarshall@CO.YUBA.CA.US>; Patti McFarland <PMcfarland@partnershiphp.org>; Amy Turnipseed <aturnipseed@partnershiphp.org>; Liz Gibboney <egibbone@partnershiphp.org>; Kirill Obraztsov <kirill.obraztsov@countyofcolusa.com>; Dustin Lyda <DLyda@partnershiphp.org> Subject: Letter of Support from Senator Nielsen and also Response from DHCS about Model Options ATTENTION: This message originated from outside Butte County. Please exercise judgment before opening .. attachments, clicking on links, or replying. All, For the five counties (aside from Yuba County and Sutter County) in Senate District 4, please see attached for Senator Nielsen's letter of support of the COHS transition. Each county has its own letter addressed to your BOS Chair. In the past several days, we have seen an aggressive campaign by California Health and Wellness (CHW) to our Yuba County and Sutter County Supervisors relaying some deeply concerning misinformation. Essentially, CHW is advising our Supervisors to reject the COHS model transition, stick with the two-plan commercial regional model, and CHW will be able to guarantee the County local governance and a "wellness fund" similar to Imperial County's model. It's complicated but essentially, what CHW is presenting as an "alternative" is not possible for many reasons. Please see attached presentation that we've put together to explain this to our Supervisors. We hope that this will help you all in your effort to educate yours. In addition, we were able to ask DHCS to put in writing emphasizing that there are only two options: 1) Stick with two-plan commercial model - status quo or2)Transition to COHS model with Partnership. That response is attached. Finally, Partnership will be hosting a special meeting soon (September 1, 2021 - once at the noon hour and again at 5 p.m.) for the Chair and Vice-Chair of all ten counties, and CAOs and County Counsels will also be welcomed to attend. Dustin Lyda will be sharing that information shortly. Please share the meeting link with your BOS Chair, Vice-Chair, and if they are interested in attending, your CAO and County Counsel. Please let me know if you have any questions. Thanks, Dr. Luu August 20, 2021 Bill Connelly, Chair Butte County Board of Supervisors 25 County Center Drive, Suite 200 Oroville, CA 95965 RE: Letter of Support for Passage of the Ordinance to Establish a COHS with Partnership HealthPlan Dear Chair Connelly: I am writing in support of Butte Regional Medi-Cal Managed Care model to the County Organized Health System (COHS) model with Partnership HealthPlan of California (PHC). As you are aware, California has implemented a variety of Medi-Cal managed care models over the years. In 2013, a limited number of counties were allowed to enter into the COHS model. DHCS then assigned the remaining counties, including Butte, to the Regional model, and chose Anthem Blue Cross and California Health and Wellness as the two Medi-Cal managed care plans. care in the 18 small and rural counties under the Regional model. In August 2019, the State Auditor released a report entitled Department of Health Care Services: It Has Not Ensured That Medi-Cal Beneficiaries in Some Rural Counties Have Reasonable Access to Care. This report found that the Regional model was inferior to the COHS model and concluded that the quality of care provided to Medi-Cal enrollees in the Regional model counties was worse, on average, when compared to Medi-Cal managed care plans in other rural counties. While it would be a significant change for all parties, local health officials in all seven counties in my district are actively pursuing ordinance passage to transition to the COHS model with PHC. They are excited about the prospect of transitioning because the COHS model allows more local control, is cost effective, and improves access to care. Moreover, PHC is a nonprofit with a proven track record for working collaboratively with the counties it serves and consistently receives high satisfaction scores from both members and providers. For these reasons, I believe that transitioning from the Regional model to a COHS model with PHC would be in the best interest of Butte Sincerely, Senator Jim Nielsen Fourth District From: Philip, Susan@DHCS <Susan.Philip@dhcs.ca.gov> Sent: Thursday, August 19, 2021 12:16 PM To: Marshall, Meghan <mmarshall@CO.YUBA.CA.US> Cc: Hansen, Brian@DHCS <Brian.Hansen@dhcs.ca.gov>; Retke, Michelle@DHCS<Michelle.Retke@dhcs.ca.gov>; Cisneros, Bambi@DHCS<Bambi.Cisneros@dhcs.ca.gov> Subject:RE: \[External\]URGENT INQUIRY-Managed Care Plan Model Transition Importance:High Meghan: DHCS can confirm that the following are the only available options for Yuba County. 1.Pass an ordinance to adopt the COHS model of care. And the COHS plan would have to be Partnership Healthplan of California, as indicated on the county Letter of Intent. 2.Continue as a Regional model county. And Regional Model commercial plans will be selected through the upcoming commercial plan procurement process. Also: DHCSis offering a few days of flexibility for the October 1 ordinance due date. A board- approved ordinance submitted to DHCS by October 10 is acceptable. DHCS communicated this to County and Local Plan associations recently based on a request from counties. This response is applicable for Medi-Cal Managed Care Plan operations that begin January 1, 2024. This response is applicable for all of the Regional Model counties that submitted a Letter of Intent for model change with Partnership Healthplan of California. We can still plan to meet at 2PM if that’s helpful. I’ll keep it on the calendar unless I hear otherwise. Thanks, Susan SusanPhilip,MPP DeputyDirector,HealthCareDeliverySystems CaliforniaDepartmentofHealthCareServices Susan.Philip@dhcs.ca.gov Feasibility August 20, 2021 County” Plan Misconceptions of “Imperial profit health plan so - Model Cal Managed Care Plans can - Medi It’s not just Anthem and CHW that must decline to pass the ordinance by October bid in the RFP. - any commercial – re “this is the current Imperial County model” – The County keeps the status quo of two commercial plans with Anthem and CA Health and Wellness and 10, 2021 to transition to COHS model with Partnership Then, in a Request for Proposal (RFP), Anthem and California Health and Wellness (CHW) must can apply for the RFP make the bid (Molina, Aetna, etc.). Partnership is a nonthey do not qualify for this type of commercial plan RFP. •• “Builds on regional model” but adds local governance and wellness fund What does it actually mean to build on the regional model? Let’s Review the CHW Option #1 •• will (not us to continue Anthem Cal Managed - This is very ambitious and likely unrealistic. If somehow CA Health and Wellness (CHW) is chosen by DHCS in the Counties since we do not get to make that decision)as one of the two commercial health plans in the continued regional model, CHW is proposing that they will be able to successfully push out the other commercial plan and dominate the MediCare share. not cede market share willingly to CHW. cont.) Let’s Review the CHW Option #1 Model (• all currently enrolled Anthem Cal patients - of choice and cause havoc and grief for medical providers and facilities to only that would mean antithesis chance that CHW can succeed in decreasing Anthem’s medically fragile Medi low Cal beneficiaries would be forced to change to CHW in order - Even in the market share by convincing contract with them, This would be the vulnerable, Medito continue to get healthcare in our Counties. cont.) Let’s Review the CHW Option #1 Model (•• COHS single plan - for Medicare and Model currently has) - Center less (that’s what their commercial or Molina Health – waivers after determining if the single plan proposal is federal must submit t would likely take up to 10 years for CHW to build out a fully functioning single plan DHCS feasible through considerable plan deliverable analysis and review I •• Let’s assume that CHW is successful with Option #1 by pushing Anthem down to limited market share of 20% plan competitor in Imperial County The “build on regional model with option #1” into a nonoption is NOT possible without federal authorization through either new federal statute or 1115 waiver expenditure authority, or waiver of plan choice for rural/frontier counties to the Federal Medicaid Services Let’s Review the CHW Option #2 •• Cal - for CHW to plan is truly COHS single Cal procurement process and - - has been one of the two Medi be able to deliver on? in our County since 2013 not Wellness (CHW) promise benefits (wellness fund, local governance), that why did it take 8 years (2013 until March 2021) CA Health and If the regional model progression to the “Imperial County” model with the eventual progression to a nonviable, propose this?Or is this plan of CHW to present option #1 progressing to option #2 just an attempt to obfuscate the Medi verbally most likely they will Managed Care plans If Options #1 and #2 are so great, why wait until 2021?••• Feasibility August 20, 2021 County” Plan Misconceptions of “Imperial