To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Contract #77-560 with John Muir Health (dba John Muir Physician Network)
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
Contract #77-560 with John Muir Health (dba John Muir Physician Network), a non-profit corporation, in an amount not to exceed $50,000,000, to provide primary care, medical specialist physician, therapy services and diagnostic imaging and laboratory services for Contra Costa Health Plan (CCHP) members for the period January 1, 2024 through December 31, 2025.
FISCAL IMPACT:
Approval of this contract will result in contractual service expenditures of up to $50,000,000 over a two-year period and will be funded 100% by CCHP Enterprise Fund II.
BACKGROUND:
CCHP has an obligation to provide certain specialized primary care physician, specialty medical health care services, and outpatient therapy services, including but not limited to urgent care medical services, primary care physician services, outpatient physical, occupational and speech therapy services, and laboratory and diagnostic services for its members under the terms of their Individual and Group Health Plan membership contracts with the county. This contractor has been providing services formerly under a Memorandum of Understanding and is an approved CCHP Network Provider effective January 1, 2024.
John Muir Health (dba John Muir Physician Network) was selected to provide medical professional and non-physician services that require specific certifications, licenses or DHCS and CMS regulatory approvals that this Contractor holds. Contractor’s established compliance history ensures adherence to industry regulations and reduces potential legal and regulatory risks. This contractor will maintain the comprehensive area coverage for the entire CCHP Membership and meet the health care needs of CCHP members and meet the time and distance mandate required by the State of California Department of Managed Health Care Services and assist with the CCHP Single Plan Model which will be effective January 1, 2024. Other sources providing these services are unacceptable as they do not meet the State regulations and accreditation standards required for Medi-Cal Managed Care Plans, such as CCHP.
The nature of these services needed is complex and requires seamless coordination, integration, and collaboration with existing programs, systems, and personnel. John Muir Health (dba John Muir Physician Network) is familiar with CCHP’s specific requirements to help ensure a smoother implementation and delivery process. This contract is entered into under and subject to the following legal authorities: California Government Code §§ 26227 and 31000; Health and Safety Code § 1451. Health Services Personnel approved this contract to ensure no conflicts with labor relations. This contractor fosters a deep understanding of the CCHP organization’s mission, values, and long-term objectives. Per Administrative Bulletin 600.3 this provider has met the solicitation requirements for non-physician services and contractor was approved by Public Works Department’s Purchasing Division on December 12, 2023. In addition, this contractor provides physician services that are exempt from Solicitation requirements.
Under new Contract #77-560, this contractor will provide primary care, urgent medical care, medical specialty services, outpatient physical therapy and laboratory and diagnostic imaging services for CCHP members for the period January 1, 2024 through December 31, 2025.
CONSEQUENCE OF NEGATIVE ACTION:
If this new contract is not approved certain specialized health care services for CCHP members under the terms of their Individual and Group Health Plan membership contracts with the county will not be provided by this contractor and may cause a delay in services to CCHP members.