To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Cancellation Agreement #77-091-6 and Contract #77-091-7 with Healthflex Home Health Services
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County, as follows: (1) Cancellation Agreement #77-091-6 with Healthflex Home Health Services, a corporation, effective at the end of business on January 31, 2024; and Contract #77-091-7 with Healthflex Home Health Services, a corporation, in an amount not to exceed $300,000, to provide home health care services for Contra Costa Health Plan (CCHP) members and county recipients for the period February 1, 2024 through January 31, 2027.
FISCAL IMPACT:
Approval of this contract will result in contractual service expenditures of up to $300,000 over a three-year period and will be funded 100% by CCHP Enterprise Fund II revenues. (Rate increase)
BACKGROUND:
CCHP has an obligation to provide certain specialized home health care services for its members under the terms of their Individual and Group Health Plan membership contracts with the county. Home health care services are mandated by the Department of Health Care Services (DHCS) and Department of Managed Health Care (DMHC) and is a Medi-Cal Managed Care benefit available to eligible Medi-Cal beneficiaries enrolled in CCHP. This Contractors proven track record and established reputation within the medical community mitigates potential risks associated with CCHP’s success and patient well-being. Healthflex Home Health Services has been a part of the CCHP Provider Network providing home health care services and fostering a deep understanding of the CCHP organizations mission, values, and long-term objectives since August 1, 2017.
This contract is entered into under and subject to the following legal authorities: California Government Code §§ 26227 and 31000; Health and Safety Code § 1451. Home Health agencies must adhere to all State and Federal rules and regulations and are required to enroll with the California Department of Public Health (CDPH) and meet Center for Medicare and Medicaid Services (CMS) regulations 42 CFR part 484 and 42 CFR 440.70(d). Health Services Personnel approved this contract to ensure no conflicts with labor relations in December 2023. This contractor currently cooperates with and participates in CCHP’s Quality Management Program which consists of quality improvement activities to improve the quality of care and services and member experience. Cooperation includes collection and evaluation of performance measurement data and participation in the organization’s clinical and service measure Quality Improvement Programs.
The nature of the home health care services needed is complex and requires seamless coordination, integration and collaboration with existing programs and systems. There are a total of 55 home health care agencies in CCHP’s service area. CCHP is currently contracted with 50 of the home health agencies. This new contract will maintain comprehensive area coverage for the entire CCHP membership and meet the Knox-Keene Act, time and distance mandate required by the State of California DMHC services. This contractor has been approved by the Public Works Department’s Purchasing Division on November 16, 2023.
In October 2022, the County Administrator approved and the Purchasing Services Manager executed Contract #77-091-5 with Healthflex Home Health Services, in an amount not to exceed $200,000, for the provision of home health care services for CCHP members and county recipients for the period October 1, 2022 through September 30, 2024.
In consideration of the contractor’s agreement to continue providing home health care services and the departments need to increase rates to maintain an adequate network for CCHP members to meet DHCS and DMHC mandates, the department and contractor have agreed to (1) mutual cancellation of the current contract in accordance with General Conditions Paragraph 5 (Termination), of the contract (Cancellation Agreement #77-091-6) will accomplish this cancellation, and (2) establish a new contract with the correct terms and conditions for the next three years.
Under new Contract #77-091-7, this contractor will provide home health care services for CCHP members and county recipients for the period February 1, 2024 through January 31, 2027.
CONSEQUENCE OF NEGATIVE ACTION:
If this contract is not approved certain specialized home 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 and may cause a delay in services to CCHP members.