To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract Amendment Agreement #23-864-2 with Health Management Associates, Inc.
Recommendation: Recommendation of the County Administrator
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Amendment #23-864-2 with Health Management Associates, Inc. (HMA), a corporation, effective November 1, 2026, to amend Contract #23-864 (as amended by #23-864-1), to increase the payment limit by $5,747,147, from $5,971,000 to a new payment limit of $11,718,147 to include the services previously provided under Contract #23-864 and allow both Medi-Cal and Medicaid actuarial services for the Contra Costa Health Plan (CCHP) under a single contract, with no change to the original term of January 1, 2025 to June 30, 2029.
FISCAL IMPACT:
Approval of this Contract Amendment will result in additional expenditures of up to $5,747,147, funded 100% by CCHP Enterprise Fund II.
BACKGROUND:
On November 5, 2024, the Board of Supervisors approved Contract #23-864 (as amended by Amendment/Extension Agreement #23-864-1) with HMA in an amount not to exceed $5,971,000 to provide currently provide actuarial and analytic services to CCHP, for the period January 1, 2025 thought June 30, 2029.
HMA also provided actuarial consulting services under a separate agreement, Contract #23‑773, originally approved on August 15, 2023, to support CCHP’s Medi‑Cal actuarial functions, including IBNR reserve calculations, annual Rate Development Template (RDT) submissions, and State premium rate file analysis. Over its term, Contract #23‑773 underwent several amendments that increased the payment limit to $3,820,000 and extended the contract through September 30, 2026, at which point the contract expired.
Because the scope of actuarial services under Contract #23‑773 has become fully aligned with the services provided under Contract #23‑864, and Contract #23‑773 is now expired, CCHP recommends consolidating all actuarial work under Contract #23‑864. This amendment merges the functions previously performed under Contract #23‑773 into Contract #23‑864, updates the actuarial rate schedule, and increases the payment limit to support the combined workload. There is no change to the contract term.
This Contract is entered into under and subject to the following legal authorities: California Government Code §§ 26227 and 31000. Health Services Personnel approved this Contract to ensure no conflicts with labor relations. Division Contract monitoring staff meet on a regular basis to ensure monitoring of performance measures set forth in the Contract are upheld. This amendment was approved by Public Works Purchasing on October 19, 2026.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract Amendment is not approved, the Contract will not have sufficient funds to pay Contractor and CCHP will not be compliant with Center for Medicare and Medicaid Services (CMS) Network Adequacy regulatory requirements.