To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract Amendment/Extension #23-864-1 with Health Management Associates, Inc.
☒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 Contract Amendment/Extension #23-864-1 with Health Management Associates, Inc., a corporation, effective December 1, 2025, to amend Contract #23-864, to increase the payment limit by $4,500,000, from $1,471,000 to a new payment limit of $5,971,000 and extend the termination date from June 30, 2026 through June 30, 2029, to provide additional consultation and technical assistance services with regard to implementation of the Medicaid Dual Eligible Special Needs Plan (D-SNP), and modify the contract provisions to include Department of Managed Health Care (DMHC) required language concerning D-SNP obligations and requirements.
FISCAL IMPACT:
Approval of this Contract Amendment/Extension will result in additional annual expenditures of up to $4,500,000 and will be funded 100% by Contra Costa Health Plan (CCHP) Enterprise Fund II. (No rate increase)
BACKGROUND:
Health Management Associates, Inc has been providing consultation and technical assistance with regard to technology implementation of the Medicaid Dual Eligible Special Needs Plan (D-SNP) services to the CCHP since January 1, 2025. The Contractor’s services include acting as the D-SNP expert advisor to the Office of Information and Technology by participating in training, testing and ensuring compliance with business needs and regulatory requirements. 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 Contractor was approved by Public Works Purchasing on October 16, 2024.
On November 5, 2024, the Board of Supervisors approved Contract #23-864 with Health Management Associates, Inc., in an amount not to exceed $1,471,000, to provide consultation and technical assistance with regard to technology implementation of the Medicaid D-SNP implementation for the period January 1, 2025 through June 30, 2026.
Approval of Contract Amendment/Extension #23-864-1 will allow the Contractor to provide additional D-SNP consultation and technical assistance for the implementation of the Medicaid D-SNP through June 30, 2029, and will allow CCHP to modify the contract’s service plan provisions to conform with DMHC requirements by including DMHC required language concerning D-SNP requirements and obligations. This Contract Amendment/Extension was delayed due to calculation of increased payment limit needed because of increased utilization which had depleted funds.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract Amendment/Extension is not approved, the Contract will not have sufficient funds to pay Contractor and the Office of the Director/Finance will not be compliant with Center for Medicare and Medicaid Services (CMS) Network Adequacy regulatory requirements.