Medi-Cal: County of Sacramento.

(1) Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which health care services are provided to qualified low-income persons under various health care delivery systems, including fee-for-service and managed care. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes the department to enter into various types of contracts for the provision of services to beneficiaries, including contracts with Medi-Cal managed care plans. Existing law provides that in counties selected by the Director of Health Care Services with the concurrence of the county, a special county health authority may be established, and in any county, by ordinance, a special commission may be established, in order to meet the problems of delivery of publicly assisted medical care in each county, and to demonstrate ways of promoting quality care and cost efficiency. Existing law authorizes several counties, including the County of Alameda, to establish, by ordinance, a health authority, and specified counties, such as the Counties of San Joaquin and Tulare, to establish, by ordinance, a special county health commission. This bill would authorize the Board of Supervisors of the County of Sacramento to establish, by ordinance, a health authority to perform specified duties, including negotiating and entering into contracts with health plans, as prescribed. The bill would require the health authority to meet with any health plans intending to contract with the department, and, subsequent to meeting with all interested health plans, to designate to the department at least 2 licensed health plans for the department's approval based on specified criteria. The bill would require the health authority to be governed by a commission, would require the board to appoint commission members, and would require those members to include specified individuals, including representatives of nonprofit community health centers and hospital systems that operate in the County of Sacramento. The bill would specify the responsibilities and duties of each member of the commission, including serving the public interest of Medi-Cal beneficiaries served by the health authority and ensuring the fiscal solvency of the health authority. The bill would require the commission to establish advisory committees, including an executive committee, and would prohibit members of the commission and advisory committees from receiving compensation for activities relating to their duties, except as specified. The bill would provide that a member of the commission shall not be deemed to be interested in a contract entered into by the department if the member is a Medi-Cal recipient or if certain facts apply, including that the member was appointed to represent the interests of physicians, health care practitioners, hospitals, or other health care organizations. The bill would require the health authority to be considered a separate entity from the county, to be deemed a public agency for various purposes, including for purposes of grant programs, and to have specified authority as necessary to perform its functions, including the power to acquire real or personal property. The bill would authorize the board, by ordinance, to terminate the health authority under prescribed circumstances, and would require certain acts to be performed by the health authority, the County of Sacramento, the board, and the department, including requiring the department to conduct an audit of the health authority's records, before the termination of the health authority. (2) This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Sacramento.