HomeMy WebLinkAbout052019_ca03 JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Greg Brotherton, District 3 Commissioner
DATE: May 20, 2019
SUBJECT: Interlocal Agreement between Kitsap, Clallam and Jefferson County
(Olympic Regions Service Area) and the Health Care Authority (HCA) re:
Participate in Interagency Administration of Integrated Managed Care of
Physical and Behavioral Health Services
STATEMENT OF ISSUE:
Interlocal Agreement between Kitsap, Clallam and Jefferson County (Olympic Regions Service Area) and
the Health Care Authority (HCA) re: Participate in Interagency Administration of Integrated Managed Care
of Physical and Behavioral Health Services
ANALYSIS:
1) Fully cooperate in efforts to fully integrate clinical care within the RSA, including:
• Provide leadership to behavioral health agencies in continuing to move forward with clinical
integration.
• Encourage co-location of services, MOU's between physical and behavioral health programs, and
warm handoffs in all care transitions.
2) Operate all administrative functions in a fiscally responsible manner while minimizing costs and ensuing
compliance with contracts, regulations and laws pertaining to managed care.
FISCAL IMPACT:
No Dollar Amount
RECOMMENDATION:
Review and approve re: Interlocal Agreement between Kitsap, Clallam and Jefferson County
(Olympic Regions Service Area) and the Health Care Authority (HCA) re: Participate in Interagency
Administration of Integrated Managed Care of Physical and Behavioral Health Services
V D :
111 ML4 5/I,J
ip Morle my Admini or Date
HCA Contract K3299
Interagency Agreement for the Administration of Integrated Managed Care
Between
The State of Washington Health Care Authority,
And
Clallam County, Jefferson County and Kitsap County
THIS INTERAGENCY AGREEMENT (Agreement) is made and entered into by and between
the Washington State Health Care Authority (HCA) and Clallam County, Jefferson County and
Kitsap County(herein referred to as the Counties), pursuant to the authority granted by Chapter
39.34 RCW.
RECITALS
WHEREAS, the Washington State Legislature (Legislature), in accordance with federal law,
and to facilitate the State's receipt of federal Medicaid funding, has designated Washington
State Health Care Authority (HCA) as the "single state agency" for the Medicaid program;
as such, HCA retains full authority and responsibility for all final decisions regarding the
Medicaid program. See42 U.S.C. § 1396a(a)(5); 42 C.F.R. §431.10(e); RCW
41.05.021(1)(m)(i); RCW 74.04.050(2); RCW 74.09.530(1)(a);
WHEREAS, the counties of Clallam, Jefferson and Kitsap collectively make up the Olympic
Regional Service Area (RSA);
WHEREAS, in 2014, the Legislature directed HCA to fully integrate the delivery of physical
and behavioral health services in Washington's Medicaid program via managed care by
January 1,2020;
WHEREAS, the purpose of this Agreement is to spell out certain terms and conditions that
the parties anticipate will be negotiated between HCA and the Counties for the
administration of Integrated Managed Care (IMC); and
NOW, THEREFORE, the parties hereby enter into the following Agreement, under the
terms and conditions specified herein, and incorporating the above Recitals.
AGREEMENT
1. HCA AGREES TO:
1) Participate in a Leadership Structure. HCA will actively support and accept the
Counties, or their Designee, as the entity within the Olympic Regional Service Area
that fully represents local County governments, and which has the authority to
collaborate with the HCA on the design and implementation of the integrated
managed care model.
2) Ensure that Managed Care Organizations (MCOs) and the Behavioral Health
Administrative Services Organization (BH-ASO) have established adequate
networks, prior to the January 1, 2020 implementation date so that services available
HCA Contract K3299
to citizens west of Lake Crescent are at least as accessible as they are during
Calendar Year 2019, as determined by the number of contracted entities available
and number of services provided.
3) Promptly appoint a new BH-ASO for the RSA, should the BH-ASO within the RSA fail, or
is unable to meet the readiness review requirements.
4) Monitor MCOs to ensure:
A) A sufficient network of providers are available to provide adequate access
to behavioral health services for residents of the RSA.
B) The maintenance of quality improvement processes.
5) Collaborate with the MCOs and the Counties on the shared goal of continuing to
maintain or improve:
A) The current level of services provided, including access to non-Medicaid
support services.
B) The current funding levels to behavioral health providers so they remain
fiscally sound immediately following the transition date.
6) Work with the Counties to identify the level of non-Medicaid and Administrative funds that
are deemed necessary to meet the state's and MCO requirements for a BH-ASO; and
support the region in providing this information to the Governor's Office.
7) If appropriated by the Legislature, provide funding via contract to the BH-ASO, to maintain
an inpatient risk reserve and stabilize the continuum of care in crisis services.
8) Provide reimbursement to any future BH-ASO that passes readiness review requirements
for the administration of crisis services provided by subcontractors, in accordance with the
contract.
9) Put strategies in place to ensure that behavioral health services to individuals with dual
eligibility for Medicaid and Medicare, including those with third party coverage, are not
adversely affected by the change to IMC.
10) Provide technical support to the Counties to assist with preparation for IMC.
11) Support a contractual arrangement between the selected MCOs and the Counties for
mutually agreed upon functions and services (e.g. Behavioral Health Advisory Board,
Ombuds, etc.), in accordance with contract terms and conditions.
12) Commit to exploring strategies with the Counties for minimizing the burden on the Salish
Behavioral Health Organization's (SBHO) staff during the seven months prior to
implementation of IMC; with the goal of achieving a balance between adherence to
existing SBHO contract requirements and allowing for staff capacity to support the BHO
closeout process, while simultaneously designing and implementing the BH-ASO
processes for the integrated managed care transition. This includes consideration for
HCA Contract K3299
reducing the Behavioral Health Organization's subcontractor monitoring requirements and
the state's annual BHO External Quality Review Organization (EQRO) review
requirement.
13) If funds are appropriated by the legislature, provide funds to behavioral health providers
within the Olympic RSA to improve their readiness for full integration.
14) Will provide clear written communication detailing required ASO Readiness activities and
corresponding timelines for completion.
2. THE COUNTIES AGREE TO:
1) Fully cooperate in efforts to fully integrate clinical care within the RSA, including:
• Provide leadership to behavioral health agencies in continuing to move forward with
clinical integration.
• Encourage co-location of services, MOUs between physical and behavioral health
programs, and warm handoffs in all care transitions.
2) Operate all administrative functions in a fiscally responsible manner while minimizing costs
and ensuring compliance with contracts, regulations and laws pertaining to managed care.
3. TERM
This Agreement takes effect on the date of full execution by all parties and will remain in effect
through December 31, 2021, and will automatically renew year-after-year unless modified by
the parties through an amendment. No change in terms and conditions will be permitted
during this term unless specifically agreed to in writing by both parties.
4. AGREEMENT MANAGEMENT
The Agreement manager for each of the parties shall be responsible for and shall be the
contact person for all communications regarding the performance of this Agreement.
The Contract Manager for HCA is:
Alice Lind
P.O. Box 45502
Olympia,WA 98504-5502
Phone: (360) 725-2053
alice.lind(cr�hca.wa.gov
The Contract Manager for the Counties is:
Stephanie Lewis, LMFT, Administrator
614 Division St. MS723
Port Orchard, WA 98366
Phone: (360) 337-4422
sjlewis(a�co.kitsap.wa.us
HCA Contract K3299
5. CONFIDENTIALITY
Each party will protect and preserve the confidentiality of (a) all data provided by any other
party and (b) all information that is defined as confidential under state law or regulation, federal
law or regulation, or by HCA in the normal course of business. Each party will comply with all
applicable federal and state laws and regulations pertaining to the collection, use, and
disclosure of confidential information and personal or protected health information, including
but not limited to RCW 70.02 and the federal Health Insurance Portability and Accountability
Act of 1996 (and its implementing regulations).
6. DISPUTES
In the event that a dispute arises under this Agreement, it shall be determined by a Dispute
Board in the following manner: Each party to this Agreement shall appoint one member to the
Dispute Board. The members so appointed shall jointly appoint an additional member to the
Dispute Board. The Dispute Board shall review the facts, the Agreement, and applicable
statutes and rules and make a determination of the dispute. The Dispute Board shall thereafter
decide the dispute with the majority prevailing. The determination of the Dispute Board shall be
final and binding on the parties hereto.
7. GOVERNING LAW AND VENUE
This Agreement shall be construed and interpreted in accordance with the laws of the state of
Washington. The venue of any action brought hereunder shall be in the Superior Court for
Thurston County.
8. INDPENDENT CAPACITY
The employees or agents of each party who are engaged in the performance of this Agreement
shall continue to be employees or agents of that party and shall not be considered for any
purpose to be employees or agents of the other party.
9. NO THIRD-PARTY BENEFICIARIES
There are no third-party beneficiaries to this Agreement. No person or entity other than a party
to this Agreement shall have any rights hereunder or any authority to enforce is provisions.
10. RECORDS MAINTENANCE
The parties shall each maintain books, records, documents and other evidence which sufficiently
and properly reflect any direct and indirect costs expended by either party in the performance
of the services described herein. These records shall be subject to inspection, review or audit
by personnel of both parties, other personnel duly authorized by either party, the Office of the
State Auditor, and federal officials so authorized by law. All books, records, documents, and
other material relevant to this Agreement will be retained for six years after expiration and the
Office of the State Auditor, federal auditors, and any persons duly authorized by the parties
shall have full access and the right to examine any of these materials during this period.
HCA Contract K3299
Records and other documents, in any medium, furnished by one party to this Agreement to the
other party, will remain the property of the furnishing party, unless otherwise agreed. The
receiving party will not disclose or make available this material to any third parties without first
giving notice to the furnishing party and giving it a reasonable opportunity to respond. Each
party will utile reasonable security procedures and protections to assure that records and
documents provided by the other party are not erroneously disclosed to third parties.
11. SEVERABILITY
If any provision of this Agreement or any provision of any document incorporated by reference
shall be held invalid by a court of competent jurisdiction, such invalidity shall not affect the other
provisions of this Agreement, which can be given effect without the invalid provision if such
remainder conforms to the requirements of applicable law and the fundamental purpose of this
Agreement, and to this end the provisions of this Agreement are declared to be severable.
12. STATE IMMUNITY
Nothing in this Agreement shall be construed as a waiver by HCA of the State's immunity under
the 11th Amendment to the United States Constitution.
13. TERMINATION
The Counties may terminate this agreement with ten (10) business days written notice to HCA,
as long as the termination is confirmed in writing to HCA within that same ten-day period by a
majority of the county commissioners from each county in the RSA. HCA may terminate this
Agreement with ten (10) business days written notice to the Counties.
14.WAIVER
A failure by either party to exercise its rights under this Agreement shall not preclude that party
from subsequent exercise of such rights and shall not constitute a waiver of any other rights
under this Agreement unless stated to be such in a writing signed by an authorized
representative of the party and attached to the original Agreement.
15. WRITINGS CONTAINED HERIN
This Agreement contains all the terms and conditions agreed upon by the parties. No other
understandings, oral or otherwise, regarding the subject matter of this Agreement shall be
deemed to exist or to bind any of the parties hereto.
16.AUTHORITY TO BIND PARTIES
Each person signing below affirms that he or she has legal authority to bind the party to all of the
terms of this Agreement.
17. RECORDING
This Agreement shall be filed with the Thurston County Auditor and placed on its web site or other
electronically retrievable public source.
HCA Contract K3299
IN WITNESS WHEREOF, the parties have executed this Agreement.
STATE OF WASHINGTON
HEALTH CARE AUTHORITY
Signature
Title Date
HCA Contract K3299
PASSED AND APPROVED on this day of , 2019
BOARD OF COUNTY COMMISSIONERS
CLALLAM COUNTY, WASHINGTON
RANDY JOHNSON Commissioner
MARK OZIAS, Commissioner
BILL PEACH, Commissioner
ATTEST:
Loni Gores, Clerk of the Board
HCA Contract K3299
PASSED AND APPROVED on this day of , 2019
BOARD OF COUNTY COMMISSIONERS
JEFFERSON COUNTY, WASHINGTON
KATE DEAN, Commissioner
GREG BROTHERTON, Commissioner
DAVID SULLIVAN, Commissioner
ATTEST:
Carolyn Gallaway, Deputy Clerk of the Board
A po oved as t form:
Date: S%6//
Philip C.Hunsucker,Chief Civil Deputy Prosecuting Attorney
Jefferson County Prosecuting Attorney's Office
HCA Contract K3299
PASSED AND APPROVED on this day of , 2019
BOARD OF COUNTY COMMISSIONERS
KITSAP COUNTY, WASHINGTON
ROBERT GELDER, Commissioner
EDWARD E. WOLFE, Commissioner
CHARLOTTE GARRIDO, Commissioner
ATTEST:
Dana Daniels, Clerk of the Board