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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