Fremont City Council Meeting: 03/18/25 07:00 PM
3300 Capitol Avenue Div/Dept: Human Services Department Fremont, CA 94538 Category: Agreements and Contracts
SCHEDULED
Sponsors:
COUNCIL STAFF REPORT (ID # 5364) DOC ID: 5364
Updated: 3/13/2025 2:09 PM by Dina Lewis Page 1
FY 2024/25 MEMORANDUM OF UNDERSTANDING WITH ALAMEDA COUNTY FOR MEDI-CAL CASE MANAGEMENT PROGRAM - Authorize the City Manager to Execute a Memorandum of Understanding with Alameda County Health for FY 2024/25 Targeted Case Management Services
Contact Persons:
Name: Leticia Leyva Arquimides Caldera
Title: Management Analyst II Human Services Director
Div/Dept: Human Services Department Human Services Department Phone: 510-574-2072 510-574-2056
E-Mail: [email protected] [email protected]
Executive Summary: Staff recommends the City Council adopt a resolution authorizing the City Manager to execute a Memorandum of Understanding (MOU) with Alameda County Health (ACH) for FY 2024/25 to enable the City to continue receiving reimbursement of funds through Alameda County’s Targeted Case Management (TCM) program for eligible activities carried out by Human Services Department staff. Staff anticipates receiving approximately $390,000 in reimbursements for eligible TCM activities. Additionally, the proposed resolution delegates to the City Manager, Finance Director, or their designee, the authority to sign, certify or execute documents on behalf of the City with respect to the TCM and Medi-Cal Administrative Activities (MAA) programs for FY 2024/25.
BACKGROUND: Both the TCM and MAA programs are funded by Medicaid Title XIX through the federal Centers for Medicare and Medicaid Services (CMS). The California Department of Health Care Services (DHCS) administers the programs at the state level, with each county in California designating a Local Government Agency (LGA) to administer the programs locally. In Alameda County, Alameda County Health (ACH) serves as the LGA for the City of Fremont. These TCM and MAA programs allow service providers to receive partial federal reimbursement of local funds (i.e., City, County and State funding) expended on direct services and administrative activities necessary for the proper and efficient provision and administration of the Medi-Cal program. Funding flows from CMS through DHCS, then to ACH, and finally to the City. The City has participated in the TCM program since FY 2002/03 and the MAA program since FY 2006/07.
DISCUSSION/ANALYSIS:
Targeted Case Management (TCM) Program: The City is reimbursed for TCM services provided by Case Managers in the Fremont Family Resource Center (FRC) and the Aging and Family Services (AFS) Division of the Human Services Department. FRC Case Managers work with families and individuals that fit within the TCM target population of “Individuals in Jeopardy of Negative Health or Psycho-Social Outcomes.” AFS Case Managers work primarily with seniors that fit within the TCM target population of “Medically Fragile Individuals.”
Council Staff Report (ID # 5364) Meeting of March 18, 2025 Updated: 3/13/2025 2:09 PM by Dina Lewis Page 2
Eligible Activities: Case Managers help people within these two target populations access needed medical, social, educational and other services. To be reimbursable, TCM activities must fall under one of the following components:
1. Assessment and reassessment of individual needs;
2. Development and periodic revision of a care plan;
3. Referral and linkage activities; and
4. Monitoring and follow-up activities
Reimbursement: The TCM program reimburses the City for approximately 48% of the estimated costs associated with providing case management encounters to Medi-Cal eligible clients. The exact amount of funding the City receives is generally based on the following:
1. An ongoing survey of time spent carrying out TCM activities;
2. The actual number of face-to-face encounters Case Managers have with Medi-Cal eligible individuals during the year;
3. The Federal Medical Assistance Percentage (FMAP) rate; and
4. A cost report completed by Human Services Department staff in cooperation with the Finance Department. The City’s cost of providing these services varies each year; therefore, new cost reports and an MOU must be completed for each year the City participates in the program.
Medi-Cal Administrative Activities (MAA) Program: Many of the administrative activities carried out by Human Services Department are eligible for reimbursement under the MAA program. These administrative activities support the provision of case management, counseling, and health promotion services in our community.
Eligible Activities: Activities eligible for MAA reimbursement include the following:
1. Outreach that brings potentially Medi-Cal eligible people into the Medi-Cal system for the purpose of determining their Medi-Cal eligibility, or links Medi-Cal eligible individuals with Medi-Cal covered services;
2. Referral, coordination, and monitoring of Medi-Cal services;
3. Facilitating the completion of Medi-Cal applications;
4. Arranging and/or providing non-emergency, non-medical transportation to a Medi-Cal covered servicer;
5. Administering contracts for Medi-Cal services and administrative activities; and
6. Program planning and policy development with the goal of increasing the Medi-Cal system’s capacity.
Reimbursement: DHCS has approved the City’s five current MAA claiming plans, which describe the eligible activities the City will carry out, the staff for whom claiming will be done and the methodology for determining costs.
Participating staff complete a MAA program time survey each month to determine the percentage of time spent on reimbursable administrative activities during FY 2024/25.
Once FY 2024/25 closes, ACH and City staff will use the time surveys and actual FY 2024/25 expenses to calculate the reimbursement for eligible administrative activities during the fiscal year. ACH will then submit the request for reimbursement to DHCS on the City’s behalf.
Council Staff Report (ID # 5364) Meeting of March 18, 2025 Updated: 3/13/2025 2:09 PM by Dina Lewis Page 3
Local Public Entity (LPE) Requirements: The City is recognized by DHCS as a Local Public Entity (LPE) for the purpose of participating in the TCM and MAA programs. This designation allows the City to self-certify local public expenditures that support the provision of Medi-Cal programs.
Therefore, staff also recommends the City Council adopt a resolution delegating to the City Manager, Finance Director, or their designee, the authority to sign, certify or execute documents on behalf of the City with respect to both the TCM and MAA programs for the FY 2024/2025.
FISCAL IMPACT: Based on revenue from prior years, for FY 2024/25, staff estimates that the City may receive reimbursement of up to $390,000 for TCM activities, including up to $140,000 for AFS case management services and $250,000 for FRC case management services. On July 16, 2024, the City Council previously authorized the City Manager to execute an MOU for FY 2024/25 for the MAA program.
TCM and MAA revenues are important components of the Human Services Department’s strategy to cultivate outside revenue sources needed to sustain safety net services and support administrative overhead costs associated with these services. This funding was anticipated, and sufficient funds were appropriated as part of the FY 2024/25 adopted operating budget.
ENVIRONMENTAL REVIEW: This action is exempt from the California Environmental Quality Act, California Public Resources Code Section 21000, et seq., pursuant to, without limitation, CEQA Guidelines Section 15378(b)(2)(continuing administrative activities), Section 15378(b)(4)(governmental fiscal activities), 15378(b)(5)(administrative activities) and/or Section 15061(b(3)(no possibility of significant effect on the environment), each of the foregoing providing a separate and independent basis for CEQA exemption.
ATTACHMENTS:
• Draft Resolution Medi-Cal Administrative Activities and Targeted Case Management Programs
RECOMMENDATION: Adopt a resolution: (1) authorizing the City Manager, or her designee, to execute a Memorandum of Understanding with Alameda County Health to enable the City’s Human Services Department to receive reimbursement for eligible FY 2024/25 expenses through Alameda County’s Targeted Case Management (TCM) program, and making findings of CEQA exemption, as described in this staff report; and (2) delegating to the City Manager, Finance Director, or their designee, the authority to sign, certify or execute documents on behalf of the City with respect to the TCM and MAA programs.