Fremont City Council Meeting: 06/09/26 07:00 PM
3300 Capitol Avenue Div/Dept: Human Services Department Fremont, CA 94538 Category: Agreements and Contracts
SCHEDULED
Sponsors:
COUNCIL STAFF REPORT (ID # 5730) DOC ID: 5730
Updated: 6/5/2026 10:43 AM by Alberto Quintanilla Page 1 FY 2026/27 Memoranda of Understanding With Alameda County Health For Medi- Cal Programs - Authorize the City Manager to Execute Memoranda of Understanding with Alameda County Health for FY 2026/27 Medi-Cal Administrative Activities and 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 recommend the City Council authorize the City Manager, or designee, to execute FY 2026/27 Memoranda of Understanding (MOUs) with Alameda County Health (ACH) to enable the City to continue receiving reimbursements through Alameda County’s Targeted Case Management (TCM) and Medi-Cal Administrative Activities (MAA) programs for eligible activities carried out by the City’s Human Services Department.
Staff anticipate receiving approximately $499,000 in reimbursements for eligible TCM activities and $1,000,000 for eligible MAA activities. Staff also recommend the City Council adopt a resolution delegating to the City Manager, Finance Director, or designees, the authority to sign, certify or execute documents on behalf of the City with respect to the MAA and TCM programs.
Background: The Medi-Cal TCM and MAA programs are both funded with Medicaid Title XIX funds administered through the federal Centers for Medicare and Medicaid Services (CMS). The California Department of Health Care Services (DHCS) oversees these programs at the state level, with each county in California designating a Local Government Agency to administer the programs locally. In Alameda County, Alameda County Health (ACH) serves as the Local Government Agency for the Medi-Cal TCM and MMA programs. The TCM and MAA programs allow service providers to receive partial federal reimbursement of local funds (i.e., City, County and/or State funds) expended on certain direct services and administrative activities necessary for the proper and efficient provision and administration of the Medi-Cal TCM and MAA programs. 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.
Council Staff Report (ID # 5730) Meeting of June 9, 2026 Updated: 6/5/2026 10:43 AM by Alberto Quintanilla Page 2 Discussion/Analysis:
Targeted Case Management (TCM) Program: The City is reimbursed for targeted case management services provided by the Family Service Team at the Fremont Family Resource Center (FRC), as well as Older Adult Support Specialists in the Aging and Family Services Division (AFS). FRC staff work with families and individuals that fit within the TCM target population of “Individuals in Jeopardy of Negative Health or Psycho-Social Outcomes.” AFS staff works primarily with seniors that fit within the TCM target population of “Medically Fragile Individuals.”
Eligible Activities: Targeted case management services are defined as services provided to individuals in gaining access to needed medical, social, educational and other services. Services 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
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 services to Medi-Cal eligible clients. The exact amount of funding the City receives is based on a cost report completed by the City’s Human Services Department in cooperation with the Finance Department, which includes the following:
1. An ongoing time survey of staff time spent supporting TCM activities;
2. The actual number of face-to-face encounters case managers have with Medi-Cal eligible individuals during the year; and
3. The Federal Medical Assistance Percentage (FMAP) rate.
As the City’s costs and time spent providing these services vary each year, new cost reports and an MOU must be completed for each year the City to participate in the program.
Medi-Cal Administrative Activities (MAA) Program: Many of the administrative activities carried out by the Human Services Department are eligible for reimbursement through the MAA program. These administrative Council Staff Report (ID # 5730) Meeting of June 9, 2026 Updated: 6/5/2026 10:43 AM by Alberto Quintanilla Page 3 activities support the provision of case management, counseling, and health promotion services in our community.
Eligible Activities: DHCS has approved the City’s four current MAA claiming plans, which describe the reimbursable activities to be carried out, the staff for whom claiming will be done, and the methodology for determining costs.
Eligible activities 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. Administering contracts for Medi-Cal services and administrative activities; and
5. Program planning and policy development with the goal of increasing the Medi-Cal system’s capacity.
Reimbursement: Participating staff will complete a MAA program time survey each month to determine the percentage of time spent on reimbursable administrative activities during FY 2026/27. At the close of FY 2026/27, ACH and City staff will use the time surveys and actual FY 2026/27 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.
Local Public Entity Requirements: The City is recognized by DHCS as a Local Public Entity for the purposes of participating in the MAA and TCM programs. This designation allows the City to self-certify local public expenditures that support the provision of Medi-Cal programs.
Therefore, staff also recommend the City Council adopt a resolution delegating to the City Manager, Finance Director, or designees, the authority to sign, certify or execute documents on behalf of the City with respect to the Medi-Cal Administrative Activities and Targeted Case Management Programs.
Fiscal Impact: Based on revenue from prior years, for FY 2026/27 TCM activities, staff estimate that the City may be reimbursed up to a maximum of approximately $499,000, including up to $250,000 for AFS case management services and $249,000 for FRC case management services. For Council Staff Report (ID # 5730) Meeting of June 9, 2026 Updated: 6/5/2026 10:43 AM by Alberto Quintanilla Page 4 MAA activities, based on the most recent completed reimbursement cycle, staff anticipate receiving approximately $1,000,000 in reimbursement for eligible activities.
TCM and MAA revenues are important components of the Human Services Department’s strategy to cultivate the outside revenue sources needed to sustain safety net services and support administrative overhead costs associated with these programs. This funding is anticipated and will be appropriated as part of the FY 2026/27 adopted budget.
Environmental Review: The proposed actions are not subject to review under the California Environmental Quality Act (CEQA) because they are not a “project” under CEQA Guidelines Sections 15378(b)(2) (continuing administrative activities), (b)(4) (governmental fiscal activities), and/or (b)(5) (administrative activities), and/or under Section 15601(b)(3), because it can be seen with certainty that there is no possibility that the actions will have a significant effect on the environment. Each of the foregoing provides 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 designee, to execute Memoranda of Understanding with Alameda County Health to enable the City’s Human Services Department to receive reimbursement for eligible FY 2026/27 expenses through Alameda County’s Targeted Case Management (TCM) and Medi-Cal Administration Activities (MAA) programs, and making findings of CEQA exemption, as described in this staff report; and (2) delegating to the City Manager, Finance Director, or designees, the authority to sign, certify or execute documents on behalf of the City, with respect to the MAA and TCM programs for FY 2026/27.