Supervisors direct ad hoc review of Kern Health Systems governance and board composition

The Kern County Board of Supervisors on April 29 directed staff to establish an ad hoc committee to review the governance, board composition and county coordination with Kern Health Systems, the county’s Local Initiative for Medi‑Cal managed care.

Assistant County Administrative Officer Elsa Martinez briefed the board on the history and role of Kern Health Systems, noting the entity is a public agency separate from the county and that the board formed the local initiative in 1994 to preserve safety‑net provider financing while Medi‑Cal moved to managed care. Martinez listed recent changes in Medi‑Cal policy — including CalAIM and new requirements that managed‑care plans address social determinants of health and expanded behavioral‑health responsibilities — and said those changes increase the need for closer coordination between county agencies and the managed‑care local initiative.

Martinez noted the enabling county ordinance (chapter G6155 / chapter 294) has been amended several times and currently sets a 16‑member Kern Health Systems board that includes up to 10 community representatives; she said some community appointees’ terms have expired and that the ordinance’s representative categories (for example, a pharmacy seat) no longer map neatly to current responsibilities because pharmacy benefits have moved to the state. Martinez recommended reviewing board size, membership categories and qualification language, and asked whether the county should require approval of Kern Health Systems bylaws or tighten the ordinance’s appointment/term language.

Supervisor Couch said the Medi‑Cal population in Kern is large and in flux and asked the board to be more engaged in fiscal oversight. The board discussed possible ordinance changes including adding a behavioral‑health or social‑services representative, setting clearer qualifications for community representatives (including a beneficiary representative), and whether one or two county supervisors should sit on the Kern Health Systems board. County counsel confirmed supervisors may serve on the KHSD board provided a quorum of the Board of Supervisors is not present on that body.

Board members directed staff to form a small ad hoc committee of board members to meet with Kern Health Systems and county departments and return with recommendations. Supervisors Couch and Parlier volunteered to serve on the ad hoc group; the board approved the motion and the appointments by unanimous vote.