Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Calaim And Revenue Recovery topic
No spam. Unsubscribe anytime.
Committee forwards CalAIM technical assistance participation and retroactive Health Advocates contract; BLA projects strong net revenue
Summary
The committee advanced a no-cost CalAIM technical assistance agreement to help implement community supports and enhanced care management, and forwarded a retroactive five-year $11.4M contract with Health Advocates LLC to pursue uncompensated care reimbursement; the Budget & Legislative Analyst estimated the contract could bring ~$97M over five years.
The Budget and Finance Committee on April 17 advanced two Department of Public Health items related to Medi‑Cal (CalAIM) implementation and reimbursement recovery services.
Bernadette Gates, San Francisco Health Network CalAIM director, asked the committee to authorize participation in the California Department of Health Care Services PATH technical assistance marketplace. Gates said the marketplace is a no‑cost resource to plan and implement CalAIM community supports and Enhanced Care Management (ECM) initiatives, and that the DPH would accept certain nonstandard agreement terms from DHCS, including a release and hold‑harmless clause for DHCS and its third‑party administrator (Public Consulting Group/PCG).
For item 3, Janine Smith, patient financial services manager at Zuckerberg San Francisco General, presented a retroactive five‑year contract with Health Advocates LLC to provide uncompensated care reimbursement recovery services across Zuckerberg San Francisco General Hospital and Laguna Honda Hospital. Smith said the contract (not to exceed $11,391,540) funds services such as eligibility screening, program application assistance, third‑party liability pursuit and appeals; staff reported a historical recovery rate and cited prior contract performance (a prior ten‑year contract produced ~$79M in recoveries over a portion of the period cited). Nick Menard of the BLA recommended approval, projecting the new contract would bring about $97M in additional revenues over the five‑year term and concluding the contract is expected to more than pay for itself.
There was limited public comment on these items, one speaker objecting to complexity. Vice Chair Mandelmann and several supervisors requested to be added as co‑sponsors; the committee voted 3–0 to forward the items to the full Board with positive recommendations. The DPH and BLA recommended standard reporting and oversight; the committee recorded no formal dissent.
