Common use of County Responsibilities Clause in Contracts

County Responsibilities. A. MCIP Services 1) Except as provided in (vi.) of this section, the County is responsible for reimbursing DHCS for the nonfederal share of MCIP services paid by DHCS to Medi-Cal providers rendering MCIP services to the County’s MCIP eligible beneficiaries. i. The County may pay a Medi-Cal provider to the extent required by or otherwise permitted by state and federal law to arrange for services for the MCIP individuals. Such additional amounts shall be paid entirely with County funds, and shall not be eligible for Social Security Act Title XIX FFP. ii. If DHCS pays the Medi-Cal provider more than what the county would have paid for services rendered, the county cannot request the difference from the Medi-Cal provider. iii. If the county would have paid the Medi-Cal provider less than what DHCS paid the Medi-Cal provider, the county is still obligated to reimburse DHCS for the nonfederal share of the payment from DHCS for MCIP services. iv. In the event that FFP is not available for any MCIP service claimed pursuant to this Agreement, the County shall be solely responsible for arranging and paying for any such MCIP service. v. If the Centers for Medicare & Medicaid Services (CMS) determines an overpayment has occurred for a payment made to a Medi-Cal provider for MCIP services to the County’s MCIP-eligible inmate, including the application of any federal payment limit that reduces the amount of FFP available for MCIP services, then DHCS shall seek the overpayment amount from the provider and return the collected FFP to CMS and return the collected nonfederal share of the overpayment to the County. In the event that DHCS cannot recover from the Medi-Cal provider such overpayment, the County shall pay DHCS an amount equal to the FFP portion of the unrecovered amount to the extent that section 1903(d)(2)(D) of the Social Security Act is found not to apply. vi. The County is not responsible for reimbursing DHCS for the nonfederal share of expenditures for MCIP services provided by DPHs when those services are reimbursed under the CPE process because DHCS is not responsible for the nonfederal share of expenditures for MCIP services reimbursed in the CPE process. vii. The County is responsible for reimbursing DHCS for the nonfederal share of MCIP services provided by DPHs that are not reimbursed under the CPE process. 2) If CMS determines DHCS claimed a higher federal medical assistance percentage (FMAP) rate than is allowed and FFP is reduced by CMS for the MCIP services provided to a County’s MCIP-eligible inmate for MCIP services, then the County shall hold DHCS harmless for the return of the FFP to CMS. B. MCIP Administrative Services 1) As a condition of participating in MCIP, the County accepts its responsibility for reimbursing DHCS for the County’s apportioned share of the nonfederal share of costs of MCIP administrative services based on Addendum A, performed by DHCS in administering MCIP, so that there is no expenditure from the State General Fund. 2) The County shall reimburse DHCS its allotted portion of the nonfederal share of funding for compensation, associated operating expenses, equipment, and travel costs for no more than 3.50 full-time equivalent (FTE) positions composed of: one-half (0.50) FTE Staff Service Manager I, two (2) FTE Staff Services Analysts/Associate Governmental Program Analysts, one-half (0.50) FTE Attorney, and one-half (0.50) FTE Accounting Officer, to be established and housed at DHCS, to support the reported expenditures submission process for obtaining federal reimbursement under this Agreement. The County’s allotted portion shall be based on a methodology specified in Addendum A. C. General Responsibilities 1) Upon the County’s compliance with all applicable provisions in this Agreement and applicable laws, the County may send its MCIP-eligible inmates to Medi-Cal providers to receive MCIP services. 2) The County shall reimburse DHCS pursuant to Paragraphs A and B with funds from the County’s General Fund, or from any other funds allowed under federal law and regulation, including but not limited to, Section 1903(w) of the Social Security Act and Code of Federal Regulations, title 42, part 433, subpart B. 3) In the event of any federal deferral or disallowance which is applicable to MCIP expenditures, the County shall provide all documents requested by DHCS within fourteen (14) days. 4) The County shall assist with the completion of and delivery of completed Medi-Cal applications to County Welfare Department (CWD) within 90 calendar days after the date of admission of the inmate to an Medi-Cal provider off of the grounds of the county correctional facility which results in an expected stay of more than 24 hours.

County Responsibilities. A. MCIP Services 1) . Except as provided in subdivision (vi.f.) of this section, the County is responsible for reimbursing DHCS for the nonfederal share of MCIP services paid by DHCS to Medi-Cal providers rendering MCIP services to the County’s MCIP eligible beneficiariesDHCS. i. a. The County may pay a Medi-Cal provider to the extent required by or otherwise permitted by state and federal law to arrange for services for the MCIP individualsMedi-Cal beneficiaries. Such additional amounts shall be paid entirely with County county funds, and shall not be eligible for Social Security Act Title XIX FFP. ii. b. If DHCS pays the Medi-Cal provider more than what the county County would have paid for services rendered, the county County cannot request and receive the difference from the Medi-Medi- Cal provider. iii. c. If the county County would have paid the Medi-Cal provider less than what DHCS paid the Medi-Cal provider, the county County is still obligated to reimburse DHCS for the nonfederal share of DHCS’ payment for the payment from DHCS for MCIP services. iv. d. In the event that FFP is not available for any MCIP service claimed pursuant to this AgreementPA, the County shall be solely responsible for arranging and paying for any such the MCIP service. v. e. If the Centers for Medicare & Medicaid Services (CMS) determines an overpayment has occurred for a payment made to a Medi-Cal provider for MCIP services to the County’s MCIP-eligible inmate, including the application of any federal payment limit that reduces the amount of FFP available for MCIP services, then DHCS shall seek the overpayment amount from the provider and provider, return the collected FFP to CMS CMS, and return the collected nonfederal share of the overpayment to the County. In the event that DHCS cannot recover the overpayment from the Medi-Cal provider such overpaymentprovider, the County shall pay DHCS an amount equal to the FFP portion of the unrecovered amount to the extent that section Section 1903(d)(2)(D) of the Social Security Act is found not to apply. vi. f. The County is not responsible for reimbursing DHCS for the nonfederal share of expenditures for MCIP services provided by DPHs when those services are reimbursed under the CPE process because DHCS is not responsible for the nonfederal share of expenditures for MCIP services reimbursed in the CPE process. vii2. The County is responsible for reimbursing DHCS for the nonfederal share of MCIP services provided by DPHs that are not reimbursed under the CPE process. 2) If CMS determines DHCS claimed a higher federal medical assistance percentage Federal Medical Assistance Percentage (FMAP) rate than is allowed and FFP is reduced by CMS for the MCIP services provided to a County’s MCIP-eligible inmate for MCIP services, then the County shall hold DHCS harmless for the return of the FFP to CMS. B. MCIP Administrative Services 1) As a condition of participating in MCIP, the County accepts its responsibility for reimbursing DHCS for the County’s apportioned share of the nonfederal share of costs of MCIP administrative services based on Addendum A, performed by DHCS in administering MCIP, so that there is no expenditure from the State General Fund. 2) The County shall reimburse DHCS its allotted portion of the nonfederal share of funding for compensation, associated operating expenses, equipment, and travel costs for no more than 3.50 full-time equivalent (FTE) positions composed of: one-half (0.50) FTE Staff Service Manager I, two (2) FTE Staff Services Analysts/Associate Governmental Program Analysts, one-half (0.50) FTE Attorney, and one-half (0.50) FTE Accounting Officer, to be established and housed at DHCS, to support the reported expenditures submission process for obtaining federal reimbursement under this Agreement3. The County’s allotted portion shall be based on a methodology specified in Addendum A. C. General Responsibilities 1) Upon the County’s compliance with all applicable provisions in this Agreement PA and applicable laws, the County may send its MCIP-eligible inmates beneficiaries to Medi-Cal providers to receive MCIP services. 2) 4. The County shall reimburse DHCS pursuant understands and agrees that the overall nature of the medical facilities in which an inmate receives medical services must be one of community interaction such that members of the general public may be admitted to Paragraphs A receive services and B with funds from admission into the County’s General Fund, medical facility or from any other funds allowed under federal law and regulation, including but into specific beds within the facility is not limited toto individuals under the responsibility of a correctional facility, Section 1903(w) and that inmates are admitted to specific medical units based not on their statutes as inmates of a correctional institution, but rather on their treatment needs and plan of care. 5. Ensure that an appropriate audit trail exists within records and accounting system and maintain expenditure data as indicated in this PA. 6. The County agrees to provide to DHCS or any federal or state department with monitoring or reviewing authority, access and the Social Security Act right to examine its applicable records and Code of Federal Regulationsdocuments for compliance with relevant federal and state statutes, title 42rules and regulations, part 433, subpart B.and this PA. 3) 7. In the event of any federal deferral or disallowance which is applicable to MCIP expenditures, the County shall provide all documents requested by DHCS within fourteen (14) 14 days. 4) 8. The County shall assist with the completion of and delivery of completed Medi-Cal applications to the County Welfare Department (CWD) within 90 calendar days after the date of admission of the inmate beneficiary to an a Medi-Cal provider off of the grounds of the county County correctional facility which results resulting in an expected stay of more than 24 hours. 9. As a condition of participation in MCIP, and in recognition of revenue generated by MCIP, the County shall pay quarterly administrative costs directly to DHCS. a. The quarterly administrative costs payment shall be used to cover DHCS’ administrative costs associated with MCIP, including, but not limited to, claims processing, technical assistance, and monitoring. DHCS shall determine and report staffing requirements upon which projected costs will be based. b. The amount of the administrative costs shall be based upon the anticipated state salaries, benefits, operating expenses, and equipment necessary to administer MCIP and other costs related to that process. c. The County shall enter in to a separate agreement with DHCS to reimburse DHCS for the administrative costs of administering MCIP.

County Responsibilities. A. MCIP Services 1) Except as provided in (vi.) of this section, the County is responsible for reimbursing DHCS for the nonfederal share of MCIP services paid by DHCS to Medi-Cal providers rendering MCIP services to the County’s MCIP eligible beneficiaries. i. The County may pay a Medi-Cal provider to the extent required by or otherwise permitted by state and federal law to arrange for services for the MCIP individuals. Such additional amounts shall be paid entirely with County funds, and shall not be eligible for Social Security Act Title XIX FFP. ii. If DHCS pays the Medi-Cal provider more than what the county would have paid for services rendered, the county cannot request the difference from the Medi-Cal provider. iii. If the county would have paid the Medi-Cal provider less than what DHCS paid the Medi-Cal provider, the county is still obligated to reimburse DHCS for the nonfederal share of the payment from DHCS for MCIP services. iv. In the event that FFP is not available for any MCIP service claimed pursuant to this Agreement, the County shall be solely responsible for arranging and paying for any such MCIP service. v. If the Centers for Medicare & Medicaid Services (CMS) determines an overpayment has occurred for a payment made to a Medi-Cal provider for MCIP services to the County’s MCIP-eligible inmate, including the application of any federal payment limit that reduces the amount of FFP available for MCIP services, then DHCS shall seek the overpayment amount from the provider and return the collected FFP to CMS and return the collected nonfederal share of the overpayment to the County. In the event that DHCS cannot recover from the Medi-Cal provider such overpayment, the County shall pay DHCS an amount equal to the FFP portion of the unrecovered amount to the extent that section 1903(d)(2)(D) of the Social Security Act is found not to apply. vi. The County is not responsible for reimbursing DHCS for the nonfederal share of expenditures for MCIP services provided by DPHs when those services are reimbursed under the CPE process because DHCS is not responsible for the nonfederal share of expenditures for MCIP services reimbursed in the CPE process. vii. The County is responsible for reimbursing DHCS for the nonfederal share of MCIP services provided by DPHs that are not reimbursed under the CPE process. 2) If CMS determines DHCS claimed a higher federal medical assistance percentage (FMAP) rate than is allowed and FFP is reduced by CMS for the MCIP services provided to a County’s MCIP-eligible inmate for MCIP services, then the County shall hold DHCS harmless for the return of the FFP to CMS. B. MCIP Administrative Services 1) As a condition of participating in MCIP, the County accepts its responsibility for reimbursing DHCS for the County’s apportioned share of the nonfederal share of costs of MCIP administrative services based on Addendum A, performed by DHCS in administering MCIP, so that there is no expenditure from the State General Fund. 2) The County shall reimburse DHCS its allotted portion of the nonfederal share of funding for compensation, associated operating expenses, equipment, and travel costs for no more than 3.50 full-time equivalent (FTE) positions composed of: one-half (0.50) FTE Staff Service Manager I, two (2) FTE Staff Services Analysts/Associate Governmental Program Analysts, one-half (0.50) FTE Attorney, and one-half (0.50) FTE Accounting Officer, to be established and housed at DHCS, to support the reported expenditures submission process for obtaining federal reimbursement under this Agreement. The County’s allotted portion shall be based on a methodology specified in Addendum A. C. General Responsibilities 1) Upon the County’s compliance with all applicable provisions in this Agreement and applicable laws, the County may send its MCIP-eligible inmates to Medi-Medi- Cal providers to receive MCIP services. 2) The County shall reimburse DHCS pursuant to Paragraphs A and B with funds from the County’s General Fund, or from any other funds allowed under federal law and regulation, including but not limited to, Section 1903(w) of the Social Security Act and Code of Federal Regulations, title 42, part 433, subpart B. 3) In the event of any federal deferral or disallowance which is applicable to MCIP expenditures, the County shall provide all documents requested by DHCS within fourteen (14) days. 4) The County shall assist with the completion of and delivery of completed Medi-Medi- Cal applications to County Welfare Department (CWD) within 90 calendar days after the date of admission of the inmate to an Medi-Cal provider off of the grounds of the county correctional facility which results in an expected stay of more than 24 hours.