Here’s what you need to know:
- The supervisors approved a revised and updated resolution calling for a special election on retail transactions and using the tax ordinance for Measure T Extension. Supervisor Wheeler said that Measure T is crucial for local transportation improvements.
- Received a presentation on the County Medical Services Program, including the Camino A La Salud Pilot Project, which provides primary care for undocumented adults. The current enrollment is approximately 11,582 individuals in Madera County.
- Public Health Officer Simon Paul announced that Covid cases have “slowed down” from the 40s to 30s, with hospitalizations between 10 to 15 cases.
- Chief of Developmental Services Matthew Treber announced that Self Help Enterprises withdrew their conditional use permit application for River Grove Apartment Community in Oakhurst.
The Scene
According to its website, the Madera Board of Supervisors is the legislative and executive governing body of the Madera County government. Each of the five supervisorial districts of the county elects one supervisor.
Within limits prescribed by State law, the board enacts ordinances and rules, determines county policy, supervises the activities of county departments, adopts an annual budget, and fixes salaries.
The board meets regularly on the first three Tuesdays of each month and occasionally on Mondays in the Board Chambers of the County Government Center in Madera. On Tuesday, August. 9, 2022, the meeting was at 9:00 a.m.
Madera County Board of Supervisors Members present:
- Brett Frazier (District #1)
- David Rogers (District #2)
- Robert Poythress (District #3)
- Letizia Gonzalez (District #4)
- Tom Wheeler (District #5)
Others Present:
- Chief of Developmental Services Matthew Treber
- Madeleine Harris from Leadership Counsel for Justice and Accountability
- Dan Metz
- CMSP Executive Director Kari Brownstein
- CMSP Director of Finance and Administration Meegan Forrest
- CMSP Program Director Alison Kellen
- Public Health Officer Simon Paul
Discussions/Actions
The board (5-0) unanimously approved items A to Z in the consent agenda:
A. 8835: The board (5-0) adopted a resolution approving a temporary reduction in adoption fees for August.
B. 8817: The board (5-0) entered into an agreement with Turning Point of Central California, Inc., not exceeding $633,720.00 for the operation of Hope House for the Fiscal Year 2022-2023.
C. 8818: The board (5-0) entered into an agreement with Davis Guest Home for board and care services for the Fiscal Year 2022-2023.
D. 8820: The board (5-0) entered into an Agreement with Community Social Model Advocates, Inc. to provide substance use services for the Fiscal Year 2022- 2023.
E. 8821: The board (5-0) entered into an agreement with Denham Resources not to exceed $200,000.00 for employment and placement services for individuals working as Community Service Liaisons through the Mental Health Services Act for the Fiscal Year 2022-2023.
F. 8833: The board (5-0) entered into an Agreement with California Mental Health Services Authority (1445-PEI-2022-MC) for $62,515.00 for the Statewide Prevention and Early Intervention (PEI) program for the Fiscal Year 2022-2023.
G. 8829: The board (5-0) adopted a resolution approving the County of Madera Board of Supervisors Letterhead Use Policy.
H. 3740: The board (5-0) reaffirmed Resolution No. 2015-101, declaring a Local Emergency due to the tree mortality disaster in the county and throughout the State.
I. 6072: The board (5-0) reaffirmed Resolution No. 2020-032, ratifying and extending the declaration of a Local Emergency and Local Health Emergency (COVID19).
J. 8834: The board (5-0) approved a land transfer between the Oakhurst Library (APN 066-010-022) and Sierra Telephone Company (APN 066-010-048 and 066-010-030).
K. 8832: The board (5-0) agreed with Acclamation Insurance Services Management Services, Inc. to provide workers’ compensation claims administration services for a five-year term.
L. 8822: The board (5-0) adopted a resolution authorizing the grant application submission and acceptance of the award for the 2022 Vibrant Recreation and Tourism Grant from the Sierra Nevada Conservancy.
M. 7925: The board (5-0) reaffirmed Resolution No. 2021-130, recognizing and determining meeting risks under the Covid-19 proclaimed the State of Emergency under Assembly Bill 361 related to statutory Brown Act exemptions.
N. 8812: The board (5-0) entered into a grant agreement with the California Office of Traffic Safety (DI23014) to accept a $205,200.00 grant award for the Alcohol and Drug Impaired Driver Vertical Prosecution Grant Program for the Fiscal Year 2022-2023.
O. 8825: The board (5-0) authorized Madera County Library to apply for the California State Library’s Zip Books Grant for the Fiscal Year 2022-2023 for $10,000.00.
P. 8830: The board (5-0) approved Receipt of Unanticipated Revenue No. 22-048 for $5,000.00 derived from Library Administration – OtherGovernment Agency to Special Department Expense for the Fiscal Year 2022-2023.
Q. 6644: The board (5-0) reaffirmed Resolution 2020-123, declaring a Local Health Emergency (Creek Fire) by the County Health Officer.
R. 8828: The board (5-0) Consideration of entering into an Agreement with Avita for participation in the 340B pharmacy reimbursement program receiving outpatient medication at reduced prices for eligible patients.
S. 8749: Road 225 Bicycle & Pedestrian Path project.
1. The board (5-0) entered into an agreement with Peters Engineering Group for $620,135.63 for professional engineering services for the Road 225 Bicycle & Pedestrian Path project in Madera County.
2. The board (5-0) authorized the Chief of Development Services or his designee to issue the Notice to Proceed for each task under the Contract’s provisions.
3. The board (5-0) authorized the Auditor-Controller to issue payments for contingencies up to 10 percent of the total contract award amount per established County policy.
4. The board (5-0) authorized the Chief of Development Services or his designee to solely issue and approve Contract Change Orders under the Public Contract Code, not to exceed authorized contingencies.
T. 8786: The board (5-0) adopted a resolution to accept work and authorize the filing of the Notice of Completion for MCC No. 11602-20 (11-07-RD) Road 23 Bridge Replacement at Dry Creek.
U. 8815: The board (5-0) adopted a resolution stating the County Maintained Road Mileage Report for December 31, 2021.
V. 8865: The board (5-0) adopted a resolution authorizing the California Department of Resources Recycling and Recovery (CalRecycle) application for grant programs and related authorizations.
W. 3639: The board (5-0) reaffirmed Resolution No. 2015-087, proclaiming a Local Emergency created by the severe drought conditions in the County and throughout the State.
X. 6908: The board (5-0) reaffirmed Resolution No. 2020-123, ratifying and extending the declaration of a Local Emergency for the Creek Fire.
Y. 7047: The board (5-0) reaffirmed Resolution No. 2021-015, ratifying and extending the declaration of a Local Emergency (winter storm events).
Z. 7629: The board (5-0) reaffirmed Resolution No. 2021-101, ratifying and extending the declaration of a Local Emergency and Local Health Emergency caused by the River Fire.
The Board discussed the following:
6.a. 8778: Presentation of County Medical Services Program (CMSP) and Governing Board Overview by Kari Brownstein, CMSP Executive Director.
In 1982 California law eliminated Medi-Cal eligibility for medically indigent adults (MIA).
MIA population became county responsibility under WIC Section 17000 (county aid to medically indigent)
CMSP was created in 1983 to address the needs of smaller counties:
- A “pooled risk” health benefit program
- Eligible counties have populations of 300,000 or less (in the base year 1980)
- 35 participating counties (Yolo County joined 7/1/12)
In April 1995 CMSP Governing Board was established by California law:
- Charged with overall policy and fiscal responsibility for CMSP
- Ten county officials elected by CMSP counties
- Ex-officio, non-voting State representative (CA HHS Agency Secretary)
Following the Affordable Care Act that went into effect in 2014:
- Significant decrease in CMSP membership
- Path to Health, Connect to Care, and Additional Grant Programs Launched
CMSP is administered through contracts with:
- Advanced Medical Management (AMM) for medical and dental benefits administration MedImpact Health Systems for pharmacy benefit administration
- California DHCS provides eligibility data file transfers
- Other consultants and contractors provide various services
Now, CMSP is serving 35 counties from Alpine to Yuba.
To be eligible for CMSP, one must be:
- A resident of a CMSP county
- County Social Services Departments enroll individuals into CMSP
- Incomes 139% – 300% FPL
- Not eligible for Medi-Cal or other publicly funded health coverage
- Enrollment terms up to 6 months (1-month retroactive eligibility)
Benefits consist of:
- Full scope benefits for legal residents & emergency benefit coverage for undocumented adults
- No-cost primary care coverage for all CMSP enrollees (regardless of immigration status)
- Primary & specialty care office visits, minor procedures, screening labs & vaccinations
- Prescription drugs (CMSP drug formulary) with a $5.00 copay CMSP Contracted Providers within Madera County include: Madera Community Hospital & Madera Community Hospital Family Health Services in Madera & Chowchilla.
Central Valley Indian Health in North Fork current enrollment is approximately 724 members.
Path to Health or Camino A La Salud Pilot Project is primary care for undocumented adults (age 26 to 49) that reside in a CMSP county and are enrolled in a restricted scope Medi -Cal aid code.
Clinics currently use Alluma’s One-E-App enrollment platform.
The pilot began in February 2019. Enrollment & care is provided at 22 community health center systems with 106 locations in 21 counties.
Current enrollment is approximately 11,582 members.
Currently, there is one community health center and two locations in Madera County. The enrollment is approximately 11,582 members.
Connect to Care/Conexion a la Salud is primary care for both documented & undocumented adults (age 21 to 64) that reside in a CMSP county, have incomes between 139% and 300% FPL and have no existing health coverage.
The pilot began in December 2020. Enrollment & care is provided at 26 community health center systems with 110 locations in 22 counties.
Current enrollment is approximately 954 members. Now, there are no contracted enrollment clinics in Madera County.
The CMSP Governing Board has allocated $50,000,000 to be released through the Local Indigent Care Needs Grant (LICN). To date, there are 22 awarded Planning Grants and 18 Implementation Grants.
Madera County Department of Public Health was awarded a planning grant of $50,000 to research and better understand health and behavioral health issues, services gaps, and barriers to care experienced by homeless individuals.
The Governing Board released the COVID-19 Emergency Response Grant (CERG) in response to the pandemic and awarded $9,634,445 of emergency COVID-19 funding to 31 of 35 CMSP counties.
Madera County Department of Public Health received a CERG Grant totaling $417,738. Funds are being used to provide mobile testing, public information, and outreach to lower-income and farmworker populations across the county.
Twenty-three county or non-profit organizations have been collectively awarded $6,857,261 in Health Systems Development (HSG) grants.
Madera County Department of Public Health received an HSG grant totaling $293,616 to improve the overall health care delivery system.
Specifically, project funds are being utilized to update Public Health lab medical equipment and IT infrastructure and to provide employee training in phlebotomy and medical management of HIV/AIDS.
Specialty Care Access Grant is Operation Access – Expand specialty care access for low-income, uninsured, unfunded adults by arranging elective, outpatient procedures through donated care.
The Specialty Care Access Grant is a:
- A 5-year grant totaling $5,700,000
- Services are available in twelve CMSP counties in 2021 and an additional seven CMSP counties (including Madera) in 2022-2024
- Serves patients up to 300% of the federal poverty level who are not eligible for Medi-Cal, Medicare, or CMSP full-scope coverage
- Operation Access is working with Camarena Health & local hospital systems to operationalize the program in Madera County Partner with community clinics, specialists, hospitals, and medical societies.
CMSP is financed through:
- Pre Affordable Care Act (ACA)
- County Realignment
- CMSP Realignment
- County Participation Fees
- Post-Affordable Care Act (ACA)
- County Realignment now directed to the State
- County Realignment Capped at Pre-ACA CMSP amount established in 1983
- Significantly reduced CMSP Realignment through 2018-2019
- Realignment is postponed starting 2019-2020 until CMSP Reserves are reduced to two years of operating costs
- County Participation Fees waived every fiscal year Post-ACA
6.b. 8251: Update on COVID-19 and current vaccination administration status for Madera County residents.
Public Health Officer Simon Paul announced that Covid cases have “slowed down” from the 40s to 30s, with hospitalizations between 10 to 15 cases.
He maintained that 60 percent of residents in Madera County are vaccinated with one dose or more.
The Public Health Department, Valley Children’s Hospital, and Camarena Health provide Saturday vaccinations.
The Board held a public hearing on the following:
6.c. 8874: The board (5-0) adopted a revised and updated resolution calling for a special election on retail transactions and using the tax ordinance for Measure T Extension.
Since the board hearing on Measure “T” extension held on July 26, 2022, the Madera County Transportation Authority Board has adopted the Madera County 2006 Transportation Authority Ordinance No. 2022-01.
The Authority took final action on August 5, 2022. The adopted Ordinance is identical to the one attached to Board Resolution No. 2022-102, adopted on July 26, 2022.
Dan Metz and Madeleine Harris from Leadership Counsel for Justice and Accountability opposed Measure T due to the lack of accountability and community involvement in the resolution.
Supervisor Wheeler maintained that Measure T is crucial for local transportation improvements.
Chief of Developmental Services Matthew Treber announced that Self Help Enterprises withdrew their conditional use permit application for River Grove Apartment Community in Oakhurst.
During the closed session, the board discussed the following items:
2.a. 8842: Request for Closed Session:
Government Code Section 54957.6
Conference With Labor Negotiators
Agency designated representatives: Joel Bugay, Deputy County Administrative Officer-Finance; Michele May, Interim Human Resources Director; and Susan Carter, Human Resources Manager.
Employee Organization: All Units
Unrepresented Employees: All Classifications (Excluding Elected Officials)
The meeting lasted until 1 p.m. The next board meeting will be on Tuesday, August 16, 2022, at 9:00 a.m.
If you believe anything in these notes is inaccurate, please email us at Documenters-admin@fresnoland.org with “Correction Request” in the subject line.