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Huntington Beach Hospital - 2018-09-04
City of Huntington Beach Wk"DV 7-0 File #: 18-280 MEETING DATE: 9/4/2018 REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Antonia Graham, Assistant to the City Manager Subject: Approve a Memorandum of Understanding (MOU) between the City and Huntington Beach Hospital to enable the Huntington Beach Hospital to participate in the 340B Program Statement of Issue: On September 5, 2017 the City Council voted to enter into a Memorandum of Understanding (MOU) with Huntington Beach Hospital to allow them to participate in the 340B Program. Huntington Beach Hospital is a non-profit that provides a disproportionate share of healthcare services to the Medicare populations, in addition to supporting many programs that benefit the indigent, uninsured, or underinsured populations in Huntington Beach. The CEO of the Hospital has again asked the City to enter into a new MOU to enable them to continue to participate in the 340B program which would enable the Hospital to participate in a low-cost drug program that benefits the aforementioned populations. This Council Action seeks to once again enter into a no -cost MOU that allows the Hospital to take part in a drug discount program. Financial Impact: There is no fiscal impact as this is a no -cost Memorandum of Understanding. Recommended Action: Authorize the Mayor and City Clerk to execute the Memorandum of Understanding between the City of Huntington Beach and the Huntington Beach Hospital for the 340B Program. Alternative Action(s): Do not approve the Memorandum of Understanding between the City of Huntington Beach and the Huntington Beach Hospital and direct staff accordingly. Analysis: Created in 1992, the 340B Program works with manufacturers to provide outpatient drugs to covered hospitals (e.g. Huntington Beach Hospital) at significantly reduced prices. The intent of the program is to maintain services and lower medication costs for patients. In order for the Hospital to participate in this Program, the Hospital must enter into an agreement with City of Huntington Beach Page 1 of 2 Printed on 8/29/2018 111 powered by LegistarTl File #: 18-280 MEETING DATE: 9/4/2018 a unit of the state or local government pursuant to which the Hospital commits to provide health care services to low-income individuals who are not entitled to Medicare or Medicaid benefits - at no reimbursement or considerably less than full reimbursement from these patients. By entering into this MOU, the Hospital agrees to continue its commitment to the provision of health care to indigent, uninsured, and underinsured residents of Huntington Beach and Orange County. The Hospital wishes to enter into this Program in order to maintain current levels of service. The savings from this program are roughly eleven (11) percent greater than those obtained through the Medicaid Rebate Program. Environmental Status: Not applicable. Strategic Plan Goal: Improve quality of life Attachment(s): 1. Memorandum of Understanding between the City of Huntington Beach and Huntington Beach Hospital 2. Office of Pharmacy Affairs (OPA) Certification Contract Between Private, Non -Profit Hospital and State/Local Government to Provide Health Care Services to Low Income Individuals City of Huntington Beach Page 2 of 2 112 Printed on 8/29/2018 powered by LegistarT"^ MEMORANDUM OF UNDERSTANDING BETWEEN City of Huntington Beach Huntington Beach Hospital, a not -for -profit Disproportionate Share Hospital THIS NO -COST MEMORANDUM OF UNDERSTANDING is made this 1S` day of August 2018 by and between the undersigned representatives of the City of Huntington Beach, located at 2000 Main Street, Huntington Beach, CA 92648, Prime Healthcare Huntington Beach, LLC dba Huntington Beach Hospital, a Delaware limited liability company registered to do business in the state of California located at 17772 Beach Blvd., Huntington Beach, CA 92647. RECITALS: WHEREAS, Huntington Beach Hospital is a not -for -profit hospital that provides a disproportionate share of healthcare services to the Medicare and Medicaid populations in addition to supporting many programs that benefit the indigent, uninsured or underinsured populations in Huntington Beach CA; WHEREAS, A study by Moody's Investors Service published in June 2015 found that Medicaid Expansion under the Affordable Care Act is having a minimal affect on hospital financial viability given other financial pressures, especially on non-profit hospitals. Payor restrictions and accelerated drug costs increases are major factors. Generic drug prices are also rising at an alarming rate; WHEREAS, Huntington Beach Hospital desires to participate in the drug discount program established under Section 340B of Public Health Services Act (the "340B program"); WHEREAS, in order to participate in the 340B Program Huntington Beach Hospital must enter into an agreement with a unit of the state or a local government pursuant to which Huntington Beach Hospital commits to provide health care services to low income individuals who are not entitled to Medicare or Medicaid benefits at no reimbursement or considerably less than full reimbursement from these patients; WHEREAS, Huntington Beach Hospital desires to make such a formal commitment to the City of Huntington Beach; WHEREAS, the City of Huntington Beach agrees to accept such commitments on behalf of Orange County/Huntington Beach residents; NOW, THEREFORE, in consideration of the mutual agreements and covenants contained therein and for other good valuable consideration, the receipt and sufficiency of which hereby are acknowledged, it is mutually agreed and covenanted by and between the parties to this Agreement, as follows: 1. Commitment of Huntington Beach Hospital to Provide Uncompensated Care. During the term of this MOU, Huntington Beach Hospital agrees to continue its commitment to provide health care to indigent, uninsured and underinsured residents of Huntington Beach and Orange County, CA through the operation of its Uncompensated Care Program and maintain its current eligibility standards. In fiscal year 2017, this commitment totaled $ $2,418,418 in uncompensated care as reported on the latest Medicare Cost Report. Care provided under this program is inclusive of the scope of services provided by Huntington Beach Hospital, including but not limited to emergency care, general outpatient care, including ambulatory surgery and all levels of inpatient care. Pursuant to this commitment, it is the intention of Huntington Beach Hospital to continue providing this level of service regardless of patients' ability to pay. Huntington Beach Hospital is entering the 340B Drug Discount Program in order to maintain current levels of service to uninsured, underinsured and indigent patients. Huntington Beach Hospital will include 340B drugs for its Medicaid Payors and thereby pass on 340B savings to California's Medicaid Program. 340B savings are roughly 11% greater than those obtained through the Medicaid Rebate Program. This pass -through of 340B savings is not applicable to contract pharmacy arrangements because of 340B requirements. 2. Commitment of Huntington Beach Hospital to Submit Reports of Benefit to Residents of Orange County. During the term of this MOU, Huntington Beach Hospital agrees to submit to the City of Huntington Beach relevant sections of the latest annual Medicare Cost Report after audit and acceptance by the CMS Fiscal Intermediary. This report will be submitted within 30 days after notification of acceptance of the annual Medicare Cost Report by Fiscal Intermediary. Costs of care for Orange County/Huntington Beach and California residents will be specified within the report. 3. Acceptance and Acknowledgements of the City of Huntington Beach. (a) City of Huntington Beach accepts the commitments of Huntington Beach Hospital set forth above; (b) City of Huntington Beach hereby acknowledges that the healthcare services provided by Huntington Beach Hospital hereunder are in the public interest and are being provided to individuals who are not entitled to benefits under Title VII or eligible for assistance under any State plan pursuant to Title XIX of the Social Security Act: and (c) City of Huntington Beach acknowledges that Huntington Beach Hospital is providing these services at no reimbursement or considerably less than full reimbursement from the qualifying patients. 4. Representations of Hospital: Huntington Beach Hospital represents that as of the date this Agreement is executed by City and Huntington Beach Hospital: (a) Huntington Beach Hospital constitutes a corporation duly organized and validly existing in good standing under the laws of the State of California with the corporate power and authority to enter into and perform its obligations under this MOU; and (b) Huntington Beach Hospital is a tax-exempt corporation under Section 501 (c)(3) of the Internal Revenue Code of the United States, as amended, and under applicable laws of the State of California. 5. Term and Termination. The term of this MOU shall commence on the date first above written shall continue until terminated by either party upon not less than sixty (60) days prior written notice to the other. MOU shall be reviewed and in the absence of identified issues, automatically renew on an annual basis. 6. Notices. All notices required or permitted to be given under the MOU shall be deemed given when delivered by hand or sent by registered or certified mail, return receipt requested, addressed as follows: Huntington Beach Hospital 17772 Beach Boulevard, Huntington Beach, CA 92647 7. Governing Law. This MOU shall be governed by and construed in accordance with the laws of the State of California. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on August 1st , 2018. CONSULTANT, HUNTINGTON BEACH HOSPITAL, A not -for profit corporation By. 1 C('<<-c�.�.....z Fictw(A vAi oaptAtm "D print name ITS: (circle one) Chairman/President/Vice President CFO CITY OF HUNTINGTON BEACH a municipal corporation of the State of California 0 Mayor ATTEST: AMU City Clerk\ INITIATED AND APPROVED: Assistant to the City Manager APPROVED AS TQFORM: Ci AND APPROVED: Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau OMB No. 0915-0327; Expiration Date: 1013112015 OFFICE OF PHARMACY AFFAIRS (OPA) CERTIFICATION OF CONTRACT BETWEEN PRIVATE, NON-PROFIT HOSPITAL AND STATEILOCAL GOVERNMENT TO PROVIDE HEALTH CARE SERVICES TO LOW INCOME INDIVIDUALS To demonstrate that the hospital meets the statutory definition of covered entity under section 340B(a)(4)(L)(1) as a private non-profit hospital which. has a contract with a State or local government to provide health care services to low income individuals, this certification must be completed and signed by both parties._ n M City, Stai4, Zip Pursuant to the requirement of Section 3408 of the Public Health Service Act (42 U.S.C. 256b), I certify that a valid contract (please provide contract number or identifier if applicable # ) is currently in place between the private, non- profit hospital named above, and he State or Local Government Entity named below, to provide health care services to low income individuals who are not entitled to benefits under Title XVIII of the Social Security Act or eligible for assistance under the State plan of Title XIX of the Social Security Act. in addition, the authorizing official certifies that when this contract is no longer valid, appropriate notice will be provided to the Office of Pharmacy Affairs. The undersigned represents and confirms that he/she is fully authorized to legally bind the covered entity and certifies that the contents of any statement made or reflected in this document are truthful and accurate. Sig ature of Hospital Ai am and Title of Aut c h um r Si re of State or 0 o eq Name of State fr Loc 1 Title and Ynit f over 1*0 EEi Addr s -�1t�s3� -59'S 3-59's 3 Phone Number rizing Official Date 13.1.2&f Nlfsiro ng Official (e.g., CYO, CFO,COO) (please print or type) _ Ga iR 1. LGt( t, YA Ext. -Mail Ad ress Government Official Date 11 (please print or type) �yt. Qse ja Ext. E-Mail Address ti Thts registration form must be completed and submitted according to the established deadlines that are published on the OPA websile (www hrsa.gov. opa) 117 City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk - Robin Estanislau, City Clerk September 5, 2018 Huntington Beach Hospital Attn: Richard M. Rowe, Pharm. D. 17772 Beach Boulevard Huntington Beach, CA 92647 Dear Mr. Rowe: Enclosed is a copy of the fully executed "Memorandum of Understanding between City of Huntington Beach and Huntington Beach Hospital, a not -for -profit Disproportionate Share Hospital." Sincerely, Robin Estanislau, CIVIC City Clerk RE:ds Enclosure 4 Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand ncil September 4, 2018 Richard M. Rowe, Pharm.D, Chief Executive Officer QHuntington Beach Hospital the Communitv for the Past Huntington Intercommunity Hospital opens on April 3r1 H. C.h a� _ i967� rw� w w April 4, 1967 — First Born Lance Patrick Emma was I born just one day after the hospital's dedication. �. New Hospital t All Electric Longest Employees +. --- honored at 50`h� =- Anniversary SUPPLEMENTAL COMMUNICATION Meeting DFb: 9 — ozz Agenda item No.z_a �d O� J0 8/31/2018 1 8/31/2018 Key Services • 24/7 Emergency Care GREAT CARE • Medical/Surgical Unit CLOSE TO HOME • Telemetry Unit • Intensive Care / Critical Care • Surgical Services • Behavioral Health Services • Dialysis • Stroke Care • Rehabilitation Services • Inpatient and Outpatient Services • Diagnostic Services including CT and MRI Huntington Beach Hospital Prime Healthcare Behavioral Health 49 Acute Behavioral Health Designated LPS (5150) Beds. • 25 Beds Dedicated to Geriatric Patient Needs 24/7 Behavioral Health Call Center Psychiatric Clinical Decision Unit (PCDU) Joint Commission Accredited Primary Stroke Center — December 2017 Q•,.ri ' Gold Seal of Approval for Stroke Care Primary Stroke Center © Huntington Beach Hospital Award Winning Care`•""11•, A w TREATMENT OF TREATMENT OF MEART ATTACK I thfilUUy 5.Mke C�JJW SEPSIS FIVE-STAR C�tlfl b' , RECIPIE-V �IENT ! TirJdtrtCarmtdssion RECIPIENT M1U GREAT CARE CLOSE TO HOME APPENDECTOMY FIVE-STAR RECIPIENT wry 13 Huntington Beach Hospital 8/31/2018 3 340B Drug Pricing Program Health Resources & Services Administration Program Public Health Services Act 42 USC 256b, § 340b a Huntington Beach Hospital Purpose of 340B Permits eligible safety net providers "to stretch scarce Federal Resources as far as possible, reaching more eligible patients and providing more comprehensive services." H.R. Rep. No. 102-384(II), at 12 (1992) QHuntington Beach Hospital 8/31/2018 4 Overview and Benefits • Provides discounts on outpatient drugs to certain safety -net covered entities • Participating covered entities report savings that range between 25-50% of Average Wholesale Price (AWP) for covered outpatient drugs as a result of 340B discounts Savings may be used to: ➢Reduce price of pharmaceuticals for patients ➢Provide services to more patients Q Huntington Beach Hospital 8/31/2018 What is needed from the Huntington Beach ? No Cost Memorandum of Understanding between the City of Huntington Beach and Huntington Beach Hospital, a not -for -profit Disproportionate Share Hospital. HRSA requires a local government official to certify that the facility is providing needed service to the indigent, uninsured or underinsured population in Huntington Beach and Orange County. Q Huntington Beach Hospital 5 Commitment of Huntington Beach Hospital To continue the provision of health care services to the indigent, uninsured, or underinsured population in Huntington Beach and Orange County. This commitment totaled $2,418,418 in FY 2017. Huntington Beach Hospital agrees to submit to the City of Huntington Beach relevant sections of the annual Medicare Cost report after audit. a Huntington Beach Hospital 8/31/2018 A