Date:
August 18, 2026
09
To:
Board of Supervisors
SUBJECT
Title
Approve Intergovernmental Transfer Agreements with California Department of Health Care Services (Districts: All)
Title
Body
Overview
Medicaid is a means-tested entitlement program that finances the delivery of primary and acute medical services as well as long-term services and supports to an estimated 74.9 million people in the United States as of the February 2026 enrollment count. Medi-Cal is the Medicaid program for California, a public health insurance program that provides needed health care services to eligible seniors, persons with disabilities, families with children, foster care youth, pregnant women, and eligible individuals with diseases such as tuberculosis, breast cancer, or HIV/AIDS. Medi-Cal is financed through State and federal funds.
To support increased State payments to Medi-Cal Managed Care Plans (MCPs), California counties participating in Medi-Cal Managed Care may enter into Intergovernmental Transfer (IGT) and Assessment Fee Agreements with the California Department of Health Care Services (DHCS). IGT agreements consist of the transfer of eligible local funding to DHCS, which the State then uses to increase the rates it pays the participating MCPs within an actuarially sound range. Historically, the San Diego County Board of Supervisors (Board) has supported the County of San Diego's (County) participation in this program, with the most recent authorization approved on June 25, 2024 (3). Participating in an IGT Agreement allows the County to utilize local funds to increase federal matching dollars for Medicaid programs, which can then come to the County to support services provided to Medi-Cal Managed Care recipients including public health services, behavioral health services, and services provided to patients of the Edgemoor Distinct Part Skilled Nursing Facility.
Today's action requests the Board authorize the Chief Administrative Officer to pursue and e...
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