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Private Hospital Supplemental Fund
The Medi-Cal Hospital/Uninsured Care Demonstration Project Act created the Private Hospital Supplemental Fund (Welfare and Institutions Code section 14166.12). Payments available to qualifying SPCP hospitals under the Private Hospital Supplemental Fund are based on the provisions in the Act, or subject to negotiations with the California Medical Assistance Commission. The program is currently supported with State General Funds, which are matched by the federal government.
To be eligible for payments from the Private Hospital Supplemental Fund, private hospitals must meet criteria in current State law for the Emergency Services and Supplemental Payment Program, Medi-Cal Medical Education Supplemental Payment and Medi-Cal Large Teaching Emphasis Hospital and Children’s Hospital Medical Education Supplemental Payment Programs, or the Small and Rural Hospital Supplemental Payment Program. Payments will no longer be made from the funds that were established for these prior supplemental payment programs. Payments for hospitals that meet the eligibility criteria will now be made solely from the Private Hospital Supplemental Fund. Criteria for these prior supplemental payment programs are as follows:
Emergency Services and Supplemental Payment Program
The Emergency Services and Supplemental Payment Program was enacted in 1989 in response to threatened emergency department closures and trauma system collapse in Los Angeles County (Welfare and Institutions Code section 14085.6).
To be eligible for the Emergency Services and Supplemental Payment Program, a hospital must:
- Be a contract hospital under the SPCP; and
- Be a disproportionate share Medi-Cal provider (Welfare and Institutions Code sections 14105.98 and 14163); and
- Demonstrate a purpose for additional funding including proposals for expanding and/or improving access to emergency room and other health care services; and
- Be licensed to provide basic or comprehensive emergency services (or be a Childrens' hospital which provides emergency services in conjunction with another hospital); or
- Be a hospital designated by the National Cancer Institute as a comprehensive or clinical cancer research center.
Medi-Cal Medical Education Supplemental Payment and Medi-Cal Large Teaching Emphasis Hospital and Children's Hospital Medical Education Supplemental Payment Programs
Welfare and Institutions Code sections 14085.7 and 14085.8 were adopted in the mid-1990s to create two new supplemental payment programs in support of medical education. The purpose of such programs is to recognize medical education costs associated with health care services rendered to Medi-Cal beneficiaries.
To be eligible for these Medical Education programs, a hospital must:
- Be a contract hospital under the SPCP; and
- Be a university teaching hospital or major (non-university) teaching hospital, as defined in Welfare and Institutions Code, section 14085.7; or
- Be a large teaching-emphasis hospital, or children's hospital, as defined in Welfare and Institutions Code, section 14085.8, and be eligible under the Disproportionate Share Hospital program as defined in Welfare and Institutions Code, section 14105.98, subdivision (a)(3).
Small and Rural Hospital Supplemental Payment Program
Welfare and Institutions Code section 14085.9 authorizes the Small and Rural Hospital Supplemental Payment Program. This program was established to provide supplemental reimbursements to small and rural hospitals with standby emergency rooms that do not qualify for reimbursement under the Emergency Services and Supplemental Payment Program (Welfare and Institutions Code section 14085.6).
To be eligible for this program, a hospital must:
- Be a contract hospital under the SPCP; and
- Be a small and rural hospital; and
- Be a disproportionate share Medi-Cal provider (Welfare and Institutions Code sections 14105.98 and 14163); and
- Be licensed to provide standby emergency room services.
Fiscal Year 2007/08 (Round 3B) Letter
Fiscal Year 2007/08 (Round 3B) Certifications and Declarations Form