History & Overview

Our Mission…
Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

Our History and Overview…
The California Department of Health Care Services (DHCS) released the final version of its strategic plan for expanding Medi-Cal Managed Care in March 1993. Under this plan for 13 counties, DHCS proposed to place a significant number of Medi-Cal beneficiaries into one of two Knox-Keene licensed health maintenance organizations (HMOs). As a result, the State of California went to these thirteen counties and offered them an opportunity to participate by forming a county-sponsored plan, known as a Local Initiative.

The Kern County Board of Supervisors established Kern Health Systems (KHS), in April 1993 as a non-profit, public-benefit corporation to be the Kern County Local Initiative. The composition of the KHS Board of Directors was approved, which would include provider and community/consumer representatives. Board members are subsequently appointed by the Board of Supervisors and are responsible for leading, directing and monitoring the activities of KHS and have been instrumental in molding our goals and objectives.

As a governmental agency, KHS was required to comply with the Brown Act in all aspects of operations, which meant that peer review and credentialing activities could not be conducted in closed session. Because of the potential adverse impact on these processes from the requirements of the Brown Act, the Board of Supervisors, acting under enabling legislation, established a County Health Authority, known as Kern Health Systems, in January 1995. The conversion to a Health Authority allowed for the protection of provider peer review and credentialing activities.

KHS’ primary activities during start-up were related to applications for licensure from the Department of Corporations under the Knox-Keene Act and for a contract with the Department of Health Care Services to assume primary responsibility for the delivery of health care to the Medi-Cal recipients who choose our plan. To demonstrate our ability to provide the full range of services necessary within compliance with all regulations, KHS built a network of over 500 health care providers and submitted detailed information regarding our plan systems, including financial viability, information systems, quality assurance, utilization review programs, health education programs, and cultural and bilingual capabilities. KHS was awarded Knox-Keene licensure on May 2, 1996 and a contract with the Department of Health Care Services to administer care beginning July 1, 1996.

In 1998, the Department of Corporations approved expansion of our Knox-Keene license that allowed KHS to contract with the Managed Risk Medical Insurance Board (MRMIB) to provide prepaid health care services to the children of working poor under the federal and state funded Healthy Families Program. On July 1, 2005, the contractual obligations for the operations of this health plan were assigned to Knox-Keene licensed, KHS Group Health Plan. This separate health authority, created by the Kern County Board of Supervisors, alleviates KHS from the payment of quality improvement tax imposed on all revenues of health plans that contract with the DHS for the provision of health care services to Medi-Cal beneficiaries. KHS continues the management and administration of the Healthy Families Program health plan under a management service contract with KHS Group Health Plan.

Medi-Cal…
Medi-Cal is California’s Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Through our Kern Family Health Care product, KHS provides health services to Medi-Cal beneficiaries in Kern County (with the exception of Ridgecrest). Enrollment for Kern Family Health Care began June 1, 1996 and our first members were seen on July 1, 1996. Our membership as of April 2010 is over 100,383. Our market share is 77% of eligibles enrolled in the two participating Medi-Cal Managed Care health plans in Kern County.

Healthy Families Program…
The Healthy Families Program offers low-cost comprehensive health coverage for children and teens up to age 19. It provides health, dental and vision coverage to children who meet the program rules and do not qualify for no-cost Medi-Cal. In April 1998, KHS partnered with MRMIB to become a participating health plan for the Healthy Families Program in Kern County, to provide prepaid health care services to eligible children. Through our Kern Family Health Care product, KHS began serving Healthy Families Program members in Kern County on July 1, 1998. Our membership as of February 2010 is over 11,866. Our market share is 49% of the eligibles enrolled in the four participating Healthy Families Program health plans in Kern County.

The Care We Offer…
Kern Health Systems was created to assure that the under-served and uninsured families of Kern County are provided with quality health services. It is important to ensure good health through continuity of care by connecting each member to a provider of their choice within our provider network. Our extensive provider network includes the existing infrastructure that historically delivered care to Medi-Cal recipients and private providers throughout Kern County and some parts of Los Angeles County. We believe good patient/physician relationships and effective preventive care are true indicators of our success. We also offer a continuum of care that extends beyond doctor visits. With a full range of health education classes, we provide quality educational and preventive services to the population we serve. We are able to achieve this through partnerships with our providers and community-based organizations within Kern County. The difference is clear: We hold the standard high when it comes to quality health care for our members.

Giving Back to the Community…
Caring for our community is important to us as an organization. Kern Health Systems recognized the lack of health education services in our community and made it a goal to promote health and wellness in our community, however, we knew we could not do this alone. In June 2001, our Board of Directors designated $2 million in grant monies intended to promote the health of our community. Grant monies are awarded to organizations capable of providing culturally and linguistically appropriate health education services or health-related community service projects to promote health and decrease disease and disability. Additionally, over $4 million dollars have been granted to improve access and the quality of medical care in our community.