Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Lizelle Lirio de Luna, Director, Family Health Services
Subject: Agreement with the San Mateo Health Commission dba the Health Plan of San Mateo to Provide Community Support Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with the San Mateo Health Commission dba the Health Plan of San Mateo to provide funding for Community Support Services provided by the County of San Mateo, for a term of one year from the effective date of May 20, 2026, and thereafter automatically renewing for subsequent terms of one year each to a maximum of ten (10) years, in an amount not to exceed $12,000,000.
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BACKGROUND:
The Health Plan of San Mateo (HPSM) administers Medi-Cal benefits for San Mateo County residents, including children and youth enrolled in the Whole Child Model (WCM). Under the CalAIM initiative, HPSM offers Community Support Services designed to address social determinants that impact health outcomes. San Mateo County Health has historically partnered with HPSM to deliver services that support families caring for children and youth with special healthcare needs and complex medical conditions. The proposed agreement continues this partnership with HPSM funding the County’s delivery of Community Support Services, including Respite Services, to eligible WCM families.
DISCUSSION:
Under the proposed agreement, HPSM will provide funding to San Mateo County Health to support the implementation and delivery of Community Support Services under CalAIM. These services help meet the complex needs that affect a child’s health and a parent’s/caregiver’s ability to sustain care. Respite is a short-term, nonmedical service that offers temporary supervision for a child so caregivers can attend medical appointments, manage essential tasks, or support their own wellbeing, allowing them to continue safely caring for a child with serious and/or chronic medical needs at home.
Respite utilization is expected to begin with a limited number of families during the first year of implementation, with approximately 30 WCM clients projected to participate. As the program becomes established and families become familiar with the service, participation is anticipated to grow gradually each year. Based on utilization patterns observed in comparable programs and the proportion of families who typically require respite services, it is reasonable to expect that respite use will stabilize at approximately 10 percent of the WCM population over time. With an estimated 1,100 eligible WCM clients, this represents a long-term caseload of roughly 110 clients annually.
Although the agreement includes an automatic annual renewal provision without a stated maximum term, San Mateo County Health will conduct internal evaluations of program effectiveness and financial sustainability at the third, fifth, and seventh years of implementation. These evaluation checkpoints will guide operational and fiscal planning while allowing the agreement to remain in its California Department of Health Care Services approved format.
This Board is also being asked to authorize the Chief of San Mateo County Health, or their designee, to execute subsequent amendments that do not exceed an aggregate of $25,000. The County Attorney has reviewed and approved the resolution and agreement as to form.
It is anticipated that 40 WCM clients will receive respite services, with participation increasing gradually as the program becomes established and families become familiar with Community Supports Services.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Number of WCM clients receiving respite services |
30 clients |
40 clients |
COMMUNITY IMPACT:
This agreement supports broader access to respite services for families of children and young with special healthcare needs and complex medical conditions. Families enrolled in the WCM are disproportionately low-income, ethnically diverse, and often face significant caregiving demands that limit their ability to work, attend appointments, or maintain family stability. By funding Community Support Services, the County helps reduce gaps in access to supportive services that strengthen caregiver capacity, lower stress, and promote family health and well-being. This aligns with the County’s commitment to ensuring services are accessible, culturally responsive, and focused on communities with the greatest needs.
FISCAL IMPACT:
The term of the agreement is from the effective date of May 20, 2026, and thereafter automatically renewed for subsequent terms of one year each to a maximum of ten (10) years. The amount of the agreement is not to exceed $12,000,000 for the ten-year term. Funds in the amount of $1,000,000 will be included in the Family Health Services FY 2026-27 Adopted Budget. Similar arrangements will be made for future years. Since the County is receiving this funding, there is no Net County Cost.