Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Tamarra Jones, Director, Public Health, Policy and Planning
Subject: Amendment to the Agreement with Mental Health Association of San Mateo County for Housing and Related Services for HIV Program Clients
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Mental Health Association of San Mateo County to provide housing and related services for HIV Program Clients, extending the term for an additional 2 years through February 28, 2028, and increasing the amount by $2,500,000 to an amount not to exceed $5,500,000.
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BACKGROUND:
On September 12, 2023, this Board approved a Ryan White A funding award to County Health from the City and County of San Francisco Department of Public Health to provide HIV/AIDS health services, for the term of March 1, 2023, through February 29, 2028, in an amount not to exceed $8,559,404. A portion of this funding is allocated to provide housing services to County residents affected by HIV/AIDS. For the past 20 years, San Mateo County Health has contracted with Mental Health Association of San Mateo County (MHA) to provide housing and housing-related services.
DISCUSSION:
Under this agreement, MHA has provided short-term rent and mortgage assistance, benefits counseling, and case management services to County residents affected by HIV/AIDS. A Request for Proposals was released in December 2022, and MHA was the sole participant with a proposal to provide housing and related services. The selection committee reviewed the proposal and determined that the proposal met the service requirements. this amendment to the current agreement, which expires on February 28, 2026, would allow services to be provided to this community without interruption.
The resolution contains the County’s standard provisions allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
The County Attorney has reviewed and approved the amendment and resolution as to form.
It is anticipated that these services will enable 95% of clients receiving housing assistance services to maintain or improve their quality of life.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Actual |
FY 2025-26 Estimated |
|
Percentage of clients receiving housing assistance services that maintain or improve their quality of life |
95% 125 clients |
95% 125 clients |
COMMUNITY IMPACT:
Based on the 2025 Department of Finance population projections, Black and Hispanic individuals are overrepresented among those living with HIV and AIDS in San Mateo County. Black individuals are estimated to be only 2% of the County but comprise about 6% of those living with HIV and 11% of those living with AIDS. Hispanic individuals are estimated to be about 20% of the County but comprise 44% of the population living with HIV and 39% of the population living with AIDS. Housing instability also disproportionately impacts people of color in San Mateo County: Hispanic and Black residents face heavier rent burdens-63% and 56%, respectively-compared to 45% of White residents. Unstably housed individuals are significantly more likely to face gaps in HIV treatment, poorer adherence to antiretroviral therapy, and lower rates of viral suppression. HIV viral load suppression is vital for community health because it lowers transmission risk, especially in high-risk populations and areas with high HIV prevalence. Providing stable housing to people living with HIV in San Mateo County can enhance their continuity of care, improve health outcomes, reduce hospitalizations, and lower long-term healthcare costs-directly advancing better health outcomes for all.
Safe and sustained housing is foundational to extended life expectancy. Housing stability supports adherence to HIV treatment and increases the likelihood of viral suppression, improving quality of life and reducing transmission risks. This HOPWA and Ryan White A funding will provide housing support for this community and address some of the challenges they face.
FISCAL IMPACT:
The term of the amended agreement is March 1, 2023, through February 28, 2028.
The amount of the agreement is not to exceed $5,500,000. This amendment
increases the contract amount by $2,500,000. Funds in the amount of $1,080,000 are budgeted in Public Health, Policy and Planning FY 2025-26 Adopted Budget and $1,080,000 is included in the FY 2026-27 Recommended Budget. Similar arrangements will be made in future years. The payment provisions and levels of service in this agreement are similar to the previous agreement. There is no Net County Cost associated with this agreement, as Ryan White A is providing these funds.