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: Measure K: Amendment to the Memorandum of Agreement with the San Mateo County Health Commission Regarding Housing Services Program Funded by Measure K
RECOMMENDATION:
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Measure K: Adopt a resolution authorizing a seventh amendment to the memorandum of agreement between the County of San Mateo and the San Mateo County Health Commission to extend the term through June 30, 2027, to replace Exhibit A.3 with Exhibit A.4 (Rev. 2/12/2026) to include Orthodontia Access Pilot and Vision to Learn, and to increase the fiscal obligation by $4,000,000 in Measure K funds, in an amount not to exceed $40,333,453.
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BACKGROUND:
To support housing services for high-risk clients, the Board approved Measure K funding of $1 million in FY 2016-17 and $2 million annually thereafter. On June 6, 2017, the Board also approved a Memorandum of Agreement (MOA) with the Health Plan of San Mateo (HPSM) to implement housing subsidies as a strategy to increase access to and maintain engagement in healthcare services with this funding.
The MOA has been amended several times to update program scope, funding, and administrative details:
• March 6, 2018: Added and clarified the scope of work, care coordination approach, and payment plan.
• December 10, 2019: Updated recuperative care start-up costs, reporting requirements, and payment plan.
• March 9, 2021: Extended the agreement through June 30, 2022; increased funding by approximately $6.0 million (to $30.3 million); and reorganized key documents into exhibits.
• January 3, 2022: Reallocated $300,000 in Measure K funds to expand access to vision services for up to 3,000 Medi-Cal beneficiaries in county school districts.
• June 28, 2022: Extended the agreement through June 2025; increased funding by $6.0 million (to $36.3 million); reallocated $250,000 to an Orthodontia Access Pilot; and removed certain exhibits.
• January 17, 2023: Reallocated $1.2 million in Measure K savings to support medical services at the Navigation Center.
DISCUSSION:
Under this agreement, HPSM currently provides three areas of service to high-risk clients: the Housing Subsidies Program, Orthodontia Access Program, and Vision to Learn Program. The Measure K Housing Services program supports vulnerable homeless individuals through direct rental subsidies as well as housing location and retention services. Under the instant proposed amendment, the MOA term will be extended to June 30, 2027, and an additional $2,000,000 in Measure K funds will be allocated annually for the Housing Program. Also under this amendment, the one-time reallocated Measure K Housing funds from 2022 for the use of the Orthodontia Access Pilot will be extended due to length of treatment and delay in providers starting treatment. There will be also a minor reallocation of funding for Vision to Learn to assist students with free eye exams and glasses.
This agreement is going to this Board late due to personnel transitions and time needed to coordinate these MOA amendments with HPSM; however, housing subsidies and services have not been impacted by this delay.
The amendment and resolution have been reviewed and approved by the County Attorney as to form.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
It is anticipated that at least 50 individuals and families will receive a direct rental subsidy annually and that 90% of recipients, who do not require a higher level of care, will maintain their housing.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Number of individuals and families that receive direct rental housing subsidy Percentage of clients who do not require a higher level of care, that maintain their housing |
≥50 individuals 90% |
≥50 individuals 90% |
COMMUNITY IMPACT:
This MOA extending Measure K funding for Housing Services will enable unhoused individuals and families with complex needs access to housing subsidies and services, as well as previously unhoused individuals and families with complex needs to remain in housing. Additionally, this agreement aligns with local objectives of ending homelessness and improving health outcomes.
FISCAL IMPACT:
The term of the amended MOA is July 1, 2022, through June 30, 2027. The amount of the amendment is not to exceed $4,000,000 in Measure K funds. Funds in the amount of $2,000,000 are included in the FY 25-26 Public Health, Policy and Planning Adopted Budget. Similar arrangements will be made for future year.