Special Notice / Hearing: None__
Vote Required: 4/5 Vote
To: Honorable Board of Supervisors
From: Ken Cole, Director, Human Services Agency
Subject: Acceptance of Grant Funding in the Amount of $843,000 for FY 2022-2026 from the Department of Health Care Services
RECOMMENDATION:
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Recommendation to:
A) Adopt a resolution:
1. Authorizing the Director of the Human Services Agency (HSA), or Director’s designee, to accept and implement the grant award from the California Department of Health Care Services (DHCS) to support the Medi-Cal Health Enrollment Navigators Project for $843,000 for the period of October 1, 2022, through June 30, 2026; and
2. Authorizing the Director of HSA, or Director’s designee, to accept future awards and/or amendments from DHCS that are consistent with the requirements of the grant award that may extend the term for two additional years, at amounts to be determined by DHCS; reflect non-material and/or ministerial revisions to the award’s terms and conditions; allow for the rollover of unspent funds and/or redirection of funds; adjust the term of the award for an additional six months; and/or provide an increase or decrease in funding, subject to review and approval by the County Attorney and notification to the Board; and
B) Approve an Appropriation Transfer Request (ATR) in the amount of $175,000 from unanticipated revenue to corresponding appropriations in salaries and benefits and services and supplies.
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BACKGROUND:
California Assembly Bill 74 (AB 74), enacted on June 27, 2019, authorizes DHCS to manage and allocate funding to support health enrollment navigators for two years to provide Medi-Cal outreach, enrollment, retention, and utilization assistance to underserved Californians. The goal of AB 74 funds is to connect uninsured residents to healthcare, and to provide aid in navigating the healthcare system.
On September 13, 2019, DHCS released the Medi-Cal Health Enrollment Navigators Project (the “Navigators Project”). On January 15, 2020, DHCS notified HSA that it was a recipient of the grant award in the amount of $778,231 to assist with outreach, enrollment, and retention activities for the period of January 1, 2020 through September 30, 2022.
The Department of Health Care Services (DHCS) announced an additional $60M ($30M General Fund) in the May 2022 Revision to the Governor’s Budget, in order to continue support for activities associated with the Navigators Project. The Extension of the Navigators Project is for FYs 2022-2026.
HSA applied for the additional funds and the extension on July 5, 2022 and received notice of approval for $843,000 in additional funds for FYs 2022-2026 on September 16, 2022.
The receipt of grant funding is for the intended purpose of enrollment and retention of the following target populations:
• Persons who are homeless
• Aged persons
• Immigrants and families of mixed immigration status
• Persons with limited English proficiency
• Low-wage workers and their families or dependents
DISCUSSION:
Approval of Recommendation A of this memo will allow the Director of HSA, or the Director’s designee, to accept the Medi-Cal grant award from DHCS, which will support the Medi-Cal outreach, enrollment, and retention services project in San Mateo County. The grant will be used to increase HSA’s Medi-Cal retention rate; increase HSA’s Medi-Cal outreach efforts to get a higher number of eligible County residents on aid; and to hire two additional term Community Workers to join the current Outreach team. The Outreach team will identify the most common reasons for Medi-Cal discontinuance and work to decrease the number to ensure eligible clients continue to receive aid. In addition, the team will do intensive outreach to recently discontinued clients in our target populations to reinstate Medi-Cal. The Outreach team will identify populations that are harder to reach and work to eliminate barriers for those populations. HSA will develop outreach materials and increase outreach activities through facilitation of and/or attendance at community events.
Approval of Recommendation B of this memo will allow the Director of HSA, or the Director’s designee, to accept future awards and/or amendments from DHCS that are consistent with the requirements of the grant award that may extend the term for two additional years, at amounts to be determined by DHCS; reflect non-material and/or ministerial revisions to the awards terms and conditions; allow for the rollover of unspent funds and/or redirection of funds; adjust the term of the award for an additional six months; and/or provide an increase or decrease in funding. This recommended action will enable HSA to accept future awards and/or amendments that adjust the period up to six months, in those instances where there has been an unanticipated extension of the term, to allow additional time to complete services and utilize funding.
Approval of Recommendation C of this memo will allow HSA to appropriate funding necessary to implement the Navigators Project.
By the end of the funding term on June 30, 2026, HSA anticipates it will have increased Medi-Cal enrollment and assisted 950 clients with new applications; will have been able to retain 4,100 clients that would otherwise have been discontinued; and will have reached 196,475 San Mateo County residents via direct outreach and/or media outreach. All outreach and retention efforts made during the Navigators Project will be tracked and sent to DHCS monthly.
The County Attorney has reviewed and approved the resolution as to form.
There are no performance measures for this item.
FISCAL IMPACT:
The DHCS grant award, in the amount of $843,000, is for the period of October 1, 2022 through June 30, 2026. There is no Net County Cost. The Appropriation Transfer Request recognizes and appropriates $175,000 for initial project implementation in FY 2022-23. Funding will be appropriated in the FY 2023-26 Recommended Budget to allow HSA to utilize the remaining $668,000 in grant funding.