Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lisa Mancini, Director, Aging and Adult Services
Subject: Amendment to Agreement with the Health Plan of San Mateo
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement between San Mateo County Aging and Adult Services and the San Mateo Community Health Authority, dba Health Plan of San Mateo, to provide Multipurpose Senior Services Program services for the term of July 1, 2019 through June 30, 2022, in an amount not to exceed $2,731,662.
body
BACKGROUND:
The Multipurpose Senior Services Program (MSSP) provides social and health care management services to frail elders who are eligible for Medi-Cal. MSSP aims to keep clients living independently in the community and to prevent or delay placement in a nursing facility. Since 2014, the Health Plan of San Mateo (HPSM) has paid Aging and Adult Services (AAS) to provide MSSP services. On April 8, 2014, the Board approved an agreement with HPSM to provide MSSP for the term of April 1, 2014, through October 31, 2015, in an amount not to exceed $1,085,280.
Through HPSM, San Mateo County was selected by the State to be one of eight California counties to participate in Cal MediConnect, a three-year demonstration project with the goal of developing new approaches to coordinated care for people who are eligible for both MSSP and Medi-Cal. In November 2015, MSSP transitioned from operating as a waiver program to a Medi-Cal managed care benefit, as part of the full implementation of the Coordinated Care Initiative. As a result, on December 8, 2015, AAS entered into an agreement to provide MSSP for HPSM for the term of November 1, 2015 through October 31, 2018, with automatic, successive 12-month renewals.
In November 2019, the California Department of Aging announced a new MSSP rate. The MSSP rate increased from $357.08 to $446.35 per client, per month. AAS will update its agreement with HPSM, retroactive to July 1, 2019, to reflect the new rate.
DISCUSSION:
The proposed amendment between AAS and HPSM allows HPSM to (1) inform its members about MSSP and (2) establish a mechanism to refer members who are enrolled in the Medi-Cal plan for managed long-term services and support to the MSSP provider for an eligibility determination. HPSM and AAS will coordinate care and benefits for MSSP recipients.
This amendment also puts an end to the automatic successive 12-month renewals, with the contract term ending on June 30, 2022.
Under the proposed agreement, HPSM will pay AAS a fixed monthly amount for each MSSP client.
The agreement and resolution have been reviewed and approved by County Counsel as to form.
It is anticipated that 170 at-risk clients will be maintained in the least restrictive setting through MSSP services each month.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Estimated |
FY 2020-21 Projected |
|
Number of at-risk individuals maintained in the least restrictive setting through MSSP services each month. |
160 clients per month |
170 clients per month |
FISCAL IMPACT:
AAS is expected to receive $910,554 annually for MSSP services. The term of the agreement is July 1, 2019, to June 30, 2022. The total amount received for the three years is $2,731,662.