Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lizelle Lirio de Luna, Director, Family Health Services
Subject: Agreement with the State of California Department of Health Care Services and Sierra Health Foundation: Center for Health Program Management for Implementation and Administration of the Asthma Mitigation Project
RECOMMENDATION:
title
Adopt a resolution authorizing the acceptance of an award from the State of California Department of Health Care Services and Sierra Health Foundation: Center for Health Program Management for implementation and administration of the Asthma Mitigation Project for the term of August 1, 2020 through May 15, 2023, in an amount not to exceed $500,000.
body
BACKGROUND:
Asthma is the most common chronic childhood disease with 6.8 million children affected nationwide. In California, upwards of one in six children have been diagnosed with asthma, and it is one of the leading causes of hospitalization. According to the 2016 California Health interview Survey, 16.1% of children in San Mateo County ages 1-17 had asthma, greater than overall state prevalence (14.6%). While asthma affects people of all ages, races and ethnic groups, low-income communities and communities of color suffer substantially higher fatality rates, hospital admissions and emergency department visits due to asthma. In San Mateo County, 60% of children with asthma come from communities of color.
Due to the discontinuation of funding, San Mateo County has not had a home visiting program dedicated to asthma mitigation since 2016; current interventions are provided in clinical settings with phone support for medication adherence. In February of 2020, the Sierra Health Foundation issued a request for proposals to participate in the Asthma Preventative Services Project (APSP). The APSP is funded by the California Department of Health Care Services as one-time funding to support local health departments, medical providers and community-based organizations to offer asthma home visiting services, including education and environmental trigger mitigation. Awarded funds aim to support environmental mitigation, education and disease-management services to individuals with poorly controlled asthma.
DISCUSSION:
The APSP requires asthma home visiting service to include 1) asthma education, 2) home environmental asthma trigger assessments, and 3) home environmental trigger remediation. Asthma education includes providing information to a patient about basic asthma facts, the use of medications, self-management techniques and self-monitoring skills, and actions to mitigate or control environmental exposures that exacerbate asthma symptoms. County asthma supports for children currently do not fully consider the home environment the child might live in, for example substandard housing with exposure to certain indoor allergens.
San Mateo County’s Asthma Mitigation Project aims to provide 100 children receiving Medi-Cal with as many as five asthma home visits per year. In addition to funding staff time for 1.5 FTE Senior Community Workers and .5 FTE Public Health Nurse, up to $1,000 per client may be used for minor to moderate remediation of environmental asthma triggers. Service providers administer an asthma medical assessment to identify the client’s current knowledge/needs, medical history, and current asthma plan adherence in order to develop an individual service plan (ISP). ISPs are reassessed every six months to review improvement.
This grant agreement may require an annual signature to receive funds. As a result, Family Health Services (FHS) seeks authorization for the Chief of San Mateo County Health or their designee to sign the agreement in lieu of your Board.
The Board is being asked to authorize the Chief of San Mateo County Health or her designee to execute subsequent amendments which do not exceed an aggregate of $25,000.
The resolution has been reviewed and approved by County Counsel as to form.
It is anticipated that 50% of the 100 children enrolled in the program will receive 3 or more home visits.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Estimated |
FY 2021-22 Projected |
|
The percentage of children under 21 receiving 3 or more home visits. |
50% 100 children |
50% 100 children |
FISCAL IMPACT:
The term of the agreement is August 1, 2020 through May 15, 2023. The amount of the agreement is not to exceed $500,000 for the thirty-three month term. Funds in the amount of $166,666 are included in the FHS FY 2020-21 Adopted Budget. Similar arrangements will be made for future years.