Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Subject: Transfer of Children’s Health Initiative Funds to the San Mateo County Immigrant Relief Fund, as approved by the San Mateo Health Commission, and Approval of Grant Agreement
RECOMMENDATION:
title
Recommendation to:
A) Adopt a resolution authorizing and directing:
1. The use of funds in the Children’s Health Initiative Trust Fund to address shared priorities related to children’s health, as determined by voting members of the Children’s Health Initiative Coalition, subject to approval by the San Mateo Health Commission, in accordance with the Children’s Health Initiative Coalition’s amendment of its Memorandum of Understanding, with the restriction in place regarding the use of such funds to be amended accordingly; and
2. The contribution of $2,000,000 in Children’s Health Initiative funds to the San Mateo County Immigrant Relief Fund to provide financial assistance to residents of San Mateo County who have been economically impacted by COVID-19 and who are ineligible for federal financial assistance programs because of their immigration status; and
3. The Board of Supervisors to execute a grant agreement with Legal Aid Society of San Mateo County and Mission Asset Fund, in a substantially similar form to the agreement in place for the term of July 15, 2020, through December 31, 2020, for the contribution of a total amount not to exceed $2,000,000 to the San Mateo County Immigrant Relief Fund and distribution of this amount to selected recipients for a term of January 26, 2021 through June 30, 2021; and
B) Approve an Appropriation Transfer Request (ATR) in the amount of $2,000,000, transferring revenue from the Children’s Health Initiative Trust Fund to Mission Asset Fund, and direct the Controller shall take such steps as are necessary to effectuate this transfer.
body
BACKGROUND:
In 2003, the County and key partners launched the Children’s Health Initiative (CHI) to achieve universal health insurance coverage in San Mateo County. The County worked with many partners to further this aim through: outreach to uninsured children and families; enrollment into public health coverage programs; and a locally supported health insurance program called Healthy Kids that was designed to serve children ineligible for federal and state programs.
In 2007, governance for this initiative was moved from the County to the San Mateo Health Commission, the governing body for the Health Plan of San Mateo, with the newly formed CHI Coalition (Coalition) serving as an advisory body.
When State policy actions expanded the State’s role in health insurance coverage for children, the CHI Coalition took actions to align local responsibilities accordingly, including a decision to close the local Healthy Kids program in 2019. The Coalition amended its Memorandum of Understanding (MOU) in 2020, stating that the Coalition would, among other things, assure responsible stewardship of the financial resources originally contributed to support universal health coverage so that the funding is directed to address shared priorities related to children’s health. The MOU further provided that County Health would oversee the financial stewardship of the restricted Children’s Health Initiative Trust Fund established to support CHI.
The San Mateo County Immigrant Relief Fund was created pursuant to a July 2020 grant agreement among the County, the Legal Aid Society of San Mateo County, and the Mission Asset Fund to provide financial assistance to residents of San Mateo County who have been economically impacted by COVID-19 and who are ineligible for federal financial assistance programs because of their immigration status. It was initially capitalized with grant funds from the County, with the distribution of these funds scheduled to be completed by December 31, 2020.
DISCUSSION:
In November 2020, the Coalition’s Oversight Committee (Oversight Committee) voted to recommend that the San Mateo Health Commission approve a grant of $2,000,000 in CHI funds to the San Mateo County Immigrant Relief Fund, in alignment with the Coalition’s goal of addressing the health challenges of low-income children and their families. The recommendation of the Oversight Committee followed research and analysis on the needs facing children and their families during the COVID-19 pandemic, including the County’s action to direct $4 million to the Immigrant Relief Fund and estimated unmet need from applicants living in San Mateo County.
In December 2020, the San Mateo Health Commission adopted the Oversight Committee’s recommendation and approved the grant of $2,000,000 in CHI funds to the San Mateo County Immigrant Relief Fund.
Approval from this Board is now being sought to effectuate the transfer of these CHI funds (the original source of which were the County as well as several other members of the Coalition), as they are held by the County in a restricted Children’s Health Initiative Trust Fund. The County’s role in overseeing financial stewardship of the restricted fund established to support CHI includes executing the recommended Appropriation Transfer Request (ATR), which transfers $2,000,000 from the Children’s Health Initiative Trust Fund to Mission Assets Fund. Your Board’s approval of the ATR satisfies the County financial requirements to document all financial transactions with the appropriate action by your Board.
In addition, Board approval is sought for a new grant agreement among the County, the Legal Aid Society of San Mateo County, and the Mission Asset Fund setting forth terms and conditions related to this expenditure. The grant agreement is modeled after the grant agreement that was previously entered into among these parties, but which terminated on December 31, 2020.
The amended MOU, grant agreement, and resolution have been reviewed and approved by County Counsel as to form and have been approved by Risk Management.
FISCAL IMPACT:
This Appropriation Transfer Request appropriates $2,000,000 in revenue from the Children’s Health Initiative Trust Fund into the Health Coverage Unit’s operating budget, as well as appropriates the expenditure of the grant agreement. No Net County Cost is associated with this agreement.