Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Srija Srinivasan, Acting Director, Public Health, Policy and Planning
Subject: Amendment to Agreement with the Mental Health Association of San Mateo County for Supportive Housing Services for San Mateo County Health Clients
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Mental Health Association of San Mateo County to provide supportive housing services for San Mateo County Health clients extending the term through December 31, 2021, increasing the amount by $100,000 to an amount not to exceed $525,144 and incorporating emergency response provisions.
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BACKGROUND:
Whole Person Care (WPC) is a pilot program funded under the five-year renewal of California’s Section 1115 Medicaid Waiver (Medi-Cal 2020). San Mateo County Health (SMCH) is implementing the WPC pilot to provide a coordinated, efficient, and effective delivery of medical, behavioral health, and social services to the County’s highest-risk and vulnerable populations. Through an agreement with the California Department of Health Care Services (DHCS), SMCH receives up to $16,536,771 in new revenue annually, with funds rolling over from year to year as needed for WPC services. Your Board also approved the allocation of Measure K funds, $1,000,000 in FY 2016-17 and $2,000,000 per fiscal year thereafter, for housing services for WPC clients. To date, this funding has supported 101 homeless individuals in securing housing. Experience shows that clients served through Measure K subsidies and Mainstream Vouchers from the Housing Authority need supportive housing services to maintain their housing. In May 2019, through a Request for Proposal (RFP) process, WPC selected Mental Health Association (MHA) of San Mateo County, as the contractor to provide supportive housing services to San Mateo County health clients. On September 17, 2019, your Board approved an agreement with MHA to implement Supportive Housing Services for San Mateo County Health clients for a period of 15 months from October 1, 2019 through December 31, 2020. At the time, it was anticipated that the DHCS funding to the WPC pilot would end in December 2020, and services would be funded through savings realized from the pilot though June 30, 2021. On December 8, 2019 your board approved resolution #077900) increasing the fiscal obligation by $74,144 to an amount not to exceed $425,144 and extended the term through June 30, 2021.
DISCUSSION:
In 2019, DHCS conducted significant planning for a transition away from the Section 1115 waiver authority for many aspects of the Medi-Cal program. At the time, it was anticipated that WPC would transition into the California Advancing and Innovating Medi-Cal (CalAIM) initiative effective January 1, 2021. CalAIM creates two new benefit packages for most at risk populations, some of whom are currently served under WPC: In Lieu of Services (ILOS) and Enhanced Care Management (ECM). ILOS includes selected services, including supportive housing services currently funded by WPC.
In May 2020, DHCS officially announced the delay of CalAIM due to the impact of the public health emergency caused by COVID-19. On December 29, 2020 the Centers for Medicare and Medicaid services (CMS) approved the DHCS’ proposal for an extension of the 1115 Waiver through December 2021. On March 4, 2021, DHCS approved SMCH’s budget request for additional $16,536,771 in new revenue for the period January 1, to December 31, 2021.
In order to avoid a gap in services and ensure continuity of the supportive housing services program, SMCH seeks to extend the agreement with MHA through December 31, 2021 as set out in the amendment to the agreement. SMCH is also incorporating emergency response provisions in the agreement to ensure that the needs of our patients and clients will continue to be met in the event of an emergency.
The resolution contains the County’s standard provisions allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
The agreement and resolution have been reviewed and approved by County Counsel as to form.
It is anticipated that 95% of clients surveyed will express satisfaction with the housing services and support.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Actual |
FY 2021-22 Projected |
|
Percentage of clients surveyed who express satisfaction with the housing services and support |
92% |
95% |
FISCAL IMPACT:
The term of the amended agreement is October 1, 2019 through December 31, 2021 in an amount not to exceed $525,144. The amendment increases the contract amount by $100,000. This amount is included in the PHPP FY 2021-22 Recommended Budget. There is no Net County Cost associated with this agreement.