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 LifeMoves for Homeless Outreach, Location and Engagement Services for the Whole Person Care Pilot
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with LifeMoves for community health outreach services, extending the term through December 31, 2021, increasing the fiscal obligation by $103,000 to an amount not to exceed $309,770, and incorporating emergency response provisions.
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BACKGROUND:
Whole Person Care (WPC) is a pilot program funded under the 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 for the period January 1, 2017 through December 2020.
SMCH has focused its efforts on persons who are high utilizers of emergency services and meet one of three target populations including: those with mental health challenges, substance use disorders, and those who experience homelessness. Many clients served meet two or more of these criteria and have multiple existing chronic health conditions that are poorly managed. The pilot funds specific programs within County Health, Health Plan of San Mateo and the Human Services Agency (HSA) to directly serve these individuals. The WPC pilot, through the Bridges to Wellness Team, in partnership with LifeMoves, a community based organization (CBO), seeks to outreach, locate and engage homeless individuals who are high utilizers of emergency services and whose health and/or behavioral health conditions place them at high risk for poor health outcomes.
In 2017, through a Request for Proposals (RFP) process, HSA awarded a contract to LifeMoves, for community health outreach services covering FY 2017-20, a three-year term. In June 2020, SMCH entered a separate agreement with LifeMoves for FY 2020-21, based upon HSA’s original 2016 RFP, as well as the waiver to the RFP process obtained by HSA to extend its RFP cycle to five years. On June 30, 2020, this Board approved Resolution 077550, an agreement between the County of San Mateo and LifeMoves for community health outreach services for the period July 1, 2020 through June 30, 2021.
DISCUSSION:
In 2019, DHCS conducted significant planning for a transition away from the Medi-Cal 2020 authority for many aspects of the Medi-Cal program. At the time, it was anticipated that the WPC pilot would end in December 2020 and eligible clients 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. ILOS includes selected housing services for individuals experiencing homelessness currently funded by WPC. It is anticipated that LifeMoves will become an ILOS provider and continue to serve clients experiencing homelessness when the benefit becomes effective post-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 US Centers for Medicare and Medicaid services approved the DHCS’ proposal for an extension of Medi-Cal 2020 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, 2021 through December 31, 2021.
In order to avoid a gap in services and ensure continuity of the community health outreach work program through the end of the WPC pilot, SMCH seeks to extend the agreement with LifeMoves 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 patients and clients will continue to be met in the event of an emergency.
The agreement and resolution have been reviewed and approved by County Counsel as to form.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate)
It is anticipated that 80% of referred homeless WPC clients will be successfully located.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Estimated |
FY 2021-22 Projected |
|
Percentage of referred homeless WPC clients who are successfully located |
60% |
80% |
FISCAL IMPACT:
The term of the amended agreement is July 1, 2020 through December 31, 2021. The amendment increases the fiscal obligation by $103,000 to an amount not to exceed $309,770 for the 18-month term. $103,000 will be funded through the WPC pilot funds. This amount is included in the PHPP FY 2021-22 Recommended Budget. There is no Net County Cost associated with this agreement.