Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Srija Srinivasan, Deputy Chief, San Mateo County Health
Subject: Transfer of Children’s Health Initiative Funds to Increase Oral Health Services and Equity Planning as Approved by the San Mateo Health Commission
RECOMMENDATION:
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Recommendation to:
A) Adopt a resolution authorizing a Memorandum of Understanding between the County and the San Mateo Health Commission dba Health Plan of San Mateo for the purpose of administering grant agreements related to oral health services and equity planning, funded by Children’s Health Initiative funds, for the term of November 16, 2021 through June 30, 2025, in an amount not to exceed $415,000; and
B) Approving an Appropriation Transfer Request (ATR) in the amount of $415,000, transferring revenue from the Children’s Health Initiative Trust Fund and associated expenditures to the Health Coverage Unit budget, and direct the Controller to take such steps as are necessary to effectuate this transfer.
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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 (HPSM), with the newly formed CHI 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 CHI Coalition amended its Memorandum of Understanding (MOU) in 2020, stating that the CHI 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.
Data from 2013-2015 show that forty percent of three-year-olds in the San Mateo County Head Start program had untreated dental decay. Children of color had higher levels of decay than other children in their cohort. Many pregnant women and elderly lacked dental resources and services. The most affected regions of the County were: Daly City and Brisbane; central San Mateo; East Palo Alto, Redwood City and East Menlo Park; and the coastal areas of Half Moon Bay, El Granada and Miramar.
To address these issues, the San Mateo County Oral Health Coalition began to work with consultants to develop a local needs assessment and strategic plan starting in FY 2015-16. The San Mateo County Oral Health Strategic Plan (2017-2020) has five main objectives: 1) to increase access to dental services and oral health education for children and pregnant women; 2) to increase access to dental services and oral health education for adults; 3) to build oral health provider capacity; 4) to increase awareness of the importance of oral health; and 5) to establish an oral health infrastructure and oral health surveillance system.
DISCUSSION:
In support of the San Mateo County Oral Health Strategic Plan the CHI Coalition recommended, and the San Mateo Health Commission has approved, the transfer of $415,000 from the CHI Trust Fund to fund grant agreements with North East Medical Services (NEMS), Sonrisas Dental Health, Inc. (Sonrisas), and First 5 San Mateo County (First 5).
NEMS will be receiving $210,000 for a three-year term the purpose of building and equipping three dental operatories, hiring one dentist and two dental assistants, and providing significant assistance to low-income children. The three dental operatories will be located in the NEMS Daly City location.
Sonrisas will be receiving $105,000 for a two-year term to provide access to dental services to Medi-Cal eligible children residing in San Mateo County. Sonrisas will be building and equipping one dental operatory and conducting two public dental screening events.
First 5 will be receiving $100,000 for a one-year term to engage a consultant to assist in its Ensuring Equity through School-Based Oral Health Partnerships Initiative. This assistance includes asset mapping, developing strategies for promoting equitable access to oral health, implementing improvements in coordination and alignment between oral health service providers, childcare providers, and educators, and identifying opportunities to more effectively invest and leverage oral health resources.
The San Mateo Health Commission dba HPSM will be the administrator of grant agreements with Sonrisas, First 5, and NEMS to implement these services. The MOU and Appropriation Transfer Request (ATR) designate funds from the CHI Trust Fund to HPSM for the purpose of these three contracts.
The MOU and resolution have been reviewed and approved by County Counsel as to form.
In FY 2021-22, it is anticipated that there will be 388 visits conducted for oral health treatment and 1,550 visits in the following year.
PERFORMANCE MEASURE:
|
Measure |
FY 2021-22 Estimated |
FY 2022-23 Projected |
|
Number visits conducted for oral health treatment |
388 visits |
1,550 visits |
FISCAL IMPACT:
This ATR appropriates $415,000 in revenue from the CHI Trust Fund into the Health Coverage Unit’s operating budget, as well as appropriates the expenditure for the agreements to HPSM. There is no Net County Cost associated with this agreement.