Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Marc Meulman, 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 June 30, 2022, increasing the fiscal obligation by $103,000 to an amount not to exceed $412,770 and correctly labeling the title to the first amendment which was inadvertently labelled the second amendment.
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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) has implemented the WPC pilot since 2017 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, through December 2021.
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 (HPSM) and the Human Services Agency (HSA) to directly serve these individuals. The WPC pilot, through the Bridges to Wellness Team, in partnership with the community-based organization LifeMoves, seeks to reach out to, 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 a three-year term (FY 2017-20). In June 2020, SMCH entered a separate agreement with LifeMoves for FY 2020-21, based upon HSA’s original 2016 RFP. On June 30, 2020, this Board approved an agreement between the County of San Mateo and LifeMoves for community health outreach services for the period of July 1, 2020 through June 30, 2021. 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. To avoid a gap in services and ensure continuity of the community health outreach work program through the end of the WPC pilot, on June 29, 2021, this Board approved an agreement between the County of San Mateo and LifeMoves for community health outreach services for the period of July 1, 2021 through December 31, 2021.
DISCUSSION:
Based, in part, upon the successes of the WPC Pilots, DHCS has received approval to implement a multi-year initiative entitled California Advancing and Innovating Medi-Cal (CalAim) beginning January 1, 2022. CalAim is designed to improve the quality of life and health outcomes of California residents by implementing a broad delivery system, as well as program and payment reform across the Medi-Cal program. As part of this initiative, a new Medicaid benefit entitled Enhanced Care Management (EMC) will be administered by managed care plans. It is anticipated that the Bridges to Wellness program, within Public Health, Policy and Planning (PHPP), will become a provider of ECM under contract with HPSM within the first six months of 2022. Prior to that time, Bridges to Wellness will continue to provide services to its existing caseload.
Currently, Bridges to Wellness contracts for services through LifeMoves to meet some of the outreach needs of the unhoused that will eventually be provided by HPSM. It is anticipated that HPSM will contract for similar services sometime after June 30, 2022. In order to avoid a gap in services and to ensure continuity of the community health outreach services to the unhoused population, SMCH seeks to extend the current agreement with LifeMoves through June 30, 2022, as set out in the amendment to the agreement.
The amendment and resolution have been reviewed and approved by County Counsel as to form. This amendment is late because of last minute incorporation of new developments relating to ECM and to provide additional information on performance measures.
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.
FISCAL IMPACT:
The term of the amended agreement is July 1, 2020 through June 30, 2022. The amendment increases the fiscal obligation by $103,000 to an amount not to exceed $412,770 for the two-year term. $103,000 will be funded through the WPC pilot funds. This amount is included in the PHPP FY 2021-22 Adopted Budget. There is no Net County Cost associated with this amendment.