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 the Memorandum of Agreement with the San Mateo County Health Commission
RECOMMENDATION:
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Measure K: Adopt a resolution authorizing an amendment to the Memorandum of Agreement between the County of San Mateo and the San Mateo County Health Commission to redirect Measure K savings to provide one-time funds to support the provision of on-site medical services to the Navigation Center in an amount not to exceed $1,212,600.
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BACKGROUND:
Whole Person Care (WPC) was a pilot program funded under the five-year renewal of California’s Section 1115 Medicaid Waiver (Medi-Cal 2020). San Mateo County Health (SMCH) implemented 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, SMCH received 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 of January 1, 2017, through December 2020.
As part of the WPC pilot this Board approved the allocation of Measure K funds: $1,000,000 in FY 2016-17 and $2,000,000 per fiscal year thereafter, for WPC client housing services until the end of the pilot.
On June 6, 2017, this Board approved a resolution approving a Memorandum of Agreement (MOA) between the County of San Mateo and the San Mateo County Health Commission dba the Health Plan of San Mateo (HPSM) to enhance the Community Care Setting Pilot and implement Measure K Housing Services for SMCH clients for the remaining term of the WPC pilot.
On March 6, 2018, the MOA between SMCH and HPSM was amended to: incorporate the scope of work as Section One, add the WPC Care Coordination Policy and Approach inadvertently labeled as Section Two, and add WPC and Measure K Payment Plan inadvertently labeled as Section Three.
On December 10, 2019, the MOA was amended to add recuperative care start-up costs to Section One, the requirement of labeled reports to Section Two, and to amend the payment plan labeled as Section Three.
On March 9, 2021, the MOA was amended to extend the term through June 30, 2022, clarify the reporting requirements, correct mislabeled amended paragraphs and exhibits, amend the payment plan to include recuperative care services, and increase the fiscal obligation by $5,992,990 from $24,340,463 to $30,333,453.
On January 3, 2022, the MOA was amended to replace Exhibit A with Exhibit Al to reallocate $300,000 in Measure K funds from Housing Services to the Vision to Learn program. These funds supplement the HPSM vision provider network to create additional access to vision care for up to 3,000 Medi-Cal beneficiaries in the twelve San Mateo County school districts.
On June 28, 2022, the MOA was amended: extend the term through June 2025; provide the housing program with an additional $2,000,000 in Measure K funds annually; and reallocate $250,000 in Measure K funds to the Orthodontia Access Pilot.
DISCUSSION:
The Measure K Housing Services program, under the MOA with HPSM, was extended through June 30, 2025, to support vulnerable homeless individuals through direct rental subsidies, as well as housing location and retention services. Under this amendment, a one-time allocation of $1,212,600 in Measure K savings will be redirected to provide medical services to homeless individuals, through an agreement between HPSM and Healthcare in Action, to persons residing at the new Navigation Center and in the surrounding community. Funds will be allocated in the amount of $412,300 for calendar year 2023 and $800,300 for calendar year 2024.
The amendment and resolution have been reviewed and approved by the County Attorney 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 estimated that after the initial start-up period, 67% of Navigation Center patients will be eligible to receive Medi-Cal reimbursable health services from Healthcare in Action reimbursed by HPSM and 33% will likely be uninsured and reimbursed through Measure K.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Estimated |
FY 2023-24 Projected |
|
Percentage and number of Navigation Center patients receiving services from Healthcare in Action who are uninsured out of total at Navigation Center (assuming 6- month average length of stay). |
50% 50/100 patients |
33% 172/520 patients |
FISCAL IMPACT:
The term of this amended MOA is June 6, 2017, through June 30, 2025, in an amount not to exceed $36,333,453. This amendment represents a one-time reallocation of funds, reallocating $1,212,600 in savings from Measure K funds to support the provision of medical services at the Navigation Center, with no change to the MOA term or aggregate amount.