To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Leah Benz, 565-6614
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Whole Person Care Program Delegated Authority
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute agreements and amendments to support the Whole Person Care Program in a not-to-exceed amount of $1,386,153 through December 31, 2021.
B) Adopt a budget resolution authorizing budgetary adjustments to the fiscal year 2020-2021 adopted budget to reflect additional revenues and expenditures supporting the extension of the Whole Person Care Program in the amount of $566,514 within the Department of Health Services.
(4/5th Vote Required)
end
Executive Summary:
The Sonoma County Whole Person Care Pilot Program began in 2017 and was scheduled to end on December 31, 2020. In January 2021 the state notified Sonoma County that an additional year of program funding would be provided for continuation of the program through December 31, 2021. The contract with the Department of Health Care Services (DHCS) is extended through June 30, 2022 to include close-out of reporting requirements, however spending is extended only through December 31, 2021. The Department of Health Services requests authority to execute agreements and amendments to support the continuation of the Whole Person Care Program through the end of the additional program year, December 31, 2021.
The Department is also requesting approval of a budget resolution adjusting the fiscal year 2020-2021 budget to support the additional year of the Whole Person Care Program. Additional appropriations are necessary to accommodate additional program funding provided by the state for January 1, 2021 through June 30, 2021.
Discussion:
The Sonoma County Whole Person Care Program, which has been integrated into the ACCESS Sonoma County Initiative, targets Medi-Cal beneficiaries who are homeless or at risk of homelessness, have a serious mental illness, and possess at least one of the following characteristics: 1) have other co-occurring health conditions, including substance use disorders; 2) are high users of emergency services; and 3) are served by multiple agencies. The program’s high-touch, on-the-ground approach helps connect participants to the important health care services they need. The Whole Person Care Program includes outreach and integrated care coordination to disparate and historically underserved populations in an effort to engage individuals in mental health services, as well as to expand community health center partner outreach and case management capacity. Federally Qualified Health Centers and community-based peer organizations are integral members of the multi-disciplinary teams that focus on this vulnerable population and support comprehensive care management between different types of needed services.
In calendar year 2020 (Year 5 of Whole Person Care), 1,457 individuals were served through outreach and engagement and 154 of these individuals participated in Intensive Case Management. Among those 154 clients:
- (92%) Enrolled in Medi-Cal
- (10%) Enrolled in General Assistance
- (68%) Enrolled in CalFresh
- (31%) Enrolled in SSI
- (31%) Placed in a Shelter or Temporary Housing
- (30%) Placed in Permanent Housing
- (64%) Enrolled in Coordinated Entry
- (6%) Placed in residential substance use treatment
- (5%) Enrolled in Mental Health services
Continuing contracts with health centers will allow services to be available to help address the needs of the vulnerable population. The health centers provide staff who will work and collaborate with the Department’s Whole Person Care team. Collaboration will be achieved through multi-disciplinary team meetings and exchange of information. They will also identify potential eligible Whole Person Care Program clients, link clients to primary care at community health centers, assist local emergency departments with expediting the discharge and coordinating the care of clients experiencing a medical event, and collect, document, and report all activities performed related to the Whole Person Care Program. The peer services providers will be responsible for helping individuals and their support system navigate and access community services, other resources, and introduce healthy behaviors. Additionally they support Whole Person Care staff through an integrated approach to care management and community outreach, provide social support and informal counseling, advocate for individuals and community health needs.
On August 4, 2020, your Board allocated delegated authority in the amount of $975,506 for these health centers. The Department is requesting an additional $1.386 million of delegated authority through December 2021. The Department plans to adjust the contracts and delegated authority with health contractors in the amounts shown in this table below:
|
Contractor |
FY 20-21 Delegated Authority per 8/4/21 Board Item |
Delegated Authority Needed Jan-Jun 2021 |
FY 21-22 Delegated Authority Jul-Dec 2021 |
|
Alliance Medical Center |
85,000 |
(85,000) |
- |
|
Coppertower Family Medical Center Inc dba Alexander Valley Healthcare |
126,029 |
- |
- |
|
Drug Abuse Alternatives Center |
136,500 |
117,650 |
119,600 |
|
Drug Abuse Alternatives Center |
- |
29,645 |
29,645 |
|
Petaluma Health Center |
161,300 |
49,136 |
100,394 |
|
Santa Rosa Community Health Centers |
201,415 |
335,000 |
335,000 |
|
West County Community Services |
164,837 |
10,083 |
125,000 |
|
West County Health Centers |
100,425 |
110,000 |
110,000 |
|
Total |
975,506 |
566,514 |
819,639 |
This item also includes a request for approval of a budget resolution adjusting the fiscal year 2020-2021 budget to support the Whole Person Care Program. Additional appropriations are necessary to accommodate additional program funding provided by the state for January 1, 2021 through June 30, 2021.
Prior Board Actions:
On August 4, 2020 the Board approved agreements and amendments for mental health and substance use disorder services, including several to support the Whole Person Care Program.
Fiscal Summary
|
Expenditures |
FY 20-21 Adopted |
FY 21-22 Projected |
FY 22-23 Projected |
|
Budgeted Expenses |
1,157,391 |
819,639 |
|
|
Additional Appropriation Requested |
566,514 |
|
|
|
Total Expenditures |
1,723,905 |
819,639 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
1,440,648 |
819,639 |
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
283,257 |
|
|
|
Contingencies |
|
|
|
|
Total Sources |
1,723,905 |
819,639 |
0 |
Narrative Explanation of Fiscal Impacts:
Additional appropriations and delegated authority for Whole Person Care are needed due to the state extending the program through December 31, 2021. For FY 20-21, the Department is requesting additional appropriations in the amount of $566,514 to bring the total appropriations for WPC contracts to $1.723 million. Appropriations for July - December 2021 are included in the Department’s recommended budget in the amount of $819,638.
Additional Delegated Authority to execute contracts in the amount of $566,514 is requested for FY 2020-21 and $819,639 for July through December of 2021 for a total of $1.386 million.
Funding will come from Whole Person Care revenue with the match coming from Mental Health Services Act accumulated fund balance. The Department anticipates savings in staffing due to vacancies that will offset the use of fund balance. However, the extent of the offset will not be fully known until the end of the fiscal year. The Department may reallocate funds across contractors depending on spending and ramp-down that will vary by vendor/provider.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - List of Whole Person Care Contracts
Attachment 2 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None