To: Board of Supervisors
Department or Agency Name(s): Human Services
Staff Name and Phone Number: Paul Dunaway 565-3673, Tracy Repp 565-5982
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Area Agency on Aging Medicare Improvements for Patients and Providers Act Fiscal Year 2022-23 Standard Agreement and Emergency Funding for Provider Contracts for American Rescue Plan Act and Older Adults Recovery and Resilience funding
End
Recommended Action:
Recommended action
A) Adopt a resolution authorizing the Director of the Human Services Department to execute the Medicare Improvement for Patients and Providers Act Standard Agreement #MI-2223-27 with the State of California Department of Aging to receive funding of $104,683.
B) Adopt a resolution authorizing budgetary adjustments to the FY 2022-23 Human Services budget to increase appropriations in the amount of $9,356 to reflect increased funding from the State of California Department of Aging for the Medicare Improvement for Patients and Providers Act Standard Agreement #MI-2223-27. (4/5 Vote Requirement)
C) Adopt a resolution authorizing budgetary adjustments to the FY 2022-23 Human Services budget by increasing appropriations in the amount of $812,964 to reflect a new American Rescue Plan Act funding allocation from the California Department of Aging. (4/5 Vote Requirement)
D) Authorize the Director of the Human Services Department to execute contracts with Council on Aging to provide intergenerational activities and nutrition services in the amount of $247,898, and with Legal Aid of Sonoma County to provide legal services to older adults in the amount of $332,626, using Older Adults Recovery and Resilience funding distributed by the State of California Department of Aging totaling $580,524.
E) Authorize the Director of the Human Services Department to execute contracts with Ceres Community Project, Council on Aging, and Petaluma People Services Center using American Rescue Plan Act funding distributed by the California Department of Aging totaling $1,178,443.
F) Approve the new Sonoma County Area Agency on Aging Grievance Policy. A Grievance Policy is required per the Older Americans Act Section 306 (10) for the Area Agency on Aging to provide a procedure for older individuals who are dissatisfied with or denied services.
(4/5th Vote Required)
end
Executive Summary:
Each year the Sonoma County Area Agency on Aging (AAA) receives funding from the California Department of Aging (CDA) to support the Medicare Improvement for Patients and Providers Act program (MIPPA). The CDA requires the AAA to provide a Resolution authorizing the Director of the Human Services Department (HSD) to execute the Standard Agreement.
HSD requests FY 2022-23 budgetary adjustments to account for additional MIPPA funding and new American Rescue Plan Act (ARPA) funding. Older Adults Recovery and Resilience (OARR) funding was previously accepted by the Board on September 13, 2022.
HSD requests authorization for the Director of HSD to execute contracts with Council on Aging and Legal Aid of Sonoma County. This reflects emergency funding received from CDA as part of the OARR Nutrition Programs for Intergenerational Activities and Legal Services funding. The OARR standard agreement was approved on September 13, 2022, by this board.
HSD requests authorization for the Director of HSD to execute contracts with Ceres Community Project, Council on Aging, and Petaluma People Services Center, which reflects emergency funding received from CDA as part of ARPA.
The Grievance Policy for approval in this Board item was created in accordance with guidance from CDA. A Grievance Policy is required per the Older Americans Act Section 306 (10) for the AAA to provide a procedure for older individuals who are dissatisfied with or denied services. Per federal regulation, the Sonoma County Board of Supervisors is the governing board of the AAA and holds the responsibility of approving the AAA Grievance Policy.
Discussion:
The AAA is responsible for planning, advocating, and providing funding for services that support the needs of older adults, adults with disabilities, and their caregivers throughout Sonoma County. This board item puts forward requests regarding the funding that the AAA has received and contracts with local service providers for programs and services to support these needs.
I. Medicare Improvement for Patients and Providers Act Program
MIPPA funding is used to provide expanded outreach, awareness, and education efforts to older individuals currently receiving Medicare who are unaware of valuable benefits. Services include targeted education to assist Medicare beneficiaries to apply for benefits if they are not currently receiving them. MIPPA funding is allocated on a year-by-year basis and is based on a modified federal fiscal year (FFY) funding cycle of September 1 through August 31.
The HSD Adult and Aging Division is requesting that the Board adopt two resolutions designated for the MIPPA program.
The first resolution is a CDA requirement confirming the Director of HSD is authorized to execute the CDA revenue contract accepting federal funding for MIPPA services.
The second is a resolution authorizing budgetary adjustments to the FY 2022-2023 HSD budget in the amount of $9,356 for MIPPA due to the increase in funding.
II. Older Adults Recovery and Resilience Funding Service Provider Contracts
The AAA has received time-limited OARR funding for the term of October 15, 2022 through December 31, 2024 for a total of $1,151,611. The total to allocate to local service providers is $1,036,450 after deducting the allowable Administrative cost of $115,161. The board item from September 13, 2022 approved this administrative funding with additional emergency funds to add a time-limited Program Development Manager in the AAA.
Per CDA guidance, the purpose of the OARR funding is to strengthen older adults, adults with disabilities, and caregivers’ recovery and resilience from the severe isolation and health impacts from staying at home during the COVID-19 pandemic. OARR serves as an additional resource to help aid the transition of older Californians back into their local communities, which will reduce isolation and loneliness, and mitigate other health concerns.
The request to accept the OARR funding allocation into the Human Services budget was brought to the Board of Supervisors and approved at the meeting on September 13, 2022. This Board request is to approve the service provider contracts resulting from the OARR funding received.
The OARR funding is dedicated to support four distinct programs with separate budget allocations totaling $1,036,450. The four programs are:
1) Older Adult Nutrition and Intergenerational Nutrition Activities: $428,531
2) Fall Prevention Home Modifications and Education: $218,349
3) Legal Services: $332,626
4) Caregiver Support Services: $56,944
Contracts resulting from OARR funding with a total value of $100,000 or more over a twelve-month period are required to have Board of Supervisors’ approval. The two OARR contracts included in this board item meeting this threshold are with Council on Aging and Legal Aid of Sonoma County. Additional OARR funded contracts not requiring Board approval are listed below and identified as “Does not require Board of Supervisors’ Approval”.
A) Older Adult Nutrition and Intergenerational Nutrition Activities: $428,531
Contract terms are October 15, 2022 through December 31, 2024.
A Request for Applications was released on March 31, 2022 resulting in contracting with three existing AAA older adult nutrition service providers listed below. The providers will develop and implement intergenerational activities that connect older adults with younger generations. The activities will promote greater understanding and respect between generations and strengthen older adults’ recovery and resilience from the isolation and health impacts from COVID.
$247,898 - Council on Aging - Requires Board of Supervisors’ Approval
$65,578 - Ceres Community Project - Does not require Board of Supervisors’ approval
$115,055 - Petaluma People Services Center - Does not require Board of Supervisors’ approval given that the term is over two years and does not exceed the threshold of $100,000 over a 12-month period.
B) Fall Prevention Home Modifications and Education: $218,349
Contract terms are October 15, 2022, through December 31, 2024 between CDA and HSD.
The OARR funding is to provide fall-prevention modifications, education, outreach, and training to reduce falls in older adults and adults with disabilities. This service is provided by the Human Services Department and is not contracted out.
C) Legal Services: $332,626
Contract terms are October 15, 2022 through December 31, 2024.
A Request for Application was released on June 2, 2022; Legal Aid of Sonoma County was the sole applicant. This service is contracted to Legal Aid of Sonoma County and requires Board of Supervisor’s Approval.
The OARR funding is designed to expand existing legal services that assist older adults and older adults with disabilities, with a variety of legal problems concerning housing, consumer fraud, elder abuse, Social Security, Supplemental Security Income (SSI), Medicare, Medi-Cal, age discrimination, pensions, nursing homes, protective services, conservatorships, and other matters.
D) Caregiver Support Services: $56,944
Contract terms are October 15, 2022, through December 31, 2024.
The purpose of this funding is to strengthen older adults and caregivers’ recovery and resilience by providing assessment of caregiver needs, caregiver support groups, and respite. Funding was allocated to the existing AAA caregiver support providers listed below.
$5,694 - Alzheimer’s Association - Does not require Board of Supervisors’ Approval
$51,250 - Redwood Caregiver Resource Center - Does not require Board of Supervisors’ Approval
III. American Rescue Plan Act (ARPA) Funding
The AAA has received time-limited ARPA funding from the CDA for the term of April 21, 2021 through September 30, 2024 for a total of $1,846,128. The total funds available to allocate to local service providers is $1,668,970 after deducting the allowable administrative cost of $177,158.
On March 11, 2021, ARPA was signed into law in response to the COVID-19 pandemic. ARPA provides additional funding for existing Older Americans Act (OAA) programs. The ARPA funds are distinct and separate from regular OAA funds.
The CDA distributed federal ARPA funds to local AAAs who then contracted with local service providers that support older adults and adults with disabilities to remain in the home of their choice for as long as possible. ARPA funding was allocated in the CDA FY 2021-22 Standard Agreement Amendment #3. The Board approved the initial OAA Standard Agreement for FY 2021-22 on June 8, 2021, and authorized the Director of HSD to execute the AAA Area Plan Standard Agreement #AP-2122-27 with CDA for FY 2021-22 and to execute future Standard Agreement amendments to adjust for revenue levels based on future changes to funding.
This Board request is to approve the service provider contracts resulting from the ARPA funding received.
Contracts from this funding with a total value of $100,000 or more over a twelve-month period are required to have Board approval. The three contracts included in this Board item meeting this threshold are Ceres Community Project, Council on Aging, and Petaluma People Services Center. In addition to these providers the contracts not requiring Board approval are also listed below:
Total ARPA Allocation: $1,846,128
All funding was allocated to existing AAA service providers with the exception of Senior Center Activities. Funding for Senior Center Activities is specifically to be contracted to senior centers. All nine Sonoma County Senior Centers were contacted to respond to the AAA solicitation for inclusion to receive this dedicated funding and seven of the nine Senior Centers requested to be funded. The contract terms are October 15, 2022 through September 30, 2024.
ARPA provides additional funding for existing OAA programs. The ARPA funds are distinct and separate from regular OAA funds.
$303,056 - Ceres Community Project - Requires Board of Supervisors’ Approval
• Home Delivered Meals for seniors.
$461,620 - Council on Aging - Requires Board of Supervisors’ Approval
• Congregate Meals for seniors.
• Alzheimer’s Day Program
$413,767 - Petaluma People Services Center - Requires Board of Supervisors’ Approval
• Case Management for seniors.
• Congregate Meals for seniors.
• Fall Prevention
• Home Delivered Meals for seniors.
• Telephone Reassurance for seniors.
• Transportation and Mobility Management for seniors.
ARPA contracts Not Requiring Board of Supervisors’ Approval:
$29,379 - Alzheimer’s Association - Caregiver Support Groups
$90,000 - Catholic Charities - Telephone Reassurance, Transportation and Mobility
$15,000 - Circuit Rider - Transportation and Mobility
$10,000 - Coastal Seniors - Congregate Meals
$10,000 - Cloverdale Senior Center - Senior Center Activities
$10,000 - Healdsburg Senior Center - Senior Center Activities
$168,484 - Redwood Caregiver Resource Center - Caregiver Respite, Caregiver Support Groups ($84,242 per year that does not require Board approval)
$15,478 - Northern California Center for Well-Being - Diabetes Self-Management and Education
$10,000 - Petaluma Senior Center - Senior Center Activities
$39,086 - Sebastopol Area Senior Center - Transportation and Mobility, Senior Center Activities
$16,958 - Senior Advocacy Services - Ombudsman
$10,000 - Vintage House Senior Center - Senior Center Activities
$10,000 - Windsor Senior Center - Senior Center Activities
$35,022 - West County Community Services - Case Management, Senior Center Activities
$21,120 - Website Supports
$177,158 - Administrative Cost
IV. Grievance Policy Approval of the Sonoma County Area Agency on Aging
The Sonoma County Board of Supervisors is the governing board of the AAA, which is administered by the Adult & Aging Services Division of HSD. The Sonoma County AAA is part of a national system of Area Agencies on Aging created by the OAA. The AAA’s mission is to provide leadership, services, and advocacy to promote the dignity, independence, and quality of life for older adults, adults with disabilities, and their caregivers.
As the governing board of the AAA, the Board has the responsibility of final approval of changes to the AAA Grievance Policy. A grievance policy is required per the Older Americans Act Section 306 (10) for the AAA to provide a procedure for older individuals who are dissatisfied with or denied services. AAA did not previously have a grievance policy in place. The grievance policy for approval in this board item was created in accordance with the CDA.
Strategic Plan:
N/A
Prior Board Actions:
September 13, 2022 - Board of Supervisors adopted a resolution to Authorize the Director of the Human Services Department to execute contract #IF-2223-27 with CDA to accept OARR Intergenerational Nutrition and Legal Services funding.
October 19, 2021: Board approved Resolution #21-0873 authorizing the Director of Human Services to execute an agreement for MIPPA funding.
June 8, 2021 - Board approved the Human Services Director to execute CDA Area Plan Standard Agreement #AP-2122-27.
April 21, 2020 - Authorized the Human Services Department Director to accept COVID-19 Emergency Funding from the CDA
September 22, 2020: Board approved Resolution #20-0358 authorizing the Director of Human Services to execute an agreement for MIPPA funding.
October 16, 2018: Board approved Resolution #18-0433 authorizing the Director of Human Services to execute an agreement for MIPPA funding.
Fiscal Summary
|
Expenditures |
FY 22-23 Adopted |
FY 23-24 Projected |
FY 24-25 Projected |
|
Budgeted Expenses |
95,327 |
812,964 |
203,242 |
|
Additional Appropriation Requested |
822,320 |
|
|
|
Total Expenditures |
$917,647 |
$812,964 |
$203,242 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
917,647 |
812,964 |
203,242 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
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|
|
Contingencies |
|
|
|
|
Total Sources |
$917,647 |
$812,964 |
$203,242 |
Narrative Explanation of Fiscal Impacts:
ARPA funding in the amount of $1,829,170 was not budgeted for FY 2022-23. HSD requests approval to increase FY 2022-23 appropriations by $812,964 based on a contract term of 27 months as follows: FY 2022-23 $812,964 (12 months), FY 2023-24 $812,964 (12 months), and FY 2024-25 $203,242 (3 months).
HSD’s FY 2022-23 budget only assumed MIPPA revenue of $95,327. The CDA awarded HSD MIPPA revenue of $104,683 for FY 2022-23. HSD requests approval to increase FY 2022-23 appropriations by $9,356 due to unanticipated revenues.
Total expenditures in FY 2022-23 will total $917,647 based on budgeted expenses of $95,327 for MIPPA and additional appropriations requested of $822,320 ($812,964 for ARPA and $9,356 for MIPPA.
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Staffing Impacts: |
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Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - MIPPA CDA Resolution
Attachment 2 - MIPPA Budget Resolution
Attachment 3 - MIPPA Standard Agreement #MI-2223-27
Attachment 4 - ARPA Funding Resolution-Budget Changes for FY2022-
Attachment 5 - OARR Council on Aging-Intergenerational Nutrition
Attachment 6 - OARR Legal Aid of Sonoma County Contract - Senior Legal Services
Attachment 7 - ARPA Ceres Community Project Contract - Senior Nutrition
Attachment 8 - ARPA Council on Aging Contract - Senior Nutrition
Attachment 9 - ARPA Petaluma People Services Center Contract - Senior Nutrition
Attachment 10 - Sonoma County Area Agency on Aging Grievance Policy
Related Items “On File” with the Clerk of the Board:
California Department of Aging Area Plan Standard Agreement #AP-2122-27