To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Barbie Robinson, 565-7876
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Project Nightingale Respite Care Program Agreements
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services to execute the second amendment to an agreement with Catholic Charities of the Diocese of Santa Rosa to provide expanded post-acute medical respite care program services for homeless individuals, increasing the amount by $337,500, resulting in a new not-to-exceed amount of $1,687,500 and extending the term end date from June 30, 2019 to December 31, 2019.
B) Authorize the Director of Health Services to execute revenue agreements with Kaiser Foundation Hospitals, Sutter Medical Center of Santa Rosa, St. Joseph Health/Santa Rosa Memorial Hospital, and Partnership HealthPlan of California to accept revenue that will fund the second amendment to the agreement with Catholic Charities of the Diocese of Santa Rosa through December 31, 2019 for a total amount not to exceed $337,500.
end
Executive Summary:
Catholic Charities’ Project Nightingale program provides post-acute medical respite care for homeless persons who are too ill or frail to recover from a physical illness or injury on the streets, but are not ill enough to be in a hospital or skilled nursing facility. On August 15, 2017 the Board approved an agreement with Catholic Charities of the Diocese of Santa Rosa to provide expanded post-acute medical respite care program services for homeless individuals from July 1, 2017 through December 31, 2017 and on June 11, 2018 the Board approved an amendment to the agreement to continue services through June 30, 2019. This item requests approval of an amendment to the agreement for Catholic Charities to continue to provide services through December 31, 2019.
Funding for the agreement with Catholic Charities, including the proposed amendment, is provided by St. Joseph Health/Santa Rosa Memorial Hospital, Sutter Medical Center of Santa Rosa, Kaiser Foundation Hospitals, and Partnership HealthPlan of California. This item includes a request for authorization to enter into agreements with these organizations to receive revenue to fund the agreement with Catholic Charities.
Discussion:
In Sonoma County, approximately two percent of the population experiences homelessness. The homeless often suffer from mental health and substance use issues, and have disproportionate rates of acute and chronic illness. When the homeless require hospitalization in a Sonoma County hospital, the absence of a safe environment for discharge often leads to more serious illness; complicates discharge planning; and results in longer inpatient stays, higher rates of re-admission, and increased use of the emergency room. The impact on our local health system is increased health care costs, and for the homeless patient, reduced health outcomes.
The Catholic Charities’ Project Nightingale program provides medical respite care, with a focus on post-acute medical care for homeless individuals who are too ill or frail to recover from a physical illness or injury on the streets, but are not ill enough to be in a hospital or skilled-nursing facility. Clients have access to three meals per day and bed rest as needed. The Department has contracted with Catholic Charities for Nightingale program services since April 2013 through a series of services agreements. The current agreement was originally approved by the Board on August 15, 2017 for services from July 1, 2017 through December 31, 2017 and was amended on June 11, 2018 to allow for the continuation of services through June 30, 2019. This item requests approval of an amendment to the agreement with Catholic Charities to allow for the continuation of direct services through December 31, 2019. During this extension period staff will work with community partners to develop a consensus regarding next steps for the program.
Funding for the proposed agreement with Catholic Charities will be provided by St. Joseph Health/Santa Rosa Memorial Hospital, Sutter Medical Center Santa Rosa, Kaiser Foundation Hospitals, and Partnership HealthPlan of California. This item includes a request to authorize the Director of Health Services to execute revenue agreements with these community partners to accept revenue to fund the proposed amendment.
From July 1, 2018 through March 31, 2019 the program provided 26 medical respite beds, which allowed 327 homeless clients to receive short-term, residential care and the opportunity to rest in a safe environment while accessing medical care and other supportive services. In addition, the integrated home health care services provided by St. Joseph Home Care Network connected 11 clients to permanent housing.
The Project Nightingale program is an efficient and cost-effective way to provide respite care and wrap-around care coordination for homeless individuals. This program supports the County’s strategic goal of a safe, healthy, and caring community and the goal of economic stewardship as it creates downstream cost savings across the County. The program also aligns with the Department’s strategic plan goal regarding access to high quality and coordinated services for health and recovery. Project Nightingale is an existing program funded by partner organizations and has not been evaluated for potential program and contract changes to better align with the contracting principles for safety net programs. Should the Department continue to contract for Project Nightingale services beyond the term of the proposed contract extension, the Department will assess how best to align the program with the contracting principles.
Prior Board Actions:
On June 11, 2018 the Board authorized the Director of Health Services to execute 1) the first amendment to an agreement with Catholic Charities of the Diocese of Santa Rosa to provide expanded post-acute medical respite care program services for homeless individuals, increasing the amount by $1,012,500, resulting in a new not-to-exceed amount of $1,350,000 and extending the term end date from December 31, 2017 to June 30, 2019 and 2) revenue agreements with Kaiser Foundation Hospitals, Sutter Medical Center of Santa Rosa, St. Joseph Health/Santa Rosa Memorial Hospital, and Partnership HealthPlan of California to accept revenue that will fund the first amendment to the agreement with Catholic Charities of the Diocese of Santa Rosa and will provide funding for administrative costs through June 30, 2019 for a total amount not to exceed $1,139,063.
On August 15, 2017 the Board approved an agreement with Catholic Charities of the Diocese of Santa Rosa to provide post-acute medical respite care services for homeless individuals for the period of July 1, 2017 through December 31, 2017.
On June 14, 2016 the Board approved an agreement with Partnership HealthPlan of California to accept $250,000 in revenue to provide expanded post-acute medical respite care pilot program services for homeless individuals for the period of July 1, 2016 through June 30, 2017. Additionally, the Board authorized the Director of Health Services to execute revenue agreements with Kaiser Foundation Hospitals, Sutter Medical Center of Santa Rosa, and St. Joseph - Sonoma County up to a total amount of $615,000 in revenue to provide expanded post-acute medical respite care pilot program services for homeless individuals for the period of July 1, 2016 through December 31, 2017.
On March 1, 2016 the Board approved a grant agreement with Kaiser Foundation Hospitals Fund for Community Benefit Programs at the East Bay Community Foundation to accept $205,000 in revenue to provide expanded post-acute medical respite care pilot program services for homeless individuals for the period January 1, 2016 through January 1, 2017.
On August 11, 2015 the Board approved an agreement with Catholic Charities of the Diocese of Santa Rosa to provide expanded post-acute medical respite care pilot program services for homeless individuals for the period of July 1, 2015 through June 30, 2017 for a total of $1,350,000.
Fiscal Summary
|
Expenditures |
FY 19-20 Adopted |
FY 20-21 Projected |
FY 21-22 Projected |
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Budgeted Expenses |
337,500 |
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Additional Appropriation Requested |
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Total Expenditures |
337,500 |
0 |
0 |
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Funding Sources |
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General Fund/WA GF |
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State/Federal |
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Fees/Other |
337,500 |
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Use of Fund Balance |
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Contingencies |
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Total Sources |
337,500 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
Revenue and expenditures associated with the proposed amendment to the agreement with Catholic Charities and partner revenue agreements are included in the FY 19-20 budget.
Since 2015 the Department has received a total of $2,391,063 from Project Nightingale partners (St. Joseph Health/Santa Rosa Memorial Hospital, Sutter Medical Center Santa Rosa, Kaiser Foundation Hospitals, and Partnership HealthPlan of California). Funding for the proposed agreement amendment will be provided by these community partner organizations.
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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:
Second amendment to agreement with Catholic Charities of the Diocese of Santa Rosa
Related Items “On File” with the Clerk of the Board:
None