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: 4/5th
Supervisorial District(s): Countywide
Title:
Title
California Accountable Communities for Health Initiative Grant
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services to execute a grant agreement with Community Partners to accept $200,000 in revenue to support participation in the California Accountable Communities for Health Initiative through which the Department and Health Action will continue implementation of a local Accountable Community for Health to address the most pressing health issues facing our communities, for the period September 1, 2019 through August 31, 2021.
B) Adopt a resolution adjusting the fiscal year 2019-2020 adopted budget by increasing revenues and expenditures in the Department of Health Services by $51,982 to include grant funding from Community Partners. (4/5th Vote Required)
C) Adopt a resolution amending the position allocation list of the Department of Health Services to extend the term of an existing full-time time-limited Health Program Manager position through August 31, 2021.
end
Executive Summary:
Since 2016 the Department of Health Services has received grant funding totaling $850,000 from Community Partners for the California Accountable Communities for Health Initiative to support the transformation of Health Action into a local Accountable Community for Health. The Department has been awarded an additional $200,000 to continue this work through 2021. This item requests approval to execute a grant agreement with Community Partners to accept $200,000 in revenue through August 2021. This funding will enable Health Action to continue implementation of the innovative local Accountable Communities for Health model, including establishing a wellness fund, advancing racial equity, expanding data sharing, and reducing the number of preventable heart attacks and strokes through a portfolio of strategies that links local health care systems, providers, and health plans to public health, community, and social services organizations serving diverse communities in Sonoma County.
This item also requests approval to 1) adjust the Department’s fiscal year 2019-2020 budget to reflect receipt of grant revenue and associated expenditures, and 2) extend the term of an existing full-time time-limited Health Program Manager position through August 31, 2021.
Discussion:
California Accountable Communities for Health Initiative was established by The California Endowment, Blue Shield of California Foundation, Kaiser Permanente, and Sierra Health Foundation to lead efforts to modernize the health system and build healthier communities. The initiative aims to improve the health system of entire communities, not just individual patients, and will result in greater health equity. To realize this vision, California Accountable Communities for Health Initiative is utilizing a new model known as Accountable Communities for Health. An Accountable Communities for Health is a groundbreaking vehicle for collaboration across multiple sectors to address the most pressing health issues facing our communities. It brings together clinical providers with public health departments, social service agencies, nonprofit organizations, business groups, and others, in a collective effort to make a community healthier.
By coordinating and aligning activities to address particular health issues in a community, an Accountable Communities for Health can achieve meaningful and lasting improvements in individual and population health. The goals are: 1) improve community-wide health outcomes and reduce disparities with regard to identified health needs; 2) reduce costs associated with health care and, potentially, non-health sectors; and 3) develop financing mechanisms through a self-sustaining wellness fund, to sustain the Accountable Communities for Health and provide ongoing investments in prevention and system-wide efforts to improve population health.
The Department of Health Services was originally selected as one of six innovative communities in California to receive $250,000 in 2016 to support the development of a local Accountable Communities for Health structure and model. The Department was awarded an additional $600,000 over two additional years to advance this work through 2019. The proposed grant agreement with Community Partners provides an additional $200,000 to continue local Accountable Communities for Health efforts through 2021. Community Partners is a Los Angeles-based non-profit contracted to manage the California Accountable Communities for Health Initiative grantmaking process and serve as the administrative home for the initiative. For over 20 years Community Partners has worked with individuals, groups, foundations, and other institutions to create new non-profits, establish coalitions, and manage major initiatives such as the California Accountable Communities for Health Initiative.
Using Health Action's existing multi-sector partnerships and current work as a foundation for the Sonoma Accountable Communities for Health, the Department of Health Services and Health Action are building off the success of Health Action’s Committee for Healthcare Improvement’s “Hearts of Sonoma” initiative to focus on cardiovascular disease, as it remains the County’s most prevalent chronic health condition and a leading cause of death.
In the first three years of the California Accountable Communities for Health Initiative efforts, Health Action made significant progress in advancing the initiative’s goals. Partners established the shared goal of reducing the number of preventable heart attacks and strokes and developed a comprehensive strategy across community and clinical settings to achieve the long-term goal of reducing preventable heart attacks and strokes. Organizations aligned their existing work and collaborated to develop and implement newly identified interventions as part of a cohesive portfolio. Aggregated blood pressure data to date indicate a 20 percent overall improvement in hypertension control since 2014 for adult patients of Hearts of Sonoma County clinical partner organizations. Though the initial focus of the California Accountable Communities for Health Initiative was addressing cardiovascular disease, the work is in service of the long-term goal of applying the Accountable Communities for Health model as a framework for all of Health Action’s work to address social determinants of health and other root causes of health inequities. Health Action has made significant progress in expanding the Accountable Communities for Health model to all of its efforts in the last few years. Health Action chapters designed a community engagement guide for authentically engaging community members and developing community leaders. They subsequently hosted a daylong training for over 100 community members to implement these strategies. Health Action formed a Wellness Fund Development Team with the goal of launching a wellness fund to support Health Action priorities.
In the next two years, Health Action will continue to focus on implementing the following core elements of the Accountable Communities for Health model: sustainable financing, racial equity, data sharing, and the portfolio of interventions. Health Action will establish a wellness fund to support sustainable financing for community health priorities. Health Action will address racial disparities in health outcomes by implementing racial equity trainings and applying racial equity tools to its work. Health Action will establish a data dashboard to track shared outcomes. Hearts of Sonoma County clinical and community partners will continue to expand the portfolio of strategies to reduce preventable heart attacks and strokes and Cradle to Career will develop a portfolio of strategies to address early childhood education.
Staffing Request to Support the California Accountable Communities for Health Initiative: At the September 13, 2016 Board meeting, the Board approved one new full-time limited-term Health Program Manager position to support the California Accountable Communities for Health Initiative. In January 2018, when additional grant funding was confirmed, the Health Program Manager position was extended to August 31, 2019. The fiscal year 2019-2020 supplemental budget included funding for the Health Program Manager position along with an extension of the allocation’s term through September 30, 2020 to align with an extension to the grant term. With confirmation of additional funding through August 31, 2021, the Department is requesting, via resolution, an extension of the term for the full-time time-limited Health Program Manager position through August 31, 2021. The Health Program Manager filling this position currently spends 60% of their time supporting California Accountable Communities for Health Initiative efforts and 40% of their time supporting other Health Action efforts.
Budget Adjustment Needed for Community Partners Grant Revenue and Associated Expenditures: The Department is requesting, via resolution, an adjustment to the Department’s fiscal year 2019-2020 adopted budget by increasing revenues and expenditures by $51,982 to include grant funding from Community Partners.
Strategic Plan Alignment: Accountable Communities for Health initiatives can achieve meaningful and lasting improvements in individual and population health by improving community-wide health outcomes and reducing disparities with regard to identified health needs and by reducing costs associated with health care.
Prior Board Actions:
In June 2019 the Board approved an extension of the Health Program Manager allocation through September 30, 2020 as part of the budget approval process.
On January 9, 2018 the Board 1) approved a grant agreement with Community Partners to accept $600,000 in revenue to support participation in the California Accountable Communities for Health Initiative through which the Department and Health Action will continue implementation of an Accountable Communities for Health to address the most pressing health issues facing our communities, for the period September 1, 2017 through August 31, 2019, and 2) adopted a resolution amending the position allocation list of the Department of Health Services to extend the term of an existing full-time time-limited Health Program Manager position through August 31, 2019.
On December 5, 2017 the Board approved the Health Action: Framework for Action and its priority strategies to improve the health and well-being of all Sonoma County residents through partnerships and planning with community partners and residents.
On September 13, 2016 the Board approved 1) a grant agreement with Community Partners to accept $250,000 in revenue to support participation in the California Accountable Communities for Health Initiative through August 31, 2017 and 2) one new full-time limited-term Health Program Manager position to support the California Accountable Communities for Health Initiative.
Fiscal Summary
|
Expenditures |
FY 19-20 Adopted |
FY 20-21 Projected |
FY 21-22 Projected |
|
Budgeted Expenses |
|
148,018 |
0 |
|
Additional Appropriation Requested |
51,982 |
|
|
|
Total Expenditures |
51,982 |
148,018 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
|
|
|
|
Fees/Other |
51,982 |
148,018 |
0 |
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
51,982 |
148,018 |
0 |
Narrative Explanation of Fiscal Impacts:
Grant revenue and expenditures of $51,982 will be added to the FY 19-20 budget via the attached budgetary adjustment resolution. FY 20-21 revenue and expenditures of $148,018 will be included in the FY 20-21 budget.
The annualized salary and benefits cost of the 1.0 full-time equivalent time-limited Health Program Manager position is approximately $184,642. Funding for this position was included in the FY 19-20 budget. The Health Program Manager filling this position currently spends 60% of their time supporting California Accountable Communities for Health Initiative efforts and 40% of their time supporting other Health Action efforts. Approximately $348,000 of the previous California Accountable Communities for Health Initiative grant was unspent as of July 1, 2019 and available to fund program efforts during through August 2020.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Health Program Manager |
$7,128 - $8,663 |
0.0 |
0.0 |
|
|
|
|
|
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
No new position(s) are being requested. The Health Program Manager position currently supporting the California Accountable Communities for Health Initiative was added to the Department’s position allocation list via the fiscal year 2016-2017 first quarter consolidated budget adjustments process. The position term is currently scheduled to end on September 30, 2020. With confirmed additional California Accountable Communities for Health Initiative funding, the Department is requesting, via resolution, an extension of the term for the full-time time-limited Health Program Manager position through August 31, 2021.
Attachments:
Grant agreement with Community Partners, budgetary adjustment resolution, personnel resolution
Related Items “On File” with the Clerk of the Board:
None