To: Board of Supervisors
Department or Agency Name(s): Human Services
Staff Name and Phone Number: Paul Dunaway 565-3673, Sara Avery 565-6722
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Adult and Aging Home and Community Based Alternatives Waiver Standard Agreement
End
Recommended Action:
Recommended action
Adopt a Resolution Authorizing the Director of the Human Services Department to execute the State of California Department of Health Care Services Home and Community Based Alternatives Waiver Standard Agreement AA-DCHS-HCBA-2427 in the amount of $5,011,780 for the term of January 1, 2024 to December 31, 2027 and authorize the director to execute future Standard Agreement amendments to adjust for changes to funding during this period.
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Executive Summary:
The Human Services Department is requesting that the Board adopt a resolution authorizing the Director of the Human Services Department to execute the Home and Community Based Alternatives Waiver Standard Agreement with the State of California Department of Health Care Services in the amount of $5,011,780 and authorize the Director of the Human Services Department to execute future contract amendments for subsequent contract years. The Home and Community Based Alternatives Waiver program provides home-based care management services to persons at risk for nursing home or institutional placement.
Discussion:
The Human Services Department (HSD) was awarded a contract with the State of California Department of Healthcare Services (DHCS) to fund the Home and Community Based Alternatives (HCBA) Waiver care management services. The Human Services Department, Adult and Aging division implemented HCBA in 2018 when initially awarded. The funding for the remainder of this fiscal year is $466,502. The term of this contract is from January 1, 2024 to December 31, 2027.
HCBA provides home-based care management services to Medi-Cal eligible Sonoma County residents of all ages who are at risk for nursing home or institutional placement due to complex medical conditions and significant functional support needs. The care management services are provided by a multidisciplinary care management team comprised of 3.0 FTE Senior Public Health Nurses, 5.0 FTE Adult and Aging Social Workers, and 1.0 FTE Adult and Aging Supervisor. This contracted funding from DHCS applies to the salary and benefits of these positions. The care management team coordinates waiver and state plan services (such as medical, behavioral health, In-Home Supportive Services, etc.), and arranges for other available long-term services and supports to be put in place for participants. Without care management and other support systems, HCBA participants would require placement in a skilled nursing facility or other institutional setting.
Strategic Plan:
N/A
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
12-14-2021 - Authorized a contract extension with DHCS for the HCBA program.
04-17-2018 - Authorized HSD to accept funding and execute a contract with DHCS for the HCBA program.
Fiscal Summary
|
Expenditures |
FY 23-24 Adopted |
FY 24-25 Projected |
FY 25-26 Projected |
|
Budgeted Expenses |
466,502 |
$1,070,122 |
$1,252,945 |
|
Additional Appropriation Requested |
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|
|
Total Expenditures |
$466,502 |
$1,070,122 |
$1,252,945 |
|
Funding Sources |
|
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General Fund/WA GF |
|
|
|
|
State/Federal (including Realignment) |
$466,502 |
$1,070,122 |
$1,252,945 |
|
Fees/Other |
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Use of Fund Balance |
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Contingencies |
|
|
|
|
Total Sources |
$466,502 |
$1,070,122 |
$1,252,945 |
Narrative Explanation of Fiscal Impacts:
HCBA revenue in the amount of $466,502 was budgeted for Fiscal Year (FY) 2023-24. This amount is for January 1, 2024 through June 30, 2024. The revenue will be allocated as follows: $466,502 for FY 2023-24, $1,070,122 for FY 2024-25, $1,252,945 for FY 2025-26, $1,435,768 for FY 2026-27, and $786,443 for FY 2027-28. No general fund contribution is needed.
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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):
Funding from DHCS pays for the salary and benefits for a care management team that includes 3.0 FTE Senior Public Health Nurses, 5.0 FTE Adult and Aging Social Workers, and 1.0 FTE Adult and Aging Supervisor. Without this funding, these positions would be eliminated.
Attachments:
1) Acceptance of Revenue Resolution
2) DHCS Standard Agreement
Related Items “On File” with the Clerk of the Board:
None