REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  October  10, 2017
CATEGORY:  Consent - Health and Human Services-4.

SUBJECT:

Far Northern Regional Center one time funding in order to meet the Federal Centers for Medicare and Medicaid Services (CMS) Home and Community-Based Services regulations for consumers.

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Melissa Janulewicz, Branch Director, HSSA Regional Services (530)245-7638

STAFF REPORT APPROVED BY:  Melissa Janulewicz, Branch Director, HHSA Regional Services

RECOMMENDATION

Take the following actions:  (1) Approve and authorize the Chairman to sign a retroactive revenue agreement (No. PS-2139) with the Far Northern Regional Center (FNRC) in an amount not to exceed $264,140 to enable the Health and Human Services Agency-Regional Services-Opportunity Center (OC) to provide services in the community to become compliant with new federal Home and Community Based Services regulations for the period July 1, 2017 through June 30, 2018; (2) approve a budget amendment increasing appropriations by $31,000 and revenue by $264,140 in the OC budget; and (3) approve the purchase of a new capital asset vehicle for the OC and increase the County Fleet by one vehicle.

SUMMARY

The Health and Human Services Agency (HHSA) Regional Services, Opportunity Center (OC) provides a variety of rehabilitation services including supported employment. In January 2014, the Federal Centers for Medicare & Medicaid Services issued final regulations that require Federal Home and Community-Based Services (HCBS) Medicaid funded services and supports to be provided in settings that are integrated in the community rather than center based. In recognition that service providers would need to modify services to be compliant with these new federal requirements, the State 2016 Budget Act (SB 826) contained $15 million to fund providers to make changes to provide services that are in compliance with the HCBS rules by March 2019. The Shasta County OC submitted a grant proposal to access this new FNRC funding and was awarded $264,140 to assist the program to start providing services in the community, rather than at the center, in compliance with the new federal regulations. 

DISCUSSION

The Shasta County Opportunity Center Work Activity Program currently has five staff responsible for 80 on-site clients who perform assembly, packaging, and shredding services for the community.  Additional staff, technology to improve client skills and manage information, and vehicles are necessary to transport clients out into the community as envisioned by the new HCBS rules.  The OC is excited to transition clients into the Community Integration Training program, but requires additional resources to supervise and transport groups of two to four clients into the community.  To meet the community integration requirements for the Work Activity Program, funds from the FNRC grant will be directed toward increased supervisory personnel, additional vehicles and other aids set forth below. These resources will allow the OC clients to perform work activities or educational activities in the community, as mandated by the new requirements.  Individual and small groups of clients (two to four) will be transported to various sites in the community to acquire skills and knowledge to assist them to integrate into the community. The necessary staff and equipment to be funded through the FNRC grant include:  two full-time and one half -time OC employees (two Employment Services Instructors and one half-time Job Developer funded for 12 months); administrative costs of 15% of staff salaries for oversight and administration of the program in accordance with State guidelines; one crew cab truck and one sedan for transporting clients within the community; cloud-based case management and Department of Labor compliant client payroll system (VERTEX) to provide services in a community setting while allowing real time access by staff to secured case information, case plans and the ability to enter data in a Health Insurance Portability and Accountability Act compliant system within the community setting; Reliant Learning training software for providing developmentally disabled population specific courses for staff and clients within an integrated community setting; and nine iPads and four MS Surface Pro 4 with protective covers and chargers to access training software in the community and participate in community employment preparation activities.

ALTERNATIVES

The Board could choose not to approve the agreement and/or direct the department to renegotiate the agreement terms.

OTHER AGENCY INVOLVEMENT

County Counsel has approved the agreement as to form.  Risk Management has approved the agreement.  The County Information Technology Department has approved the agreement. This recommendation has been reviewed by the County Administrative Office.

FINANCING

There is no General Fund impact form the recommended action. The OC staff, the new sedan, and new technology items, as well as the agreement revenue, were not included in the OC’s 2017-18 fiscal year Adopted Budget and thus a budget amendment is also recommended.