| | | | | | | | REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS
BOARD MEETING DATE: November 15, 2016
CATEGORY: Regular - Health and Human Services-11.
SUBJECT:
Whole Person Care Project Agreement with the California Department of Healthcare Services, Budget Amendments, and Salary Resolution |
| | | | | | | | DEPARTMENT: Health and Human Services Agency-Adult
Supervisorial District No. : All
DEPARTMENT CONTACT: Dean True, Branch Director, (530) 225-5900
STAFF REPORT APPROVED BY: Dean True, Branch Director
Vote Required?
4/5 Vote | General Fund Impact?
No Additional General Fund Impact |
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| | | | | | | | RECOMMENDATION
Take the following actions: (1) Approve and authorize the Chairman to sign a revenue agreement with the California Department of Healthcare Services for the Whole Person Care project, for the period from the date of signing through June 30, 2021 in the amount of $3,880,710 per Fiscal Year (FY) for FYs 2016-17 through 2020-21; (2) approve a budget amendment in the Health and Human Services Agency (HHSA)-Mental Health budget increasing appropriations by $992,756 and revenues by $1,940,355 (4/5 vote required); (3) approve a budget amendment in the Health and Human Services-Business and Support Services (BSS) budget increasing appropriations by $41,135, offset by an increase in the cost applied from HHSA-Mental Health budget in the amount of $41,135 (4/5 vote required); and (4) adopt a Salary Resolution which, effective November 13, 2016, amends Shasta County’s Position Allocation List to add three positions, all with sunset dates of June 30, 2021, for the HHSA as follows: (a) adds 1.0 Full-Time Equivalent (FTE) Community Development Coordinator and 1.0 FTE Senior Staff Services Analyst in the HHSA-Mental Health budget; and (b) adds 1.0 FTE Accountant Auditor I/II in the HHSA-BSS budget. |
| | | | | | | | SUMMARY
Approval of the Whole Person Care (WPC) Pilot revenue agreement with the Department of Health Care Services (DHCS) will allow implementation of the WPC Pilot project, establishing a demonstration project focused on coordinating care for individuals with complex behavioral and physical health conditions who are homeless or at risk of homelessness. |
| | | | | | | | DISCUSSION
In July 2016, the State Legislature adopted Welfare and Institutions Code (WIC) sections 14184 through 14184.80, known as the Medi-Cal 2020 Demonstration Project Act. Welfare and Institutions Code section 14184.60 establishes a demonstration project known as the Whole Person Care pilot program (WPC Pilot), which is focused on coordinating care for individuals with complex behavioral and physical health conditions who are homeless or at risk of homelessness. In June 2016, with the County Executive Officer’s approval, HHSA-Adult Services submitted a WPC Pilot application to DHCS for consideration and in September 2016 responded to a request for revisions to the application which were submitted with the final proposal. Shasta’s five-year pilot project was approved by DHCS on October 24, 2016 and has the potential of bringing up to $10,000,000 in funds into Shasta County over the next five years by leveraging existing funds to support the needs of program participants. This project represents an unprecedented level of coordination between government, medical, and social services agencies as we seek to find new ways to serve some of our most high-need community members. Under the WPC Pilot project, a multi-disciplinary team will provide services in a comprehensive integrated way.
Program participants will be assisted by intensive medical case managers, housing case managers, and volunteer peers. The program will also incorporate many of the strategies currently in development or recently proposed during the many community conversations that have occurred around the issue of homelessness in our community. These include the Mental Health Resource Center, Assisted Outpatient Treatment, sobering center, Homeless Management Information System data entry, and a mobile crisis team. The expected outcomes for participants of the WPC Pilot include improved health, lower utilization of local emergency departments, lower hospital readmission rates, and an increase in permanent housing. The expected overall community benefits include reduced costs associated with use of emergency department services, lower crime rates, and fully participating residents whose behavioral and physical health conditions are better managed.
Welfare and Institutions Code section 14184.60 requires that Shasta County, as Lead Entity, formally accept or decline approval of the application and enter into an agreement with DHCS to implement the project. The agreement requires certification that Shasta County agrees to the conditions of the Attestation in Section 6.1 of the agreement. The HHSA Director certifies that the HHSA agrees to and can meet the conditions of the Attestation and asks the Board to make a finding as such. The Board is also requested to formally accept approval of the WPC Pilot project application, and enter into the agreement on behalf of HHSA so that the County can meet these statutory requirements. The budget amendment is necessary to increase appropriations for Mental Health – Adult Services and BSS to facilitate implementation of the proposed WPC project. The salary resolution will add three positions to implement, operate, and monitor the WPC project as proposed in the WPC project application. The three positions are scheduled to sunset on the termination date of the agreement, June 30, 2021.
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| | | | | | | | ALTERNATIVES
The Board could choose not to approve the proposed agreement, the budget amendment, and/or the Salary Resolution. |
| | | | | | | | OTHER AGENCY INVOLVEMENT
County Counsel has reviewed and approved the agreement as to form. Information Technology has approved the agreement. Risk Management has approved the agreement. The Auditor-Controller has approved the budget amendment. Support Services-Personnel prepared the Salary Resolution. The County Administrative Office has reviewed the recommendation. |
| | | | | | | | FINANCING
Seventy Five percent of the first year’s funds will be made available to the County to provide cash flow for the initial year of project implementation. The remaining twenty five percent funding will be available once DHCS receives the required baseline data from HHSA. During subsequent project years, funds will be disbursed to Shasta County as the Lead Entity, twice per year following the submission of the reports required pursuant to this agreement with DHCS. The County match required per the agreement is comprised of Mental Health Services Act, Behavioral Health Realignment, and Inter-Governmental Transfer (IGT) funds. Should the department exceed the expenditures in the grant or if state or federal revenue is not realized or if there are state or federal audit exceptions, HHSA fund balance will be required to cover those expenditures. There is no additional General Fund impact associated with approval of the recommendation. |
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