COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

March 13, 2002

BOARD MEETING DATE:

March 26, 2002

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Charlene A. Silva, Director of Aging and Adult Services

SUBJECT:

Application to the State of California Department of Health Services for the Long Term Care Integration Development Phase Grant

Recommendation

Adopt a resolution authorizing Aging and Adult Services to submit an application in conjunction with the Health Plan of San Mateo to the State of California Department of Health Services (DHS) for the Long Term Care Integration (LTCI) Development Phase Grant.

Background

Aging and Adult Services (AAS) and the Health Plan of San Mateo (HPSM) have been collaborating to develop a Long Term Care Supportive Services Project (LTSSP) since 1995. The goal of LTSSP is to provide a comprehensive continuum of long-term care services for seniors, children and adults with disabilities. The project will remove barriers to services by blending funding across all levels of care: acute, long-term, primary care, and home and community-based services. In 1992, AAS convened a broad-based group of seniors, persons with disabilities, caregivers and service providers to form the New Beginning Coalition (NBC). The Coalition's focus is the development of a long-range plan for a continuum of services that meet the needs of consumers and acknowledge and incorporate the county's diversity. LTSSP is a goal of the NBC and is supported by the Commission on Disabilities and the Commission on Aging. Your Board approved the NBC Strategic Plan on October 17, 1995.

Since 1999, your Board has approved the applications for two planning grants ($50,000 each) and one development grant ($150,000) from the California Office of Long Term Care for Long Term Care Integration. The County was awarded each of these grants. In 1999-2000, the first planning grant was used to develop a menu for LTSSP services, including pre-admission assessment and eligibility criteria, protocols for skilled nursing facilities (SNFs) and Adult Day Health Care and a plan to enhance communication among consumers, primary care providers and care coordinators. In the following fiscal year, the second planning grant was used to plan for projection of a rate and payment structure and a technology assessment to assure appropriate screening of patients before they enter a SNF. The first development grant is currently being used to improve the care coordination system by developing a universal assessment tool for both care coordination and eligibility screening for LTSSP services.

Discussion

DHS has issued a Request for Application (RFA) through its Office of Long Term Care. Grants of $150,000 will be awarded to organizations that received planning grants or development grants last year and wish to continue with LTCI's development process. The San Mateo County Health Services Agency and the Health Plan of San Mateo are submitting a proposal that would implement the universal assessment and eligibility tools created during the FY 01-02 development phase. This implementation will take place through a pilot project to be conducted at the San Mateo County Health Center. This project will test the new tool's ability to support need-based as opposed to eligibility-driven hospital discharge planning to SNFs, Adult Day Health Care Centers, or home and community-based services. In addition, this pilot will assess the capacity of county resources to provide the appropriate long-term care needs for these clients. Funds from the new grant will be used to continue working on the following three goals currently in progress:

Goal 1: To implement the proposed eligibility screening process

Goal 2: To evaluate the proposed assessment and care coordination process

Goal 3: To assess the proposed plan for service authorization

DHS requires a resolution from the Board of Supervisors stating your commitment to the vision of Long Term Care Integration, that is, a capitated program that provides the full continuum of integrated medical, social and supportive services to its eligible population in order to process the application for the development grant.

Vision Alignment

The support of the application to the State of California Department of Health Services for the Long Term Care Integration Development Phase Grant keeps the commitment of ensuring basic health and safety for all and goal number 8: People- Help vulnerable people-
the aged, disabled, mentally ill, at-risk youth and others-achieve a better quality of life. If funded, this grant will contribute to this commitment and goal by providing appropriate referral to long term care services of those disabled and older residents using the San Mateo County Health Center.

Fiscal Impact

As a condition for receiving the funding, the Health Services Agency and HPSM will be required to provide a 20% ($ 30,000) match to the grant either in cash or in-kind contributions. AAS and HPSM will meet this condition by providing in-kind contributions of time, space, equipment and support. There is no impact on the county General Fund as a result of this action.