COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

August 22, 2002

BOARD MEETING DATE:

September 10, 2002

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services
Charlene A. Silva, Director of Aging and Adult Services

SUBJECT:

Agreements with Various Providers of Older Americans Act (OAA) and Community-Based Services Program (CBSP) Funded Programs for Fiscal Year 2002-2003

Recommendation

Adopt a resolution:

1.

Authorizing the President of the Board of Supervisors to execute agreements with Avenidas, City of Belmont, Catholic Charities, Center for Independence of the Disabled, Coastside Adult Day Health Center, City of Daly City, Family Service Agency, Legal Aid Society, City of Menlo Park, City of Millbrae, Mills-Peninsula Senior Focus, Inc., Ombudsman of San Mateo, Inc., City of Pacifica, Peninsula Volunteers, Inc., City of San Bruno, Self-Help for the Elderly, Senior Coastsiders, and City of South San Francisco and to execute the changes to agreements with Alzheimer's Association of Northern California, Edgewood Center for Children and Families, and Family Caregiver Alliance;

2.

Authorizing the County Manager to execute amendments and minor modifications to these agreements, not to exceed $100,000; and

3.

Authorizing the Director of Health Services to execute amendments and minor modifications to these agreements, not to exceed $25,000.

Background

Fiscal year 2002-03 is the second year of a four-year planning and funding cycle for OAA and CBSP funded programs initiated through a RFP released by Aging and Adult Services (AAS) in FY 2000-01. Additionally, the California Department of Aging (CDA) released Title IIIE Family Caregiver Support Program (FCSP) funds made available through an amendment to the Older American's Act in October of 2001. The Commission on Aging approved issuance of an RFP that same month for services for family caregivers. The agreements and changes to agreements included here provide for the second year of services under both RFPs.

Funding for these services is a combination of federal, state, and county dollars, contributions from providers and the individuals served, and other grants and contributions from the community. Federal and state funding is provided through the Title III/VII, Title V, and CBSP agreements for 2002-03.

Discussion

Services to be funded through these provider agreements include Congregate Nutrition, Home- Delivered Meals, Adult Day Care/Adult Day Health Care, Assisted Transportation, Transportation, Senior Employment, Disease Prevention/Health Promotion, Legal Assistance and Ombudsman Programs, Foster Grandparents/Senior Companions (FG/SC), Health Insurance Counseling and Advocacy (HICAP), Community Support for Adults with Disabilities, Family Caregiver Support Services and Alzheimer's Day Care Resource Center (ADCRC). All service providers other than FG/SC were selected through the aforementioned approved RFP processes, which were open to any interested providers and reviewed by an evaluation team approved by the Commission on Aging (CoA). FG/SC programs were awarded with CDA's approval to the only organization in San Mateo County licensed by the National Service Corporation.

The CoA recommended that the 2002-03 funding and service levels for the providers be maintained at amounts similar to 2001-02 because state and federal allocations did not differ significantly between these two years. Highlights include the development of the Family Caregiver Support Program funded through Title IIIE of the Older Americans Act. Eight providers contracted to bring this new program to informal family caregivers. Services including caregiver training, support, respite and case management are now being offered to supplement existing programs for dependent adults and grandparents raising grandchildren under age 18. In accord with the CoA's recommendations, AAS has prepared agreements with the service providers for these programs. Details of individual agreements are reflected in the attached budget chart.

The three changes to formal agreements include Alzheimer's Association of Northern California, Edgewood Center for Children and Families, and Family Caregiver Alliance. These three providers contracted to provide services under the Family Caregiver Support Program for an initial period of eighteen months. The changes in service units and additional funding necessitated amendments to the initial agreements.

Agreements with providers are reviewed quarterly to determine if additional units of service are needed and also to accommodate state allocations of one-time-only funds. We are requesting your Board's authorization to execute amendments and minor modifications as needed to these agreements as follows: County Manager not to exceed $100,000 and Director of Health Services not to exceed $25,000.

Performance Measures

AAS has continued to make the provision of services which help maintain severely impaired individuals in independent settings a division-wide performance measure. With the assistance of the services provided through these agreements we have met this measure as a division. The following table shows performance measures for 2000-01, 2001-02, and projected outcomes for 2002-03 for contracted prevention and protection services designed to serve severely impaired clients.

CLIENTS SERVED BY CONTRACT PROVIDERS

2000-01 ACTUAL

2001-02 ACTUAL

2002-03 PROJECTED

NUMBER OF SEVERELY
IMPAIRED CLIENTS

3,119

3,142

3,181

SEVERELY IMPAIRED CLIENTS LIVING INDEPENDENTLY

1,903

1,942

1,981

All of the providers comply with the Equal Benefits Ordinance, except for the City of South San Francisco, who requested a waiver. A waiver was granted to this provider because there was no other compliant contractor able to provide services in this specific area.

County Counsel has reviewed and approved these agreements.

Vision Alignment

These agreements with various providers keep the commitment of Ensuring Basic Health and Safety for All and goal number 8: Help vulnerable people - the aged, disabled, mentally ill, at-risk youth and others - achieve a better quality of life. The agreements contribute to this commitment and goal by providing services throughout the county designed to assist individuals with the greatest needs to maintain their independence and dignity within the least restrictive setting possible.

Fiscal Impact

The term of these agreements is July 1, 2002 through June 30, 2003. The total contracted program cost for this package of agreements is $9,021,670. Of this amount, 36.2% or $3,266,976 is provided through state and federal funding (Title III/VII/V, CBSP, and United States Department of Agriculture), 41.1% or $3,707,512 represents the provider contribution, 18.7% or $1,685,460 represents anticipated client contributions, and 1.6% or $147,798 represents funding for the Supplemental Meals on Wheels (SMOW) program from the Meals on Wheels Trust Fund specifically for this purpose. The remaining $213,924 or 2.4% of the total program expense represents the county general fund contribution. These funds are included in the tentatively approved 2002-03 AAS budget. The attached chart shows how these funds are spread among the programs and service providers.