COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

March 10, 2003

BOARD MEETING DATE:

March 25, 2003

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 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 and 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 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. The second planning grant was used to plan for projection of a rate and payment structure and a technology assessment to ensure appropriate screening of patients before they enter a SNF. The first development grant was used to design the LTSSP care management system and research a universal assessment tool to improve care coordination and avoid unnecessary institutionalization.

Discussion

DHS has issued a Request for Application (RFA) for development grants in the amount of $150,000 through its Office of Long Term Care. The San Mateo County Health Services Agency is submitting a proposal to implement the universal assessment tool researched during the past development grant period. San Mateo County is currently working with the State Assembly Committee on Aging and Long-Term Care to adopt legislation naming San Mateo County as the State’s pilot on implementation of the Minimum Data Set for Home and Community-Based Services (MDS-HC) uniform assessment tool. Implementation of the tool will begin with home and community-based services programs in AAS and with discharge planners at the San Mateo Medical Center and expand to one Adult Day Health Care provider. If the pilot is successful, expansion to all home and community-based service providers will follow. Funds from the new grant will be used to pay for necessary technology to support the assessment tool, to clarify reporting requirements to the State, and for consultant time to adapt the MDS-HC to the needs of San Mateo County residents.

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

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 of disabled and older residents of San Mateo County into home and community-based services.

Fiscal Impact

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