COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

July 15, 2003

BOARD MEETING DATE:

August 5, 2003

TO:

Honorable Board of Supervisors

FROM:

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

SUBJECT:

Amendment 2 to the Agreements with Arcadia Health Services, Inc., Care Resource, and Matched Caregivers and Amendment 3 to the Agreements with At Home Health Care, Medical Care Professionals, Nurse Providers, Inc., and Rainbow Home Care Services

Recommendation

Adopt a resolution authorizing the President of the Board to execute Amendment 2 to the Agreements with Arcadia Health Services, Inc., Care Resource, and Matched Caregivers and Amendment 3 to the Agreements with At Home Health Care, Medical Care Professionals, Nurse Providers, Inc., and Rainbow Home Care Services

Background

Aging and Adult Services (AAS) provides protective and supportive services, case management, and conservatorship services to functionally impaired adults and seniors. Supportive services provided by AAS include attendant care to individuals living independently. Attendants provide a variety of personal and health-related services that enable clients, including some of the more severely impaired, to remain in their own homes and avoid institutionalization. AAS programs that provide attendant care include Multipurpose Senior Services Program (MSSP), AIDS Case Management and Waiver (AIDS), Linkages/Respite, Centralized Intake/Adult Protective Services (APS), and Public Guardian.

MSSP serves persons age 65 or over who are eligible for or are receiving Medi-Cal and who are eligible for placement in a skilled nursing facility. The AIDS Case Management Program, including AIDS Waiver, provides services to clients who are at risk due to deterioration in health related to HIV. Linkages provides assessment and case management services for the elderly and younger disabled adult population through the purchase of services such as in-home chore care, attendant care, and transportation, enabling persons having difficulty caring for themselves to continue to live independently in the community. The APS staff assess and develop care plans in situations where the elderly or dependent adults have been subjected to or are at risk of neglect, abandonment, isolation, abduction, or physical, mental, or financial abuse. The Public Guardian manages the personal care and financial resources of individuals who are unable to provide for their own personal or financial needs.

Discussion

Five contractors were selected from a Request for Proposals (RFPs) for a four-year cycle from July 1, 2000 to June 30, 2004, for attendant care services for clients in the programs AIDS, MSSP, Linkages/Respite, APS, and Public Guardian that was issued in July 2000. On February 5, 2002, your Board waived the Request for Proposal process for the period of January 1, 2002 to June 30, 2004 for Arcadia Health Services, Inc., Care Resource, and Matched Caregivers. Contracts are amended annually to reflect the available state funding.

Use of attendant care in programs throughout AAS helps the division achieve one of its primary performance measures: maintaining severely impaired clients in an independent setting. The Division's minimum acceptable goal is to achieve at least 78%, although it may vary within a range of 74-82%. Case management is the most important factor affecting this percentage, however, variance can result from other factors as well, such as caseload growth or reduction in various programs.

Performance Measures

Actual
FY 2001-02

Actual

FY 2002-03

Estimated

FY 2003-04

Percent of severely impaired client population who are maintained in an independent setting through case management

81%

82%

78%

County Counsel has reviewed and approved these amendments as to form and content.

Vision Alignment

Attendant care services keep 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. Funds for these services will contribute to this commitment and goal by helping clients to remain safely in their own homes.

Term and Fiscal Impact

The term of the agreements with At Home Health Care, Medical Care Professionals, Nurse Providers, Inc., and Rainbow Home Care Services is July 1, 2000 through June 30, 2004. The term of the agreements with Arcadia Health Services, Inc., Care Resource and Matched Caregivers is January 1, 2002 to June 30, 2004. The maximum the County shall be obligated to pay collectively for these agreements for fiscal year 2003-04 under a single resolution is $600,000. Funding is a blend of state, federal and client (conservatee) funds. All funds are included in AAS's recommended budget for FY 2003-04. There is no impact on the County General Fund as a result of this action.