COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

January 8, 2004

BOARD MEETING DATE:

January 27, 2004

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

SUBJECT:

Children's Health Initiative (CHI) annual report and changes to administrative contracts

Recommendation

1. Accept the annual report of the Children's Health Initiative

2. Adopt a resolution authorizing the president of the Board to execute an agreement with the San Mateo County First 5 Commission

3. Adopt a resolution authorizing the president of the Board to execute an amendment to the agreement with the San Mateo Health Commission

4. Adopt a resolution authorizing the president of the Board to execute an amendment to the agreement with the Peninsula Community Foundation

5. Approve an Appropriation Transfer Request for $1,526,000

Background

In 2002 your Board established and funded the San Mateo County Children's Health Initiative (CHI) to address community-wide concern for the 17,000 county children who lacked access to comprehensive medical, dental and vision health insurance coverage. With your actions, a broad-based, local coalition collaborated to offer every child insurance by providing easier access to two existing government funded insurance programs, Medi-Cal and Healthy Families, and developing and implementing a third new program, Healthy Kids.

Several organizations have been involved with CHI. The Health Services Agency has served as the lead organization in administering the various components of the CHI. It oversees a contract for Healthy Kids' outreach, enrollment and marketing activities, and the project's overall administration, evaluation, and fiscal oversight. The San Mateo Health Commission, doing business as the Health Plan of San Mateo (HPSM), serves as the plan administrator for Healthy Kids, receiving a monthly premium per-member per-month to provide comprehensive health benefits. The First 5 San Mateo County Commission and the Peninsula Community Foundation (PCF), on behalf of children ages 0-5 and private donors, have provided Health Services and HPSM with funds to accomplish these outlined objectives. Recently, the Peninsula Healthcare District and the California Healthcare Foundation awarded PCF additional grants for CHI.

Discussion

The attached annual report outlines the success of CHI during its first year. Healthy Kids enrollment has exceeded projections, with 4,800 children enrolled in the first year, more than double the expected enrollment rate. Also, 10,000 children have been enrolled into the Medi-Cal and Healthy Families.

The First 5 Commission seeks to renew its contract with the County for an additional three years and change the scope of work so that the County, rather than First 5, will contract with the HPSM for administration of Healthy Kids for children ages 0-5. With this revised scope of work, the San Mateo Health Commission and the County must amend their agreement to include language that enables the County to pay for Healthy Kids premiums for children ages 0-5 on behalf of the First 5 Commission. The combination of the First 5 and Health Commission changes will enable the County to have fiscal oversight of all funds used for premium and non-premium activities related to the Children's Health Initiative.

In addition, the PCF seeks to amend its grant agreement with the County to extend the term through December 31, 2005 and increase the grant amount from $1,333,000 to $9,000,000.

The Appropriation Transfer Request (ATR) recognizes the reduction in funds needed for advertising and contract special services and the additional funds needed to pay for Healthy Kids premiums due to the administration of Healthy Kids for children 0-5 and the higher than projected total number of Healthy Kids members. One-third of the additional funds will come from the Solid Waste Fund, as part of the County's commitment to match CHI private contributions up to $2.7 million per year. First 5 and PCF will cover the other two-thirds of additional funding.

Vision Alignment

The contract, the amendment to the grant agreements, the ATR, the resolutions, and the annual report keep to the commitment of Ensuring Basic Health and Safety for All and goal number 5: Residents have access to health care and preventive care. They contribute to this commitment and goal by providing health care coverage to all children from low-income and middle-income families.

Fiscal Impact

Approval of these items has no impact on the County General Fund. It has a projected fiscal impact on the Solid Waste Fund of $445,000, increasing the projected total fiscal impact on the Solid Waste Fund to $1,965,000 for 2003-04.