COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

May 21, 2004

BOARD MEETING DATE:

July 27, 2004

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director of Health Services

Lisa L. Mancini, Director of Aging and Adult Services

SUBJECT:

Agreement with the California Department of Aging for continuation of the Multipurpose Senior Services Program

Recommendation

Adopt a resolution authorizing the President of the Board to execute Agreement No. MS-0405-13 with the California Department of Aging (CDA) for the continuation of the Multipurpose Senior Services Program (MSSP) for Fiscal Year 2004-05

Background

Aging and Adult Services (AAS) provides adult protective services, case management, representative payee, conservatorship, and in-home supportive services to functionally impaired adults and seniors. MSSP, one of the division’s case management programs, provides social and health care management services to Medi-Cal eligible, at-risk elders through an agreement with the state. The program operates under a Medi-Cal waiver obtained by the state, which specifically allows Medi-Cal reimbursement for health care services provided in the home rather than in a more costly institutional setting.

The goal of the program is to arrange for and monitor the use of community services to assist individuals who would otherwise require an intermediate or skilled nursing level of care to remain in their own homes. The grant includes funds for social workers and nurses to provide assessments and case management services. Funds are also made available through the grant to provide home modifications, purchase durable medical equipment and other supplies, and provide attendant care.

A client becomes ineligible for MSSP when the program’s services are no longer sufficient to enable the individual to remain safely at home. Though many clients stop participation because of necessary institutionalization, many others are able to avoid institutionalization altogether through MSSP’s services and are able to remain at home as clients with the program for the remainder of their lives.

Discussion

This state agreement currently limits the number of clients served by MSSP at any given time to 180. However, because of terminations during the year, the program serves approximately 232 clients annually.

Two performance measures were developed to help determine MSSP’s success at meeting its goal of assisting clients to delay or avoid institutionalization. The first measure looks at the average number of months clients are served by MSSP. This represents the amount of time the program has succeeded in avoiding institutionalization. The second performance measure looks at the number of clients who terminate from the program because of institutionalization. The lower this percentage is, the better the program is doing at meeting its goal of avoiding institutionalization.

Performance Measures

Actual
FY 2002-03

Actual
FY 2003-04

Estimated
FY 2004-05

Average number of months that MSSP services prevented institutionalization

33

34

35

Number and Percent of case terminations due to institutionalization

23/36%

20/33%

22/35%

Consistent with contract approval level limitations in County Administrative Memorandum B-1, the Director of Health Services will be authorized to execute amendments and modifications to this agreement, not to exceed $25,000 in aggregate.

County Counsel has reviewed and approved the agreement as to form and content.

Vision Alignment

The Multipurpose Senior Services Program 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. Funds for MSSP will contribute to this commitment and goal by providing clients with adult day care, attendant care, home health coordination, emergency response system, home modification, adaptive equipment, and transportation services, as well as case management services.

Fiscal Impact

The term of the agreement is July 1, 2004 through June 30, 2005. The State awards San Mateo County $631,892, and there is no County match required to accept this grant. All program costs and revenues are included in the 2004-2005 Aging and Adult Services recommended budget.

If CDA changes the funding for this program there will an amendment to the agreement and an Appropriation Transfer Request submitted for approval.