COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

February 9, 2004

BOARD MEETING DATE:

February 24, 2004

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Lisa L. Mancini, Director of Aging and Adult Services

SUBJECT:

Amendment 1 to the 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 Amendment 1 to Agreement No. MS-0304-13 with the California Department of Aging (CDA) for the continuation of the Multipurpose Senior Services Program (MSSP) for Fiscal Year 2003-04

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 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.

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.

On September 9, 2003, the Board of Supervisors authorized Resolution Number 66245, which approved state agreement MS-0304-13. This agreement incorporated a 15% reduction in Medi-Cal to reflect the Governor's proposed budget for 2003-04. To achieve this reduction the State limited the number of clients served by MSSP at any given time to 171.

Discussion

When the state budget for 2003-04 was finally passed, it included only a 2.5% reduction for MSSP, instead of the 15% reduction that had been incorporated into the original MSSP agreement. This amendment is necessary to return funds to MSSP, which will enable the program to serve an additional 29 clients for a total of 200 clients for the fiscal year 2003-04.

County Counsel has reviewed and approved the amendment 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

This amendment does not alter the term of the original agreement, July 1, 2003 through June 30, 2004. An Appropriation Transfer Request is not necessary at this time because this additional funding will replace other revenues that may not be realized this year. Appropriations, which are primarily in salaries and benefits, were already included in the budget. There is no additional Net County Cost as a result of this action. The $107,493 added to the original amount of $631,892 brings the total amount of the agreement to $739,385.