COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

August 29, 2005

BOARD MEETING DATE:

September 13, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

SUBJECT:

Contract Amendment with Urban Institute to Evaluate the Children’s Health Initiative

RECOMMENDATION:

Adopt a resolution authorizing the president of the Board to execute an amendment to the agreement with the Urban Institute increasing the amount to $1,338,931 for the term April 29, 2003 – April 28, 2008.

VISION ALIGNMENT:

Commitment: Ensuring Basic Health and Safety for All.

Goal (s): 5: residents have access to healthcare and preventative care.

This Contract contributes to this commitment and goal by evaluating the most effective approaches to providing health care coverage to all children from low-income and middle-income families.

Performance Measure(s):

Measure

2004
Actual

2005
Projected

Medi-Cal membership for children*

13,906

14,500

Healthy Families membership

7,514

8,100

Healthy Kids membership

5,170

5,900

*MC Membership has been revised to include only children with comprehensive coverage. Previous reports included children with limited coverage who were also covered by HF and HK.

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 health insurance coverage. With your actions, a broad-based local coalition collaborated to develop and implement an initiative that offers all children in low-income and middle-income households comprehensive medical, dental and vision health insurance coverage. In January 2003, the Coalition moved the County closer to the Board’s vision of 100 percent coverage for children by implementing the new Healthy Kids insurance program to cover all children ineligible for the existing Medi-Cal and Healthy Families programs and by expanding outreach and enrollment efforts, reaching out to the unions, childcare organizations, schools, and faith-based sites.

The Coalition allocated approximately $1.25 million over 5 years to pay an independent contractor to evaluate CHI. The evaluation ensures program effectiveness and builds a case for long-term funding and community support. In June 2003, the Coalition selected The Urban Institute from an RFP process as the lead evaluator of The Children’s Health Initiative. In June 2003, your board adopted a resolution to execute a five year agreement with the Urban Institute.

DISCUSSION:

At the request of the First 5 Commission, CHI seeks to amend the agreement to include analysis specific to the 0-5 population. In order to conduct an accurate analysis for this subpopulation, the evaluators will add 400 parents of children age 0-5 to their survey evaluation, and two focus groups for parents of children age 0-5 to their qualitative analysis. They will also include a separate chapter on this population in their annual reports. The First 5 Commission will cover the cost of the new evaluation components.

FISCAL IMPACT:

The amendment increases the contract by $88,931, from $1,250,000 to $1,338,931. The term of the agreement remains April 29, 2003 through April 28, 2008. The expenses for the amendment will be made in the 2005-06 and are in the approved 2005-06 budget. The increase in costs will be covered by a contribution from the San Mateo First 5 Commission.

Approval of this item has no impact on the County General Fund. The approved CHI budget for Fiscal Year 04-05 is $8.2 million. $5.5 million is covered with contributions from First 5 San Mateo County, Peninsula and Sequoia health care districts, and foundations; the County’s Solid Waste Fund contributes $2.7 million. The projected budget for Fiscal Year 05-06 is $8.3 million