COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

August 16, 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
Lisa L. Mancini, Director, Aging and Adult Services

SUBJECT:

First Amendment to the Agreements with various Home Health and Attendant Care providers for FY 2004-2007

RECOMMENDATION:

Adopt a resolution

1.

Authorizing the first amendment to the agreements with A Warm Embrace; Addus HealthCare, Inc.; American CareQuest, Inc.; Medical Care Professionals; Nurse Providers Plus, Inc.; and Nursing Resources increasing the amount by $970,000 for FY 2005-06, and extending the term of the agreement with A Warm Embrace through June 30, 2007;

2.

Authorizing the eligibility of the Family Caregiver Support program for referrals for home health and attendant care services;

3.

Authorizing the establishment of a separate rate scale for the Public Guardian program; and

4.

Authorizing the Director of the Health Department to execute subsequent amendments and minor modifications not to exceed $25,000 and to make minor changes in the types of services and activities provided under the agreements.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all

Goal 8: Help vulnerable people — the aged, disabled, mentally ill, at-risk youth and others — achieve a better quality of life.

These agreements contribute to this commitment and goal by providing services throughout the county designed to assist individuals with the greatest needs to maintain their independence and dignity within the least restrictive setting possible. Use of attendant care in programs throughout Aging and Adult Services (AAS) helps the division achieve one of its primary performance measures: maintaining severely impaired clients in an independent setting.

Performance Measure(s):

Measure

FY 2004-05
Actual

FY 2005-06
Projected

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

95%*

90%

*The 2004-05 performance was in excess of the division’s performance goal and standard.

BACKGROUND:

A Request for Proposals (RFP) for a three-year cycle starting July 1, 2004 to June 30, 2007, for home health and attendant care services for Aging and Adult Services’ programs was issued in January 2004. Applicant selection was based on the recommendation of a review committee whose evaluation included consideration of specific criteria addressing experience and competence as put forth in the RFP.

Resolution Number 66913, dated September 14, 2004, and Agreement 57000-05-D014, dated October 26, 2004, authorized agreements with these providers for home health and attendant care services in a collective amount of $970,000 for fiscal year 2004-05. The term of these agreements is July 1, 2004 through June 30, 2007 and October 15, 2004 though June 30, 2005, respectively.

DISCUSSION:

Aging and Adult Services’ programs using home health and attendant care services under these agreements include AIDS Case Management, Multipurpose Senior Services Program, Linkages/Respite, Adult Protective Services, Public Guardian and, new to the division this year, the Family Caregiver Support Program. Family Caregiver Support is a program with a unique perspective of treating the caregiver as the client. Clients access these support and respite services through assessment and referral from a social worker in the Family Caregiver Support program.

The Public Guardian serves frail elderly adults and adults with physical or mental disabilities that result in clients being unable to provide for their own needs for health care, food, clothes or shelter. These clients may have behavior problems or cognitive impairments that present challenges that require ongoing supervised intervention and oversight to ensure that their health and safety needs are met. Due to the requirements for a higher level of ongoing-care, it has become necessary to establish a separate rate scale for services provided to conservatees of the Public Guardian program; and that scale is incorporated into the contracts.

County Counsel has reviewed and approved the Resolution and Amendments as to form.

FISCAL IMPACT:

The amendment to the agreement with A Warm Embrace extends its term through June 30, 2007. The term of the other five agreements remains the same: July 1, 2004 through June 30, 2007. The maximum the County shall be obligated to pay collectively for these agreements for fiscal year 2005-06 under a single resolution is $970,000 for a contract total amount of $1,940,000. Funding is a combination of state, federal and client (conservatee) funds. Funds for these services are included in AAS’s Recommended Budget for 2005-06. There is no impact on the County General Fund as a result of this action.