COUNTY OF SAN MATEO

Inter-Departmental Correspondence

HEALTH DEPARTMENT

DATE:

March 10, 2006

BOARD MEETING DATE:

March 28, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Srija Srinivasan, Director, Health Policy, Planning and Promotion

SUBJECT:

Contract Amendment with the Public Health Institute One-e-App Program Office

RECOMMENDATION:

Adopt a resolution authorizing the execution of an amendment to the FY 2005-06 maintenance and enhancement agreement with the Public Health Institute One-e-App Program Office increasing the amount by $74,600, from $274,580 to $349,180, with no change in term.

VISION ALIGNMENT:

Commitment: Ensuring Basic Health and Safety for All.

Goal 5: Residents have access to healthcare and preventive care.

This Agreement contributes to this commitment and goal by modifying the One-e-App application system to ensure that all county residents seeking health coverage will be screened for all available health coverage and health insurance programs.

Performance Measure(s):

Measure

FY 2004-05
Actual

FY 2005-06
Projected

Percentage of applications screened through modified One-e-App tool that are determined eligible or preliminarily eligible for the following:

N/A

- Adult Medi-Cal

30%

- Other Governmental Programs

15%

- WELL Program

35%

-Discounted Health Care (charity care discount)

10%

-Self-Pay

10%

Percentage of applications converted to Self-Pay status after 45 days because applicant did not bring in documents to prove eligibility.

N/A

15% *

* Data will be collected from October 24, 2005 – March 31, 2006.

BACKGROUND:

In early 2003 your Board approved a contract with Deloitte Consulting to begin the development and implementation of the One-e-App tool to process applications for the Children’s Health Initiative programs and the WELL Program for adults.

Effective June 1, 2005, the One-e-App Program Office under the umbrella of the Public Health Institute took over the One-e-App maintenance and application development from Deloitte Consulting. The County entered into an agreement with the Public Health Institute One-e-App Program Office effective as of July 1, 2005.

DISCUSSION:

In May 2005 the County Medically Indigent Healthcare Work Group completed a report and made recommendations toward creating a long-term, financially viable business model for providing healthcare to the County’s medically indigent population.

As part of the FY 2005-06 budget, your Board approved funds to conduct a pilot study that would implement a full screening process as recommended by the Work Group. In September 2005 your Board approved modifications in the One-e-App system, which incorporated the necessary features to implement this process.

At the request of the implementation workgroup, led by the County Manager’s Office, the Health Department seeks to amend the agreement to provide enhancements in the One-e-App system to determine eligibility for WELL, DHC and Adult Medi-Cal more thoroughly. These system modifications will assist in achieving the county’s goals of developing a long-term, financially viable business model that: (1) meets the County’s Welfare and Institutions Code Section 17000 responsibilities for medically indigent healthcare in a cost-effective manner, (2) defines responsibilities and costs between the County General Fund and San Mateo Medical Center (SMMC) Enterprise Fund, and (3) provides a stable funding source to SMMC for the medically indigent population.

This contract was reviewed by County Counsel and by ISD.

FISCAL IMPACT:

The amendment increases the contract by $74,600, from $274,580 to $349,180. The term of the agreement remains July 1, 2005 through June 30, 2006. Human Services Agency will pay $25,000 of the increase in the contract to cover the Adult Medi-Cal enhancements. The remaining balance of $49,600 represents Net County Cost. This will be funded by the FY 2005-06 Non-Departmental Services budget as part of the Medically Indigent Healthcare pilot study.