COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

February 8, 2007

BOARD MEETING DATE:

February 27, 2007

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:

Amendment to the Agreement with The 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 to evaluate the Children’s Health Initiative, increasing the amount to $1,378,538 for the term April 29, 2003 through April 28, 2008.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

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

This Agreement and Amendment contribute to this commitment and goal by evaluating the most effective approaches to providing healthcare coverage to all children from low-income and middle-income families.

Performance Measure(s):

Measure

FY 05-06
Actual

FY 06-07
Projected

Medi-Cal (MC) membership for children*

24,058

26,005

Healthy Families membership

8,585

8,750

Healthy Kids membership

6,073

6,768

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

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 (the CHI Coalition) collaborated to develop and implement an initiative that provides 100% health insurance coverage for children in San Mateo County. In January 2003 the County moved closer to the Board’s vision of 100% 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.

As a member of the CHI Coalition, the Health Department allocated approximately $1.25 million over five 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 CHI Coalition selected The Urban Institute through a Request for Proposal process as the lead evaluator of the CHI. In June 2003 your Board adopted Resolution Number 066093 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 with The Urban Institute to expand the client survey component of the CHI evaluation. The client survey is a household interview conducted with new and continuing Healthy Kids members. The survey is conducted in two phases during the five-year evaluation period. The survey includes a zero to five-year-old group and a six to eighteen-year-old group. These two groups represent the full range of Healthy Kids members. The client survey provides a core source of data for the CHI evaluation. In order to obtain an adequate second phase sample size for both groups, the evaluators must increase the sampling time period. Based on Healthy Kids enrollment history and a better understanding of enrollment and reenrollment rates, the time period must be expanded to cover more months than initially planned. The First 5 Commission’s current appropriation will meet the cost of the new evaluation components for the age zero to five population. Other CHI evaluation funders will pay the additional costs for a survey of the age six to eighteen population.

The Amendment has been reviewed and approved by County Counsel and Risk Management.

FISCAL IMPACT:

The Amendment increases the Agreement with The Urban Institute by $39,607, from $1,338,931 to $1,378,538. The term of the Agreement remains April 29, 2003 through April 28, 2008. The cost associated with this Amendment will be included in the FY 2007-08 Recommended Budget and will be paid by the current appropriation from the San Mateo First 5 Commission and additional CHI funders. There is no impact on the County General Fund as a result of this action.