COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

March 23, 2007

BOARD MEETING DATE:

April 10, 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:

Transferring Governance of the San Mateo County Children’s Health Initiative to the San Mateo Community Health Authority

RECOMMENDATION:

Adopt a resolution authorizing execution of a Memorandum of Understanding among the Children’s Health Initiative organizations and transferring the governance of the Children’s Health Initiative to the San Mateo Community Health Authority.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

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

The Memorandum of Understanding contributes to this commitment and goal by ensuring that the Children’s Health Initiative continues to lead efforts in providing outreach for and enrollment into health care coverage to all children from low-income families in San Mateo County.

Performance Measure(s):

Measure

FY 2005-2006
Actual

FY 2006-2007
Projected

Medi-Cal membership for children

24,058

26,005

Healthy Families membership

8,585

8,750

Healthy Kids membership

6,073

6,768

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) comprised of seven organizational members -- San Mateo County Central Labor Council, Hospital Consortium of San Mateo County, Silicon Valley Community Foundation, Health Department, Human Services Agency, First 5 San Mateo County and the Health Plan of San Mateo (HPSM) -- was established.

The CHI Coalition collaborated to develop and implement an initiative to provide universal health insurance coverage for children in San Mateo County. In January 2003 San Mateo County moved closer to the Board’s vision of universal 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. In the current Memorandum of Understanding of the CHI coalition organizations, your Board serves as the ultimate governing body.

CHI is funded through a commitment from the First 5 Commission, local hospital districts, private foundations, and matching funds of $2.7 million a year for five years from the County of San Mateo.

DISCUSSION:

Over the past five years, CHI has matured and institutionalized several key features necessary to promote access to health care for all children in San Mateo County. The Healthy Kids insurance product has also gained broad-based recognition and acceptance. At the same time, HPSM has taken on a more active leadership role on health access issues, specifically with its responsibility as the sole plan administrator of the Healthy Kids insurance product and with the implementation of a CareAdvantage product for dually eligible Medi-Cal/Medicare beneficiaries. In addition, HPSM has coordinated several countywide workgroups addressing health access issues. Given the growth of CHI and HPSM’s leadership role on health access issues, the Coalition voted at its November 2006 meeting to recommend that your Board transfer governance of the CHI Coalition to HPSM’s governing board, the San Mateo Community Health Authority. Under this structure, the CHI Coalition will serve as an advisory body to the Authority. It is also recommended that the lead organization for coordinating CHI’s overall efforts become the Health Plan of San Mateo. The Authority approved this recommendation at its February 2007 meeting.

The County through the Health Department and the Human Services Agency will continue its active involvement in CHI. As staff completes transition planning of CHI operational functions, some activities will remain with the Health Department to ensure continuity of services and functions. The majority of CHI operational functions including grants and contracts administration will be transitioned to HPSM in phases and is anticipated to be completed by December 31, 2007.

FISCAL IMPACT:

Approval of this Memorandum of Understanding has no impact on Net County Cost.