COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

July 13, 2007

BOARD MEETING DATE:

July 24, 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 and Planning

SUBJECT:

Agreement with First 5 San Mateo County to fund the Children’s Health Initiative

RECOMMENDATION:

Adopt a Resolution authorizing the President of the Board to execute an Agreement with First 5 San Mateo County to fund the Children’s Health Initiative in an amount not to exceed $1.8 million for the term July 1, 2007 through June 30, 2008.

VISION ALIGNMENT:

Commitment: Ensure 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 providing funds to pay for the health coverage for children ages zero to five years and a portion of the personnel and operational costs of the Children’s Health Initiative program, which provides healthcare coverage outreach, enrollment, utilization, and retention services to all children from low-income and middle-income families in San Mateo County.

Performance Measures:

Measure

FY 2006-07
Estimated

FY 2007-08
Projected

Medi-Cal membership for children*

26,005

13,500

Healthy Families membership

8,750

8,800

Healthy Kids membership

6,768

7,200

* Medi-Cal numbers for FY 2007-08 have been revised to reflect an unduplicated count.

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. In January 2003 the new Healthy Kids (HK) insurance program was established to provide comprehensive medical, dental, and vision coverage to all uninsured children ineligible for the existing Medi-Cal (MC) and Healthy Families (HF) programs.

CHI is funded through a commitment from the Board of Supervisors, First 5 San Mateo County (F5SMC), Sequoia and Peninsula Healthcare Districts, and other private funders. F5SMC has been a funder of CHI since the program’s inception. On January 27, 2004, your Board executed Resolution 066462 approving a Grant Agreement with the F5SMC that provided CHI $6.9 million in funding for the period of January 1, 2004 through December 31, 2006. In December 2006, an Amendment to the Agreement was signed by the Health Department Director extending the contract term through June 30, 2006.

In March 2007 your Board approved the transfer of governance of CHI to the Health Plan of San Mateo (HPSM). CHI operational functions, such as financial administration and contracts management, are being transferred to HPSM in phases.

DISCUSSION:

CHI manages the HPSM contract to administer the HK benefits of members ages zero to five years and coordinates the CHI Oversight Coalition. CHI will also continue to provide a variety of services including conducting and monitoring outreach, enrollment, navigation, and retention activities to children and their families who are uninsured or enrolled in MC, HF, and HK.

In addition to paying for the Healthy Kids premiums of members ages zero to five years, the F5SMC funds are used to pay for a portion of the CHI personnel and operational expenses including the outreach contracts with six community-based organizations, the maintenance and system enhancements of the One-e-App web-based application processing system, administrative costs, and the CHI program evaluation. Based on a review of the program enrollment among children ages zero to five during the past three years, this Agreement reduces the level of funding from F5SMC from $2.3 million a year to $1.8 million a year for FY 2007-08. A fuller analysis and projection of future costs will be completed this year.

This Agreement, Board Memo, and Resolution have been reviewed and approved by County Counsel.

FISCAL IMPACT:

The term of the Agreement is July 1, 2007 through June 30, 2008. The Agreement amount is not to exceed $1.8 million and has been included in CHI’s tentatively Adopted FY 2007-08 Budget. Acceptance of these funds and approval of this item has no Net County Cost impact.