COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

August 31, 2007

BOARD MEETING DATE:

September 11, 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:

Amendment to the Grant Agreement with Silicon Valley Community Foundation, Supporting Implementation of the Healthier Outcomes through Multi-disciplinary Engagement (HOME) Team

RECOMMENDATION:

Adopt a Resolution:

1.

Authorizing the President of the Board to execute an Amendment to the Grant Agreement with Silicon Valley Community Foundation, extending the Grant Term from December 1, 2006 through November 30, 2007 to December 1, 2006 through May 31, 2008 with no change to the Grant Agreement amount of $100,000; and

2.

Authorizing the Director of the Health Department or the Director's designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.

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.

This Amendment contributes to this commitment and goal by supporting activities targeting frequent users of the San Mateo Medical Center Emergency Department, many of whom are chronically homeless, suffer from mental illness, and are at risk for poor health outcomes.

Performance Measure:

Measure

FY 2006-07
Actual

FY 2007-08
Projected

Number of frequent users of the San Mateo Medical Center Emergency Department engaged in HOME Team case management program

N/A

60

BACKGROUND:

In October 2006 your Board approved Resolution Number 068334, in support of the Healthier Outcomes through Multidisciplinary Engagement (HOME) Team. The HOME Team was collaboratively planned by the San Mateo County Health Department, San Mateo Medical Center (SMMC), and the Human Services Agency (HSA).

The program seeks to provide case management to a group of patients who frequently rely on the SMMC Emergency Department (ED) for routine care. These clients suffer from multiple diagnoses, including substance abuse and mental health issues. Many are also chronically homeless, which acts as an access barrier.

The complexity of issues experienced by this population led the workgroup to take a system-wide approach. Many of these clients have a very weak link to non-emergency services, and refuse or are consistently unable to comply with medication and treatment regimens. The limited case management options within our current system of care contribute to frequent ED users experiencing relapse and repeat cycles of ED use and hospitalization.

DISCUSSION:

The HOME Team was developed to improve access to care for clients who could greatly benefit from comprehensive case management as a means of relying less on the ED for routine care. The HOME Team is made up of a Social Work Supervisor, Public Health Nurse, Social Worker III, and a Community Worker. Since recruitment targeted a diverse, specialized team with working knowledge of multiple languages, the recruitment process took longer than anticipated. The delay will not impact the outcomes of the pilot, but will simply extend the implementation timeline. This extension requires an Amendment to the Agreement with Silicon Valley Community Foundation (previously named Peninsula Community Foundation) to extend the grant term accordingly.

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

FISCAL IMPACT:

The total cost for HOME Team for FY 2007-08 is $388,378. This cost is funded with a $100,000 grant from the Silicon Valley Community Foundation, an Intra-fund transfer in the amount of $100,000 from the Human Services Agency, and an allocation in the amount of $188,378 from the Health Department Aging and Adult Services Realignment Funds. All funds have been included in the tentatively Adopted FY 2007-08 Budget. Approval of this Amendment has no Net County Cost impact.