COUNTY OF SAN MATEO

Inter-Departmental Correspondence

County Manager’s Office

DATE:

March 10, 2008

BOARD MEETING DATE:

March 25, 2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

John L. Maltbie, County Manager

SUBJECT:

Health System Redesign Implementation Plan

RECOMMENDATION:

Adopt a Resolution accepting the Health System Redesign Initiative implementation plan for the period February 2008 through March 2009.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all

Goals 8 and 22: Help vulnerable people – the aged, disabled, mentally ill, at-risk youth, and others – achieve a better quality of life.

This Resolution contributes to this commitment and goal by providing the County with a work plan to address key priority areas within the local health system in which the County can achieve greater effectiveness.

BACKGROUND:

On February 5, 2008, your Board accepted a Phase 2 final report prepared by Health Management Associates (HMA) titled, “Assessment of Strategic Priorities for San Mateo Health Services,” that outlined several opportunities for the County to continue delivering healthcare in a more effective, efficient, and collaborative system of care. This report confirmed and built on the work of the Blue Ribbon Task Force on Adult Health Care Coverage Expansion (BRTF), which developed preliminary recommendations adopted by your Board on July 24, 2007. The BRTF will be bringing final recommendations to your Board by the end of this fiscal year. To ensure appropriate leadership and focus on the important policy and programmatic issues addressed by these efforts, the County Manager initiated a two-year “Health System Redesign Initiative” involving the senior executives leading San Mateo Medical Center (SMMC), the Health Department (HD) and Health Plan of San Mateo (HPSM) to craft and implement priority recommendations from the HMA study in alignment with the work of the BRTF. The Redesign team members were charged with developing six-month and one-year implementation plans, with the assistance of HMA, which would be presented to your Board for approval.

DISCUSSION:

As the attached implementation plan details, the Redesign team members selected seven areas for priority focus during the Redesign Initiative’s first year:

1.

Eligibility and Administration

2.

Chronic Disease Management and Care Coordination

3.

Integration Across Levels of Care

4.

Physician Leadership, Structures and Accountability

5.

Community Health Network for the Underserved

6.

Long-Term Care

7.

Strategic and Operational Financial Improvement

Across these areas, Redesign team members have identified areas of both positive client and financial impact. In addition, Redesign team members anticipate addressing additional unanticipated policy or programmatic opportunities that align with the overall goals of the Redesign Initiative.

Because some of the areas addressed by the Implementation Plan involve changes to current policy or programmatic strategies, Redesign team members expect to obtain guidance and approval from both the SMMC Hospital Board and the Health Commission governing HPSM prior to bringing such items to your Board for policy decisions.

The Redesign team has completed a communication plan that includes updates to key stakeholders, such as community partners involved in the BRTF, at regular points in the Redesign Initiative’s first year. The Redesign team has also initiated an evaluation plan that will include the retention of an external evaluator under an Agreement that will be submitted to your Board for approval. Targeted goals, both programmatic and financial, are included in the attached implementation plan.

FISCAL IMPACT:

There is no Net County Cost associated with adoption of the implementation plan. Staff and consultant costs associated with the Health System Redesign Initiative have been included in the Health Department’s FY 2007-08 Revised Budget and will be included in the FY 2008-09 Recommended Budget. The Redesign Initiative supports the FY 2008-09 Recommended Budget for the San Mateo Medical Center that incorporates no increase in General Fund contributions. The five-year financial goal of Health System Redesign is to reduce total General Fund contributions from $72.2 million to $50 million by FY 2012-13.