COUNTY OF SAN MATEO

Inter-Departmental Correspondence

County Manager’s Office

DATE:

June 17, 2008

BOARD MEETING DATE:

July 8, 2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

John L. Maltbie, County Manager

Srija Srinivasan, Special Assistant to the County Manager

SUBJECT:

Agreement with The Urban Institute to Complete a Local Evaluation of the County’s Pilot Effort to Improve Healthcare Access

RECOMMENDATION:

Adopt a Resolution:

1.

Waiving the Request for Proposals (RFP) process; and

2.

Authorizing the President of the Board to execute an Agreement with The Urban Institute to evaluate the Blue Ribbon Task Force Pilot, a coverage expansion and access improvement program, for a maximum amount of $342,000 for the term July 8, 2008 through December 31, 2010.

3.

Authorizing the County Manager or the County Manager’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 5: Residents have access to healthcare and preventive care.

This Agreement contributes to this commitment and goal by providing an external evaluation of County efforts to improve healthcare access for adults living in San Mateo County at or below 400% Federal Poverty Level.

Performance Measure:

Measure

FY 06-07
Actual

FY 07-08
Estimated

Number of Adults Enrolled in ACE

N/A

2,100

BACKGROUND:

In June, 2003, following an RFP process, your Board executed an Agreement with Urban Institute (UI) to complete a comprehensive, five-year evaluation of the Children’s Health Initiative (CHI), which was launched in 2003 to provide universal health insurance coverage for children in San Mateo County. Your Board approved Amendments to the original agreement, in 2005 and 2007, that together augmented the scope of the contract to a total of $1,378,538 for the five-year term of April 29, 2003 through April 28, 2008. UI has met all of its contract deliverables in the above Agreement, within the established timeframe and budget. As part of its role, UI has provided a series of recommendations related to program administration, policy development, and systems integration that have assisted the County in reducing the number of uninsured children from 17,000 to 3,000 over the past five years.

In January, 2008, your Board executed an Agreement with The California Endowment to accept a grant of $345,750 to support an evaluation of the San Mateo Access and Care for Everyone (ACE) Program, a coverage expansion program created by the Blue Ribbon Task Force (BRTF) on Adult Health Care Coverage Expansion. The County sought this funding to enable an external review of success in meeting access and systems improvement goals integral to launching the BRTF pilot. The pilot includes key roles for the San Mateo Medical Center (SMMC), the Health Department (HD), Health Plan of San Mateo (HPSM), and Ravenswood Family Health Center (RFHC).

DISCUSSION:

Given the short timeframe for the BRTF pilot, which was launched in September, 2007 as a three-year pilot funded by the State, as well as the extensive knowledge and experience of County data and systems accumulated by UI through its work on the CHI evaluation, it is uniquely qualified to perform this evaluation. For this reason, the Health Department is requesting a waiver for the RFP process.

UI will perform qualitative and quantitative analysis to assess the County’s success in improving access and health through the BRTF pilot. UI will also assess County progress in achieving systems improvements necessary to continue to work toward health coverage expansion, as outlined by the BRTF preliminary recommendations accepted by your Board in July, 2007. The evaluation will be guided by a committee that includes SMMC, HPSM, HD and RFHC representatives. The Special Assistant to the County Manager for the Health System Redesign Initiative will oversee this work.

This Agreement has been reviewed and approved by County Counsel. The contractor has assured compliance with the County's Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

FISCAL IMPACT:

The Agreement with UI is for a maximum obligation of $342,000. The term of this Agreement is July 8, 2008 through December 31, 2010. There is no Net County Cost associated with this agreement, as it is fully covered by the grant received from The California Endowment.