COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

December 11, 2008

BOARD MEETING DATE:

January 6, 2009

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department
Lisa Mancini, Director, Aging and Adult Services

SUBJECT:

Approval of a grant awarded to Aging and Adult Services, Healthier Outcomes through Multidisciplinary Engagements Team by the Silicon Valley Community Foundation

RECOMMENDATION:

Adopt a Resolution:

1.

Authorizing the President of the Board to execute a Grant Agreement with the Silicon Valley Community Foundation in the amount of $230,364 for continued support of the Healthier Outcomes through Multidisciplinary Engagements Team for the term September 1, 2008 through August 31, 2010; and

2.

Authorizing the Health Director or designee to execute all necessary applications, contracts, agreements, amendments and payment requests hereto for the purposes of implementing the Grant Agreement.

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 Grant Agreement contributes to this commitment and goal by funding the Healthier Outcomes through Multidisciplinary Engagements (HOME) Team. HOME Team’s goal is to improve access to care by connecting the frequent users of the San Mateo Medical Center (SMMC) Emergency Department (ED) to appropriate primary care, achieve improved client well-being through better management of complex health and social needs, and reduce the demand on the SMMC ED.

Aging and Adult Services (AAS) strives to provide a continuum of services necessary to allow at-risk seniors and adults with disabilities to remain in a least restrictive setting. The HOME Team is a part of the continuum that helps maintain individuals in the most independent setting possible.

Performance Measure:

Measure

FY 2007-08
Actual

FY 2008-09
Projected

Percent of at-risk individuals maintained in a least restrictive setting through case management

95%

95%

BACKGROUND:

In November 2002 staff of the Health Department, SMMC, and Human Services Agency formed a workgroup to address the challenges facing patients who were frequently relying on the SMMC ED for routine healthcare. Because of the complex issues experienced by these clients the workgroup decided that a system-wide approach was necessary.

On October 17, 2006, by ordinance, your Board approved the establishment of the AAS, HOME Team. This case management team is made up of a Social Work Supervisor, Community Worker, Public Health Nurse, and Social Worker. Your Board also adopted Resolution 68334 authorizing a grant agreement with the Silicon Valley Community Foundation, formerly known as the Peninsula Community Foundation, for the term of December 1, 2006 through November 30, 2007, in the amount $100,000.

On September 11, 2007, by Resolution 68973, your Board authorized Amendment One extending the term of the grant agreement from December 1, 2006 through November 30, 2007 to December 1, 2006 through May 31, 2008, with no increase to the amount of $100,000.

DISCUSSION:

HOME Team clients are the County’s most vulnerable population: adults with chronic disease and mental health diagnoses, often homeless and often having few support systems. The HOME Team engages and motivates these clients to define problems, seek treatment, set priorities and establish goals. The HOME Team also creates individual service plans and provides access to established systems and services such as primary care, housing resources and substance abuse treatment. This year the HOME Team will also examine jail days and ambulance usage of clients in order to evaluate the program’s success in reducing incarceration and the need for emergent care.

Approval of this Grant Agreement with the Silicon Valley Community Foundation in the amount of $230,364 will pay part of the costs for the continuation of the HOME Team.

The Resolution and Grant Agreement have been approved as to form by County Counsel.

FISCAL IMPACT:

The term of the Grant Agreement is September 1, 2008 through August 31, 2010. The total award is $230,364. AAS has included $100,000 of this funding in the FY 2008-09 Adopted Budget. The Net County Cost included in the AAS FY 2008-09 Adopted Budget is $309,544. There is no change in Net County Cost for the HOME Team as this is a continuation of grant funding.