COUNTY OF SAN MATEO

Inter-Departmental Correspondence

HEALTH SYSTEM

DATE:

November 9, 2009

BOARD MEETING DATE:

December 1, 2009

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

4/5^th Vote Required

TO:

Honorable Board of Supervisors

FROM:

Jean S. Fraser, Chief, Health System
Lisa Mancini, Director, Aging and Adult Services

SUBJECT:

Agreement with the California Department of Aging for Medicare Improvements for Patients and Providers Act of 2008 services

RECOMMENDATION:

1.

Adopt a Resolution:

A.

Authorizing the President of the Board to execute Agreement No. MI-0910-08 with the California Department of Aging for funding under the Medicare Improvements for Patients and Providers Act of 2008 for expanding Medicare beneficiary enrollment for the term August 1, 2009 through May 31, 2011, in the amount of $23,986; and

B.

Authorizing the Chief of the Health System or designee to execute contract amendments which modify the funding amount 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.

2.

Approve an Appropriation Transfer Request recognizing unanticipated revenue in the amount of $11,993 increasing appropriations in Provider Services Programs for FY 2009-10.

BACKGROUND:

In June 2008 the Medicare Improvements for Patients and Providers Act (MIPPA) was signed into law. MIPPA amended titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access.

The California Department of Aging (CDA) received a two-year non-competitive grant in MIPPA funding from the federal government. These funds were allocated to Area Agencies on Aging Health Insurance Counseling and Advocacy Programs (HICAP) and Aging and Disability Resource Centers.

DISCUSSION:

Aging and Adult Services (AAS) contracts with a community-based organization, Self-Help for the Elderly, to provide HICAP, a volunteer-supported program that provides three basic services: community education, lay counseling, and advocacy related to Medicare. Self Help for the Elderly was selected to provide HICAP services through a Request for Proposals process conducted in December 2008 for the contract term July 1, 2009 through June 30, 2013. HICAP is an integral component of California’s community-based long-term care system. Medicare beneficiaries and those under 65 who are about to become eligible for Medicare or who are disabled and on Medicare are eligible for HICAP services.

This Agreement with CDA allows AAS to receive federal MIPPA funds and to work with HICAP to expand Medicare beneficiary enrollment in the Prescription Drug Benefit Low Income Subsidy Program, the Medicare Savings Program, and in general rural outreach and enrollment efforts for Medicare Part D. In our County, 92% of the funds will be passed on to the community provider. The remaining 8% will be put toward the administrative costs to the County for this State-funded program.

County Counsel has reviewed and approved the Agreement and Resolutions as to form.

The funding from this Agreement contributes to the Shared Vision 2025 by allowing AAS to provide HICAP services for at-risk individuals that are eligible for Medicare and to help them remain in the most independent setting possible. It is anticipated that 95% of at-risk individuals will be maintained in a least restrictive setting through case management.

Performance Measure:

Measure

FY 2008-09
Actual

FY 2009-10
Projected

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

94%

95%

FISCAL IMPACT:

The term of this Agreement is August 1, 2009 through May 31, 2011. Execution of this Agreement with CDA allows the County to claim its allocation of MIPPA funding in the amount of $11,993 for FY 2009-10 and $11,993 for FY 2010-11. The total amount of the Agreement is $23,986 in federal funds. Funds for FY 2010-11 will be included in the AAS FY 2010-11 Recommended Budget. There is no Net County Cost associated with this Agreement.