COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health System

DATE:

December 30, 2009

BOARD MEETING DATE:

January 26, 2010

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Four-fifths

TO:

Honorable Board of Supervisors

FROM:

Jean S. Fraser, Chief, Health System

Susan Ehrlich, MD, MPP, Chief Executive Officer,

San Mateo Medical Center

SUBJECT:

Award from the Department of Health and Human Services Health Resources and Services Administration for the Facility Improvement Project for Coastside Clinic Renovation

RECOMMENDATION:

Approve an Appropriation Transfer Request in the amount of $1,765,876 from unanticipated revenue in the Health System to Capital Projects for the Facility Improvement Project for the Coastside Clinic renovation.

BACKGROUND:

The County is the master tenant in a building at 225 Cabrillo Highway in Half Moon Bay. The building houses several Health System divisions and previously housed the Coastside Family Medical Center (CFMC) as a subtenant. The Health System provides mental health and medical services through its divisions of Behavioral Health and Recovery Services and San Mateo Medical Center (SMMC) on the second floor. CFMC, a private, non-profit community clinic that served private-pay patients as well as uninsured and Medi-Cal patients provided services on the first floor of the building until CFMC’s bankruptcy in March 2009.

There is only one dental clinic, Sonrisas, serving poor and uninsured patients on the Coast. With the demise of CFMC the Coastside Clinic, operated by SMMC, is the sole, fixed-site clinic providing primary care to un-/under-insured patients on the Coast. It has insufficient space to absorb escalating demand and lacks facilities for dental care. Public transportation is limited on the Coast and few homeless or migrant seasonal farm workers (MSFW) have vehicles to make the 30-60 minute car trip “over the hill” to San Mateo. The estimated Coastside population of MSFWs and their family members is 3,343 to 4,564, and of homeless people is 466.

On August 6, 2009, the Health System submitted a grant proposal to the Department of Health and Human Services Health Resources and Services Administration (HRSA) for facility improvement to the Coastside Clinic building The grant opportunity is a part of the American Recovery and Reinvestment Act of 2009 (ARRA). Nationwide there were almost 650 applications for more that $508 million. The County’s project was one of only 85 grants awarded.

DISCUSSION:

On December 9, 2009, HRSA awarded San Mateo County $1,756,876 for the clinic renovation project. SMMC will expand and renovate the first floor to provide access to primary care and dental services for un-/under-insured homeless people in the County’s rural Coastside area.

The renovation project will expand the primary care areas; construct dental operatories and a dental lab area; add a children’s waiting area; make internal modifications to reflect design of patient-centered clinical areas and efficient work areas; upgrade systems and fixtures for energy efficiency and to accommodate more patients; and ensure that entry, path of travel, and use-of-services comply with the Americans with Disabilites Act (ADA) and Health Insurance Portability and Accountability Act (HIPAA).

Your Board previously authorized the County Manager to execute applications and other documents associated with ARRA-funded projects. The Grant Award and this memo have been reviewed and approved by County Counsel.

Acceptance of this Award contributes to the Shared Vision 2025 outcome of a Healthy Community by expanding the County’s patient service capacity resulting in increased use by un-/under-insured patients. It is anticipated that 78% of clinic patients will be assigned a primary care physician which is an indicator of overall patient quality of care.

Performance Measure(s):

Measure

FY 2008-09
Actual

FY 2009-10
Projected

Percent of Clinic Patients assigned to a Primary Care Provider

--*

78%

*Methodology was revised in FY 2008-09 for data-collection consistency.

FISCAL IMPACT:

The term of the Award is December 9, 2009 through December 8, 2011 and the maximum amount of funding is $1,765,876. The Appropriation Transfer Request appropriates the funds to the Health System and supports subsequent payment to the Department of Public Works who will manage the project and oversee construction.