Inter-Departmental Correspondence

Health System



April 27, 2010


May 25, 2010







Honorable Board of Supervisors


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



Agreement with Addus HealthCare, Inc. for In-Home Supportive Services



Adopt a Resolution:


Authorizing the President of the In-Home Supportive Services Public Authority to execute an Agreement with Addus HealthCare, Inc., for the term July 1, 2010 through June 30, 2013, in the amount of $10,652,850 for the administration of contracted provider components of In-Home Supportive Services; and



Authorizing the Chief of the Health System or 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.



In September 1993 by ordinance of the San Mateo County Board of Supervisors, a Public Authority was established to administer the provider components of the In-Home Supportive Services (IHSS) program. The enabling ordinance designated the Board of Supervisors as the Governing Board of the Public Authority (PA). There are approximately 3,200 senior and disabled clients receiving IHSS in San Mateo County. Services are delivered by both individual providers, who serve a majority of the clients, and a contract agency serving approximately 150 clients annually. Clients who are unable to hire, supervise or fire their own providers due to the type or severity of their disabilities are referred to the contractor for services. Contract services are reserved for the most at-risk clients who would otherwise need to be placed outside their homes. These services are an integral part of our service delivery system. Contract services enable individuals to remain independent for as long as safely possible and avoid premature institutionalization.


In December 2009 Aging and Adult Services (AAS), acting on behalf of the PA, issued a Request for Proposals (RFP) for IHSS contract services for a three-year period beginning July 1, 2010. Two organizations submitted proposals in response to the RFP: Addus HealthCare, Inc., and Maxim Healthcare Services, Inc. A review committee made up of representatives from various Health System divisions and a community-based agency evaluated the proposals. The committee reviewed each applicant’s experience, cost, and ability to comply with program requirements. Based on the criteria and the committee’s evaluation, Addus HealthCare, Inc., was selected to provide IHSS contract services for the three-year period.



Payment for services provided under this Agreement is dependent on the availability of federal, State and County revenues at the sharing ratios in existence as of the date of execution of this Agreement. The current State-approved Maximum Allowable Contract Rate (MACR) for IHSS Contract Services is $19.02 per hour. AAS has agreed to pay the contractor at a rate of $19.02 per hour for direct services and a monthly fee for administrative services. Risk Management has reviewed and approved this Agreement. County Counsel has reviewed and approved the Resolution and Agreement as to form.


Approval of this Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by allowing AAS to provide IHSS to clients who are unable to hire, supervise or fire their own providers due to the type of severity of their disabilities; thus helping maintain the client in the least restrictive setting and improving their quality of life. It is anticipated that 96% of consumers will indicate that their quality of living situation has improved as a result of services received through the PA.


Performance Measure:


FY 2008-09

FY 2009-10

Percent of consumers indicating their quality of living situation has improved as a result of services received through the Public Authority



*The PA exceeded the target measure of 96% in FY 2008-09.



The term of this Agreement is July 1, 2010 through June 30, 2013. The maximum hours that can be purchased under this Agreement each year are 172,500 at a fixed rate of $19.02 per hour. That with $270,000 for administrative services make up the total annual amount of $3,550,950. The maximum amount payable under the Agreement for the three-year term is not to exceed $10,652,850. State and federal funds pay approximately 82.17% of the cost of this Agreement. The remaining 17.83% ($1,899,403) represents the required County obligation for the Agreement. Appropriation for the first year of this Agreement is included in the PA’s FY 2010-2011 Recommended Budget.




General Description of RFP

Contract Services for In-Home Supportive Services


List key evaluation criteria

    Prior experience

    Demonstrated competence in performing the services required

    Appropriate plan for delivery of services including staff training and experience, skills, staff-to-client ratio, effective system of supervision

    Cost and cost allocations

    Ability to document services, provide reports, and maintain records


Where advertised

Daily Journal: once on a weekday and once on a weekend


In addition to any advertisement, list others to whom RFP was sent

73 letters were mailed to providers and service organizations informing them of the RFP.


Total number of RFP’s sent to prospective proposers

Requests were downloaded from the Health System’s website.


Number of proposals received



Who evaluated the proposals

The review committee consisted of members from:

Public Authority

Aging and Adult Services

Legal Aid Society

Health System Administration


In alphabetical order, names of proposers (or finalists, if applicable) and location

Addus HealthCare, Inc., Clovis, CA

Maxim Health Care Services, Inc., San Jose, CA