Inter-Departmental Correspondence

Health System



May 20, 2010


June 22, 2010







Honorable Board of Supervisors


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



Second Amendment to the Agreement with Self Help for the Elderly modifying funding and services



Adopt a Resolution authorizing the President of the Board to execute the Second Amendment to the Agreement with Self Help for the Elderly, for the provision of supportive, nutrition and community-based services and to expand services and increase the total amount by $62,161 from $443,271 to $505,432 with no change to the term of July 1, 2009 through June 30, 2010.



On November 10, 2009, your Board authorized Resolution 70507 approving agreements with 25 providers for Adult Day Care/Adult Day Health Care, Alzheimer’s Program, Brown Bag Program, Case Management, Congregate Nutrition, Family Caregiver Support, Health Insurance Counseling and Advocacy Program (HICAP), Health Promotion/Disease Prevention, Home-Delivered Meals, Legal Assistance, Ombudsman Services, Senior Employment and Transportation. The total aggregate amount of the 25 agreements was $3,151,236 for the term of July 1, 2009 through June 30, 2010, to provide these services to at-risk individuals in San Mateo County. This Resolution also authorized 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.


On March 16, 2010, Change Order 5700010R70507X-1 was approved by the Health System. This amendment authorized the use of $10,337 in federal Medicare Improvements for Patients and Providers Act (MIPPA) funds, which were accepted by your Board on December 1, 2009, through the adoption of Appropriation Request Transfer (ATR) 70529. The total amount of the agreement increased to $443,271 with no change to the term. The MIPPA funds are being used to enhance the outreach and enrollment services of HICAP.


On April 27, 2010, an ATR was brought before your Board authorizing the acceptance of additional federal and State one-time-only Older Americans Act and HICAP funding in the amount of $334,026. Upon receiving notification of the one-time-only funding, Aging and Adult Services (AAS) invited the 25 current providers to submit proposals for the additional funds that were not used to backfill mid-year State reductions. Exhibit A notes each of the 17 contractors and the change amount to the corresponding Agreement. Of the 17 amendments 13 will be approved by the Chief of the Health System due to the amounts being less than $25,000 in aggregate. The other three amendments requiring your Board’s approval were approved at the June 8, 2010 meeting. This Amendment to the Agreement with Self Help for the Elderly is being brought to your Board separately due to a delay in receiving the signed Amendment from the provider.



This fiscal year the State allowed baseline direct client services to be enhanced through one-time-only funds. These baselines include Adult Day Care, Case Management, Congregate, Legal Assistance, Ombudsman, and Transportation services. One-time-only funding for baseline services will be used to increase the units of assistance, trips, congregate and home-delivered meals, to purchase food and supplies, and to expand direct client services. One-time-only funds not used for baseline services will be used for the purchase of food preparation and computer equipment, and for the development of outreach projects for the provision of information services in multiple languages to increase community education and awareness of programs and services available in the County.


County Counsel has reviewed and approved the Resolution and Amendment as to form.


This Amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by allowing AAS to provide services to at-risk individuals that 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:


FY 2009-10

FY 2010-11

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





The term of the Agreement remains the same, July 1, 2009 through June 30, 2010. The maximum the County shall be obligated to pay for this amended Agreement for FY 2009-10 is $62,161 in one-time-only funds for a total amount of $505,432 for the full contract term. There is no Net County Cost associated with this action.