COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health System

DATE:

September 29, 2010

BOARD MEETING DATE:

December 7, 2010

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Jean S. Fraser, Chief, Health System
Susan Ehrlich, MD, MPP, Chief Executive Officer
San Mateo Medical Center

SUBJECT:

Agreements with Ravenswood Family Health Center

RECOMMENDATION:

Adopt a Resolution authorizing the:

A)

President of the Board to execute two Agreements with Ravenswood Family Health Center: (1) providing dental health care for homeless individuals, for a maximum obligation of $150,000; and (2) providing primary medical care for homeless individuals for a maximum obligation of $271,371, each for a term of

November 1, 2010 through October 31, 2013; and

B)

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.

BACKGROUND:

San Mateo Medical Center (SMMC) was awarded the Health Care for the Homeless (HCH) grant from the Federal Bureau of Primary Health Care of the Health and Resources Services Administration to provide primary, dental, and behavioral health care to San Mateo County’s homeless population. The HCH Program is designed to assist homeless adults, families and youth with access to and utilization of SMMC’s continuum of care and other support services. The HCH Program contracts with both County and community-based programs to provide this care.

In July 2010 SMMC conducted a Request for Proposals (RFP) process for the Homeless Program – Primary Care (fixed site and mobile) and Dental Care (fixed site). Four proposals, two in each category, were received and evaluated. Each responder provided a unique capacity in service delivery or in reaching target populations.

DISCUSSION:

Ravenswood Family Health Center (RFHC) was selected to receive funding for both Primary Health Care and Dental Care for the homeless population in the East Palo Alto/Belle Haven neighborhoods. The 2009 San Mateo County Homeless Census identified that 88% of the homeless persons in East Palo Alto were unsheltered, and the proportion of homeless was significantly higher than any other area of the County. In order to better track grant funding, RFHC will have two agreements, one agreement will provide comprehensive primary health care services to at least 504 unique homeless individuals and the second agreement will provide dental health care services to at least 133 homeless individuals each year.

RFHC has been providing primary health care for the homeless under contract with HCH since 2004, and in 2009 delivered services to over 750 homeless patients. RFHC opened the Ravenswood Family Dentistry facility in April 2010 and provided dental services to more than 50 homeless individuals within the first three months.

County Counsel has reviewed and approved these Agreements and Resolution as to form. The Contractor’s insurance has been reviewed and approved by Risk Management.

The Contractor has assured compliance with the County’s Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

These Agreements contribute to the Shared Vision 2025 outcome of a Healthy Community by providing access to primary health care services and dental care services to homeless individuals. It is anticipated that the average number of primary care visits per homeless patient will be 4.6 visits per patient. This is an indicator of the establishment of a medical home for the homeless patients.

Performance Measure:

Measure

FY 2009-10
Actual

FY 2010-11
Projected

Average number of primary care visits per homeless patient (standard is 3.0 visits per patient for “medical home”)

4.6

4.6

FISCAL IMPACT:

The term of these Agreements is November 1, 2010 through October 31, 2013. The maximum fiscal obligation is $421,371. Funds in the amount of $140,457 are included in the SMMC Adopted FY 2010-11 Budget. Funds in the amount of $140,457 will be included in the SMMC FY 2011-12 Recommended Budget. Similar arrangements will be made for future years.

Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care are covered by the County’s General Fund contribution to SMMC.

1.

General Description of RFP

Provide for the Healthcare for the homeless program – primary care (fixed and mobile) and dental care (fixed)

2.

List key evaluation criteria

Quality and feasibility of proposed approach to meeting program requirements, RFP intent and target population services, including the quality of the proposals: Program Service Description; Program Service Delivery; Program Objectives; Program Community Collaboration; Program Management; Outcome Reporting; and Budget.

Client Service

Efficiency of Services Provided Against Amount of Funds

3.

Where advertised

San Mateo Medical Center Website

4.

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

Ravenswood Family Health Center, Attn: Aaron Lones

Ravenswood Family Health Center, Attn: Wilfredo Cerrato

Public Health Mobile Van and Edison Clinic

Public Health Mobile Van

Onsite Health, Inc.

St. Vincent de Paul Society

Shelter Network, Attn: Brian Greenberg

Shelter Network, Attn: Chris Canter

AOD, BHRS, Attn: Catherine Barber

AOD, BHRS, Attn: Mark Korwald

Center on Homelessness, HSA

Project 90 Inc.

Sonrisas Community Dental Center

VA Palo Alto Health Care System

S.M.A.R.T., Adult Resource Mgmt, BHRS

Home and Hope

Safe Harbor Shelter (Samaritan House), Attn: Melissa Moss

Safe Harbor Shelter (Samaritan House), Attn: Maryam Bhimji

El Concilio of San Mateo County

Pacifica Resource Center

Fair Oaks Community Center

North Peninsula Neighborhood Services Center

Puente de la Costa Sur

Coastside Hope Community Assistance Center

Daly City Partnership

Coastside Collaborative

Pacifica Collaborative

Community Information Program

Multicutural Institute

Next Step Center, Attn: Anthony Baugh

Next Step Center, Attn: Elizabeth Fraley

First Step for Families, San Mateo

Inn Vision/Clara Mateo

WeHOPE, EPA

5.

Total number sent to prospective proposers

34

6.

Number of proposals received

4

7.

Who evaluated the proposals

Bob Stebbins, St. Vincent DePaul Society;, Pernille Gutschick, Supervising Mental Health Clinician, BHRS; Ann Marie Silvestri, SMMC Dental Program Manager; Tish Birkby, HSA Center on Homelessness; and Jim Beaumont, SMMC HCH Program Manager

8.

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

Coastside Medical Clinics doing business as Sonrisas

210 San Mateo Road, Suite 104

Half Moon Bay, CA 94019

Ravenswood Family Health Center (Dental Care)

1798 A Bay Road

East Palo Alto, CA 94303

Ravenswood Family Health Center (Primary Care)

1798 A Bay Road

East Palo Alto, CA 94303

San Mateo County Health System/Mobile Clinic

225 37^th Avenue

San Mateo, CA 94403