To: Board of Supervisors
From: DHHS: Public Health
Agenda Section: Consent
SUBJECT:
title
Agreement for the County Medical Services Program (CMSP) Governing Board Health Systems Development Grant Program
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve the Health Systems Development Grant Program agreement between the CMSP Governing Board and the Department of Health and Human Services (DHHS) - Public Health;
2. Authorize the DHHS - Public Health Director or designee to sign four original signature pages of the agreement and four original Grantee Data Sheets (Exhibit D); and
3. Authorize the DHHS - Public Health Director or designee to sign future amendments or budget revisions directly related to this agreement upon review and approval of County Counsel and Risk Management.
Body
SOURCE OF FUNDING:
Public Health Funds
DISCUSSION:
The County Medical Services Program (CMSP) oversees healthcare services to indigent adults in rural counties within the state of California who do not qualify for Medi-Cal. Humboldt County is a CMSP county. The CMSP Governing Board is authorized to set overall program and fiscal policy for the program.
Recently, the CMSP Governing Board offered a Health Systems Development Grant, which is intended to support local health care systems in CMSP counties to develop and implement strategies that strengthen the overall health care delivery system and facilitate effective delivery of services to enrolled CMSP members, potential CMSP members and other patients receiving publicly funded health coverage. Upon County Administrative Office approval, DHHS - Public Health applied for the Health Systems Development Grant Program and was awarded a one-time, 3-year grant of $300,000.
DHHS - Public Health has been approved to pursue two objectives with this grant funding. The first objective is to link CMSP and other publicly funded Humboldt County residents to hepatitis C virus (HCV) services including prevention, treatment and other supportive services to assist in achieving sustained virologic response (or suppression of the virus). Humboldt County has high rates of HCV, with 436 newly reported chronic cases from 2014 to 2018, establishing an estimated prevalence of 5.26%, well above national prevalence estimates of 1.0% from the Centers for Disease Control & Prevention. DHHS - Public Health’s Communicable Disease and Healthy Communities programs work together to identify people with HCV and link them to treatment. Communicable Disease staff monitor all case reports, contacting those diagnosed to care. This grant will strengthen the programs’ capacity to improve surveillance systems and identify and reduce barriers to successful treatment by partially funding a HCV specialist, who will work with health care providers and patients alike in improving access to care. The HCV specialist will also work to reduce the number of new HCV diagnoses by providing confidential HCV testing, prevention resources and supplies, risk reduction counseling and providing educational sessions to individuals identified to be at high risk for contraction of HCV, and/or those seeking support in prevention.
The second goal for this grant project is to support the development of a collective impact approach to improving the health status of Humboldt County. Not only are Humboldt County’s overall health outcomes poor in comparison to the state and on a national level, there are notable health disparities that indicate health inequities. DHHS - Public Health has recognized that in order to effectively improve population health outcomes, Public Health staff, health care providers and other stakeholders in the health system need to strategically align efforts to tackle these issues. DHHS - Public Health, in collaboration with local health care providers and stakeholders, have begun to create a collective impact initiative, Live Well Humboldt. This grant will effectively strengthen the backbone for the Live Well Humboldt initiative through funding a contracted facilitator to lead meetings and align goals and strategies amongst health care providers, DHHS - Public Health and other stakeholders in the community, with the goal of developing a Community Health Improvement Plan (CHIP). Improving population health takes time and effort, and through building a data-sharing platform to monitor progress of the CHIP through aligned strategies and collaboration, improved health outcomes are more likely over time.
The Health Systems Development Grant Program agreement before your Board today would allow DHHS - Public Health to accept the $300,000 grant award for the period of May 1, 2019 through Sept. 30, 2022.
This agreement appears before your Board after the start date due to late receipt of the agreement from CMSP at the end of April 2019.
FINANCIAL IMPACT:
Acceptance of the grant award from CMSP will allow DHHS - Public Health to be reimbursed a maximum of $300,000 for the period of May 1, 2019 through Sept. 30, 2022. This grant will reside in in fund 1175, budget unit (BU) 400 - Public Health Administration in the amount of $75,000, BU 419 - TB Control in the amount of $150,000 and BU 437 - CARE NorCAP in the amount of $75,000. The grant agreement requires a 20% match, DHHS-Public Health will meet this requirement with budgeted staff activities that are related to the support and implementation of the grant projects.
Upon execution of the grant agreement, CMSP will issue the first grant payment in the amount of $30,000. The funds will be held in trust until expended. The remaining amount of the agreement will be provided on a bi-annual basis for the duration of the funding period.
There is sufficient appropriation in the fiscal year (FY) 2018-19 budgets in fund 1175, BU 400 - Public Health Administration, BU 419 - TB Control, and BU 437 - CARE NorCAP.
The expenditures for the grant funds were included in the proposed FY 2019-20 budgets in fund 1175, BU 400 - Public Health Administration and fund 1175, BU 419 - TB Control. Execution of this grant agreement will result in savings to budgeted Public Health Realignment revenues and expenditures for these BUs. The grant expenditures that relate to BU 437 - CARE NorCAP were not included in the proposed budgets for FY 2019-20. A supplemental budget for FY 2019-20 budget in fund 1175, BU 437 - CARE NorCAP will go before the Board after the FY 2019-20 budget adoption.
The funding amounts for subsequent years of the agreement will be included in the annual budget process.
There is no impact to the county’s General Fund.
STRATEGIC FRAMEWORK:
This action supports your Board’s Strategic Framework by creating opportunities for improved safety and health.
OTHER AGENCY INVOLVEMENT:
N/A
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board could choose to not approve the Health Systems Development Grant Program agreement. However, that is not recommended as it would result in loss of opportunity for outside funding to address public health needs in Humboldt County.
ATTACHMENTS:
Agreement for the County Medical Services Program Governing Board Health Systems Development Grant Program
PREVIOUS ACTION/REFERRAL:
Board Order No.: N/A
Meeting of: N/A
File No.: 19-833