The County of Santa Clara
California

Agreement/Amendment
97908

Consider recommendations relating to various Community Health Clinic One-time Subsidy Contracts. (Santa Clara Valley Health and Hospital System)

Information

Department:Santa Clara Valley Health and Hospital SystemSponsors:
Category:Agreement

Multiple Recommendations

Possible action:
a. Ratify agreement with Asian Americans for Community Involvement, Inc., for one-time operating supplement relating to participation in the County's Waiver-related programs in an amount not to exceed $400,000 for period June 1, 2019 through June 30, 2019, that has been reviewed and approved by County Counsel as to form and legality. A single source exception to competitive procurement has been approved by the Office of Countywide Contracting Management pursuant to Board of Supervisors Policy 5.6.5.1(D)(2)(a).
b. Ratify agreement with Gardner Family Health Network, Inc., for one-time operating supplement relating to participation in the County's Waiver-related programs in an amount not to exceed $380,000 for period June 1, 2019 through June 30, 2019, that has been reviewed and approved by County Counsel as to form and legality. A single source exception to competitive procurement has been approved by the Office of Countywide Contracting Management pursuant to Board of Supervisors Policy 5.6.5.1(D)(2)(a).
c. Ratify agreement with Indian Health Center of Santa Clara Valley, for one-time operating supplement relating to participation in the County's Waiver-related programs in an amount not to exceed $525,000 for period June 1, 2019 through June 30, 2019, that has been reviewed and approved by County Counsel as to form and legality. A single source exception to competitive procurement has been approved by the Office of Countywide Contracting Management pursuant to Board of Supervisors Policy 5.6.5.1(D)(2)(a).
d. Ratify agreement with School Health Clinics of Santa Clara County, for one-time operating supplement relating to participation in the County's Waiver-related programs in an amount not to exceed $95,000 for period June 1, 2019 through June 30, 2019, that has been reviewed and approved by County Counsel as to form and legality. A single source exception to competitive procurement has been approved by the Office of Countywide Contracting Management pursuant to Board of Supervisors Policy 5.6.5.1(D)(2)(a).
e. Ratify agreement with Planned Parenthood Mar Monte, for one-time operating supplement relating to participation in the County's Waiver-related programs in an amount not to exceed $351,000 for period June 1, 2019 through June 30, 2019, that has been reviewed and approved by County Counsel as to form and legality. A single source exception to competitive procurement has been approved by the Office of Countywide Contracting Management pursuant to Board of Supervisors Policy 5.6.5.1(D)(2)(a).
f. Ratify agreement with East Valley Community Clinic, dba Mar Monte Community Clinic, for one-time operating supplement relating to participation in the County's Waiver-related programs in an amount not to exceed $196,000 for period June 1, 2019 through June 30, 2019, that has been reviewed and approved by County Counsel as to form and legality. A single source exception to competitive procurement has been approved by the Office of Countywide Contracting Management pursuant to Board of Supervisors Policy 5.6.5.1(D)(2)(a).

Body

FISCAL IMPLICATIONS

Approval of the recommended actions would not require modification to the FY 19/20 Adopted Budget for Santa Clara Valley Medical Center (SCVMC), Valley Health Plan (VHP) or Community Health Services (CHS).  The funds required to support the proposed amendments were included in the services and supplies appropriations for these budget units.

CONTRACT HISTORY

These are new agreements. The Community Health Clinics have been receiving funding from the County for the operation of their clinics to provide primary care services to residents of Santa Clara County for a number of years with the most recent agreement ending June 30, 2019.

REASONS FOR RECOMMENDATION

As community health clinics are transitioning to performance-based contracts, this one-time funding is to aid with the transition and ensure they remain financially viable.

In order to assist community health clinics with the operating supplement, the funds needed to be distributed during FY 18/19. The decision to provide the supplement was made late in FY 18/19, therefore the agreements were signed under the County Executive’s emergency authority pursuant to Board Policy Chapter 5.3.5.1., for which approval was received on June 28, 2019 and used as the effective date.

CHILD IMPACT

The recommended action will have no/neutral impact on children and youth, as the program would cover those 19 years of age and older.

SENIOR IMPACT

The recommended action would have a positive impact on seniors who would qualify for the programs.

SUSTAINABILITY IMPLICATIONS

The recommended action will have no/neutral sustainability implications.

BACKGROUND

The Health System has been working closely with the community health clinics to further develop the Medical 2020 Waiver programs by improving processes and communications and working harder to meet metrics. While some clinics have hit certain marks for performance, there are areas for improvement and the Health System is helping clinics transition to the performance-based model. 

The Centers for Medi-cal and Medicaid Services and the California Department of Health Care Services negotiated California’s 1115 Waiver renewal for the period January 1, 2016 through December 31, 2020. The new Waiver, called Medi-Cal 2020, included $7.4 billion of federal funding to support the state’s Medi-Cal program and health care coverage of more than 12.8 million individuals.

Medi-Cal 2020 Waiver was intended to continue California’s momentum and successes in innovation achieved under the Bridge to Reform and shift attention from preparing for the Affordable Care Act (ACA) to developing systems in order to transform care delivery from episodic to preventive care. With this Waiver, public systems were incentivized to move further upstream in the care delivery system by integrating care models for disease management, disease prevention and caring for the whole person.

The Medi-Cal 2020 Waiver was designed to:

·        Bring innovative changes in the way Medi-Cal provides services to its enrollees.

·        Improve efficiency, access and quality of care.

·         Ensure long-term viability of the delivery system post-ACA expansion.

CONSEQUENCES OF NEGATIVE ACTION

Community health clinics would suffer operating budget shortfall in FY 19/20 and future Waiver-related services would be negatively impacted.

STEPS FOLLOWING APPROVAL

The Clerk of the Board of Supervisors will send notification to Veronica Vargas Soliz, Contracts Manager, Health System Contract Solutions Department.

Meeting History

Aug 13, 2019 9:30 AM Video Board of Supervisors Regular Meeting
RESULT:RATIFIED [UNANIMOUS]
MOVER:Cindy Chavez, Vice President
SECONDER:S. Joseph Simitian, President
AYES:Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Simitian