Title
a. Approve and authorize the Director of Health or their designee to sign Amendment No. 5 to Agreement No. A-14311 (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) extending the term to July 31, 2023, for a revised full term of May 21, 2019, through July 31, 2023, and increasing the total contract amount by $125,000 for a new agreement total of $1,058,445 for continued legal services to patients of the Monterey County Health Department Clinic Services Bureau (“Clinic Services”) addressing social determinants of health.
b. Authorize the Director of Health, or Assistant Director of Health to sign up to two (2) future amendments where the amendments do not exceed 10% ($105,844) of the agreement amount and do not significantly change the scope of work.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health or their designee to sign Amendment No. 5 to Agreement No. A-14311 (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) extending the term to July 31, 2023, for a revised full term of May 21, 2019, through July 31, 2023, and increasing the total contract amount by $125,000 for a new agreement total of $1,058,445 for continued legal services to patients of the Monterey County Health Department Clinic Services Bureau (“Clinic Services”) addressing social determinants of health.
b. Authorize the Director of Health, or Assistant Director of Health to sign up to two (2) future amendments where the amendments do not exceed 10% ($105,844) of the agreement amount and do not significantly change the scope of work.
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Clinic Services) operates ten community clinic sites designated as Federally Qualified Health Centers (FQHCs) which provide preventive, primary, and specialty medical care services.
CRLA is a non-profit legal service program created to help low-income individuals and communities throughout California.
CRLA began providing on-site legal services at the Alisal Health Center clinic in December 2017 and has since expanded its services to three different sites and added additional CRLA staff to support growing patient caseloads. Services are provided at no cost to patients to help address a wide variety of legal issues facing them which can adversely affect their ability to improve their health and well-being. Many of these issues arise from social determinants of health, including workplace safety, environmental health, exposure to violence, and lack of adequate housing. Referrals are also provided to other legal service organizations for immigration, criminal, and other legal needs.
Since December 2017, data shows that 682 Clinic Services’ patients have accessed the legal services available to them at no-cost through this Medical-Legal Partnership (MLP).
Agreement No. A-14311 was first approved by the Board of Supervisors on May 21, 2019 to expand the MLP program to additional patients in other clinic locations with funding from the Monterey County Health Department’s Whole Person Care program (WPC). Amendment No. 1 was approved by the Board of Supervisors on August 18, 2020, to increase approved funding for one additional CRLA attorney and one administrative staff member in support of the growing MLP patient caseload across the clinics. Amendment No. 2 was approved on July 1, 2021 to extend the term of the Agreement to December 31, 2021, and Amendment No. 3 was approved on January 1, 2022 to extend the contract an additional six months through June 30, 2022 while County and CRLA negotiated continued services and new funding sources for 2022.
Clinic Services was able to maintain this Agreement through a new funding opportunity from the State Epidemiology and Laboratory Capacity (ELC) Program executed under Amendment No. 4 and effective May 1, 2022 through January 1, 2023. To continue providing uninterrupted patient access to these no-cost services, Clinic Services seeks approval of Amendment No. 5 effective retroactively to February 1, 2023 through July 31, 2023.
This work supports the Monterey County Health Department 2018-2022 Strategic Plan initiatives: 2. Enhance community health and safety through prevention; and 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports one or more of the ten essential public health services, specifically: 4. Mobilize community partnerships and action to identify and solve health problems, and 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Amendment as to form. Auditor-Controller has reviewed and approved as to fiscal provisions. This Amendment has been reviewed by Public Health in relation to the funding component.
FINANCING:
This Amendment No. 5 will be fully funded with Whole Person Care funds. Appropriations for this Agreement are included in the Health Department’s (023-4000-8473-HEA017) FY 2022-23 Adopted Budget and will be included in the FY 2023-24 Requested Budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Prisca Segovia, Management Analyst II, 755-4939
Approved by:
______________________________Date:_________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachments:
Board Report
Amendment No. 5
Amendment No. 4
Amendment No. 3
Amendment No. 2
Amendment No. 1
Agreement