Title
a. Authorize the Director of Health, or Assistant Director of Health to sign a Standard Agreement (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) to provide legal services to patients of the Clinic Services Bureau to address social determinants of health, for the term May 21, 2019 to December 31, 2020 and an Agreement amount not to exceed $387,520.00;
b. Approve the recommendation of the Director of Health to approve non-standard risk provisions regarding indemnification and business automobile liability insurance; and
c. Authorize the Director of Health or Assistant Director of Health to sign up to three (3) future amendments that do not exceed 10% ($38,752.00) of the total Agreement amount and do not significantly change the scope of work.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Authorize the Director of Health, or Assistant Director of Health to sign a Standard Agreement (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) to provide legal services to patients of the Clinic Services Bureau to address social determinants of health, for the term May 21, 2019 to December 31, 2020 and an Agreement amount not to exceed $387,520.00;
b. Approve the recommendation of the Director of Health to approve non-standard risk provisions regarding indemnification and business automobile liability insurance; and
c. Authorize the Director of Health or Assistant Director of Health to sign up to three (3) future amendments that do not exceed 10% ($38,752.00) of the total Agreement amount and do not significantly change the scope of work.
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Clinic Services) operates nine community clinic sites designated as Federally Qualified Health Center Look-Alikes (FQHC-LA), which provide preventative, primary, and specialty medical care services.
As health care systems continue to gain depth as patient centered medical homes for patients, primary care providers are incorporating legal services on-site. CRLA is a non-profit legal service program created to help low-income individuals and communities throughout California. Since December 2017, CRLA has been providing on-site legal services to County patients at the Alisal Health Center clinic through a Facility Use Agreement. Services are provided at no cost to help patients 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. Data from December 13, 2017 through December 12, 2018, shows 170 patients have accessed legal services through the Medical-Legal Partnership (MLP) at the Alisal Health Center.
With the approval of this Agreement and through the funding of the Monterey County Health Department’s Whole Person Care program, CRLA will be able to expand and offer the MLP program to additional patients in other clinic locations.
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 and the Auditor-Controller have reviewed the Agreement as to legal form and fiscal provisions. The Health Department is requesting modification of the Business Automobile Liability Insurance owned and leased provision and indemnification provision. County Counsel-Risk has reviewed and requests Board approval of the non-standard indemnification and business automobile insurance provisions. The Health Department recommends moving forward with this Agreement to comply with the Whole Person Care grant application, which has been approved by the State.
FINANCING:
This Agreement is funded by Calendar Year 2019 and Calendar Year 2020 Whole Person Care grant revenues. The funds for this Agreement for FY 2019-20 and FY 2020-21 ($387,520.00) will be included in the Health Department Clinic Services HEA007, Unit 8096 budget.
Sufficient appropriations are available in the FY 2018-19 Health Department Clinic Services Proposed Budget (4000-HEA007). There is no financial impact to the General Fund resulting from the approval of this Agreement.
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: Sheena Morales, Management Analyst III, x1393
Approved by: Elsa Jimenez, Director of Health, x4526
Attachment:
Standard Agreement is on file with Clerk of the Board