Title
Authorize the Deputy Purchasing Agent for Natividad Medical Center (NMC) or his designee to execute renewal and Amendment No. 1 to the funding agreement with Healthcare Foundation of Northern and Central California (“Healthcare Foundation”), a California corporation, for assisting in meeting the direct costs of a Medical Respite Program (“MRP”) for homeless persons in Monterey County (Resolution No. 16-093), which has a direct and primary public purpose, benefiting Monterey County, in general, and NMC, in particular, to renew and extend the agreement an additional fourteen (14) month period (April 19, 2017 through June 30, 2018) for a revised full agreement term of April 19, 2016 through June 30, 2018, and adding $93,500 for a revised total agreement amount not to exceed $198,500.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
Authorize the Deputy Purchasing Agent for Natividad Medical Center (NMC) or his designee to execute renewal and amendment No. 1 to the funding agreement with Healthcare Foundation of Northern and Central California (“Healthcare Foundation”), a California corporation, for assisting in meeting the direct costs of a Medical Respite Program (“MRP”) for homeless persons in Monterey County (Resolution No. 16-093), which has a direct and primary public purpose, benefiting Monterey County, in general, and NMC, in particular, to renew and extend the agreement an additional fourteen (14) month period (April 19, 2017 through June 30, 2018) for a revised full agreement term of April 19, 2016 through June 30, 2018, and adding $93,500 for a revised total agreement amount not to exceed $198,500.
SUMMARY/DISCUSSION:
In 2013, the hospitals of Monterey County convened and collaborated with the Hospital Council of Northern and Central California to search for a solution to meet the needs of the homeless population as they are discharged from hospital stays. All hospitals have struggled with increasing readmissions that require a solution that supports timely, post-acute safe discharges for these members of the county homeless population. Historically, there are a limited number of safe discharge options for homeless individuals and hospitals often rely on motel vouchers, board and care facilities, Skilled Nursing Facilities (“SNFs”) or extended inpatient stays.
On April 19, 2016, the Monterey County Board of Supervisors approved a Resolution authorizing Natividad Medical Center to contribute to the development of a Respite Program for the homeless via a funding agreement with an initial contribution of $105,000. The respite facility is a collaboration among Community Hospital of the Monterey Peninsula, Salinas Valley Memorial Hospital and Natividad Medical Center, and Community Homeless Solutions.
This request is to extend the term of the funding agreement and add an additional contribution of $93,500 so that the program may continue and grow.
In the first year of operations, there were 41 referrals and 23 client admissions. Reasons for denial were in part due to presenting conditions indicated the patients needed higher levels of care or extensive violent history. Of the six beds in the MRP, NMC leased two beds maintaining a 74% occupancy rate, the highest of the three hospitals. The average length of stay of NMC patients was 53 days.
The initial $105,000 was used to fund MRP operating expenses. Similarly, the additional $93,500 will be used for cost of operations.
Continued availability of the medical respite program will enable hospitals to continue to implement discharge plans for clinically appropriate homeless patients that better manage hospital utilization. Homeless patients who receive post discharge care at the respite experience reduced re-hospitalizations and emergency department visits.
Hospital Council of Northern and Central California is co-collaborator, process facilitator, and convener. Healthcare Foundation of Northern and Central California is the fiscal intermediary between the three hospitals, Community Homeless Solutions, and the respite facility.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this renewal and amendment No. 1 as to legal form and risk provisions, and the Auditor-Controller and Budget Office have reviewed and approved as to payment provisions. The renewal and amendment No. 1 has also been reviewed and approved by NMC’s Finance Committee on August 24, 2017 and by its Board of Trustees on September 8, 2017.
FINANCING:
This action does not impact General Fund contribution as the changes will be contained within the approved Natividad Medical Center’s FY17-18 Adopted Budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Extending the funding agreement an additional year allows for the much needed continued monetary support to ensure the Respite program becomes successful. The program provides primary and behavioral healthcare to the homeless and helps break the cycle of homelessness by working with the client to create connections to family and friends, and offers assistance with benefit enrollment, transitional or permanent housing, and job training.
__ Economic Development
__ Administration
X Health and Human Services
__ Infrastructure
__ Public Safety
Prepared by: Dr. Craig Walls, Chief Medical Officer, 783-2521
Approved by: Gary R. Gray, DO, Chief Executive Officer, 783-2504
Attachments:
Healthcare Foundation Renewal and Amendment No. 1 to Funding Agreement
Healthcare Foundation Funding Agreement for Respite Facility with Resolution