Title
Approve and Authorize the Director of Health or Assistant Director of Health to sign Amendment No. 1 to Agreement No. A-14311 (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) to extend the term for an additional six (6) months, for a revised term of May 21, 2019 through June 30, 2021 and to increase the contract by $274,925 for a new agreement total of $662,445 for legal services to patients of the Clinic Services Bureau to address social determinants of health.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and Authorize the Director of Health or Assistant Director of Health to sign Amendment No. 1 to Agreement No. A-14311 (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) to extend the term for an additional six (6) months, for a revised term of May 21, 2019 through June 30, 2021 and to increase the contract by $274,925 for a new agreement total of $662,445 for legal services to patients of the Clinic Services Bureau to address social determinants of health.
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.
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. In December 2017, CRLA started providing on-site legal services to County patients at the Alisal Health Center clinic and has expanded its services to three different sites, has added two more attorneys. 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. Since January 1, 2020, 106 more Clinic Services patients have accessed these critical legal services.
Agreement No. A-14311 was 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).
Approval of Amendment No. 1 will continue legal services to patients through June 30, 2021 and also allow the increase of CRLA staff by one additional attorney and one legal secretary to support the growing MLP patient caseload across the clinics.
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:
The Office of County Counsel has approved Amendment No. 1 as to form. The Health Department recommends moving forward with Amendment No. 1 to comply with the Whole Person Care grant, which has been approved by the State for FY2020-21.
FINANCING:
This Amendment is funded by the Calendar Year 2020 WPC grant, the FY2020-21 Health Realignment Fund and the General Fund. The FY2020-21 Health Department Clinic Services Approved Budget (4000-HEA007) includes contribution of $67,500 from the General Fund to fund services of CRLA.
Sufficient appropriations are available in the FY2020-21 Health Department Clinic Services Approved Budget (4000-HEA007). There is no additional 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: Prisca Segovia, Management Analyst II, 755-4939
Approved by:
______________________Date:__________
Elsa Jimenez, Director of Health, 755-4526
Attachments:
Amendment No 1 is on file with the Clerk of the Board
Agreement is on file with the Clerk of the Board