Title
a. Ratify the execution by the Director of Health Services on December 11, 2024 of the Memorandum of Understanding with Oregon Community Health Information Network, Inc. (OCHIN) for participation in the Community Health Workers SYStematically Assessing and Addressing Social Determinants of Health To IMprove Outcomes in Community-based Health Centers (CHW-SYSTIM) study to measure CHW-led interventions in treating uncontrolled chronic conditions, for a term effective upon execution to June 30, 2026; and
b. Accept a clinic impact fee of either $12,000 dependent on whether County of Monterey is selected as a Control group, or $58,175 if selected as an Intervention Group, for County of Monterey’s participation in the study; and
c. Authorize the Director of Health Services or designee to act as the agent for the County in processing all documentation in coordination of this project; and
d. Authorize the Director of Health Services or designee to sign up to three (3) future amendments to this Memorandum where the amendments do not significantly change the scope of work.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
a. Ratify the execution by the Director of Health Services on December 11, 2024 of the Memorandum of Understanding with Oregon Community Health Information Network, Inc. (OCHIN) for participation in the Community Health Workers SYStematically Assessing and Addressing Social Determinants of Health To IMprove Outcomes in Community-based Health Centers (CHW-SYSTIM) study to measure CHW-led interventions in treating uncontrolled chronic conditions, for a term effective upon execution to June 30, 2026; and
b. Accept a clinic impact fee of either $12,000, dependent on whether County of Monterey is selected as a Control group, or $58,175, if selected as an Intervention Group, for County of Monterey’s participation in the study; and
c. Authorize the Director of Health Services or designee to act as the agent for the County in processing all documentation in coordination of this project; and
d. Authorize the Director of Health Services or designee to sign up to three (3) future amendments to this Memorandum where the amendments do not significantly change the scope of work.
SUMMARY DISCUSSION:
The Health Department Clinic Services Bureau (Clinic Services) operates twelve community clinic sites designated as Federally Qualified Health Centers (FQHCs), which provide preventive, primary, and specialty medical care services. Clinic Services has been a member of the OCHIN collaborative since 2007, which allows for access and usage of Epic’s Practice Management (PM) and Electronic Medical Record (EMR) systems.
Through the years, OCHIN has provided valuable health information technology support and services to Clinic Services during the course of the Epic PM and EMR System utilization, including hosting studies focused to improve health care and health outcomes for its members’ patients.
The purpose of this CHW-SYSTIM study is to measure the effectiveness of a Community Health Worker (CHW)-led social risk screening, referral, and support model compared to usual care for member health centers’ patients with uncontrolled chronic conditions (Type 2 diabetes and/or hypertension) across three health center networks.
Participation period for this study will be October 1, 2024 - June 30, 2026. In recognition for participation and contribution to the study, Clinic Services will receive compensation based on its designation as either a Control Group or Intervention Group upon Memorandum execution.
Clinic Services began evaluating this opportunity in November with an execution deadline of December 11, 2024. Due to the reduced evaluation period and expedited study timeline, this Memorandum was executed by the Director of Health Services.
Approval of this action allows Clinic Services to contribute to the scientific knowledge on measuring the effectiveness of a CHW-led social risk screening, referral, and support model compared to usual care for health center patients with uncontrolled chronic conditions (Type 2 diabetes, hypertension).
This work supports the Monterey County Health Department 2025 - 2028 Strategic Plan Goal(s): (1) Empower the community to improve health. It also supports the following of the ten essential public health services, specifically: (1) Monitor health status to identify and solve community health problems; and (9) Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed as to form. Auditor-Controller has reviewed as to fiscal provisions.
FINANCING:
Clinic Services will be compensated the amount of either $12,000 or $58,175 for participation in this study based on which intervention group Clinic Services is assigned to. There is no financial impact to the General Fund resulting from approval of this Memorandum. Sufficient appropriations are available in FY 2024-25 Adopted Budget of Clinic Services Bureau, Health Department (4000-HEA007).
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, 755-4939
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachment:
Board Report
Memorandum of Understanding