Title
Approve and authorize the Director of Health or their designee to sign Amendment No. 4 to Agreement No. A-14311 (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) extending the term to January 31, 2023, for a revised full term of May 21, 2019 through January 31, 2023 and increasing the total contract amount by $271,000 for a new agreement total of $933,445 for continued legal services to patients of the Monterey County Health Department Clinic Services Bureau (“Clinic Services”) to address social determinants of health.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Director of Health or their designee to sign Amendment No. 4 to Agreement No. A-14311 (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) extending the term to January 31, 2023, for a revised full term of May 21, 2019 through January 31, 2023 and increasing the total contract amount by $271,000 for a new agreement total of $933,445 for continued legal services to patients of the Monterey County Health Department Clinic Services Bureau (“Clinic Services”) 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 began providing on-site legal services to County patients at the Alisal Health Center clinic 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. 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. From January 1, 2020 through November 2021, 351 more 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). 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.
The Whole Person Care (WPC) Program ended December 31, 2021 and Clinic Services has received confirmation of new funding opportunity from the State Epidemiology and Laboratory Capacity (ELC) Program effective January 1, 2022. Approval of this action will allow continued funding to provide free legal services to patients through January 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:
The Office of the County Counsel has reviewed and approved this Amendment as to form. Auditor-Controller has reviewed and approved as to financial provisions. This Amendment has been reviewed by Public Health in relation to the funding component.
FINANCING:
This Amendment No. 4 is funded 100% by the Public Health grant Epidemiology and Laboratory Capacity (ELC). Appropriations for this agreement are included in the Health Department’s (HEA003-8124) FY 2021-22 Adopted Budget and FY 2022-23 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 Jimenez, Director of Health, 755-4526
Attachments:
Amendment No 4
Amendment No 3
Amendment No 2
Amendment No 1
Agreement