Title
a. Ratify the submittal of a New Access Point (NAP) grant application by the Monterey County Health Department to the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA) in the amount of $650,000 per year for two (2) years from September 1, 2019 through August 31, 2021, to expand access to quality health care services for vulnerable populations; and
b. Accept a NAP grant award from HHS, through HRSA, in the amount of $650,000 per year for two (2) years retroactive from September 1, 2019 through August 31, 2021, to expand access to quality health care services for vulnerable populations; and
c. Authorize the Director of Health or Assistant Director of Health to act as an agent for the County in processing all HRSA documentation in connection with the NAP Grant; and
d. Approve the intra-County transfer of the management of the Natividad Immunology Division Outpatient (NIDO) Clinic from Natividad Medical Center to the Monterey County Health Department as NIDO is a newly approved Federally Qualified Health Center (FQHC) site in the NAP Grant.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Ratify the submittal of a New Access Point (NAP) grant application by the Monterey County Health Department to the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA) in the amount of $650,000 per year for two (2) years from September 1, 2019 through August 31, 2021, to expand access to quality health care services for vulnerable populations; and
b. Accept a NAP grant award from HHS, through HRSA, in the amount of $650,000 per year for two (2) years retroactive from September 1, 2019 through August 31, 2021, to expand access to quality health care services for vulnerable populations; and
c. Authorize the Director of Health or Assistant Director of Health to act as an agent for the County in processing all HRSA documentation in connection with the NAP Grant; and
d. Approve the intra-County transfer of the management of the Natividad Immunology Division Outpatient (NIDO) Clinic from Natividad Medical Center to the Monterey County Health Department as NIDO is a newly approved Federally Qualified Health Center (FQHC) site in the NAP Grant.
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Health Department) operates nine Federally Qualified Health Center (FQHC) look-alike primary care clinic sites which provide preventive, primary, and specialty medical care services. Operating FQHC look-alike clinics provides the opportunity for the County to serve the most vulnerable populations in the community but does not afford the opportunity to qualify for various funding opportunities to enhance those services.
In order to improve the County’s ability to serve the community, the Health Department applied for a New Access Point Grant (NAP) through the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA). A NAP is a new service delivery site offering comprehensive primary health care services to underserved populations. As part of the Health Department’s application, Natividad Immunology Division Outpatient (NIDO) was proposed as a new service delivery site, in addition to the Health Department’s existing nine clinics.
On September 11, 2019, the Health Department received notification from HRSA that the Health Department was 1 of 77 health centers across 23 states, awarded a NAP Grant in the amount of $650,000 per year from September 1, 2019 through August 31, 2021, totaling $1.2 million. As a result of this award, the Health Department clinics and the NIDO clinic become a FQHC Grantee. In order for the NIDO clinic to transition as a FQHC site under this grant, management of the clinic must be transferred to the Health Department. More details about the NIDO transition of the Health Department will be presented to the Board of Supervisors at a future date.
This transition will enable the Health Department clinics and NIDO to become a FQHC Grantee, qualifying them for grant funding going forward under Section 330 of the Public Health Service Act for the purpose of enhancing and increasing medical service delivery to Monterey County residents. Examples of these types of funding opportunities can be found in Attachment B attached to this report.
The intra-County transfer of management from Natividad to the Health Department will not cause an elimination or reduction in the level of medical services provided and is not a “transfer of management” within the meaning of Health and Safety Code section 1442.5, requiring the County to give notice and hold hearings before a “transfer of management” of a county hospital or medical facility. Because the transfer involves two departments of the County, the County retains ownership of or overall authority over the NIDO clinic.
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: 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
The Health Department and Natividad management continue to work with all parties involved to assure the success of the transfer of authority and responsibility. This report was presented to the Budget Committee on October 24, 2019 who supported moving this action to the full Board along with a list of potential funding opportunities available to FQHCs.
FINANCING:
Approval of this report will result in revenue enhancement for the Health Department’s primary care clinics in the amount of $650,000 per year for two years. This will also open the opportunity to apply for additional funding to enhance services provided to the community.
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: Julie Edgcomb, Ambulatory Services Administrator, Natividad Medical Center and Monterey County Health Department, x1386
Approved by: Elsa Jimenez, Director of Health, x4526
Dr. Gary Gray, Natividad CEO, x2553
Attachments:
Attachment A- HRSA Notice of Award is on file with the Clerk of the Board
Attachment B- Potential HRSA Funding Opportunities is on file with the Clerk of the Board