REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 8, 2023
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Grant Award and Budget Adjustment for the Providing Access and Transforming Health Supports - Justice Involved Capacity Building Grant, Round 2
End
RECOMMENDATION(S)
Recommendation
1. Accept grant award from the California Department of Health Care Services for the Providing Access and Transforming Health Supports - Justice Involved Capacity Building Grant, Round 2, in an amount up to $1,050,000 for the performance period of January 1, 2023 through December 31, 2026.
2. Authorize the Chief Executive Officer or Director of Arrowhead Regional Medical Center to approve, electronically execute, and submit acknowledgment of the Providing Access and Transforming Health Supports - Justice Involved Capacity Building Grant, Round 2, grant terms and conditions associated with acceptance of grant funds, and administrative documents, including progress reports, required under the grant.
3. Direct the Director of Arrowhead Regional Medical Center to transmit the Providing Access and Transforming Health Supports - Justice Involved Capacity Building Grant, Round 2, grant award documents, including the grant terms and conditions, to the Clerk of the Board of Supervisors within 30 days of execution.
4. Authorize the Auditor-Controller/Treasurer/Tax Collector to post the budget adjustments to the 2023-24 budget for Arrowhead Regional Medical Center, as detailed in the Financial Impact section (Four votes required).
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). Upon acceptance by the Board of Supervisors (Board), Arrowhead Regional Medical Center (ARMC) will receive a total grant award in an amount not to exceed $1,050,000 from the California Department of Health Care Services (DHCS) for the Providing Access and Transforming Health Supports (PATH) Justice Involved Capacity (JIC) Building Grant, Round 2. The funds will be used as supplemental funding to the Enhanced Care Management Provider Agreement No. 21-983 with Inland Empire Health Plan (IEHP) for the Enhanced Care Management (ECM) Program.
On April 11, 2023 (Item No. 16), the Board authorized the acceptance of the PATH Capacity and Infrastructure Transition, Expansion and Development (CITED) Round 1B grant in an amount up to $2,781,853. Of this amount, $462,613 is allocated for ARMC and will be used to procure vehicles for ECM staff use in the amount of $91,396, computers in the amount of $29,400, and contracted staffing in the amount of $341,817.
To allocate the PATH JIC and PATH CITED grant funding, approval of Recommendation No. 4 will allow the Auditor-Controller/Treasurer/Tax Collector to post the following adjustments to the 2023-24 budget for ARMC:
|
ARMC Fund |
Commitment Item |
Description |
Action |
Amount |
|
9110004200 |
51001010 |
Regular Salary |
Increase |
$1,391,817 |
|
9110004200 |
54504050 |
Vehicles |
Increase |
$91,396 |
|
9110004200 |
52002116 |
Computer Hardware |
Increase |
$29,400 |
|
9110004200 |
40408955 |
State Grant |
Increase |
$1,512,613 |
BACKGROUND INFORMATION
California State Assembly Bill 133 authorized PATH grant funding to support the implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiatives, such as the Justice Involved Capacity (JIC) Building Grant Program and the Capacity and Infrastructure Transition, Expansion and Development (CITED) Program that build on the successful work conducted through the state Whole Person Care Program. The PATH Program will expand access to and facilitate the transition to the ECM Program by building capacity and infrastructure.
The PATH grant provides funding opportunities to correctional agencies, correctional institutions, and county departments of social services and was made available in two rounds. Round 1/1B is a planning funding opportunity to identify and scope out the processes, protocols, and information technology (IT) system infrastructure modifications necessary to implement or modify pre-release Medi-Cal enrollment and suspension processes. Subsequently, DHCS released Round 2 funding to support entities as they implement the processes, protocols, and IT system modifications identified during Round 1.
On September 30, 2022, the Chief Executive Officer (CEO) approved the submission of a grant application for the PATH CITED grant program Round 1B. On March 24, 2023, DHCS notified the County that it would be awarded a grant. Thereafter, on April 11, 2023 (Item No. 16), the Board of Supervisors (Board) authorized the acceptance of the PATH CITED grant in an amount up to $2,781,853, and authorized the CEO to execute acknowledgment of the PATH CITED grant terms and conditions associated with the acceptance of the grant funds.
The recommended budget adjustment will allocate ARMC’s portion of the PATH CITED funds in the amount of $462,613, in accordance with the grant award. The PATH CITED funds allocated to ARMC will be used to procure two vehicles through County Fleet Services Department; seven computers, including hardware and software, through ARMC Information Management; and staffing salary expenses as identified in the Financial Impact section. The vehicles will be used by ECM staff to meet with patients wherever they are, including patients who are unhoused. Furthermore, the computer equipment and software will be used by ECM staff in the performance of ECM Program services and activities. Services are provided with a whole-person care approach to address medical and non-medical circumstances of high-need Medi-Cal beneficiaries, including individuals who have complex medical needs, are homeless and/or have serious mental illnesses, children with complex medical conditions, justice-involved populations with significant clinical needs, and the growing aging population, at their County medical location of preference.
On March 29, 2023, the CEO approved the submission of the grant application for the PATH JIC grant, Round 2. On July 7, 2023, DHCS identified the grant awardees under Round 2, but the County did not receive notification of the award until July 25, 2023. The County was selected to receive PATH JIC Round 2 funding, of which $1,050,000 is designated for ARMC, for the performance period January 1, 2023 through December 31, 2026. All of the PATH JIC grant funds awarded will be used for staffing salary expenses as identified in the Financial Impact section. ARMC will be providing the staff to support the pre-release Medi-Cal enrollment activities at the detention centers and probation centers. Specifically, the staff placed in the detention centers will be ARMC staff funded by the PATH JIC grant.
Recommendation No. 1 will allow the County to accept the grant funds. Recommendation Nos. 2 and 3 allow the CEO or Director of ARMC to electronically execute acknowledgment of the grant terms and conditions associated with acceptance of the grant, and to approve, electronically execute and submit administrative documents, including progress reports, required under the PATH JIC grant terms. Under the PATH JIC grant terms, the County agrees to release and hold harmless Public Consulting Group LLC (third-party administrator that DHCS has contracted with to administer the grant program) for any claim or liability arising out of, or relating to the receipt of grant funds.
ARMC recommends approval of this item to provide for the health, safety and social service needs of County residents through the expanded implementation of the ECM Program as made possible by the PATH grants.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on July 28, 2023; Auditor-Controller/Treasurer/Tax Collector (Vanessa Doyle, Deputy Chief Controller, 382-3193) on July 31 2023; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on July 28, 2023; Finance (Jenny Yang, Administrative Analyst, 387-4884) on July 28, 2023; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on July 28, 2023.