Title:
Title
Approvals for Implementation of Pathways to Health + Home Program
End
FileID
File ID: 2018-04197
Location
Location: Citywide
Recommendation:
Recommendation
Pass a Resolution authorizing the City Manager or City Manager’s designee to: 1) execute the attached Data Sharing Agreement (DSA) with the County of Sacramento, Department of Health Services (DHS) and; 2) increase revenue and expenditure budgets by $2,206,918 in the Whole Person Care Program (I02000900) in the Operating Grants Fund (Fund 2702) to account for the City’s receipt of Program Year 4 operating costs from the California Department Health Care Services.
Contact: Anira Khlok, Homeless Services Program Analyst, (916) 808-7948, Office of the City Manager
Body
Presenter: None.
Attachments:
1-Description/Analysis
2-County of Sacramento DHS Data Sharing Agreement
3-Resolution
4-Exhibit A to the Resolution-Data Sharing Agreement with County of Sacramento, Department of Health Care Services
Description/Analysis
Issue Detail: In June 2017, the City of Sacramento was accepted into the State Department of Health Care Services’ (DHCS) Whole Person Care (WPC) program, with a budget of approximately $64 million over a four-year term, inclusive of local funding re-aligned to support WPC and new matching dollars, to support development of the WPC program model and to fund new services. WPC is a statewide Medi-Cal waiver program that allows communities to create a system of supportive services aimed to improve health outcomes and reduce utilization of high-cost services for vulnerable populations. In Sacramento, the WPC program is called the Pathways to Health + Home (Pathways) program and will support broader City strategies to reduce and prevent homelessness, by creating a robust system of outreach, case management and supportive services for those frequent users of health care, homeless services, and emergency services.
Pathways operates over the course of four “program years” which, except for program
years one and two, generally match calendar years. Currently, the program is in year three of operation and has enrolled 512 individuals as of October 5, 2018. A total of 19,872 services have been provided to the community. Pathways is collaborating with over twenty health care, housing, and social service providers to ensure continuity of care for program enrollees.
The program’s current success is due in part to the improved data sharing capability between the Pathways Data Management Entity, Housing Service Providers, Managed Care Organizations, Hospitals, Social Service Organizations and Federally Qualified Health Centers, allowing for better care coordination. This data sharing would not be possible without the City’s Data Sharing Agreements which have been executed with various entities since March 2018. The Pathways program is hoping to strengthen care coordination by executing a Data Sharing Agreement with the County of Sacramento, Department of Health Services (DHS). The agreement and partnership between DHS will permit Pathways Community Health Workers (CHWs) to coordinate not only physical health services, but behavioral health services as well. For some Pathways enrollees, medical and behavioral health services may not be available within the same facility which could result in gaps in care. Through this Data Sharing Agreement, Pathways CHWs can communicate with county-contracted health and behavioral health care providers to determine if enrollees are established at a county-operated facility or need to be linked to care within the county. This Data Sharing Agreement will ensure greater continuity of care on the behavioral health side of the program.
Policy Considerations: The Pathways program aligns with the federal directive and City commitment that funding for addressing homelessness follow a “housing first” approach, which offers permanent housing as quickly as possible for individuals and families experiencing homelessness. In housing first programs, supportive services are offered (but not required as a condition of tenancy) to help people keep their housing and avoid returning to homelessness. This evidence-based approach is consistent with the strategies and funding priorities of the other public agencies working to end homelessness in Sacramento. Partnering with other agencies to leverage resources and improve livability is consistent with the City Council’s past actions and current direction.
Economic Impacts: None.
Environmental Considerations: The actions specified in this report do not constitute a
“project” under the California Environmental Quality Act (CEQA) because they are continuing administrative activities and amount to general policy and procedure making [CEQA Guidelines section 15378(b)(2)].
Sustainability: Not Applicable.
Commission/Committee Action: The Pathways Executive Committee recommended approval of the Data Sharing Agreement approach on February 1, 2018.
Rationale for Recommendation: The Pathways program is an opportunity for a community to transform healthcare and housing systems serving vulnerable populations by aligning services and data through performance-based contracts. The recommended partner has extensive experience working in Sacramento and providing services and support to vulnerable populations. The Pathways program offers an opportunity to leverage the experience and expertise of these organizations in a large, collaborative program that aims to change the way services are delivered in Sacramento. While Pathways is currently only funded for four program years, a key goal of Pathways is to achieve long-term sustainability and continue program services after the program sunsets. The intention is that through the development of partnerships and data sharing infrastructure, Pathways will create a more streamlined system resulting in cost-savings that can be reinvested to support this population in the future.
Financial Considerations: On October 12, 2018, the City submitted an Intergovernmental Transfer (IGT) in the amount of $2,206,992.54 to the DHCS for the City’s non-federal contribution towards the first half of Pathways Program Year 3 activities (January 1, 2018 through June 30, 2018). The City anticipates that DHCS will accept the IGT and obtain federal matching dollars to be used for a portion of Program Year 4 operating costs. Staff recommends establishing revenue and expenditure budgets for $2,206,918 in the Whole Person Care Program (I02000900) in the Operating Grants Fund (Fund 2702) for receipt of DHCS matching funds. Staff will return to City Council in 2019 to request approval for receipt of a second IGT payment from DHCS which will pay for operating costs for the second half of Program Year 4.
The Data Sharing Agreement does not involve the expenditure or receipt of funds.
Local Business Enterprise (LBE): All of the Pathways service partners are local businesses with established operations in Sacramento and have a history of serving Sacramento’s medically fragile and homeless populations.