Title:
Title
Approvals for Implementation of Pathways to Health + Home Program
End
FileID
File ID: 2019-00224
Location
Location: Citywide
Recommendation:
Recommendation
Pass a Motion authorizing the City Manager or City Manager’s designee to: 1) execute the five attached service provider agreements for Pathways Program Year 4, which runs through December 31, 2019, with: a) Elica Health Centers for a not-to-exceed of $206,250; b) WellSpace Health, Inc. for a not-to-exceed of $412,500; c) Sacramento Native American Health Center, Inc. (SNAHC) for a not-to-exceed of $222,750; d) Sacramento Self Help Housing (SSHH) for a not-to-exceed of $925,000; and e) Lutheran Social Services of Northern California (LSS) for a not-to-exceed of $325,000.
Contact: Emily Halcon, Homeless Services Coordinator, (916) 808-7896; Anira Khlok, Homeless Services Program Analyst, (916) 808-7948, Office of the City Manager
Body
Presenter: None.
Attachments:
1-Description/Analysis
2-Elica Health Centers Hub Entity Agreement
3-WellSpace Health, Inc Hub Entity Agreement
4-SNAHC Hub Entity Agreement
5-SSHH Housing Entity Agreement
6-LSS Housing Entity Agreement
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 up to approximately $64 million over a four-year term, inclusive of local funding re-aligned to support WPC and federal 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 is currently in Program Year 4 which will run from January 1, 2019 through December 31, 2019. Program Year 5 will run from January 1, 2020 through December 31, 2020. As of January 31, 2019, Pathways has 578 individuals enrolled and has had a total of 1,007 total program enrollments. A total of 47,584 total services, including outreach, navigation, care coordination, and housing support, have been provided to the community and 235 people have been moved into permanent or transitional housing. Pathways is collaborating with over 20 health care, housing, and social service providers to ensure continuity of care for program enrollees.
Staff recommends executing new contracts with Elica Health Centers (Elica), WellSpace Health, Inc. (WellSpace), Sacramento Native American Health Center, Inc. (SNAHC), Sacramento Self-Help Housing (SSHH), and Lutheran Social Services of Northern California (LSS) for Hub Entity and Housing Entity services through December 31, 2019 to maintain continuity of care for existing Pathways enrollees and increase the number of individuals served through the end of Program Year 4. All five entities are currently providing services under Pathways and were selected pursuant to the City’s Request for Qualifications issued in December 2017. City Council approved initial contracts with the providers on April 24, 2018 and October 9, 2018, but all five contracts expire on February 28, 2019. Staff is thus seeking execution of new contracts.
The role of the Hub Entity is to provide medical care coordination to enrollees of the Pathways program. The Hub Entity will provide individualized care management services aimed at achieving health, behavioral health, and housing stability with a focus on improving functioning levels, and quality of life of participants, as appropriate and acceptable to enrollees. Elica, WellSpace, and SNAHC currently have active hub contracts and have been serving a range of 125 to 250 program enrollees each. To ensure continuity of care for program enrollees, staff recommends executing new contracts with each of these hub entities to continue Pathways services through the end of Program Year 4. Under the new contracts, the hub entities will serve a range of 125 to 250 program enrollees each.
The role of the Housing Services Entity is to work with unsheltered Pathways enrollees to locate the most appropriate and available housing, both subsidized and non-subsidized. The Pathways Program is a unique model in that wrap-around services are provided to an enrollee to ensure a medical home is established and referrals to housing and social supports are made, with the ultimate goal of decreasing reliance on emergency response systems and decreasing homelessness within Sacramento. Clients experiencing homelessness will not be able to maintain their health without some form of housing and therefore it is essential that Housing Entities continue providing services through December 31, 2019. The City currently contracts with LSS and SSHH for housing services and staff recommends executing new contracts with these two entities to continue such housing services through the end of Program Year 4. LSS and SSHH currently serve 120 to 435 enrollees respectively but will serve 120 to 350 enrollees each under the new contracts.
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: None.
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 contract partners have 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 through December 31, 2020, a key goal of Pathways is to achieve long-term sustainability and continue program services after the program sunsets.
The WPC funding mechanism for drawing down matching dollars requires the delivery of the services and meeting program outcomes before funds are provided. In this way, the City must expend funds to draw down the federal match. In Program Year 3, the City successfully met all reporting requirements for DHCS and has established strong program and financial controls. In order to maintain current level of service, the City must enter into contracts sized to meet the outcomes necessary to draw down the maximum match-funding in Program Year 4.
Financial Considerations: There is sufficient funding in the Pathways Program I02000900 to cover the five contracts outlined in the table below.
|
Contract Type |
Organization |
Contract Amount |
|
Hub Entity |
Elica Health Centers |
$206,250 |
|
Hub Entity |
WellSpace Health, Inc. |
$412,500 |
|
Hub Entity |
Sacramento Native American Health Center |
$222,750 |
|
Housing Entity |
Sacramento Self Help Housing |
$925,000 |
|
Housing Entity |
Lutheran Social Services |
$325,000 |
|
|
Total |
$2,091,500 |
Local Business Enterprise (LBE): All 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.