Title:
Title
Supplemental Agreements: Implementation of Pathways to Health + Home Program
End
FileID
File ID: 2019-01064
Location
Location: Citywide
Recommendation:
Recommendation
Pass a Motion authorizing the City Manager or the City Manager’s designee to: 1) execute Supplemental Agreement No. 5 to Agreement No. 2018-0696 with Sacramento Covered for extension of outreach, housing, and care coordination services through August 31, 2019, with an increased cost of $263,450 for a new total not-to-exceed amount of $2,615,250; 2) execute Supplemental Agreement No. 7 to Agreement No. 2017-1528 with Sacramento Covered for extension of IT services through August 31, 2019, with an increased cost of $50,000 for a new total not-to-exceed amount of $1,325,000; 3) execute Supplemental Agreement No. 3 to Agreement No. 2019-0257 with WellSpace Health, Inc. to increase service capacity to support another 25 enrollees with an increased cost of $29,250 for a new total not-to-exceed amount of $609,000; and 4) revise the funding source for the professional services agreement with Desert Vista Consulting, LLC as approved by Council on June 25, 2019 from the Whole Person Care Project (I02000900) (General Fund, Fund 1001) to the Homeless Housing Initiative Project (I02000200) (General Fund, Fund 1001).
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-Sacramento Covered Enhanced Care Coordination Contract Supplement
3-Sacramento Covered IT Contract Supplement
4-WellSpace Health, Inc. Hub Entity Contract Supplement
5-Desert Vista Consulting, LLC Professional Services 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. 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 (PY 4) which began on January 1, 2019 and ends on December 31, 2019. Program Year 5 (PY 5) will run from January 1, 2020 through December 31, 2020. As of June 15, 2019, Pathways had 736 individuals enrolled and had served a total of 1,344 individuals through the life of the program. A total of 86,301 services, including outreach, navigation, care coordination, and housing support, have been provided to the community. Additionally, Pathways has housed a total of 376 individuals. Pathways is collaborating with over 20 health care, housing, and social service providers to ensure continuity of care for program enrollees and is continuing to explore other partnerships.
Extending Outreach, Housing and Enhanced Care Coordination Services
Staff recommends approval of Supplemental Agreement No. 5 to City Agreement No. 2018-0696 with Sacramento Covered to maintain the provision of outreach, enhanced care coordination and housing services for Pathways enrollees through August 31, 2019. The attached contract supplement will extend the outreach, housing, and enhanced care coordination services for an additional month while a new contract is being negotiated with Sacramento Covered. The execution of this contract supplement will ensure continuity of care for up to 900 program enrollees. The supplement has an increased cost of $263,450, for a new total not-to-exceed amount of $2,615,250. Staff will return to Council seeking approval for a new Master Services Agreement with Sacramento Covered for these services shortly.
Extending Information Technology (IT) Services
Staff recommends approval of Supplemental Agreement No. 7 to City Agreement 2017-1528 with Sacramento Covered for IT services to ensure that Pathways enrollee data, care coordination activities, and program outcomes continue to be monitored and tracked through August 31, 2019. The supplement has an increased cost of $50,000 for a new total not-to-exceed of $1,325,000. Staff will return to Council seeking approval for a new Master Services Agreement with Sacramento Covered for these services shortly.
Expanding Pathways Hub Capacity
The City currently contracts with five Hub Entities, who provide medical case management and care coordination for Pathways enrollees. Pathways Hubs ensure that program enrollees connect with their primary care provider, manage their medical conditions, assist individuals with securing specialty care, and even expediting appointments as needed. Staff recommends approval of the contract supplement No. 3 for WellSpace Health, Inc. (Agreement #2019-0257) to expand medical care coordination to support an additional 25 new program enrollees (for a total of 350 enrollees). The supplemental agreement has an increased cost of $29,250 for a new total not-to-exceed of $609,000. This contract supplement will enable the City to meet the programmatic goal of serving 1,000 program enrollees at any given point in time.
Pathways Program Evaluation
On June 25th, 2019, Council approved Desert Vista Consulting, LLC Professional Services Agreement to be funded through the Whole Person Care Project (I02000900) (General Fund, Fund 1001) in the amount of $199,550. Staff is seeking approval to change the funding source from the Whole Person Care Program (I02000900) (General Fund, Fund 1001) to the Homeless Housing Initiative Project (I02000200) (General Fund, Fund 1001) to fund the Desert Vista Consulting, LLC Professional Services Agreement.
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. Service providers 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.
Financial Considerations: There are sufficient resources in the Whole Person Care Program (I02000900) to fund the three supplemental agreements in this report, totaling an amount not-to-exceed $342,700.
Additionally, staff recommends revising the funding source for council approved agreement with Desert Vista Consulting, LLC from the Whole Person Care Program (I02000900) (Fund 1001) to the Homeless Housing Initiative Project (I02000200) (Fund 1001). There are sufficient resources in I02000200 to fund the agreement in an amount not-to-exceed $199,550.
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.