Title:
Title
Approvals for Implementation of Pathways to Health + Home Program [Two-Thirds Vote Required]
End
FileID
File ID: 2020-00322
Location
Location: Citywide
Recommendation:
Recommendation
Pass a Motion by two-thirds vote: 1) waiving the requirement for 10-day posting of agreements over $1.0 million pursuant to City Code section 4.04.020(C); and 2) authorizing the City Manager or City Manager’s designee to: a) execute contract supplement No. 6 to Agreement 2019-0260 with Sacramento Self-Help Housing, Inc. to extend Pathways Housing Services through December 31, 2020 with an increase of $1,582,635, for a new total not-to-exceed amount of $4,404,610; b) execute contract supplement No. 4 to Agreement 2019-0256 with Lutheran Social Services of Northern California to extend Pathways Housing Services through December 31, 2020 with an increase of $465,481, for a new total not-to-exceed amount of $1,437,795; c) execute contract supplement No. 5 to Agreement 2019-0257 with WellSpace Health, Inc. to extend Pathways Hub Services through December 31, 2020 with an increase of $634,335, for a new total not-to-exceed amount of $1,423,740; d) execute contract supplement No. 3 to Agreement 2019-0258 with Sacramento Native American Health Center, Inc. to extend Pathways Hub Services through December 31, 2020 with an increase of $270,075, for a new total not-to-exceed amount of $642,345; e) execute contract supplement No. 3 to Agreement 2019-0259 with Elica Health Centers to extend Pathways Hub Services through December 31, 2020 with an increase of $228,540, for a new total not-to-exceed amount of $564,060; f) execute contract supplement No. 2 to Agreement 2019-1061 with Cares Community Health dba One Community Health to extend Pathways Hub Services through December 31, 2020 with an increase of $169,455, for a new total not-to-exceed amount of $364,455; and g) execute contract supplement No. 3 to Agreement 2019-1542 with Healthy Community Forum for the Greater Sacramento Region dba Sacramento Covered to extend Pathways Outreach, Housing, Hub and IT Services through December 31, 2020 with an increase of $3,893,385, for a new total not-to-exceed amount of $7,592,447.
Contact: Emily Halcon, Homeless Services Manager, (916) 808-7896, Homeless Services Division, Office of the City Manager
Body
Presenter: None
Attachments:
1-Description/Analysis
2-Sacramento Self-Help Housing Contract Supplement
3-Lutheran Social Services of Northern California Contract Supplement
4-WellSpace Health, Inc. Contract Supplement
5-Sacramento Native American Health Center, Inc. Contract Supplement
6-Elica Health Centers Contract Supplement
7-One Community Health Contract Supplement
8-Sacramento Covered MSA Contract Supplement
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 it supports 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 5 (PY 5) which began on January 1, 2020 and ends on December 31, 2020. Program Year 5 is the final year of the Pathways program. As of March 15, 2020, Pathways had 905 individuals enrolled and had served a total of 1,923 individuals through the life of the program. A total of 182,334 services, including outreach, navigation, care coordination, and housing support, have been provided to the community. Additionally, Pathways has helped house a total of 612 individuals. Pathways is collaborating with over 20 health care, housing, and social service providers to ensure continuity of care for program enrollees. This staff report requests an extension of existing service contracts to support service delivery for the remainder of Program Year 5 which will run from April 1, 2020 through December 31, 2020.
Extension of Housing Services
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. As the program winds down, the City wants to support housing providers to continue housing clients quickly. Thus, the housing contract extensions will ensure there is no interruption of housing services. The housing contract extensions will enable housing services to be delivered through December 31, 2020. Pathways is currently supported by three housing providers: Sacramento Self-Help Housing (SSHH), Lutheran Social Services of Northern California (LSS), and Sacramento Covered. By extending the existing housing contracts, Pathways will be able to provide housing support services for up to 975 enrollees for the remainder of the program.
Extension of Hub Services
The role of the Hub Entity is to provide medical care coordination to enrollees of the Pathways program. The Hub Entity provides 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 Health Centers (Elica), WellSpace Health (WSH), Sacramento Native American Health Clinic (SNAHC), One Community Health, and Sacramento Covered currently have active hub contracts and have been serving a range of 125 to 375 program enrollees each. To ensure continuity of care for program enrollees, staff recommends extending contract terms with each of these hub entities to continue Pathways services for the remainder of Program Year 5 through December 31, 2020. By extending the existing hub contracts, Pathways will be able to provide medical care coordination supports for up to 1,055 enrollees through the end of the program.
Extension of Outreach and IT Services
Staff recommends approval of a contract supplement to the nonprofessional master services agreement 2019-1542 with Sacramento Covered to extend outreach services through December 31, 2020. Such supplement will ensure that outreach services continue to be delivered to participants for the remainder of Program Year 5. Approval of such contract supplement will also extend Pathways IT services through December 31, 2020 and ensure that Pathways enrollee data, care coordination activities, and program outcomes continue to be monitored and tracked.
Table 1 below outlines the requested contract extensions as mentioned in the above narrative.
Table 1: Requested Contract Extensions for PY5 Activities
|
Service Type |
Vendor Name |
Contract Number |
Supplement Number |
Supplemental Increase Amount |
New Contract Not-to-Exceed Amount |
|
Housing |
SSHH |
2019-0260 |
6 |
$1,582,635 |
$4,404,610 |
|
Housing |
LSS |
2019-0256 |
4 |
$465,481 |
$1,437,795 |
|
Hub |
WSH |
2019-0257 |
5 |
$634,335 |
$1,423,740 |
|
Hub |
SNAHC |
2019-0258 |
3 |
$270,075 |
$642,345 |
|
Hub |
Elica |
2019-0259 |
3 |
$228,540 |
$564,060 |
|
Hub |
One Community |
2019-1061 |
2 |
$169,455 |
$364,455 |
|
Housing, Hub, Outreach, IT |
Sacramento Covered |
2019-1542 |
3 |
$3,893,385 |
$7,592,447 |
|
Total Amount Requested for Contract Supplements |
$7,243,906 |
|
SSHH, LSS, WSH, SNAHC, Elica, and Sacramento Covered (outreach services) were selected as Pathways service providers pursuant to City Request for Qualifications #Q1802101002 issued on December 01, 2017 and One Community and Sacramento Covered (housing and hub services) were selected as Pathways service providers pursuant to City Request for Qualifications #Q19021011001 issued on February 25, 2019. City Council suspended competitive bidding on September 24, 2019 in the best interests of the City for execution of the Master Services Agreement with Sacramento Covered.
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: This report concerns administrative activities and governmental fiscal activities that do not constitute a “project” as defined by the CEQA Guidelines Sections 15378(b)(2) and 15378(b)(4) and are not subject to the provisions of CEQA (CEQA Guidelines Section 15060(c)(3)).
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 impact of Pathways on both service delivery for vulnerable populations and the expansion of partnerships with the health care community has been significant. Staff’s recommendation will allow maintenance of the existing level of services for Pathways through December 31, 2020, which include health care coordination, outreach and referral, as well as housing supports.
Financial Considerations: There is sufficient funding in the Whole Person Care Multi-Year Operating Project (I02000900), Operating Grants (Fund 2702) to fund the contract extensions mentioned in this report in the amount of $7,243,905.
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.