Fremont City Council Meeting: 12/20/22 07:00 PM
3300 Capitol Avenue Div/Dept: Human Services Department Fremont, CA 94538 Category: Agreements and Contracts
SCHEDULED
Sponsors:
COUNCIL STAFF REPORT (ID # 4767) DOC ID: 4767
Updated: 12/15/2022 5:30 PM by Susan Gauthier Page 1
ALAMEDA COUNTY HOUSING COMMUNITY SUPPORTS CONTRACTS - Authorize the City Manager to Execute Agreements to Provide Housing Transition Navigation and Housing Tenancy and Sustaining Services; Appropriation Actions.
Contact Persons:
Name: Laurie Flores Suzanne Shenfil
Title: Homeless Services Manager Director
Div/Dept: Human Services Department Human Services Department Phone: 510-574-2040 510-574-2051
E-Mail: [email protected] [email protected]
Executive Summary: Medi-Cal, California’s Medicaid health care program for children and adults, is currently undergoing a transformative system change, moving away from the state funding individual services to a county led system. This system transformation is known as California Advancing & Innovating Medi-Cal (CalAIM).
As part of CalAIM, Alameda County Health Care Services Agency (HCSA) has invited the City to enter into agreements to provide homeless individuals and families with Housing Community Supports, including Housing Transition Navigation Services (HN), Tenancy, Sustaining Services (TSS) and one-time rental deposits.
Staff recommends the City Council:
Authorize the City Manager to execute a $30,000 capacity building agreement that provides the City incentives for the hiring and retaining of new care management staff;
Authorize the City Manager to execute a service agreement not to exceed $290,000, for the City to provide HN, TSS and one-time rental deposits, which may include hiring of additional homeless support personnel, to be offset through this funding source;
Approve related appropriation actions; and
making findings of CEQA exemption.
BACKGROUND: Medi-Cal is California’s Medicaid health care program. This program pays for services for children and adults with limited income and resources. Currently, the Medi- Cal program is undergoing a transformative system change, moving away from the state funding individual services, to CalAIM, with the goal of:
• improving population health using a whole person care model and social determinants of health,
• Reducing complexity and variation, and increase flexibility of services across Medi - Cal, and
• Improving quality outcomes, reducing health disparities, and modernizing systems through value-based initiatives and payment reform.
As part of this CalAIM program, HCSA’s Office of Homeless Care and Coordination is spearheading the County’s effort to expand Housing Community Supports for homeless Council Staff Report (ID # 4767) Meeting of December 20, 2022 Updated: 12/15/2022 5:30 PM by Susan Gauthier Page 2
populations. This program is funded through a combination of CalAIM funding via Anthem Blue Cross and Alameda Alliance for Health, as well as additional County general funds.
The Human Services department has provided Medi-Cal funded services to South County residents for many years, including mental health services, substance use disorder services and targeted Case Management services. Continuing to serve low-income clients will necessitate the City’s involvement in the CalAIM system.
DISCUSSION/ANALYSIS: HCSA currently contracts with 17 providers for Housing Community Supports including Housing Transition Navigation Services (HN), Tenancy and Sustaining Services (TSS) and one-time flexible Housing Deposits (HD) with a combined capacity to serve approximately 1,700 people at a time (1,400 TSS and 300 HN). Current capacity does not meet the need to support the more than 10,000 people experiencing homelessness at a time (approximately 2,000 of which are on County housing queues).
HCSA proposes to expand the capacity of service providers, like the City of Fremont Human Services Department, to provide CalAIM funded services, including:
• Maintaining combined strength-based housing transition navigation services and/or housing tenancy and sustaining services for homeless and formerly homeless individuals living in or transitioning to HCSA designated permanent housing units. • Administer one-time flexible housing deposits for consumers authorized by HCSA to assist with costs associated with move-in expenses.
To incentivize service providers to increase care management capacity, The County is proposing a $30,000 capacity building agreement that would reward the City for hiring and maintaining care management staff as shown in Table 1 below:
Table 1: Capacity Building Agreement Structure
Objective
Total
“Not to Exceed”
Amount
Hire 1.0 FTE care management staff $15,000
Retain 1.0 FTE care management staff for 3 months $5,000 Retain 1.0 FTE care management staff for 6 months $10,000 Total: $30,000
Ongoing, HCSA proposes a Service Agreement that would reimburse the City at a rate of $550 per client per month. HCSA has also designated up to 25 client “slots” for the City. The agreement would also provide a one-time housing deposit of up to $5,000 per client. Based on these assumptions, staff estimates an agreement not to exceed $290,000 per year, as shown in Table 2 below:
Council Staff Report (ID # 4767) Meeting of December 20, 2022 Updated: 12/15/2022 5:30 PM by Susan Gauthier Page 3
Table 2: 2023 “Services As Needed” Agreement Structure
Rate
per client
per month
Housing
Deposit
Max Slots Months
Total
“Not to Exceed”
Amount
Services as Needed $550 25 12 $165,000
Housing Deposit $5,000 25 N/A $125,000
Total: $290,000
FISCAL IMPACT: There are no impacts to the General Fund. In order to meet required ratio of clients to care manager, the additional revenue will be used to increase care management staff hours by 1.0 FTE. The service contract will also cover the cost of housing deposits, as well as internal service and administrative overhead costs.
Staff recommends the City Council authorize the City Manager to enter into agreements with the County for capacity building and services as needed, and appropriate $320,000 to Fund 193.
ENVIRONMENTAL REVIEW: The action is exempt from CEQA pursuant to, without limitation, CEQA Guidelines Section 15378(b)(2), (4) and/or (5) and/or 15061(b)(3), each as a separate and independent basis for CEQA exemption, as it is a fiscal or administrative activity of a government agency that has no possibility, either directly or indirectly, to cause a significant effect on the environment.
ATTACHMENTS: None.
RECOMMENDATIONS:
1. Authorize the City Manager or her designee to execute agreements with Alameda County including a capacity building agreement not to exceed $30,000, and a service agreement not to exceed $290,000.
2. Increase the revenue estimate in the Miscellaneous Operating Grants Fund (Fund 193) by $320,000 and appropriate the additional revenue for the purposes described in the staff report.
3. Make findings of CEQA exemption.