COUNTY ADMINISTRATOR 220 NORTH MAIN STREET, P.O. BOX 8645 ANN ARBOR, MICHIGAN (734) FAX (734)

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1 COUNTY ADMINISTRATOR 220 NORTH MAIN STREET, P.O. BOX 8645 ANN ARBOR, MICHIGAN (734) FAX (734) TO: THROUGH: FROM: Martha Kern, Chair Ways & Means Committee Robert E. Guenzel County Administrator Ellen J. Clement Health Officer DATE: June 20, 2001 SUBJECT: Health Resources and Services Administration (HRSA) - Community Access Program (CAP) Grant application for the Enhanced Health Service Delivery for Washtenaw County s Underinsured, for the period of October 1, 2001 through September 30, BOARD ACTION REQUESTED: The Department of Public Health requests that the Board of Commissioners ratify the signature of the County Administrator on the Community Access Program Grant application for the Enhanced Health Service Delivery for Washtenaw County to the Health Resources and Services Administration (HRSA) in the amount of $792,079 for the time period of October 1, 2001 through September 30, BACKGROUND: Recent estimates suggest that as many as 29,000 county residents are uninsured with as many as 24% of low-income persons being uninsured. Washtenaw s current delivery system is relatively good for low-income and uninsured persons but there is a need to improve access to and the coordination of mental health and substance abuse services with other health care services. The County has funded the Washtenaw County Health Care (WCHC) program since 1998 (Resolution # ). This program, originally known as the Resident County Hospitalization program, has been modified to provide access to health care services for uninsured, low-income residents. The County also supports the Washtenaw Community Health Organization (WCHO), created in July 2000 as a joint venture with the University of Michigan Medical Center. The WCHO provides integrated mental health, substance abuse and physical health services to

2 Medicaid and low-income county residents covered by Community Mental Health and M-Care. DISCUSSION: The Public Health Department, in collaboration with the Washtenaw Community Health Organization (WCHO), has submitted a grant application to the Health Resources and Services Administration (HRSA) for funding through its Community Access Program. The grant, if funded, will create a unique coordinated project that will improve access to and integration of primary, specialty, mental health and substance abuse services for the County s uninsured, low-income population. The grant would support the following programmatic objectives: 1) improve the quality of care provided to uninsured indigent residents by increasing the integration of care across the major provider systems in the county through a shared data warehouse and by monitoring results; 2) increase and improve access to specialty care, including mental health and substance abuse providers; 3) develop a plan to create a third-share program; 4) improve access to pharmaceuticals; 5) enhance enrollment and education for WCHC enrollees; and 6) create a Liaison Management Group to enhance collaboration between Public Health, WCHC, WCHO, and Allegiance, a Physician-Hospital Organization. IMPACT ON HUMAN RESOURCES: Public Health will create four full time grant status positions within the Public Health Department if the grant is funded. Position # Status Title Grade Group FTE G PH Program Administrator G Program Manager G Management Assistant G Administrative Coordinator IMPACT ON BUDGET: The total grant program of $792,079 will be funded by $760,779 in federal funding and $31,300 in local match ($6,300 in in-kind staff time and $25,000 in state grant funding from a WCHO database integration project). In order to keep administrative costs to a minimum, the Washtenaw County Public Health Department will contract with the Southeastern Michigan Health Association (SEMHA) to act as the grant fiduciary. SEMHA is a corporation formed by the seven local health departments of southeast Michigan, including Washtenaw County, and has an administrative staff and Executive Director. SEMHA serves as a financial management agent for many of the local public health department programs and activities carried out by its member departments. It facilitates the delivery of health services and acts as a fiduciary for health departments applying for grants. SEMHA manages approximately 25 grants at any given time, including state grants and federal grants, such as Ryan White Title IV, WIC, and the Immunization Registry.

3 No increase is required to the County appropriation. The Public Health Department budget will increase by $234,103 for the costs associated with the positions being created for this grant. Public Health will enter into an agreement with SEMHA, the grant fiduciary, to be reimbursed for all expenses incurred for these positions. The remainder of the federal grant funds will be expended on supplies & other services and charges (194,164); contracts with WCHO (130,285), Allegiance (142,000), and University of Michigan (24,000) for data and technology services, quality improvement, and program and process evaluation; and SEMHA administrative costs (5% or 36,228). IMPACT ON INDIRECT COSTS: No impact on indirect costs. Washtenaw County will not be the fiduciary for this grant. IMPACT ON OTHER COUNTY DEPARTMENTS OR OUTSIDE AGENCIES: This grant will enhance linkages between the Public Health Department, the WCHO, and Community Mental Health, as well as local health providers. CONFORMITY TO COUNTY POLICIES: This request is in conformance with County policies. ATTACHMENTS/APPENDICIES: Community Access Program Grant Application Preparer: Ellen J. Clement, Health Officer

4 A RESOLUTION RATIFYING THE COUNTY ADMINISTRATOR S SIGNATURE ON THE APPLICATION TO THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) COMMUNITY ACCESS PROGRAM (CAP) FOR THE ENHANCED HEALTH SERVICE DELIVERY FOR WASHTENAW COUNTY S UNDERINSURED IN THE AMOUNT OF $792,079 FOR THE PERIOD OF OCTOBER 1, 2001 THROUGH SEPTEMBER 30, 2002; AUTHORIZING THE ADMINISTRATOR TO SIGN THE NOTICE OF GRANT AWARD; AMENDING THE BUDGET AND AUTHORIZING THE ADMINISTRATOR TO SIGN DELEGATE CONTRACTS WASHTENAW COUNTY BOARD OF COMMISSIONERS July 18, 2001 WHEREAS, the Board of Commissioners is requested to ratify the signature of the County Administrator on the HRSA Community Access Program Grant application submitted by the Public Health Department in the amount of $792,079 for the period of October 1, 2001 through September 30, 2002; and WHEREAS, the purpose of the funding request is to improve access to a wide range of health care services for the County s uninsured, indigent population; and WHEREAS, the grant application is a collaborative effort of the Public Health Department and the WCHO; and WHEREAS, the grant fiduciary will be the Southeastern Michigan Health Association (SEMHA), and the Public Health Department will receive $234,103 in reimbursement for salaries and fringes of four grant-funded positions; and WHEREAS, this matter has been reviewed by Corporation Counsel, the Finance Department, Human Resources, the County Administrator s Office and the Ways & Means Committee NOW THEREFORE BE IT RESOLVED that the Washtenaw County Board of Commissioners hereby ratifies the signature of the Administrator on the HRSA Community Access Program Grant application in the amount of $792,079 for the period October 1, 2001 through September 30, 2002, as on file with the County Clerk

5 BE IT FURTHER RESOLVED that the Board of Commissioners takes the following actions contingent upon receipt of the grant award in conformity with the grant application: 1. Authorizing the Administrator to sign the Notice of Grant Award 2. Amending the budget, as attached hereto and made a part of 3. Authorizing the creation of the following grant status positions: Position # Status Title Grade Group FTE G PH Program Administrator G Program Manager G Management Assistant G Administrative Coordinator Authorizing the Administrator to sign delegate contracts upon review of Corporation Counsel to be filed with the County Clerk

6 Washtenaw County Public Health HRSA Community Access Program Enhanced Health Service Delivery for Washtenaw County s Underinsured October 1, 2001 September 30, 2002 Original Revised Description Budget Budget Variance Revenue: Other Revenue & Reimb. $0 $234,103 $234,103 Total Revenue $0 $234,103 $234,103 Expenditures: Personal Services $0 $234,103 $234,103 Total Expenditures $0 $234,103 $234,103