Title
The Health and Human Services Agency, Public Health Division, recommending the Board consider the following:
1) Authorize the termination of Agreement for Services 222-S1311 with Sierra Foothills AIDS Foundation, Inc. for the provision of medical case management and supportive care services for persons living with Human Immunodeficiency Virus or Acquired Immunodeficiency Syndrome pursuant to its Article XI, "Default, Termination and Cancellation," Item D "Termination or Cancellation Without Cause;" due to Sierra Foothills AIDS Foundation, Inc. receiving funding directly from Sacramento County, which acts as the Fiscal Agent for Health Resources and Services Administration and;
2) Authorize the Health and Human Services Agency Director to sign a letter to Sierra Foothills AIDS Foundation, Inc. terminating Agreement for Services 222-S1311.
FUNDING Federal Ryan White Comprehensive Acquired Immunodeficiency Syndrome Resources Emergency Act Funds with the County of Sacramento acting as the fiscal agent.
Body
Fiscal Impact/Change To Net County Cost
There is no change to the Net County Cost associated with this agenda item.
Background
The Sacramento County Ryan White Program serves as the Fiscal Agent for Health Resources and Services Administration (HRSA) funds allocated to Sacramento, Yolo, El Dorado, Placer, and Alpine Counties. Ryan White programs are "payer of last resort," which fund treatment when no other resources are available.
On August 21, 2012, the Board adopted Resolution 115-2012 authorizing the Chair to sign Ryan White Comprehensive AIDS Resources Emergency (CARE) Act Funding Agreement 223-F1311 with the County of Sacramento (Sacramento) for the term of July 1, 2012 through June 30, 2015 and in the amount of $472,578 for the provision of case management and supportive care services on behalf of the County of El Dorado for its Ryan White Program for persons living with Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS).
Sierra Foothills Aids Foundation, Inc. (SFAF) has been serving the Sierra foothills region since 1988 and is the sole provider of Ryan White Program services in El Dorado County. On February 26, 2013, the Board approved Agreement for Services 222-S1311 with SFAF for the retroactive term of July 1, 2012 through June 30, 2015 with a maximum compensation of $450,074 for the provision of Ryan White Program case management and supportive care services on behalf of the County of El Dorado Health and Human Services Agency (HHSA).
In mid-2013, HHSA performed an analysis of each party's roles as it applied to the delivery of services and continuity of care to the afflicted HIV/AIDS population within El Dorado County and the reimbursement to SFAF for the provision of these crucial services. The results of the analysis identified redundancies and practical impediments to the efficient and expedient distribution of Ryan White Care Act funds to SFAF that affected SFAF's ability to provide continuous and comprehensive support services to people living with HIV or AIDS and their families. In the interest of a collaborative partnership to provide the most effective and efficient services under the Ryan White Care Act and to ensure the needs and interests of HIV/AIDS afflicted residents of El Dorado County are represented, HHSA, Sacramento, and SFAF agreed that the best course of action was for Sacramento, as the Fiscal Agent for the Ryan White Transitional Grant Area, contract directly with SFAF for provision of locally delivered specialized services to HIV/AIDS afflicted residents of El Dorado County and for HHSA to enter into a zero dollar continuous MOU with Sacramento for continuation of HHSA's active participation as a member of the Sacramento Transitional Grant Area Title I HIV Health Services Planning Council.
On October 25, 2013, the Board authorized the HHSA Director to sign a letter to the County of Sacramento relinquishing the County of El Dorado's role as Local Jurisdiction Fiscal Agent for the Ryan White HIV/AIDS Program funds. To maintain continuity of care for their El Dorado County patients, SFAF continued to provide services under their current agreement with HHSA until Sacramento formally entered into an agreement with SFAF to be the El Dorado County Ryan White services provider, at which time HHSA would terminate their services agreement with SFAF.
Reason for Recommendation
On February 25, 2014, County of Sacramento, via Agenda Item 12, Resolution No. 2014-0125, authorized executing a zero dollar continuous MOU with the County of El Dorado that details each party's role and responsibilities as members of the Sacramento Transitional Grant Area Title I HIV Health Services Planning Council and Resolution No. 2014-0126 that authorized a retroactive pooled authority expenditure agreement with Sierra Foothills AIDS Foundation funded by the Ryan White CARE Act to be effective December 1, 2013, thereby negating the need for the County of El Dorado Agreement for Services 222-S1311 with Sierra Foothills AIDS Foundation. Sending a letter of termination is the final step in completing this change in roles.
Contact
Don Ashton, M.P.A., Director