1

Alameda County Health Care for the Homeless Commission

Friday, August 18, 2017 9:00am-11:00am

Health Care Services Agency 1000 San Leandro Blvd #300, San Leandro CA 94577

AGENDA

Item Presenter TAB Time

A. CALL TO ORDER 1. Welcome & Introductions 2. Adopt agenda

David Modersbach, HCH Grants Manger

9:00 AM 5 min

B. CLOSED SESSION

1. No Closed Session.

C. PUBLIC COMMENT**

Persons wishing to address items on or off agenda

5 min

D. CONSENT AGENDA

Review and Approve Minutes of 7/21/17 Meeting

TAB 1

5 min

E. BOARD ORIENTATION

No Board Orientation scheduled

F. REGULAR AGENDA

1. Consumer/Community Input – Report from HCH Consumer/Community Advisory Board

2. Board Ad Hoc Committee reports - no reports 3. HCH Program report : HCH Director Resignation

4. Action Item: Discuss/Approve HCH Program/Health Center

2018 HRSA Budget Period Renewal and budget.

5. Encampments/Unsheltered Homeless: Report and Discussion from HCH Deputy Director Lucy Kasdin

Sam Weeks, DDS CCAB Board Chair Lucy Kasdin, HCH Deputy Director Quyen Tran, HCH Finance Manager Lucy Kasdin, HCH Deputy Director

TAB 2

TAB 3

5 min 10 min 20 min 20 min

G. OTHER ITEMS

1. Items for upcoming agendas 2. HCH Commission Selection of Chair, Vice Chair and Executive

Committee 3. Discussion of 9th Commissioner, and vacant/vacating seats. 4. Housekeeping

5 min 20 min 10min

H. ADJOURNMENT 11:00 AM

* Meetings are accessible to people with disabilities. Individuals who need special assistance or a disability-related modification or

accommodation (including auxiliary aids or services) to participate in this meeting, or who have a disability and wish to request an alternate

format for the agenda, meeting notice, or other documents that may be distributed at the meeting, should contact the HCH Grant Manager at

least five working days before the meeting at (510) 667-4487 in order to make reasonable arrangements to ensure accessibility to this meeting

and the materials related to it. The HCH Commission regular meeting documents are posted at least 72 hours prior to the meeting and are

accessible online at: http://www.achch.org/. ** Any person may address the HCH Commission during its Public Comments period. Presentations must not exceed three (3) minutes in

length. HCH Commission members may not take actions or respond immediately to any Public Comments presented, but may choose to

follow up at a later time, either individually, or on a subsequent Commission Agenda.

2

Tab 1:

Minutes 7/21/2017 HCH

Commission Meeting

3

Alameda County Health Care for the Homeless Commission

Friday, July 21, 2017 9:00am-11:00am

Health Care Services Agency 1000 San Leandro Blvd #300, San Leandro CA 94577

draft MINUTES HCH Commissioners Present Absent: County Staff/Partners Present: Adria Walker Gay McDaniel boona Cheema Samuel Weeks DDS Lynette Lee Fr. Rigo Caloca-Rivas Mark Shotwell (Ex Officio)

Jean Richardson-Prasher

Heather MacDonald-Fine AHS Homeless Coordination Office Quyen Tran, HCH Finance Manager Stacee Brackens, HCH staff (notes)

Item Discussion/Recommendation Action

B. CALL TO ORDER

Mark Shotwell, ACHCH Director called the meeting to order at 9:02am. Introductions Action Item: Approve Agenda

Motion: b.cheema; second Caloca-Rivas, Yea: unanimous

B. CLOSED SESSION

Closed session this meeting HCH Director Self-Evaluation & discussion. HCH Commission Meeting. Mark Shotwell HCH Director and Members of HCH Commission.

Notes:

b.cheema

C. PUBLIC COMMENT

Public comments were invited; none were made Session:

began at 9:45am

D. CONSENT AGENDA

Review and Approve Minutes of May 19, 2017 Motion:

b.cheema; second Caloca-Rivas, Yea: unanimous

F. REGULAR AGENDA

Board Ad Hoc Committee reports - no reports this meeting Fr. Rigo discusses the Quorum & how it affects being a committee; Look at the bylaws and ordinances; powers and duties of this commission.

o Also covered 2 items o Directors evaluation; Process of strategic planning for the

center; new job description; o What roles we are to play

o Question about New responsibilities on director Mark: Directors position/Job description is being rewritten

o Position is outdated; commission will get new job description o Commission will have no direct input o JD is different & very specific is diff than the job classification o Performance eval is out dated o The commission may not have direct input due to the Civil Service

rules; will have input you want as a part of a performance eval. Andrea -discuss how we handle our business Gay – had a question about the way the committee communicates with all to inform of attendance etc. question; how do we let all know whether we will be there or not Mark- mentioned an outlook calendar re: doodle; more efficient.

4

b. cheema – danger of using doodle or other calendar; more important that it is a critical meting and we all need to be there; important to a Quorum; Andria – looking for a confirmation of a quorum Lynette Lee- discussed forming a committee that will make it more efficient (regarding evaluations, housing committees, another committee tracking budgets, what’s been approved; having details Andria- at some point to have an executive committee Mark- will address the two potential open seats on the agenda later Mark is requesting that on the August Agenda to have time to vote for an executive committee; start putting it out there; over time other committees can be added as the commission sees fit Adria-discusses how Important for everyone to prioritize the meeting Fr. Rigo; motions to select a committee at this mtg (listed on page 6); contributing to us not being as organized as we’d like to be (headless as a commission) Mark- has been a standing item every meeting; Fr. Rigo- before talking about any other committees; need to establish the exec committee Advisory Board (HCH CCAB) Sam Weeks, DDS, CCAB Board Chair Sam Weeks reported HCH CCAB meeting on 7/14; discussed HCH CCAB members attending National Health Care for the Homeless Council national conference in Washington DC in June. Sam discusses the challenges of the HCH CCAB Executive Committee setting policies. The CCAB sets out the learning pieces however they have membership issues. The board is working on a thorny issue of expanding membership of CCAB. Currently the mandate has no limit on membership; money for the stipend is limited. CCAB members receive a stipend which is directly effecting our growth of our CAB; this is complicating issue of new members, too much expansion of members could be over budget, and CCAB is trying to balance attraction of stipend with hope to compensate CCAB members for their hard work. HCH Commissioners consensus was that funds shouldn’t become a limitation for having new HCH CCAB board members and discussed how to make sure budget is adequate for HCH CCAB. Sam proposed for putting money into a fund vs a stipend; then they all can vote on what the fund approves. That was a wash (half approved/have opposed). Question: if more comes how do get the money for a stipend/who gets it and not. Or do we put it in a fund where it can be used and everyone gets a benefit? They are hashing things out; membership is frozen at this time. Some members are annoyed because they are not getting a stipend and others have the stipend in their budget but not willing to give it up. Dilma; do we take from to benefit the group; no one wants to say yay or nay. Sam discussed other projects: Continuing to build skills (amazing) & Co-sponsoring with or rep and St. Mary’s regarding homelessness encampments. Sam mentioned the retreat coming up in September and others coming to speak and help on very specific areas. Sam mentioned that Mark Smith reported on Trust Clinic and the changes in the committees & the CCAB involvement in reviewing the patient surveys that are going out which give the patients some say in what’s being asked and populate the questions until the right answers are achieved. Look and review the various surveys and the ones that were done. Sam brings up Sup Valle letter to change state law so that wine bottles and whiskey bottles are considered CRV items so those who recycle can get some money. Mark Shotwell reported out on the focus group in recycling; with Valle; wine or liquor to get redemptive

Valle runs Tri-Ced (wife now runs it)

5

Recycling –very important to the homeless and way to make significant income; clean up community

Beer bottle it is crv but a wine bottle is not (wine and liquor industry has fought really hard to not have extra 5cents charged on the bottle which would go to pay for recycling; as a result all of the glass of wine/liquor creates no income which ends up in landfill and have affected people who are homeless

More limited access to recycling centers as before; if this opens up it would

Role of recycling; augment income; staple in their recovery allows them to have peace of mind; augment income what is so limited in their lives

6-8 hrs. collecting; 4+ to bag and take to center

Full time jobs; $100 per week to help them supplement or $300-$400 for income

Boona-Dog Town Redemption-documentary regarding Oakland recyclers; producer gave out a lot of copies (to give and to sell) Gay-shared about a couple who collected recycle; she would help; in so cal ; they lived on it and make a difference for the ppl; Mark – about the wine logging (beer pays; wine and liquor does not pay out) Sam- finished discussing letter sent out lastly we appoint officers for every meeting; supportive of folks ; looked at skills building; pg. 14; Appoint offers/rotate officer at every meeting CCAB is doing much better; and what the letter is doing for the CCAB CCAB want to do by the CAB for the CCAB; everyone ideas are in the letter b. cheema-discussed who is not in favor of the encampments? Mayor is not in favor; the city manager and police chief are not in favor of the encampment; lets do action instead of politics, etc; Sent to all networks in Berkeley; the info got out. Lynette had a question-should this commission vote to support this item; will put on next agenda

F. REGULAR AGENDA

6.

HCH Program report : HCH Director’s Report Mark moves on the next item; Commission needs to approve submission of prior notification

Change directors role from David to Mark (roles)

Referred to the letter about David being in the gap between directors Submission approved for submission to HRSA Project Officer. Mark turning over next item to Quyen; overview of the HRSA budget renewal. QUYEN: will be staying here until Oct; make sure that all year end closing and HRSA budgets complete; Everyone congratulating Quyen on moving to Vietnam; hand off this program in a good place. Andria - what a loss Rigoberto – north or south Queyen; Saigaon Gay – recruiting going on? Mark – happy for Quyen; a huge hit to the program; started recruiting for this position

Hope to get someone in asap-get cross training from Quyen

Motion:

Caloca-Rivas second McDaniel: Yea: unanimous

6

Updated regarding the Contract Mgr role has been filled: Terri Moore is the selected candidate and made an offer yesterday; contract mgt experience; CATS in SF; replacing Harit

QUYEN-BPR

Deadline is August 18th-same day as the next commission; break in 2pts Gay- question: does the county contribution out of general fund Quyen – 1.5 million;-Trust Clinic + MAA program This year bring up the revenue from 100K to 200K in this year; looking for opportunity in growing the program; money from the state so we can grow the program. Snapshot of County 23 FTE/Health Center-105 FTE review; Almost a full funded program Current draft of Program budget compared to last year; draft is in early stage of program; Mark and Quyen are working on it; reduction in budget but not reduction in funds We raised more nonfederal fund from the county (MAA program) Salary reduced 94 FTE less) Small change from this year to last year More sub abuse contracts Allocate the budget as is; 200,000 what project to allocate to Question; Gay – What is HCH positions;

Staff- break down of program budget

Breakdown of Health Center budget

Tobacco fund –used to draw for HCHP

Gay - ask to get budget ahead of time;

Ask question and send the answer out to all Draft Staff list;

o Lucy replaces Suzanne Warner as Deputy Director o Plan to hire Sr. Mgt Analyst to focus on data and one of the key member

for building the strategy of the program. o One position offered to a person (Contracts Manager) o Vacant position open for years: Stacee is filling position as a TAP; open up

and fill as a permanent position o Dr. Ayslin Bird; hire for position #3; Street Psychology to help with the

Trust Clink o One person retired (one of the mobile van drives; deciding if this positon is

needed and will use the fund for depends on strategy. Will be decided in BBR process:

o 19 FTE (15 filled and 4 in the process of being filled) o Breakdown in allocation of Funding (HRSA, MHSA & General Fund)

Quyen: Comparison of Health Center Budget (draft this year compared to last year).

o FTE Budget reduced; o Last Year report discount to clients (learning in process) o This year report income as a net 9show up in system Net vs Gross; can

prove to fed that it is cash. o Other Funds: MHSA, AHS (Ryan White, Measure A, health Pac, ) o Difference from last year; AHS was under reported

Quyen mentions that the info will provide to you; Plan to have the packet a week before the August Mtg for review Rigoberto – mentions that this plan looks very complete

TAB 4 TAB 3 TAB 4

7

Adria comments; the impression on where the budge it’s…How Is it compared who what you are looking go do? Mark discussed the following:

o there is money to make some decisions; grant highlighted in director’s report is a great opportunity; big vision for the program

o Big vision for the program is really big vision that can’t all be accomplished with this year’s budget.

o Street psychiatry and (3yrs) move forward) o What is our staff doing now; do we want to reallocate ore move positions

around with responsibility. o Health Care form; can impact things in the county around our population

with medicate, trust clinic, our clients with AHS; may be put off for a couple of years.

Rigoberto- question: overall assessment for performance-any concerns; whats your assessment and any concerns we should be aware of? Quyen – responds that financially this is best year in the last 4 years:

o staff list more stable settle down the budget; who’s holding what and doing what; big cost of budget of grant which help settle down budget

o Services not able to give summary yet-encumbered important services over the last few years; allocating to 2 street medicine & 1 psychologist street medicine; maximize dollars that we have

o Source of funding; financially best year seen (13.8 to 15+ this yr) o Push to have medical rate to be increased-more money for state in program

income and less from County o Eventually our pocket money will spend and use more efficiently elsewhere;

continuing to help fund the program Question: this is from the certification for the clinic? Mark-Able to past cost on to LifeLong;

o success and unique process from Refer to Director’s report; a number of staff embedded into the costs

o Increases their cost which increases rate but will be sustainable in the long run. Quite a success to get passed; important

o Clinic is an expensive to run; need to get a higher rate; complex services o Needed to get higher rate

GAY-comment; so efficient; connect dots and maximize every pot money Rigoberto- do we have a reserve fund? Quyen: two pockets of

Tobacco – allocated almost 500K for the last 4 yrs (280 left)

MAA revenue; kept at HCSA (last 5yrs as savings acct; bal is 230K) –

Every year keep adding money

By the end of the year we want to spend their dollar

Closing county fiscal year; Be sure to maximize; tatic of how to do diff things; find ways to report it; if we don’t we don’t get to keep it

Mark – wanting to wrap portion up:

o a couple of expansion; specialty & highland dental o Major changes; impact of housing crisis o As AC3 comes in will augment our services is great o Filing in key staff in the agency was one of the best accomplishments o Lower number of patients vs Target patient name: o Switched to a more assertive model; going out to encampments (being

effective) Gay – question about outcome:

8

Mark: Not at the point to be able to Look over outcomes; there is a lot of movement year to year in percentage of outcome. Mark: asking if there are any questions about the Point in time count Final comments and any items added to the agenda:

o Vote to support the cab letter that was offered o Role of commission o BPR approval o Formation of committees; ready to nominate yourself or others or that

committee? Mark: Do we have any nominations for the executive committe?

o Do we have a sense of when the meeting will occur? o Roles; process of planning agenda; work around the program director’s

evaluation o Executive committee -1 meeting in between commission meetings o Prioritize committee

Lynette –housing Boona-how to work with Mark during Andrea- willing to be a part of committee Sam –no Gay-no Rigoberto –no; let’s see if we can be more creative We won’t have a housing committee; be quite demanding; what does an executive Look like? Mark – suggestion-what time works make sense Next month discuss Exec meeting;

o Jean is not at the meeting and thinking of stepping down o Person who will be coming on the 9th seat to be filled o Betty’s seat to be filled o And now Jean’s seat need to be filled o Let’s follow up on next month.

9

G. OTHER ITEMS

HCH Commission Selection of Chair, Vice Chair and Executive Committee Adria: Recommend review of HCH Commission Bylaws and founding documents at next meeting. Sam: Recommend waiting till we get all 9, or at least 8 members before development of Executive Committee. General consensus of commissioners to this recommendation. Boona: Moved that HCH Commission officers should be selected at July 21 HCH Commission meeting.

Recruitment for HCH Commission seats Betty’s Seat: This seat will be recruited and approved by HCH Commission itself. David sent out packet of recruitment info & letters for review of Commissioners. Gay: I will approach parishes, Tri-City Volunteers, and South County programs for nominations. Lynette had recommended Jean Fong for AHS seat, possibly for Betty’s seat? 9th Seat (AHS/Hospital Expertise) David reported that recruitment for the AHS seat, which is approved by BOS, is moving slowly. Sadly not a high priority at AHS, BOS or HCSA levels. Working with AHS BOT to identify a potential candidate. Mark: We will work more aggressively seeking out an AHS appointee for the 9th seat, contact AHS, BOS and HCSA again. Fr. Rigo: Move to have HCH push hard for a 9th seat nominee, if it doesn’t pan out then let’s move forward to identify our own candidate for this seat. Give a deadline of July 21 meeting; if there is no candidate, we’ll move forward with own nominees.

Items for upcoming agendas: Next HCH Commission Meeting:

Friday August 18, 9-11Am 1000 San Leandro Blvd #325

Motion:

Cheema, second Weeks: Yea: unanimous Motion:

Caloca-Rivas second McDaniel: Yea: unanimous

Adjourned 11:00am Motion:

Caloca-Rivas second Lee Yea: unanimous

* Meetings are accessible to people with disabilities. Individuals who need special assistance or a disability-related modification or

accommodation (including auxiliary aids or services) to participate in this meeting, or who have a disability and wish to request an alternate

format for the agenda, meeting notice, or other documents that may be distributed at the meeting, should contact the HCH Grant Manager at

least five working days before the meeting at (510) 667-4487 in order to make reasonable arrangements to ensure accessibility to this meeting

and the materials related to it. The HCH Commission regular meeting documents are posted at least 72 hours prior to the meeting and are

accessible online at: http://www.achch.org/. ** Any person may address the HCH Commission during its Public Comments period. Presentations must not exceed three (3) minutes in

length. HCH Commission members may not take actions or respond immediately to any Public Comments presented, but may choose to

follow up at a later time, either individually, or on a subsequent Commission Agenda

Tab 2:

HCH Program Director’s

Report

No Directors Report 8/18/17

From: "Shotwell, Mark, HCHP" <Mark.Shotwell@acgov.org> Date: August 16, 2017 at 9:32:28 AM PDT To: "Shotwell, Mark, HCHP" <Mark.Shotwell@acgov.org> Subject: Letter of Resignation

Dear Staff of the Health Care for the Homeless Program, I am sending this letter to let you know I have made the decision to resign from my position as Director of the Health Care for the Homeless Program. This has been a very difficult decision for me to make. I have had a successful career as a Direct Service Staff and Senior Operations Manager in Behavioral Health and Homeless Services for the last 25 years. The opportunity to assume the Director position at HCH was very exciting and allowed me to experiment with stepping into an Executive Leadership role with a diverse and complex health center. Over this last 8 months I have worked diligently to assume those responsibilities, as well as leading in the new role for the HCH Director as a central player in the public dialogue on homelessness in Alameda County. Unfortunately, I now realize that this position is really not a good fit for me and my skills and I am not a good fit for the position. I am aware that this transition in leadership for HCH presents challenges for you in the short term. However, I believe two core values all leaders must champion are truthfulness and trustworthiness. So, in line with these values, I have come to the conclusion that the best long term outcomes for the Health Care for the Homeless Program and me is to step down. Dr. Kathleen Clanon and I have discussed my resignation and she will schedule a meeting right away with HCH leadership regarding transition plans. I remain strongly committed to Alameda County and HCSA and am working with HCSA leadership to explore opportunities in the long-term that would be a good match for me and my skills. In the short term, I will continue to work with HCSA on projects regarding Housing, Homelessness and Whole Person Care. My work with all of you has confirmed my faith in our field. I admire your skills, compassion and commitment to our clients/patients. Thank you for the assistance, support, and guidance that you provided me in my time with the program. I look forward to our paths crossing in the future and the opportunities we may have to collaborate in our work. I wish you all the best in your lives and in your work with Health Care for the Homeless. I will reach out to many of you personally, but if you would like to reach out to me, please do so. You can reach me on this e-mail or on my cell phone at (510) 542-6605. Sincerely, Mark Shotwell

Tab 3:

HCH Budget Period Renewal

CY2018 Budget

ALAMEDA COUNTY

HEALTH CARE SERVICES AGENCY

HEALTH CARE FOR THE HOMELESS

1404 Franklin Street, Suite 200 Oakland, CA 94612

TEL (510) 891-8950 FAX (510) 832-2139

www.achch.org

DATE: August 18, 2016 TO: Alameda County Health Care for the Homeless Commission FROM: David Modersbach, Grants Manager/HRSA Authorized Official SUBJECT: REQUEST FOR THE HCH COMMISSION TO TAKE ACTION TO APPROVE BUDGET

PERIOD RENEWAL PROGRAM BUDGET CY2018 Under the HRSA/BPHC Health Center Program the project term of the Alameda County Health Care for the Homeless Program is from 1/1/2017 through 12/31/2019. This project period is created through the Services Area Competition, a competitive renewal process. Each project year within the 3 year project period requires submission of an annual Budget Period Renewal to HRSA where the following year budget is proposed and program updates and reporting is made to HRSA. Under Article II of the Bylaws of the Alameda County Health Care for the Homeless Commission, the HCH Commission has the authority and responsibility for approving annual budget of the HCH health center within appropriations made available by the BOS and BOT. The HCH program through its Fiscal Manager has provided the HCH Commission with adequate training and information about the HCH health center budget in the January 2017 meeting and the July 2017 meeting, and has sent copies of draft budget for the 2018 BPR for Commissioner review prior to the August 18 meeting. Approval of this item by the HCH Commission requires a majority vote of the HCH Commissioners present.

Quyen TranACHCH Commission Meeting

August 18, 2017

Budget Period: Jan – Dec 2018 Budget Details and Narrative. Allocated Federal award for

2018 is $3,857,421. Program Specific Information◦ Form 3: Income Analysis◦ Form 5A: Services Provided◦ Form 5B: Service Site◦ Form 5C: Other Activities/Locations◦ Project Narrative Update

HCH Commission approval on Friday, Aug 18. Submit to HRSA same day.

2018: $15.7 M $3.9M $3.4M $8.4M

Key Category Program Budget 2018

Health Center Budget 2018

Scope of Budget County Program County Program + AHS + Contractors

FTE 19.00 97.98

Total Budget ($) $7,272,961 $15,651,833

- Federal Fund $3,857,421 $3,857,421

- Non Federal Fund $3,415,540 $11,794,412

Program Income $0 $5,574,101

Program Budget2017 2018

FTE 23 19 - 3 HS, - 1 AA, -1 SCI, +1 SCII

Total Budget $7,071,980 $7,272,961 2.8% increase

- Fed Fund 3,803,524 3,857,421 1.4% decrease

- Non-Fed Fund 3,268,456 3,415,540 4.5% decrease

Line Cost - Fed only $3,803,524 $3,857,421 1.4% increase

- Salary & Benefits 1,891,394 1,438,781 -23.9% decrease

- Travel 15,860 18,840 - Supplies 56,800 60,300

- Contractual 1,530,452 1,837,267 + 150K SA, $50K optometry, increase ROOTS & Onsite

- Others 141,750 151,559 - Indirect Cost 167,268 350,675 Incl. 1 AA + 1 SCI position

- Unallocated Fund - -

Key Category Notes

HCH Program Budget 2018DIRECT PERSONNEL

Staff Category Total Program HRSA Non-HRSAFiscal & Admin Staff Staff Name 9.00 6.20 2.80 Prog Director/HCPA II Mark Shotwell 1.00 0.80 0.20 Deputy Director/HCPA I Lucy Kasdin 1.00 - 1.00 Senior Management Analyst Vacant 1.00 0.80 0.20 Management Analyst David Modersbach 1.00 0.70 0.30 Program/Financial Specialist Quyen Tran 1.00 0.70 0.30 Admin Specialist II Carolyn Ellison 1.00 1.00 - Admin Specialist II Vacant 1.00 0.20 0.80 Specialist Clerk I Matha Cardenas 1.00 1.00 - Specialist Clerk II Vacant 1.00 1.00 - Clinical Staff 4.00 1.80 2.20 Med Dir/PhysIV (P) Jeffrey Seal 1.00 0.80 0.20 Physician III Aislin Bird 1.00 - 1.00 Clinical Psychologist (P) Ted Aames 1.00 - 1.00 Mid Level Practitioner Oteria Randall 1.00 1.00 - Care Management Staff 3.00 1.20 1.80 Social Worker III William Quan 1.00 0.60 0.40 Social Worker III Nancy Quintero 1.00 0.60 0.40 CHOW II Wilma Lozada 1.00 - 1.00 Mobile Health Staff 3.00 3.00 - Mobile Supp Clk Ronald Richardson 1.00 1.00 - Mobile Supp Clk Vacant 1.00 1.00 - Medical Assistant Noemi Joves 1.00 1.00 -

Total Filled FTE 15.00 9.20 5.80 Total Vacant FTE 4.00 3.00 1.00 Total Budget FTE 19.00 12.20 6.80

Health Center Budget2017 2018

FTE 105.15 97.98 - AHS, HCH & Contractors

Total Revenue $13,791,570 $15,651,833 13.5% increase

- Federal 3,803,524 3,857,421 - Billing Income 4,670,984 3,691,580 Net off patient discount in 2018

- Other Funding 4,628,264 6,614,001 Increase from AHS

- County Funds 688,798 1,488,831 Incl. HPAC funding to AHS

Total Expenditures $13,791,570 $15,651,833 13.5% increase

- Salary & Benefits 3,076,395 2,595,172 -15.6% decrease

- Travel 15,860 18,840 18.8% increase

- Supplies 81,800 98,300 20.2% increase

- Contractual 9,382,637 11,976,287 27.6% increase

- Others 591,970 612,559 3.5% increase

- Indirect Cost 642,908 350,675 -45.5% decrease

- Unallocated Fund - -

Key Category Notes

Alameda Health System

Subrecipient primary care, specialty care, case management, behavioral health care, enabling services, drug/alcohol services, and collaborative Mobile Health services. Directly pay 3 staff FTEs $602,463

4,500 patients treated in 20,500 visits.

La Clinica de la Raza

Contracted dental care for 240 prebooked time blocks of four 4-hour blocks per week for emergency, restorative and specialty dental services. $127,363 200 patients in 960 visits.

On Site Dental Foundation

Contracted portable/mobile dental care provided for health center patients for one weekly mobile dental unit clinic, providing patients with emergency, restorative and specialty dental services in coordination with health center patient care managers.

$220,000

50 weekly clinic sessions 1,400 visits/year to 200 health center patients.

ROOTS Community Health Center

North County Street Medicine - Contract to provide direct street primary care/urgent care clinical medical services, outreach, and enabling services to unsheltered persons living in encampments and on streets. $332,440

Target: 1,200 medical visits; 2,200 outreach contacts.

Tri-City Health Center

South County Street medicine : Contract to provide direct street primary care/urgent care clinical medical services, outreach, and enabling services to unsheltered persons living in encampments and on streets. $200,000

Target: 225 unique patients in 700 medical encounters.

East Bay Community

Recovery Project

Contract with community-based substance use provider for substance use services for unsheltered homeless health center patients. Harm reduction, case management, care coordination, housing navigation and outreach and enabling services

$150,000

Target 210 patients engaged in substance use services, outreach to at least 1000 patients annually.

Fruitvale Optical Contract with centrally-located North County optometry clinic to provide optometry exams and optical services to health center patients in coordination with health center care managers. $25,000

Projected goal is 200 patients per year.

South County Optometry Service

(NEW)

Contract with centrally-located South County optometry clinic to provide optometry exams and optical services to health center patients in coordination with health center care managers. $25,000

Projected goal is 200 patients per year.

LifeLong Medical Care

TRUST Clinic Care Services- integrated primary care, behavioral health, substance use and enabling services to address physical, mental, and social well-being of indigent, disabled persons experiencing homelessness. 1,660,148

Projected 1500 unique patients served / year.

Contractor Service Amount Patient/Visit Target

2018 HCH Health Center Contracts

9

ACHCH HRSA Budget Period Renewal CY 2018 Operational Highlights

Changes in Health Center Structure?• No significant changes in program• Expansion of Specialty Care Services (Alameda Health System HGH)• Expansion of Dental Services (HGH Dental)• Planned Street Psychiatry services expansion

Environment Major Changes:• Impact of Housing Crisis and Unsheltered/Encampment Homeless• Impact of AC3

Organizational Capacity• Key Staff Vacancies (as of 8/19/17)

Target Patient Number:• 9,301 homeless patients to be served in CY2018 • We’re currently about 10% below that (8300 patients): Decline in Substance Use

patients due to new contract and focus on unsheltered encampment outreach/engagement services & clinic-based Medication Assisted Treatment

10

HRSA Performance Measures HCH Program

Measure2016

Compliance Rate

2015-2016

difference

Notes

Childhood Immunization 69% decline Primary Care AHS onlyPap Tests 59% improved Mobile and primary careChild and Adolescent Weight Assessment and Counseling 86% declined

Primary Care AHS only

Adult Weight Screening and Follow-up 63% improved Mobile and primary care

Tobacco Use Screening and Cessation Intervention 83% declinedMobile and primary care

Asthma Pharmacological Therapy 91% improved Mobile and primary care

Coronary Artery Disease (CAD): Lipid Therapy 69% declined Primary Care AHS only

Ischemic Vascular Disease (IVD): Aspirin or Antithrombotic Therapy 94% improved

Primary Care AHS only

Colorectal Cancer Screening 47% improved Mobile and primary careHIV Linkage to Care 75% same Mobile and primary care

Depression Screening and Follow-up 80% same Mobile and primary care

Dental Sealants Children 27% improved Primary Care AHS onlyControlled Hypertension 76% improved Mobile and primary care

Diabetes: Compliance: Aa1c ≤ 9% 61%Slight

declineMobile and primary care

HCH Oral Health Access to Care 25% Same Dental access for HCH mobile patients

Cost Per Patient $1277 Higher Overall Program Costs

Revenue Growth 0% Same Increase program revenue to enable expanded svcs.