To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Grant Agreement #78-051-2 with California Department of Health Care Services (DHCS)
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director or designee, execute on behalf of the County Grant Agreement #78-051-2 with California Department of Health Care Services (DHCS) for providing Access and Transforming Health (PATH) Capacity and Infrastructure Transition, Expansion and Development (CITED) Grant - Round 4 funding in an amount not to exceed $2,714,912 to provide housing support through a bridge housing model for unhoused persons, and expand capacity for Short Term Post Hospitalization placements for Medi-Cal eligible, medically vulnerable individuals to develop and expand California Advancing and Innovating Medi-Cal (CalAIM) services in Contra Costa County for the period January 1, 2026 through December 31, 2026.
FISCAL IMPACT:
Approval of this Agreement will result in an amount not to exceed $2,714,912 from DHCS’s CITED Program. No County match is required.
BACKGROUND:
This Round-4 funding from DHCS will help expand and develop CalAIM services in California. In calendar year 2022, there were 5,896 Contra Costa Health Plan (CCHP) patients who had at least one-episode of homelessness during the year. Additionally, 194 patients exited a county run shelter into housing without the tenancy sustaining supports (aftercare) necessary to prevent recurrence of homelessness. Currently, there is no streamlined way to access community support services, nor does County have the workforce in place to deliver these much-needed services. County’s current system works in silos and with CITED funding, County can more seamlessly integrate services to create a more robust system of care that can address housing and health together. CITED funding will also enable health care and homeless service providers to have access to housing navigation and tenancy sustaining services to support their patients with their housing needs. Currently, unless a person is accessing services at a shelter or is getting help through street outreach or a drop-in center, there is no dedicated resource that can offer housing navigation services and/or tenancy sustaining services. We also have a dearth of street outreach teams that have the capacity to support those who are discharging from hospitals and other medical programs and need housing supports. CITED funding will enable County’s Health, Housing, and Homeless Services Division (H3) to expand outreach efforts and provide dedicated housing resources to any CCHP member who needs it. H3 works closely with County’s Public Health Partners who operate the Enhanced Care Management (ECM) program in Contra Costa County are working to identify step down plans for those that no longer need intensive ECM services, but who may still need community supports, such as housing navigation and tenancy sustaining services. CITED funding will enable H3 to scale up to ensure that County will have the capacity to accept referrals from ECM graduates who still need support with housing. H3 also works closely with case managers from CCHP who need to refer patients for housing supports services. H3 holds the role as Contra Costa County’s Continuum of Care (CoC) leadership and understands County’s homeless system of care is highly impacted and has reached its capacity causing long waiting periods for individuals to get the services that they desperately need to remedy their housing crisis. CITED funding will decrease the bottleneck in services and will help us meet the demands in the community. By adding housing navigation services paired with street outreach workers, we can meet the needs of those being served from anywhere. This includes support for people discharging from hospitals and emergency rooms with no place to go.
DHCS has designated Public Consulting Group LLC as the Third-Party Administrator (TPA), to administer the grant program and to communicate with County with respect to grant administration in connection with the CITED Program.
On October 22, 2024, the Board of Supervisors approved Grant Agreement #78-051-1 with DHCS to receive Round-3 funding in an amount not to exceed $2,932,106 to provide housing support for unhoused persons and expand capacity for Short-term Post Hospitalization placements for Medi-Cal eligible, medically vulnerable individuals the period July 1, 2024 through June 30, 2025.
Approval of Grant Agreement #78-051-2 will allow the County to receive Round-4 funding in an amount not to exceed $2,714,912 to provide housing support for unhoused persons and expand capacity for short-term post-hospitalization placement for Medicare eligible, medically vulnerable individuals through December 31, 2026. This Agreement requires the County to release and hold harmless Public Consulting Group LLC and DHCS from any claims relating to the receipt of grant funds and associated activities in connection with the CITED program.
CONSEQUENCE OF NEGATIVE ACTION:
Without CITED funding, County will be unable to increase program capacity, leaving a large gap in the homeless system of care negatively impacting homeless residents in Contra Costa County.