Agenda Item

AGENDA STAFF REPORT

 

ASR Control 23-000839

 

MEETING DATE:

12/05/23

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

Health Care Agency (Approved)

Department contact person(s):

Regina Chinsio-Kwong (714) 834-2729

 

 

Debra Baetz (714) 834-2830

 

 

Subject: Amendments for HIV Housing Services Contracts

 

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

Budgeted: Yes

Current Year Cost: $826,430

Annual Cost: N/A

 

 

 

Staffing Impact:

No

# of Positions:

Sole Source: N/A

Current Fiscal Year Revenue: N/A

Funding Source: FED: 90% (Housing Opportunities for Persons with AIDS (HOPWA) and Ryan White), State: 10% (ELC Enhancing Detection Expansion - ELC 2)

County Audit in last 3 years: No

Levine Act Review Completed: Yes

 

Prior Board Action: 10/18/2022 #24, 5/10/2022 #34

 

RECOMMENDED ACTION(S):

 

 

1.

Approve Amendment No. 3 to the Contract with AIDS Services Foundation Orange County dba Radiant Health Centers for provision of HIV Housing Services, increasing the not to exceed amount by $592,956, effective December 5, 2023, for a revised cumulative contract amount not to exceed $2,627,070.

 

2.

Approve Amendment No. 2 to the Contract with Special Service for Groups, Inc. for provision of HIV Housing Services, increasing the not to exceed amount by $233,474, effective December 5, 2023, for a revised cumulative contract amount not to exceed $879,842.

 

3.

Authorize the County Procurement Officer or Deputized designee to execute Amendment No. 3 with AIDS Services Foundation Orange County dba Radiant Health Centers and Amendment No. 2 with Special Service for Groups, Inc., as referenced in the Recommended Actions above.

 

 

 


 

 

 

SUMMARY:

 

Approval of Amendment No. 3 with AIDS Services Foundation Orange County dba Radiant Health Centers and Amendment No. 2 with Special Service for Groups, Inc. will increase support to eligible people living with HIV to establish and/or maintain housing stability, support improved health outcomes, HIV viral load suppression, and reduced HIV transmission.

 

 

 

BACKGROUND INFORMATION:

 

The Health Care Agency (HCA) receives funding from the U.S. Department of Housing and Urban Development (HUD), Housing Opportunities for Persons with AIDS (HOPWA) program through the City of Anaheim, and from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) through the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Ryan White Act), to provide housing and supportive services for people living with HIV (PLWH). Services are intended for, but are not limited to, persons living at or near the federal poverty level, persons who are low income as defined by HUD standards; and persons who are ineligible for other housing programs. In addition to HOPWA and Ryan White funding, other funding sources may be utilized to meet the need for HIV Housing Services, if available. For the proposed Amendments other funding sources include Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases Enhancing Detection Expansion (ELC-2) funding from the California Department of Public Health to ensure housing for PLWH and reduce transmission of COVID-19. HIV Housing Services are provided throughout the County of Orange (County).

 

On May 10, 2022, your Honorable Board of Supervisors (Board) approved the selection of and Contracts with AIDS Services Foundation Orange County dba Radiant Health Centers (RHC) and Special Service for Groups, Inc. (SSG) for provision of HIV Housing Services for the term of July 1, 2022, through June 30, 2025. On October 18, 2022, the Board approved Amendment No. 1 with RHC and SSG to reflect an increase in funding and services. All previous actions for HIV Housing Services are summarized in the table below.

 

Board Date

Contract/

Amendment

Action

Term

May 10, 2022

Contract

Board Approved Contract

July 1, 2022 - June 30, 2025

October 18, 2022

Amendment No.1 with RHC and SSG

Board Approved Contract Amendment

October 18, 2022 - June 30, 2023

N/A

Amendment No. 2 with RHC

Deputy Purchasing Agent Authority - Budget Modification

April 24, 2023 - June 30, 2023

 

The current contracts for HIV Housing Services with RHC and SSG are being amended to reflect additional funds and expansion of HIV Housing Services. HIV Housing Services, specifically Emergency Financial Assistance for Housing and Short-Term Supportive Housing were expanded to provide additional support (i.e., increased amount of financial assistance available and additional bed nights) as detailed in the Scope of Services section to better meet the needs of eligible PLWH in Orange County.


 

Scope of Services

HIV Housing Services are for eligible low-income PLWH and are intended to help PLWH achieve viral load suppression in addition to establishing and/or maintaining housing stability, reducing chronic homelessness; and increasing access to health care and other HIV related services. HIV Housing Services help to address chronic homelessness by supporting PLWH to maintain existing housing or providing temporary housing to facilitate the transition to permanent housing. HIV Housing Services include:

 

 

 

Emergency Financial Assistance (EFA) for Housing/Short-Term Assistance for Rent (STAR) Services Assistance with rent, mortgage, utilities, and move-in costs (deposits for rent or utilities) for persons below 80 percent area median income ($80,400 for a single person household in 2023).

 

Short-Term Supportive Housing (STSH) Services Provision of interim housing in a hotel, motel, or recovery residence/sober living for persons below 80 percent area median income or 500 percent Federal Poverty Level ($72,900 for a single person household in 2023), whichever is less and who are: (1) experiencing homeless or at risk of becoming homeless; (2) are coming from emergency housing, mental health and/or drug treatment programs; or (3) were recently released from incarceration.

 

Housing Coordination Services Coordination of the Tenant-Based Rental Assistance Program (RAP) wait list, provision of referrals to other housing services, as needed and housing advocacy services.

 

Life Skills Training Services Group education to support the development of practical living skills, communication skills, and access to community resources. Topics include medical treatment adherence, nutritional counseling, and other topics that support the development of personal management skills.

 

The Contract does not contain language regarding the Homeless System Service Pillar Report since the solicitation was released prior to the requirement to implement. HCA, RHC, and SSG will work to implement the principles and commitments of the Outreach and Supportive Services, Shelter, and Housing Pillars as applicable.

 

RHC

Based on the available funding and annual allocation, it is anticipated that 500 new and existing clients (7,049 units of service) will be provided with HIV Housing Services for FY 2023-24.

 

SSG

Based on the available funding and annual allocation, it is anticipated that 42 new and existing clients (5,115 units of service) will be provided with HIV Housing Services in FY 2023-24.

 

Units of service listed include all HIV Housing Services in scope of the contracts.

 

Performance Outcomes

Outcome measures for HIV Housing Services are monitored on the Ryan White Fiscal Year (March through February) and are listed in the table below. The outcomes indicate that HIV Housing Services have helped clients maintain or improve their health as well as stay engaged in care. Viral load is an indication of the amount of active HIV in the blood; a suppressed viral load is an indication of improved health and reduces the risk of HIV transmission. The viral load outcome measure is collected through laboratory reports and current housing status is collected through client self-report.

 

Outcome measures for HIV Housing Services are presented below. The Ryan White Quality Management (QM) Committee establishes service specific outcome goals annually, reviews outcomes data quarterly and develops quality improvement initiatives to improve and achieve outcome measures. The outcome goals for FY 2023-24 reflect the baseline outcomes established in the prior year (FY 2022-23) which were calculated based on a revised methodology to better reflect services rendered.

 

Outcome Measures

FY 2022-23 Goals*

FY 2022-23 Outcome

FY 2023-24 Goals*

Percentage of virally suppressed clients receiving Housing services.

82%

78%

78%

RHC - Percentage of virally suppressed clients receiving Housing services.

 

76%

 

SSG Percentage of virally suppressed clients receiving Housing services.

 

79%

 

Percentage of Housing clients who reported stable/permanent housing at last encounter.

72%

70%

70%

RHC Percentage of Housing clients who reported stable/permanent housing at last encounter.

 

72%

 

SSG - Percentage of Housing clients who reported stable/permanent housing at last encounter.

 

42%**

 

* Performance outcome goals established annually by the Ryan White QM Committee are service specific, not provider specific.

 

**The service provider experienced data and reporting issues in FY 2022-23, which contributed to the significantly lower outcome. The data and reporting issues have been resolved by the provider in the current fiscal year.

 

Contracts do not currently include subcontractors or pass through to other providers. See Attachment C for Contract Summary Forms.

 

The County of Orange Preference Policy is not applicable to these Amendments.

 

The Contractors' Performance has been confirmed as satisfactory. HCA has verified there are no concerns that must be addressed with respect to Contractor's ownership/name, litigation status or conflicts of interests.

 

HCA requests that the Board approve Amendment No. 3 to the Contract with RHC and Amendment No.2 to the Contract with SSG for HIV Housing Services as referenced in the Recommended Actions.

 

 

 

 

FINANCIAL IMPACT:

 

Appropriations for the Amendments to these Contracts are included in Budget Control 042 FY 2023-24 Budget.

 

These Contracts include provisions allowing HCA to terminate the Contracts, reduce the level of services, and/or renegotiate the levels of services provided, as necessary. This includes a notice that allows HCA adequate time to transition or terminate services to clients, if necessary.

 

 

 

STAFFING IMPACT:

 

N/A

 

REVIEWING AGENCIES:

 

Office of Care Coordination

 

ATTACHMENT(S):

 

Attachment A - Amendment No. 3 to Contract MA-042-22011374 for HIV Housing Services with AIDS Services Foundation Orange County dba Radiant Health Centers
Attachment B - Amendment No. 2 to Contract MA-042-22011375 for HIV Housing Services with Special Service for Groups, Inc.
Attachment C - Contract Summary Form
Attachment D - Redline to Attachment A
Attachment E - Redline to Attachment B