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Agenda Item
ASR
Control 23-000839 |
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MEETING
DATE: |
12/05/23 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
All
Districts |
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SUBMITTING Agency/Department: |
Health
Care Agency (Approved) |
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Department contact person(s): |
Regina
Chinsio-Kwong (714) 834-2729 |
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Debra
Baetz (714) 834-2830 |
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Subject: Amendments for HIV Housing Services
Contracts
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ceo CONCUR |
County Counsel Review |
Clerk of the Board |
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Concur |
Approved
Agreement to Form |
Discussion |
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3
Votes Board Majority |
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Budgeted: Yes |
Current Year
Cost: $826,430 |
Annual Cost: N/A |
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Staffing Impact: |
No |
# of Positions: |
Sole Source: N/A |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 10/18/2022 #24, 5/10/2022 #34 |
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RECOMMENDED
ACTION(S):
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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. |
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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. |
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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.
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Board
Date |
Contract/ Amendment |
Action |
Term |
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May 10, 2022 |
Contract |
Board Approved Contract |
July 1, 2022 - June 30, 2025 |
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October 18, 2022 |
Amendment No.1 with RHC and SSG |
Board Approved Contract Amendment |
October 18, 2022 - June 30, 2023 |
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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:
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• |
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). |
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• |
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. |
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• |
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. |
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• |
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.
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Outcome Measures |
FY
2022-23 Goals* |
FY
2022-23 Outcome |
FY
2023-24 Goals* |
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Percentage of
virally suppressed clients receiving Housing services. |
82% |
78% |
78% |
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RHC - Percentage of
virally suppressed clients receiving Housing services. |
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76% |
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SSG – Percentage of
virally suppressed clients receiving Housing services. |
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79% |
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Percentage
of Housing clients who reported stable/permanent housing at last encounter. |
72% |
70% |
70% |
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RHC – Percentage of
Housing clients who reported stable/permanent housing at last encounter. |
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72% |
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SSG - Percentage of
Housing clients who reported stable/permanent housing at last encounter. |
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42%** |
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*
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