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  Regular-General Government   #   40.    
Board of Supervisors County Administrator  
Meeting Date: 01/12/2021  
Brief Title:    Adult Day Health Center - Approval of Funding Plan
From: Jill Cook, Deputy County Administrator, County Administrator's Office
Staff Contact: Chad Rinde, Chief Financial Officer, Department of Financial Services, x8050

Approve funding plan for the Adult Day Health Center and adopt budget resolution appropriating $2,750,000 in funding to the project. (General fund impact $1,250,000) (4/5 vote required) (Cook/Rinde)
Recommended Action
  1. Approve funding plan for the Adult Day Health Center Project;
  2. Adopt budget resolution appropriating $2,750,000 in funding to the project; and
  3. Authorize County Administrator to negotiate and sign agreement with Dignity Health with final form to be approved by County Counsel.
Strategic Plan Goal(s)
Thriving Residents
  • Outcome: Reduce economic and health disparities while building resiliency and supportive care for aging residents of Yolo County.
  • Strategy: Increase opportunities for aging adults to attend Adult Day Health or Adult Day Care by June 30, 2022.
Reason for Recommended Action/Background
The Board has for several years supported efforts to acquire, renovate, and operate a new Adult Day Health Center (ADHC) to serve County Residents. County staff have during this time worked closely with Dignity Health and the Yocha Dehe Wintun Nation in order to develop a framework to achieve this objective and a related funding plan for the expansion of the Adult Day Health Center (ADHC).

The project terms (Attachment A - Draft Term Sheet) would have Dignity Heath acquire and renovate a facility of suitable size and amenities to provide the customary range of services offered at the ADHC including social work, transportation, psychiatric, dietary assistance, speech, physical and occupational therapies, social acetifies, nursing, and caregiver support. The objective would be to reduce hospital days, emergency room visits, re-admissions, and doctor visits. Dignity would retain sufficient staff equipment and materials to provide the services for an expected term of 20 years and it is expected that the premises would consider a portion of the Stollwood facility. The expected size of the facility is expected to be 14,700 square feet of space which would allow for sufficient average daily attendance (ADA) in order for the program to be financially sustainable moving forward. The expectation is that dignity would make efforts to enroll all individuals on the waitlist and that an average daily attendance would be 120 individuals with a service target of 140 individuals and overall enrollment target of 175 individuals. As part of this project, Dignity would assume and maintain ADP and ADHC licensing with the California Department of Health Services and California Department of Aging. The County Administrator's Office and County Counsel's office are working with Dignity Health to finalize an agreement to memorialize these terms and this item requests authority for the completion of negotiations and the County Administrator to have authority to execute the agreement. 

As part of the project, a funding plan has been developed in order to allow for the acquisition and renovation of the facility. The County's contributions are expected to be structured as a loan in which over the 20-year term, interest and principal will be forgiven (annually in 1/20th increments) as long as Dignity meets its obligations to provide ADHC services. Below is a summary of the funding sources to the project: 
Source Amount
Intergovernmental Transfer Funds (IGT) $1,000,000
West Davis Active Adult Community (WDAAC) Developer Contribution* $1,250,000
Accumulated Capital Outlay Funds $500,000
Tribal Contribution $1,250,000
Dignity Foundation - Capital Contribution $600,000
Total Project Cost $4,600,000
*Developer contribution will arrive when development milestones are achieved. County would need to advance General funds until developer fees are received. The County General Fund assumes the risk if the development and expected contributions do not materialize.  

Dignity Health is the manager of the project and would be performing acquisition, construction, and renovation activities. These are expected to start as early as January of 2021 and the County would be providing the capital contributions as specified above to further the project. Dignity will select a project manager that will keep the County informed as to the progress of construction and would notify and consult with the County should there be any significant change to the project. 

Staff is requesting the Board to approve the funding plan above and authorize the Budget Resolution (Attachment B) to appropriate County Funding needed to complete the project. In addition, staff is requesting authorization for the County Administrator to negotiate with Dignity Health and sign the agreement with a final form to be approved by County Counsel.
Collaborations (including Board advisory groups and external partner agencies)
The County Administrator’s Office has collaborated with Dignity Health on arriving at a framework for the project and has collaborated with Department of Financial Services on the funding plan and County Counsel throughout the process. The funding plan was supported by the Board Budget Ad-Hoc Subcommittee at their December 17, 2020 meeting.
Competitive Bid Process
Not applicable. The County is providing funding to the project in order to support Dignity’s acquisition, renovation, and operation of a new ADHC servicing County residents. Dignity Health will perform the acqusition, renovation, and construction of a facility for ADHC services. Dignity Health would assume the state licensing as part of the project to operate an ADHC.

Fiscal Information
Fiscal impact (see budgetary detail below)
Fiscal Impact of this Expenditure
Total cost of recommended action $2,750,000
Amount budgeted for expenditure $0
Additional expenditure authority needed $2,750,000
One-time commitment     Yes
Source of Funds for this Expenditure
General Fd/Developer Cont $1,250,000
ACO Fund $500,000
IGT Funds $1,000,000
Further explanation as needed
The County would contribute $2,750,000 from various funding sources to the project. The general fund would advance the developer contributions that will occur as certain milestones are achieved on the construction of units at the West Davis Active Adult Community (WDAAC). These contributions when received would repay the advance of funds to the ADHC project. The general fund would be responsible if these contributions do not materialize.
Att. A. ADHC Draft Term Sheet
Att. B. Resolution
Att. C. Presentation

Form Review
Inbox Reviewed By Date
Chad Rinde Chad Rinde 01/04/2021 02:59 PM
Jill Cook Jill Cook 01/04/2021 08:26 PM
Chad Rinde Chad Rinde 01/06/2021 08:23 AM
Financial Services (Originator) Chad Rinde 01/06/2021 08:23 AM
County Counsel Hope Welton 01/06/2021 08:52 AM
Form Started By: Chad Rinde Started On: 12/21/2020 12:00 PM
Final Approval Date: 01/06/2021
Level double AA conformance,
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