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Regular-General Government # 31.
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| Board of Supervisors |
Board of Supervisors |
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| Subject |
| Receive update on the Yolo Adult Day Health Center Ad Hoc Board Subcommittee. (No general fund impact) (Blacklock/West) |
| Recommended Action |
Receive update on the Yolo Adult Day Health Center (ADHC) Ad Hoc Board Subcommittee.
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| Strategic Plan Goal(s) |
Thriving Residents
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| Reason for Recommended Action/Background |
The Yolo ADHC provides an out-patient day program in Woodland for older persons and adults with chronic medical, cognitive or mental health conditions and/or disabilities that are at risk of needing institutional care. Due to issues regarding facility limitations and a structural deficit, on November 17, 2015 the Yolo County Board of Supervisors established an Ad Hoc Board Subcommittee to assist the Yolo ADHC in identifying strategies for continued sustainability. What follows is an update on the efforts of that subcommittee.
Background
The Yolo ADHC currently operates in accordance with a 2009 agreement, No. 09-151, (See Attachment A) between the County and the non-profit organization Dignity Health. Under the agreement the County leases the facility to Dignity Health for use as the Yolo ADHC and also provides the operating license. Dignity Health manages the Yolo ADHC and provides the services (equipment, personnel, labor, materials, etc.) necessary for its operation.
For several years the Yolo ADHC has struggled with both facility limitations and a structural deficit. A July 2015 strategic space utilization study conducted by Jacobs, found the current facility of the Yolo ADHC, which is owned by the County, to be inadequate to meet the needs of the program. The size of the facility results in a license limit of 59 clients that may be served daily in the facility despite a waiting list of over 50 individuals. Space for staff, clinic, and activities are restricted and the facility also does not meet full Americans with Disability Act compliance standards. Additionally, the Yolo ADHC has been operating with a structural deficit. In FY 2015-2016 this resulted in a deficit of $240,543 and a deficit of approximately $200,000 is anticipated for FY 2016-17.
Ad Hoc Board Subcommittee
In accordance with the November 2015 Board of Supervisors directive, a Yolo ADHC Ad Hoc Board Subcommittee was formed with representatives from the County (Board of Supervisors, County Administrator’s Office, Health and Human Services, and County Counsel), Yolo Adult Day Health Center, Dignity Health, and the Yolo Healthy Aging Alliance.
Shortly after the development of the Ad Hoc Board subcommittee, an amendment, No. 16-75, (See Attachment B) to the 2009 agreement was formed between the County and Dignity Health. This amendment extended the term of the original agreement by one year to June 30, 2017 with the option to extend for one additional year. It also altered the original contract so that operating losses for the Yolo ADHC are shared equally between Dignity Health and the County with an amount payable for the County not to exceed $150,000 per fiscal year.
During 2016 staff conducted site visits at various ADHCs in the region and met with potential stakeholders. The purpose of the meetings was to determine best practices and explore potential partnerships for future operations of the Yolo ADHC. Through this outreach it became apparent that structural deficits among ADHCs is common and that the key to a balanced budget was the number of participants; essentially, an ADHC must have enough participants to generate sufficient revenue to cover expenses.
With this information in mind, Dignity Health determined that in order to operate with a balanced budget the Yolo ADHC would need a facility that accommodated an average daily attendance of approximately 110. Since the current facility is limited by license requirements to an average daily attendance of 59, the Subcommittee began exploring options to expand the facility. In 2017 County staff toured potential locations in Woodland and developed cost estimates which were presented to Dignity Health.
Next Steps
The County has presented facility options to Dignity Health for consideration and set aside $500,000 in Intergovernmental Transfer funds for Dignity to put towards tenant improvements or purchase of a facility for the Yolo ADHC. It is the desire of the County to extend the current amended agreement with Dignity for an additional year to allow time for Dignity to acquire and transfer operation of the Yolo ADHC into a new facility. |
| Collaborations (including Board advisory groups and external partner agencies) |
Yolo ADHC Ad Hoc Board Subcommittee: County (Board of Supervisors, County Administrator’s Office, Health and Human Services, and County Counsel); Yolo Adult Day Health Center; Dignity Health; and the Yolo Healthy Aging Alliance.
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| Fiscal Impact |
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| Source of Funds for this Expenditure |
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Explanation (Expenditure and/or Revenue) |
| Further explanation as needed: |
Based on the FY 2016 third quarter budget for the Yolo ADHC it is anticipated that the County’s portion of the operational losses for the program will total $150,000 to be paid out of the General Fund.
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