DATE: April 4, 2017
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Dental Transformation Initiative - Local Dental Pilot Project Grant Application
RECOMMENDED ACTION(S):
TITLE
Retroactively authorize the Department of Public Health’s previous submittal of a grant application in the amount of $12,138,275 to the Department of Health Care Services for Dental Transformation Initiative - Local Dental Pilot Project.
REPORT
Approval of the recommended action will authorize the retroactive submission of a competitive grant application to the Department of Health Care Services (DHCS) for Dental Transformation Initiative (DTI) - Local Dental Pilot Project (Pilot Project) funding. The DTI, a component of the Medi-Cal 2020, is a critical mechanism to improve dental health for Medi-Cal children by focusing on high-value care, improved access, and utilization of performance measures to drive delivery system reform. On September 30, 2016, the Department of Public Health submitted a comprehensive Fresno - Pilot Project application, revised and resubmitted on February 3, 2017 following evaluator feedback, for the total project award of $12,138,275. The Department was notified of the County’s selection; once the agreement is received, the Department will return to your Board to accept the grant funds and approve agreements with the collaborative partners.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the grant application would be withdrawn and pending award declined.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The final agreement is expected by May 2017, the Department will return to your Board to request that the grant funds be accepted and to increase the Department’s Org 5620 FY 2016-17 appropriations and estimated revenues. The grant will provide $12,138,275 (Year 2017: $2,558,603, Year 2018: $2,969,289, Year 2019 $3,202,145; and, Year 2020: $3,408,238) for four consecutive years to implement the project from FY 2016-17 through FY 2019-20. Sufficient appropriations and estimated revenues will also be requested in the Department Org 5620 FY 2017-18 Requested Budget and subsequent fiscal year budget requests for the duration of the grant term.
DISCUSSION:
A $750 million funding opportunity for the DTI was made available by DHCS in mid-2016 for (1) increased utilization of preventative dental services among children; (2) prevention and treatment of more early childhood caries; (3) increased dental continuity of care for children and, (4) Local Dental Pilot Projects. The Pilot Project is designed to improve dental health for Medi-Cal children by focusing on high-value care and providing incentive payment to dentists that become Denti-Cal providers and opt-in to the project.
The Department submitted a project proposal as the lead entity to coordinate the project and serve as the single point of contact. DHCS will identify 15 Pilot Project awardees and funding will be for a term of four consecutive years. The Department requested $12,138,275; however, the total grant award is dependent upon approval and subsequent judgement of the submitted application.
In Board Briefing Report (BBR) dated December 22, 2016, the Department advised your Board of the grant opportunity and provided details regarding the initial application submitted by the Department on September 30, 2016. At the time, the Department anticipated notification of acceptance or denial by January 2017.
The proposed project will add interventions to increase oral health education and preventive and treatment participation for Medi-Cal children 0-20 years old and will target the 93701, 93702 and 93722 zip codes. The goals, outcomes and performance metrics included in the application are consistent with and build upon the performance metrics of the DTI. As the lead entity, the Department proposed a working partnership with various local organizations. Each organization will be responsible for various functions in the project including, but not limit to, client intake, provider relations and recruitment, oral health education, and case management.
One of the most innovative functions proposed by the Department is the integration of a Virtual Dental Home (VDH), a relatively new technology, known as Tele-Dentistry. VDH allows a small group of dentists to review electronic dental records (EDR) from many different community sites. Once a participating dentist has reviewed a client’s EDR, the dentist can determine whether to refer the client to a participating dentist for advanced treatment or to allow the community center to perform the needed preventive services.
In February, the Department received notification from DHCS that the County’s application was selected for award and since then, Department staff has been working with DHCS to finalize agreement details. On February 3, 2017, the Department resubmitted the application addressing recommendations from the application evaluator. The Department intended to request your Board’s approval for the retroactive grant submittal and agreement at the same time, as DHCS indicated that the award announcement would be imminent. However, given the announcement delay, the Department is requesting that your Board retroactively authorize the grant application submittal.
Should the grant be received, a resolution allowing the Department to accept the grant funds and an agreement will be presented to your Board for consideration. DHCS tentatively anticipates announcing awarded grant recipients by May 2017.
REFERENCE MATERIAL:
BBR - December 22, 2016 - Dental Transformation Initiative Grant Application
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Dental Transformation Initiative Grant Application
CAO ANALYST:
Sonia De La Rosa