Fiscal Note
Funding is included in the Executive 2015 Public Health Operating Budget under account number UA77-54920-771100. The Operating Budget amendment required for 2014 is as follows:
$1,750 UA77-54920-771100 Community Agency Contracts
($1,750) UA77-51100-771100 Permanent Salaries
There is no anticipated impact on the tax levy.
Title
Authorizing a contract with Madison Dental Initiative, Inc. for the coordination of dental services
Body
Preamble: As a local health department, Public Health-Madison and Dane County (PHMDC) is required by the state to monitor access to services, particularly for residents without medical or dental coverage or those who do not have the means to pay for those services. Access to medical services for the uninsured is less of an issue in Dane County than in many other communities due to the presence of Access Community Health Center (ACHC), a federally-qualified health center that has been providing services since 1982. ACHC is currently serving about 23,000 clients each year; most reside in Dane County.
Access to dental services has been more problematic. There has been a dearth of providers willing to work with clients with medical assistance or clients with no insurance at all. ACHC and the Max Pohle Clinic at Meriter Hospital have been the primary providers of dental services for uninsured residents. PHMDC has had a contract with ACHC for the provision of emergency dental services for more than a decade. There is also a small cluster of volunteer dentists involved with the Madison Dental Initiative, Inc (MDI). They have been working through a clinic at the Salvation Army, but have limited capacity.
Unfortunately, Max Pohle Clinic will be closing at the end of June 2015. Access is currently working at capacity and has not been able to take on new clients for several months. Indications are that they will not be able to take on new clients for at least a year. Access to dental services for uninsured clients has never been great, but it is quickly becoming a much more serious problem.
PHMDC staff have been working with the Oral Health Coalition to identify alternatives. MDI has developed a plan to recruit volunteer dentists to help at their clinic site at the Salvation Army, but also to identify dentists willing to provide services at their own practices. MDI is currently only staffed by volunteers-to be able to sustain such an effort will require hiring a person to coordinate this effort. In addition to recruiting dentists, MDI will serve as the public service portal, receiving and screening referrals from a variety of agencies and members of the public. Information on referrals and services provided will be sent to PHMDC quarterly to assess the growth and impact of the referral network.
MDI will be ready to launch by mid-November. They have been working on a plan to secure private funding for this effort, but it will take two to three years before this can fully support this project. At this point, this is the only viable alternative that will build capacity for dental services for uninsured clients.
The Inter-Governmental Agreement that created PHMDC requires that the department follow City of Madison purchasing guidelines. MGO 4.26 requires the purchase of services to be made consistent with the policies of the Finance Director (aka Purchasing Guidelines.) The Purchasing Guidelines require a request for proposal (RFP) for purchase of services over $25,000. A RFP was not used because there are no other organizations already working to recruit dentists and have experience in receiving, screening and triaging referrals. With this resolution, Common Council is being asked to authorize PHMDC to enter into a sole-source agreement with MDI.
The initial term of this agreement will be November 15, 2014 through December 31, 2015. Funding for the 2014 portion of this agreement ($1,750) will come from excess salary savings. In 2015, $30,000 will be available. The initial term will be followed by two one-year renewals. The agreement will contain language indicating that if the renewal option is exercised in 2016, $25,000 will be available and if the renewal option is exercised in 2017, $20,000 will be available. The agreement will contain a clause indicating that funding for the two one-year renewals in this contract is contingent upon PHMDC receiving funds for this purpose in the budget appropriations process.
Body:
WHEREAS Public Health-Madison and Dane County is a local health department statutorily required to monitor access to medical and dental services; and
WHEREAS Public Health has determined that there is not sufficient capacity in our community to assure access to dental services; and
WHEREAS Public Health staff has determined that the most viable means to increase the availability of dental services for uninsured residents is a plan by the Madison Dental Initiative, Inc. to recruit volunteer dentists to help at the dental clinic at the Salvation Army, in addition to identifying dentists willing to provide services at their own practices; and
WHEREAS the Inter-Governmental Agreement that created Public Health-Madison and Dane County requires that the department follow City of Madison purchasing guidelines, and the Purchasing Guidelines require Common Council approval for a sole-source contract over $25,000; and
NOW THEREFORE BE IT RESOLVED THAT the Board of Health for Madison and Dane County on behalf of Public Health-Madison and Dane County is authorized to enter into a purchase of services agreement with Madison Dental Initiative, Inc. for the purposes described above for an initial term of November 15, 2014 through December 31, 2015, with the possibility of two one-year renewals.
BE IT FURTHER RESOLVED the Director of Public Health-Madison and Dane County is authorized to sign the agreement.
BE IT FINALLY RESOLVED that the 2014 Adopted Operating Budget is amended using $1,750 in excess salary savings to cover the cost of services provided November 15, 2014 through December 31, 2014.