ALLIANCE SAFETY-NET SUSTAINABILITY FUND ELIGIBILITY
In evaluating an application for the Alameda Alliance for Health Safety-Net Sustainability Fund, the Evaluation Committee will take into consideration the following factors as they may apply to a particular entity and the responses provided in the application. Funding allocations are at the discretion of the Evaluation Committee based on meeting the eligibility criteria below and demonstrated need.
Definitions:
a. A “safety net” provider is defined by the mission and vision of their organization, and earning a majority of their revenue through serving the underserved and uninsured residents in Alameda County. For hospitals only, if the hospital appears on the most recent Department of Managed Health Care’s (DMHC) Disproportionate Share Hospital (DSH) Program eligibility list, then the applicant hospital will be considered a safety-net hospital (DSH Eligibility List SFY 2018-19).
b. A “frontline” provider is a health care entity or an organization that is actively serving vulnerable Alameda County residents, including Alameda Alliance for Health members, during the COVID-19 crisis. The frontline providers serve as a first point of contact for vulnerable populations, and support the needs of families and caregivers. The frontline workers include clinical and non-clinical staff to support the needs of vulnerable populations affected by the COVID-19 crisis.
Common Eligibility Factors:
1) Provider is a safety-net provider earning a majority of revenue through serving underserved and uninsured residents in Alameda County.
2) Organization is located (headquartered or has satellite sites) in Alameda County.
3) Organization is serving as a frontline provider and treating or supporting Alliance members.
4) To be eligible for funding as a safety-net hospital, safety-net health center, or safety-net directly-contracted primary care physician the following applies:
a. The safety-net provider must be contracted with the Alliance and receive fee-for-service payments for covered services.
b. The contracted safety-net providers who only receive capitation payments are not eligible for this program.
c. If the safety-net provider is contracted with the Alliance and receives both capitation and fee-for-service payments, the provider may be eligible for participation; however, only the fee-for-service paid amounts are considered in the funding allocation.
Additional Eligibility by Safety-Net Category (this is in addition to the Common Eligibility Factors Above):
1) Safety-net hospital:
a. Eligibility criteria is based on percent of total revenue for underserved and uninsured services; may also include revenue from programs serving undocumented residents (such as HealthPAC in Alameda County)
b. Revenue associated to commercial products (Medicare, Covered California, or other employer-based groups) is excluded when determining funding allocations.
2) Safety-net health center:
a. Eligibility criteria is based on percent of revenue for underserved and uninsured services;
b. Revenue associated to commercial products (Medicare, Covered California, or other employer-based groups) is excluded when determining funding allocations.
3) Safety-net primary care physician, directly contracted to the Alliance:
a. Eligible provider must be contracted with the Alliance and participating in the Pay-for-Performance “P4P” program in calendar year 2020.
4) COVID-19 testing:
a. Organization is a county agency or private entity providing testing or testing related services.
b. Testing sites may be in a fixed location (e.g. community clinic, FQHC, or other designated site), mobile clinic, or street-based testing (drive-thru).
c. Testing applies to PCR (swab, verifies active virus) testing and antibody testing (i.e. verifying if a person had the virus and has recovered).
d. Funding pays for testing and contact tracing activities.
e. Funding pays for supplies (swabs, PPE, etc.), staffing/labor costs, and other operating expenses.
5) Other Saftey-Net Service Providers:
a. Eligibility criteria is based on percent of total revenue from services provided to underserved and uninsured residents of Alameda County.
b. Examples of entities include, skilled nursing, food banks, family services, aging adult services, and entities that provide services to vulnerable Alameda County residents.
Considerations to funding the safety-net entities by the Alliance:
1) Amount of funding the safety-net entity is receiving, has received, or is expected to receive from business loans, grants, or other types of funding from public agencies. Including but not limited to:
a. County (Measure A dollars, intergovernmental transfers “IGTs”);
b. State agencies (general fund); and
c. Federal agencies (CMS, CARES Act, etc.).
2) Amount of external funding the safety-net entity is receiving, has received, or is expected to receive from foundations, and other organizations (e.g. commercial health plans).
3) Extent to which the entity has demonstrated an operational need and has been affected by COVID-19.
4) Extent to which the entity has demonstrated its continuous efforts to serving the vulnerable residents across Alameda County.
5) Amount of claims payments paid by the Alliance to entity. (For safety-net providers that are paid on a fee-for-service basis.)
6) At the discretion of the committee, factors such as the number of Alliance members served or assigned to the applicant, the types of services offered by the applicant, and other factors deemed valuable in determining funding allocations.