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Committee forwards DPH participation in CMS dementia-care model (Guide) to full Board
Summary
The committee approved forwarding a retroactive participation agreement for the CMS 'GUIDE' dementia-care model, expected to bring approximately $3.5 million in revenue over the contract term; the retroactive authorization addressed a 26-day term extension after CMS's later signature.
The Budget & Finance Committee on Sept. 18 voted to forward to the full Board a resolution retroactively authorizing the Department of Public Health (DPH) to enter a participation agreement with the Centers for Medicare and Medicaid Services for a 10-year model test called GUIDE (Guiding an Improved Dementia Experience).
Alex Boyter, an administrative analyst with the San Francisco Health Network, said GUIDE provides care navigation and coordination for older adults with dementia who have Medicare Part B, and aims to improve quality of life, reduce caregiver strain, and support people living with dementia to remain in their homes. DPH does not currently have a program that bills Medicare Part B for these services; Boyter said anticipated revenue over the contract term is $3,500,000 (presenter framed this as an eight-year revenue projection to the committee and as roughly $437,000 per year in the staff presentation).
DPH requested retroactive approval because CMS’s execution of the agreement (June 5) pushed the effective term 26 days beyond a 10-year administrative limit, and DPH had a May 15 signing deadline. Committee members asked about reimbursement rates and enrollment assumptions; Boyter said reimbursement depends on the number of people served and the rates are set by the program. Vice Chair Rafael Mandelman offered to be a sponsor of the item. No members of the public spoke on the item.
The committee voted 3–0 to forward the resolution to the full Board with a positive recommendation. The Board will consider the item on Sept. 24.
