Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors, Acting as the Governing Board of the Public Authority
From: Colleen Chawla, Chief, San Mateo County Health
Lee Pullen, Director, Aging and Disability Services
Subject: Amendment to the Agreement with Benefit Service Center to Provide Dental and Vision Benefits to Independent Providers of the In-Home Supportive Services Program
RECOMMENDATION:
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Acting as the Governing Board of the San Mateo County Public Authority, adopt a resolution authorizing an amendment to the agreement with Benefit Service Center to provide dental and vision benefits to independent providers of the In-Home Supportive Services (IHSS) program, extending the term through December 31, 2026, and increasing the maximum amount payable by $601,000 to a total amount not to exceed $4,927,000.
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BACKGROUND:
In 1993, the Board of Supervisors approved an ordinance establishing the Public Authority (PA) as the legal entity to administer the provider component of the In-Home Supportive Services (IHSS) program. The ordinance also designated the San Mateo County Board of Supervisors as the PA’s Governing Board (Board). The mission of IHSS is to help eligible elderly, blind, and disabled individuals remain in their homes for as long as safely possible. The program uses independent providers to assist County residents with a wide variety of daily living activities, including bathing, eating, preparing meals, and performing certain paramedical services authorized by a physician.
The Service Employees International Union (SEIU) Local 2015 represents the IHSS independent providers in negotiations regarding issues such as wages and health, dental, and vision benefits.
In January 2024, this Board adopted the current Memorandum of Understanding (MOU), pursuant to which the PA administers benefits, including health benefits, for IHSS providers. This MOU is due to expire on December 31, 2026.
In 2015, this Board approved an agreement with Benefit Service Center (BSC) to provide dental and vision benefits to IHSS providers for the term of July 1, 2015, through June 30, 2016, in an amount not to exceed $600,000.
In August 2016, this Board authorized an amendment to the agreement extending the term through December 31, 2017, and increasing the maximum amount payable to $1,500,000.
Additional annual amendments extended the term through December 31, 2025, and increased the maximum payable to a total amount not to exceed $4,326,000.
DISCUSSION:
This amendment increases the dental premium from $15.33 to $16.07 and increases the vision premium from $6.35 to $6.45 per member. A maximum of 2,200 providers may receive BSC benefits. The total estimated cost of vision and dental benefit premiums for the IHSS providers who receive coverage through BSC and for Consolidated Omnibus Budget Reconciliation Act (COBRA) participants (22 providers) for the 2026 calendar year is $600,473.28. As such, this amendment extends the term of the agreement by one year, through December 31, 2026, to align with the expiration of the MOU, and increases the maximum amount payable by $601,000 to an amount not to exceed $4,927,000.
A waiver of the Request for Proposals process is requested from this Board to ensure continuous and uninterrupted dental and vision insurance benefits for IHSS and COBRA participants. These benefits were specifically negotiated in the agreement with SEIU. The agreement expires on December 31, 2026. The next round of negotiations will include health, dental, and vision benefits.
The PA is currently exploring options with SEIU to provide dental and vision insurance benefits to their members, following the expiration of this agreement.
The resolution contains the County’s standard provision allowing amendment of the fiscal obligations under the agreement by a maximum of $25,000 (in aggregate).
The amendment and resolution have been reviewed and approved by the County Attorney’s Office as to form.
It is anticipated that 100% of 1,469 eligible IHSS providers and COBRA participants who apply for dental and vision benefits will be enrolled.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of eligible IHSS providers and COBRA participants who apply for dental and vision benefits that are enrolled |
100% 1,473 IHSS providers and COBRA participants |
100% 1,469 IHSS providers and COBRA participants |
COMMUNITY IMPACT:
This contract will have a positive impact on caregivers of the IHSS program by providing them access to dental and vision benefits. Currently, there are 9,094 caregivers delivering home care services through the IHSS program. There are 2,200 slots for BSC benefits, and 1,447 caregivers are currently enrolled. Although this benefit has been highly publicized, the cap on enrollment has never been reached. The number of caregivers utilizing this benefit is comparable to the number of those applying for health benefits. The County continues to collaborate with SEIU 2015 to promote these services effectively.
A strategy BSC uses to encourage enrollment is providing a multilingual call center and translated applications in the County’s threshold languages to accommodate the language diversity of our caregivers. The language distribution of caregivers is English (78%), Spanish (16%), Chinese languages (2%), Tagalog (1%), and Russian (1%).
FISCAL IMPACT:
The term of this amended agreement is January 1, 2025 through December 31, 2026. This amendment increases the maximum amount payable by $601,000 to a maximum amount not to exceed $4,927,000. Funds for these services were included in the Aging and Disability Services FY 2025-26 Adopted Budget. This amendment will be 100% funded by State and federal sources, with no Net County Cost.