Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lee Pullen, Director, Aging and Adult 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 program, extending the term through December 31, 2025, and increasing the maximum amount payable by $576,000, to an amount not to exceed $4,326,000.
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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 Medi-Cal 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 represents the IHSS independent providers in negotiations regarding issues such as wages and health, dental, and vision benefits.
In January 2021, the Board adopted the current MOU, pursuant to which the PA administers benefits, including health benefits, for IHSS providers.
In 2015, the 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, the 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, 2024, and increased the maximum payable to an amount not to exceed $3,750,000.
DISCUSSION:
This amendment increases the dental premium from $13.86 to $15.33 and increases the vision premium from $5.85 to $6.35 per member. A maximum of 2,200 providers may receive BSC benefits. The use of the 2,200 slots has historically been underutilized, peaking at 1,400 in January 2020. The utilization is currently at 1,329. Permanently reducing available slots will occur when negotiations with SEIU for dental/vision begin in early 2025.
The total estimated cost of vision and dental benefit premiums for the IHSS providers who receive coverage through BSC and for COBRA participants (total:12 providers) for the 2025 calendar year is $575,474. As such, this amendment extends the term of the agreement by one year through December 31, 2025, and increases the maximum amount payable by $576,000 to an amount not to exceed $4,326,000.
A waiver of the Request for Proposal process is requested to ensure continuous and uninterrupted dental and vision insurance benefits for IHSS and COBRA participants. In early 2025, the PA plans to begin exploring alternatives to the current 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% (i.e.,1473 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% 1,329 IHSS providers and 12 COBRA participants |
100% 1,473 combined IHSS providers and COBRA participants |
EQUITY IMPACT:
This agreement will positively impact IHSS caregivers by providing them with dental and vision benefits. There are currently 8,158 caregivers who provide home care services through the IHSS program. This IHSS caregiver population is diverse, reflecting the County population as a whole. The only caregiver demographic information collected at the time of enrollment with the California Department of Social Services is written and spoken primary language. Using language as a proxy, the County’s distribution of IHSS caregivers is English (spoken 64%, written 67%), Spanish (spoken 13%, written 14%), Chinese (spoken 6%, written 6%), Tagalog (spoken 3%, written 3%), Russian (spoken 3%, written 3%).
BSC offers a multilingual call center to support this diverse population of IHSS caregivers and provide answer to inquiries related to dental and vision insurance coverage. Applications for dental/vision benefits are currently available in the threshold languages of English, Spanish, and Chinese. Finally, the PA will have the application translated into Tagalog and Russian to assist the IHSS caregiver community in accessing coverage.
Currently, there are 2,200 slots allotted toward this benefit offered by BSC, with 1,329 caregivers enrolled.
FISCAL IMPACT:
The term of this amended agreement is January 1, 2025, through December 31, 2025. This amendment increases the maximum amount payable by $576,000 to a maximum amount not to exceed $4,326,000. Funds for these services were included in the Aging and Adult Services FY 2024-25 Adopted Budget. This amendment will be 100% funded by State and federal sources, with no Net County Cost.