Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lisa Mancini, Director, Aging and Adult Services
Subject: Amendment to the Agreement with San Mateo Community Health Authority, dba Health Plan of San Mateo, to Provide Health Benefits for 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 San Mateo Community Health Authority, dba Health Plan of San Mateo for provision of health benefits to independent providers of the In-Home Supportive Services Program to extend the term of the agreement through December 31, 2021, and to increase the amount payable under the agreement by $6,000,000, for a total amount not to exceed $27,500,000.
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BACKGROUND:
In 1993, the San Mateo County 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 San Mateo County Board of Supervisors as the PA’s Governing 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 contracts with 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.
In 2000, 2013, 2015, and 2018, the Board adopted Memoranda of Understanding (MOU) with Service Employees International Union, Local 521 (Local 521), under which Local 521 is the exclusive representative for IHSS providers in the County and the PA administers wages and benefits, including health benefits, for IHSS providers.
In 2001, the Board first approved an agreement with Health Plan of San Mateo to provide health benefits through HealthWorx for IHSS providers. In November 2012, the Board authorized an agreement with Health Plan of San Mateo for HealthWorx benefits in an amount not to exceed $9,134,934. In June 2015, the Board authorized a subsequent agreement with the Health Plan of San Mateo for HealthWorx benefits for the period of July 1, 2015 through June 30, 2016 for an amount not to exceed $3,000,000. In December 2018, the Board approved an amendment to the agreement to increase the amount payable thereunder by $4,500,000, to an amount not to exceed $16,500,000, and to extend the term through December 31, 2019. The Board approved a subsequent amendment to the agreement to increase the amount payable to $21,500,000 and to further extend the term through December 31, 2020.
DISCUSSION:
The County pays for health benefits through HealthWorx for covered IHSS providers pursuant to the terms of the MOU with SEIU. The current HealthWorx monthly premium for health benefits is $417.95 per covered IHSS provider member, for the term January 1 through December 31, 2020. This amendment provides for an increase in the monthly premium to $438.85 per member, effective January 1, 2021. The total estimated cost of health care benefit premiums for the 1,100 IHSS providers on HealthWorx and for COBRA participants for the 2021 calendar year is $5,792,820. This amendment increases the maximum amount payable under the agreement by this $5,792,820 figure for a revised maximum total amount authorized to be expended under the agreement of $27,500,000 and extends the term of the agreement through December 31, 2021. The premium increase is anticipated to be covered by state and federal reimbursements for health-related provider benefits.
The resolution contains the County’s standard provisions allowing amendment of the fiscal obligations by a maximum of $25,000 (in aggregate).
The amendment and resolution have been reviewed and approved by County Counsel as to form. It is anticipated that 100% of available HealthWorx slots will be filled with eligible IHSS providers.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Estimated |
FY 2021-22 Projected |
|
Percent of available HealthWorx slots filled with eligible IHSS providers |
100% 1,100 slots |
100% 1,100 slots |
FISCAL IMPACT:
Funds for these services were included in the AAS FY 2020-21 Adopted Budget. The costs will be funded by State and federal sources. There is no Net County Cost impact associated with this amendment and resolution.