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 to Independent Providers of the In-Home Supportive Services Program
RECOMMENDATION:
title
Acting as the Governing Board of the Public Authority, adopt a resolution waiving the request for proposal process and authorizing an amendment to the agreement with San Mateo Community Health Authority, dba Health Plan of San Mateo, to extend the agreement through December 31, 2019 to provide health benefits to independent providers of the In-Home Supportive Services program and to increase the amount by $4,500,000 for a total contract amount not to exceed $16,500,000.
body
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 San Mateo County Board of Supervisors as the PA’s Governing Board (Board). The mission of IHSS is to assist eligible elderly, blind, and disabled individuals with remaining in their own homes for as long as safely possible. The program uses independent providers to assist County residents with a wide variety of daily living activities such as: bathing, feeding, preparing meals, and performing certain paramedical services authorized by a physician.
In the years 2000, 2013, 2015, and 2018, the Board adopted Memoranda of Understanding with Service Employees International Union, Local 521 (SEIU521), under which the PA administers salaries and benefits, including health benefits, for the IHSS providers.
In 2001, the Board approved an agreement with Health Plan of San Mateo (HPSM) to provide health benefits through the HealthWorx plan for the IHSS providers.
In November 2012, the Board authorized an agreement in an amount not to exceed $9,134,934. In July 2015, the Board authorized a subsequent agreement for the term beginning July 1, 2015. There have been subsequent amendments to increase the agreement amount to $12,000,000 through December 31, 2018.
As of July 1, 2018, HealthWorx provides coverage for up to 1,100 eligible IHSS providers as well as approximately 50 HealthWorx COBRA participants in any given month.
DISCUSSION:
The current HealthWorx monthly premium for health benefits is $300.46 per member, for the term January 1 through December 31, 2018. This agreement will increase the monthly premium to $321.50 per member, for the period January 1 through December 31, 2019. The total estimated cost of health care benefit premiums for the approximate 1150 IHSS providers on HealthWorx and COBRA participants for the 2019 calendar year is $4.44 million. This amendment adds $4,500,000 to the current agreement for a new total not to exceed $16,500,000 and extends the agreement through December 31, 2019. The premium increase is anticipated to be covered by state and federal reimbursement funds for health-related provider benefits.
A waiver of the request for proposal process is requested to ensure continuous and uninterrupted health insurance benefits for IHSS and COBRA participants.
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.
This amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by allowing IHSS providers to stay healthy and continue their employment as caregivers to at-risk individuals. It is anticipated that 100% of eligible IHSS home care providers who apply for health benefits will be enrolled.
PERFORMANCE MEASURE:
|
Measure |
FY 2017-18 |
FY 2018-19 |
|
Percent of eligible IHSS home care providers enrolled for health benefits |
100% 1,000 providers |
100% 1,100 providers |
FISCAL IMPACT:
Funds for these services were included in the FY2018-19 Adopted Budget. There is no Net County Cost impact by adopting this amendment and Resolution, as the increased cost of medical premiums is expected to be covered by state and federal contributions to the cost of operating the IHSS program.