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:
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Acting as the Governing Board of the Public Authority:
A) 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, 2020, to provide health benefits to independent providers of the In-Home Supportive Services program and to increase the amount by $5,000,000 for a total contract amount not to exceed $21,500,000; and
B) Authorizing an Appropriation Transfer Request in the amount of $651,616 from unanticipated intergovernmental revenue to cover the projected increase in Independent Provider’s Health Premium.
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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 (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, 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 to provide health benefits through the HealthWorx plan for 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.
In December 2018, the Board approved an amendment to increase the agreement amount to $16,500,000 through December 31, 2019.
DISCUSSION:
The current HealthWorx monthly premium for health benefits is $321.50 per member, for the term January 1 through December 31, 2019. This agreement will increase the monthly premium to $417.95 per member. The total estimated cost of health care benefit premiums for the approximate 1,100 IHSS providers on HealthWorx and COBRA participants for the 2020 calendar year is $5,520,000. This amendment adds to the current agreement for a new total not to exceed amount of $21,500,000 and extends the agreement through December 31, 2020. The premium increase will 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. It is anticipated that 100% of available HealthWorx slots will be filled with eligible IHSS providers.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Projected |
FY 2020-21 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 FY 2019-20 Adopted Budget, but approval of this Appropriation Transfer Request (ATR) is needed to cover the increase and extend the term through December 2020. The ATR results in an increased appropriation of $651,616 to cover the Independent Provider’s Health Premium increase. The additional cost of the premium increase will be covered entirely by state and federal funds. There is no Net County Cost impact by adopting this amendment and resolution.