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 Public Authority, adopt a resolution waiving the Request for Proposals process and authorizing an amendment to the agreement with San Mateo Community Health Authority, dba Health Plan of San Mateo to extend the term of agreement through December 31, 2022 to provide health benefits to independent providers of the In-Home Supportive Services program and to increase the amount payable under the agreement by $6,500,000 to a maximum amount not to exceed $34,000,000.
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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. Independent providers 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) 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 Memorandum of Understanding (MOU), pursuant to which the PA administers benefits, including health benefits, for IHSS providers.
In 2001, the Board first approved an agreement with Health Plan of San Mateo (HPSM) to provide health benefits through HealthWorx for IHSS providers. In November 2012, the Board authorized an agreement with HPSM for HealthWorx benefits in an amount not to exceed $9,134,934. The Board approved further amendments in June 2015, December 2018, and January 2021. The most recent amendment extended the term of the agreement through December 31, 2021 and increased the maximum amount payable by $6,000,000 for a total amount not to exceed $27,500,000.
DISCUSSION:
The County pays for health benefits through HealthWorx for covered IHSS providers pursuant to the terms of the MOU with SEIU. This amendment maintains the current HealthWorx monthly premium of $438.85 per covered IHSS provider member. The total estimated cost of health care benefit premiums for the 1,215 IHSS providers on HealthWorx and for COBRA participants for the 2022 calendar year is $6,398,433. This amendment increases the maximum amount payable under the agreement by $6,500,000, for a revised maximum total amount authorized to be expended under the agreement of $34,000,000, and also extends the term of the agreement through December 31, 2022. The premium increase is anticipated to be covered by state and federal reimbursements for health-related provider benefits.
A waiver to the Request for Proposals process is requested from your Board 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 2021-22 Estimated |
FY 2022-23 Projected |
|
Percentage of available HealthWorx slots that are filled with eligible IHSS providers |
100% 1,215 slots |
100% 1,215 slots |
FISCAL IMPACT:
Funds for these services were included in the AAS FY 2021-22 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.