Special Notice / Hearing: None__
Vote Required: 4/5ths
To: Honorable Board of Supervisors, Acting as the Governing Board of the Public Authority
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
RECOMMENDATION:
title
Acting as the Governing Board of the Public Authority:
A) Adopt a resolution authorizing an 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, extending the term through December 31, 2024, and increasing the amount payable by $8,000,000 to a maximum amount not to exceed $49,000,000; and
B) Authorizing an Appropriation Transfer Request (ATR) in the amount of $800,000 from unanticipated intergovernmental revenue to cover the projected increase in independent providers’ health premiums.
body
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 approved an agreement with the Health Plan of San Mateo (HPSM) to provide health benefits through HealthWorx for IHSS providers.
In June 2015, the Board authorized an agreement with HPSM for HealthWorx benefits for the term of July 1, 2015, through June 30, 2016, in an amount not to exceed $3,000,000. The Board approved further amendments from 2016 through 2023, extending the term and increasing the maximum amount payable. The most recent amendment extended the term of the agreement through December 31, 2023, and increased the maximum amount payable by $7,000,000, for a total amount not to exceed $41,000,000.
The County pays for health benefits through HealthWorx for covered IHSS providers pursuant to the terms of the MOU with SEIU.
DISCUSSION:
This amendment increases the current HealthWorx monthly premium to $521.40 per covered IHSS provider member. The total estimated cost of health care benefit premiums for the 1,200 IHSS providers on HealthWorx and for COBRA participants for the 2023 calendar year is $7,595,755. As such, this amendment increases the maximum amount payable under the agreement by $8,000,000, for a revised maximum total amount authorized to be expended under the agreement of $49,000,000 and extends the term of the agreement by one year through December 31, 2024.
A waiver to the Request for Proposals process is requested from this 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 the County Attorney’s Office as to form.
It is anticipated that 100% of available HealthWorx slots will be filled with eligible IHSS providers.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Estimated |
FY 2024-25 Projected |
|
Percentage of available HealthWorx slots that are filled with eligible IHSS providers |
100% 1,200 slots |
100% 1,200 slots |
FISCAL IMPACT:
The term of this amended agreement is from July 1, 2015, through December 31, 2024. This amendment increases the maximum amount payable by $8,000,000 to a total amount not to exceed $49,000,000 for the 114-month term. Funds for these services were included in the AAS FY 2023-24 Adopted Budget. Approval of the Appropriation Transfer Request (ATR) is needed to cover the increase and extend the term through December 2024. The ATR results in an increased appropriation of $800,000 to cover the independent providers’ Health Premium increase. The cost of the premium increase will be covered entirely by State and federal reimbursements for health-related provider benefits. There is no Net County Cost associated with this amendment.