COUNTY OF SAN MATEO
Inter-Departmental Correspondence

Health Department

DATE:

July 14, 2008

BOARD MEETING DATE:

August 5, 2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors acting as the Governing Board of the In-Home Supportive Services Public Authority of San Mateo County

FROM:

Charlene A. Silva, Director, Health Department
Lisa Mancini, Director, Aging and Adult Services

SUBJECT:

Superseding Agreement with the Health Plan of San Mateo

RECOMMENDATION:

Adopt a Resolution authorizing the President of this Governing Board to execute a Superseding Agreement with the 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 for $6,785,070 for the term of July 1, 2008 through June 30, 2011.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goal 8: Help vulnerable people—the aged, disabled, mentally ill, at-risk youth and others—achieve a better quality of life.

The Agreement with the Health Plan of San Mateo (HPSM) contributes to this commitment and goal by providing health benefits to independent providers of In-Home Supportive Services (IHSS).

Aging and Adult Services strives to provide services to severely impaired individuals to help them remain in the most independent setting possible. Providing health benefits to independent providers helps to ensure this goal.

Performance Measures:

Measure

FY 2007-08
Estimated

FY 2008-09
Projected

Percent of at-risk individuals maintained in a least restrictive setting through case management

95%

95%

BACKGROUND:

In September 1993 your Board approved an ordinance establishing a separate Public Authority (PA) to administer the provider components for IHSS and designating the San Mateo County Board of Supervisors as the Governing Board of the PA. The goal of IHSS is to assist eligible aged, blind, and disabled individuals to remain in their own homes as long as safely possible. Using independent providers, IHSS provides participants with a wide variety of personal care and domestic services such as meal preparation, feeding, bathing, dressing, transferring, protective supervision, laundry, shopping, transportation, and certain paramedical services authorized by a physician.

In November 2000 the IHSS PA signed an Agreement with SEIU, Local 521, which included the provision of health benefits for the independent providers. In accordance with the Agreement between the PA and SEIU, independent providers who are authorized to work a minimum of 35 hours a month are offered the opportunity to request health benefits.

A health benefits product called HealthWorx was developed by the HPSM specifically for independent providers of IHSS. On July 31, 2001, your Board, as the Public Authority, approved the first Agreement with the HPSM to provide health benefits for the IHSS independent providers. In August 2001, the PA began providing health benefits to eligible providers.

On November 15, 2005, the IHSS PA, by Resolution 067663, authorized an Agreement between the HPSM and the PA for the continuation of health insurance coverage for IHSS independent providers in the amount of $5,203,059 for the term August 1, 2005 through July 31, 2008.

DISCUSSION

The Agreement supersedes Agreement 067663 to adjust the term to begin on July 1, 2008 and continue services through June 30, 2011.The new Agreement is substantially the same as the previous Agreement except the total number of HealthWorx slots has increased to reflect the current Board-approved Memorandum of Understanding with SEIU. HPSM continues to be the best provider of health insurance for IHSS independent providers.

County Counsel has reviewed and approved the Resolution and Agreement as to form.

FISCAL IMPACT:

The term of the new Agreement is July 1, 2008 through June 30, 2011, in the amount of $6,785,069. The monthly premium per provider is $185.31 plus a $10.00 co-pay from the provider. The maximum number of providers who can be insured in FY 2008-09 is 950 per month with an additional average of 15 COBRA members. Total cost for each year of the Agreement is anticipated to be $2,261,690 for a total Agreement amount of $6,785,070. The projected County share of this cost annually is $640,861 and the remainder is covered by State funds. The cost for the health insurance coverage has been included in the Aging and Adult Services FY 2008-09 tentatively Adopted Budget for the PA for IHSS.