Title
a. Approve and authorize the Chair of the Board of Supervisors to sign Amendment No. 3 to Agreement A-16373 with Central California Alliance for Health to provide to provide health plan benefits for eligible In-Home Supportive Services providers adding $9,900,078 for a new contract total of $26,818,404 and extend the term by twelve months for a new agreement term of July 1, 2023 through June 30, 2027; and
b. Authorize the Chair of the Board of Supervisors to sign up to three amendments to this Agreement where the total amendments do not exceed 10% ($2,681,840) of the amended contract amount, do not significantly change the scope of work, and do not exceed the maximum aggregate amount of $29,500,244.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Chair of the Board of Supervisors to sign Amendment No. 3 to Agreement A-16373 with Central California Alliance for Health to provide to provide health plan benefits for eligible In-Home Supportive Services providers adding $9,900,078 for a new contract total of $26,818,404 and extend the term by twelve months for a new agreement term of July 1, 2023 through June 30, 2027; and
b. Authorize the Chair of the Board of Supervisors to sign up to three amendments to this Agreement where the total amendments do not exceed 10% ($2,681,840) of the amended contract amount, do not significantly change the scope of work, and do not exceed the maximum aggregate amount of $29,500,244.
SUMMARY:
The Central California Alliance for Health (CCAH) has offered the Alliance Care In-Home Supportive Services (IHSS) health plan since July 1, 2005. The plan provides comprehensive and high-quality coverage including hospital, outpatient, primary and specialized care, prescription drugs, and mental health services for IHSS providers who meet eligibility criteria.
DISCUSSION:
The Alliance Care IHSS health plan provides culturally and linguistically sensitive access to health care throughout the County. Service Employee International Union (SEIU) Local 2015, representing IHSS providers, supports this health plan for their members. Central California Alliance for Health continues to have all regulatory approvals from the California Department of Managed Health Care and maintains the necessary Knox-Keene license to provide the Alliance Care IHSS plan.
Pursuant to the Memorandum of Understanding (MOU) approved by your Board on October 28, 2025 between the Monterey County Public Authority for IHSS and SEIU Local 2015, IHSS providers must work at least 80 hours per month for the last three continuous months to become eligible and, once enrolled in the health plan, must work at least 80 hours per month to maintain eligibility.
It is recommended that the proposed amendment’s non-standard termination and non-standard mutual indemnification language be approved as modified, and as set forth in the exhibits to this amendment. It is the Department of Social Services’ (DSS) position that these modifications to the County’s standard provisions are necessary due to limited alternative resources for these services, the desire to preserve an ongoing positive relationship with the current provider, and the need for uninterrupted service. The new agreement contains the modified contractual language and is being brought before the Board for approval.
OTHER AGENCY INVOLVEMENT/COMMITTEE ACTIONS:
The Auditor-Controller and Purchasing have reviewed and approved this agreement. County Counsel has approved the agreement as to form.
FINANCING:
This Amendment extends the term out one year through June 30, 2027, and adds an additional $9,900,078 for the health benefit premiums. The contract specifies that the monthly premium will increase from $698.04 to $878.34 effective July 1, 2026, with the enrolled IHSS Provider paying $15.00 per month and the balance being funded by Federal and State revenues. The County Share portion ($2,499,467) for these health benefits are charged back thru the State IHSS Maintenance of Effort (MOE) billing.This agreement can serve approximately 981 individuals for FY 25/26 and 824 individuals for FY 26/27 based upon the negotiated rate of $0.80 of financial participation for each hour of paid services each month. The current plan has 825 participants. Sufficient appropriations and estimated revenues in Social Services Fund 001-SOC001 are included in both the FY 25-26 Adopted Budget and the FY 26-27 Recommended Budget.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
This contract correlates to the Health & Human Services Strategic Initiative adopted by the Board of Supervisors by allowing the Department to provide health benefits to In-Home Supportive Services providers, whose services help allow seniors and people with disabilities to remain safely in their homes.
Mark a check to the related Board of Supervisors Strategic Plan Goals:
_X__Well-Being and Quality of Life
____ Sustainable Infrastructure for the Present and Future
____ Safe and Resilient Communities
____ Diverse and Thriving Economy
____ Dynamic Organization and Employer of Choice
____ Administrative
Prepared by: Nick Ledo, Management Analyst II, and x4904
Approved by: Roderick W. Franks, Director, x4430
Attachments: Amendment No. 3
Amendment No. 2 EXECUTED
Amendment No. 1 EXECUTED
Original Agreement EXECUTED
Proposed agreement is on file with Clerk of the Board as an attachment to this Board Report.