Title
It is recommended that the Board of Supervisors:
a) Approve and authorize the Chair of the Board of Supervisors to sign Amendment #3 retroactively with the Central California Alliance for Health by adding $79,141 for FY 2019-20 effective June 1, 2020, and adding $3,241,057 to extend services for the period July 1, 2020 to June 30, 2021, increasing the total contract amount to $6,380,016, and extending the term of the agreement through June 30, 2021; and
b) Authorize the Director of the Department of Social Services to sign up to three (3) amendments to this Agreement where the total amendments do not exceed 10% ($638,002) of the contract amount and do not significantly change the scope of work.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Chair of the Board of Supervisors to sign Amendment #3 retroactively with the Central California Alliance for Health by adding $79,141 for FY 2019-20 effective June 1, 2020, and adding $3,241,057 to extend services for the period July 1, 2020 to June 30, 2021, increasing the total contract amount to $6,380,016, and extending the term of the agreement through June 30, 2021; and
b). Authorize the Director of the Department of Social Services to sign up to three (3) amendments to this Agreement where the total amendments do not exceed 10% ($638,002) of the contract amount and do not significantly change the scope of work.
SUMMARY/DISCUSSION:
The Central California Alliance for Health (CCAH) has offered the Alliance Care In-Home Supportive Services (IHSS) health plan since July 1, 2005. On June 18, 2019, the Board of Supervisors approved the execution of an agreement dated July 1, 2019, to provide comprehensive and high-quality coverage including hospital, outpatient, primary and specialized care, prescription drugs, and mental health services for over 550 IHSS providers who meet eligibility criteria. 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 February 26, 2019 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. A Side Letter was approved on April 28, 2020, increasing health premium rate to $0.48 per hours worked by the IHSS Providers.
On June 11, 2019 Amendment #1 was approved to include the updated Evidence of Coverage attachment from CCAH, Amendment #2 provided additional funding for May and June 2020, partially. Amendment #3 adds the remaining funds of $79,141 needed for the remaining June premiums invoiced and extends the term of the agreement through June 30, 2021, adding $3,241,057 for a total contract amount of $6,380,016.
Beginning July 1, 2020, the monthly premium will be $512.00 with the enrolled IHSS Provider paying $15.00. The maximum number of individuals that can be enrolled is determined by the state funding formula that provides $0.48 of financial participation for each hour of paid services each month and any necessary attrition. Amendment #3 is expected to serve 510-521 individuals per month.
The Evidence of Coverage (Attachment AA-I-E) contained within this Agreement is for the period of July 1, 2019 through June 30, 2020. CCAH will not have the new Evidence of Coverage available for FY 2020-21 until after the term start date of the agreement. To avoid delaying the contract further, DSS is recommending approval of this Agreement with the prior year Evidence of Coverage Attachment. DSS will amend this agreement to add the current Evidence of Coverage once it becomes available.
OTHER AGENCY INVOLVEMENT:
The Auditor-Controller and Purchasing has reviewed and approved this amendment. County Counsel has approved the amendment as to legal form.
FINANCING:
This amendment adds $79,141 necessary to cover the June 2020 premium payment needed due to the estimated number of hours served was estimated back in February 2019, the rate increased July 2019, and the Health Plan saw a higher number of IHSS Providers accepting Cobra benefits and reimbursing the County for the premium. Additionally, Amendment #3 extends the term to June 30, 2021, adding $3,241,057 for a total amendment of $6,380,016.
The health premiums are funded $15/per premium by the IHSS Providers. The remaining cost of the premiums are 80% Federal and State funded. The County share of cost is approximately 20% and it is covered through General Fund Contributions and 1991 Realignment revenues. Sufficient appropriations and estimated revenues in SOC008 are included in both FY 2019-20 Adopted Budget and the FY 2020-21 Recommended Budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
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 Initiatives
__Economic Development
__Administration
X Health & Human Services
__Infrastructure
__Public Safety
Prepared by: Emily Nicholl, Program Manager x4720
Approved by: Lori A. Medina, Director x4434
Attachments: Original Agreement, Amendment # 1, Amendment # 2, and Amendment # 3
Proposed agreement is on file with Clerk of the Board as an attachment to this Board Report