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HomeMy WebLinkAboutMINUTES - 07141998 - D14 � .. ru: BOARD OFSUPt RV1St?i2S Jiro Rogers, Supervisor, District l %{- ��,, ont ra FROM: f' Costa DATE: July 14, 1998 ' ,` t� °r t UKK SUBJECT: Consider proposal to provide membership in the Contra Costa Health.Plan(CCHP)to all In-Home Supportive Services(IHSS)workers SPECIFIC REOUEST(S)OR RECOMMENDATIONS)&BACKGROUND AND JUSTIFICATION BACKGROUND Approximately 5,000 people work in the county's In-Home Supportive Services program as home care providers. They receive no health care insurance through their employment leaving the great majority of the workers with no health care insurance at all. Beyond the obvious hardship this causes to the workers and their families, this situation places a number of burdens on various county agencies. As uninsured low-income persons, many home care workers rely on county emergency rooms as their source of primary care. The cost of this care is absorbed by county facilities'budgets. Moreover,the severity of ailments have often reached such a level of acuity by the time love incomeuninsured persons seek emergency care,that the county-borne casts for treatment rise to extremes, which would have been largely avoidable had access to routine preventative health care been available. These financial costs to the county cannot begin to describe the human costs of untreated illness and injuries over a course of years within this large population of 5,000 Contra Costa residents. The process for considering other wage or benefit increases is likely to be a lengthy one. The county can get reimbursed for an average of 3 5%of the CCHP monthly premium from the federal reimbursement. If the monthly premium can be set at a rate comparable :ONTINUEO ON ATTACHMENT: _,LS.YES SIGNATURE: ..,,..RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD OMMtTTEE APPROVE OTHER IGNATURE S : ,CTION OF BOARD ON 1111y 14 , 1998 APPROVED AS RECOMMENDED OTHER SEE THE ATTACHED ADDENDUM FOR2 �BOARD ACTION )TE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE ._ U ANI US BSENT } AND CORRECT COPY OF AN ACTION TAKEN AYES:TT, 111, & NOES'_NbW AND ENTERED ON THE MINUTES OF THE DOARO ASSENT:BbM ABSTAIN:V. OF SUPERVISORS ON THE DATE SHOWN, ATTESTED a_ .111 Contact: PHIL BATCHELOR,CLERK OF THE BOARD OF cc: CACI SUPERVISORS AND COUNTY AOM INISTRATOP BY DEPUTY to other health pians(e.g. $110- $130 per month)then there is a significant reimbursement, Unlike other wage or benefit increases that may be negotiated rates, if the IHSS workers gain membership in CCHP, many if not most of the county costs are fixed costs (e.g. clinics, machines and many specialists)which need to paid for regardless of whether IHSS workers are CCHI' members. Net county costs are further reduced by the co-payment and by the saving due to avoiding IHSS workers using the county. health system as uninsured, non-paying patients Due to the chance to provide a very significant benefit at a relatively very low net county cost, I believe we should break the CCFIP membership item out of the general negotiating process and provide this benefit right away, The public health implications of any pool of residents of similar size lacking access to health care are serious. The fact that this group of 5,000 workers provide health care functions in the homes of the elderly, the disabled and persons with chronic illness, lack health insurance has profoundly serious public health implications for a)the workers themselves, b)their families; c)the persons for wham they provide care, and d)for the general public. A model for providing health care insurance to IHSS providers has been established in San Francisco County, which is providing substantial benefit to the workers, consumers and community as a whole, in a manner that creatively limits costs, brings in new revenues, and simultaneously reduces costs previously borne by county health facilities and other county-funded services. RECOMMENDATION The Board of Supervisors states its intention to mare health care insurance available to IHSS home care workers through the Contra Costa Health Plan(subject to review of a plan) and directs the health Services Director, the Director of the Contra Costa health Plan, the Director of the Social. Services Department and the County Administrator to report back to the Board on July 28, 1998 with a proposed plan for implementation and analysis of projected costs and saving. *Workers would have to work a minimum number of hours per month to be eligible(e.g. San Francisco requires 25 hours per month). A waiting period will be imposed prior to eligibility(e.g. 60 days in San Francisco). *Workers would be required to pay a small (e.g, $3 - $5 per month)co-payment in order to discourage workers who have some the form of health insurance to opt into this plan, thereby reducing the total number of insured. * The plan must avail the county of the maximum amount of federal or state reimbursement possible. One form of reimbursement will include applying the federal government's policy of sharing in the costs of the IHSS providers'wage or benefit increases. A portion of the costs of the Contra Costa Health Plan premiums for these workers must reimbursed by the federal government to the maximum extent lallowable. *As coverage would be offered through Contra Costa Health Plan, payments from the health plan will be made to the greatest extent possible to county-owned health care facilities. *Providing health insurance to this group of workers establishes neither a positive nor a negative precedent relative to future wage or benefit discussions which may take place in the county budget process, or in future negotiations involving the workers, the county and the IHSS Public Authority. ADDENDUM TO EPEM D.14 July 14, 1998 Agenda On this date, the Board of Supervisors considered the proposal by Supervisor Jim Rogers to provide membership in the Contra Costa Health Plan (CCHP) to In-Home Supportive Services (IHSS) workers. John Cullen, Social Service Department Director, appeared for the department. The public hearing was opened and the following people presented testimony: Charlie R.idgell, SEIU Local 250, 560 20th Street, Oakland; Virginia Martinez, SEIU Local 250, 72 1I2 W. 10th Street, Pittsburg; Paula Brown-Seabaugh, SEIU Local 250, 2918 Center Avenue, Richmond; Dana Simon, SEIU Local 250, 560 20th Street, Oakland; Terrie Gaines, SEIU Local 250, 138 Warren Way, Pittsburg; Kagey Dorosz, Elder Abuse Prevention, IHSS Task Force, 101.5 Nevin Street, #102, Richmond; Henry Clark, Local One, Martinez; Douglas Rainey, SEIU Local 250, 3531 Florda Avenue, Richmond; Milt Camhi, Executive Director of CCHP, and Patrick Godley, Chief Finance Officer of the Health Services Department, reported on the possible fees and costs for enrolling IHSS workers in the County Health. Plan Mr. Cullen offered a possible timeline pertaining to the public authority being considered for IHSS workers. The Board discussed the issues. Supervisor Rogers moved the proposed recommendation and suggested that the requested information be reported Yuck to the Beard on September 1., 1998. The motion failed for lack of a second. Supervisor Gerber moved that the Board request the County Administrator and appropriate department staff to prepare information and data necessary to consider mechanisms for meeting the health care needs of IHSS workers, and County temporary employees, and advised that this information would be submitted in Closed Session for the Board's review. Supervisor DeSaulnier seconded the motion. "Victor Westman, County Counsel., advised the Board that the understanding was that staff was to provide the necessary information to the Board in Closed Session so that the County's negotiators could mediate matters with the appropriate parties. Supervisor Gerber noted that her motion was intended to request staff to collect the information, and that it may well be preparatory to a collective'bargaining process. 1 Supervisor Canciamilla advised the Board that he would be abstaining on the motion and commented that he voted to recognize the IHSS workers with the understanding that they would be going through the traditional process of negotiation, and he believed that bringing these types of mattersbefore the Board undermined the meet and confer, and bargaining processes. Following Rather discussion, the Board took the following actions: 1. CONSIDERED the proposal to provide membership in the Contra Costa Health Plan (CCHP) to In-Home Supportive Services (IHSS) workers; 2. DIRECTED the County Administrator, Health Services Director, Social Service Director, and Contra Costa Health Plan Director to prepare a collaborative analysis and proposed plan for the Board's review in Closed Session in September 1998, regarding possible membership in the CCHP for In-Home Supportive Services workers, and temporary County employees. 2 OFFICE OF THE COUNTY ADMINISTRATOR CONTRA COSTA COUNTY Administration Building 651 Pine Street, 11th Floor Martinez DATE: July 15, 1998 TO: John Cullen, Social Service Director William B. Walker, MV., Health Services Director FROM: Claude L. `Van Mart r ssistant County Administrator SUBJECT: HEALTH BENEFITS FOR IN-HOME SUPPORTIVE SERVICES CAREGIVERS Board Agenda Date: July 14, 1998 Agenda Item #: D.14 On July 14, 1998, the Board of Supervisors considered the attached recommendation from Supervisor Rogers and took the following actions: • Requested the Health Services Director and Social Service Director to prepare a report which outlines options for the Board to consider which would provide membership in CCHP for IHSS caregivers and their families. These options should take into account, but not be limited to, the attached recommendations and should address minimum numbers of hours of service being provided by the caregiver, the length of time the caregiver has been providing service, possible copayments, the benefit package that might be available and other factors which would influence the cost of providing health care coverage. This report should include a discussion of the marginal cost of providing services to additional CCHP enrollees and of the revenue which would be available from the Federal and State governments to offset the CCHP premiums. • Requested the Health Services Director and Social Service Director to take the steps necessary to identify and enroll any children of IHSS caregivers in the Health Family Program who are eligible for that program (or in the Medi- Cal or ether programs which would provide health care coverage for IHSS caregivers and their families). - 2 - Requested the Health Services Director to prepare a report which outlines options for the Board to consider which would provide membership in CCHP for temporary County employees. These options should take into account, but not be limited to, the attached recommendations and should address minimum numbers of hours the employee is working, the benefit package that might be available and other factors which would influence the cost of providing health care coverage. • This information is to be reported back to the Board in closed session on September 1, 1998 so the Board can determine what instructions to give to its negotiators. CLVM:amb BS-0714.002 Attachment cc: Members, Board of Supervisors Milt Camhi, Executive Director, CCHP Pat Godley, Chief Finance Officer, HSD Leslie T. Knight, Director of Human Resources Victor J. Westman, County Counsel Sara Hoffman, Senior Deputy County Administrator Clerk of the Board's Correspondence File ............................................................................................................................................................................................................................................................................................................................