Agenda

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D. 1

To:	Board of Supervisors
From:	Theresa Speiker, Employment & Human Services
Date:	December 4, 2012

Contra

Costa

County

Subject:

Health Benefit Exchange Proposal

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 12/04/2012

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

Contact:

Dorothy Sansoe, 925-335-1009

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: December 4, 2012
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

CONSIDER authorizing the Employment and Human Services Interim Director to determine whether to submit a proposal to the State of California for operation of a Health Benefit Exchange Call Center and, if competitive, submit the proposal by the due date of December 7, 2012, or to withdraw from consideration.

FISCAL IMPACT:

None at this time. If the State accepts the proposal and authorizes an exchange in Contra Costa County, all costs associated with the exchange will be reimbursed by the State of California.

BACKGROUND:

BACKGROUND: (CONT'D)

Our conversations with the CA Health Exchange staff concerning the specifics of bidding to provide call center services have been ongoing since this matter was originally presented to the Board of Supervisors. On November 16, 2012, based on these conversations, the Exchange issued a revised Request for Offers (RFO) to the three counties (Stanislaus, Sacramento and Contra Costa) who have been expressing interest in responding to it. We were also told they will be issuing an amendment to the RFO after Thanksgiving. However, based on the existing RFO and our conversations over the past six weeks we have sufficient information to proceed with development of a proposal, if the Board of Supervisors authorizes us to continue development.

So far, the call center operations timeline has been laid out as follows:

• December 7, 2012: Response to the RFO must be received at the Exchange by this date;
• End of December, 2012: Exchange selects successful bidder and contract negotiations can begin;
• End of January, 2013: By this date, Board of Supervisors must have accepted the award and approved the contract;
• Month of February, 2013: During this month, recruitment and hiring within the county must begin;
• End of March/early April, 2013: Training of new staff begins, conducted by Health Board Exchange trainers;
• April/May-September, 2013: Training continues and “Shake down” for both state (2) and county (1) call centers is taking place; and
• October, 2013: All call centers go “live” and insurance enrollment begins.

In response to the RFO, the Employment and Human Service and Human Resources departments have been developing a financing proposal and business plan that includes recruitment and hiring strategies and the EHSD staffing model for delivering the call center service. Because the Exchange projects that about half of all Californians eligible for insurance assistance through the Exchange are Latinos, county HR is factoring in a significant need for bilingual staff as they develop recruitment and hiring strategies as well as financing needed to carry out these duties in the time frames allowed within the RFO.

We have asked Public Works Department, General Services staff to begin a preliminary search for available office space. One of our goals in responding to the RFO was to provide expanded employment opportunities within Contra Costa communities still experiencing the highest unemployment rates and with high numbers of available and vacant commercial buildings/office space that would be suitable for a call center operation. At this time, we would like approval to conduct a restricted building search in the following cities/areas because they have the highest unemployment rates in the county: San Pablo at 17%, Richmond at 13.7% and Pittsburg at 13.4%. At this time, we anticipate a business model that calls for up to 90 permanent full time, part-time or intermittent employees to accommodate the ebb and flow of work volume and a non-traditional work schedule. Because of these new job opportunities, locating the call center in an area with higher unemployment would be a benefit for the entire county.

We continue to have concerns about the ins and outs of state reimbursement and are drafting our response accordingly. We understand and have clearly communicated to Exchange staff that our proposal will be revenue neutral for Contra Costa County. For the successful bidder, the state has committed to funding all up front all costs associated with acquiring and maintaining the building and installing and maintaining the technology necessary to operate the call center. They will also cover the costs associated with and provide training for staff at the call center sites. They will reimburse the chosen county for all other labor related costs including charge-backs to the project from other county departments, incidental overhead, staff salaries and benefits. We will include cost reimbursement and an annual true-up mechanism into our response.

Because we did not receive a final RFO until the week of Thanksgiving, we are still in the process of developing our response. If the Board authorizes submittal of a response to the State by noon on December 7, 2012, we will complete this work. Otherwise, we will notify the Exchange of our decision to withdraw from responding to the RFO.

CONSEQUENCE OF NEGATIVE ACTION:

The Employment and Human Services Department will not have sufficient direction by the Board to proceed.

CHILDREN'S IMPACT STATEMENT:

Not applicable.

CLERK'S ADDENDUM

Speaker: Jael Myrick, office of Assemblymember Nancy Skinner; Ralph Hoffman, resident of Walnut Creek.

AUTHORIZED the Employment and Human Services Interim Director to determine whether to submit a proposal to the State of California for operation of a Health Benefit Exchange Call Center and, if competitive, submit the proposal by the due date of December 7, 2012.