HomeMy WebLinkAboutGrant Application - SMSI - Local Health Insurance Program 10.20.2006.PDF/"
,i
ula E. Ii. Younger
ueputy CountY Administrator
125 East Oourt Street, Ithaca, New York 14850
Shawn Mart6l Moore
DePufY CountY Adminisfrator
fl07\ 274-5551 Fax: 1607]1 274-5558
Or;tober 20, 2006
Mr'. Kyle Wilber
Nt:w York State DePartment of State
Division of Local Governrnent Services
41 State Street
Albany, NY 12231
Dr=rar Mr. Wilber:
On behalf of the Tompkins County Council of Governments (TCCOG)a.l uT pleased to submit a
g'iant application under the Shared ttltunicipat Services Inceniive (SMSI) - Local Health lnsurance
Program.
I i:rm confident that our application is especially strong because:
, Every municipality in the county, and the County of Tornpkins, has committed to
ParticiPate in the Project;. The pioject design is very porlable to other counties arrd;
. Most important, the potential r*Li;"] cost savings are impressive (nearly $5'3 million)'
This project represents a leap fonsard for inter-municipal cooperation involving Tompkins county
and its municipalities. After more than , Vu"i of wg1,'TCCOG was formed in August of this year to
provide a forum for discussion and n"gotLtion leading to.agreenrents.to.achieve more efficient and
fiscally responsible delivery of government services. ns itjhigfrerst priority, TCCOG resolved to
enter into an agreement to explore torming a Health Care Consortium to reduce the cost for
providing health insurance coverage for the municipalities in Tonrpkins County'
Tlne SMSI grant will provide essential funciing to complete this project at a time when local
governments, which must meet the immediai" dutrnds of existing programs, find it very difficult to
allocate funds to develop pilot projects holding the promise of long-term benefit' Your incentive
arrvard will enable this effort to proceed from discussion to implernentation in an efficient yet
irrnovative fashion.
F,lease contact me if further information is needed. Thank you for considering our request'
Stephen F. Whicher
County Administrator
Sincerely,
F.2. Objectives to be Achieved by The Proposed Activity.
To meet its goal of establishing a comprehensive employee health insurance program
(TCCOG) proposes a three-phase approach:
' Phase I-creating a project structure for Health care consortium;. Phase Il-Developing a health insurance program design;
' Phase lll-Implementing the new program and establishing a new administrative
framework.
Phase I.create the Tompkins county Health care cronsortium and establish
proiect structure. We will establish the Consortium and its method of govemance andwill conduct the necessary in-depth research to ftnalize design and implementation steps.
We will first secure the services of an independent consultant experienced in working
with municipalities to establish such health insurance collaborati-ons. The consultant willr
work with us to develop the Health Care Consortium Agreement, outline the project
design phase, and draft the Request for Proposals for project design. (The consultant
participating in this phase will not be eligible to respond to the RFP for consulting
services for Phase 2.) This phase concludes with securing of professional support to
design the program during the next stage of the project. This objective inciudes the
following action steps:
' Develop and release the 'oRequest for Qualifications" for an independent
consultant to guide Phase I ofthe project. Select independent consultant. Draft Health Care Consortium Agreement. Finalize study elements for Phase II
' Draft "Request for Proposals" for phase II consulting servicesr Select an independent consultant to provide Phase II lrroject design services.
Phase II. Develop project design. During this stage, with the assistance of our
program design consultant, we will conduct a comprehensive review of the
municipalities' experience with their current health insurance: programs and, analyze the
existing municipal health plans, comparing to industry benchmarks. once program
design is final, we will develop and release the Request for Proposals to provide health
insurance coverage, analyze responses from qualified insuranrce providers, and will select
a provider by the end of January 2008. This objective includes the following action steps:
' Review current employee utilization of health care seivices. Analyze current adrninistrative design. Identify and address potential financial and legal barrjers
' Develop health insurance plan designr Develop and release Request for Proposals for health insurance provider. Analyze responses. Recommend and select provider.
Page 21
Phase III. Implement the comprehensive employee health cure program, During
this final stage, we will work with the provider to develop a selection of plans and
benefits for municipalities and staff, negotiating plan designs that will reduce overall
spending on health care insurance by at least ten percent. We will create the program
administrative structure, developing technology platforms to support delivery and
administration, and will.provide oollective bargaining incentives to expedite transition to
the new system. We will educate employees about the program and will enroll
individuals in the plan, which will be fully operational by the beginning of 2009. This
objective includes the following action steps:
. Finalize and implement program administrative framework. Design employee participation incentive program. Educate employees
', Enroll employeesr Activate comprehensive health insurance program.
A detailed schedule and timeline for these activities is presented in Section F.4.
To anticipate and address potential legal and financial barriers to forming and operating
the Consortium, we will first ide.ntify pertinent issues by consulting other municipalities,
such as Tioga County, which have already established collaborative health care
programs. We will work with our independent consultants to structure the consortium
and design the health insurance program in a way that effectively addresses the issues
identified, and will obtain legal advice from the Tompkins County Attorney's Office
throughout the project, as needed. In addition, the Tompkins County Finance
Department will work with us to address potential financial barriers that are identified.
As a primary vehicle for incorporating public participation into the project, we will
involve in the process the Health Planning Council of the Human Services Coalition of
Tompkins County. The mission r>f the Health Planning Council is to improve the health
of Tompkins County residents by increasing access to quality health care, improving the
efficiency of health services, and promoting healthy lifestyles. The Health Plaruring
Council, which has been active for over 35 years and has more than 160 members on its
Advisory Board and committees, conducts needs assessments and collaborates on
projects with community partners in the areas of healthcare workforce development,
long-term care, primary care, community wellness and health promotion, and prescription
medicine access.
Pap;e22
F.3. Description of the Proposed Activity and Key Tasks
As its first initiative, TCCOG resolved to enter into an agreement to explore formation ofa Health Care Consortium to provide health insurance for the County and its
municipalities and to reduce the cost to
Tompkins County taxpayers. TCCOGwill bring into play the governance
model established in 1992 by the Tioga
County Consolidated Municipal Health
Insurance Program (TCCMHIP), which
for the past 14 years has provided
affordable health insurance for its
county's municipalities. In formulating
the proposal and costing the project,
TCCOG also has incorporated the model
set forth by Ontario County et. al. in
formation of The Lskes Plan, which also
explored establishing a health care
consortium.
Goals of
The Tompkins County Council of Governments
(TCCoG)
(Officially formed on August 24, 2006)
I Provide a forum for discussion and negotiation
leading to agreements for more efficient and
fiscally responsible delivery of government
servtces.
r Expand cooperation among taxing entities and
resolve duplication of servicesr lmprove communication among local
governments in Tompkins County;r Increase collaboration with the county's school
districts.
' Seek, allocate and administer appropriate funding
from local, state, federal and private sources,
including various grants.We anticipate the TCCOG initiative to
produce more than $5 million in savinss for the
county's taxpayers within its first five years of operation, with accelerated savings in
future years, as more and more employees join the new program, It can be expected ttrat
as group size increases, so to an increase in the proposed Corisortium's ability to
negotiate savings in both health care and prescription drug coverage. Further, the
centtalization of benefits management should produce better service at a reduced overall
cost. Uniformity in coverage across municipal lines also will improve health benefits for
municipal employees, especially for those smaller municipalities within the County.
Key tasks associated with the design and development of the TCCOG proposed
consolidated municipal health program include :
' Soliciting and selecting one or more consultants to guide the TCCOG in
researching, designing and implementing the Tompkins Health Care Consortium;
. Developing the Health Care Consortium Agreement;
' Conducting a comprehensive utilization review of employee health insurance
benefits;
Analyzing current program designs and identifying potential legal barriers to a
new coilaborative health insurance program;
Designing the new comprehensive health insurance program,
Page 23
Both the current municipal budget climate and the nature of bringing municipalities
together to achieve common goals represent significant barriers to supporting'a project of
thls size solely through local iesources, Despite the desire to achieve greater efficiency
and long-term costsavings, local govemments, which as their top priority must meet the
demands of existing programs, do not possess the financial flexibility to support pilot
projects. Municipaliiieslpproach collaborative projects such as ttrls yjltr varying
demographics, piiorities and perspectives, Assistance tluough the SMSI program will
provide esSential start-up support to forge a countywide initiative that will address the
problem of rapidly
"rratuting
ltealth insurance cosis and will ease the financial and
administrative burden for all.
Page 29
G-4. Project Budget, cost savings, and Return on Investment
TCCOG seeks SMSI assistance to reimburse expenses directly rrelated to creating a local healthcare consortium and to designing a comprehensive health care program for the county and its l6municipalities' Sections H and I of the Completed Application provides a detailed budget andisummary of estimated costsavings. In addition, Exhibits 2 and 3, below, shows similar
':alculations to include the first year of collective bargaining incentives to encourage employeemigration to the new health program. Our estimat.a"rta.t-u! costs, to be supported by the SMSIitward, arc $266,030.00' The estimated return on investm.ni fo, all municipaiities over theoourse of five years is s5,257,156, with a savings per SMSI dollar ratio of 19.76.
Exhibit 2
{s 1<7 r <$142,780 $t23.2
Municipal Expenses
GRANT USE
S avinss
Travel,
Supplies, &
Professional
S ervices
Grant
Fu nded
In cen ti ve s
Partial
IParticipation- |
Cosr of New I Cost of ota
Program * | program
Anticipat
ed
Participat
lon
Municipal
Funded
Incentives
Municipalif ies
Ex penses
Cost to
Municipalites
(8s%)
lrojr;ct Year $21,240 ,569 $ 18,054,484 $3 7,5 00$2,670,6'l $8,054,484 15%s20,725.162 $7,616.387 $43 8.09 ($ r 05,28 $123,25(rt $4,45 1, l3 0 sts,930.42 25%$207.2s $20,58 8,8 07 $7 .500.486 $730,1613 ene,:lit Year 3 $6,23 I .5 82 $3,806,37 (35%$291.25\$20,329.202 $17,279.822 $1,022,22:
$8.0 1 2.034 $,682,313 45%$37 s.2sc $ 20.06 9.s 9 7 $7 ,059 .157 sl ,31 4.289$10,682,712 $8,49 6,228 60%$459,25(s19,638,190 $16,692,461 $ I .752.38J
Page 33
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