Fiscal Note
Due to a number of vacancies within Public Health and the length of time required to fill vacancies, the Department is anticipated to have over $1 million savings in salaries and benefits. The proposed resolution amends Public Health’s operating budget by transferring $107,148 from Salaries to Purchased Services and authorizes the Department to sign an agreement with the University of Wisconsin Board of Regents to provide short-term support for the Covering Wisconsin-Marketplace Insurance Enrollment Assistance Program. The funds for the contract will be encumbered in 2017.
Title
Amending Public Health-Madison and Dane County’s 2017 budget to transfer funds from and authorizing the Director of Public Health to sign an agreement with the Board of Regents for the University of Wisconsin System to spend these funds to provide short-term support for the University of Wisconsin’s Covering Wisconsin-Marketplace Insurance Enrollment Assistance Program.
Body
PREAMBLE - Covering Wisconsin (CWI), based within University of Wisconsin-Madison and affiliated with UW Extension, runs the state’s largest federally -certified and state-licensed Navigator agency. CWI connects residents with and promotes effective use of insurance coverage and other programs that support health. In 2016, CWI’s work centered around three primary engagement areas: 1) health coverage outreach and enrollment assistance; 2) education on using health coverage to access care; and 3) assistance with free school meals enrollment through direct certification.
Navigators work with partners to promote enrollment in the Affordable Care Act (ACA)/Obamacare plans and in Medicaid/BadgerCare. Beyond the services provided by fee based agents and brokers, Navigators fill an essential role in meeting the diverse needs of lower-income consumers. Navigators enroll consumers in Medicaid along with Marketplace plans in a single appointment and location. This can assure that the whole family gets appropriate coverage when a parent qualifies for Marketplace insurance coverage and a child qualifies for Medicaid. Navigators handle complex cases, spending as much time as needed with a single case and providing post-enrollment assistance. Navigators provide Spanish-language and bi-cultural services and locate themselves in community-based locations throughout the service area.
In Dane County, since 2014 Covering Wisconsin has had three federally-certified, state-licensed bi-lingual and bi-cultural Marketplace Insurance Navigators working at numerous locations throughout the County to support our residents in connecting to health insurance and other health programs that improve health. CWI maintains enrollment services at six community-based locations in Dane County, and conducts enrollment events at libraries and other sites. In the past year, CWI provided individual appointments with 1,708 Dane County consumers, enrolling 595 in Marketplace coverage and 265 in Medicaid coverage.
In September of this year, less than two months before the open enrollment period was to start, CWI was notified by CMS, the federal funding agency, that financial support outreach and enrollment services would be reduced by 42%, a loss of $422,763 for the state; $214, 294 of which was dedicated to maintaining Navigator services in Dane County.
The cut in federal assistance requires CWI to reduce its service area and scope of services within its remaining counties. In order for Covering Wisconsin to maintain full effort for Navigator assistance and outreach in Madison and Dane County, and fill the gap left in by the reduction in federal support for advertising and public education, the City of Madison and Dane County, are supportive of PHMDC providing funding in the amount of $107, 148.
With these funds, Covering Wisconsin will go far beyond the otherwise thin capacity stretched by the reduced federal funds, allowing CWI to fulfill the following functions in the Madison/Dane County area:
- Campaigning/canvassing: Engage services of a community organizer and/or volunteer coordinator to conduct door-to-door outreach and a "get-out-the-enroll" campaign
- Provide Navigator enrollment services and referral support specifically focusing on the African American and Latinx communities and service provider organizations
- Conduct Madison/Dane County targeted digital/social media advertising, bus advertising, and pursuing utility bill inserts, and partnerships with private sector/business interests
The intergovernmental agreement (IGA) that created Public Health-Madison and Dane County gives the Board of Health for Madison and Dane County (BOHMDC) the authority to make budget transfers of up to $50,000. Appropriations above the amounts approved in the annual budget require the approval of both the Dane County Board of Supervisors and the City of Madison Common Council and budget transfers of more than $50,000 require review by the Dane County and City financial committees. (IGA, Section VIII, Paragraph G).
Additionally, budget transfers require a ¾ vote of BOHMDC members present and voting and this resolution is being referred to the BOHMDC for that purpose.
NOW, THEREFORE, BE IT RESOLVED that the Public Health 2017 Operating Budget is amended to move funds from salary savings to community agency contracts pending the necessary approval of the Common Council and Dane County Board; and
BE IT FURTHER RESOLVED that upon the above-described budget amendment being granted by both the City Council and Dane County Board; the Director of Public Health is authorized to enter into an agreement with The Board of Regents of the University of Wisconsin System on behalf of University of Wisconsin-Madison providing a total of $107,148 for CWI Navigator activities taking place between November 1, 2017 and June 30, 2018 as described above.
BE IT FURTHER RESOLVED that the funding authorized by this Resolution for CWI will be contingent on certain federal matching funds being available to CWI and the availability of special enrollment periods after open enrollment, with such contingencies to be verified by the Director of Public Health; and
BE IT FURTHER RESOLVED that payment to CWI will be made in December 2017 and June 2018 after submission of reports containing the data elements described in the scope of service.
Account strings:
32309- 51110-0000 Permanent Salaries ($107,148)
32309 -54820-0000 Community Agency Contracts $107,148