Fiscal Note
The proposed resolution authorizes a non-competitive selection contract to provide short-term support for the University of Wisconsin’s Covering Wisconsin-Marketplace Insurance Enrollment Assistance Program. The Board of Public Health has authorized an amendment to the Public Health budget to transfer $50,000 from Salaries to Purchased Services to pay for the contract.
As of July 2, 2019, Public Health is projecting a savings of approximately $300,000 in salaries and benefits. The Department will closely monitor vacancies and hourly wages for the remainder of the year to ensure staying within budget.
Title
A Resolution authorizing a non-competitive selection contract between the Board of Health for Madison and Dane County and the Board of Regents for the University of Wisconsin System, a past consultant, to provide short-term support for the University of Wisconsin’s Covering Wisconsin-Marketplace Insurance Enrollment Assistance Program.
Body
In 2017 and 2018 the Board of Health for Madison and Dane County (BOHMDC), the City of Madison Common Council and the Dane County Board of Supervisors agreed to provide support to Covering Wisconsin (CWI) to assure the continuation of federal marketplace (ACA insurance) and Medicaid/BadgerCare Navigator enrollment support to Dane County residents.
Until September 2018, CWI received federal funding to provide health insurance education, outreach, and enrollment services in communities in the southern tier of the state, including Dane County. While federal support for Navigator outreach and enrollment functions was significantly reduced in FY18 and was eliminated entirely effective September 12, 2019. Despite the significant reduction in funding to support enrollment services, the federal Marketplace is still a viable option for individuals in need of health insurance. As the result of a collaborative funding commitment from SSM Health, GHC-SCW, UW Health, UW Carbone Cancer Center, and the City of Madison and Dane County via PHMDC, CWI has been able to leverage federal Medicaid matching funds via Wisconsin DHS to maintain a robust navigator presence in Dane County.
WHEREAS, CWI, based within the 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 2019, CWI’s work continues to be 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.
WHEREAS, 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.
WHEREAS, CWI has three federally-certified, state-licensed bi-lingual and bi-cultural Marketplace Insurance Navigators working at numerous locations in Dane County throughout the year to support our residents in connecting to health insurance and other health programs that improve health. In 2018 there were five bi-lingual, bi-cultural navigators working during Open Enrollment. CWI maintains enrollment services at six community-based locations in Dane County, and conducts enrollment events at libraries and other sites. In the six-month period from October 1, 2018 through March 30, 2019, CWI provided individual consultations with 1,268 Dane County consumers and enrolled 584 in Marketplace coverage and 358 in Medicaid coverage.
WHEREAS, With support from the City and County, though the ACA 2018 open enrollment period was 6 weeks long, compared to a 12-week period for the 2017, the funding provided by PHMDC allowed CWI to provide support for open enrollment efforts in Madison and Dane County that achieved nearly the same level of enrollment in 2018 compared to 2017. Nationally, the shortened open enrollment timeframe and reduced federal promotion of coverage options and opportunities appeared to contribute to a decrease in consumer sign-ups. Wisconsin saw a reduction of 7% in health insurance enrollments from 2017 to 2018, however the decline in Dane County was much smaller: only 3.9%.
WHEREAS, To date, for FY19, UW Health has committed $50,000, SSM Health has committed $25,000, and the BOHMDC has amended the PHMDC budget to provide $50,000 to CWI. Combined, this $125,000 will allow CWI to achieve $125,000 in matching federal Medicaid money so that for FY19, as long as the Affordable Care Act Insurance Marketplace continues as per Federal Law; Navigators are available to Dane County residents to support them choosing health plans.
NOW, THEREFORE BE IT RESOLVED that the City of Madison Common Council authorizes the Board of Health for Madison and Dane County on behalf of Public Health-Madison and Dane County to enter into a noncompetitive contract with The Board of Regents of the University of Wisconsin System on behalf of the University of Wisconsin-Madison to provide a total of $50,000 for CWI navigators activities that will take place between September 13, 2019 and September 12, 2020.
BE IT FURTHER RESOLVED that the funding authorized by this Resolution for CWI will be contingent on certain Medicaid 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 FINALLY RESOLVED that the payment to CWI will be made, with an initial payment in October 2019, and subsequent payments in January 2020 and September 2020 after submission of reports containing the data elements described in the scope of service.