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Health commission unanimously backs study of Bridge to Coverage and employee wellness options
Summary
The Health Commission voted unanimously to advance a resolution to modernize the Health Care Security Ordinance, including a city-option "Bridge to Coverage," after staff presented UC Berkeley stress-test modeling and agreed to study collective wellness-program options for small employers.
Colleen Chawla, presenting follow-up analysis of a Health Care Security Ordinance modernization proposal, told commissioners staff had asked the UC Berkeley Labor Center to assess how a recession would affect incomes and program participation. She said the labor center found a shift toward lower incomes during the 2007'009 downturn and Chawla summarized model results saying the proposed Bridge to Coverage would remain sustainable under those scenarios because lower incomes increase federal subsidy eligibility.
"We anticipate that the program would be sustainable in this scenario because lower incomes actually increase eligibility for federal participation and decrease reliance on local subsidies," Chawla said, describing the modeling approach and assumptions.
Chawla also described options for an Employee Wellness Fund. She and staff said the Small Business Commission and the department's Population Health Division recommended studying models that allow small employers to participate collectively rather than requiring each small firm to run its own wellness program. Commissioners and staff discussed potential foundation support and third-party administration; Chawla said the San Francisco Health Plan would serve as a third-party administrator to help track enrollment and utilization metrics.
Commissioner Singer asked that future reports include severe-injury data alongside fatalities; commissioners urged careful evaluation of wellness-fund return on investment and emphasized building evaluation metrics into program design from the start. The commission received a written endorsement from the San Francisco Labor Council supporting the Bridge to Coverage proposal and concerns about wellness incentives.
Commissioner Sanchez moved the resolution to study and explore these options and it was seconded; the commission then voted unanimously to approve the revised resolution to explore a city option for Bridge to Coverage and to study multiple employee-wellness models.
The resolution directs staff to continue stakeholder engagement, evaluate small-employer collective options for wellness services, and develop evaluation metrics for any pilot or program design. The commission requested a continuing report-back schedule and analysis of budget and implementation implications.
