Miami-Dade Legislative Item
File Number: 080787
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File Number: 080787 File Type: Ordinance Status: Deferred in Committee
Version: 0 Reference: Control: Economic Development and Human Services Committee
File Name: CREATE HEALTH INSURANCE ELIGIBILITY FOR DEPENDENT RELATIVES Introduced: 3/11/2008
Requester: NONE Cost: Final Action:
Agenda Date: 3/18/2008 Agenda Item Number: 4G
Notes: Title: ORDINANCE CREATING A SEPARATE ARTICLE TO BE INCLUDED IN CHAPTER 11A OF THE MIAMI-DADE COUNTY CODE; PROVIDING HEALTH INSURANCE ELIGIBILITY AND OTHER BENEFITS TO THE DEPENDENTS OF MIAMI-DADE COUNTY EMPLOYEES; ESTABLISHING DEPENDENT RIGHTS OF VISITATION; PROVIDING SEVERABILITY, INCLUSION IN THE CODE, AND AN EFFECTIVE DATE
Indexes: BENEFIT PLAN
Sponsors: Jose "Pepe" Diaz, Prime Sponsor
  Joe A. Martinez, Co-Sponsor
  Dorrin D. Rolle, Co-Sponsor
  Natacha Seijas, Co-Sponsor
  Rebeca Sosa, Co-Sponsor
Sunset Provision: No Effective Date: Expiration Date:
Registered Lobbyist: None Listed


Legislative History

Acting Body Date Agenda Item Action Sent To Due Date Returned Pass/Fail

Economic Development and Human Services Committee 5/14/2008 1F1 Deferred P
REPORT: Assistant County Attorney Cynthia Johnson-Stacks read the foregoing proposed ordinance into the record. Chairwoman Edmonson opened the public hearing. The following persons appeared and spoke in support and urged the Committee to forward this proposed ordinance to the County Commission for consideration: 1. Mr. Santiago Leon, 11600 SW 69 Avenue, Miami, Florida; 2. Mr. Martin Lampkin, 10235 SW 172 Street, Miami, Florida; 3. Mr. Eladio Jose Armesto, President, Cuban-American Publishers Association; 4. Mr. Nathanial Wilcox, 3111 NW 135 Street; 5. Reverend Robert Meyers, Miami Baptist Church of West Kendall; 6. Mr. Dennis Baxley, Executive Director, Christian Coalition of Florida, 26 SE 9 Terrace, Ocala, Florida; 7. Mr. John Waddell, 8411 SW 202 Street; 8. Ms. Sybel Lee, 602 NW 100 Street; 9. Reverend David Vega, Executive Director, Mission Miami, 18650 SW 210 Street; 10. Mr. Reginald Thompson, 585 NW 121 Street, North Miami, Pastor of Trinity Church; 11. Ms. Karen Thompson, 585 NW 121 Street, Trinity Church; 12. Mr. Tian Parnther; 13. Ms. Sandra Wong, 19660 SW 87 Street; 14. Reverend Agusto Valverde; 15. Reverend Albert Guthrie; 16. Dr. Andres Estevez; 17. Mr. David Allen; 18. Mr. Robert Rodriguez, 16261 SW 287 Street; 19. Ms. Teresita Miglio, 310 SW 67 Court; 20. Reverend Arthur White, 19091 NW 15 Court; 21. Ms. Lillian Delgado; 22. Mr. Anthony Verdugo, submitted a list of organizations and elected officials in support of this proposal; 23. Mr. Eddy Gervais, 100 NW 198 Street; 24. Mr. Noel Lozano, 7850 SW 146 Court; 25. Mr. Dennis Villalobos, 19720 NW 39 Avenue. Hearing no one else wishing to speak before the Committee, Chairwoman Edmonson closed the public hearing. Commissioner Diaz explained the intent of the foregoing ordinance and emphasized the importance of the proposed project to the residents of this community, particularly considering the health care crisis. He noted Salt Lake City, Utah; Vancouver, Canada; and San Francisco, California was currently adopting similar legislation. Commissioner Diaz urged Committee member to forward this proposed ordinance for consideration by the County Commission simultaneously with Legislative File No. 080986 previously considered at April 16, 2008, Committee relating to health insurance eligibility and other benefits to domestic partners of County employees. Responding to Chairwoman Edmonson’s inquiry regarding the impact to the County’s self-insured health insurance program, Ms. Wendi Norris, Director, General Services Administration, noted the County had no past experience with a self-insured health insurance program. Consequently, she was unable to comment on the impact on the County’s program at this time. She stated staff would review the legislation being considered in Salt Lake City, Utah and other cities previously mentioned by Commissioner Diaz. Concerning Commissioner Sorenson’s question as to whether this proposal was applicable to domestic partners, Assistant County Attorney Johnson-Stacks stated this proposal would not prohibit coverage to domestic partners. She noted staff had prepared some additional language, which she asked Assistant County Attorney Scott Mario to read into the record. Assistant County Attorney Mario advised the Committee of the following proposed amendments to this proposed ordinance: (1) To change the language on page 2, Section 2 subsection (e), to read as follows: “Jointly responsible means that the members of the household mutually agree to provide for the other members basic food, shelter and living expenses while they share a household; except that members need not contribute equally or jointly to set basic food, shelter and living expenses.” (2) To delete the language on page 3, Section 3 subsection (b) (3). (3) To change the language in Section 3 subsection (c) to read as follows: “Members of the single household may jointly declare a dependent relationship by filing a declaration, which shall contain the name and address of each member of the household, and the names of any dependents of the members, the signature of each member, and the signature of any dependents over the age of eighteen and competent to contract. The declaration shall certify: (1) Each member of the relationship is at least 18 years old and competent to contract; (2) Each member of the relationship that reside in the same household; (3) Each member of the relationship consider himself or herself to be a member of the immediate family of the other and to be jointly responsible for maintaining and supporting the Registered Dependent Relationship; (4) Any person identified as a dependent meets the definition of either a Dependent relative or Household dependent; (5) Each member agrees to immediately notify the Consumer Services, in writing, if the terms of the Dependent Relationship are no longer applicable or a member or dependent wishes to terminate the dependent relationship. (4) To add language to Section 5, subsection (c) to read as follows: “The Mayor is authorized and directed to take all action necessary to implement the provisions of this section within 90 days after this ordinance is enacted.” Commissioner Sorenson pointed out that as proposed, this resolution would call for a universal health care plan which was the Federal Government’s responsibility, not the County’s. She also noted the County was facing potential budget cuts this year in parks, human services, health care, police, fire and libraries; and could not assume this type of responsibility. Commissioner Sorenson noted health care insurance companies were asked in 2007, whether they would provide this type of dependent health insurance coverage before the County implemented the self-insured plan; and Vista, Humana, Jackson Memorial Hospital Health Plan, and Av-Med indicated that they were concerned regarding the risks and the additional costs involved in this type of coverage. She reiterated that the County could not afford this type of insurance coverage at this time. Commissioner Diaz noted this proposal was not universal health care. He explained the risks and the additional costs would be minimal on this issue. Commissioner Diaz stated the question referenced by Commissioner Sorenson was asked of insurance companies during consideration of his proposal regarding elderly health care. He asked staff to provide any other questions that were presented to the insurance companies to him. Commissioner Jordan noted she concurred with Commissioner Sorenson’s comments regarding universal health care; that she was also concerned that sufficient data was not available to Committee members. She noted a survey of County employees was needed to determine the need for extended family health coverage and the additional cost to the employee. Commissioner Diaz urged Committee members to forward this ordinance to the County Commission with or without a recommendation. Commissioner Moss stated he supported the concept of this proposed ordinance, but he also supported Commissioner Jordan’s suggestion for a survey and additional information. Commissioner Diaz noted no historical data existed on coverage for domestic partners; however, he would ensure that the questions raised by Committee members were addressed before the ordinance was considered by the County Commission. Commissioner Seijas noted the community needed this proposed ordinance. She urged Committee members to forward it to the County Commission without a recommendation, as previously requested by Commissioner Diaz. Chairwoman Edmonson supported the comments regarding the study recommended by Commissioner Jordan. It was moved by Commissioner Souto to forward this proposed ordinance to the County Commission without a recommendation. This motion died due to the lack of a second. Responding to Commissioner Moss’ inquiry regarding the time needed to conduct an actuary study on this proposed ordinance, Ms. Norris stated an actuary study could not be done without data, but staff could conduct a survey among the County employees to determine what percentage of employees would use this type of dependent health coverage. Concerning Commissioner Moss’ request for further regarding the proposal being considered Salt Lake City, Utah and other cities, Commissioner Diaz stated he would provide copies of the articles on this proposal regarding the study. He pointed out that specific question must be framed to ask health insurance companies. Commissioner Moss questioned whether insurance companies were asked to review this proposal in broader pool, Ms. Norris noted questions were asked of health insurance companies before the Board adopting Resolution No. R-434-07, which was sponsored by Commissioner Diaz on February 28, 2007. She noted this resolution essentially directed the County Manager to study the feasibility of including “dependent parents” under the category of dependents for County health insurance benefit plans for County employees. Commissioner Moss inquired whether a separate program and/or account would have to be implemented or established if this proposal was adopted by the County Commission, Ms. Norris noted currently the proposal outlined in this ordinance would be part of the family coverage. She pointed out the current County health plan had four tiers: (1) the Employee only, (2) the Employee and Spouse, (3) the Employee plus child/children, and (4) the Employee and family which include the spouse and the children. Commissioner Moss stressed the need to extend health insurance in a responsible way. A discussion ensued between Commissioners Diaz and Jordan regarding the County not having stop loss insurance, which was designed to reduce the financial risk for those employers who choose to self-fund their employee medical plans and to protect the self-funded employer from losing money due to devastating or catastrophic claims; and the 20 year history that did not include stop loss insurance of the County not having extended family coverage. Responding to Commissioner Jordan’s question regarding the feasibility of the County Administration providing information on the willingness of County employees to pay the cost for the needed dependent health care insurance, Ms. Marsha Pascual, Risk Management Division Director, General Services Administration, stated staff would conduct a study of the employees who may need this proposed health insurance coverage, and she indicated it would be a statistical balanced sample. It was moved by Commissioner Jordan that the Miami-Dade County General Services Administration conduct a study to determine the costs and risks involved in the implementation of proposed ordinance as well as a survey that polls a valid sample County employees and to report back to the Committee within 90 days. Commissioner Moss seconded this motion for discussion. A discussion ensued among the Committee members and Ms. Norris regarding the County providing assistance to Jackson Health System to increase its revenue stream and considering other alternative approaches for health care coverage. Commissioner Diaz urged the Committee to forward this proposed ordinance without a recommendation to the County Commission. Commissioner Souto requested that the study requested by Commissioner Jordan also address, as an alternative approach, the feasibility of providing these services through the Jackson Health System, in an effort to increase its revenue stream. Commissioner Jordan accepted the amendment offered by Commissioner Souto. The Committee by motion duly made, seconded and carried, directed the Miami-Dade County General Services Administration to conduct a study to determine the costs and risks involved in the implementation of proposed ordinance; including a survey that polls a valid sample County employees and a determination regarding the possibility of providing the proposed health care coverage through Jackson Health System; and to report back to the Committee within 90 days. Following further discussion regarding the intent of the foregoing motion, Commissioner Moss offered a motion to reconsider. He subsequently withdrew his motion to reconsider following further clarification Chairwoman Edmonson recommended the Committee defer this proposed ordinance until the study was completed. Chairwoman Edmonson relinquished the Chair to Vice Chairwoman Sorenson. It was moved by Commissioner Edmonson that the Committee forward this proposed ordinance to the County Commission without a recommendation. Vice Chairwoman Sorenson noted, for the record, that Chairwoman Edmonson’s motion would fail because she intended to vote “No,” and an unanimous vote was required to forward it to the County Commission. Commissioner Moss seconded the motion for discussion. Vice Chairwoman Sorenson noted the Committee had requested a study that did not preclude the Committee from moving forward with this proposed ordinance later. Commissioner Seijas reemphasized the importance of the Committee forwarding this ordinance to the County Commission. She maintained that everyone needed health insurance. The Committee proceeded to vote on the motion to forward this proposed ordinance without a recommendation, and the vote failed by a vote of 4-1, (Vice Chairwoman Sorenson voted “No”). Later in the meeting, the Committee proceeded to vote for deferral of this proposed ordinance to no date certain.

Economic Development and Human Services Committee 4/16/2008 1E2 Deferred P
REPORT: See Report under Agenda Item 1E1 Substitute, Legislative File No. 080986.

Board of County Commissioners 3/18/2008 Tentatively scheduled for a public hearing Economic Development and Human Services Committee 4/16/2008

Board of County Commissioners 3/18/2008 4G Adopted on first reading 4/16/2008 P
REPORT: The foregoing proposed ordinance was adopted on first reading and tentatively set for public hearing before the Economic Development and Human Services Committee meeting on April 16, 2008 at 9:30 a.m.

County Attorney 3/11/2008 Assigned Economic Development and Human Services Committee 4/16/2008

County Attorney 3/11/2008 Assigned Lee Kraftchick

Legislative Text


TITLE
ORDINANCE CREATING A SEPARATE ARTICLE TO BE INCLUDED IN CHAPTER 11A OF THE MIAMI-DADE COUNTY CODE; PROVIDING HEALTH INSURANCE ELIGIBILITY AND OTHER BENEFITS TO THE DEPENDENTS OF MIAMI-DADE COUNTY EMPLOYEES; ESTABLISHING DEPENDENT RIGHTS OF VISITATION; PROVIDING SEVERABILITY, INCLUSION IN THE CODE, AND AN EFFECTIVE DATE

BODY
Section 1. The Code of Miami-Dade County, Florida, is hereby amended by adding the following new sections to Chapter 11A:

ARTICLE __ DEPENDENT HEALTH INSURANCE COVERAGE AND VISITATION RIGHTS

Sec. 1. Legislative Findings and Purpose

(a)     The Miami-Dade County Board of County Commissioners finds that a significant number of Miami-Dade residents establish and maintain important personal, emotional, and economic relationships with relatives and other persons living in the same household in addition to the relationships they establish with their spouses and children. When such relatives and others are dependent upon each other for the provision of basic needs, they should be treated as immediate family members.

(b)     The Miami-Dade County Board of County Commissioners finds that employment benefits form an essential portion of the compensation provided to County employees.


(c)      The rules developed to implement the provisions of this ordinance shall be liberally construed to accomplish the policies and purposes of the ordinance. However, this ordinance shall not be construed to supersede any federal, state, or county laws or regulations, nor shall this ordinance be interpreted in a manner as to bring it into conflict with federal, state, or other county laws.


Sec. 2. Definitions.

For purposes of this Act:

(a)     County employee means any employee of Miami-Dade County, including employees of the Miami-Dade Public Health Trust and all other agencies and instrumentalities of the County.

(b) Relative, for purposes of this ordinance only, means a person who is related to another as a parent, child, grandparent, grandchild, sibling, first cousin, aunt or uncle, nephew or niece.

(c)    Dependent relative means a person’s relative who lives in the same household and is dependent on that person for the provision of basic needs, including food, shelter and health care.

(d) Household dependent means a person, other than a relative, who lives in the same household as another person and is dependent on that other person for the provision of basic needs, including food, shelter and health care.

(e)     Declaration of Dependent Relationship means a sworn form under penalty of perjury, which certifies that two persons meet the requirements of a dependent relative relationship as described in section 11A-72.

(f) A declarant is a person who files a declaration of dependent relationship.

(g)     Health Care Facility means any hospital, convalescent facility, walk-in clinic, doctor’s office, mental health care facility and any other short- or long-term health care facility located within Miami-Dade County.


Sec. 3.  Registration of Dependent Relationship.

(a)     A valid dependent relationship may be registered by any person residing in this County by filing a declaration of dependent relationship with the Miami-Dade County Consumer Services Department, which declaration shall comply with all requirements set forth in this ordinance for establishing such dependent relationship. Upon payment of any required fees, the Consumer Services Department shall file the declaration of dependent relationship and issue a certificate reflecting the registration of the dependent relationship in Miami-Dade County.

(b)     A declaration of dependent relationship shall contain the name and address of the declarant and the name of the dependent, the signature of the declarant, and the signature of any dependent over the age of eighteen and competent to contract. The declaration shall certify:

(1)    The declarant is at least 18 years old and competent to contract;

(2) The person identified as a dependent meets the definition of either a dependent relative or household dependent;

(3)     Each person in the dependent relationship considers himself or herself to be a member of the immediate family of the other and to be jointly responsible for maintaining and supporting the Registered Dependent Relationship;

(4) Each person agrees to immediately notify the Consumer Services Department, in writing, if the terms of the Dependent Relationship are no longer applicable or the declarant or dependent wishes to terminate the dependent relationship.

(c)     Any declarant, or dependent who is over the age of eighteen and competent to contract, may file an amendment to the dependent relationship certificate issued by the Consumer Services Department to reflect a change in his or her legal name or address.



Sec. 4.  Termination of registered dependent
relationship.

(a)     A declarant, or a dependent who is over the age of eighteen and competent to contract, may terminate a dependent relationship by filing a notarized declaration of termination of dependent relationship with the Consumer Services Department. Upon the payment of the required fee, the Consumer Services Department shall file the declaration and issue a certificate of termination of dependent relationship to the declarant and dependent. The termination shall become effective 30 days from the date the certificate of termination is issued.

(b)     If any household dependent enters into a legal marriage with someone outside the household, the dependent relationship shall terminate automatically, and all rights, benefits, and entitlements there under shall cease as of the effective date of the marriage. The marrying dependent shall file a declaration terminating the dependent relationship within 10 days after entering into a legal marriage.

(c) The death of either the declarant or the dependent shall automatically terminate the dependent relationship.

(d) If the declarant of the dependent relationship ceases to be responsible for the other’s basic food and shelter, the dependent relationship shall be considered terminated.

Sec. 5.  Maintenance of records; filing fees.

(a)     The Miami-Dade County Mayor shall by administrative rule prescribe the form of all declarations, amendments, and certificates required to be filed under this act. The Consumer Services Department shall maintain a record of all declarations, amendments, and certificates filed pursuant to this ordinance.

(b)     Filing Fees. The Mayor is authorized to establish fees for the filing of any declarations, amendments, and the issuance of any certificates required by this act, subject to the approval of the County Commission. The fees shall be included within a Miami-Dade County Administrative Order. Any fees established under this section shall be commensurate with the actual costs of administering the provisions of this ordinance.


Sec. 6.  Extension of benefits to dependents
of County employees.

(a)     Any County employee who is a party to a registered dependent relationship under this ordinance shall be entitled to elect insurance coverage for his or her dependent or the children of such dependent on the same basis in which any County employee may elect insurance coverage for his or her spouse or children. A County employee’s right to elect insurance coverage for his or her dependent, or the dependent’s children, shall extend to all forms of insurance provided by the County to the spouses and children of County employees, unless such coverage is prohibited by state or federal law or the terms of a collective bargaining agreement. All elections of coverage shall be made in accordance with the requirements of applicable county ordinances, administrative rules, county policies and applicable collective bargaining agreements. However, in no event shall an employee make an election for coverage of a dependent more than two times in a plan year.

(b)      Any County employee who is a party to a dependent relationship under this ordinance shall be entitled to use all forms of leave provided by the County including, but not limited to, sick leave, annual leave, funeral leave and family leave to care for his or her declarant, dependent or the children or parents of the declarant or dependent, as applicable. The use of leave authorized in this section shall be consistent with the applicable requirements in county ordinances, administrative rules, and collective bargaining agreements.

(c)     Unless prohibited by state or federal law or the terms of a collective bargaining agreement, all other benefits available to the spouses and children of County employees shall be made available on the same basis to the declarant, dependent, or child of such declarant or dependent, of a County employee who is a party to a registered dependent relationship pursuant to this ordinance.

(d) Any County employee who obtains or attempts to obtain benefits under this provision fraudulently shall be subject to discipline, up to and including termination.

(e) The Mayor is authorized and directed to take all actions necessary to implement the provisions of this section within ninety (90) days after this ordinance is enacted.

Sec. 7. Health care facility visitation rights.

Whenever a dependent or declarant is a patient in a health care facility in Miami-Dade County, the health care facility shall afford:

(a) the dependent or declarant of the patient the same right to visit the patient as the facility would provide to the relative of a patient;

(b) the parent of the dependent or declarant of the patient the same right to visit the patient as the facility would provide to the parent of a relative of a patient.

(c) the children of a dependent or declarant of the patient the same right to visit the patient as the facility would provide to the children of a patient.

Sec. 8. Visitation rights at county correctional and juvenile detention facilities.

(a) Any person who is a party to a registered dependent relationshiprelationship, pursuant to section 3, shall be entitled to visit his or her declarant or dependent, or other family member of the declarant or dependent, who is an inmate at a county correctional facility or a juvenile detention facility, upon the same terms and conditions under which visitation is afforded to spouses, children, or parents of inmates. Visitation rights provided by this section shall extend to any children of the dependent or declarant.

(b) In any situation providing for mandatory or permissible notification of family members of inmates, including notification of family members in an emergency, or when permission is granted to inmates to contact family members, “notification of family” shall include declarants and their dependents.

Sec. 9. Enforcement

County employees who believe the County has violated any right established by this ordinance shall have the right to file a complaint with the Office of Fair Employment Practices in accordance with section 11A-37 and the rules promulgated by that Office. The terms of this ordinance may be enforced by persons other than County employees, and by County employees against private businesses, through the filing of a private action in any court of competent jurisdiction for declaratory or injunctive relief or both.


Section 2. If any section, subsection, sentence, clause or provision of this ordinance is held invalid, the remainder of this ordinance shall not be affected by such invalidity.
Section 3. It is the intention of the Board of County Commissioners, and it is hereby ordained that the provisions of this ordinance, including any sunset provision, shall become and be made a part of the Code of Miami-Dade County, Florida. The sections of this ordinance may be renumbered or relettered to accomplish such intention, and the word “ordinance” may be changed to “section,” “article,” or other appropriate word.
Section 4. This ordinance shall become effective ten (10) days after the date of enactment unless vetoed by the Mayor, and if vetoed, shall become effective only upon an override by this Board.
AND ADOPTED:

Approved by County Attorney as
to form and legal sufficiency: ________

Prepared by: ________

Lee Kraftchick

Sponsored by Commissioner Jose “Pepe” Diaz

Agenda Item No. 4(G)
Page 7






Approved                     Mayor Agenda Item No. 4(G)
Veto __________ 03-18-08
Override __________



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