Strength in Numbers: Pooling Resources Means More Money for Kids 

Friday May 10, 2024

The pieces of East Kern Americana are reminders of a recent past. A black-and-white portrait of a horse-back cowboy, a gift from his mother-in-law, peers over his shoulder as he works at his computer. Atop a nearby credenza, three framed pictures are proudly displayed, each depicting scenes that one could see on the ranges at the China Lake Naval Warfare Center or in the foothills surrounding the Indian Wells Valley. 

“Having lived in Ridgecrest for almost 30 years, I liked the idea of bringing a piece of East Kern with me to Bakersfield,” said Dave Ostash, CEO of Self-Insured Schools of California (SISC), who took over the organization last July.  

SISC CEO Dave Ostash

His entire career has been focused on service. After graduating from UCLA, Ostash moved to eastern Kern County to teach English for the Sierra Sands Unified School District. He would remain in the district for nearly three decades, eventually rising to superintendent. The opportunity to join the team at SISC meant he could serve public education throughout the entire state, so he jumped at the chance. 

“It is a privilege to support student learning by making sure our educators have access to the foundational supports needed to provide every student a world class education,” Ostash said. 

By supporting educators and those who support education, SISC plays a crucial role in fostering the health and well-being of California’s educators and their families while saving schools money that can be put back into the classroom. 

The organization was founded in 1978 as a response to escalating workers’ compensation rates and limited coverage options. Changes to California law resulted in insurance and workers’ compensation providers pulling out of the state. With nowhere else to turn, school districts banded together with the KCSOS to form a Joint Powers Authority (JPA) known as the Self-Insured Schools of Kern.

Over the years, as more school districts joined, the organization branched out to other counties across the state, and SISK became SISC. Now, the organization has evolved into the largest public school pool in the United States, boasting more than 400,000 members throughout the state. 

Ostash explained that SISC can offer stability, affordability, and innovation in insurance solutions by pooling its member resources.

“I think of it as a member-owned organization,” he said. “Our overarching goal is to leverage the pooled resources to get the very best products and services at the lowest cost.”

All SISC personnel and board members are public school employees who ensure that policies are in the best interest of schools. Deputy Executive Officer of Health Benefits John Stenerson says its relationship with KCSOS is a significant benefit.

“When people learn that we’re part of KCSOS, it gives them relief. They can trust what we’re saying because we’re them. We’re school employees just like our members,” he said.

Recently, SISC stepped onto the national stage, with a representative participating in a White House event focused on the Cancer Moonshot initiative. Nicole Mata, SISC’s Director of Health Benefits, highlighted the importance of broadening access to primary care. Mata’s participation at the event alongside representatives from 27 large businesses reaffirmed SISC’s role in shaping healthcare discussions at a more impactful level.

“We’ve gone from this little local JPA in Kern County to this statewide program that’s being recognized on a federal level for what we’re doing with our health plans,” she said. “I truly feel like we’re doing something just so important. There’s nothing more important in someone’s life than their family’s health, and we can provide that access.”

Nicole Mata, Director of Health Benefits

For the second time in as many months, SISC headed to the White House to continue the national conversation on health care. Stenerson recently met with White House staff to talk about SISC’s pharmacy program and how it benefits members.Ten years ago, SISC partnered with a new pharmacy benefit manager (PBM) called Navitus Health Solutions. A PBM directs prescription drug programs by processing prescription claims. Stenerson says Navitus was chosen because it is transparent in disclosing all of its pricing and rebates for prescription drugs.

“It makes a huge difference because if you don’t understand what you’re paying for, you’re just at the will of the health care delivery system to pay whatever they charge,” Stenerson said.

SISC’s research has shown that establishing trusted relationships with primary care physicians significantly improves compliance rates, leading to better health outcomes for members.

“We believe all of our members, healthy or not, need a trusting relationship with primary care,” Mata said. “That’s really the cornerstone to managing chronic conditions, to find things before they become problems that keep people out of the hospital.”

SISC has incorporated telehealth services into its offerings, ensuring members have 24/7 access to a primary care team at no cost. By removing barriers to primary care, such as cost and availability, SISC aims to increase early detection of serious medical conditions, ultimately improving overall health and well-being for its members. 

One of SISC’s key advantages is its size. Through partnerships with leading healthcare providers and leveraging its large pool of members, SISC commands discounts and offers comprehensive coverage, safeguarding districts against rising healthcare costs. This ensures that millions of dollars stay in the classroom instead of being spent on premiums.

“We get those discounts because we have this large pool that brings a more competitive edge,” Ostash said. “When you have the scale of a larger pool, everybody’s got each other’s back.”

But SISC encompasses much more than just health benefits. It is also a member pool for workers’ compensation, property and liability, and other financial services.

Gabriel Rodriguez is the executive director of SISC workers’ compensation. He and his team work directly with more than 90 school districts and more than 40,000 employees to provide workers’ comp coverage.

When someone is injured, the goal is to get them the timely care they need and then do everything necessary to ensure they can come back to work safely and efficiently. The larger goal, Rodriguez says, is to have safety protocols and programs in place to reduce the risk of injury in the first place.

“Our safety and loss control program offers all kinds of webinars on various safety products. All of these programs are to reduce reportable claims and to protect our covered employees,” he said.  

Robert Kretzmer is the director of the property and liability division at SISC. This division works directly with more than 150 school districts across the state to cover everything from school property damage to lawsuits and playground safety. Kretzmer says they proactively work with member districts to help them build a culture of safety to prevent unnecessary claims. Several online resources and training tools are available to promote best practices on campus before they become a liability issue.

“Ongoing education of our employees is really significant,” he said. “We are available to answer questions they have as to how they can improve and ensure a safe school environment.”

When something happens at a member school site, such as a burst pipe or malfunctioning equipment, Kretzmer says the goal is to get it fixed as quickly as possible to get students back to learning.

“We make sure that everything is done to mitigate those damages, get the repairs done as quickly as possible, and get that facility back up and running so we can continue to educate our students with as minimal disruption as possible,” he said.

As SISC continues to innovate, the organization aims to drive positive change across the state and the nation, while continuing its commitment to providing quality healthcare, insurance coverage, and support for school districts remains steadfast.  

“We have a long history and a great legacy,” Ostash said. “We’re growing, and we’re really proud of what we do.”

By Katie Avery

By Katie Avery

Katie Avery joined the Kern County Superintendent of Schools in 2023 as a Communications Specialist. As a former journalist and marketing professional, her passions include media and storytelling. Before joining KCSOS, Avery worked for various local TV stations as well as the health care industry.