BOARD OF GOVERNORS MEETING
June 3, 2021 ● 2:00 PM L.A. Care Health Plan 1055 W. 7th Street, Los Angeles, CA 90017
1 About L.A. Care Health Plan
Statement
L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Overview
Committed to the promotion of accessible, affordable and high quality health care, L.A. Care Health Plan (Local Initiative Health Authority of Los Angeles County) is an independent local public agency created by the State of California to provide health coverage to low-income Los Angeles County residents. Serving more than two million members in five product lines, L.A. Care is the nation’s largest publicly operated health plan.
L.A. Care Health Plan is governed by 13 board members representing specific stakeholder groups, including consumer members, physicians, federally qualified health centers, children’s health care providers, local hospitals and the Los Angeles County Department of Health Services.
L.A. Care advances individual and community health through a variety of targeted activities including a Community Health Investment Fund and sponsorships program that have awarded more than $180 million throughout the years to support the health care safety net and expand health coverage. The patient-centered health plan has a robust system of consumer advisory groups, including 11 Regional Community Advisory Committees (governed by an Executive Community Advisory Committee), 35 health promoters and six Family Resource Centers and one Community Resource Center that offer free health education and exercise classes to the community, and has made significant investments in Health Information Technology for the benefit of the more than 10,000 doctors and other health care professionals who serve L.A. Care members.
Programs
Medi-Cal – In addition to offering a direct Medi-Cal line of business, L.A. Care works with three subcontracted health plans to provide coverage to Medi-Cal members. These partners are Anthem Blue Cross, Blue Shield of California Promise Health Plan and Kaiser Permanente. Medi-Cal beneficiaries represent a vast majority of L.A. Care members.
L.A. Care Covered™ – As a state selected Qualified Health Plan, L.A. Care provides the opportunity for all members of a family to receive health coverage under one health plan in the Covered California state exchange.
2
L.A. Care Cal MediConnect Plan – L.A. Care Cal MediConnect Plan provides coordinated care for Los Angeles County seniors and people with disabilities who are eligible for Medicare and Medi-Cal.
PASC-SEIU Homecare Workers Health Care Plan – L.A. Care provides health coverage to Los Angeles County’s In-Home Supportive Services (IHSS) workers, who enable our most vulnerable community members to remain safely in their homes by providing services such as meal preparation and personal care services.
L.A. Care Membership by Product Line – As of April 2021 Medi-Cal 2,232,144 L.A. Care Covered 95,521 Cal MediConnect 18,656 PASC-SEIU 51,530 Total membership 2,397,851 L.A. Care Providers – As of September 2018 Physicians 4,926 Specialists 19,024 Both 1,537 Hospitals, clinics and other health care 8,778 professionals Financial Performance (FY 2020 -2021 budget) Revenue $7.7M Fund Equity $778,308 Net Operating Surplus ($169,273) Administrative cost ratio 5.8% Staffing highlights Full-time employees (Actual as of September 2,088 2020) Projected full-time employees (FY 2020-2021 2,033 budget)
3 AGENDA BOARD OF GOVERNORS MEETING L.A. Care Health Plan Thursday, June 3, 2021, 2 PM L.A. Care Health Plan, 1055 W. 7th Street, 10th Floor, Los Angeles, CA 90017 California Governor issued Executive Order N-25-20 and N-29-20, which, among other provisions, amend the Ralph M. Brown Act. Accordingly, members of the public should now listen to this meeting via teleconference as follows: https://lacare.webex.com/lacare/j.php?MTID=mdf47b9171c69d95a56f2b4134ae5b5c0 English Audio Call (213) 306-3065 or (415) 655-0002 Access Code 187 264 9534 Password: lacare Spanish Audio Call: (213) 306-3065 or (415) 655-0002 Access Code 1878 41 9954 Password: lacare Members of the Board of Governors or staff may participate in this meeting via teleconference. The public is encouraged to submit public comments or comments on Agenda items in writing by e-mail to [email protected], or by sending a text or voicemail to (213) 628-6420. The text, voicemail, or email must indicate if you wish to be identified or remain anonymous, and must also include the name of the item to which your comment relates. Comments received by voicemail, email or text by 2:00 pm on June 3, 2021 will be provided to the members of the Board of Governors. Public comments submitted will be read for 3 minutes. Once the meeting has started, voicemails, emails and texts for public comment should be submitted before the agenda item is called by the meeting Chair. If you wish to submit public comment on a specific agenda item, you must submit it at any time prior to the time the Chair announces the item and asks for public comment. Please take note that if your public comment is not related to any of the agenda item topics, your public comment will be read in the general public comment agenda item. Please take note that there may be delay in the digital transmittal of emails, texts and voicemail. The Chair will announce when public comment period is over. If your public comments are not received on time for the specific agenda item you want to address, your public comments will be read at the public comment section prior to the board going to closed session. The purpose of public comment is that it is an opportunity for members of the public to inform the governing body about their views. The Board appreciates hearing the input as it considers the business on the Agenda. All votes in a teleconferenced meeting shall be conducted by roll call. If you are an individual with a disability and need a reasonable modification or accommodation pursuant to the Americans with Disabilities Act (ADA) please contact L.A. Care Board Services staff prior to the meeting for assistance by text to 213 628-6420 or by email to [email protected]. Welcome Hector De La Torre, Chair 1. Approve today’s Agenda Chair 2. Public Comment (Please read instructions above.) Chair 3. Consent Agenda Items Chair Minutes of May 6, 2021 Board of Governors Meeting p.15 Imagenet, LLC Contract Amendment (FIN 100) p.41 L.A. Care Health Plan Joint Powers Authority Authorized Signatories all Bank & Investment Accounts (JPA FIN 100) p.42 2021 Internal Audit Services Work Plan (COM 100) p.43 Revised Legal Services Policy LS-005 (Fair Hearing for Competency Decision) (COM 101) p.49 5/26/2021 5:40 PM 4 Board of Governors Meeting Agenda June 3, 2021 Page 2 of 3
4. Chairperson’s Report Chair 5. Chief Executive Officer Report p.67 John Baackes Community Health Investment Fund (CHIF) Summary for Fiscal p.70 Chief Executive Officer Year 2019-20 Monthly Grants & Sponsorship Reports p.122 6. Chief Medical Officer Report p.123 Richard Seidman, MD, MPH Chief Medical Officer Advisory Committee Reports 7. Executive Community Advisory Committee Hilda Perez / Layla Gonzalez Consumer member and Advocate member 8. Children’s Health Consultant Advisory Committee Richard Seidman, MD, MPH Committee Reports 9. Executive Committee Chair Government Affairs Update p.160 Cherie Compartore o 2021-22 Budget May Revise p.204 Senior Director, Government Affairs 10. Finance & Budget Committee Robert H. Curry, Committee Chair Chief Financial Officer Report p.219 Marie Montgomery o Financial Report April 2021 (FIN 101) p.230 Chief Financial Officer o Monthly Investment Transaction Reports p.241 C3/Customer Contact Channels (Everise) Contract Acacia Reed Amendment (FIN 102) p.267 Chief Operations Officer 11. Compliance & Quality Committee Stephanie Booth, MD, Committee Chair
12. Public Comment on Closed Session Items (Please read instructions Chair above.) ADJOURN TO CLOSED SESSION (Estimated time: 30 minutes) Chair 13. CONTRACT RATES Pursuant to Welfare and Institutions Code Section 14087.38(m) Plan Partner Rates Provider Rates DHCS Rates 14. REPORT INVOLVING TRADE SECRET Pursuant to Welfare and Institutions Code Section 14087.38(n) Discussion Concerning new Service, Program, Technology, Business Plan Estimated date of public disclosure: June 2023 15. CONFERENCE WITH LEGAL COUNSEL—ANTICIPATED LITIGATION Significant exposure to litigation pursuant to Section 54956.9(d)(2) of Ralph M. Brown Act: Three Potential cases
5/26/2021 5:40 PM 5 Board of Governors Meeting Agenda June 3, 2021 Page 3 of 3 16. CONFERENCE WITH LABOR NEGOTIATOR Section 54957.6 of the Ralph M. Brown Act Agency Designated Representative: John Baackes Unrepresented Employee: All L.A. Care Employees RECONVENE IN OPEN SESSION Chair Adjournment Chair
The next meeting is scheduled on Thursday, July 29, 2021 at 2:00 PM and may be conducted as a teleconference meeting. Public comments will be read for up to three minutes. The order of items appearing on the agenda may change during the meeting. If a teleconference location is listed at the top of this agenda, the public can participate in the meeting by calling the teleconference call in number provided. If teleconference arrangements are listed at the top of this Agenda, note that the arrangements may change prior to the meeting. THE PUBLIC MAY SUBMIT COMMENTS TO THE BOARD OF GOVERNORS BEFORE DISCUSSION OF EACH ITEM LISTED ON THE AGENDA BY SUBMITTING THE COMMENT BY VOICE MESSAGE OR IN WRITING BY TEXT MESSAGE TO 213 628 6420, OR IN WRITING BY EMAIL TO [email protected]. Please follow additional instructions on the first page of this Agenda. ACTION MAY NOT BE TAKEN ON ANY MATTER RAISED DURING THE PUBLIC COMMENT PERIODS UNTIL THE MATTER IS SPECIFICALLY LISTED ON A FUTURE AGENDA, according to California Govt Code Section 54954.2 (a)(3) and Section 54954.3. NOTE: THE BOARD OF GOVERNORS CURRENTLY MEETS ON THE FIRST THURSDAY OF MOST MONTHS AT 2:00 P.M. AGENDA and PRINTED MEETING MATERIALS ARE AVAILABLE FOR INSPECTION AT http://www.lacare.org/about-us/public-meetings/board-meetings and by email request to [email protected] Any documents distributed to a majority of the Board Members regarding any agenda item for an open session after the agenda has been posted will be available for public inspection at http://www.lacare.org/about-us/public-meetings/board-meetings and can be requested by email to [email protected].
An audio recording of the meeting is made to assist in writing the minutes and is retained for 30 days. Meetings are accessible to people with disabilities. Individuals who may require any accommodations (alternative formats – i.e., large print, audio, translation of meeting materials, interpretation, etc.) to participate in this meeting and wish to request an alternative format for the agenda, meeting notice, and meeting packet may contact L.A. Care’s Board Services Department at (213) 628 6420. Notification at least one week before the meeting will enable us to make reasonable arrangements to ensure accessibility to the meetings and to the related materials.
5/26/2021 5:40 PM 6 Schedule of Meetings June 2021
Monday Tuesday Wednesday Thursday Friday 1 2 3 4 Board of Governors Meeting 2 pm (for approx. 2 hours)
7 8 9 10 11 ECAC Meeting 1 pm (for approx. 2 hours)
14 15 16 17 18
21 22 23 24 25
28 29 30 Finance & Budget 1 pm (for approx. 1 hour)
Executive Committee 2 pm (for approx. 2 hours)
Due to COVID 19 pandemic, California Governor issued Executive Order N-25-20, N-29-20, which among other provisions amends the Ralph M. Brown Act and Executive Order N 33-20, ordering all residents to stay in their homes, except for specific essential functions.
L.A. Care has temporarily suspended some of its public meetings.
For information on the current month’s meetings, check calendar of events at www.lacare.org. Meetings may be cancelled or rescheduled at the last moment. To check on a particular meeting, please call (213) 694-1250 or send email to [email protected]. 7 Prepared by mhbalones/printed on 05/25/21 BOARD OF GOVERNORS & PUBLIC ADVISORY COMMITTEES 2021 MEETING SCHEDULE / MEMBER LISTING
1055 W. 7th Street, 1st Floor, Los Angeles, CA 90017 Tel. (213) 694-1250 / Fax (213) 438-5728
MEETING DAY, TIME MEETING DATES BOARD MEMBERS / & LOCATION STAFF CONTACT
st BOARD OF 1 Thursday June 3 Hector De La Torre, Chairperson 2:00 PM July 29** Alvaro Ballesteros, MBA, Vice Chairperson GOVERNORS (for approximately 3 hours) No meeting in August Robert Curry, Treasurer
L.A. Care Health Plan September 2*** Layla Gonzalez, Secretary
1055 W. 7th Street, October 7* Stephanie Booth, MD 1st Floor, Los Angeles, November 4 Christina R. Ghaly, MD CA 90017 December 2 George W. Greene, Esq. (213) 694-1250 Antonia Jimenez Supervisor Holly J. Mitchell *Placeholder meeting Hilda Perez ** last Thursday of the G. Michael Roybal, MD, MPH month Ilan Shapiro, MD *** All Day Retreat – Nina Vaccaro location TBD
Staff Contact:
John Baackes
Chief Executive Officer, x4102
Linda Merkens
Senior Manager, Board Services, x4050
BOARD COMMITTEES
th EXECUTIVE 4 Monday of the June 28 Hector De La Torre, Chairperson month No meeting in July Alvaro Ballesteros, MBA, Vice Chairperson COMMITTEE 2:00 PM August 23 Robert H. Curry, Treasurer (for approximately 2 hours) September 27 Layla Gonzalez, Secretary L.A. Care Health Plan October 25 Stephanie Booth, MD 1055 W. 7th Street, November 15* Hilda Perez 1st Floor, Los Angeles, No meeting December Staff Contact: CA 90017 Linda Merkens (213) 694-1250 Senior Manager, Board Services, x4050
rd Malou Balones *3 Monday due to Board Specialist III, Board Services x4183 Thanksgiving holiday
For information on the current month’s meetings, check calendar of events at www.lacare.org. Meetings may be cancelled or rescheduled at the last moment. To check on a particular meeting, please call (213) 694-1250 or send email to [email protected]. 8 BOARD OF GOVERNORS, BOARD COMMITTEES, PUBLIC ADVISORY COMMITTEES AND REGIONAL COMMUNITY ADVISORY COMMITTEES 2021 MEETING SCHEDULE / MEMBER LISTING
MEETING DAY, TIME MEETING DATES BOARD MEMBERS / & LOCATION STAFF CONTACT
COMPLIANCE & 3rd Thursday every 2 August 19 Stephanie Booth, MD, Chairperson QUALITY months September 16 Alvaro Ballesteros, MBA 2:00 PM November 18 Hilda Perez COMMITTEE (for approximately 2 hours) Ilan Shapiro, MD
L.A. Care Health Plan Nina Vaccaro
1055 W. 7th Street, 1st Floor, Los Angeles, Staff Contact: CA 90017 Victor Rodriguez (213) 694-1250 Board Specialist II, Board Services x 5214
FINANCE & 4th Monday of the June 28 Robert H. Curry, Chairperson BUDGET month No meeting in July Stephanie Booth, MD 1:00 PM August 23 Hector De La Torre COMMITTEE (for approximately 1 hour) September 27 Hilda Perez
L.A. Care Health Plan October 25 G. Michael Roybal, MD, MPH
1055 W. 7th Street, November 15*
1st Floor, Los Angeles, No meeting December CA 90017 Staff Contact: (213) 694-1250 Malou Balones Board Specialist III, Board Services x4183 *3rd Monday due to Thanksgiving holiday
GOVERNANCE L.A. Care Health Plan Hilda Perez, Chairperson COMMITTEE 1055 W. 7th Street, Stephanie Booth, MD 1st Floor, Los Angeles, Layla Gonzalez CA 90017 Antonia Jimenez (213) 694-1250 Nina Vaccaro
Staff Contact: MEETS AS NEEDED Malou Balones
Board Specialist III, Board Services/x 4183
SERVICE L.A. Care Health Plan Layla Gonzalez, Chairperson AGREEMENT 1055 W. 7th Street, George W. Greene 1st Floor, Los Angeles, Antonia Jimenez COMMITTEE CA 90017 Hilda Perez (213) 694-1250 Staff Contact MEETS AS NEEDED Malou Balones Board Specialist III, Board Services/x 4183
FOR INFORMATION ON THE CURRENT MONTH’S MEETINGS, CHECK CALENDAR OF EVENTS AT WWW.LACARE.ORG. MEETINGS MAY BE CANCELLED OR RESCHEDULED AT THE LAST MOMENT. TO CHECK ON A PARTICULAR MEETING, PLEASE CALL (213) 694-1250 OR SEND EMAIL TO [email protected]. 9 BOARD OF GOVERNORS, BOARD COMMITTEES, PUBLIC ADVISORY COMMITTEES AND REGIONAL COMMUNITY ADVISORY COMMITTEES 2021 MEETING SCHEDULE / MEMBER LISTING
MEETING DAY, TIME MEETING DATES BOARD MEMBERS / & LOCATION STAFF CONTACT
AUDIT L.A. Care Health Plan Alvaro Ballesteros, MBA, Interim COMMITTEE 1055 W. 7th Street, Chairperson 1st Floor, Los Angeles, Stephanie Booth, MD, CA 90017 Layla Gonzalez (213) 694-1250 Staff Contact
Malou Balones MEETS AS NEEDED Board Specialist III, Board Services, x 4183
Meets Annually or as Hector De La Torre, Chairperson L.A. CARE needed Alvaro Ballesteros, MBA, Vice Chairperson COMMUNITY L.A. Care Health Plan Robert Curry, Treasurer 1055 W. 7th Street, Layla Gonzalez, Secretary HEALTH PLAN 1st Floor, Los Angeles, Stephanie Booth, MD
CA 90017 Christina R. Ghaly, MD
(213) 694-1250 George W. Greene, Esq. Antonia Jimenez Supervisor Holly J. Mitchell Hilda Perez G. Michael Roybal, MD, MPH Ilan Shapiro, MD Nina Vaccaro
Staff Contact: John Baackes, Chief Executive Officer, x4102 Linda Merkens, Senior Manager, Board Services, x4050
L.A. CARE JOINT Meets as needed Hector De La Torre, Chairperson POWERS L.A. Care Health Plan Alvaro Ballesteros, MBA, Vice Chairperson 1055 W. 7th Street, Robert Curry, Treasurer AUTHORITY 1st Floor, Los Angeles, Layla Gonzalez, Secretary
CA 90017 Stephanie Booth, MD
(213) 694-1250 Christina R. Ghaly, MD George W. Greene, Esq. Antonia Jimenez Supervisor Holly J. Mitchell Hilda Perez G. Michael Roybal, MD, MPH Ilan Shapiro, MD Nina Vaccaro
Staff Contact: John Baackes, Chief Executive Officer, x4102 Linda Merkens, Senior Manager, Board Services, x4050 FOR INFORMATION ON THE CURRENT MONTH’S MEETINGS, CHECK CALENDAR OF EVENTS AT WWW.LACARE.ORG. MEETINGS MAY BE CANCELLED OR RESCHEDULED AT THE LAST MOMENT. TO CHECK ON A PARTICULAR MEETING, PLEASE CALL (213) 694-1250 OR SEND EMAIL TO [email protected]. 10 BOARD OF GOVERNORS, BOARD COMMITTEES, PUBLIC ADVISORY COMMITTEES AND REGIONAL COMMUNITY ADVISORY COMMITTEES 2021 MEETING SCHEDULE / MEMBER LISTING
MEETING DAY, TIME MEETING DATES BOARD MEMBERS / & LOCATION STAFF CONTACT
PUBLIC ADVISORY COMMITTEES
CHILDREN’S 3rd Tuesday of every August 17 Tara Ficek, MPH, Chairperson
HEALTH other month September 21
CONSULTANT 8:30 AM November 16 Staff Contact: ADVISORY (for approximately 2 hours) Victor Rodriguez COMMITTEE Board Specialist II, Board Services/x 5214 GENERAL L.A. Care Health Plan
MEETING 1055 W. 7th Street, 1st Floor, Los Angeles, CA 90017 (213) 694-1250
EXECUTIVE 2nd Wednesday of the June 9 Fatima Vasquez, Chairperson COMMUNITY month No meeting in July ADVISORY 10:00 AM August 11 COMMITTEE (for approximately 3 hours) September 8 October 13 L.A. Care Health Plan November 10 1055 W. 7th Street, December 8 Staff Contact: 1st Floor, Los Angeles, Idalia Chitica, Community Outreach & CA 90017 Education, Ext. 4420 (213) 694-1250
TECHNICAL Meets Quarterly July Richard Seidman, MD, MPH, Chairperson ADVISORY October COMMITTEE L.A. Care Health Plan 1055 W. 7th Street, Staff Contact: 1st Floor, Los Angeles, Victor Rodriguez CA 90017 Board Specialist II, Board Services/x 5214 (213) 694-1250
FOR INFORMATION ON THE CURRENT MONTH’S MEETINGS, CHECK CALENDAR OF EVENTS AT WWW.LACARE.ORG. MEETINGS MAY BE CANCELLED OR RESCHEDULED AT THE LAST MOMENT. TO CHECK ON A PARTICULAR MEETING, PLEASE CALL (213) 694-1250 OR SEND EMAIL TO [email protected]. 11 BOARD OF GOVERNORS, BOARD COMMITTEES, PUBLIC ADVISORY COMMITTEES AND REGIONAL COMMUNITY ADVISORY COMMITTEES 2021 MEETING SCHEDULE / MEMBER LISTING
MEETING DAY, TIME MEETING DATES BOARD MEMBERS / & LOCATION STAFF CONTACT
REGIONAL COMMUNITY ADVISORY COMMITTEES DUE TO COVID 19 PANDEMIC, CALIFORNIA GOVERNOR ISSUED EXECUTIVE ORDER N-25-20, N-29-20, WHICH AMONG OTHER PROVISIONS AMENDS THE RALPH M. BROWN ACT AND EXECUTIVE ORDER N 33-20 ORDERING ALL RESIDENTS TO STAY IN THEIR HOMES, EXCEPT FOR SPECIFIC ESSENTIAL FUNCTIONS. L.A. CARE HAS TEMPORARILY SUSPENDED SOME OF ITS PUBLIC MEETINGS.
REGION 1 3rd Friday of every other Russel Mahler, Chairperson ANTELOPE VALLEY month 10:00 AM (for approximately 2-1/2 hours) Staff Contact: L.A. Care Family Kristina Chung Resource Center- Community Outreach & Education, x5139 Palmdale 2072 E. Palmdale Blvd. Palmdale, CA 93550 (213) 438-5580
REGION 2 3rd Monday of every Estela Lara, Chairperson SAN FERNANDO other month VALLEY 10:00 AM (for approximately 2-1/2 hours) L.A. Care Family Staff Contact: Resource Center- Martin Vicente Pacoima Community Outreach & Education, x 4423 10807 San Fernando Road Pacoima, CA 91331 (844) 858-9942 REGION 3 3rd Tuesday of every Cynthia Conteas-Wood, Chairperson ALHAMBRA, other month PASADENA AND 9:30 AM FOOTHILL (for approximately 2-1/2 hours) Staff Contact: Robinson Park Frank Meza Recreation Center Community Outreach & Education, x4239 1081 N. Fair Oaks Avenue Pasadena, CA 91103 (626) 744-7330
FOR INFORMATION ON THE CURRENT MONTH’S MEETINGS, CHECK CALENDAR OF EVENTS AT WWW.LACARE.ORG. MEETINGS MAY BE CANCELLED OR RESCHEDULED AT THE LAST MOMENT. TO CHECK ON A PARTICULAR MEETING, PLEASE CALL (213) 694-1250 OR SEND EMAIL TO [email protected]. 12 BOARD OF GOVERNORS, BOARD COMMITTEES, PUBLIC ADVISORY COMMITTEES AND REGIONAL COMMUNITY ADVISORY COMMITTEES 2021 MEETING SCHEDULE / MEMBER LISTING
MEETING DAY, TIME MEETING DATES BOARD MEMBERS / & LOCATION STAFF CONTACT
REGION 4 3rd Wednesday Sylvia Poz, Chairperson HOLLYWOOD- of every other month WILSHIRE, 9:30 AM CENTRAL L.A. AND (for approximately 2-1/2 GLENDALE hours) L.A. Care Health Plan Staff Contact: Conference Room 100 Kristina Chung 1055 W. 7th Street Community Outreach & Education, x5139 Los Angeles, CA 90017 (213) 694-1250
REGION 5 3rd Monday of every Maria Sanchez, Chairperson
CULVER CITY, other month VENICE, SANTA 2:00 PM MONICA, MALIBU, (for approximately 2-1/2 WESTCHESTER hours) Veterans Memorial Staff Contact: Building Jose Rivas Garden Room Community Outreach & Education, x4090 4117 Overland Avenue Culver City, CA 90230 (310) 253-6625
REGION 6 3rd Thursday of every Andria McFerson, Chairperson COMPTON, other month INGLEWOOD, 3:00 PM WATTS, GARDENA, (for approximately 2-1/2 HAWTHORNE hours) South LA Sports Activity Staff Contact: Center Frank Meza 7020 S. Figueroa Street Community Outreach & Education, x4239 Los Angeles, CA 90003 (323) 758-8716
REGION 7 3rd Thursday of every Fatima Vasquez, Chairperson HUNTINGTON other month PARK, 2:00 PM BELLFLOWER, (for approximately 2-1/2 NORWALK, CUDAHY hours) Community Staff Contact: Empowerment Center Martin Vicente 7515 Pacific Blvd. Community Outreach & Education, x 4423 Walnut Park, CA 90255 (213) 516-3575
FOR INFORMATION ON THE CURRENT MONTH’S MEETINGS, CHECK CALENDAR OF EVENTS AT WWW.LACARE.ORG. MEETINGS MAY BE CANCELLED OR RESCHEDULED AT THE LAST MOMENT. TO CHECK ON A PARTICULAR MEETING, PLEASE CALL (213) 694-1250 OR SEND EMAIL TO [email protected]. 13 BOARD OF GOVERNORS, BOARD COMMITTEES, PUBLIC ADVISORY COMMITTEES AND REGIONAL COMMUNITY ADVISORY COMMITTEES 2021 MEETING SCHEDULE / MEMBER LISTING
MEETING DAY, TIME MEETING DATES BOARD MEMBERS / & LOCATION STAFF CONTACT
REGION 8 3rd Friday of every other Ana Romo – Chairperson CARSON, month TORRANCE, SAN 10:30 AM PEDRO, (for approximately 2-1/2 WILMINGTON hours) Providence Community Staff Contact: Health Wellness and Jose Rivas Activity Center Community Outreach & Education, x4090 470 N. Hawaiian Ave. Wilmington, CA 90744 (424) 212-5699
REGION 9 3rd Monday of every Tonya Byrd, Chairperson LONG BEACH other month 10:00 AM (for approximately 2-1/2 hours) Staff Contact: Albert Jewish Kristina Chung Community Center Community Outreach & Education, x5139 9801 E. Willow Street Long Beach, CA 90815 (562) 426-7601
REGION 10 3rd Thursday of every Damaris de Cordero, Chairperson EAST LOS ANGELES, other month WHITTIER AND 2:00 PM HIGHLAND PARK (for approximately 2-1/2 Staff Contact: hours) Jose Rivas L.A. Care East L.A. Community Outreach & Education, x4090 Family Resource Center 4801 Whittier Blvd Los Angeles, CA 90022 (213) 438-5570
REGION 11 3rd Thursday of every Maria Angel Refugio, Chairperson POMONA AND EL other Month MONTE 10:00 AM (for approximately 2-1/2 Staff Contact: hours) Frank Meza Pomona Community Community Outreach & Education, x4239 Resource Center 696 W. Holt Street Pomona, CA 91768 (909) 620-1661
FOR INFORMATION ON THE CURRENT MONTH’S MEETINGS, CHECK CALENDAR OF EVENTS AT WWW.LACARE.ORG. MEETINGS MAY BE CANCELLED OR RESCHEDULED AT THE LAST MOMENT. TO CHECK ON A PARTICULAR MEETING, PLEASE CALL (213) 694-1250 OR SEND EMAIL TO [email protected]. 14 Board of Governors Regular Meeting Minutes #297 May 6, 2021 L.A. Care Health Plan, 1055 W. 7th Street, Los Angeles, CA 90017 Members Management/Staff Hector De La Torre, Chairperson Antonia Jimenez John Baackes, Chief Executive Officer Alvaro Ballesteros, MBA, Vice Chairperson Honorable Holly J. Mitchell * Terry Brown, Chief of Human Resources Robert H. Curry, Treasurer Hilda Perez Linda Greenfeld, Chief Product Officer Layla Gonzalez, Secretary G. Michael Roybal, MD, MPH Augustavia Haydel, General Counsel Stephanie Booth, MD Ilan Shapiro, MD * Francisco Oaxaca, MBA, Chief, Communications and Community Relations Christina R. Ghaly, MD Nina Vaccaro, MPH Tom MacDougall, Chief Information & Technology Officer George W. Greene, Esq.* Thomas Mapp, Chief Compliance Officer Marie Montgomery, Chief Financial Officer Noah Paley, Chief of Staff *Absent **All via teleconference (COVID-19) Richard Seidman, MD, MPH, Chief Medical Officer California Governor issued Executive Order Nos. N-25-20 and N-29-20, which among other provisions amend the Ralph M. Brown Act. Members of the public can listen to this meeting via teleconference, and can share their comments via voicemail, email, or text. AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN WELCOME Hector De La Torre, Chairperson, called to order at 2:08 p.m. the regular meetings of L.A. Care Board of Governors and L.A. Care Health Plan Joint Powers Authority Board of Directors. The L.A. Care Board of Governors and the L.A. Care Health Plan Joint Powers Authority Board of Directors regular meetings were held simultaneously. He welcomed members of the public and thanked those who have submitted public comment by voice mail, text or email. Board Members have received in writing the voice messages and written comments that were sent before the meeting. Comments sent before and during the meeting will be read for up to three minutes. Public comments on any topic that are not listed on the Agenda will be heard at the Public Comment section of the Agenda, and comments on the items listed on the Agenda will be heard before the item is discussed by the Board. Submission of public comment must be sent before public comment period for an item. For those with access to the internet, the materials for today’s meeting are available on the L.A. Care website. If you need information about how to locate the materials, please let us know.
DRAFT 15 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN APPROVAL OF There was no public comment for this item. The agenda was approved as submitted. Unanimously MEETING approved by roll call. AGENDA 8 AYES (Ballesteros, Booth, De La Torre, Ghaly, Gonzalez, Jimenez, Roybal and Vaccaro)
PUBLIC Text April 21, 8:47 am COMMENT General public comment 5-6-21 Carolyn Rogers Navarro I witnessed no issue with Medi Cal prior to joint initiatives and HMOs being assigned, now I’m seeing serial abuse of patients just trying to get appointments or access when they call MSOs, even with verified diagnosis. Also with these HMOs I observe more and more homeless and I don’t believe it’s a coincidence, how many of these people were denied treatment for mental illness, substance abuse or general health by their Medi Cal HMO, how many of these people were ruined financially or died because of blocked care? Opportunists are exploiting Medi Cal instead of fulfilling services. LA Care is not fulfilling services, people are very unhappy with your agency. Text April 21, 10:01 am, not self-identified Add to last comment 5-6-21 in other words LA Care, stop knowingly forcing enrollees to call
CONSENT PUBLIC COMMENT AGENDA ITEMS Via Email on May 6 12:20pm by Anonymous 4/1/2021 Board of Governors Meeting Minutes. 3.3.1 Preservation of Records. Board of Governors Meeting Minutes of 4/1/2021. It appears that you have missed some public comment/s in the minutes that were made by email, before close of topic, and the meeting. As well as, it seems you reframed some of the Board Member statements, i.e.; De La Torre’s public comment ADA accommodation request, and Ms. Booth’s comments regarding a closed session item (Baackes’ s salary). Please review the audio. Preservation of Records. Question – Is the requester notified prior to record destruction? If so, when is the requester notified of possible record destruction date, Also concerned that you are omitting 3.3.1 as it is removing a level of internal oversight.
Board of Governors Meeting May 6, 2021, Page 3 of 26 DRAFT 17 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Via telephone May 6 at 1:02pm by Elizabeth Cooper Bullet two on the consent agenda. I would like an explanation of motion EXE 100.
Consent Agenda Items: Minutes of April 1, 2021 Board of Governors Meeting Revisions to Legal Services Policy LS-007 (Legal Hold of Records, Documents; Preservation of Evidence) Motion EXE 100.0521* To approve the revisions to the attached Legal Services Policy & Procedure No. LS- 007 (Legal Hold of Records, Documents; Preservation of Evidence) and delegate authority to General Counsel or designee to make any non-substantive or technical Consent Agenda items changes. were unanimously Quarterly Investment Report approved by roll call. Motion FIN 100.0521* Unanimously To accept the Quarterly Investment Report for the quarter ending March 31, 2021, as approved by roll call. submitted. 8 AYES Microsoft Agreement Renewal Motion FIN 101.0521* To approve a three year Microsoft Enterprise Agreement for the purpose of renewing licensing and support of mission critical Microsoft products from May 31, 2021 to May 31, 2024 in an amount not to exceed $6,620,000.
CHAIRPERSON’S PUBLIC COMMENT REPORT Via text, April 8, 9:51 am, from Carolyn Rogers Navarro Public comment 5-6 agenda chairperson report Carolyn Rogers Navarro Stop using the special needs community to make yourselves look good! I have located special needs people who you have failed terribly including my daughter , when the families tried to alert you that Synermed who also contracted with LA Care using a front company which was THEM was violating their rights, you continue to do the same things Synermed did to enrollees, ignoring or undermining grievances, retaliating for grievances, delaying action taken on grievances, enabling abuse against special needs enrollees, you’re a waste of tax dollars, a danger to the special needs community , not an asset! Your management and board does not represent the community you claim to serve, all your management does is cover up your lies to the public while you pay news stations to make you look good to sell more policies while you treat your existing members like shit and are not capable of providing service to Board of Governors Meeting May 6, 2021, Page 4 of 26 DRAFT 18 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN them! Read your reviews online, all of them are true, except for the occasional fake looking review that look like an employee wrote them! You have no business serving autism spectrum enrollees, my dead daughter was autistic and you acted defensive about the fraud I discovered and alerted you to instead of helping her! Much of your management needs to be fired! Via telephone May 6, 1:02 pm from Elizabeth Cooper Chairperson De La Torre thank you for your leadership as the chairperson of the Board of governors, but I am deeply impressed about the involvement of the RCAC members that participate during public comment but I would like to see more information about what the CCI councils are doing. And I hope that it will be more transparent for consumers and family members that have not been able to participate. Since the disabled community are part of the L.A. Care family. And also I would like to ask you Mr. De La Torre what are your thoughts on the recall? This will help the members and public be more informed about your outlook as it relates to health care, etc. Chairperson De La Torre reported that L.A. Care previously committed to providing reports to the Executive Consumer Advisory Committee (ECAC) about the Coordinate Care Initiative (CCI) so members will know what is taking place since those meetings were restructured last year. There will likely be changes with the California Advancing and Innovating Medi-Cal initiative which is mandated to start next year. John Baackes, Chief Executive Officer, reminded the Board that the CCI Councils were replaced with the Cal Medi-Connect Advisory Committee. L.A. Care will report on those meetings to the Board or to ECAC members, who can in turn report to the Regional Community Advisory Committee (RCAC) members. L.A. Care’s performance is regularly reviewed by Centers for Medicare and Medicaid Services (CMS), and the scores are much stronger that other health plans in California. L.A. Care is constantly looking to improve what we do for our members. Chairperson De La Torre repeated his statement made at the Executive Committee meeting, that he is proud of L.A. Care staff for arranging for the vaccination events in conjunction with the USC School of Pharmacy. He commended the staff that has volunteered on weekdays and weekends, to help with these complex events. He has been to several, and it is not easy to stand out in the sun all day, with cars coming through with people getting vaccinations, and to be on the lookout for reactions. He thanked staff and administration for putting the events together, and to rank and file staff members who volunteered at the various events, noting it is really going above and beyond their work roles to provide that service in this very troubling time. The
Board of Governors Meeting May 6, 2021, Page 5 of 26 DRAFT 19 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN United States population is under 33% vaccinated, and it may be higher in California, but still nowhere near when it needs to be to end the COVID-19 pandemic.
CHIEF PUBLIC COMMENT EXECUTIVE Via text, April 13, 11:54 am OFFICER REPORT 5-6-21 board meeting, chief officer report. Carolyn Rogers Navarro, I only recently realized a comment made at a board meeting that west published was a HIPAA violation, my child rights were violated in so many ways that it’s literally taken me years to sort out what you perpetrators did. I didn’t like the comment before but didn’t make the HIPAA connection, I have repeatedly asked LA Care for a copy of the record where my daughters case is mentioned by a board member publically and LA Care will not give it to me. I have also asked for copies of the repeated emails I sent to the assigned contact person trying to get assistance for my autistic daughter who ended up dying and LA Care will not give me copies! I saved the emails I sent, what is wrong with your agents ignoring emails from patients they are assigned as contacts to. I made state and federal HIPAA complaints. I have requested these agencies take into consideration my daughter was profoundly disabled and I was doing my best to assist my daughter but could move fast enough for you crooks!
Via Email on May 6 12:20 pm from Anonymous #5 – ANNONYMUS, CEO Report and Vision Report VISION REPORT John Baackes, clearly you are not upholding your mission statement. If you John Baackes would have listened to Members and Employees, and each grievance I have made; which delineates LA Care’s systemic problems, and possible solutions as you and former Grievance and Appeals Director LisaMarie Golden promised to do more than 2 years ago; and still have not done, many of the items on your Vision Report would have already been taken care of. Instead, it has been seven years of the same poor access to my health care. There have been many problems in my assignment to a Care Manager at LA Care and have incorrectly terminated and/or excluded me from services and care I qualified for based on LA Care’s Case Management criteria. Recently I was re-assigned to a Care Manager and learned LA Care has a new telephone system and protocols which may jeopardize my privacy, and made it more difficult for me to contact my Care Manager for services.
Board of Governors Meeting May 6, 2021, Page 6 of 26 DRAFT 20 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN CEO REPORT My personal experience is that the state of affairs is not how you are presenting. I have filed legitimate grievances, which you, John Baackes have personally found issue with the amount of grievances in the past. I agree, there have been too many, but for different reasons, which is LA Care and John Baackes are responsible due to lack of responsiveness, resolution, as well as obtuse responses. Why should I have to make public statements about my private health care, and there is still little to no resolution. All you had to do was review my initial grievances, actually resolve them, and systemic problems t likely would have gone away. Many grievances are related to issues that can be resolved through established protocols (Three minutes expired for this submitter and the rest of the comments from this submitter for this Agenda item will be added at the end of these meeting minutes.)
Via Telephone May 6 1:02 pm by Elizabeth Cooper Mr. Baackes I would thank you for your leadership and your position as Chief Exec officer. I would welcome your encouragement of your staff to be always reminded that the consumer members of L.A. Care are very vital to organization and your comments regarding my statement would welcomed
Mr. Baackes reported (a copy of his written report may be obtained by contacting Board Services): He thanked Ms. Cooper for her comments. He has said many times, and will say again, as he looks at other public health plans in California, it appears that L.A. Care has the most robust member involvement through the Regional Community Advisory Committees (RCACs) and the Executive Community Advisory Committee (ECAC). The discussions at many of these meetings are very good, as the RCAC and ECAC members are not at all shy about making suggestions and pointing out areas for improvement. He reported that based on a suggestion from ECAC, L.A. Care has now distributed 135,000 masks to members identified as high-risk. There are also masks available for visitors to the Community Resource Centers (CRCs). He thanked ECAC members for encouraging L.A. Care to do that. Today is National Nurses Day and the first day of National Nurses Week. The pandemic has made the role of Nurse far more visible to the general public because of their front-line presence in acute care hospitals and emergency rooms, as well as the nurses that work at L.A. Care to provide care management to our members. We are greatly indebted to the nurses in Los Angeles County. He knows for Dr. Ghaly, the nurses at the public hospitals have seen a bigger share of COVID-19 patients than most of the hospitals around the Board of Governors Meeting May 6, 2021, Page 7 of 26 DRAFT 21 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN County, and we are very thankful for their dedication and focus. The 2021 theme for National Nurses Week is, Nurses: A Voice to Lead. He congratulated and acknowledged all nurses at L.A. Care and across Los Angeles County. L.A. Care’s enrollment has continued to grow. In May, it will likely be over 2.4 million members. This is partially due to the suspension of the process for redetermination of eligibility for Medi-Cal, due to the pandemic and public health emergency. The public health emergency is expected to last until the end of 2021. L.A. Care is advocating a modification by California and by the federal government of the normal process for redetermination to recognize that a tremendous amount of work would be necessary to conduct a retrospective redetermination process. The California Department of Health Care Services (DHCS) has appointed a workgroup, which will include two L.A. Care representatives. Phinney Ahn, Executive Director, Medi-Cal, will be one of the representatives. Ms. Ahn works closely with the Los Angeles County Department of Public Social Services on Medi-Cal enrollment. The workgroup will develop a modified redetermination process. L.A. Care’s voluntary enrollment is proportionately higher than our commercial plan competitor, Health Net, by a 10:1 margin. This will be reflected in L.A. Care’s growing market share. At this time L.A. Care has 69% of the Medi-Cal market in Los Angeles County, and L.A. Care continues to get 69% of the default assignment of members. The default assignment rate is based on quality scores. L.A. Care’s financial position is improving as Marie Montgomery, Chief Financial Officer, will report later in the meeting. Staff is making advances on the “big five” information technology (IT) initiatives that should help L.A. Care continue as a high functioning health plan with increased efficiency and better accuracy in its reporting. Recently a portion of a new finance system, SAP, was installed for billing/collection for L.A. Care Covered members. For these members, L.A. Care is paid by members for their premium payment after the federal subsidy is applied. A component of the new care management platform, Syntranet, was also installed and is functioning for members enrolled using the directly- contracted provider network. These are both improving operations and are very important for continued operations, particularly as L.A. Care’s membership increases. At the Executive Committee meeting, Mr. Baackes reported about challenges for L.A. Care in the expansive programs proposed by DHCS for Medi-Cal plans. L.A. Care is not opposed to the new CalAIM proposal, which includes Enhanced Care Management (ECM), In Lieu of Services (ILOS), and Population Health Management (PHM). These new programs are based on waiver programs that will wind down at the end of 2021, Health
Board of Governors Meeting May 6, 2021, Page 8 of 26 DRAFT 22 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Homes and Whole Person Care. The new programs will require a tremendous amount of work to implement in eight months’ time, and many of the details for the initiatives have yet to be resolved, including the rates. He thanked Dr. Ghaly for cooperation from Los Angeles County Department of Health Services, in the transition of services under Health Homes and Whole Person Care to the new benefits. Another issue on the horizon is the proposed carve out of prescription drug benefits for Medi-Cal. The change has been delayed indefinitely and no implementation date has been set. A conflict of interest arose when Magellan, the third party vendor selected by DHCS, was acquired by Centene, a national health plan. The request for proposal (RFP) used in selecting Magellan included a prohibition for the selected third party vendor from being owned by a health plan with Medi-Cal enrollment in California. The resulting delay in implementation of the pharmacy carve out is adding to the administrative burden of Medi-Cal plans. L.A. Care is advocating for a new RFP process. A proposal being discussed for the Federally-Qualified Health Centers (FQHCs) continues the trend of rates being adjusted to include funding which formerly was paid directly to providers. The FQHCs receive direct funding from DHCS. It is proposed that funding will be paid to health plans in the capitated rates. The county-wide averaging process, which is opposed by public health plans, compares the rates of both plans in a county with the two plan model and averages the payment. Last year this resulted in $180 million in additional funding paid to L.A. Care’s commercial competitor, Health Net. L.A. Care formally objected to the policy of county wide averaging and is working with state legislators to address this egregious process. Mr. Baackes asked Richard Seidman, Chief Medical Officer, to report on the COVID-19 vaccine events. Dr. Seidman reported that L.A. Care is executing its mission through the COVID-19 vaccine events, held in partnership with Blue Shield Promise and USC School of Pharmacy. L.A. Care’s logistics vendor did an incredible job in planning the events at a variety of sites. While we originally had 16 events planned to distribute 16,000 doses of vaccine, after the first week, and after four events in early April with over 3,000 vaccinations, the Centers for Disease Control (CDC) temporarily suspended administration of the Johnson & Johnson vaccine. L.A. Care cancelled some events. When the suspension was lifted, L.A. Care continued with two events and vaccinated another 500 people. Dr. Seidman commended Yana Paulson, Chief Pharmacy Officer, and Francisco Oaxaca, Chief Communications Officer, and the staff at the Community Resource Centers and Communications teams, along with many people at L.A. Care and Blue Shield Promise for their work. Board of Governors Meeting May 6, 2021, Page 9 of 26 DRAFT 23 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Dr. Seidman reported that over 560,000 L.A. Care members eligible for the vaccine have received at least one dose of the vaccines available. L.A. Care continues to seek opportunities to reach members with encouragement to get a vaccine, and will work to get as many members as possible vaccinated, as quickly as possible. Chairperson De La Torre noted that L.A. Care will continue to promote information about any events to provide COVID-19 vaccinations. Chairperson De La Torre responded to the question about elections by Ms. Cooper. He clarified that L.A. Care can take positions on ballot measures, but cannot take a stance on individuals for elected office. L.A. Care will encourage voter turnout. He thanked Ms. Cooper for her comment. Board Member Roybal asked about L.A. Care’s work with providers on coordinating post COVID-19 care for L.A. Care members. Dr. Seidman responded that L.A. Care is seeking to learn about what contracted providers are doing and to determine what the plan can do to assist providers and members. Board Member Jimenez asked about the committee to discuss Medi-Cal renewals. Los Angeles County Department of Public and Social Services (DPSS) has developed a process through negotiation with CMS, for processing Medi-Cal renewals. Mr. Baackes responded that Jacey Cooper, Chief Deputy Director & State Medicaid Director, Health Care Programs at DHCS announced the workgroup. He offered to send to Member Jimenez the information about the workgroup and the input Director Cooper is seeking from health plans. Director Cooper asked for two plan representatives for the committee. 2nd Quarter FY 2020-21 Chairperson De La Torre referred Board Members to the written report included in the meeting Vision 2021 Progress materials. Report Grants and Sponsorship Chairperson De La Torre referred Board Members to the written report included in the meeting Report materials.
ADVISORY COMMITTEE REPORTS Executive PUBLIC COMMENT Community Advisory Via email May 6, 12:21 pm, from Anonymous Committee (ECAC) #6 - ANNONYMUS 3/10/2021 Executive Committee Advisory Meeting Minutes
Board of Governors Meeting May 6, 2021, Page 10 of 26 DRAFT 24 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Please review the audio on the topic of inclusion, is that a typo on page 125, first paragraph; regarding a “colored” community? Via telephone May 6 at 1:02 pm from Elizabeth Cooper To the two consumer advisory committee reps at la care, Hilda Perez and Layla Gonzalez, I thank you for your leadership on the Board of governors to represent members. I do hope that you look into the issue of the CCI councils to create more transparency for those consumer members that are disabled and care givers of disabled members. And looking forward to those concerns being addressed. Thank you Board Member Layla Gonzalez, Member Advocate Representative, reported that ECAC met on April 14. Board Member Gonzalez reported: Sent her condolences to those who have lost someone due to COVID-19, and added not to forget about the thousands that have passed away. She has recently gotten a first dose and plans on getting the second later this month. She encouraged everyone to get vaccinated when they can to protect their loved ones. Mr. Baackes gave an update regarding the temporary suspension of the Johnson & Johnson vaccine. ECAC would like to thank Mr. Baackes for his help with the distribution of face masks to members and the community. He also gave an update on the status of the Medi- Cal redeterminations, proposed prescription drug carve out, and the CalAIM program. Dr. Seidman reported that efforts are still underway to vaccinate members that are unable to leave their homes and spoke about the L.A. Care COVID-19 Vaccine clinics. Auleria Eakins, EdD, Manager, Community Outreach & Engagement, provided update on CRCs. The Wilmington CRC is due to open next month. The El Monte and Norwalk sites are still under construction. RCAC members will be holding discussions on how to address hate against the Asian and Asian American community beginning in May. ECAC will be receiving presentations on Colorectal Cancer in May and Urgent Care Access and Controlling Blood Pressure in June. ECAC created an ad hoc committee to provide recommendations on reading public comment before or during the Agenda items. (Board Member Perez joined the meeting.) Lynne Kemp, Health Education Program Manager, and Naoko Yamashita, Interim Manager, Cultural and Linguistics, provided information on the Population Needs Assessment. Members discussed member health needs and helped identify health disparities, gaps in health education and quality improvement programs.
Board of Governors Meeting May 6, 2021, Page 11 of 26 DRAFT 25 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Board Member Gonzalez thanked all of the RCAC members that have attended the BOG and ECAC meetings either by phone or zoom throughout the year during this pandemic. She encouraged them to continue to give their public comments and to not hesitate to ask questions. Feedback is needed in order to make improvements. She reminded everyone that May is Mental Health Awareness month. Especially with the pandemic, and the need to focus on TOTAL health which includes mental health. She expressed that she has her difficult days and it takes much effort to get through the day. She added you are not alone. She thanked Ms. Cooper for her comments and wished her and all mothers a Happy Mother’s Day. Board Member Perez thanked Board Member Gonzalez for her reports. She noted that Moms do a lot of work to keep families healthy, and are pillars for the well-being of the family. She saluted all Moms, and recognized the Moms on the Board. She stated that the most challenging role for women is Mom. Board Member Booth noted that a comment was made about the use of the word, “colored” on page 125. She thought the reference may have been to “people of color”. Chairperson De La Torre thanked Board Member Booth for her comment. He assured Board Members that staff reviews the comments made during meetings and will make corrections if needed. Technical Advisory PUBLIC COMMENT Committee Via telephone May 6 at 1:02pm from Elizabeth Cooper Thank you Dr. Seidman for the information regarding the COVD-19 vaccine that you are sharing with the members. It impacts their knowledge of the issue. Thank you Dr. Seidman thanked Ms. Cooper for her comment. He reported that the Technical Advisory Committee (TAC) met on April 29: Mr. Baackes reported on the COVID-19 pandemic’s impact on L.A. Care and its members. He gave a Chief Medical Officer report. The committee received an update on CalAIM from Cynthia Carmona, Senior Director, Safety Net Initiatives, and Alison Klurfield, Director, Safety Net Programs & Partnerships, Safety Net Initiatives. They spoke about new Enhanced Care Management benefit and In-Lieu-Of Services and how they will advance and expand case management and non-traditional services for members. L.A. Care is expected to lead the way in Los Angeles County, with the Department of Health Services, other county agencies, plan partners. L.A. Care’s competitor, Health Net, is looking to L.A. Care to set the tone. There was a robust
Board of Governors Meeting May 6, 2021, Page 12 of 26 DRAFT 26 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN discussion with ECAC members and great feedback was received. The feedback will help L.A. Care plan the program and inform interactions with various stakeholders and regulators with regard to the new benefits.
BOARD COMMITTEE REPORTS Executive Committee The Executive Committee met on April 26. A copy of the approved meeting minutes can be obtained by contacting Board Services, and is available on the L.A. Care website. Government Affairs Cherie Compartore, Senior Director, Government Affairs, reported: Update Last week the President announced America’s Family Plan, which is a policy proposal to be developed by Congressional leadership. The proposal includes: permanently extending the Affordable Care Act premium tax credit, which lowers the cost by about $50 per month for those who buy health care coverage in Covered California. expanding several of the school meal programs. providing two years of community college funding. providing two years of universal pre-school for three- and four-year olds. child care income tax credits. making substantial improvements to the federal paid family and medical leave program. Congressional representatives will begin discussions on this proposal on which provisions will be in a final bill to be considered by the House of Representatives and the Senate. L.A. Care is engaged on this issue and has begun reaching out to Congress members representing Los Angeles County. Additional information will be provided at future meetings. The Federal Communications Commission (FCC) announced that May 12, 2021 will be the start-up date for eligible households to apply for the new temporary federal Emergency Broadband Benefit Program. This program aims to relieve families struggling to get online because of the COVID-19 pandemic. It will assist families in accessing the internet to carry out their day-to-day life and attend virtual classrooms, take advantage of telehealth services, and seek new employment opportunities. This benefit will provide significant help to eligible people with disabilities (including developmental), mental health needs, seniors and their families and others in low-income households. It can also help eligible people who provide direct care and other supports and services, people who work in community based organizations who provide services, or who coordinate or determine eligibility for services including eligible people who work in non-profit regional centers.
Board of Governors Meeting May 6, 2021, Page 13 of 26 DRAFT 27 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN The Emergency Broadband Benefit will provide: Up to $50/month discount for broadband services. Up to $75/month discount for broadband services for households on Tribal Lands. A one-time discount of up to $100 for a laptop, desktop computer, or tablet purchased through a participating provider. This benefit is limited to one monthly service discount and one device discount per eligible household. More information will be provided at future meetings. In addition to the federal proposal above, California legislative representatives have introduced several bills to expand broadband access and reduce the cost in rural and low-income areas. California’s Governor will release changes to the January State Budget Proposal, called the May Revise, next on May 14. The May Revise will take into consideration the revenue and environmental changes that occurred since January. The legislature will consider his changes in approving the new State Budget. There is an unexpected $17 billion revenue surplus. Because of a delay in implementing the Golden State Stimulus package, which expanded the earned income tax credits for low-income residents, there was a one-month delay in the deadline for filing federal tax forms with the Internal Revenue Service (IRS). The $17 billion revenue surplus may be adjusted based on the IRS filings. Government Affairs will provide to Board Members a written summary of the key provisions of the May Revise which may impact L.A. Care prior to the June Board Meeting. Ms. Compartore noted that a public comment was made requesting information about the recall of California’s Governor. A similar request was made at the April ECAC meeting. Information has been provided to Community Outreach and Engagement (COE) staff and will be passed along to members at the May ECAC meeting. Government Affairs staff is working on providing information about L.A. Care’s engagement in legislative policy, and will share the document with Board Members and staff. Approve Funding to Mr. Baackes noted that L.A. Care’s Elevating the Safety Net (ESN) program currently provides support Charles R. scholarships to 12 students at the Charles R. Drew University School of Medicine and Science Drew University of (CDU), and four more will be announced in June. L.A. Care has been approached by CDU Medicine and Science regarding funding support for a new four-year medical degree program aimed at addressing the physician workforce shortage in South Los Angeles. The new independent medical education program (IMEP) will admit 60 medical students annually starting in the summer of 2023. This program will complement, and not replace, the current CDU 40-year partnership with the
Board of Governors Meeting May 6, 2021, Page 14 of 26 DRAFT 28 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN University of California, Los Angeles (UCLA), and that successfully trains 24-28 medical students per year in the CDU/UCLA Medical Education Program. Mr. Baackes invited Cynthia Carmona, Senior Director, Safety Net Initiatives, to describe the request. Ms. Carmona summarized longstanding plan at CDU to establish an independent medical education program. Currently 24-28 medical students are trained by CDU in a partnership with UCLA, and UCLA supports the CDU efforts to establish an independent program that would raise the potential training opportunities to 88 students. The establishment of an independent program at CDU was called out in the California Future Health Workforce Commission report published in 2019. That report was used in developing the founding principles for L.A. Care’s Elevating the Safety Net initiatives. CDU has raised $11,975,00.00, from institutions such as the Kaiser Foundation Hospitals, Cedars Sinai and the California Endowment, toward the five-year, $75 million comprehensive campaign. To further support the fund raising efforts, CDU has been working with members of the California legislature and the U.S. Congress to seek appropriations or an earmark for the IMEP as well as inclusion in a higher education bond measure; has hired a major gift officer to secure major gifts to the university; and has planned meetings with several foundations to confirm additional funding support. CDU is seeking a one-time $5 million grant from L.A. Care to support four key developments: Enhance the current Simulation Center to offer medical training activities for students and faculty; Establish a center for faculty development to focus on the recruitment, retention and development of faculty; Establish a service learning program for medical students to offer certifications as emergency medical technicians, community health workers and patient navigators; and Develop a community health pre-matriculation training experience focused on professionalism and wellness activities for medical students. The IMEP builds on L.A. Care’s current funding support for CDU under the ESN initiative, Medical School Scholarship Program and Residency Support Program. L.A. Care considers this program well-aligned with the ESN guiding principles of increasing health access, promoting equity and cultural competence, as well as building a premier health care workforce. L.A. Care’s ESN programs seek to increase access to health care for our members in Los Angeles County and improve equity and cultural competence among our provider network. For this reason, staff is recommending to support this endeavor through a
Board of Governors Meeting May 6, 2021, Page 15 of 26 DRAFT 29 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN one-time $5 million grant to CDU. At a previous meeting, staff was requested to gather data about student residency. The data for CDU medical students shows that: 40% are Los Angeles County residents, 44% are Spanish speakers, and 50% placed in Los Angeles County for residency. 62% of students in residency training are staying to practice in Los Angeles County. All these numbers are relatively high in comparison to other institutions with which L.A. Care is doing business. Mr. Baackes added that it is proposed that this funding come from the ESN funds approved by the Board and set aside from L.A. Care’s unassigned reserves. To date, just under $100 million in funding has been committed for ESN programs. There are funds available for this grant. Board Member Vaccaro suggested that CDU work with Martin Luther King Jr. Community Hospital for residency positions. Ms. Carmona offered to discuss it with CDU representatives. Board Member Curry asked about funding for innovative infrastructure as opposed to redundant infrastructure, and asked if residency training may be a better investment. He noted that his question is intended to consider the opportunities, and is not intended to cast the request in a negative light. Mr. Baackes responded that the previous request from the Keck Institute at Claremont Colleges was for an innovative program. In this case, by expanding the potential pool of doctors from 28 to 88 and with CDU’s long history of focusing on students from South Los Angeles and students of color, this is perhaps not innovative in teaching techniques, but it is innovative in its focus on developing a supply of health care providers with diverse backgrounds that matches the demographics of L.A. Care members. The four key developments Ms. Carmona spoke about are innovative in their approaches. Mr. Baackes recommends this primarily because of the cohort of students which they plan to attract, which he thinks is critical to the safety net in Los Angeles County. Mr. Curry stated that is why Emanate Health started a new 30-person program for residency in family medicine, to promote safety net coverage. Three classes of students have graduated and 80% have remained in the community. He wondered if it would be more beneficial to fund residency slots and medical school scholarships.
Board of Governors Meeting May 6, 2021, Page 16 of 26 DRAFT 30 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Board Member Ghaly thanked L.A. Care for bringing this forward. The Los Angeles County Department of Health Services (DHS) has partnered closely with CDU on planning this program, and is working on identifying additional opportunities for philanthropic investment for the medical school as well as opportunities for the Whole Person Care program to potentially fund expansion of the program. She noted that both infrastructure and training opportunities are needed. This program expands medical school openings to 88 students. CDU has a reputation for drawing students from East and South Los Angeles areas; people who know the communities and are committed to staying and working in those communities. CDU has a tremendous track record for bringing in a high rate of individuals to be physicians who are people of color, who speak the languages in those communities, and who are committed to working in those communities on a long-term basis, and those are reasons why this is so important. More physicians of color are needed, more physicians dedicated to communities like South Los Angeles and other jurisdictions that have low rates of physicians who are really committed to working in those areas. All too often, local medical schools recruit students from all across the United States, and those students go to residency programs and eventually take jobs all across the United States; they don’t stay in Los Angeles, and certainly don’t stay in South Los Angeles. Board Member Ghaly noted that residency slots are needed to increase this workforce. DHS fully funds and partners with CDU on two residency training programs, one for family medicine and one in partnership with the Department of Mental Health for psychiatry. DHS is planning to continue to expand residency training programs in partnership with CDU. Residency scholarships are important and helping CDU to become fully accredited independent medical school with the expanded residency slots is very needed. Mr. Baackes reported that L.A. Care is currently supporting nine residency slots. Working to fund the residency programs is extremely complicated and takes a lot of staff time to manage. Ms. Carmona added that the residencies are complicated because additional planning must be done by the institutions to accommodate the students. Each residency requires accreditation approvals, faculty and infrastructure. L.A. Care works hard to ensure that funding makes a difference for the residency program. Establishing a residency slot requires an assurance of stability to maintain the position over time. Board Member Booth proposed an amendment to the motion to include two priorities, or non- binding commitments, in providing funding for CDU, to be certain that L.A. Care’s aspirations are realized: 1. A commitment to serve in the Los Angeles County safety net when the residency is completed, and Board of Governors Meeting May 6, 2021, Page 17 of 26 DRAFT 31 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN 2. Students who are fluent in one of the languages of non-English speaking patients should be given priority over potential students who do not have that ability. She also suggested that more data about the physicians that CDU trains would be helpful in deciding on funding for the programs. Chairperson De La Torre noted that tracking students after the residency ends is difficult. He wrote legislation for the Steven M. Thompson Physician Corps Loan Repayment Program (STLRP) for the California legislature, and even that program does not have data on graduates, although there is anecdotal evidence that some did remain in the community. He suggested that L.A. Care could ask for the data, and he agreed that it is important to understand the results of funding. Non-binding requests could be made to track the location of graduates. Board Member Ghaly asked for clarification of the language for the amendment. Board Member Booth provided the following: High Priority 1: Consider requiring a formal commitment from students to serve in the Los Angeles County safety net once they have completed their residency. High Priority 2: Students who are fluent in one of the languages necessary to communicate with non-English speaking patients will be preferred over otherwise similar candidates for the medical college. Board Member Ghaly asked about priority 1, which is related to residency while the motion before the Board is to support the infrastructure for a new medical school. Board Member Booth clarified that the students could complete a residency elsewhere, but would be asked to commit to serving in the Los Angeles County safety net after the residency has been completed. Board Member Vaccaro noted that the funding would be for developing the infrastructure of the school and is not directed toward individual students. She asked how we could ask for a commitment if the funding is directed toward the school. Board Member Booth stated that a suggestion could be made to the school: Thank you for respecting the L.A. Care Board of Governors’ two high-priority items as potential students are reviewed as candidates for acceptance to the medical college. Board Member Ghaly commented that she, in part, loves this school and its track record, in that they are clearly committed to the community, to recruiting and identifying medical students and residents who are committed as included in the amendment. She stated that she cannot support the amendment because it sets up an impractical expectation for the school and the residency program. It also seems to set a double standard because similar expectations are not imposed on students or residents at other local schools, some of which have a much worse track record for recruiting and training individuals to go into underserved areas despite soliciting and Board of Governors Meeting May 6, 2021, Page 18 of 26 DRAFT 32 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN receiving funding under that guise. Board Member Ghaly is not comfortable with imposing the requirement on a school that is already doing an amazing job. Board Member Ghaly respects the desire inherent in Board Member Booth’s amendment. Board Member Perez suggested that language should not be the only marker, as it is important to recruit Black students and residents for the residencies. Board Member Roybal stated that since funding is for the infrastructure of the new school, it may not be appropriate to make these requests for funding that does not go directly to students or residents. The funding is to help a medical school with a great track record to expand their class for incoming medical students, so that they can provide more services to the populations that include L.A. Care members. Board Member Curry asked if L.A. Care could link the $5 million in capital funding to a residency program at Federally Qualified Health Centers (FQHCs) with a student commitment to continue to serve the safety net in Los Angeles County. He invited Board Member Ballesteros to comment on his suggestion. Mr. Baackes noted that the 12 scholarships currently funded through ESN cost about $2.4 million. L.A. Care proposed funding these scholarships, and in discussions with both schools L.A. Care recognized that the schools have the expertise to identify students that are likely to remain in Los Angeles County and will continue to serve in the safety net of providers. At the time, the Board did consider requirements for the students to remain in Los Angeles County, and eventually determined it was not feasible. The request under consideration is different because it came to L.A. Care from CDU, as a request to help build the infrastructure to start an independent medical education program to support CDU’s mission. Board Member Ballesteros commented that a better job can be done to promote working in the FQHCs with the potential for benefits such as medical school loan repayment and other compensation that may be available. There is always an opportunity to enhance visibility for these safety net positions to attract physicians. Board Member Vaccaro commented that in development of the Kaiser Medical School, Community Clinic Association of Los Angeles County worked closely with Kaiser to make sure there were community health rotations and partnerships with the FQHCs created for those medical students. In a prior role she worked with CDU and CDU has strong relationships with FQHCs in the South Los Angeles area. She is confident that CDU will reach out to FQHCs to be part of the actual academic learning of students in the medical school. There is continuity in getting early exposure to the FQHCs and then the FQHCs providing additional opportunities
Board of Governors Meeting May 6, 2021, Page 19 of 26 DRAFT 33 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN for residency slots. It is challenging for FQHCs to provide those rotations for medical residents as there are limited resources to oversee students. It is possible, however, and CCALAC works closely with the workforce team to create those pipelines. A motion to amend was not approved by Board Member Booth noted that the funding to increase the number of physicians serving in roll call. 2 AYES the safety net in Los Angeles County. Her amendment is a suggestion to request that the (Booth, Curry), school to consider having the students sign an agreement to provide care in the Los 6 NAYS (Ballesteros, Angeles County safety net at the end of the residency. A second priority would be to De La Torre, Ghaly, consider that those who are fluent in a language other than English would be given a Gonzalez, Roybal and higher priority that an otherwise similar candidate. The information about continuity is Vaccaro) anecdotal, and she thinks it is likely true. 1 ABSTENTION Board Member Roybal commented that when he attended medical school, many students found (Perez) their preferred type of practice as they rotated through their residency program. It may not be realistic to ask the school to request a commitment from the students prior to experiencing residency. He thinks L.A. Care would be best served by responding with funding as it was requested. There are many ways that L.A. Care can work on trying to improve and encourage people to work in the safety net, and L.A. Care should continue to do that in a coordinated way with whomever wants to work with L.A. Care. He stated that L.A. Care should stick to the intent of this request, to develop the badly needed infrastructure so that CDU, Los Angeles County, and graduate and undergraduate medical education, can continue providing people to work in the safety net. L.A. Care can do other things in other ways to address the issues raised Unanimously by Board Member Booth. approved by roll call. 9 AYES (Ballesteros, Motion EXE 101.0521 Booth, Curry, De La Authorize an expenditure in the amount of $5 million for the Charles R. Drew University Torre, Ghaly, of Medicine and Science (CDU) to support the development of an independent medical Gonzalez, Perez, education program (IMEP) in South Los Angeles for the period of July 1, 2021 through Roybal and Vaccaro) December 31, 2027. Finance & Budget PUBLIC COMMENT Committee Via telephone May 6 at 1:02 pm from Elizabeth Cooper Chairperson of the financial committee. I would like for you to continue to give your support to the RCAC members so they are able to continue to participate through their voices. Also I would like to encourage you as a RCAC member to encourage your committee to continue to support la care staff. Text received 3:55 pm May 6, not self-identified
Board of Governors Meeting May 6, 2021, Page 20 of 26 DRAFT 34 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Finance and budget committee public comment 5-6-21 if you don’t have enough doctors, why do you keep adding and soliciting members at your resource centers? Committee Chair Curry stated that it is clear that L.A. Care is not passive in wanting to cure the problem of a physician shortage but is in front of the issue. L.A. Care is supportive of addressing the issue and is investing money to make a difference. L.A. Care is to be commended for its commitment and its initiatives aimed at improving the health care safety net in Los Angeles. He reported that the Finance & Budget Committee met on April 26. (A copy of the approved meeting minutes may be requested contacting Board Services.) The Committee received the monthly investment transactions reports and the quarterly internal policies reports. Chief Financial Officer Ms. Montgomery reported: Report Membership March 2021 membership is 2,381,458, which is 9,996 members favorable to the 3+9 forecast and 27,000 member months favorable to the year-to-date (YTD). The suspension of eligibility redetermination for Medi-Cal continues to drive the membership favorability in March. Membership for LACC increased to 94,000 members in March, just shy of the forecast of 95,000 . As open enrollment has been extended, there may be another small increase in April. Consolidated Financial Performance Month of March 2021 net surplus is $21.6 million, $28 million favorable to the 3+9 forecast. This is driven primarily by operating margin being favorable by $33 million. This favorability is driven by incurred claims favorability of $30 million versus the forecast. March 2021 was a high paid claims month with a longer month in terms of calendar days and work days. Some of this favorability relates to moving more members from shared risk to dual risk arrangements that resulted in unfavorable $4.2 million of cap expense. Other variances for the month include favorability due to a risk adjustment factor (RAF) from 0.76 to 0.80 for L.A. Care Covered LACC). The net favorability is $10.7 million Pharmacy is unfavorable by $8.5 million for the month. This is primarily due to more business days in March and also March is a high utilization month for medication refills. Net surplus YTD is $90 million, $118 million favorable to the 3+9 forecast. Operating margin is favorable by $99 million driven primarily by incurred claims favorability of $90 million versus the forecast. YTD Pharmacy is $5.5 million unfavorable driven by the higher paid claims amounts in March and CBAS is $3.9 million unfavorable.
Board of Governors Meeting May 6, 2021, Page 21 of 26 DRAFT 35 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN YTD Administrative expenses are $13.3 million favorable driven primarily by lower spending in Purchased Services and Professional Fees. YTD Non-operating expense is $5.7 million favorable due to timing of grant spending. The unrealized gain position has been volatile due to market conditions and represents a $7.3 million loss YTD which is $5.4 million unfavorable to the forecast. Reported vs. Paid Claims Trend L.A. Care experienced volatility beginning in April when claims payments were accelerated to alleviate cash flow concerns for providers on a fee for service reimbursement. The claims recovery activities were suspended and changes in payment practices were made to assist with cash flow to the network. In August, L.A. Care resumed its historical payment practices. With that volatility, the assumptions in the budget were conservative in claim reserving. Board Member Roybal asked about the surge in COVID-19 cases in December and January and how it might be reflected in the level of claims reported. Ms. Montgomery noted that claims reserves are being released cautiously with the dynamic of the recent surge in mind. Operating Margin by Segment Overall Medical Care Ratio (MCR) is 93.1% versus forecast of 95.2%, lower than forecast due to favorable Fee-For-Service (FFS) claims. Plan Partners is just ahead of forecast. SPD/CCI SPD and CCI is lower due to the favorable FFS claims. TANF/MCE is lower due to lower FFS claims. CMC is unfavorable due to the shared risk true-up and unfavorable Pharmacy claims in March. Commercial is lower due to the LACC RAF adjustment from 0.76 to 0.80 and favorable FFS and pharmacy claims on the LACC side. Chairperson De La Torre commented that having the MCR at over 95% for the two biggest groups of members, represents a “Medicare level” of medical cost ratio and not at all normal for Medi-Cal patient population to be that high. He complimented the staff for that achievement. Ms. Montgomery noted that given the way funding is calculated, the low administrative rate is very good. Key Financial Ratios The administrative ratio was 4.8%, better than the forecast of 5.2% due to lower spending in Purchased Services and Professional Fees.
Board of Governors Meeting May 6, 2021, Page 22 of 26 DRAFT 36 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Working Capital and Tangible Net Equity are ahead of benchmarks. Cash to claims is ahead of the benchmark due to receipt of pass-through funds including the hospital directed payment pools. Tangible Net Equity and Days of Cash on Hand March 2021 Fund Balance was $1 billion which represents 500% of Tangible Net Equity. There is enough cash to cover operating expenses for the next 41 days. Board Chairperson De La Torre noted that the rebate for MCR is annualized, and asked what happens when a month is below. Unanimously approved by roll call. Ms. Montgomery stated that the calculation is for the year. L.A. Care is very close to being on 8 AYES (Ballesteros, rebate positon which means LACC might need to rebate back to members. Staff is working on Booth, Curry, De La the calculation now. Torre, Gonzalez, Motion FIN 100.0521 Perez, Roybal and To accept the Financial Report for March 2021, as submitted. Vaccaro) Monthly Investments Ms. Montgomery referred to the investment transactions report included in the meeting Transactions Report materials. (A copy of the report can be obtained by contacting Board Services). As of March 31, 2021, L.A. Care’s total investment market value was $2.5 billion (including $336 million of pending purchases). $1.8 billion managed by Payden & Rygel and New England Asset Management (NEAM) $73 million in Local Agency Investment Fund $252 million in Los Angeles County Pooled Investment Fund Quarterly Internal Ms. Montgomery referred to the 2nd Quarter Expenditure Reports required by L.A. Care Policy Reports Internal Policies for the FY 2020-21, included in the meeting materials. (A copy of the reports can be obtained by contacting Board Services). L.A. Care’s internal policies require reports on all expenditures for business related travel expenses incurred by employees, members of the Board of Governors, Stakeholder Committees, and members of the Public Advisory Committees. The Authorization and Approval Limits policy requires reports for executed vendor contracts for all expenditures and the Procurement Policy requires reports for all sole source purchases over $250,000. These are informational items only, and do not require approval. Policy AFS-004 (Non-Travel Expense Report) Policy AFS-027 (Travel Expense Report) Policy AFS-006 (Authorization and Approval Limits) Policy AFS-007 (Procurement)
Board of Governors Meeting May 6, 2021, Page 23 of 26 DRAFT 37 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN PUBLIC Via email May 6, 12:21pm, Anonymous COMMENT ON # 10 – ANNONYMUS CLOSED SESSION Public Comment Closed Session ITEMS LA Care’s statement (given current public health guidelines); Public Comments must be submitted by, Email Voice mail Text I am again making an ADA accommodation request to also deliver my public comment verbally and in real time during the meeting. I am really curious as to how speaking over the phone line in real-time during the meeting may be in violation of the public health guidelines. Via telephone May 6 at 1:02 pm from Elizabeth Cooper Good wishes to those in the Asian community and their upcoming holiday. Via text May 6, 11:57 am, not self-identified You people are weirdos and a danger to enrollees! Via text May 6, 2:23 pm, not self-identified Yes, you omit all comments Your doctor publically discussed my autistic daughter ! Discussed my child in front of your board Via text May 6 at 2:43 pm, not self-identified If your so great why do people keep complaining, Baackes , you only seem concerned with number of members , not quality of care! Via text May 6 at 3:06 pm, not self-identified You are liars! Via email, May 6 at 4:19 pm, from Andria McFerson Chairperson Del La Torre, My name is Andria McFerson and this comment is regarding Item 10. Anticipated Litigations and all other items regarding relative to this comment. During the March ECAC meeting I feel there may have been some unethical practices or tactics not adhering properly to the Brown act and Roberts Rule of Order. The LA Care staff helps the Chair and the committee to carry out proper protocol but, when I carried
Board of Governors Meeting May 6, 2021, Page 24 of 26 DRAFT 38 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN out a motion the proper voting process was not practiced. Ms. Haydel came and confirmed this information. I continue to get openly harassed and no one feels it has any significance. I would like the appropriate staff to publicly address these discrepancies and to please update staff on the proper ethical practices while assisting ECAC during a meeting. I would also request that the ECAC have training classes with simple updates on how to carry our committee meeting also explaining the significance like we used to but, virtually. Thank you
Chairperson De La Torre noted that L.A. Care has continued public comment in the same process for over a year now. There are three different ways to submit comment, and the process does not limit comments. L.A. Care is taking comments and incorporating them into the meeting as expected under the Brown Act. He declined to comment on the ECAC meeting process as he had asked staff to address the issue raised.
ADJOURN TO The meeting of the Joint Powers Authority Board of Directors was adjourned. Augustavia J. Haydel, General Counsel, CLOSED SESSION announced the following items to be discussed in closed session. The L.A. Care Board of Governors adjourned to closed session at 4:31 pm. CONTRACT RATES Pursuant to Welfare and Institutions Code Section 14087.38(m) Plan Partner Rates Provider Rates DHCS Rates REPORT INVOLVING TRADE SECRET Pursuant to Welfare and Institutions Code Section 14087.38(n) Discussion Concerning new Service, Program, Technology, Business Plan Estimated date of public disclosure: May 2023 CONFERENCE WITH LEGAL COUNSEL – ANTICIPATED LITIGATION Initiation of litigation pursuant to Section 54956.9(d)(2) of Ralph M. Brown Act One Potential Case The last item below was not discussed. CONFERENCE WITH LEGAL COUNSEL – ANTICIPATED LITIGATION Initiation of litigation pursuant to Section 54956.9(d)(2) of Ralph M. Brown Act One Potential Case Board of Governors Meeting May 6, 2021, Page 25 of 26 DRAFT 39 AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN
RECONVENE IN The Board reconvened in open session at 4:47 p.m. OPEN SESSION There was no report from closed session.
ADJOURNMENT The meeting was adjourned at 4:49 p.m.
Respectfully submitted by: APPROVED BY: Linda Merkens, Senior Manager, Board Services Malou Balones, Board Specialist III ______Victor Rodriguez, Board Specialist II Layla Gonzalez, Board Secretary
Date Signed ______Public comments not read at the meeting are included below: Via text received May 4, 4:08 pm You published it online that you discriminated against an adult autistic woman, I have the copy of that now, you liars ! Via text received May 4, 4:42 pm You “doctor” on your made all these decisions about Vanessa but not once did anyone speak with me! Via text received May 4, 4:42 pm Only time you spoke with me was to defend Synermed early in my complaint! Via text May 5, 1:55 am, not self-identified You’ve done the same to 1,000s of other people , deny and block their rights without discussing it with THEM because you know you’re being improper! Via text May 5, 9:52 am, not self-identified You keep adding enrollees while not providing services to current ones ! Via text May 6, 11:57 am You people are weirdos and a danger to enrollees! (continued from CEO Report above) Via Email on May 6 12:20pm from Anonymous / regulations. There’s seems to be a major disconnect in LA Care’s arena.
Board of Governors Meeting May 6, 2021, Page 26 of 26 DRAFT 40
Board of Governors MOTION SUMMARY
Date: June 3, 2021 Motion No. FIN 100.0621
Committee: Finance & Budget Chairperson: Robert H. Curry
Issue: Amend a contract with Imagenet, LLC to continue to provide L.A. Care with scanning solution services that will enable conversion of paper claims/forms into an electronic format.
New Contract Amendment Sole Source RFQ was conducted
Background: L.A. Care staff requests approval to amend a contract with Imagenet, LLC in the amount of $500,000 through June 30, 2022. The vendor will continue to provide us with document handling, document acquisition, document preparation, document sorting, document scanning, data processing, 837 EDI transmission, document storage, and document destruction. The three paper claim/form types the vendor will continue to handle are: 1) CMS1500 - claims submitted by health care professionals and suppliers; 2) UB04 - claims submitted by institutional providers; and 3) PM- 160 - Confidential Screening/Billing Report claim form.
The $500,000 requested in this amendment will cover expenses estimated at an average of $41,000 per month from July 2021 to June 2022.
Member Impact: L.A. Care Members will benefit from this motion through efficient processing of provider claims, allowing providers and their staff to focus on serving the member.
Budget Impact: Sufficient funds are accounted for in the Claims Department budget for FY 2020- 21. Budget will be appropriated in FY 2021-22.
Motion: To authorize staff to amend a contract with Imagenet, LLC, in the amount of $500,000 (total contract amount not to exceed $2,600,000), through June 30, 2022, for scanning solution services.
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L.A. CARE HEALTH PLAN JOINT POWERS AUTHORITY Board of Directors MOTION SUMMARY
Date: June 3, 2021 Motion No. JPA FIN 100.0621
Committee: Finance & Budget Chairperson: Robert H. Curry
Issue: Authorization for John Baackes, Chief Executive Officer; Marie Montgomery, Chief Financial Officer, and Angela Bergman, Controller, with authority over all L.A. Care Health Plan Joint Powers Authority (JPA) banking and investment accounts.
Background: Authorized signatories are needed for L.A. Care Health Plan Joint Powers Authority (JPA) because the Department of Managed Health Care (DMHC) has required JPA to pledge a total of $300,000 to DMHC as per California Code Regulations Title 28 Section 1300.76.1.
The motion below designates John Baackes, Chief Executive Officer, Marie Montgomery, Chief Financial Officer, and Angela Bergman, Controller, as authorized signatories to all L.A. Care Health Plan Joint Powers Authority banking and investment accounts.
Member Impact: None
Budget Impact: None
Motion: To authorize John Baackes, Chief Executive Officer; Marie Montgomery, Chief Financial Officer; and Angela Bergman, Controller, as authorized signatories for all L.A. Care Health Plan Joint Powers Authority banking and investment accounts.
42
Board of Governors MOTION SUMMARY
Date: June 3, 2021 Motion No. COM 100.0621 Committee: Compliance and Quality Chairperson: Stephanie Booth, MD
Issue: Approve 2021 Internal Audit Services Work Plan
Background: In 2021, the Internal Audit Department will focus its efforts on mitigating any operational and regulatory deficiencies and proactively identifying gaps in internal controls and process. All audits will be based on regulatory protocols and, as appropriate, industry standards.
Member Impact: No direct member impact. This is internal planning for the Internal Audit Department within Compliance.
Budget Impact: No financial impact.
Motion: To approve the 2021 Internal Audit Services Work Plan, as submitted.
43 Compliance & Quality Committee
DRAFT Internal Audit Plan
44 DRAFT Executive summary
• The FY21 Internal Audit Plan consists of 3 main projects, 2 contingent projects, in addition to annual activities such as testing 3 closed Corrective Action Plans, Annual Risk 20% 20% Management Assessment and Annual IA Planning.
Apr-Jun • The FY21 Internal Audit Plan has Sequencing Jul- Sep been developed with consideration of projects Oct-Dec alternate coverage provided by other Jan-Mar '22 assurance functions, such as Information Security, Regulatory, 30% 30% Ethics and Compliance Organization.
• Projects can be are delivered internally and may need Subject Matter Resources
45 2 DRAFT Internal audit planning process
LA Care’s Internal Audit Plan is driven by the information gathered through the Compliance and IT Security
Recognizing the importance of being fully operational and effective the projects which make up the Internal Audit Plan were identified and prioritized based on a number of key inputs.
Key Inputs to the development of the Internal Audit Plan:
Past risk assessment
Input from senior Industry knowledge and management from CCO experience
Results of Corrective FY21 internal In-depth knowledge of Action Plans (High-Med- control environment Low Risks) audit plan
Examination of strengths, Feedback from weaknesses, opportunities Compliance and threats
Analysis of LA Care’s strategic and operational plans
46 3 DRAFT FY21 internal audit plan (10 activities) Timeline
Area of Focus Apr – Jun Jul – Sep Oct - Dec Jan- Mar 2022
. Proposed: Portal Assessment Information . Proposed: Asset . Contingent: System Technology Inventory Configuration Assessment
. Proposed: CMC . Contingent: Core 2.1 Regulatory & Sales and and Core 3.2 data Compliance Marketing review validation
Corrective Action . DHCS Audit- Plan (CAP) Annual Network . Provider terminations . RA Billing Issue Follow-up- High Certification Risk . Annual Risk Assessment Other . Internal Audit Planning FY2022
Total Projects 2 3 3 2
47 4 DRAFT Audit plan details
Proposed / Estimated Area of focus Audit name Brief description Contingency Timeframe • Asset Inventory • Assess the process of how IT assets are managed • Proposed • Jul-Sep 2021 by LA Care’s ITOI to decrease show IT issues
• Portal • Assess all portals that process ePHI to ensure • Proposed • Jan-Mar Assessment confidentiality, integrity, and availability of the ePH 2022 Information process is not compromised Technology • System • Assess effectiveness of the current defined and • Contingent • Jan-Mar Configuration approved system configuration process to ensure 2022 Assessment technologies to be deployed and after go-live are properly configured and meet the LA Care security requirements. • CMC Sales and • Review Sales and Marketing policies and • Proposed • Mar-Apr Marketing procedures against the CMS and California 2021 Regulatory & Guidelines. Compliance • Core 2.1 and • Assess current data validation process for Core 2.1 • Contingent • Jul-Sep 202 Core 3.2 Data and Core 3.2 Validation • DHCS Audit • Proposed • Apr-Jun 2021 Corrective Action • The assessment will review the closed documents • Provider • Proposed • Jul-Sep 2021 Plan (CAP) for sufficiency if reassessed by CMS, DMHC or Termination Follow-up internally by Compliance • RA Billing • Proposed • Oct-Dec Issues 2021 • Annual Risk • This will process will help inform the current risks of • Proposed • Oct-Dec Assessment LA Care for the annual plans for Compliance and 2021 Internal Audit Other • Internal Audit • Creating a draft FY2022 Internal Audit plan for • Proposed • Oct-Dec Planning resources and communications of support 2021 FY2022
48 5
Board of Governors MOTION SUMMARY
Date: June 3, 2021 Motion No. COM 101.0621
Committee: Compliance & Quality Chairperson: Stephanie Booth, MD
Issue: Board review and approval of updates to the Legal Services Policy LS-005 (Board of Governors Oversight).
Background: Legal Services has been working to revise LS 005 (Fair Hearing For Competency Decision) in order to streamline and simplify the process, while remaining compliant with the guiding statutory scheme set out in Health & Safety Code sections 805 et seq.
Among other revisions intended to ensure compliance with the Health & Safety Code while streamlining the review process, this revised version of the policy includes language changing the reviewing entity following the decision by an arbitrator from the Compliance and Quality Committee of the Board to L.A. Care’s internal Sanctions Committee.
Legal Services anticipates that additional minor changes will be made, pursuant to discussions with the Committee Chairperson and input from outside counsel.
Member Impact: This action will not directly affect L.A. Care members.
Budget Impact: None
Motion: To approve Legal Services Policy LS-005 (Fair Hearing for Competency Decision), as submitted.
49 FAIR HEARING FOR COMPETENCY DECISION LS-005A
DEPARTMENT HEALTHCARE LEGAL SERVICES Supersedes Policy Number(s)
DATES Next Annual Effective Date 7/11/2002 Review Date 10/30/2020 10/30/2021 Review Date Legal Review Click here to Committee Click here to
Date enter a date. Review Date enter a date.
LINES OF BUSINESS Cal MediConnect L.A. Care Covered L.A. Care Covered Direct MCLA PASC-SEIU Plan Internal Operations
DELEGATED ENTITIES / EXTERNAL APPLICABILITY PP – Mandated PP – Non-Mandated PPGs/IPA Hospitals Specialty Health Plans Directly Contracted Providers Ancillaries Other External Entities
ACCOUNTABILITY MATRIX Enter department here Enter policy §§ here
ATTACHMENTS Enter all attachments here (e.g., desktop procedures/job aids, templates, reports, letters)
ELECTRONICALLY APPROVED BY THE FOLLOWING OFFICER DIRECTOR NAME Augustavia Haydel Nadia Grochowski DEPARTMENT Legal Services Legal Services TITLE General Counsel Associate Counsel
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50 FAIR HEARING FOR COMPETENCY DECISION LS-005
AUTHORITIES Enter all authorities here. Authorities include all legal, regulatory, contractual, or accreditation requirements.
REFERENCES Enter all references, including policies and procedures, here.
HISTORY REVISION DESCRIPTION OF REVISIONS DATE
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51 FAIR HEARING FOR COMPETENCY DECISION LS-005
1.0 OVERVIEW:
These Procedures applyTo provide a fair hearing process consistent with legal requirements when L.A. Care Health Plan (“L.A. Care”) takes or proposes to deny, terminate, or suspend a contractual relationship or otherwise deny, restrict, or suspend to take an individual physician’s, podiatrist’s, dentist’s, or psychologist’s (“Practitioners”) ability to provide health care services to L.A.Care Members (“Members”) Adverse Action, as that term is defined in this policy, if such action is based on any aspect of the Practitioner’s quality of care, professional competence, or professional conduct that is reasonably likely to be detrimental to patient safety or to the delivery of patient care (“Medical Disciplinary Cause or Reason”). These Procedures are implemented to provide a fair hearing to the fullest extent required by law. The fair hearing rights in this policy apply only if a fair hearing is required by California Business and Professions Code Section 809 et seq. or other California legal requirement, or if the action is reportable to the National Practitioner Data Bank under the Federal Health Care Quality Improvement Act of 1986. This policy does not apply to any action that is not taken for a medical disciplinary cause or reason, as that term is defined below.
2.0 DEFINITIONS:
Whenever a word or term appears capitalized in this policy and procedure, the reader should refer to the “Definitions” below.
2.1 Adverse Action: An action or recommendation by L.A. Care or its designated committee to deny, terminate, suspend, or otherwise substantially restrict the ability of a Practitioner to provide health care services to L.A. Care members, if such action or recommendation is based on a Medical Disciplinary Cause or Reason.
2.2 Days: Calendar days.
2.3 Medical Disciplinary Cause or Reason: Any aspect of the Practitioner’s quality of care, professional competence, or professional conduct that is reasonably likely to be detrimental to patient safety or to the delivery of patient care.
2.4 Practitioner: For the purposes of this policy only, a health care professional defined as a “licentiate” in Business and Professions Code Section 809.
2.5 Summary Action: An Adverse Action that becomes effective before the exercise of any rights pursuant to this Policy LS-005 because the failure to take that action may result in an imminent danger to the health of any individual. Summary Actions include, but are not limited to, summary restrictions and summary suspensions.
3.0 PROCEUDRES:
3.1 APPLICABILITY
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52 FAIR HEARING FOR COMPETENCY DECISION LS-005
3.1.1 This policy and the processes it describes applies only if each of the following conditions are met:
3.1.1.1 L.A. Care (or its designated committee) takes or recommends an Adverse Action against a Practitioner, as those terms are defined in this policy and regardless of how the term “practitioner” may be defined or used in any other policy or definition;
3.1.1.2 L.A. Care is required by law to provide the Practitioner with a hearing to challenge the Adverse Action, or L.A. Care is required to report the Adverse Action (if finalized) to the National Practitioner Data Bank; and
3.1.1.3 The Practitioner did not agree to the Adverse Action.
3.1.2 This policy and the processes it describes does not apply in any of the following circumstances:
3.1.2.1 When LS-011, “Fair Hearing for Administrative/Business Decisions” applies;
3.1.2.2 When a revocation, restriction, limitation, or suspension of the Practitioner’s license to practice is imposed by a State licensing board/agency or by a certifying authority, in which case the scope of the restrictions imposed by the State licensing board/agency or certifying authority shall automatically apply to the Practitioner’s care of Members. This provision does not limit L.A. Care’s ability to take or make an Adverse Action against the Practitioner that is in addition to or greater than that imposed by the State licensing board/agency or certifying authority, in which case this policy may apply if the provisions under 3.1.1. are met;
3.1.2.3 When L.A. Care restricts, suspends, or terminates a Practitioner’s ability to provide health care services to Members “without cause,” pursuant to the terms of a contract with L.A. Care, and that restriction, suspension, or termination is unrelated to a Medical Disciplinary Cause or Reason and does not give rise to a hearing under California law;
3.1.2.4 When an entity other than L.A. Care that is delegated with credentialing authority restricts, suspends, or terminates for any reason a Licentiate’s Practitioner’s ability to provide health care services to Members;
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3.1.2.5 When the denial, restriction, suspension, or termination arises from the Practitioner’s failure to meet L.A. Care’s credentialing eligibility criteria;
3.1.2.6 When the restriction, suspension, or termination arises from the Licentiate’s Practitioner’s failure to maintain any certification, licensure, or qualification required under the terms of any contract with L.A. Care or with any L.A. Care delegated entity;
3.1.2.7 When the Licentiate’s Practitioner’s initial application to contract with L.A. Care to provide health care services to Members is denied for being incomplete or inaccurate;
3.1.2.8 Where a Licentiate Practitioner has a contract with an L.A. Care delegate and the delegate initiates the restriction, suspension, or termination;
3.1.2.9 Where the applicable laws, regulations, or common law principles do not require L.A. Care to make this policy available to Licentiates Practitioners; and
3.1.2.10 When L.A. Care has determined that, based on L.A. Care’s reasonable assessment of its provider network, L.A. Care already has adequate access to the types of services provided by the Licentiate Practitioner.
3.2 Grounds for Hearing
3.2.1 Any one or more of the following actions by L.A. Caer is an adverse Action and grounds for a hearing when such an action is proposed based on Medical Disciplinary Cause or Reason: Adverse Actions are grounds for a hearing under this policy only if the Adverse Action (if it becomes final) entitles the Practitioner to a hearing under California law, including California Business and Professions Code Section 809 et seq., or if it is reportable to the National Practitioner Data Bank under the Federal Health Care Quality Improvement Act of 1986, or both. Examples of such Adverse Actions or Recommendations may include, depending on the circumstances:
3.2.1.1 Termination or non-renewal of a contract to provide health care services to Members;
3.2.1.2 An immediate suspension of a Practitioner’s ability to provide health care services to Members lasting more than fourteen (14) calendar days;
3.2.1.3 Imposition Involuntary imposition of restrictions or limitations on a Practitioner’s ability to provide health care services to
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Members for a cumulative total of thirty (30) calendar days or more within a twelve (12) month period;
3.2.1.4 Denial of an initial application (where the initial application is complete) or request to contract with L.A. Care to become a L.A. Care Practitioner; and
3.2.1.5 Any other action by L.A. Care requiring L.A. Care to file a report pursuant to Business & Professions Code §805 or to the National Practitioner Data Bank.
3.3 Notice of Adverse Action
3.3.1 In all cases where an Adverse Action constituting grounds for If a Practitioner is entitled to a hearing as set forth in Section 2.1.1 atove is proposed under this policy, L.A. Care shall, within twenty (20) calendar days after proposing to take Adverse Action, (a) furnish the Practitioner with a copy of L.A. Care’s Policy LS-005: Fair Hearing for Competency Decisions and this procedure, and give (b) provide the Practitioner a written Notice of Adverse Action stating, at a minimum, the following:
3.3.1.1 That an Identifying the Adverse Action against the Practitioner that has been proposed;
3.3.1.2 That the proposed Adverse Action, if adopted, could may be reported to the National Practitioner Data Bank pursuant to the Health Care Quality Improvement Act of 1986, and/or to applicable State California licensing boards or agencies entities pursuant to applicable State California law, or may, if the Adverse Action already have has been so reported pursuant to Business & Professions Code section 805.01, noting that this has occurred;
3.3.1.3 That the Practitioner has the right to request a hearing on the proposed Adverse Action by submitting a written Notice of Request for Hearing within the time period specified below; and thirty (30) calendar days from the date of transmittal of the Notice of Adverse Action; and
3.3.1.4 That the Practitioner’s failure to file a Notice of Request for Hearing in the manner required by this procedure constitutes a waiver of the rights to a hearing and acceptance of the proposed Adverse Action.
3.4 Practitioner’s Notice of Request for Hearing
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3.4.1 Practitioner shall have thirty (30) calendar days from the date of transmittal of the Notice of Adverse Action to request a hearing on the to challenge a proposed Adverse Action by filing. To request a hearing, the Practitioner must send a written Notice of Request for Hearing. The Notice of Request for Hearing shall be delivered to the Chief Medical Officer (“CMO”). If a the Practitioner timely requests a hearing, no the Adverse Action will be taken against the Practitioner not go into effect until the conclusion of the hearing, except as permitted Practitioner has exhausted or waived the remedies in connection with automatic suspension or this Policy, unless the Practitioner is subject to an immediate suspension, or under exigent circumstances as provided in LS-005, or as required by law.
3.5 Waiver of Hearing Right
3.5.1 Failure of the Practitioner to submit a Notice of Request for Hearing within the time and in the manner described in Section 2.1.3 above shall constitute a waiver of the right to a hearing. In the case of such a waiver, the Practitioner shall be deemed to have accepted the proposed Adverse Action, and the proposed Adverse Action shall become effective pending final review and approval by the Compliance and Quality Committee of L.A. Care’s Board of GovernorsSanctions Committee (“BoardSanctions Committee”).
4.0 PRE-HEARING PROCEDURE:
4.1 Notice and Time of Hearing 4.1.1 Within ten (10 calendar days after L.A. Care’s receipt of a Practitioner’s Notice of Request for Hearing, the CMO shall issue a Notice of Hearing, scheduling a hearing to begin not more than sixty (60) days from the date on which the Notice of Request for Hearing is received by L.A. Care. At least 30 days prior to the hearing, the CMO shall issue a Notice of Hearing.
4.1.2 The Notice of Hearing shall contain:
4.1.2.1 The place, time, and date of the hearing;
4.1.2.2 The proposed Adverse Action to be taken against Practitioner;
4.1.2.3 The reasons for the proposed Adverse Action, including the acts or omissions with which the Practitioner is charged; and
4.1.2.4 Notice of the Practitioner’s right to be represented by an attorney or another person of the Practitioner’s choice and the requirement that the Practitioner inform the CMO within 10 days following receipt of the Notice of Hearing whether he or she intends to be represented by an attorney;
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4.1.2.5 A statement that the CMO reserves the right to amend the reasons for the proposed Adverse Action.
4.1.3 The Notice of Hearing shall require the Practitioner to submit to the CMO within ten (10) calendar days following receipt of the Notice of Hearing a list of witnesses expected to testify on behalf of the Practitioner and a statement as to whether or not the Practitioner intends to be represented by an attorney (see Section 2.2.2 below). The CMO shall schedule the hearing to begin not more than 60 days, and no sooner than 30 days, from the date on which the Notice of Request for Hearing is received by L.A. Care, and completed within a reasonable time. The parties may agree in writing to set an alternative hearing date outside of this time frame, or the Arbitrator may set an alternative hearing date upon a motion from either party or upon the Arbitrator’s own motion. A hearing is deemed to have commenced when the Arbitrator is selected.
4.2 Representation by Attorney or Other Person 4.2.1 Practitioner’s Right to Representation: The Except as provided below, the Practitioner is entitled to be represented by an attorney or other person of his or her choice at all stages of the hearing and appeal procedures provided for in Policy Number LS-005 and in this policy and procedure. However, the The Practitioner must give the CMO a written statement of whether or not the Practitioner intends to be represented by an attorney within ten (10) calendar days following receipt of the Notice of Hearing. The written statement shall be binding upon the Practitioner. Failure to submit a written statement constitutes waiver of Practitioner’s right to be represented by an attorney at the hearing.
4.2.2 L.A. Care’s Right to Representation: L.A. Care shall be entitled to be represented by an attorney or other person of its choice at all stages of the hearing and appeal procedures provided for in this policy and procedure. However, L.A. Care may not be represented at the hearing by an attorney if the Practitioner elects not to be represented or fails at the hearing. The foregoing shall not be deemed to submit a statement under Section 2.2.2.1 above deny any party of its right to the assistance of legal counsel for the purpose of preparing for the hearing.
4.3 Arbitrator Pursuant to Business & Professions Code section 809.2, the Practitioner’s application By applying for, and/ or acceptance of accepting provider status with L.A. Care constitutes acceptance of, the Practitioner's agrees that the following process is acceptable for selection of an Arbitrator to serve as the trier of fact who will determine applicable law and render a finding.
4.3.1 L.A. Care shall provide to the Practitioner two (2) or more names of prospective arbitrators who will be individuals who will obtain no direct financial benefit from the outcome of the hearing and who are qualified to preside at a quasi-judicial hearing. The Practitioner shall select the
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Arbitrator from the names provided by L.A. Care. L.A. Care will pay all fees associated with the Arbitrator. The arbitrator may not be one that L.A. Care has engaged for fair hearings in the preceding three years, and may not be engaged for fair hearings for three years after the present engagement concludes.
4.3.2 The Arbitrators duties shall include: 4.3.2.1 Serving as the trier of fact;
4.3.2.2 Maintaining decorum;
4.3.2.3 Ensuring that all participants have an opportunity to present relevant oral and documentary evidence in an efficient and expeditious manner; and
4.3.2.4 Ruling on scheduling matters, pre-hearing disclosure of documents, the admissibility of evidence, objections, and such other issues and matters necessary to advance the hearing.
4.3.3 The Arbitrator shall not act as a prosecuting officer or advocate. However, if either party is without attorney representation at the hearing, the Arbitrator shall have the authority to interpose appropriate objections, and to rule on those objections throughout the course of the hearing.
4.3.4 The hearing and appeal rights established in this procedure are strictly “judicial” rather than “legislative” in structure and function. The arbitrator shall have no authority to adopt or modify rules and standards or to decide questions about the merits or substantive validity any L.A. Care policy or procedure.
4.4 Request for Postponement
4.4.1 A request for postponement of a hearing or extension of time shall be permitted only upon either the mutual agreement of the Parties, or by the Arbitrator upon a showing of good cause by either Party. Good cause shall include, but is not limited to, an amendment to a Notice of Hearing by L.A. Care that significantly amends the reasons for the proposed Adverse Action; the failure of either Party to provide access to requested information at least thirty (30) days prior to the hearing as provided for in Section 2.2.5 below; and failure by either Party to disclose the identity of witnesses or produce copies of all documents to be used at the hearing at least 10 days prior to the hearing, as provided for in Section 2.2.6 below.
4.5 Document Exchange
4.5.1 On request, the Practitioner and L.A. Care shall each be entitled to review and obtain copies of documents relevant to the proposed Adverse Action
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charges in possession or under the control of the other Party. The exchange shall take place within twenty (20) days of receipt of a request and at least thirty (30) days before the hearing. The right to inspect and copy by either Party does not extend to confidential information, including Attorney Work Product, or information not relevant to the proposed Adverse Action, or any information referring solely to another individually identifiable practitioner other than the Practitioner under review. The Arbitrator shall consider and rule upon any request for access to information and may impose any safeguards that the protection of the peer review process and justice requires.
4.6 Exchange of Witness and Exhibit Lists
4.6.1 At least ten (10) days before the hearing date, the Parties shall exchange a list of the witnesses that each intends to call and copies of the exhibits that each intends to introduce at the hearing. Witnesses Failing to provide the lists of witnesses and exhibits not identified at this time shall not be permitted at the hearing except good cause for rebuttal or at the discretion of the Arbitrator a continuance. The Arbitrator shall exercise discretion to allow as complete an evidentiary record as possible and to avoid prejudice to either Party.
5.0 HEARING PROCEDURE:
5.1 Right of Parties at Hearing
5.1.1 Subject to reasonable limitations as determined by the Arbitrator, during the hearing, both Parties shall have the right to the following:
5.1.1.1 Be provided with all of the information and evidence made available to the Arbitrator; 5.1.1.2 Have a record made of the proceedings, copies of which may be obtained by the Practitioner on payment of reasonable charges associated with the preparation thereof;
5.1.1.3 Call and examine witnesses on relevant matters;
5.1.1.4 Present and rebut evidence determined to be relevant by the Arbitrator; and
5.1.1.5 Introduce exhibits and documents relevant to the issues.
5.1.2 If the Practitioner does not testify, he or she may be called and questioned by L.A. Care or the Arbitrator, or both, as if under cross examination.
5.1.3 The Arbitrator may question witnesses called by either party.
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5.2 Admissibility of Evidence; Examination of Witnesses
5.2.1 The hearing shall be conducted in accordance with California Business & Professions Code §809.3. et seq. to the extent applicable.
5.2.2 Judicial rules of evidence and procedure relevant to the conduct of the hearing, examination of witnesses, and presentation of evidence shall not apply. Except as provided in this policy, any relevant evidence, including hearsay, shall be admitted if it is the sort of evidence on which responsible persons are accustomed to rely in the conduct of serious affairs, regardless of the admissibility of such evidence in a court of law.
5.2.3 Notwithstanding the above, evidence of mediation, compromise, or offers of settlement, as well as any conduct or statements made in negotiation thereof, is inadmissible to prove either parties’ opinion regarding the strength or weakness of the actions that provide the grounds for the hearing. Communications that confirm that mediation was mutually accepted and pursued may be disclosed and admitted as proof that otherwise applicable time frames were tolled or waived or to demonstrate the good faith of one or both of the parties in their attempts to resolve the matter. 5.2.4 The Arbitrator shall have the ability to control the conduct of the Parties and proceeding before it, including ruling upon the admissibility of evidence and examination of witnesses. The Arbitrator shall exercise discretion to allow as complete an evidentiary record as possible and to avoid prejudice to either party.
5.3 Burdens of Presenting Evidence and Proof 5.3.1 L.A. Care shall have the initial burden of presenting evidence that supports the proposed Adverse Action. 5.3.2 Except as provided below, L.A. Care shall have the burden of proving by a preponderance of the evidence that its proposed Adverse Action is reasonable and warranted. “Reasonable and warranted” means within the range of alternatives reasonably open to L.A. Care under the circumstances, and not necessarily that the action or recommendation is the only measure or the best measure that can be taken or formulated in the Arbitrator’s opinion.
5.3.3 However, Notwithstanding the above, in the case in which a Practitioner challenges exclusion from L.A. Care as an initial applicant, the Practitioner shall have the burden of persuading the Arbitrator by a preponderance of the evidence of his/her qualifications and resolving L.A. Care’s reasonable doubts concerning his/her current qualifications for L.A. Care membership
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participation. In doing so, the Practitioner shall may not be permitted to introduce information not submitted with his/her application or reapplication for membership participation or not produced in response to a request of the Credentialing/ Peer Review Committee or their designee during the application process, unless the Practitioner establishes that the information could not have been produced previously in the exercise of reasonable diligence.
5.4 Failure to Appear and Proceed/Terminating Sanctions 5.4.1 Unless excused by the Arbitrator for good cause, the Practitioner shall personally attend every session of the hearing. Failure of the Practitioner to appear and proceed at the hearing shall, unless excused by the Arbitrator on a showing of good cause by the Practitioner, be a waiver of the Practitioner’s right to a hearing and a voluntary acceptance of the proposed Adverse Action, which unless excused by the Arbitrator on a showing of good cause by the Practitioner, shall become effective immediately.
5.4.2 If the Arbitrator determines that either side is not proceeding in a fair, efficient, and expeditious manner, the Arbitrator may take such discretionary action as seems warranted by the circumstances including, but not limited to, limiting the scope of examination and cross- examination and setting fair and reasonable time limits on either side’s presentation of its case.
5.4.3 Upon motion of either party, the Arbitrator may terminate the hearing if it finds that either party has:
5.4.3.1 exhibited flagrant or repeated noncompliance with this policy in a manner that prejudices the other party or results in repeated delays to the hearing process,
5.4.3.2 has egregiously interfered with the orderly conduct of the hearing, or
5.4.3.3 has failed without good cause to appear at the hearing.
5.4.4 Evidence of, or a finding that, a party intended to prejudice the other party, delay the hearing process, or interfere with the orderly conduct of the hearing is not necessary to support or grant the motion to terminate the hearing.
5.4.5 The party against whom the terminating sanctions have been ordered may request that the Board of Governors review the order. The request must be made within 10 days of the terminating order, and the scope of the review shall be limited to reviewing the appropriateness of the terminating order.
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The Board of Governors shall review any request made, and if, giving deference to the Arbitrator’s determination, it finds that the order to terminate the hearing is unwarranted, the Arbitrator shall reconvene and resume the hearing.
5.5 Record 5.5.1 At L.A. Care’s expense, a record of the hearing shall be kept and all testimony shall be taken by a certified shorthand reporter. Copies of all or any portion of the record may be obtained by either Party at the requesting Party’s expense.
5.6 Conclusion of Hearing 5.6.1 The Arbitrator may recess and/or adjourn and reconvene the hearing without further notice for the convenience of the Parties, with due consideration given to reaching an expeditious conclusion to the hearing. At the conclusion of the presentation of evidence, the hearing shall be closed, at which time the Parties each Party may submit a written statement. The Arbitrator may set reasonable limits on and deadlines for the written statement. The Arbitrator shall then privately conduct deliberations deliberate and reach a decision, as set forth in Section 2.4.
6.0 DECISION OF THE ARBITRATOR
6.1 Basis for Decision 6.1.1 The Arbitrator shall render a decision as to whether the proposed Adverse Action is reasonable and warranted. In the case of an immediate suspension, whether the suspension was reasonable and warranted shall be based on the facts which were known or should reasonably have been known at the time of the suspension.
6.1.2 The Arbitrator’s decision of the Arbitrator shall be based on the evidence produced at the hearing, including all logical and reasonable inferences drawn from the evidence, which shall include the oral testimony of witnesses and the exhibits from the Parties admitted into evidence by the Arbitrator. The Arbitrator shall also consider the written or oral arguments made by the Parties in connection with the hearing. The Arbitrator does not have authority to reach a decision that is contrary to a bylaw, rule, regulation, or policy adopted or approved by the Board.
6.2 Decision of Arbitrator 6.2.1 Within forty-five (45) calendar days after conclusion of the hearing, the Arbitrator shall issue a written decision stating his/her findings of fact, decision, and the connection between the evidence produced at the hearing and the decision reached. If the Practitioner is under suspension, the tine for issuing the decision Arbitrator shall be fifteen issue a brief written statement of his or her conclusion within 15 calendar days, and a written
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decision as described above within 30 calendar days of the conclusion of the hearing. The decision shall be served on the CMO, the Practitioner, and the Compliance and Quality Committee of the BoardL.A. Care Sanctions Committee.
7.0 FINAL DECISION OF THE BOARD OF GOVERNORSL.A. CARE SANCTIONS COMMITTEE
7.1 Decision of BoardSanctions Committee 7.1.1 The Arbitrator’s decision of the Arbitrator shall be presented to the BoardL.A. Care’s Sanctions Committee, or its delegate, as soon as practicable. The Board Sanctions Committee may affirm, modify, or reject the decision of the Arbitrator Arbitrator’s decision, or refer the matter back to the Arbitrator for further action consistent with written instructions to be provided by the BoardSanctions Committee. A copy of the Board’s Sanctions Committee’s decision shall be delivered to the Practitioner, CMO, L.A. Care’s Credentialing/Peer Review Committee, and the appropriate Plan Partner, if applicable.
7.1.2 Except where the matter is referred back to the Arbitrator, the Board’s Sanctions Committee’s decision shall be the final action of L.A. Care and shall be immediately effective and not subject to further hearing or review within L.A. Care.
7.1.3 The Board may, in its sole discretion, delegate its review of the Arbitrator’s decision to the Compliance and Quality Committee to affirm, modify, or reject, or to send back to the Arbitrator with written instructions, consistent with Section 7.1.1 above. In such instances, the Compliance and Quality Committee’s decision shall be the final action of L.A. Care and shall be immediately effective and not subject to further hearing or review within L.A. Care.
7.2 Further Proceedings Before Arbitrator
7.2.1 If the Board or Compliance and Quality CommitteeSanctions Committee refers the decision back to the Arbitrator, either Party may submit a written statement to the Arbitrator within fifteen (15) calendar days after the date of notice that the matter has been referred back to the Arbitrator.
7.2.2 The Arbitrator shall conduct such further proceedings as instructed by the Board or Compliance and QualitySanctions Committee and shall make his/her written response back to the Board or Compliance and QualitySanctions Committee within thirty (30) calendar days of the referral, except as Parties may otherwise stipulate or as may be directed by the Board or Compliance and QualitySanctions Committee. Thereafter, the decision of the Arbitrator will be presented to the Board or Compliance and
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QualitySanctions Committee for affirmation, rejection, or resubmission to the Arbitrator, pursuant to the procedures in this Section.
8.0 REPORTING
8.1 L.A. Care shall report any Adverse Action against Practitioner as required by law, including, but not limited to, Business & Professions Code §§805 and 805.01 and the National Practitioner Data Bank provisions of the Health Care Quality Improvement Act of 1986. This reporting shall be in addition to any other reporting obligation L.A. Care may have as a matter of law.
8.1 8.2 L.A. Care staff shall report any Adverse Action to the chair of the Compliance & Quality (C&Q) Committee of L.A. Care’s Board of Governors. At the discretion of the C&Q Committee Chair, L.A. Care staff may report any Adverse Action against a Practitioner to the C&Q Committee in closed session in compliance, if allowed pursuant to applicable law. 9.0 SUMMARY ACTION
9.1 Notwithstanding any other provision in this policy, L.A. Care may impose a Summary Action against a Practitioner’s ability to care for Members prior to the exercise of any rights under this Policy LS-005, where the failure to take such action might result in an imminent danger to any individual.
9.2 As soon as reasonably practical after the imposition of a Summary Action, but prior to 14 calendar days after its imposition, L.A. Care shall make reasonable efforts to communicate L.A. Care’s concerns to the Practitioner and to provide the Practitioner an opportunity to submit information about the facts and circumstances which are the basis of the Summary Action. Such an opportunity to exchange information is not a “hearing” for purposes of this policy.
9.3 If, as a result of the Summary Action, the Practitioner has the right to a hearing pursuant to Business and Professions Code Section 809, L.A. Care shall provide the process described in this Policy. If the Practitioner requests a hearing pursuant to his Policy, the Summary Action shall remain in effect pending the outcome of the hearing, unless earlier terminated by L.A. Care.
10.0 MISCELLANEOUS
10.1 Service of Notice
10.1.1 All notices provided for herein shall be either personally delivered, with a signed acknowledgement of receipt; sent by certified or registered mail with return receipt requested; or sent by an overnight delivery service such as Federal Express which provides documentation of delivery. Notices to the Practitioner may be sent to the Practitioner’s last known address in L.A.
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Care’s possession or the address shown for Practitioner by the Medical Board of California on its public Internet site.
10.2 Substantial Compliance
10.2.1 Deviations from the procedures set forth in this policy and procedure that are technical or not materially prejudicial to one any Party shall not be grounds for invalidating any action taken.
10.3 Confidentiality
10.3.1 The records and proceedings of any proceeding under this procedure shall, to the fullest extent permitted by law, be confidential. Participants in any part of the proceeding shall, except as otherwise required by law, limit their discussion of the matters involved to the formal avenues provided for in this procedure. Practitioners may not use proprietary, quality-related, or other confidential or sensitive information that (a) is shared, disclosed, or discovered during the pre-hearing process or during the hearing sessions, and (b) relates in any way to L.A. Care, including but not limited to L.A. Care’s services, processes, providers, and members, outside of the hearing process described in this policy or in any other L.A. Care process or proceeding. Misuse of such information is independent grounds for Adverse Action, up to and including termination.
10.4 Right to One Hearing Only 10.4.1 No Practitioner has the right to more than one hearing per single matter that shall have been the subject of an Adverse Action. No Practitioner shall have a right to an additional separate hearing with a Plan Partner addressing the issues subject to the Adverse Action, it being understood that the hearing provided under this policy and procedure by L.A. Care shall take the place of any required hearing by a Plan Partner.
10.5 Credentialing/Peer Review Committee 10.5.1 The peer review body for L.A. Care is the Credentialing/Peer Review Committee. The CMO or his/her designee is the chairperson of the Credentialing/Peer Review Committee and may act as and on behalf of the Credentialing/Peer Review Committee and the Board in all matters under this policy and procedure. All references herein to “L.A. Caer” are also a reference to the CMO (and his/her designee) and the Credentialing/Peer Review Committee.
10.6 Relation to Statute 10.6.1 This policy and procedure is intended to implement the statutory notice and hearing rights in California Business & Professions Code §809 et seq. and other comparable legal mandates. The statutory or common law rights shall supersede any conflicting provision of this policy and procedure and
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supplement this policy and procedure in regard to any matter that it does not expressly address.
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May 28, 2021
TO: Board of Governors
FROM: John Baackes, Chief Executive Officer
SUBJECT: CEO Report – June 2021
This past month, Los Angeles County has begun to advance towards reopening and resuming activities that we have been without for over a year. More people are getting vaccinated – including children, there are fewer cases and deaths due to COVID-19, and Los Angeles County moved into the yellow tier which allowed more businesses to open at increased capacity. With these improvements, L.A. Care was able to reopen the Community Resource Centers and resume essential services to community members.
Given how tumultuous 2020 was, this year we have been focused on improving efficiencies, eliminating redundancies, and reducing siloes within our organization. This will serve us well leading into January 2022, when we will encounter some of the biggest changes to managed care since the Affordable Care Act. California’s proposed waiver, California Advancing and Innovating Medi-Cal (CalAIM) will add new benefits such as Enhanced Care Management and In Lieu of Services. Over the next few months, you will hear more about how we are preparing for these new benefits and how they will help members.
I am immensely proud of how we have responded to this pandemic as well as the day-to-day work of maintaining access to a quality network of providers for members of our community. Together we are making a difference and adding value, as you will see in our updates below.
Following is a snapshot of the progress we are making on some of our community- and provider-focused work. Change since last CEO report As of 5/28/21 (4/26/21) Elevating the Safety Net 14 183 grants awarded Grants for primary care physicians -3 121 physicians hired Elevating the Safety Net 2 99 Grants for medical school loan repayment Elevating the Safety Net — 32 Grants for medical school scholarships Housing for Health 254 Households with housing secured -3 IHSS+ Home Care Training — 3,498 IHSS worker graduates from CLTCEC program
67 CEO Report – June 2021
Below please find organizational updates for May:
L.A. Care and Blue Shield Promise Reopen Community Resource Centers After a temporary closure, L.A. Care and Blue Shield of California Promise Health Plan reopened our jointly-operated Community Resource Centers (CRCs) on May 3. Our CRCs provide essential resources and information to community members, and I am glad to see them reopen. Currently, they will offer limited services by appointment only, including: Member services support Health care coverage enrollment assistance Connection to social service assistance programs Free Wi-Fi for telehealth services Food pantry distributions
L.A. Care Sponsors Booklets on How to Report Hate Crimes Amid the increase in hate crimes towards Asian Americans, L.A. Care committed $25,000 to print 17,000 booklets titled How to Report a Hate Crime. The booklet release aligns with Asian American and Pacific Islander Heritage Month (May), and was distributed at a wide variety of locations, including government offices, consulates, senior centers, immigrant resource centers, and neighborhood councils. L.A. Care was fortunate to meet Esther Lim, the author of the booklet, while participating as a member of the LA vs. Hate Coalition during L.A. County’s inaugural United Against Hate Week.
L.A. Care Commits Nearly $2 Million to Increase COVID-19 Vaccines in Low-Income Communities of Color To help address low vaccination rates in communities of color who have been disproportionately impacted by COVID-19, L.A. Care awarded $1,950,000 in grants through the Robert E. Tranquada Safety Net Initiative XII. Twenty-six community-based safety net clinics across Los Angeles County will each receive $75,000 grants to conduct vaccination projects with an expectation that together they can get more than 190,000 doses into arms. The clinics will be operating at more than 70 sites in low-income communities of color.
L.A. Care Awards $2 Million in Physician Recruitment Grants L.A. Care has been working to address the longstanding physician shortage, and we recently announced 14 awardees in our ninth round of Elevating the Safety Net Provider Recruitment Program grants. Each new physician recruited into the safety net can serve as many as 2,000 new patients. The $2 million in grants announced this month brings the total award amount offered from all nine rounds to approximately $23.3 million.
L.A. Care Partners with Leonard Nimoy Family to Launch the Live Long and Prosper™ Billboard Campaign L.A. Care is collaborating with the family of the late “Star Trek” actor Leonard Nimoy on a billboard and social media campaign to encourage COVID-19 vaccinations and mask use. The Live Long and Prosper billboard features a masked individual and includes a message encouraging people to get vaccinated. Vaccinations and masking are two things that L.A. Care has long been promoting. Collaborating with the Nimoy Family on the Live Long and Prosper campaign, with the generous permission of ViacomCBS, was a perfect way to amplify the message in communities disproportionately impacted by COVID-19.
Speaking Engagements: May 14 – HIMSS Southern California Chapter, Annual Healthcare IT Virtual Conference 2021. Payer Panel: Impact of the Pandemic and Changes in Administration on the Payers.
Attachment Cal MediConnect Enrolee Advisory Committee Meeting Summary
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CEO Report to the Board of Governors Cal MediConnect Enrollee Advisory Committee (CMC EAC) Meeting Summary
CMC EAC Meeting Date: May 18, 2021 CMC EAC Meeting Attendees: 6 CMC members, via conference call
Meeting Summary I. L.A. Care Updates a. Attendees were informed about i. Community Resources Center (CRC) Reopenings – by appointments only ii. CRC Food Pantries – dates, times and locations iii. L.A. Care’s 2020 Annual Report iv. The Live Long and Prosper COVID-19 Vaccination Campaign with the Remembering Leonard Nimoy Foundation
II. Medicare-Covered Telehealth Services – Why is Telehealth Important During a Pandemic? a. A presentation on Telehealth services, its benefits, how to access it, what to expect during a telehealth visit, and why it is important during the COVID-19 pandemic.
III. Colorectal Cancer Screening Awareness a. A presentation on why colorectal cancer screening is important, and about how to talk with healthcare providers, friends, and family about colorectal cancer screening.
IV. CCI Ombudsman Report a. Staff reviewed the role of the CCI Ombudsman’s office, shared the prevalent issues reported by the Ombudsman, and provided members with the office’s contact information.
V. Close-Out a. Members were informed that a Member Advocate would be calling them after the meeting to privately address any personal member issues. b. The next CMC EAC meeting is currently scheduled for Tuesday August 17, 2021, from 2:00pm-3:00pm, via conference call.
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May 24, 2021
To: Board of Governors
From: Wendy Schiffer, Senior Director, Strategic Planning Roland Palencia, Director, Community Benefit Programs
Subject: Community Health Investment Fund (CHIF) Summary for Fiscal Years 2019-20
Introduction Every year we provide the Board of Governors with a summary of our Community Health Investment Fund (CHIF) awards. This memo and the accompanying attachment summarize our FY 2019-20 awards and highlights some achievements from earlier years.
The crises of the COVID-19 pandemic, racial injustice and unrest, and the economic downturn informed Community Benefits’ grantmaking for fiscal year 2019-20. These extraordinary and overlapping circumstances adversely affected community clinics and other community-based organizations and the populations they serve. Community Benefits shifted much of its grantmaking to address these needs.
In FY 2019-20, L.A. Care made 49 CHIF awards for a total of $11,105,000. In addition, we accelerated 62 payments from grants approved in previous years that totaled $3,192,500. These advanced payments assisted existing grantees with emergent cash-flow needs caused by the pandemic and its financial consequences.
CHIF Priorities To best support L.A. Care’s strategic vision, CHIF awards align with four foundational priorities: 1. Support safety net clinics’ infrastructure to provide high quality and coordinated services and help community-based clinics to thrive in a managed care environment. 2. Expand access to high-barrier services for low-income and under-resourced populations. 3. Improve community health for underserved populations by addressing the social conditions that lead to poor health outcomes. 4. Provide housing resources to persons experiencing homelessness, including L.A. Care members.
These overarching priorities ensure that grants target projects that have the greatest impact on the health and well-being of our members and the community at large and support the safety net providers that serve them. Within these priority areas, most of our grants for FY 2019-20 focused on addressing COVID-19 with racial equity lenses.
Some highlights include: The flagship Robert E. Tranquada, MD Safety Net XI initiative was repurposed from general infrastructure support to specifically address the COVID-19 related needs of providers that included core operational support, prevent further furloughed staff, and massive in-person patient
70 Community Health Investment Fund (CHIF) Awards Summary Memo – Fiscal Years 2017-2020 May 24, 2021
visit cancellations and the buildup of telehealth infrastructure as well as the need to redesign clinical space to meet social distance guidelines. Oral Health Initiative XII grantees were selected pre-COVID and were allowed to revise their workplans and extend their grant term to accommodate losses due to pandemic-related closures and recommended cleaning protocols. We launched our first Equity and Resilience initiative, which addresses the issue of historic under- investment in organizations led by and serving Black, Indigenous, and People of Color (BIPOC) and ensures trusted organizations have the resources to address critical needs during these unprecedented times. The Housing Stability II initiative, designed to prevent evictions, was needed to address the economic disruption and confusion around the myriad of COVID-related temporary eviction moratoria. Ad hoc grants helped to address immediate survival needs, including food, housing, health care access, personal protective equipment (PPE), Project Room Key support for unhoused populations, and telehealth infrastructure development and coaching.
The tables below summarize our initiatives (grants awarded via a Request for Applications process) and provide some key examples of ad hoc grants, which are projects that meet CHIF priorities but don’t fall under an initiative. More details, including quantitative objectives, can be found in Attachment A: CHIF Summary Report FY 2017-20.
Priority 1: Safety Net Clinic Infrastructure Number of Initiative/Ad Hoc Grant Awards and Description
Funding Robert E. Tranquada 10 Awards Support personnel, technology, and basic renovation of Safety Net Initiative XI $1,425,000 clinical space to reach out to over 4,300 “hardly reached” individuals traditionally on the margins of the healthcare system. Grantees realigned their programs to address challenges brought about by the pandemic. Ad Hoc Grants United Way, Inc. $500,000 The Health Pathways Expansion program engages healthcare and homeless services providers to create a system of care to reach up to 720 individuals and families experiencing homelessness during the COVID- 19 pandemic through grants to four health service providers United Way, Inc. $475,000 Procured and distributed essential supplies to 6,000 people experiencing homelessness during the pandemic such as hygiene kits, cooling packs, first aid kits, mylar blankets, and water bottles. Additionally, 500 tents, 500 tarps, and 200 sleeping bags were distributed to unsheltered families and individuals as well as PPE for the frontline homeless service providers delivering supplies.
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71 Community Health Investment Fund (CHIF) Awards Summary Memo – Fiscal Years 2017-2020 May 24, 2021
National Medical $150,000 Place seven second- or third-year physician or mid-level Fellowships, Inc. students close to graduation at four Los Angeles County Community Health Centers and provide
stipends to complete 200 hours of service at their respective clinic site, including clinical rotations and care delivery, leadership training, and execution of site- directed team-based service-learning projects designed to enhance care delivery by building the workforce pipeline.
Priority 2: High Barrier Services Number of Initiative/Ad Hoc Grant Awards and Description
Funding Oral Health Initiative XII 11 Awards Integrate medical and dental care by expanding services $1,650,000 in geographic regions that Health Resources and Services Administration (HRSA) has designated as Health Professional Shortage Areas (HPSA) by increasing the number of new dental providers who serve low-income populations in Los Angeles County, expanding services to over 8,300 dental patients.
Priority 3: Improve Community Health by Addressing Social Conditions that Lead to Poor Health Outcomes. Number of Initiative/Ad Hoc Grant Awards and Description
Funding Equity & Resilience I 7 Awards Connect low-income BIPOC communities $850,000 disproportionally impacted by COVID-19 and systemic racism to trusted messengers and service providers that offer resources such as food, housing, social and emotional support , as well as vocational opportunities, while enhancing the capacity and infrastructure of under-resourced BIPOC-led organizations, serving over 1,500 individuals and affiliated organizations. Ad Hoc Grants Esperanza Community $100,000 Healthy Homes Healthy Breathing is a partnership with Housing Corporation St. John’s Well Child and Family Center and Strategic Actions for a Just Economy (SAJE) that educates 170 individuals how to remediate indoor environmental hazards as well as COVID-19 safety. It aims to decrease emergency room use, reduce the number of missed days of school or work due to asthma for 75% of participants using its flagship Promotora home visitation and case management model among Latino and African American communities.
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72 Community Health Investment Fund (CHIF) Awards Summary Memo – Fiscal Years 2017-2020 May 24, 2021
Project Angel Food $550,000 Provides over 55,000 medical tailored meals for one year to 151 L.A. Care members with medically complex conditions and who are homebound due to safer at home restrictions resulting from the COVID-19 pandemic.
Priority 4: Housing Resources Number of Initiative/Ad Hoc Grant Awards and Description
Funding Housing Stability II 7 Awards Prevent, stop, or ameliorate housing evictions, which $850,000 contribute to economic hardship and homelessness, leading to poor health outcomes exacerbated during the pandemic, serving over 2,000 clients and provide Know Your Rights sessions to over 3,600 individuals. Ad Hoc Grants Brilliant Corners IV (pre- $4,000,000 Provides permanent supportive housing for up to 300 COVID-19) homeless individuals with medically complex conditions and ensures that medical, behavioral, social and human services are received for up to five years in partnership with the County of Los Angeles’ Whole Person Care, Housing for Health Program. This is the fourth allocation out of a five-year commitment.
Defining Grant Initiatives and Ensuring Strategic Alignment Community Benefits staff assess the strategic direction of health care policy, programs, statistics, and related sectors to determine the best use of CHIF resources. As members of local, statewide, and national philanthropic and health care collaboratives, the department leverages external partnerships to take on new and enduring barriers to care. Internally, Community Benefits and Strategic Planning staff participate in L.A. Care’s Equity Council activities to mutually align a number of Community Benefits priorities with those of the Council. Staff also work with other departments to explore opportunities to enhance clinic infrastructure operations, support major program launches, improve living conditions, and incite member involvement and satisfaction with their care Staff conduct literature reviews, interviews, and periodic focus groups with key stakeholders to develop each initiative’s requests for applications (RFA) and to ensure projects will align with the organization’s strategic vision.
CHIF Grant Approval and Administrative Processes All CHIF awards go through a review process that includes a formal application and internal vetting. The CHIF-driven initiatives are reviewed by a panel of community and L.A. Care staff subject matter experts, for a total of up to 20 reviewers. Ad hoc grants are also vetted and reviewed by an internal committee. Recommendations for all grant awards up to $150,000 are referred to L.A. Care’s CEO for approval. Award recommendations above $150,000 are brought to the Board Executive Committee for consideration and then to the Board of Governors for final approval. However, given the urgency of the COVID-19 pandemic, at its May 2020 meeting L.A. Care’s Board of Governors delegated the CEO authority to approve grants that exceeded the $150,000 limit approval per grantee.
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73 Community Health Investment Fund (CHIF) Awards Summary Memo – Fiscal Years 2017-2020 May 24, 2021
To improve grant management and grants operations efficiency and to optimize remote grantmaking activities, Community Benefits staff is migrating hundreds of grants and the related thousands of data points into the Blackbaud Grantmaking (BBG) database. This will further automate the grantmaking processes, become a one-stop shop for grantee database, allow for electronic grant approval process, and permit grantees to electronically submit progress reports into the database, rather than via emails. BBG grantmaking will become a depository that allows CB staff to most efficiently carry out its grantee obligations.
Approval of CHIF awards are governed by BOG Grants and Sponsorships Policy 603, including potential conflicts of interests.
Ongoing CHIF Monitoring In addition to the 49 grants made in FY 2019-20, Community Benefits continues to monitor 110 CHIF grants from prior years but still active during part or all the reported fiscal year, for a total of 159 active grants. Because grants are made throughout the year for a minimum of 12 month terms, project objectives are often reported on and completed in subsequent fiscal years, which is why we continue to monitor grants from prior years. When grant activities have been completed, the progress update on each grant in Attachment A is marked “CLOSED.” This CLOSED grant, reflected in this current report, will be removed from next year’s Attachment A.
One example is the 2018-19 grant to the California Community Foundation, made two fiscal years ago, which was designed to coordinate a Los Angeles County wide 2020 Census campaign to increase participation among hard to count populations. This grant contributed to the development of messaging and materials, which were L.A. Care branded and distributed to our members and public at large. The grant also contributed to several dozen community based organizations’ ability to reach and educate non-high school graduates, multi-family and crowded households, and people involved in the justice system. All these activities most impact our members and the communities served by our grantees. Details for other active grant awards made in previous fiscal years, can be found in Attachment A: CHIF Summary Report FY 2017-20.
Grant Support Acknowledgement and Recognition In partnership with the Communications department, the Community Benefits department monitors recognition and acknowledgment activities of its grantees. Every CHIF award doubles as sponsorships, allowing L.A. Care to receive enhanced recognition and acknowledgment for its long-standing community investments. Grantee specific acknowledgement activities are included in the Project Update section of Attachment A: CHIF Summary Report FY 2017-20.
There are varied and multiple types of recognition, and due to the COVID-19 pandemic, they also include virtual events. Acknowledgements range from recognizing CHIF grant contributions in electronic and hard copy newsletters, joint press releases to local and regional media, permanent signage in waiting rooms and clinical rooms, plaques and decals on equipment, prominently displayed wall donors recognition, websites and electronic articles, social media posts, marketing and program related literature, recognition at public events such as ground breaking, ribbon cutting ceremonies, open houses and annual galas attended by community stakeholders that include elected officials. Some public events provide speaking opportunities and involvement for L.A. Care’s CEO, Community Benefits staff, Communications, Sales and Marketing, and other L.A. Care staff. As COVID-19 pandemic prevented many in person gatherings during this fiscal year, most grantees provided digital and virtual recognitions for this fiscal year’s grants.
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74 Community Health Investment Fund (CHIF) Awards Summary Memo – Fiscal Years 2017-2020 May 24, 2021
Grantee Technical Assistance and Capacity Building Support Community Benefits staff provides technical assistance and capacity building support to CHIF grantees throughout the grant terms. These services include program development coaching, organizing focus groups and training sessions, and sharing lessons learned. These services help to ensure that grantees operate at an optimal level and for projects to incorporate best practices.
COVID-19 Pandemic Technical Support The onset of the COVID-19 pandemic and the safer-at-home mandates in March 2020 required some healthcare providers and other clinic staff to work remote and to provide virtual and telehealth clinical care to their patients. These overnight changes created new challenges, and opportunities for CHIF grantees. To learn more about these evolving changes and to build our own capacity during the crisis, Community Benefits staff participated in philanthropic webinars, teachings, and workshops to learn about best practices helpful in guiding grantmaking efforts. This included aligning our funding with other funders’ initiatives to address short and long-term needs of grantees and the populations they serve, funding grants that addressed emergency needs of food, shelter, and personal protective equipment (PPE), as well as funding long-term infrastructure support. Many of these projects and initiatives also addressed racial inequities. These partnerships enabled grantees to complement and supplement CHIF funding with that of other funders.
Progress Report Submission Guide Accurate and timely progress reports are essential to evaluating the success of the grants. To facilitate this, in June 2020, Community Benefits staff released the Progress Report Submission Guide (Guide), which complements previous one-on-one and group Progress Report Orientations. The main objectives of the Guide are to: 1. Identify key clauses in the grant agreement that impact program purpose, goals, and objectives; 2. Clarify the three progress report forms; 3. Summarize the key elements of the three progress report forms including instruction on defining specific, measurable, attainable, relevant, and time-based (SMART) objectives; and 4. Explain the importance of timely and accurate progress report submissions and their impact on the release of future payments and potential grant opportunities. Since the release of the Guide almost ten months ago, we have seen an improvement in the quantity as well as quality of reporting from a greater number of grantees, leading to fewer corrections and lessening confusion while receiving more accurate data and timely reports. Community Benefits staff will continue to improve on this process, while sharing best practices with grantees, including when projects do not fulfill their stated goals and objectives.
Program Planning and Proposal Writing Community Benefits staff contracted with The Grantsmanship Center, an organization with over 45 years of experience in program development and grantmaking, to provide a five-day workshop on Program Planning and Proposal Writing in early November 2019, with 25 CHIF grantees attending. The training targeted organizations with small budgets and that Community Benefits staff assessed as benefiting from this type of learning. Attendees learned about the basics of grantmaking and strategic online funder matchmaking tools. Some of the training topics included: (1) The critical role of the problem/need in program planning and proposal writing; how to assess and document problem/need; and how the problem/need relates to program outcomes, (2) How to develop specific, measurable goals that reflect a realistic, achievable, and positive change in the problem/need, and (3) The role of evaluation in program and organizational management, and how to assess program implementation and outcomes.
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75 Community Health Investment Fund (CHIF) Awards Summary Memo – Fiscal Years 2017-2020 May 24, 2021
In subsequent CHIF funding cycles, we noticed that the quality of proposals had improved as they were more structured, the link between program objectives and outcomes was more direct, and all the components of the application were more aligned and connected. Also, the workshop gave attendees and their respective organizations the tools to expand their funder base beyond L.A. Care, which was a major objective of this training.
Conclusion In fiscal year 2019-20, the Community Benefits Department managed a cumulative $29,512,000 and 159 active grants, many of them reconfigured to address the deep challenges during this reported fiscal year. The extraordinary events of 2020 that included the COVID-19 pandemic, racial injustice and unrest, and the economic downturn will inform Community Benefits’ grantmaking and that of our peers in philanthropy for decades to come.
Every CHIF project presents the opportunity to improve internal and external systems that lead to increased access and improved quality of care. The effect of these systemic improvements are deep and broad and have also influenced other funders’ strategies and programs. Our financial and non-financial contributions demonstrate that L.A. Care is making impactful investments and is a leader in the philanthropic community, especially during these turbulent times.
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76 Attachment A - Annual Community Health Investment Fund (CHIF) Summary Report Active Grants from FY 2017 through FY 2020 Total 159 Active Grants for $29,512,000 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update Fiscal Year 2019-2020 - Total of 49 Awards for $11,105,000 AD HOC GRANTS - TWELVE AWARDS
Update: Housed 329 unique families since April 2017 partnering with the DHS Housing for House 300 homeless individuals and families in permanent supportive Health program. The Los Angeles Flexible Housing Subsidy Pool (FHSP) had 259 families in housing (PSH), including L.A. Care members, over a five year period, housing on March 1, 2021. Since the COVID-19 pandemic quarantine began, Brilliant Corners 1 Brilliant Corners - IV H $4,000,000 9/1/2021 of which this is the fourth year. Project also supports the goals of the moved 31 clients into PSH. Seventy-eight percent of all clients housed are L.A. Care members. In Whole Person Care (WPC) initiative under the 2015 California Medi- addition, 90% of clients ever housed retained housing for at least one year. Cal waiver and enables DHS to draw down matching funds. Acknowledgment: News Article featured on website.
Update: Equipped nine COVID-19 Response Teams (CRT) with PPE while training shelter and Acquire personal protective equipment (PPE) for Los Angeles County interim housing staff. Provided infection control technical assistance and PPE for 308 shelters Department of Health Services' (LAC DHS) COVID-19 Response and interim housing sites, including 265 site-specific COVID Prevention Plans based on risk level, Teams that provide technical assistance on COVID screening, testing facility layouts, and other best practice recommendations. This grant helped to leverage funding 2 Brilliant Corners H $75,000 9/1/2021 protocols, and infection control methods at 250 shelters and interim provided for testing from other sources that included 101,266 COVID tests for 69,869 PEH and housing sites to mitigate the spread of COVID-19 among people 31,397 shelter staff. experiencing homelessness (PEH) in Los Angeles. Acknowledgment: Posted in Latest News section of website and social media. CLOSED
Update: Provided coaching, evaluation, and technical support to eight Los Angeles County based Administer and expand the Connected Care Accelerator, a virtual care clinics to launch expand, or improve virtual care for their patients and establish lasting changes learning collaborative, to provide one-time grants and technical Center for Care intended to improve timely access to care for low-income residents. Preliminary evaluation data assistance to two additional Los Angeles area safety net clinics, totaling 3 Innovation (Tides INF $200,000 8/31/2021 indicate that the majority of clinic visits were phone visits and limited differences in utilization by eight. A report will be published to help guide telehealth utilization, Center as fiscal agent) payer source and race/ethnicity during year one of the COVID quarantine. efficacy, and clinical practices for various demographic groups and Acknowledgment: Final evaluation report will note contributors to the Connected Care payer types among community clinics. Accelerator.
1 77 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Through virtual home visits, nearly 120 clients have participated in the Healthy Breathing Program receiving education about healthy homes, asthma, tenants’ rights, medication Decrease preventable emergency room use by 102 clients due to use, lead poisoning prevention, and indoor environmental health hazards. Clients received Esperanza asthma as well as to reduce the number of missed days of school mitigation materials like cleaning supplies and air purifiers. Promotoras have educated clients on 4 Community Housing SD $100,000 10/1/2021 and/or work due to asthma by 85 through the Healthy Homes Healthy COVID safety and distributed free face masks. Pre-post data will be presented by the end of the Corporation Breathing Program modifying program implementation to reduce risk program of COVID-19 transmission for staff and clients. Acknowledgment: Publication distribution and presentation of program results at future meetings and conferences.
Provide support to Community Benefits staff for projects that include Update: Assisted with three grant initiative review processes and conducted research on issues 5 KED Consultants $25,000 9/30/2021 collating review committee data, grantee progress reports, and other and subjects related to inform ad hoc and initiative grantmaking. projects as needed. Acknowledgment: Recognized at meetings
Update: Introduced seven underrepresented minority health profession students to primary care in a community-based health setting through virtual platforms in Summer 2020, including 4 MD and 3 PA students; six of which were female, one, male. Fifty-seven percent were African Supports National Medical Fellowships' Primary Care Leadership American, 29% Hispanic American/Latino, and 14% Asian American. Students completed Program (PCLP), an immersive Summer program that will place service-hours with their assigned CHCs; experienced leadership training webinars, meetings with National Medical 6 INF $150,000 10/1/2022 medical and mid-level clinical students in Los Angeles County safety executive leadership team, observation of management meetings including Board of Directors, Fellowships, Inc. net clinics, including Federally Qualified Health Centers, to expand the provider meetings, quality meetings, and their health profession mentors, along with real-world pipeline of community health providers. projects for their PCLP clinic site. Acknowledgment: Listed on all national and city-based electronic and printed program materials and noted by NMF President & CEO at the 2020 NMF Los Angeles Champions of Health Awards and Gala.
Update: Exceeded target number of critically ill homebound L.A. Care members enrolled in Provide home-delivered medically tailored meals (MTM) to 151 MTM program within first six months of the grant term, with 197 enrolled out of 151 target. critically ill, homebound L.A. Care members who are especially 7 Project Angel Food SD $550,000 12/31/2021 Delivered 23,495, or 42% of targeted daily meals to enable members to shelter safely at home. vulnerable to experiencing serious complications from COVID-19, with Acknowledgment: KABC7 TV news segment and interview with Dr. Seidman, CMO, and 55,115 meals served during the grant term. Richard Ayoub, PAF Executive Director. Post on website.
2 78 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Curated over 117 health related programs attended by more than 4,000 participants. Increase knowledge and awareness among the grantmaking community Hosted 36 online sessions directly related to the pandemic to incite policy, advocacy, and about trends, best practices, and emerging issues, and skills around philanthropic response, including a 16 part webinar series entitled “Funders Briefing on Covid- health and health equity by providing programs and convenings for at 19”, attended by over 1,400 individuals from 176 organizations. Overall, 96% of program Southern California 8 HB $20,000 6/30/2021 least 425 total participants through virtual and/or in-person attendance participants indicated that they gained knowledge and/or skills that would enhance their work Grantmakers at least 7 programs addressing topics related to health equity and and/or effectiveness. advancing wellness and at least 3 convenings addressing systemic Acknowledgment: Named a Silver Sponsor at the 2020 Virtual Annual Conference with listing change through public policy education and advocacy. and link on conference site, organization webpage, and related social media post. CLOSED
Update: Delivered essential supplies to more than 10,000 unsheltered people experiencing homelessness (PEH) during the pandemic through DHS Multi-Disciplinary teams (MDT) and United Way of GLA outreach teams, who also received personal protective equipment (PPE). Procure and distribute essential supplies to 5,000 frontline providers UWGLA and Brilliant Corners procured 6,000 hygiene kits with toiletries, cooling packs, first aid United Way, Inc. dba and 10,000 unsheltered people experiencing homelessness across Los kits, PPE, and mylar blankets. Additionally, 500 tents, 500 tarps and 200 sleeping bags were 9 United Way of SD $475,000 6/1/2021 Angeles County during COVID-19 through multidisciplinary outreach distributed for quarantine within encampments with an outbreak. Remote technology such as Greater Los Angeles teams. tablets, phones, and data plans were provided to connect PEH to ongoing telehealth and case management services when needed. Acknowledgment: Social media platforms; logo on Pandemic Relief Fund Impact Report. CLOSED
Engage healthcare and homeless services providers in creating a system Update: Established 16 health services providers partnerships for the Health Pathways of care for individuals and families experiencing homelessness during Expansion, including four provider partners through L.A. Care funding. Served 2,864 patients United Way, Inc. dba the COVID-19 pandemic. Funding will support United Way’s Health experiencing homelessness through 3,492 care contacts. As a result, access to care increased and 10 United Way of INF $500,000 7/15/2021 Pathways Expansion program by providing at least four (4) one-time 47% of those served were enrolled in Medi-Cal, My Health LA, or other insurance, and 73% of Greater Los Angeles grants to health service providers expanding health services for patients were connected to a medical home creating long-term pathways to care. approximately 720 people experiencing homelessness in interim Acknowledgment: Recognized in pandemic relief impact report; press release and blog entry housing sites and/or on the streets throughout Los Angeles County. featuring name and logo.
3 79 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Engaged 15 clients of MLK Hospital recuperative care clients to two, six-week workshop sessions per week. Clients participated in the first program evaluation of Neighborhood Provide an 18-week community singing workshop called Neighborhood Sing, conducted by a team from Claremont Graduate University. 57% of clients achieved a Sing, engage at least twenty (20) homeless individuals and assess 11 Urban Voices Project SD $10,000 2/1/2021 positive affect and 89% increased their skill development. program effectiveness at JWCH Recuperative Care Center at Martin Acknowledgment: Recognized at final performance at each session and with logo in final Luther King Hospital. evaluation report. CLOSED.
Update: For first six months, Neighborhood Sing and Performance Choir programs each reached approximately 25 people per week at the Wesley clinic in Skid Row, an additional 40 Develop and expand virtual technology to allow the organization to people at MLK Hospital, Safe Place for Youth, and LA Central Library. Virtual programs provide all four of its programs (i.e., Neighborhood Sing, Family Sing, routinely reached approximately 300 people weekly on Facebook and Zoom. It achieved its first 12 Urban Voices Project SD $75,000 8/1/2021 Music Lab, and Performance Choir) to under-resourced individuals, objective of sixty individuals attending at least 75% of weekly music engagement workshops, 39 including those experiencing homelessness and mental health of 52 workshops. challenges. Acknowledgment: At all performances, fundraisers, and with logo on UVP’s website and promotional materials.
Ad Hocs Total $6,180,000
Equity & Resilience Initiative I (E&R) - NINE AWARDS
Update: Developed and distributed COVID-19 safety and risk-aversion materials targeting the Black community through the digital newsletter and SuiteEvents’ media platform reaching over Train 25 skilled community volunteers as advocates and facilitators to 24,500 LA-based subscribers; trained four volunteer facilitators to lead four Sister Circles with 97 organize evidence-based community well-being, healing, and resiliency Black women age 25-75 years old in partnership with local chapters of the Links, Inc. and the trainings for 200 women that support policy and educate on solutions California Black National Council for Negro Women; developed IT infrastructure during the pandemic to hold for health disparities, including COVID-19, and inequities leading to 13 Women's Health HB $125,000 9/14/2022 virtual Sister Circles; and selected a new platform to enhance customer relations. To support poor outcomes for Black women and girls. The project will launch a Project organizational resilience, hired a full-time Grants and Administrative Coordinator and supported culturally effective digital campaign to reduce Coronavirus transmission staff with enhanced benefits and tools for remote work, such as ergonomic furniture and in the Black community, while building organizational resilience technology reimbursements. through coaching from a capacity building consultant. Acknowledgment: Logo on all grant outreach/collateral materials & named co-sponsor at Sister Circle events.
4 80 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Serve as partner and fiscal agent of a Native Hawaiian collaborative including Southern California Pacific Islander Coalition, Pacific Islander Health Partnership, and Native Hawaiian and Pacific Islander Alliance Update: Met monthly with the initiative’s Capacity Building Consultants during the first six to participate in a one-year organizational development training months to identify each organizations’ capacity-building goals. Learning to utilize the Strengths, Kutturan Chamoru program with a capacity building consultant to enhance ability to 1) Challenges, Opportunities, Threats (SCOT) assessment framework to determine each 14 HB $100,000 9/24/2021 Foundation educate community partners about best practice to engage the NHPI organization’s capacity-building priorities and objectives. The Collaborative is planning a retreat to community; and 2) ensure accurate reporting of COVID-19 and other explore action steps for each priority area to implement their respective strategies. health information, culturally appropriate media dissemination, and Acknowledgment: California NHPI Data Dashboard Virtual Town Hall sponsor increased awareness of how to reduce coronavirus transmission in the NHPI community.
Update: Conducted three arts-based youth leadership development initiatives in South Los Angeles, involving 88 Black and Latino youth, ages 15-25.. These and previous cohorts advocate Deliver cultural arts programs to 150 youth in South Los Angeles for voter education and mental health services among community members and government neighborhoods and improve three civic partners' strategic methods for agencies through their art. To strengthen organizational resilience, LA Commons Board received LA Commons engaging with community by using LA Commons inclusive cultural fund development training and staff received consultation on QuickBooks, in addition to 15 (Community Partners, HB $125,000 9/14/2022 equity framework to depict community derived goals around health, pursuing and redirecting future campaigns with government entities. Hired a Communications fiscal agent) justice, and countering gentrification and displacement using artistic Coordinator, a Development and Campaign Coordinator, and an Operations Coordinator to expression, while building organizational resilience through coaching manage expanding projects, budgets, and service levels to build a better infrastructure for their from a capacity building consultant. community campaigns. Acknowledgment: Named as sponsor on the We Rise and Creating Our Next LA exhibits and on grantee’s website.
5 81 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Engaged 113 youth and 72 parents through workshops, counseling, discussion groups, and programming on COVID-19 resources/where to get tested, leadership development, and mental health support. Hosts a Pride Food Pantry every Friday providing food to 60 families per Provide direct support services for 330 LGBTQ youth and their week and launched a Parent Academy, a series of Spanish workshops to educate parents on families through workshops, counseling, discussion groups, and LGBTQ issues by allowing youth to exercise leadership skills and express themselves through art. Latino Equality programming on COVID-19 resources and mental health support, as Website development is underway and program evaluation tools are being prepared with capacity Alliance 16 HB $125,000 9/14/2022 well as, leadership development. Develop and distribute 2,500 culturally building consultant. To support organizational resilience, organization has met with two (Community Partners, relevant promotional materials on program services. Improve consultants to begin an evaluation template to strengthen data collection and quality of program fiscal agent) organizational resilience and infrastructure by engaging with a capacity services. The Board is taking a survey created by the consultant to help members understand their building consultant. role, expectations, and to evaluate their progress. In addition it has established a committee to focus on plans related to organizational development and the Board’s donor engagement fundraising plan. Acknowledgment: Social media, flyers, and e-blasts. Logo displayed at six events to date.
lead policy and advocacy committees to address service systems issues Update: Hired 12 interns with lived experience with the justice system and facilitated three Los Angeles Regional related to criminal justice reform affecting the lives of 3,500 justice sessions on key social justice issues pertinent for a broad understanding of reentry work and Reentry Partnership involved individuals. Provide three capacity building and technical criminal justice reform. Offered three workshops to their members, including getting involved in 17 (LARRP) HB $125,000 9/14/2022 assistance workshops for member organizations. Provide paid social justice policy work in Los Angeles County. To support organizational resilience, working (Community Partners, leadership development and training to 10 individuals with lived with a CB consultant to develop systems to track attendance at virtual trainings and workshops fiscal agent) experience. Improve organizational resilience and infrastructure by and taking CCAT organizational assessment to refine capacity building priorities. engaging with a capacity building consultant. Acknowledgment: None to date
Update: Maintained, and in some areas increased, the level of services by devising innovative Address the digital divide exacerbated by COVID-19 by providing approaches to service provision, including delivery of materials by post mail, while developing a tablets, hotspots, and help desk support for at least 150 Black, Latino, longer term solution to the digital divide. Established a new partnership with Human IT to NAMI Urban Los and Korean families, and program peers, teachers, and administrators. acquire and deliver internet connectivity and technical support for volunteer facilitators educating 18 HB $125,000 9/14/2022 Angeles Facilitate virtual classes, support groups, and speaker sessions for at family members how to best manage a loved one's mental health disorder in African American least 500 individuals. Improve organizational resilience and and Latino families of South LA. To support organizational resilience, has met with CB consultant infrastructure by engaging with a capacity building consultant. regularly and discussing positioning organizational leadership to suit the current client population. Acknowledgment: Included on program marketing materials.
6 82 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Provided rental assistance to five TGI clients experiencing financial issues and Enhance existing program services, including rental assistance and/or distributed grocery cards to 12 who are food insecure. Hired a TGI intern for three months and food delivery programs to prevent homelessness and food insecurity immersed them into the organization’s policy advocacy work with the California Transgender for 70 clients during COVID-19. Provide paid internship opportunities The Translatin@ Policy Alliance (CATPA). To support organizational resilience, working with CB consultant to 19 HB $125,000 9/14/2022 to enhance employment skills and job attainment for nine trans, gender Coalition identify an expert in fundraising and development to assist with the development of a multi-year non-conforming, and intersex (TGI) people. Improve organizational fundraising plan. resilience and infrastructure by engaging with a capacity building Acknowledgment: Highlighted as one of the grantee’s funders in its 2020 services report consultant. released in March 2021.
Provide technical assistance, coaching, assessment insights, networking Update: Held orientation and matched each ER I grantee with a lead consultants. Consultant/ and other assistance to enable Equity & Resilience I (ER I) grantees to Grantee teams have established a workplan, including a timeline for organizational assessments Jemmott Rollins 20 HB $75,000 11/30/2021 assess, refine, and achieve grantees' capacity building goals leading to using the Core Capacity Assessment Tool (CCAT) or other assessment tools, provided 52 hours Group, Inc. greater organizational resilience among Black Indigenous and People of of coaching and technical assistance, and conducted one professional development seminar. Color led and serving organizations. Acknowledgment: Posted on website.
Update: Serving as the evaluator of the ER I Initiative, developed a theory of change and Conduct an evaluation of L.A. Care's Equity & Resilience I initiative evaluation plan, including objectives, outcomes and interview protocols for the ER I Initiative. using quantitative research methods and provide L.A. Care an interim Conducted and documented baseline interviews with leadership of initiative grantees'. Assessed all 21 RDP Consulting HB $75,000 12/31/2022 and final report containing evaluation results of interviews and surveys grantees evaluation plans and infrastructure to inform capacity building consultant team of from key initiative stakeholders to inform the direction of future specific technical evaluation needs. initiatives. Acknowledgment: L.A. Care logo placed on website.
E&R I Total $1,000,000
Oral Health Initiative XII (OHI XII) - ELEVEN AWARDS
7 83 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Serve a minimum of 563 patients by providing oral examinations and diagnostic screening for oral cancers, x-rays, treatment for periodontal Update: Reopened for all services in September 2020 at both sites and began recalling patients disease, malocclusion, temporomandibular joint (TMJ), dental caries, that had cancelled their appointments due to the Pandemic, allowing for social distancing and Arroyo Vista Family 22 HB $150,000 8/1/2022 restorations to remove dental caries, endodontic, periodontal care, increased disinfection between patients. Expanded services by 40 hours per week and served 939 Health Foundation prosthetics replacement for lost dentition, restoring masticatory unduplicated patients and provided prophylaxis to 61 diabetic patients. function (e.g. dentures, fixed bridges, removable partials), oral surgery Acknowledgment: Listed on website as a donor. for wisdom teeth extractions, fluoride treatments, and/or prescriptions.
Serve a minimum of 200 patients by providing 450 diagnostic, preventive and basic restorative dental services, basic dental screenings, Update: Opened a new Baldwin Park dental clinic during the COVID pandemic, expanding Central City sealants, oral hygiene instructions, topical application of fluoride, overall dental access by 64 hours per week. Fifty-four patients received 206 diagnostic, preventive 23 Community Health HB $150,000 8/1/2022 composite fillings, stainless steel crowns, space maintainers, root canal and basic restorative services since its opening. Center treatment, dental trauma management, single unit crowns, and Acknowledgment: Plan to include in Newsletter, website and on social media. extractions
Serve a minimum of 1100 patients by providing preventive, diagnostic, Community Health and restorative oral health services, including cleanings, fluoride Update: 536 patients completed their treatment plan, 524 new patients have been provided care, 24 Alliance of Pasadena HB $150,000 8/1/2022 treatments, and sealants to prevent Early Childhood Caries. Restorative and 1,053 medical patients have been referred to dental services. (ChapCare) care includes fillings, pulp-otomys, and crowns and spacers. Also, tooth Acknowledgment: On the organization’s Partners webpage and on social media channels. extractions and gum treatments
Update: Expanded dental capacity by 32 hours per week with the hiring of a .20 FTE Serve a minimum of 750 patients by providing oral health risk Pedodontist and 1.0 FTE General Dentist. Provided new dental services to 713 patients (0 – 20 Comprehensive assessments during well child visits; diagnostic/X-ray services, simple years old) at its Glendale, Sunland, and Eagle Rock clinics combined, meeting 90% of its 25 Community Health HB $150,000 8/1/2022 extractions, preventative care (oral hygiene instruction, sealants, objective. An average of 80% of 0 – 20 year old patients, approximately 2,000 total, are accessing Center, Inc. fluoride treatments, cleanings), emergency care, basic restorative and both dental services and primary care services. An average of 38% of children ages 6 - 9 years old rehabilitative services, and anterior root canals with moderate to high risk for caries received sealants, exceeding target objective of 35%. Acknowledgment: Social media platforms such as Facebook and Instagram.
8 84 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Grantee has seen 1,421 unduplicated patients in the new Arleta dental clinic, 129% of its goal of 1,100, with 255 of those being new patients referred from primary care, thereby meeting Serve a minimum of 1,100 patients by providing diagnostic, 73% of its goal of 350 referrals. Grantee had 222 total HIV patients, which was 80% of the goal. preventative, restorative, and emergency services at the new Arleta On reducing caries risk in youth 0 - 12 (objective #5), 11.1% have reduced caries risk from High facility in eastern San Fernando Valley. Also, screenings, examinations, 26 El Proyecto del Barrio HB $150,000 8/1/2021 to Moderate or from Moderate to Low. This is 74% of its goal of 15% of patients with reduced x-rays, education, cleanings, sealants, fluoride varnish application, caries risk. restorative treatment (fillings, stainless steel crowns), extractions, and Acknowledgment: In written materials for public (patient) distribution, signage in its dental basic endodontics, extensive restorative treatment and nitrous oxide. clinic, and via all communications with members of the board of directors as well as with other funding sources.
Serve a minimum of 750 patients by providing comprehensive oral health care, including acute care and preventive services, X-rays; Prophylaxis; Sealants; Fluoride Treatments, Space maintainers; Restorative services; Laboratory processed crowns; Scaling and root Update: Expanded dental capacity by 36 hours and provided dental services to 938 clients, with Garfield Health planing; Root canals; Extractions; Comprehensive assessment for oral 97% of patients reporting positive outcomes such as resolved pain following care. Over 2,800 27 HB $150,000 8/1/2021 Center diseases and conditions; Individualized preventive dental health diagnostic, preventive and restorative procedures were completed. program based on a caries risk assessment and a periodontal disease Acknowledgment: Informed staff and providers. risk assessment; Anticipatory guidance about growth and development; Plan for responding to acute dental trauma; Dietary counseling; Oral health education; and Referrals to dental specialists.
Serve a minimum of 950 patients by providing dental screenings and Update: Expanded dental services hours to 40 per week, served a total of 309 low-income recommendations for preventive intervention; oral health education, children and adults for dental care, referred 249 patients from or to primary care; and 129 patients oral prophylaxis; topical application of fluorides and dental x-rays for completed a Phase 1 treatment plan. Workflows were adjusted and interim policies & procedures Harbor Community diagnostic screening for both caries and periodontal disease. Diagnose 28 HB $150,000 8/1/2021 developed to address dental service provision in the time of a pandemic. Completed a total of 569 Clinic and treat disease, injury, or impairment in teeth and associated procedures, including the dental visit, radiographic images, prophylaxis for child and adult, structures of the oral cavity, including treatment of caries, non-surgical sealants, and varnish. endodontics, extractions of non-restorable teeth, periodontal therapies, Acknowledgment: Informed staff and providers orthodontic screenings, and maintenance.
9 85 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Serve a minimum of 1,100 patients by providing comprehensive dental services including, diagnostic-x-rays, oral screenings, comprehensive Update: Expanded dental capacity by 40 hours per week. Increased the number of unduplicated exams, preventive-cleanings, topical fluoride, sealants, restorative- patients by 1,100 and provided preventive care to 1,100 patients, resulting in 206 patients 29 JWCH Institute Inc. HB $150,000 8/1/2021 fillings and crowns, periodontics- deep cleanings (scaling and root completing dental treatment plans within six months of initial visit. planning), periodontal maintenance, removable prosthodontics- Acknowledgment: In special 60th anniversary celebration video. dentures and partials, endodontics-root canals and pulpotomies, oral surgery-extractions, and palliative-emergency dental services.
Serve a minimum of 1,100 patients by providing cleanings, oral exams, Update: Grantee served 491 unduplicated dental patients and provided 976 primary and intraoral comprehensive radiography (x-rays), periodontal exams, preventive oral health services, fulfilling 87% of the objective. Four hundred fifteen (415) patients 30 KHEIR Center HB $150,000 8/1/2021 topical applications of fluoride, scaling and root planing, and other completed both primary care and dental visits, achieving met 76% of the objective. Of 112 dental services that prevent, treat, and support recovery from oral health patients surveyed, 80% reported positive outcomes and satisfaction with dental services. conditions. Acknowledgment: Website and social media platforms
Serve a minimum of 1100 patients by providing screenings, anticipatory Update: Opened dental office in Compton, expanding dental capacity by 32 hours per week. guidance, oral hygiene and health education, oral prophylaxis, fluoride St. John's Well Child After reopening, Provided dental services to 2,172 existing patients and 1,000 new patients and a 31 HB $150,000 8/1/2021 varnish, sealants, x-rays, fillings and single unit crowns, non-surgical & Family total of 5,443 visits. Of these, 177 (3%) were provided via tele-dentistry. endodontics, extractions, periodontal therapies, orthodontic screenings, Acknowledgment: Displayed on website's dental services landing page. and maintenance.
Serve a minimum of 1,100 patients by providing initial risk assessment, Update: Completed 1,933 dental visits for 856 unique patient, including same-day referrals from Wilmington screening and exam, oral health education, sealants, or restorative work medical visits. The clinic is in the final stage of hiring an additional dentist. Expects to open both 32 HB $150,000 8/1/2022 Community Clinic such as fillings or emergency services to treat infections or tooth evening and weekend schedules to complete services. extraction as necessary. Acknowledgment: Special video slides displayed on Wilmington site lobby TV monitors.
OHI XII Total $1,650,000
HOUSING STABILITY INITIATIVE II - SEVEN AWARDS
10 86 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Grantee has resolved 16 evictions through pre-litigation services (32% of objective), 7 Provide legal representation primarily in the Antelope Valley to at least evictions through litigation services (14% of objective), provided tenants' rights education to 50 170 eligible clients with incomes up to 300% Federal Poverty Level, residents (20% of objective) and referred 38 clients to external organizations for social resources 33 BASTA, Inc. H $100,000 3/1/2022 engage 300 tenants in education sessions, and make at least 75 service (25% of objective). referrals to social service providers. Acknowledgment: Intake form that is co-branded indicating grant support, messaging regarding workshop sponsor
Update: Has achieved 29% of objectives. The COVID-19 pandemic has resulted in emergency laws and court rules halting eviction cases for months during the grant period, making it less feasible for Bet Tzedek to meet its litigation service deliverables during the first reporting period. Provide legal representation to at least 70 households with incomes up The Preventing and Ending Homelessness Program (PEHP) team provided seven households to 300% FPL, engage at least 100 high-risk tenants in education 34 Bet Tzedek H $125,000 2/1/2022 with pre-litigation services, and held six online public education presentations that were attended sessions, and make at least 30 service referrals to social service by 203 community members. There have been no new litigation cases to report during the start of providers. the HS II grant; however, grantee resolved litigation cases during the Housing Stability I grant. Acknowledgment: Named as supporter of homelessness prevention legal aid work at outreach events and informational brochures and fliers.
Provide legal representation for 340 households with incomes up to 300% FPL, provide tenants' rights education to 500 residents, and refer 630 people to social service organizations. Funds will also provide Update: Provided assistance to six households living 300% under the Federal Poverty Level counsel and advice to 500 Pasadena and West Covina hub court area through full scope pre-litigation services (3% of objective to date). Thirty-five (35) households residents. were assisted during litigation stage (25% of objective to date). Grantee provided tenants' rights Eviction Defense education to 1218 people at 42 webinars, Finally, grantee conducted 104 interventions with 35 H $150,000 2/1/2022 Network tenants facing illegal lock outs successfully resolving 92% of these illegal displacement situations. All families/households served are living at 300% under the Federal Poverty Level (FPL Acknowledgment: Grantee acknowledges support via its email signature lines, announcements during its webinars and written statement posted in its office lobby
11 87 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Has achieved 165% of its goal to provide tenants’ rights education to 100 residents (an additional 2,159 people viewed the tenants’ rights workshops after the live event); (b) 100% of its Assist at least 50 individuals or families with incomes up to 300% FPL goal to refer clients to external organizations for social resources; (c) 15% of its goal to resolve 20 with legal representation, inform at least 100 people about the program 36 Inner City Law Center H $100,000 2/1/2022 evictions through litigation services; and (d) 3% of its goal to resolve 30 evictions through pre- through tenants' rights outreach events and refer at least 30 people to litigation services partner social service organizations. Acknowledgment: Identified as a supporter of homelessness prevention work during outreach events.
Update: Served 5 new clients (14% of objective) through full in-court representation in addition to cases from earlier in 2020 that were temporarily suspended by the pandemic. Provided pre- eviction to 21 individuals (32% of objective) ranging from advice on enforcing tenants’ rights Help prevent evictions for 55 underserved LGBTQ individuals with against habitability violations and retaliation, to advice on approaching trials, to stopping evictions. Legal Aid Foundation incomes up to 300% FPL through legal representation, provide tenants' Provided tenants' rights education to 36 residents (36% of objective). Provided virtual weekly 37 H $150,000 2/1/2022 of Los Angeles rights education to 200 residents and refer 40 clients to partner social clinics with community based organizing partners and also recorded several “Know Your Rights” service organizations. clinics and posted on the organization’s social media websites designed to inform, educate and empower tenants and the community. Virtual sessions has amassed more than 3,300 views to date (94% of objective). Acknowledgment: Plan for later acknowledgment
Update: Hired a new, full-time attorney whose primary focus is working on resolving eviction issues for the LQBTQ population. Assisted 14 clients with pre-litigation services (40% of Provide legal representation to 100 individuals/families with incomes objective) by negotiating with landlords and management companies and advising clients as to Los Angeles LGBT up to 300% FPL, provide tenants' rights education to 100 residents, COVID related rights and issues. Represented 3 clients (15% of objective) through litigation 38 H $125,000 2/1/2022 Center engage 3,600 viewers in Know Your Rights sessions via social media, services. Provided an educational seminar in to 60 people (30% of objective) to address tenant and refer at least 30 people to partner social service organizations. rights and issues in light of the COVID pandemic. Referred 14 individuals (35% of objective) to internal and external legal and social service groups to provide additional client support. Acknowledgment: Plan for later acknowledgment.
12 88 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Provided legal advice and assistance to 16 new individuals or families (53% of objective) resolving their housing issues through pre-litigation services; provided legal advice and assistance Provide legal representation to at least 50 eligible clients with incomes to 5 new individuals or families (25% of objective), resolving their eviction issues through 39 Public Counsel H $100,000 2/1/2022 up to 300% FPL, engage 100 tenants in education sessions, and make at litigation services; provided tenants’ rights education to 37 residents (37% of objective); and least 30 service referrals to social service providers. referred 15 individuals or families (50% of objective) to homelessness prevention providers for non-legal social services and financial assistance. Acknowledgment: Posted on website.
Housing Stability II Total $850,000
ROBERT E. TRANQUADA, MD, SAFETY NET INITIATIVE XI - TEN AWARDS
Provide medical care to at least 500 Latino patients over a two-year Update: Expanded nurse practitioners hours from 20 to 40 hours per week and hired bilingual period. Seek a 15% increase from baseline of Latino patients with Garfield Health Spanish/English outreach staff to attract Latino community members. Saw 327 new Latino 40 INF $150,000 6/1/2022 diabetes whose most recent hemoglobin A1c (HbA1c) is less than 9. Center patients, of which 67 were diabetic patients and more than 35 have an AIC < 9. The percentage of Latinos in the overall patient population will increase Acknowledgment: Informed staff and providers of the award and program. from 6% to 14%.
Update: Purchased forty percent of the work stations and is pursuing six NexGen provider Provide medical care to at least 175 new African American patients. licenses to facilitate clinic's ability to provide telehealth and face-to-face medical and behavioral Out of an existing population of 5,500 African American patients, more health visits with a focus on maintaining 15% base of African American patients. In addition to than 3% (165) of African American patients will receive weight providing care to 521 new African American/Black patients in the Antelope Valley clinic 41 JWCH, Inc. INF $150,000 6/1/2022 counseling and 5% (275) smoking cessation counseling, plus needed locations,. Of all African American patients at JWCH clinics, 143 out of 718 had an A1C>9. clinical services. The percentage of African Americans compared to Another 673 out of 1176 had controlled hypertension. Acknowledgment: Plan to provide highest the overall patient population will increase from 15% to about 15.1 %.. level sponsorship on Donors page on website under development. Acknowledgment: Plan for later acknowledgment.
13 89 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Registered 65 new Latinx SPA4 patients, bringing the current SPA4 Latinx patient Provide medical care to at least 330 new, unduplicated Latino patients population to 2,278 of 7,348, or 31% of its SPA4 patients (an increase of 1% of the 5% overall L.A. Lesbian, Gay, over a two-year period, with a specific focus on the LGBT community. projected increase). Retained into the PrEP program 77% of SPA4 Latinx PrEP patients who Bisexual, and The Center will increase retention of Latino pre-exposure prophylaxis were active within six months prior to the grant period start. Establishing this as a baseline, the 42 Transgender Center INF $150,000 6/1/2022 (PrEP) patients--those who have been identified as at-risk for HIV--by Center will aim to increase retention by 15% to 88% by the end of the grant period. Of the (Los Angeles LGBT 15%. Of these new PrEP users, 85% will be retained over the grant targeted PrEP patient population, 98% remains HIV negative, which represents 41 out of 42 new Center) period and remain HIV negative. The percentage of Latinos in the SPA4 Latinx PrEP patients. This surpasses its 85% benchmark by 118%. clinic's overall SPA4 patient population will increase from 30% to 35%. Acknowledgment: Listed on donor page of website
Provide medical care to at least 528 new, unduplicated African Update: Increased diabetes diagnosis by 15%. The total number of African American patients American patients over a two-year period. The Center seeks to improve increased by 222 in calendar year 2020. Initiated minor renovations at Inglewood site. Diabetes health outcomes related to diabetes for its target population by ensuring South Bay Family control outreach and education for this population will resume when preventive services restart 43 INF $150,000 6/1/2022 at least 65% of these new patients with patients diabetes or prediabetes Health Care by mid-summer. will have HbA1c < 9.0% (controlled levels). The percentage of African Acknowledgment: Diabetes Management Program materials will have L.A. Care logo and American patients in the Inglewood clinic's overall patient population statement regarding funding. will increase from 22% to 30%.
Provide medical care to at least 800 new, unduplicated African Update: Performed 59,000+ total COVID-19 tests at all sites, with 17% yielding positive results. American patients and 265 Bengali patients over a two-year period. The At the Compton site, of 5,008 tests administered (all races), 452 (9%) of patients tested were Center seeks to improve health outcomes related to COVID-19 Black/African-American, with 10 of them testing positive. At the Crenshaw site, of 910 tests diagnoses and diabetes control for its target populations by ensuring at administered (all races), 315 (35%) of patients tested were Black/African-American, with 29 of St. John’s Well Child 44 INF $150,000 6/1/2022 least 75% of its new African American and Bengali patients receive them testing positive. At the Rolland Curtis Gardens site, of 3,105 patients tested (all races), 59 and Family Center COVID-19 testing and 65% have HbA1c < 9.0% (controlled levels). patients tested were Asian, (2 specified “Bangladeshi,”) with three of the fifty-nine testing The percentage of African American patients across all three targeted positive. Due to the reassignment of staff to testing, no progress has been made thus far on the clinic sites will increase from 12% to 18% and will increase from 0% to diabetes control program for these populations at these sites 4% at the one targeted clinic site for Bengali patients. Acknowledgement: Plan for future acknowledgment.
14 90 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Provide medical care to at least 350 new, unduplicated Latino patients over a two-year period. The Center seeks to improve health outcomes related diabetes and hypertension by ensuring at least 72% of new Update: Hired a physician who has worked with the sites underserved community. A total of 323 Latino patients with a diagnosis of diabetes will have HgA1C levels of the 1,537 served were new patients. Of the 142 new patients whose ethnicity was reported, under 9% (controlled diabetes) and at least 70% of new Latino patients 41% (58) are Latinx. Services are offered on two Saturdays per month in person or through The Achievable 45 INF $150,000 6/1/2022 with a diagnosis of hypertension will have controlled blood pressure. virtual visits. Additional quality improvement is underway to ensure staff thoroughly complete Foundation Additionally, the center seeks to help 75% of newly enrolled Latino intake forms. The clinic is also establishing a baseline for its target populations. Progress has been patients without diabetes or hypertension maintain or improve their limited by long-term leaves during COVID-19 and the use of temporary staff in the interim. health as evidenced by the absence of a new diagnosis of either Acknowledgment: Listed with website link as major supporter on website and donor wall. condition by the end of the project period. The percentage of Latino patients will increase from 35% to 45%.
Provide medical care to at least 1,000 new, unduplicated Cambodian Update: Identified and assigned Cambodian Registered Nurse to oversee hard to reach patients (ages 18 – 75 years old) over a two-year period. TCC seeks to Cambodian patient population outreach program. Provided assistance to patients during visits improve health outcomes related to its new Cambodian patients with with a provider to ensure care is delivered in a culturally and linguistically appropriate and trauma diabetes and hypertension by ensuring at least 70% of its new 46 The Children’s Clinic INF $100,000 6/1/2022 informed manner, and partnered with civic and government sponsored initiatives focused on the Cambodian patients have HbA1c < 9.0% (controlled levels) and no Cambodian population to engage patients. Progress on recruitment and care coordination will more than 40% have diagnosed “uncontrolled” hypertension after one increase as patient visits and capacity return to higher levels. year of being followed at TCC with at least two visits. The percentage Acknowledgment: Upcoming social media and Social Impact Report. of Cambodian patients will increase from 3% to 5.5%.
Update: Hired a Patient Care Coordinator and dedicated a Physician Assistant, who represents and understands the African American community's cultural needs. Providing outreach to all Provide medical care to at least 200 new, unduplicated African African American/Black patients by sending communication and education in a few modalities American patients over a two-year period. The Center seeks to increase including using the LUMA text message system. Purchased 10 Ipads and installed Luma Health Universal Community the hypertension control rate of its overall African American patient 47 INF $150,000 6/1/2022 platform on these new devices for patients to use as needed. Purchased three mobile blood Health Center population from 65% to 80%. The percentage African American pressure monitors for patients who need intervention and/or treatment of hypertension or other patients in the clinic’s overall patient population will increase from 3% chronic illnesses, including remote monitoring. The number of African American patients to 6%. increased from 167 to 200. Acknowledgment: Listed with link on website
15 91 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Provide medical care to at least 298 patients of Asian descent over a Update: Made significant progress on the infrastructure component of the grant by completing two-year period. The following health outcome baselines will be the final design, budget and timeline for the minor alteration/renovation improvements. Clinic established: Percentage of patients with a history of periodontitis who staff and providers have begun training on cultural competence to better serve the target Via Care Community receive at least two visits per year; patients who receive at least two 48 INF $150,000 6/1/2022 population. Outreach efforts with community organizations like local colleges will intensify Health Center topical fluoride application; and diabetics who receive a comprehensive toward the end of 2021, closer to the completion of the clinic renovations. a periodontal evaluation. The percentage of Asians in its overall patient Acknowledgment: Noted project page for the new renovated health center on website, social population will increase from less than 1% to over 1% and increasing media posts and outreach materials. 10% per year.
Provide medical care to at least 150 new, unduplicated Asian American patients, with a focus on women, over a two-year period. The clinic will Update: Hired an Information Systems Technician, a part time RNP and a part time Medical help 85% of the 150 targeted new Asian patients to maintain or Assistant. Researched linguistic tools to target the Asian Community, resulting in the development Wilmington 49 INF $125,000 6/1/2022 improve their health status as evidenced by the absence of: unintended of various marketing materials that have been utilized in the community posted on lobby Community Clinic pregnancy, diagnoses of diabetes, or tuberculosis. The percentage Asian monitors, social media sites and website. patients in the clinic’s overall patient population will increase from 2% Acknowledgement: Slide thanking LA Care on lobby monitor at Wilmington location. to 4%.
Tranquada XI Total $1,425,000 CHIF FY 2019-2020 GRAND $11,105,000 TOTAL Priorities: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Fiscal Year 2018-2019 - Total of 70 Awards for $10,240,000 AD HOC GRANTS - TWENTY-ONE AWARDS
Update: Increased the number of counseling trainees to 14 and the number of queer-identified clients served to a total of 50 individuals with two clinical supervisors on board. COLORS has Provide 2,800 one-hour no-cost LGBTQ-affirmative mental health delivered 2,304 units of service. Facilitated two speaker panels. The first uplifted the voices of Antioch University counseling services to at least 70 queer-identified young people under trans-identified activists and organizers, and the second celebrated Black families of trans- 50 INF $50,000 3/15/2021 Los Angeles (Colors) the age of 25 annually through the Antioch University’s Counseling identified children. Both panels had 60+ participants in attendance. Center. Acknowledgment: Recognized in printed materials, brochures, signage and online outreach and marketing. CLOSED
16 92 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: The Brilliant Corners/Housing for Health has housed 322 unique families since April House 300 homeless individuals and families in permanent supportive 2017. As of September 2020, the program has housed 264 families, and 78% are L.A. Care housing (PSH), including L.A. Care members, over a five year period, members. Over 90% of clients who were ever housed retained housing for at least one year. 51 Brilliant Corners III H $4,000,000 9/1/2021 of which this is the third year. Project also supports the goals of the Acknowledgment: Project presented at legislative hearing Whole Person Care (WPC) initiative under the new California Medi-Cal waiver and enables DHS to draw down matching funds.
Update: Supported community-based education, outreach and assistance efforts for hard-to- count (HTC) communities across Los Angeles County in the Census 2020. Developed and To develop and implement a countywide marketing campaign to released a Digital Toolkit, with input from more than 100 community based organizations, which promote a thorough Census 2020 count of all Los Angeles County contained culturally and linguistically relevant materials to demystify the Census and address California Community residents, especially low-income and the traditionally undercounted, 52 SD $50,000 9/15/2020 specific populations' concerns. Conducted virtual outreach to assist individuals to access and Foundation (CCF) including most L.A. Care Health Plan members. Campaign materials accurately complete census forms online, and achieved a 65.1% response rate despite COVID, will be made available to the L.A. Care Health Plan’s Census Action limited digital access, and moving deadlines. Group for direct distribution to plan members. Acknowledgment: Listed as a partner for the Census 2020 WeCount LA Campaign. CLOSED
Update: Successfully met and surpassed all three project objectives. Educated 4,600 community Provide “Know Your Rights” educational workshops, flyers and social members on incidents of hate and fear among immigrant community through collaboration with media messages to over 2,500 individuals, legal consultations to 50 rapid response efforts and workshops (included education on disproportionate impact of COVID- CARECEN - Central unaccompanied minors and/or refugee families, refer 150 people to 19 pandemic). Provided quality immigration legal services to 86 unaccompanied minors and 53 American Resource SD $300,000 3/15/2021 medical and social service agencies, and engage 1,000 impacted refugee families. Center immigrants to protect their families through policy advocacy education Acknowledgment: Listed in outreach material; logo recognition on website, newsletter, press and sessions. media coverage. CLOSED
Update: A total of 60 students were enrolled and completed the Math Summer Camp for three Provide four weekly three-hour Math Summer Camp sessions to 75 low- Charles R. Drew hour per week and 94% of participants improved their math skills as indicated by a pre and post income students in grades 3rd through 12th from underperforming 54 University of SD $50,000 12/31/2020 assessment. schools in South LA to improve math performance and preparation for Medicine and Science Acknowledgment: Program White Coat Ceremony. higher education in STEM fields. CLOSED
17 93 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Hired consultant and delivered six trainings in September 2020 utilizing the University Charles R. Drew Train 6 Psychiatry Residents and 8 Family Medicine residents in the of Washington’s Advancing Integrated Mental Health Solution Center Curricula to 6 Psychiatry 55 University of INF $100,000 9/25/2021 Collaborative Care Model, an evidence-based approach for integrating Residents and 8 Family Medicine Residents. Medicine and Science physical and behavioral health Acknowledgment: At resident trainings.
Update: CHIRLA made a total of 34,866,627 impressions through Census-themed media Provide information regarding Know Your Rights (KYR), Public campaigns; reached 178,046 individuals with Public Charge information; provided Know Your Charge, and the 2020 Census that will reach the following: 51,000 Rights information to 241,563 individuals through community education and outreach efforts; unique individuals through community presentations, 4,000 unique assisted a total of 22,581 callers through a toll-free Immigrant Assistance Hotline; and completed CHIRLA - Coalition callers via CHIRLA's Toll Free Immigrant Access Hotline, 5,000 322 naturalization applications. 56 for Humane SD $150,000 3/15/2021 people through presentations to Legal Services clients at all CHIRLA's Acknowledgment: Social media content relating to Public Charge and community presentations Immigrant Rights LA County offices; and 150,000 individuals through 3 media events, 20 on accessing healthcare services. earned media hits, two live social media events, and four recorded CLOSED. videos.
Update: Held workshop for various levels of clinic management staff to improve the financial strength and sustainability of various clinics. Thirty-two participants attended from 20 clinics and Community Clinic Provide a full day of training and technical assistance support through all the workshop materials were released to all 65 clinic members. Additionally, at least 75% of Association of Los the Advancing the Financial Strength program to a minimum of 45 Los 57 INF $30,000 4/1/2020 attendees reached financial acumen thresholds. Angeles County Angeles County Federally Qualified Health Centers (FQHCs), FQHC Acknowledgment: L.A. Care logo on website, printed materials, email correspondence, displayed (CCALAC) Look-alikes, or licensed community clinics in Los Angeles County. at all events, and is acknowledged in all marketing activities. CLOSED
18 94 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Sponsored a webinar for community residents on the Vision Zero's Avalon Blvd safety project attended by the Mayor’s office; 15 youth met weekly via Zoom to develop art skills, learn about the HKZ initiative, reflect on social justice and equity issues through art, and prepare for the launch of the story gathering action. An online story gathering circle was held in June with 25 Implement a Healthy Kids Zone (HKZ) initiative to impact the Community Health people. The stories gathered informed the artwork for the HKZ Medallions, which were placed 58 SD $125,000 12/31/2020 neighborhoods surrounding Fremont High School in South Los Councils on the fence at Fremont on Avalon Boulevard to support HKZ priorities on public health safety Angeles. and food insecurity. Staff are working with the school to determine the best time to do an official ceremony to showcase the medallions. Acknowledgment: L.A. Care is recognized on website and all public facing documents. CLOSED
Update: Established the Coalition on Economic Resilience (CoER), an 88-member cross-sector coalition, in September of 2019. Produced a landscape analysis with recommendations on creating a strategy for economic resilience which was presented to the CoER on November 19, 2019. A Establish and convene a cross-sector coalition of up to 80 thought report on Solidarity Economics was presented at a second CoER meeting on April 16, 2020 and leaders and key decision makers that will produce an actionable plan Community Health at the Women, Wealth and Equity Summit in October of 2020. Next steps include the 59 SD $50,000 12/31/2020 aimed at building economic resilience and protecting the health of Councils development of an Equity Scorecard to help organizations assess their justice, equity, diversity and under-resourced communities in South Los Angeles during economic inclusion profiles and develop action plans to better target their resources. downturns. Acknowledgment: L.A. Care logo was placed on event agenda, program, signage, and presentations. Funding was also acknowledged during the Coalition launch event. CLOSED.
Update: The CSULB Health on Wheels (HOW) clinic provided care to 173 children during 199 Provide health care services, in collaboration with local service partners, total visits. Of those children seen, 82% of the children were Hispanic, 7% Asian, 4% Black, 6% to at least 300 patients including 50 Child Health and Disability CSULB Research White and 2% Other Race/Ethnicity. HOW has administered 500 childhood immunizations and 60 INF $70,000 10/1/2021 Prevention (CHDP) Well Child examinations and 500 vaccinations to Foundation provided 28 well child visits. children from the Norwalk La Mirada Unified School District and Acknowledgment: Recognized in a brochure and in CSULB's College of Health and Human surrounding areas. Services winter newsletter and collateral material.
19 95 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Assessed the health needs of 100 DL/DW and educated 750 DL/DW on their health care access options. Established one MOU with Clinica Romero through their Health Access Conduct a health needs assessment of 100 day laborers and domestic Campaign, and enrolled 42 workers in My Health LA program. Also, conducted several Instituto de workers (DL/DW), establish partnerships with four community clinics workshops on My Health LA for laborers and domestic workers. Provided free health services, Education Popular del 61 SD $75,000 12/15/2020 to serve as medical home for those surveyed, educate 750 day laborers such as vaccinations and screenings, for low-wage workers at Pico Union Resource fair, and Flu Sur de California and domestic workers on health care options, and enroll 50 low-wage Vaccine Clinic at Harbor City. (IDEPSCA) workers in My Health LA. Acknowledgment: Health Assessment Report, presentations to DL/DW, and Community Emergency Guide. CLOSED
Update: Modified program design and workflows to mitigate the impact and the increased risks LAC+USC Medical Recruit and enroll at least 25 high-cost, high-need type 2 diabetic of COVID-19 on diabetic patients and has enrolled five patients in program. Two patients Center Foundation, patients from the LAC + USC Medical Center to participate in a 26- completed the intervention and had dramatic reduction in outcomes measures of HBA1C 62 SD/INF $150,000 12/15/2021 Inc./The Wellness week Medically-Tailored Meal Program to be delivered in conjunction reduction, BMI weight reduction, hospitalization, and drug burden. Center with the standard diabetes clinical care. Acknowledgment: Program materials and presentation slides used at a California Healthcare Foundation event related to Food is Medicine.
Update: During the Fall, 752 9th-12th grade students from Ortho High School participated in a Biotech and Community Health Careers Day, and 306 students attended healthcare career panels Los Angeles Area at the Tu Futuro LA: Beyond the Diploma Conference. 235 high school students participated in a Recruit at least 10 healthcare employers who will provide 75 or more Chamber of mock interview and received interview/resume feedback. Out of those 306, 183 students were 63 SD/INF $75,000 12/15/2020 students work-based paid-summer internships and will provide access Commerce deemed "work ready" and 89 of those students were hired for Summer 2019 internships. to career preparation activities in the healthcare field to 450 students. Foundation Acknowledgment: Chamber's Weekly, through Twitter, signage and program materials for the Beyond the Diploma Conference, and at their Titans of Talent Employer event. CLOSED.
20 96 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Facilitated virtual trainings for 140 medical and social service providers at Cedars Sinai Medical Center and Watts Health Care's WIC affiliate. Launched a virtual Safe & Sacred Provide trainings to at least 100 medical providers, 100 social services Pregnancy Support Group in October 2020 through iDREAM for Racial Health Equity whose providers and 50 mental health professionals of color on the signs, staff facilitated seven series of the peer led support group for 59 Black pregnant women and their Maternal Mental symptoms and treatment options for perinatal mood and anxiety partners. Promoted support group and storytelling programs to more than 2000 families. Forty- 64 HB/INF $150,000 3/15/2021 Health NOW disorders affecting Black women, and facilitate peer-led Mind & Body one percent of providers trained reported comfort with incorporating cultural humility into their Support Circles to at least 180 Black perinatal women receiving care at care and 80% of women served at participating sites were screened for perinatal mood and Cedars Sinai, Watts Healthcare and a third site to be identified. anxiety and anxiety disorders. Acknowledgment: Support group flyers and in the conference materials. CLOSED
Update: Of the 61 awards across the county, seven were chosen for the L.A. Care program: 2 MD, 2 Nursing, and 3 PA. During the six-week summer program, Scholars were exposed to primary healthcare practice in a community health center setting in LA County. The seven Support the Primary Care Leadership Program (PCLP), an immersive Scholars completed all PCLP activities and requirements including 200 service-hours at their National Medical summer program to place medical and mid-level clinical students at Los assigned clinics experienced leadership trainings via webinars, attendance at administration and 65 INF $150,000 4/1/2020 Fellowships, Inc. Angeles County safety net clinics, including Federal Qualified Health management meetings including Board of Directors, provider meetings, or quality improvement Centers. meetings. Acknowledgment: In electronic and printed program materials, and acknowledged by NMF President and CEO at their LA Champions of Health Awards and Gala. CLOSED.
Update: Completed its HIPAA compliance project and received a final Fiducial Information Develop and adopt policies and procedures necessary to be in Security Assessment Score of “Good.” Among program staff with direct access to its clients 66 Project Angel Food INF $15,000 12/15/2020 compliance with Health Insurance Portability and Accountability Act Protected Health Information (PHI), the training completion rate was 100%. (HIPAA) privacy rules and standards. Acknowledgment: Recognized with a thank you letter and in materials for next event. CLOSED
21 97 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Have provided 12 major cross-cutting programs exploring health and health equity issues with funders, reaching beyond health funders to educate other grantmaker members about Provide at least 7 education and engagement opportunities to at least how their work is health-related, and connecting funders across silos. Also provided 11 in-person 125 grantmakers addressing health equity and wellness; provide at least Southern California and online programs to engage funders in Census 2020. Public Policy Conference held in April 67 INF $20,000 12/31/2020 4 programs focusing on the 2020 Census and fair redistricting to at least Grantmakers welcomed over 300 funders and community leaders in attendance. 75 participants.; and facilitate 3 convenings for grantmakers and Acknowledgment: Highlighted as sponsor at Public Policy Conference, on website, email policymakers on health equity attended by at least 300 participants marketing, and print promotion. CLOSED
Update: Completed the feasibility study that outlines proposed services, patient/visit assumptions, staffing assumptions, 5-year financial projections, facility requirements, capital expense ranges, and potential financial strategies. Findings were presented to Achievable’s Board Implement plan to expand comprehensive, integrated health care of Directors focused on the Inglewood and Hawthorne area, which represented the highest The Achievable services for individuals with intellectual and developmental disabilities, 68 INF $75,000 12/31/2020 unmet needs and potential for positive impact on individuals with intellectual and developmental Foundation their families, and other vulnerable individuals through the launch of a disabilities. Due to the COVID-19 pandemic, the identification and opening of the second site second health center site, potentially in South LA. was delayed as well as an MOU with the local regional center. Acknowledgment: Website, donor wall, annual report, and quarterly newsletters. CLOSED
Update: Hired and on boarded two new clinicians to handle an expected increase in new patients. At least 5,300 new patients were provided direct patient health care services, with approximately To empanel up to 5,300 new patients each with his/her own assigned Valley Community 80% served through telehealth services and all patients assigned to a primary care VCH clinician. 69 INF $50,000 12/31/2020 clinician and incorporate them into the clinic's Electronic Health Healthcare Acknowledgment: Recognized on the permanent Donor Board and continue to be listed on Record system. Corporate and Foundation Donor List. CLOSED
22 98 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Hire a dental consultant to facilitate the completion of a plan for the Update: Hired a dental consultant who completed a workplan to start up a dental program. start-up of a new dental program with the capacity to provide 1,000 oral Equipment for four dental operatories was purchased and installed and a dental module is in the Westside Family health visits to a minimum of 500 clients per year. Update: The search process of being integrated into its EHR. The pandemic has delayed the opening of the new clinic 70 HB $50,000 12/15/2020 Health Center for a dental consultant is underway. Renovation is more than 55% program., but it will resume as clinics are opening up. complete and the estimated move-in date is May 2020. Acknowledgments: L.A. Care will be widely recognized at the grand opening planned for July of Acknowledgments: None at this time. 2021.
Ad Hocs Total $5,785,000
ORAL HEALTH INITIATIVE XI - NINE AWARDS
Update: Contracted with seven LAUSD schools and 12 WIC sites and 10 Headstart sites. Hired a hygienist and developed a Teledentistry model that combines a community dental coordinator, a registered dental hygienist, and a dental provider. Rendered oral assessments and dental services Hire a dental hygienist for schools and mobile units. Provide cleanings, for 685 additional vulnerable patients through 2,379 total visits and outreached to 2,887 unique AltaMed Health 71 HB $100,000 12/31/2020 sealants, and interim therapeutic restorations to at least 1,250 dental patients and provided screenings, cleanings, fluoride, sealant, and a comprehensive oral health Services patients in the Greater East L.A. area plan. Acknowledgment: On social media channels and internal communication methods such as monthly newsletters, biweekly all staff updates, and annual Impact Report. CLOSED
Update: Hired dentist in April and started providing services at JWCH Wesley/AVCC's Health and Wellness Dental Clinic located in Lancaster. Clinic provides Teledentistry and Comprehensive Dental Services five days per week. Provided 3,832 encounters to 1,940 Hire a general dentist. Provide complete treatment plans, and unduplicated patients. Appointment wait times have been reduced to 1 week for new patients and Antelope Valley 72 HB $125,000 10/1/2020 preventive dental care to approximately 1,500 dental patients in the 2 weeks for treatment. Treatment plans are completed at 80% due to COVID restrictions. Community Clinic Antelope Valley: Acknowledgment: Mentioned on website, at Benefit Dinner, and in email blasts .L.A. Care will be listed as platinum sponsor in JWCH's 60th. virtual Anniversary event and commemorative book. CLOSED
23 99 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: After hiring a new full-time dentist, dental care visits have increased to 5,819 in San Gabriel and to 10,177 in Chinatown location. The latter saw an increase in new patient visits of 394%. Treatment plan completions reached 46%, a 4% increase; and 51.7% of patients 65 and Chinatown Service Hire a general dentist. Provide comprehensive prevention and older have returned for maintenance visits within 8 months following prior services. Working on 73 HB $125,000 10/1/2020 Center treatment services to at least 650 patients in the San Gabriel Valley. moving dental services into a (3rd floor) larger space and expanding their dental capacity from 3 to 7 chairs. The new timeline is to open by 2nd quarter of 2021. Acknowledgment: At annual gala in September 2019. CLOSED
Update: After hiring a new full-time dentist and adding two additional days of service at the Watts location, provided 11,431 dental visits, with a total of 3,341 unduplicated dental patients Hire a general dentist. Provide preventive education and treatment for Los Angeles Christian being served. Grantee had a target objective of increasing the percentage of phase 1 dental patient 74 HB $125,000 10/1/2020 over 250 primarily homeless individuals in the Skid Row area and Health Centers treatment plans from 29% to 32%, but exceeded this target by completing 42%. Watts. Acknowledgment: None CLOSED
Park Tree Community Update: A new full-time dentist was hired in May. This addition has increased access to children Health Center Hire a dentist. Provide diagnostic, preventive and restorative dental and adults within the community. The Holt Dental Clinic served 428 children and 1,237 adults. 75 (formerly Pomona HB $125,000 10/1/2020 services to over 500 dental patients in Pomona area. Acknowledgment: Website, social media blasts, and a plaque in the Holt Dental Clinic. Community Health CLOSED Center).
Hire part-time, general dentist and registered dental hygienist. Provide Update: A full-time dentist was hired increasing dental access hours by a full 16 hours per week. San Fernando prophylactic and restorative dental care to at least 380 dental patients in A total of 11,824 patient encounters were delivered to 4,221 unduplicated patients 76 Community Health HB $115,000 12/31/2020 the City of San Fernando, Pacoima, Sylmar, Panorama City, Van Nuys, Acknowledgment: Website and donor plaques posted in the health center. Center and North Hollywood. CLOSED
Update: Grantee hired one FTE general dentist and provided 11,431 dental visits, with a total of 3,341 unduplicated dental patients being served. Grantee had a target objective of increasing the Hire a dental hygienist. Provide prophylaxis, sealant application, Valley Community percentage of phase 1 dental patient treatment plans from 29% to 32%, but exceeded this target 77 HB $125,000 12/31/2020 fluoride treatment, and non-surgical periodontal therapy to over 550 Healthcare by completing 42%. dental patients in the North Hollywood and San Fernando Valley areas. Acknowledgment: On their permanent Donor Board and is listed on their Corporate and Foundation Donor List.
24 100 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Hired dentist and served 1,062 patients before COVID. After a 10-week shutdown due to the pandemic, they reopened in June and have provided 1,651 patient encounters. Hire a dentist. Provide preventive, rehabilitative, and oral surgery Acknowledgment: L.A. Care was recognized as a sponsor of Venice Family Clinic's daily food 78 Venice Family Clinic HB $125,000 12/31/2020 services to at least 720 patients. in West L.A. and Culver City. distributions in the community during November and December and John Baackes participated in a video presentation during clinic's 50th Anniversary celebration. CLOSED
Update: After hiring a new full-time dentist, it served 4,120 unique dental patients and 382 Hire a general dentist. Provide preventive and rehabilitative services to pregnant mothers. Sealants were administered to 192 children. The wait list for preventive dental 79 Via Care HB $125,000 12/31/2020 at least to 1,500 dental patients due to a newly purchase dental practice services was eliminated and walk-ins and same-day appointments are now available in the Greater East L.A. region Acknowledgment: L.A. Care’s logo added to website. CLOSED OHI XI Total $1,090,000 HEALTH HOMES PROGRAM (HHP) INITIATIVE I - TWENTY AWARDS
Hire full-time Housing Navigator, select a separate case management Update: An HHP team was hired, trained on health homes requirements, created policies and system and train Health Homes Program (HHP) team staff, leverage procedures, updated their EHR for HHP data, and created/modified project workflows. Enrolled AltaMed Health 80 INF $60,000 5/15/2020 the medical management team, and create a dedicated mobile HHP 403 patients and completed 341 health risk assessments. Services Corporation team, to serve up to 120 HHP patients in the greater East Los Angeles Acknowledgment: Social media blast and annual newsletter. area CLOSED
Update: Clinic became a Community-based Care Management Entity as of October 2019. A total Hire Case Manager and identify key partners to increase access to Arroyo Vista Family of 84 individuals were enrolled in the program. 81 INF $60,000 12/31/2020 resources in Northeast Los Angeles, to serve up to 50 HHP patients in Health Foundation Acknowledgment: Listed on website and promotional materials as a sponsoring partner. the Northeast Los Angeles, Pasadena corridor, Eagle Rock. CLOSED
25 101 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Established policies and procedures for the Health Homes Program, integrated program into EHR system, established Program Workgroup consisting of a Program Director, an Asian Pacific Hire and train staff and formally link Behavioral Health unit to connect Enrollment Community Outreach Worker, a Care Coordinator and a Care Manager, along with a 82 Healthcare Venture, INF $60,000 12/31/2020 patients to social service resources, and redesign EHR and clinic Behavioral Health Care Coordinator and a Housing Navigator. Outreach and Enrollment Inc. workflow. Serve up to 200 HHP patients in the greater Hollywood area activities began in January 2020, reaching 32 patients by the end of May 2020. Acknowledgment: None to date. CLOSED
Update: Reassigned two care coordinators and one lead staff member to support the Health Homes Program. Collaborating with Union Station Homeless Services in Pasadena to refer ChapCare - Launch referral-based care coordination tracking and reporting IT vulnerable patients for Housing Navigation services. Currently managing 250 enrolled individuals 83 Community Health INF $60,000 12/31/2020 system with claims submission capacity to support HHP start-up staff, in HHP, with 13% of these being L.A. Care members. Alliance of Pasadena and serve up to 100 HHP patients in Pasadena Acknowledgment: Website and through social media. CLOSED
Update: Two full-time care coordinator were hired and completed all required trainings. signed Hire full-time Assistant Clinical Social Worker Care Coordinator to join an MOU with LA Family Housing, has outreached to over 600 patients, and has successfully Comprehensive existing planning team and finalize workflows, policy and procedures, enrolled 25 members into the HHP program. 84 Community Health INF $60,000 5/15/2020 including outreach strategies and referral procedures, to serve 100 HHP Acknowledgment: Fourth annual Back to School Health & Wellness Event and through social Centers, Inc. patients in the greater Glendale and Burbank areas media. CLOSED
Update: Hired three LVN case coordinators to complete the team, trained staff on LA Care Establish IT infrastructure (referral management module, Health Homes program and care coordination, including motivational interviewing and care East Valley computers/phone) and hire 2 LVN level case coordinators and a management strategies facilitated by a consultant, and finalized workflow enhancements to EHR 85 Community Health INF $60,000 12/31/2020 consultant to train staff on EHR functionality, to serve up to 40 HHP system. Enrolled and initiated services with 132 participants. Center patients in the East San Gabriel Valley Acknowledgment: Posted on website. CLOSED
26 102 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Enrolled 108 patients in program, of which 92 remained active as of May 2020. A Hire core program staff, (Director & Care Coordinator) to work with program manager, care coordinator, and patient navigator are all in place and fully functioning. Eisner Health existing team and consultants to transform IT, redesign workflow, and Training of staff for the HHP took place and customized templates for their EHR systems have 86 (Pediatric and Family INF $60,000 12/31/2020 train staff as needed to support implementation, to serve up to 100 been completed. Medical Center) HHP patients in the greater Downtown Los Angeles area. Acknowledgment: Annual Report and in patient education materials. CLOSED
Update: Enrolled 390 eligible individuals in the HHP program and has initiated services with all Customize care coordination module in EHR system to facilitate HHP enrollees. Established partnerships with Asian Pacific Health Care Venture, Inc., Union Station reporting and referrals. Implement patient portal to support self-care. Garfield Health Homeless Services, WIC (Alhambra) and the County of Los Angeles Department of Public Social 87 INF $60,000 12/31/2020 Support Community Outreach Worker to establish MOUs with Center Services. community agencies, to serve 60 HHP patients in San Gabriel area, Acknowledgment: An internal newsletter was sent to staff and providers. including Alhambra and Monterey Park. CLOSED
Hire a HHP Director and Clinical Consultant, a case manager and a Update: Hired and trained program staff in HHP and trauma-informed care; modified EHR to contracted housing navigator, implement care management module to be able to document HHP patient encounters; development of HHP policies and procedures Harbor Community 88 INF $60,000 12/31/2020 capture Health Action Plans and establish new templates for case manual is in progress, and enrolled 109 eligible individuals into the HHP program. Clinic managers documentation, to serve up to 40 HHP patients in the harbor Acknowledgment: None at this time. and South Bay areas. CLOSED
Update: Provided 20 staff members (HHP team, street outreach team, managed care team) with trainings to better support HHP clients; completed EHR enhancements; and established Enhance technical ability to capture data in EHR, purchase equipment partnerships with ten organizations serving the homeless. Enrolled a total of 1,054 members in and supplies, partially support HHP Director salary and provide staff the HHP, including 848 L.A. Care members. 89 JWCH Institute, Inc. INF $60,000 12/31/2020 training, to serve 200 HHP patients in the greater Downtown and skid Acknowledgment: LA Honored as a Title Sponsor and included in the Commemorative book at row areas. JWCH's 2019 Benefit Dinner and Dance. John Baackes was recognized as an honoree and was awarded the Community Leadership Award. An e-blast was also sent to all sponsors. CLOSED
27 103 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Selected and trained staff for HHP program; hired expert HHP consultant to train and guide program staff through start up. Engaged and enrolled 70 patients in program, including 17 Hire Care Coordinator and Housing Navigator, Community Health people housed through Project Room Key. Although Care Coordinators were diverted to COVID- Kedren Community Worker, and partially for HHP Director. Hire Clinical Consultant to 90 INF $60,000 5/15/2020 19 testing, staff continue to provide care to clients offering telehealth services. An additional Health Center provide expertise on HHP implementation and to train staff, to serve report will be requested following COVID to determine program status. up to 150 HHP patients in South Los Angeles. Acknowledgment: None at this time. CLOSED
Update: A Director of Care Coordination and two existing employees were promoted to Partially fund Director of Care Coordination to adapt policy and Community Outreach Workers for the program; a template capturing the required data for HHP procedures, asses training needs, launch redesigned workflows, and Los Angeles Christian reporting was created, and training materials were developed. Out of 256 eligible L.A. Care 91 INF $60,000 5/15/2020 improve internal coordination, provide outreach and cross-referral, to Health Centers members, 60 were enrolled. serve 120 HHP patients in 14 sites, including skid row in Downtown Acknowledgment: Welcome Packet given to all members after enrolling in program. L.A. and Watts. CLOSED
Update: Hired 0.75 FTE RN Case Manager. Additionally, hired 1.0 HHP Program Manager, 3.4 FTE Care Coordinator, and 1.0 FTE Community Health Worker. Contracted with LA Family Hire Register Nurse as HHP Care Coordinator, finalize policies and Housing for 0.2 FTE Housing Navigator. Outreached to 1,040 Health Homes-eligible members Northeast Valley procedures, design outreach, enrollment and training, reconfigure IT 92 INF $60,000 12/31/2020 and enrolled 156 members in the Health Homes Program of which 104 were LA Care members. Health Corporation systems to track compliance and outcomes, and purchase equipment, to The Housing Navigator from LA Family Housing has placed 3 members in housing. serve 54 HHP patients in the greater San Fernando Valley. Acknowledgment: Monthly newsletter to our board of directors. CLOSED
Update: Partners in Care developed a robust HHP. Agency conducted 410 Health Risk Assessment visits, and enrolled and initiated services with 273 members. Partners in Care is now Hire a based core team of HHP Director, outreach Specialist, Clinical Partners in Care part of the LAHSA Coordinated Entry System (CES), and able to access HMIS database, which 93 INF $60,000 5/15/2020 Consultant, and provide training, to serve 100 HHP patients in the San Foundation facilitates the coordination and management of resources and services with more than 25 active Fernando Valley. partnerships. Acknowledgment: Announcements on website and social media platforms. CLOSED
28 104 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Hire part time Service Navigator and Community Health Worker, Update: Completed hiring, training, and certification of HHP staff; achieved NCQA Patient San Fernando purchase software and complete NCQA Patient Centered Medical Centered Medical Home re-certification; and enrolled 50 patients in the HHP program. 94 Community Health INF $60,000 12/31/2020 Home training to establish Care Coordination model, build formal Acknowledgment: Logo and statement of support posted on website and Clinic Sponsorship Center referral and transfer relationships with community agencies, to serve up plaque posted onto donor wall at clinic entrance. to 50 HHP patients in San Fernando Valley. CLOSED
Update: Reassigned, hired and trained staff for HHP care team, including one program director, nine care coordinators for the program, a full-time and a part-time Community Health Worker. Add Community Health Worker to care team to conduct outreach and Provided additional training on Motivational Interviewing, Mental Health Services, and working St. John's Well Child enroll participants from targeted engagement list and in reach with 95 INF $60,000 12/31/2020 with Transgender patients; enrolled 793 patients into the program and have begun delivering & Family Center current patients, provide training, to serve 200 HHP patients in South services. Acknowledgment: Announced to staff through email and trainings and posted on Los Angeles. website. CLOSED
Update: A care coordinator has been hired and trained on all aspects of the Health Homes Program. A consultant group has also been hired to work with the care coordinator to ensure they Hire Care Coordinator, Consultant to provide Dramatic Performance provide the best care to patients and that there is a workflow for a care team to be assigned to Valley Community Improvement training in best practices, care coordination requirements, 96 INF $60,000 5/15/2020 enrolled members; 63 members were enrolled and services were initiated. Healthcare and quality improvement, to serve 100 HHP patients in the North Acknowledgment: Recognized on permanent Donor List and continues to be listed on Hollywood and greater San Fernando Valley. Corporate and Foundation Donor List. CLOSED
Update: On-boarded staff for HHP; created workflow for care delivery; developed partnership Hire and reassign staff to launch program by establishing partnerships, with The People Concern for housing navigation, and enrolled a total of 81 patients (6 patients IT systems, data sharing agreements, clinical guidelines, assessment, 97 Venice Family Clinic INF $60,000 12/31/2020 subsequently dis-enrolled for assorted reasons). workflows and protocols for EMR, to serve 140 HHP patients in West Acknowledgment: None at this time. Los Angeles, including Santa Monica and Venice. CLOSED
Update: Integrated HHP into its clinical workflow. Three full-time Health Homes Care Managers Partially fund HHP Case Manage; enhance EHR for reporting, have a caseload of between 40 and 45 clients each, with a total enrolment of 120 clients. L.A. Care Via Care Community population based health tracking, including electronic referral, and care members make up 71% of Via Care's Health Homes client caseload. 98 INF $60,000 12/31/2020 Health Center management; and train Case Managers on required HHP trainings, to Acknowledgment: Via Care created a dedicated Health Homes webpage on its website, in which serve up to 120 HHP patients in the East Los Angeles area. L.A. Care is acknowledged. CLOSED
29 105 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Hired and trained staff; updated EHR system to enable HHP data tracking; finalized HHP policy procedure manual; established partnerships with one homeless service provider; and Hire part time Clinical Support staff and CCM Coordinator to connect Watts Healthcare enrolled 93 patients across four health plans into the HHP. 99 INF $60,000 12/31/2020 HHP members to social services and supports, and enhance EHR Corporation Acknowledgment: Reported to board of director and in rolling public announcements displayed through IT consultant, to serve 200 HHP patients in South Los Angele in building lobby. CLOSED
HHP I TOTAL $1,200,000
HOUSING STABILITY INITIATIVE I - FOUR AWARDS
Update: Provided 45 households with pre-ligation services and represented 16 through litigation Provide a minimum of 60 pre-litigation or litigation cases, educate up to cases. Referred 36 clients to comprehensive service providers, e.g. financial assistance, case 120 community members about their housing rights, and make at least 100 Bet Tzedek SD $150,000 8/1/2020 management. 36 referrals to comprehensive service providers to help with financial Acknowledgment: On flyers distributed via email. assistance, education and case management CLOSED
Update: Provided legal advice and representation for 205 clients; referred 48 to comprehensive Provide a minimum of 108 pre-litigation or litigation cases, educate up service providers; and educated 184 individuals about available tenants rights legal services. to 120 community members about their housing rights, and make at 101 Inner City Law Center SD $150,000 8/1/2020 Acknowledgment: Outreach events and distributed flyers. least 36 referrals to comprehensive service providers to help with CLOSED financial assistance, education and case management
Update: Provided prelitigation services to 204 people; full in-court representation to 36 clients; Provide a minimum of 60 pre-litigation or litigation cases, educate up to referred 38 to comprehensive service providers, and educated to 138 community members about Legal Aid Foundation 120 community members about their housing rights, and make at least 102 SD $150,000 8/1/2020 tenants rights and available legal services. of Los Angeles 36 referrals to comprehensive service providers to help with financial Acknowledgment: Annual Report prominently displayed on its website. assistance, education and case management. CLOSED
Update: Provided pre-litigation advice and assistance to 59 individuals; represented 27 Provide a minimum of 60 pre-litigation or litigation cases, educate up to individuals through litigation cases; refereed 56 individuals to comprehensive service providers; 120 community members about their housing rights, and make at least 103 Public Counsel SD $150,000 8/1/2020 and educated 489 individuals about tenants rights and available legal services. 36 referrals to comprehensive service providers to help with financial Acknowledgment: On agency's website. assistance, education and case management CLOSED
30 106 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Housing Stability I TOTAL $600,000
ROBERT E. TRANQUADA, MD SAFETY NET INITIATIVE X - NINE AWARDS
Update: Due to COVID-19, the Diabetic Retinal Eye Exam Compliance among patients who Complete a quality improvement project to improve patient satisfaction Asian Pacific are 18 - 75 years old with an active diabetes diagnosis actually decreased from 60.29% to 48%. 104 INF $100,000 9/15/2021 with the pediatric care team by at least 7% and improve retinal eye Healthcare Venture Percent of referrals that were closed in 60 days increased from 23% to 42% (398/946), exceeding exam completion among adult diabetics by fourteen percentage points. grant goal. Acknowledgment: None at this time.
Update: Decreased overall cycle time per visit from 70 minutes to 48 minutes. Patient satisfaction Complete a quality improvement project to improve medication survey results on wait time remain at an average of 4.5 points on a scale of 1 to 5. Improved Bartz Altadonna management by at least 10% for hypertensive patients at high risk for medication compliance for Statin Therapy (cholesterol lowering drug) by 30% from start of 105 Community Health INF $100,000 9/15/2021 cardiovascular events and reduce cycle time to 60 minutes to improve project. Current rate is at 70.65%-- well above the national average of 62.3%. Center patient satisfaction with wait times to 90%. Acknowledgment: Pop up banners, on literature and community publications, on website and at events and outreaches
Complete a quality improvement project to increase colorectal cancer Update: Increased Colorectal Cancer (CRC) screenings from 73.25% to 87.38% among patients Central screenings for patients over 50 years old to 59% and improve patient's aged 50 to 75 years. Clinic decreased wait times by more than 60% over baseline from 118 106 Neighborhood Health INF $100,000 9/15/2021 satisfaction with wait time by 20% by decreasing cycle time to less than minutes to 45.6 minutes. Foundation 90 minutes. Acknowledgment: By care coordinators during meetings including staff meetings.
Update: Scheduled 200 diabetic foot exams and completed 67. Was unable to meet goal because most visits were provided via telemedicine during the pandemic. In the most recent patient Complete a quality improvement project to increase the number of satisfaction survey, when asked the question: “Was the first call by the receptionist who registered Clinica Msgr. Oscar 107 INF $100,000 9/15/2021 scheduled diabetic foot exams by 200 and improve patient satisfaction you for your appointment, one who was friendly and made you feel comfortable?,” 96% of A. Romero with office staff respectfulness by ten percentage points. Spanish-speaking respondents answered yes and 98% of English speaking respondents answered yes. Acknowledgment: On website.
31 107 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Improved colorectal cancer screening rate: of 3,295 eligible patients, 90% received a Complete a quality improvement project to increase colorectal colorectal cancer screening up from baseline of 77% and 97% of patients who received a Fecal Garfield Health screenings by eligible patients to at least 80% and improve patient Immunochemical Test (FIT) kit returned it to the lab increased from 66%. In addition, 97% of 108 INF $100,000 9/15/2021 Center satisfaction with office staff's helpfulness by at least seven percentage patients taking the CAHPS survey reported that they ‘usually’ or ‘always’ found the clerks and points. receptionists to be helpful from baseline 73%. Acknowledgment: Internal email notifying staff and providers grant award.
Update: Because colonoscopy referrals were suspended due to COVID-19, SBFHC has experienced a decrease in colorectal cancer screenings. March 2020 HEDIS measures were at a rate of 51%, and as of March 31, 2021, the rate has decreased to 42 %. Patient satisfaction Complete a quality improvement project to increase patients satisfied remains high: 85% of patients were satisfied with the amount of time spent with the provider; South Bay Family with time spent with provider to 50% and improve appropriate 109 INF $100,000 9/15/2021 90% were satisfied with the time spent with other members of their care team; and 76% were Healthcare colorectal cancer screening by eligible patients by twenty percentage satisfied with the overall amount of time spent with their care team, which the clinic is seeking to points. improve. Acknowledgment: None at this time.
Update: Improved communications between eCW and CAIR; provided data entry training for new vaccine coordinator and pediatric staff to utilize a bi-directional interface between eCW and Complete a quality improvement project to improve HEDIS CIS CAIR; designed and implemented a new patient satisfaction survey including CAPHS question T.H.E. Health and 110 INF $100,000 9/15/2021 Combo 10 to 50% and achieve at least a 10% improvement in patient and received an average score on the survey of 3.71, on a scale from 1.0 to 5.0. Due to the Wellness perception of courtesy and respect. pandemic, HEDIS CIS Combo 10 measures actually decreased to 28.7% in 2020. Acknowledgment: On website, banners for events, on plaques at clinics, and via social media channels.
Update: Increased patient satisfaction for timely access to appointments from 79% to 89%; decreased no-show broken appointments from 27.3% to 25%; increased childhood immunization Complete a quality improvement project to improve HEDIS CIS UMMA Community rate for the Combo 10 immunizations from 22.5% to 41.8% for children 2 years of age; and 111 INF $100,000 9/15/2021 Combo 10 to 50% and increase patients reporting ease of access to Clinic increased the number of follow-up calls to parents of patients to 80%. appointments by ten percentage points. Acknowledgment: Named as a grantor in all communications related to this project and acknowledged as a funder on clinic's website.
32 108 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Provide quality improvement technical assistance to up to eight Update: Provided quality improvement assistance to eight Tranquada X awarded FQHC and Community Health Investment Fund (CHIF) Robert E. Tranquada, community clinics. Met monthly with grantees and provided guidance on methods to improve Comagine Health M.D. Safety Net Initiative X grantees. Each community clinic and track HEDIS scores and data collection methods on the selected CAHP measures. 112 (formerly Qualis INF $75,000 12/31/2020 participant will receive assistance to implement their Tranquada X Coordinated two grantee virtual learning sessions during COVID-19 quarantine. Learnings were Health) Healthcare Effectiveness Data and Information Set (HEDIS) and identified and shared best practices. Consumer Assessment of Healthcare Providers and Systems (CAHPS) Acknowledgment: During training sessions and listed as client of Comagine. quality improvement projects.
TRANQUADA X TOTAL $875,000
COMMUNITY WELLNESS INITIATIVE IV - SEVEN AWARDS
Update: Grantee secured 136 approved applications for new CalFresh cases, with 62% of new Secure the approval of at least 290 electronic CalFresh applications, CalFresh enrollees being adults 50 years of age and older living with HIV. Grantee also facilitated including approval for up to 73 gay men 18-29 and 116 adults 50 or 113 APLA Health SD $100,000 3/15/2021 nutrition education classes in which 924 unduplicated clients attended. The 50 semi-annual older living with HIV; 50 semi-annual reports; and 50 recertification reports and 50 recertification applications are incomplete. A no-cost extension will be provided. applications. Acknowledgment: On promotional materials and through social media.
Update: Filed 826 new CalFresh applications, 536 SAR 7/renewal cases, and 106 recertifications. Secure the approval of at least 115 electronic CalFresh applications, 300 Also assisted 1,165 clients to receive Earned Income Tax Credit (EITC) on their tax returns. Chinatown Service semi-annual reports, and 117 recertification applications. This grant 114 SD $100,000 3/15/2021 Acknowledgment. Recognized in social media, in program flyers and in 2020 virtual fundraising Center will also assist 910 clients to receive Earned Income Tax Credit (EITC) event. on their 2018 or2019 tax returns. CLOSED
Update: Assisted over 3,700 people with EITC tax filings during tax season with the help of Koreatown Youth and more than 300 volunteers to . Of those, more than 780 people had their EITC tax filings accepted Assist 667 clients to receive Earned Income Tax Credit (EITC) on their 115 Community Center, SD $100,000 3/15/2021 and claimed more than $1.2 million in refunds. 2019 tax returns. Inc. Acknowledgment: Social media, flyers, and website. CLOSED
33 109 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Filed 197 applications with approximately 582 people on the case. 155 were approved in this reporting period; 42 apps were denied, and no pending cases. This is about an 83% approval Secure the approval of at least 195 electronic CalFresh applications, 120 rate. Also helped with 94 SAR7s, 97 Recertifications, and provided troubleshooting for 280 Maternal and Child Semi-annual reports, and 116 recertification applications. Grantee will participants to resolve their case. Assisted 32 participants to add their newborn baby to their 116 SD $100,000 3/15/2021 Health Access also release at least two communications to address public charge issues CalFresh case. related to existing or new CalFresh regulations. Acknowledgment: Distributed more than 700 flyers and material acknowledging support at two local events and flyers to other local funders. CLOSED
Update: Submitted 1,615, for 2019 and 2020 tax returns, 34% above the 1,200 target. Between CW III and CW IV, 395 people received $1,732,034 in EITC and other tax credits during the Pacific Asian 2019 and 2020 tax seasons. Grantee secured 59 volunteers as tax preparers (goal was 30). Assist 600 clients to receive Earned Income Tax Credit (EITC) on their 117 Consortium in SD $90,000 3/15/2021 Acknowledgment: Placed on VITA website, posters displayed at VITA sites, in flyers, and listed 2019 tax returns. Employment-PACE as a supporter in the annual report. CLOSED
Secure the approval of at least 245 electronic CalFresh applications, 26 Update: Assisted with the submission of 1,595 applications of which 954 were approved. Providence Little Semi-annual reports and recertification applications. Grantee will also Assisted with 384 Semi-annual reports and recertification applications. 118 SD $100,000 3/15/2021 Company of Mary screen and refer up to 1,000 individuals for food insecurity in clinical Acknowledgment: Recognized through project flyers. and community settings. CLOSED
Update: Secured approval of 218 electronic CalFresh applications. Assisted 26 clients with semi- JWCH - Antelope Secure the approval of at least 285 electronic CalFresh applications, 76 annual reports, and annual recertification applications. 119 SD $100,000 9/15/2021 Valley -CalFresh semi-annual reports, and 70 recertification applications. Acknowledgment: Circle of Care 2020 special video to commemorate 60 years of service and on its website.
CWI IV TOTAL $690,000 CHIF 2018-2019 $10,240,000 GRAND TOTAL Priorities: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Fiscal Year 2017-2018 - Total of 40 Awards for $8,167,000
AD HOC GRANTS - SIXTEEN AWARDS
34 110 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Housed 249 individuals out of a total of 298 people experiencing homelessness enrolled and receiving services. Coordinated with Whole Person Care/DHS Housing for Health program House homeless individuals and families, including L.A. Care members. to provide intensive case management and supportive services to those housed. Project also supports the goals of the Whole Person Care initiative 120 Brilliant Corners II H $4,000,000 9/1/2020 Acknowledgment: Recognized in presentation given by FHSP Associate Director in Sacramento under the new California Medi-Cal waiver and enables DHS to draw on a panel about Housing Access Services at the Lanterman Housing Alliance's Fall Housing down matching funds. Thought Leaders Summit. Services continued in FY 2018-19. CLOSED
Educate and train 2,500 immigrants and refugees through Know Your Central American Rights workshops, provide legal services to 50 unaccompanied minors Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 121 Resources Center SD $150,000 3/15/2020 and refugee families, make a minimum of 150 direct referrals for health term. For current progress, see progress update for Grant #53 above.. (CARECEN) and social services, and engage and educate 1,000 impacted immigrants to protect their families.
Update: A total of 2,501 Chrysalis clients obtained employment and 71% of working clients retained employment for six months or longer. After randomly selecting 40 Medi-Cal recipient The Chrysalis Center Train at least 40 low-income Medi-Cal recipients with substantial clients, 27 have obtained outside employment.. 122 dba Chrysalis SD $100,000 3/14/2020 barriers for employment, including homelessness; and secure full-time, Acknowledgment: Sponsorship Acknowledgments at Annual Butterfly Gala and in 2018 Annual Enterprises long-term employment for 15 training participants. Report, also available on website. CLOSED
Assist 200 eligible legal residents with completion of the N-400 Coalition for Humane naturalization form to begin the process of becoming naturalized U.S. Immigrant Rights of citizens; educate 80,000 immigrants and their families through social Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 123 SD $150,000 3/15/2020 Los Angeles and Spanish media about Know Your Rights and the public charge term. For current progress, see progress update for Grant #56 above. (CHIRLA) ruling, and provide information to at least 600 individuals through the hotline, with a focus on mixed status families.
35 111 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Per a needs assessment conducted in 2019 that identified housing, food insecurity, and transportation as priorities, CCALAC has facilitated and participated in a number of Roundtables, Create a Social Determinants of Health Roundtable (SDOH) to assess Community Clinic Advisory Committees and external regional meetings to stay informed of initiatives surrounding gap in service for social risk factors, host an SDOH Summit, develop Association of Los social determinant of health (Sod) in L.A. County. The learnings have been shared across the 124 INF $150,000 3/15/2020 comprehensive resource guide and establish policy and advocacy Angeles County CCALAC membership as a Sod Toolkit available on CCALAC’s website. priorities intended to improve services in a managed care environment, (CCALAC) Acknowledgment: Recognized as a primary sponsor of 2020 Health Care Symposium and in all particularly around the homeless. marketing and advertising materials and live streams. CLOSED
Update: Twenty-eight immigrants completed training. Of those, 11 completed the Hospitality Industry LAX/Hospitality Worker training, 5 completed the Barista training, 7 completed the Room Train 95 and place 78 of 95 recently trained clients in unionized jobs in Training and Attendant training, and 5 completed the Entry Level Kitchen training. As of March 2020 and the growing hospitality industry through language immersive job 125 Educational Fund SD $107,000 12/31/2020 prior to the onset of COVID-19, 24 of immigrant participants had retained employment for 6 or training program for Limited English speakers, including but not (Hospitality Training more months. limited to Asian/Pacific Islander and Latino populations. Academy - HTA) Acknowledgment: Recognized on all recruitment flyers, and social media posts related to their English as a Second Language classes.
Update: A total of 28 formerly homeless individuals graduated from the program and 20 In partnership with Corporation for Supportive Housing, train 25 obtained paid employment. formerly homeless individuals to be placed as Community Health 126 Housing Works SD $100,000 12/31/2020 Acknowledgment: Recognized in all program materials, including PowerPoint training, Workers or Housing Navigators employees in a variety of non-profit participant handbooks, program marketing materials, and social media. agencies that serve homeless individuals and families. CLOSED
Update: Completed all construction and tenant improvements at The Irmas Family Campus, Support security-related staff and systems throughout The Campus, a which officially opened. Key fobs were installed to control the flow of people in and out of The building complex with collocated health and social service agencies, Campus, as well as installing and upgrading security cameras at South Campus, North Campus, 127 L.A. Family Housing SD $150,000 10/15/2019 including Northeast Valley Healthcare Corporation, that will provide the underground parking structure, and the surrounding street areas. supportive housing and comprehensive services for homeless Acknowledgment: Winter newsletter, at the Grand Opening event for The Campus, prominent individuals and families in the San Fernando and Santa Clarita Valleys. signage in the main lobby of The Irmas Family Campus, and in Bi-Annual Report. CLOSED
36 112 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Improve mental health awareness of at least 350 pregnant or Maternal Mental postpartum African American women and enhance the acumen of 30 Health Now (fiscal medical providers to detect and respond to perinatal mood disorders Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 128 HB/INF $150,000 3/15/2020 agent Community among African American women to positively impact African term. For current progress, see progress update for Grant #64 above. Partners ) American infant mortality in partnership with Cedars Sinai Hospital and Watts Healthcare.
Update: Occidental received 13 applications for its public health summer internship program and will support four interns for the summer of 2021. Internships will begin remotely and may transition to in-person as things develop over the time. Placement sites include: Koreatown Youth Place at least six Occidental College students enrolled in its Public and Community Center (KYCC), Every Woman Counts, Foothill Unity Center, and Saban Health minor in community public health internships, and provide 129 Occidental College INF $75,000 9/15/2021 Community Clinic. To institutionalize the program, Occidental submitted a proposal to the capacity building funds to develop a financially sustainable long-term College for a new part-time public health faculty member who would be focused on teaching the plan. public health practicum and internship courses and developing community partnerships for those classes. Acknowledgment: Recognized in student presentations and within the college.
Update: Increased the number of teams participating in the sports league to 14, including 2 all- Expand grantee's sports league to two new neighborhoods with high women teams. A total of 20 individuals were recruited and trained to become Peace Reclaiming America’s gang activity through the addition of 20 new Peace Ambassadors, Ambassadors. Facilitated 43 mediation roundtables with 20 participants each on average. Made 96 Communities through conduct six mediation roundtables and make 50 case management referrals for various services including personal interventions, victims services, employment 130 SD $150,000 3/15/2020 Empowerment referrals through gang intervention agencies. Hire development and preparation and job placement, and academics/education. Hired and trained administrative staff (R.A.C.E.) office management staff to increase development activities and other and retained accounting and development consultants. infrastructure. Acknowledgment: Listed on all marketing material and website. CLOSED
37 113 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Support philanthropic healthcare infrastructure in the Greater Los Angeles area. Update: Provided twelve cross-cutting programs Update: Provided twelve cross-cutting programs exploring health and health equity issues with exploring health and health equity issues with funders; provided a funders; provided a monthly “Public Policy Roundup” e-newsletter to more than 500 subscribers; Southern California monthly “Public Policy Roundup” e-newsletter to more than 500 and provided eleven in-person and online Census 2020 programs; hosted Public Policy 131 INF $20,000 12/31/2019 Grantmakers (SCG) subscribers; and provided eleven in-person and online Census 2020 Conference attended by 300 funders. programs; hosted Public Policy Conference attended by 300 funders. Acknowledgment: Sponsor level at Annual SCG Conference. Acknowledgments: SCG acknowledged L.A. Care as a sponsor at its CLOSED Annual Conference. CLOSED
Update: The training program was implemented in November 2018, and 184 unduplicated medical assistants have received professional development training resulting in a total of 62 hours Implement a professional development training program for a of training being completed; 12 topics have been presented to the medical assistances and 20 Southside Coalition of minimum of 80 medical assistants working at eight federally qualified sessions have been held. 132 Community Health INF $150,000 3/15/2020 health centers (FQHCs) in South Los Angeles who will receive at least Acknowledgment: Listed as a sponsor at a health and resource fair hosted at Los Angeles Trade Centers 30 hours of professional development training. Tech. Also recognized as sponsor at their annual Walk4Health and Back2School Health and Resource Fair. CLOSED
Update: Received signed Business Associate Agreements from 10 of the 12 community clinic partners and have received medical data from 11 of the 15 Wellness Centers. Created four types of reports using available data since 2015 to include the executive overview reports that provide The Los Angeles Develop a centralized data network and connect at least 14 school- aggregate data across the Wellness Network, clinic comparison reports across several variables, 133 Trust for Children’s INF $150,000 10/15/2019 based health centers and Los Angeles Unified School District schools clinic-specific reports, and analyst reports for more granular data on a specific topic such as Health to link health outcomes and student achievement. asthma. Acknowledgment: Acknowledged in Summary and PowerPoint presentation. CLOSED
38 114 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Completed all capacity building activates including drafting its bylaws, establishing a board of directors, identifying CRM system for donor management, and developed evaluation protocols for its programs. Urban Voices engaged 40 homeless individuals in its programs, Build up the organizational infrastructure and hire professional staff of including 20 who completed a pilot workshop in Skid Row and an additional 20 who were Urban Voices (fiscal an organization that will engage at least 40 homeless individuals in its 134 SD $75,000 12/31/2020 engaged in a 6-week series held in a satellite location. agent JWCH) music programs while connecting them to a system of care to address Acknowledgment: Featured as a primary partner in organization’s literature, website, and in Fall their medical and social needs. newsletter. CLOSED
Update: Seventeen community members were recruited to serve on Neighborhood Watch; 52 In partnership with law enforcement, reduce crime and build civic residents attended educational sessions on their legal rights; 17 adults and 14 youth became Watts Century Latino responsibility with a focus on immigrant communities and youth in 135 SD $150,000 3/15/2020 certified in the Citizen Police Academy and completed Mediation trainings. Organization South Los Angeles by enrolling at least 15 adults and 10 youth in Acknowledgment: Recognized in program flyers, during workshops, and on agency website. Citizen Police Academies and Mediation trainings. CLOSED
Ad Hocs Total $5,827,000
ORAL HEALTH INITIATIVE X - THREE AWARDS
Update: The new Pediatric Clinic Project broke ground in April 2019. Purchased and installed six Complete construction of new dental site, including licensing and Adec dental chairs for its new clinic. Pending permit approval to initiate services in January 2020. Harbor Community 136 HB $100,000 12/31/2020 furnishing. Provide a minimum of 2,500 pediatric dental visits, Opening was further delayed due to the COVID-19 pandemic. Clinic, Inc. including mobile unit dental visits. Acknowledgment: Upon opening, clinic will have an art piece designed for the lobby engraved with all donors' names.
39 115 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Completed purchase and installation of 3 adult and 3 pediatric dental operatories. There were delays in the opening of the dental clinic due to structural and permitting issues at the beginning of the project. Further delays were experienced related to the COVID-19 pandemic. JWCH Institute, Inc. Complete conversion of Lynwood primary care site to a dental clinic, Clinic expects to open to provide full dental services by early 2021. 137 (John Wesley HB $100,000 11/15/2020 and provide a minimum of 2,300 adult dental visits and a minimum of Acknowledgment: Honored as a Title Sponsor and in the Commemorative book for JWCH Community Health) 300 pediatric dental visits. 2019 Benefit Dinner and Dance. An e-blast was also sent to all sponsors and was listed as a sponsor on the events page of website. John Baackes was honored and awarded the Community Leadership Award at the event. A plaque with LA Care’s name as a sponsor of the Lynwood Dental Clinic will be placed in the waiting room.
Update: Completed construction and fully furnished new Transitions to Wellness North Hollywood Homeless Health Center. Provided 619 dental visits to 191 unique homeless patients, Complete construction and fully furnish the new dental clinic in North Northeast Valley less than originally projected as a result of COVID-19. Hollywood in partnership with LA Family Housing. Provide 138 Healthcare HB $100,000 11/15/2020 Acknowledgment: Recognized on website, on a tile installed on the Newhall Health Center, comprehensive dental services to a minimum of 1,000 visits to at least Corporation during the grand opening. Acknowledged at the Healthy Valleys 2020 Moving Community Health 280 homeless patients. Forward campaign and at the opening of the Pacoima Women’s Health Center.
OHI X Total $300,000
ROBERT E. TRANQUADA , MD SAFETY NET INITIATIVE IX - SEVEN AWARDS
Update: Increased percentage of patients who feel they were treated with courtesy and respect from 73 to 86.8%. 281 patients received a diabetic retinal screening, increasing from 11 to 12.76% Central City To improve on one CAHPS question and three HEDIS measures: in spite of COVID-19. The total number of diabetic patients with controlled blood pressure 139 Community Health INF $150,000 12/31/2020 breast cancer screening, diabetic care-retinal eye exam, and diabetic care- increased from 60% to 73.43%. Due to the pandemic, mammogram screenings decreased to Centers blood pressure < 140/90. 11.17%, as these required an in-person visit. Acknowledgment: Public newsletter and website.
40 116 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Conducted survey of 500 patients to assess patient satisfaction with health care services, in which there was a 96% positive rate of responses (an increase of 3% from previous survey Comprehensive To improve on one CAHPS patient experience question and three results). The rate in which Eagle Rock diabetic patients who received preventive services were the 140 Community Health INF $150,000 8/14/2020 chronic diabetic care HEDIS measures: retinal eye exam, HbA1c<8, following: 95% for retinal eye exam, 90% with HbA1c is controlled, and 95% with controlled Centers, Inc. and blood pressure < 140/90. blood pressure is controlled. Acknowledgment: In social media outlets. CLOSED
Update: Increased Child Well visits to 33%, immunizations to 55% of patients for IMA Combo JWCH (John Wesley To improve on one CAHPS patient experience question and three 2, 34% with CIS Combo 10, and provide WCC to 56% of patients. 58% of patients were satisfied 141 Health Center) INF $150,000 12/31/2020 Child Health HEDIS measures: weight assessment, early childhood with their ability to access these services, a slight decrease as a result of the COVID-19 pandemic. Institute, Inc. immunization, and adolescent immunization. Acknowledgment: Recognized during staff trainings across the agency and during Board Member CQI and Provider CQI meetings.
Update: 72.4% of eligible patients completed their Cervical Cancer Screening in August 2020; To improve on one CAHPS patient experience question and three Northeast Valley 75% of patients completed their Postpartum check; and the percentage of diabetic patients who 142 INF $150,000 12/31/2020 HEDIS measures: cervical cancer screening, postpartum care, and Health Corporation have HgbA1c in control (<8) improved from 57.4% in February 2020 to 59.3% in August 2020. diabetic care - HbA1c<8. Acknowledgment: None at this time.
Update: Reduced average visit time from 103 minutes to 57; increased average daily number of patients per provider from 17 to 20; and decreased no-show rate from 30% to 23%. Opened a Saturday Diabetes Clinic at the Magnolia site, which teams up an endocrinologist with a nurse, To improve on one CAHPS patient experience question and three St. John's Well Child dietitian and clinical pharmacist to provide comprehensive and coordinated care for patients 143 INF $150,000 8/14/2020 diabetic care HEDIS measures: Retinal exam, HbA1c <8, and blood and Family Center whose diabetes is least controlled. The clinic served 324 patients through 808 visits. Fifty-three pressure <140/90. percent (53%) of diabetic patients received retinal screening; 61% had HbA1c less than 8%, and 86% had BP less than or equal to 140/90. Acknowledgment: Highlighted on the website.
41 117 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Fully implemented the AZARA Data Reporting and Visualization System. As a result, clinic saw improvements on two CAHPS patient experience measures: overall patient satisfaction To improve on one CAHPS patient experience question and three (75%) and patients felt treated with respect (85%). In addition, waiting times were decreased by 144 Watts Healthcare INF $150,000 12/31/2020 HEDIS measures: early childhood immunization, cervical cancer 20%; number of diabetic patients with improved blood pressure increased from 68% to 80%; screening, and diabetic care - retinal exam. number of diabetics receiving a retinopathy screening improved from 57% to 75%; rate of women entering prenatal care improved from 57% to 70%. Acknowledgment: Monthly quality reports to the board.
Update: Increased on CAHPS question regarding clerks and receptionists at provider’s office being "as helpful as you thought they should be” from 69% to 91%. Improved on HEDIS immunization combo 10 from 54% to 64% of children under 2 years old fully vaccinated and White Memorial To improve on one CAHPS patient experience question and three combo 2 for adolescents with 71% of teens in compliance from a 55% baseline, both exceeding 145 Community Health INF $150,000 12/31/2020 Child Health HEDIS measures: weight assessment, early childhood the goal. Weight assessment goal increased from 81% to 85% but did not reach goal of 90% due Center immunization, and adolescent immunization. to fewer inpatient visits during COVID-19. Acknowledgment: Announcement of L.A. Care's grant award was communicated to Board of Directors.
Total Tranquada IX $1,050,000
LICENSED PRACTITIONERS OF THE HEALING ARTS II - FOUR AWARDS
Update: Increased the number of women served through residential treatment from 20 to 85 and Serve an additional 100 women through the residential treatment provided family therapy to 108 individuals. Reviewed 1,241 ASAM assessments and treatment program, conduct 720 American Society of Addiction Medicine plans. Achieved successful program completion with 161 of the 190 client records reviewed. Alcoholism Center for (ASAM) assessments and treatment plan reviews and ensure 90 146 HB $60,000 3/24/2020 Provided 102 individual therapy sessions, 600 group sessions, and 1,288 Family Therapy Program Women participants successfully complete the program. Grantee will also sessions. provide enhanced care through a new Family Therapy Program for 540 Acknowledgment: On Facebook page and eNewsletter. clients. CLOSED
42 118 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Update: Exceeded goal for outpatient counseling for individuals, which increased by 30 hours Provide Drug Medi-Cal (DMC) participants an additional 20 hours per per month. Increased the number of individual counseling sessions from 141 to 192. The number month of individual outpatient counseling. Augment group therapy by of group counseling sessions went from 494 to 620 per month with 75 additional hours of Fred Brown Recovery 75 hours per month. Provide 584 bed days of residential treatment counseling available per month. Residential counseling services increased from 389 to 743 bed 147 HB $60,000 3/24/2020 Services services per month and recovery bridge housing for 118 additional days per month and recover bridge housing provided 1,499 bed days per month. DMC clients to maximize Drug Medi-Cal reimbursements and thereby Acknowledgment: Published on social media accounts, logo was added to organizational sustain the START-ODS program. brochures, and sponsor of Music by the Sea event. CLOSED
Update: Provided the Family Therapy Program to a total of 60 clients and their families. Develop curriculum and train staff in a Family Therapy Program (FTP) Achieved 80% behavioral compliance for 56% of the 60 clients served and 30 clients completed to serve 30 mono-lingual and bilingual Spanish families, while the therapy program. Homeless Health 148 HB $70,000 3/24/2020 expanding the English FTP to an additional 30 families. This will result Acknowledgment: Named in monthly staff meeting reports and in all external outreach Care Los Angeles in behavioral compliance and successful program completion for up to meetings and community coalitions. All Spanish outreach and enrollment materials included LA 80% for all served clients. Care logo and sponsorship. CLOSED
Update: Enrolled 604 clients in its Drug Medi-Cal program, an increase of more than 450% enrollment (130 clients) since the start of the grant term. Reduced Drug Medi-Cal denial claims by Hire a Quality Assurance Coordinator to reduce the rate of claim 76 percent, a decrease from 25 claim denials per week/bi-weekly to 6 or less per week/bi-weekly. denials by 75% and serve a total of 195 clients. This grant will also Special Services for Increased the number of clients who exited its substance abuse treatment program due to 149 HB $70,000 12/31/2020 increase successful program completion from 27% to 50%. All these Groups, Inc. successful completion from 27 to 50 percent. activities will maximize Drug Medi-Cal reimbursement and sustain the Acknowledgment: Mentioned as a funder of grantee's Drug Medi-Cal program at one of its program. keynote annual virtual events. CLOSED
LPHA II Total $260,000
COMMUNITY WELLNESS III - TEN AWARDS
43 119 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Secure the approval of at least 210 electronic CalFresh applications, Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 150 APLA Health SD $75,000 3/15/2020 provide assistance to at least 120 SemiAnnual Report applicants, and re- term. For current progress, see progress update for Grant #113 above. certify a minimum of 67 applicants.
Update: Enrolled 123 individuals in the CalFresh program. Successfully assisted clients with 35 Asian Pacific Secure the approval of at least 350 electronic CalFresh applications. semi-annual reports, and 35 re-certification approvals as well. Ability to retain multi-lingual 151 SD $75,000 3/15/2020 Healthcare Venture Assist 35 families with SemiAnnual Reports and recertification. outreach staff challenged enrollment success for new clients. Acknowledgment: Posted on website
Secure the approval of at least 40 electronic CalFresh applications, Chinatown Service provide assistance to at least 140 SemiAnnual Report applicants, and re- Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 152 SD $75,000 3/15/2020 Center certify a minimum of 52 applicants. Additionally, produce accepted term. For current progress, see progress update for Grant #114 above. filing of at least 500 Earned Income Tax Credit (EITC) applications.
Secure the approval of at least 225 electronic CalFresh applications and Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 153 JWCH Institute, Inc. SD $75,000 3/15/2020 re-certify a minimum of 30 applications. term. For current progress, see progress update for Grant #119 above.
Koreatown Youth and Achieve accepted filing status for at least 750 Earned Income Tax Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 154 Community Center, SD $75,000 3/15/2020 Credit (EITC) applications. term. For current progress, see progress update for Grant #115 above. Inc.
Secure the approval of at least 185 electronic CalFresh applications, provide assistance to at least 104 SemiAnnual Report applicants, and Maternal and Child Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 155 SD $80,000 3/15/2020 recertify a minimum of 106 applications. Additionally, will provide an in- Health Access term. For current progress, see progress update for Grant #116 above. service workshop for CalFresh enrollment grantees to increase the quality of submissions and enrollment approval ratio.
44 120 Priority: HB = High Barriers; H= Housing for Health; INF = Safety Net Infrastructure; SD - Social Determinants of Health Organization Priority Amount Ends Grant Purpose Progress Update
Pacific Asian Achieve accepted filing status for at least 750 Earned Income Tax Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 156 Consortium in SD $75,000 3/15/2020 Credit (EITC) applications. term. For current progress, see progress update for Grant #117 above. Employment (PACE)
Secure the approval of at least 230 electronic CalFresh applications, provide assistance to at least 20 SemiAnnual Report applicants, and Providence Little recertify a minimum of 4 applicants. Update: Assisted 573 households Grant was amended and renewed in FY 2018-19, which augmented the budget, objectives, and 157 SD $75,000 3/15/2020 Company of Mary with CalFresh enrollments, semi-annual reports, and annual term. For current progress, see progress update for Grant #118 above. recertifications. Acknowledgments: Placed on CalFresh flyers used in all outreach and health events, in both Spanish and English.
Increase to four the number of Southside Coalition members who Update: Six clinics are participating in the project and a total of 125 CalFresh applications were Southside Coalition of provide onsite CalFresh enrollment assistance by providing clinics submitted along with 75 renewals. 158 SD $50,000 3/15/2020 Community Clinics technical assistance to enroll at least 80 patients into CalFresh and Acknowledgment: At LA Trade Tech and LA County AC Bilbrew Library health and resource strengthen clinics' relationship with DPSS to address systemic issues. fairs, at annual Walk4Health and Back2School Health and Resource Fair, and on website.
The Robert F. Secure the approval of at least 175 electronic and 50 paper CalFresh Update: Enrolled 229 individuals in CalFresh. In addition, 63 (SAR) 7 semi-annual reports, and Kennedy of 159 SD $75,000 12/31/2020 applications, provide assistance to at least 50 SemiAnnual Report 81 re-certifications were approved by DPSS. Community and applicants, and re-certify a minimum of 75 applicants. Acknowledgment: In written materials for public distribution and during 2019 health. Family Medicine
Total CW III $730,000
TOTAL FY 2017-18 $8,167,000
A TOTAL OF 159 ACTIVE GRANTS FROM FY 2017 through $29,512,000 2020
45 121 April2021 Grants& S ponsorshipsReport June2021 BoardofGovernorsM eeting FYCHIF& April April S ponsorships O rganization Grant/S ponsorship GrantCategory/ Grant S ponsorship Cum m ulative # N ame P rojectDescription AprovalDate S ponsorship Am ount⁺ Am ount T otal Am ericanHeart 1 Association AnnualHeart& S trokedinner 4/29/2021 S ponsorship - $25,000 $25,000 Comm unityFamily 2 GuidanceCenter Fooddistributionevent 4/20/2021 S ponsorship - $10,000 $10,000 3 EisnerHealth Annualconference 4/29/2021 S ponsorship - $10,000 $10,000 4 FEAS T Fooddistribution-CR C 4/13/2021 S ponsorship - $3,000 $3,000 5 FrontlineDoulas Fooddistributionevents 4/26/2021 S ponsorship - $10,000 $10,000 6 KJLH Annualwomen'shealthforum 4/13/2021 S ponsorship - $10,000 $10,000
P rovidetrainingandengageatleast40 comm unityagency L ibertyHill leadersinsettingandimplementingL A County'sM easure Foundation* Jpriorities.Atleast20 individualsandfamilieswillbe providedtechnologicalaccess(tablets/hotspots,etc.)for organizing,andtheM easureJImplementationP lanw ill include65% oftheR eimagineL A Coalition’sprioritiesfor 7 thepreventionofincarcerationandfundsocialservices. 3/29/2021 AdHoc $50,000 $0 $50,000 L osAngelesM edical 8 Association Annualconference 4/1/2021 S ponsorship - $5,000 $5,000
S upportanimm ersivesix-weekInternshipS um m er N ationalM edical programatthreeFederallyQ ualifiedHealthCentersand Fellowships placethreem edical(M D) andfourR N P /P A students,fora 9 totalofsevenstudentsattheseclinics. 4/26/2021 AdHoc $150,000 $0 $150,000 10 R esilientAgency Fooddistributionevent 4/13/2021 S ponsorship - $5,000 $5,000 S peakU p Empowerment 11 Foundation Annualempowermentconference 4/1/2021 S ponsorship - $3,000 $3,000
S tarView Comm unity S ervices 12 AnnualPridecomm unityevent 4/13/2021 S ponsorship - $4,000 $4,000 U CL A HealthP olicy andM anagement 13 Alum niAssociation Annualconference 4/13/2021 S ponsorship - $3,720 $3,720 T otalofgrantsandsponsorshipsapprovedinApril2021 $ 200,000 $88,720 ⁺P er the Comm unity Health Investment Fund (CHIF) grant agreements, the fi rst half of the grant award is released upon receipt of a fully executed agreement. T hesecondhalfofgrantawardisreleaseduponcompletionofatleasthalfoftheentireprojectobjectives,whicharedetailedintheprogressreports submittedeverysixm onths.Granteem ustalsohavespentallfundsfrom thefirstpayment. *L ibertyHillFoundationw asapprovedinM archaftertheBO G reporthadbeensubmitted.
122
Chief Medical Officer Report May 2021
COVID-19 Update By early May, 2021, there were more than 150 million cases and nearly 3.2 million deaths from COVID-19 worldwide. Following a 6-week decline in cases after the winter surge, a nine-week long increase in global cases has pushed the number of new cases worldwide to the highest weekly average (+5.7 million/week) since the beginning of the pandemic. These increases have been driven by the surge in India, accounting for 90% of the cases in Southeast Asia, 46% of cases and 25% of deaths globally.
As vaccination counts continue to rise and increasing cases in hot spots throughout the country declined, the United States has seen a 27% reduction in the 14-day average case rate and a 4% reduction in deaths. California and Los Angeles are seeing a sustained reduction in cases and deaths. Los Angeles County moved into the Yellow Tier of the Blueprint for a Safer Economy on Thursday, May 6 after meeting the thresholds in our adjusted case rate (< 2.0 cases/100,000) and percent positivity for COVID-19 tests (< 2%) for two weeks in a row.
The Los Angeles County Department of Public Health press release on May 6 declares “Los Angeles County’s case rate remains low and stable.” Cases in Los Angeles have dropped from more than 15,000 per day down during the winter surge to less than 300 a day in late April, a 35% reduction since late March. Over the same period of time, hospitalizations dropped 37% and deaths dropped by 87%. L.A. Care has identified over 120,000 cases, 20,000 hospitalizations, and over 4,000 deaths (16% of Los Angeles County total) among our members.
The demand for vaccinations has dropped nationwide to 2.1 million per day, down from a peak of over 3 million per day. Los Angeles County experienced a 30% reduction in vaccine administration in the last week of April. Despite these declines, more than 550,000 L.A. Care members have received at least one vaccine, accounting for more than 10% of the nearly 5 million Los Angeles County residents vaccinated to date. L.A. Care staff are working closely with the Department of Public Health to identify and confirm populations for targeted outreach to improve vaccination coverage in demographic (65+ for example), geographic (SPAs 1 and 6) and race and ethnic groups (African Americans) where we are seeing lower vaccination rates.
L.A. Care staff continue to support our members enrolled in our Care Management and Disease Management Programs, Medication Therapy Management, and are taking advantage of a host of virtual classes now offered through our Community Resource Centers. Utilization of Community Link, our online Community Resource Platform, Nurse Advice Line and telehealth services has increased and remained higher than prior to the pandemic and our provider network has widely adopted telehealth for appropriate visits as routine.
Due to the Covid-19 pandemic, the Health Education team of registered dietitians and health educators have been providing over the phone consulting and group appointments have been suspended. Working with the IT security department, the Health Education team is now able to offer both group appointments
123 CMO Report – May 2021 Page 2
and individual consulting using both video and audio on following patient education services: diabetes, healthy heart, weight management, asthma, self-care during pregnancy, etc.
WebEx offers a visual component not available telephonically. This visual component greatly enhances the personalization and effectiveness of the education experience. These include: The ability to show visual cues or written material which can assist hard of hearing members. Demonstration food portion sizes which can assist cognitively challenged members. Exhibit portion sizes with plate, cup, and measuring spoon demonstrations which can assist members with low health literacy, particularly those with difficulty understanding numbers such as 6oz or 1/3 cup And the ability to visually demonstrate the correct use of medical devices, such as glucometers during diabetes education. The team plans to measure member satisfaction, participation levels, and education effectiveness using WebEx.
L.A. Care continues its robust COVID-19 communication plan including the COVID-19 resource page on L.A. Care’s website and frequently asked questions (FAQs) document available to our Call Center and Nurse Advice Line vendor staff. These resources are updated frequently, including information to address vaccine hesitancy and information to help them find and schedule appointments for COVID-19 vaccinations. Provider communications efforts have included a QI Webinar focused on vaccine hesitancy and communication tips for talking with patients and a COVID-19 CME event.
California Advancing and Innovating Medi-Cal (CalAIM) Work is in full swing throughout the organization led by a cross functional team to manage preparation for the implementation of CalAIM deliverables by 1/1/22. A significant part of the effort is focused on the transition from our existing Health Homes Program (HHP) and the LA County administered Whole Person Care Program (WPC) into a combined set of benefits called Enhanced Care Management (ECM) and In Lieu of Services (ILOS). L.A. Care is well positioned to meet the Population Health Management (PHM) goals included in CalAIM because the requirements are aligned with the NCQA PHM requirements.
L.A. Care has provided comments to the Local Health Plans of California (LHPC) and the California Association of Health Plans (CAHP) and continues to work closely with the L.A. County Department of Health Services and the Department of Health Care Services (DHCS) regarding the State’s proposed budget and payment methodology. Staff are currently reviewing recommendations for the development of the provider network and ILOS options we will offer as part of the program.
Quality Improvement and Healthcare Effectiveness Data and Information Set (HEDIS) Update L.A. Care staff work on improving our measured performance and clinical outcomes throughout the year. We work closely with our Plan Partners, network providers and contracted groups and IPAs to prioritize improvement effects. Current efforts include: Bus shelter and social media ads ran from November through February promoting well care visits were placed in South Los Angeles, East Los Angeles and Antelope Valley. There were 1.2 million impressions made based on an evaluation done by our marketing team. An adolescent immunization social media campaign Automated outreach calls were made to members with diabetes and/or hypertension across all lines of business with an option to transfer to a live agent when our call center capacity allows. In this way, the effectiveness of live agent transfers can be evaluated against the calls without. Follow up calls will be scheduled two months after the initial call to assess visit experience and/or to assist members with scheduling a visit with their provider if they have not yet done so.
124 CMO Report – May 2021 Page 3
Efforts to improve ER utilization and transitions of care include meetings with PPGs to increase engagement and focus on readmissions and ED utilization. Other improvement projects are underway the Diabetes Disparities Performance Improvement Project (PIP), the Child Immunization Status PIP.
On March 2, 2021, Department of Health Care Services (DHCS) responded positively to our COVID -19 Quality Improvement Project (QIP) submission. They were impressed with the various organizational efforts around COVID-19 as well as the scale. DHCS also released a notice that they will not issue financial sanctions or mandate corrective action plans for measurement year 2020 (MY 2020) for performance below the minimum performance level (MPL) but will resume these potential consequences for MY 2021. They will still require plans to submit a COVID-19 strategy and implement quality improvement projects for measures falling below the MPL in MY 2020.
Each year, we undergo an audit to certify our HEDIS data collection and reporting process. We passed that audit in March and will submit our data to the National Committee for Quality Assurance (NCQA).
Pharmacy Update
Comprehensive Medication Management (CMM) via California Right Meds Collaborative (CRMC) This program has grown with the addition of two more community pharmacies participating which have been on-boarded into the CRMC program (The Prescription Shop Pharmacy and Bellwood Pharmacy). As of April 23, 2021, 176 patients are engaged in the program. A total of 775 medication related problems (MRPs) have been identified, and an average A1c reduction of 2.5% in patients with 5 or more CMM visits with participating pharmacists.
Clinical Pharmacy Pilot Program (Ambulatory Care) In this program, an ambulatory care pharmacist is dispatched into partnering federally qualified health center clinics to provide clinical services in managing diabetes, hypertension, and hyperlipidemia. As of April 23, 2021, 133 members are enrolled in the program. o Wilmington Community Clinic: 58 members have been actively seen by the pharmacist; average A1c reduction of 3.48% among high-risk members. o APLA Health: 35 members have been actively seen by the pharmacist; average A1c reduction of 2.72% among high-risk members. o Watts Healthcare Corporation: 40 members have been actively seen by the pharmacist; average A1c reduction of 2.65% among high-risk members.
Medication Adherence – Comprehensive Adherence Solutions Program (CASP) As we prepare for DSNP transition, the pharmacy team is preparing to launch a comprehensive medication adherence outreach program. Intern pharmacists will be outreaching to non-adherent or at- risk members to offer mail order service, 90-day prescription conversion, and medication education to overcome any potential hurdle the members may be facing to become adherent. We are working with CSC to restart and revamp IVR medication refill reminder calls later this year. This call campaign was on pause in mid-2020 as a result of TCPA guidance. We will also coordinate efforts with QI in implementing medication adherence verbiage for the IVR call campaign.
Asthma Medication Ratio (AMR) Education Kit Evaluation In collaboration with QI, the pharmacy team launched the AMR Education Kit intervention on 11/6/2020, which was mailed to 6,277 members. The kit included a member letter, stickers to differentiate their
125 CMO Report – May 2021 Page 4 controllers from their rescue inhalers, a magnetic postcard to remind members to take their medications, and educational handouts from Health Ed. The pharmacy team recently conducted an evaluation of the 5,601 members in this intervention to compare the effectiveness 12 months pre- vs. post-intervention. o The average AMR ratio demonstrated a statistically significant improvement from .42 to .45 (an improvement of 0.03, P<0.001). o When examining the number of medication units filled, the results appear to substantiate the results above. The total number of members for this analysis is 6,026 (251 members disenrolled). When looking at a 4-month comparison, 47% of the members filled less rescue inhalers in the 4 months after intervention than before intervention. This result is sustained when extrapolated to 12 months, where 66% members filled less rescue inhalers overall.
Taken together, these findings suggest that the intervention was successful in achieving more appropriate asthma medication use. Further evaluation will be required to determine if we can also demonstrate that these improvements are correlated with achieving better asthma control, lower overall medication costs and decreased ER utilization and admissions.
Medi-Cal Rx Transition Governor Gavin Newsom issued Executive Order N-01-19, which requires the Department of Health Care Services (DHCS) to transition all Medi-Cal Pharmacy Services from Managed Care to Fee-for-Service by January 1, 2021. This new transition is termed Medi-Cal Rx. DHCS decided to delay the planned Go-Live date of April 1, 2021 to review new conflict avoidance protocols submitted by Magellan, the contracted vendor, per a January 2021 announcement of plans for Centene Corporation to acquire Magellan. Further updates are expected from DHCS in May 2021.
Transitions of Care Program (TCP) As of April 15, 2021, there are 48 completed cases in which the pharmacist has completed the medication reconciliation and provider clinical notice. If eligible, members will also be referred to the CRMC program for continued chronic disease state management (see above). Thus far, one TCP member has been identified as eligible for CRMC.
Transform L.A. program Transform L.A. is coaching 13 engaged DN practices, encompassing 88 providers, 3,200 DN members and 29,550 total L.A. Care members. Practice coaching modality remains primarily virtual, but we are now accommodating on-site coaching on a limited basis. Cohort 3 outreach calls began April 19 – we have 4 new practices in the pipeline/on the waitlist.
126 Board of Governors Executive Community Advisory Committee
Meeting Minutes – April 14, 2021 1055 W. 7th Street, Los Angeles, CA 90017 ECAC Members RCAC Members/Public L.A. Care Board of Governors/Senior Staff Russell Mahler, RCAC 1 Chair **** Pablo De La Puente, Interpreter *** Hilda Pérez, Member, Board of Governors *** Estela Lara, RCAC 2 Chair *** Isaac Ibarlucea, Interpreter *** Layla Delgado, Advocate, Board of Governors *** Cynthia Conteas-Wood, RCAC 3 Chair, Eduardo Kogan, Interpreter *** John Baackes, Chief Executive Office, L.A. Care *** ECAC Vice-Chair *** Alex Mendez, Interpreter *** Richard Seidman, MD, MPH, Chief Medical Officer, L.A. Care *** Silvia Poz, RCAC 4 Chair *** Ruth Nuno, Interpreter *** Shavonne Caldwell, Community Outreach Liaison, CO&E *** Maria Sanchez, RCAC 5 Chair *** Stephanie Webb, Interpreter *** Kristina Chung, Community Outreach Field Specialist, CO&E *** Andria McFerson, RCAC 6 Chair *** Idalia De La Torre, Field Specialist Supervisor, CO&E *** Fátima Vázquez, RCAC 7 Chair, ECAC Auleria Eakins, Manager, CO&E *** Chair *** Joseph Gonzales, Unified Communication Mobility Engineer I, IT Ana Romo, RCAC 8 Chair *** Operations & Infrastructure*** Tonya Byrd, RCAC 9 Chair *** Nicole Justo, Community Outreach Liaison CO&E *** Damares O Hernández de Cordero, Lynne Kemp, Health Education Program Manager II, Health RCAC 10 Chair *** Education Department *** Maria Angel Refugio, RCAC 11 Chair Linda Merkens, Senior Manager, Board Services *** *** Frank Meza, Community Outreach Field Specialist, CO&E *** Lluvia Salazar, At-Large Member *** Nicole Moussa, Manager, Technical Information, Pharmacy & Deaka McClain, At Large Member *** Formulary *** Candace Nafissi, Communications and Community Relations Specialist III, Communications Department *** * Excused Absent ** Absent Cindy Pozos, Community Outreach Liaison CO&E *** *** Via teleconference Jose Ricardo Rivas, Community Outreach Field Specialist, CO&E *** **** Via teleconference (with technical issues) Victor Rodriquez, Board Specialist, Board Services *** Prity Thanki, Local Government Advisor, Government Affairs *** Martin Vicente, Community Outreach Field Specialist, CO&E *** Naoko Yamashita, Cultural & Linguistic Program Manager, Cultural & Linguistic Department ***
APPROVED 127 AGENDA ACTION TAKEN ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS CALL TO ORDER Fatima Vazquez, ECAC Chair, called the meeting to order at 10:00 a.m. She read the instructions on today’s meeting agenda.
California Governor issued Executive Order N-25-20 and N-29-20, which among other provisions amend the Ralph M. Brown Act. Accordingly, members of the public should now listen to this meeting via teleconference as follows:
Teleconference Call –In information/Site Call-in number: 1-415-655-0002 Participants Access Code: 123 811 6402 (English) Call-in number: 1-415-655-0002 Participants Access Code: 123 490 2256 (Spanish)
meeting via teleconference. The public is encouraged to submit public comments or comments on Agenda items in writing by email to [email protected] or by sending a text or voicemail to (323) 541-7900 .
The text, voicemail, or email must indicate if you wish to be identified or remain anonymous, and must also include the name of the item to which your comment relates. If you do not indicate an Agenda item for your comment, your comment(s) will be read for up to 3 minutes at item IX Public Comment on the Agenda.
Comments received by voicemail, email, or text by 10:00 a.m. on April 14, 2021 will be provided in writing to the members of the Executive Community Advisory Committee at the meeting. Once the meeting has started, emails and texts for public comments should be submitted before the item is called by the meeting Chair. If you wish to submit public comment on an item, you must submit it at any time prior to the time the Chair starts consideration of the item. The Chair will ask for public comment and will announce the item. The Chair will announce when public comment period is over. Public Comments will be read for up to 3 minutes at the meeting. All votes in a teleconference meeting shall be conducted by roll call.
If you are an individual with a disability and need a reasonable modification or accommodation pursuant to the Americans with Disabilities Act please contact the Community Outreach & Engagement staff prior to the meeting for assistance by text (323) 541-7900 or by email to [email protected].
Executive Community Advisory Committee April 14, 2021 / Page 2 of 22 APPROVED 128
APPROVE Chairperson Vazquez asked any members having issues obtaining health care services to MEETING AGENDA please reach out to L.A. Care Health Plan Member Services at 888-839 -9909. She informed the committee of the changes to the order of agenda items.
The approval of the March 10, 2021 meeting minutes will be discussed after Standing Items,
section B, John Baackes, Chief Executive Officer, and section A, Richard Seidman, MD, MPH,
Chief Medical Officer. Mr. Baackes will be giving his report Dr. Seidman.
Estela Lara, RCAC 2 Chair, stated that there was something wrong with her connection and asked that the changes to the agenda be repeated. Approved by roll call. (Russel Mahler, RCAC 1 Chair, and Ms. Lara are having technical difficulties.) 9 AYES (Byrd, Andria McFerson, RCAC 6 Chair, stated that public comment should be read before each Conteas-Wood, agenda item. She asked that an official list of Community Outreach and Engagement Hernandez de department budget be provided to see how much was received and how they are bringing it Cordero, McClain, to the community on a positive level. Ms. McFerson asked that it be placed on the agenda. Poz, Refugio, Romo, She has asked for it to be placed on the agenda before and it hasn’t been done. Ms. Sanchez, and McFerson asked the chair go over the Zoom meeting instructions for each ECAC member, Vazquez) because two ECAC members are having technical difficulties. 1 NAY McFerson Ms. De La Torre stated that staff is working with Members Mahler and Lara to address 1 Abstention connection issues. Salazar (Members Mahler and Lara were not able to cast a vote due to technical difficulties.)
The Agenda for today’s meeting was approved.
APPROVE Deaka McClain, Member At-Large, stated that on the bottom of page 10, where it says MEETING MINUTES “unintelligible”, she unsure of what that means. She did not say that word.
Member McFerson stated that she would like to let the chairs know that previously
members could review the minutes for 5 minutes. Everyone does not have proper access
and she did not have proper access. She thinks that’s important.
Member Lara stated that there was an email sent out this morning with the meeting minutes. Approved by roll call. She would like to know if the minutes and agenda that were sent out this morning, have any 10 AYES (Byrd, changes from the documents emailed to members last week. Ms. Pozos responded there Hernandez de were no changes made to the agenda and the meeting minutes. Two additional documents Cordero, Lara, were sent to members this morning: the Board Motion Log and the Board report. Mahler, McClain, Poz, Refugio, (Member Mahler was having technical difficulties and casted a vote via chat.) Salazar, Sanchez, and Vazquez) Executive Community Advisory Committee April 14, 2021 / Page 3 of 22 APPROVED 129
(Cynthia Conteas-Wood, RCAC 3 Chair, and Ana Romo, RCAC 8 Chair, were having technical 1 Abstention difficulties and did not cast a vote.) (McFerson)
The March 10, 2021 meeting minutes were approved with corrections mentioned above.
STANDING ITEMS UPDATE FROM CHIEF PUBLIC COMMENT EXECUTIVE OFFICER Public Comment submitted by Elizabeth Cooper, RCAC 2 Chair: First I would like to acknowledge your retention from the Board of Governors to John Baackes lead L.A. Care another year. I would also hope during your leadership that you always remember the members of the RCACs and the staff who serve the RCACs and that the services continue to those members who face many challenges. Your leadership would be most important during this time. Also, I would like you to address the issue that will be on the ballot regarding the recall of the Governor, please inform us where members can get more information on this issue because it will possibly impact health care and the services members receive. Finally, I hope that your office would be more respectful to members. Thank you Mr. Baackes.
John Baackes, Chief Executive Officer, apologized for changing the order of items on the agenda to allow him and Dr. Seidman to give their updates first. Mr. Baackes gave the following report:
There was a development about 48 hours ago in regards to the Johnson & Johnson vaccine. L.A. Care completed four vaccine clinics last week. The four upcoming vaccine clinics had to be postponed due to a pause announced by Centers for Disease Control (CDC) for the Johnson & Johnson vaccine. L.A. Care is waiting for guidance from public health agencies.
Mask Distribution In two weeks, 50,000 masks will be mailed directly to high risk L.A. Care members that were identified based on data that L.A. Care obtained in house. Two weeks later, another 65,000 masks will be distributed. Twenty-thousand are being set aside for community members to be mailed by request. There is a form on the L.A. Care website. Ten-thousand masks will be distributed at Family Resource Centers and Community Resource Center event. Masks will continue to be distributed as available.
Medi-Cal Redeterminations The process for redetermination of eligibility for Medi-Cal is suspended until the public health emergency is over. Some eligibility is renewed automatically. About 40% percent of Medi-Cal beneficiaries will need to fill out paperwork. L.A. Care is pushing to have Executive Community Advisory Committee April 14, 2021 / Page 4 of 22 APPROVED 130
redeterminations be done moving forward and not retroactively. Payments to L.A. Care or to medical service providers will not be taken back.
Pharmacy Carve-Out The Governor proposed a carve out of pharmacy benefits that has now been postponed indefinitely because of a conflict of interest with a contractor that was hired to run the program. That issue needs to be resolved before they can implement the new program. When the program changes there will be a separate pharmacy ID card for prescriptions.
2022 Enhanced Benefits Benefits will be added to Medi-Cal to help address social determinants of health such as poverty, lack of food security, and language barriers. L.A. Care is currently planning the new program, and a report is due by July 1. This information will be shared with members later this year. He would love L.A. Care to be able to be the agency that can help members access resources that help address social determinants of health.
With regard to Ms. Cooper’s comments, he will ask Cherie Compartore, Senior Director, Government Affairs, Government Affairs, to create a report for a future ECAC meeting and for distribution to RCAC members.
Member McFerson stated that she is a public member and also a Chair. Member McFerson said, “As a public member I think it is important, if we’re going to be discussing social determinants of health and different things like that, that we have an ad hoc to discuss public opinion of what is important in the community. What is most prevalent. The Board or staff members may not be low income and may not have been through those dire situations. It would not be easy to reach out to the community if they do not have that information. It would affect the public, me, myself. If it is a new program, I would like to be a part of it.” She appreciates it, because she has been talking about for a long time. Member McFerson stated that during the Board meeting she was being grouped with other comments. Many public comments were very straight forward and she kept it professional. She said she wanted an overall audit and did receive one, but it did not specify what was important in their department. She never stated anything about Mr. Baackes’ salary or his work ethic. She believes he is doing a good job. She hopes that the RCAC members will have more of a say when it comes to reading public comments after an agenda item. Mr. Baackes thanked Member McFerson for her comments and stated that he thinks she is doing a great job as RCAC Chair. He advised Member McFerson received an audit created for L.A. Care by Certified Public Accountants. That report will not have the level of detail she is looking for. He stated that a separate report can be developed that shows the funds spent on the RCACs and ECAC. It will show the budget and the spending for last year. He stated that he will speak to Ms. Eakins and Ms. De La Torre to schedule an informational session about social determinants of health. Executive Community Advisory Committee April 14, 2021 / Page 5 of 22 APPROVED 131
Chairperson Vazquez thanked Mr. Baackes for the updates in his report. It is always a pleasure to hear him speak. She has heard about all of the work that L.A. Care is doing like the vaccine clinics. She uses public transportation and sees L.A. Care publications everywhere. She would L.A. Care to take into consideration the fact that some people do not have access to transportation and can’t participate at these events. She would like L.A. Care to help address this challenge so that community members can participate. Mr. Baackes responded that he is aware of the challenge and noted that L.A. Care provides about 100,000 rides a month for members to access medical care services, and he will definitely take that suggestion into consideration. The vaccine clinics are designed for people to drive up and walk up. He noted that that doesn’t do anything about getting people there, but it does give people without vehicles a chance to participate. The same thing is done at food pantries. Dr. Seidman will speak about vaccinations for homebound members during his updates.
UPDATE FROM CHIEF PUBLIC COMMENT MEDICAL OFFICER Public Comment submitted by Elizabeth Cooper, RCAC 2 Chair: Good morning Dr. Siedman my name is Elizabeth Cooper, Member of RCAC 2. Richard Seidman, MD, On behalf of Jonathan Cooper (L.A. Care Member) both he and I have received MPH the Covid-19 vaccine. Particularly I would like to acknowledge Kedren Community Health Clinic in East Los Angeles where he received his vaccine. The staff and volunteers were very compassionate event due to his special needs. It was a very culturally sensitive experience for Johnathan. I hope others who have special needs get the same treatment during their experience.
Ms. De La Torre announced that Member Mahler will use the chat feature due his technical difficulties. To comply with the Brown Act it will still be disabled for everyone else. Member McFerson stated that she would like the chat feature open to ECAC members so they can reach out to staff in case they have technical issues.
Deaka McClain, Member At Large, said that she is having technical difficulties and does not
know who to reach out to. Cindy Pozos, Liaison, CO&E, responded that ECAC members
can reach out to Ricardo Rivas, Field Specialist, CO&E, 213-719-7148 and Nicole Justo 213-
500-8640.
Dr. Seidman gave the following COVID-19 update:
He thanked Ms. Cooper for her comments about Jonathan Cooper’s experience. He noted
that South Los Angeles is doing a great job in getting people immunized. Over 100,000
vaccine doses have been administered. Transportation to L.A. Care vaccine events and
other vaccine clinics throughout the county is an issue. L.A. Care has been advocating for
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providers to give a walk-up option so that L.A. Care can provide transportation for its members. It is difficult to provide transportation for drive-thru events due to delays. Walk
up members can be dropped off and then picked up after they are vaccinated.
L.A. Care is working with the Department of Public Health to provide vaccinations to home stricken members. L.A. Care is trying to leverage home health contracts that send nurses to members’ homes and provide a wide variety of other services, and they have the capability of administering vaccinations. They will have to first become COVID-19 vaccine providers or partner with organizations that have access to vaccines.
COVID-19 Update Worldwide there are 135 million cases reported to date. Cases have been increasing for the last 7 weeks. Cases came down and are now going back up. Worldwide, there were 4.5 million new cases in the past week, and deaths have increased to 75,000 in the past week. The overall trend in the U.S. is increasing, up about 8% over the past week. There are three million new cases across the country and 72,000 deaths. The good news is that the Northeastern U.S. is getting better. The U.S. is making good advances in the nationwide vaccine effort, with over 1.5 million doses administered per day. About 37% of the adults in the U.S. have gotten at least one vaccine, and is working to get all adults vaccinated by late June. In L.A. County cases, hospitalizations, and deaths are going down. There is no sign of a significant increase. He encouraged everyone to do their part by continuing to socially distance and practice good hand hygiene. L.A. County is rated in the orange tier of California’s Blueprint for a Safer Economy. The county needs to get below 2 cases per 100,000 to get into the yellow tier, with lower restrictions. New guidance is expected shortly from public health agencies.
Johnson & Johnson COVID-19 Vaccine Of the seven million doses administered, six cases were identified in which people suffered blood clots in the brain; a very rare condition. The CDC placed this vaccine on hold out of an abundance of caution. Health officials are unsure if the vaccine caused the blood clots. It may be that the blood clots were in the process of forming before they were vaccinated. The women were in the 18-48 age range. The complications took place 3 weeks after vaccination.
Current guidance is that if it has been more than a month after people got the vaccine, they shouldn’t have anything to worry about. Women that are younger than 50 years of age should be cautious. People that experience abdominal pain or drowsiness should seek medical attention. Planned L.A. Care vaccine events have been cancelled. The Advisory Committee of Immunization Practice is meeting today but it is not certain an announcement will be made after that meeting. He apologized to those that made appointments for the
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vaccine. If people are eager to get vaccinated, he recommended that one looks for an appointment through other sources.
Member Lara thanked Dr. Seidman for taking time to attend ECAC, and she asked Dr. Seidman if he believes the vaccination card will become a requirement to go back to work as people become vaccinated. Dr. Seidman responded that the vaccine card that people get should be held on to. Many businesses are offering various forms of incentives for people that get vaccinated. He noted that people needing a vaccine card to get back to work is a controversial issue. He has seen the private sector and individual employers make these types of decisions. He has not seen any public agency or government make these decisions yet. Some Governors are looking at this for the states as well.
Member McFerson stated that due to city laws, people that walked up at some vaccine clinics had to be turned away. She noted that there were low income people, seniors and disabled people who did not have vehicles that had to be turned away. She will work with Mr. Rivas and RCAC 6 to make a general statement at town hall meetings to express how important it is to make these events accessible to everyone. She expressed her concerns and received a letter from the city of Lynwood stating that they host food programs for elderly and disabled people. Ms. McFerson noted that the colored and black community would be less reluctant to get vaccinated if they see publicity by people that are from the same community. She stated that this is important, because people like her are important as well. She said that she has spoken to some people that are reluctant to get vaccinated, because of the treatment they have received in the medical field or in society. Some medical treatments are being undiagnosed, misdiagnosed, and diagnosed late. This leads to a high amount of sickness and death. Whether or not it is a RCAC member advocating for people to get the vaccine, it should be people that are from the same community, and that is how you can reach the African American community. She stated that the yellow tier information that Dr. Seidman shared should be broken down into laymen’s terms. She asked that there be a PowerPoint presentation at the next meeting so that everyone can understand. Dr. Seidman responded that there is a state blueprint for a safer economy and fact sheets are available. Every two weeks in L.A. County there is a survey of Angelinos called the L.A. Barometer Survey from a survey team at USC. In the most recent survey results from 3 weeks ago, 70 % of respondents said they were vaccinated or intended to get vaccinated. It was higher than the earlier results. One thing being learned during the pandemic is that people’s thinking can change and there is more open-mindedness and willingness to get vaccinated. The thinking evolves over time, including among African Americans. He said many people in Los Angeles are high at risk and more than 40% of vaccines administered have gone to those identified as most at-risk. California has been doing a great job of getting vaccines to the areas that are most infected and are most at risk of infection.
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Member McFerson thanked Dr. Seidman for his comments and stated that she hopes ECAC can have information about the survey that was distributed at the L.A. Care vaccine events.
Tonya Byrd, RCAC 9 Member, stated that she is fully vaccinated even though she is not fond of shots. She is concerned about getting a booster shot. She asked Dr. Seidman whether or not they will need to be vaccinated again. Dr. Seidman responded that about 30% of adults don’t like shots. He is unsure about the potential need for booster, and it is too soon to worry about it. He does not know how long immunity lasts from a national infection and he doesn’t know how long immunity lasts from the vaccine. So far there have been good results. Dr. Seidman said that he also does not know how the vaccines work against variants. Currently the vaccines are working well, about 70% don’t get infected after 1st dose, 90% don’t get infected after second. There is no indication yet that boosters will be recommended and he does not know if there will be a need for an annual shot. He is happy that she was able to get vaccinated. The benefits of the vaccine far outweigh the potential side effects.
Chairperson Vazquez thanked Dr. Seidman for attending ECAC and answering member‘s questions.
BOARD MEMBER PUBLIC COMMENT REPORT Public Comment submitted by Elizabeth Cooper, RCAC 2 Chair: Thank you Hilda and Layla for your leadership. I do hope for the upcoming Layla Gonzalez election for those two seats, whoever is elected, that they will remember to focus on the needs and concerns of their members who they represent in a culturally Hilda Perez and linguistically sensitive way and to always keep in touch even as Board
Members.
Layla Gonzalez, Member Advocate, Board of Governors, gave the following updates:
The Board of Governors met virtually on April 1. She thanked all RCAC members that participated at the Board meeting and thanked them for their comments. She reminded everyone that they can text, voicemail, or email their public comments. For more information, they can reach out to CO&E staff. She sent gave her condolences to the families that have lost someone due to COVID- 19. She advised people that are trying to make their appointments for the vaccine to not give up and reminded them that the Community Resource Centers will be having events for vaccines throughout the county in the coming weeks. A list has been distributed to ECAC members. She thanked the CO&E staff for contacting members.
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A copy of the agenda can be obtained from Board Services. Meeting minutes will be posted on the website after they are approved at the next Board meeting. Misty de Lamare, Director, Communications, gave a presentation on L.A. Care’s Vaccination Outreach Efforts. April is National Volunteer Month. She thanked the countless doctors, nurses and people that have helped with connecting people to getting tested for COVID-19, food distributions, taking calls during this crisis and now all of those people providing help for vaccination efforts. She thanked them for their service and efforts in keeping the community healthy and thriving. She wished everyone a Happy Earth Day. She asked not to forget to recycle when possible. As people do their spring cleaning she asked they remember to recycle and donate their used items.
Hilda Perez, Member Representative, Board of Governors, stated that the rest of the report is based on an issue that was raised at the Board of Governor’s meeting. The Cal MediConnect (CMC) product line is part of the Coordinated Care Initiative (CCI) program. This program will end at the end of calendar year 2022. She noted that as part of the CMC and CCI, L.A. Care has an Enrollee Committee. She wanted to ask this question while Mr. Baackes was still in the meeting, about what is going to happen to the committee. Mr. Perez said she would like L.A. Care to be as transparent as possible so that the members of the Enrollee Committee are informed. She has not seen any reports come out of this committee. She spoke to Mr. Baackes about it and he stated that he would be speaking more about this committee.
Member McFerson stated that these are trying times right now and there needs to be information about how the Asian Community is impacted. She would like the Board members to speak to ECAC about how the Asian Community is being impacted. She has spoken about this before. She made a suggestion about a COVID-19 at home test, for people who do not have a vehicle, and L.A. Care implemented it. She also suggested making recorded calls to members so that they are aware that they have access to services like the vaccine. The best way to reach people is person to person. The recorded calls have been implanted, but now they have person to person at the FRCs. The masks were approved and she thinks it is great, because it is a necessity. She thinks it is important to figure out how to get gloves and hand sanitizers approved as well. She knows it is a large amount of money, but they are in dire need. She asked Ms. Perez and Ms. Gonzalez to bring this up to the Board.
Ms. Perez thanked Ms. McFerson for all of her suggestions. She will follow up on these issues. Ms. Perez thanked Ms. McFerson for always bringing issues to the table and she will
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make sure that her concerns are heard, to ensure a fair and transparent process. Every time they speak about the LatinX, Hispanic, and African American population they always say that L.A. Care is an inclusive organization and they should be open and proud to be able to speak on behalf of their communities.
Member Lara stated that she likes the fact that Ms. Perez brought up CMC, because she is unaware of what they are up to. For a long time, she has been pondering what is going on with them; she thought they didn’t exist anymore. She asked if they are doing things on their own, she thinks it’s great that they are still meeting and that there will be a report soon.
COMMUNITY PUBLIC COMMENT OUTREACH & Public Comment submitted by Elizabeth Cooper, RCAC 2 Chair: ENGAGEMENT Auleria Eakins please continue to help us be relevant under your leadership and UPDATES please be aware that we are still the RCACs and there are issues that need to be addressed by you and your staff. Auleria Eakins, EdD
Auleria Eakins, EdD, Manager, CO&E, gave Community Outreach & Engagement updates (a copy of the written report can be obtained from CO&E.).
Community Resource Centers (CRC) CRCs remain closed until May 1. L.A. Care has updated its website to reflect the closure. She encouraged everyone to forward this update to members of their community.
New CRC Openings Wilmington CRC is under construction with an open date of June 1. El Monte and Norwalk CRCs are under construction.
Upcoming Food Pantries A list was provided to ECAC members in the meeting packet. For more information on the upcoming food pantries members can contact their field specialist or go on the L.A. Care website: https://www.lacare.org/events/food-pantry. She asked everyone to refer to the website to confirm location, time and date of the food pantries.
Vaccine Efforts L.A. Care was honored to be invited by the nonprofit Ad Council to join its massive communications effort to help build confidence in the COVID-19 vaccines. This campaign is targeting Black, Latino and rural communities where vaccine hesitancy is a big problem. James Kyle, MD, Medical Director for Quality, Diversity, Equity and Inclusion, is among the trusted and credentialed medical experts from across the country who were asked to record a public service announcement offering a message that would encourage people to get a vaccine as soon as they are eligible.
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RCAC Work Plans Applications are due by close of business on May 7, and the organization suggested must be a Community-Based Organization or nonprofit that work in the area of food security or technology justice. One organization for Tech Justice called Human IT has been identified, and will be giving a presentation at a future ECAC meeting.
Upcoming ECAC Presentations May: Colorectal Cancer Screening June: Controlling Blood Pressure and an update on Urgent Care Service
(There were brief technical difficulties with the audio recording at this point.)
Ms. Eakins announced that there would be an informational session with Dr. Seidman with an update on the COVID-19 pandemic, and he will answer questions on April 20 at 2:00 pm (a copy of the flyer/invitation can be obtained from CO&E). She noted that the meeting is informational and will be a “COVID-19 discussion with Dr. Seidman.” It will be an opportunity for everyone to participate and ask questions. Questions must be submitted to the Field Specialist. Ms. De La Torre stated that staff will be conducting outreach calls to members starting tomorrow and she encouraged everyone to participate.
Ms. Perez gave a brief overview of colorectal cancer screening services. She thanked CO&E staff for reaching out to members and making the informational sessions more accessible to members. The fact that L.A. Care’s Liaisons and Field Specialists reach out to members is amazing. She thanked CO&E for having an event that gives members a chance to ask questions about COVID-19. She asked if the event was going to be via phone or will it also be accessible by videoconference? She has questions about the budget and would like to know when she can ask these questions. Ms. Eakins responded that the meeting will be accessible via WebEx. She asked that they give Human IT an opportunity to present. She feels it will be very insightful and is happy about the opportunity.
Member McFerson stated that there should be flyers for the food pantry events. Those flyers should be mailed out to them so they can go person to person. Many people don’t have a good memory or something to note down the information. Many people don’t take the information seriously, because some people need a piece of paper. She prefers to have paper flyers to be able to hand out. She asked if the May 19 Asian Dialogue meeting will allow public comment or will it just be a one-sided conversation. Ms. Eakins responded that she will see what can be done about paper flyers. She asked that RCAC members provide names of organizations for the RCAC Work Plans to their Field Specialist.
Member Lara asked about an update on the RCAC 2 motion to increase stipend. Ms. Eakins responded that she will need to look into where talks left off last and she will follow up. Executive Community Advisory Committee April 14, 2021 / Page 12 of 22 APPROVED 138
Maria Angel Refugio, RCAC 11 Chair, stated that she would like to know about the food bank events. The schedule she saw stated that on April 7 there would be a food pantry event and she sent messages to RCAC 11 members. Members went to the site and no event was actually held. She asked if the event on May 15 at the same location was going to take place. She would like to know who she has to speak to. Ms. Eakins apologized for the mishap. She advised members to visit the website for the most up to date schedule.
Silvia Poz, RCAC 4 chair, asked if people who have appointments for the Johnson & Johnson vaccine should still go. She noted that the appointments were made through L.A. Care. Ms. Eakins responded that as of right now vaccine clinics have been postponed, and more information will be provided as it becomes available. Ms. Poz asked that staff reach out to her as soon as possible, because she helped sign up people in her community.
OLD BUSINESS ECAC AD HOC PUBLIC COMMENT COMMITTEE – Public Comment submitted by Elizabeth Cooper, RCAC 2 Chair: PUBLIC COMMENT To the ad-hoc committee, remember the Brown Act and L.A. Care structure, and
get the RCAC members input before you vote on this. Idalia De La Torre Idalia De La Torre, Field Specialist Supervisor, CO&E, discussed creating an ECAC ad-hoc committee to discuss and make recommendations on the order of public comment for ECAC agenda items.
Member McFerson stated that she needs to be on the ad hoc, because she provided the motion.
Lluvia Salazar, Member At-Large, asked Ms. McClain if she would like to be part of the ad hoc committee. Ms. McClain asked Ms. Salazar to participate if she has time.
Ad Hoc Committee for Public Comment Andria McFerson Ana Romo Lluvia Salazar Silvia Poz (Alternative)
Ms. De La Torre stated that staff will reach out to the ad hoc members to confirm a date and time. Member McFerson stated they need to come up with a general consensus on the times available for the ad hoc to meet. It is important that committee members agree on a time to meet. Ms. De La Torre responded that staff look at available dates and times that
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the committee can meet and they will reach out to members. The most convenient date and time for all members will be selected.
Augustavia J. Haydel, General Counsel, hopes that everyone is doing well. At the March 10 ECAC meeting, a motion was presented regarding public comment during discussion of an agenda item. The motion was discussed and amended. The amended motion was stated and seconded by Ms. McFerson. There were no objections to the amended motion by members and that amended motion replaced the original motion. There was a vote on the amended motion. Member McFerson asked if a motion is put on the floor and the original motion is not voted against, but someone asked to amend the motion and is voted on, does the original motion still stay on the floor? She stated that the original motion was not voted on. Ms. Haydel clarified that vote was on the amended motion, which replaced the motion on the floor. If the committee was following formal Robert’s Rules of Order, there would be a vote to accept the amended motion. Since the committee is following informal rules, and there were no objections, the amended motion is accepted by consensus. The vote that occurred was to approve the amended motion.
Ms. Haydel also noted that the amended motion that was voted on looks like it may have had a typo. The motion states public comment allowed after the agenda item presentation, but before the ECAC comments and decisions. After she read the meeting minutes she thinks that the committee may have intended to have public comment after the agenda item presentation and ECAC comments, but before the decisions are made. Ms. McFerson stated that she agrees. Ms. Haydel reported that if the group decides to bring the motion back they may want to consider looking at the language to make sure that the position of public comment was written correctly. The vote taken was on the amended motion not just to accept the amendment. Ms. McFerson responded that she agrees and she brought it up, but it is not in the meeting minutes. She noted that this has happened before. Ms. Haydel stated that living in the COVID-19 era time is interesting, particularly with virtual meetings. She noted that she was having technical issues earlier in this meeting. Sometimes there are delays in the audio. It does not require a vote to accept an amendment if there is no objection or controversy. That’s her understanding of what happened with that motion.
Member McFerson stated that they need to follow Robert’s Rules of order. She asked that staff assist ECAC in ensuring that the rules are being followed. She asked if the motion is still on the floor, because they solved the issue by creating an ad hoc. She asked what the committee should do at this point. Ms. Haydel responded that the original motion was to create an ad hoc. The ad hoc committee was not in the final amended motion. Unless there was a vote taken at another time, the ECAC has not formally authorized an ad hoc. Ms. McFerson responded that ECAC has created an ad hoc and are working to set a date and time. Executive Community Advisory Committee April 14, 2021 / Page 14 of 22 APPROVED 140
NEW BUSINESS POPULATION NEEDS Naoko Yamashita, Interim Manager C&L, and Lynne Kemp, Health Education Program ASSESSMENT Manager, gave a presentation on Population Needs Assessment (A copy of the presentation can be obtained from CO&E.). Naoko Yamashita Purpose of the PNA Lynne Kemp Identify member health needs and health disparities Identify gaps in health education, C&L, and QI programs Address identified health needs, health disparities or gaps
Member Input We want to hear from you! We will use what you tell us to help us better meet your needs.
Health Education Programs, services and resources to keep members healthy or manage health conditions. Individual telephone counseling Written materials Online tools and workshops Special programs (diabetes, asthma, pregnancy)
Ms. Kemp asked the committee if they had any suggestions to improve health education programs, services, or resources.
Ms. Gonzalez thanked her for her patience. She asked about the different plans that L.A. Care has. She noted that L.A. Care has different product lines with different services, she would like to know if these services are provided across the organizations or only specific populations. Ms. Kemp responded that health education services are standardized by the state. Regardless if they are L.A. Care direct members or plan partners. They delegate services to plan partners. They should be offering services as well. Direct line of business members can go directly to her department. She stated that she is hear to learn how they can improve their services. Sometimes they target specific populations through flyers or letters. They do try to tailor services, but always based on state standards.
Ms. McFerson stated that due to the fact that we are in the virtual world right now, there should be some sort of robo call, so they can get help get through the virtual world and follow up. In order to get everyone on the same page they need to inform their members that there are other options.
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Ms. Kemp responded that this is a great opportunity for expansion. She noted that this is something that can be explored.
(The recording experienced technical issues.)
Ms. Yamashita presented the following information:
FY19-20 C&L Program Evaluation Summary L.A. Care Bilingual Staff 398 qualified bilingual staff in 11 languages.
Interpreting Services In-person: 5,590 requests in 30 languages. 85% of members were satisfied. Telephonic: 200,275 calls in 89 languages. 95% of members were satisfied.
Translation Services 2,706 documents processed.
Cultural Competency Training 3,475 L.A. Care staff and 1,367 providers completed cultural competency related trainings.
Ms. Yamashita asked the committee if they had any suggestions to improve the C&L program.
Ms. McFerson said that she is very happy about the empathy training. This information is available for whoever needs it. They have education on what they go through and how they feel. She has spoken about this before and it happy that L.A. Care is following through. She asked how members can speak to doctors virtually and how to receive test results from L.A. Care. Ms. Yamashita responded that interpreter requests for virtual doctor appointments can be challenging sometimes. Interpreter services can also be obtained through the phone. It has been an interesting year and are looking at how providers can better serve members in this environment.
Ms. Gonzalez noted that members when they first sign up get a big packet of information. She is concerned that sometimes members get overwhelmed and push this useful information to the side. She asked if magnets that include this information can be sent out to members. Ms. Yamashita responded that the welcome packet is sent out and has a lot of information. There is a card in the packet called I-Speak, but would like to explore the idea of a magnet.
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COVID-19 VACCINE Misty de Lamare, Director, Communications, gave a presentation about L.A. Care’s Vaccine COMMUNCATION & Communication & Outreach Efforts (A copy of the presentation can be obtained from CO&E.). OUTREACH EFFORTS Goals
Misty de Lamare Build trust in the safety of the COVID-19 vaccine by dispelling common myths and sharing facts about the vaccine’s safety and availability so that community members decide to — and know how and when to — get vaccinated. Assist eligible members in accessing the vaccine when it becomes available to them. Be true to L.A. Care’s mission as a public health plan, by supporting public health efforts to end the pandemic.
Strategy
Position L.A. Care as a reliable source of truth about the COVID-19 vaccine by
providing information while being respectful of the histories of the communities that we
are serving, so that people can make an informed decision about getting vaccinated
Messaging and tactics will roll out in phases in alignment with the state and county public health departments approved tiers and target populations that are identified by the COVID-19 vaccination program in Los Angeles County.
Addressing Health Equity Advocating for the equitable distribution of COVID-19 vaccines Multiple media publications Support letter: Site-based vaccination strategy for people experiencing homelessness (2/18/2021) Postcard and mask sent to high-risk Asian and Pacific Islander community Tranquada XII initiative $1.6 million for FQHC projects that increase the number of COVID-19 vaccine doses administered to low-income, racially and ethnically diverse populations disproportionally impacted by the pandemic.
Sample Key Messages L.A. Care and public health agencies recommend that everyone who is eligible get the COVID-19 vaccine. It is the best way to protect yourself and your loved ones and for us all to get back to a more normal life. All three of the vaccines authorized for emergency use by the FDA are highly effective in preventing hospitalization and death. The vaccines do not infect you with the COVID-19 virus. Side effects are generally mild and go away after a day or two, while the benefit of the vaccine remains. Executive Community Advisory Committee April 14, 2021 / Page 17 of 22 APPROVED 143
There is no cost to L.A. Care members to receive the vaccine. Vaccine supply at sites throughout L.A. County is increasing, but appointments at all locations will still be required. Local public health departments ask the public for patience and persistence when scheduling appointments. You can access vaccine appointment tools at lacare.org/vaccine. Even after you get the vaccine, good public health measures will still be required. Please continue to wear a mask, wash your hands, and watch your distance (Three Ws). You should also continue to follow local public health orders and avoid traveling or gathering with people outside of your household to the extent possible.
Employee Outreach Weekly COVID-19 Q&A with chief medical officer Dedicated intranet page Answers to FAQs Links to blogs from L.A. Care doctors and staff Staff polling Educational videos (coming soon) Regular updates at Town Hall meetings Regular updates in CEO emails Selfie campaign (coming soon)
Provider Outreach Examples Continuing Medical Education (CME) trainings “COVID-19, Public Health and Practice Perspectives on Equity” Landing page on lacare.org to centralize COVID-19 vaccine-related provider resources Mass e-mail and mail reminders to providers to get vaccinated
Member & Community Outreach Examples Targeted identification model for high-risk groups Partnering with other organizations to help give our members access to the COVID-19 vaccine MLK Hospital Dignity Health Hollywood Presbyterian Robocalls and staff outreach Informing members as they become eligible Community health worker training Transportation to walk-up vaccination appointments
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Two-day requirement waived
CRC Vaccine Efforts 1,000 doses per clinic x 16 clinics 16,000 total doses Johnson & Johnson vaccine Targeted member outreach by zip code Staff calls to high-risk members Targeted social media campaign on standby Walk-up, drive-thru, and drop off options offered Members will be able to use their transportation benefit to get to their vaccine appointment
Community Advisory Council (CAC) Member Engagement Sharing general COVID-19 and COVID-19 vaccine information with our CAC members at conferences and meetings Member comments have directly influenced our messaging and materials Provided all CAC members with vaccine information fliers to share with friends, family, and neighbors Recruiting vaccine “ambassadors” from CACs to feature in messaging Exploring Tele Town Hall partnership to help bridge the information technology gap Individual outreach to all CAC members to pre-screen them for vaccine eligibility and, if eligible, to provide them with a vaccine appointment at a CRC vaccine clinic CAC Member Survey
Member Lara stated that the presentation was amazing and had much useful information. She thanked Ms. de Lamare for her time.
Member McFerson thanked Ms. de Lamare for her presentation. She noted that there needs to be more community involvement in the fight against COVID-19. There would be more people participating if there was an incentive such as food cards. Anything that can help members access food. Ms. de Lamare thanked her for her suggestions and advised that she will take this information back to the vaccine command center. She asked that members continue to send in their photos.
FUTURE AGENDA ITEMS Member McFerson asked that an increase in stipends or providing a food card with the stipend be added to the agenda for the next meeting. She originally fought for a motion to possibly add a food card instead of raising the stipend. She would like an update on CO&E
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budget and how it is positively impacting the community. She would also like to see demographic data from the L.A. Care vaccine events.
Member Lara stated that the agenda has too many items on the agenda and members do not have enough time to speak. They are not respecting every committee members’ time. That needs to be taken into consideration when the agenda is created. Lately the meetings have been running over by a great amount of time. She suggests removing agenda items to have more time to advocate for members.
PUBLIC COMMENTS PUBLIC COMMENT Public Comment submitted by Elizabeth Cooper, RCAC 2 Chair: Public Comment from Ms. Elizabeth Cooper, RCAC 2 Member, Madam Chair, Ms. Vazquez, and the members of the ECAC, and staff. I would like to share my deep concern to those who have lost family members, staff and others to Covid- 19 on behalf of me and my son. Finally, I would like all of us as Americans and hope that we can express our concerns with the issues of violent incidents that have been happening to our fellow Americans.
(The following message was to be read during the Chief Executive Officer Report agenda item) Public Comment submitted by Carolyn Navarro: I only recently realized a comment made at a board meeting that west published was a HIPAA violation, my child rights were violated in so many ways that it’s literally taken me years to sort out what you perpetrators did. I didn’t like the comment before but didn’t make the HIPAA connection, I have repeatedly asked LA Care for a copy of the record where my daughters case is mentioned by a board member publically and LA Care will not give it to me. I have also asked for copies of the repeated emails I sent to the assigned contact person trying to get assistance for my autistic daughter who ended up dying and LA Care will not give me copies! I saved the emails I sent, what is wrong with your agents ignoring emails from patients they are assigned as contacts to. I made state and federal HIPAA complaints, you people know perfectly well what I’m talking about
Public Comment submitted by Carolyn Navarro: Stop using the special needs community to make yourselves look good! I have located special needs people who you have failed terribly including my daughter , when the families tried to alert you that Synermed who also contracted with LA Care using a front company which was THEM was violating their rights, you continue to do the same things Synermed did to enrollees, ignoring or undermining grievances, retaliating for grievances, delaying action taken on
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grievances, enabling abuse against special needs enrollees, you’re a waste of tax dollars, a danger to the special needs community , not an asset! Your management and board does not represent the community you claim to serve, all your management does is cover up your lies to the public while you pay news stations to make you look good to sell more policies while you treat your existing members like shit and are not capable of providing service to them! Read your reviews online, all of them are true, except for the occasional fake looking review that look like an employee wrote them! You have no business serving autism spectrum enrollees, my dead daughter was autistic and you acted defensive about the fraud I discovered and alerted you to instead of helping her! Much of your management needs to be fired!
Public Comment submitted by Ismael Maldonado, RCAC 2 Member: How are we going to work on getting people vaccinated in each RCAC Because of The new problem that came with the Johnson and Johnson vaccine because la care wanted me to go and get that vaccine thank heavens I did not
Public Comment submitted by Ismael Maldonado, RCAC 2 Member: Is LA Care health plan working with doctor’s office that are contracted to due telemedicine call when patient don’t want to go out of home due to underlining health conditions
Public Comment submitted by Ismael Maldonado, RCAC 2 Member: I have seen a problem with Walgreens is not accepting Anthem blue cross
Public Comment submitted by Ismael Maldonado, RCAC 2 Member: Possible ADA violation blocking the chat box because title 5 of the American with disability act blocking alternative communication
Public Comment submitted by Ismael Maldonado, RCAC 2 Member: The ECAC is in Violations of the Ralph M Brown Act from Public comment not being hear to ADA American with disability act all RCAC should be Consulted anything that goes on with ECAC thats why we are a body of LA CARE
Public Comment submitted by Maricruz Alavarez, RCAC 2 Member: Last Monday, on April 5, a friend of mine got the vaccine – he felt really bad, but did not go to his doctor; and on Wednesday April 7, he died (around 5pm). In cases like this, is this considered a “natural death”, or is it considered “death of COVID”? Thank you, Maricruz Alavarez R2
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Ms. Eakins announced that the May 15 Pomona CRC food pantry event has been moved to May 22.
Member McFerson stated that, once again, she wanted to reiterate that Johnson & Johnson have a hold on vaccinations and the public and participants at the L.A. Care vaccine events may not have that information. People that have appointments today and tomorrow may not be informed. She asked if staff can make robo calls or calls from staff about the cancellations. She will reiterate the fact that robo calls are very important.
ADJOURNMENT The meeting was adjourned at 1:39 p.m.
RESPECTFULLY SUBMITTED BY: APPROVED BY: Victor Rodriguez, Board Specialist II, Board Services Fatima Vasquez (due to public health orders the document will be signed when it is possible) Malou Balones, Board Specialist III, Board Services Fatima Vasquez, ECAC Chair ______Linda Merkens, Senior Manager, Board Services Date: ______5/12/2021______
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BOARD OF GOVERNORS Children’s Health Consultant Advisory Committee Meeting Minutes – March 16, 2021 1055 W. Seventh Street, Los Angeles, CA 90017
Members Management Tara Ficek, MPH, Chair Toni Frederick, PhD Maryjane Puffer, BSN, MPA Katrina Miller Parrish, MD, FAAP, Linda Aragon, MPH* Gwendolyn Ross Jordan* Diana Ramos, MD Chief Quality and Information Executive, Health Edward Bloch, MD* Lyndee Knox, PhD Richard Seidman, MD, MPH Services Maria Chandler, MD, MBA James Kyle, MD, MDiv Ilan Shapiro, MD, FAAP* Cynthia Carmona, Senior Director, Safety Net Rebecca Dudovitz, MD, MS Nayat Mutafyan* Diane Tanaka, MD* Initiatives, Safety Net Initiatives Rosina Franco, MD* Hilda Perez *Absent **Present, but not quorum Susan Fleischman, MD
California Governor Newsom issued Executive Orders No. N-25-20 and N-29-20, which among other provisions amend the Ralph M. Brown Act. Members of the public can hear and observe this meeting via teleconference and videoconference, and can share their comments via voicemail, email or text.
AGENDA ITEM/ PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN
CALL TO ORDER Chairperson Tara Ficek, MPH, called the meeting to order at 8:33 a.m. without quorum. She stated that the committee has a full agenda with presentations. She advised the committee that Fatima Clark, MSW, Senior Policy and Outreach Associate, Health and The Children’s Movement, Children Now!, will be presenting information about the Children’s Well- Being Scorecard.
APPROVAL OF MEETING T he Committee reached a quorum at 9:05 a.m. Approved unanimously. AGENDA 10 AYES (Chandler, Dudovitz, Ficek, Fleischman, Frederick, Knox, Kyle, Puffer, The Agenda for today’s meeting was approved as submitted. Ramos, Seidman)
APPROVAL OF THE The minutes of the January 21, 2021 meeting were approved as submitted. Approved unanimously.
MEETING MINUTES 10 AYES
APPROVED 149
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CHAIRPERSON REPORT Chairperson Ficek noted that the county has hit important milestones in the last few days. The county has moved into the purple tier due to the reduction in COVID-19 case count. She stated that this paves the wave for the opening of businesses and schools. For the population that committee members represent it is a big milestone. All districts in the county have presented their plan for returning students to campus. It is a win for children to get back to class. Family mental health is something that should continue to be looked at as well as health disparities. She imagines they will continue to be discussed throughout the year.
PUBLIC COMMENT A Public comment was removed at the request of the submitter.
CHIEF MEDICAL Richard Seidman, MD, MPH, Chief Medical Officer, gave the March 2021 Chief Medical OFFICER REPORT Officer report. (A copy of his written report can be obtained from Board Services.)
Richard Seidman, MD, MPH COVID-19 By early March 2021, there were more than 113 million cases and 2.5 million deaths from COVID-19 worldwide. The surge peaked in January, and after a 6-week decline in the number of cases, there was a 7% increase believed to be driven by a combination of increased transmission due to re-openings, to circulating variants of concern, and reduced compliance and fatigue with basic public health measures. Vaccination efforts ramp up unevenly throughout the world and the emergence of variants of concern are being studied closely.
The United States has seen a similar drop in cases and deaths, which is beginning to level off causing concern about the potential for another surge as has occurred in other places throughout the world. California and Los Angeles are seeing a sustained reduction in cases and deaths and, despite the many challenges with the vaccine effort, are keeping pace with the national pace which has succeeded in vaccinating nearly 60 million people (18% of the eligible population have received at least one dose of vaccine).
(Member Rebecca Dudovitz, MD, MS, Member Rosina Franco, MD, and Member Mary Jane Puffer, BSN, MPA, joined the meeting.)
Cases in Los Angeles have dropped from more than 15,000 per day down to 1,000 -2,000 and hospitalizations, which pushed our delivery system to the edge, have now dropped from more than 8,000 per day to less than 1,500. L.A. Care has identified nearly 120,000
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cases, 20,000 hospitalizations, and 3,600 deaths (16% of LA County total) among our members. The approval of the Johnson and Johnson single dose vaccine on February 27 marks another significant milestone in the course of the pandemic, expected to significantly increase vaccine supplies locally and throughout the United States and worldwide.
March 16th will mark the one-year anniversary when the majority of L.A. Care staff began working remotely, and we continue to do so today. Even while working remotely, L.A. Care staff continue to support our members enrolled in our Care Management and Disease Management Programs, Medication Therapy Management, and are taking advantage of a host of virtual classes now offered through our Community Resource Centers. Utilization of Community Link, our online Community Resource Platform, Nurse Advice Line and telehealth services has increased and remained higher than prior to the pandemic and our provider network has widely adopted telehealth for appropriate visits as routine.
L.A. Care has developed a robust COVID-19 communication plan, which was shared at L.A. Care’s Technical Advisory Committee in January. The plan includes the creation and maintenance of a COVID-19 resource page on L.A. Care’s website and the development of frequently asked questions (FAQs) documents made available to our Call Center staff and shared with our Nurse Advice Line vendor. In addition to these activities including updated information available to members to help them find and schedule appointments for COVID-19 vaccinations, L.A. Care is conducting outreach efforts to members, and is collaborating with vaccine providers by doing targeted outreach to L.A. Care members to increase the rate of vaccine administration among our members.
Member Dudovitz stated that the committee that advised the Federal Drug Administration to authorize the Johnson & Johnson vaccine actually considered prioritizing it over the other vaccines. Some people think it is the most effective vaccine to combat the pandemic. Member Seidman thanked Member Dudovitz for her comments.
Member Seidman said that a panel on COVID-19 with Muntu Davis, MD, L.A. County Department of Public Health, and Peter G. Szilagyi, MD, MPH, Pediatrics at UCLA Health. He noted that Dr. Szilagyi is also on the Committee for Immunization Practice. He has the insight, because he is part of the discussions. He also has access to data from surveys on COVID-19 acceptance. Hector Flores, MD, White Memorial Residency will also be speaking on behalf of the LatinX community.
Member Puffer asked Member Seidman if there is a vaccine plan released to the RCACs. Member Seidman responded that L.A. Care has been working very closely with the Children’s Health Consultant Advisory Committee (CHCAC) 151 March 16, 2021, Page 3 of 11 APPROVED
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Executive Community Advisory Committee (ECAC). ECAC’s membership includes the leadership of the all RCACs. L.A. Care has updated the committee with L.A. Care’s overall communication plan. Part of the discussion is always about how ECAC and RCAC members can help the word out to their peers. In a separate session he and Member James Kyle, MD, MDiv, held discussion with members to encourage members to engage with their peers.
Member Kyle responded that L.A. Care has held two seminars with RCAC members. He attended an ECAC meeting, gave an update on COVID-19, and answered member questions. He noted that there seems to be a decline in vaccine hesitancy in minorities, but it is not where it should be. He is unsure of the strategy to encourage people who base their decision not to be vaccinated on reasons that do not have anything to do with science. He thinks that L.A. Care is making headway with the LatinX and Black community, but it is not where it ought to be. He is hopeful that enough people will be vaccinated in those communities to reach some immunity.
Member Susan Fleischman, MD, asked if he committee had taken a formal position on school reopening. Member Seidman responded that the committee has not taken a position. If the committee would like to take a position, it would come in the form of a recommendation to L.A. Care’s Board of Governors. Member Fleischman noted that it is a complicated issue and would let the committee think about it. Member Seidman stated that it is political and it would be best to take an independent position.
In additional to these efforts, L.A. Care is working with Blue Shield Promise Health Plan, our Plan and Community Resource Center partner to offer COVID-19 clinic events at each of our eight Community Resource Centers (CRCs). Vaccine supply allowing, the events will begin in late March, but may be delayed as needed if our Pharmacy partner is not able to secure sufficient vaccine. The schedule will also be adjusted if our Pharmacy partner is able to secure the Johnson and Johnson vaccine for these events, necessitating only one dose, rather than the two doses required for both the Pfizer and Moderna vaccines. Our goal is to administer 1,000 vaccines per day at each of these events to our members and to eligible members of the communities surrounding our CRCs. We will offer both drive- through and walk-up options, and will require appointments to manage the demand and increase access and transportation options to and from the clinics. L.A. Care does provide transportation as a Plan benefit to assist members with walk-up appointments for COVID- 19 vaccine.
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California Advancing and Innovating Medi-Cal (CalAIM) Work is ramping up across the organization with the launch of a cross functional team to manage preparation for the implementation of CalAIM deliverables by January 1, 2022. A significant part of the effort is focused on the transition from our existing Health Homes Program and the LA County administered Whole Person Care Program into a combined set of benefits call Enhanced Care Management (ECM) and In Lieu of Services (ILOS).
L.A. Care has provided comments to the Local Health Plans of California and the California Association of Health Plans and to the Department of Health Care Services (DHCS) regarding the State’s proposed budget and payment methodology. Staff are currently reviewing recommendations for the development of the provider network and ILOS options we will offer as part of the program.
Cynthia Carmona, Senior Director, Safety Net Initiatives, and Mary Zavala, Director, Health Home Programs, Health Homes, stated that generally speaking L.A. Care is excited for ECM to come online with the addition of the children and youth population. In the Severe Mental Illness category, L.A. Care will also be able to serve children and youth that experience severe emotional disturbance. There are two areas in ECM where children and youth will have access. Those two populations are not normally prioritized for services under Health Homes or Whole-Person Care. Children and youth under the age of 18 make up a very small percentage. Only about 5% of total enrollment are children and predominant diagnosis is Asthma. Shifting to ECM in 2022 will broaden the openings to be able to serve additional with complex health needs. Physical, behavioral, developmental, and oral health needs will be better met. The state has provided very broad categories. One of the things that L.A. Care is actively working on right now is how to refine these criteria to be able to serve the children most in need. Mainly Children up to age 21 and foster children up to age 26. Children and Youth will be able to enroll into ECM services starting in July 1, 2022. L.A. Care is waiting from additional guidance from DHCS on the launch date for children with serious emotional disturbance. Could be as early as June 1 2022.
Member Seidman asked Ms. Zavala if she had any comments about the CCS population and ECM. Ms. Zavala responded that that is something that L.A. Care is currently looking at. DHCS advised that these services are not duplicates.
Chairperson Ficek recommended that this be table as a future agenda item. Member Seidman agreed.
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PROP 56: VALUE-BASED Katrina Miller-Parrish, MD, FAAP, Chief Quality and Information Executive, Health Services gave PAY PROGRAM UPDATE a presentation about PROP 56: Value-Based Pay Program Update (A copy of the written report can be obtained from Board Services.) Katrina Miller-Parrish, MD, FAAP. On November 8, 2016, California voters approved the California Healthcare, Research and Prevention Tobacco Tax Act (commonly known as Proposition 56) to increase the excise tax on cigarettes and tobacco products to help fund health care expenditures. The funding appropriated for Proposition 56 by the Department of Health Care Services (DHCS) specifies the issuance of supplemental payments to Managed Care Plans for Eligible Network Providers performing qualifying Value-Based Payment (VBP) Program services. L.A. Care will release supplemental funding to contracted PPGs with the expectation that the contracted PPGs release a communication to Eligible Network Providers detailing the payment process, including a Prop. 56 Payment Summary, and that said payment will be released to Eligible Network Providers based on the criteria below.
Payment Criteria The Proposition 56 payments are based on Dates of Service (DOS) July 1, 2019 to June 30, 2020 (Fiscal Year 1) and DOS July 1, 2020 to September 30, 2020 (Fiscal Year 2, Quarter 1) for clean claims or “Accepted” Encounters Received by September 30, 2020 – Payment #1. L.A. Care defines “Accepted” Encounter data as encounter data received by L.A. Care (clean data after edit process) submitted timely, formatted properly, and coded accurately in compliance with national standards. Please reference All Plan Letter (APL 20-014) for further specifications regarding encounter submission.
For a summary list of Proposition 56 VBP codes and descriptions, please refer to the VBP Program Technical Specifications, which can be found here: https://www.dhcs.ca.gov/provgovpart/Documents/VBP-Specifications-9.30.20.pdf.
# Prop 56 Program Payments Unique DOS beg DOS end Providers VBP $ 461,350.00 780 8/1/2019 6/30/2020 Developmental $ 37,730.20 58 1/3/2020 2/8/2021 Screenings ACES Screenings $ 37,352.00 39 1/2/2020 2/5/2021 Overall $ 536,232.20 872
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VBP Measures
Early Childhood Well Child Visits in First 15 Months of Life Well Child Visits in 3rd – 6th Years of Life All Childhood Vaccines for Two Year Olds Blood Lead Screening Dental Fluoride Varnish
Chronic Disease Controlling High Blood Pressure Diabetes Care Control of Persistent Asthma
Behavioral Health Screening for Clinical Depression Management of Depression Medication Screening for Unhealthy Alcohol Use
Member Puffer asked Dr. Parrish if the adolescence well visits are eliminated or are not considered for L.A. Care. She also if these scores were based on HEDIS measures. Dr. Parrish confirmed that the scores are based on HEDIS measures. 21 measures were chosen sometimes between 2017 and 2018. Although the adolescent program is not in the Prop 56 VBP program through L.A. Care, the organization still incentivizes these services. Unfortunately, Prop 56 does not cover everything, but L.A. Care has many other incentive programs even if they are not included in this program.
Chairperson Ficek that developmental screenings being lower than desired. She asked if L.A. Care sets target goals for providers. She asked what L.A. Care was trying to achieve. Dr. Parrish respond that this is the 2nd or 3rd time a group has looked at these numbers. There has been much activity trying to get these payments out. The programs can be very complex. L.A. Care does not have a goal related to Prop 56, but it could set one in the future.
Member Maria Chandler, MD, stated that as a provider she would like to know how they are getting feedback on how they are doing. She said she it can be improved greatly, but
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have not been receiving reports or payments. Dr. Parrish responded that it would go to the Independent Physician Association (IPA). The IPA will then distribute payment to the provider. It depends on the payment program. Dr. Parrish asked Member Chandler what her payment structure is. Member Chandler stated that the information goes to Finance and may not go to her directly. Dr. Parrish responded that she would try to assist her in figuring out who receives the report.
CHILDREN’S WELL- (Member Hilda Perez joined the meeting.) BEING SCORECARD Fatima D. Clark, MSW, Senior Policy and Outreach Associate, Health and The Children’s Movement, Fatima D. Clark, MSW Children Now, gave a presentation about the Children’s Well-Being Scorecard. (A copy of the presentation can be obtained from Board Services.)
Whole-Child Approach A whole-child approach to systems change is necessary to address each child’s unique needs from prenatal to age 26. The Children’s Movement of California Children Now leads The Children’s Movement to connect 4,100 and growing diverse groups to speak at the right time with one voice on behalf of kids. Resource: Join The Children’s Movement www.childrennow.org/thechildrensmovement/
CA Average CA Average LA County 2018-19 2020-21 Average Indicator 2020-21
Children who had health insurance 95% 96% 96%
Pregnant women who received prenatal care beginning the first 84% 84% 85% trimester
Newborns who were exclusively breastfed while in the hospital 70% 70% 64%
Newborns who were not low birthweight 93% 93% 85%
Children with Medi-Cal who had an annual preventive check-up -- 41% 42%
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Kindergarteners with up-to-date immunizations 95% 95% 95%
Children, ages birth-to-5 and who are in low-income families, who 26% 39% 42% visited a dentist in the last year 13-year-olds who were vaccinated for Human Papillomavirus -- 28% 30% (HPV)
2021 Priorities and Opportunities Protect and prevent cuts to children’s health services. Eliminate the suspension of Prop. 56 payments that support children’s health services, like well-child visits, developmental screenings, pediatric specialty care, and trauma screenings.
Redesign Medi-Cal to improve quality of care for children. Institute reforms that ensure compliance with existing contractual requirements, align payments and incentives with measurable outcomes and performance, and proactively eliminate disparities in children’s health outcomes via CalAIM, Medi-Cal Managed Care Procurement, and Medi-Cal Dental ASO Procurement.
Expand mental health services for students and youth. Increase funding for the school- county partnerships program to ensure kids receive the mental health care they need by supporting more local partnerships that increase access to mental health services for students through schools. SB 682 (Rubio): would require the State to establish a plan to reduce racial disparities in five childhood chronic disease areas: asthma, depression, dental carries, diabetes, and vaping- related diseases. Among other requirements, the plan must include cross-sector and interagency agreements, as well as establishing clear accountability for meeting target reductions.
Preventing and Protecting Cuts to Children’s Health Services National decline in children’s preventive care (March to July 2020, compared to March to July 2019). Data shared by DHCS show similar trends for children in Medi-Cal. 12% decline: Fewer vaccinations for children up to age two 29% decline: Fewer child screening services 35% decline: Fewer outpatient mental health services and those delivered via telehealth 50% decline: Fewer dental services Children’s Health Consultant Advisory Committee (CHCAC) 157 March 16, 2021, Page 9 of 11 APPROVED
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Expand Mental Health Services for Students and Youth Disconnection from school and peers, plus the challenges and unpredictability of distance learning, add new and additional stressors. Mental health needs are increasing according to parents, students, and emergency room visits: 14% of parents report worsening behavioral health for their children Almost half of California’s students report needing mental health support, including 32% of students who were not receiving services before the pandemic but feel they may now need services Proportion of emergency department visits related to mental health increased dramatically: Up 24% for children aged 5-11 Up 31% among adolescents aged 12-17
Childhood Chronic Health Conditions: Racial Disparities (SB 682) Requires the State to Develop & Implement A Plan for Eliminating Racial Disparities in Childhood Chronic Disease in California.
Pediatric Asthma Reduction in asthma death rate for Black children Reduction in asthma ER visits and asthma hospitalizations for Black and Latino children Reduction in asthma prevalence for children of color Reduction in number of Black and brown children who experience secondhand smoke exposure
Childhood Diabetes Reduction in diabetes deaths among Black children Reduction in diabetes hospitalizations for Black children Reduction in diabetes and pre-diabetes diagnoses among children of color Reduction in rates of overweight/obesity among youth of color
Youth Depression Reduction in unidentified need in Black and brown youth Children’s Health Consultant Advisory Committee (CHCAC) 158 March 16, 2021, Page 10 of 11 APPROVED
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Increase in school attendance for Black and brown youth Increase in “feelings of connectedness” among Black and brown youth Decrease in suicidality among Black and brown youth
Childhood Dental Caries Reduction in dental caries among Latino, Black, Asian, and Native American children Reduction in ED visit for avoidable dental issues for Latino and Black children Decrease in missed school days for Latino, Black, Asian, and Native American children
Vaping-Related Diseases Decrease in number of Black and brown youth who use e-cigarette products Decrease in vaping related advertisements targeted to Black and brown communities
Member Seidman asked Ms. Clark is she knew if funding is part of the discussion on the bill. At the plan level when legislature passes laws, it is passed along to DHCS, then the plans, and then the provider network. No matter the focus, sometimes it can be an unfunded mandate. He asked is there are additional resources that will be provided. Ms. Clark responded that she does not know if funding will be made available. It seems there is a stated commitment on reducing disparities.
Member Perez stated that as a mother of 3 children. One child is 17 and in high school, one child is 15 and is autistic, and the third is a student at UCLA. She noted that they are a low-income family from Compton. She asked if the presentation could be shared with her. Ms. Clark responded that the presentation could be shared with anyone. She asked staff to forward her the presentation.
ADJOURNMENT The meeting was adjourned at 10:02 a.m.
Respectfully submitted by: APPROVED BY: Malou Balones, Board Specialist III, Board Services Tara Ficek, MPH, Chair:person__Tara Ficek______Victor Rodriguez, Board Specialist II, Board Services Linda Merkens, Senior Manager, Board Services Date Signed: ______5/25/21______
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Legislative Matrix
Last Updated: May 26, 2021
Legislative Matrix - Post Appropriations Suspense File The following is a list of the priority legislation currently tracked by Government Affairs that has been introduced during the 2021 Legislative Session and is of interest to L.A. Care. These top priority bills, if passed, could have a direct impact on L.A. Care. Also, included in this matrix are the bills that did not pass off of the suspense file and the bills that the author has decided to make a two year bill. Both statuses have been noted on the bills and those bills will not be acted upon this calendar year. If there are any questions, please contact Cherie Compartore, Senior Director of Government Affairs at [email protected] or 916.216.7963.
Please note, Government Affairs also has a list of all the bills that may not have a direct impact, but do have the possibility to be amended in the future to do so. Some of the bills included are spot bills, legislative place holders, in code sections that could have a policy impact on L.A. Care. If you would like a copy of this list please contact Cherie Compartore.
Bills by Issue 2021 Legislation (90)
Bill Number Last Action Status Position AB 4 Read Second Time Ordered To Third Reading In Assembly Support 2021 05 24
Labels: Medi-Cal Title Medi-Cal: eligibility.
Description AB 4, as introduced, Arambula. Medi-Cal: eligibility. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. The federal Medicaid program provisions prohibit payment to a state for medical assistance furnished to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law.Existing law requires individuals under 19 years of age enrolled in restricted-scope Medi-Cal at the time the Director of Health Care Services makes a determination that systems have been programmed for implementation of these provisions to be enrolled in the full scope of Medi-Cal benefits, if otherwise eligible, pursuant to an eligibility and enrollment plan, and extends eligibility for full scope Medi-Cal benefits to individuals who are under 25 years of age, and who are otherwise eligible for those benefits but for their immigration status. Existing law makes the effective date of enrollment for those individuals the same day that systems are operational to begin processing new applications pursuant to the director’s determination. Existing law requires an individual eligible for Medi-Cal under these provisions to enroll in a Medi-Cal managed care health plan. Existing law provides that Medi-Cal benefits for individuals who are 65 years of age or older, and who do not have satisfactory immigration statuses or are unable to establish satisfactory immigration statuses, as specified, are to be 160 prioritized in the Budget Act for the upcoming fiscal year if the Department of Finance projects a positive ending balance in the Special Fund for Economic Uncertainties for the upcoming fiscal year and each of the ensuing 3 fiscal years that exceeds the cost of providing those individuals full scope Medi-Cal benefits.Effective January 1, 2022, this bill would instead extend eligibility for full scope Medi-Cal benefits to anyone regardless of age, and who is otherwise eligible for those benefits but for their immigration status, pursuant to an eligibility and enrollment plan. The bill would delete the above-specified provisions regarding individuals who are under 25 years of age or 65 years of age or older and delaying implementation until the director makes the determination described above. The bill would require the eligibility and enrollment plan to ensure that an individual maintains continuity of care with respect to their primary care provider, as prescribed, would provide that an individual is not limited in their ability to select a different health c... (click bill link to see more).
Primary Sponsors Joaquin Arambula, Rob Bonta, David Chiu, Mike Gipson, Lorena Gonzalez, Eloise Reyes, Miguel Santiago
Organizational Notes
Last edited by Joanne Campbell at Apr 8, 2021, 4:18 PM Support: L.A. Care, LHPC
Bill Number Last Action Status Position AB 14 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Title Communications: broadband services: California Advanced Services Fund.
Description AB 14, as introduced, Aguiar-Curry. Communications: broadband services: California Advanced Services Fund. (1) Existing law establishes the State Department of Education in state government, and vests the department with specified powers and duties relating to the state’s public school system.This bill would authorize local educational agencies to report to the department their pupils’ estimated needs for computing devices and internet connectivity adequate for at-home learning. The bill would require the department, in consultation with the Public Utilities Commission, to compile that information and to annually post that compiled information on the department’s internet website. (2) Existing law expressly authorizes a county service area to acquire, construct, improve, maintain, and operate broadband internet access services, and requires a county service area that does so to take certain actions regarding the accessing of content on the internet by end users of that service.This bill would similarly authorize the board of supervisors of a county to acquire, construct, improve, maintain, or operate broadband internet access service, and any other communications service necessary to obtain federal or state support for the acquisition, construction, improvement, maintenance, or operation of broadband internet access service, and would require a board that does so to take certain actions regarding the accessing of content on the internet by end users of that service. (3) Existing law establishes the 161 Governor’s Office of Business and Economic Development, known as “GO-Biz,” within the Governor’s office to serve the Governor as the lead entity for economic strategy and the marketing of California on issues relating to business development, private sector investment, and economic growth. This bill would require the office, on or before June 30, 2022, to develop recommendations and a model for streamlined local land use approval and construction permit processes for projects related to broadband infrastructure deployment and connectivity and to adopt, and post on its internet website, the recommendations and model, as specified.(4) Under existing law, the Public Utilities Commission has regulatory authority over public utilities, including telephone corporations. Existing law requires the commission to develop, implement, and administer the California Advanced Services Fund (CASF) program to encourage deployment of high- quality advanced communications services to all Californians that will promote economic growth, job creation, and the substantial social benefits of advanced information and communications technologies. Existing law requires the commission, in approving CASF infrastructure projects, to give preference to proj... (click bill link to see more).
Primary Sponsors Richard Bloom, Rob Bonta, Eduardo Garcia, Cristina Garcia, Evan Low, Cottie Petrie-Norris, Bill Quirk, Sharon Quirk-Silva, Eloise Reyes, Robert Rivas, Miguel Santiago, Mark Stone, Shirley Weber, Rebecca Bauer-Kahan, Wendy Carrillo, Susan Eggman, Lena Gonzalez, Jacqui Irwin, Aguiar-Curry
Bill Number Last Action Status Position AB 32 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 25
Labels: Medi-Cal Telehealth Title Telehealth.
Description AB 32, as amended, Aguiar-Curry. Telehealth. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low- income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, Medi-Cal services may be provided pursuant to contracts with various types of managed care health plans, including through a county organized health system. Under existing law, in-person contact between a health care provider and a patient is not required under the Medi-Cal program for services appropriately provided through telehealth. Existing law provides that neither face-to-face contact nor a patient’s physical presence on the premises of an enrolled community clinic is required for services provided by the clinic to a Medi-Cal beneficiary during or immediately following a proclamation declaring a state of emergency. Existing law defines “immediately following” for this purpose to mean up to 90 days following the termination of the proclaimed state of emergency, unless there are extraordinary circumstances.Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene), provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law provides for the regulation of health insurers by the Department of Insurance. 162 Existing law requires a contract issued, amended, or renewed on or after January 1, 2021, between a health care service plan or health insurer and a health care provider to require the plan or insurer to reimburse the provider for the diagnosis, consultation, or treatment of an enrollee, subscriber, insured, or policyholder appropriately delivered through telehealth services on the same basis and to the same extent as the same service through in- person diagnosis, consultation, or treatment. Existing law requires a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2021, to specify that coverage is provided for health care services appropriately delivered through telehealth on the same basis and to the same extent as in-person diagnosis, consultation, or treatment. Existing law exempts Medi-Cal managed care plans that contract with the State Department of Health Care Services under the Medi-Cal program from these provisions, and generally exempts county organized health systems that provide services under the Medi-Cal program from Knox-Keene.This bill would delete the above- described references to contracts issued, amended, or renewed on or after January 1, 2021, would require these provisions to apply to the plan or insurer’... (click bill link to see more).
Primary Sponsors Robert Rivas, Aguiar-Curry
Organizational Notes
Last edited by Joanne Campbell at Mar 12, 2021, 10:12 PM Support: California Association of Public Hospitals and Health Systems (CAPH) (Sponsor) California Health+ Advocates/California Primary Care (Sponsor) Association (CPCA) (Sponsor) California Medical Association (CMA) (Sponsor) Essential Access Health (EAH) (Sponsor) Planned Parenthood Affiliates of California (PPAC) (Sponsor)
163 Bill Number Last Action Status Position AB 34 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Title Broadband for All Act of 2022.
Description AB 34, as amended, Muratsuchi. Broadband for All Act of 2022. Dead Bill Existing law requires the Department of Technology to improve the governance and implementation of information technology by standardizing reporting relationships, roles, and responsibilities for setting information technology priorities. Existing law requires the Public Utilities Commission to develop, implement, and administer the California Advanced Services Fund program to encourage deployment of high-quality advanced communications services to all Californians. Existing law provides that the goal of the program is to, no later than December 31, 2022, approve funding for infrastructure projects that will provide broadband access to no less than 98% of California households, as provided.This bill would enact the Broadband for All Act of 2022, which, if approved by the voters, would authorize the issuance of bonds in the amount of $10,000,000,000 pursuant to the State General Obligation Bond Law to support the 2022 Broadband for All Program that would be administered by the department for purposes of providing financial assistance for projects to deploy broadband infrastructure and broadband internet access services.The bill would provide for the submission of the bond act to the voters at the November 8, 2022, statewide general election.
Primary Sponsors Al Muratsuchi, Eduardo Garcia, Miguel Santiago, Steve Glazer, Devon Mathis, Carlos Villapudua
Bill Number Last Action Status Position AB 71 Read Second Time Ordered To Third Reading In Assembly Support 2021 05 25
Labels: Housing/Homelessness Title Homelessness funding: Bring California Home Act.
Description AB 71, as amended, Luz Rivas. Homelessness funding: Bring California Home Act. (1) The Personal Income Tax Law, in conformity with federal income tax law, generally defines gross income as income from whatever source derived, except as specifically excluded, and provides various exclusions from gross income. Existing federal law, for purposes of determining a taxpayer’s gross income for federal income taxation, requires that a person who is a United States shareholder of any controlled foreign corporation to include in their gross income the global intangible low-taxed income for that taxable year, as provided.This bill, for taxable years beginning on or after January 1, 2022, would include a taxpayer’s global intangible low-taxed income in their gross income for purposes of the Personal Income Tax Law, in modified conformity with the above-described federal provisions. The bill would exempt any regulation, standard, criterion, procedure, determination, rule, notice, or guideline established or issued by the Franchise Tax Board to implement its provisions from 164 the rulemaking provisions of the Administrative Procedure Act.The Corporation Tax Law, when the income of a taxpayer subject to tax under that law is derived from or attributable to sources both within and without the state, generally requires that the tax be measured by the net income derived from or attributable to sources within this state, as provided. Notwithstanding this requirement, the Corporation Tax Law authorizes a qualified taxpayer, as defined, to elect to determine its income derived from or attributable to sources within this state pursuant to a water’s- edge election, as provided. For taxable years beginning on or after January 1, 2003, existing law requires that a water’s-edge election be made on an original, timely filed return for the year of the election, as provided, and provides for the continued effect or termination of that election.This bill, beginning January 1, 2022, would require that a taxpayer that makes a water’s-edge election under these provisions take into account 50% of the global intangible low-taxed income and 40% of the repatriation income of its affiliated corporations, as those terms are defined. The bill would allow a taxpayer, for calendar year 2022 only, the opportunity to revoke a water’s-edge election if the taxpayer includes global intangible low-taxed income pursuant to these provisions. The bill would prohibit the total of all business credits, as defined, and all credits allowed under specified provisions of the Corporation Tax Law, with specified exceptions, from reducing the additional tax liability added by this bill’s provisions by more than $5,000,000, as provided. The bill would exempt any regulation, standa... (click bill link to see more).
Primary Sponsors Luz Rivas, Richard Bloom, David Chiu, Buffy Wicks, Ash Kalra
Organizational Notes
Last edited by Joanne Campbell at Apr 8, 2021, 4:15 PM Support: L.A. Care, United Way of Greater Los Angeles, HOPICS, CSH, Housing California, All Home, Los Angeles Homeless Service Authority, Brilliant Corners, NPH, Steinburg Institute, The City and County of San Francisco, City of Los Angeles, County of Los Angeles, ECS, National Alliance to End Homelessness
165 Bill Number Last Action Status Position AB 77 Re Referred To Com On Health 2021 03 26 In Assembly Monitor
Labels: Behavioral Health Medi-Cal Title Substance use disorder treatment services.
Description AB 77, as amended, Petrie-Norris. Substance use disorder treatment services. Existing law requires the State Department of Health Care Services to license and regulate alcoholism or drug abuse recovery or treatment facilities serving adults. Existing law authorizes the department to certify qualified alcoholism or drug abuse recovery or treatment programs, as prescribed. Under existing law, the department regulates the quality of these programs, taking into consideration the significance of community- based programs to alcohol and other drug abuse recovery and the need to encourage opportunities for low-income and special needs populations to receive alcohol and other drug abuse recovery or treatment services.This bill, commencing January 1, 2026, would require any substance use disorder treatment program to be licensed by the department, except as specified. The bill would require the department, in administering these provisions, to issue licenses for a period of 2 years for substance use disorder treatment programs that meet the requirements in these provisions. The bill would require the department to issue a license to a substance use disorder program once various requirements have been met, including an onsite review. The bill would authorize the department to renew a license, as provided. The bill would prohibit providing substance use disorder treatment services to individuals without a license.The bill would require a substance use disorder program licensed pursuant to these provisions to adopt written policies and procedures, as specified. The bill would require a person or entity applying for a license to submit, among other things, a licensure fee to the department. The bill would require various quality parameters of licensed substance use disorder treatment programs, including, among others, that patients admitted for treatment meet specified medical necessity criteria. The bill would require the department to conduct a site visit if a program is alleged to be in violation of those quality parameters and to provide written notice to the program, as specified.The bill would authorize a licensed substance use disorder treatment program to treat persons 12 to 17 years of age, inclusive, provided certain additional requirements are met, including that assessments include documentation of the person’s unique abilities and strengths in the patient treatment plan.The bill would require certain minimum requirements for substance use disorder program administrators and staff who provide services pursuant to these provisions and would grant the department sole authority to establish qualifications that exceed those requirements.The bill would require the department to conduct onsite visits to ensure compliance... (click bill link to see more).
Primary Sponsors Cottie Petrie-Norris, Henry Stern
166 Bill Number Last Action Status Position AB 93 Re Referred To Com On Health 2021 03 26 In Assembly Monitor
Labels: Health Services Title Pandemic response practices.
Description AB 93, as amended, Eduardo Garcia. Pandemic response practices. Existing law establishes the California Health and Human Services Agency, under the direction of the Secretary of California Health and Human Services, which includes, among other departments, the State Department of Public Health and the State Department of Health Care Services. Existing law establishes various programs for the prevention and control of communicable diseases, including programs that provide for the testing for, notifications of exposure to, and tracking by the state of, communicable diseases.This bill would require the Legislative Analyst’s Office to conduct a comprehensive review and analysis of issues related to the state’s response to the COVID-19 pandemic, including, among others, whether local public health departments were sufficiently staffed and funded to handle specified pandemic-related responsibilities, and what specific measures of accountability the state applied to monitor and confirm that local public health departments were following state directives related to any dedicated COVID-19 funds allocated to counties. The bill would require the office to report to the Joint Legislative Audit Committee and the health committees of the Legislature by June 30, 2022.The bill would require the state to include community health centers as a part of its organizational pandemic response structure, and would require community health centers, including federally qualified health centers, to serve as points of contact at the local and regional level, in the same manner as local health departments. The bill would require the state to establish a supply chain of medical supplies and equipment necessary to address the level of need established by the COVID-19 pandemic. The bill would authorize the state to provide economic incentives to help relocate manufacturers of medical supplies, as required to address a pandemic or public health crisis.The bill would require the State Department of Public Health and the State Department of Health Care Services to develop a statewide, comprehensive plan to provide an outreach and education campaign for implementation during a viral pandemic or health care emergency. The bill would require the campaign to focus on those communities in each county with the highest rates of health disparities. The bill would require the education and outreach campaign materials to be culturally sensitive to populations that experienced a high rate of health disparities that contributed to greater susceptibility to COVID- 19.The bill would establish initial priority tiers of priority populations for rapid testing and vaccination during a pandemic. Tier I would include health care workers and first responders and Tier II... (click bill link to see more).
Primary Sponsors Eduardo Garcia, Robert Rivas
167 Bill Number Last Action Status Position AB 97 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: Commercial Pharmacy Title Health care coverage: insulin affordability.
Description AB 97, as amended, Nazarian. Health care coverage: insulin affordability. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act’s requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or disability insurance policy issued, amended, delivered, or renewed on or after January 1, 2000, that covers prescription benefits to include coverage for insulin, if it is determined to be medically necessary.This bill would prohibit a health care service plan contract or a health disability insurance policy, as specified, issued, amended, delivered, or renewed on or after January 1, 2022, from imposing a deductible on an insulin prescription drug. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.
Primary Sponsors Adrin Nazarian
Organizational Notes
Last edited by Cherie Compartore at Apr 26, 2021, 3:11 PM Oppose: CAHP
168 Bill Number Last Action Status Position AB 112 In Committee Held Under Submission 2021 05 In Assembly Support 20
Labels: Medi-Cal Title Medi-Cal eligibility.
Description AB 112, as amended, Holden. Medi-Cal eligibility. Existing law Dead Bill provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides for the suspension of Medi-Cal benefits to an inmate of a public institution, which ends on the date they are no longer an inmate of a public institution or one year from the date they become an inmate of a public institution, whichever is sooner.Existing federal law prohibits a state from terminating Medi-Cal eligibility for an eligible juvenile if they are an inmate of a public institution, authorizes the suspension of Medicaid benefits to that eligible juvenile, and requires a state to conduct a redetermination of Medicaid eligibility or process an application for medical assistance under the Medicaid program for an eligible juvenile who is an inmate of a public institution. Under existing state law, the suspension of Medi- Cal benefits to an inmate of a public institution who is a juvenile, as defined in federal law, ends when the individual is no longer an eligible juvenile pursuant to federal law or one year from the date the individual becomes an inmate of a public institution, whichever is later.This bill would instead require the suspension of Medi-Cal benefits to an inmate of a public institution who is not a juvenile to end on the date they are no longer an inmate of a public institution or 3 years from the date they become an inmate of a public institution, whichever is sooner. The bill would also require the suspension of Medi-Cal benefits to an inmate of a public institution who is a juvenile on the date that the individual is no longer an inmate of a public institution or 3 years after the date the individual is no longer an eligible juvenile under federal law, whichever is sooner.
Primary Sponsors Chris Holden
Organizational Notes
Last edited by Joanne Campbell at Apr 8, 2021, 4:14 PM Support - L.A. Care
169 Bill Number Last Action Status Position AB 114 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 25
Labels: Medi-Cal Title Medi-Cal benefits: rapid Whole Genome Sequencing.
Description AB 114, as amended, Maienschein. Medi-Cal benefits: rapid Whole Genome Sequencing. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services pursuant to a schedule of benefits. The Medi- Cal program is, in part, governed and funded by federal Medicaid program provisions. The Budget Act of 2018 appropriates $2,000,000 for the Whole Genome Sequencing Pilot Project, and requires the department to provide a grant to a state nonprofit organization for the execution of a one-time pilot project to investigate the potential clinical and programmatic value of utilizing clinical Whole Genome Sequencing in the Medi-Cal program.This bill would expand the Medi-Cal schedule of benefits to include rapid Whole Genome Sequencing, as specified, for any Medi-Cal beneficiary who is one year of age or younger and is receiving inpatient hospital services in an intensive care unit. The bill would authorize the department to implement this provision by various means without taking regulatory action.
Primary Sponsors Brian Maienschein
Bill Number Last Action Status Position AB 214 Referred To Com On Budget 2021 01 28 In Assembly Monitor
Title Budget Act of 2021.
Description AB 214, as introduced, Ting. Budget Act of 2021. This bill would make appropriations for the support of state government for the 2021–22 fiscal year.This bill would declare that it is to take effect immediately as a Budget Bill.
Primary Sponsors Phil Ting
170 Bill Number Last Action Status Position AB 221 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: CalFresh/Food Assistance Title Emergency food assistance.
Description AB 221, as amended, Santiago. Emergency food assistance. Existing law establishes and requires the State Department of Social Services to administer the CalFood Program to provide food and funding to food banks whose primary function is to facilitate the distribution of food to low-income households, as specified.Upon the appropriation of funds by the Legislature for this purpose, or a determination by the Governor that specified funds available to the Governor may be used for this purpose, this bill would require the department to provide a food assistance benefit statewide to low- income California residents and to contract with specified entities, including a Feeding America partner state organization, to issue this benefit in the form of a one-time use, prepaid card preloaded with $600 for use at retailers that sell groceries. The bill would provide that a person is eligible for this benefit if they are an adult who self-attests to eligibility for at least one of 3 prescribed benefits, including the Federal Emergency Food Assistance Program, and that this benefit is a disaster benefit rather than a public social service. The bill would authorize the contractor to subcontract with local nonprofit organizations to issue the food assistance benefit, and would require any subcontracting nonprofit to comply with specified requirements, including maintaining records. The bill would establish various administrative requirements related to the benefit.The bill would require the department, in consultation with a workgroup, to conduct a study to provide recommendations and solutions to a permanent food assistance program for low-income California residents experiencing food insecurity, to complete that study by January 1, 2023, and to submit a copy of that study to the Legislature. This bill would declare that it is to take effect immediately as an urgency statute.
Primary Sponsors Miguel Santiago, David Chiu, Mike Gipson, Robert Rivas, Susan Rubio
171 Bill Number Last Action Status Position AB 265 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: Medi-Cal Title Medi-Cal: reimbursement rates.
Description AB 265, as introduced, Petrie-Norris. Medi-Cal: reimbursement rates. Existing law provides for the Medi-Cal program, which is Dead Bill administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, including clinical laboratory or laboratory services. The Medi-Cal program is, in part, governed by, and funded pursuant to, federal Medicaid program provisions. Existing law requires the department to develop, subject to federal approval, reimbursement rates for clinical or laboratory services according to specified standards, such as requiring that reimbursement to providers for those services not exceed the lowest of enumerated criteria, including 80% of the lowest maximum allowance established by the federal Medicare Program for the same or similar services.This bill would delete provisions relating to the above-specified 80% standard and would make conforming changes.
Primary Sponsors Cottie Petrie-Norris
172 Bill Number Last Action Status Position AB 278 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: Medi-Cal Title Medi-Cal: podiatric services.
Description AB 278, as introduced, Flora. Medi-Cal: podiatric services. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which Dead Bill qualified low-income individuals receive health care services, including podiatric services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law does not require prior authorization for podiatric services provided on an outpatient or inpatient basis, but podiatric services are subject to the same Medi-Cal billing and services policies as required for a physician and surgeon, including a maximum numerical service limitation in any one calendar month. Existing law requires a health care provider applying for enrollment as a Medi-Cal services provider or a current Medi-Cal services provider applying for continuing enrollment, or a current Medi-Cal services provider applying for enrollment at a new location or a change in location, to submit a complete application package. Under existing law, a licensed physician and surgeon practicing as an individual physician practice or a licensed dentist practicing as an individual dentist practice, who is in good standing and enrolled as a Medi-Cal services provider, and who is changing the location of that individual practice within the same county, is eligible to instead file a change of location form in lieu of submitting a complete application package.This bill would make conforming changes to the provisions that govern applying to be a provider in the Medi-Cal program, or for a change of location by an existing provider, to include a doctor of podiatric medicine licensed by the California Board of Podiatric Medicine.
Primary Sponsors Heath Flora
173 Bill Number Last Action Status Position AB 339 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 20
Labels: Legal Title Local government: open and public meetings.
Description AB 339, as amended, Lee. Local government: open and public meetings. Existing law, the Ralph M. Brown Act, requires, with specified exceptions, that all meetings of a legislative body of a local agency, as those terms are defined, be open and public and that all persons be permitted to attend and participate. Under existing law, a member of the legislative body who attends a meeting where action is taken in violation of this provision, with the intent to deprive the public of information that the member knows the public is entitled to, is guilty of a crime.This bill would, until December 31, 2023, require all open and public meetings of a city council or a county board of supervisors that governs a jurisdiction containing least 250,000 people to include an opportunity for members of the public to attend via a telephonic option or an internet-based service option. The bill would require all open and public meetings to include an in-person public comment opportunity, except in specified circumstances during a declared state or local emergency. The bill would require all meetings to provide the public with an opportunity to comment on proposed legislation in person and remotely via a telephonic or an internet- based service option, as provided.By imposing new duties on local governments and expanding the application of a crime with respect to meetings, this bill would impose a state-mandated local program.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for specified reasons.The California Constitution requires local agencies, for the purpose of ensuring public access to the meetings of public bodies and the writings of public officials and agencies, to comply with a statutory enactment that amends or enacts laws relating to public records or open meetings and contains findings demonstrating that the enactment furthers the constitutional requirements relating to this purpose.This bill would make legislative findings to that effect.
Primary Sponsors Alex Lee, Cristina Garcia
174 Bill Number Last Action Status Position AB 347 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 25
Labels: Commercial Medi-Cal Title Health care coverage: step therapy.
Description AB 347, as amended, Arambula. Health care coverage: step therapy. Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene), provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes a health insurer to require step therapy if there is more than one drug that is appropriate for the treatment of a medical condition, and authorizes a health care service plan to utilize step therapy consistent with Knox-Keene. Under existing law, if a health care service plan, health insurer, or contracted physician group fails to respond to a completed prior authorization request from a prescribing provider within a specified timeframe, the prior authorization request is deemed to have been granted.This bill would clarify that a health care service plan that provides coverage for prescription drugs may require step therapy, as defined, if there is more than one drug that is appropriate for the treatment of a medical condition. The bill would require a health care service plan or health insurer to expeditiously grant a step therapy exception if the health care provider submits justification and supporting clinical documentation, if needed, that specified criteria are met. The bill would authorize an enrollee or insured or their designee, guardian, primary care physician, or health care provider to file an appeal of a prior authorization or the denial of a step therapy exception request, and would require a health care service plan or health insurer to designate a clinical peer to review those appeals. The bill would require a prior authorization request or step therapy exception request to be deemed to have been granted if a health care service plan, health insurer, or contracted physician group fails to send an approval or denial within a specified timeframe. Because a willful violation of the bill’s requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.
Primary Sponsors Joaquin Arambula
Organizational Notes
Last edited by Cherie Compartore at Mar 29, 2021, 3:38 PM Oppose Unless Amended: CAHP
175 Bill Number Last Action Status Position AB 361 In Senate Read First Time To Com On Rls For In Senate Monitor Assignment 2021 05 18
Labels: Legal Title Open meetings: local agencies: teleconferences.
Description AB 361, as amended, Robert Rivas. Open meetings: local agencies: teleconferences. Existing law, the Ralph M. Brown Act requires, with specified exceptions, that all meetings of a legislative body of a local agency, as those terms are defined, be open and public and that all persons be permitted to attend and participate. The act contains specified provisions regarding the timelines for posting an agenda and providing for the ability of the public to directly address the legislative body on any item of interest to the public. The act generally requires all regular and special meetings of the legislative body be held within the boundaries of the territory over which the local agency exercises jurisdiction, subject to certain exceptions. The act allows for meetings to occur via teleconferencing subject to certain requirements, particularly that the legislative body notice each teleconference location of each member that will be participating in the public meeting, that each teleconference location be accessible to the public, that members of the public be allowed to address the legislative body at each teleconference location, that the legislative body post an agenda at each teleconference location, and that at least a quorum of the legislative body participate from locations within the boundaries of the local agency’s jurisdiction. The act provides an exemption to the jurisdictional requirement for health authorities, as defined. The act authorizes the district attorney or any interested person, subject to certain provisions, to commence an action by mandamus or injunction for the purpose of obtaining a judicial determination that specified actions taken by a legislative body are null and void.Existing law, the California Emergency Services Act, authorizes the Governor, or the Director of Emergency Services when the governor is inaccessible, to proclaim a state of emergency under specified circumstances, and authorizes a specified legislative body or an official designated to proclaim a local emergency. Existing law allows a local health officer to declare a local public health emergency, which, after 7 days, must be ratified by the county board of supervisors, or city council, as applicable, in order to remain in place.Executive Order No. N-29-20 suspends the Ralph M. Brown Act’s requirements for teleconferencing during the COVID-19 pandemic provided that notice and accessibility requirements are met, the public members are allowed to observe and address the legislative body at the meeting, and that a legislative body of a local agency has a procedure for receiving and swiftly resolving requests for reasonable accommodation for individuals with disabilities, as specified.This bill would authorize a local agency to use... (click bill link to see more).
Primary Sponsors Robert Rivas
176 Bill Number Last Action Status Position AB 368 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: CalAIM CalFresh/Food Assistance Medi-Cal Title Food prescriptions.
Description AB 368, as amended, Bonta. Food prescriptions. Existing law provides for the Medi-Cal program, which is administered by the Dead Bill State Department of Health Care Services, under which qualified low-income individuals receive health care services, including enteral nutrition products, pursuant to a schedule of benefits, and subject to utilization controls, such as prior authorization. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law requires the department to establish a Medically Tailored Meals Pilot Program to operate for a period of 4 years from the date the program is established, or until funding is no longer available, whichever date is earlier, in specified counties, including the Counties of Alameda and Sonoma, to provide medically tailored meal intervention services to Medi-Cal participants with specified health conditions, such as diabetes and renal disease.This bill would require the department to establish, no earlier than January 1, 2022, a pilot program for a 2-year period in the Counties of Alameda, Fresno, and San Bernardino to provide food prescriptions to eligible Medi-Cal beneficiaries, including individuals who have a specified chronic health condition, such as Type 2 diabetes and hypertension, when utilizing evidence-based practices that demonstrate the prevention, treatment, or reversal of those specified diseases. The bill would authorize the department, in consultation with stakeholders, to establish utilization controls, including the limitation on food prescriptions, and to enter into contracts for purposes of implementing the pilot program. The bill would require a Medi-Cal managed care plan or their contractor that participates in the pilot program to establish procedures for referring and enrolling eligible Medi-Cal beneficiaries in the pilot program. The bill would require the department to evaluate the pilot program upon its conclusion, to report to the Legislature on those findings, and to implement these provisions by various means, including provider bulletins, without taking regulatory action. The bill would repeal these provisions on January 1, 2027.This bill would make legislative findings and declarations as to the necessity of a special statute for the Counties of Alameda, Fresno, and San Bernardino.
Primary Sponsors Rob Bonta
177 Bill Number Last Action Status Position AB 369 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: Health Services Housing/Homelessness Title Medi-Cal services: persons experiencing homelessness. Medi-Cal
Description AB 369, as amended, Kamlager. Medi-Cal services: persons experiencing homelessness. Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law requires the department to provide presumptive Medi-Cal eligibility to pregnant women and children. Existing law authorizes a qualified hospital to make presumptive eligibility determinations if it complies with specified requirements. Existing law authorizes the department, on a regional pilot project basis, to issue an identification card to a person who is eligible for Medi-Cal program benefits, but does not possess a valid California driver’s license or identification card issued by the Department of Motor Vehicles. Existing law requires the department, in consultation with the board governing the California Health Benefit Exchange, to develop a single paper, electronic, and telephone application for insurance affordability programs, including Medi-Cal.This bill would require the department to implement a program of presumptive eligibility for persons experiencing homelessness, under which a person would receive full-scope Medi-Cal benefits without a share of cost. The bill would require the department to authorize an enrolled Medi-Cal provider to issue a temporary Medi-Cal benefits identification card to a person experiencing homelessness, and would prohibit the department from requiring a person experiencing homelessness to present a valid California driver’s license or identification card issued by the Department of Motor Vehicles to receive Medi-Cal services if the provider verifies the person’s eligibility. The bill would require the insurance affordability program’s paper application to include a check box, and electronic application to include a pull-down menu, for an applicant to indicate if they are experiencing homelessness at the time of application.This bill would authorize an enrolled Medi-Cal provider to make a presumptive eligibility determination for a person experiencing homelessness. The bill would authorize an enrolled Medi-Cal provider to bill the Medi-Cal program for Medi- Cal services provided off the premises to a person experiencing homelessness, as specified. The bill would require a Medi-Cal managed care plan to allow a beneficiary to seek those services and allow a provider to provide those services, but would authorize a Medi-Cal managed care plan to establish reasonable requirements governing utilization protocols and network participation. If Medi-Cal covered health care services covered by a Medi-Cal managed care pl... (click bill link to see more).
Primary Sponsors Sydney Kamlager
178 Bill Number Last Action Status Position AB 382 Referred To Com On Health 2021 05 19 In Senate Monitor
Labels: Medi-Cal Title Whole Child Model program.
Description AB 382, as amended, Kamlager. Whole Child Model program. Under existing law, the State Department of Health Care Services administers various health programs, including the California Children’s Services (CCS) program, which is a statewide program providing medically necessary services required by physically handicapped children whose parents are unable to pay for those services, and the Medi-Cal program, under which qualified low- income individuals receive health care services under specified health care delivery systems, such as managed care. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes the department to establish a Whole Child Model (WCM) program, under which managed care plans served by a county organized health system or Regional Health Authority in designated counties provide CCS services to Medi-Cal eligible CCS children and youth. Existing law requires the department to establish a statewide WCM program stakeholder advisory group that includes specified persons, such as CCS case managers and labor organizations, to consult with that advisory group on the implementation of the WCM, and to consider the advisory group’s recommendations on prescribed matters. Existing law terminates the advisory group on December 31, 2021.This bill would remove labor organizations from the stakeholder advisory group, and would instead include recognized exclusive representatives of CCS county providers. The bill would instead terminate the advisory group on December 31, 2023.
Primary Sponsors Sydney Kamlager, Richard Pan
179 Bill Number Last Action Status Position AB 407 In Senate Read First Time To Com On Rls For In Senate Monitor Assignment 2021 05 13
Labels: Health Services Pharmacy Scope of Practice Title Optometry: scope of practice.
Description AB 407, as amended, Salas. Optometry: scope of practice. Existing law, the Optometry Practice Act, establishes the California State Board of Optometry in the Department of Consumer Affairs for the licensure and regulation of the practice of optometry. Existing law provides that the practice of optometry includes various functions relating to the visual system and the treatment and management of certain disorders and dysfunctions of the visual system, as well as the provision of rehabilitative optometric services, and doing certain things, including, but not limited to, the examination of the human eye or eyes. Existing law further authorizes an optometrist who is certified to use therapeutic pharmaceutical agents, as specified, to diagnose and treat certain conditions including, among others, hypotrichosis and blepharitis.This bill additionally would authorize an optometrist who is certified to use therapeutic pharmaceutical agents to diagnose and treat acquired blepharoptosis, ametropia, and presbyopia through medical treatment.
Primary Sponsors Rudy Salas, Evan Low
180 Bill Number Last Action Status Position AB 454 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: Commercial Medi-Cal Title Health care provider emergency payments.
Description AB 454, as amended, Rodriguez. Health care provider emergency payments. Existing law, the Knox-Keene Health Care Service Plan Dead Bill Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes a health care service plan or health insurer to contract with a provider for alternative rates of payment and authorizes a plan or insurer to seek reimbursement from a provider who has been overpaid for services.This bill would authorize the Director of the Department of Managed Health Care or the Insurance Commissioner to require a health care service plan or health insurer to provide specified payments and support to a provider during and at least 60 days after the end of a declared state of emergency or other circumstance if two conditions occur, as specified. The bill would require that, when determining the appropriate amount and type of support to be provided by the health care service plan or health insurer, the director or commissioner take specified factors into consideration, including whether the plan or insurer’s providers have received support from the Federal Emergency Management Agency. Because a willful violation of the bill’s requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.
Primary Sponsors Freddie Rodriguez
Organizational Notes
Last edited by Cherie Compartore at Mar 10, 2021, 9:41 PM Oppose: CAHP, LHPC
181 Bill Number Last Action Status Position AB 470 Read Second Time Ordered To Third Reading In Assembly Support 2021 05 24
Labels: Medi-Cal Title Medi-Cal: eligibility.
Description AB 470, as amended, Carrillo. Medi-Cal: eligibility. Existing law, the Medi-Cal Act, provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law requires Medi- Cal benefits to be provided to individuals eligible for services pursuant to prescribed standards, including a modified adjusted gross income (MAGI) eligibility standard. Existing law prohibits the use of an asset or resources test for individuals whose financial eligibility for Medi-Cal is determined based on the application of MAGI. Existing federal law authorizes a state to establish a non- MAGI standard for determining the eligibility of specified individuals, and existing law imposes the use of a resources test for establishing Medi-Cal eligibility for prescribed populations.This bill would prohibit the use of resources, including property or other assets, to determine eligibility under the Medi-Cal program to the extent permitted by federal law, and would require the department to seek federal authority to disregard all resources as authorized by the flexibilities provided pursuant to federal law. The bill would authorize the department to implement this prohibition by various means, including provider bulletins, without taking regulatory authority. By January 1, 2023, the bill would require the department to adopt, amend, or repeal regulations on the prohibition, and to update its notices and forms to delete any reference to limitations on resources or assets. Because counties are required to make Medi-Cal eligibility determinations, and this bill would expand Medi-Cal eligibility, the bill would impose a state-mandated local program. With respect to the prohibition on resources, the bill would make various conforming and technical changes to the Medi-Cal Act.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Primary Sponsors Wendy Carrillo
Organizational Notes
Last edited by Joanne Campbell at Apr 8, 2021, 4:17 PM Support - L.A. Care, LHPC
182 Bill Number Last Action Status Position AB 493 Referred To Com On Health 2021 05 12 In Senate Monitor
Labels: Commercial Title Health insurance.
Description AB 493, as introduced, Wood. Health insurance. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing federal law, the Patient Protection and Affordable Care Act (PPACA), enacts various health care market reforms. Existing law requires an individual or small group health insurance policy issued, amended, or renewed on or after January 1, 2017, to cover essential health benefits as prescribed, and provides that these provisions shall be implemented only to the extent essential health benefits are required pursuant to PPACA.This bill would delete the provision that conditions the implementation of that provision only to the extent essential health benefits are required pursuant to PPACA, and would make technical, nonsubstantive changes to that provision.Existing law prohibits a nongrandfathered health benefit plan for individual coverage from imposing a preexisting condition provision or waivered condition provision upon a person, and makes this provision inoperative if prescribed federal law on minimum essential coverage is repealed or amended.This bill would delete the conditional operation of that provision.Among other things, PPACA requires each health insurance issuer that offers health insurance coverage in the individual or group market in a state to accept every employer and individual in the state that applies for coverage, and prohibits discriminatory premium rates, as specified. PPACA also requires applicable individuals to maintain minimum essential coverage, and imposes a shared responsibility penalty on an applicable individual who does not maintain minimum essential coverage. This provision is referred to as the individual mandate.Existing law requires a carrier to fairly and affirmatively offer, market, and sell all of the carrier’s health benefit plans that are sold to, offered through, or sponsored by, small employers or associations that include small employers for plan years on or after January 1, 2014, to all small employers in each geographic region in which the carrier makes coverage available or provides benefits. Existing law provides that the premium rate for a small employer health benefit plan issued, amended, or renewed on or after January 1, 2014, shall vary with respect to the particular coverage involved only by age, geographic region, and whether the contract covers an individual or family, as specified. Under existing law, these provisions would become inoperative 12 months after the repeal of the federal coverage guarantee and premium rate regulation provisions, as prescribed.This bill would delete the conditional operation of the above-described provisions based on the continued operation of the federal coverage guarantee and premium rate r... (click bill link to see more).
Primary Sponsors Jim Wood
183 Bill Number Last Action Status Position AB 510 In Committee Set First Hearing Hearing In Assembly Monitor Canceled At The Request Of Author 2021 04 20
Labels: Commercial Title Out-of-network health care benefits.
Description AB 510, as introduced, Wood. Out-of-network health care benefits. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, Two Year Bill provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law provides for the regulation of health insurers by the Department of Insurance. If an enrollee or insured receives services under a health care service plan contract or health insurance policy issued, amended, or renewed on or after July 1, 2017, that includes coverage for out-of-network benefits, existing law authorizes a noncontracting individual health professional to bill or collect the out-of-network cost-sharing amount directly from the enrollee or insured if specified criteria are met, including that the enrollee or insured consents in writing to receive services from the noncontracting individual health professional at least 24 hours in advance of care. Existing law requires the consent to advise the enrollee or insured that they may seek care from a contracted provider for lower out-of-pocket costs and to be provided in the language spoken by the enrollee or insured, as specified.This bill would instead authorize a noncontracting individual health professional, excluding specified professionals, to bill or collect the out-of-network cost-sharing amount directly from the enrollee or insured receiving services under a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2022, if the enrollee consents in writing or electronically at least 72 hours in advance of care. The bill would require the consent to include a list of contracted providers at the facility who are able to provide the services and to be provided in the 15 most commonly used languages in the facility’s geographic region.
Primary Sponsors Jim Wood
184 Bill Number Last Action Status Position AB 521 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: Medi-Cal Title Medi-Cal: unrecovered payments: interest rate.
Description AB 521, as amended, Mathis. Medi-Cal: unrecovered payments: interest rate. Existing law provides for the Medi-Cal program, which Dead Bill is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law requires the Director of Health Care Services to establish administrative appeal processes to review grievances or complaints arising from the findings of an audit or examination. Under existing law, if recovery of a disallowed payment has been made by the department, a provider who prevails in an appeal of that payment is entitled to interest at the rate equal to the monthly average received on investments in the Surplus Money Investment Fund, or simple interest at the rate of 7% per annum, whichever is higher. Under existing law, with exceptions, interest at that same rate is assessed against any unrecovered overpayment due to the department.In the case of an assessment against any unrecovered overpayment due to the department, this bill would authorize the director to waive any or all of the interest or penalties owed by a provider, after taking into account specified factors, including the importance of the provider to the health care safety net in the community and the impact of the repayment amounts on the fiscal solvency of the provider.
Primary Sponsors Devon Mathis
185 Bill Number Last Action Status Position AB 523 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: Health Services Medi-Cal Title Program of All-Inclusive Care for the Elderly.
Description AB 523, as amended, Nazarian. Program of All-Inclusive Care for the Elderly. Existing federal law establishes the Program of All- Inclusive Care for the Elderly (PACE), which provides specified services for older individuals at a PACE center, as defined, in part, as a facility that includes a primary care clinic, so that they may continue living in the community. Federal law authorizes states to implement the PACE program as a Medicaid state option.Existing state law establishes the California Program of All-Inclusive Care for the Elderly (PACE program), to provide community-based, risk- based, and capitated long-term care services as optional services under the state’s Medi-Cal State Plan, and authorizes the State Department of Health Care Services to implement the PACE program by various means, including letters, or other similar instructions, without taking regulatory action. Under this authority, the department implemented various guidance on the PACE program in response to the state of emergency caused by the 2019 novel coronavirus (COVID-19), including authorizing a PACE organization to deliver prescribed services, including medically necessary services through telehealth. Existing law authorizes the department to enter into contracts with various entities to implement the PACE program and fully implement the single state agency responsibilities assumed by the department pursuant to those contracts, as specified.This bill would generally require the department to make permanent the specified PACE program flexibilities instituted, on or before January 1, 2021, in response to the state of emergency caused by COVID-19 by means of all-facility letters or other similar instructions taken without regulatory action, with prescribed modifications, such as instead limiting a PACE organization’s use of telehealth to specified services, including conducting assessments for eligibility for enrollment in the PACE program, subject to the federal waiver process. The bill would require the department to work with the federal Centers for Medicare and Medicaid Services to determine how to extend PACE program flexibilities approved during the COVID-19 emergency.
Primary Sponsors Adrin Nazarian
186 Bill Number Last Action Status Position AB 540 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: Medi-Cal PACE Title Program of All-Inclusive Care for the Elderly.
Description AB 540, as amended, Petrie-Norris. Program of All-Inclusive Care for the Elderly. Existing federal law establishes the Program of All- Inclusive Care for the Elderly (PACE), which provides specified services for older individuals at a PACE center, defined, in part, as a facility that includes a primary care clinic, so that they may continue living in the community. Federal law authorizes states to implement the PACE program as a Medicaid state option.Existing state law establishes the California Program of All-Inclusive Care for the Elderly (PACE program) to provide community-based, risk- based, and capitated long-term care services as optional services under the state’s Medi-Cal State Plan, as specified. Existing law authorizes the State Department of Health Care Services to enter into contracts with various entities for the purpose of implementing the PACE program and fully implementing the single- state agency responsibilities assumed by the department in those contracts, as specified. This bill would exempt a Medi-Cal beneficiary who is enrolled in a PACE organization with a contract with the department from mandatory or passive enrollment in a Medi-Cal managed care plan, and would require persons enrolled in a PACE plan to receive all Medicare and Medi-Cal services from the PACE program. The bill would require, in areas where a PACE plan is available, that the PACE plan be presented as a Medi-Cal managed care plan enrollment option in the same manner as other Medi-Cal managed care plan options. In areas of the state where a presentation on Medi-Cal managed care plan enrollment options is unavailable, the bill would require the department or its contracted vendor to provide outreach and enrollment materials on PACE. The bill would require the department to establish a system to identify Medi-Cal beneficiaries who appear to be eligible for PACE based on age, residence, and prior use of services, and, with respect to that system, would require the department to conduct specified outreach and referrals.
Primary Sponsors Cottie Petrie-Norris
187 Bill Number Last Action Status Position AB 552 Re Referred To Com On Health 2021 04 06 In Assembly Monitor
Labels: Behavioral Health Title Integrated School-Based Behavioral Health Partnership Program.
Description AB 552, as amended, Quirk-Silva. Integrated School-Based Behavioral Health Partnership Program. Existing law requires the governing board of any school district to give diligent care to the health and physical development of pupils and authorizes the governing board of a school district to employ properly certified persons for the work.The School-based Early Mental Health Intervention and Prevention Services for Children Act of 1991 authorizes the Director of Health Care Services, in consultation with the Superintendent of Public Instruction, to award matching grants to local educational agencies to pay the state share of the costs of providing school-based early mental health intervention and prevention services to eligible pupils at schoolsites of eligible pupils, subject to the availability of funding each year. Existing law establishes the Mental Health Student Services Act as a mental health partnership competitive grant program for the purpose of establishing mental health partnerships between a county’s mental health or behavioral health departments and school districts, charter schools, and the county office of education within the county, as provided.This bill would establish the Integrated School- Based Behavioral Health Partnership Program to provide prevention and early intervention for, and access to, behavioral health services for pupils. The bill would authorize a county behavioral health agency and the governing board or governing body of a local educational agency to agree to collaborate on conducting a needs assessment on the need for school-based mental health and substance use disorder services, and implement an integrated school-based behavioral health partnership program, to develop a memorandum of understanding outlining the requirements for the partnership program, and to enter into a contract for mental health or substance use disorder services.As part of a partnership program, the bill would require a county behavioral health agency to provide, through its own staff or through its network of contracted community-based organizations, one or more behavioral health professionals that meet specified contract, licensing, and supervision requirements, and who have a valid, current satisfactory background check, to serve pupils with serious emotional disturbances or substance use disorders, or who are at risk of developing a serious behavioral health condition. The bill would require a local educational agency to provide school- based locations, including space at schools, appropriate for the delivery of behavioral health services, and would additionally authorize these services to be provided through telehealth or through appropriate referral. The bill would establish processes for delivering se... (click bill link to see more).
Primary Sponsors Sharon Quirk-Silva
188 Bill Number Last Action Status Position AB 563 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: Behavioral Health Medi-Cal Title School-based health programs.
Description AB 563, as amended, Berman. School-based health programs. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed by, and funded pursuant to, federal Medicaid program provisions. Existing law establishes the Administrative Claiming process under which the department is authorized to contract with local governmental agencies and local educational consortia for the purpose of obtaining federal matching funds to assist with the performance of administrative activities relating to the Medi-Cal program that are provided by a local governmental agency or local educational agency (LEA). Existing law also provides that specified services provided by LEAs are covered Medi-Cal benefits and are reimbursable on a fee-for-service basis under the LEA Medi-Cal billing option.Existing law requires the department to engage in specified activities relating to the LEA Medi-Cal billing option, such as amending the Medicaid state plan to ensure that schools are reimbursed for all eligible services and examining methodologies for increasing school participation in the LEA Medi-Cal billing option. Existing law requires that these activities be funded and staffed by proportionately reducing federal Medicaid payments allocable to LEAs for the provision of benefits funded by federal Medicaid program payments under the LEA Medi-Cal billing option in an amount not to exceed $1,500,000 annually.This bill would require the State Department of Education to, no later than July 1, 2022, establish an Office of School-Based Health Programs for the purpose of administering current health-related programs under the purview of the State Department of Education and advising it on issues related to the delivery of school-based Medi-Cal services in the state. The bill would require the office to, among other things, provide technical assistance, outreach, and informational materials to LEAs on allowable services and on the submission of claims. The bill would authorize the office to form advisory groups, as specified, and, to the extent necessary, would require the State Department of Health Care Services to make available to the office any information on other school-based dental, health, and mental health programs, and school-based health centers, that may receive Medi-Cal funding. The bill would require the office to be supported through an interagency agreement with the State Department of Health Care Services, and would authorize the office to receive additional funds from grants and other sources.The bill would increase the annual funding limit for the activities of the State D... (click bill link to see more).
Primary Sponsors Marc Berman, Patrick O'Donnell, James Ramos
189 Bill Number Last Action Status Position AB 671 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: Health Services Medi-Cal Pharmacy Title Medi-Cal: pharmacy benefits.
Description AB 671, as amended, Wood. Medi-Cal: pharmacy benefits. Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to qualified low-income persons pursuant to a schedule of benefits, which includes pharmacy benefits, through various health care delivery systems, including fee-for-service and managed care. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law authorizes the department to contract with a vendor for the purposes of surveying drug price information, collecting data from providers, wholesalers, or drug manufacturers, and calculating a proposed actual acquisition cost. Existing law authorizes the department to establish a list of maximum allowable ingredient cost for generically equivalent drugs, and to establish the actual acquisition cost based on 3 specified factors, including the volume weighted actual acquisition cost adjusted by the department to verify that the actual acquisition cost represents the average purchase price paid by retail pharmacies in California, or the proposed actual acquisition cost as calculated by a vendor, as specified. Existing law requires the department to establish a fee schedule for the list of pharmacist services. Existing law specifies the pharmacist services that may be provided to a Medi-Cal beneficiary.This bill would require the department to provide a disease management or similar payment to a pharmacy that the department has contracted with to dispense a specialty drug to Medi-Cal beneficiaries in an amount necessary to ensure beneficiary access, as determined by the department based on the results of the survey completed during the 2020 calendar year.
Primary Sponsors Jim Wood
190 Bill Number Last Action Status Position AB 685 Re Referred To Com On Health 2021 03 15 In Assembly Monitor
Labels: Commercial Medi-Cal Title Health care service plans: reimbursement.
Description AB 685, as amended, Maienschein. Health care service plans: reimbursement. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law requires a health care service plan to reimburse complete claims, or portions thereof, within specified timeframes. Existing law establishes the process and for a health care service plan to contest or deny a claim for reimbursement. Existing law requires every insurer issuing group or individual policies of health insurance that cover hospital, medical, or surgical expenses to reimburse claims within specified timeframes and establishes the process for an insurer to contest or deny a claim for reimbursement.This bill would require health service plans and insurers to obtain an independent board- certified emergency physician review of the medical decisionmaking related to a service before denying benefits, reimbursing for a lesser procedure, reducing reimbursement based on the absence of a medical emergency, or making a determination that medical necessity was not present for claims billed by a licensed physician and surgeon for emergency medical services, as specified. Because a willful violation of the bill’s requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.
Primary Sponsors Brian Maienschein
191 Bill Number Last Action Status Position AB 703 Re Referred To Com On L Gov 2021 05 03 In Assembly Monitor
Labels: Legal Title Open meetings: local agencies: teleconferences.
Description AB 703, as amended, Blanca Rubio. Open meetings: local agencies: teleconferences. Existing law, the Ralph M. Brown Act, requires, with specified exceptions, that all meetings of a legislative body of a local agency, as those terms are defined, be open and public and that all persons be permitted to attend and participate. The act contains specified provisions regarding the timelines for posting an agenda and providing for the ability of the public to observe and provide comment. The act allows for meetings to occur via teleconferencing subject to certain requirements, particularly that the legislative body notice each teleconference location of each member that will be participating in the public meeting, that each teleconference location be accessible to the public, that members of the public be allowed to address the legislative body at each teleconference location, that the legislative body post an agenda at each teleconference location, and that at least a quorum of the legislative body participate from locations within the boundaries of the local agency’s jurisdiction. The act provides an exemption to the jurisdictional requirement for health authorities, as defined.Existing law, Executive Order No. N-29-20, suspends the Ralph M. Brown Act’s requirements for teleconferencing during the COVID-19 pandemic, provided that notice requirements are met, the ability of the public to observe and comment is preserved, as specified, and that a local agency permitting teleconferencing have a procedure for receiving and swiftly resolving requests for reasonable accommodation for individuals with disabilities, as specified.This bill would remove the notice requirements particular to teleconferencing and would revise the requirements of the act to allow for teleconferencing subject to existing provisions regarding the posting of notice of an agenda, provided that the public is allowed to observe the meeting and address the legislative body directly both in person and remotely via a call-in option or internet-based service option, and that a quorum of members participate in person from a singular physical location clearly identified on the agenda that is open to the public and situated within the jurisdiction. The bill would require that, in each instance in which notice of the time of the teleconferenced meeting is otherwise given or the agenda for the meeting is otherwise posted, the local agency also give notice of the means by which members of the public may observe the meeting and offer public comment and that the legislative body have and implement a procedure for receiving and swiftly resolving requests for reasonable accommodation for individuals with disabilities, consistent with the federal Americans with Disa... (click bill link to see more).
Primary Sponsors Blanca Rubio
Bill Number Last Action Status Position AB 822 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: Behavioral Health Medi-Cal Title 192 Medi-Cal: psychiatric emergency medical conditions. Description Dead Bill AB 822, as amended, Rodriguez. Medi-Cal: psychiatric emergency medical conditions. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, and under which qualified low-income individuals receive health care services, which are delivered through various delivery systems, including fee-for-service and managed care. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law requires the department to implement managed mental health care for Medi-Cal beneficiaries through contracts with mental health plans. Under existing law, mental health plans are responsible for providing specialty mental health services to enrollees, and Medi-Cal managed care plans deliver nonspecialty mental health services to enrollees. Under existing law, emergency services and care, mental health benefits, substance use disorder benefits, and specialty mental health services are covered under the Medi-Cal program.This bill would specify that observation services for a psychiatric emergency medical condition, as defined, are covered under the Medi-Cal program, consistent with coverage under the above provisions and any other applicable law. Under the bill, the scope of coverage of those services would include facility services for observation services provided within the emergency department, or an onsite or offsite observation unit, as defined, of a general acute care hospital to a Medi-Cal beneficiary with a confirmed or suspected psychiatric emergency medical condition.Existing law imposes certain requirements on mental health plans and Medi-Cal managed care plans, including network adequacy standards and a requirement to enter into a memorandum of understanding if the 2 plans serve some of the same Medi-Cal recipients.This bill would require the applicable mental health plan and Medi-Cal managed care plan to notify each other within 24 hours from notification by a general acute care hospital of a Medi-Cal beneficiary with a condition as described above. The bill would require the memorandum of understanding to include a process to coordinate the provision of the above services, as specified. The bill would require disputes between a mental health plan and a Medi-Cal managed care plan, or between mental health plans, regarding the responsibility to pay for the charges for those services to be resolved pursuant to certain processes under existing law. The bill would require that the mental health plan be responsible for observation services for a psychiatric emergency medical condition. If those services are provided to a Medi-Cal fee-for-service beneficiary, the bill would require the department to reimburse the hospital using a s... (click bill link to see more).
Primary Sponsors Freddie Rodriguez
Organizational Notes
Last edited by Cherie Compartore at Apr 5, 2021, 5:54 PM Oppose Unless Amended: LHPC
193 Bill Number Last Action Status Position AB 848 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: Medi-Cal Title Medi-Cal: monthly maintenance amount: personal and incidental needs.
Description Dead Bill AB 848, as introduced, Calderon. Medi-Cal: monthly maintenance amount: personal and incidental needs. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low- income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Qualified individuals under the Medi-Cal program include medically needy persons and medically needy family persons who meet the required eligibility criteria, including applicable income requirements.Existing law requires the department to establish income levels for maintenance need at the lowest levels that reasonably permit a medically needy person to meet their basic needs for food, clothing, and shelter, and for which federal financial participation will still be provided under applicable federal law. In calculating the income of a medically needy person in a medical institution or nursing facility, or a person receiving institutional or noninstitutional services from a Program of All-Inclusive Care for the Elderly organization, the required monthly maintenance amount includes an amount providing for personal and incidental needs in the amount of not less than $35 per month while a patient. Existing law authorizes the department to increase, by regulation, this amount as necessitated by increasing costs of personal and incidental needs.This bill would increase the monthly maintenance amount for personal and incidental needs from $35 to $80, and would require the department to annually adjust that amount by the same percentage as the Consumer Price Index.
Primary Sponsors Lisa Calderon
194 Bill Number Last Action Status Position AB 875 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: CalAIM Health Services Housing/Homelessness Title Medi-Cal: demonstration project. Medi-Cal
Description AB 875, as amended, Wood. Medi-Cal: demonstration project. (1) Existing law authorizes the board of supervisors in each county Dead Bill to designate an entity or entities to assist county jail inmates to apply for a health insurance affordability program, as defined, consistent with federal requirements.Commencing January 1, 2023, this bill would instead require the board of supervisors, in consultation with the county sheriff, to designate an entity or entities to assist both county jail inmates and juvenile inmates with the application process. The bill would make conforming changes to provisions relating to the coordination duties of jail administrators. By creating new duties for local officials, including boards of supervisors and jail administrators, the bill would impose a state-mandated local program. No sooner than January 1, 2023, this bill would require the department to develop and implement a mandatory process for county jails and county juvenile facilities to coordinate with Medi-Cal managed care plans and Medi-Cal behavioral health delivery systems to facilitate continued behavioral health treatment in the community for inmates, as specified. The bill would authorize the sharing of health information, records, and other data with and among counties and other specified entities to the extent the department determines necessary to implement these provisions. (2) Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, either through a fee-for-service or managed care delivery system. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law, the Medi-Cal 2020 Demonstration Project Act, requires the department to implement specified components of a Medi-Cal demonstration project, including the Global Payment Program (GPP), the Whole Person Care pilot program, and the Public Hospital Redesign and Incentives in Medi- Cal (PRIME) program, consistent with the Special Terms and Conditions approved by the federal Centers for Medicare and Medicaid Services. Pursuant to existing law, the department has created a multiyear initiative, the California Advancing and Innovating Medi-Cal (CalAIM) initiative, for purposes of building upon the outcomes of various Medi-Cal pilots and demonstration projects, including the Medi-Cal 2020 demonstration project. Under the GPP, existing law makes designated public hospitals, and any successor or differently named hospital, eligible to receive global payments that are calculated using a value-based point methodology based on the health care that they provide to the uninsured.This bill would allow those design... (click bill link to see more).
Primary Sponsors Jim Wood
195 Bill Number Last Action Status Position AB 933 Referred To Com On Health 2021 02 25 In Assembly Monitor
Labels: Commercial Pharmacy Title Prescription drug cost sharing.
Description AB 933, as introduced, Daly. Prescription drug cost sharing. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law limits the maximum amount an enrollee or insured may be required to pay at the point of sale for a covered prescription drug to the lesser of the applicable cost-sharing amount or the retail price.This bill would require an enrollee’s or insured’s defined cost sharing for each prescription drug to be calculated at the point of sale based on a price that is reduced by an amount equal to 90% of all rebates received, or to be received, in connection with the dispensing or administration of the drug. The bill would prohibit a health care service plan, health insurer, or a plan’s or insurer’s agents from publishing or otherwise revealing information regarding the actual amount of rebates the health care service plan or health insurer receives on a product-specific, manufacturer-specific, or pharmacy- specific basis. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.
Primary Sponsors Tom Daly
Bill Number Last Action Status Position AB 935 From Committee Do Pass And Re Refer To In Assembly Monitor Com On Appr Ayes 12 Noes 0 April 27 Re Referred To Com On Appr 2021 04 28
Labels: Behavioral Health Commercial Medi-Cal Title Telehealth: mental health. Telehealth
Description AB 935, as amended, Maienschein. Telehealth: mental health. Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to low-income individuals pursuant to a schedule of benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of that act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plan contracts and health insurance policies that provide hospital, medical, or 196 surgical coverage to provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses, as defined, of a person of any age. Existing law also requires health care service plans and health insurers, by July 1, 2019, to develop maternal mental health programs.This bill would require health care service plans and health insurers, including Medi-Cal managed care plans, by July 1, 2022, to provide access to a telehealth consultation program that meets specified criteria and provides providers who treat children and pregnant and certain postpartum persons with access to a mental health consultation program, as specified. The bill would require the consultation by a mental health clinician with expertise appropriate for pregnant, postpartum, and pediatric patients to be conducted by telephone or telehealth video, and to include guidance on the range of evidence-based treatment options, screening tools, and referrals. The bill would add mental health consultations through this program to the Medi-Cal schedule of benefits. The bill would require health care service plans and insurers to communicate information relating to the telehealth program at least twice a year in writing. The bill would require health care service plans and health insurers to monitor data pertaining to the utilization of the program to facilitate ongoing quality improvements, as necessary, and to provide a description of the program to the appropriate department. The bill would exempt certain specialized health care service plans and health insurers from these provisions. Because a willful violation of the bill’s requirement by a health care service plan would be a crime, the bill would impose a state-mandated local program.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that ... (click bill link to see more).
Primary Sponsors Brian Maienschein
Organizational Notes
Last edited by Joanne Campbell at Apr 26, 2021, 6:12 PM Oppose - CAHP Oppose Unless Amended - LHPC
197 Bill Number Last Action Status Position AB 1050 In Committee Held Under Submission 2021 05 In Assembly Monitor 20
Labels: Medi-Cal Pharmacy Title Medi-Cal: application for enrollment: prescription drugs.
Description AB 1050, as amended, Gray. Medi-Cal: application for enrollment: Dead Bill prescription drugs. (1) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law requires the department to create and implement a simplified application package for children, families, and adults applying for Medi-Cal benefits.Existing federal law, the Telephone Consumer Protection Act, among other provisions, prohibits any person within the United States, or any person outside the United States if the recipient is within the United States, from making any call to any telephone number assigned to a paging service, cellular telephone service, specialized mobile radio service, or other radio common carrier service, or any service for which the called party is charged for the call, without the prior express consent of the called party, using any automatic telephone dialing system or an artificial or prerecorded voice. Under existing case law, a text message is considered a call for purposes of those provisions.This bill would require the application for Medi-Cal enrollment to include a statement that if the applicant is approved for Medi-Cal benefits, the applicant agrees that the department, county welfare department, and a managed care organization or health care provider to which the applicant is assigned may communicate with them regarding appointment reminders or outreach efforts at no more than a 6th grade reading level through Free to End User text messaging unless the applicant opts out.(2) Existing federal law, known as the 340B discount drug purchasing program, generally requires pharmaceutical manufacturers participating in Medicaid to give discounts on pharmaceutical drugs to covered entities, as defined, serving the Medicaid population. This program is commonly referred to as the 340B program.Under existing law, the Medi-Cal program requires a covered entity to dispense only drugs purchased through the 340B program to a Medi-Cal beneficiary, except under specified circumstances.This bill would prohibit the Director of Health Care Services from taking action that materially increases the administrative burden or cost of dispensing 340B drugs by federally qualified health centers and rural health clinics, including, but not limited to, changes that adversely impact the use of contract pharmacy arrangements. The bill would require the director to prepare a report, including specified information, before taking any action that materially impacts the 340B program, and to publish the report on the department’... (click bill link to see more).
Primary Sponsors Adam Gray
198 Bill Number Last Action Status Position AB 1051 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: Behavioral Health Medi-Cal Title Medi-Cal: specialty mental health services: foster youth.
Description AB 1051, as amended, Bennett. Medi-Cal: specialty mental health services: foster youth. Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services (department), under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, specialty mental health services include federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services provided to eligible Medi-Cal beneficiaries under 21 years of age. Existing law requires each local mental health plan to establish a procedure to ensure access to outpatient specialty mental health services, as required by the EPSDT program standards, for youth in foster care who have been placed outside their county of adjudication, as described.Existing law requires the department to issue policy guidance concerning the conditions for, and exceptions to, presumptive transfer of responsibility for providing or arranging for specialty mental health services to a foster youth from the county of original jurisdiction to the county in which the foster youth resides, as prescribed.This bill would make those provisions for presumptive transfer inapplicable to a foster youth or probation-involved youth placed in a community treatment facility, group home, or a short-term residential therapeutic program (STRTP) outside of their county of original jurisdiction, as specified.The bill would prohibit the presumptive transfer of foster youth placed in a group home, community treatment facility, or a STRTP unless an exception is invoked, as requested by one of specified individuals or entities pursuant to certain criteria. The bill would make the county probation agency or the child welfare services agency responsible for determining whether invoking the exception is appropriate. Upon the approval of an exception by the county probation agency or the child welfare services agency, the bill would require presumptive transfer to immediately occur, and would require the mental health plan in the county in which the foster youth resides to assume responsibility for the authorization and provision of specialty mental health services and payments for those services. The bill would impose various notification requirements on the county placing agency and county mental health plans, and would require documentation of the invoked exception to be included in the foster youth’s case plan. The bill would authorize a requester who disagrees with the county agency’s determination to request judicial review, as specified.The bill would impose procedural requirements for mental health assessments of the affected foster y... (click bill link to see more).
Primary Sponsors Steve Bennett
199 Bill Number Last Action Status Position AB 1064 Read Second Time Ordered To Consent In Assembly Monitor Calendar 2021 05 20
Labels: Medi-Cal Pharmacy Title Pharmacy practice: vaccines: independent initiation and administration.
Description AB 1064, as amended, Fong. Pharmacy practice: vaccines: independent initiation and administration. Existing law, the Pharmacy Law, establishes the California State Board of Pharmacy within the Department of Consumer Affairs and sets forth its powers and duties relating to the licensing and regulation of pharmacists. A violation of the Pharmacy Law is a crime.Existing law authorizes a pharmacist to administer immunizations pursuant to a protocol with the prescriber.Existing law provides additional authority for the pharmacist to independently initiate and administer any COVID-19 vaccines approved or authorized by the federal Food and Drug Administration, or vaccines listed on the routine immunization schedules recommended by the federal Advisory Committee on Immunization Practices (ACIP), in compliance with individual ACIP vaccine recommendations, and published by the federal Centers for Disease Control and Prevention for persons 3 years of age and older.This bill would recast this provision to instead authorize a pharmacist to independently initiate and administer any vaccine approved or authorized by the United States Food and Drug Administration for persons 3 years of age and older.
Primary Sponsors Vince Fong
Bill Number Last Action Status Position AB 1131 In Committee Hearing Postponed By In Assembly Monitor Committee 2021 05 20
Labels: Commercial Data Medi-Cal Title Health information network.
Description AB 1131, as amended, Wood. Health information network. Existing law makes legislative findings and declarations on health Two Year Bill information technology, including that there is a need to promote secure electronic health data exchange among specified individuals, such as health care providers and consumers of health care, and that specified federal law provides unprecedented opportunity for California to develop a statewide health information technology infrastructure to improve the state’s health care system.Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.This bill would establish the statewide health information network (statewide HIN) 200 governing board, an independent public entity not affiliated with an agency or department with specified membership, to provide the data infrastructure needed to meet California’s health care access, equity, affordability, public health, and quality goals, as specified. The bill would require the governing board to issue a request for proposals to select an operating entity with specified minimum capabilities to support the electronic exchange of health information between, and aggregate and integrate data from multiple sources within, the State of California, among other responsibilities. The bill would require the statewide HIN to take specified actions with respect to reporting on, and auditing the security and finances of, the health information network. The bill would require the statewide HIN to convene a health technology advisory committee with specified membership to advise the statewide HIN and set agendas, hold public meetings with stakeholders, and solicit external input on behalf of the statewide HIN.The bill would also require a health care entity, including a hospital, health system, skilled nursing facility, laboratory, physician practice, health care service plan, health insurer, and the State Department of Health Care Services, to submit specified data to the operating entity. The bill would authorize the statewide HIN to add additional health care entities or data to the list of entities required to submit data to the statewide HIN by adopting a subsequent regulation. The bill would also require a health care service plan, health insurer, and a health care provider to col... (click bill link to see more).
Primary Sponsors Jim Wood
Organizational Notes
Last edited by Cherie Compartore at Apr 6, 2021, 3:46 PM Support: Anthem Blue Cross, Blue Shield, Inland Empire Health plan, Manifest Medex, SEIU.
201 Bill Number Last Action Status Position AB 1132 Read Second Time Ordered To Third Reading In Assembly Monitor 2021 05 24
Labels: CalAIM Title Medi-Cal.
Description AB 1132, as amended, Wood. Medi-Cal. Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, either through a fee-for- service or managed care delivery system. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing federal law provides for the federal Medicare program, which is a public health insurance program for persons who are 65 years of age or older and specified persons with disabilities who are under 65 years of age. Under existing law, a demonstration project known as the Coordinated Care Initiative (CCI) enables beneficiaries who are dually eligible for the Medi-Cal program and the Medicare Program to receive a continuum of services that maximizes access to, and coordination of, benefits between these programs.Existing law, the Medi-Cal 2020 Demonstration Project Act, requires the department to implement specified components of a Medi-Cal demonstration project, including the Global Payment Program and the Whole Person Care pilot program, consistent with the Special Terms and Conditions approved by the federal Centers for Medicare and Medicaid Services. Pursuant to existing law, the department has created a multiyear initiative, the California Advancing and Innovating Medi- Cal (CalAIM) initiative, for purposes of building upon the outcomes of various Medi-Cal pilots and demonstration projects, including the Medi-Cal 2020 demonstration project.This bill would make specified portions of the CCI operative only through December 31, 2022, as specified, and would repeal its provisions on January 1, 2025. The bill would also require Medi-Cal managed care plans to operate, or continue to operate, a Medicare Advantage Dual Special Needs Plan, commencing January 1, 2023, in CCI counties, and, commencing January 1, 2025, in all other counties, as specified. The bill would make various changes to the CCI component of the CalAIM initiative, including requiring the department to convene, in collaboration with the State Department of Social Services, a workgroup to address specified matters relating to the transition of beneficiaries residing in certain facilities from the Medi-Cal fee-for-service delivery system to the Medi-Cal managed care delivery system. This bill would make its provisions severable and would make other legislative findings and declarations.
Primary Sponsors Jim Wood
202 Bill Number Last Action Status Position AB 1160 Referred To Com On Health 2021 03 04 In Assembly Monitor
Labels: CalFresh/Food Assistance Medi-Cal Title Medically supportive food.
Description AB 1160, as introduced, Blanca Rubio. Medically supportive food. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, including enteral nutrition products, pursuant to a schedule of benefits. Under existing law, these health care services are provided through various delivery systems, including fee-for- service and managed care. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law authorizes the department to enter into various types of contracts for the provision of services to beneficiaries, including contracts with a Medi-Cal managed care plan. Existing law imposes various requirements on managed care plan contractors, including network adequacy standards relating to time and distance, and requires the department to ensure that specified benefits, such as mental health, are provided by the contractors in compliance with prescribed federal law. Existing federal law authorizes specified managed care entities that participate in a state’s Medicaid program to cover, for enrollees, services or settings that are in lieu of services and settings otherwise covered under a state plan.Existing law requires the department to establish a Medically Tailored Meals Pilot Program to operate for a period of 4 years from the date the program is established, or until funding is no longer available, whichever date is earlier, in specified counties to provide medically tailored meal intervention services to Medi-Cal participants with prescribed health conditions, such as diabetes and renal disease.Effective for contract periods commencing on or after January 1, 2022, this bill would authorize Medi-Cal managed care plans to provide medically tailored meals to enrollees. The bill would authorize the department to implement this provision by various means, including plan or provider bulletins, and would require the department to seek federal approvals. The bill would condition the implementation of this provision on the department obtaining federal approval and the availability of federal financial participation.
Primary Sponsors Blanca Rubio
203
2021-22 Budget May Revise On May 14, Governor Newsom released his 2021-22 May Revise. The May Revise contains the revisions to the proposed state budget that the Governor released in January 2021. The May Revise includes updated spending and revenue estimates, as well as updated priorities and proposals. The Legislature will have a month to review, offer revisions, and negotiate the high level components of the 2021-22 budget. The Legislature must pass a budget by June 15 for Governor Newsom to sign into law before the fiscal year begins July 1. However, much of the detail will follow the signing of the overall budget, in the form of budget trailer bills. Most budget trailer bills are finalized after the passage of the main budget bill and usually follow in July and August (the budget trailer bills contain much of the details on how to implement the main budget concepts). However, based on the magnitude of spending proposed in the budget, the Legislature will likely have some concerns on the levels of spending, and the budget trailer bill releases could even extend to the fall. It is just unknown at this point.
Medi-Cal Caseload Estimates The estimated impact of COVID-19 on the Medi-Cal caseload, and related costs, have been revised downward from the January budget proposal in the May Revise. The May Revise assumes an average Medi-Cal caseload growth of 14.5 million beneficiaries for 2021-22. This represents a growth of approximately 900,000 beneficiaries from 2020-21 to 2021-22. The May Revise contains funding for counties to support the increased workload to re-determine eligibility for those beneficiaries that remained enrolled in Medi-Cal due to the continuous eligibility requirement during the pandemic. ($37 million General Fund costs/$73 Total Funds – w/fed match) Expansion of Medi-Cal Coverage Effective no sooner than 05/01/22, Medi-Cal will be expanded to provide full scope coverage to adults 60 years of age and older, regardless of immigration status. California currently provides full-scope Medi-Cal coverage to those under age 26, regardless of immigration status. California will continue to receive a federal match for emergency services provided to this population. However, any non-emergency services/benefits provided to this population will be ineligible for federal match and funded solely by the state’s General Fund. (General Fund cost of $50 million) Medi-Cal Coverage of Continuous Glucose Monitors Effective 01/01/22, Continuous Glucose Monitoring systems will be added as a Medi-Cal benefit for those enrollees ages 21 and older with Type 1 diabetes. OTC Adult Acetaminophen & Cough/Cold Products OTC adult acetaminophen and cough/cold benefits were temporarily reinstated under the current 2020-21 budget for the COVID-19 Public Health Emergency. The May Revise proposes that effective 07/01/21, this benefit permanently be reinstated with the 2021-22 budget. Medi-Cal Doula Benefit Effective 01/01/22 Doula services will be added to the Medi-Cal program. Doula services may include personal support to pregnant individuals throughout pregnancy, labor, and postpartum. Department of Health Care Services (DHCS) indicates that the benefit will include maternity and labor support visits, which can be at the beneficiary’s home or as an office visit. ($152 million General Fund cost)
204 2021-22 Budget May Revise
Medi-Cal Dyadic Services Benefit Proposal to add new Dyadic services benefit in the Medi-Cal program. Dyadic services provide integrated physical and behavioral health services. ($100 million General Fund costs) Medi-Cal Optional Benefits – Continued Funding CBAS, MSSP, adult dental services, acupuncture, optometry, nurse anesthetists’ services, occupational and physical therapy, pharmacist services and the Diabetes Prevention Program will continue to be funded. Medi-Cal Optional Benefits – Removal of Suspension The May Revise proposes to permanently remove all suspensions of optional benefits currently in law including audiology and speech therapy, incontinence creams and washes, optician and optical lab services, podiatry, and opioid and other illicit drug screenings and referrals. Therefore, these optional benefits will continue to be funded. Community Health Workers (CHWs) Effective 01/01/22, adds CHWs to the class of individuals who can provide clinically appropriate Medi-Cal covered benefits and services. Some examples of services could include providing assistance to beneficiaries in accessing health care services, providing health education resources, etc. ($6.2 million General Fund cost) Medi-Cal Eligibility Extension for Postpartum Individuals Effective 04/01/22, California will implement a new federal option to provide postpartum benefits for an additional 12 months following the last day of pregnancy. ($45.3 million General Fund cost) Elimination of Dental Managed Care Effective 01/01/22, eliminates dental managed care in Los Angeles and Sacramento counties and transitions dental to fee-for-service entirely. Currently Medi-Cal beneficiaries may choose to obtain their Medi-Cal dental benefit via managed care (Health Net) or fee-for-service. The budget proposal will eliminate the managed care choice. IHSS – Permanent Restoration of 7% Reduction The May Revise proposes to restore the 7% reduction to IHSS service hours. As background, the 7% reduction has not been implemented in several years, as the state funded the 7% reduction via General Fund dollars each year. This makes that reduction in law permanently removed. COVID Vaccine Admin Costs The budget assumes the cost of COVID vaccines will be fully funded by the federal government. However, the cost of the vaccine administration will be paid by the Medi-Cal FFS program to providers. There is no managed care payment responsibility. Telehealth Flexibilities Provides funding for the extension of some telehealth services. DHCS will establish a rate for audio-only telehealth that is set at 65% of the Medi-Cal fee-for-service rate and a comparable rate established for clinics as an alternative payment methodology rate that would have to be approved by the federal government.
205 2021-22 Budget May Revise
CalAIM Assumes implementation of most CalAIM proposals on 01/01/22. ($673 million General Fund cost). The individual breakdown of CalAIM proposal General Fund costs for 2021-22 are as follows:
Enhanced Care Management $93.8 million In Lieu of Services $24 million Incentives $150 million Transitioning Populations $174.7 million Dental Preventive Services $29.8 million Dental Continuity of Care $21.7 million Dental Caries Risk Assessment $5 million Dental Silver Diamine Fluoride $0.5 million Behavioral Health Quality Improvement Program $21.8 million Carve Organ Transplants in Managed Care $1.4 million Carve-Out MSSP Program to Fee-for-Service $0.8 million Carve Out Specialty Mental Health Services -$2.3 million Population Health Management $30 million Medi-Cal Providing Access and Transforming Health $100 million Medically Tailored Meals Augmentation $9.3 million State Operations Funding $12.5 million Total $673 million General Fund Costs
Medi-Cal Population Health Management (PHM) The budget contains detail that would provide Medi-Cal PHM services that will utilize administrative and clinical data and information for DHCS, managed care plans, counties, providers, and beneficiaries to use in support of the delivery of care. Examples of items included: standardized statewide risk stratification, quality metrics, identifying gaps in beneficiary referrals to social services, identifying beneficiaries for care management, provide beneficiaries with a longitudinal patient record, Medi-Cal standard assessments, etc. (General Fund cost of $31.5 million)
Medi-Cal Pharmacy Carve Out The Governor’s January budget had assumed implementation of Med-Cal Rx would begin in April 2021. However, the May Revise is indicating that the Medi-Cal pharmacy carve out may begin on 01/01/22. However, the implementation date may change (could be sooner or later than 01/01/22). The revised timeline for implementation is due to DHCS needing time to ensure that there will be acceptable firewalls put in place for the state’s pharmacy benefit manager. 340B Financing Provides funding for specific non-hospital clinics participating in the 340B program. Non-hospital 340B clinics will begin billing Medi-Cal FFS at their acquisition cost (when Rx carve out begins), which will result in cost savings to the state, but less funding available to clinics. To mitigate the revenue impact to these 340B clinics, DHCS proposes to create a supplemental payment pool to help offset their costs. ($26.3 million General Fund cost) Proposition 56 Proposes the permanent elimination of the Proposition 56 suspensions.
206 2021-22 Budget May Revise
Behavioral Health Services and Supports In addition to the $750 million for the behavioral health continuum infrastructure and $400 million for increased access to student behavioral health services proposed in the Governor’s January budget proposal, the May Revise contains additional funding in BH funding for children and youths that include the following proposals: Statewide BH Services and Supports. Provides funding for the state to implement an all-payer BH direct service and supports virtual platform to be integrated with screening, app-based supports for those under age 25. The app would facilitate a statewide e-consult service to allow PCPs to receive asynchronous support and consultation to assist in managing BH conditions for their patients in their practices Capacity and Infrastructure Grants for BH Services in Schools. Proposal that would build infrastructure, partnerships and capacity statewide to increase access to BH services on or near school campuses. Provides opportunity for schools, counties, and Medi-Cal managed care plans to participate and provide data sharing systems. Grants to Support Development and Expand Age-Appropriate and Evidenced-Based BH Programs for Children and Youth. Provides funding to develop and expand evidence-based interventions proven to improve outcomes for children and youth. Foster Youth. Provides funding for counties to service foster youth with complex behavioral health needs and youth returning from out-of-state congregate placement. ACES. Provides funding for 7 demonstration projects focused on advancing research and building scalable approaches to treating and preventing ACEs.
Covered California – State Subsidies The May Revise proposes to revert state subsidy funding to the General Fund. As part of the American Rescue Plan (ARP) signed into law by President Biden, there was significant funding provided to all who purchase coverage on federal and state-based exchanges. Specifically, the ARP provides subsidies so that no individual at any income level will have to pay more than 8.5% of their income for a silver plan in the exchange. In addition, no individual with income below 150% of FPL or those receiving unemployment benefits at any point in 2021, will pay for any premiums at all for silver level coverage. As a result of the federal actions, the 3-year state subsidy would be absorbed by the new federal subsidies. Therefore, the budget assumes that no state premium subsidy is necessary anymore.
Covered California - $1 Premium Subsidy Program The budget proposes to fund the $1 per month premium required for the cost of providing abortion services, for which federal funding is prohibited. The Affordable Care Act (ACA) prohibited the use of federal funds to pay for coverage of abortion services by Qualified Health Plans in exchanges, including Covered California. The ACA required health plans to charge and collect at least $1 per month for coverage of such abortion services. As a result, Covered California enrollees that would receive federal or state subsidies that would combine to reduce premium costs to zero, instead have to arrange to pay one dollar per month. The budget proposal, while still adhering to ACA requirements, would use state-only funds to provide the $1 per month premium subsidy program. This would also assist enrollees in preventing coverage lapses due to non-payment of premiums. Health Information Exchange Includes $250 million in General Fund costs for the Administration to lead discussions with stakeholder engagement and planning and buildout for information exchange for health and social service programs. No specific detail is provided. Directs DHCS to draw down enhanced federal funding that has been available to states to support HIOs onboarding and technical assistance in regards to the HIE Interoperability Rule.
207 2021-22 Budget May Revise
Population Health Management. Provides for a population health management business solution to utilize administrative and clinical data and information for DHCS, providers, Medi-Cal managed care plans, and beneficiaries to use in support of care delivery. DHCS will contract with a vendor to provide these services. See CalAIM update above.
Broadband Access As part of the federal American Rescue Plan Act and with federal funding, the state proposals to invest $7 billion in broadband access and building fiber networks, making internet more affordable and increasing access to high-speed service. Housing and Homelessness In addition to the federal and state laws already enacted to assist people with housing assistance during the pandemic, the May Revise also includes $12 billion for homelessness, including investments to get 65,000 people off the streets through investments in Homekey, affordable housing, funding to support student homelessness, encampment strategies and Project Roomkey. This includes $3.5 billion for behavioral health infrastructure to build 28,000 new housing or clinical beds. Next Steps: Government Affairs will continue to provide written updates on the budget. In the meantime, if you have any questions, please contact Cherie Compartore, Senior Director of Government Affairs, at [email protected] or 916.216.7963.
Links: The May Revise may be found online at http://www.ebudget.ca.gov
DHCS budget summary may be found online at https://www.dhcs.ca.gov/Documents/Budget_Highlights/DHCS- FY-2021-22-Governors-Budget-Highlights.pdf
Department of Finance Budget Trailer bills may be found online at: https://esd.dof.ca.gov/trailer-bill/trailerBill.html
208
BOARD OF GOVERNORS Executive Committee
Meeting Minutes – April 26, 2021 1055 West 7th Street, Los Angeles, CA 90017
Members Management/Staff Hector De La Torre, Chairperson John Baackes, Chief Executive Officer Al Ballesteros, Vice Chairperson Terry Brown, Chief Human Resources Officer Robert H. Curry, Treasurer * Linda Greenfeld, Chief Product Officer Layla Gonzalez, Secretary Augustavia J. Haydel, Esq., General Counsel Stephanie Booth, MD Tom MacDougall, Chief Information & Technology Officer Hilda Perez Marie Montgomery, Chief Financial Officer Francisco Oaxaca, Chief of Communications & Community Relations Noah Paley, Chief of Staff Acacia Reed, Chief Operating Officer Richard Seidman, MD, MPH, Chief Medical Officer
California Governor issued Executive Order No. N-25-20 and N-29-20, which among other provisions amend the Ralph M. Brown Act. Members of the public can listen to this meeting via teleconference.
AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN CALL TO ORDER Hector De La Torre, Chairperson, called to order the L.A. Care Executive Committee and the L.A. Care Joint Powers Authority Executive Committee meetings at 2:21 p.m . The
meetings were held simultaneously. He welcomed everyone to the meetings. For those who provided public comment for this meeting by voice message or in writing, we are really glad that you provided input today. The Committee will hear your comments and we also have to finish the business on our Agenda today. If you have access to the internet, the materials for today’s meeting are available at the lacare.org website. If you need information about how to locate the meeting materials, please let us know. Information for public comment is on the Agenda available on the web site. Staff will read the comment from each person for up to three minutes. The Chairperson will invite public comment before the Committee starts to discuss the item. If the comment is not on a specific agenda item, it will be read at the general Public Comment item 2 on today’s agenda.
APPROVED 209
AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN APPROVE MEETING The Agenda for today’s meeting was approved. Approved unanimously by AGENDA roll call. 5 AYES (Ballesteros, Booth, De La Torre, Gonzalez and Perez)
PUBLIC COMMENTS T here were no public comments.
APPROVE MEETING T he minutes of the March 22, 2021 meeting were approved as submitted. A pproved unanimously by MINUTES roll call. 5 AYES
CHAIRPERSON’S C hairperson De La Torre commended staff for doing a wonderful job in managing the REPORT incredibly difficult COVID-19 pandemic while continuing to serve L.A. Care’s members. He noted that L.A. Care remains steady despite the challenges. He has attended a couple of the vaccination clinics and has seen staff volunteering to help members and others getting the vaccine. It was incredibly difficult to arrange the vaccination events, particularly after underserved communities, in the early months of the pandemic, were not getting vaccines at the same rates as other communities. It is still the case that healthier and wealthier communities are getting the vaccines at a much higher percentage than lower income underserved communities. L.A. Care is really trying to address this disparity by scheduling these vaccination clinics. He saw a report from the Center for Disease Control (CDC) that 8% nationwide of people who received the first dose of a two-part vaccine have not gotten the second dose. The effectiveness of the vaccine increases tremendously with the second dose. He feels we need to do more to promote and encourage people to get the second dose, and to overcome the recent misinformation and distrust around the Johnson & Johnson vaccine. L.A. Care is doing a great job, and there is more work to be done.
CHIEF EXECUTIVE John Baackes, Chief Executive Officer, reported: OFFICER REPORT L.A. Care’s vaccine clinics using the Johnson & Johnson vaccine are directed to helping members and others receive the COVID-19 vaccine. Four of the 16 scheduled clinics were completed when the CDC and the Federal Drug Administration (FDA) announced a pause in administering the vaccine. On Friday, the CDC and FDA announced that the Johnson & Johnson vaccine can again be administered. L.A. Care is working to reorganize the schedule to resume the vaccination events and continue to administering the vaccine.
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AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN He thanked Chairperson De La Torre for his compliments to the staff. L.A. Care’s staff has been working hard. The fiscal year budget was approved with a deficit, revised the financial projections, and is outperforming the restated budget. This is because of good work by staff, and he feels the organization is working hard together, and the success of a remote workforce will be considered as a return to the offices is considered at some point in the future. Of concern in the future, there are major changes for managed care health plans in January 2022, in the implementation of new programs in Population Health Management (PHM), Enhanced Care Management (ECM) and In Lieu of Services (ILOS). There are currently more questions than answers about the responsibilities of health plans and the resources that will be available to implement these new programs. The new benefits are built on two federal 1115 waiver programs, Whole Person Care and Health Homes, which expire at the end of 2021, under a one-year extension. In the midst of the current pandemic, the new programs are creating an unrelenting stream of additional work for health plan staff. L.A. Care is working with state officials to help them understand the impact of the new programs on our workforce.
Mr. Baackes asked Richard Seidman, MD, MPH, Chief Medical Officer, for his report: Over 3,000 vaccines were distributed in the first week of scheduled COVID-19 vaccine events. The second and third weeks were canceled due to the pause in administration of the Johnson & Johnson vaccine. Following the reauthorization to administer the vaccine, two of the four vaccine events for this week were successfully rescheduled, and L.A. Care will work with Los Angeles County Department of Public Health and Blue Shield Promise to reschedule all of the scheduled vaccine events and to address any concerns about the vaccine. An estimated 500,000 L.A. Care’s members have received at least the first dose of a vaccine, and about half of those have received both doses. Of L.A. Care’s 2.2 million members, approximately 500,000 are children under 16 years of age and are not yet eligible to receive a vaccine. There is continued focus on reaching the most vulnerable in Los Angeles County, which is estimated to be 25% of the population, particularly with messages to address vaccine hesitancy. A report received two weeks ago estimated that 40% of the available vaccine had been administered to that 25% of the population. This is a
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AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN better performance that some areas in California and across the nation. There is more work to be done. Female L.A. Care members are vaccinated at a higher rate than males, so messages are being developed to encourage the male members to get vaccinated. L.A. Care’s Cal MediConnect members have a higher rate of vaccination than members in other programs. Geographically, data is showing that members in South Los Angeles and in the Antelope Valley have lower rates of vaccination.
Mr. Baackes noted that L.A. Care membership continues to grow, and is currently just short of 2.4 million members. Many members have retained their benefits because of the suspension of the redetermination of eligibility process for Medi-Cal. Los Angeles County has a population of 10 million, so 1 in 4 residents receive their health coverage from L.A. Care.
Strategic Vision Progress A written report was included in the meeting materials (a copy of the report can be obtained by Report contacting Board Services).
Government Affairs Cherie Compartore, Senior Director, Government Affairs, reported: Update In addition to the California Advancing and Innovating Medi-Cal (CalAIM) trailer bill that California’s Governor administration and the Department of Health Care Services (DHCS) is working on, it is important to remember that it will be the general guidelines or framework and the legislature will enact legislation to implement the managed care related programs. L.A. Care has begun communicating the concerns about the program with legislative representatives as well. It has been announced that AB 1400, which proposes single payor for health care, has stopped moving forward because additional funding sources are being sought. L.A. Care will continue to watch legislation and engage with legislators in this area.
Member Gonzalez asked about the format of the legislative report in the meeting materials. Ms. Compartore offered to discuss individual legislation. Member Gonzalez asked about bills that are not included in this report. Ms. Compartore noted that only priority bills are listed on this report. A public comment had been received to include all bills, and Ms. Compartore will include all bills that are being monitored in future reports.
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AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Chairperson De La Torre noted that bills are submitted and are edited in committee to reflect a narrower focus on components that are more acceptable to other legislators, in order to garner votes to move forward through the legislative process.
Approve Revised Legal Augustavia J. Haydel, Esq., General Counsel, summarized the revisions to Legal Services Services Policy LS 007 Policy & Procedure No. LS-007 (Legal Hold of Records, Documents; Preservation of (Legal Hold of Records, Evidence) pertaining to notifying staff and others of a placement of legal hold on Documents; Preservation documents and preservation of records, which expand the definition of covered of Evidence) individuals, ensure consistent use of defined terms, and comply with format of new template.
Member Booth asked about current responsibilities of Board Members for preservation
of records. Ms. Haydel indicated that the responsibilities of Board Members remain
unchanged from the previous version. L.A. Care has retention guidelines. Member
Booth asked for a copy of those guidelines.
Motion EXE 100.0521 To approve the revisions to the attached Legal Services Policy & Procedure No. Approved unanimously by LS-007 (Legal Hold of Records, Documents; Preservation of Evidence) and roll call. 5 AYES delegate authority to General Counsel or designee to make any non-substantive or technical changes.
Approve Funding to M r. Baackes noted that when the Elevating the Safety Net program was created by the support Charles R. Drew Board of Governors; unassigned financial reserves were set aside to fund the program. A University of Medicine request was previously approved for funding to Claremont College Keck Graduate and Science Institute for a new Community Medicine Medical School. This additional request is also consistent with L.A. Care’s goal to expand access to medical services by building a pipeline of future safety net providers.
Cynthia Carmona, Senior Director, Safety Net Initiatives, summarized a motion requesting
approval to provide funding support for the development of a new independent medical
education program (IMEP) at the Charles R. Drew University of Medicine and Science
(CDU), College of Medicine. Since 1981 CDU has partnered with the University of
California, Los Angeles (UCLA) with support from the state legislature, to train 24-28
medical students per year.
There have been longstanding plans by CDU to have an independent medical education program, with support from UCLA. The new independent medical education program Executive Committee Meeting Minutes April 26, 2021 Page 5 of 10 APPROVED 213
AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN (IMEP) will admit 60 medical students annually starting in the summer of 2023. This program will complement, and not replace, the current CDU forty-year partnership with the University of California, Los Angeles (UCLA).
As of April 15, 2021, CDU has raised $11,975,00 towards the five-year, $75 million
comprehensive campaign, from institutions such as the Kaiser Foundation Hospitals and
the California Endowment. To further support the fund raising efforts, CDU has been
working with California legislature and Congress to seek appropriations or an earmark
for the IMEP as well as inclusion in a higher education bond measure; has hired a major
gift officer to secure major gifts to the university; and has planned meetings with several
foundations to confirm additional funding support.
CDU is seeking a one-time $5 million grant from L.A. Care to support the following key developments: Enhance the current Simulation Center to offer medical training activities for students and faculty; Establish a center for faculty development to focus on the recruitment, retention and development of faculty; Establish a service learning program for medical students to offer certifications as emergency medical technicians, community health workers and patient navigators; and
Develop a community health pre-matriculation training experience focused on
professionalism and wellness activities for medical students.
The IMEP builds on L.A. Care’s current funding support for CDU under our Elevating the Safety Net (ESN) initiative - Medical School Scholarship Program and Residency Support Program.
L.A. Care considers this program well-aligned with our ESN guiding principles of increasing health access, promoting equity and cultural competence, as well as building a premier health care workforce. L.A. Care’s ESN programs seek to increase access for our members in Los Angeles County and improve equity and cultural competence among our provider network.
Member Booth commented that this could be a great program, involving people who are really invested in the community and will be able to do a good job caring for them. She wants to be sure that it will help patients in Los Angeles County. She noted that hopes are high that the matriculating students will want to practice in Los Angeles County at Executive Committee Meeting Minutes April 26, 2021 Page 6 of 10 APPROVED 214
AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN the end of their residencies. But there is no commitment, and they may not want to remain in Los Angeles County. She also noted that this program will begin in 2023, and the benefit that may be seen for primary care doctors would not materialize until at least 2030, and for sub-specialty practice it could be 2034 or 2035. She asked about making recommendations to the school for requesting a commitment from students to remain in Los Angeles County, and for students to achieve Spanish language fluency.
Ms. Carmona responded that the request is not for scholarship funding, and she will
discuss the recommendations with CDU. Mr. Baackes stated that the recommendations
could be presented to CDU as highly desirable outcomes. He noted that in the three
years L.A. Care has worked with CDU, it seems CDU looks for students who are from
the area, as those students are more likely to remain. Dr. Seidman commented that as an
alumnus of CDU, he has remained in Los Angeles. CDU is committed to recruiting local
students and training them to be sensitive to the needs of the community surrounding
Martin Luther King Jr. Community Hospital. CDU recognizes the relatively low rate of
physicians for the local population and the need to train students that are likely to remain
in the area. The workforce is not sufficient to meet the needs of low-income parts of
Los Angeles County. CDU acknowledges that the number of students has remained at
24 to 28 since 1981. By starting up this program to train 60 more students per year,
significantly increasing the opportunity for students who are more likely to stay and serve
the underserved communities in Los Angeles County.
Member Gonzalez asked if there is support for students who may need additional services to ensure support for graduation. Mr. Baackes noted that the young adults entering the program will have already earned a Bachelor’s Degree, and with that accomplishment, they probably are not in need of much help. Dr. Seidman commented that CDU makes a very determined effort to support the students, while recognizing that these students have overcome many obstacles in being accepted to medical school. Students that may need support may be offered the opportunity to enroll in a transitional period, where additional support is available to enable them to successfully transition to medical school and to graduate. CDU also has an extensive network of funders to provide scholarships for the students. Ms. Carmona responded that as part of discussions with CDU, it was noted that in the first year of the program the workload for the new students is handled with sensitivity to avoid overload.
Member Perez asked about opening L.A. Care’s funding opportunity to students at other
universities. Mr. Baackes responded that research at the beginning of the program found
Executive Committee Meeting Minutes April 26, 2021 Page 7 of 10 APPROVED 215
AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN that these two schools produced students that aligned with L.A. Care’s goals. The request for funding of the Claremont College Keck Graduate Institute Community Medicine program, was because of the goal of that program to graduate doctors who would want to work in the safety net. L.A. Care has limited funds and participates in programs that have the most promise. Ms. Carmona added that L.A. Care staff has met with a number of institutions with regard to the scholarships and residency programs. Not all are the same in terms of the focus and commitment to the communities L.A. Care is seeking to support.
Member Perez stated that she understands that students may not accept a medical school
opportunity if there is a requirement to remain in the area after graduation. Mr. Baackes
acknowledged that L.A. Care funds the scholarships in good faith with students that
understand the stated goal for graduates to remain in the community. His conversations
with the students assures him that most, if not all, will serve Los Angeles County
residents after graduation.
Member Perez asked if other institutions that may have seen the benefit of these scholarships might be inclined to align with L.A. Care’s goals. Ms. Carmona indicated that no other institutions have reached out to her regarding the scholarships. There have been inquiries regarding residency support through Elevating the Safety Net, and it is sometimes clear that the program is not aligned.
Dr. Seidman indicated that it is understandable that other institutions may not need
additional funding for their students, and there may be a different focus for other
institutions in the ways their students are trained.
Member Booth suggested that additional information about the number of students that remain in Los Angeles County may help the Board in making these decisions.
Member Ballesteros commented that he has seen that students recruited from the
community do return to apply for positions in that community. The investment in those
students represents a benefit to the community whether or not they return.
Member Booth suggested that CDU be asked to provide data about the number of students that remain in Los Angeles County, to consider it highly desirable for graduates to (1) commit to remaining in Los Angeles County to practice medicine after graduation, and (2) achieve proficiency in a language (other than English) spoken in Los Angeles County.
Executive Committee Meeting Minutes April 26, 2021 Page 8 of 10 APPROVED 216
AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN The Board directed that Ms. Carmona discuss addressing the suggestions by the Board and report at the May 6 Board of Governors’ meeting.
Motion EXE 101.0521 Approved unanimously by Authorize an expenditure in the amount of $5 million for the Charles R. Drew roll call. 5 AYES University of Medicine and Science (CDU) to support the development of an independent medical education program (IMEP) in South Los Angeles for the period of July 1, 2021 through December 31, 2027,
AB 2589 – Annual Terry Brown, Chief Human Resources Officer, summarized the Annual Disclosure of Broker Disclosure of Broker Fees Fees report included in the meeting material to comply with the requirements of AB 2589 in reporting insurance broker fees associated with the various health and welfare benefits L.A. Care offers to its employees, identified below is the disclosure of the commission earned by Woodruff Sawyer, our broker of record for the majority of our various health and wellness insurers providing L.A. Care employee benefits for the last two fiscal years (2019-2020 and 2020-2021). Commission is paid to Woodruff Sawyer on a monthly or annual basis, and the amount is based on the number of participants in the benefit program. This disclosure also includes commissions paid to LTC Solutions, Inc., the writing agent for the Genworth policy. L.A. Care is paying 1.9%, and the median in Los Angeles County is 2.83%. L.A. Care also benefits from consulting services provided by the broker out of those fees.
Approve the Consent Approve the list of items that will be considered on a Consent Agenda for May 6, 2021 A pproved unanimously by Agenda for May 6, 2021 Board of Governors Meeting. roll call. 5 AYES Board of Governors Minutes of April 1, 2021 Board of Governors Meeting meeting Revisions to Legal Services Policy LS-007 (Legal Hold of Records, Documents;
Preservation of Evidence) Quarterly Investment Report Microsoft Agreement Renewal
PUBLIC COMMENTS T here were no public comments for the closed session items.
ADJOURN TO CLOSED Augustavia J. Haydel, Esq., General Counsel, announced the items to be discussed in closed ses sion. She announced there is SESSION no report anticipated from the closed session. The meeting adjourned to closed session at 3:32 p.m.
CONTRACT RATES Pursuant to Welfare and Institutions Code Section 14087.38(m) Executive Committee Meeting Minutes April 26, 2021 Page 9 of 10 APPROVED 217
AGENDA ITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN Plan Partner Rates Provider Rates DHCS Rates
REPORT INVOLVING TRADE SECRET Pursuant to Welfare and Institutions Code Section 14087.38(n) Discussion Concerning New Service, Program, Business Plan Estimated date of public disclosure: April 2023
CONFERENCE WITH LEGAL COUNSEL – ANTICIPATED LITIGATION Significant exposure to litigation pursuant to Section 54956.9(d) (2) of Ralph M. Brown Act Two Potential Cases
The following item was not discussed. CONFERENCE WITH LEGAL COUNSEL—ANTICIPATED LITIGATION Significant exposure to litigation pursuant to Section 54956.9(d)(2) of Ralph M. Brown Act: One Potential case
RECONVENE IN The meeting reconvened in open session at 3:49 p.m. No reportable actions were taken OPEN SESSION during the closed session.
ADJOURNMENT T he meeting adjourned at 3:50 p.m.
Respectfully submitted by: APPROVED BY: Linda Merkens, Senior Manager, Board Services Malou Balones, Board Specialist III, Board Services ______Victor Rodriguez, Board Specialist II, Board Services Hector De La Torre, Chair Date: ______5/24/2021 | 3:49 PM PDT
Executive Committee Meeting Minutes April 26, 2021 Page 10 of 10 APPROVED 218 Financial Update Board of Governors Meeting June 3, 2021
219 Agenda
Financial Performance – April 2021 YTD . Membership . Consolidated Financial Performance . Operating Margins by Segment . Reported vs. Paid Claims Trend . Key Financial Ratios . Tangible Net Equity & Days of Cash On-Hand Comparison Financial Informational Updates . Investment Transactions
220 2 Membership for the 7 months ended April 2021
221 3 Consolidated Financial Performance for the month of April 2021
222 4 Consolidated Financial Performance for the 7 months ended April 2021
223 5 Reported vs Paid Claims Trend Paid Claims through April 2021
224 6 Operating Margin by Segment for the 7 months ended April 2021
225 7 Key Financial Ratios for the 7 months ended April 2021
Actual Forecast MCR 92.7% vs. 95.2% Admin Ratio 4.8% vs. 5.2%
Working Capital 1.27 vs. 1.00+ Cash to Claims 0.56 vs. 0.75+ Tangible Net Equity 5.07 vs. 1.30+
226 8 Tangible Net Equity & Days of Cash On-Hand for the 7 months ended April 2021
227 9 Questions & Consideration
Motion FIN 101 . To accept the Financial Reports for the seven months ended April 30, 2021, as submitted.
228 10 Informational Items
Investment Transactions . As of April 30, 2021 L.A. Care’s total investment market value was $1.7B . $1.4B managed by Payden & Rygel and New England Asset Management (NEAM) . $73M in Local Agency Investment Fund . $252M in Los Angeles County Pooled Investment Fund
229 11
Board of Governors MOTION SUMMARY
Date: June 3, 2021 Motion No. FIN 101.0621
Committee: Finance & Budget Chairperson: Robert H. Curry
New Contract Amendment Sole Source RFP/RFQ was conducted
Issue: Acceptance of the Financial Reports for April 2021.
Background: N/A
Member Impact: N/A
Budget Impact: N/A
Motion: To accept the Financial Report for April 2021, as submitted.
230
Financial Performance April 2021 (Unaudited)
231 Financial Performance Results Highlights - Year-to-Date April 2021
Overall
The combined member months are 16.4 million year-to-date, which is 44,180 member months favorable to the 3+9 forecast. The performance is a surplus of $118.7 million or 2.2% of revenue and is $154.0 million favorable to the forecast. The favorable variance is due to better than forecasted inpatient claims, outpatient claims and skilled nursing facility costs. Due to the delay in the transition of pharmacy to DHCS, the YTD actual results include the pharmacy revenues, capitation expense for plan partners and pharmacy expense for the month of April which are not forecasted. Other items also contributed to the favorable variance in net surplus are a favorable update to LACC RAF score, the timing in provider incentives expense accrual and lower operating expenses, but slightly offset by the shared risk true-up for CY 2020.
MediCal Plan Partners
The member months are 7.2 million, which is 5,919 member months favorable to the 3+9 forecast. The performance is a surplus of $46.8 million and is $13.8 million favorable to the forecast. The favorability in net surplus is driven primarily by the timing in provider incentives expense accrual and lower operating and non-operating expenses. The favorable variance in revenue which is offset by an unfavorable variance in capitation expenses are driven by an adjustment in institutional member count and the inclusion of April's pharmacy actual results due to the delay in the transition to DHCS. The forecast assumes March 2021 termination date for pharmacy.
MediCal SPD-CCI
The member months are 1.6 million, which is 1,279 member months favorable to the 3+9 forecast. The performance is a deficit of $11.5 million and is $58.3 million favorable to the 3+9 forecast. The favorable variance is due to better than forecasted skilled nursing facility costs, inpatient claims and outpatient claims. Lower operating expenses also contributed to the favorable variance in net surplus. The majority of the favorable variance in revenue which is offset by an unfavorable variance in pharmacy expenses are due to the inclusion of April's pharmacy actual results caused by the delay in the transition to DHCS. The forecast assumes March 2021 termination date for pharmacy.
MediCal TANF-MCE
The member months are 6.6 million, which is 43,581 member months favorable to the 3+9 forecast. The performance is a surplus of $58.1 million and is $60.6 million favorable to the 3+9 forecast. The favorability is driven by better than forecasted inpatient and outpatient claims and the timing in provider incentives expense accrual. The majority of the favorable variance in revenue which is offset by an unfavorable variance in pharmacy expenses are due to the inclusion of April's pharmacy actual results caused by the delay in the transition to DHCS. The forecast assumes March 2021 termination date for pharmacy.
Cal MediConnect (CMC)
The member months are 129,537, which is 2,790 member months favorable to the 3+9 forecast. The performance is a surplus of $5.9 million and is $2.4 million unfavorable to the forecast. The unfavorability is driven by higher than forecasted pharmacy expenses, true-up of shared risk for CY 2020, and disenrollment penalty for CY 2019. Partially offsetting these unfavorable variances are the timing in provider incentives expense accrual and lower operating expenses.
Commercial L.A. Care Commercial consists of LACC and PASC-SEIU. The member months are 964,610, which is 9,389 member months unfavorable to the 3+9 forecast. The performance is a surplus of $40.2 million and is $23.0 million favorable to the forecast due to a favorable update to the LACC RAF score, lower than forecasted inpatient claims, outpatient claims, and pharmacy expenses. Partially offsetting these favorable variances are the true-up of shared risk for CY 2020 and higher operating expenses.
Page 2 of 10 232 Consolidated Operations Income Statement ($ in thousands) April 2021
Current Current Fav(Unfav) YTD YTD Fav(Unfav) Actual Budget Budget Actual Budget Budget $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM Membership Membership 2 ,399,082 2,381,950 1 7,132 Member MonthsMember Months 16,443,787 16,399,607 4 4,180
Revenue Revenue $ 7 74,848 $ 322.98 $ 679,827 $ 285.41 $ 95,021 $ 37.57 1. Capitation Capitation $ 5,292,844 $ 321.88 $ 5 ,148,246 $ 313.92 $ 144,598 $ 7.95 $ 774,848 $ 322.98 $ 6 79,827 $ 285.41 $ 95,021 $ 37.57 Total Revenues $ 5 ,292,844 $ 321.88 $ 5,148,246 $ 313.92 $ 144,598 $ 7.95
Healthcare EHxepealnsthceasre Expenses $ 4 00,298 $ 166.85 $ 3 68,828 $ 154.84 $ (31,470) $ ( 12.01) 1. Capitation Capitation $ 2,774,333 $ 168.72 $ 2,704,974 $ 164.94 $ (69,359) $ ( 3.77) $ 1 03,276 $ 43.05 $ 106,112 $ 44.55 $ 2,837 $ 1.50 3. Inpatient Clai m Isnpatient Claims $ 6 56,009 $ 39.89 $ 7 16,223 $ 43.67 $ 60,214 $ 3.78 $ 6 9,324 $ 28.90 $ 77,242 $ 32.43 $ 7,917 $ 3.53 4. Outpatient C la Oimutspatient Claims $ 4 96,472 $ 30.19 $ 516,594 $ 31.50 $ 20,122 $ 1.31 $ 60,942 $ 25.40 $ 73,641 $ 30.92 $ 12,700 $ 5.51 5. Skilled Nu r siSnkgil lFaed ciNlituyrsing Facility $ 4 75,079 $ 28.89 $ 5 04,855 $ 30.78 $ 29,776 $ 1.89 $ 59,377 $ 24.75 $ 9 ,168 $ 3.85 $ (50,209) $ ( 20.90) 6. Pharmacy Pharmacy $ 427,895 $ 26.02 $ 3 72,160 $ 22.69 $ (55,735) $ ( 3.33) $ 1,440 $ 0.60 $ 6 ,098 $ 2.56 $ 4,658 $ 1.96 6a. Pr o Prvidoevir dInecer Inncetiventives ansd a Snhda Sredha rRedisk Risk $ 28,589 $ 1.74 $ 40,190 $ 2.45 $ 11,601 $ 0.71 $ 5,598 $ 2.33 $ 6,374 $ 2.68 $ 776 $ 0.34 7. Medica Ml eAddicaminl istAdrmatiinveist Eraxtpiveen seExspenses $ 4 7,089 $ 2.86 $ 4 7,011 $ 2.87 $ (77) $ 0.00 $ 700,255 $ 291.88 $ 6 47,464 $ 271.82 $ (52,791) $ ( 20.06) Total Healthcare Expenses $ 4 ,905,465 $ 298.32 $ 4 ,902,007 $ 298.91 $ (3,458) $ 0.59 90.4% 95.2% 4.9% MCR(%) MCR(%) 92.7% 95.2% 2.5%
$ 7 4,593 $ 31.09 $ 3 2,363 $ 13.59 $ 42,230 $ 17.51 Operating MargiOpen rating Margin $ 3 87,379 $ 23.56 $ 246,239 $ 15.01 $ 141,140 $ 8.54
$ 37,949 $ 15.82 $ 3 6,835 $ 15.46 $ (1,114) $ (0.35) Total Operating Expenses $ 256,630 $ 15.61 $ 268,845 $ 16.39 $ 12,216 $ 0.79 4.9% 5.4% 0.5% Admin Ratio(%) Admin Ratio(%) 4.8% 5.2% 0.4%
$ 36,644 $ 15.27 $ (4,472) $ (1.88) $ 41,116 $ 17.15 IncomeInc (Loomess) (fLoromss) O fperomrat Oionpesrations $ 130,749 $ 7.95 $ (22,607) $ (1.38) $ 153,356 $ 9.33
$ (9,043) $ ( 3.77) $ (3,319) $ (1.39) $ (5,724) $ (2.38) Other Income/(Expense), net $ (14,466) $ (0.88) $ (18,459) $ (1.13) $ 3,993 $ 0.25 $ 873 $ 0.36 $ 884 $ 0.37 $ (11) $ ( 0.01) Interest Income, net $ 7,251 $ 0.44 $ 6,912 $ 0.42 $ 338 $ 0.02 $ (22) $ ( 0.01) $ - $ - $ (22) $ (0.01) Realized Gain / Loss $ 1 ,788 $ 0.11 $ 799 $ 0.05 $ 989 $ 0.06 $ 715 $ 0.30 $ - $ - $ 715 $ 0.30 Unrealized Gain / Loss $ (6,576) $ (0.40) $ (1,872) $ (0.11) $ (4,703) $ ( 0.29) $ (7,478) $ ( 3.12) $ (2,435) $ (1.02) $ (5,043) $ ( 2.09) Total Non-Operating Income (Expense) $ (12,003) $ ( 0.73) $ (12,619) $ (0.77) $ 616 $ 0.04
$ 2 9,167 $ 12.16 $ (6,907) $ (2.90) $ 36,074 $ 15.06 Net Surplus/(NDeetf icSurplusit) (Deficit) $ 118,746 $ 7.22 $ (35,226) $ (2.15) $ 153,972 $ 9.37 3.8% -1.0% 4.8% % Margin(%) 2.2% -0.7% 2.9%
Page 3 of 10 233 MediCal Plan Partners Income Statement ($ in thousands) April 2021
Current Current Fav(Unfav) YTD YTD Fav(Unfav) Actual Budget Budget Actual Budget Budget $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM Membership Membership 1,039,954 1,038,641 1,313 Member Months Member Months 7,171,112 7,165,193 5,919
Revenue Revenue $ 272,527 $ 262.06 $ 236,866 $ 228.05 $ 35,661 $ 34.00 1. Capitation Capitation $ 1,881,120 $ 262.32 $ 1,821,476 $ 254.21 $ 59,644 $ 8.11 $ 272,527 $ 262.06 $ 236,866 $ 228.05 $ 35,661 $ 34.00 Total Revenues $ 1,881,120 $ 262.32 $ 1,821,476 $ 254.21 $ 59,644 $ 8.11
Healthcare ExpHealthensescare Expenses $ 257,502 $ 247.61 $ 224,865 $ 216.50 $ (32,637) $ (31.11) 1. Capitation Capitation $ 1,782,618 $ 248.58 $ 1,724,415 $ 240.67 $ (58,203) $ (7.92) $ 43 $ 0.04 $ - $ - $ (43) $ (0.04) 3. Inpatient Claim sInpatient Claims $ 121 $ 0.02 $ 46 $ 0.01 $ (75) $ (0.01) $ 2 $ 0.00 $ - $ - $ (2) $ (0.00) 4. Outpatient Cl aim Outps atient Claims $ 5 $ 0.00 $ 1 $ 0.00 $ (4) $ (0.00) $ - $ - $ 2,461 $ 2.37 $ 2,461 $ 2.37 6a. Pr ovider Provider Incent Inciventes ivesand anSharedd Shared Risk Risk $ 7,056 $ 0.98 $ 16,843 $ 2.35 $ 9,787 $ 1.37 $ 911 $ 0.88 $ 1,063 $ 1.02 $ 152 $ 0.15 7. Medic al M Aedidmcalini strAdmatiivniestr Exatipenveses Expenses $ 7,707 $ 1.07 $ 7,444 $ 1.04 $ (263) $ (0.04) $ 258,458 $ 248.53 $ 228,389 $ 219.89 $ (30,068) $ (28.64) Total Healthcare Expenses $ 1,797,508 $ 250.66 $ 1,748,750 $ 244.06 $ (48,758) $ (6.60) 94.8% 96.4% 1.6% MCR(%) MCR(%) 95.6% 96.0% 0.5%
$ 14,069 $ 13.53 $ 8,477 $ 8.16 $ 5,593 $ 5.37 Operating MargOinperating Margin $ 83,612 $ 11.66 $ 72,727 $ 10.15 $ 10,886 $ 1.51
$ 6,265 $ 6.02 $ 5,856 $ 5.64 $ (409) $ (0.39) Total Operating Expenses $ 40,545 $ 5.65 $ 42,480 $ 5.93 $ 1,935 $ 0.27 2.3% 2.5% 0.2% Admin Ratio(%) Admin Ratio(%) 2.2% 2.3% 0.2%
$ 7,804 $ 7.50 $ 2,621 $ 2.52 $ 5,183 $ 4.98 IncomeIn (Lcooss)me f(rLoomss) Op freromat ionOpserations $ 43,067 $ 6.01 $ 30,246 $ 4.22 $ 12,821 $ 1.78
$ 1,390 $ 1.34 $ 752 $ 0.72 $ 638 $ 0.61 Total Non-Operating Income (Expense) $ 3,762 $ 0.52 $ 2,737 $ 0.38 $ 1,025 $ 0.14
$ 9,194 $ 8.84 $ 3,372 $ 3.25 $ 5,821 $ 5.59 Net Surplus/(DefNeticit) Surplus (Deficit) $ 46,829 $ 6.53 $ 32,984 $ 4.60 $ 13,846 $ 1.93 3.4% 1.4% 1.9% % Margin(%) 2.5% 1.8% 0.7%
Page 4 of 10 234 SPD-CCI Income Statement ($ in thousands) April 2021
Current Current Fav(Unfav) YTD YTD Fav(Unfav) Actual Budget Budget Actual Budget Budget $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM Membership Membership 230,240 231,890 (1,650) Member MonthsMember Months 1,604,386 1,603,107 1,279
Revenue Revenue $ 187,932 $ 816.24 $ 169,427 $ 730.64 $ 18,504 $ 85.61 1. Capitation Capitation $ 1,275,496 $ 795.01 $ 1,249,652 $ 779.52 $ 25,844 $ 15.49 $ 187,932 $ 816.24 $ 169,427 $ 730.64 $ 18,504 $ 85.61 Total Revenues $ 1,275,496 $ 795.01 $ 1,249,652 $ 779.52 $ 25,844 $ 15.49
Healthcare EHealthxpensescare Expenses $ 17,455 $ 75.81 $ 18,285 $ 78.85 $ 829 $ 3.04 1. Capitation Capitation $ 126,138 $ 78.62 $ 124,624 $ 77.74 $ (1,513) $ (0.88) $ 42,951 $ 186.55 $ 38,092 $ 164.27 $ (4,859) $ (22.28) 3. Inpatient Clai ms Inpatient Claims $ 267,344 $ 166.63 $ 271,281 $ 169.22 $ 3,937 $ 2.59 $ 41,243 $ 179.13 $ 40,833 $ 176.09 $ (410) $ (3.04) 4. Outpatient Cl aimOutps atient Claims $ 271,996 $ 169.53 $ 274,176 $ 171.03 $ 2,180 $ 1.50 $ 51,220 $ 222.46 $ 64,094 $ 276.40 $ 12,874 $ 53.94 5. Skilled Nur singSkilled Fac Nurilitysing Facility $ 404,495 $ 252.12 $ 438,803 $ 273.72 $ 34,308 $ 21.60 $ 17,058 $ 74.09 $ - $ - $ (17,058) $ (74.09) 6. Pharmacy Pharmacy $ 123,158 $ 76.76 $ 105,473 $ 65.79 $ (17,685) $ (10.97) $ (647) $ (2.81) $ (493) $ (2.12) $ 155 $ 0.69 6a. P rovi Prderovider Incent Incentivesiv anesd an Sdhared Shared Risk Risk $ (1,987) $ (1.24) $ (2,368) $ (1.48) $ (381) $ (0.24) $ 1,697 $ 7.37 $ 2,235 $ 9.64 $ 538 $ 2.27 7. Medi cal M ediAdmcalini Asdmtratiinivestrati Expenve Esesxpenses $ 14,816 $ 9.23 $ 15,673 $ 9.78 $ 857 $ 0.54 $ 170,977 $ 742.60 $ 163,046 $ 703.12 $ (7,931) $ (39.49) Total Healthcare Expenses $ 1,205,960 $ 751.66 $ 1,227,662 $ 765.80 $ 21,703 $ 14.14 91.0% 96.2% 5.3% MCR(%) MCR(%) 94.5% 98.2% 3.7%
$ 16,955 $ 73.64 $ 6,381 $ 27.52 $ 10,574 $ 46.12 Operating MarOginperating Margin $ 69,536 $ 43.34 $ 21,989 $ 13.72 $ 47,547 $ 29.62
$ 11,531 $ 50.08 $ 13,350 $ 57.57 $ 1,819 $ 7.49 Total Operating Expenses $ 82,889 $ 51.66 $ 92,974 $ 58.00 $ 10,085 $ 6.33 6.1% 7.9% 1.7% Admin Ratio(%) Admin Ratio(%) 6.5% 7.4% 0.9%
$ 5,424 $ 23.56 $ (6,969) $ (30.05) $ 12,393 $ 53.61 IncomeInco (Lomss)e (Lfrooss)m Op froermat Oiopners ations $ (13,353) $ (8.32) $ (70,985) $ (44.28) $ 57,632 $ 35.96
$ 587 $ 2.55 $ 260 $ 1.12 $ 327 $ 1.43 Total Non-Operating Income (Expense) $ 1,850 $ 1.15 $ 1,211 $ 0.76 $ 638 $ 0.40
$ 6,010 $ 26.11 $ (6,709) $ (28.93) $ 12,720 $ 55.04 Net Surplus/(NetDef icit)Surplus (Deficit) $ (11,503) $ (7.17) $ (69,773) $ (43.52) $ 58,270 $ 36.35 3.2% -4.0% 7.2% % Margin(%) -0.9% -5.6% 4.7%
Page 5 of 10 235 TANF-MCE Income Statement ($ in thousands) April 2021
Current Current Fav(Unfav) YTD YTD Fav(Unfav) Actual Budget Budget Actual Budget Budget $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM Membership Membership 964,823 946,944 17,879 Member Months Member Months 6,574,142 6,530,561 43,581
Revenue Revenue $ 239,771 $ 248.51 $ 199,730 $ 210.92 $ 40,041 $ 37.59 1. Capitation Capitation $ 1,622,593 $ 246.81 $ 1,574,695 $ 241.13 $ 47,898 $ 5.69 $ 239,771 $ 248.51 $ 199,730 $ 210.92 $ 40,041 $ 37.59 Total Revenues $ 1,622,593 $ 246.81 $ 1,574,695 $ 241.13 $ 47,898 $ 5.69
Healthcare EHealthxpensescare Expenses $ 95,829 $ 99.32 $ 94,183 $ 99.46 $ (1,646) $ 0.14 1. Capitation Capitation $ 658,000 $ 100.09 $ 644,218 $ 98.65 $ (13,782) $ (1.44) $ 44,897 $ 46.53 $ 53,836 $ 56.85 $ 8,940 $ 10.32 3. Inpatient Claim sInpatient Claims $ 309,681 $ 47.11 $ 358,570 $ 54.91 $ 48,889 $ 7.80 $ 21,948 $ 22.75 $ 29,902 $ 31.58 $ 7,954 $ 8.83 4. Outpatient Cl aim Outps atient Claims $ 180,434 $ 27.45 $ 195,417 $ 29.92 $ 14,983 $ 2.48 $ 8,266 $ 8.57 $ 8,455 $ 8.93 $ 189 $ 0.36 5. Skilled Nur sing Skill Fedac Nurilitysing Facility $ 56,903 $ 8.66 $ 56,196 $ 8.61 $ (708) $ (0.05) $ 33,635 $ 34.86 $ - $ - $ (33,635) $ (34.86) 6. Pharmacy Pharmacy $ 239,066 $ 36.36 $ 199,028 $ 30.48 $ (40,038) $ (5.89) $ 667 $ 0.69 $ 2,094 $ 2.21 $ 1,427 $ 1.52 6a. Pr ovider Provider Incent Inciventesi vesand an Sharedd Shared Risk Risk $ 8,928 $ 1.36 $ 13,403 $ 2.05 $ 4,475 $ 0.69 $ 2,642 $ 2.74 $ 2,693 $ 2.84 $ 51 $ 0.11 7. Medic alM Aedidmcalini Astrdmatiinivestrati Expenve sesExpenses $ 22,348 $ 3.40 $ 21,452 $ 3.28 $ (895) $ (0.11) $ 207,883 $ 215.46 $ 191,163 $ 201.87 $ (16,720) $ (13.59) Total Healthcare Expenses $ 1,475,360 $ 224.42 $ 1,488,284 $ 227.90 $ 12,924 $ 3.48 86.7% 95.7% 9.0% MCR(%) MCR(%) 90.9% 94.5% 3.6%
$ 31,888 $ 33.05 $ 8,567 $ 9.05 $ 23,321 $ 24.00 Operating MargOinperating Margin $ 147,232 $ 22.40 $ 86,411 $ 13.23 $ 60,822 $ 9.16
$ 14,328 $ 14.85 $ 12,016 $ 12.69 $ (2,312) $ (2.16) Total Operating Expenses $ 92,026 $ 14.00 $ 92,973 $ 14.24 $ 947 $ 0.24 6.0% 6.0% 0.0% Admin Ratio(%) Admin Ratio(%) 5.7% 5.9% 0.2%
$ 17,560 $ 18.20 $ (3,449) $ (3.64) $ 21,009 $ 21.84 IncomeInco (Loss)me f(rLoomss) Op freromat ioOpnserations $ 55,206 $ 8.40 $ (6,563) $ (1.00) $ 61,769 $ 9.40
$ 1,072 $ 1.11 $ 904 $ 0.95 $ 167 $ 0.16 Total Non-Operating Income (Expense) $ 2,898 $ 0.44 $ 4,033 $ 0.62 $ (1,135) $ (0.18)
$ 18,631 $ 19.31 $ (2,545) $ (2.69) $ 21,176 $ 22.00 Net Surplus/(DefNeticit) Surplus (Deficit) $ 58,104 $ 8.84 $ (2,530) $ (0.39) $ 60,634 $ 9.23 7.8% -1.3% 9.0% % Margin(%) 3.6% -0.2% 3.7%
Page 6 of 10 236 CMC Income Statement ($ in thousands) April 2021
Current Current Fav(Unfav) YTD YTD Fav(Unfav) Actual Budget Budget Actual Budget Budget $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM Membership Membership 18,546 18,001 545 Member MonthsMember Months 129,537 126,747 2,790
Revenue Revenue $ 24,998 $ 1,347.91 $ 25,435 $ 1,412.99 $ (437) $ (65.08) 1. Capitation Capitation $ 175,016 $ 1,351.09 $ 178,349 $ 1,407.12 $ (3,332) $ (56.03) $ 24,998 $ 1,347.91 $ 25,435 $ 1,412.99 $ (437) $ (65.08) Total Revenues $ 175,016 $ 1,351.09 $ 178,349 $ 1,407.12 $ (3,332) $ (56.03)
Healthcare EHxpeaenlthsecasre Expenses $ 10,442 $ 563.03 $ 10,817 $ 600.89 $ 375 $ 37.86 1. Capitation Capitation $ 75,638 $ 583.91 $ 76,853 $ 606.35 $ 1,215 $ 22.44 $ 7,783 $ 419.69 $ 6,189 $ 343.84 $ (1,594) $ (75.85) 3. Inpatient Clai m Isnpatient Claims $ 34,226 $ 264.22 $ 36,051 $ 284.43 $ 1,825 $ 20.21 $ 2,181 $ 117.61 $ 2,599 $ 144.39 $ 418 $ 26.78 4. Outpatient C lai Omutspatient Claims $ 17,220 $ 132.94 $ 18,537 $ 146.25 $ 1,317 $ 13.31 $ 1,370 $ 73.88 $ 1,092 $ 60.68 $ (278) $ (13.20) 5. Skilled Nur si Sngkil ledFaci Nluritysing Facility $ 12,985 $ 100.24 $ 9,683 $ 76.39 $ (3,302) $ (23.85) $ 1,497 $ 80.71 $ 1,173 $ 65.15 $ (324) $ (15.56) 6. Pharmacy Pharmacy $ 10,121 $ 78.13 $ 8,194 $ 64.65 $ (1,927) $ (13.49) $ 569 $ 30.66 $ 1,004 $ 55.75 $ 435 $ 25.09 6a. P r ov Prideovride Incer Incentivntesiv anesd an Shad Sredhared Risk Risk $ 6,113 $ 47.19 $ 5,460 $ 43.08 $ (653) $ (4.11) $ 239 $ 12.89 $ 276 $ 15.31 $ 37 $ 2.42 7. Med i cal M edAdmicalini Astdmratiniivest rEatxpeivense Expes nses $ 1,546 $ 11.94 $ 1,738 $ 13.72 $ 192 $ 1.78 $ 24,081 $ 1,298.47 $ 23,150 $ 1,286.01 $ (932) $ (12.45) Total Healthcare Expenses $ 157,850 $ 1,218.57 $ 156,516 $ 1,234.87 $ (1,334) $ 16.30 96.3% 91.0% -5.3% MCR(%) MCR(%) 90.2% 87.8% -2.4%
$ 917 $ 49.44 $ 2,286 $ 126.98 $ (1,369) $ (77.54) Operating MargiOpnerating Margin $ 17,166 $ 132.52 $ 21,832 $ 172.25 $ (4,666) $ (39.73)
$ 1,631 $ 87.93 $ 1,904 $ 105.79 $ 274 $ 17.86 Total Operating Expenses $ 11,264 $ 86.96 $ 13,436 $ 106.01 $ 2,172 $ 19.05 6.5% 7.5% 1.0% Admin Ratio(%) Admin Ratio(%) 6.4% 7.5% 1.1%
$ (714) $ (38.48) $ 381 $ 21.19 $ (1,095) $ (59.67) IncomeIn (coLomsse) (fLrossm )O fproeratm Oiopnerats ions $ 5,901 $ 45.56 $ 8,396 $ 66.24 $ (2,495) $ (20.68)
$ 21 $ 1.12 $ 3 $ 0.15 $ 18 $ 0.98 Total Non-Operating Income (Expense) $ 46 $ 0.36 $ (6) $ (0.05) $ 52 $ 0.41
$ (693) $ (37.36) $ 384 $ 21.34 $ (1,077) $ (58.70) Net Surplus/(NDetef iSciutr)plus (Deficit) $ 5,948 $ 45.92 $ 8,390 $ 66.19 $ (2,442) $ (20.28) -2.8% 1.5% -4.3% % Margin(%) 3.4% 4.7% -1.3%
Page 7 of 10 237 Commercial Income Statement ($ in thousands) April 2021
Current Current Fav(Unfav) YTD YTD Fav(Unfav) Actual Budget Budget Actual Budget Budget $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM Membership Membership 145,519 146,474 (955) Member Months Member Months 964,610 973,999 ( 9,389)
Revenue Revenue $ 49,620 $ 340.99 $ 48,368 $ 330.22 $ 1,252 $ 10.77 1. Capitation Capitation $ 338,619 $ 351.04 $ 324,074 $ 332.73 $ 14,545 $ 18.32 $ 49,620 $ 340.99 $ 48,368 $ 330.22 $ 1,252 $ 10.77 Total Revenues $ 338,619 $ 351.04 $ 324,074 $ 332.73 $ 14,545 $ 18.32
Healthcare ExpHealthensescare Expenses $ 19,070 $ 131.05 $ 20,679 $ 141.18 $ 1,609 $ 10.13 1. Capitation Capitation $ 131,940 $ 136.78 $ 134,864 $ 138.46 $ 2,924 $ 1.68 $ 7,601 $ 52.24 $ 7,995 $ 54.58 $ 393 $ 2.34 3. Inpatient Claim sInpatient Claims $ 44,636 $ 46.27 $ 50,275 $ 51.62 $ 5,639 $ 5.34 $ 3,951 $ 27.15 $ 3,907 $ 26.68 $ (43) $ (0.47) 4. Outpatient Cl aim Outps atient Claims $ 26,816 $ 27.80 $ 28,461 $ 29.22 $ 1,646 $ 1.42 $ 85 $ 0.59 $ - $ - $ (85) $ (0.59) 5. Skilled Nur sing Skill Fedac Nurilitysing Facility $ 696 $ 0.72 $ 175 $ 0.18 $ (521) $ (0.54) $ 7,186 $ 49.39 $ 7,995 $ 54.59 $ 809 $ 5.20 6. Pharmacy Pharmacy $ 55,550 $ 57.59 $ 59,465 $ 61.05 $ 3,916 $ 3.46 $ 852 $ 5.86 $ 1,032 $ 7.05 $ 180 $ 1.19 6a. Pr ovi Pderrovider Incent Inciventesi vesand anSharedd Shared Risk Risk $ 8,478 $ 8.79 $ 6,851 $ 7.03 $ (1,627) $ (1.76) $ 109 $ 0.75 $ 107 $ 0.73 $ (2) $ (0.02) 7. Medic al M Aedidmcalini Astrdmatiivniestrati Expenve sesExpenses $ 672 $ 0.70 $ 703 $ 0.72 $ 32 $ 0.03 $ 38,856 $ 267.01 $ 41,716 $ 284.80 $ 2,860 $ 17.79 Total Healthcare Expenses $ 268,787 $ 278.65 $ 280,795 $ 288.29 $ 12,008 $ 9.64 78.3% 86.2% 7.9% MCR(%) MCR(%) 79.4% 86.6% 7.3%
$ 10,764 $ 73.97 $ 6,652 $ 45.42 $ 4,112 $ 28.55 Operating MargOinperating Margin $ 69,832 $ 72.39 $ 43,280 $ 44.44 $ 26,552 $ 27.96
$ 4,020 $ 27.63 $ 3,505 $ 23.93 $ (515) $ (3.70) Total Operating Expenses $ 29,146 $ 30.22 $ 25,505 $ 26.19 $ (3,641) $ (4.03) 8.1% 7.2% -0.9% Admin Ratio(%) Admin Ratio(%) 8.6% 7.9% -0.7%
$ 6,744 $ 46.35 $ 3,148 $ 21.49 $ 3,597 $ 24.86 IncomeIn (Lcooss)me f(rLoomss) Op freromat ionOpers ations $ 40,686 $ 42.18 $ 17,775 $ 18.25 $ 22,911 $ 23.93
$ (63) $ (0.43) $ (71) $ (0.49) $ 8 $ 0.05 Total Non-Operating Income (Expense) $ (442) $ (0.46) $ (495) $ (0.51) $ 54 $ 0.05
$ 6,681 $ 45.91 $ 3,076 $ 21.00 $ 3,605 $ 24.91 Net Surplus/(DefNeticit) Surplus (Deficit) $ 40,244 $ 41.72 $ 17,279 $ 17.74 $ 22,965 $ 23.98 13.5% 6.4% 7.1% % Margin(%) 11.9% 5.3% 6.6%
Page 8 of 10 238 Comparative Balance Sheet April 2021
(Dollars in thousands) May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21
ASSETS
CURRENT ASSETS Total Current Assets $4,217,117 $4,184,322 $4,252,870 $4,203,693 $4,998,308 $4,241,836 $4,207,217 $4,181,392 $4,809,535 $4,330,863 $5,190,573 $4,329,113 Capitalized Assets - net $110,885 $110,438 $110,474 $110,650 $106,386 $106,066 $106,179 $105,925 $106,571 $106,748 $106,854 $106,981 NONCURRENT ASSETS $24,974 $24,868 $25,273 $3,533 $4,542 $4,385 $4,249 $4,114 $3,978 $3,843 $3,707 $3,572 TOTAL ASSETS $4,352,976 $4,319,628 $4,388,617 $4,317,877 $5,109,236 $4,352,287 $4,317,645 $4,291,430 $4,920,085 $4,441,454 $5,301,134 $4,439,665
LIABILITIES AND FUND EQUITY
CURRENT LIABILITIES Total Current Liability $3,198,738 $3,281,130 $3,354,605 $3,247,809 $4,189,202 $3,441,433 $3,412,807 $3,385,813 $3,982,202 $3,453,802 $4,291,997 $3,401,470 Long Term Liability $3,012 $2,943 $2,800 $2,770 $3,474 $3,385 $3,441 $3,296 $3,177 $3,078 $2,998 $2,890 Total Liabilities $3,201,750 $3,284,074 $3,357,405 $3,250,579 $4,192,676 $3,444,817 $3,416,248 $3,389,109 $3,985,380 $3,456,879 $4,294,995 $3,404,360
FUND EQUITY Invested in Capital Assets, net of related debt $110,885 $110,438 $110,474 $110,650 $106,386 $106,066 $106,179 $105,925 $106,571 $106,748 $106,854 $106,981 Restricted Equity $300 $300 $300 $300 $300 $300 $300 $300 $300 $300 $300 $300 Minimum Tangible Net Equity $180,036 $186,410 $188,522 $189,555 $192,597 $193,021 $194,442 $196,418 $198,522 $198,522 $201,033 $204,021 Board Designated Funds $96,729 $84,460 $79,351 $76,347 $74,752 $72,431 $99,641 $96,946 $95,648 $94,811 $117,246 $107,345 Unrestricted Net Assets $763,276 $653,947 $652,565 $690,446 $542,525 $535,652 $500,835 $502,733 $533,663 $584,193 $580,706 $616,659 Total Fund Equity $1,151,226 $1,035,554 $1,031,211 $1,067,298 $916,560 $907,470 $901,397 $902,321 $934,705 $984,575 $1,006,139 $1,035,306
TOTAL LIABILITIES AND FUND EQUITY $4,352,976 $4,319,628 $4,388,617 $4,317,877 $5,109,236 $4,352,287 $4,317,645 $4,291,430 $4,920,085 $4,441,454 $5,301,134 $4,439,665
Solvency Ratios Working Capital Ratio 1.32 1.28 1.27 1.29 1.19 1.23 1.23 1.23 1.21 1.25 1.21 1.27 Cash to Claims Ratio 0.57 0.58 0.58 0.57 0.82 0.55 0.52 0.51 0.72 0.53 0.83 0.56 Tangible Net Equity Ratio 6.39 5.56 5.47 5.63 4.76 4.70 4.64 4.59 4.71 4.96 5.00 5.07
Page 9 of 10 239 Cash Flows Statement ($ in thousands) April 2021
Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21 YTD #N/A #N/A #N/A #N/A #N/A #N/A #N/A
Cash Flows from Operating Activities: Capitation Revenue $ 733,660 $ 660,475 $ 725,317 $ 820,712 $ 672,640 $ 870,447 $ 819,682 $ 5,302,933 Other Income (Expense), net $ 8,578 $ 229 $ (1,303) $ 84 $ (134) $ (1,043) $ (1 4,237) $ (7,826) Healthcare Expenses $ (653,134) $ (666,833) $ (692,179) $ (669,618) $ (6 57,134) $ (719,999) $ (765,164) $ (4,824,061) Operating Expenses $ (40,394) $ (31,516) $ (46,394) $ (30,344) $ (32,090) $ (29,565) $ (3 8,339) $ (248,642) Net Cash Provided By Operating Activities $ 48,710 $ (37,645) $ (14,559) $ 120,834 $ (1 6,718) $ 119,840 $ 1,942 $ 222,404
Cash Flows from Investing Activities Purchase of investments - Net $ (39,775) $ 183,866 $ (32,271) $ 25,040 $ 38,635 $ 373,890 $ (401,184) $ 148,201 Purchase of Capital Assets $ (2,115) $ (2,545) $ (2,268) $ (3,109) $ (2,716) $ (2,761) $ (2 ,929) $ (18,443) Net Cash Provided By Investing Activities $ (41,890) $ 181,321 $ (34,539) $ 21,931 $ 35,919 $ 371,129 $ (4 04,113) $ 129,758
Cash Flows from Financing Activities: Gross Premium Tax (MCO Sales Tax) - Net $ (21) $ (16,034) $ (26,731) $ 24,849 $ 13,253 $ 15,394 $ (2 3,854) $ (13,144) Pass through transactions (AB 85, IGT, etc.) $ (850,679) $ 8,822 $ 8,765 $ 551,296 $ (5 68,538) $ 463,260 $ (5 06,673) $ (893,747) Net Cash Provided By Financing Activities $ (850,700) $ (7,212) $ (17,966) $ 576,145 $ (5 55,285) $ 478,654 $ (5 30,527) $ (906,891)
Net Increase in Cash and Cash Equivalents $ (843,880) $ 136,464 $ (67,064) $ 718,910 $ (536,084) $ 969,623 $ (9 32,698) $ (554,729)
Cash and Cash Equivalents, Beginning $ 1,144,914 $ 301,034 $ 437,498 $ 370,434 $ 1,089,344 $ 553,260 $ 1,522,883 $ 1,144,914 Cash and Cash Equivalents, Ending $ 301,034 $ 437,498 $ 370,434 $ 1,089,344 $ 553,260 $ 1,522,883 $ 590,185 $ 590,185
Reconciliation of Income from Operations to Net Cash Provided By (Used In) Operating Activities:
Excess of Revenues over Expenses $ (9,090) $ (6,073) $ 924 $ 32,384 $ 49,869 $ 21,565 $ 29,167 $ 118,746
Adjustments to Excess of Revenues Over Expenses: Depreciation $ 2,435 $ 2,432 $ 2,522 $ 2,463 $ 2,539 $ 2,655 $ 2,803 $ 17,849 Realized and Unrealized (Gain)/Loss on Investments $ 1,031 $ 11 $ 31 $ 569 $ 2,188 $ 1,650 $ (6 92) $ 4,788 Deferred Rent $ (90) $ 56 $ (145) $ (119) $ (99) $ (79) $ (108) $ (584) Gross Premium Tax provision $ 501 $ 368 $ 328 $ (1,232) $ (2,842) $ (1,334) $ (1 ,440) $ (5,651) Total Adjustments to Excess of Revenues over Expenses $ 3,877 $ 2,867 $ 2,736 $ 1,681 $ 1,786 $ 2,892 $ 563 $ 16,402
Changes in Operating Assets and Liabilities: Capitation Receivable $ (21,495) $ (43,146) $ (5,090) $ 55,489 $ (77,042) $ 87,038 $ (1 2,268) $ (16,514) Interest and Non-Operating Receivables $ 75 $ 1,244 $ (329) $ 96 $ 20 $ 255 $ 148 $ 1,509 Prepaid and Other Current Assets $ (2,504) $ 5,666 $ (1,815) $ 213 $ (2 0,181) $ (4,217) $ (7 ,096) $ (29,934) Accounts Payable and Accrued Liabilities $ (4,181) $ 519 $ (8,306) $ 1,923 $ (2,432) $ 4,351 $ (3 ,554) $ (11,680) Subcapitation Payable $ 25,915 $ 28,318 $ (533) $ (5,044) $ 55,745 $ 16,701 $ (5 3,397) $ 67,705 MediCal Adult Expansion Payable $ (824) $ 771 $ (41) $ 4,583 $ (15) $ 2 $ (3 2) $ 4,444 Deferred Capitation Revenue $ 26,137 $ (27,093) $ (188) $ 1,873 $ (3 2,459) $ 1,231 $ 57,102 $ 26,603 Accrued Medical Expenses $ (4,760) $ (233) $ 1,166 $ 82 $ (1 ,621) $ 16,562 $ 3,836 $ 15,032 Reserve for Claims $ 30,835 $ 11,611 $ 4,913 $ 25,601 $ 12,534 $ (32,359) $ (7 ,755) $ 45,380 Reserve for Provider Incentives $ 3,990 $ (11,696) $ (8,819) $ 1,608 $ (2,984) $ (918) $ 4 $ (18,815) Grants Payable $ 735 $ (400) $ 823 $ 345 $ 62 $ 6,737 $ (4,776) $ 3,526 Net Changes in Operating Assets and Liabilities $ 53,923 $ (34,439) $ (18,219) $ 86,769 $ (6 8,373) $ 95,383 $ (2 7,788) $ 87,256
Net Cash Provided By Operating Activities $ 48,710 $ (37,645) $ (14,559) $ 120,834 $ (1 6,718) $ 119,840 $ 1,942 $ 222,404
Page 10 of 10 240
DATE: May 24, 2021 TO: Finance & Budget Committee FROM: Marie Montgomery, Chief Financial Officer
SUBJECT: Monthly Investment Portfolio Securities Transaction Report for April 2021
To keep the Committee apprised of L.A. Care’s investment portfolios and to comply with California Government Code Section 53607, attached are the monthly investment transaction details from April 1 to April 30, 2021.
L.A. Care's investment market value as of April 30, 2021, was $1.7 billion. This includes our funds invested with the government pooled funds. L.A. Care has approximately $73 million invested with the statewide Local Agency Investment Fund (LAIF), and approximately $252 million invested with the Los Angeles County Pooled Investment Fund (LACPIF).
The remainder as of April 30, 2021, of $1.4 billion is managed by two independent asset managers, 1) Payden & Rygel and 2) New England Asset Management (NEAM) and is divided into three portfolios based on investment style,
1. Payden & Rygel - Short-term portfolio 2. Payden & Rygel - Extended term portfolio 3. New England Asset Management - Corporate notes extended term portfolio
The transactions within these three portfolios are included in the attached reports.
LA Care, as a California government entity, only makes investments in bonds/fixed income, as per the California Government Code. The entries on the Investment Securities Portfolio Transaction Report reflect transactions undertaken by financial management companies on L.A. Care’s behalf. L.A. Care does not direct these individual transactions. The firms, managing investments on behalf of L.A. Care, conduct the transactions based on L.A. Care’s investment guidelines.
241 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/05/21 04/05/21 Buy 10,000,000.000 U.S. TREASURY BILL (9,999,958.33) 0.00 0.00 (9,999,958.33) MAT 04/15/21 Cpn 9127964Y2 04/07/21 04/08/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,951.39) 0.00 0.00 (49,999,951.39) MAT 04/15/21 Cpn 9127964Y2 04/07/21 04/08/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,951.39) 0.00 0.00 (49,999,951.39) MAT 04/15/21 Cpn 9127964Y2 04/07/21 04/08/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,951.39) 0.00 0.00 (49,999,951.39) MAT 04/15/21 Cpn 9127964Y2 04/07/21 04/08/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,951.39) 0.00 0.00 (49,999,951.39) MAT 04/15/21 Cpn 9127964Y2 04/07/21 04/08/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,951.39) 0.00 0.00 (49,999,951.39) MAT 04/15/21 Cpn 9127964Y2 04/07/21 04/08/21 Buy 26,000,000.000 U.S. TREASURY BILL (25,999,620.83) 0.00 0.00 (25,999,620.83) MAT 05/20/21 Cpn 9127962Y4 04/06/21 04/08/21 Buy 3,164,148.640 CARMAX 2019-2 A3 CAR (3,220,757.23) (5,417.73) 0.00 0.00 (3,226,174.96) MAT 03/15/24 Cpn 2.68 14316LAC7 04/07/21 04/08/21 Buy 30,000,000.000 FHLB DISCOUNT NOTE (29,994,720.83) 0.00 0.00 (29,994,720.83) MAT 10/06/21 Cpn 313385MQ6 04/06/21 04/08/21 Buy 1,184,000.000 FORD 2018-3 A1 FLOOR (1,203,795.00) (2,662.68) 0.00 0.00 (1,206,457.68) MAT 10/15/23 Cpn 3.52 34528QGH1 04/06/21 04/08/21 Buy 2,584,000.000 FORD 2018-3 A1 FLOOR (2,627,504.06) (5,811.13) 0.00 0.00 (2,633,315.19) MAT 10/15/23 Cpn 3.52 34528QGH1 04/08/21 04/09/21 Buy 7,000,000.000 U.S. TREASURY BILL (6,999,986.10) 0.00 0.00 (6,999,986.10) MAT 04/22/21 Cpn 9127962Q1 04/07/21 04/09/21 Buy 2,146,392.750 CARMAX 2019-1 A3 CAR (2,185,631.49) (4,364.33) 0.00 0.00 (2,189,995.82) MAT 03/15/24 Cpn 3.05 14315NAC4
Payden & Rygel
242 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/07/21 04/09/21 Buy 2,450,000.000 VERIZON 2019-B 1A1 PHONE (2,486,462.89) (3,012.82) 0.00 0.00 (2,489,475.71) MAT 12/20/23 Cpn 2.33 92349GAA9 04/12/21 04/13/21 Buy 10,000,000.000 U.S. TREASURY BILL (9,999,980.56) 0.00 0.00 (9,999,980.56) MAT 04/27/21 Cpn 912796F20 04/12/21 04/13/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,902.78) 0.00 0.00 (49,999,902.78) MAT 04/27/21 Cpn 912796F20 04/12/21 04/13/21 Buy 45,000,000.000 U.S. TREASURY BILL (44,999,850.00) 0.00 0.00 (44,999,850.00) MAT 04/29/21 Cpn 9127964Z9 04/12/21 04/13/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,833.33) 0.00 0.00 (49,999,833.33) MAT 04/29/21 Cpn 9127964Z9 04/12/21 04/13/21 Buy 10,000,000.000 U.S. TREASURY BILL (9,999,983.75) 0.00 0.00 (9,999,983.75) MAT 04/22/21 Cpn 9127962Q1 04/12/21 04/13/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,918.75) 0.00 0.00 (49,999,918.75) MAT 04/22/21 Cpn 9127962Q1 04/12/21 04/13/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,918.75) 0.00 0.00 (49,999,918.75) MAT 04/22/21 Cpn 9127962Q1 04/12/21 04/13/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,918.75) 0.00 0.00 (49,999,918.75) MAT 04/22/21 Cpn 9127962Q1 04/12/21 04/13/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,918.75) 0.00 0.00 (49,999,918.75) MAT 04/22/21 Cpn 9127962Q1 04/12/21 04/13/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,918.75) 0.00 0.00 (49,999,918.75) MAT 04/22/21 Cpn 9127962Q1 04/12/21 04/13/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,918.75) 0.00 0.00 (49,999,918.75) MAT 04/22/21 Cpn 9127962Q1 04/06/21 04/14/21 Buy 5,000,000.000 GMCAR 2021-A A2 CAR (4,999,732.00) 0.00 0.00 (4,999,732.00) MAT 06/17/24 Cpn 0.27 380149AB0
Payden & Rygel
243 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/14/21 04/15/21 Buy 10,000,000.000 U.S TREASURY BILL (9,999,927.78) 0.00 0.00 (9,999,927.78) MAT 05/25/21 Cpn 912796G29 04/14/21 04/15/21 Buy 50,000,000.000 U.S TREASURY BILL (49,999,638.89) 0.00 0.00 (49,999,638.89) MAT 05/25/21 Cpn 912796G29 04/14/21 04/15/21 Buy 15,000,000.000 U.S. TREASURY BILL (14,999,965.00) 0.00 0.00 (14,999,965.00) MAT 04/29/21 Cpn 9127964Z9 04/14/21 04/15/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,883.33) 0.00 0.00 (49,999,883.33) MAT 04/29/21 Cpn 9127964Z9 04/14/21 04/15/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,883.33) 0.00 0.00 (49,999,883.33) MAT 04/29/21 Cpn 9127964Z9 04/14/21 04/15/21 Buy 30,000,000.000 U.S. TREASURY BILL (29,999,615.00) 0.00 0.00 (29,999,615.00) MAT 05/27/21 Cpn 912796A33 04/14/21 04/15/21 Buy 5,000,000.000 BANK OF NOVA SCOTIA YCD (4,999,999.96) (27.78) 0.00 0.00 (5,000,027.74) MAT 01/07/22 Cpn 0.20 06417MNR2 04/19/21 04/20/21 Buy 3,500,000.000 ROYAL BANK OF CANADA YCD FR (3,502,516.50) (1,028.58) 0.00 0.00 (3,503,545.08) MAT 12/15/21 Cpn 0.29 78012UZG3 04/20/21 04/28/21 Buy 2,150,000.000 HYUNDAI 2021-A A2 CAR (2,149,785.00) 0.00 0.00 (2,149,785.00) MAT 02/15/24 Cpn 0.23 44933LAB9 04/28/21 04/29/21 Buy 23,000,000.000 U.S. TREASURY BILL (22,999,995.21) 0.00 0.00 (22,999,995.21) MAT 05/04/21 Cpn 912796F79 04/27/21 04/29/21 Buy 615,000.000 VERIZON 2019-B 1A1 PHONE (623,432.23) (358.24) 0.00 0.00 (623,790.47) MAT 12/20/23 Cpn 2.33 92349GAA9 04/27/21 04/29/21 Buy 5,000,000.000 VERIZON 2019-C A1A PHONE (5,082,031.25) (2,425.00) 0.00 0.00 (5,084,456.25) MAT 04/22/24 Cpn 1.94 92348AAA3
Payden & Rygel
244 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount
Fixed Income - cont. 04/27/21 05/07/21 Buy 3,350,000.000 FHMS Q015 A 1MOFRN CMBS (3,350,000.00) 0.00 0.00 (3,350,000.00) MAT 08/25/24 Cpn 3137FYUR5 1,052,143,541.390 (1,052,423,662.11) (25,108.29) 0.00 0.00 (1,052,448,770.40)
04/01/21 04/01/21 Coupon CA BAY AREA WTR SPLY & CONSV 48,038.25 0.00 0.00 48,038.25 MAT 10/01/21 Cpn 2.54 072031AH0 04/05/21 04/05/21 Coupon FFCB 1ML+13 FRN 2,387.60 0.00 0.00 2,387.60 MAT 11/05/21 Cpn 0.24 3133EK5T9 04/12/21 04/12/21 Coupon SUMITOMO MITSUI BANK YCD FRN 4,532.85 0.00 0.00 4,532.85 MAT 10/12/21 Cpn 0.57 86565B4S7 04/15/21 04/15/21 Coupon CARMAX 2019-1 A3 CAR 5,455.41 0.00 0.00 5,455.41 MAT 03/15/24 Cpn 3.05 14315NAC4 04/15/21 04/15/21 Coupon CARMAX 2019-2 A3 CAR 7,066.60 0.00 0.00 7,066.60 MAT 03/15/24 Cpn 2.68 14316LAC7 04/15/21 04/15/21 Coupon FORD 2018-3 A1 FLOOR 3,473.07 0.00 0.00 3,473.07 MAT 10/15/23 Cpn 3.52 34528QGH1 04/15/21 04/15/21 Coupon FORD 2018-3 A1 FLOOR 7,579.73 0.00 0.00 7,579.73 MAT 10/15/23 Cpn 3.52 34528QGH1 04/15/21 04/15/21 Coupon HONDA 2019-3 A2 CAR 1,130.44 0.00 0.00 1,130.44 MAT 04/15/22 Cpn 1.90 43815NAB0 04/15/21 04/15/21 Coupon HONDA 2020-2 A2 CAR 2,775.73 0.00 0.00 2,775.73 MAT 11/15/22 Cpn 0.74 43813DAB4 04/15/21 04/15/21 Coupon HARLEY 2020-A A-2A CYCLE 3,161.46 0.00 0.00 3,161.46 MAT 01/17/23 Cpn 1.83 41284UAB0
Payden & Rygel
245 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/15/21 04/15/21 Coupon INTER-AMERICAN DEVELOPMENT 6,634.38 0.00 0.00 6,634.38 MAT 01/15/22 Cpn 0.18 45818WBA3 04/15/21 04/15/21 Coupon JOHN DEERE 2020-B A2 EQP 852.63 0.00 0.00 852.63 MAT 03/15/23 Cpn 0.41 47787NAB5 04/15/21 04/15/21 Coupon JOHN DEERE 2020-B A2 EQP 1,961.57 0.00 0.00 1,961.57 MAT 03/15/23 Cpn 0.41 47787NAB5 04/15/21 04/15/21 Coupon MERCEDES 2019-B A2 LEASE 419.72 0.00 0.00 419.72 MAT 12/15/21 Cpn 2.01 58769QAB7 04/15/21 04/15/21 Coupon MERCEDES 2020-A A2 CAR LEASE 2,045.04 0.00 0.00 2,045.04 MAT 03/15/22 Cpn 1.82 58770FAB8 04/15/21 04/15/21 Coupon MERCEDES 2020-A A2 CAR LEASE 6,827.27 0.00 0.00 6,827.27 MAT 03/15/22 Cpn 1.82 58770FAB8 04/15/21 04/15/21 Coupon MERCEDES 2020-B A2 LEASE 1,812.80 0.00 0.00 1,812.80 MAT 02/15/23 Cpn 0.31 58769EAB4 04/15/21 04/15/21 Coupon MERCEDES 2019-1 A2A CAR 595.81 0.00 0.00 595.81 MAT 06/15/22 Cpn 2.04 58769TAB1 04/15/21 04/15/21 Coupon MERCEDES 2019-1 A2A CAR 1,629.18 0.00 0.00 1,629.18 MAT 06/15/22 Cpn 2.04 58769TAB1 04/15/21 04/15/21 Coupon MERCEDES 2020-1 A2 CAR 1,218.31 0.00 0.00 1,218.31 MAT 03/15/23 Cpn 0.46 58769VAB6 04/15/21 04/15/21 Coupon NISSAN 2020-A A2A LEASE 2,586.13 0.00 0.00 2,586.13 MAT 05/16/22 Cpn 1.80 65479NAB0 04/15/21 04/15/21 Coupon TOYOTA 2018-A A3 CAR 829.64 0.00 0.00 829.64 MAT 05/16/22 Cpn 2.35 89238BAD4 04/15/21 04/15/21 Coupon TOYOTA 2019-A A3 CAR 13,557.06 0.00 0.00 13,557.06 MAT 07/17/23 Cpn 2.91 89239AAD5
Payden & Rygel
246 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/15/21 04/15/21 Coupon TOYOTA 2019-C A2A CAR 455.20 0.00 0.00 455.20 MAT 04/15/22 Cpn 2.00 89238UAB6 04/15/21 04/15/21 Coupon TOYOTA 2019-C A3 CAR 6,984.23 0.00 0.00 6,984.23 MAT 09/15/23 Cpn 1.91 89238UAD2 04/15/21 04/15/21 Coupon TOYOTA 2019-C A3 CAR 700.33 0.00 0.00 700.33 MAT 09/15/23 Cpn 1.91 89238UAD2 04/15/21 04/15/21 Coupon TOYOTA 2019-D A2 CAR 2,237.60 0.00 0.00 2,237.60 MAT 07/15/22 Cpn 1.92 89233MAB9 04/15/21 04/15/21 Coupon TOYOTA 2019-D A2 CAR 817.21 0.00 0.00 817.21 MAT 07/15/22 Cpn 1.92 89233MAB9 04/15/21 04/15/21 Coupon TOYOTA 2020-C A2 CAR 1,758.84 0.00 0.00 1,758.84 MAT 02/15/23 Cpn 0.36 89237VAA7 04/18/21 04/18/21 Coupon HONDA 2019-1 A3 CAR 7,913.46 0.00 0.00 7,913.46 MAT 03/20/23 Cpn 2.83 43814WAC9 04/18/21 04/18/21 Coupon HONDA 2020-3 A2 CAR 2,205.00 0.00 0.00 2,205.00 MAT 02/21/23 Cpn 0.27 43813KAB8 04/20/21 04/20/21 Coupon FFCB FRN 2,081.82 0.00 0.00 2,081.82 MAT 10/20/21 Cpn 0.13 3133ELW42 04/20/21 04/20/21 Coupon VOLKSWAGEN 2019-A A2A LEASE 792.83 0.00 0.00 792.83 MAT 03/21/22 Cpn 2.00 92867XAB2 04/20/21 04/20/21 Coupon VERIZON 2019-B 1A1 PHONE 4,757.08 0.00 0.00 4,757.08 MAT 12/20/23 Cpn 2.33 92349GAA9 04/21/21 04/21/21 Coupon HONDA 2020-1 A2 CAR 4,049.51 0.00 0.00 4,049.51 MAT 10/21/22 Cpn 1.63 43813RAB3 04/23/21 04/23/21 Coupon INTL FINANCE CORP FRN 2,001.40 0.00 0.00 2,001.40 MAT 08/23/21 Cpn 0.24 45950VNE2
Payden & Rygel
247 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/24/21 04/24/21 Coupon FHLB FRN 1,252.92 0.00 0.00 1,252.92 MAT 05/24/21 Cpn 0.10 3130AJVE6 04/25/21 04/25/21 Coupon BMW 2019-A A3 CAR 3,601.42 0.00 0.00 3,601.42 MAT 01/25/24 Cpn 1.92 05588CAC6 04/25/21 04/25/21 Coupon BMW 2020-A A2 CAR 339.30 0.00 0.00 339.30 MAT 02/27/23 Cpn 0.39 09661RAB7 04/25/21 04/25/21 Coupon FHMS KF36 A 882.92 0.00 0.00 882.92 MAT 08/25/24 Cpn 0.45 3137FBAR7 04/25/21 04/25/21 Coupon FHMS KI04 A 1MOFRN CMBS 1,561.10 0.00 0.00 1,561.10 MAT 07/25/24 Cpn 0.47 3137FNAV2 04/25/21 04/25/21 Coupon FHMS KI05 A 1,479.47 0.00 0.00 1,479.47 MAT 07/25/24 Cpn 0.45 3137FQXG3 04/25/21 04/25/21 Coupon FHMS KI06 A 1MOFRN CMBS 1,817.97 0.00 0.00 1,817.97 MAT 03/25/25 Cpn 0.33 3137FVNA6 04/01/21 04/25/21 Coupon FHMS KS01 A2 CMBS 12,861.82 0.00 0.00 12,861.82 MAT 01/25/23 Cpn 2.52 3137B1U75 04/25/21 04/25/21 Coupon FHMS Q009 A 1MOFRN CMBS 769.10 0.00 0.00 769.10 MAT 04/25/24 Cpn 0.46 3137FMTW 04/01/21 04/25/21 Coupon FNA 2012-M2 A2 CMBS 2,629.35 0.00 0.00 2,629.35 MAT 02/25/22 Cpn 2.72 3136A4TX7 04/26/21 04/26/21 Coupon FHMS KF38 A 448.51 0.00 0.00 448.51 MAT 09/25/24 Cpn 0.44 3137FBUC8 04/26/21 04/26/21 Coupon NATL AUSTRALIA BANK YCD FRN 1,219.49 0.00 0.00 1,219.49 MAT 05/24/21 Cpn 0.18 63253TW38
Payden & Rygel
248 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount
Fixed Income - cont. 04/30/21 04/30/21 Coupon U.S. TREASURY FRN 20,277.95 0.00 0.00 20,277.95 MAT 10/31/21 Cpn 0.32 912828YN4 212,466.51 0.00 0.00 212,466.51
04/01/21 04/01/21 Income 742.000 STIF INT 742.00 0.00 0.00 742.00 MAT Cpn USD 04/01/21 04/01/21 Income (688.900) ADJ NET INT (688.90) 0.00 0.00 (688.90) MAT Cpn USD 53.100 53.10 0.00 0.00 53.10
04/12/21 04/12/21 Contributn 405,000,000.000 NM 405,000,000.00 0.00 0.00 405,000,000.00 MAT Cpn USD
04/01/21 04/05/21 Sell Long 50,000,000.000 U.S. TREASURY BILL 49,999,225.69 750.00 6.94 0.00 49,999,975.69 MAT 04/06/21 Cpn 912796D71 04/13/21 04/14/21 Sell Long 5,000,000.000 U.S. TREASURY BILL 4,999,931.04 68.75 1.87 0.00 4,999,999.79 MAT 04/15/21 Cpn 9127964Y2 04/15/21 04/15/21 Sell Long 5,000,000.000 U.S. TREASURY BILL 4,999,950.70 47.22 4.86 0.00 4,999,997.92 MAT 04/20/21 Cpn 912796D97 04/19/21 04/20/21 Sell Long 15,000,000.000 U.S. TREASURY BILL 14,999,976.67 23.33 1.67 0.00 15,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 5,000,000.000 U.S. TREASURY BILL 4,999,992.22 7.78 0.56 0.00 5,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 10,000,000.000 U.S. TREASURY BILL 9,999,960.28 39.72 3.06 0.00 10,000,000.00 MAT 04/22/21 Cpn 9127962Q1
Payden & Rygel
249 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/19/21 04/20/21 Sell Long 30,000,000.000 U.S. TREASURY BILL 29,999,920.83 79.17 8.33 0.00 30,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 5,000,000.000 U.S. TREASURY BILL 4,999,991.60 8.40 1.53 0.00 5,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 2,000,000.000 U.S. TREASURY BILL 1,999,996.64 3.36 0.61 0.00 2,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 10,000,000.000 U.S. TREASURY BILL 9,999,987.36 12.64 3.61 0.00 10,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 38,000,000.000 U.S. TREASURY BILL 37,999,951.98 48.02 13.73 0.00 38,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 12,000,000.000 U.S. TREASURY BILL 11,999,984.83 15.17 4.33 0.00 12,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 38,000,000.000 U.S. TREASURY BILL 37,999,951.98 48.02 13.73 0.00 38,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 12,000,000.000 U.S. TREASURY BILL 11,999,984.83 15.17 4.33 0.00 12,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 38,000,000.000 U.S. TREASURY BILL 37,999,951.98 48.02 13.73 0.00 38,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/19/21 04/20/21 Sell Long 4,000,000.000 U.S. TREASURY BILL 3,999,994.38 5.06 0.88 0.00 3,999,999.44 MAT 04/22/21 Cpn 9127962Q1 04/21/21 04/22/21 Sell Long 10,000,000.000 U.S. TREASURY BILL 9,999,987.50 12.50 6.94 0.00 10,000,000.00 MAT 04/27/21 Cpn 912796F20 04/21/21 04/22/21 Sell Long 1,000,000.000 U.S. TREASURY BILL 999,998.75 1.25 0.69 0.00 1,000,000.00 MAT 04/27/21 Cpn 912796F20 04/23/21 04/26/21 Sell Long 49,000,000.000 U.S. TREASURY BILL 48,999,904.72 88.47 (0.00) 0.00 48,999,993.19 MAT 04/27/21 Cpn 912796F20
Payden & Rygel
250 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/23/21 04/26/21 Sell Long 30,000,000.000 U.S. TREASURY BILL 29,999,872.08 104.17 (11.25) 0.00 29,999,976.25 MAT 04/29/21 Cpn 9127964Z9 04/23/21 04/26/21 Sell Long 45,000,000.000 U.S. TREASURY BILL 44,999,842.51 121.87 (7.49) 0.00 44,999,964.38 MAT 04/29/21 Cpn 9127964Z9 04/23/21 04/26/21 Sell Long 5,000,000.000 U.S. TREASURY BILL 4,999,982.50 13.54 (0.83) 0.00 4,999,996.04 MAT 04/29/21 Cpn 9127964Z9 04/27/21 04/28/21 Sell Long 31,000,000.000 U.S. TREASURY BILL 30,999,907.44 96.87 10.77 0.00 31,000,004.31 MAT 04/29/21 Cpn 9127964Z9 04/27/21 04/28/21 Sell Long 14,000,000.000 U.S. TREASURY BILL 13,999,958.19 43.75 4.86 0.00 14,000,001.94 MAT 04/29/21 Cpn 9127964Z9 04/27/21 04/28/21 Sell Long 15,000,000.000 U.S. TREASURY BILL 14,999,969.58 32.50 4.58 0.00 15,000,002.08 MAT 04/29/21 Cpn 9127964Z9 04/27/21 04/28/21 Sell Long 21,000,000.000 U.S. TREASURY BILL 20,999,957.42 45.50 6.42 0.00 21,000,002.92 MAT 04/29/21 Cpn 9127964Z9 04/27/21 04/28/21 Sell Long 29,000,000.000 U.S. TREASURY BILL 28,999,941.20 62.83 8.86 0.00 29,000,004.03 MAT 04/29/21 Cpn 9127964Z9 04/27/21 04/28/21 Sell Long 21,000,000.000 U.S. TREASURY BILL 20,999,957.41 45.50 6.41 0.00 21,000,002.91 MAT 04/29/21 Cpn 9127964Z9 04/30/21 05/03/21 Sell Long 12,000,000.000 U.S. TREASURY BILL 11,999,970.50 30.00 3.50 0.00 12,000,000.50 MAT 05/04/21 Cpn 912796F79 562,000,000.000 561,998,002.80 1,918.59 117.23 0.00 561,999,921.39
04/15/21 04/15/21 Pay Princpl 171,201.091 CARMAX 2019-1 A3 CAR 171,201.09 (3,095.87) 0.00 171,201.09 MAT 03/15/24 Cpn 3.05 14315NAC4 04/15/21 04/15/21 Pay Princpl 232,850.091 CARMAX 2019-2 A3 CAR 232,850.09 (4,122.82) 0.00 232,850.09 MAT 03/15/24 Cpn 2.68 14316LAC7
Payden & Rygel
251 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/15/21 04/15/21 Pay Princpl 351,217.109 HONDA 2019-3 A2 CAR 351,217.11 0.00 2.28 351,217.11 MAT 04/15/22 Cpn 1.90 43815NAB0 04/15/21 04/15/21 Pay Princpl 646,571.701 HONDA 2020-2 A2 CAR 646,571.70 (1,184.09) 0.00 646,571.70 MAT 11/15/22 Cpn 0.74 43813DAB4 04/15/21 04/15/21 Pay Princpl 676,054.415 HARLEY 2020-A A-2A CYCLE 676,054.42 (131.50) 0.00 676,054.42 MAT 01/17/23 Cpn 1.83 41284UAB0 04/15/21 04/15/21 Pay Princpl 377,336.026 JOHN DEERE 2020-B A2 EQP 377,336.03 11.30 0.00 377,336.03 MAT 03/15/23 Cpn 0.41 47787NAB5 04/15/21 04/15/21 Pay Princpl 868,104.355 JOHN DEERE 2020-B A2 EQP 868,104.36 (446.29) 0.00 868,104.36 MAT 03/15/23 Cpn 0.41 47787NAB5 04/15/21 04/15/21 Pay Princpl 250,577.972 MERCEDES 2019-B A2 LEASE 250,577.97 0.00 (0.00) 250,577.97 MAT 12/15/21 Cpn 2.01 58769QAB7 04/15/21 04/15/21 Pay Princpl 469,875.487 MERCEDES 2020-A A2 CAR LEASE 469,875.49 0.00 4.97 469,875.49 MAT 03/15/22 Cpn 1.82 58770FAB8 04/15/21 04/15/21 Pay Princpl 1,568,652.718 MERCEDES 2020-A A2 CAR LEASE 1,568,652.72 (3,024.24) 0.00 1,568,652.72 MAT 03/15/22 Cpn 1.82 58770FAB8 04/15/21 04/15/21 Pay Princpl 646,112.588 MERCEDES 2020-B A2 LEASE 646,112.59 38.82 0.00 646,112.59 MAT 02/15/23 Cpn 0.31 58769EAB4 04/15/21 04/15/21 Pay Princpl 197,763.979 MERCEDES 2019-1 A2A CAR 197,763.98 0.00 2.61 197,763.98 MAT 06/15/22 Cpn 2.04 58769TAB1 04/15/21 04/15/21 Pay Princpl 540,760.881 MERCEDES 2019-1 A2A CAR 540,760.88 (1,085.98) 0.00 540,760.88 MAT 06/15/22 Cpn 2.04 58769TAB1 04/15/21 04/15/21 Pay Princpl 439,000.942 MERCEDES 2020-1 A2 CAR 439,000.94 4.00 0.00 439,000.94 MAT 03/15/23 Cpn 0.46 58769VAB6 04/15/21 04/15/21 Pay Princpl 501,886.772 NISSAN 2020-A A2A LEASE 501,886.77 0.00 7.16 501,886.77 MAT 05/16/22 Cpn 1.80 65479NAB0
Payden & Rygel
252 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/15/21 04/15/21 Pay Princpl 182,400.755 TOYOTA 2018-A A3 CAR 182,400.76 0.00 0.01 182,400.76 MAT 05/16/22 Cpn 2.35 89238BAD4 04/15/21 04/15/21 Pay Princpl 511,208.872 TOYOTA 2019-A A3 CAR 511,208.87 (9,104.94) 0.00 511,208.87 MAT 07/17/23 Cpn 2.91 89239AAD5 04/15/21 04/15/21 Pay Princpl 246,797.748 TOYOTA 2019-C A2A CAR 246,797.75 0.00 0.54 246,797.75 MAT 04/15/22 Cpn 2.00 89238UAB6 04/15/21 04/15/21 Pay Princpl 372,619.563 TOYOTA 2019-D A2 CAR 372,619.56 0.00 5.24 372,619.56 MAT 07/15/22 Cpn 1.92 89233MAB9 04/15/21 04/15/21 Pay Princpl 136,087.145 TOYOTA 2019-D A2 CAR 136,087.15 (207.91) 0.00 136,087.15 MAT 07/15/22 Cpn 1.92 89233MAB9 04/15/21 04/15/21 Pay Princpl 767,329.911 TOYOTA 2020-C A2 CAR 767,329.91 15.28 0.00 767,329.91 MAT 02/15/23 Cpn 0.36 89237VAA7 04/18/21 04/18/21 Pay Princpl 336,090.117 HONDA 2019-1 A3 CAR 336,090.12 (4,949.55) 0.00 336,090.12 MAT 03/20/23 Cpn 2.83 43814WAC9 04/18/21 04/18/21 Pay Princpl 198,084.911 HONDA 2020-3 A2 CAR 198,084.91 9.19 0.00 198,084.91 MAT 02/21/23 Cpn 0.27 43813KAB8 04/20/21 04/20/21 Pay Princpl 175,382.765 VOLKSWAGEN 2019-A A2A LEASE 175,382.77 0.00 2.44 175,382.77 MAT 03/21/22 Cpn 2.00 92867XAB2 04/21/21 04/21/21 Pay Princpl 504,507.808 HONDA 2020-1 A2 CAR 504,507.81 (2,426.49) 0.00 504,507.81 MAT 10/21/22 Cpn 1.63 43813RAB3 04/25/21 04/25/21 Pay Princpl 186,349.188 BMW 2019-A A3 CAR 186,349.19 (2,577.28) 0.00 186,349.19 MAT 01/25/24 Cpn 1.92 05588CAC6 04/25/21 04/25/21 Pay Princpl 159,646.803 BMW 2020-A A2 CAR 159,646.80 6.04 0.00 159,646.80 MAT 02/27/23 Cpn 0.39 09661RAB7 04/25/21 04/25/21 Pay Princpl 1,377.227 FHMS KF36 A 1,377.23 0.00 0.81 1,377.23 MAT 08/25/24 Cpn 0.45 3137FBAR7
Payden & Rygel
253 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/25/21 04/25/21 Pay Princpl 1,172.080 FHMS KF38 A 1,172.08 0.00 1.10 1,172.08 MAT 09/25/24 Cpn 0.44 3137FBUC8 04/25/21 04/25/21 Pay Princpl 893,295.741 FHMS KI06 A 1MOFRN CMBS 893,295.74 (0.00) 0.00 893,295.74 MAT 03/25/25 Cpn 0.33 3137FVNA6 04/01/21 04/25/21 Pay Princpl 19,060.418 FHMS KS01 A2 CMBS 19,060.42 (472.01) 0.00 19,060.42 MAT 01/25/23 Cpn 2.52 3137B1U75 04/25/21 04/25/21 Pay Princpl 146,613.077 FHMS Q009 A 1MOFRN CMBS 146,613.08 0.00 0.00 146,613.08 MAT 04/25/24 Cpn 0.46 3137FMTW 04/01/21 04/25/21 Pay Princpl 34,324.078 FNA 2012-M2 A2 CMBS 34,324.08 0.00 (369.44) 34,324.08 MAT 02/25/22 Cpn 2.72 3136A4TX7 12,810,314.335 12,810,314.37 (32,744.36) (342.28) 12,810,314.37
04/01/21 04/01/21 Mature Long 5,000,000.000 U.S. TREASURY BILL 4,999,775.42 224.58 0.00 0.00 5,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/01/21 04/01/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,997,754.17 2,245.83 0.00 0.00 50,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/01/21 04/01/21 Mature Long 10,000,000.000 U.S. TREASURY BILL 9,999,941.67 58.33 0.00 0.00 10,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/01/21 04/01/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,708.33 291.67 0.00 0.00 50,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/01/21 04/01/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,708.33 291.67 0.00 0.00 50,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/01/21 04/01/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,708.33 291.67 0.00 0.00 50,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/01/21 04/01/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,708.33 291.67 0.00 0.00 50,000,000.00 MAT 04/01/21 Cpn 9127964P1
Payden & Rygel
254 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/01/21 04/01/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,708.33 291.67 0.00 0.00 50,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/01/21 04/01/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,708.33 291.67 0.00 0.00 50,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/01/21 04/01/21 Mature Long 13,000,000.000 U.S. TREASURY BILL 12,999,949.44 50.56 0.00 0.00 13,000,000.00 MAT 04/01/21 Cpn 9127964P1 04/08/21 04/08/21 Mature Long 5,000,000.000 U.S. TREASURY BILL 4,999,797.78 202.22 0.00 0.00 5,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/08/21 04/08/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,997,977.78 2,022.22 0.00 0.00 50,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/08/21 04/08/21 Mature Long 38,000,000.000 U.S. TREASURY BILL 37,999,487.00 513.00 0.00 0.00 38,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/08/21 04/08/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,325.00 675.00 0.00 0.00 50,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/08/21 04/08/21 Mature Long 20,000,000.000 U.S. TREASURY BILL 19,999,850.00 150.00 0.00 0.00 20,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/08/21 04/08/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,625.00 375.00 0.00 0.00 50,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/08/21 04/08/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,625.00 375.00 0.00 0.00 50,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/08/21 04/08/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,625.00 375.00 0.00 0.00 50,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/08/21 04/08/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,625.00 375.00 0.00 0.00 50,000,000.00 MAT 04/08/21 Cpn 9127964X4 04/13/21 04/13/21 Mature Long 10,000,000.000 U.S. TREASURY BILL 9,999,866.67 133.33 0.00 0.00 10,000,000.00 MAT 04/13/21 Cpn 912796D89
Payden & Rygel
255 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/13/21 04/13/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,333.33 666.67 0.00 0.00 50,000,000.00 MAT 04/13/21 Cpn 912796D89 04/15/21 04/15/21 Mature Long 35,000,000.000 U.S. TREASURY BILL 34,999,504.16 495.84 (0.00) 0.00 35,000,000.00 MAT 04/15/21 Cpn 9127964Y2 04/15/21 04/15/21 Mature Long 10,000,000.000 U.S. TREASURY BILL 9,999,958.33 41.67 0.00 0.00 10,000,000.00 MAT 04/15/21 Cpn 9127964Y2 04/15/21 04/15/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,951.39 48.61 0.00 0.00 50,000,000.00 MAT 04/15/21 Cpn 9127964Y2 04/15/21 04/15/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,951.39 48.61 0.00 0.00 50,000,000.00 MAT 04/15/21 Cpn 9127964Y2 04/15/21 04/15/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,951.39 48.61 0.00 0.00 50,000,000.00 MAT 04/15/21 Cpn 9127964Y2 04/15/21 04/15/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,951.39 48.61 0.00 0.00 50,000,000.00 MAT 04/15/21 Cpn 9127964Y2 04/15/21 04/15/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,951.39 48.61 0.00 0.00 50,000,000.00 MAT 04/15/21 Cpn 9127964Y2 04/20/21 04/20/21 Mature Long 20,000,000.000 U.S. TREASURY BILL 19,999,783.34 216.66 0.00 0.00 20,000,000.00 MAT 04/20/21 Cpn 912796D97 04/20/21 04/20/21 Mature Long 35,000,000.000 U.S. TREASURY BILL 34,999,836.67 163.33 0.00 0.00 35,000,000.00 MAT 04/20/21 Cpn 912796D97 04/22/21 04/22/21 Mature Long 8,000,000.000 U.S. TREASURY BILL 7,999,987.00 13.00 0.00 0.00 8,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/22/21 04/22/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,918.75 81.25 0.00 0.00 50,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/22/21 04/22/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,918.75 81.25 0.00 0.00 50,000,000.00 MAT 04/22/21 Cpn 9127962Q1
Payden & Rygel
256 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/22/21 04/22/21 Mature Long 50,000,000.000 U.S. TREASURY BILL 49,999,918.75 81.25 0.00 0.00 50,000,000.00 MAT 04/22/21 Cpn 9127962Q1 04/29/21 04/29/21 Mature Long 29,000,000.000 U.S. TREASURY BILL 28,999,932.33 67.67 (0.00) 0.00 29,000,000.00 MAT 04/29/21 Cpn 9127964Z9 1,338,000,000.000 1,337,988,323.27 11,676.73 (0.00) 0.00 1,338,000,000.00
04/01/21 04/01/21 Withdrawal (45,000,000.000) WD (45,000,000.00) (45,000,000.00) 0.00 (45,000,000.00) MAT Cpn USD 04/01/21 04/01/21 Withdrawal (3,333.330) CUSTODY FEE (3,333.33) (3,333.33) 0.00 (3,333.33) MAT Cpn USD 04/05/21 04/05/21 Withdrawal (40,000,000.000) WD (40,000,000.00) (40,000,000.00) 0.00 (40,000,000.00) MAT Cpn USD 04/08/21 04/08/21 Withdrawal (40,000,000.000) WD (40,000,000.00) (40,000,000.00) 0.00 (40,000,000.00) MAT Cpn USD 04/15/21 04/15/21 Withdrawal (40,000,000.000) WD (40,000,000.00) (40,000,000.00) 0.00 (40,000,000.00) MAT Cpn USD 04/16/21 04/16/21 Withdrawal (70,000,000.000) WD (70,000,000.00) (70,000,000.00) 0.00 (70,000,000.00) MAT Cpn USD 04/20/21 04/20/21 Withdrawal (270,000,000.000) WD (270,000,000.00) (270,000,000.00) 0.00 (270,000,000.00) MAT Cpn USD 04/22/21 04/22/21 Withdrawal (130,000,000.000) WD (130,000,000.00) (130,000,000.00) 0.00 (130,000,000.00) MAT Cpn USD 04/26/21 04/26/21 Withdrawal (130,000,000.000) WD (130,000,000.00) (130,000,000.00) 0.00 (130,000,000.00) MAT Cpn USD
Payden & Rygel
257 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN 04/01/2021 Account Number: 2365 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount
Cash - cont. 04/28/21 04/28/21 Withdrawal (100,000,000.000) WD (100,000,000.00) (100,000,000.00) 0.00 (100,000,000.00) MAT Cpn USD (865,003,333.330) (865,003,333.33) (865,003,333.33) 0.00 (865,003,333.33)
Payden & Rygel
258 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN-LOW DURATION PORT 04/01/2021 Account Number: 2367 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/01/21 04/05/21 Buy 935,000.000 U.S. TREASURY NOTE (927,804.88) (95.80) 0.00 0.00 (927,900.68) MAT 03/31/26 Cpn 0.75 91282CBT7 04/01/21 04/06/21 Buy 510,000.000 CARMX 2020-1 A3 CAR (521,176.17) (562.28) 0.00 0.00 (521,738.45) MAT 12/16/24 Cpn 1.89 14315XAC2 04/08/21 04/09/21 Buy 910,000.000 U.S. TREASURY NOTE (906,018.75) (167.83) 0.00 0.00 (906,186.58) MAT 03/31/26 Cpn 0.75 91282CBT7 04/06/21 04/14/21 Buy 220,000.000 GMCAR 2021-2 A3 CAR (219,980.66) 0.00 0.00 (219,980.66) MAT 04/16/26 Cpn 0.51 380149AC8 04/13/21 04/20/21 Buy 340,000.000 INTL BANK RECON & DEVELOP (339,296.20) 0.00 0.00 (339,296.20) MAT 04/20/23 Cpn 0.13 459058JV6 04/13/21 04/21/21 Buy 950,000.000 CARMX 2021-2 A3 AUTO (949,795.28) 0.00 0.00 (949,795.28) MAT 02/17/26 Cpn 0.52 14314QAC8 04/30/21 05/03/21 Buy 470,000.000 U.S. TREASURY NOTE (468,127.34) (317.83) 0.00 0.00 (468,445.17) MAT 03/31/26 Cpn 0.75 91282CBT7 4,335,000.000 (4,332,199.28) (1,143.74) 0.00 0.00 (4,333,343.02)
04/01/21 04/01/21 Coupon CA BAY AREA TOLL AUTH TOLL BR 13,749.40 0.00 0.00 13,749.40 MAT 04/01/24 Cpn 2.25 072024WP3 04/01/21 04/01/21 Coupon CA STATE GO/ULT-TXB 5,680.80 0.00 0.00 5,680.80 MAT 04/01/22 Cpn 2.37 13063DAD0 04/01/21 04/01/21 Coupon CA STATE GO/ULT TXBL 11,200.00 0.00 0.00 11,200.00 MAT 04/01/21 Cpn 2.80 13063DGA0 04/01/21 04/01/21 Coupon CA MANTECA REDEV AGY TAB TX 4,345.00 0.00 0.00 4,345.00 MAT 10/01/23 Cpn 1.74 56453RAX2 04/01/21 04/01/21 Coupon CA SAN MARCOS REDEV AGY TAB 5,793.75 0.00 0.00 5,793.75 MAT 10/01/22 Cpn 2.25 79876CBS6
Payden & Rygel
259 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN-LOW DURATION PORT 04/01/2021 Account Number: 2367 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/01/21 04/01/21 Coupon CA STOCKTON PFA WTR REV-GRE 3,561.00 0.00 0.00 3,561.00 MAT 10/01/24 Cpn 2.37 861398CH6 04/15/21 04/15/21 Coupon CARMX 2020-1 A3 CAR 803.25 0.00 0.00 803.25 MAT 12/16/24 Cpn 1.89 14315XAC2 04/15/21 04/15/21 Coupon CAPITAL ONE 2020-1 A3 CAR 640.00 0.00 0.00 640.00 MAT 11/15/24 Cpn 1.60 14043MAC5 04/15/21 04/15/21 Coupon FIFTH THIRD 2019-1 A3 CAR 570.03 0.00 0.00 570.03 MAT 12/15/23 Cpn 2.64 31680YAD9 04/15/21 04/15/21 Coupon HONDA 2019-3 A3 CAR 623.00 0.00 0.00 623.00 MAT 08/15/23 Cpn 1.78 43815NAC8 04/15/21 04/15/21 Coupon JOHN DEERE 2020-A A3 EQP 660.00 0.00 0.00 660.00 MAT 08/15/24 Cpn 1.10 47789KAC7 04/15/21 04/15/21 Coupon JOHN DEERE 2021-A A3 EQP 192.50 0.00 0.00 192.50 MAT 09/15/25 Cpn 0.36 47788UAC6 04/15/21 04/15/21 Coupon MERCEDES 2020-A A3 CAR LEASE 352.67 0.00 0.00 352.67 MAT 12/15/22 Cpn 1.84 58770FAC6 04/15/21 04/15/21 Coupon CA SAN DIEGO CITY PUB FACS LE 13,731.75 0.00 0.00 13,731.75 MAT 10/15/22 Cpn 3.23 797299LU6 04/15/21 04/15/21 Coupon TOYOTA 2019-A A3 CAR 1,012.26 0.00 0.00 1,012.26 MAT 07/17/23 Cpn 2.91 89239AAD5 04/15/21 04/15/21 Coupon TOYOTA 2019-C A3 CAR 668.50 0.00 0.00 668.50 MAT 09/15/23 Cpn 1.91 89238UAD2 04/19/21 04/19/21 Coupon INTER-AMERICAN DEVELOPMENT 6,168.75 0.00 0.00 6,168.75 MAT 04/19/21 Cpn 2.63 4581X0DB1 04/20/21 04/20/21 Coupon VOLKSWAGEN 2019-A A4 LEASE 538.67 0.00 0.00 538.67 MAT 08/20/24 Cpn 2.02 92867XAE6
Payden & Rygel
260 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN-LOW DURATION PORT 04/01/2021 Account Number: 2367 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/20/21 04/20/21 Coupon VERIZON 2020-B A PHONE 372.08 0.00 0.00 372.08 MAT 02/20/25 Cpn 0.47 92290BAA9 04/22/21 04/22/21 Coupon FNMA 3,000.00 0.00 0.00 3,000.00 MAT 04/22/25 Cpn 0.63 3135G03U5 04/25/21 04/25/21 Coupon BMW 2021-1 A4 LEASE 138.75 0.00 0.00 138.75 MAT 07/25/24 Cpn 0.37 05591RAD6 04/25/21 04/25/21 Coupon BMW 2019-A A3 CAR 857.48 0.00 0.00 857.48 MAT 01/25/24 Cpn 1.92 05588CAC6 04/01/21 04/25/21 Coupon FHMS K020 A2 CMBS 613.03 0.00 0.00 613.03 MAT 05/25/22 Cpn 2.37 3137ATRW 04/01/21 04/25/21 Coupon FHMS K020 A2 CMBS 751.45 0.00 0.00 751.45 MAT 05/25/22 Cpn 2.37 3137ATRW 04/01/21 04/25/21 Coupon FHMS K029 A2 CMBS 664.00 0.00 0.00 664.00 MAT 02/25/23 Cpn 3.32 3137B36J2 04/01/21 04/25/21 Coupon FHMS K029 A2 CMBS 1,051.33 0.00 0.00 1,051.33 MAT 02/25/23 Cpn 3.32 3137B36J2 04/01/21 04/25/21 Coupon FHMS K029 A2 CMBS 498.00 0.00 0.00 498.00 MAT 02/25/23 Cpn 3.32 3137B36J2 04/01/21 04/25/21 Coupon FHMS K031 A2 2,200.00 0.00 0.00 2,200.00 MAT 04/25/23 Cpn 3.30 3137B3NX2 04/01/21 04/25/21 Coupon FHMS K033 A2 2,091.00 0.00 0.00 2,091.00 MAT 07/25/23 Cpn 3.06 3137B4WB8 04/01/21 04/25/21 Coupon FHMS K034 A2 1,412.40 0.00 0.00 1,412.40 MAT 07/25/23 Cpn 3.53 3137B5JM6 04/01/21 04/25/21 Coupon FHMS K725 AM CMBS 2,095.20 0.00 0.00 2,095.20 MAT 02/25/24 Cpn 3.10 3137BWWE
Payden & Rygel
261 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN-LOW DURATION PORT 04/01/2021 Account Number: 2367 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/01/21 04/25/21 Coupon FHMS K726 AM CMBS 1,417.88 0.00 0.00 1,417.88 MAT 04/25/24 Cpn 2.99 3137BYPR5 04/25/21 04/25/21 Coupon FHMS KI05 A 100.30 0.00 0.00 100.30 MAT 07/25/24 Cpn 0.45 3137FQXG3 04/01/21 04/25/21 Coupon FHMS KJ28 A1 549.87 0.00 0.00 549.87 MAT 02/25/25 Cpn 1.77 3137FREB3 04/01/21 04/25/21 Coupon FHMS KJ30 A1 CMBS 158.85 0.00 0.00 158.85 MAT 01/25/25 Cpn 0.53 3137FUZN7 04/01/21 04/25/21 Coupon FHMS KS01 A2 CMBS 651.67 0.00 0.00 651.67 MAT 01/25/23 Cpn 2.52 3137B1U75 04/01/21 04/25/21 Coupon FHMS KSMC A2 CMBS 1,939.46 0.00 0.00 1,939.46 MAT 01/25/23 Cpn 2.62 3137B04Y7 04/01/21 04/25/21 Coupon FNA 2011-M5 A2 CMBS 101.39 0.00 0.00 101.39 MAT 07/25/21 Cpn 2.94 3136A07H4 04/30/21 04/30/21 Coupon U.S. TREASURY NOTE 1,753.13 0.00 0.00 1,753.13 MAT 04/30/25 Cpn 0.38 912828ZL7 04/30/21 04/30/21 Coupon U.S. TREASURY NOTE 300.00 0.00 0.00 300.00 MAT 10/31/24 Cpn 1.50 912828YM6 04/30/21 04/30/21 Coupon U.S. TREASURY NOTE 4,350.00 0.00 0.00 4,350.00 MAT 10/31/22 Cpn 2.00 9128283C2 97,358.60 0.00 0.00 97,358.60
04/05/21 04/06/21 Sell Long 470,000.000 U.S. TREASURY NOTE 479,198.05 2,530.77 0.00 9,547.56 481,728.82 MAT 06/15/22 Cpn 1.75 9128286Y1 04/05/21 04/06/21 Sell Long 95,000.000 U.S. TREASURY NOTE 97,460.35 29.20 0.00 2,638.52 97,489.55 MAT 09/30/22 Cpn 1.88 9128282W9
Payden & Rygel
262 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN-LOW DURATION PORT 04/01/2021 Account Number: 2367 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 04/05/21 04/06/21 Sell Long 105,000.000 U.S. TREASURY NOTE 107,719.34 32.28 0.00 2,934.97 107,751.62 MAT 09/30/22 Cpn 1.88 9128282W9 04/08/21 04/09/21 Sell Long 910,000.000 FNMA 903,921.20 1,415.56 (4,498.72) 0.00 905,336.76 MAT 06/17/25 Cpn 0.50 3135G04Z3 04/13/21 04/14/21 Sell Long 340,000.000 U.S. TREASURY NOTE 340,053.13 16.26 226.36 0.00 340,069.39 MAT 09/30/22 Cpn 0.13 91282CAN1 1,920,000.000 1,928,352.07 4,024.07 (4,272.36) 15,121.04 1,932,376.14
04/12/21 04/12/21 Pay Princpl 522,222.223 FHLB C 4/12/21 M 522,222.22 (0.00) 0.00 522,222.22 MAT 03/12/24 Cpn 0.50 3130ALJZ8 04/15/21 04/15/21 Pay Princpl 24,436.420 FIFTH THIRD 2019-1 A3 CAR 24,436.42 0.00 2.34 24,436.42 MAT 12/15/23 Cpn 2.64 31680YAD9 04/15/21 04/15/21 Pay Princpl 38,170.262 TOYOTA 2019-A A3 CAR 38,170.26 0.00 2.75 38,170.26 MAT 07/17/23 Cpn 2.91 89239AAD5 04/25/21 04/25/21 Pay Princpl 44,368.854 BMW 2019-A A3 CAR 44,368.85 0.00 3.01 44,368.85 MAT 01/25/24 Cpn 1.92 05588CAC6 04/01/21 04/25/21 Pay Princpl 943.319 FHMS KJ28 A1 943.32 0.00 0.00 943.32 MAT 02/25/25 Cpn 1.77 3137FREB3 04/01/21 04/25/21 Pay Princpl 928.910 FHMS KJ30 A1 CMBS 928.91 0.02 0.00 928.91 MAT 01/25/25 Cpn 0.53 3137FUZN7 04/01/21 04/25/21 Pay Princpl 965.728 FHMS KS01 A2 CMBS 965.73 0.00 (6.63) 965.73 MAT 01/25/23 Cpn 2.52 3137B1U75
Payden & Rygel
263 TRANSACTIONS BY TYPE
Account Name: L.A. CARE HEALTH PLAN-LOW DURATION PORT 04/01/2021 Account Number: 2367 through 04/30/2021
Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount
Fixed Income - cont. 04/01/21 04/25/21 Pay Princpl 6,571.380 FNA 2011-M5 A2 CMBS 6,571.38 0.00 4.12 6,571.38 MAT 07/25/21 Cpn 2.94 3136A07H4 638,607.096 638,607.09 0.01 5.60 638,607.09
04/01/21 04/01/21 Mature Long 800,000.000 CA STATE GO/ULT TXBL 800,000.00 0.00 0.00 800,000.00 MAT 04/01/21 Cpn 2.80 13063DGA0 04/19/21 04/19/21 Mature Long 470,000.000 INTER-AMERICAN DEVELOPMENT 470,000.00 0.00 0.00 470,000.00 MAT 04/19/21 Cpn 2.63 4581X0DB1 1,270,000.000 1,270,000.00 0.00 0.00 1,270,000.00
Payden & Rygel
264
LA CARE Cash Activity by Transaction Type GAAP Basis Accounting Period From 04/01/2021 To 04/30/2021
Cash Trade/Ex- Settle/Pay Income Principal Contributions/ Total Date Date Date Custodian Cusip Description Quantity Amount Amount Withdrawals Amount
BUY
04/16/21 04/16/21 04/16/21 BKAMER19 09248U718 BLACKROCK TREASURY TRUST 10,014,961.93 0.00 (10,014,961.93) 0.00 (10,014,961.93) 04/20/21 04/13/21 04/20/21 BKAMER19 459058JV6 INTL BK RECON & DEVELOP 3,000,000.00 0.00 (2,993,790.00) 0.00 (2,993,790.00)
TOTAL BUY 13,014,961.93 0.00 (13,008,751.93) 0.00 (13,008,751.93)
DIVIDEND
04/01/21 04/01/21 04/01/21 BKAMER19 09248U718 BLACKROCK TREASURY TRUST 12,112,113.53 258.28 0.00 0.00 258.28
TOTAL DIVIDEND 12,112,113.53 258.28 0.00 0.00 258.28
INTEREST
04/01/21 04/01/21 04/01/21 BKAMER19 20030NDJ7 COMCAST CORP 0.00 77,500.00 0.00 0.00 77,500.00 04/01/21 04/01/21 04/01/21 BKAMER19 341081FZ5 FLORIDA POWER & LIGHT CO 0.00 106,875.00 0.00 0.00 106,875.00 04/01/21 04/01/21 04/01/21 BKAMER19 369550BK3 GENERAL DYNAMICS CORP 0.00 81,250.00 0.00 0.00 81,250.00 04/01/21 04/01/21 04/01/21 BKAMER19 375558AW3 GILEAD SCIENCES INC 0.00 111,000.00 0.00 0.00 111,000.00 04/01/21 04/01/21 04/01/21 BKAMER19 677415CP4 OHIO POWER COMPANY 0.00 53,750.00 0.00 0.00 53,750.00 04/01/21 04/01/21 04/01/21 BKAMER19 68233JBY9 ONCOR ELECTRIC DELIVERY 0.00 8,387.50 0.00 0.00 8,387.50 04/01/21 04/01/21 04/01/21 BKAMER19 828807CS4 SIMON PROPERTY GROUP LP 0.00 42,187.50 0.00 0.00 42,187.50 04/01/21 04/01/21 04/01/21 BKAMER19 911312BX3 UNITED PARCEL SERVICE 0.00 97,500.00 0.00 0.00 97,500.00 04/12/21 04/12/21 04/12/21 BKAMER19 05565EAW5 BMW US CAPITAL LLC 0.00 51,750.00 0.00 0.00 51,750.00 04/15/21 04/15/21 04/15/21 BKAMER19 67021CAG2 NSTAR ELECTRIC CO 0.00 59,375.00 0.00 0.00 59,375.00 04/15/21 04/15/21 04/15/21 BKAMER19 91324PDD1 UNITEDHEALTH GROUP INC 0.00 57,593.75 0.00 0.00 57,593.75 04/18/21 04/18/21 04/18/21 BKAMER19 05565EBH7 BMW US CAPITAL LLC 0.00 94,500.00 0.00 0.00 94,500.00 04/23/21 04/23/21 04/23/21 BKAMER19 61761JVL0 MORGAN STANLEY 0.00 55,500.00 0.00 0.00 55,500.00
TOTAL INTEREST 0.00 897,168.75 0.00 0.00 897,168.75
SELL
04/16/21 04/16/21 04/16/21 BKAMER19 09248U718 BLACKROCK TREASURY TRUST 12,112,113.53 0.00 12,112,113.53 0.00 12,112,113.53
TOTAL SELL 12,112,113.53 0.00 12,112,113.53 0.00 12,112,113.53
WITHDRAW
04/07/21 04/07/21 04/07/21 BKAMER19 CASHCASH6 C-04 CUSTODY FEE 0.00 0.00 0.00 (788.63) (788.63)
5/5/2021 5:11:10AM INCPRIN2 265
LA CARE Cash Activity by Transaction Type GAAP Basis Accounting Period From 04/01/2021 To 04/30/2021
Cash Trade/Ex- Settle/Pay Income Principal Contributions/ Total Date Date Date Custodian Cusip Description Quantity Amount Amount Withdrawals Amount
TOTAL WITHDRAW 0.00 0.00 0.00 (788.63) (788.63)
GRAND TOTAL 37,239,188.99 897,427.03 (896,638.40) (788.63) 0.00 Avg Date 16
5/5/2021 5:11:10AM INCPRIN2 266
Board of Governors MOTION SUMMARY
Date: June 3, 2021 Motion No. FIN 102.0621
Committee: Finance & Budget Chairperson: Robert H. Curry
Issue: To amend a contract with third party vendor, C3/Customer Contact Channels (parent company is Everise), to provide call center support services for L.A. Care members, prospective members and providers as an extension and augmentation of L.A. Care staff. This request is to expand the value of the purchase order of the current contract with C3/Customer Contact Channels to accommodate the additional expense to be realized through the end of the contract on September 30, 2021.
New Contract Amendment Sole Source RFP/RFQ was conducted 2017
Background: L.A. Care is requesting approval for an additional $3 million to be added to the current purchase order for the contract with C3/Customer Contact Channels, which expires September 30 2021. C3 will continue to provide call center services to respond to inbound calls for all L.A. Care Lines of Business (LOBs). C3/Customer Contact Channels was originally selected in 2017 through an RFP process. The original motion dated July 26, 2018 for $18 million, provided approval for L.A. Care to enter into agreement with C3. We are currently assessing with vendor the contract structure and pricing beyond September 30, 2021, while preparing for a request for proposal process.
Member Impact: Positively impacts all L.A. Care members by the continuation of call center services for inbound calls to address member, prospective member, provider inquiries, and prevents interruption of services.
Budget Impact: The charges are anticipated and included in the approved budget for the Customer Service Center Call Center for the FY 2021-22 as a professional services line item.
Motion: To authorize staff to increase the authorized spend of the existing $18 million purchase order, in the amount of $3 million, not to exceed a total spend of $21 million, with C3/Customer Contact Channels for call center services rendered through the end of the contract term on September 30, 2021.
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