Board of Governors Meeting - L.A. Care Health Plan

BOARD OF GOVERNORS MEETING

December 2, 2021 ● 2:00 PM

L.A. Care Health Plan

1055 W. 7th Street, Los Angeles, CA 90017

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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 2.4 million members in four 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 nine Resource Centers 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.

About L.A. Care Health Plan

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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 October 2021 Medi-Cal 2,304,374 L.A. Care Covered 103,197 Cal MediConnect 18,730 PASC-SEIU 50,807 Total membership 2,477,108

L.A. Care Providers – As of December 2020 Physicians 6,061 Specialists 13,723 Both 731 Hospitals, clinics and other health care professionals

12,257

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 2020)

2,088

Projected full-time employees (FY 2020-2021 budget)

2,033

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AGENDABOARD OF GOVERNORS MEETINGL.A. Care Health PlanThursday, December 2, 2021, 2:00 PML.A. Care Health Plan, 1055 W. 7th Street, 10th Floor, Los Angeles, CA 90017

Please recheck these directions for updates prior to the start of the meeting.This meeting will be conducted in accordance with the provisions of the Ralph M. Brown Act ,

allowing members of the Board, members of the public and staff to participate via teleconference,because State and Local officials are recommending measures to promote social

distancing. Accordingly, members of the public should join this meeting via teleconference asfollows:

https://lacare.webex.com/lacare/j.php?MTID=mf95f9c5faa834c11cab0ae0de7eef1a0

English Audio Call (213) 306-3065Access Code 248 690 95912 Password: lacare

Spanish Audio Call: (213) 306-3065Access Code 2480 462 1371 Password: lacare

Members of the Board of Governors or staff may participate in this meeting via teleconference. Thepublic 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.

Attendees who log on to lacare.webex using the URL above will be able to use “chat” duringthe meeting for public comment. You must be logged into Webex to use the “chat” feature.The log in information is at the top of the meeting Agenda. This is new function during the

meeting so public comments can be made live and direct.1. The “chat” will be available during the public comment periods before each item.2. To use the “chat” during public comment periods, look at the bottom right of your screen

for the icon that has the word, “chat” on it.3. Click on the chat icon. It will open two small windows.4. Select “Everyone” in the To: window,5. The chat message, 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 commentrelates.

6. Type your public comment in the box that says “Enter chat message here”.7. When you hit the enter key, your message is sent and everyone can see it.8. L.A. Care staff will read the chat messages for up to three minutes during public comment

so people who are on the phone can hear the comment.

Your comments can also be sent by voicemail, email or text. If we receive your comments by 2:00 pm onDecember 2, 2021, it will be provided to the members of the Board of Governors at the beginning of themeeting.. The chat message, text, voicemail, or email must indicate if you wish to be identified orremain anonymous, and must also include the name of the item to which your comment relates.

Public comments submitted will be read for up to 3 minutes during the meeting.

Once the meeting has started, public comment must be received before the agenda item is called by themeeting Chair and staff will read those comments for up to three minutes. Chat messages submitted during the

public comment period for before each item will be read for up to three minutes. If your public comment isnot related to any of the agenda item topics, your public comment will be read in the general public comment

agenda item.These are extraordinary circumstances, and the process for public comment is evolving and may change at

future meetings. We thank you for your patience.

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Board of Governors Meeting AgendaDecember 2, 2021Page 2 of 4

Please note that there may be delay in the digital transmittal of emails, texts and voicemail. The Chair willannounce when public comment period is over for each item. 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 publiccomment 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 governingbody 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 theAmericans 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. Approval of findings under the Ralph M. Brown Act (BOG 100) Chair

3. Public Comment (Please read instructions above.) Chair

4. Approve Consent Agenda Items

November 4, 2021 Board of Governors Meeting Minutes

Nomination for Charitable Organizations for donated Board Stipends (BOG 101)

Department of Health Care Service Contract 04-36069 A36, 2022a Risk MitigationAmendment (BOG 102)

Milliman Contract Amendment for Statement of Work 1 (BOG 103)

Milliman Contract Amendment for Statement of Work 2 (BOG 104)

Revised 2022 Board and Committee Meeting Schedule (EXE 100)

Quarterly Investment Report (FIN 100)

Chair

5. Chairperson’s Report

2022 Committee Assignments

Chair

6. Chief Executive Officer Report

Grants & Sponsorships Report

John BaackesChief Executive Officer

7. Chief Medical Officer Report Richard Seidman, MD, MPHChief Medical Officer

8. Vaccine Incentive Program Phinney AhnExecutive Director, Medi-Cal

Advisory Committee Reports

9. Executive Community Advisory Committee Hilda Perez / Layla GonzalezConsumer member and Advocate member

10. Children’s Health Consultant Advisory Committee Richard Seidman, MD, MPH

11. Technical Advisory Committee Richard Seidman, MD, MPH

Committee Reports

12. Executive Committee Chair

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MalouB

Text Box

MalouB

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MalouB

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Government Affairs Updateo L.A. Care’s 2022 State and Federal Policy Agenda (EXE 101)

Cherie CompartoreSenior Director, Government Affairs

Approve Employee Annual Incentive Program (EXE 102) John Baackes

13. Finance & Budget Committee Ilan Shapiro, MD, MBA, FAAP, FACHECommittee Chair

Chief Financial Officer Reporto Financial Report September 2021 (FIN 101)o Monthly Investment Transaction Reports September 2021o Quarterly/Annual Internal Policies Reports

Marie MontgomeryChief Financial Officer

14. Compliance & Quality Committee Stephanie Booth, MDCommittee Chair

15. Public Comment on Closed Session Items (Please read instructions above.) Chair

ADJOURN TO CLOSED SESSION (Estimated time: 15 minutes) Chair

16. CONTRACT RATESPursuant to Welfare and Institutions Code Section 14087.38(m)

Plan Partner Rates

Provider Rates

DHCS Rates

Plan Partner Services Agreement

Medi-Cal Managed Care Supplemental Payment

17. REPORT INVOLVING TRADE SECRETPursuant to Welfare and Institutions Code Section 14087.38(n)Discussion Concerning new Service, Program, Technology, Business PlanEstimated date of public disclosure: December 2023

18. CONFERENCE WITH REAL PROPERTY NEGOTIATORSSection 54956.8 of the Ralph M. Brown ActProperty: 11173 Pico Blvd., Los Angeles, CA. 90064Agency Negotiator: John Baackes, Chief Executive OfficerNegotiating Parties: Zane Averbach for the Shirley M. Wachler TrustLandlord: The Shirley M. Wachler TrustUnder Negotiation: Price and Terms of Payment

19. CONFERENCE WITH LEGAL COUNSEL—EXISTING LITIGATIONPursuant to Section 54956.9(d)(1) of Ralph M. Brown ActPrime Healthcare Services- Alvarado LLC et al. v. Local Initiative Health Authority for Los Angeles County – CaseNo. 21STC1751Prime Healthcare Services – Alvarado LLC et al. v. Local Initiative Health Authority for Los Angeles County – JAMSNo. No. 1220069752

PIH Downey & PIH Whittier v. L.A. Care. Case No. 19STCV18084 PIH Downey & PIH Whittier v. L.A. Care. Case No. 20STCV08190PIH Downey & PIH Whittier v. L.A. Care. Case No. 21NWCV18084

20. CONFERENCE WITH LEGAL COUNSEL—ANTICIPATED LITIGATIONSignificant exposure to litigation pursuant to Section 54956.9(d)(2) of Ralph M. Brown Act:Four Potential Cases 6


21. CONFERENCE WITH LABOR NEGOTIATORPursuant to Section 54957.6 of the Ralph M. Brown ActAgency Designated Representative: John BaackesUnrepresented Employee: All L.A. Care Employees

RECONVENE IN OPEN SESSION Chair

Adjournment Chair

There is no Board of Governors meeting in January 2022The next meeting is scheduled on Thursday, February 3, 2022 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 callin 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 ITEMLISTED ON THE AGENDA BY SUBMITTING THE COMMENT BY VOICE MESSAGE OR IN WRITING BY TEXT MESSAGETO 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 THEMATTER 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 [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 themeeting will enable us to make reasonable arrangements to ensure accessibility to the meetings and to the related materials.

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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]. Prepared by mhbalones/printed on 11/16/21

Monday Tuesday Wednesday Thursday Friday

1 2 Board of Governors

Meeting 2 PM

3

6 7 8

ECAC Meeting 10 AM

(for approx. 2 hours)

9

10

13

14

15

16

17

20

21 22 23

24

27

28

29

30

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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.

Schedule of Meetings

December 2021

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mailto:[email protected]

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].

1055 W. 7th Street, 1st Floor, Los Angeles, CA 90017 Tel. (213) 694-1250 / Fax (213) 438-5728

MEETING DAY, TIME

& LOCATION

MEETING DATES BOARD MEMBERS / STAFF CONTACT

BOARD OF

GOVERNORS

1st Thursday

2:00 PM (for approximately 3 hours) L.A. Care Health Plan

1055 W. 7th Street, 1st Floor, Los Angeles,

CA 90017 (213) 694-1250

December 2

Hector De La Torre, Chairperson Alvaro Ballesteros, MBA, Vice Chairperson Ilan Shapiro MD MBA FAAP FACHE, Treasurer Stephanie Booth, MD, Secretary Christina R. Ghaly, MD Layla Gonzalez George W. Greene, Esq. Antonia Jimenez Supervisor Holly J. Mitchell Hilda Perez G. Michael Roybal, MD, MPH Nina Vaccaro VACANT

Staff Contact: John Baackes Chief Executive Officer, x4102 Linda Merkens Senior Manager, Board Services, x4050

BOARD COMMITTEES

EXECUTIVE

COMMITTEE

4th Monday of the

month 2:00 PM

(for approximately 2 hours) L.A. Care Health Plan


CA 90017 (213) 694-1250

No meeting December

Hector De La Torre, Chairperson Alvaro Ballesteros, MBA, Vice Chairperson Ilan Shapiro MD MBA FAAP FACHE, Treasurer Stephanie Booth, MD, Secretary Hilda Perez Staff Contact: Linda Merkens Senior Manager, Board Services, x4050 Malou Balones Board Specialist III, Board Services x4183

BOARD OF GOVERNORS & PUBLIC ADVISORY COMMITTEES 2021 MEETING SCHEDULE / MEMBER LISTING

9


BOARD OF GOVERNORS, BOARD COMMITTEES, PUBLIC ADVISORY COMMITTEES

AND REGIONAL COMMUNITY ADVISORY COMMITTEES

2021 MEETING SCHEDULE / MEMBER LISTING

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].

MEETING DAY, TIME

& LOCATION


COMPLIANCE &

QUALITY

COMMITTEE

3rd Thursday every 2 months 2:00 PM

(for approximately 2 hours) L.A. Care Health Plan


CA 90017 (213) 694-1250

Stephanie Booth, MD, Chairperson Alvaro Ballesteros, MBA Hilda Perez Ilan Shapiro, MD Nina Vaccaro

Staff Contact: Victor Rodriguez Board Specialist II, Board Services x 5214

FINANCE &

BUDGET

COMMITTEE

4th Monday of the month 1:00 PM

(for approximately 1 hour) L.A. Care Health Plan


CA 90017 (213) 694-1250

No meeting December

Ilan Shapiro MD MBA FAAP FACHE, Chairperson Stephanie Booth, MD Hector De La Torre Hilda Perez G. Michael Roybal, MD, MPH

Staff Contact: Malou Balones Board Specialist III, Board Services x4183

GOVERNANCE

COMMITTEE

L.A. Care Health Plan 1055 W. 7th Street,

1st Floor, Los Angeles, CA 90017

(213) 694-1250

MEETS AS NEEDED

Hilda Perez, Chairperson Stephanie Booth, MD Layla Gonzalez Antonia Jimenez Nina Vaccaro

Staff Contact: Malou Balones Board Specialist III, Board Services/x 4183

SERVICE

AGREEMENT

COMMITTEE



(213) 694-1250

MEETS AS NEEDED

Layla Gonzalez, Chairperson George W. Greene Antonia Jimenez Hilda Perez Staff Contact Malou Balones Board Specialist III, Board Services/x 4183

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MEETING DAY, TIME

& LOCATION


AUDIT

COMMITTEE



(213) 694-1250

MEETS AS NEEDED

Alvaro Ballesteros, MBA, Chairperson Stephanie Booth, MD, Layla Gonzalez

Staff Contact Malou Balones Board Specialist III, Board Services, x 4183

L.A. CARE

COMMUNITY

HEALTH PLAN

Meets Annually or as needed



(213) 694-1250


Staff Contact: John Baackes, Chief Executive Officer, x4102 Linda Merkens, Senior Manager, Board Services, x4050

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MEETING DAY, TIME

& LOCATION


L.A. CARE JOINT

POWERS

AUTHORITY

Meets as needed L.A. Care Health Plan


CA 90017 (213) 694-1250


Staff Contact: John Baackes, Chief Executive Officer, x4102 Linda Merkens, Senior Manager, Board Services, x4050

PUBLIC ADVISORY COMMITTEES

CHILDREN’S

HEALTH

CONSULTANT

ADVISORY

COMMITTEE GENERAL

MEETING

3rd Tuesday of every

other month 8:30 AM

(for approximately 2 hours)



(213) 694-1250

Tara Ficek, MPH, Chairperson Staff Contact: Victor Rodriguez Board Specialist II, Board Services/x 5214

EXECUTIVE

COMMUNITY

ADVISORY

COMMITTEE

2nd Wednesday of the month

10:00 AM (for approximately 3 hours)



CA 90017 (213) 694-1250

December 8

Fatima Vasquez, Chairperson

Staff Contact:

Idalia Chitica, Community Outreach & Education, Ext. 4420

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MEETING DAY, TIME

& LOCATION


TECHNICAL

ADVISORY

COMMITTEE

Meets Quarterly



CA 90017 (213) 694-1250

Richard Seidman, MD, MPH, Chairperson Staff Contact: Victor Rodriguez Board Specialist II, Board Services/x 5214

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 ANTELOPE VALLEY

3rd Friday of every other month

10:00 AM (for approximately 2-1/2

hours) L.A. Care Family Resource Center-

Palmdale 2072 E. Palmdale Blvd.

Palmdale, CA 93550 (213) 438-5580

Russel Mahler, Chairperson Staff Contact: Kristina Chung Community Outreach & Education, x5139

REGION 2 SAN FERNANDO

VALLEY

3rd Monday of every other month


hours) L.A. Care Family Resource Center-

Pacoima 10807 San Fernando

Road Pacoima, CA 91331

(844) 858-9942

Estela Lara, Chairperson Staff Contact: Martin Vicente Community Outreach & Education, x 4423

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MEETING DAY, TIME

& LOCATION


REGION 3 ALHAMBRA,

PASADENA AND

FOOTHILL

3rd Tuesday of every other month


hours) Robinson Park

Recreation Center 1081 N. Fair Oaks

Avenue Pasadena, CA 91103

(626) 744-7330

Cynthia Conteas-Wood, Chairperson Staff Contact: Frank Meza Community Outreach & Education, x4239

REGION 4 HOLLYWOOD-

WILSHIRE, CENTRAL L.A. AND

GLENDALE

3rd Wednesday of every other month


hours) L.A. Care Health Plan Conference Room 100

1055 W. 7th Street Los Angeles, CA 90017

(213) 694-1250

Sylvia Poz, Chairperson Staff Contact: Kristina Chung Community Outreach & Education, x5139

REGION 5 CULVER CITY,

VENICE, SANTA

MONICA, MALIBU, WESTCHESTER


2:00 PM (for approximately 2-1/2

hours) Veterans Memorial

Building Garden Room

4117 Overland Avenue Culver City, CA 90230

(310) 253-6625

Maria Sanchez, Chairperson Staff Contact: Jose Rivas Community Outreach & Education, x4090

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MEETING DAY, TIME

& LOCATION


REGION 6 COMPTON,

INGLEWOOD, WATTS, GARDENA,

HAWTHORNE

3rd Thursday of every other month


hours) South LA Sports Activity

Center 7020 S. Figueroa Street Los Angeles, CA 90003

(323) 758-8716

Andria McFerson, Chairperson Staff Contact: Frank Meza Community Outreach & Education, x4239

REGION 7 HUNTINGTON

PARK, BELLFLOWER,

NORWALK, CUDAHY



hours) Community

Empowerment Center 7515 Pacific Blvd.

Walnut Park, CA 90255 (213) 516-3575

Fatima Vasquez, Chairperson Staff Contact: Martin Vicente Community Outreach & Education, x 4423

REGION 8 CARSON,

TORRANCE, SAN

PEDRO, WILMINGTON

3rd Friday of every other month


hours) Providence Community

Health Wellness and Activity Center

470 N. Hawaiian Ave. Wilmington, CA 90744

(424) 212-5699

Ana Romo – Chairperson Staff Contact: Jose Rivas Community Outreach & Education, x4090

REGION 9 LONG BEACH



hours) Albert Jewish

Community Center 9801 E. Willow Street

Long Beach, CA 90815 (562) 426-7601

Tonya Byrd, Chairperson Staff Contact: Kristina Chung Community Outreach & Education, x5139

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MEETING DAY, TIME

& LOCATION


REGION 10 EAST LOS ANGELES,

WHITTIER AND

HIGHLAND PARK



hours) L.A. Care East L.A.

Family Resource Center 4801 Whittier Blvd

Los Angeles, CA 90022 (213) 438-5570

Damaris de Cordero, Chairperson Staff Contact: Jose Rivas Community Outreach & Education, x4090

REGION 11 POMONA AND EL

MONTE

3rd Thursday of every other Month


hours) Pomona Community

Resource Center 696 W. Holt Street Pomona, CA 91768

(909) 620-1661

Maria Angel Refugio, Chairperson Staff Contact: Frank Meza Community Outreach & Education, x4239

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Board of Governors

MOTION SUMMARY

Date: December 2, 2021 Motion No. BOG 100.1221

Committee: Chairperson: Hector De La Torre

Issue: Remote Teleconference Meetings

Background: On March 17, 2020, Governor Newsom issued Executive Order N-29-20 suspending certain provisions of the Ralph M. Brown Act (the “Brown Act”) in order to allow for local legislative bodies to conduct their meetings completely telephonically or by other electronic means due to public health orders restricting gatherings during the COVID-19 pandemic.

Recent legislation and amendments to the Brown Act allow legislative bodies to continue meeting virtually provided there is a state of emergency declared by the Governor, and either (1) state or local officials have imposed or recommended measures to promote social distancing; or (2) the legislative body determines by majority vote that meeting in person would present imminent risks to the health and safety of attendees. The Governor, by executive order signed on September 20, 2021, suspended the effective date of this new legislation to October 1, 2021. And, the virtual meetings must be held consistent with these new requirements.

In order to continue conducting virtual meeting under the revised provisions of the Brown Act the Board of Governors, or any other legislative bodies of L.A. Care Health Plan, including Committees, must, within thirty (30) days of the first meeting following the effective date and every thirty (30) days thereafter, make findings that (a) state or local officials continue to recommend measures to promote social distancing, or that (b) an in-person meeting would constitute an imminent risk to the safety of attendees.

Findings: 1. The Board of Governors has reconsidered the circumstances of the state of emergency initially

declared by the Governor on March 4, 2020, pursuant to section 8625 of the California Emergency Services Act, relating to the COVID-19 public health crisis and finds that the declaration still remains in effect. The continuation of virtual meetings will allow for full participation by members of the public while social distancing recommendations remain in effect and will facilitate the purposes of such social distancing recommendations by preventing large crowds from congregating in indoor facilities for extended periods of time. Given that the vaccination status of meeting participants is not known, it is prudent to use caution in protecting the health of the public, L.A. Health Care’s employees and its members where, as here, adequate virtual means exist to permit the meeting to occur by teleconference/videoconference with the public being afforded the ability to comment in real time.

2. The Board of Governors finds that state and local officials continue to impose or recommend measures to promote social distancing. The Department of Industrial Relations’ issuance of COVID-19 Prevention regulations through Title 8 of the California Code of Regulations, section

17

Board of Governors

MOTION SUMMARY

3205 et seq., includes informing employees that masking and social distancing in the workplace are most effective when used in combination because particles containing the virus can travel more than six feet. Further, as of the date of this Motion, the Los Angeles County Department of Public Health continues to recommend measures to promote social distancing, including recommendations to avoid crowded indoor spaces and to maintain six feet of social distancing, especially in cases where the vaccination status of persons outside a person’s household is unknown.

As such, staff recommends approval of this motion so that the Board of Governors and all legislative bodies of the L.A. Care Health Plan may continue to meet virtually. The Board of Governors, or other legislative bodies on the Board’s behalf, may extend the authorization for an additional thirty (30) days via another motion summary that makes the above specific findings in support of continuing virtual meetings.

Member Impact: L.A. Care members will benefit from this motion by providing for public

participation in Board of Governor meetings, while following social distancing measures promoted by State and Local public health officials.

Budget Impact: The approval of a motion to continue virtual meetings will maintain the status quo

and minimal financial impact is anticipated by the approval of this motion, though some costs may be associated with the technical solutions required to conduct teleconference meetings in compliance with the Brown Act.

Motion: 1. Authorize remote teleconferencing consistent with the Ralph M. Brown

Act; 2. Adopt findings as set forth in this Motion Summary and, 3. For all L.A. Care meetings subject to the Ralph M. Brown Act that are

not held within 30 days, delegate authority to the Executive Committee to authorize findings to continue remote teleconferencing consistent with the Ralph M. Brown Act.

18

APPROVED

Board of GovernorsRegular Meeting Minutes #302November 4, 2021L.A. Care Health Plan, 1055 W. 7th Street, Los Angeles, CA 90017

Members Management/StaffHector De La Torre, Chairperson Antonia Jimenez * John Baackes, Chief Executive OfficerAlvaro Ballesteros, MBA, Vice Chairperson Honorable Holly J. Mitchell Terry Brown, Chief of Human ResourcesLayla Gonzalez, Secretary Hilda Perez Linda Greenfeld, Chief Product OfficerStephanie Booth, MD G. Michael Roybal, MD, MPH Augustavia Haydel, General CounselChristina R. Ghaly, MD * Ilan Shapiro, MD James Kyle, MD, Chief of Equity & Quality Medical DirectorGeorge W. Greene, Esq. * Nina Vaccaro, MPH Thomas Mapp, Chief Compliance Officer

Marie Montgomery, Chief Financial OfficerFrancisco Oaxaca, Chief of Communications & Community Relations

All via teleconference Noah Paley, Chief of Staff*Absent Acacia Reed, Chief Operating Officer

Richard Seidman, MD, MPH, Chief Medical OfficerState and local officials continue to impose or recommend measures to promote social distancing to reduce transmission of the COVID 19 virus. It is

prudent to use caution in protecting the health of the public, L.A. Health Care’s employees and its members where adequate virtual means exist to permitthe meeting to occur by teleconference/videoconference with the public being afforded the ability to comment in real time. The Board of Governors and

all legislative bodies of the L.A. Care Health Plan will continue to meet virtually and the Board will review that decision as provided in the Brown Act.

AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENWELCOME Hector De La Torre, Chairperson, called to order at 2:06 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 AuthorityBoard of Directors regular meetings were held simultaneously.

He announced that, for those with access to the internet, the materials for today’s meeting areavailable on the L.A. Care website. If you need information about how to locate the materials,please let us know.

He welcomed members of the public and thanked those who have submitted public commentby voice mail, text or email. He informed participants that for those using the video softwareduring the meeting, the “chat” function will be available to provide live and direct publiccomment.

Board Members have received in writing the voice messages and written comments that weresent before the meeting. Comments sent before and during the meeting will be read for up tothree minutes. Public comments on any topic that are not listed on the Agenda will be heard at

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Board of Governors MeetingNovember 4, 2021, Page 2 of 33 APPROVED

AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN

the Public Comment section of the Agenda, and comments on the items listed on the Agendawill be heard before the item is discussed by the Board. Submission of public comment mustbe sent before public comment period for an item.

APPROVAL OFMEETINGAGENDA

There was no public comment for this item. The agenda was approved as submitted.Unanimouslyapproved by roll call.8 AYES (Ballesteros,Booth, De La Torre,Gonzalez, Mitchell,Roybal, Shapiro andVaccaro)

APPROVAL OFFINDINGS UNDERTHE RALPH M.BROWN ACT

Motion BOG 100.11211. Authorize remote teleconferencing consistent with the Ralph M. Brown Act;2. Adopt findings as set forth in this Motion Summary and,3. For all L.A. Care meetings subject to the Ralph M. Brown Act that are not held

within 30 days, delegate authority to the Executive Committee to authorize findings tocontinue remote teleconferencing consistent with the Ralph M. Brown Act.

Unanimouslyapproved by roll call.8 AYES (Ballesteros,Booth, De La Torre,Gonzalez, Mitchell,Roybal, Shapiro andVaccaro)

PUBLICCOMMENTS

Received October 7 at 10:28 am via voice mail by anonymousThis is anonymous for the next Board of Governors meeting. I think probably theonly thing more annoying and irritating than listening to the audio tapes on this thatyou guys are so concerned about our health and that its your top priority is notgetting the health care that you say is you top priority. We have to listen to thesehypocritical tapes for ridiculous amounts of time while we are trying to call and file agrievance because we are not getting our health care at all. Because there’s aproblem. A simple one that could be easily solved. But you guys continue to violateHIPPA, compliance, protocol, medical laws, all sorts of things. Why? Either, wellwhy don’t you change the tapes so they are not so aggravating because we are notgetting what you guys are saying you are putting out there. And, actually do whatyour mission statement says and give us your high quality health care. And accessto high quality health care. We can’t even get our health care. You aren’t evengiving us information.

Received October 19, 2:40 am via voice message by anonymousThis is anonymous and this is for the next Board of Governors meeting, wheneverthat’s going to be. Why is L.A. Care continuing to violate medical protocols, medical

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practices, the law, ADA, HIPPA, patient rights and more. I still cannot get my healthcare in a timely, consistent manner or completely. I’m getting expiredauthorizations. Then, having Global Care yank my health care and transfer me tonew providers instead of following the proper protocols. L.A. Care is still messing upmy address. Global care is messing up my address. All of these things and moreare delaying my health care, my ability to access it and L.A. Care is deliberatelyviolating their mission statement under the guidance, apparently, of JohnBaackes. If a grievance is made with his name in it, his name tends to disappearfrom the grievance. Why are these things happening? Why is L.A. Care stillallowing these violations to happen and making it exceedingly difficult for clients toget access to their health care. L.A. Care is being paid quite well and yet they arenot providing the health care that they are supposed to be, or at all in many cases. Iam constantly jumping through L.A. Care’s hoops, L.A. Care isn’t following its ownprotocols. When L.A. Care does follow protocol it means it is going to bedetrimental to the client and it’s not going to be because they actually read theclient’s file. This has been an ongoing complaint, DHCS has audited la carerepeatedly for items that I brought up prior to me bringing them up and prior to mybeing an L.A. Care member. DHCS continues to audit L.A. Care and L.A. Care gotdinged for things like hiring pharmacists who were not licensed in the state ofCalifornia and non-emergency medical transportation that was not validated,verified, vetted, accepted by Medi-Cal and Medicare. Those are very basicthings. And yet L.A. Care won’t take care of the very basis things so that we can getaccess to our health care. Nor will they take care of the higher level things. Andthey just keep on making more and more work for the clients and deliberatelyexhausting us. Stop it. Fix it.Received October 25, 10:25 am via voice mail anonymousThis is anonymous for the next Board meeting. <Unintelligible> spends so muchmoney on things that nobody is able to access and yet you are not taking care of thebasics. So we can’t get our health care in a timely consistent manner or at all, andwe can’t call anybody unless we know their extension already because your phonesystem is not working. You’ve just gotten a new phone system apparently and spenta ton of money on it and yet we can’t get through and there’s an unusually high callvolume and then also it disconnects after about a half an hour of waiting on hold andthe number that you refer to if you call another number is non existent it doesn’twork, that’s the recording on it. really? Your 288 number. Wow. Justwow. Maybe you could spend the money, the new money that you’ve gotten ongiving us the old things that we were supposed to have gotten from the oldmoney. That would be helpful so we could actually get healthy.

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Submitted by Jonathan Cooper, L.A. Care Member, via phone call on November 3, 2021 at10:04 am:GM, Chairperson Mr. De La Torre, Member of the BOG, Mr. John C. Baackes CEO,and members of the public. Also I would like to make a welcome to the HonorableL.A. County Supervisor Holly J. Mitchell and I can’t forget a welcome to the newDPSS Director Antonia Jimenez and all the County employees under herdirection. My public comment is as follows I would first like to wish everyone whocelebrate holidays in November, my good wishes to you all. And my good wishes toLatino Heritage Month which was also in November. In particular, I would likeeveryone to remember Nov 11, Veteran’s Day. I would like to thank the women andmen in the military, some have been family members and other, etc. And those whohave passed to protecting our freedom and democracy. Also my thank you to theBoard of governor’s members and the staff of all departments at L.A. Care who havebeen very helpful and supportive of the members. Please remember the followingissues voting rights, healthcare issues, and climate issues, etc. Protecting ourconstitutional rights and better health care is my concern. And finally I ask themembers of L.A. Care and all to please pray for me and my mom for the comingyear. Thank you very much and Happy Thanksgiving.

Submitted by Elizabeth Cooper, RCAC 2 Member, via phone call on November 3, 2021 at10:04 am:GM and welcome to Chairperson De La Torre, Board Members and Mr. John C.Baackes and members of the public. I wish you all a good Board meeting andHappy Thanksgiving.

Submitted by sender not self-identified on Nov 3, 7:44pm via textEnforcements against LA Care

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Email received from Andria McFerson, received November 4, at 12:55 PM

Chair Person,

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I feel I have been racially discriminated against. Many meetings repetitively whilehaving the floor I was denied an attempt to file a motion, the agenda items per myrequest, during the ECAC meetings as a RCAC 6 chair were openly denied by staff.Discussing topics regarding the disparities of the colored communities with the Blackpeople of LA County of course being the highest chronic conditions and morality rateof the overall population there are many reasons this topic should openly be broughtto the fore-front. Why shouldn't we be able to discuss how the social determinants ofhealth effects health disparities of the Black population overall. I feel this topic isbeing ignored and we need to openly discuss these disparities and preventativecare information. I believe we need ad-hoc meetings carrying out complete andproper protocols to openly speak with other Chairs and talk about otherperspectives, dealing with this crisis so we could take it seriously just like the Boardof Supervisors motion Measure H approving an ad-hoc about a similar subject butwith an official process of carrying out their meetings. Now, as Chairs and officialExecutive representatives we need to fulfill our responsibilities I don't know if Dr.Kyle directly would be apart of this ad-hoc but it would be nice if the equitydepartment he represents would be apart of this.Important topics like; how Black people have received negative and positive

impacts on all aspects of the SDH and thrived. Also giving job info & Healthcareopportunities, notifications and successful techniques for theColored communities to thrive it especially the Black population due to the highestmortality, chronic illness and poverty rates as well! � �I was not just attempting to vote on an ad-hoc for the Black community I also

believe that more health coverage for the undocumented should be openlydiscussed have an official, credible platform to discuss health concerns and betteraccess so we as RCAC & ECAC can publicly enact the initiative which is originallyhow LA Care grew into the largest public insurance company in the Nation!I feel Racially Profiles every time this happens.Andria McFersonChairperson De La Torre asked that Community Outreach & Engagement staff please have aconversation with Ms. McFerson regarding the motions that she has made and find anappropriate setting to consider those discussions. He noted that sometimes issues are raisedwhere it is not the appropriate setting to have the conversation, and that has nothing to do withthe individual but with timing and process.

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AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENAPPROVECONSENTAGENDA ITEMS

PUBLIC COMMENTSubmitted by Elizabeth Cooper, RCAC 2 Member, via phone call on November 3, 2021 at10:04 am:Member of the Board I would like the consent items made shorter. I know you do alot of work in your different committees, but the public needs the opportunity tospeak on items on the consent agenda.

Chairperson De La Torre noted that the Consent Agenda is placed on the Agenda for themeetings and materials for each of the Consent Agenda items to be considered is included inthe meeting packet. Items placed on the Consent Agenda are discussed by members at acommittee meeting and public comment for the items can be submitted at the committeemeetings. This is a common practice. He invited people to review the materials included in themeeting packet.

September 2, 2021 Board of Governors Meeting & Retreat Minutes

September 27, 2021 Board of Governors Special Meeting Minutes

Revised 2022 Board & Committee Meeting ScheduleMotion BOG 100.1121*To approve the revised 2022 Board of Governors and Committees meeting scheduleas submitted.

Ratify execution of Amendment A33 to Contract 04-36069, and Amendment A15 toContract 03-75799, between L.A. Care Health Plan and the California Department ofHealth Care ServicesMotion EXE 100.1121*To ratify execution of Amendment A33 to Contract 04-36069, and to ratify executionof Amendment A15 to Contract 03-75799, between L.A. Care Health Plan and theCalifornia Department of Health Care Services, by L.A. Care Chief ExecutiveOfficer, John Baackes.

Accounting & Financial Services Revised PoliciesMotion FIN 100.1121*To approve the following Accounting & Financial Services Policies as attached:

o AFS-008 (Annual Investments)o AFS-027 (Travel Expenses)

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Ntooitive ContractMotion FIN 101.1121*To authorize staff to execute a new statement of work with Ntooitive in the amount of$7,346,802.00 for marketing campaigns for L.A. Care’s direct lines of business, includingthe LACC Shop and Compare Tool, and the Community Resource Centers for the periodof October 1, 2021 through September 30, 2022.

Change Healthcare Resources Contract AmendmentMotion FIN 102.1121*To authorize staff to amend a contract authorizing the expenditure of up to$4,100,000 with Change Healthcare Resources, LLC to provide Appeals andGrievances staff augmentation services from June 17, 2021 to May 31, 2022.

Claris Health Contract Amendment Scope of Works 2, 4, and 6 (FIN 103)Motion FIN 103.1121*To authorize staff to amend the contracts for three (3) Scope of Works (SOWs) in theamount of $6,587,057 (for a new total of $10,474,974 for all three SOWs) with ClarisHealth to provide workflow management, data distribution, analytics modules tosupport L.A. Care data mining services as well as a clinical audit workflow to includean analytics module, workflow management, medical records management andreview through December 31, 2024.

The Consent Agendaitems wereunanimously approvedby roll call.9 AYES (Ballesteros,Booth, De La Torre,Gonzalez, Mitchell,Perez, Roybal, Shapiroand Vaccaro)

CHAIRPERSON’SREPORT

Nominations forCharitableOrganizations fordonated BoardStipends

PUBLIC COMMENTSubmitted by Carolyn Rogers Navarro October 30 2021 11:07am via textRef letter sent to me. The letter posted letter claims L.A. Care was justifieddiscussion my concerns mentioned at a Board meeting at a later ECAC meeting onNov 19, 2015 while I was waiting on hear back from an advocate who never followedup, my daughter died about 3 weeks later! I was never notified my daughter wouldbe publicly discussed at an ECAC meeting which I question had anything to do withme commenting at a Board meeting. The reason you people would justify notfollowing with me is because you full of [expletive] (and I just happened to reportSynermeds fraud)! I blotted out the perps name because I intend to paint you lowlives into a corner where I can mention anyone, anywhere with No recourse fromL.A. Care! You claim you resolved my complaints when in fact I told you Synermedwas doing improper things and you defended Synermed and would not respond tomy attempts to get assistance for my autistic daughter who coulsd not speak forherself, all this makes you opeople look like the [expletive] you really are, your

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taking advamntage of the special needs community and you need to be shut down!Letter attached (will verify that, you incompetent phonies)At ECAC meeting it’s claimed my grievances were resolved when I don’t believethey properly documented.

Submitted by Carolyn Rogers Navarro October 30 2021, at 11:07am via textThe state needs to shut you down, it could happen because of your already shownincompetence, you people are a danger to enrollees.Even though you claim you had a “right” to discuss my child without notifying me,your letter affirms that you people have zero common sense and zero businessservicing special needs people or anyone else!Add, I was also told around that time I was not allowed to comment at a meetingother than Board meeting, may have been this November 19 meeting, severalpeople told me that over the phone, I remember their voices!

Submitted by Carolyn Rogers Navarro November 3, at 7:48 am via text

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Submitted by Carolyn Rogers Navarro November 3, 8:24 am via textPhoto for chairpersons report comment just made proving LA Care got my initialgrievance in 2014 and refused to help our daughter after “investigating “defendingSynermed and stopped responding to my follow up attempts, makes LA Care looklike <expletive>!

Submitted by Carolyn Rogers November 3, at 8:26 am via text^note the “management “ people courtesy copied and thus were aware of the horrifictreatment of my autistic child!

Three minutes expired for this public comment and the remaining comment will be included at the end of theseminutes.

Received via text Nov 3, 10:32 am, sender not self-identified

This email from 2014 clearly shows your management was aware of my daughterand LA Care still would not assist me!

Received Nov 3, 12:25 pm, sender not self-identified^ add,to prior general comment, look at the names on this email, then a “big wig” onyour board claims you handled out daughters case just fine without me beingnotified when it was not handled just fine, you crooks!

Board Member Perez joined the meeting.

Chairperson De La Torre invited Augustavia Haydel, General Counsel, to describe the process forBoard Members to nominate charitable organizations to receive donated stipends from BoardMembers. Ms. Haydel explained that Board Members have the opportunity to suggest non-profit organizations to receive stipends donated by Board Members. Two organizations will beselected in a random drawing by staff on November 22. A motion will be brought forconsideration at the December 2 Board Meeting. Board Members are asked to submitnominations by November 22.

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CHIEFEXECUTIVEOFFICER REPORT

PUBLIC COMMENTReceived via text on Oct 14, 2021, at 2:31 am, Carolyn Rogers Navarro Comment Nov 4 2021board meeting, CEO report:a former board member Thomas, for LA Care is indicted for fraud, same boardmember who was filmed milling about talking out loud with Mr. Baackes who wasalso milling about while I addressed the board! WHAT is wrong with you people,what else is going on!? The lives of vulnerable people are in the hands of arrogantassholes, anyone who talks in the background while the mother of a dead autisticwoman addresses the board is an <expletive>, there I said it! Then it’s claimed at anLA Care public meeting without my knowledge you helped our child, that is a lie! LACare is a lie, you people can’t service your members but you keep soliciting newones at your cult recruitment like resource centers!

Received via text, Oct 20, 3:05amIn Aug 2021, LA Care was fined $50,000 for not keeping track of their emails anddata load in reference to grievances and inquires from the Dept of Managed Care,the Dept of Managed Care would have emails bounce back, just like members of LACare. LA Care repeatedly abused requests for extensions in response to DMHCrequests, this affirms LA Cares inability to handle existing enrollees, what businessdo they have adding new ones and actively soliciting them co-branding with BlueShield? What does Blue Shield really have to do with LA Care other than to confusethe public?!

Received via text, Oct 31, 2:08 amEven though you claim you had a “right “ to discuss my child without notifying me,your letter affirms that you people have zero common sense and zero businessservicing special needs people or anyone else!

Received via text, Oct 31, 2:11 amAdd, I was also told around that time I was not allowed to comment at a meetingother than board meeting, may have been this Nov 19 meeting, several people toldme that over the phone, I remember their voices!

Received via text, Oct 26, 8:23 am, sender not self-identified

add to CEO report comment, talking in background durimg public comment. during^

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https://m.youtube.com/watch?v=G-cw606Yz0E&feature=share&fbclid=IwAR1L3czTLpVDABZIU8L8srWSirvHYoBJD2VoF4DsOF8inHaR7dNelLsRt-s

Received via email from Ismael Maldonado, received November 2, 2021, at 3:52 PM

To Mr. BaacksI would like to say that the morale of the way that Los Angeles care health plan hasbeen treating there regional community advisory committee members very badlystipend is having not been given out Should they haven't been meeting phonemeetings have been hectic because of language barrier not having a translator foreach language which is a violation of title five of the ADA the way that thetechnology department is going we need to have a meeting with them to hear whatthe regional community advisory committee members who want and also we needto have a retreat to hear what we want from LA Care Health plane. Comment andquestion for CEOThe way non emergency services are working they are not working as well as theyshould be I heard from a member at her own fun what's left four hours in anemergency room to his natural support system after he was seen and had a hardtime getting him home and that is a violation I also myself experience beingtransported by non emergency EMT's they took hours to come to get me fromProvidence Saint Joseph we need to look into because this is not right for talking tothe transportation department if they could do a better job people with disciplinesand people without disabilities to experiencing these things is a question for theCEOWill you have alternative formats offers for people with disabilities under title twounder the Americans with disability act of 1990 cool caption is well needed trainingmeetings and learning to be a meeting where we can see the scratch scription inactual live screen I have seen it on teams program the county of Los Angeles has away of doing that I have seen it done in many meetings with the county with thestate on teams this is a comment to the CEO N as well alternative format in largeprintI am in support of California assembly bill 15 twist in the moratorium are peoplebeing evicted from their homes fighting galley cares doing a great job there you cansupport the mayor San Jose LA San Diego San Francisco Sacramento Long BeachOakland Santa Ana RiversideA word of advice I would like to tell you guys you guys are doing OK but if you guys(three minutes expired for this public comment and the remaining text is included at the end of these minutes.)

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Submitted by Elizabeth Cooper, RCAC 2 Member, via phone call on November 3, 2021 at10:04 am:Mr. Baackes Good Afternoon, welcome. I would like you to, thank you for yourleadership this season. It has been a tough year because of the virus which hasaffected so many some of which have passed off. I would like to thank your staff fortheir participation and keeping as members involved or in touch. It means a lot tome as a member and others I’m sure. Also, please give recognition to Dr. SeidmanChief Medical Officer of L.A. Care for the information he has given to us as L.A.Care and RCAC members. Finally, Mr. Baackes on a friendlier note, make surestaff is taken care of with compensation and raises (smile).

John Baackes, Chief Executive Officer, reported:CalAIM

There are 58 days until the first day of 2022 and the implementation of a suite of newbenefits and programs under California Advancing and Innovating Medi-Cal (CalAIM),which has been discussed at many previous meetings. The biggest challenge being faced isthat two current programs are ending on December 31, 2021 and the replacement programsbegin on January 1, 2022. The two programs are Whole Person Care and Health Homes.

Whole Person Care (WPC) is a program that Los Angeles County Department of HealthServices (DHS) and other county agencies, using additional funding in a demonstrationprogram, provides additional services to people and who are homeless or coming out of jail,who have extraordinary needs that Medi-Cal, alone, could not address. Los Angeles Countyhad the most successful of the eight WPC demonstration programs in California.

Also, about three years ago, L.A. Care joined a program called Health Homes (HH), whichidentified people with extraordinary additional needs, based on co-morbidities and socialdeterminants of health.

The challenge is to transfer the members of both the WPC and HH demonstrationprograms into the new programs on January 1, 2022, and continue providing the samebenefits to those members. These demonstration programs were intended to be temporary,providing data so that new, permanent programs could be developed.

The new programs are called Enhanced Care Management (ECM) and CommunitySupports (CS), which was formerly known as In Lieu of Services.

The provider of services to about 7,000 members of the HH demonstration will not becontinuing to serve L.A. Care members, and L.A. Care will notify them and help them find adifferent provider. Many of the other providers for HH beneficiaries will continue to serveL.A. Care members.

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Qualifications for the new ECM and CS programs are not identical to the WPC and HHprograms. L.A. Care believes it is critical that members who received services under WPCand HH and who may not qualify under the criteria for the new programs, are able tocontinue receiving services. This will require significant effort by L.A. Care. Hecomplimented the team that is working on this difficult task.

All the Medi-Cal health plans in Los Angeles County are experiencing the same difficulty,and plans are working together to help all Medi-Cal beneficiaries continue to receive neededservices.

Plans had some discretion on which services it could implement under CS. Based on thecost of providing benefits, L.A. Care selected four important services from the list providedby the state, and is meeting with representatives from California Department of Health CareServices (DHCS) to consider adding other CS benefits in July 2022 and January 2023.

Pharmacy Benefit Changes

Medi-Cal members will have received notice sent from DHCS on November 1, 2021, thatthe pharmacy benefits will transition to a new system on January 1, 2022. L.A. Care willsend a separate notice to its affected members on December 1, 2021. Everyone in Medi-Calprogram who receives prescription drug coverage from L.A. Care will get a new ID card justfor prescription drugs. Instead of having one card for L.A. Care benefits, those memberswill need two cards, one for medical services, and the other for pharmacy services.

The vendor selected by California to manage the new prescription drug program, Magellan,is merging with another health care company, called Centene. The merger has yet to beapproved. L.A. Care representatives have provided public comment to the CaliforniaDepartment of Managed Health Care (DMHC) which oversees the transaction, raisingobjections about the conflict of interest. Centene would be the owner of the new statepharmacy benefits administrator. Centene also owns Health Net, the commercial healthinsurance firm that competes with L.A. Care for Medi-Cal members in Los Angeles County.It appears that the pharmacy benefit administration contract will go forward despite themerger between Centene and Magellan.

L.A. Care Member Enrollment

L.A. Care’s enrollment continues to increase, with total membership at 2,477,000 onOctober 1, 2021, and it is expected that about 10,000 new members will enroll inNovember.

The increased enrollment is partly driven by the suspension of the eligibility redeterminationprocess, during the public health emergency that began in March, 2020 and is expected toexpire in January 2022. One more 90 day extension of health emergency may be granted,which would push redetermination out for another 90 days in early 2022.

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The redetermination process is difficult for members and for health plans. Steps have beentaken to automatically renew eligibility for about 60% of beneficiaries. Paperwork to sustainbenefits must be filed by the other 40% of Medi-Cal members. L.A. Care is working withLos Angeles County Department of Public and Social Services to provide as much notice aspossible to its members. Health Plans are not provided with the redetermination dates forMedi-Cal members. L.A. Care will keep advisory committee members informed about theredetermination process so they can inform their communities and help to ensure thatmembers continue to receive Medi-Cal health care services.

Enrollment in L.A. Care’s Covered California program has reached 103,000. Over the lastyear, special enrollment conditions allowed people to enroll under special circumstances,and the official open enrollment began on November 1, 2021. There are five other healthplans participating for enrollment in Los Angeles County. L.A. Care has the lowest pricedplan, which will increase L.A. Care enrollment in this price-sensitive program, where peopleare looking for the highest premium subsidy and lowest premium and out of pocket costs.

COVID 19 Vaccine

Increasing the vaccination rate will help eliminate COVID 19. Unfortunately, thevaccination rate for Medi-Cal beneficiaries are lower than the vaccination rates for thegeneral population. L.A. Care has a vaccination rate of just over 60% of members aged 12and over, who until yesterday were the only people eligible to receive the vaccine. Ingeneral, Los Angeles residents are vaccinated at about 80%. When the number of residentson Medi-Cal are taken out of that statistic, the vaccination rate is closer to 90% of non-Medi-Cal residents. L.A. Care is focused on closing the gap in rates, making vaccinesavailable and helping Medi-Cal members learn about the vaccine and overcome theirhesitancy to get a vaccine. L.A. Care participates in the California vaccine incentiveprogram, and will provide more information at a future meeting.

Mr. Baackes invited Richard Seidman, MD, MPH, Chief Medical Officer, to provide moreinformation about the vaccine and the COVID 19 pandemic in Los Angeles County.Dr. Seidman reported:

Los Angeles County is in much better shape now than it was a couple of months ago.There is still a substantial level of transmission of the virus, with about 80 new cases per100,000 on a weekly basis. Caution is still recommended and we need to get as many peopleas possible vaccinated and boosters have been approved for all three of the vaccines, andthere is a new recommendation for vaccines for children ages 5-11 years. The bottom lineon that recommendation is that the various committees that reviewed the data on loweringthe age to receive the vaccine determined that the benefits outweighed the potential risks.There may be mild side effects, from which children are recovering. It is fortunate that datahas shown that children in this age group don’t die from the virus at significant rates. Data

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does show, however, that COVID infection has become the sixth most common cause ofdeath in this age group. There are many opinions and attitudes about the need forvaccination in this age group. Even as the risk may be low overall for the majority ofpeople, there is still a real risk, and the health committees have determined that the benefitsdo outweigh that risk.

There are positive notes during this time of the year with the holidays, and the cold and fluseason. He reported that in the Southern Hemisphere of the world, the flu season was stillvery low this past winter; incidence of influenza was close to the lower inter-seasonal ratesand there was no significant peak. It is hoped for the same experience in the NorthernHemisphere.

L.A. County Department of Public Health released information on November 2 about theconditions that need to be met before masking requirements can be relaxed for outdoor andindoor settings. He encouraged everyone to get vaccinated, and to be cautious. He alsoencouraged everyone to be optimistic that we will achieve the conditions that must be met,like lower case rates that need to persist for three weeks, before we can see relaxed maskmandates.

Mr. Baackes continued his report:Flu Shots

As in past years, L.A. Care will offer flu shot clinics. Eight have been held so far, with thetenth clinic to be held on Saturday. He attended one last Saturday in El Monte, and therewas a long line of people in cars and walking up, to receive a flu shot. He commendedBoard Member Hilda Perez for volunteering at the flu clinic.

Board Member Booth asked about the providers that will not continue to provide services forHH and WPC. Mr. Baackes responded that there were 34 community based care managemententities providing those care management services. One declined to participate and LA Careended its relationship with another because of quality issues. The remaining providers willcontinue to provide services for L.A. Care members under ECM. There are about 7,000members who will not be able to keep the providers because the primary care provider was notwithin the Los Angeles County Department of Health Services (DHS). L.A. Care has 27 newvendors that have been screened, of the 60 or more that applied. It is expected that all will becontracted by December 31 except maybe five of those, which will be added in January.Contractors can be added every six months. There were over 100 expressions of interest byproviders for the program. In a show of cooperation by the managed care plans working withinMedi-Cal, those 100 expressions of interest were reviewed together. It will add value to theservices to align the criteria for determination of the providers for the program. Hecomplimented the L.A. Care staff that coordinated the meetings among the health plans.

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Board Member Booth asked about the merger between Centene and Magellan. Ms. Haydelnoted that no decision has been made yet. The written public comment period has just ended.Ms. Haydel will provide more information as it becomes available.Board Member Perez received a letter from DHCS regarding the Medi-Cal pharmacy services.She reminded Mr. Baackes that Board Member Gonzalez suggested that L.A. Care send its letterin a colored envelope so members will notice the information more easily. Included was a listof phone numbers for Medi-Cal members seeking more information. Mr. Baackesacknowledged that L.A. Care will be sending its letter in a bright blue envelope.Board Member Perez thanked L.A. Care for the effort put into holding the flu clinics. Thevendor that organizes the event also works hard. There is outreach in the community toencourage vaccination. She showed the incentive items and information that are provided topeople who attend a vaccination clinic. She noted that many participants are not aware of theCommunity Resource Centers (CRCs), and it is a good way for them to learn. Participants areasked how they learned about the flu clinic, and the responses show a variety of sources. Shehas advocated for more interactive ways to work with the community members through thesocial media platforms and the responses show that it is working. Member Perez looked up “fluvaccine near me” online and found L.A. Care referenced on the internet. She is a HealthPromoter and she is honored to be invited to serve the community. Health Promoters areworking on a project for cooking, and helping get everybody vaccinated.Board Member Ballesteros asked about the incentive program for COVID 19 vaccines. Mr.Baackes described the program as $100 million to pay for gift cards, and L.A. Care hasdeveloped a program to use the gift cards. In February, there will be a measurement of theprogress made. There is another fund of $250 million, about 20% of which has beendistributed to the plans participating in the program. L.A. Care received about $9 million,which has been proportionally shared with the Plan Partners. L.A. Care has developed a planfor this segment that will maximize the effectiveness of the campaign by focusing on thepopulations that are more difficult to reach, in order to encourage vaccination. That the healthplans are proposing the programs is a recognition by DHCSDMHC that health plans know theneeds in their local communities, and allows the plans to work across multiple venues.Pasadena Department of Public Health has taken an incentive grant to vaccinate 8,000 L.A.Care members and 1,000 members of the general public in that city. At the December Boardmeeting a presentation can be made about the vaccine incentive program. At its core, theprogram seeks to link unvaccinated members to trusted individuals for a conversation about thevaccine.Member Ballesteros asked if the incentive gift cards would be distributed at the vaccinationevents. Mr. Baackes responded that those who are eligible to receive the gift card will receive itin the mail after the event.

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Dr. Seidman added that L.A. Care is working on an incentive program for providers, such aspharmacies, to promote vaccination. He noted that L.A. Care is also working with Los AngelesCounty Community Clinic Association to develop a program with community clinics topromote vaccination among the patients.Board Member Ballesteros asked about a transition period for the HH and WPC members. Mr.Baackes reported that there is a six-month period to evaluate members under the new criteria.Members who don’t meet the new criteria will receive support services until they can be safelydischarged. Members will continue to have benefits provided during the assessment period.Board Member Mitchell noted all the change coming in January impacting L.A. Care, withCalAIM, the pharmacy carve out and Health Homes. She inquired about the allocation ofresources, including sufficient staff to accomplish these important tasks. It has been anoverwhelming two years. She also would like to be sure L.A. Care has allocated appropriateresources to be able to communicate to members how all the changes will impact them, as thereare a lot of changes that will be rolling out quickly. Mr. Baackes acknowledged that it is a lot ofchange. L.A. Care is challenged in staffing levels, as everyone is right now, particularly withlicensed staff such as nurses. L.A. Care has vacancies that it needs to fill and is workingdiligently on that. The communication will be made directly to Health Homes members, notgeneral communication to every member of the health plan. The people in Health Homes andthose receiving services through Whole Person Care will be directly contacted by L.A. Care orby DHS. Member Mitchell asked about communications around the other changes, such as thepharmacy carve out. Mr. Baackes responded that L.A. Care will send information by mail onDecember 1 in a bright blue envelope to inform Medi-Cal members about the pharmacy carveout. Member Mitchell asked if traditional mail is the best, most effective mode ofcommunication with health plan members. He responded that it is not the best and mosteffective mode, but it is the mode required by the state of California. It could be doneeffectively by telephone or by email. But regulations require that a letter be mailed to themember through the US Postal Service. L.A. Care would like to discuss modes of membercommunication with DHCS. Member information is supplemented through social media andother ways, but in the end, regulations require that important direct communication to membersmust be done by mail. Member Mitchell noted that as long as mailing isn’t the only way. L.A.Care knows its members, and using the other means of communication is amazing. Shethanked L.A. Care for working with her constituent services staff on a training session led bythe L.A. Care Customer Support Services (CSC) manager. CSC have been very timely andprofessional in helping her staff navigate constituent challenges. There are some issues that shewill send to Mr. Baackes in writing. She appreciates the coordination of a training session forher staff so they can be useful and effective in helping constituents navigate challenges they areexperiencing, to help resolve the issues. Mr. Baackes stated that members can walk into the

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CRCs to have their problems addressed. Members do not have to rely on the telephone foreverything, there is a face-to-face option in the community.Board Member Gonzalez asked how members will know that the $50 gift cards will bedistributed, as members are more likely to participate in the vaccination clinic if they are awareof the gift cards. Mr. Baackes responded that L.A. Care has issued a press release tocommunicate the information and additional communication is planned about the vaccinationprogram. Dr. Seidman added that work is being done to reach members, and the details couldbe provided during the presentation that Mr. Baackes spoke of earlier in the meeting. MarieMontgomery, Chief Financial Officer, noted that L.A. Care will use the same vendor it has beenusing to process member incentive gift cards. Mr. Baackes offered to provide more informationto Board Members in writing regarding the gift card program. Member Gonzalez invited Mr.Baackes to provide the information at the November 10 meeting of the Executive CommunityAdvisory Committee. Mr. Baackes agreed to provide the information and noted that he isalready scheduled to provide a report at that meeting.Board Chairperson De La Torre noted that it is important to increase the vaccination rate somore people are protected. Even if one has had COVID 19, the vaccine is protective againstvariants and from severe illness. Vaccination can help stop the pandemic and its variants, andcan help protect people against severe illness. Mr. Baackes noted that the gap in vaccinationrates between Medi-Cal beneficiaries and the rest of the population is typical across the UnitedStates. Health plans are working to get those who are hesitant to receive a vaccine together witha trusted source to talk about the facts about the benefit of getting a vaccine.

4TH Quarter FY2020-21 Vision2021 ProgressReport

Mr. Baackes referred Board Members to the written report included in the meeting materials.

Vision 2024 Mr. Baackes referred Board Members to the written report included in the meeting materials.

Grants andSponsorship Report

Mr. Baackes referred Board Members to the written report included in the meeting materials.

ADVISORY COMMITTEE REPORTS

ExecutiveCommunity AdvisoryCommittee (ECAC)

PUBLIC COMMENTSubmitted via phone call by Elizabeth Cooper, RCAC 2 Member, on November 3, 2021 at10:04 am:I would like to request that during the ECAC meetings there be a report from an adhoc committee regarding issues affecting persons of disability. I would like to have

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their input at meetings. I would it like it addressed through Community Outreachand Engagement.

Submitted via email by Andria McFerson, RCAC 6 Chair, on November 4, 2021, at 2:44pm

Mr. ChairpersonI have a correction on my previous comment stating BOS/Measure H.The motion passed was Measure J. Per: BOS website “On November 3, 2020, thevoters of Los Angeles County approved Measure J which dedicated no less than tenpercent of the County’s locally generated unrestricted funding to address thedisproportionate impact of racial injustice through community investments such asyouth development, job training, small business development, supportive housingservices and alternatives to incarceration."We do need this AD-HOC for our Advisory Committee. Mr. Chairperson, pleasedon't assume that I am not following proper protocol while trying to carry out proper,effective, procedure while practicing the Brown Act and Robert's rule of Order andusing similar successful tactics practiced throughout LA County approved byupstanding individuals like the Board of Supervisors.Thank You,Andria McFerson

Layla Gonzalez, Consumer Advocate, reported that the ECAC met on September 8 and October13. She thanked all of the RCAC members, staff, and public that attended both meetings. Shesent her condolences to everyone who has lost a family member due to COVID 19. Shethanked those who have already received a vaccine and asked that they please spread the wordand remember to use masks indoors and whenever close to others.

On September 8:•Dr. Seidman gave an update from his CMO report.•Mr. Baackes gave an update from his CEO report.•Dr. Auleria Eakins, Manager, CO&E, presented the Communications and CommunityRelations report.

-Diversity, Equity and Inclusion efforts: Part II of the Asian Health Series took place atthe end of September and focused on the Cambodian community, Cambodian cultureand access to care issues specific the Cambodian community.-A COVID-19 Informational Update with Dr. Seidman took place on September 28.He spoke about the increase in COVID-19 cases, booster shots, and vaccine hesitancy.

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-CO&E co-hosted a Tech Justice /Access Seminar in honor of “Tech Inclusion Week”from October 4-8. This project is a result of the current partnership betweenCommunity Outreach and Engagement and Human I.T. The purpose of this project isto address the digital divide among low income residents throughout Los AngelesCounty.

•Siddharth Raich, MPH, Project Manager II, Quality Improvement Department, presentedinformation about the outcomes of the automated robo-call through our vendor HMS-ELIZA.Calls went out to more than 44,000 people to provide health education about asthma response,and condition management for diabetes and hypertension.•Amber Perrier, Managed Care Pharmacy Resident II, Pharmacy & Formulary, providedinformation on why it is important to get vaccinated for the flu and who is eligible to receivevaccinations. Ms. Perrier also provided statistics for the 2020-2021 flu season.

On October 13:•Dr. Seidman and Mr. Baackes gave updates.•Dr. Eakins provided an update on Communications and Community Relations:

-CO&E, in conjunction with Human IT, hosted a virtual event on October 5 to shareinformation about the digital divide and how to access computer hardware, computerliteracy and internet access at free or low-cost from the CO&E Community Partnership.-CO&E hosted its first Hispanic Heritage Virtual event on October 14 titled, “Acelebration of Lived Experiences”. It was a great opportunity to hear from consumeradvisory committee members as they shared their journey here to the states, challengesand triumphs accessing health care as well their perspective on the importance of healthadvocacy.-CO&E staff is currently planning a rental and housing assistance clinic for advisorycommittee members. The date for this event is yet to be determined; staff is looking atdates in November.

•The committee heard recommendations from an ECAC ad hoc committee on planning forBlack History Month. The focus was to address Health Disparities in the Black community andhighlight individuals and organizations that champion improvement in their conditions andoverall wellness. The ad- hoc committee recommended inviting speakers or presenters toeducate members on topics such as food security, housing the unhoused, access to communitybased resources, and Mental health and Black youth.•Ms. Schiffer presented L.A. Care’s Strategic Plan Overview – Vision 2024.

Member Gonzalez thanked Member Perez for her participation and posting on social mediaabout the El Monte flu clinic. Member Gonzalez had the pleasure of attending the opening ofthe Wilmington Senior Center, and it is a gem. I am sure that the members of that RCAC will

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be pleased. She participated at the flu clinic in Palmdale and it was a lot of fun. She encouragedBoard Members to participate if they are able. The event was well coordinated and she looksforward to doing it again. Mr. Baackes responded that she is welcome to come out andparticipate. He noted that the vendor that sets up the events is very good at arranging thelogistics. The booths and all contact with members is done by L.A. Care volunteer staff.Member Perez added that many of the participants that attended the flu clinics asked her whenL.A. Care would hold COVID 19 vaccine clinics again. She understands that there are manyother agencies distributing the vaccine. She also noted that the number of CommunityResource Centers and Family Resource Centers is growing, and her concern is with safety andsecurity around the sites, so that members will be safe volunteering at events. She thanked L.A.Care for hearing the concerns of RCAC members. Many of the members don’t have theopportunity to join the Board Meetings by video, but they are able to listen to the meeting. Ifshe was not a Board Member and could only listen to the meeting, it would be difficult for herto understand and follow the discussion. She understands why the members are asking for in-person meetings to resume. It would be great to see one another, but it is also important to beable to learn from the meeting discussion and to ask questions. She encouraged members toreach out to Community Outreach & Engagement department staff with any questions orconcerns. She assured the members that L.A. Care is here to assist them. Hopefully with thevaccination efforts, in-person meetings will be held again soon. She thanked L.A. Care forimplementing closed captioning and effective use of interpreters during the video meeting. Shewants to be sure that members can receive the messages clearly and that they feel welcome toask questions, express themselves and their concerns. Member Perez invited Board Members toattend a flu clinic; the last flu clinic will be held on November 6 in Pomona, an area with greatneed, and we are happy to go there.Member Booth stated that as she was reading the quality improvement report on the 40,000people who received a robo call, she wasn’t clear about the data, so she asked for moreinformation or offered to send questions. Mr. Baackes suggested that she send a list ofquestions.Member Perez asked if L.A. Care is able to send text messages to health plan members. Dr.Seidman responded that we can text members, but, due to regulations, it is not a simple task.L.A. Care has plans to leverage that technology more and more. In addition, L.A. Care ishoping to expand communications with members in other ways that are more efficient.

BOARD COMMITTEE REPORTS

Executive Committee PUBLIC COMMENT

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Submitted via phone by Elizabeth Cooper, RCAC 2 Member, on November 3, 2021, 10:04 am:I hope the Officers that are elected to represent the Board will be culturally diverseand sensitive. And that is my hope whomever you elect as your Officers. That theyculturally sensitive to all members of L.A. Care.

The Executive Committee met on October 25. A copy of approved meeting minutes can beobtained by contacting Board Services and is also available on the website. The Committeereviewed and approved motions for revisions to Human Resources Policies: HR-602 (AnnualOrganizational Incentive and HR-609 Wage and Salary). Those motions do not require fullBoard approval.

Board OfficerElection

Board Member Perez stated that she is excited to do this because it is a pleasure to be part ofthis Board. She has seen so many members with an eager desire to make a difference with theirparticipation. She presented the motion as a member of the Executive Committee who is not acandidate for an officer position, and she is the Chair of our Governance Committee.Nominations for 2022 Board Officers have been received and the Executive Committeerecommends a slate of officers.

Motion BOG 101.1121To approve the following 2022 Board of Governors Officers:

Hector De La Torre ChairpersonAlvaro Ballesteros Vice ChairpersonIlan Shapiro, MD TreasurerStephanie Booth, MD Secretary

Member Perez congratulated the new Officers. She thanked them for accepting the nominationand wished them the best. She thanked them for taking on the responsibility of the position.

Ms. Haydel asked the Board if there is a preference for the start of the term for the newofficers. Chairperson De La Torre suggested the Officers would be effective for the ExecutiveCommittee meeting in November.Member Booth asked about the Executive Committee seat occupied by the Chairperson ofCompliance & Quality Committee. Augustavia Haydel, General Counsel, indicated that theCompliance & Quality Committee members will meet on November 18, 2021, and therepresentative for that seat can be discussed by the Committee at that meeting.

Unanimouslyapproved by roll call.9 AYES (Ballesteros,Booth, De La Torre,Gonzalez, Mitchell,Perez, Roybal, Shapiroand Vaccaro)By consensus, the BoardMembers agreed that theelected officers will take officeeffective as of the nextExecutive Committee meetingon November 15, 2021.

GovernmentAffairs Update

Cherie Compartore, Senior Director, Government Affairs, referred Board Members to the documentincluded in the meeting materials, and she reported:

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A new “Doula” benefit was enacted for Medi-Cal as part of the approval of the statebudget, but implementation will be delayed until July 2022 to allow time to develop thedetails for this new program.

The Community Health Worker (CHW) benefit in Medi-Cal will also be delayed until July2022.

The new budget proposal is being developed and will be released in January. A surplus isbeing projected.

L.A. Care was contacted by Children Now to ask for support of a budget provision to fundthe premiums and co-pays for coverage of children in the Children’s Health InsuranceProgram (CHIP).

There will be bills introduced to get closer to universal health care coverage in California.A list of bills that have a direct impact on L.A. Care is provided in the meeting packet:

Reimbursement of PPE equipment and COVID test costs.

Colon screening and testing for those between 50-75 years of age.

Mandated screening for Alzheimer’s/dementia

Home sexually transmitted disease (STD) test kits that are ordered by the health careprovider

Adverse childhood screening tests.

Board Member Mitchell asked about the continuation of pay for CHWs currently working. Ms.Compartore replied that the current program will continue as it is until it becomes a Medi-Calbenefit. She noted also that L.A. Care continues to work with Los Angeles County to expandthe local doula program as well. Mr. Baackes added that L.A. Care employs CHWs at L.A. Careand they will continue working.Board Member Gonzalez noted that the bill providing STD test kits in the home also providesthat the doctor will be able to provide a prescription for the partner. It is great to be able to usea test kit in the privacy of one’s own home, and also to test the partner, to prevent spread ofSTDs. She asked how L.A. Care will be reimbursed for the partner’s test kit, if that person isnot covered by L.A. Care? Ms. Compartore suggested that the cost would come from a stateprogram, and she will follow up with Member Gonzalez.

CHIF FY 2021-22Priorities

PUBLIC COMMENTSubmitted by Andria McFerson, RCAC 6 Chair, via email on 11/4 at 3:35 PM

Chairperson,I would like to know how we could be updated about the Inglewood FRC? We havebeen advised since 2016 that we were receiving a more effective, feasible location

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in a more convenient area but, we still have not moved and we haven't had a openlocation for a long time. Why? This FRC exist to help the community of South LA inRegion 6 of which I'm chair of but, for some reason many CRC's have been openedyet Inglewood FRC still has not been opened. Why? Can all ECAC chairs andRCAC members be invited directly to the grand openings of FRC's relative to theirown location they are representing?ThanksAndria McFerson,

Mr. Baackes responded that L.A. Care will invite those people, if they are not already on theinvitation list. Unfortunately, the Inglewood Resource Center is now a victim of the supplychain problems being experienced throughout the economy, as certain equipment needed toopen that center will not be available to us until March or April. Otherwise we were preparedto open in January. L.A. Care is very disappointed and is trying to find a way to get thenecessary equipment. L.A. Care attempted to negotiate but the previous landlord would notagree to a month to month lease, and it did not make economic sense to sign a long term leasewhen a new center was under construction.Chairperson De La Torre noted that Mr. Baackes reported about the landlord a month or twoago. This item has been discussed. It is a priority for L.A. Care and we will do it as quickly aspossible. Mr. Baackes noted that there will be an official opening of the El Monte CRC inJanuary and L.A. Care will make sure the invitations are sent.

Members Ballesteros, Roybal and Shapiro may have financial interests in Plans, Plan Participating Providers orother programs and as such refrained from the discussion of item 1 identified below. In order to expedite theprocess, their vote on this motion reflects a vote concerning the entire motion excluding Section 1a, for which themembers are abstaining.

Member Booth noted that she had suggested an amendment during the Executive Committee,item d) should read, “empower and invest in health/social determinants of health relatedorganizations …”.

Roland Palencia, Director, Community Benefits, stated that on a yearly basis, the Board considers amotion on the Community Health Investment Fund priorities. At the September 2, 2021 BoardMeeting, as part of the general organizational budget, the L.A. Care Board of Governors approved aCHIF funding allocation of $10 million for FY 2021-22.

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Motion EXE 101.11211. To approve the recommended approach for the Community Health Investment

Fund (CHIF) FY 2021-22 allocation of up to $10 million in the following prioritycategories:a) support the health care safety net to improve infrastructure and address racial

inequities, recommended at $4.1 million,b) address social determinants of health that result in inequities, recommended at

$2.4 million,c) close the health disparities gap, recommended at $1.8 million, andd) empower and invest in health/social determinants of health related

organizations that address systemic racism, recommended at $1.7 million.2. Delegate authority to the CEO to implement the CHIF program and approve up to

$250,000 per grant through September 30, 2022. This authority will allow L.A. Care tomake grants for larger projects as well as respond to COVID-19 ongoing needs and itsaftermath. Also, allow for CEO to adjust CHIF priority category amounts noted aboveto align with changing community needs and requests. All other policies and approvalsrelated to grant making investments will remain in place.

Board Member Mitchell commended L.A. Care for its responsive grant making, particularlyduring the pandemic. She appreciates the ability to access PPE for direct service workers andthe attention paid to the African-American maternal and infant health programming andupcoming programing activities led by the Community Benefit Team. She finds value in thatinvestment and she acknowledged and appreciates how responsive L.A. Care’s grant making hasbeen even in this public health crisis. Mr. Palencia acknowledged Shavonda Webber-Christmasfor her work.

Unanimouslyapproved by roll call.9 AYES (Ballesteros,Booth, De La Torre,Gonzalez, Mitchell,Perez, Roybal, Shapiroand Vaccaro) withabstention as noted

Continue fundingof Elevating theSafety NetResidency SupportProgram

Member Shapiro may have financial interests in Plans, Plan Participating Providers or other programs and assuch refrained from the discussion of the motion.

Mr. Baackes introduced the motion, noting that one of the five elements of the Elevating theSafety Net program is providing support to residency programs, particularly in primary care,where the resident would be working within a safety net site. This year’s allocation is smallerthan what was requested in prior years, and is consistent in supporting this segment for anotheryear.

Chairperson De La Torre noted that Dr. Dowling at UCLA runs a program to bring in foreigntrained physicians and help them obtain a license in the United States to practice medicine. Hesuggested that L.A. Care reach out to discuss mutual support in that process, to bring morediversity to the medical provider work force.

Unanimouslyapproved by roll call.8 AYES (Ballesteros,Booth, De La Torre,Ghaly, Gonzalez,Greene, Jimenez,Mitchell, Perez,Roybal and Vaccaro).

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Motion EXE 102.1121Approve and authorize an expenditure of up to $3.23 million to continue funding awardsunder the Residency Support Program (RSP).

1 ABSTENSION(Shapiro)

Finance & BudgetCommittee

PUBLIC COMMENTSubmitted by Sender not self-identified at 11/4 at 2:58pmComment finance and budget, why does LA Care have Harley Davidsons listed intheir online finance reports?Comment finance and budget agenda item, why does LA Care co brand with BlueShield Promise plan which also offers <expletive> services?

Submitted on 11/4 At 3:09 pm via email sender not self-identifiedFinance agenda comment. LA Care doesn’t pay providers in a timely manner,known deadbeats!

Submitted by Sender not self-identified at 11/4 at 3:12 pmCEO report comment why does LA Care harass people on Yelp and Facebook andflagged my review so I put up a new one that stays at the very top of the page! LOL!

Add to CEO report why do yo hire people in other countries to harass reviewersalong with having people on your staff who harass reviewers

Submitted on 11/4 At 3:21 pm via email sender not self-identifiedChange to finance agenda add they waste money paying someone to harassreviewers online

Submitted on 11/4 At 3:32 pm via email sender not self-identifiedYes for Finance agenda comment, why do you have so many people who arerelated to each other working there who lie for each other?

^also finance relevant, abusing taxpayer funds

Submitted on 11/4 At 3:38 pm via email sender not self-identified^finance, it’s stated on your Facebook that moderators in India and Argentina abusepublic comments on your pg for your public agency!

Submitted on 11/4 At 3:50 pm via email sender not self-identified^ add to finance commit are any of your board members related to LA Care or BlueShield Promise Plan employees

I commented on finance pursuant to brown act

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Chairperson De La Torre reported that the Finance & Budget Committee met on October 25.Motions approved by the Committee were on the Consent Agenda earlier in this meeting. TheCommittee also approved a motion for Quest Analytics contract amendment that does notrequire approval by the full Board. (Contact Board Services to obtain a copy of approved meeting minutes.)

Chief FinancialOfficer Report

Marie Montgomery, Chief Financial Officer, reported on financial results for July and August 2021:

Membership continues on a positive trend, relative to our forecast, almost 22,000 membersfavorable for the month and 31,000 members year to date. In the SPD and CCI there was aretroactive increase in SPD members in a reconciliation made by regulators.

Results for August

The results for the month of August reflect a net deficit of $8.3 million, which results in adeficit of $13 million unfavorable to the forecast. The unfavorability was driven by theoperating margin, due to $6 million fee for service and $10 million in pharmacy claims.Those items were somewhat offset by a $4 million capitation expense recovery relating toHealth Homes.

Administrative expenses are favorable for August by $3 million.

Non-operating costs are unfavorable due to higher CRC spending and some timing ongrants.

Year to Date Results

There is a $111 million surplus, virtually flat to the forecast.

Administration expense is $4.5 million favorable to forecast

Non-operating expense is unfavorable for the reasons mentioned above for August.

Fiscal Year EndThe fiscal year end results appear to be very close to the forecast expectations. Unauditedfinancial reports for September 2021 will be presented at the next Finance & Budget Committeemeeting in November and at the December Board meeting.

Reported vs. Paid ClaimsSome volatility was experienced during the pandemic, and paid claims have been more stablerecently.

Operating Margin by SegmentThe overall medical cost ratio is 93.7, very close to the forecast, and there is not much variabilityby segment.

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Key Financial RatiosBenchmark ratios are good. For Cash to Claims, the ratio will be improved when we are able tofinalize IHSS reconciliations with regulators. Additional detail is needed to finalize this,projections are for the end of the year.

Tangible Net EquityL.A. Care’s reserves are 503%, with 40 days’ cash on hand.

Motion FIN 104.1121To accept the Financial Report for July and August 2021, as submitted.

Unanimouslyapproved by roll call.9 AYES (Ballesteros,Booth, De La Torre,Gonzalez, Mitchell,Perez, Roybal, Shapiroand Vaccaro)

MonthlyInvestmentsTransactionsReport

Ms. Montgomery referred to the investment transactions report included in the meetingmaterials. (A copy of the report can be obtained by contacting Board Services). As of May 31, 2021, L.A.Care’s total investment market value was $2.4 billion.

$2.1 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

PUBLICCOMMENT onClosed Session Items

Submitted via email by Rachel Rose Luckey, RCAC 4 Chair, at November 4, 2021, at 2:37pm

It has now been about 21 months since our RCAC met in February of 2020. The city of Los Angeles wasable to set up a system for 99 Neighborhood Councils for meeting virtually. The city's Department ofNeighborhood Empowerment (DONE) issued a document called Virtual Governance Protocols that goes intogreat detail as to how to hold a Brown Act compliant meeting on Zoom. I sent these protocols to CO&E a littleover a year ago. There was no action taken that I am aware of.I am greatly disappointed that LA Care cannot figure out how 11 RCACs can meet virtually while the City ofLA can figure it out for 99 Neighborhood Councils. It is telling how little LA Care respects the RCACs by notputting the resources needed for us to meet virtually.End Comment

Submitted by Sender not self-identified on November 4, 2021, at 2:37pm via emailClosed session comment, contracts rates , so board members are related to employees, aren’t they?!^incompetents hiring incompetent family members^ nepotism

Submitted by Andria McFerson via email November 4, 2021, 4:18 PM

Mr. Chairperson,A ECAC meeting WITHOUT the ability to SPEAK is like a broken pencil it's POINTLESS.

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A lot of different times when a Black Woman speaks it is purposely improperly judged as lacking actual meritwhile only ascending actual roles that they deserve to be apart of as a normal person who could empathizewith many Colored people in general and all of their health disparities.Fearing the worst, feeling harassed during each ECAC meeting while just trying to fulfill my duty as a Chairrepresenting the community of RCAC 6 South LA and Inglewood, just carrying out proper procedure I believeI am hindered from doing so by staff. Chairperson Del La Rosa I feel Idalia Del La Rosa has continued toimpede on Robert's Rule of Order and the Brown Act procedures when I request to speak and converse withother Chairs to make valid decisions according to relative agenda items. Also I am restricted from placingrelative items on the agenda regarding what the community is facing according to the social determinants ofhealth and the disparities of the most highest mortality and chronic disease rated races based on concretestatistics.Please direct staff to show proper and equal respect to everyone, and follow proper protocols and serviceagreements during our ECAC meetings.Thank You,Andria McFerson

ADJOURN TOCLOSED SESSION The Joint Powers Authority Board of Directors meeting was adjourned. Augustavia J. Haydel, General Counsel, announced

the following items to be discussed in closed session. The L.A. Care Board of Governors adjourned to closed session at4:31 pm.

CONTRACT RATESPursuant to Welfare and Institutions Code Section 14087.38(m)

Plan Partner Rates

Provider Rates

DHCS Rates


REPORT INVOLVING TRADE SECRETPursuant to Welfare and Institutions Code Section 14087.38(n)Discussion Concerning new Service, Program, Technology, Business PlanEstimated date of public disclosure: November 2023

RECONVENE INOPEN SESSION

The Board reconvened in open session at 5:52 p.m.

There was no report from closed session.

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AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENADJOURNMENT The meeting was adjourned at 5:53 p.m.

Respectfully submitted by: APPROVED BY:Linda Merkens, Senior Manager, Board ServicesMalou Balones, Board Specialist III _______________________________________Victor Rodriguez, Board Specialist II Stephanie Booth, MD, Board Secretary

Date Signed _____________________________

Public comments on the following pages were not read during the meeting because the submitter reached the three-minute maximum.

(three minutes expired for this public comment and this is the remaining text continued from page 11, above.) Submitted by Carolyn Rogers November 3, 8:29 am via textYeah, I’m this “<explicit>” mother complaining at your meetings but if one really reads my proof of how LA Care refused to assist us it’sobvious I’m right and it shows that people at LA Care are liars!

(three minutes expired for this public comment and this is the remaining text continued from page 13, above.)Received via email from Ismael Maldonado, received November 2, 2021, at 3:52 PM

don't get the things straighten up in with in LA Care people are going to go back to state legislator and ask for the full scope medicalwhere they were able to do whatever they wanted to pick whatever doctor they wanted to pick an not being government under you.I have a question as well when are the FRCS gonna be open what are the requirements that you guys are gonna require four membersof Los Angeles care health plan.2 do I know it's wear your mask back and take your temperature but do you have to have a vaccinationcard to go in because a lot of people are missing out on the services that you guys are supposed to be providing to us he was healthywithin the community and he was whole person care Sincerely Ismael Maldonado equities council LAe RACA 2Ismael MaldonadoDisability Rights advocate & Special educationDMH LA County SALT 2 LA Care health plan Equity Council La Care RCAC 2 San Fernando valley [email protected]@gmail.COM Cell:(818)231-8872

Email received from Ismael Maldonado. November 2, 2021 at 5:08 PMTo mr john baackes what are we gonna do with the California RX program is it one eliminate all mom and pop type of establishmentsincluding my local pharmacy do I have to order out of the county my medicine or do I still continue using my same pharmacists that ismy question

Ismael Maldonado Disability Rights advocate & Special educationDMH LA County SALT 2 LA Care health plan Equity Council La Care RCAC 2 San Fernando valley [email protected]@gmail.COM Cell:(818)231-8872

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Email received from Ismael Maldonado, November 4, 2021 at 8:40 am

This is a question for the CEO of LA Care I would like to know if you know of the new agency that has taken over case managementwhich is called partners in Care foundation in the San Fernando valley what is in the city of San Fernando on Mott Street I would like toknow why is anthem Blue Cross using them as a service The anthem could give you without a registered nurse who knows your casebetter then an individual whose just has a bachelor's maybe in psychology or sociology and that's what I would like to know thank youvery much sincerelyIsmael Maldonado

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Board of Governors

MOTION SUMMARY



Issue: Selection of two charitable organizations to receive Board members’ stipend.

New Contract Amendment Sole Source RFP/RFQ was conducted

Background: L.A. Care Board members receive $100 stipend for each meeting, up to a maximum of

$400 per month. For Board members who wish to contribute their stipend to charitable organizations, a random selection process was developed to comply with IRS guidance so Board members are not responsible for taxes on the value of the donated stipend.

In December 2017, the process for choosing the charitable organizations was updated. 1. L.A. Care staff will identify charitable organizations nominated to receive Board stipend based on

nominations received from Board members.2. The random selection of two charitable organizations will be conducted by staff prior to the Board

meeting and a motion will be presented to the Board with the first two organizations drawn.

The two organizations listed in the motion below were randomly selected for this motion.

The following are the organizations selected in the past 10 years: 2021: Community Coalition and New Life Community Food Pantry Pomona 2020: Homeboy Industries and Housing Works for California 2019: Project Angel Food and Insure the Uninsured Project 2018: Kurka Children’s Health Fund and The American Lung Association 2017: Strong Food/LA Kitchen and The American Lung Association 2016: Kurka Children’s Health Fund and The American Lung Association 2015: Watts Willowbrook Boys and Girls Club and Downtown Women’s Center Los Angeles 2014: Watts Willowbrook Boys and Girls Club and Downtown Women’s Center Los Angeles 2013: Watts Willowbrook Boys and Girls Club and National Health Foundation 2012: Los Angeles Regional Food Bank and Para Los Niños

Member Impact: None.

Budget Impact: None.

Motion: To designate MEND (Meet Each Need with Dignity) and National Alliance on Mental Illness, Greater Los Angeles County (NAMI GLAC) as authorized recipients of funds from Board Member stipends according to Legal Services Policy 300 for the calendar year 2022.

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Boys and Girls Clubs of Metro Los Angeles (BGCMLA)

800 S. Figueroa Street, Suite 950, Los Angeles, CA 90017

Boys & Girls Clubs of Metro Los Angeles was founded in December 2015 as a scalable and

sustainable solution to reversing the opportunity crises facing some of the most vulnerable children

in the neediest neighborhoods of Los Angeles. BGCMLA is designed to increase programmatic

offerings and serve a greater number of youth in the areas of Los Angeles most in need of its

services. The mission of BGCMLA is to enable all young people, especially those who need us most

to reach their full potential as productive, caring, responsible citizens.

Our mission is fulfilled by offering nationally recognized, research-based programs and activities in

three core areas: Academic Success, Good Character and Citizenship and Healthy Lifestyles. We

believe in empowering youth to explore a future with endless possibilities by offering creative

programming, such as new approaches to science, technology, engineering and math (STEM)

created in collaboration with our community partners. BGCMLA is safe, stable place that ensures

physical and emotional safety while discouraging crime in our local communities.

The individual Clubs which presently make up BGCMLA have a deep history of impact in the

neediest areas of Los Angeles County. This new collaboration of Clubs and community partners

currently includes the following Boys & Girls Clubs: Challengers, since 1968; Watts/Willowbrook,

since 1968; Bell Gardens, since 1960; Jordan Downs was opened in collaboration with the Housing

Authority of the City of Los Angeles.

At BGCMLA, we are wholly committed to maximizing our Clubs potential to service more kids,

more often, and to build strong, sustainable organizations.

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The Downtown Women’s Center is a nationally recognized pioneer of permanent supportive housing and

the only resource in Los Angeles that is exclusively dedicated to serving the unique needs of homeless and

very low-income women in downtown Los Angeles’s Skid Row community. Permanent supportive housing is

a successful, cost-effective combination of affordable housing with services that help people live more

stable, productive lives. This housing model improves stability and reduces the use of high cost public

services.

A SAFE PLACE TO CALL HOME

Founded in 1978 by social worker Jill Halverson and her client turned friend, Rose, DWC will provide a

permanent home to 119 formerly homeless women by the end of 2012- making us one of the largest

providers of Permanent supportive housing for women in the country. 95% of the women we house never

return to homelessness- a high success rate for ending homelessness.

In 1986, DWC took a giant step toward ending homelessness for women. The Residence, adjacent to the

Day Center, opened 47 unique single apartments- the first permanent supportive housing program for

women in the US.

For two decades DWC operated the Day Center and Residence lead by the core values of community,

sustainability, compassion, creativity, flexibility, dignity and empowerment. Our comprehensive program

became a prototype for social service agencies across the nation.

OUR LOS ANGELES STREET HOME

We proudly reopened our Los Angeles Street home on November 29th, 2012. The former Day Center

transformed into our MADE by DWC Resale Boutique. The Residence provides an additional 48 units of

permanent supportive housing.

OUR SAN PEDRO STREET HOME

Our San Pedro Street home has 71 units of permanent supportive housing and a Day Center offering meals,

personalized case management, computer literacy, government benefits advocacy, support groups, job

counseling, and health and wellness classes. The building is silver LEED Certified and received recognition

from the National Trust for Historic Preservation.

The Medical and Mental Health Center, a collaboration with JWCH Institute Inc. and the first of its kind for

women on Skid Row, completes the comprehensive care offered by DWC. Onsite medical services such as

mammograms and preventative disease services decrease the barriers for women to access healthcare.

DWC is also home to MADE by DWC, a café and gift shop where women from the community learn job skills

and create handmade products. MADE by DWC was created to help break the cycle of poverty by

helping low-income and homeless women discover their talents and develop their skills through job training.

One hundred percent of proceeds go directly to supporting the programs and services at DWC.

OUR IMPACT

DWC is making a major impact in the community.

• 4300 women overcoming homelessness and poverty were served by DWC in 2012 -- a 72% increase

from previous years • 200 women a day visit our drop-in Day Center for basic needs, healthcare, and education

• 90,000 delicious and nutritious meals were served last year, with more than a third prepared by volunteers

• 119 homeless women now have a home at one of DWC's two permanent supportive housing Residences • 95% of the women we house do not return to homelessness

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MEND (Meet Each Need with Dignity) 10641 N. San Fernando Rd. Pacoima, CA 91331 Phone: (818) 897-2443 or (818) 896-0246 Fax: (818) 897-0128

MEND offers a range of comprehensive services delivered with dignity and respect by exceptionally

dedicated staff and volunteers. For 50 years, MEND has opened its doors to the most vulnerable members

of our community and over the years we have become one of the most comprehensive and empowering

poverty relief agencies in Los Angeles County.

MEND serves the poorest families & individuals in the San Fernando Valley; meeting their most

immediate basic needs and helping them build resources and skills to address and overcome long-term

poverty.

MEND’s Foodbank has long been a point of entry for a majority of clients. Those utilizing the food bank often include families with children struggling to make ends meet, low-income seniors and people who are homeless who—because of few options—sometimes rely on foraging to survive. As MEND’s 2019 Humanitarian Award honoree, Dr. LaVonna Blair Lewis put it, “Food is not discretionary.” Equitable access to nutritious food supports a healthy life, and a healthy life supports better overall outcomes.”

In addition to direct services at MEND’s facility in Pacoima, MEND’s Emergency Foodbank distributes food to dozens of community and faith-based organizations who operate food pantries that touch the lives of thousands of people throughout LA County. In 2020, the Foodbank benefited individuals and families through 126,584 encounters. By distributing more than 2.5 million pounds of food, the Foodbank empowered families throughout LA County to consume 2,142,140 healthy meals in 2020.

In the Fall of 2018, MEND started its first case management program – the Family Support Program (FSP). Our hypothesis was that with intensive 1:1 social work support, guidance and resource connections, families in poverty could reduce their dependence on MEND’s and other safety net services and gain greater stability and independence. The overarching goal of FSP is to build family self-sufficiency and disrupt cycles of generational poverty. In the program’s pilot year, MEND hired its first Licensed Clinic Social Worker (LCSW) and focused on families with long-time use of our services and/or who were in crisis requiring additional supports. Joining the social worker was a team of 4 MSW student interns from CSUN.

55

tel:8188972443

tel:8188960246

National Alliance of Mental Illness (NAMI) Greater Los Angeles County

3600 Wilshire Boulevard, Suite 1804 Los Angeles, CA 90010 [email protected] (213) 386-3615

Mission

National Alliance on Mental Illness, Greater Los Angeles County (NAMI GLAC) is the leading countywide organization composed of grassroots-based chapters that promotes wellness, recovery, equality, and dignity for individuals and families affected by mental illness and the community at large. We provide leadership in advocacy, education, support, and public awareness throughout Los Angeles County.

What We Do

We provide evidence-based education classes and support groups at no cost to participants in English and Spanish.

We offer local expertise, help, and hope in navigating the challenging path of mental health treatment and recovery.

We advocate for policies and programs that improve the lives of everyone affected by mental health challenges.

56


Board of Governors

MOTION SUMMARY



Issue: Request to delegate authority to negotiate revisions and execute Amendment 36 to L.A. Care’s

Medi-Cal Contract (Contract No. 04-36069) with the California Department of Health Care Services (DHCS).


Background: L.A. Care received Amendment No. 36 from DHCS on November 16, 2021 with a

request that it be reviewed, signed, and returned to DHCS no later than December 7, 2021. This Amendment No. 36 incorporates new calendar year 2022 Risk Mitigation language, specifically related to the CalAim Enhanced Care Management risk corridor provisions.

Member Impact: Staff is reviewing the member impact.

Budget Impact: There is no impact to 2021-22 budget.

Motion: To delegate authority to L.A. Care Chief Executive Officer, John Baackes, to negotiate and make any substantive changes to Amendment A36 to Contract 04-36069, between L.A. Care Health Plan and the California Department of Health Care Services, which may be made or negotiated by the Chief Executive Officer and/or his designees, and to execute Amendment A36.

57

L.A. Care Health Plan 04-36069 A36

Page 2 of 4

IV. Exhibit B, BUDGET DETAIL AND PAYMENT PROVISIONS, is amended to read: Budget Detail and Payment Provisions 1. Budget Contingency Clause 2. Amounts Payable 3. Contractor Risk in Providing Services 4. Capitation Rates 5. Capitation Rates Constitute Payment in Full 6. Determination of Rates 7. Redetermination of Rates - Obligation Changes 8. Reinsurance 9. Catastrophic Coverage Limitation 10. Financial Performance Guarantee 11. Recovery of Amounts Paid to Contractor 12. Medical Loss Ratio (MLR) 13. Adult Expansion Risk Corridor 14. Supplemental Payments 15. Special Contract Provisions Related to Directed Payment Initiatives and Pass-

Through Payment Programs 16. Special Contract Provisions Related to Incentive Arrangements 17. Additional Payments 18. Medicare Coordination 19. COVID-19 Risk Corridor 20. State Programs Receiving Federal Financial Participation 21. Enhanced Care Management (ECM) Risk Corridor

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Page 3 of 4

21. Enhanced Care Management (ECM) Risk Corridor

A. A risk-sharing arrangement shall be in effect for the Rating Period

covering dates of services from January 1, 2022 through December 31, 2022, for those capitation increments, services and populations associated with ECM, as determined by DHCS.

1) The risk-sharing arrangement described in this Provision may

result in payment by the State to Contractor or by Contractor to the State in a form and manner specified by DHCS through APLs or other technical guidance.

2) The risk-sharing arrangement shall be symmetrical and based

on the results of an ECM Risk Corridor calculation performed in a form and manner specified by DHCS through APLs or other technical guidance, aggregated across applicable Medi-Cal Managed Care Contracts between Contractor and the State for those capitation increments, services, and populations associated with ECM, as determined by DHCS.

3) Contractor shall provide and certify Allowable Medical

Expense data necessary for the ECM Risk Corridor calculation in a form and manner specified by DHCS. The data and any related substantiating documentation may be subject to review and adjustment at DHCS’ discretion in a form and manner specified by DHCS through APLs or other technical guidance, and may be subject to audit by the State or its designee.

4) DHCS or its designee will initiate the ECM Risk Corridor

calculation for a given Rating Period no sooner than 12 months after the end of the applicable Rating Period.

B. If DHCS determines that the continuation of the risk-sharing

arrangement is actuarially appropriate and necessary to account for the impacts of the ECM implementation for a given Rating Period starting on or after January 1, 2023, the ECM Risk Corridor, as described in Paragraph A of this Provision, shall continue to apply in a form and manner specified by DHCS through APLs or other technical guidance for the applicable Rating Period(s).

59


Page 4 of 4

V. Exhibit E, Attachment 1, DEFINITIONS, is amended to read:

Enhanced Care Management (ECM) means a whole-person, interdisciplinary approach to care that addresses the clinical and non-clinical needs of high-cost and/or high-need Members who meet ECM Populations of Focus eligibility criteria through a systemic coordination of services and comprehensive case management that is community-based, interdisciplinary, high-touch, and person-centered.

VI. All rights, duties, obligations and liabilities of the parties hereto otherwise remain unchanged.

60

STATE OF CALIFORNIA

STANDARD AGREEMENT AMENDMENT STD. 213A_DHCS (Rev. 06/16)

Check here if additional pages are added: 3 Page(s)

Agreement Number Amendment Number

04-36069 A36 Registration Number:

1. This Agreement is entered into between the State Agency and Contractor named below: State Agency’s Name (Also known as DHCS, CDHS, DHS or the State)

Department of Health Care Services Contractor’s Name (Also referred to as Contractor)

L.A. Care Health Plan 2. The term of this Agreement is: April 1, 2005 through December 31, 2022 3. The maximum amount of this Budget Act Line Items Agreement after this amendment is: 4260-601-0912 and 4260-601-0555 4. The parties mutually agree to this amendment as follows. All actions noted below are by this reference made a part

of the Agreement and incorporated herein:

I. Amendment effective date: January 1, 2022 or until approved by DGS (if DGS approval is required).

II. Purpose of amendment: This amendment incorporates new Calendar Year 2022 Risk Mitigation language.

III. Certain changes made in this amendment are shown as: Text additions are displayed in bold and underline. Text deletions are displayed as strike through text (i.e., Strike).

(Continued on next page)

All other terms and conditions shall remain the same. IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.

CONTRACTOR CALIFORNIA Department of General Services

Use Only Contractor’s Name (If other than an individual, state whether a corporation, partnership, etc.)


By(Authorized Signature) Date Signed (Do not type)

Printed Name and Title of Person Signing

John Baackes, Chief Executive Officer Address

1055 West 7th Street, 10th Floor Los Angeles, CA 90017 STATE OF CALIFORNIA Agency Name

Department of Health Care Services By (Authorized Signature) Date Signed (Do not type)

Printed Name and Title of Person Signing Exempt per: W&I Code Section 14087.55(c) Michelle Retke, Chief

Managed Care Operations Division Address

1501 Capitol Avenue, MS 4415, P.O. Box 997413 Sacramento, CA 95899-7413

61

Board of Governors

MOTION SUMMARY



Issue: Amend a contract with Milliman to provide actuarial models and services in connection with

L.A. Care’s Medicare lines of business.


Background: L.A. Care staff requests approval to extend and amend Statement of Work No. 1 with

Milliman from January 1, 2022 through December 31, 2022, in the amount of $300,000, for a new contract total of $1,299,000. The contract number for the original Statement of Work No. 1 is PRO-000002248. The vendor will provide us with actuarial support in connection with L.A. Care’s Medicare lines of business. This includes assistance with Medicare Data Reports, projections, trend analysis and filling out the Medicare bid. L.A. Care requires these services because of regulatory requirements. We have used this vendor since before 2012 and we are pleased with their work. Other departments, including Medicare Operations use this vendor for support with our upcoming Dual Special Needs Plan bid.

No request for proposal was conducted for this vendor because they are a preferred vendor.

Member Impact: This action will not affect L.A. Care members.

Budget Impact: The cost was anticipated and included in the approved budget for the actuarial

Service Department in this fiscal year.

Motion: To authorize staff to amend Statement of Work No. 1 with Milliman in the amount of $300,000 (for a new contract total of $1,299,000) for Milliman to provide actuarial models and services for the period of January 1, 2022 to December 31, 2022.

62

Board of Governors

MOTION SUMMARY



Issue: Amend a contract with Milliman to provide actuarial models and services in connection with

L.A. Care’s Covered California line of business.


Background: L.A. Care staff requests approval to extend and amend Statement of Work No. 2 with

Milliman from January 1, 2022 to December 31, 2022 in the amount of $300,000, for a new contract total of $1,250,000. The contract number for the original Statement of Work No. 2 is PRO-000002249. The vendor will provide us with actuarial support in connection with L.A. Care’s Covered California line of business. This includes completing the rate filing actuarial memorandum and all other rate templates required by Covered California. L.A. Care requires these services for our commercial product rate development. We have used this vendor for our commercial product bid since 2013. Other departments, including Commercial Product use this vendor for support.

No request for proposal was conducted for this vendor because they are a preferred vendor.

Member Impact: This action will not affect L.A. Care members.

Budget Impact: The cost was anticipated and included in the approved budget for the actuarial

Service Department in this fiscal year.

Motion: To authorize staff to amend Statement of Work No. 2 with Milliman in the amount of $300,000 (for a new contract total of $1,250,000) for Milliman to provide actuarial models and services for the period of January 1, 2022 to December 31, 2022.

63

Board of Governors

MOTION SUMMARY

Date: December 2, 2021 Motion No. EXE 100.1121

Committee:

Chairperson: Hector De La Torre

Issue: Approval of revision to 2022 schedule of meetings for the Board of Governors and Committees.

Background: The schedule is revised to moving the meeting days of Finance & Budget and Executive

Committee meetings to 4th Tuesdays of the month.

Member Impact: Public input is welcome at all Board and Committee meetings.

Budget Impact: None.

Motion: To approve the revised 2022 Board of Governors and Committees meeting schedule as submitted.

64

2022 Regular Board and Committee Meeting schedule BoG: Board of Governors, meets at 2:00 for approximately 3 hours, and

meets all day in September for strategic discussion C&Q: Compliance and Quality Committee, meets at 2:00 p.m. for approximately 2 hours

Exec: Executive Committee meets at 2:00 p.m. for approximately 90 minutes F&B: Finance & Budget Committee meets at 1:00 p.m. for approximately 60 minutes

CHCAC: Children’s Health Consultant Advisory Committee meets at 8:30 a.m. for approximately 2 hours ECAC: Executive Community Advisory Committee meets at 10:00 a.m. for approximately 2 hours

TAC: Technical Advisory Committee meeting schedule to be determined JPA and LACH: Joint Powers Authority and L.A. Care Community Health Plan

meet concurrently with a BoG meeting

Meetings are usually held at 1055 West 7th Street, 1st Floor, Los Angeles, CA 90017 Except where offsite meetings are indicated below or if a different address is posted on the

meeting agenda.

January 2022 No Board meeting 1/12 – ECAC 1/20 – C&Q 1/18 – CHCAC 1/25 –F&B, Exec TBD – Audit, TAC

February 2022 2/3 – BoG 2/9 - ECAC 2/22 –F&B, Exec

March 2022 3/3 BoG (tentative) 3/9 – ECAC 3/15 – CHCAC 3/17 - C&Q 3/22 – F&B, Exec TBD – GOV

April 2022 4/7 – BoG 4/13 - ECAC 4/26 – F&B, Exec TBD - TAC

May 2022 5/5 – BoG 5/11 – ECAC 5/17 – CHCAC 5/19 – C&Q 5/24 – F&B, Exec

June 2022 6/2 – BoG (offsite)* 6/8 - ECAC 6/28 – F&B, Exec

July 2022 No BoG Committee Meetings 7/28 – BOG

August 2022 No Board meeting 8/10 - ECAC 8/16 – CHCAC 8/18 – C&Q 8/23 – F&B, Exec TBD – Audit, TAC

September 2022 9/1 – BoG (offsite all day retreat)* 9/14 - ECAC 9/15 – C&Q 9/20 - F&B, Exec* *Due to religious holiday 9/20 – CHCAC TBD –GOV

October 2022 10/6 BoG (tentative) 10/12 - ECAC 10/25 - F&B, Exec TBD - TAC

November 2022 11/3 – BoG 11/9 – ECAC 11/15 - F&B, Exec* *Due to Thanksgiving holiday 11/15 – CHCAC 11/17 – C&Q

December 2022 12/1 – BoG 12/14 – ECAC No other meetings

*Offsite locations are tentative

65

Board of Governors

MOTION SUMMARY

Date: December 2, 2021 Motion No. FIN 100.1221

Committee: Finance & Budget

Chairperson: Ilan Shapiro, MD

Issue: Accept the Investment Report for the quarter ended September 30, 2021.


Background: Per L.A. Care’s Investment Policy, the Finance & Budget Committee is responsible for

reviewing L.A. Care’s investment portfolio to confirm compliance with the Policy, including its diversification and maturity guidelines.

Member Impact: N/A

Budget Impact: L.A. Care budgets a reasonable return on investment holdings.

Motion: To accept the Quarterly Investment Report for the quarter ending September 30, 2021, as submitted.

66

DATE:

TO:

FROM:

November 15, 2021

Finance & Budget Committee

Marie Montgomery, Chief Financial Officer

SUBJECT: Quarterly Investment Report – September 2021

As of September 30, 2021, L.A. Care's combined investments value was approximately $2.1 billion. Interest income, amortization, realized gains and losses was approximately $3.1 million for the quarter. Unrealized loss due to market price fluctuations was $2.4 million for the quarter. The rate of return for the quarter was 0.04%. Based upon an independent compliance review performed as of September 30, 2021, LA Care is in compliance with its investment policy guidelines pursuant to the California Government Code and the California Insurance Code.

At quarter end $1.45 billion (or approx. 69% of total investments) and $0.34 billion (or approx. 16% of total investments) were under the management of Payden & Rygel and New England Asset Management, respectively. Both are external professional investment management firms. A list of the securities held under management of these two firms are attached. Below are the same securities grouped by investment type:

Payden NEAM Combined Cash and Money Market Mutual Fund 5% 1% 4%

U.S. Treasury Securities 65% 1% 53%

U.S. Agency & Municipal Securities 9% 4% 8%

Corporate bonds 0% 93% 17%

Asset Backed and Mortgage Backed Securities 12% 0% 10%

Negotiable CDs 7% 0% 6% Other 2% 1% 2%

100% 100% 100%

Average credit quality: AAA A1 Average duration: 0.35 years 2.62 years Average yield to maturity: 0.11% 0.77%

The funds managed by Payden & Rygel are managed as two separate portfolios based on investment style – 1) the short-term portfolio and 2) the extended term portfolio. The short-term portfolio had approximately $1.36 billion invested as of September 30, 2021, and returned 0.02% for the quarter. The comparative benchmark returned 0.02% for the quarter. The extended term portfolio had

67

approximately $94 million invested September 30, 2021, and returned 0.09% for the quarter. The comparative benchmark had a return of 0.03%.

The $0.3 billion portfolio managed by New England Asset Management, Inc (NEAM), focused on corporate fixed income bonds returned -0.02% for the quarter. The comparative benchmark returned 0.07% for the quarter. LA Care also invests with 2 government pooled investment funds, the Local Agency Investment Fund (LAIF) and the Los Angeles County Pooled Investment Fund (LACPIF). L.A. Care’s investment balances as of September 30, 2021 were $73 million in LAIF and $253 million in LACPIF. The Local Agency Investment Fund (LAIF) yielded approximately 0.06% for the quarter. The fund’s total portfolio market value as of August 31, 2021, was $176.7 billion, with a weighted average maturity of 312 days. LAIF is administered and overseen by the State Treasurer’s office. The fund’s investment holdings as of August 31, 2021 were as follows:

U.S. Treasury Securities 69% Agencies 16% CD’s and bank notes 8% Commercial paper 5% Time deposits 2% 100%

The Los Angeles County Pooled Investment Fund (LACPIF) yielded approximately 0.12% for the quarter. The fund’s market value as of August 31, 2021, was $37.3 billion, with a weighted average maturity of 1059 days. LACPIF is administered and overseen by the Los Angeles County Treasurer. The fund’s most recent published investment holdings (August 31, 2021) were as follows:

U.S. Govt. and Agency Securities 73% Commercial paper 24% CD’s 3% 100%

Lastly, LA Care also has a $100,000 certificate of deposit (CD) account at Banc of California. The CD account is FDIC insured. The CD yielded 0.03% for the quarter and will mature on May 11, 2022.

68

L A CareS ecuritiesHoldingsasof9/30/21

P orfolio CU S IP /Identifier S ecurity T ype P ar M aturity date

P ayden U S D DR EYFU S T R EAS U R Y & AGEN CY CAS H Cash/M oney M arketFunds 67,091,637 N A

N EAM U S D BL ACKR O CKT R EAS U R Y T R U S T Cash/M oney M arketFunds 1,762,129 N A

P ayden 9127964V8 U .S .T R EAS U R Y BIL L U .S .T reasury S ecurity 379,000,000 10/7/2021

P ayden 9127964W 6 U .S .T R EAS U R Y BIL L U .S .T reasury S ecurity 40,000,000 11/4/2021

P ayden 912796G52 U .S .T R EAS U R Y BIL L U .S .T reasury S ecurity 30,000,000 10/14/2021



P ayden 912796M 30 U .S .T R EAS U R Y BIL L U .S .T reasury S ecurity 70,000,000 10/12/2021



P ayden 912796N 54 U .S .T R EAS U R Y BIL L U .S .T reasury S ecurity 10,000,000 11/9/2021

P ayden 912796ZB8 CAS H M GM T BIL L U .S .T reasury S ecurity 80,000,000 10/15/2021

P ayden 912796ZC6 CAS H M GM T BIL L U .S .T reasury S ecurity 50,000,000 11/1/2021

P ayden 9128285U 0 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 595,000 12/31/2023

P ayden 9128285Z9 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 798,000 1/31/2024

P ayden 9128286G0 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 430,000 2/29/2024


P ayden 912828W 71 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 1,170,000 3/31/2024

P ayden 912828X T 2 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 4,010,000 5/31/2024

P ayden 912828YH7 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 890,000 9/30/2024

P ayden 912828YM 6 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 40,000 10/31/2024

P ayden 912828YN 4 U .S .T R EAS U R Y FR N U .S .T reasury S ecurity 25,000,000 10/31/2021

P ayden 912828YV6 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 305,000 11/30/2024



P ayden 912828ZC7 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 455,000 2/28/2025

P ayden 912828ZF0 U .S .T R EAS U R Y N O T E U .S .T reasury S ecurity 1,686,000 3/31/2025

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P age1 of6 69



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P ayden 13032U VB1 CA HEAL T H FACS -N O P L ACEL IKEHO M E-T X B M unicipalS ecurities 380,000 6/1/2024

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P age2 of6 70



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P ayden 769036BL 7 CA CIT Y O FR IVER S IDEP O B T X B M unicipalS ecurities 320,000 6/1/2024

P ayden 76913CAX 7 CA R IVER S IDECN T Y P EN S N O BL G T X B M unicipalS ecurities 280,000 2/15/2023

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P ayden 797381BW 9 CA S AN DIEGO CN T Y T R AN S T X B M unicipalS ecurities 3,120,000 1/31/2022

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P age3 of6 71



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P ayden 3137FBAR 7 FHM S KF36A M ortgage-BackedS ecurity 2,012,658 8/25/2024

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P ayden 3137FR EB3 FHM S KJ28A1 M ortgage-BackedS ecurity 336,784 2/25/2025

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P ayden 3137FYU R 5 FHM S Q 015A 1M O FR N CM BS M ortgage-BackedS ecurity 2,908,602 8/25/2024

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N EAM 26442CAV6 DU KEEN ER GY CAR O L IN AS CorporateS ecurity 5,000,000 3/15/2023

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N EAM 693475AV7 P N C FIN AN CIAL S ER VICES CorporateS ecurity 5,250,000 1/23/2024

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N EAM 459200HU 8 IBM CO R P CorporateS ecurity 2,000,000 2/12/2024

N EAM 38141GX E9 GO L DM AN S ACHS GR O U P IN C CorporateS ecurity 9,000,000 2/20/2024

N EAM 20030N BJ9 CO M CAS T CO R P CorporateS ecurity 1,000,000 3/1/2024

N EAM 06051GHF9 BAN KO FAM ER ICA CO R P CorporateS ecurity 7,000,000 3/5/2024

N EAM 375558AW 3 GIL EAD S CIEN CES IN C CorporateS ecurity 6,000,000 4/1/2024

N EAM 05565EBH7 BM W U S CAP IT AL L L C CorporateS ecurity 6,000,000 4/18/2024

N EAM 904764AX 5 U N IL EVER CAP IT AL CO R P CorporateS ecurity 1,250,000 5/5/2024

N EAM 66989HAG3 N O VAR T IS CAP IT AL CO R P CorporateS ecurity 5,000,000 5/6/2024

N EAM 46625HJX 9 JP M O R GAN CHAS E& CO CorporateS ecurity 1,000,000 5/13/2024

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N EAM 14913Q 2V0 CAT ER P IL L AR FIN L S ER VICE CorporateS ecurity 2,500,000 5/17/2024

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P age4 of6 72



N EAM 24422ES P 5 JO HN DEER ECAP IT AL CO R P CorporateS ecurity 2,000,000 6/12/2024

N EAM 02665W CZ2 AM ER ICAN HO N DA FIN AN CE CorporateS ecurity 2,250,000 6/27/2024

N EAM 05531FBH5 T R U IS T FIN AN CIAL CO R P CorporateS ecurity 5,000,000 8/1/2024

N EAM 828807DG9 S IM O N P R O P ER T Y GR O U P L P CorporateS ecurity 5,000,000 9/13/2024

N EAM 828807CS 4 S IM O N P R O P ER T Y GR O U P L P CorporateS ecurity 2,500,000 10/1/2024

N EAM 61761JVL 0 M O R GAN S T AN L EY CorporateS ecurity 3,000,000 10/23/2024

N EAM 05348EAU 3 AVAL O N BAY CO M M U N IT IES CorporateS ecurity 5,000,000 11/15/2024

N EAM 46647P AY2 JP M O R GAN CHAS E& CO CorporateS ecurity 4,000,000 12/5/2024

N EAM 07330N AT 2 T R U IS T BAN K CorporateS ecurity 4,750,000 12/6/2024

N EAM 976656CL 0 W IS CO N S IN EL ECT R IC P O W ER CorporateS ecurity 1,500,000 12/15/2024

N EAM 57629W CG3 M AS S M U T U AL GL O BAL FU N DIN CorporateS ecurity 2,500,000 1/11/2025

N EAM 89236T GT 6 T O YO T A M O T O R CR EDIT CO R P CorporateS ecurity 3,000,000 2/13/2025

N EAM 384802AE4 W W GR AIN GER IN C CorporateS ecurity 1,000,000 2/15/2025

N EAM 69353R EK0 P N C BAN KN A CorporateS ecurity 2,000,000 2/23/2025

N EAM 57636Q AN 4 M AS T ER CAR D IN C CorporateS ecurity 3,000,000 3/3/2025

N EAM 30231GBH4 EX X O N M O BIL CO R P O R AT IO N CorporateS ecurity 2,000,000 3/19/2025

N EAM 254687FN 1 W AL T DIS N EY CO M P AN Y/T HE CorporateS ecurity 3,000,000 3/24/2025

N EAM 458140BP 4 IN T EL CO R P CorporateS ecurity 2,500,000 3/25/2025

N EAM 20030N DJ7 CO M CAS T CO R P CorporateS ecurity 5,000,000 4/1/2025

N EAM 341081FZ5 FL O R IDA P O W ER & L IGHT CO CorporateS ecurity 7,500,000 4/1/2025

N EAM 369550BK3 GEN ER AL DYN AM ICS CO R P CorporateS ecurity 5,000,000 4/1/2025

N EAM 911312BX 3 U N IT ED P AR CEL S ER VICE CorporateS ecurity 5,000,000 4/1/2025

N EAM 438516CB0 HO N EYW EL L IN T ER N AT IO N AL CorporateS ecurity 5,000,000 6/1/2025

N EAM 29157T AC0 EM O R Y U N IVER S IT Y CorporateS ecurity 4,305,000 9/1/2025

N EAM 68233JBZ6 O N CO R EL ECT R IC DEL IVER Y CorporateS ecurity 3,000,000 10/1/2025

N EAM 64952W DW 0 N EW YO R KL IFEGL O BAL FDG CorporateS ecurity 10,000,000 1/15/2026

N EAM 927804FU 3 VIR GIN IA EL EC & P O W ER CO CorporateS ecurity 5,000,000 1/15/2026

N EAM 06406R AQ 0 BAN KO FN Y M EL L O N CO R P CorporateS ecurity 5,000,000 1/28/2026

N EAM 20030N BS 9 CO M CAS T CO R P CorporateS ecurity 3,500,000 3/1/2026

N EAM 14913R 2K2 CAT ER P IL L AR FIN L S ER VICE CorporateS ecurity 5,000,000 3/2/2026

N EAM 74456Q CF1 P U BL IC S ER VICEEL ECT R IC CorporateS ecurity 9,000,000 3/15/2026

N EAM 95000U 2N 2 W EL L S FAR GO & CO M P AN Y CorporateS ecurity 7,000,000 4/30/2026

N EAM 57629W DE7 M AS S M U T U AL GL O BAL FU N DIN CorporateS ecurity 5,000,000 7/16/2026

N EAM 61761J3R 8 M O R GAN S T AN L EY CorporateS ecurity 3,000,000 7/27/2026

N EAM 931142ER 0 W AL M AR T IN C CorporateS ecurity 5,000,000 9/17/2026

P ayden 05588CAC6 BM W 2019-A A3 CAR Asset-BackedS ecurity 1,625,214 1/25/2024

P ayden 05591R AD6 BM W 2021-1 A4 L EAS E Asset-BackedS ecurity 300,000 7/25/2024

P ayden 09661R AB7 BM W 2020-A A2 CAR Asset-BackedS ecurity 215,771 2/27/2023

P ayden 09690AAB9 BM W 2021-2 A2 L EAS E Asset-BackedS ecurity 5,500,000 11/27/2023

P ayden 14043M AC5 CAP IT AL O N E2020-1 A3 CAR Asset-BackedS ecurity 480,000 11/15/2024

P ayden 14314Q AC8 CAR M X 2021-2 A3 AU T O Asset-BackedS ecurity 950,000 2/17/2026

P ayden 14315N AC4 CAR M AX 2019-1 A3 CAR Asset-BackedS ecurity 1,250,956 3/15/2024

P ayden 14315P AD7 CAR M AX 2019-3 A3 CAR Asset-BackedS ecurity 6,018,529 8/15/2024

P ayden 14315X AC2 CAR M X 2020-1 A3 CAR Asset-BackedS ecurity 510,000 12/16/2024

P ayden 14316L AC7 CAR M X 2019-2 A3 CAR Asset-BackedS ecurity 1,964,846 3/15/2024

P ayden 14317DAC4 CAR M X 2021-3 A3 CAR Asset-BackedS ecurity 950,000 6/15/2026

P ayden 14317JAB3 CAR M X 2021-4 A2A CAR Asset-BackedS ecurity 4,050,000 11/15/2024

P ayden 14687T AB3 CR VN A 2021-P 2 A2 CAR Asset-BackedS ecurity 7,000,000 7/10/2024

P ayden 24702VAA0 DEFT 2021-2 A1 EQ P 144A Asset-BackedS ecurity 3,100,000 9/22/2022

P ayden 31680YAD9 FIFT H T HIR D 2019-1 A3 CAR Asset-BackedS ecurity 138,633 12/15/2023

P ayden 34528Q GH1 FO R D 2018-3 A1 FL O O R Asset-BackedS ecurity 7,440,000 10/15/2023

P ayden 345329AC0 FO R DL 2021-B A3 L EAS E Asset-BackedS ecurity 900,000 10/15/2024

P ayden 36259P AB2 GM AL T 2020-2 A2A L EAS E Asset-BackedS ecurity 1,984,609 10/20/2022

P age5of6 73



P ayden 380144AB1 GM AL T 2021-2 A2 L EAS E Asset-BackedS ecurity 4,075,000 7/20/2023

P ayden 380144AD7 GM AL T 2021-2 A L EAS E Asset-BackedS ecurity 750,000 5/20/2025

P ayden 380149AB0 GM CAR 2021-A A2 CAR Asset-BackedS ecurity 4,719,063 6/17/2024

P ayden 380149AC8 GM CAR 2021-2 A3 CAR Asset-BackedS ecurity 220,000 4/16/2026

P ayden 43811JAB3 HO N DA 2021-2 A2 CAR Asset-BackedS ecurity 6,000,000 11/15/2023

P ayden 43813DAB4 HO N DA 2020-2 A2 CAR Asset-BackedS ecurity 1,073,746 11/15/2022

P ayden 43813KAB8 HO N DA 2020-3 A2 CAR Asset-BackedS ecurity 4,926,494 2/21/2023

P ayden 43813R AB3 HO N DA 2020-1 A2 CAR Asset-BackedS ecurity 392,058 10/21/2022

P ayden 43814W AC9 HO N DA 2019-1 A3 CAR Asset-BackedS ecurity 1,681,257 3/20/2023

P ayden 43815EAB0 HO N DA 2021-3 A2 CAR Asset-BackedS ecurity 3,000,000 2/20/2024

P ayden 43815N AC8 HO N DA 2019-3 A3 CAR Asset-BackedS ecurity 299,438 8/15/2023

P ayden 44933L AB9 HYU N DAI2021-A A2 CAR Asset-BackedS ecurity 2,150,000 2/15/2024

P ayden 44933M AB7 HAL S T 2021-C A2 CAR L EAS E144A Asset-BackedS ecurity 5,050,000 1/16/2024

P ayden 47787N AB5 JO HN DEER E2020-B A2 EQ P Asset-BackedS ecurity 2,640,950 3/15/2023

P ayden 47788U AC6 JO HN DEER E2021-A A3 EQ P Asset-BackedS ecurity 550,000 9/15/2025

P ayden 47789KAC7 JO HN DEER E2020-A A3 EQ P Asset-BackedS ecurity 720,000 8/15/2024

P ayden 50117W AC8 KU BO T A 2020-1A A3 EQ P 144A Asset-BackedS ecurity 5,530,000 3/15/2024

P ayden 50117X AE2 KU BO T A 2021-2A A3 EQ P 144A Asset-BackedS ecurity 950,000 11/17/2025

P ayden 58769EAB4 M ER CEDES 2020-B A2 L EAS E Asset-BackedS ecurity 3,161,804 2/15/2023

P ayden 58769KAC8 M ER CEDES 2021-B A2 L EAS E Asset-BackedS ecurity 7,500,000 1/16/2024

P ayden 58769KAD6 M ER CEDES 2021-B A3 L EAS E Asset-BackedS ecurity 600,000 11/15/2024

P ayden 58769VAB6 M ER CEDES 2020-1 A2 CAR Asset-BackedS ecurity 920,613 3/15/2023

P ayden 58770FAC6 M ER CEDES 2020-A A3 CAR L EAS E Asset-BackedS ecurity 172,123 12/15/2022

P ayden 80286CAB6 S R T 2021-C A2 L EAS E144A Asset-BackedS ecurity 4,000,000 4/22/2024

P ayden 80286CAC4 S R T 2021-C A3 L EAS E144A Asset-BackedS ecurity 500,000 3/20/2025

P ayden 88161KAB1 T ES L A 2021-B A2 L EAS E144A Asset-BackedS ecurity 3,450,000 9/22/2025

P ayden 89237VAA7 T O YO T A 2020-C A2 CAR Asset-BackedS ecurity 2,008,194 2/15/2023

P ayden 89238U AD2 T O YO T A 2019-C A3 CAR Asset-BackedS ecurity 3,408,920 9/15/2023

P ayden 89239AAD5 T O YO T A 2019-A A3 CAR Asset-BackedS ecurity 3,352,422 7/17/2023

P ayden 89240BAB4 T O YO T A 2021-A A2 CAR Asset-BackedS ecurity 4,227,010 7/17/2023

P ayden 92290BAA9 VER IZO N 2020-B A P HO N E Asset-BackedS ecurity 950,000 2/20/2025

P ayden 92348AAA3 VER IZO N 2019-C A1A P HO N E Asset-BackedS ecurity 7,450,000 4/22/2024

P ayden 92349GAA9 VER IZO N 2019-B 1A1 P HO N E Asset-BackedS ecurity 2,115,224 12/20/2023

P ayden 92867X AD8 VO L KS W AGEN 2019-A A3 L EAS E Asset-BackedS ecurity 4,696,980 11/21/2022

P ayden 92867X AE6 VO L KS W AGEN 2019-A A4 L EAS E Asset-BackedS ecurity 320,000 8/20/2024

P age6of6 74

Local Agency Investment FundP.O. Box 942809Sacramento, CA 94209-0001(916) 653-3001

October 01, 2021

LAIF HomePMIA AverageMonthly Yields

LOCAL INITIATIVE HEALTH AUTHORITYFOR LOS ANGELES COUNTYDIRECTOR, ACCOUNTING SERVICES1055 WEST 7TH STREET, 10TH FLOORLOS ANGELES, CA 90017

Account Number: 20-19-007

September 2021 Statement

Tran TypeDefinitions

Account Summary

Total Deposit: 0.00 Beginning Balance: 72,784,737.54

Total Withdrawal: 0.00 Ending Balance: 72,784,737.54

Page 1 of 1LAIF Regular Monthly Statement

10/1/2021https://laifms.treasurer.ca.gov/RegularStatement.aspx

75

Board of Supervisors

HILDA L. SOLIS First District

HOLLY J. MITCHELL Second District

SHEILA KUEHL Third District

JANICE HAHN Fourth District

KATHRYN BARGER Fifth District

KEITH KNOX TREASURER AND TAX COLLECTOR

COUNTY OF LOS ANGELES

TREASURER AND TAX COLLECTOR

Kenneth Hahn Hall of Administration 500 West Temple Street, Room 462, Los Angeles, California 90012

Telephone: (213) 974-3385 Fax: (213) 626-1701 ttc.lacounty.gov and propertytax.lacounty.gov

October 8, 2021

Mr. Jason Chen, Manager

Financial Planning and Analysis


1055 West 7th Street, 10th Floor

Los Angeles, California 90017

Dear Mr. Chen:

MONTHLY eCAPS REPORT

Attached please find for your review and reference, the Balance Sheet Detail Activity by

Fund report from eCAPS for the month ended September 30, 2021.

Should you have any questions, you may contact Jennifer Koai, Assistant Operations

Chief, of my staff at (213) 974-7371 or [email protected].

Very truly yours,

KEITH KNOX

Treasurer and Tax Collector

Damia J. Johnson

Operations Chief

DJJ:JK:en

Attachment

Fund: T4P

76


77

1

© 2021 Wilshire


Quarterly Investment Compliance Report July 1, 2021 through September 30, 2021

OVERVIEW The California Government Code requires the L.A. Care Treasurer to submit a quarterly report detailing its investment activity for the period. This investment report covers the three-month period from July 1, 2021 through September 30, 2021.

PORTFOLIO SUMMARY As of September 30, 2021, the market values of the portfolios managed by Payden & Rygel and New England Asset Management are as follows:

Portfolios Payden & Rygel

Cash Portfolio #2365 $1,360,886,939.47

Low Duration Portfolio #2367 $93,797,829.53

Total Combined Portfolio $1,454,684,769.00

Portfolios NEAM

Government and Corporate Debt $338,950,989.58

COMPLIANCE WITH ANNUAL INVESTMENT POLICY Based on an independent compliance review of the Payden & Rygel and NEAM portfolios performed by Wilshire (using 3rd party data), L.A. Care is in compliance with the investment guidelines pursuant to the California Government Code and California Insurance Code. The Payden & Rygel and NEAM investment reports for L.A. Care are available upon request. L.A. Care has invested funds in California’s Local Agency Investment Fund (LAIF) and the Los Angeles County Treasurer’s Pooled Investment Fund (LACPIF). In a LAIF statement dated October 1, 2021, the September 30, 2021 balance is reported as $72,784,737.54 with accrued interest of $43,087. In the LACPIF statement dated October 8, 2021, the September 30, 2021 balance was $252,428,592.31. The LACPIF account balance does not reflect accrued interest.

78

© 2021 Wilshire

Payden & Rygel Compliance Verification

California Government Code Compliance Verification Detail as of September 30, 2021

#2365 #2367 #2365 #2367

Enhanced Cash Low Duration Enhanced Cash Low Duration

US Treasuries 5 Years 5 Years 2.21 Years 5.00 Years YES

Federal Agencies 5 Years 5 Years 0.13 Years 4.37 Years YES

Supranational 5 Years 5 Years 1.75 Years 2.15 Years YES

State of CA 5 Years 5 Years 1.58 Years 4.09 Years YES

Negotiable CDs 270 Days 270 Days 236 days - YES

Money Market and Mutual Funds NA NA 1 Day 1 Day YES

Mortgage and Asset Backed Securities 5 Years 5 Years 3.98 Years 4.71 Years YES

Maximum Permitted Maturity Actual Maximum Maturity

Compliance

79

© 2021 Wilshire

Payden & Rygel Compliance Verification

Combined #2365 and #2367 Portfolios as of September 30, 2021

(1) Approved security

(2) Meets minimum rating (A3/A-) (3) Meets diversification maximums (max market value of issue: 5%) (4) NAIC High Grade Obligations

(5) Authorized by Insurance Code Sections 1174 and 1194.5

(6) Authorized by Insurance Code Section 1196.1

Govt. Code

Insur. Code

Sections

Section 1170-1182

53601 1191-1202

US Treasuries YES (1)(2)(3) YES (4)(5)

Federal Agencies YES (1)(2)(3) YES (4)(5)

Supranational YES (1)(2)(3) YES (4)(5)

State of CA YES (1)(2)(3) YES (4)(5)

Negotiable CDs YES (1)(2)(3) YES (4)(5)

Money Market and Mutual Funds YES (1)(2)(3) YES (4)(5)

Mortgage and Asset Backed Securities YES (1)(2)(3) YES (4)(5)

80

4

© 2021 Wilshire

New England Asset Management Compliance Verification

California Government Code Compliance Verification Detail as of September 30, 2021

NEAM NEAM

US Treasuries 5 Years 1.13 Years YES

Federal Agencies 5 Years - YES

Supranational 5 Years 1.55 Years YES

State of CA 5 Years 3.87 Years YES

MTNs 5 Years 4.96 Years YES

Money Market and Mutual Funds NA 1 Day YES

Compliance

Maximum

Permitted Maturity

Actual Maximum

Maturity

81

© 2021 Wilshire

New England Asset Management Compliance Verification

As of September 30, 2021

(1) Approved security (2) Meets minimum rating (A3/A-) (3) Meets diversification maximums (max market value of issue: 5%) (4) NAIC High Grade Obligations (5) Authorized by Insurance Code Sections 1174 and 1194.5 (6) Authorized by Insurance Code Section 1196.1

Based on an independent review of Payden & Rygel’s and New England Asset Management’s month-end portfolios performed by Wilshire, L.A. Care’s portfolios are compliant with its Annual Investment Guidelines, the California Government Code, and the Insurance Code sections noted above. In addition, based on the review of the latest LAIF and LACPIF reports and their respective investment guidelines, the LAIF and LACPIF investments comply with the Annual Investment Policy, the California Government Code, and the California Insurance Code.

Govt. Code

Insur. Code

Sections

Section 1170-1182

53601 1191-1202

US Treasuries YES (1)(2)(3) YES (4)(5)

Federal Agencies YES (1)(2)(3) YES (4)(5)

Supranational YES (1)(2)(3) YES (4)(5)

State of CA YES (1)(2)(3) YES (4)(5)

MTNs YES (1)(2)(3) YES (4)(5)

Money Market and Mutual Funds YES (1)(2)(3) YES (4)(5)

82

© 2021 Wilshire

MARKET COMMENTARY

Economic Highlights

GDP: Real GDP grew by an annualized 6.7% during the second quarter of 2021, and is now above its pre-COVID high. The largest (and only positive) contributor to growth was personal consumption, up 12.0% for the quarter. Although business spending was up, a major inventory drawdown and a drop in residential spending led to an overall negative contribution from private investment. Rising imports during the quarter also acted as a drag on economic growth. The Atlanta Fed’s GDPNow forecast for the third quarter currently stands at 3.2%. Source: Bureau of Economic Analysis

Interest Rates: The Treasury curve rose somewhat during the quarter, with short rates increasing more than long rates. The 10-year Treasury closed at 1.49%, up two basis points since June. The 10-year real yield (i.e. net of inflation) barely changed, finishing at -0.89%. The Federal Open Market Committee met twice during the quarter with no changes to the Fed Funds rate. At the September meeting, the committee indicated that a 25 basis point increase in the overnight rate in 2022 was possible, while stating that bond purchases may be reduced “soon” should economic progress continue. Source: U.S. Treasury

Inflation: Consumer price changes have accelerated rapidly this year as the Consumer Price Index jumped 1.7% for the three months ending August. For the one-year period, CPI is up 5.2%. The 10-year breakeven inflation rate increased slightly to 2.38% in September versus 2.34% in June. Source: Dept. of Labor (BLS), U.S. Treasury

Employment: While jobs growth has been quite strong this year, with an average of 586k jobs added per month, the August number of 235k jobs added fell significantly short of expectations. The unemployment rate fell to 5.2% in August. Job openings continue to rise and now exceed the number of those reported as unemployed. Despite these improving conditions, the Labor Force Participation Rate remains well below pre-COVID levels. Source: Dept. of Labor (BLS)

U.S. Fixed Income Markets

The U.S. Treasury yield curve was up, generally, during the quarter, with yields in the 3- to 10-year maturity range rising the most. The 10-year Treasury yield ended the quarter at 1.49%, up two basis points from June. Credit spreads widened, with the spread on the broad high yield market closing the quarter at 2.89%. The Federal Open Market Committee (FOMC) met twice during the quarter, as scheduled, with no change to their overnight rate. Through the Fed’s “dot plot,” they are messaging that the current intent is for a 25 basis point increase in the overnight rate before the end of 2022. Their median forecast for year-end 2023 is for a Fed funds rate of 1.0%. The greatest point of interest for the Fed during the fourth quarter will be their decisions on possible tapering of bond purchases, known as quantitative easing. Fed chair Jerome Powell says that he believes the U.S. has made substantial progress towards moderate inflation and maximum employment and that the Fed could “easily” announce a tapering strategy at its next meeting in November.

83

PAYDEN.COMLOS ANGELES | BOSTON | LONDON | MILAN

3rd Quarter 2021

QUARTERLY PORTFOLIO REVIEWQUARTERLY PORTFOLIO REVIEW

84

LETTER FROM THE CEO

September 2021

Dear Client,

As we approach another year-end, we want to take this opportunity to share with you how the firm, in this very challenging time, has maintained its ability to ensure the highest quality of service to our clients. September marked our 38th year in business, and the structure and focus of the firm have not changed. We continue to nurture a culture of collaboration where competition is external, not internal, allowing us to concentrate solely on the needs of our clients.

As a result of our collaborative structure, working from home during the pandemic has gone very well. Although we are anxious to get back to the office on a full-time basis, the health and safety of our employees is a top concern. We will continue to evaluate the situation and keep you well informed of the return-to-office schedule that is adopted.

Turning now to the U.S. and global economies, Delta variant disruptions have led to a slowdown in growth. For example, countries across the Asia-Pacific region reinstituted lockdown procedures to keep the virus at bay, hospitals in the U.S. were forced to ration care in some states, and the prices for input materials skyrocketed across the U.S. and Europe. Looking specifically at the U.S. there are two very important decisions that will need to be made before year-end. First, the debt ceiling will need to be lifted or suspended, and second, President Biden will have to decide whether to reappoint Jerome Powell to another term as chair of the Federal Reserve or to tap someone new. Against this backdrop, we want to assure you that your portfolio is positioned, if necessary, to have increased liquidity.

Again, we want to reiterate that, over the past 38 years, we have maintained a strong culture focused on teamwork and collaboration. This focus has allowed us to manage the firm and our business in a consistent manner, regardless of the market environment. Looking ahead, we continue to monitor the markets as new developments occur and we are always available to answer questions or concerns. Most importantly, our very best wishes for your health and safety in the coming months.

Warmest regards,

Joan A. Payden

President & CEO

85

ECONOMIC REVIEW AND OUTLOOK

GDP growth appeared to slow somewhat in the third quarter due to the Delta-driven resurgence in Covid-19 cases and supply chain issues, after reaching new highs in the second quarter. The slight pull-back in consumer activity also had an impact on consumer prices, leading to a deceleration in month-over-month and year-over-year readings in July and August. While inflation has appeared to have reached a near-term peak, it’s possible price pressures could re-emerge as Delta fades and the labor market tightens. For example, home prices have shot up this year, and, while asset prices aren’t included in CPI, rent and owner’s equivalent rent (OER) constitute roughly 40% of the price index and both categories have recorded robust increases this year, as shown in the graph below.

-0.5%

0.0%

0.5%

1.0%

Feb '20 Apr '20 Jun '20 Aug '20 Oct '20 Dec '20 Feb '21 Apr '21 Jun '21 Aug '21

Used Cars & Trucks New Vehicles Air Fares Hotels

Rent + OER Other* Core CPI

Change Month-Over-Month

Source: U.S. Bureau of Labor Statistics *Contribution of all other categories not listed excluding food and energy

HIGH INFLATION READINGS HAVE BEEN DRIVEN BY A HANDFUL OF CATEGORIES

The labor market was another hot topic in the third quarter as headlines warned of a “Great Resignation.” While the number of people quitting reached a series high (see graph below) and some businesses are finding it difficult to hire enough people to keep up with blossoming consumer demand, there are still millions of Americans who remain unemployed. Despite strong job growth in July, the August jobs report surprised to the downside. The Federal Open Market Committee decided not to taper their asset purchases at the September meeting, but Chair Powell said that a taper announcement could come “as soon as the next meeting” if the economy progressed broadly as expected.

ECONOMIC REVIEW AND OUTLOOKECONOMIC REVIEW AND OUTLOOK

STRONG LABOR DEMAND HAS LED TO A RECORD NUMBER OF QUITS

Quits can be a sign of labor market health

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

2001 2003 2005 2007 2009 2011 2013 2015 2017 2019 2021

Recession QuitsMillions of People

Source: U.S. Bureau of Labor Statistics86

F:\GRAPHICS\TEMPLATE\Bound Books\P&R Marketing Book\P&R Overview.pptx

Payden&Rygel 333 S. Grand Avenue Los Angeles, California 90071 (213) 625-1900 www.payden.com

L.A. CARE HEALTH PLAN COMBINED PORTFOLIO

SECTOR ALLOCATION MATURITY DISTRIBUTION

PORTFOLIO RETURNSPeriods over one year annualized

PORTFOLIO CHARACTERISTICS (As of 9/30/2021)

* ICE BoA 91 Day Treasury Index** Bloomberg US Govt 1-5 Yr Bond Index

Market Value 1,454,684,769 Avg Credit Quality AAAAvg Duration 0.35Avg YTM 0.11%

Periods ended 9/30/2021

Sector Market Value % of Port<90 day 1,091,285,208 75.0%90 days - 1 Year 199,730,638 13.7%1 - 2 Years 86,510,115 5.9%2 - 5 years 77,158,808 5.3%

Total 1,454,684,769 100%

Portfolio Review and Market Update – 3rd Quarter 2021

Sector Market Value % of PortCash 67,091,637 4.61%Money Market 100,999,043 6.94%Treasury 951,259,923 65.39%Agency 68,595,394 4.72%Government Related 31,785,728 2.19%Credit - 0.00%ABS/MBS 174,396,819 11.99%Municipal 60,556,224 4.16%Total 1,454,684,769 100.0%

Performance

3rdQuarter

YTD2021

Trailing1 Year

Trailing 3 Year

LA Care - Short-Term Portfolio 0.02 0.06 0.13 1.27Benchmark* 0.02 0.04 0.07 1.18

LA Care - Extended-Term Portfolio 0.09 -0.15 0.07 3.30Benchmark** 0.03 -0.45 -0.43 3.27

LA Care - Combined Portfolio 0.03 0.05 0.14 1.43

87



L.A. CARE HEALTH PLAN SHORT TERM PORTFOLIO





* ICE BofA 91 Day Treasury Index


Market Value 1,360,886,939 Avg Credit Quality AAAAvg Duration 0.20Avg YTM 0.08%

Sector Market Value % of PortCash 66,327,158 4.87%Money Market 100,999,043 7.42%Treasury 910,915,203 66.94%Agency 64,105,435 4.71%Government Related 30,005,568 2.20%Corporate Credit - 0.00%ABS/MBS 154,869,834 11.38%Municipal 33,664,699 2.47%Total 1,360,886,939 100.0%

Sector Market Value % of Port<90 day 1,090,295,719 80.1%90 days - 1 Year 190,126,505 14.0%1 - 2 Years 68,514,665 5.0%2 - 5 years 11,950,051 0.9%Total 1,360,886,939 100.0%

Performance

3rd Quarter

YTD2021

Trailing 1 Year

Trailing 3 Year

L.A. Care - Short-Term Portfolio 0.02 0.06 0.13 1.27Benchmark* 0.02 0.04 0.07 1.18

88



L.A. CARE HEALTH PLAN EXTENDED TERM PORTFOLIO




Market Value 93,797,830 Avg Credit Quality AA+Avg Duration 2.6Avg YTM 0.59%



Sector Market Value % of PortCash 764,478 0.82%Money Market - 0.00%Treasury 40,344,720 43.01%Agency 4,489,959 4.79%Government Related 1,780,161 1.90%Credit - 0.00%ABS/MBS 19,526,985 20.82%Municipal 26,891,526 28.67%Total 93,797,830 100.0%

** Bloomberg US Govt 1-5 Yr Bond Index

Performance

3rd Quarter

YTD2021

Trailing 1 Year

Trailing 3 Year

LA Care - Extended-Term Portfolio 0.09 -0.15 0.07 3.30Benchmark** 0.03 -0.45 -0.43 3.27

Sector Market Value % of Port<90 day 989,490 1.1%90 days - 1 Year 9,604,133 10.2%1 - 2 Years 17,995,450 19.2%2 - 5 years 65,208,757 69.5%

Total 93,797,830 100%

89




STRATEGY

INTEREST RATES

Interest rates moved higher and the curve steepened in the wake of the September FOMC meeting, whereparticipants signaled a more aggressive path of rate hikes. However, maturities less than one year andoutside of the debt ceiling range of mid-October to mid-November remain well anchored, as the glut of cashin the market continues to keep downward pressure on money market rates. Excess liquidity could pushthe Fed Funds rate of 7 basis points towards the 5 basis point reverse repo floor, while yields shouldremain low in the front end, as a steeper yield curve reflects the increased pace of tapering.

• U.S. Treasury yields with maturities one year and shorter barely moved during the quarter, and thethree-month bill ended down one basis point to 0.03%. However, the two-year note jumped from aquarter low of 0.17% to 0.28%, and the three-year note moved from a quarter low of 0.32% to 0.51%.

• One-month and three-month LIBOR yields declined slightly to 0.08% and 0.13%, respectively.

SECTORS

Asset-backed securities were the dominant source of returns for the quarter. Short maturity ABSspreads were relatively unchanged resulting in positive performance. Floating-rate sectors such asTreasuries, U.S. Government Agencies, Quasi-Sovereigns and CDs benefitted as rates rose and theyield curve steepened.

MARKET THEMES

The third quarter of 2021 brought increased volatility across both equity and bond markets. On themacroeconomic front, a rapid rise in case counts from the Delta variant interrupted the strong recoveryglobal economies had experienced in the first half of the year. In the U.S., the economy slowed, whileinflation remained elevated, albeit driven by just a few particularly volatile sectors. In a somewhatsurprising move at the September Federal Open Market Committee (FOMC) meeting, it was announcedthat a tapering of asset purchases could begin shortly. This news pushed U.S. Treasury yields modestlyhigher toward the end of the quarter. In commodity markets, crude oil and natural gas prices extendedtheir rally, benefiting from rising global fuel consumption and supply chain disruptions.

• We continue to diversify our credit exposure through asset-backed securities (ABS) andmortgage-backed securities (MBS) to maintain differentiated sources of high-quality income.

• We continue to maintain a bias toward a shorter maturity profile within the non-governmentallocation to limit the portfolio’s sensitivity to changes in credit risk premiums while maintaininga yield advantage.

90

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91

L.A.�Care�Health�PlanNEAM's�L.A.�Care�Board�Report

Data�as�of�September�30,�2021

Please�refer�to�last�page�of�this�presentation�for�important�disclosures.92

Table�of�Contents

Proprietary�&�Confidential��|��©2021�New�England�Asset�Management,�Inc.

1.�Portfolio�Summary�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�. 1

2.�Activity�Report�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�. 4

3.�Performance�Report�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�. 6

4.�Appendix�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�. 9-�Risk�Reports�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�. 10

5.�Disclaimers�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�. 12

93

Portfolio�Summary

94

12/31/2020 6/30/2021 9/30/2021Changesince

6/30/2021Portfolio Overview (000's Omitted)

329,137Book Value 322,620 326,969 2,167336,749Market Value 336,396 336,631 117

7,612Total Unrealized Gain/Loss 13,776 9,662 (2,050)8,322 Net Gains 13,786 9,952 (1,630)(709) Net Losses (11) (290) (420)

263Realized Gain / Loss 970 6586,577Annualized Book Income 7,548 7,006 (429)5,196After Tax Book Income 5,963 5,535 (339)

Asset Types0.5%Cash / Cash Equivalents 1.0% 1.8% (1.3%)

99.5%Taxable Fixed Income 99.0% 98.2% 1.3%Portfolio Yields

2.00%Book Yield (Before Tax) 2.34% 2.14% (0.14%)1.58%Book Yield (After Tax) 1.85% 1.69% (0.11%)0.77%Market Yield 0.50% 0.63% 0.13%

Fixed Income Analytics2.62Average OAD 2.56 2.46 0.162.82Average Life 2.78 2.65 0.177.68Average OAC 6.45 7.01 0.67

A+Average Quality A+ A+12.48%144A % 9.59% 9.61% 2.87%

1.07%Average Purchase Yield 2.29% 0.92% 0.14%40Average Spread Over Tsy 59 33 7

0.97%5 Year US Govt On The Run 0.36% 0.89% 0.08%

L.A.�Care�Health�Plan�-�Comparative�Overview

95

12/31/2020 6/30/2021 9/30/2021Changesince

6/30/2021Sector

1%Cash & Cash Equivalents 1% 2% (1%)1%Sovereigns 1% 1% - 1%Supranationals - 1% -

93%Corporates 94% 92% 1%4%Municipals - Taxable 4% 4% -

100%Fixed Income 100% 100%Duration

6%< 1 Year 10% 13% (7%)55%1-3 Years 53% 55% - 39%3-5 Years 37% 32% 7%2.62Average Duration 2.56 2.46 0.16

Quality9%AAA 7% 8% 1%

29%AA 24% 28% 1%62%A 69% 64% (2%)

A+Average Quality A+ A+

L.A.�Care�Health�Plan�-�Fixed�Income�Summary

96

Activity�Report

97

(000's Omitted)DurationSpread (Bp)Purchases Market Value % Book Yld High

4.2834,822 100.0 1.07Total Purchases AA-404.2840Corporates 34,822 100.0 1.07 AA-

DurationRealized G/LSales Market Value % Trade / Book Yld High

0.3726328,034 100.0 0.17 / 2.84Total Sales A+0.37263Corporates 28,034 100.0 0.17 / 2.84 A+

L.A.�Care�Health�Plan�-�Transaction�Summary

98

Performance�Report

99

Sep 2021 Aug 2021 Jul 2021 Q3 YTD 12 Month 3 Year 5 Year InceptionAnnualized

Inc Date0.27LA Care HealthPlan (0.21) (0.08) 0.45(0.02) 0.02 3.294.05 Jan 20180.36Barclay Bloomberg U.S. Credit: 1-5 Yr A- or better (Highest) (0.24) (0.05) 0.530.07 (0.06) 3.264.05 Jan 2018

(0.09)Difference 0.03 (0.03) (0.08)(0.09) 0.08 0.030.00

0.40BB U.S. Treasury: 1-5 year AAA (0.29) (0.08) (0.45)0.02 (0.46) 2.563.29 Jan 20180.33BB U.S. Agency: 1-5 year (0.20) (0.02) (0.01)0.11 (0.16) 2.342.85 Jan 2018

0.00ICE BofA 0-3 Month US Treasury Bill 0.00 0.00 0.060.01 0.03 1.231.11 Jan 20180.02ICE BofA 1 year US Treasury Bill 0.01 0.01 0.200.03 0.13 1.791.86 Jan 20180.03ICE BofA 1 year US Treasury Note (0.01) 0.00 0.170.02 0.11 1.791.88 Jan 2018

Please see the accompanying Disclosure Page for important information regarding this Performance Exhibit.

L.A.�Care�Health�Plan�-�Performance�Report�Not�TaxAdjusted

100

DisclosuresManagement start date is 10/1/17 and performance start date is 1/1/18 to allow for seasoning. The performance results reflect LA Care Health Plan's portfolio managed by NEAM. A Daily Valuation Methodology that adjusts for cash flows is utilized to calculate portfolio performance. Portfolioreturns are calculated daily and geometrically linked to create monthly gross of fee rates of return. Performance results are reported gross of management fees and of custody fees and other charges bythe custodian for your account and net of commissions, mark-ups or mark-downs, spreads, discounts or commission equivalents. The performance results for your account are shown in comparison to anindex that has been chosen by you. The securities comprising this index are not identical to those in your account. The index is comprised of securities that are not actively managed and does not reflectthe deduction of any management or other fees or expenses. Past performance is not indicative of future performance.

L.A.�Care�Health�Plan�-�Performance�Report�Not�TaxAdjusted

101

Appendix

102

Risk�Reports

103

Rating Analysis - Highest% of Portfolio

AAA 8.58AA 29.49A 61.93BBB - Below BBB - NR - Total Fixed Income 100.00Equity - Total 100.00

A+Average Rating:

Quantity Book MarketUnrealizedGain/ Loss

BookYield OAY OAD OAC

% ofAvgLife

Distribution by ClassPortfolio

Cash & Cash Equivalents 1,762,129 1,762,129 1,762,129 - 0.01 0.04 0.08 0.05 0.520.08Sovereigns 4,800,000 4,801,507 4,881,000 79,493 1.60 0.12 1.11 1.81 1.451.13Supranationals 3,000,000 2,995,176 2,995,182 6 0.23 0.23 1.55 3.18 0.891.56Corporates 260,035,000 265,557,830 272,322,711 6,764,880 2.07 0.78 2.62 7.21 80.872.85144A 41,000,000 41,162,915 42,017,176 854,261 2.19 0.78 2.72 10.14 12.482.81Municipals - Taxable 12,800,000 12,856,992 12,770,459 (86,533) 0.63 0.82 3.43 13.86 3.793.49Total Portfolio 323,397,129 329,136,550 336,748,657 7,612,107 2.00 0.77 2.62 7.68 100.002.82

15 YearKey Rate Duration

Market Value 1 Year 2 Year 3 Year 5 Year 7 Year 10 Year 30 Year20 YearCash & Cash Equivalents 1,762,129 0.08 - - - - - - - - Sovereigns 4,881,000 0.97 0.14 - - - - - - - Supranationals 2,995,182 0.69 0.86 - - - - - - - Corporates 272,322,711 0.18 0.62 1.20 0.62 < 0.00 - - - - 144A 42,017,176 0.28 0.54 0.76 1.14 - - - - - Municipals - Taxable 12,770,459 0.01 0.22 2.15 1.06 - - - - - Total Portfolio 336,748,657 0.20 0.59 1.15 0.68 < 0.00 - - - -

Scenario Analysis - % of Market-200 -100 -50 +50 +100 +200 +300-300

Cash & Cash Equivalents 0.01 0.01 0.01 (0.04) (0.08) (0.17) (0.25)0.01Sovereigns 0.22 0.22 0.22 (0.55) (1.10) (2.19) (3.26)0.22Supranationals 0.43 0.43 0.43 (0.77) (1.53) (3.04) (4.51)0.43Corporates 1.72 1.49 0.98 (1.30) (2.58) (5.09) (7.53)1.72144A 2.03 1.61 1.02 (1.35) (2.67) (5.23) (7.71)2.03Municipals - Taxable 2.68 2.25 1.38 (1.70) (3.37) (6.60) (9.71)2.68Total Portfolio 1.76 1.50 0.98 (1.30) (2.58) (5.08) (7.51)1.76

L.A.�Care�Health�Plan�-�Profile�Report

104

Disclaimers

105

Disclaimers

2

The� terial�contained�in�this�presentation�has�been�prepared�solely�for�informational�purposes�by�New�England�Asset�Management,�Inc.�("NEAM"),�and�is�not�to�bedistributed�outside�of�the�organization�to�which�it�is�presented.�The�material�is�based�on�sources�believed�to�be�reliable�and/or�from�proprietary�data�developed�by�NEAM,but�we�do�not�represent�as�to�its�accuracy�or�its�completeness.�This�is�not�an�offer�to�buy�or�sell�any�security�or�financial�instrument.�Certain�assumptions,�including�taxassumptions,�may�have�been�made�which�have�resulted�in�any�returns�detailed�herein.�Past�performance�results�are�not�necessarily�indicative�of�future�performance.Changes�to�the�assumptions,�including�valuations�or�cash�flows�of�any�instrument,�may�have�a�material�impact�on�any�results.�Please�consult�with�your�tax�experts�beforerelying�on�this�material.�Additional�information�is�available�upon�request.�This�document�and�its�contents�are�proprietary�to�NEAM.�They�were�prepared�for�the�exclusive�useof�L.A.�Care�Health�Plan.��Neither�this�document�nor�its�contents�are�to�be�given�or�discussed�with�anyone�other�than�employees,�directors,�trustees�or�auditors�of�L.A.�CareHealth�Plan�without�our�prior�written�consent.

NEAM's�portfolio�management�tools�utilize�deterministic�scenario�analysis�to�provide�an�estimated�range�of�total�returns�based�on�certain�assumptions.�These�assumptionsinclude�the�assignment�of�probabilities�to�each�possible�interest�rate�and�spread�outcome.�We�assume�a�12�month�investment�horizon�and�incorporate�historical�returndistributions�for�each�asset�class�contained�in�the�analysis.��These�projected�returns�do�not�take�into�consideration�the�effect�of�taxes,�fees,�trading�costs,�changing�riskprofiles,�operating�cash�flows�or�future�investment�decisions.�Projected�returns�do�not�represent�actual�accounts�or�actual�trades�and�may�not�reflect�the�effect�of�materialeconomic�and�market�factors.�

Clients�will�experience�different�results�from�any�projected�returns�shown.�There�is�a�potential�for�loss,�as�well�as�gain,�that�is�not�reflected�in�the�projected�informationportrayed.�The�projected�performance�results�shown�are�for�illustrative�purposes�only�and�do�not�represent�the�results�of�actual�trading�using�client�assets�but�wereachieved�by�means�of�the�prospective�application�of�certain�assumptions.�No�representations�or�warranties�are�made�as�to�the�reasonableness�of�the�assumptions.�Resultsshown�are�not�a�guarantee�of�performance�returns.��Please�carefully�review�the�additional�information�presented�by�NEAM.

Limitations�On�Use:�L.A.�Care�Health�Plan�understands�that�NEAM�is�providing�this�report�solely�for�informational�purposes�and�that�any�data,�research,�information�ormaterial�obtained�from�NEAM�(the�"Data")�may�be�proprietary�in�nature�and�subject�to�confidentiality�and�licensing�provisions�contained�in�vendor�agreements�to�whichNEAM�is�a�party.�Regarding�the�Data,�L.A.�Care�Health�Plan�shall�not:�1)�(except�for�month-end�investment�reports)�publish,�display,�distribute�or�transfer�in�any�form�anyData�to�any�third�party�who�is�not�an�employee�of�recipient,�unless�prior�permission�is�granted�by�NEAM;�2)�(except�for�month-end�investment�reports)�incorporate�into,�orwarehouse�on,�any�computer�system�of�recipient,�any�Data;�3)�resell,�make�available�or�distribute�any�Data�to�any�third�party�whether�by�license�or�by�any�other�means;��4)copy,�adapt,�reverse�engineer,�decompile,�disassemble,�or�modify,�any�portion�of�the�Data;�5)�use�the�Data�for�the�benefit�of�a�third�party,�including,�but�not�limited�to,�on�atime-share�basis�or�acting�as�a�service�bureau�or�application�service�provider;��6)�use,�evaluate,�or�view�any�Data�for�the�purpose�of�designing,�modifying,�or�otherwisecreating�any�software�program,�or�any�portion�thereof.

106

November 22, 2021 TO: Board of Governors FROM: John Baackes, Chief Executive Officer SUBJECT: CEO Report – December 2021

November 1 marked the beginning of the annual Open Enrollment period for people who purchase their health care coverage through the Covered California individual market exchange. You may have already seen or heard an advertisement promoting L.A. Care as a choice in Covered California. For the 2022 rate year, L.A. Care is the price leader in all metal levels among the plans available in L.A. County. I am proud of our continued ability to offer an affordable choice within the exchange market.

Since we last met, we concluded our 2021 flu vaccine clinics as part of our “Fight the Flu” campaign. Ten clinics were offered throughout the county in partnership with Blue Shield of California Promise Health Plan, and we immunized over 2,300 members. The success of our clinics is due to the dedication of staff and volunteers.

This year has rushed by and it is hard to believe we are already nearing 2022. To our hardworking staff, our tireless providers, our valued members, and to you, our trusted Board of Governors, thank you. I am grateful for every one of you and honored to be the CEO of this organization.

Happy holidays to you and yours. Be well and be safe! Following is a snapshot of our progress on some of our community- and provider-focused work.

Since last CEO report (10/25/21)

As of 11/22/21

Elevating the Safety Net Physicians hired under Physician Recruitment Program

9 137

Elevating the Safety Net Grants for medical school loan repayment

-3 94

Elevating the Safety Net Grants for medical school scholarships

— 32

L.A. Care’s Housing Initiatives* Households with housing secured

— 324

IHSS+ Home Care Training IHSS worker graduates from CCA** program

— 4,181

* As of July 1, two similar housing initiatives have been combined (Housing for Health and Housing for Healthy California) for updates in this report. ** The Center for Caregiver Advancement (CCA) was previously known as the California Long-Term Care Education Center (CLTCEC).

107

Below please find organizational updates for November: L.A. Care Awards Vaccine Grant to Pasadena L.A. Care awarded the City of Pasadena a $167,500 Community Health Investment Fund grant to boost COVID-19 vaccinations by the Pasadena Public Health Department. At least 8,000 COVID-19 vaccine doses will be given to L.A. Care members living in Pasadena and 1,000 doses to Pasadena residents who are not members of the health plan. The project will prioritize communities that have disproportionately low levels of COVID-19 vaccinations. L.A. Care Awards $3.2 Million to Support Medical Residency Positions in L.A. County We recently announced our third round of Residency Support Program grants as part of the Elevating the Safety Net initiative. We are committing $3.2 million to support 25 residency positions at four medical institutions in L.A. County. Nineteen of these positions were created in two previous grants. L.A. Care’s grants will support residency slots starting in fall 2022 at the following institutions: White Memorial Medical Center Charitable Foundation, AltaMed Health Services Corporation, Charles R. Drew University of Medicine and Science, and the David Geffen School of Medicine at UCLA. L.A. Care Participates in United Against Hate Week L.A. Care joins the L.A. vs Hate Coalition to participate in United Against Hate Week 2021 from November 14-20. Activities will be held throughout the county to raise awareness about the dangers of hate and spur actions to build stronger, more inclusive communities. The attached article includes more details about the events and resources available during United Against Hate week.

Additional Community Resource Center COVID-19 Vaccine Clinics Announced

L.A. Care, in partnership with Blue Shield of California Promise Health Plan and the L.A. County Department of Public Health, is hosting five COVID-19 vaccine clinics at several of our Community Resource Centers (CRCs). Similar to our previous events, there will also be food pantries located at the CRCs. As part of our state approved vaccine incentive plan, we will offer eligible Medi-Cal and CMC members who get a COVID-19 vaccine a $50 gift card. Elevating the Safety Net Featured in an Innovation Showcase Part of the Elevating the Safety Net initiative, the Provider Loan Repayment Program, received third place in the Advisory Board’s 2021 Innovation Showcase: Strategies to Advance Diversity. The awards were focused on innovative solutions to improve representation of historically marginalized and underrepresented staff in clinical and leadership roles. Each finalist gave a short presentation highlighting their innovation. The winner of the award was one of our local providers, Family Care Specialists Medical Group.

Attachments

The Los Angeles Post United Against Hate Week

Cal MediConnect Enrollee Advisory Committee

108

LA County Launches “United Against Hate Week 2021” BY ADMIN · NOVEMBER 15, 2021

LOS ANGELES, CA – Today, the LA vs. Hate Coalition, led by the Los

Angeles County Department of Workforce Development, Aging and

Community Services (WDACS) and the LA County Human Relations

Commission, announced LA vs. Hate United Against Hate Week 2021,

November 14-20. Through a unique, community-building blend of art, social

media, and educational resources, the LA vs. Hate Coalition urges

communities to reject hate and bigotry by promoting inclusion and

understanding.

For a complete list of United Against Hate Week activities in LA County,

including shareable community-centric graphics ready-made for social

media, please click here.

“Hate has no place in Los Angeles County,” shared Los Angeles County

Board of Supervisors Chair Hilda L. Solis, Supervisor to the First District.

“That is why I directed the County’s Human Relation Commission to launch a

public education campaign called “LA vs. Hate” back in 2019, and work with

local organizations to empower Angelenos to unite against and resist hate.

Unity and kindness are the only way forward. To that end, my hope is that

United Against Hate Week serves as an opportunity for all to embrace of the

diversity of our County and support inclusion and safety for all.”

“The increase in hate crimes this past year reinforces the need to speak up

and take a stand with United Against Hate Week. I am hopeful that initiatives

like this, will empower residents with the ability to help create a turning point

and a step in the right direction for Los Angeles County” said Supervisor Holly

J. Mitchell. “In a County as large and diverse as ours, it is our humanity that

109

https://lapost.us/?author=1

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holds us together and there is no reason why we cannot celebrate our

differences. I will remain committed to supporting policies and initiatives that

embrace compassion and respect for all. As we know from Dr. Martin Luther

King, Jr., “Hate cannot drive out hate; only love can do that.”

“It’s time to stand up and be counted,” said Supervisor Sheila Kuehl. “LA is

seeing a sharp rise in racist, homophobic, and xenophobic crimes, and one

good way to combat this tide of hate is to participate in the LA vs. Hate

activities, which range from workshops to walkathons. Let LA know you stand

for equity and inclusion.”

“I am wholeheartedly committed to advocating for victims’ rights, and our

County’s Unite Against Hate Week is an important campaign that raises

awareness to ultimately help victims of hate who have been attacked in a

variety of settings,” stated Supervisor Kathryn Barger, who oversees the

County’s Fifth District. “Many public places such as our transportation systems

are open and easily accessible to attacks by hate actors. As County leaders,

we must focus our efforts into combatting hate at every possible touchpoint to

keep the public safe.”

“Our diversity has made LA County a global economic and cultural success,”

said Otto Solórzano, Acting Director of WDACS. “It’s more important than ever

that we stand together, united against hate. United Against Hate Week is an

important reminder that we cannot remain silent in the face of hate, but

instead we must act.”

“Our United Against Hate Week may be more important than ever this year,”

said Robin Toma, Executive Director of the Human Relations Commission.

Cognizant of the fact that the Commission’s Annual Hate Crime Report

revealed an increase in reported hate crimes that reached the highest level in

LA County since 2008, Toma noted that “LA vs Hate calls on everyone to do

something, big or small, and become connected to the overwhelming numbers

of us who are against hate and bigotry, and for love and embracing of the

diversity in our County.”

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“From November 14-20, United Against Hate Week will invite LA County

residents to take action against hate by going to www.lavshate.org/united-

against-hate-week and using the toolkits, participating in an event, and getting

involved at the community level to fight acts of hate,” stated Dr. Debra

Duardo, the Superintendent of the LA County Office of Education. “All school

districts will be alerted to this event’s goals of providing safe schools, inclusive

classrooms, and alerting staff to the dangers of bullying and bias.”

“Participating in United Against Hate Week is another way L.A. Care is

working to advance health equity,” said James Kyle, MD, Chief of Equity and

Quality Medical Director, L.A. Care Health Plan. “The COVID-19 pandemic put

a spotlight on health inequities in low-income communities of color, and it also

exposed the ugly side of fear as hate incidents rose due to misplaced blame.

United Against Hate Week shines a light on how we can change that dynamic.

We believe everyone should have a fair and just opportunity to be as safe and

healthy as possible.”

“Blue Shield of California Promise has a long-standing commitment to

diversity, equity, and inclusion, and stands against racism of all forms,” said

Sandra Rose, senior director of community & provider engagement of Blue

Shield of California Promise Health Plan. “The County of Los Angeles’ LA vs.

Hate program is bringing critical dialogue and resources to communities we

serve while giving community members tools to develop resilience. We are

proud to support the program’s bystander training, mass meditation, and art

resiliency projects for local residents of all ages,” added Rose.

The Executive Director of the LA Chamber of Commerce, Maria Salinas,

noted that recent studies illuminated the disparate impact hate crimes have on

minority-owned businesses. “The Chamber has several initiatives to promote

policies that strengthen small business, expand opportunities for higher

education to develop a 21st Century workforce capable of competing in a

global economy, and that offer cost-effective advances to promote economic

growth and address climate change,” said Ms. Salinas. “United Against Hate

Week helps to address all our signature policies, ensuring a safe, inclusive

economic region for all.”

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“Inclusion and equity are vital to building healthy, resilient communities,”

stated Maribel Marin, Executive Director, 211-LA. “United Against Hate Week

provides cities the opportunity to build stronger connections that will lead to

year-round engagement in LA County’s unique and diverse communities.”

In response to the rise in hate, in 2018 the Board of Supervisors directed

LACCHR to develop an initiative to prevent and respond to hate incidents in

the County, which resulted in “LA vs. Hate.” The initiative has three

components: (1) a community-driven public engagement campaign to

encourage residents and organizations to unite against and report acts of

hate; (2) the first government hotline (via 211) for reporting all acts of hate and

providing assistance to hate victims; and (3) a network of community agencies

that can address systemic prejudice by providing hate prevention and rapid

response advocacy and services. Since launching in June 2020, “LA vs. Hate”

content has been viewed over 468 million times and has been shared over 88

million times. Since September 2019, when LA vs. Hate and 211 began

accepting calls to report hate, more than 1,400 calls have been received. The

LA vs. Hate Coalition includes civic leaders, educators, LA County

departments, artists, health plans, immigrant rights groups, and more.

United Against Hate Week Coalition:

Los Angeles County Commission on Human Relations

211-LA County

Antelope Valley Partners for Health

Anti-Defamation League

Arroyo West

Asian Americans Advancing Justice – LA

Asian Pacific Policy & Planning Council and Stop AAPI Hate

Asian Youth Center

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Berkeley’s Office of the Mayor

Bienestar

Blue Shield Promise Health Care Plan

Brotherhood Crusade

California Conference for Equality & Justice

Chinatown Service Center

City of Los Angeles Civil & Human Rights Department

Coalition for Humane Immigrant Rights of LA

Jane Gauthier, School of Criminal Justice & Criminalistics, California State

University Los Angeles

Hate Violence Prevention Partnership of LA

Kaiser Permanente

Los Angeles Chamber of Commerce


LA County Internal Services Department

LA County Library

LA County Office of Education

LA County Parks & Recreation Department

LA County Quality & Productivity Commission

LA Metropolitan Transportation Authority

Long Beach LGBT Center

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Los Angeles LGBT Center

Muslim Public Affairs Council

Not In Our Town

Pepperdine Caruso School of Law

San Fernando Valley Community Mental Health Center, Inc.

South Bay Cares

South Bay Council of Governments

Southern California Grantmakers

Special Service for Groups, Inc.

Taskforce PR, LLP

UCLA Asian American Studies Center

Urban League

U.S. Department of Justice

Western Justice Center

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# Organization Name Project Description

Grant/

Sponsorship

Aproval Date

Grant

Category/

SponsorshipGrant Amount*

Sponsorship

Amount

FY CHIF &

Sponsorships

Cummulative

Total

15 Breads 2 Fish COVID vaccination clinic 10/14/2021 Sponsorship -$ $ 5,000 5,000$

2California Association for

Adult Day ServicesAnnual conference 10/28/2021 Sponsorship -$ $ 1,000 1,000$

3 California Coverage and

Health InitiativeAnnual conference 10/6/2021 Sponsorship -$ $ 5,000 5,000$

4California School Based

Health AllianceAnnual conference 10/6/2021 Sponsorship -$ $ 5,000 5,000$

5

City of Pasadena

To administer a minimum of 8,000 COVID-

19 vaccine doses to L.A. Care Health Plan

members as part of L.A. Care’s Vaccine

Incentive Program, plus an additional

1,000 doses for Pasadena residents who

are not L.A. Care members for a total of

9,000 doses.

10/28/2021 CHIF Grant 167,000$ $ - 167,000$

6 Clinica Msgr. Oscar A.

Romero

COVID Vaccination Recovery Fundraising

event10/25/2021 Sponsorship -$ $ 2,500 2,500$

7 Coalition for Humane

Immigrant RightsAnnual gala 10/6/2021 Sponsorship -$ $ 5,000 5,000$

8El Proyecto Del Barrio Annual gala 10/6/2021 Sponsorship -$ $ 5,000 5,000$

9Kids in the Spotlight Annaul awards ceremony 10/6/2021 Sponsorship -$ $ 5,000 5,000$

10 Los Angeles Business

Journal

SoCal CIO ORBIE Awards and Book of Lists

Milestone ad10/29/2021 Sponsorship -$ $ 7,500 7,500$

11 Los Angeles County

Medical AssociationAnnual gala 10/6/2021 Sponsorship -$ $ 7,500 7,500$

12 National Hispanic Health

FoundationScholarship Gala 10/6/2021 Sponsorship -$ $ 500 500$

13Resilient Agency

Food distribution and COVID vaccination

clinic10/6/2021 Sponsorship -$ $ 5,000 5,000$

14 Special Needs Network,

Inc.Annual gala 10/6/2021 Sponsorship -$ $ 5,000 5,000$

15World Mission University COVID vaccination clinic 10/6/2021 Sponsorship -$ $ 5,000 5,000$

167,000$ 64,000$

October 2021

Grants & Sponsorships Report

December 2021 Board of Governors Meeting

Total of grants and sponsorships approved in October 2021

* Per the Community Health Investment Fund (CHIF) grant agreements, the first half of the grant award is released upon receipt of a fully executed agreement. The second half of

grant award is released upon completion of at least half of the entire project objectives, which are detailed in the progress reports submitted every six months. Grantee must also

have spent all funds from the first payment.

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CEO Report to the Board of Governors

Cal MediConnect Enrollee Advisory Committee (CMC EAC) Meeting Summary Meeting Date: November 16, 2021 Attendees: 6 CMC members, via conference call Meeting Summary I. L.A. Care Updates

a. Attendees were informed about

i. COVID-19 Vaccine Updates

ii. Community Resource Center Food Pantries

iii. 2022 Open Enrollment

iv. Flu Shot Clinics

v. Community Resources Centers Re-Opening for select services

II. Cal MediConnect (CMC) Member Experience Enhancements for 2022 a. A presentation on enhanced benefits, communications, website, and member engagement

III. Improving the Experience of L.A. Care Members

a. A presentation on improving member experience and why it is important. Participants

provided feedback on their member experience

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, February 15, 2022, from 2:00

pm - 3:30 pm, via conference call.

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Chief Medical Officer Report November/December 2021

COVID-19 Update By mid-November, there have been more than 250 million reported cases and 5 million deaths from COVID-19 worldwide. After more than a month long declining trend, cases and deaths are increasing in the Americas, Europe, and the Western Pacific, with trends remaining stable or declining in the rest of the world. In the United States, cases increased 30% in November with Michigan and Minnesota having the highest per capita rates in the nation. While also experiencing an increase in cases, the South now has the lowest per capita rates in the nation and California is among 12 states with decreasing rates over the past 2 weeks. The Centers for Disease Control published a study in September 2021 reporting findings that case rates for unvaccinated individuals are reported at more than 5 times the rate of fully vaccinated individuals and hospitalization and death rates are reported more than 10 times higher in the unvaccinated. Recent reports by the Los Angeles County Department of Public Health show even more increased risk to the unvaccinated.

Booster doses of COVID-19 vaccine are now recommended for everyone over 18, following the earlier recommendations limited to people over 65, for people 18-64 with underlying conditions at high risk for serious disease and death from COVID-19, and for people who live or work in high risk settings for exposure to COVID-19. The FDA has authorized Pfizer’s lower dose vaccine for children 5-11 and the CDC now recommends that all children in that age range get the vaccine after each of the panel of experts reviewed the data from their clinical trials and found the vaccine to be safe and effective with benefits that outweigh the risks. New oral medications for the treatment of COVID-19 have been announced by Merck and Pfizer with strong clinical trial results showing significant reductions in the risk of hospitalization if given early in the course of disease.

Effective November 8, 2021, the City of Los Angeles extended its vaccine requirements to indoor dining, shopping centers, movie theaters, hair and nail salons, coffee shops, gyms, museums, bowling alleys, performance venues and other settings, a more stringent requirement than that required by the Los Angeles County Department of Public Health. The City’s requirements do allow for medical and religious exemptions with a negative test result within 72 hours, and for customers without proof of vaccination to briefly enter the facility to use the restroom or pick up food orders.

COVID-19 Vaccine Update By the second week of November, nearly 63% of L.A. Care members 12+ had received at least one dose of COVID vaccine. This compares to 84% of all LA County and 82% for State residents 12+, a gap also seen statewide when comparing Medi-Cal beneficiaries to the community at large. In response, the Department of Health Care Services (DHCS) has committed $350 million to the statewide effort to close this gap. The program offers $250 million to Medi-Cal Managed Care Plans statewide to fund communications, outreach, vaccine administration and provider incentives, and another $100 million to fund member incentives up to $50 for members getting their first dose of COVID vaccine before the end of February 2022.

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Chief Medical Officer Report November 2021 L.A. Care received approximately $9 million after the submission and approval of our COVID Vaccine Response Plan, and will have the opportunity to receive additional funding based on the extent to which we are able to close the gap in vaccination rates. The State has identified the following targeted populations:

Homebound

50 – 64-year-old with one or more chronic conditions

American/Indian- Alaska Native

Black/African American

12-25-year-old

Our response plan builds upon our previous funding and communications campaign which included $2 million in grant funding to 26 Federally Qualified Health Centers (FQHCs) to support COVID-19 outreach, education and vaccination, and targeted communications campaigns focused on homebound and high risk members. Between now and February 2022, plans include offering member, provider and pharmacy incentives, additional COVID vaccination clinics at or near our Community Resource Centers, communications campaigns targeting American Indian and Alaska Native populations and funding outreach efforts.

COVID Provider Relief Funding The U.S. Department of Health and Human Services (HHS) has made $25.5 billion in new provider relief funding available to healthcare providers. L.A. Care helped get the word out to our network providers to encourage them to apply to help cover COVID-19 related losses and increased costs dating back to July 2020 for things such as personal protective equipment (PPE) and testing. The application was due on October 26, 2021. California Advancing & Innovating Medi-Cal (CalAIM) As discussed previously, our Safety Net Initiatives (SNI) department continues to work with business units across the organization and with stake holders throughout the County to transition our Health Homes Program (HHP) network and build our Enhanced Care Management (ECM) network. In addition, we are rolling out Community Support Services, formerly known as In Lieu of Services (ILOS) in January 2022 with more to come in July 2022. There is extensive work being done internally, on contracting and capacity building of our network in collaboration with the other Medi-Cal Managed Care Plans in the County. The team is also working on our submission, due to DHCS in late December, to identify gaps and provide a gap closure plan in an effort to optimize our ability to draw down the maximum amount of the $109 million incentive funding offered by the state for infrastructure and capacity building for ECM and Community Support programs.

Population Health Management (PHM) is another strategic element of CalAIM that is not scheduled to be implemented until 1/1/23. DHCS has announced plans to contract with a vendor to provide a PHM platform at the state level. The platform is expected to provide risk stratification and incorporate member level SDOH data collected through multiple sources including at enrollment, at providers’ offices and through various assessment tools to determine individual risk. More details on how this impacts health plans with data platforms who are already pulling data for the population, segmentation and stratification of members will be available soon.

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Chief Medical Officer Report November 2021 Quality Improvement/Population Health Update The California Department of Healthcare Services (DHCS) released statewide Managed Care Accountability Sets (MCAS) results by Health Plan. Auto Assignment percentages for Measurement Year (MY) 2020 will not be calculated, however, L.A. Care outperformed HealthNet in 35 out of 46 measures. For measures that were required to hit the Minimum Performance Level (MPL), L.A. Care met 9 out of 17 while HealthNet met 6 out of 17. Auto Assignment percentages will remain at 67% for L.A. Care and 33% for HealthNet for the coming year.

Quality improvement efforts continue to evolve to consider equity and disparities issues in our improvement efforts and to focus on Medicare and Covered California STAR ratings to improve outcomes. STAR ratings will play an increasingly important role in contracting and compensation with the launch of the D-SNP product and with contract changes Covered California is contemplating. Campaigns and performance improvement projects include efforts to improve hospital quality, diabetes, blood pressure, colorectal cancer screening and prenatal visits, as well as encouraging members to get back into care for everyone who has deferred getting care during the pandemic.

Molina, Health Net and L.A. Care have established a collaborative that includes standardizing metrics, scorecards, hospital agreements and incentives to improve inpatient quality and safety in coordination with Covered California and the California Hospital Collaborative (CHC). Meetings with Blue Shield Promise and Anthem Blue Cross to be scheduled on the topic of joining the health plan quality collaborative to oversee and monitor network hospital quality and safety. L.A. Care is developing our own hospital quality score card to be considered to establish a hospital value based incentive program.

An Instagram reel highlighting a colorectal cancer survivor was developed in collaboration with the American Cancer Society and posted on the L.A. Care Instagram account on September 23, 2021. The American Cancer Society California page will also re-share the video. The video encourages colorectal cancer screenings starting at age 45 and targets African American males. A breast cancer screening video and general cancer screening video are currently in development and set to launch in October and November 2021.

The “Back to Care” social media campaign launched September 2. This campaign aims to drive members to seek preventive primary care, with a focus on well visits. Health Net, Anthem Blue Cross, and Blue Shield Promise are partnering with us on this effort by aligning messaging and maximizing reach.

Member experience also accounts for a significant proportion of the overall STAR rating score. 2020 PPG survey results will be compared to those from 2019 and follow up meetings with the top CMC PPGs will be scheduled to collaborate on strategy to improve member experience and aspects of the Medicare Health Outcomes Survey (HOS). Results will be presented to Stars Workgroup and Products Intra-Team to inform development of an enterprise wide strategy. Initial Health Assessment (IHA) and Annual Wellness Exams (AWE)

The DHCS audit on the IHA process was held July 13, 2021. IHA was not included in the DHCS draft findings for L.A. Care.

Work continues to revise the reports, enhance training and create a coordinated monitoring program with Facility Site Review (FSR), Enterprise Performance Optimization (EPO), and internal audit team to improve the IHA monitoring process. The IHA requirement is on hold during the COVID Public Health Emergency, however all IHAs will need to be completed after, so work to get L.A. Care’s monitoring process in place continues. We are encouraging providers to complete IHA encounters through virtual and in person visits as much as possible.

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Chief Medical Officer Report November 2021

Now that there are established CPT codes for IHA and Staying Healthy Assessment (SHA) completion, the Health Information Management department (HIM) developed a report showing IHA completion including SHA codes. While many providers are not using the SHA codes, PHM and Incentives team are working together to develop an incentive for IHA completion and educating providers on using the SHA codes. This will likely be added to Physician P4P once the hold is lifted.

Annual Wellness Exam (AWE) records were collected by our Risk Adjustment department to close HEDIS MY2021 gaps for Cal MediConnect (CMC) members. Approximately 800 records and 1,700 gaps have been abstracted as compliant. Soon this data will come through an electronic process (Edifecs) so manual review will no longer be required.

Lead Screening Another state priority is to improve lead screening. The L.A. Care Quality Improvement (QI) Department conducted an analysis looking at the geographic distribution by zip code of increased lead levels among our members. This led to identifying a lead “hotspot” in the community in the 90011 zip code in Southeast LA. Based on the information, QI reached out to the Los Angeles County Department of Public Health (LAC DPH) Childhood Lead Poisoning Prevention Program. County DPH runs a lead abatement, a case management and education program called Lead Free Homes in LA. As a result of this analysis and outreach, L.A. Care will be collaborating with Public Health on social media to promote their hotline and lead abatement program in high risk zip codes, including 90011. L.A. Care also sends a list of members not yet screened for lead to their doctors, to encourage efforts to get them in for lead screening and routine care they may need such as Well Child Care visits and immunizations. Practice Transformation First 5 LA Grant

Program educational materials for providers and the community/members (patients & families) are in the final stages of readiness for use in the Community Resource Centers (CRCs), planned education classes and practices enrolled in the pilot program. These materials are sourced from the CDC and the Help Me Grow: LA program. Next steps: create a distribution plan.

The team is working to partner with the CRCs and Community Based Organizations (CBOs) to offer developmental milestone education classes by a contracted vendor for families and caregivers of children ages 0-5 years.

The education classes will be conducted by PFCC Partners. Their purchase agreement is in the final execution stages. Next steps: create curriculum for classes and submit to CRC team for review/approval.

The team has submitted our first approved article for the Progress Notes print newsletter Winter edition, and Pulse email newsletter to Marketing for publication targeting providers and members.

The team has enrolled the first practice, Kids & Teens, to participate in the 10 clinic pilot program which will begin in late October/November. Outreach is continuing to enroll two additional practices for the 1st cohort of three practices to be enrolled by December 2021.

The coach training will be conducted by LA Net. The purchase agreement is in review with Procurement. Next steps: once the contract is executed, begin training classes for coach(s) based upon HMG:LA provider toolkit.

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Chief Medical Officer Report November 2021 Transform L.A.

Transform L.A. is implementing a hybrid practice coaching model (in-person and virtual) with 13 engaged Direct Network (DN) practices representing 89 providers, 4,250 DN members, and 30,578 L.A. Care members.

Cohort 3 engagement began in September with two Baseline Practice Assessment Tools completed of new DN practices on the waitlist.

Facility Site Review (FSR)

On June 30, 2021, DHCS issued revised APL 20-011 to terminate the executive order flexibilities outlined in APL 20-011. Effective July 1, 2021, all MCPs are to begin resumption of activities and return to standard program operations, policies and procedures in place prior to the COVID-19 public health emergency, with full resumption of these activities within six months by January 1, 2022. Virtual FSR, Medical Record Review (MRR) and Corrective Action Plan (CAP) verification will be accepted during this six-month period. Four FSR nurses have volunteered to resume onsite visits prior to January 1, 2022 to address the backlog.

On February 18, 2021, DHCS issued an email memo which allowed FSR staff to conduct Medical Records Reviews (MRR) and Corrective Action Plan verifications (CAP) virtually, and after the end of the public health emergency. DHCS will not require onsite verifications in general, after the end of the public health emergency. DHCS will not allow virtual FSRs to continue after the end of the public health emergency.

FSR has been conducting virtual periodic and MRR audits to address the backlog. Total backlog (3/2020-08/2021) is 311. To date, seventeen (17) Virtual Periodic FSRs have been conducted

FSR backlog for PARS surveys (March 2020-December 2020) is 799. Working with the PARS Collaborative Workgroup to address PARS backlog, share assignments, and decrease duplication.

L.A. Care FSR is working with the Los Angeles County Collaborative regarding the periodic backlog requesting: o DHCS to grant at least a 2-year extension from the date the public health emergency is lifted, to

complete the site review backlog that accumulated during the public health emergency. Plans will continue monitoring sites (virtual/hybrids/interim reviews/education) during this time.

o DHCS asked each MCP to submit a written plan, via an MCP Site Review Tracker, detailing how the MCP will address and complete Site Reviews not conducted during the public health emergency, including projected timelines. L.A. Care submitted a two-year plan to address the backlog and DHCS approved the written plan. Quarterly progress will be submitted to DHCS on a quarterly basis via the MCP Site Review Tracker through 2022.

o DHCS to adjust the requirements for reviewer training/certification to accommodate lack of in-person site reviews caused by the public health emergency.

o Provider Training Work Group-L.A. Care is working with the County Collaborative Provider Training Work Group to prepare training for PCP sites to assist in their implementation of the New APL 20-006.

Medication Adherence – Comprehensive Adherence Solutions Program (CASP) Medication adherence, the extent to which people take their medications as directed, is important to achieving optimal outcomes. Effective patient education and satisfaction with their provider can increase adherence and control of chronic conditions including diabetes, high blood pressure and high lipid levels. The L.A. Care pharmacy team, including our pharmacy intern, technicians and a staff clinical pharmacist, have been outreaching to non-adherent or at-risk members to offer mail order service, 90-day prescription

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Chief Medical Officer Report November 2021 conversion, and medication education to overcome any potential hurdles the members may be facing which prevent them from taking their medications on a regular basis. Getting 90 day supplies and converting to mail order pharmacy services can make it more convenient to get and refill medications, reducing the risk of running out of medication between refills. Since June 2021, the team has successfully reached over 550 members to provide education, convert them to 90-day supplies and/or mail order services, synchronize the timing of their medications, promote all recommended vaccinations, and refer them to services such as our Medication Therapy Management (MTM) Program, Managed Long Term Support (MLTSS) and Social Services.

Persons Experiencing Homelessness

SNI staff participated in the United Way Health Pathways Expansion grantee closing event which celebrated the achievements of clinic and homeless services providers in serving persons experiencing homelessness in Project Room Key (PRK) sites during the COVID-19 pandemic. L.A. Care and other funders supported connections to primary care for many people experiencing homelessness. Preliminary evaluation outcomes indicate that this collaboration provided much needed primary care services to this vulnerable group and that many clients were able to connect to and receive ongoing care after the initial services received at PRK sites.

Housing for Health/Brilliant Corners Grant: As of September 2021, a total of 256 households are actively enrolled in the grant and 244 of those have secured housing, and 192 of those housed (79%) are L.A. Care members. The total number of households ever housed via this grant is 331. All enrolled participants have also been connected to services through the Housing for Health (HFH) Division at the Los Angeles Department of Health Services (DHS).

Housing for Healthy CA: As of September 2021, a total of 87 households are actively enrolled in the grant and 82 of those have secured housing. All households are L.A. Care members. The total number of households ever housed via this grant is 85. All enrolled participants have also been connected to services through the Housing for Health (HFH) Division at the Los Angeles Department of Health Services (DHS).

HHP Housing Navigation TA: In September, SNI, HHP, and HHP consultants developed an HHP housing navigation guide and completed two coaching sessions on this topic. Also, we hosted a webinar on Housing Insecurity as well as a Learning Community on Housing Success.

Behavioral Health L.A. Care is partnering with LA County Mental Health to implement the Governor’s Child and Youth Behavioral Health initiative, a $4 billion statewide plan to enhance the delivery of mental health and substance abuse services in schools and other settings. L.A. Care serves on the Statewide workgroup for this initiative. Additionally, L.A. Care co-presented its current planning at the annual meeting of the California Association of Health Plans (CAHP) alongside the Superintendent of the Los Angeles County Office of Education. Two particular areas of focus are 1) ongoing countywide assessment of school readiness to address behavioral health, and 2) the countywide Community Schools Initiative which brings mental health and public health resources to underserved high schools in 15 LA County school districts. Provider Leadership Program The L.A. Care Safety Net Initiatives (SNI) team partnered with our vendor CHCS to close-out the Provider Leadership Program (PLP) on September 24, 2021 with our first cohort presenting their Leadership Projects to Dr. Richard Seidman, CMO and Louise McCarthy of CCALAC. The PLP provided 10 seminars with several guest speakers focusing on various leadership development topics and offering coaching sessions designed to increase clinician satisfaction & retention at safety net clinics serving vulnerable populations.

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L.A. CareCOVID-19 Vaccine

Response Plan

Board of Governors Update

December 2, 2021 123

Agenda

• DHCS Vaccination Plan Rules/Goals/Metrics

• L.A. Care Vaccinated/Unvaccinated Members

• Outreach Efforts

• Member Incentives

• Next Steps

• Q&A

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DHCS Vaccination Program Rules

• Program Goal (per APL 21-010)

- Close the vaccination rate gap between Medi-Cal managed care members (49%) and all Californians (74%) (Aug 2021 data)

• Populations of Focus

- Medi-Cal managed care (MCLA, Plan Partners, CMC)

- Homebound/unable to travel

- Age 50-64 years with >1 chronic condition

- Persons of color

- Youth 12-25 years

• 3 Measurement Dates (Milestones)

- October 31, 2021, January 2, 2022, March 6, 2022

• Data source is vaccinations reported through the California Immunization Registry (CAIR)

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DHCS Vaccination Program Rules

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= L.A. Care’s Estimated Milestone 1 Targets (2021-10-31)


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Vaccine Response PlanCollaborative Efforts and Highlights

Jaime Camil PSA

(IEHP Collaboration)

Pharmacy & Provider Incentives

Antelope Valley Canvassing + Mobile Vaccine Clinic

(AVPH/DPH/UCLA)

The RAMS + LAUSD Vaccine Clinics

(Health Net Collaboration)

Member Incentives

Vaccine Clinic Sponsorship Support for CBOs, Schools,

Colleges, Faith-Based Organizations

Leonard Nimoy Family Billboard and Social Media

Campaign

Targeted Equity Initiatives for Black/African Americans

Member Materials

Live Call & Social Media Campaigns

Homebound Vaccinations

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Sample LatinoOutreach Efforts:

Jaime CamilPSA + Lives

L.A. Care and IEHP have partnered with actor Jaime Camil to produce PSAs that will encourage vaccination and return to care; the project includes TV spots, Radio spots and two Instagram Live Q&As on these topics.

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Live Long and Prosper Vaccination Campaign

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• Target and prioritize South L.A. and Antelope Valley providers and initiatives

• Seek consultants focused on Black/African-American communities that are endorsed by Equity Council Steering Committee.

• Identify Micro influencers, faith-based leaders, and other partners focused on outreaching to under-vaccinated BAA populations

Sample African-American Outreach Efforts

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L.A. Care / HealthNet / LA Rams and LAUSD Joint Effort

• Fifteen LAUSD middle schools• Pacoima and adjacent

areas• South L.A.• North Hollywood• Wilmington• Huntington Park

• Goal is 100 vaccines per event• Open to students, their families,

and the community at-large• Turn-key events• Introduction facilitated by

Health Net

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Member Vaccine Incentive Program

L.A. Care is offering eligible Medi-Cal and Cal MediConnect (CMC) members who get a COVID-19 vaccine a $50 gift card, while supplies last.

Member Qualifications

Medi-Cal and CMC members must have active eligibility with L.A. Care at the time of vaccination

Must be 12 years or older Must be directly enrolled with L.A. Care Must have received your first or second COVID-19 vaccination on or

after November 1, 2021

Program Overview Members must be identified in the California State's vaccine registry as

having received at least one dose of a COVID-19 vaccine on or after November 1, 2021

Only one $50 incentive per person Booster shots are not eligible for the incentive

Visit lacare.org/vaccine for complete program guidelines.

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Provider Incentives and Collaboration

• Public Health Departments

• Sponsorships

• Grants

• Messaging/Canvassing

• FQHCs

• ~$2 Million in Grant Support Provided

• Learning collaborative

• Unvaccinated member lists and vaccine incentive program (phase 2)

• Pharmacy

• Phase 1 - 10 retail pharmacies (target ~25K unvaccinated members)

• LA County Department of Health Services

• Collaborative efforts in discussion

• Private Providers

• High volume practices

• Unvaccinated member lists and vaccine incentive program (phase 2)135

Next Steps and Q&A

• Member incentives

• Consider additional provider (DHS, pharmacies, and private providers) incentives

• Messaging

• Collaboration with CBOs, schools etc.

• Homebound vaccine efforts

• Track/measure efforts

Thank you!

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Board of Governors

Executive Community Advisory Committee Meeting Minutes – October 13, 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 **** Estela Lara, RCAC 2 Chair *** Cynthia Conteas-Wood, RCAC 3 Chair, ECAC Vice-Chair *** Silvia Poz, RCAC 4 Chair *** Maria Sanchez, RCAC 5 Chair *** Andria McFerson, RCAC 6 Chair *** Fátima Vázquez, RCAC 7 Chair, ECAC Chair *** Ana Romo, RCAC 8 Chair *** Tonya Byrd, RCAC 9 Chair *** Damares O Hernández de Cordero, RCAC 10 Chair *** Maria Angel Refugio, RCAC 11 Chair *** Lluvia Salazar, At-Large Member *** Deaka McClain, At Large Member *** * Excused Absent ** Absent *** Via teleconference **** Via teleconference (with technical issues)

Isaac Ibarlucea, Interpreter *** Eduardo Kogan, Interpreter *** Alex Mendez, Interpreter *** Ruth Nuno, Interpreter *** Isabel Romero, Interpreter *** Stephanie Webb, Interpreter ***

Hilda Pérez, Member, Board of Governors *** Layla Gonzalez, Advocate, Board of Governors *** John Baackes, Chief Executive Office, L.A. Care *** Richard Seidman, M.D, Chief Medical Officer, L.A. Care *** Miriam Admasu, Department Assistant, CO&E *** Caitlin Crowley, Strategic Planning Specialist II, Strategy, Regulatory and External Affairs Idalia De La Torre, Field Specialist Supervisor, CO&E *** Vilma Diaz, Senior Manager, Provider Contract and Management, Provider Network Operations *** Auleria Eakins, Ed.D, Manager, CO&E *** Joseph Gonzales, Unified Communication Mobility Engineer I, IT Operations & Infrastructure*** Hilda Herrera, Community Outreach Field Specialist, CO&E *** Melissa Jones, Strategic Planning Specialist II, Strategy, Regulatory and External Affairs Nicole Justo, Community Outreach Field Specialist, CO&E *** Linda Merkens, Senior Manager, Board Services Frank Meza, Community Outreach Field Specialist, CO&E *** Nicole Moussa, Manager, Technical Information, Pharmacy & Formulary *** Amber Perrier, Managed Care Pharmacy Resident III, Pharmacy & Formulary Cindy Pozos, Community Outreach Liaison CO&E *** Victor Rodriquez, Board Specialist, Board Services *** Wendy Schiffer, Senior Director Strategic Planning, Strategy, Regulatory and External Affairs Prity Thanki, Local Government Advisor, Government Affairs ***

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Executive Community Advisory Committee October 13, 2021 / Page 2 of 18

AGENDA ITEM/PRESENTER

MOTIONS / MAJOR DISCUSSIONS

ACTION TAKEN

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: 2494 057 7029 (English) Call-in number: 1-415-655-0002 Participants Access Code: 2492 253 8816 (Spanish)

Members of the Executive Community Advisory Committee or staff may also participate in this 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 October 13, 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 prior to the time the Chair announces public comments for each agenda

item. The Chair will announce public comments after the agenda item has been presented and before ECAC has the opportunity to discuss the agenda item. 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].

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APPROVE MEETING AGENDA

Chairperson Vazquez asked any members having issues obtaining health care services to please reach out to L.A. Care Health Plan Member Services at 888-839-9909.

Andria McFerson, RCAC 6 Chair, stated that she asked for a couple of things to be placed on the agenda that were not added. She asked how she can add items on the agenda. She does not agree with the content. She asked for a motion and an ad hoc for the African American communities and disparities they are going through. She asked for the motion to be on the agenda and it’s not on the agenda. She would like to create an ad hoc committee to discuss the new law new passed that affects undocumented immigrants.

Lluvia Salazar, Member At-Large, stated that she would like to know why Member McFerson’s request is not on the agenda.

The Agenda for today’s meeting was approved, as submitted.

Approved by roll call. 10 AYES (Byrd, Conteas-Wood, Lara, Mahler, McClain, Refugio, Romo, Salazar, Sanchez and Vazquez)

1 Abstention Salazar

1 Nay McFerson

APPROVE MEETING MINUTES

(Silvia Poz, RCAC 4 Chair, and Damares Hernandez de Cordero, RCAC 10 Chair, joined the meeting.)

Member McFerson asked what is the allotted amount of time to scroll through the minutes.

Idalia De La Torre, Field Specialist Supervisor, CO&E, asked members to please use their raised hand icon to be recognized and make a comment.

Member Salazar stated that on page 8 where it says “Jane the Virgin”, she meant “Jaime Camille”. She stated that she mentioned that there was a Resource Center opening in the city of El Monte, which is RCAC 11 region, and she and RCAC 11 were not notified.

Member McFerson asked Chair Vazquez how much time they have to read the minutes to keep the meeting professional.

Hilda Perez, Member Representative, Board of Governors, asked if this is the moment for corrections to the meeting minutes.

Ms. De La Torre confirmed corrections can be made now.

Ms. Perez submitted the following corrections to the meeting minutes via email. “On page 6 it should read, “Ms. Perez expressed that she wanted to represent Mexico, her country of

origin, by wearing a folklore outfit to remind everyone about the Hispanic Heritage month

and also about Mexico and other Central and South American countries’ Independence Day. She wanted to thank Dr. Seidman for the multiple interviews, posts and articles

regarding the booster dose of the two-dose vaccines Pfizer and Moderna. This is a

common denominator in regard to questions and concerns among our communities. People

that have received these vaccines are wondering if they qualify to get the third dose or

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booster shot. Ms. Perez also mentioned those individuals that received the one-dose Johnson & Johnson (J&J) vaccine. She stated that these individuals have similar questions

about the availability of a booster for them as well. She encouraged everyone to look for

reliable sites and sources of information regarding this issue, and thanked L.A. Care for

being open and willing to share information about this with our members and the public in general. Ms. Perez also mentioned that there are undocumented individuals over 50 years

old that are now going to get enrolled into Medi-Cal starting next year, and she asked if we

had information of who they are and how many of them are vaccinated. In regard to COVID-19 vaccination efforts, Ms. Perez applauded the CO&E distribution of information

about the State’s Ambassador Program and wanted to let L .A. Care know that there are

many RCAC members that are eager to participate in this and other efforts that L.A. Care

conducts in the following months, virtually or in person, all of this of course, according with the State regulations based on the number of COVIDovid-19 cases in Los Angeles

County.”

The September 9, 2021 meeting minutes were approved as submitted.

Approved by roll call. 12 AYES (Byrd, Conteas-Wood, Hernandez de Cordero, Mahler, Lara, McClain, Poz, Refugio, Romo, Salazar, and Vazquez)

1 Abstention McFerson

STANDING ITEMS UPDATE FROM CHIEF MEDICAL OFFICER

Richard Seidman, MD, MPH

Richard Seidman, MD, MPH, Chief Medical Officer, gave the following report:

Overall there is good news in terms of trends worldwide, nationwide, and countywide. This does not mean the pandemic is over. Many parts of the world there are still increasing numbers of infections, hospitalizations and deaths. Vaccine effort is anything but equal across the world. Some developing nations are having difficulty acquiring vaccines. There are some states like Alaska, Montana and Wyoming that are still seeing significant numbers of new cases. Minnesota hospitals are being overstretched to their limits. The Summer surge is predominately in the unvaccinated geographical areas. COVID-19 is preventable if people are vaccinated in greater numbers. Over 1.1 million members that are 12 and over have gotten at least one vaccine. That is 57% of all eligible members over 12 years of age. It does not compare well against the state rate of vaccination. About 50% of L.A. Care eligible members compared to 77% of eligible people vaccinated statewide. L.A. Care members are 27 points below. That is valid data so it is not a data issue. It reflects hesitancy amongst members. He encouraged members to continue to try to provide information to those that remain hesitant to get vaccinated. He suggested meeting them where they are in terms of understanding and concerns. By far the most effective way to ending the pandemic is vaccination to reduce hospitalization and death. He asked everyone not to get overconfident. In the past week, more than 100 L.A. Care members have been admitted into the hospital and 30 members have died. If you are unvaccinated you remain increasingly at risk. This past week the Center for Disease Control (CDC) and the

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Department of Public Health highlighted that people with underlying medical conditions should be vaccinated as soon as possible. He noted that there is an increased challenge in getting disabled or immobilized people vaccinated. If people are disabled they cannot get vaccinated, because they cannot leave their home. The county has set up avenues for people to get vaccinated at home. He asked that members call member services if they needed assistance with getting access to a COVID-19 vaccine.

The Federal Drug Administration (FDA) is first in line to review data from pharmaceutical companies. Approvals for use need to happen with the FDA. This Friday they will be reviewing data submitted by various vaccine manufacturers. The only COVID-19 vaccine that has been approved for a booster does is Pfizer’s vaccine. FDA will consider approving boosters for Moderna and J&J. The FDA will also be looking at whether or not booster shots can be mixed and matched with the other vaccines. The answer is mostly unknown. There are not any formal recommendations about it. It has not been fully reviewed by the FDA or CDC. It will happen later this week. Data on vaccines among school-aged children will be looked at later. The number of outbreaks that have happened in schools are very few due to multiple layers of protection. Many clinical trials are going on in search of effective therapies, whether it’s infusion or injection. They are now going to be reviewed. The most effective way to avoid infection, hospitalization and death is vaccination.

PUBLIC COMMENT Submitted by Elizabeth Cooper, RCAC 2 Member, via phone call on October 12, 2021 at 11:20 a.m.:

Mr. Baackes, the information you provided regarded the booster shot was very helpful. Thank you.

Submitted by Carolyn Rogers Navarro, via text on October 12, 2021 at 11:28 a.m.:

LA Care keeps soliciting more members using cult like resource centers to recruit them when they cannot handle existing members and do not pay attention (more like ignoring) to red flags regarding accurate enrollees accounts that contractors LA Care uses are not doing their jobs. Why is LA Care paying people in Argentina and India to monitor their social media, on Facebook page? Even on Yelp they monitor people’s reviews, flagged several of mine so I posted a new one that sticks. Why are people on LA Cares payroll wasting time and taxpayer money trolling truthful comments and reviews, I have witnesses attesting that comments are taken down, reviews on Facebook not allowed, because LA Care is hiding that enrollees aren’t happy and not documenting that truth!

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How do enrollees have privacy or can trust LA Care when people in foreign countries are monitoring their comments about LA Care on LA Cares social media page?!

Member Perez thanked Dr. Seidman for his update on the COVID-19 booster vaccines.

Tanya Byrd, RCAC 9 Chair, stated that she has been feeling uncomfortable going to her doctor’s office. She has concerns about medical professionals being vaccinated or not. Do patients have a right to ask if people that are caring for them are vaccinated or not. Dr. Seidman responded that there is a requirement that all health care providers be vaccinated. It varies among health care practices and institutions. Doctors may have different rules for enforcement. He encouraged members to ask if they feel it is important to them. In Los Angeles County there are many other precautions that medical offices are taking in addition to enforcing vaccines. He recommends using telehealth whenever possible. He would not be hesitant to go in to get required medical care.

Layla Gonzalez, Member Advocate, Board of Governors, asked if the COVID-19 vaccine pills will be made available to members if approved. Dr. Seidman responded that L.A. Care will not have to apply, if it is approved for emergency use authorization, it will become available for pharmacies and hospitals to have in stock. If a provider requests it, it will be available for members.

Estela Lara, RCAC 2 Chair, asked when will the pill be available to administer, how soon after authorization will it be available? Dr. Seidman said that similar to the vaccines, the manufacturer is creating it in advance of the authorization to reduce timeframe. Once authorization is received, production will have it available as soon as possible. Efforts are being made in anticipation of the approval of the drug. Member Lara asked if the pill will replace the injection.

Dr. Seidman responded that the most effective way to protect against COVID-19 is to get vaccinated. Moderna, Pfeizer, and J&J are most effective at preventing infection and death. The new medication is an antiviral and effective at preventing serious infection.

Member McFerson stated “It is always great to hear from you and get information. I believe it is a necessity to this actual committee, because we give out necessary information to the community about these things and so it is very important and I appreciate it. You said 1 million of LA Care members basically have had the shot and that is 57% of, what, the members that we have, is that what you are saying?”

Dr. Seidman responded that 1.1 million members have had at least one shot. It is 50% of the eligible members and members that are 12 years of age and above. L.A. Care has a lot of members below 12 also, but about 1.9 million L.A. Care members that are 12 years and

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age and above. Of those over age 12, 1.1 million have had at least one shot and that is the 57%.

Member McFerson said, “Thank you, that [photo was taken] during Juneteenth, one of the events that we had, and I spoke about basically L.A. Care being a part of different events like that and that is what I wanted to ask about. So it was basically you are saying 29% less than the general inception of people receiving the shot in Los Angeles County or just in the nation and I wanted to just go ahead and finish the question that way and I can get everything out, because you had some important information, but I want to clarify basically because we need a general plan because if there is no participation in the events that we have with the CEO and different things like that were not actually taking the time out to actually try and get people to come in and get the actual shot itself. A lot of people can read papers or flyers in the mail or email or something like that and think it is spam and there is no actual incentive now. I believe if we had more community involvement it would be more and of course it would be successful now and we had an event at Inglewood and it was an actual different site than the actual resource center, because they've been shut down for a long time and we don't have a specific address to each event. We also need to have more activity inviting people during the event so we can have more people come out, because trust me, if you had an event primarily filled with one race, other races, sometimes it just makes them reluctant to participate and it is a shame because in our particular point in time. I guess we are more divided and I do not approve of it and what I'm saying is that we do need more diversity at events and we do need more community outreach and maybe with community-based organizations (CBO) and different places like that that have events on a regular basis like the Juneteenth picture you were talking about so how can we have more participation and make it so that the shot statisticgoes up, and not to 57% anymore but maybe 99%, knowing the events that we do reach out to more people that are, you know, you know what I'm trying to say. Success. You know”.

Dr. Seidman thanked Member McFerson for her comments. He stated that the most important thing he wants to share with everyone is the difference, the gap between the rates at which members are vaccinated compared to the county and the State of California. Members that are 12 years of age and above, 57% of them have had at least one shot and it compares to 79% in Los Angeles County and 77% in the Sstate of California and so there's a big gap. L.A. Care is actually doing a huge amount of work to respond to that gap and to reach out to members and provider communities and CBOs and the various partnerships in many different ways. He noted that staff and leadership developed L.A. Care’s COVID-19 vaccine response plan that we submitted to the state, which they approved and it is a multifactorial plan that will take a little bit of time to review.

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John Baackes, Chief Executive Officer, stated that the other thing L.A. Care needs to remember is the statistics that were about members and the general population. It is typical across the State of California and the Medi-Cal population. Every county is at least 20% behind the general population. Counties are having the same problem L.A. Care is facing. Trying to encourage more members to get vaccinated is a task shared by all of the other Medicaid Managed Care Plans in the state and L.A. Care is comparing notes and best practices. Los Angeles County is slightly ahead of most of the other counties, maybe 2% to 4% so nothing to brag about, but it is ahead. The question has not been access. There are over 1,000 locations people can get a vaccine in Los Angeles County and one of the things our response teams is working on, is really to get a one-on-one with the people who are hesitant by talking to them to see what their concerns are. The best advice L.A. Care is getting is to have a trusted source talk to someone who is hesitant and to get them over the hump and in the door for a vaccine.

UPDATE FROM CHIEF EXECUTIVE OFFICER

John Baackes

Mr. Baackes gave the following report:

He noted that the discussion the committee had with Dr. Seidman is important, in particular about increasing the vaccination rate, which is the number one issue L.A. Care is dealing with now. He was on a phone call yesterday with Secretary Becerra, who used to be California’s Attorney General, and asked the same question. He told the Secretary that L.A. Care has 57% of Medi-Cal beneficiaries vaccinated and among a general state population of 79% vaccination rate. L.A. Care has not been able to close the gap. The County will probably not get the community immunity needed. He asked if there is anything the Center for Medicare and Medicaid Services (CMS) can do to help? Secretary Beccera did not have a particular answer or plan. The reason he mentioned this is because it is being discussed at the highest levels about how L.A. Care can increase the vaccination rate. L.A. Care will be looking at the other plans around the country and other states to look for best practices for how to get this number up.

Pharmacy Update Two meetings ago he spoke about the prescription drug program which is still scheduled to go into effect on January 1, 2022. Notices will be mailed out by the state on November 1, 2021 to all beneficiaries to tell them about the change. At some point state officials will mail a new card that members must use to pick up prescription drugs that they will need after January 1. L.A. Care will send a notice emphasizing the same thing. The envelope will look bright green and blue and it has L.A. Care’s logo on it. It will have information about the prescription drug changes. There is always concern that the state will delay something that they have announced. The implementation of this has been delayed three times already. L.A. Care has incurred significant costs for each delay.

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He noted that Health Homes and Enhanced Care Management will provide a set of social services to care management beneficiaries. When we find that there are social determinants that are holding back someone from benefiting from healthcare or they ca nnot move forward because they are homeless or they have food security issues, it will be addressed through care management. It is great the state is doing this and it is something L.A. Care has always done, but now it is going to be more organized and there will be more premiums to help with the cost of the programs. The state estimated only 1% to 3% of members will be eligible for this and so it is not going to be a widely applied benefit. There are 3 million members between L.A. Care and the plan partners, which means we are talking about 23,000 up to 69,000 people who may be enrolled in this program and receive these additional services. L.A. Care and plans like it will do self-assessments on social determinants so we can determine who is impacted. A warm transfer will be made to the Department of Public Social Services. It will be a really big lift and the enhanced care management benefit begins to open the door a little bit for the 1% to 3% of the members. He suggested this be added to the agenda for the December ECAC meeting for further discussion.

PUBLIC COMMENT Submitted by Elizabeth Cooper, RCAC 2 Member, via phone call on October 12, 2021 at 11:20 a.m.:

Mr. Baackes as a member of L.A. Care, I’m very appreciative of the voters of the great state of California, which I’m sure includes L.A. County that there was no recall of the Governor. I do hope that you as the Chief Executive Officer of L.A Care, will make sure to advise the Board of Governors to make sure that the Community Outreach & Engagement Deportment have adequate budget for the next fiscal year and that your staff will continue to do outreach with the community and the RCACs.

Mr. Baackes responded that L.A. Care will continue to do that. He thinks the failure of the recall to remove the governor, at least provided some stability and he cannot imagine what would have happened if California had another governor for the next 14 months.

Member McFerson asked Mr. Baackes what members can do to help increase vaccination numbers. She said, “Thank you so much for coming to our meeting and requesting necessary things on the agenda. It actually needs to be put on the agenda and that is great and we need that information. I had a question for you, so how do we get numbers up? How do we get numbers up for the people who are actually getting vaccinated in the County of Los Angeles, and I did have a suggestion about not hiring outside contractors so much, but just so that we can have a budget to work with that is plausible that we can actually commit maybe to helping the members? We had the members who have had their

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vaccination and willing to come out and they might have been able to pay bills or feed their families or maybe be homeless, because I have been there. During this pandemic and different things like that, people are really going through difficulties, and we have received emails and basically stating we can participate and volunteer in different events and things like that but a lot of people cannot afford to do it anymore, and that is how L.A. Care grew into the largest public insurance company in the nation - through us in the way that we went out and went and made sure that we interacted with the public. And let them know that they had options and gave them necessary information in order to sign up and do all kinds of different things”.

Mr. Baackes responded that she has a great idea. L.A. Care can take a look at that. L.A. Care has had the same contractor for quite some time now who seems to do a pretty good job. If it can reduce expenses, L.A. Care will look for ways to save money.

COMMUNICATION AND COMMUNITY RELATIONS DEPARTMENT UPDATE

Auleria Eakins, Ed.D.

Hispanic Heritage Month Event

Rental Assistance Event

Auleria Eakins, Ed.D., MPA, Manager, CO&E, gave a Communications and Community Relations update (a copy of the report can be obtained from CO&E.):

Digital Inclusion Week In response to “Digital Inclusion” which was October 4-8, CO&E in conjunction with Human IT, hosted a virtual event on October 5 to share information on the digital divide and how to access their services which include computer hardware, computer literacy (how to use the computer) and internet access.

This week CO&E is conducting a digital access survey. The survey will end October 15.. If you have not received a call from CO&E staff, please reach out to your Field Specialist or Liaison so that your response is counted. This data will help inform CO&E as to the current tech needs of members.

Hispanic Heritage Celebration CO&E will host its first Hispanic Heritage Virtual event titled “A celebration of Lived Experiences” tomorrow October 14 from 10am to 11:30am . This will be a great opportunity to hear from fellow advisory committee members as they share their journey here to the states, challenges and triumphs accessing care and their overall thoughts about the importance of health advocacy from their lived experience.

Rental/housing assistance She stated that members should have received a package from CO&E with flyers to distribute to families and neighbors on rental housing assistance.

Secondly, CO&E staff is currently working to plan a rental and housing assistance clinic for advisory members. The date for this event is TBD but looking for dates in November

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Care Harbor 2021

2021. In the meantime, please utilize the resource sheet that you should have received in the mail regarding housing is key and other legal resources.

2021 Care Harbor Care harbor will take place at the REEF in downtown Los Angeles. This is the 12th mega-clinic event, and will be held on December 3-5.

COVID-19 delayed our schedule this year, but we are able to move ahead now with the active support and participation of Los Angeles County and other community partners.

This may be the most impactful Care Harbor clinic to date. We have an opportunity to reach ethnic groups most at risk for the coronavirus. At the last event at the Reef, 85% of the clients were Latinx or Black; these groups are most likely to contract the virus and least likely to be vaccinated.

Working with County Department of Public Health, vaccines will be administered during the event as well as health education on other preventive measures for themselves and their families, there will also be PPE provided to attendees. The event will continue to meet the pressing needs for medical, dental and vision care with our integrative, patient centered healthcare program.

Update on CRC and flu shot events

Inglewood CRC The Community Resource Center at the corner of Century and Crenshaw is closed, and will be moving to a new home at 2864 W. Imperial Highway in Inglewood and reopening in fall 2021. Until it reopens, L.A. Care is still serving the community at many of free events, holding virtual wellness classes and providing information on healthcare resources.

For resources, call 310.330.3130 or visit www.activehealthyinformed.org For virtual classes, visit www.YouTube.com/activehealthyinformed

To prepare for flu season, we are hosting Flu shot clinic on the following dates and sites:

Palmdale: Saturday, October 16 PAL HS Football - Palmdale High School Football Field Parking Lot – 2137 E. Avenue R Palmdale, CA 93550 - On 20th St East (Between Avenue R and Palmdale Blvd.)

East L.A. Friday, October 22

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http://www.activehealthyinformed.org/

http://www.youtube.com/activehealthyinformed


Los Angeles Christian Presbyterian Church - 2241 N. Eastern Ave., Los Angeles, CA 90032

Pacoima Saturday, October 23 Mary Immaculate School - 10390 Remick Ave., Pacoima, CA 91331

El Monte Saturday, October 30 El Monte High School - 3048 Tyler Ave, El Monte, CA 91731

Lynwood Thursday, November 4 Lynwood High School - 4050 E Imperial Hwy, Lynwood, CA 90262

Pomona Saturday, November 6 Palomares Park - 499 E. Arrow Hwy, Pomona, CA 91767

Response to Ms. McFearson’s concerns Each of Ms. McFerson’s concerns regarding ad-hocs and special requests have been addressed in writing. Frank Meza will set up a meeting to properly communicate your request to Dr. Kyle, our Chief of Equity and the staff assigned, to give guidance with these types of issues. Submitted by Elizabeth Cooper, RCAC 2 Member, via phone call on October 12, 2021 at 11:20 a.m.:

Thank you Dr. Eakins and your staff for advocating for the information on Rental Assistance to be available to all RCAC members and the community etc. I would also like to thank the CO&E department for the work they have done regarding this issue.

I would like that any upcoming meetings or presentations etc. have culturally sensitive panelist to address the issues of communication with landlords or their representatives about getting access to affordable housing. Also, I would like to recommend that the process or paperwork to access these services be made more user friendly and please invite the L.A. Housing Authority to be included in the panel discussion because they deal with low income tenants that receive housing. Ms. Perez thanked CO&E staff for all their hard work and for sharing information with RCAC members. She thanked Dr. Eakins for the flyers and resources shared in regards to

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community link, rental assistance and housing programs. She personally liked the heading of the letters that were mailed to members. They are a trusted source of information. She noted that vaccine events are only being conducted in the morning and parents may not be able to attend until after their children are out of school. She asked that there be more flexibility with the times. She asked members to share information regarding these types of events with community members.

Chairperson Vazquez stated that she is happy that these events will be realized. She would like to know when the information will be available so they are able to spread the word. She thanked CO&E for all their hard work.

Dr. Eakins responded that as soon as Communications or Sales and Marketing gives CO&E the outreach flyers, they will be sure to get them out to members.

Member McFerson said, “You just answered one of the questions. Thank you for coming on, I appreciate you taking the time out to do what you do. You do a great job. I really appreciate you taking the time out. But, I do have, I have to agree with Ms. Cooper. She basically said that we need to invite the county or whoever has options for rental assistance or assistance for the homeless and things like that. I do have three homeless friends that are L.A. Care members. They really do need assistance. They need to know where they can go beside the domestic violence shelter or you know, other options that they have out there that are not feasible to where they were or you know, it may not even be an employee option. They may even have to sleep on the floor or different things like that and they worked all their lives and became homeless. They just need rental assistance or somewhere to sign up so that they can have housing. With that being said, I do need to basically you know what? I need to comment on that Care Harbor thing and the relief you did specify that it will be December 3 through the 5. That is great. And there will be flyers. And the flyers, will they have an overview of what is available? And, with that, who will be able to receive care? Who is eligible to receive all care? Will anyone be able to come up and sign up and receive care from care harbor? Is anything changing due to the pandemic in itself? And also, I wanted to know, this is the last question. When will the Inglewood site open up? What potential date to we have specifically? I know you said the fall. We did not specify what date it would be available. We definitely need that location.”

Dr. Eakins responded that staff will work to have diverse organizations present at this event scheduled for November. CO&E is keeping in mind that those agencies that have a wide range of services for persons in need of rental and housing assistance. CO&E will do its best. There are 10 agencies that are listed on the resource sheet who will be invited to participate based on their availability. This is diverse as possible so that they help a wide range of consumer across the County of Los Angeles. This have been many member who

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have expressed their need for rental assistance and information . In response to those inquiries. Dr. Eakins provided the number to Housing Key 1-833-430-2122.

MEMBER ISSUES

Chairperson Vazquez asked the committee members if they have any member issues that they would like to discuss.

Deaka McClain, Member At-Large, stated that we can advocate to change the policy. She was at a doctor's appointment and she was picked up at her house. They took her to her appointment, and then called in the midst of her going home. Her doctor wanted her to go to the emergency room, because her blood pressure was very high. The ambulance picked her up and took her the hospital which was only two minutes away. She sat in the Emergency room for until 1:00 am. She called Call the Car to see if she could get a ride home. She was tired of sitting there all day and was told that they can’t pick her up from the emergency room because it was still considered a medical situation. She had no way to get home. She had to call Call the Car back and have the nurse tell them she was being released. Members should not have to go back to the original spot [where they were picked up]. She would like to advocate to change the policy, that would be great. That is not fair. Ms. De La Torre responded that she should call Member Services and file a grievance. She will forward this issue to AJ Lopez, Director, Provider Contracts and Relationship Management, Provider Network Management.

OLD BUSINESS

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ECAC AD HOC COMMITTEE – BLACK HISTORY MONTH

Auleria Eakins, Ed.D., MPA, Manager, CO&E, reported on the recommendation from the ad hoc committee on Black History Month.

Ad hoc Committee Purpose: To make a recommendation to ECAC members on virtual/s events for acknowledgment of Black History Month 2022.

Overall Focus: Address Health Disparities in the Black community and highlight individuals and organizations that champion for the improvement of conditions and overall wellness.

Ad hoc committee members: Member Byrd, Member McFerson, Member Cordero de Hernandez, and Member McClain CO&E staff present: Dr. Eakins, Ms. De La Torre and Cindy Pozos, Liaison, CO&E

Ad hoc committee recommendations: Social Determinants of Health Alignment: Food Security Topic: Food, Culture and Wellness Speaker: Ron Finely (also known as “The Garden Gangsta”)

Social Determinants of Health Alignment: Housing Topic: homeless and Rental Assistance “looking at the Numbers” Speaker(s): To be determined

Social Determinants of Health Alignment: Access to Care Topic: Community Based Health Services “Who is helping us?” Speaker(s): To be determined

Social Determinants of Health Alignment: Behavioral Health Topic: Mental Health and Black youth “What is on your Mind?” Speaker(s): To be determined

Next Steps: Are there any questions from the ECAC members? Are there any additions to the recommendations from the ad-hoc Committee? We would like to ask ECAC to move forward with the recommendations made by the ad hoc committee. PUBLIC COMMENT Submitted by Elizabeth Cooper, RCAC 2 Member, via phone call on October 12, 2021 at 11:20 a.m.:

Regarding Black History Month, which is the month of February, but I would like to see the acknowledgement of the contributions of the African American

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Community etc. be acknowledged in the field of healthcare and be recognized at all times not only during the month of February. Member McFerson asked if the meetings will be held virtually or in person. She would like to know if people will be able to make their comments live. There needs to be more interaction.

Dr. Eakins responded that the meetings will be held in accordance with L.A. Care’s protocols. Currently L.A. Care is operating 100% remotely and it is not holding in person meetings.

Ms. McFerson asked if there can be an ad hoc to discuss the African American History Month.

Ms. De La Torre responded that she can’t discuss a different ad hoc committee now, they must first have an overview of the comments.

Chair Vazquez asked for a vote on recommendations.

Member McClain asked for clarification on what the committee is voting on.

Chairperson Vazquez asked for a vote to approve recommendations made by the ad hoc committee for Black History month.

Approved by roll call. 12 AYES (Byrd, Conteas-Wood, Hernandez de Cordero, Mahler, Lara, McClain, McFerson, Poz, Refugio, Romo, Salazar, and Vazquez)

NEW BUSINESS VISION 2024 – L.A. CARE STRATEGIC PLAN OVERVIEW

Wendy Schiffer, Senior Director, Strategic Planning, presented information about L.A. Care’s Strategic Plan Overview (A copy of the report can be obtained from CO&E.).

High Performing Plan Achieve operational excellence by improving health plan functionality. Highlights:

• Improving Information Technology systems to support everything L.A. Care does, from customer service to care management

• Maintaining a diverse and skilled workforce and planning for future needs

• Continuing to be financially stable

• Growing and retaining membership across products

High Quality Network Support a robust provider network that offers access to high-quality, cost-efficient care. Highlights:

• Growing and supporting our Direct Network

• Improving the quality of care that our members receive

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• Investing in the providers and practices who serve our members

Member Centric Care Provide services and care that meet the broad health and social needs of our members. Highlights:

• Implementing CalAIM (California’s new requirements for Medi-Cal)

• Delivering care management services closer to where members live

• Reducing health disparities and offering providers resources to reduce bias

Health Leader Serve as a national leader in promoting equitable healthcare to our members and the community and act as a catalyst for community change. Highlights:

• Promoting our work as a “public option” (a public plan offering insurance on the Covered California exchange)

• Increasing the number of Community Resource Centers and expanding services

• Advocating for equity and social justice PUBLIC COMMENT Submitted by Elizabeth Cooper, RCAC 2 Member, via phone call on October 12, 2021 at 11:20 a.m.:

I would like to see the Board of Governors strategic plan for L.A Care health plan to keep L.A. Care consumer members input and participation as a part of their strategic plan. Please take notice of Hilda Perez and Layla Gonzalez. Ms. Schiffer stated that that L.A. Care sent a high level draft overview to all of the Board members.

Ms. Gonzalez thanked Ms. Schiffer for attending ECAC and for her presentation. She noted that grievances really affect members. She believes it is something that needs to be included in L.A. Care’s Vision.

Ms. Schiffer responded that the grievance issues came after the plan was finished, but it is something that needs to be considered and acknowledged.

FUTURE AGENDA ITEMS PUBLIC COMMENT

Submitted by Elizabeth Cooper, RCAC 2 Member, via phone call on October 12, 2021 at 11:20 a.m.:

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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 _________11/10/2021____________________

I would like to see what our neighbors in other countries, such as Mexico, specifically consumer members are doing to share with us what their experience is in regards to healthcare. Dr. Eakins requested a continuance of the ad hoc committee recommendations for future agenda planning since it is on the same topic. Ms. De La Torre responded that it will be placed on the agenda for next month.

PUBLIC COMMENTS

PUBLIC COMMENT Submitted by Wilma Ballew via phone call:

Is there some way that L.A. Care set up a group of Medical Folks that can go to Senior Housing to give them the shot for the virus? People don’t have access to transportation and will be helpful to them.

ADJOURNMENT The meeting was adjourned at 1:32 p.m.

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APPROVED

BOARD OF GOVERNORS Children’s Health Consultant Advisory Committee Meeting Minutes – August 17, 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, Chief Quality and Information Executive, Health Services Cynthia Carmona, Senior Director, Safety Net Initiatives, Safety Net Initiatives Michael Bodsky, MD, Medical Director, Behavioral Health and Social Services, Behavioral Health

Linda Aragon, MPH* Gwendolyn Ross Jordan Richard Seidman, MD, MPH Edward Bloch, MD* Lynda Knox, PhD Ilan Shapiro, MD, FAAP* Maria Chandler, MD, MBA James Kyle, MD, M.Div. Diane Tanaka, MD* Rebecca Dudovitz, MD, MS Rosina Franco, MD Susan Fleischman, MD*

Nayat Mutafyan* Hilda Perez

*Absent **Present, but not quorum

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 8:31 a.m. without quorum.

APPROVAL OF MEETING AGENDA

The Committee reached a quorum at 9:14 a.m.

The Agenda for today’s meeting was approved as submitted.

Approved unanimously. 9 AYES (Chandler, Ficek, Franco, Jordan, Knox, Kyle, Perez, Ramos, Seidman)

1 Abstention (Puffer)

APPROVAL OF THE MEETING MINUTES

Approved unanimously. 9 AYES (Chandler, Ficek, Franco, Jordan,

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Children’s Health Consultant Advisory Committee (CHCAC)

August 17, 2021, Page 2 of 9 APPROVED



The minutes of the May 18, 2021 meeting were approved with the corrections mentioned above.

Knox, Kyle, Perez, Ramos, Seidman)

1 Abstention (Puffer)

CHAIRPERSON’S REPORT

Chairperson Ficek reported the following information from her Chairperson Report: First 5 LA’s agenda has been heavily focused on the State Budget. She noted that it is an area of interest for many including her org. First 5 LA has been tracking the process to get law signed. It is a projected $2.7 billion spending plan. Once in a lifetime to spend on invest in children and families when it is mostly needed. On June 15, California lifted all restrictions on businesses. The State will try to recover jobs lost due economic shutdown. After several months of steady decline, hospitalizations are beginning to increase statewide. In L.A. County primarily due to the new Delta Variant. In California people of color face increased dipartites and economic instability. Racism will only continue to compound these challenges. The Budget largely providing funding to individual services that are often disconnected navigate or utilize.

PUBLIC COMMENT No public comment was submitted.

CHIEF MEDICAL OFFICER REPORT


Richard Seidman, MD, MPH, Chief Medical Officer, gave the May 2021 Chief Medical Officer report. (A copy of his written report can be obtained from Board Services.)

Last Monday, since that time, things have changed, Federal Drug Administration (FDA) and Center for Disease Control (CDC) extended emergency use for Pfizer and Moderna, to give a 3rd shot to people who are immune compromised. The FDA approved and the CDC added the recommendation. A very significant change, last night and this morning, the Washington Post and Politicos, it is expected as early as this week for the FDA to approve booster dose from everyone 16 and over. Not just immune compromised individuals. Another notable highlight, the State did announce that they do intend to move forward with the pharmacy carve out. They will remove the pharmacy benefit from Medi-Cal managed plans, move it up to the State level. It was delayed due to push back and the pandemic. The National Committee for Quality Assurance (NCQA) announced a change in distinction

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• California Health and Human Services Child and Youth Behavioral Health Initiative

Michael Brodsky, MD

or designation that they offer to health plans. The multicultural health distinction, received 10 years ago, has under gone audits. The NCQA has announced organizational level commitment standards that demonstrate that commitment. He noted that is a good direction they are moving in.

Michael Bodsky, MD, Medical Director, Behavioral Health and Social Services, Behavioral Health, presented information about the California Health and Human Services (CHHS) Child and Youth Behavioral Health (BH) Initiative (a copy of the presentation can be obtained from Board Services.).

Student BH Incentive Program (SBHI) ($400M)

• Authorizes Department of Health Care Services (DHCS) to award grants to entities vetted by Managed Care Plans (MCP) for certain activities:

- building partnerships

- expanding access

- build a “statewide Community-Based Organizations (CBO) provider network for behavioral health prevention and treatment services”

• Proposed incentives for 3-way contracting between Local Education Agencies, Plans, and Counties

• Year 1:

- Issue Request for Proposal (RFP) and contract for third party administrator (TPA) to administer the grant program, with close DHCS oversight.

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- Develop the funding criteria with a robust stakeholder process

• Years 2-5:

- Award grants on a phased-in basis to school districts, schools, health plans, counties, tribes and CBOs, with attention to racial equity and fair geographic distribution.

- Department Managed Health Care (DMHC) to issue guidance to commercial health plans

DHCS Grants

• Authorizes DHCS to award grants to entities for:

- Building partnerships

- Expanding access:

• “Build Mental Health (MH) and Substance Use Disorder (SUD) urgent care, intensive outpatient, crisis stabilization, crisis residential, inpatient and residential options including home-like settings.”

• Build a “statewide CBO provider network for behavioral health prevention and treatment services”

- Some grants will be linked to MCP SBHI program

Dyadic Services Benefit

• Primary care early intervention to improve the caregiver-infant dyadic relationship

• Evidence-based models include Healthy Steps and Parent-Child Psychotherapy

• Benefit goes live July 1, 2022

• Preliminary discussions with Community Clinic Association of Los Angeles County, Federally Qualified Health Centers, and CA Children’s Trust

• Potential grant opportunities with first 5 and private philanthropy

Statewide Fee Schedule

• Requires DHCS to develop a statewide fee schedule for MH/SUD treatment at a school site

• Requires DHCS to develop and maintain a school-linked statewide provider network of school site BH counselors

• Effective January 1, 2024, requires plans to reimburse schools for MH/SUD treatment provided at a school site, even if school providers are not in network or credentialed (LHPC focus)

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Virtual Platform ($680M)

• Will include:

- screening

- individual counseling

- group counseling

- peer and coaching supports

- referrals to plans (Medi-Cal and commercial)

- statewide e-consult service.

• Process to include an IT RFP and a “landscape survey” RFP

• Launch no sooner than January 1, 2024

Evidence-Based BH Practices (EBP)

• Requires DHCS to identify EBPs to improve outcomes for youth

• Provide grants to entities to support implementation of the EBPs

BH Workforce Initiatives

• Authorizes OSHPD to award grants to entities and individuals to expand supply of:

- BH counselors (have various licensures)

- Coaches (unlicensed)

- Peer supports

- Other allied health care providers

• Adds behavioral health coaches as a new category of BH provider for children and youth.

- will be trained to help address the unmet MH needs and SUD needs for children and youth

- “Earn and Learn” apprenticeship training models

- will link to higher levels of care as needed

Public Education Campaign

• Reduce the stigma on behavioral health needs

• Encourage children and youth, and families to seek needed care before a crisis

• Build a common understanding of ACEs and toxic stress

Related Proposals in Home & Community Based Services Spending Plan

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• Traumatic Brain Injury (TBI) investments

• Developmental Services Workforce Recruitment/Training

• I/DD Resource Navigation Portal

• Mental Health First Aid in Schools

• CalHOPE Media Campaign

• Affordable Housing for Individuals with I/DD

Member Hilda Perez asked Dr. Brodsky if this information is being distributed to families so they are aware these services are available. Dr. Brodsky responded that these services don’t involve schools very much. If a teacher sees a problem, they may submit a referral to be seen away from the school. Dyadic services are not designed to be provided in a school. Member Perez asked if these services are just for LAUSD or all L.A. County school districts. Dr. Brodsky responded that LAUSD has its own health staff, do expect to work with them. There are eighty school districts in the county and L.A. Care would like to make it known to as many as can be accommodated to improve services that are currently provided. L.A. Care will be working with the L.A. County Office of Education, which works with all school districts.

Chairperson Ficek asked how stakeholders will be a part of the BH incentive program. Dr. Brodsky responded that when L.A. Care developed a stakeholder group for previous incentive programs. Entities included L.A. Care, L.A. County Mental Health, L.A County Substance Abuse, Beacon and other business areas in L.A. Care. The new incentive program will have different stakeholders such as school districts and some participants in CHCAC. There will be a commitment, stakeholders may find that some districts will submit 30-40 page grants proposals, stakeholders will have to do a lot of reading.

CalAIM UPDATE

Cherie Compartore

Cherie Compartore, Senior Director, Government Affairs, Government Affairs, gave an update on CalAIM (a copy of the presentation can be obtained from Board Services.).

Budget Children and Youth Behavioral Health Initiative Multi-Year Investment TOTAL: $4.4 billion over five years

• Primarily funded through federal funds available through the American Rescue Plan Act (ARPA).

• 14 discrete programs or services funded through the Initiative.

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• New programs or services to be implemented in Medi-Cal managed care:

- Student Behavioral Health Incentive Program

- Dyadic care

- School-based behavioral health services fee schedule

- School partnership infrastructure and capacity grants*

- Evidence-based behavioral health program grants* *Multiple entities, including plans, are eligible to apply for and receive grant funding for school partnership infrastructure and capacity and EBP BH programs.

Postpartum Eligibility

• Expands eligibility from 60 days to 12 months for postpartum individuals.

• Effective April 1, 2022.

• In effect for up to five years, consistent with ARPA.

• Reference WIC Section 15840. Medi-Cal Doula Benefit • Adds a Doula benefit to Medi-Cal program, effective January 1, 2022. No other detail

provided.

• SB 65 policy bill currently in legislature with more detail.

- Includes at least 4 appointments during the prenatal period, continuous support during labor and delivery, and at least 8 appointments during postpartum.

- Effective July 1, 2023. Medi-Cal Expansion • Expands full-scope Medi-Cal to adults ages 50 and over regardless of immigration

status.

• Implementation no sooner than May 1, 2022.

• Reference WIC Section 14007.8. Elimination of Medi-Cal Asset Test • Eliminates the Medi-Cal assets test, so that seniors, and individuals with disabilities, with

assets of more than $2,000 do not lose or are not denied Medi-Cal coverage.

• Implementation no sooner than July 1, 2022.

• Reference WIC Section 14005.62. Optional Benefits

• Permanently eliminates the suspension of optional benefits, including:

- Audiology and speech therapy

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- Incontinence creams and washes

- Optician and optical lab services

- Podiatric services

• Reference WIC Section 14131.10. Continuous Glucose Monitors

• Adds continuous glucose monitors as a Medi-Cal covered benefit for beneficiaries with Type 1 diabetes.

• Effective January 2, 2022.

• No trailer bill language. Over the Counter Medications

• Reinstates adult over the counter cough/cold and acetaminophen in Medi-Cal program.

• Effective July 1, 2021.

• Reference WIC Section 14132. Whole Genome Sequencing

• Adds whole genome sequencing as a Medi-Cal benefit for infants one year of age or younger receiving inpatient hospital services in an intensive care unit.

• Effective no sooner than January 01, 2022.

• Reference WIC Section 14132. Telehealth

• Extends all telehealth PHE flexibilities through December 31, 2022.

• Requires DHCS to convene a stakeholder workgroup on billing and UM policies to inform the 2022-23 State Budget.

• Specifies stakeholders for this workgroup, including Medi-Cal managed care plans.

• Adds remote patient monitoring as a Medi-Cal covered modality for services deemed appropriate.

• Reference WIC Section 14124.12. Proposition 56

• Permanent elimination of the Proposition 56 suspensions that would otherwise have been effective on July 1, 2021 for most Proposition 56 supplemental payments.

DMHC Quality and Equity Standards

• DMHC to establish quality measures and equity benchmark standards, including enforcement actions for non-compliance.

• Requires coordination and collaboration with DHCS for Medi-Cal managed care plans.

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• Reference HSC Sections 1399.870.and 1399.871. Medi-Cal Pharmacy Carve-Out

• Carves out the prescription drug benefit from managed care into fee-for-service.

• Implementation date of January 1, 2022. Community Health Workers

• Adds community health workers as a Medi-Cal allowable provider type.

• Effective January 1, 2022.

• No trailer bill language. Covered California $1 Premium Subsidy Program

• Fund the $1 per month premium required for the cost of providing abortion services, for which federal funding is prohibited.

• Covers subsidies authorized for the 2022 coverage year. -

MEMBERSHIP (CHC 100.0921)

Member Seidman advised the committee that Susan Fleischman, MD, is no longer the Chief Medical Officer (CMO) at Blue Shield Promise Health Plan. She will now be serving as CMO for Blue Shield of California. James Cruz, MD, is now the interim CMO of Blue Shield Promise Health Plan. He asked Board Services if the committee must make a motion to approve someone for membership. Linda Merkens, Senior Manager, Board Services, responded that the committee may vote to approve a new member since it is listed on the agenda.

Motion CHC 100.0921 To approve James Cruz, MD, as member of the Children’s Health Consultant Advisory Committee (CHCAC), effective upon his acceptance of this position, and as of September 2, 2021 for the L.A. Care Plan Partner seat.

The committee discussed extending an invitation to Children Now to be a part of CHCAC.

Approved Unanimously 10 AYES

ADJOURNMENT The meeting was adjourned at 10:05 a.m.

Respectfully submitted by: APPROVED BY: Victor Rodriguez, Board Specialist II, Board Services Tara Ficek, MPH, Chairperson ____Tara Ficek___________________ Malou Balones, Board Specialist III, Board Services Linda Merkens, Senior Manager, Board Services Date Signed: ______11/18/21___________________________

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APPROVED

BOARD OF GOVERNORS Technical Advisory Committee Meeting Minutes – August 5, 2021 1055 W. Seventh Street, Los Angeles, CA 90017

Members Santiago Munoz Management

Richard Seidman, MD, MPH, Chairperson Elan Shultz* Wendy Schiffer, Senior Director, Strategic Planning

John Baackes, CEO Stephanie Taylor, PhD Katrina Parrish, Chief Quality and Information Executive, Health Services Elaine Batchlor, MD, MPH Grace Crofton, Advisor Quality Performance Informatics Paul Chung, MD, MS Alison Klurfield, Director, Safety Net Programs and Partnerships, Safety Net Muntu Davis, MD, MPH* Initiatives Hector Flores, MD Rishi Manchanda, MD, MPH * Absent ***Present (Does not count towards Quorum)





CALL TO ORDER

Member Richard Seidman, MD, MPH, Chief Medical Officer, called the meeting to order at 2:06 p.m. without a quorum.


The committee reached a quorum at 2:20 p.m. The Agenda for today’s meeting was approved as submitted.

Approved Unanimously. 6 AYES (Baackes, Chung, Flores, Manchanda, Seidman, Taylor)

PUBLIC COMMENT There were no public comments.

APPROVAL OF MEETING MINUTES

Member Hector Flores, stated that on page 3, where it reads “community hospitals” it should read “unaligned hospitals”. The April 29, 2021 meeting minutes were approved with the corrections mentioned above.

Approved Unanimously. 6 AYES (Baackes, Chung, Flores, Manchanda, Seidman, Taylor)

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Technical Advisory Committee (TAC)

August 5, 2021 Page 2 of 6

APPROVED



CHIEF EXECUTIVE OFFICER UPDATE

John Baackes

(Member John Baackes, Member Rishi Manchanda, MD, joined the meeting.)

Member John Baackes, Chief Executive Officer, gave the following report:

Medi-Cal enrollment into L.A. Care is at an all-time high. All Medicaid plans across the nation have suspended redeterminations. Normally there were 30,000 members coming into and leaving L.A. Care every month. Without that churn L.A. Care’s Medi-Cal membership has grown to about 2,250,000 members. Total plan enrollment is about 2,440,000. That includes Medicare dual eligible, L.A. Care Covered, and approximately 52,000 In-Home Support Services workers. Almost a quarter of all L.A. County will be a member at some point in the future.

In January, a host of new benefits will be introduced to L.A. Care members through CalAIM. It was aimed at trying to streamline benefits. Currently it is very chaotic. L.A. Care has not received rates from the State. The most important benefits are Whole Person Care and Health Homes. These programs were aimed at homeless and people that are getting out of incarceration and helping people with the most complex health cases. By coordinating social services for people that may benefit from those services. L.A. Care is trying to figure out whether or not members may be left behind on January 1, because the criteria may change. At the moment it seems that the State would like L.A. Care to reevaluate all members in those programs. He hopes L.A. Care can get through the planning and implementation of these services. He noted that another change that will impact members is the prescription drug carve out benefit that will also take effect on January 1. The Medicaid managed care plans will no longer manage those benefits. Fourteen States have already tried this and determined that they were not saving money. They were reversed back the plans benefit package.

Member Rishi Manchanda, MD, asked how is the issue with deciding rates impacted in Lou of Services and the partnership with community organizations. Member Baackes responded that In Lou of Services has a menu of 14 benefits that L.A. Care can pick from. L.A. Care picked four. Medically tailored meals and housing support services are two of them and they must be finalized in September. The State came out with pricing guidance and they stated that L.A. Care should be able to provide medically tailored meals for $7 a meal. L.A. Care has been doing on its own through grants to organizations like Project Angel Food. The State has received push back and stated that they surveyed 57 organizations to determine pricing. The concern is that if L.A. Care spends more than $7 per meal, it may not be spending its money wisely by providing

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APPROVED



this service. Enhanced Care Management (ECM) reimbursement is based on levels of providers and caseloads. There has also been push back on that that forced the State to provide reevaluated dates. All ECM work is done externally.

Member Flores, noted that the way the State is rolling out the prescription drug carve out program has been very confusing. He noted that his father is a Medi-Cal patient and has gotten 4 letters, 3 to 4 pages long. It was hard for him to understand let alone a senior or disabled person. His father received a phone call from his pharmacy advising that he will have to work with the State to get his prescriptions processed. He questioned whether the State realizes that this may become messy for everyone involved. Member Baackes responded that L.A. Care has raised concerns, but he does not believe they are listening. The money that was used to send notices that are now invalid is now money wasted. There is an educational component that will have to take place with members and pharmacies. He hopes that pharmacies and Navitus are switching over to the new vendor. Member Flores asked Member Baackes if the State will be providing additional funds to pay for the new In Lou of Services. Member Baackes replied that there will be $115 Million spread out across the State. L.A. Care anticipates receiving about a quarter of that amount due to the size of membership. When this was announced in 2019, the State made it clear that the plans will be paying for these services for about 2-3 years before receiving funding for the program.

(Member Paul Chung, MD, joined the meeting at 2:16 pm)



Member Richard Seidman, MD, MPH, Chief Medical Officer, gave the following updates:

COVID-19 trends are not moving in a good direction in the country or in the county. In Louisiana, they are experiencing the worst peak since the beginning of the pandemic. It is deadly consequence in the lack of progress made in their vaccination efforts. Locally nearly 4,000 cases and 16 deaths were reported in L.A. County yesterday. The surge being experienced now is for a very different age demographic than last fall. Earlier there was an impact on skilled nursing facilities. The 18 to 29-year-old cohort has the highest number of cases followed by the 30 to 49-year-old cohort. The parts of town that were highest hit last winter are now showing lower rates in cases. Vaccination efforts in those areas has affected this. Among L.A. Care members, there have been 140K reported cases and 4,300 deaths in 1.8 million 16 or older members. L.A. Care is reporting 950K members that are 16 and older getting at least partially vaccinated. That number includes plan partner membership. Compared to countywide

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data, there is a 20-point differential. L.A. Care shared its communication effort to members at the last TAC meeting. L.A. Care is trying to further expand its efforts to providers. The flu vaccine campaign will also include information on receiving two vaccines at the same time. He noted that many people deferred their medical care due to the pandemic and L.A. Care is also trying to reach out to members and encourage them to resume receiving their regular and preventive medical care.

Member Flores thanked Member Seidman for his report. He noted that reaching herd immunity in part is reaching essential workers and their families and also isolated patients. Reaching smaller practices that are key to L.A. Care’s network. CMA has set up technical assistance shop for physicians, small practices, and Federally Qualified Health Centers (FQHC), to fill out the My California Vaccine applied so they can be a certified provider for the vaccine. He suggested that L.A. Care promote this to small provider offices. He noted that in East L.A. cases are dropping but is still behind in immunizations.

Member Paul Chung, MD, thanked Dr. Seidman for his report. He asked if L.A. Care has been able to evaluate its vaccine outreach efforts. Does L.A. Care think is working or not working? What is the potential that he sees in partnerships with employers in terms of outreach in the L.A. Care community? Dr. Seidman responded that L.A. Care has not done any formal evaluations. It can be left to interpretation. People have different ideas of what may or may not work. L.A. Care has provided grants to FQHCs to assist with their immunization efforts. The county has done more direct partnering to conduct pop up clinics to provide vaccinations, but L.A. Care has not done so.

L.A. CARE’S STRATEGIC VISION

Wendy Schiffer

Wendy Schiffer, Senior Director, Strategic Planning, Strategy, Regulatory and External Affairs, presented L.A. Care’s Strategic Vision (A copy of the presentation can be obtained from Board Services.)

High Performing Plan Achieve operational excellence by improving health plan functionality. Highlights:

• Improving Information Technology systems to support everything L.A. Care does, from customer service to care management

• Maintaining a diverse and skilled workforce and planning for future needs

• Continuing to be financially stable

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• Growing and retaining membership across products

High Quality Network Support a robust provider network that offers access to high-quality, cost-efficient care. Highlights:

• Growing and supporting our Direct Network

• Improving the quality of care that our members receive

• Investing in the providers and practices who serve our members

Member Centric Care Provide services and care that meet the broad health and social needs of our members. Highlights:

• Implementing CalAIM (California’s new requirements for Medi-Cal)

• Delivering care management services closer to where members live

• Reducing health disparities and offering providers resources to reduce bias

Health Leader Serve as a national leader in promoting equitable healthcare to our members and the community and act as a catalyst for community change. Highlights:

• Promoting our work as a “public option” (a public plan offering insurance on the Covered California exchange)

• Increasing the number of Community Resource Centers and expanding services

• Advocating for equity and social justice

Member Manchanda noted that part of the transition in the business that NCQA has had is creating a second tier for Health Equity Accreditation (HEA) distinction which is now Health Equity Accreditation Plus, which is the social determinants element. He asked if that is the target to aim for over the next three year or is it too early to know what it looks like exactly. He asked if L.A. Care is aiming for HEA or HEA Plus. Member Seidman deferred to James Kyle, Chief of Equity and Quality Medical Director, Quality Improvement, to respond. Dr. Seidman stated that he does not know enough about HEA Plus. It is clear that L.A. Care works to spread its success in screening and assessing for and referring to resources for all members to the existing NCQA standard. He will try to provide an answer at later time.

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Member Manchanda noted that the vision and mission seem to be fit for these times. He asked if equity is something to elevate all the way through in the vision and mission. He suggested that L.A. Care consider it. Ms. Schiffer responded that she appreciates his suggestion.

Member Manchanda stated that one of the things that is emerging is focus on the use of quality improvement to improve equity and racial health equity. Looking at the social and structure of equity is a way to tie in Member-Centric Dare and Health Leader. He suggested this may help drive activities in the future. Member Seidman pointed that he received confirmation that L.A. Care will be going for the HEA Plus accreditation.

ADJOURNMENT

The meeting was adjourned at 3:56 p.m.

Respectfully submitted by: APPROVED BY: _________________________________ Malou Balones, Board Specialist III, Board Services Richard Seidman, MD, MPH, Chairperson Victor Rodriguez, Board Specialist II, Board Services Linda Merkens, Senior Manager, Board Services _________________________________ Date Signed

11/18/2021 | 10:47 AM PST

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MOTION SUMMARY

Date: December 2, 2021 Motion No. EXE 101.1221

Committee: Executive Chairperson: Hector De La Torre

Issue: Approval of L.A. Care’s 2022 State and Federal Policy Agenda.


Background: In accordance with the process approved by the L.A. Care Governing Board, below

is L.A. Care’s proposed 2022 State and Federal Policy Agenda (Policy Agenda) for consideration.

This Policy Agenda contains principles and policies that serve as the framework for the development and advocacy of positions on federal and state legislative, administrative, and budget issues. This Policy Agenda provides guidance for L.A. Care’s Government Affairs Department to respond effectively to proposals that could significantly impact L.A. Care’s strategic and operational interests.

2022 State and Federal Policy Principles

Federal Funding and Coverage 1. Retain coverage expansions accomplished by the Affordable Care Act (ACA), including proposals

that codify ACA provisions in state statute. 2. Support proposals that stabilize the marketplace (Covered California individual market). 3. Support proposals that provide federal stimulus funds for government-sponsored programs in

COVID-19 relief legislation. 4. Oppose efforts by the federal government to recoup Medicaid matching funds.

Public Plan Protection 5. Support proposals that strengthen L.A. Care as the Local Initiative plan in Los Angeles County. 6. Support proposals that build upon California’s public Medi-Cal managed care plans to create a local,

regional, or statewide Public Option and to continue efforts to ensure L.A. Care is recognized as a Public Option in L.A. County.

Eligibility, Benefits, and Enrollment 7. Support proposals that simplify and coordinate the Medi-Cal enrollment and redetermination

processes with existing programs (e.g., CalFresh, universal consent for communications, enrollment into Medi-Cal due to loss of Covered California eligibility, etc.)

8. Support proposals that strengthen government-sponsored programs and increase no or low-cost health insurance coverage to the uninsured and low-income populations, without eroding existing coverage or access.

9. Support proposals that would eliminate barriers to eligible populations receiving health and social services benefits for which they qualify.

10. Support proposals that improve enrollment processes and policies impacting duals specific Medicare products, in order to enable membership growth in the duals product line.

11. Support value-based purchasing strategies that are geared towards achieving value through high-quality, cost-efficient member-centric care and that do not result in diminished coverage or benefits.

12. Support proposals that strengthen and improve existing government-sponsored programs in ways that support the safety net, including expanding program eligibility and increasing reimbursement.

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13. Support proposals that promote home and community-based care for persons who would otherwise require institutionalization and that do not financially harm the health plan.

14. Support proposals that expand, simplify, or streamline access to behavioral health and substance use disorder services.

Quality 15. Support measures that result in improved quality outcomes and reduced racial disparities in

government-sponsored programs. 16. Support integrated delivery and whole person models that are designed to improve quality of care

through team-based coordination of care, and that empower patients to be a partner in their own care.

17. Support proposals that improve quality outcomes, reduce racial disparities, and drive delivery system transformation through value-based initiatives, modernization of systems, and payment reform.

Rates/Reimbursement 18. Support proposals that increase transparency, accuracy, and appropriateness in the rate-setting

process conducted by regulatory agencies (e.g., DMHC, DHCS, CMS, and Covered California). 19. Support use of health plan fees, provider fees, and intergovernmental transfers that maximize

California’s share of Federal Medicaid funding and help stabilize the Medi-Cal program. 20. Support proposals that improve accuracy in the rate adjustment process. 21. Oppose efforts that continue the countywide averaging of Medi-Cal rates in its current form. 22. Support proposals that align financial incentives among providers, patients, health plans, and payers. 23. Support efforts that result in payment equity among government-sponsored programs (e.g., Medi-

Cal payment levels being increased to Medicare payment levels). 24. Oppose proposals that shift the cost burden of COVID-19 testing primarily to health plans, with no

consideration of additional reimbursement from the federal or state governments. 25. Support proposals to align Medi-Cal reimbursement rates for providers and hospitals in medically

underserved areas in Southern California with Northern California Medi-Cal reimbursement rates.

Access to Care 26. Support proposals that increase California’s health care workforce and address the shortage of

appropriate health care providers in underserved communities in order to enhance provider access for Medi-Cal enrollees.

27. Support proposals that encourage rigorous evaluations comparing clinical, risk-adjusted patient outcomes for licensed health care professionals. The results of these evaluations will inform the discussions and deliberations surrounding the scope of practice for licensed practitioners; including their initial and ongoing education, training and supervision, in order to assure they work within their entire scope of practice to deliver safe, culturally competent, high-quality health care.

28. Support proposals that encourage team-based training of groups of medical professionals with different licensure and for these groups to practice team-based medical care. Consideration should also be given to having value-based performance rewards for teams as a whole.

29. Support proposals allowing scope of practice expansion under a particular type of license, only if the public interest is clearly protected by commensurate changes in: education and training standards; testing for knowledge and clinical proficiency; and expectations for life-long learning.

30. Support proposals that establish a Graduate Medical Education Governance Council that would expand graduate medical education to match the needs of California’s growing and diverse population, especially in geographically underserved areas.

31. Support proposals to expand the capacity for physician (M.D. and D.O.) residency positions and creating residency positions for Nurse Practitioners who desire additional training. Proposals to expand the number of residency positions that focus on educating individuals to provide medical

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care to vulnerable and underserved patient populations are considered high priority; especially if they expand primary care positions.

32. Support proposals that improve and expand access to telehealth/virtual care health services and create long-term policy to utilize technology that improves access to care (including community clinics) and include appropriate compensation.

33. Support proposals that expand access to technology to access telehealth services (e.g., broadband expansion devices, and affordable internet services).

34. Support policies that would establish mental health hotlines and expand mental health services and community workforce to meet increased need.

35. Support policies that would result in decreasing the spread of COVID-19 in vulnerable communities, such as effective contact tracing, appropriate access to testing, personal protective equipment, and timely medical intervention.

Social Determinants of Health/Equity 36. Support policies that improve social conditions and quality of life for low-income populations,

including policies that support economic stability, education, food security, housing and healthy physical environments.

37. Support proposals that would change policies, behaviors, and beliefs that perpetuate racism by identifying and addressing those policies and practices in areas where L.A. Care has control or influence, such as employment, contracting, and the provision of medical services.

38. Support programs to address implicit bias in policing and the development of funding mechanisms that support street policing with mental health rapid response units that can de-escalate a mental health emergency.

Health Information Technology 39. Support the use of health information technology and interoperability that would result in cost-

savings and patient care improvement. 40. Support proposals that improve data collection coordination to address needs and gaps, especially in

vulnerable and minority communities. 41. Support policy that improves collection and reporting of REAL (Race, Ethnicity, and Language)

data for members and providers.

Fraud 42. Support the strengthening of anti-fraud measures and programs, and provide the ability of health

plans and payers to recover lost funds.

For each proposal evaluated by L.A. Care, due consideration will be given to the financial and work burdens placed on healthcare providers and efforts will be taken to minimize those burdens whenever possible.

Member Impact: L.A. Care supports public policies that increase resources for the safety net,

and/or leads to improved access and quality of health care services for its members.

Budget Impact: Sufficient funds are budgeted in the Government Affairs Department budget for

this fiscal year. We will budget the balance in future fiscal years.

Motion: To approve L.A. Care’s 2022 State and Federal Policy Agenda, as submitted.

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MOTION SUMMARY

Date: November 15, 2021 Motion No. EXE 102.1221

Committee: Executive

Chairperson: Hector De La Torre

Issue: Approve the disbursement of funds for the Annual Incentive Plan, based on the results of

individual performance goals and organizational targets for FY 2020-2021.

Background: Currently, employees are eligible to participate based upon job classification, and under

one of the following components of the Annual Incentive Program:

Monthly Production Incentives Program based on predetermined criteria;

Individual Annual Incentives Program based on predetermined goals; and,

The Production Incentive Program was budgeted and paid monthly according to policy.

This request is for authorization to payout for the Annual Incentives Program, not to exceed $8.8 million.

Budget Impact: The Annual Incentive Program budget previously approved by the Board of

Governors for FY 2020-2021, no more than 4.0% of budgeted Salaries and Benefits. The projected amount for a potential incentive for the Chief Executive Officer has a separate budget.

Motion: To authorize the disbursement of funds not to exceed $8.8 million for the Individual Annual Incentive Program, based on the completion of pre-determined individual goals and targets in support of L.A. Care’s FY 2020-2021 Organizational Goals. Distribution of the annual incentive payout shall be guided by Human Resource Policy No. 602, Annual Organizational Incentive Program.

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BOARD OF GOVERNORS Executive Committee

Meeting Minutes – October 25, 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

State and local officials continue to impose or recommend measures to promote social distancing to reduce transmission of the COVID 19 virus. It is prudent to use caution in protecting the health of the public, L.A. Care’s employees and its members where adequate virtual means exist to permit the

meeting to occur by teleconference/videoconference with the public being afforded the ability to comment in real time. The Board of Governors and all legislative bodies of the L.A. Care Health Plan, and the Board of Directors and all legislative bodies of the Joint Powers Authority will continue to meet

virtually and the Boards will review that decision on an on-going basis as provided in the Brown Act. Members of the public had the opportunity to listen to the meeting via teleconference, and share their comments via voicemail, email, or text.



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 2:05 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.

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ACTION TAKEN

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.


The Agenda for today’s meeting was approved.

Approved unanimously by roll call. 5 AYES (Ballesteros, Booth, De La Torre, Gonzalez and Perez).

PUBLIC COMMENTS There were no public comments.

APPROVE MEETING MINUTES

The minutes of the September 27, 2021 meeting were approved as submitted.

Approved unanimously by roll call. 5 AYES


Chairperson De La Torre reported that the Officer Election will be held at the November Board Meeting. Nominations received clearly indicate four individuals, Chair: Hector De La Torre, Vice Chair: Al Ballesteros, Treasurer: Ilan Shapiro, MD and Secretary: Stephanie Booth, MD. Additional nominations can be made at that meeting.

Mr. Robert Curry has submitted a letter of resignation. Mr. Curry was nominated by Private Essential Access Community Hospitals (PEACH) in October 2017, and was appointed by the Los Angeles County Board of Supervisors as a member the L.A. Care Board of Governors in January 2018 to represent the private disproportionate share hospitals serving Medi-Cal and other government program beneficiaries in Los Angeles County. His first Board meeting was in February 2018 and later that year he was elected Treasurer of this Board. He was re-elected Treasurer in 2019 and 2020. L.A. Care experienced tremendous growth and the effects of the COVID pandemic during his tenure. Mr. Curry oversaw L.A. Care’s finances through these changes, working with L.A. Care’s staff. Chairperson De La Torre thanked Mr. Curry for his service over the years to the Medi-Cal community. He has been an effective Board Member and colleague and he wished him well in his retirement.

Board members asked that Mr. Curry be invited to a future meeting so they can express their appreciation and wish him well. (The CEO Report was presented later in the meeting.)

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Government Affairs Update

Cherie Compartore, Senior Director, Government Affairs, reported:

The California legislative year has ended. The Governor had until October 10 to sign bills into law. There are 13 bills with direct impact on L.A. Care’s operations.

At the upcoming Board Meeting Ms. Compartore will review pertinent legislation.

A written summary will be included in the board meeting materials.

California Department of Health Care Services (DHCS) announced last week that implementation of the new Doula benefit for Medi-Cal is being delayed from January 1, 2022 to July 1, 2022. From the doula stakeholder workgroup DHCS has indicated that additional effort must be made to define the program and develop rates in more detail. L.A. Care supports this new benefit for Medi-Cal beneficiaries.

Also being delayed to July are provisions to allow Community Health Workers to provide some benefits to Medi-Cal enrollees. The delays are due to the workload state departments are under as they work on the implementation of the new California Advancing and Innovating Medi-Cal (CalAIM) program.

Work is beginning on the new State Budget Proposal which is normally released around January 10 each year. A budget surplus is expected, and it is anticipated that interesting new programs and legislation will be proposed in addition to the two-year bills.

Ms. Compartore will have a more complete update on activities at the federal level for the Board Meeting next week. She noted that Democrats are still negotiating on final components of two pieces of legislation included in the Build Back Better bill package which included $3.5 trillion in cost, with investments in home health care, paid family leave, climate change and other social services, but faced serious opposition from several congressional representatives. Some Medicare benefits may be eliminated, as well as guaranteed family leave for all U.S. workers. The bill must have a yes vote from all Democrats, so the effort to negotiate a suitable final bill is critical. The other component of Build Back Better is a $1.2 trillion bill to support infrastructure, which has already passed in the Senate. Members of the Progressive Congressional Caucus have indicated they will vote against this bill in the House of Representatives if it comes up before a bill is passed on the budget reconciliation social bill.

Chairperson De La Torre noted that Mr. Baackes has been delayed in arriving at today’s meeting because he is advocating for L.A. Care and its members right now in a meeting with a group of state legislators.

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ACTION TAKEN

Ratify execution of Amendment A33 to Contract 04-36069, and Amendment A15 to Contract 03-75799, between L.A. Care Health Plan and the California Department of Health Care Services

Augustavia J. Haydel, Esq., General Counsel, reported that L.A. Care received Amendment A33 and Amendment A15 from DHCS on October 1, 2021 with a request that it be reviewed, signed, and returned to DHCS by October 15, 2021. Amendment A33 modifies the contract term of the primary Medi-Cal Agreement and Amendment A15 modifies the contract term of the Hyde Agreement. Effective dates for both contracts are extended to December 31, 2023.

Motion EXE 100.1121 To ratify execution of Amendment A33 to Contract 04-36069, and to ratify execution of Amendment A15 to Contract 03-75799, between L.A. Care Health Plan and the California Department of Health Care Services, by L.A. Care Chief Executive Officer, John Baackes.

Approved unanimously by roll call. 5 AYES By consensus, the committee agreed that this motion will be added to the consent agenda at the November 4, 2021 Board meeting.

Nomination for Charitable Organizations for donated Board Stipends

Ms. Haydel informed Committee Members that Board Members will have the opportunity to nominate non-profit organizations to receive donated stipends. Staff will randomly select two organizations and a motion will be presented at the December 2, 2021 Board meeting. Board members were invited to send the name of organizations they would like to nominate to Board Services staff.

Community Health Investment Fund (CHIF) FY 2021-22 Priorities

Roland Palencia, Director, Community Benefits, indicated that each year approval of allocation and priorities for the Community Health Investment Fund (CHIF) is presented for Board consideration. On September 2, 2021, as part of the general organizational budget, the L.A. Care Board of Governors approved a CHIF funding allocation of $10 million for FY 2021-22.

All CHIF grants are well-vetted before they reach the Board of Governors. This includes Community Benefits staff, a review committee composed of internal staff and community experts, Strategic Planning Senior Director, and CEO authorization. Grant requests over $250,000 will be brought to the Board for final approval. Upon approval, a grant agreement is executed with the grantee, outlining responsibilities and accountability to perform according to agreed objectives. Grantees will submit progress reports bi-annually and progress will be reported to the Board annually. Additionally, staff will also report monthly to the Board on approved grants and sponsorships. Member Booth suggested an amendment to the motion, to add the words “health/social determinants of health related” in front of the word, “organizations” in section 1.d.

Member Ballesteros may have financial interests in Plans, Plan Participating Providers or other programs and as such refrained from the discussion of those issues identified below. In order to expedite

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the process, his vote on this motion reflects a vote concerning the entire motion excluding Section 1a, for which the member is abstaining.

Motion EXE 101.1121 1. To approve the recommended approach for the Community Health

Investment Fund (CHIF) FY 2021-22 allocation of up to $10 million in the following priority categories: a) support the health care safety net to improve infrastructure and address

racial inequities, recommended at $4.1 million, b) address social determinants of health that result in inequities,

recommended at $2.4 million, c) close the health disparities gap, recommended at $1.8 million, and d) empower and invest in health/social determinants of health related

organizations that address systemic racism, recommended at $1.7 million. 2. Delegated authority to the CEO to implement the CHIF program and approve up

to $250,000 per grant through September 30, 2022. This authority will allow L.A. Care to make grants for larger projects as well as respond to COVID-19 ongoing needs and its aftermath. Also, allow for CEO to adjust CHIF priority category amounts noted above to align with changing community needs and requests. All other policies and approvals related to grant making investments will remain in place.

Approved unanimously as amended and by roll call, with consideration of potential conflict as noted. 5 AYES

Continue funding of Elevating the Safety Net Residency Support Program

Cynthia Carmona, Senior Director, Safety Net Initiatives, presented the motion to support the Residency Support Program. In 2019 and 2020, the Executive Board approved a combined $9,652,928 (two funding cycles) under the ESN initiative RSP to support expansion of graduate medical education training for 38 residents and 4.0 FTE faculty across five teaching institutions: AltaMed Health Services Corporation (AltaMed), Children’s Hospital of Los Angeles, Charles R. Drew University of Medicine and Science (CDU), UCLA Foundation (UCLA), and White Memorial Medical Center Charitable Foundation (White Memorial).

Residency Support Program (RSP) In 2021, L.A. Care invited AltaMed, CDU, UCLA, and White Memorial to apply for a third cycle of funding. After thoroughly reviewing the applications, the committee recommends an expenditure of up to $3.23 million to fund salaries and benefits for 25 residents across the four institutions over the course of three years. Grant awards will

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support residents starting in academic year 2022-23 through academic year 2024-25. Proposed awards are as follows:

Institution Expansion Award

AltaMed Family Medicine: 18 Residents for 3 years $1,127,380

CDU Internal Medicine: 1 Chief Resident for 1 year and 2 Internal Medicine Residents for 2 years $640,610

UCLA Pediatric Medicine: 2 Residents for 3 years $558,231

White Memorial Family Medicine: 1 Resident for 3 years

$897,600 Internal Medicine: 1 Resident for 3 years

TOTAL 25 Residents $3,223,821

Board Member Gonzalez asked if the students in the Residency positions that L.A. Care is funding will make a commitment to remain in Los Angeles County serving the safety net. Ms. Carmona responded that L.A. Care has discussed this with the institutions that are selected, which have excellent track records of students remaining in service to the safety net in Los Angeles County.

Dr. Seidman added that medical residency is a stage in training following undergraduate medical education. The people in residencies have graduated from medical schools. L.A. Care has focused funding on primary care specialties of pediatrics, internal medicine, family medicine and psychiatry. L.A. Care has been very selective in picking the institutions and the specific training programs to help fund or expand, because of the institutions’ track records of producing residents that upon graduation, are very likely to stay in Los Angeles County serving in the safety net of providers.

Board Member Booth asked if the program receives funding in one lump sum or divided over three years. Ms. Carmona responded that funds are sent as a lump sum. Board Member Booth noted that it is difficult for the Board to understand the value of this program because there is no data to indicate if there is an increase in the number of providers accessible to L.A. Care members. She suggested that measurable goals be stated for this program for measuring access during the funded residency in order to evaluate the program. Statistics to track could be the number of patients that a resident

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sees during the residency and to follow up with how many of the residents remain in practice in Los Angeles County after completing the program. Board Member Booth would like to see results that can be attributed to L.A. Care’s funding. Chairperson De La Torre noted that it is very difficult to attribute a direct effect of funding other than providing the training in the right places and the right settings in the hope the residents will remain. He noted that the statewide program and the Bureau of Indian Affairs programs operate on the same concept that placing residents in the right places leads to increased access to care. It is difficult to track the cause and effect. Member Booth noted that it is possible to state the increased access while the resident is in the program. Chairperson De La Torre noted that he has seen these in so many areas, where training is provided and there can be no obligation to make the trainee stay in the area. Measuring access during the residency could be done and he would support that effort.

Motion EXE 102.1121 Approve and authorize an expenditure of up to $3.23 million to continue funding awards under the Residency Support Program (RSP).

(The CEO Report was presented next.)

Approved unanimously by roll call with consideration of potential conflict as noted. 5 AYES

CHIEF EXECUTIVE OFFICER REPORT

John Baackes, Chief Executive Officer, reported:

He apologized for arriving late to the meeting. He attended a meeting with members of the state assembly that are touring the state to learn about homelessness and affordable housing. He was invited to represent Medi-Cal managed care plans to provide information about homelessness from the health plan perspective.

The biggest issue related to COVID-19 is to get more L.A. Care health plan members to get a vaccine. There is a significant gap in vaccination rates among the general population and the rate of Medi-Cal beneficiaries.

He reported at a previous meeting that California has made additional funds available to health plans to encourage vaccination. There are conditions on accessing those funds and L.A. Care is working hard to maneuver within those rules. More information on the program will be provided at the December Board meeting. L.A. Care is collaborating with Health Net and with Plan Partners to design an effective program.

Progress is being made with planning for implementation of the California Advancing and Innovating Medi-Cal (CalAIM) program. Some minor parts, such as

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the doula program, have been postponed. CalAIM has so many details, and there are areas that have not been addressed in sufficient clarity for health plans to move forward. The lack of detail is being recognized by state officials and health plans are comfortable with some aspects being delayed, in order that the major parts of CalAIM can be successfully launched by January 2022.

The major segments of Enhanced Care Management (ECM) and In Lieu of Services, which is now known as Community Supports, are still on the January 1 launch. The current pilot programs of Health Homes and Whole Person Care, which L.A. Care partnered with L.A. County to offer, will end December 31, 2021. It will be a challenge to transition the participants in those two programs to the new permanent programs. There may be about 10,000 L.A. Care members for which L.A. Care must find new providers under ECM. L.A. Care staff is working diligently on the details of the transition.

California is moving forward on carving pharmacy benefits out of Medi-Cal. L.A. Care co-authored, with Inland Empire Health plan, an op-ed about this topic, which is included in the meeting materials. The joint op-ed suggested that modifications could be made in the carve out to help Medi-Cal plans support their members. A big concern is that the plans will no longer have contact with members about their prescription drug benefits, a key part of their health care.

L.A. Care is continuing to open new Community Resource Centers and will have official grand openings in the future. He highlighted the reopening of the Inglewood Community Resource Center in a new location, because the landlord at the old location would not negotiate with L.A. Care, the CRC in Inglewood had to be closed since April, 2021. An official opening ceremony will be held after January 2022.

He noted that the final progress report on Vision 2021 is included in the meeting packet.

Board Member Booth asked about the new Vision statement. Wendy Schiffer, Senior Director, Strategic Planning, Strategy, Regulatory and External Affairs, reported that Vision 2024 began on October 1, 2021. The first report on Vision 2024 will be provided in January, and she offered to provide the Vision 2024 plan in the materials for the next Board Meeting.

Board Member Perez noted that she did not attend the opening of the Community Resource Center in Wilmington. Advisory committee members had complained that there was a lack of communication. She thanked Board Members for their support of

181




ACTION TAKEN

the Community Resource Centers. She noted that there is an effort to connect with the community members at the Resource Centers. She recognized the work that goes into the opening events. She complimented the work that went into the successful flu shot clinic held in Pacoima. Even with limitations due to the COVID-19 pandemic, these events do help the community. She thanked Richard Seidman, MD, MPH, Chief Medical Officer, for the information he provides to members. She thanked Olivia from Communications for the pictures she takes at the events. She enjoys attending these events and she invites Board Members to attend the events. It is an effort to help members in the community get healthier. She appreciates all that is done. She thanked Board Member Gonzalez. She noted that Board Member Gonzalez remembers to acknowledge the lives lost due to the pandemic whenever she reports to the members.

(The Approved Revisions to Human Resources Policies item was presented next.)

Approved Revisions to Human Resources Policies

HR-602 Annual Organizational Incentive

HR-609 Wage and Salary

Terry Brown, Chief Human Resources Officer, presented motions to approve revisions to two Human Resources policies.

L.A. Care has established the Incentive Program that provides monetary incentives to eligible employees based on the achievement of approved goals set by the Chief Executive Officer or his/her respective designees. The award of an annual incentive payment is not automatic and is at the sole discretion of the Board of Governors. L.A. Care reserves the right to modify or terminate the Incentive Program.

Staff is proposing additional revisions to HR-602 Annual Incentive Program, as noted in the attached document.

Motion EXE A.1021 To approve the Human Resources Policy & Procedure HR-602 Annual Incentive Program, as presented.

L.A. Care’s compensation philosophy is designed to reward employees for higher levels of performance and to pay all employees fairly and equitably, in comparison with both the external market and internal positions and classifications, and which reflects the duties and responsibilities of each employee’s job. The organization is committed to providing a work environment that supports all staff with dignity and respect and rewards individuals according to their accomplishments and work outcomes.

182




ACTION TAKEN

Staff is proposing additional revisions to HR-609 Wage and Salary, as noted in the attached document:

Motion EXE B.1021 To approve the Human Resources Policy & Procedure HR-609 (Wage and Salary), as presented.

Motions EXE A and EXE B were simultaneously and unanimously approved by roll call. 5 AYES

Approve Consent Agenda for November 4, 2021 Board of Governors Meeting.

September 2, 2021 Board of Governors Meeting & Retreat Minutes

September 27, 2021 Board of Governors Special Meeting Minutes

Ratify execution of Amendment A33 to Contract 04-36069, and Amendment A15 to Contract 03-75799, between L.A. Care Health Plan and the California Department of Health Care Services, by L.A. Care Chief Executive Officer, John Baackes

Accounting & Financial Services Revised Policies:

Policy AFS 008 (Annual Investment Review)

Policy AFS-027 (Travel Expenses)

Ntooitive Contract

Change Healthcare Resources Contract Amendment

Claris Health Contract Amendment Scope of Works 2, 4, and 6


PUBLIC COMMENTS There were no public comments for the closed session items.

ADJOURN TO CLOSED SESSION

The Joint Powers Authority Executive Committee meeting was adjourned at 3:04 p.m. Ms. Haydel announced the items to be discussed in closed session. She announced there is no report anticipated from the closed session. The meeting adjourned to closed session at 3:04 p.m.

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, Business Plan Estimated date of public disclosure: October 2023

183




ACTION TAKEN

CONFERENCE WITH LEGAL COUNSEL—EXISTING LITIGATION Pursuant to Section 54956.9(d)(1) of Ralph M. Brown Act Long Beach Memorial Medical Center et al v. L.A. Care Health Plan - AAA Case No. 012000002356

CONFERENCE WITH LEGAL COUNSEL—ANTICIPATED LITIGATION Significant exposure to litigation pursuant to Section 54956.9(d)(2) of Ralph M. Brown Act: Four Potential Cases

RECONVENE IN OPEN SESSION

The meeting reconvened in open session at 3:47 p.m. No reportable actions were taken during the closed session.

ADJOURNMENT The meeting adjourned at 3:47 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: _______________________________________ 11/15/2021 | 3:38 PM PST

184

Financial UpdateBoard of Governors MeetingDecember 2, 2021

185

Agenda

Financial Performance – September 2021 YTD Membership Consolidated Financial Performance

Actuals vs. Forecast Actuals vs. Budget Variance Walk

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 Quarterly/Annual Internal Policies Report

186

Membershipfor the 12 months ended September 2021

187

Consolidated Financial Performance – Forecast vs. Actuals

for the month of September 2021

188

Consolidated Financial Performance – Forecast vs. Actuals

for the 12 months ended September 2021

189

Consolidated Financial Performance – Budget vs. Actuals

for the 12 months ended September 2021

190

Variance Walk – Budget vs. Actualsfor the 12 months ended September 2021

191

Operating Margin by Segmentfor the 12 months ended September 2021

192

Reported vs Paid Claims TrendPaid Claims through September 2021

193

Key Financial Ratiosfor the 12 months ended September 2021

Actual Forecast

MCR 93.2% vs. 93.5%

Admin Ratio 5.1% vs. 4.9%

Actual Benchmark

Working Capital 1.25 vs. 1.00+

Cash to Claims 0.72 vs. 0.75+

Tangible Net Equity 5.23 vs. 1.30+

194

Tangible Net Equity & Days of Cash On-Handfor the 12 months ended September 2021

195

Questions & Consideration

Motion FIN 101 To accept the Financial Reports for the twelve months

ended September 30, 2021, as submitted.

196

Informational Items

Investment Transactions

As of September 30, 2021 L.A. Care’s total investment market value was $2.1B $1.8B managed by Payden & Rygel and New England Asset

Management (NEAM)

$73M in Local Agency Investment Fund

$253M in Los Angeles County Pooled Investment Fund

Quarterly/Annual Internal Policies Reports

197

Board of Governors

MOTION SUMMARY

Date: December 2, 2021 Motion No. FIN 101.1221

Committee: Finance & Budget Chairperson: Ilan Shapiro, MD


Issue: Acceptance of the Financial Reports for September 2021.

Background: N/A

Member Impact: N/A

Budget Impact: N/A

Motion: To accept the Financial Report for September 2021, as submitted.

198

Financial Performance September 2021

(Unaudited)

199

L.A. Care Commercial consists of LACC and PASC-SEIU.

Financial Performance Results Highlights - Year-to-Date September 2021

Overall

MediCal Plan Partners

MediCal SPD-CCI

MediCal TANF-MCE

Cal MediConnect (CMC)

Commercial

L.A. Care Commercial consists of LACC and PASC-SEIU. The member months are 1,714,918, which is 14,937 member months favorable to the 9+3 forecast. The

performance is a surplus of $59.2 million and is $23.0 million unfavorable to the forecast due mainly to the governmental fee incurred for prior periods. Other

unfavorable drivers are higher than forecasted inpatient claims and pharmacy costs; but offset in part by favorable membership.

The combined member months are 28.7 million year-to-date, which is 46,637 member months favorable to the 9+3 forecast. The performance is a surplus of $132.9

million or 1.4% of revenue and is $3.3 million unfavorable to the forecast. Both inpatient and outpatient claims are lower than the forecast but are offset by higher

skilled nursing facility costs and pharmacy expense. The majority of the unfavorable variance in revenues with a corresponding decrease in capitation expenses is

driven by Plan Partners as a result of HCBS-High member reclassification but offset in part by higher than forecasted institutional members. Operating expenses

are unfavorable to the forecast due mainly to a governmental fee incurred related to LACC and PASC-SEIU members for prior periods. Non-operating expenses are

also higher than the forecast due to higher spending in community resource centers and timing in grant spending.

The member months are 12.4 million, which is 7,929 member months favorable to the 9+3 forecast. The performance is a surplus of $65.4 million and is in line with

the forecast. The unfavorability in revenues and the corresponding favorability in capitation expenses are driven by HCBS-High member reclassification but partially

offset by higher than forecasted institutional members.

The member months are 2.8 million, which is 15,734 member months favorable to the 9+3 forecast. The performance is a surplus of $8.3 million and is $10.5 million

favorable to the 9+3 forecast. The favorability is due to lower than forecasted inpatient and outpatient claims but is partially offset by higher than forecasted skilled

nursing facility costs. Lower operating expenses also contributed to higher surplus. However, the surplus is negatively impacted by lower than forecasted revenues

driven by the revenue corridor as we continue to experience lower proportional institutional member count and HCBS-High member reclassification, but are offset by

a favorable DHCS system correction true-up adjustment.

The member months are 11.5 million, which is 9,160 member months favorable to the 9+3 forecast. The performance is a surplus of $35.2 million and is $19.0

million favorable to the 9+3 forecast. The favorability is driven by better than forecasted outpatient claims but is partially offset by higher than expected inpatient

claims, skilled nursing facilities costs, pharmacy costs, and operating expenses.

The member months are 223,267, which is 1,123 member months unfavorable to the 9+3 forecast. The performance is a surplus of $4.7 million and is $7.8 million

unfavorable to the forecast. The unfavorability is driven by higher than forecasted outpatient claims, skilled nursing facility costs, and pharmacy expense; but is

partially offset by favorable inpatient claims and provider incentives.

Page 2 of 10 200

Current

Actual

Current

Forecast

Fav(Unfav)

Forecast

YTD

Actual

YTD

Forecast

Fav(Unfav)

Forecast

$ PMPM $ PMPM $ PMPM $ PMPM $ PMPM $ PMPM

Membership Membership

2,466,421 2,451,025 15,396 Member MonthsMember Months 28,667,788 28,621,151 46,637

Revenue Revenue

733,738$ 297.49$ 794,997$ 324.35$ (61,258)$ (26.86)$ 1. Capitation Capitation 9,210,117$ 321.27$ 9,251,022$ 323.22$ (40,905)$ (1.95)$

733,738$ 297.49$ 794,997$ 324.35$ (61,258)$ (26.86)$ Total Revenues 9,210,117$ 321.27$ 9,251,022$ 323.22$ (40,905)$ (1.95)$

Healthcare ExpensesHealthcare Expenses

356,198$ 144.42$ 399,882$ 163.15$ 43,684$ 18.73$ 1. Capitation Capitation 4,834,938$ 168.65$ 4,867,486$ 170.07$ 32,548$ 1.41$

77,790$ 31.54$ 98,425$ 40.16$ 20,634$ 8.62$ 3. Inpatient Claims Inpatient Claims 1,141,371$ 39.81$ 1,149,420$ 40.16$ 8,049$ 0.35$

51,758$ 20.99$ 80,959$ 33.03$ 29,201$ 12.05$ 4. Outpatient Claims Outpatient Claims 843,083$ 29.41$ 899,229$ 31.42$ 56,146$ 2.01$

72,302$ 29.31$ 68,152$ 27.81$ (4,150)$ (1.51)$ 5. Skilled Nursing Facility Skilled Nursing Facility 837,796$ 29.22$ 814,786$ 28.47$ (23,010)$ (0.76)$

71,216$ 28.87$ 63,824$ 26.04$ (7,391)$ (2.83)$ 6. Pharmacy Pharmacy 760,355$ 26.52$ 745,878$ 26.06$ (14,477)$ (0.46)$

7,516$ 3.05$ 9,157$ 3.74$ 1,641$ 0.69$ 6a. Provider Incentives and Shared Risk Provider Incentives and Shared Risk 81,832$ 2.85$ 83,729$ 2.93$ 1,897$ 0.07$

7,380$ 2.99$ 7,153$ 2.92$ (227)$ (0.07)$ 7. Medical Administrative Expenses Medical Administrative Expenses 83,490$ 2.91$ 84,631$ 2.96$ 1,142$ 0.04$

644,159$ 261.17$ 727,552$ 296.84$ 83,392$ 35.66$ Total Healthcare Expenses 8,582,866$ 299.39$ 8,645,160$ 302.05$ 62,295$ 2.66$

MCR(%) MCR(%)

89,579$ 36.32$ 67,445$ 27.52$ 22,134$ 8.80$ Operating MarginOperating Margin 627,251$ 21.88$ 605,862$ 21.17$ 21,389$ 0.71$

64,930$ 26.33$ 39,820$ 16.25$ (25,110)$ (10.08)$ Total Operating Expenses 470,080$ 16.40$ 449,443$ 15.70$ (20,637)$ (0.69)$

Admin Ratio(%) Admin Ratio(%)

24,649$ 9.99$ 27,624$ 11.27$ (2,976)$ (1.28)$ Income (Loss) from OperationsIncome (Loss) from Operations 157,171$ 5.48$ 156,419$ 5.47$ 753$ 0.02$

(1,524)$ (0.62)$ (2,823)$ (1.15)$ 1,299$ 0.53$ Other Income/(Expense), net (27,566)$ (0.96)$ (25,729)$ (0.90)$ (1,837)$ (0.06)$

772$ 0.31$ 839$ 0.34$ (67)$ (0.03)$ Interest Income, net 11,269$ 0.39$ 11,312$ 0.40$ (42)$ (0.00)$

111$ 0.04$ -$ -$ 111$ 0.04$ Realized Gain / Loss 2,042$ 0.07$ 1,751$ 0.06$ 291$ 0.01$

(1,766)$ (0.72)$ -$ -$ (1,766)$ (0.72)$ Unrealized Gain / Loss (10,022)$ (0.35)$ (7,574)$ (0.26)$ (2,448)$ (0.08)$

(2,407)$ (0.98)$ (1,984)$ (0.81)$ (423)$ (0.17)$ Total Non-Operating Income (Expense) (24,276)$ (0.85)$ (20,241)$ (0.71)$ (4,035)$ (0.14)$

22,241$ 9.02$ 25,640$ 10.46$ (3,399)$ (1.44)$ Net Surplus/(Deficit)Net Surplus (Deficit) 132,895$ 4.64$ 136,178$ 4.76$ (3,283)$ (0.12)$

% Margin(%)

5.1% 4.9%

Consolidated Operations Income Statement ($ in thousands) September 2021

3.0%

-0.2%

87.8% 91.5% 3.7% 93.2% 93.5%

3.2% -0.2% 1.4% 1.5% 0.0%

0.3%

8.8% 5.0% -3.8%

Page 3 of 10 201

Current

Actual

Current

Forecast

Fav(Unfav)

Forecast

YTD

Actual

YTD

Forecast

Fav(Unfav)

Forecast



1,060,712 1,059,008 1,704 Member Months Member Months 12,441,751 12,433,822 7,929

Revenue Revenue


228,856$ 215.76$ 278,369$ 262.86$ (49,512)$ (47.10)$ Total Revenues 3,233,071$ 259.86$ 3,267,308$ 262.78$ (34,237)$ (2.92)$



0$ 0.00$ -$ -$ (0)$ (0.00)$ 3. Inpatient Claims Inpatient Claims 95$ 0.01$ 135$ 0.01$ 40$ 0.00$

0$ 0.00$ -$ -$ (0)$ (0.00)$ 4. Outpatient Claims Outpatient Claims 6$ 0.00$ 14$ 0.00$ 8$ 0.00$

-$ -$ -$ -$ -$ -$ 5. Skilled Nursing Facility Skilled Nursing Facility 4$ 0.00$ -$ -$ (4)$ (0.00)$

-$ -$ -$ -$ -$ -$ 6. Pharmacy Pharmacy (0)$ (0.00)$ (0)$ (0.00)$ -$ (0.00)$

1,173$ 1.11$ 2,443$ 2.31$ 1,270$ 1.20$ 6a. Provider Incentives and Shared Risk Provider Incentives and Shared Risk 28,198$ 2.27$ 29,318$ 2.36$ 1,120$ 0.09$

1,241$ 1.17$ 1,171$ 1.11$ (69)$ (0.06)$ 7. Medical Administrative Expenses Medical Administrative Expenses 13,714$ 1.10$ 13,925$ 1.12$ 211$ 0.02$


MCR(%) MCR(%)

12,309$ 11.60$ 11,366$ 10.73$ 943$ 0.87$ Operating MarginOperating Margin 130,223$ 10.47$ 129,013$ 10.38$ 1,209$ 0.09$

6,893$ 6.50$ 6,213$ 5.87$ (680)$ (0.63)$ Total Operating Expenses 71,268$ 5.73$ 71,022$ 5.71$ (246)$ (0.02)$


5,417$ 5.11$ 5,153$ 4.87$ 263$ 0.24$ Income (Loss) from OperationsIncome (Loss) from Operations 58,955$ 4.74$ 57,991$ 4.66$ 964$ 0.07$

(160)$ (0.15)$ 552$ 0.52$ (712)$ (0.67)$ Total Non-Operating Income (Expense) 6,482$ 0.52$ 7,374$ 0.59$ (891)$ (0.07)$

5,256$ 4.96$ 5,705$ 5.39$ (449)$ (0.43)$ Net Surplus/(Deficit)Net Surplus (Deficit) 65,437$ 5.26$ 65,365$ 5.26$ 72$ 0.00$

% Margin(%)

2.2% 2.2%

MediCal Plan Partners Income Statement ($ in thousands) September 2021

2.3%

0.0%

94.6% 95.9% 1.3% 96.0% 96.1%

2.0% 0.2% 2.0% 2.0% 0.0%

0.1%

3.0% 2.2% -0.8%

Page 4 of 10 202

Current

Actual

Current

Forecast

Fav(Unfav)

Forecast

YTD

Actual

YTD

Forecast

Fav(Unfav)

Forecast



235,337 234,662 675 Member MonthsMember Months 2,785,339 2,769,605 15,734

Revenue Revenue


170,749$ 725.55$ 192,725$ 821.29$ (21,976)$ (95.74)$ Total Revenues 2,218,068$ 796.34$ 2,240,372$ 808.91$ (22,305)$ (12.58)$


22,122$ 94.00$ 19,711$ 84.00$ (2,411)$ (10.00)$ 1. Capitation Capitation 225,474$ 80.95$ 222,495$ 80.33$ (2,979)$ (0.62)$

11,091$ 47.13$ 34,784$ 148.23$ 23,693$ 101.10$ 3. Inpatient Claims Inpatient Claims 427,711$ 153.56$ 450,398$ 162.62$ 22,687$ 9.06$


58,255$ 247.54$ 58,574$ 249.61$ 319$ 2.07$ 5. Skilled Nursing Facility Skilled Nursing Facility 704,468$ 252.92$ 692,383$ 249.99$ (12,085)$ (2.93)$

18,124$ 77.01$ 17,968$ 76.57$ (157)$ (0.45)$ 6. Pharmacy Pharmacy 212,736$ 76.38$ 212,224$ 76.63$ (512)$ 0.25$

3,301$ 14.03$ 2,156$ 9.19$ (1,146)$ (4.84)$ 6a. Provider Incentives and Shared Risk Provider Incentives and Shared Risk 10,530$ 3.78$ 6,288$ 2.27$ (4,242)$ (1.51)$

2,200$ 9.35$ 2,371$ 10.11$ 171$ 0.76$ 7. Medical Administrative Expenses Medical Administrative Expenses 26,223$ 9.41$ 27,041$ 9.76$ 818$ 0.35$


MCR(%) MCR(%)


10,613$ 45.10$ 14,076$ 59.99$ 3,463$ 14.89$ Total Operating Expenses 146,407$ 52.56$ 151,269$ 54.62$ 4,862$ 2.05$


14,896$ 63.30$ 747$ 3.18$ 14,149$ 60.11$ Income (Loss) from OperationsIncome (Loss) from Operations 5,377$ 1.93$ (5,515)$ (1.99)$ 10,892$ 3.92$


14,737$ 62.62$ 1,010$ 4.31$ 13,727$ 58.32$ Net Surplus/(Deficit)Net Surplus (Deficit) 8,254$ 2.96$ (2,235)$ (0.81)$ 10,489$ 3.77$

% Margin(%)

6.6% 6.8%

SPD-CCI Income Statement ($ in thousands) September 2021

8.6%

0.2%

85.1% 92.3% 7.2% 93.2% 93.5%

0.5% 8.1% 0.4% -0.1% 0.5%

0.3%

6.2% 7.3% 1.1%

Page 5 of 10 203

Current

Actual

Current

Forecast

Fav(Unfav)

Forecast

YTD

Actual

YTD

Forecast

Fav(Unfav)

Forecast



999,279 991,786 7,493 Member Months Member Months 11,502,513 11,493,353 9,160

Revenue Revenue


256,579$ 256.76$ 247,482$ 249.53$ 9,097$ 7.23$ Total Revenues 2,858,936$ 248.55$ 2,846,766$ 247.69$ 12,170$ 0.86$


110,270$ 110.35$ 106,187$ 107.07$ (4,082)$ (3.28)$ 1. Capitation Capitation 1,199,621$ 104.29$ 1,199,454$ 104.36$ (167)$ 0.07$

48,122$ 48.16$ 48,586$ 48.99$ 464$ 0.83$ 3. Inpatient Claims Inpatient Claims 563,398$ 48.98$ 550,698$ 47.91$ (12,701)$ (1.07)$




2,687$ 2.69$ 2,424$ 2.44$ (262)$ (0.24)$ 6a. Provider Incentives and Shared Risk Provider Incentives and Shared Risk 22,931$ 1.99$ 23,552$ 2.05$ 621$ 0.06$

3,357$ 3.36$ 3,253$ 3.28$ (104)$ (0.08)$ 7. Medical Administrative Expenses Medical Administrative Expenses 39,512$ 3.44$ 39,751$ 3.46$ 239$ 0.02$


MCR(%) MCR(%)




8,673$ 8.68$ (3,617)$ (3.65)$ 12,290$ 12.33$ Income (Loss) from OperationsIncome (Loss) from Operations 30,114$ 2.62$ 10,421$ 0.91$ 19,693$ 1.71$


8,603$ 8.61$ (3,215)$ (3.24)$ 11,818$ 11.85$ Net Surplus/(Deficit)Net Surplus (Deficit) 35,174$ 3.06$ 16,178$ 1.41$ 18,995$ 1.65$

% Margin(%)

5.6% 5.5%

TANF-MCE Income Statement ($ in thousands) September 2021

3.4%

-0.1%

89.4% 96.0% 6.7% 93.3% 94.1%

-1.3% 4.7% 1.2% 0.6% 0.7%

0.8%

7.2% 5.4% -1.8%

Page 6 of 10 204

Current

Actual

Current

Forecast

Fav(Unfav)

Forecast

YTD

Actual

YTD

Forecast

Fav(Unfav)

Forecast



18,733 19,240 (507) Member MonthsMember Months 223,267 224,390 (1,123)

Revenue Revenue

25,608$ 1,367.02$ 26,420$ 1,373.17$ (811)$ (6.15)$ 1. Capitation Capitation 312,489$ 1,399.62$ 314,584$ 1,401.95$ (2,095)$ (2.33)$

25,608$ 1,367.02$ 26,420$ 1,373.17$ (811)$ (6.15)$ Total Revenues 312,489$ 1,399.62$ 314,584$ 1,401.95$ (2,095)$ (2.33)$


11,027$ 588.66$ 11,809$ 613.80$ 782$ 25.14$ 1. Capitation Capitation 135,220$ 605.64$ 136,346$ 607.63$ 1,126$ 1.99$

6,238$ 333.01$ 6,702$ 348.36$ 464$ 15.35$ 3. Inpatient Claims Inpatient Claims 62,687$ 280.77$ 63,619$ 283.52$ 932$ 2.75$

3,289$ 175.59$ 2,654$ 137.96$ (635)$ (37.63)$ 4. Outpatient Claims Outpatient Claims 32,313$ 144.73$ 30,134$ 134.29$ (2,178)$ (10.43)$



710$ 37.91$ 2,173$ 112.96$ 1,463$ 75.05$ 6a. Provider Incentives and Shared Risk Provider Incentives and Shared Risk 9,937$ 44.51$ 13,642$ 60.80$ 3,706$ 16.29$

481$ 25.69$ 237$ 12.33$ (244)$ (13.36)$ 7. Medical Administrative Expenses Medical Administrative Expenses 2,871$ 12.86$ 2,681$ 11.95$ (189)$ (0.91)$

27,936$ 1,491.27$ 26,306$ 1,367.27$ (1,630)$ (124.00)$ Total Healthcare Expenses 288,614$ 1,292.69$ 283,066$ 1,261.49$ (5,548)$ (31.19)$

MCR(%) MCR(%)

(2,328)$ (124.25)$ 113$ 5.90$ (2,441)$ (130.15)$ Operating MarginOperating Margin 23,875$ 106.93$ 31,517$ 140.46$ (7,643)$ (33.52)$

1,803$ 96.23$ 1,585$ 82.36$ (218)$ (13.88)$ Total Operating Expenses 19,247$ 86.21$ 19,074$ 85.01$ (173)$ (1.20)$


(4,130)$ (220.49)$ (1,471)$ (76.46)$ (2,659)$ (144.03)$ Income (Loss) from OperationsIncome (Loss) from Operations 4,627$ 20.73$ 12,443$ 55.45$ (7,816)$ (34.73)$

(1)$ (0.08)$ 7$ 0.39$ (9)$ (0.47)$ Total Non-Operating Income (Expense) 90$ 0.40$ 101$ 0.45$ (11)$ (0.05)$

(4,132)$ (220.57)$ (1,464)$ (76.07)$ (2,668)$ (144.50)$ Net Surplus/(Deficit)Net Surplus (Deficit) 4,718$ 21.13$ 12,544$ 55.90$ (7,826)$ (34.77)$

% Margin(%)

6.2% 6.1%

CMC Income Statement ($ in thousands) September 2021

-16.1%

-0.1%

109.1% 99.6% -9.5% 92.4% 90.0%

-5.5% -10.6% 1.5% 4.0% -2.5%

-2.4%

7.0% 6.0% -1.0%

Page 7 of 10 205

Current

Actual

Current

Forecast

Fav(Unfav)

Forecast

YTD

Actual

YTD

Forecast

Fav(Unfav)

Forecast



152,360 146,329 6,031 Member Months Member Months 1,714,918 1,699,981 14,937

Revenue Revenue

51,946$ 340.94$ 50,001$ 341.70$ 1,945$ (0.76)$ 1. Capitation Capitation 587,553$ 342.61$ 581,992$ 342.35$ 5,561$ 0.26$

51,946$ 340.94$ 50,001$ 341.70$ 1,945$ (0.76)$ Total Revenues 587,553$ 342.61$ 581,992$ 342.35$ 5,561$ 0.26$


(1,354)$ (8.89)$ (1,215)$ (8.30)$ 140$ 0.59$ 1. Capitation Capitation 213,792$ 124.67$ 214,288$ 126.05$ 496$ 1.39$

12,340$ 80.99$ 8,353$ 57.08$ (3,987)$ (23.91)$ 3. Inpatient Claims Inpatient Claims 87,479$ 51.01$ 84,570$ 49.75$ (2,910)$ (1.26)$

4,608$ 30.24$ 4,026$ 27.51$ (581)$ (2.73)$ 4. Outpatient Claims Outpatient Claims 44,727$ 26.08$ 44,713$ 26.30$ (14)$ 0.22$

85$ 0.56$ -$ -$ (85)$ (0.56)$ 5. Skilled Nursing Facility Skilled Nursing Facility 1,222$ 0.71$ 911$ 0.54$ (311)$ (0.18)$


(356)$ (2.33)$ (40)$ (0.27)$ 316$ 2.06$ 6a. Provider Incentives and Shared Risk Provider Incentives and Shared Risk 10,237$ 5.97$ 10,929$ 6.43$ 691$ 0.46$

101$ 0.66$ 120$ 0.82$ 19$ 0.16$ 7. Medical Administrative Expenses Medical Administrative Expenses 1,169$ 0.68$ 1,234$ 0.73$ 64$ 0.04$

25,113$ 164.83$ 18,670$ 127.59$ (6,443)$ (37.24)$ Total Healthcare Expenses 456,510$ 266.20$ 449,947$ 264.68$ (6,563)$ (1.52)$

MCR(%) MCR(%)

26,833$ 176.12$ 31,331$ 214.11$ (4,498)$ (38.00)$ Operating MarginOperating Margin 131,044$ 76.41$ 132,046$ 77.67$ (1,002)$ (1.26)$



44$ 0.29$ 27,020$ 184.65$ (26,976)$ (184.36)$ Income (Loss) from OperationsIncome (Loss) from Operations 60,032$ 35.01$ 82,985$ 48.82$ (22,953)$ (13.81)$

(95)$ (0.62)$ (95)$ (0.65)$ 0$ 0.03$ Total Non-Operating Income (Expense) (851)$ (0.50)$ (852)$ (0.50)$ 0$ 0.00$

(50)$ (0.33)$ 26,926$ 184.01$ (26,976)$ (184.34)$ Net Surplus/(Deficit)Net Surplus (Deficit) 59,180$ 34.51$ 82,133$ 48.31$ (22,953)$ (13.80)$

% Margin(%)

12.1% 8.4%

Commercial Income Statement ($ in thousands) September 2021

-0.1%

-3.7%

48.3% 37.3% -11.0% 77.7% 77.3%

53.9% -53.9% 10.1% 14.1% -4.0%

-0.4%

51.6% 8.6% -42.9%

Page 8 of 10 206

Comparative Balance Sheet

(Dollars in thousands) Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21

ASSETS

CURRENT ASSETS

Total Current Assets $4,241,836 $4,207,217 $4,181,392 $4,809,535 $4,330,863 $5,190,573 $4,329,113 $5,008,584 $4,417,086 $4,476,248 $4,406,866 $4,758,435

Capitalized Assets - net $106,066 $106,179 $105,925 $106,571 $106,748 $106,854 $106,981 $108,499 $108,480 $108,396 $106,100 $105,915

NONCURRENT ASSETS $4,385 $4,249 $4,114 $3,978 $3,843 $3,707 $3,572 $3,587 $3,451 $3,525 $3,637 $3,523

TOTAL ASSETS $4,352,287 $4,317,645 $4,291,430 $4,920,085 $4,441,454 $5,301,134 $4,439,665 $5,120,670 $4,529,017 $4,588,169 $4,516,602 $4,867,873

LIABILITIES AND FUND EQUITY

CURRENT LIABILITIES

Total Current Liability $3,441,433 $3,412,807 $3,385,813 $3,982,202 $3,453,802 $4,291,997 $3,401,470 $4,098,215 $3,506,888 $3,550,234 $3,486,394 $3,814,977

Long Term Liability $3,385 $3,441 $3,296 $3,177 $3,078 $2,998 $2,890 $2,666 $2,520 $2,429 $2,994 $3,441

Total Liabilities $3,444,817 $3,416,248 $3,389,109 $3,985,380 $3,456,879 $4,294,995 $3,404,360 $4,100,881 $3,509,407 $3,552,663 $3,489,388 $3,818,418

FUND EQUITY

Invested in Capital Assets, net of related debt $106,066 $106,179 $105,925 $106,571 $106,748 $106,854 $106,981 $108,499 $108,480 $108,396 $106,100 $105,915

Restricted Equity $300 $300 $300 $300 $300 $300 $300 $450 $450 $450 $450 $600

Minimum Tangible Net Equity $193,021 $194,442 $196,418 $198,522 $198,522 $201,033 $204,021 $204,783 $202,695 $202,973 $204,075 $200,751

Board Designated Funds $72,431 $99,641 $96,946 $95,648 $94,811 $117,246 $107,345 $106,234 $101,558 $97,416 $93,180 $91,741

Unrestricted Net Assets $535,652 $500,835 $502,733 $533,663 $584,193 $580,706 $616,659 $599,822 $606,426 $626,271 $623,409 $650,449

Total Fund Equity $907,470 $901,397 $902,321 $934,705 $984,575 $1,006,139 $1,035,306 $1,019,789 $1,019,609 $1,035,506 $1,027,214 $1,049,455

TOTAL LIABILITIES AND FUND EQUITY $4,352,287 $4,317,645 $4,291,430 $4,920,085 $4,441,454 $5,301,134 $4,439,665 $5,120,670 $4,529,017 $4,588,169 $4,516,602 $4,867,873

Solvency Ratios

Working Capital Ratio 1.23 1.23 1.23 1.21 1.25 1.21 1.27 1.22 1.26 1.26 1.26 1.25

Cash to Claims Ratio 0.55 0.52 0.51 0.72 0.53 0.83 0.56 0.77 0.57 0.57 0.55 0.72

Tangible Net Equity Ratio 4.70 4.64 4.59 4.71 4.96 5.00 5.07 4.98 5.03 5.10 5.03 5.23

Page 9 of 10 207

Cash Flows Statement ($ in thousands)

Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 YTD

#N/A #N/A #N/A #N/A #N/A #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$ 739,949$ 785,543$ 821,845$ 756,440$ 874,258$ 9,280,968$

Other Income (Expense), net 8,578$ 229$ (1,303)$ 84$ (134)$ (1,043)$ (14,237)$ (823)$ (2,459)$ (4,407)$ (5,061)$ (830)$ (21,406)$

Healthcare Expenses (653,134)$ (666,833)$ (692,179)$ (669,618)$ (657,134)$ (719,999)$ (765,164)$ (724,527)$ (706,757)$ (694,076)$ (832,912)$ (687,901)$ (8,470,234)$

Operating Expenses (40,394)$ (31,516)$ (46,394)$ (30,344)$ (32,090)$ (29,565)$ (38,339)$ (30,900)$ (32,052)$ (35,886)$ (33,004)$ (37,078)$ (417,562)$

Net Cash Provided By Operating Activities 48,710$ (37,645)$ (14,559)$ 120,834$ (16,718)$ 119,840$ 1,942$ (16,301)$ 44,275$ 87,476$ (114,537)$ 148,449$ 371,766$

Cash Flows from Investing Activities

Purchase of investments - Net (39,775)$ 183,866$ (32,271)$ 25,040$ 38,635$ 373,890$ (401,184)$ 22,840$ (5,159)$ (44,234)$ 13,306$ (58,395)$ 76,559$

Purchase of Capital Assets (2,115)$ (2,545)$ (2,268)$ (3,109)$ (2,716)$ (2,761)$ (2,929)$ (4,197)$ (2,842)$ (2,710)$ (550)$ (2,956)$ (31,698)$

Net Cash Provided By Investing Activities (41,890)$ 181,321$ (34,539)$ 21,931$ 35,919$ 371,129$ (404,113)$ 18,643$ (8,001)$ (46,944)$ 12,756$ (61,351)$ 44,861$

Cash Flows from Financing Activities:

Gross Premium Tax (MCO Sales Tax) - Net (21)$ (16,034)$ (26,731)$ 24,849$ 13,253$ 15,394$ (23,854)$ 13,856$ 14,458$ (23,575)$ 14,072$ 12,065$ 17,732$

Pass through transactions (AB 85, IGT, etc.) (850,679)$ 8,822$ 8,765$ 551,296$ (568,538)$ 463,260$ (506,673)$ 666,364$ (665,000)$ 123$ 125$ 303,759$ (588,376)$

Net Cash Provided By Financing Activities (850,700)$ (7,212)$ (17,966)$ 576,145$ (555,285)$ 478,654$ (530,527)$ 680,220$ (650,542)$ (23,452)$ 14,197$ 315,824$ (570,644)$

Net Increase in Cash and Cash Equivalents (843,880)$ 136,464$ (67,064)$ 718,910$ (536,084)$ 969,623$ (932,698)$ 682,562$ (614,268)$ 17,080$ (87,584)$ 402,922$ (154,017)$

Cash and Cash Equivalents, Beginning 1,144,914$ 301,034$ 437,498$ 370,434$ 1,089,344$ 553,260$ 1,522,883$ 590,185$ 1,272,747$ 658,479$ 675,559$ 587,975$ 1,144,914$

Cash and Cash Equivalents, Ending 301,034$ 437,498$ 370,434$ 1,089,344$ 553,260$ 1,522,883$ 590,185$ 1,272,747$ 658,479$ 675,559$ 587,975$ 990,897$ 990,897$

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$ (15,517)$ (180)$ 15,896$ (8,292)$ 22,242$ 132,895$

Adjustments to Excess of Revenues Over Expenses:

Depreciation 2,435$ 2,432$ 2,522$ 2,463$ 2,539$ 2,655$ 2,803$ 2,678$ 2,861$ 2,794$ 2,847$ 3,140$ 32,169$

Realized and Unrealized (Gain)/Loss on Investments 1,031$ 11$ 31$ 569$ 2,188$ 1,650$ (692)$ (609)$ 1,644$ (557)$ 1,059$ 1,655$ 7,980$

Deferred Rent (90)$ 56$ (145)$ (119)$ (99)$ (79)$ (108)$ (224)$ (146)$ (90)$ 564$ 446$ (34)$

Gross Premium Tax provision 501$ 368$ 328$ (1,232)$ (2,842)$ (1,334)$ (1,440)$ (1,556)$ (2,095)$ (280)$ (388)$ (399)$ (10,369)$

Loss on Disposal of Capital Assets -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ 1$ 1$

Total Adjustments to Excess of Revenues over Expenses 3,877$ 2,867$ 2,736$ 1,681$ 1,786$ 2,892$ 563$ 289$ 2,264$ 1,867$ 4,082$ 4,843$ 29,747$

Changes in Operating Assets and Liabilities:

Capitation Receivable (21,495)$ (43,146)$ (5,090)$ 55,489$ (77,042)$ 87,038$ (12,268)$ (4,012)$ (26,331)$ (4,413)$ (18,786)$ 140,462$ 70,406$

Interest and Non-Operating Receivables 75$ 1,244$ (329)$ 96$ 20$ 255$ 148$ (39)$ 185$ 2$ (20)$ 178$ 1,815$

Prepaid and Other Current Assets (2,504)$ 5,666$ (1,815)$ 213$ (20,181)$ (4,217)$ (7,096)$ (13,608)$ 10,043$ 626$ (8,105)$ (39,108)$ (80,086)$

Accounts Payable and Accrued Liabilities (4,181)$ 519$ (8,306)$ 1,923$ (2,432)$ 4,351$ (3,554)$ 2,955$ 3,631$ 1,190$ (312)$ 25,057$ 20,841$

Subcapitation Payable 25,915$ 28,318$ (533)$ (5,044)$ 55,745$ 16,701$ (53,397)$ 35,383$ 29,760$ 39,650$ (55,280)$ (59,582)$ 57,636$

MediCal Adult Expansion Payable (824)$ 771$ (41)$ 4,583$ (15)$ 2$ (32)$ (29)$ (29)$ (28)$ (1,580)$ 408$ 3,186$

Deferred Capitation Revenue 26,137$ (27,093)$ (188)$ 1,873$ (32,459)$ 1,231$ 57,102$ (25,265)$ (297)$ 24,356$ (25,008)$ 55$ 444$

Accrued Medical Expenses (4,760)$ (233)$ 1,166$ 82$ (1,621)$ 16,562$ 3,836$ (17,795)$ 10,251$ 5,820$ 7,152$ (26,376)$ (5,916)$

Reserve for Claims 30,835$ 11,611$ 4,913$ 25,601$ 12,534$ (32,359)$ (7,755)$ 5,919$ 4,305$ (1,838)$ (11,623)$ (19,650)$ 22,493$

Reserve for Provider Incentives 3,990$ (11,696)$ (8,819)$ 1,608$ (2,984)$ (918)$ 4$ 15,643$ 8,981$ 5,034$ 4,250$ 99,778$ 114,871$

Grants Payable 735$ (400)$ 823$ 345$ 62$ 6,737$ (4,776)$ (225)$ 1,692$ (686)$ (1,015)$ 142$ 3,434$

Net Changes in Operating Assets and Liabilities 53,923$ (34,439)$ (18,219)$ 86,769$ (68,373)$ 95,383$ (27,788)$ (1,073)$ 42,191$ 69,713$ (110,327)$ 121,364$ 209,124$

Net Cash Provided By Operating Activities 48,710$ (37,645)$ (14,559)$ 120,834$ (16,718)$ 119,840$ 1,942$ (16,301)$ 44,275$ 87,476$ (114,537)$ 148,449$ 371,766$

September 2021

Page 10 of 10 208

DATE:

TO:

FROM:

November 15, 2021

Finance & Budget Committee

Marie Montgomery, Chief Financial Officer

SUBJECT: Monthly Investment Portfolio Securities Transaction Report for September 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 September 1 to September 30, 2021.

L.A. Care's investment market value as of September 30, 2021, was $2.1 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 $253 million invested with the Los Angeles County Pooled Investment Fund (LACPIF).

The remainder as of September 30, 2021, of $1.8 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 portfolio2. Payden & Rygel - Extended term portfolio3. 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.

209

TRANSACTIONS BY TYPE

Account Name: L.A. CARE HEALTH PLAN 09/01/2021Account Number: 2365 through 09/30/2021

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 09/03/21 09/07/21 Buy 7,500,000.000 BANK OF MONTREAL YCD (7,503,562.78) (5,750.00) 0.00 0.00 (7,509,312.78)

MAT 05/10/22 Cpn 0.23 06367CGJ0

09/03/21 09/07/21 Buy 4,850,000.000 SUMITOMO MITSUI BANK YCD (4,850,000.00) 0.00 0.00 (4,850,000.00)MAT 03/03/22 Cpn 0.15 86565C5M7

09/09/21 09/10/21 Buy 5,000,000.000 CREDIT INDUST ET COMM YCD FR (4,999,999.98) (590.28) 0.00 0.00 (5,000,590.26)MAT 05/16/22 Cpn 0.17 22536UY61

09/14/21 09/14/21 Buy 40,000,000.000 U.S. TREASURY BILL (39,997,442.67) 0.00 0.00 (39,997,442.67)MAT 10/26/21 Cpn 912796M55

09/14/21 09/14/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,996,913.89) 0.00 0.00 (49,996,913.89)MAT 10/28/21 Cpn 912796G78

09/13/21 09/14/21 Buy 40,000,000.000 U.S. TREASURY BILL (39,999,031.67) 0.00 0.00 (39,999,031.67)MAT 10/05/21 Cpn 912796M22

09/14/21 09/14/21 Buy 10,000,000.000 U.S. TREASURY BILL (9,998,988.89) 0.00 0.00 (9,998,988.89)MAT 11/09/21 Cpn 912796N54

09/13/21 09/14/21 Buy 40,000,000.000 U.S. TREASURY BILL (39,999,766.67) 0.00 0.00 (39,999,766.67)MAT 09/21/21 Cpn 912796L49

09/14/21 09/14/21 Buy 40,000,000.000 U.S. TREASURY BILL (39,997,800.56) 0.00 0.00 (39,997,800.56)MAT 10/21/21 Cpn 912796G60

09/13/21 09/14/21 Buy 30,000,000.000 U.S. TREASURY BILL (29,999,329.17) 0.00 0.00 (29,999,329.17)MAT 10/07/21 Cpn 9127964V8




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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/14/21 09/14/21 Buy 50,000,000.000 U.S. TREASURY BILL (49,999,041.67) 0.00 0.00 (49,999,041.67)

MAT 10/07/21 Cpn 9127964V8





09/14/21 09/14/21 Buy 40,000,000.000 U.S. TREASURY BILL (39,996,883.33) 0.00 0.00 (39,996,883.33)MAT 11/04/21 Cpn 9127964W6

09/14/21 09/14/21 Buy 30,000,000.000 CASH MGMT BILL (29,998,708.33) 0.00 0.00 (29,998,708.33)MAT 10/15/21 Cpn 912796ZB8

09/14/21 09/14/21 Buy 50,000,000.000 CASH MGMT BILL (49,997,847.22) 0.00 0.00 (49,997,847.22)MAT 10/15/21 Cpn 912796ZB8

09/14/21 09/14/21 Buy 50,000,000.000 CASH MGMT BILL (49,996,233.33) 0.00 0.00 (49,996,233.33)MAT 11/01/21 Cpn 912796ZC6

09/08/21 09/15/21 Buy 5,500,000.000 BMW 2021-2 A2 LEASE (5,499,650.20) 0.00 0.00 (5,499,650.20)MAT 11/27/23 Cpn 0.19 09690AAB9

09/16/21 09/17/21 Buy 6,500,000.000 CREDIT AGRICOLE YCD FRN SOFR (6,500,444.78) (920.83) 0.00 0.00 (6,501,365.61)MAT 05/18/22 Cpn 0.17 22532XQR2

09/20/21 09/21/21 Buy 2,500,000.000 BANK OF NOVA SCOTIA YCD FRN (2,500,764.22) (412.50) 0.00 0.00 (2,501,176.72)MAT 02/25/22 Cpn 0.22 06417MNB7

09/14/21 09/22/21 Buy 4,050,000.000 CARMX 2021-4 A2A CAR (4,049,959.91) 0.00 0.00 (4,049,959.91)MAT 11/15/24 Cpn 0.24 14317JAB3

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/14/21 09/22/21 Buy 3,100,000.000 DEFT 2021-2 A1 EQP 144A (3,100,000.00) 0.00 0.00 (3,100,000.00)

MAT 09/22/22 Cpn 0.18 24702VAA0

09/14/21 09/22/21 Buy 5,050,000.000 HALST 2021-C A2 CAR LEASE 144A (5,049,835.88) 0.00 0.00 (5,049,835.88)MAT 01/16/24 Cpn 0.24 44933MAB7

09/14/21 09/22/21 Buy 4,000,000.000 SRT 2021-C A2 LEASE 144A (3,999,798.80) 0.00 0.00 (3,999,798.80)MAT 04/22/24 Cpn 0.29 80286CAB6

09/14/21 09/22/21 Buy 3,050,000.000 TESLA 2021-B A2 LEASE 144A (3,049,700.19) 0.00 0.00 (3,049,700.19)MAT 09/22/25 Cpn 0.36 88161KAB1

09/23/21 09/23/21 Buy 4,000,000.000 CA SAN JOSE FIN AUTH LEASE CP (4,000,000.00) 0.00 0.00 (4,000,000.00)MAT 01/12/22 Cpn 0.10 79815WCT3

09/21/21 09/23/21 Buy 7,500,000.000 SUMITOMO MITSUI TR NY YCD FR (7,500,000.00) 0.00 0.00 (7,500,000.00)MAT 03/25/22 Cpn 0.15 86564GW64

09/22/21 09/24/21 Buy 5,000,000.000 BARCLAYS YCD (5,000,000.00) 0.00 0.00 (5,000,000.00)MAT 05/24/22 Cpn 0.19 06742TA55

09/23/21 09/27/21 Buy 50,000,000.000 U.S. TREASURY NOTE (49,957,031.25) (30,737.70) 0.00 0.00 (49,987,768.95)MAT 03/31/23 Cpn 0.13 91282CBU4

09/28/21 09/28/21 Buy 4,000,000.000 CA SAN JOSE FIN AUTH LEASE CP (3,999,648.00) (54.79) 0.00 0.00 (3,999,702.79)MAT 01/12/22 Cpn 0.10 79815WCT3

09/28/21 09/29/21 Buy 4,000,000.000 BAYERISCHE LANDESBANK YCD (4,000,997.77) (1,096.67) 0.00 0.00 (4,002,094.44)MAT 05/12/22 Cpn 0.21 0727MCNR

915,600,000.000 (915,533,088.12) (39,562.77) 0.00 0.00 (915,572,650.89)

09/01/21 09/01/21 Coupon BANK OF MONTREAL YCD 1M BSB 236.63 0.00 0.00 236.63 MAT 12/01/21 Cpn 0.18 06367CFR3

09/03/21 09/03/21 Coupon SWEDBANK NY YCD 3ML FRN 949.31 0.00 0.00 949.31 MAT 03/03/22 Cpn 0.14 87019VT56

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/05/21 09/05/21 Coupon FFCB 1ML+13 FRN 2,258.28 0.00 0.00 2,258.28

MAT 11/05/21 Cpn 0.21 3133EK5T9

09/07/21 09/07/21 Coupon BANK OF MONTREAL CHICAGO YC 6,410.42 0.00 0.00 6,410.42 MAT 09/07/21 Cpn 0.17 06367CCC9

09/09/21 09/09/21 Coupon CREDIT AGRICOLE YCD FRN SOFR 292.78 0.00 0.00 292.78 MAT 05/09/22 Cpn 0.17 22532XQP6

09/10/21 09/10/21 Coupon CREDIT AGRICOLE YCD FRN 7,768.89 0.00 0.00 7,768.89 MAT 09/10/21 Cpn 22532XMW

09/10/21 09/10/21 Coupon CRVNA 2021-P2 A2 CAR 1,750.00 0.00 0.00 1,750.00 MAT 07/10/24 Cpn 0.30 14687TAB3

09/15/21 09/15/21 Coupon CARMAX 2019-1 A3 CAR 3,521.85 0.00 0.00 3,521.85 MAT 03/15/24 Cpn 3.05 14315NAC4

09/15/21 09/15/21 Coupon CARMX 2019-2 A3 CAR 4,785.10 0.00 0.00 4,785.10 MAT 03/15/24 Cpn 2.68 14316LAC7

09/15/21 09/15/21 Coupon CARMAX 2019-3 A3 CAR 11,702.32 0.00 0.00 11,702.32 MAT 08/15/24 Cpn 2.18 14315PAD7

09/15/21 09/15/21 Coupon FORD 2018-3 A1 FLOOR 3,473.07 0.00 0.00 3,473.07 MAT 10/15/23 Cpn 3.52 34528QGH1




09/15/21 09/15/21 Coupon HONDA 2020-2 A2 CAR 982.05 0.00 0.00 982.05 MAT 11/15/22 Cpn 0.74 43813DAB4

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/15/21 09/15/21 Coupon HONDA 2021-2 A2 CAR 850.00 0.00 0.00 850.00

MAT 11/15/23 Cpn 0.17 43811JAB3

09/15/21 09/15/21 Coupon HYUNDAI 2021-A A2 CAR 412.08 0.00 0.00 412.08 MAT 02/15/24 Cpn 0.23 44933LAB9

09/15/21 09/15/21 Coupon INTER-AMERICAN DEV BANK FRN 1,141.41 0.00 0.00 1,141.41 MAT 03/15/22 Cpn 0.15 45818WCM

09/15/21 09/15/21 Coupon INTER-AMERICAN DEV BANK FRN 2,282.83 0.00 0.00 2,282.83 MAT 03/15/22 Cpn 0.15 45818WCM

09/15/21 09/15/21 Coupon JOHN DEERE 2020-B A2 EQP 337.64 0.00 0.00 337.64 MAT 03/15/23 Cpn 0.41 47787NAB5

09/15/21 09/15/21 Coupon JOHN DEERE 2020-B A2 EQP 776.77 0.00 0.00 776.77 MAT 03/15/23 Cpn 0.41 47787NAB5

09/15/21 09/15/21 Coupon KUBOTA 2020-1A A3 EQP 144A 7,284.67 0.00 0.00 7,284.67 MAT 03/15/24 Cpn 1.96 50117WAC8

09/15/21 09/15/21 Coupon KUBOTA 2020-1A A3 EQP 144A 1,747.67 0.00 0.00 1,747.67 MAT 03/15/24 Cpn 1.96 50117WAC8

09/15/21 09/15/21 Coupon MERCEDES 2020-B A2 LEASE 971.37 0.00 0.00 971.37 MAT 02/15/23 Cpn 0.31 58769EAB4

09/15/21 09/15/21 Coupon MERCEDES 2021-B A2 LEASE 1,375.00 0.00 0.00 1,375.00 MAT 01/16/24 Cpn 0.22 58769KAC8

09/15/21 09/15/21 Coupon MERCEDES 2020-1 A2 CAR 482.80 0.00 0.00 482.80 MAT 03/15/23 Cpn 0.46 58769VAB6

09/15/21 09/15/21 Coupon ROYAL BANK OF CANADA YCD FR 2,047.20 0.00 0.00 2,047.20 MAT 12/15/21 Cpn 0.23 78012UZG3

09/15/21 09/15/21 Coupon TOYOTA 2019-A A3 CAR 8,456.46 0.00 0.00 8,456.46 MAT 07/17/23 Cpn 2.91 89239AAD5

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/15/21 09/15/21 Coupon TOYOTA 2019-C A3 CAR 4,998.74 0.00 0.00 4,998.74

MAT 09/15/23 Cpn 1.91 89238UAD2

09/15/21 09/15/21 Coupon TOYOTA 2019-C A3 CAR 501.24 0.00 0.00 501.24 MAT 09/15/23 Cpn 1.91 89238UAD2

09/15/21 09/15/21 Coupon TOYOTA 2020-C A2 CAR 777.49 0.00 0.00 777.49 MAT 02/15/23 Cpn 0.36 89237VAA7

09/15/21 09/15/21 Coupon TOYOTA 2021-A A2 CAR 635.14 0.00 0.00 635.14 MAT 07/17/23 Cpn 0.16 89240BAB4

09/15/21 09/15/21 Coupon WORLD OMNI 2021-B A2 CAR 783.33 0.00 0.00 783.33 MAT 07/15/24 Cpn 0.20 98163LAB6

09/16/21 09/16/21 Coupon CREDIT INDUST ET COMM YCD FR 731.94 0.00 0.00 731.94 MAT 05/16/22 Cpn 0.17 22536UY61

09/16/21 09/16/21 Coupon GMCAR 2021-A A2 CAR 1,125.00 0.00 0.00 1,125.00 MAT 06/17/24 Cpn 0.27 380149AB0

09/18/21 09/18/21 Coupon HONDA 2019-1 A3 CAR 4,521.68 0.00 0.00 4,521.68 MAT 03/20/23 Cpn 2.83 43814WAC9

09/18/21 09/18/21 Coupon HONDA 2020-3 A2 CAR 1,304.69 0.00 0.00 1,304.69 MAT 02/21/23 Cpn 0.27 43813KAB8

09/18/21 09/18/21 Coupon HONDA 2021-3 A2 CAR 383.33 0.00 0.00 383.33 MAT 02/20/24 Cpn 0.20 43815EAB0

09/20/21 09/20/21 Coupon CREDIT AGRICOLE YCD FRN SOFR 1,012.92 0.00 0.00 1,012.92 MAT 05/18/22 Cpn 0.17 22532XQR2

09/20/21 09/20/21 Coupon FFCB FRN 1,694.32 0.00 0.00 1,694.32 MAT 10/20/21 Cpn 0.10 3133ELW42

09/20/21 09/20/21 Coupon GMALT 2020-2 A2A LEASE 1,524.57 0.00 0.00 1,524.57 MAT 10/20/22 Cpn 0.71 36259PAB2

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/20/21 09/20/21 Coupon GMALT 2021-2 A2 LEASE 747.08 0.00 0.00 747.08

MAT 07/20/23 Cpn 0.22 380144AB1

09/20/21 09/20/21 Coupon VOLKSWAGEN 2019-A A3 LEASE 7,050.66 0.00 0.00 7,050.66 MAT 11/21/22 Cpn 1.99 92867XAD8

09/20/21 09/20/21 Coupon VOLKSWAGEN 2019-A A3 LEASE 2,257.50 0.00 0.00 2,257.50 MAT 11/21/22 Cpn 1.99 92867XAD8

09/20/21 09/20/21 Coupon VERIZON 2019-B 1A1 PHONE 3,733.26 0.00 0.00 3,733.26 MAT 12/20/23 Cpn 2.33 92349GAA9

09/20/21 09/20/21 Coupon VERIZON 2019-B 1A1 PHONE 937.13 0.00 0.00 937.13 MAT 12/20/23 Cpn 2.33 92349GAA9

09/20/21 09/20/21 Coupon VERIZON 2019-C A1A PHONE 8,083.33 0.00 0.00 8,083.33 MAT 04/22/24 Cpn 1.94 92348AAA3

09/20/21 09/20/21 Coupon VERIZON 2019-C A1A PHONE 3,960.83 0.00 0.00 3,960.83 MAT 04/22/24 Cpn 1.94 92348AAA3

09/21/21 09/21/21 Coupon HONDA 2020-1 A2 CAR 1,059.13 0.00 0.00 1,059.13 MAT 10/21/22 Cpn 1.63 43813RAB3

09/23/21 09/23/21 Coupon CA SAN JOSE FIN AUTH LEASE CP 1,814.79 0.00 0.00 1,814.79 MAT 09/23/21 Cpn 0.12 79815WCP1

09/24/21 09/24/21 Coupon BARCLAYS FRN YCD 2,092.36 0.00 0.00 2,092.36 MAT 09/24/21 Cpn 06742TWX0

09/25/21 09/25/21 Coupon BMW 2019-A A3 CAR 2,314.46 0.00 0.00 2,314.46 MAT 01/25/24 Cpn 1.92 05588CAC6

09/25/21 09/25/21 Coupon BMW 2020-A A2 CAR 110.50 0.00 0.00 110.50 MAT 02/27/23 Cpn 0.39 09661RAB7

09/25/21 09/25/21 Coupon FHMS KF36 A 746.84 0.00 0.00 746.84 MAT 08/25/24 Cpn 0.42 3137FBAR7

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/25/21 09/25/21 Coupon FHMS KI04 A 1MOFRN CMBS 902.32 0.00 0.00 902.32

MAT 07/25/24 Cpn 0.44 3137FNAV2

09/25/21 09/25/21 Coupon FHMS KI05 A 1,228.00 0.00 0.00 1,228.00 MAT 07/25/24 Cpn 0.42 3137FQXG3

09/25/21 09/25/21 Coupon FHMS KI06 A 1MOFRN CMBS 1,143.60 0.00 0.00 1,143.60 MAT 03/25/25 Cpn 0.30 3137FVNA6

09/01/21 09/25/21 Coupon FHMS KS01 A2 CMBS 12,655.88 0.00 0.00 12,655.88 MAT 01/25/23 Cpn 2.52 3137B1U75

09/25/21 09/25/21 Coupon FHMS Q009 A 1MOFRN CMBS 332.29 0.00 0.00 332.29 MAT 04/25/24 Cpn 0.43 3137FMTW

09/25/21 09/25/21 Coupon FHMS Q015 A 1MOFRN CMBS 651.55 0.00 0.00 651.55 MAT 08/25/24 Cpn 0.25 3137FYUR5

09/01/21 09/25/21 Coupon FNA 2012-M2 A2 CMBS 1,916.10 0.00 0.00 1,916.10 MAT 02/25/22 Cpn 2.72 3136A4TX7

09/27/21 09/27/21 Coupon FHMS KF38 A 365.48 0.00 0.00 365.48 MAT 09/25/24 Cpn 0.41 3137FBUC8

09/30/21 09/30/21 Coupon INTL FINANCE CORP FRN SOFRRA 3,577.85 0.00 0.00 3,577.85 MAT 06/30/23 Cpn 0.14 45950KCW8

09/30/21 09/30/21 Coupon U.S. TREASURY NOTE 31,250.00 0.00 0.00 31,250.00 MAT 03/31/23 Cpn 0.13 91282CBU4

199,572.86 0.00 0.00 199,572.86

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/01/21 09/01/21 Income (6.090) ADJ NET INT (6.09) 0.00 0.00 (6.09)

MAT Cpn USD

09/01/21 09/01/21 Income 340.570 STIF INT 340.57 0.00 0.00 340.57 MAT Cpn USD

334.480 334.48 0.00 0.00 334.48

09/13/21 09/13/21 Contributn 300,000,000.000 NM 300,000,000.00 0.00 0.00 300,000,000.00 MAT Cpn USD

09/14/21 09/14/21 Contributn 630,000,000.000 NM 630,000,000.00 0.00 0.00 630,000,000.00 MAT Cpn USD

930,000,000.000 930,000,000.00 0.00 0.00 930,000,000.00

09/01/21 09/02/21 Sell Long 10,000,000.000 U.S. TREASURY BILL 9,999,461.53 493.33 6.25 0.00 9,999,954.86 MAT 09/07/21 Cpn 912796L23

09/01/21 09/02/21 Sell Long 32,000,000.000 U.S. TREASURY BILL 31,998,276.89 1,578.67 20.00 0.00 31,999,855.56 MAT 09/07/21 Cpn 912796L23






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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/10/21 09/13/21 Sell Long 10,000,000.000 U.S. TREASURY BILL 9,999,665.14 262.64 (4.44) 0.00 9,999,927.78

MAT 09/21/21 Cpn 912796L49

09/10/21 09/13/21 Sell Long 27,000,000.000 U.S. TREASURY BILL 26,999,095.88 709.12 (12.00) 0.00 26,999,805.00 MAT 09/21/21 Cpn 912796L49




09/22/21 09/22/21 Sell Long 23,000,000.000 U.S. TREASURY BILL 22,999,048.05 945.56 17.25 0.00 22,999,993.61 MAT 09/23/21 Cpn 912796F53




09/24/21 09/27/21 Sell Long 30,000,000.000 U.S. TREASURY BILL 29,998,587.50 1,312.50 (12.50) 0.00 29,999,900.00 MAT 09/30/21 Cpn 912796F61

09/24/21 09/27/21 Sell Long 20,000,000.000 U.S. TREASURY BILL 19,998,730.00 1,150.00 84.44 0.00 19,999,880.00 MAT 10/05/21 Cpn 912796M22

09/24/21 09/27/21 Sell Long 27,000,000.000 U.S. TREASURY BILL 26,999,433.38 404.62 87.00 0.00 26,999,838.00 MAT 10/05/21 Cpn 912796M22

09/28/21 09/29/21 Sell Long 13,000,000.000 U.S. TREASURY BILL 12,999,780.63 224.79 95.34 0.00 13,000,005.42 MAT 10/05/21 Cpn 912796M22

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/28/21 09/29/21 Sell Long 21,000,000.000 U.S. TREASURY BILL 20,999,752.08 306.25 221.66 0.00 21,000,058.33

MAT 10/07/21 Cpn 9127964V8 426,000,000.000 425,973,535.07 25,306.82 692.67 0.00 425,998,841.89

09/15/21 09/15/21 Pay Princpl 134,690.029 CARMAX 2019-1 A3 CAR 134,690.03 (1,755.61) 0.00 134,690.03 MAT 03/15/24 Cpn 3.05 14315NAC4

09/15/21 09/15/21 Pay Princpl 177,737.047 CARMX 2019-2 A3 CAR 177,737.05 (2,429.42) 0.00 177,737.05 MAT 03/15/24 Cpn 2.68 14316LAC7

09/15/21 09/15/21 Pay Princpl 423,113.513 CARMAX 2019-3 A3 CAR 423,113.51 (5,582.53) 0.00 423,113.51 MAT 08/15/24 Cpn 2.18 14315PAD7

09/15/21 09/15/21 Pay Princpl 518,767.680 HONDA 2020-2 A2 CAR 518,767.68 (475.02) 0.00 518,767.68 MAT 11/15/22 Cpn 0.74 43813DAB4

09/15/21 09/15/21 Pay Princpl 188,066.457 JOHN DEERE 2020-B A2 EQP 188,066.46 0.00 3.61 188,066.46 MAT 03/15/23 Cpn 0.41 47787NAB5

09/15/21 09/15/21 Pay Princpl 432,668.228 JOHN DEERE 2020-B A2 EQP 432,668.23 (142.54) 0.00 432,668.23 MAT 03/15/23 Cpn 0.41 47787NAB5

09/15/21 09/15/21 Pay Princpl 598,339.067 MERCEDES 2020-B A2 LEASE 598,339.07 22.02 0.00 598,339.07 MAT 02/15/23 Cpn 0.31 58769EAB4

09/15/21 09/15/21 Pay Princpl 338,857.112 MERCEDES 2020-1 A2 CAR 338,857.11 0.00 1.79 338,857.11 MAT 03/15/23 Cpn 0.46 58769VAB6

09/15/21 09/15/21 Pay Princpl 367,700.911 TOYOTA 2019-A A3 CAR 367,700.91 0.00 (4,614.63) 367,700.91 MAT 07/17/23 Cpn 2.91 89239AAD5

09/15/21 09/15/21 Pay Princpl 290,273.454 TOYOTA 2019-C A3 CAR 290,273.45 (448.19) 0.00 290,273.45 MAT 09/15/23 Cpn 1.91 89238UAD2

09/15/21 09/15/21 Pay Princpl 29,106.727 TOYOTA 2019-C A3 CAR 29,106.73 (44.84) 0.00 29,106.73 MAT 09/15/23 Cpn 1.91 89238UAD2

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/15/21 09/15/21 Pay Princpl 583,455.248 TOYOTA 2020-C A2 CAR 583,455.25 0.00 6.75 583,455.25

MAT 02/15/23 Cpn 0.36 89237VAA7

09/15/21 09/15/21 Pay Princpl 536,576.555 TOYOTA 2021-A A2 CAR 536,576.56 (31.67) 0.00 536,576.56 MAT 07/17/23 Cpn 0.16 89240BAB4

09/16/21 09/16/21 Pay Princpl 280,937.431 GMCAR 2021-A A2 CAR 280,937.43 11.87 0.00 280,937.43 MAT 06/17/24 Cpn 0.27 380149AB0

09/18/21 09/18/21 Pay Princpl 236,061.934 HONDA 2019-1 A3 CAR 236,061.93 (2,310.02) 0.00 236,061.93 MAT 03/20/23 Cpn 2.83 43814WAC9

09/18/21 09/18/21 Pay Princpl 872,144.520 HONDA 2020-3 A2 CAR 872,144.52 25.94 0.00 872,144.52 MAT 02/21/23 Cpn 0.27 43813KAB8

09/20/21 09/20/21 Pay Princpl 592,125.518 GMALT 2020-2 A2A LEASE 592,125.52 (909.39) 0.00 592,125.52 MAT 10/20/22 Cpn 0.71 36259PAB2

09/20/21 09/20/21 Pay Princpl 693,827.845 VOLKSWAGEN 2019-A A3 LEASE 693,827.85 (3,428.40) 0.00 693,827.85 MAT 11/21/22 Cpn 1.99 92867XAD8

09/20/21 09/20/21 Pay Princpl 222,152.218 VOLKSWAGEN 2019-A A3 LEASE 222,152.22 (1,069.96) 0.00 222,152.22 MAT 11/21/22 Cpn 1.99 92867XAD8

09/20/21 09/20/21 Pay Princpl 231,912.085 VERIZON 2019-B 1A1 PHONE 231,912.09 (2,438.89) 0.00 231,912.09 MAT 12/20/23 Cpn 2.33 92349GAA9

09/20/21 09/20/21 Pay Princpl 58,214.666 VERIZON 2019-B 1A1 PHONE 58,214.67 (584.93) 0.00 58,214.67 MAT 12/20/23 Cpn 2.33 92349GAA9

09/21/21 09/21/21 Pay Princpl 387,672.541 HONDA 2020-1 A2 CAR 387,672.54 0.00 (827.19) 387,672.54 MAT 10/21/22 Cpn 1.63 43813RAB3

09/25/21 09/25/21 Pay Princpl 133,862.622 BMW 2019-A A3 CAR 133,862.62 (1,378.49) 0.00 133,862.62 MAT 01/25/24 Cpn 1.92 05588CAC6

09/25/21 09/25/21 Pay Princpl 124,215.532 BMW 2020-A A2 CAR 124,215.53 0.00 2.48 124,215.53 MAT 02/27/23 Cpn 0.39 09661RAB7

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/25/21 09/25/21 Pay Princpl 1,960.213 FHMS KF36 A 1,960.21 0.00 1.00 1,960.21

MAT 08/25/24 Cpn 0.42 3137FBAR7

09/25/21 09/25/21 Pay Princpl 49,198.610 FHMS KF38 A 49,198.61 0.00 40.60 49,198.61 MAT 09/25/24 Cpn 0.41 3137FBUC8

09/25/21 09/25/21 Pay Princpl 211,622.830 FHMS KI04 A 1MOFRN CMBS 211,622.83 0.00 0.00 211,622.83 MAT 07/25/24 Cpn 0.44 3137FNAV2

09/01/21 09/25/21 Pay Princpl 19,415.504 FHMS KS01 A2 CMBS 19,415.50 (370.02) 0.00 19,415.50 MAT 01/25/23 Cpn 2.52 3137B1U75

09/25/21 09/25/21 Pay Princpl 117,932.527 FHMS Q015 A 1MOFRN CMBS 117,932.53 0.00 0.00 117,932.53 MAT 08/25/24 Cpn 0.25 3137FYUR5

09/01/21 09/25/21 Pay Princpl 147,908.293 FNA 2012-M2 A2 CMBS 147,908.29 0.00 (853.88) 147,908.29 MAT 02/25/22 Cpn 2.72 3136A4TX7

9,000,516.916 9,000,516.93 (23,340.10) (6,239.46) 9,000,516.93

09/02/21 09/02/21 Mature Long 4,000,000.000 U.S. TREASURY BILL 3,999,797.33 202.67 (0.00) 0.00 4,000,000.00 MAT 09/02/21 Cpn 912796D63

09/07/21 09/07/21 Mature Long 18,000,000.000 U.S. TREASURY BILL 17,999,019.50 980.50 (0.00) 0.00 18,000,000.00 MAT 09/07/21 Cpn 912796L23

09/07/21 09/07/21 Mature Long 7,500,000.000 BANK OF MONTREAL CHICAGO YC 7,500,000.00 0.00 0.00 7,500,000.00 MAT 09/07/21 Cpn 0.17 06367CCC9

09/10/21 09/10/21 Mature Long 5,000,000.000 CREDIT AGRICOLE YCD FRN 5,000,000.00 0.00 0.00 5,000,000.00 MAT 09/10/21 Cpn 22532XMW

09/23/21 09/23/21 Mature Long 17,000,000.000 U.S. TREASURY BILL 16,999,283.64 716.36 0.00 0.00 17,000,000.00 MAT 09/23/21 Cpn 912796F53

09/23/21 09/23/21 Mature Long 6,000,000.000 CA SAN JOSE FIN AUTH LEASE CP 6,000,000.00 0.00 0.00 6,000,000.00 MAT 09/23/21 Cpn 0.12 79815WCP1

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/24/21 09/24/21 Mature Long 5,000,000.000 BARCLAYS FRN YCD 5,000,000.00 0.00 0.00 5,000,000.00

MAT 09/24/21 Cpn 06742TWX0 62,500,000.000 62,498,100.47 1,899.53 (0.00) 0.00 62,500,000.00

09/01/21 09/01/21 Withdrawal (25,000,000.000) WD (25,000,000.00) (25,000,000.00) 0.00 (25,000,000.00)MAT Cpn USD

09/01/21 09/01/21 Withdrawal (3,333.330) CUSTODY FEE (3,333.33) (3,333.33) 0.00 (3,333.33)MAT Cpn USD








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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount Cash - cont.


(495,003,333.330) (495,003,333.33) (495,003,333.33) 0.00 (495,003,333.33)

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Account Name: L.A. CARE HEALTH PLAN-LOW DURATION PORT 09/01/2021Account Number: 2367 through 09/30/2021


Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/14/21 09/22/21 Buy 500,000.000 SRT 2021-C A3 LEASE 144A (499,976.20) 0.00 0.00 (499,976.20)

MAT 03/20/25 Cpn 0.50 80286CAC4

09/14/21 09/22/21 Buy 400,000.000 TESLA 2021-B A2 LEASE 144A (399,960.68) 0.00 0.00 (399,960.68)MAT 09/22/25 Cpn 0.36 88161KAB1

09/21/21 09/24/21 Buy 900,000.000 FORDL 2021-B A3 LEASE (899,841.96) 0.00 0.00 (899,841.96)MAT 10/15/24 Cpn 0.37 345329AC0

09/23/21 09/24/21 Buy 940,000.000 U.S. TREASURY NOTE (937,319.53) (680.10) 0.00 0.00 (937,999.63)MAT 07/15/24 Cpn 0.38 91282CCL3

09/23/21 09/24/21 Buy 1,880,000.000 U.S. TREASURY NOTE (1,864,137.50) (934.81) 0.00 0.00 (1,865,072.31)MAT 08/31/26 Cpn 0.75 91282CCW9

09/29/21 09/30/21 Buy 1,405,000.000 U.S. TREASURY NOTE (1,395,669.92) 0.00 0.00 (1,395,669.92)MAT 09/30/26 Cpn 0.88 91282CCZ2

6,025,000.000 (5,996,905.79) (1,614.91) 0.00 0.00 (5,998,520.70)

09/01/21 09/01/21 Coupon CA STATE GO/ULT-TXBL BABS 6,483.75 0.00 0.00 6,483.75 MAT 03/01/22 Cpn 6.65 13063BFS6

09/01/21 09/01/21 Coupon CA GLENDALE USD GO/ULT TXB 1,821.25 0.00 0.00 1,821.25 MAT 09/01/24 Cpn 1.46 378460YD5

09/01/21 09/01/21 Coupon CA HESPERIA REDEV AGY SUCCE 12,343.75 0.00 0.00 12,343.75 MAT 09/01/23 Cpn 3.13 42806KAS2

09/01/21 09/01/21 Coupon CA OAKLAND REDEV AGY TXB 8,606.33 0.00 0.00 8,606.33 MAT 09/01/22 Cpn 3.78 67232TAT2

09/01/21 09/01/21 Coupon CA RIALTO REDEV AGENCY TAB-T 13,200.00 0.00 0.00 13,200.00 MAT 09/01/22 Cpn 4.00 76246PBC1

09/01/21 09/01/21 Coupon CA SANTA ANA CMNTY REDEV AG 8,025.75 0.00 0.00 8,025.75 MAT 09/01/23 Cpn 3.57 801096AR9

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/01/21 09/01/21 Coupon CA SAN DIEGO REDEV AGY TAB T 7,593.75 0.00 0.00 7,593.75

MAT 09/01/23 Cpn 3.38 79730WAZ3

09/01/21 09/01/21 Coupon CA SAN JOSE-EVERGREEN CCD T 6,825.00 0.00 0.00 6,825.00 MAT 09/01/23 Cpn 3.50 798189RE8

09/01/21 09/01/21 Coupon CA SAN LUIS WESTLANDS WTR DI 2,970.45 0.00 0.00 2,970.45 MAT 09/01/24 Cpn 1.45 798736AW4

09/15/21 09/15/21 Coupon CARMX 2020-1 A3 CAR 803.25 0.00 0.00 803.25 MAT 12/16/24 Cpn 1.89 14315XAC2

09/15/21 09/15/21 Coupon CARMX 2021-2 A3 AUTO 411.67 0.00 0.00 411.67 MAT 02/17/26 Cpn 0.52 14314QAC8

09/15/21 09/15/21 Coupon CARMX 2021-3 A3 CAR 435.42 0.00 0.00 435.42 MAT 06/15/26 Cpn 0.55 14317DAC4

09/15/21 09/15/21 Coupon CAPITAL ONE 2020-1 A3 CAR 640.00 0.00 0.00 640.00 MAT 11/15/24 Cpn 1.60 14043MAC5

09/15/21 09/15/21 Coupon FIFTH THIRD 2019-1 A3 CAR 343.96 0.00 0.00 343.96 MAT 12/15/23 Cpn 2.64 31680YAD9

09/15/21 09/15/21 Coupon HONDA 2019-3 A3 CAR 487.91 0.00 0.00 487.91 MAT 08/15/23 Cpn 1.78 43815NAC8

09/15/21 09/15/21 Coupon JOHN DEERE 2020-A A3 EQP 660.00 0.00 0.00 660.00 MAT 08/15/24 Cpn 1.10 47789KAC7

09/15/21 09/15/21 Coupon JOHN DEERE 2021-A A3 EQP 165.00 0.00 0.00 165.00 MAT 09/15/25 Cpn 0.36 47788UAC6

09/15/21 09/15/21 Coupon KUBOTA 2021-2A A3 EQP 144A 443.33 0.00 0.00 443.33 MAT 11/17/25 Cpn 0.56 50117XAE2

09/15/21 09/15/21 Coupon MERCEDES 2020-A A3 CAR LEASE 298.21 0.00 0.00 298.21 MAT 12/15/22 Cpn 1.84 58770FAC6

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/15/21 09/15/21 Coupon MERCEDES 2021-B A3 LEASE 200.00 0.00 0.00 200.00

MAT 11/15/24 Cpn 0.40 58769KAD6

09/15/21 09/15/21 Coupon NY STATE URBAN DEV CORP TXB 630.00 0.00 0.00 630.00 MAT 03/15/22 Cpn 2.10 6500354S4

09/15/21 09/15/21 Coupon U.S. TREASURY NOTE 181.25 0.00 0.00 181.25 MAT 03/15/24 Cpn 0.25 91282CBR1

09/15/21 09/15/21 Coupon U.S. TREASURY NOTE 875.00 0.00 0.00 875.00 MAT 03/15/24 Cpn 0.25 91282CBR1

09/15/21 09/15/21 Coupon TOYOTA 2019-A A3 CAR 631.42 0.00 0.00 631.42 MAT 07/17/23 Cpn 2.91 89239AAD5

09/15/21 09/15/21 Coupon TOYOTA 2019-C A3 CAR 478.46 0.00 0.00 478.46 MAT 09/15/23 Cpn 1.91 89238UAD2

09/15/21 09/15/21 Coupon WORLD OMNI 2021-A A3 LEASE 245.00 0.00 0.00 245.00 MAT 08/15/24 Cpn 0.42 98163JAC9

09/16/21 09/16/21 Coupon GMCAR 2021-2 A3 CAR 93.50 0.00 0.00 93.50 MAT 04/16/26 Cpn 0.51 380149AC8

09/20/21 09/20/21 Coupon GMALT 2021-2 A LEASE 256.25 0.00 0.00 256.25 MAT 05/20/25 Cpn 0.41 380144AD7

09/20/21 09/20/21 Coupon TLOT 2021-B A3 LEASE 144A 336.00 0.00 0.00 336.00 MAT 10/21/24 Cpn 0.42 89239CAC3

09/20/21 09/20/21 Coupon VOLKSWAGEN 2019-A A4 LEASE 538.67 0.00 0.00 538.67 MAT 08/20/24 Cpn 2.02 92867XAE6

09/20/21 09/20/21 Coupon VERIZON 2020-B A PHONE 372.08 0.00 0.00 372.08 MAT 02/20/25 Cpn 0.47 92290BAA9

09/25/21 09/25/21 Coupon BMW 2021-1 A4 LEASE 92.50 0.00 0.00 92.50 MAT 07/25/24 Cpn 0.37 05591RAD6

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/25/21 09/25/21 Coupon BMW 2019-A A3 CAR 551.06 0.00 0.00 551.06

MAT 01/25/24 Cpn 1.92 05588CAC6

09/01/21 09/25/21 Coupon FHMS K020 A2 CMBS 607.52 0.00 0.00 607.52 MAT 05/25/22 Cpn 2.37 3137ATRW

09/01/21 09/25/21 Coupon FHMS K020 A2 CMBS 744.70 0.00 0.00 744.70 MAT 05/25/22 Cpn 2.37 3137ATRW

09/01/21 09/25/21 Coupon FHMS K029 A2 CMBS 664.00 0.00 0.00 664.00 MAT 02/25/23 Cpn 3.32 3137B36J2

09/01/21 09/25/21 Coupon FHMS K029 A2 CMBS 1,051.33 0.00 0.00 1,051.33 MAT 02/25/23 Cpn 3.32 3137B36J2

09/01/21 09/25/21 Coupon FHMS K029 A2 CMBS 498.00 0.00 0.00 498.00 MAT 02/25/23 Cpn 3.32 3137B36J2

09/01/21 09/25/21 Coupon FHMS K031 A2 2,200.00 0.00 0.00 2,200.00 MAT 04/25/23 Cpn 3.30 3137B3NX2

09/01/21 09/25/21 Coupon FHMS K033 A2 2,091.00 0.00 0.00 2,091.00 MAT 07/25/23 Cpn 3.06 3137B4WB8

09/01/21 09/25/21 Coupon FHMS K034 A2 1,412.40 0.00 0.00 1,412.40 MAT 07/25/23 Cpn 3.53 3137B5JM6

09/01/21 09/25/21 Coupon FHMS K725 AM CMBS 2,095.20 0.00 0.00 2,095.20 MAT 02/25/24 Cpn 3.10 3137BWWE

09/01/21 09/25/21 Coupon FHMS K726 AM CMBS 1,417.88 0.00 0.00 1,417.88 MAT 04/25/24 Cpn 2.99 3137BYPR5

09/25/21 09/25/21 Coupon FHMS KI05 A 83.25 0.00 0.00 83.25 MAT 07/25/24 Cpn 0.42 3137FQXG3

09/01/21 09/25/21 Coupon FHMS KJ28 A1 511.91 0.00 0.00 511.91 MAT 02/25/25 Cpn 1.77 3137FREB3

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/01/21 09/25/21 Coupon FHMS KJ30 A1 CMBS 156.66 0.00 0.00 156.66

MAT 01/25/25 Cpn 0.53 3137FUZN7

09/01/21 09/25/21 Coupon FHMS KS01 A2 CMBS 641.23 0.00 0.00 641.23 MAT 01/25/23 Cpn 2.52 3137B1U75

09/01/21 09/25/21 Coupon FHMS KSMC A2 CMBS 1,939.46 0.00 0.00 1,939.46 MAT 01/25/23 Cpn 2.62 3137B04Y7

09/30/21 09/30/21 Coupon U.S. TREASURY NOTE 625.00 0.00 0.00 625.00 MAT 09/30/25 Cpn 0.25 91282CAM3

09/30/21 09/30/21 Coupon U.S. TREASURY NOTE 4,215.00 0.00 0.00 4,215.00 MAT 03/31/25 Cpn 0.50 912828ZF0

09/30/21 09/30/21 Coupon U.S. TREASURY NOTE 3,506.25 0.00 0.00 3,506.25 MAT 03/31/26 Cpn 0.75 91282CBT7



09/30/21 09/30/21 Coupon U.S. TREASURY NOTE 6,675.00 0.00 0.00 6,675.00 MAT 09/30/24 Cpn 1.50 912828YH7

09/30/21 09/30/21 Coupon U.S. TREASURY NOTE 3,187.50 0.00 0.00 3,187.50 MAT 03/31/24 Cpn 2.13 912828W71

09/30/21 09/30/21 Coupon U.S. TREASURY NOTE 9,243.75 0.00 0.00 9,243.75 MAT 03/31/24 Cpn 2.13 912828W71

126,782.01 0.00 0.00 126,782.01

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/15/21 09/16/21 Sell Long 470,000.000 U.S. TREASURY NOTE 470,055.08 124.52 175.68 0.00 470,179.60

MAT 12/31/22 Cpn 0.13 91282CBD2

09/17/21 09/21/21 Sell Long 600,000.000 TLOT 2021-B A3 LEASE 144A 600,562.50 7.00 570.19 0.00 600,569.50 MAT 10/21/24 Cpn 0.42 89239CAC3

09/21/21 09/22/21 Sell Long 570,000.000 U.S. TREASURY NOTE 569,777.34 340.68 (19.53) 0.00 570,118.02 MAT 03/31/23 Cpn 0.13 91282CBU4

09/23/21 09/24/21 Sell Long 940,000.000 U.S. TREASURY NOTE 939,816.41 274.59 53.52 0.00 940,091.00 MAT 12/31/22 Cpn 0.13 91282CBD2

09/23/21 09/24/21 Sell Long 510,000.000 U.S. TREASURY NOTE 518,805.47 2,972.69 0.00 9,030.62 521,778.16 MAT 11/15/22 Cpn 1.63 912828TY6

09/23/21 09/24/21 Sell Long 980,000.000 U.S. TREASURY NOTE 997,877.34 8,886.27 0.00 19,254.91 1,006,763.61 MAT 09/30/22 Cpn 1.88 9128282W9

09/23/21 09/24/21 Sell Long 435,000.000 U.S. TREASURY NOTE 444,107.81 3,475.27 0.00 9,141.50 447,583.08 MAT 10/31/22 Cpn 2.00 9128283C2

09/29/21 09/30/21 Sell Long 1,405,000.000 U.S. TREASURY NOTE 1,404,725.59 439.06 75.40 0.00 1,405,164.65 MAT 12/31/22 Cpn 0.13 91282CBD2

5,910,000.000 5,945,727.54 16,520.08 855.27 37,427.03 5,962,247.62

09/15/21 09/15/21 Pay Princpl 17,711.469 FIFTH THIRD 2019-1 A3 CAR 17,711.47 0.00 1.23 17,711.47 MAT 12/15/23 Cpn 2.64 31680YAD9

09/15/21 09/15/21 Pay Princpl 29,490.649 HONDA 2019-3 A3 CAR 29,490.65 0.00 0.08 29,490.65 MAT 08/15/23 Cpn 1.78 43815NAC8

09/15/21 09/15/21 Pay Princpl 22,364.328 MERCEDES 2020-A A3 CAR LEASE 22,364.33 0.00 1.00 22,364.33 MAT 12/15/22 Cpn 1.84 58770FAC6

09/15/21 09/15/21 Pay Princpl 27,455.001 TOYOTA 2019-A A3 CAR 27,455.00 0.00 1.39 27,455.00 MAT 07/17/23 Cpn 2.91 89239AAD5

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Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 09/15/21 09/15/21 Pay Princpl 27,783.694 TOYOTA 2019-C A3 CAR 27,783.69 0.00 0.00 27,783.69

MAT 09/15/23 Cpn 1.91 89238UAD2

09/25/21 09/25/21 Pay Princpl 31,872.053 BMW 2019-A A3 CAR 31,872.05 0.00 1.61 31,872.05 MAT 01/25/24 Cpn 1.92 05588CAC6

09/01/21 09/25/21 Pay Princpl 7,154.420 FHMS K020 A2 CMBS 7,154.42 0.00 (10.18) 7,154.42 MAT 05/25/22 Cpn 2.37 3137ATRW

09/01/21 09/25/21 Pay Princpl 8,769.934 FHMS K020 A2 CMBS 8,769.93 0.00 (78.90) 8,769.93 MAT 05/25/22 Cpn 2.37 3137ATRW

09/01/21 09/25/21 Pay Princpl 11,061.360 FHMS KJ28 A1 11,061.36 0.00 0.03 11,061.36 MAT 02/25/25 Cpn 1.77 3137FREB3

09/01/21 09/25/21 Pay Princpl 1,007.860 FHMS KJ30 A1 CMBS 1,007.86 0.00 0.01 1,007.86 MAT 01/25/25 Cpn 0.53 3137FUZN7

09/01/21 09/25/21 Pay Princpl 983.719 FHMS KS01 A2 CMBS 983.72 0.00 (5.20) 983.72 MAT 01/25/23 Cpn 2.52 3137B1U75

185,654.486 185,654.48 0.00 (88.92) 185,654.48

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Cusip

Income

Amount

Total

Amount Amount

LA CARE

Cash Activity by Transaction Type GAAP BasisAccounting Period From 09/01/2021 To 09/30/2021

DescriptionCash

Date Date

Settle/Pay

Date

Principal Contributions/

WithdrawalsCustodian Quantity

BUY

09/01/21 08/30/21 64952WDW0 (4,974,030.56)(4,968,600.00)(5,430.56)09/01/21 0.00 BKAMER19 5,000,000.00 NEW YORK LIFE GLOBAL FDG

09/07/21 09/07/21 09248U718 (1,762,129.23)(1,762,129.23) 0.00 09/07/21 0.00 BKAMER19 1,762,129.23 BLACKROCK TREASURY TRUST

09/22/21 09/20/21 931142ER0 (5,010,529.17)(5,009,800.00)(729.17)09/22/21 0.00 BKAMER19 5,000,000.00 WALMART INC

09/22/21 09/20/21 95000U2N2 (5,228,052.22)(5,184,900.00)(43,152.22)09/22/21 0.00 BKAMER19 5,000,000.00 WELLS FARGO & COMPANY

TOTAL BUY (16,974,741.18)(16,925,429.23)(49,311.95) 0.00 16,762,129.23

DIVIDEND

09/01/21 09/01/21 09248U718 5.77 0.00 5.77 09/01/21 0.00 BKAMER19 1,436,451.48 BLACKROCK TREASURY TRUST

TOTAL DIVIDEND 5.77 0.00 5.77 0.00 1,436,451.48

INTEREST

09/01/21 09/01/21 14913R2K2 22,625.00 0.00 22,625.00 09/01/21 0.00 BKAMER19 5,000,000.00 CATERPILLAR FINL SERVICE

09/01/21 09/01/21 20030NBJ9 18,000.00 0.00 18,000.00 09/01/21 0.00 BKAMER19 0.00 COMCAST CORP

09/01/21 09/01/21 20030NBS9 55,125.00 0.00 55,125.00 09/01/21 0.00 BKAMER19 0.00 COMCAST CORP

09/01/21 09/01/21 29157TAC0 33,708.15 0.00 33,708.15 09/01/21 0.00 BKAMER19 0.00 EMORY UNIVERSITY

09/01/21 09/01/21 741531FA0 94,875.00 0.00 94,875.00 09/01/21 0.00 BKAMER19 0.00 PRICOA GLOBAL FUNDING 1

09/03/21 09/03/21 57636QAN4 30,000.00 0.00 30,000.00 09/03/21 0.00 BKAMER19 0.00 MASTERCARD INC

09/05/21 09/05/21 06051GHF9 124,250.00 0.00 124,250.00 09/05/21 0.00 BKAMER19 0.00 BANK OF AMERICA CORP

09/07/21 09/07/21 904764BF3 22,500.00 0.00 22,500.00 09/07/21 0.00 BKAMER19 0.00 UNILEVER CAPITAL CORP

09/13/21 09/13/21 828807DG9 50,000.00 0.00 50,000.00 09/13/21 0.00 BKAMER19 0.00 SIMON PROPERTY GROUP LP

09/15/21 09/15/21 26442CAV6 76,250.00 0.00 76,250.00 09/15/21 0.00 BKAMER19 0.00 DUKE ENERGY CAROLINAS

09/15/21 09/15/21 74456QCF1 45,362.50 0.00 45,362.50 09/15/21 0.00 BKAMER19 0.00 PUBLIC SERVICE ELECTRIC

09/19/21 09/19/21 30231GBH4 29,920.00 0.00 29,920.00 09/19/21 0.00 BKAMER19 0.00 EXXON MOBIL CORPORATION

09/21/21 09/21/21 74153WCN7 61,250.00 0.00 61,250.00 09/21/21 0.00 BKAMER19 0.00 PRICOA GLOBAL FUNDING 1

09/22/21 09/22/21 904764BA4 78,125.00 0.00 78,125.00 09/22/21 0.00 BKAMER19 5,000,000.00 UNILEVER CAPITAL CORP

09/24/21 09/24/21 254687FN1 50,250.00 0.00 50,250.00 09/24/21 0.00 BKAMER19 0.00 WALT DISNEY COMPANY/THE

09/25/21 09/25/21 458140BP4 42,500.00 0.00 42,500.00 09/25/21 0.00 BKAMER19 0.00 INTEL CORP

TOTAL INTEREST 834,740.65 0.00 834,740.65 0.00 10,000,000.00

SELL

09/01/21 08/31/21 25468PCT1 5,059,916.67 5,054,250.00 5,666.67 09/01/21 0.00 BKAMER19 5,000,000.00 WALT DISNEY COMPANY/THE

10/5/2021

5:15:40AM

INCPRIN2232

Trade/Ex-

Cusip

Income

Amount

Total

Amount Amount

LA CARE

Cash Activity by Transaction Type GAAP BasisAccounting Period From 09/01/2021 To 09/30/2021

DescriptionCash

Date Date

Settle/Pay

Date

Principal Contributions/

WithdrawalsCustodian Quantity

09/07/21 09/07/21 09248U718 1,436,541.48 1,436,541.48 0.00 09/07/21 0.00 BKAMER19 1,436,541.48 BLACKROCK TREASURY TRUST

09/22/21 09/22/21 48128BAB7 5,069,656.11 5,042,000.00 27,656.11 09/22/21 0.00 BKAMER19 5,000,000.00 JPMORGAN CHASE & CO

09/22/21 09/22/21 976843BL5 4,574,653.75 4,523,985.00 50,668.75 09/22/21 0.00 BKAMER19 4,500,000.00 WISCONSIN PUBLIC SERVICE

TOTAL SELL 16,140,768.01 16,056,776.48 83,991.53 0.00 15,936,541.48

WITHDRAW

09/07/21 09/07/21 CASHCASH6 (773.25) 0.00 0.00 09/07/21 (773.25)BKAMER19 0.00 C-04 BANK FEE

TOTAL WITHDRAW (773.25) 0.00 0.00 (773.25) 0.00

GRAND TOTAL 0.00 (868,652.75) 869,426.00

Avg Date 14

(773.25) 44,135,122.19

10/5/2021

5:15:40AM

INCPRIN2233

November 15, 2021

TO: Finance & Budget Committee

FROM: Marie Montgomery, Chief Financial Officer

SUBJECT: Accounting & Financial Services Policies AFS-004 (Non-Travel Expenses), AFS-027 (Travel Related Expenses), AFS-006 (Authorization and Approval Limits) and AFS-007 (Procurement Policy) for the 4th Quarter and Year End Reports for FY 2020-21.

The below Accounting & Financial Services (AFS) policies are required to be reported to the Finance & Budget Committee: 1. Policies AFS-004 (Non-Travel Expenses) and AFS-027 (Travel Related Expenses) 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.

2. Policy AFS-006 (Authorization and Approval Limits) requires reports for executed vendor contracts for all expenditures.

3. Policy AFS-007 (Procurement Policy) requires reports for all sole source purchases over

$250,000.

Attached are the reports for the 4th Quarter of FY 2020-21 and Year-End FY 2020-21.

234

AFS-004 Non-Travel Expense Report_Q4 FY20-21

AFS-027 Travel Expense Report_ Q4 FY20-21

Division July -

September 2021

Description

Health Services 1,081$ Expenses are related to catering for performance improvement project events.

Legal Services 303$ Expenses are attributable to refreshments for the committee meetings.

Total Non-Travel Expenses 1,384$

Division July -

September 2021

Description

Chief Product Officer 1,801$ Gift card purchase for department agents to utilize sales and marketing expense.

Clinical Operations 45$ Expenses are related to L.A. Care staff mileage reimbursement.

Grants 620$ Expenses are related to L.A. Care staff mileage reimbursement.

Health Services 2,772$ Expenses are related to Local Health Plans CA conference and staff mileage

reimbursement.

Human Resources 443$ Expenses are related to L.A. Care staff mileage reimbursement.

Information Technology 1,455$ Expenses attributable to attendance of HIMSS 2021 Conference and staff mileage

reimbursement related to site visits.

Operations 2,736$ Expenses related to approved L.A. Care staff travel and staff transportation for

CRC visits.

Strategic Services 1,265$

Primarily attributable to support fees for CRC workshops and events including

Back to School, and Food Pantry events and COVID-19 Vaccine Clinics.

Expenses are also related to approved L.A. Care staff transportation for site visits

and meetings.

Total Travel Expenses 11,138$

235

AFS-004 Non-Travel Expense Report_Year-End FY20-21

AFS-027 Travel Expense Report_Year-End FY20-21

Division FY 2020 - 2021 Description

Health Services 23,988$

Expenses are related to payment for CME/CE (Continuing Medical Education)

Conference, Behavioral Health Conferences, and catering for performance

improvement project events.

Legal Services 1,330$ Expenses are attributable to refreshments for the committee meetings.

Total Non-Travel Expenses 25,318$

Division FY 2020 - 2021 Description

Chief Product Officer 6,624$ Gift card purchase for department agents to utilize sales and marketing expense.

Clinical Operations 117$ Expenses are related to L.A. Care staff mileage reimbursement.

Executive Services 92$ Expenses are attributable to approved L.A. Care staff transportation for meetings

Finance Services 36$ Expenses are related to travel agent fees.

Grants 815$ Expenses are related to L.A. Care staff mileage reimbursement.

Health Services 3,909$ Expenses are related to member service for medical treatment, travel realted to

Local Health Plans CA conference, and staff mileage reimbursement.

Human Resources 951$ Expenses are related to L.A. Care staff mileage reimbursement.

Information Technology 12,545$

Expenses attributable to support fees for CRC Readiness Project, attendance of

HIMSS 2021 Conference, reimbursement of approved staff education including

CyberArk Training course, delivery, setup and deployment of new LogRhythm

appliance to business recovery (DR) site in Arizona, and staff mileage

reimbursement related to site visits.

Operations 4,069$

Expenses related to approved staff education and travel , NHCAA (National

Healthcare Anti-Fraud Association) training and exam, and LA Care staff

transportation for CRC visits.

Strategic Services 2,891$

Primarily attributable to support fees for CRC workshops and events including

Back to School and Food Pantry events, and Flu Shot and COVID-19 Vaccine

Clinics. Gift card purchase for department agents to utilize sales and marketing

expenses occured in Q1. Expenses are also related to approved L.A. Care staff

transportation for site visits and meetings.

Total Travel Expenses 32,050$

236

New Vendor POs and ContractsVendor Name PO and Contract Total

I Color Printing & Mailing Inc $5,095,795Sierra Pacific Constructors, Inc. $2,248,323CenturyLink Communications, LLC $1,381,482SHI International Corp $1,294,665Edifecs, Inc. $1,236,234Cognizant TriZetto Software Group, Inc. $2,221,445Daponde Simpson Rowe PC $900,000Delphix Corp $756,442Gita Murthy $750,000Oracle America, Inc. $683,700ePlus Technology, inc. $582,529Customer Motivators, LLC $500,000Martin Luther King, Jr. Community Health Foundation $500,000Mazars USA LLP $499,000Benefit Express Services, LLC $455,870Acquia, Inc $369,257Arent Fox LLP $300,000Imagenet LLC $300,000Earth Print, Inc. $291,905AltaMed Health Services Corporation $250,000NTT America Solutions, Inc. $223,535Sonia P. Guzman $215,660Advantmed, LLC $200,000HALO BRANDED SOLUTIONS, INC. $182,407UptoDate, Inc. $157,145Ollivier Corporation $155,448Project Angel Food $150,000SKKN, INC. $146,587Wakely Consulting Group, LLC $140,724Bitglass Inc. $130,990SAI Global Compliance, Inc. $130,356Jann Murray $125,150JWCH Institute, Inc. $125,000Unicare Community Health Center, Inc. $125,000Bartz Altadonna Community Health Center $125,000Critical Care Training Center $112,000Andrues/Podberesky, APLC $100,000Nixon Peabody LLP $100,000Hanson Bridgett LLP $100,000Richards, Watson & Gershon A Professional Corporation $100,000Isaacs | Friedberg LLP $100,000Crowell & Moring LLP $100,000Mintz, Levin, Cohn, Ferris, Glovsky and Popeo P.C. $100,000Musick, Peeler & Garrett LLP $100,000SonBern LLC. $94,640Verizon Business Network Services Inc $91,532GHA Technologies Inc $84,946Solarwinds, Inc. $84,868


AFS-006 Authorization and Approval Limits Quarterly Report

July 2021 - September 2021

237


Healthy Cooking LLC $75,310Tarzana Treatment Centers, Inc. $75,000Martin Luther King, Jr. Community Health Foundation $75,000Clinica Msr. Oscar A. Romero $75,000The Children's Clinic, Serving Children and Their Families $75,000Herald Christian Health Center $75,000QueensCare Health Centers $75,000Central Neighborhood Health Foundation $75,000Arroyo Vista Family Health Foundation $75,000Buddhist Tzu Chi Medical Foundation $75,000Wilmington Community Clinic $75,000PHASES INC $74,952Aunt Bertha, a Public Benefit Corporation $66,000JeffersonLarsonSmith, LLC $62,200Cactus Software LLC $62,080Gomez Research Inc. $60,000Optiv Security, Inc. $59,072Brenda Sandoval $47,700Tony Lopez International $47,495RightStar, Inc. $46,792Agile Transformation Inc $43,600Brent Powell $42,400Ricky L. Davis $42,380Embarcadero Technologies Inc $42,120University of Southern California $38,790ABF Data Systems, Inc $37,885Franklin Covey Client Sales, Inc. $33,930Jennifer Baez $33,280Office Depot, Inc. $32,424God's Pantry $32,000Partners In Care Foundation Inc. $31,830Sovos Compliance, LLC $27,974Angie Gomez $27,400Luxor Printing Inc. $27,362IPROS Insurance Professionals Agency Inc $25,000Freeman-Thomas Early Education Consulting, LLC $23,520Advantage Mailing, LLC $22,964Elliot Scott $22,000Uline, Inc. $20,570AEGIS.net, Inc. $20,000iXerv Americas Inc $19,500Amazon Capital Services, Inc. $18,948ABMS Solutions, LLC $18,522City of El Monte $18,040Acts93, Inc. $17,910Lands' End, Inc $15,920Emin Adjemian $15,333Peoples Yoga $15,200Dual Immersion Foundation $12,000Lakeshore Equipment Company $11,509Mercer US Inc. $11,325VideoGuard, LLC $9,600PhotoShelter, Inc. $9,499

238


McAfee Finance 2, LLC $9,000Altec Products, Inc. $8,983Muir-Chase Plumbing Co., Inc. $8,750Alberto Arciniega $7,200Liberty Utilities (Park Water) Corp $7,200Worksite Wellness LA $7,200RLG Enterprises, Inc $5,932Pitney Bowes Inc. $5,307Budget Holdings Inc. $5,150American National Red Cross - CCB $5,000I.D. Systems & Supplies, Inc. $4,000BrandFuse, inc. $3,825America's Health Insurance Plans, Inc. $2,100Your Glass Connection, Inc. $2,020Blue Ribbon Technologies, LLC $1,560Playcore Wisconsin, Inc. $726Social Chow Media Group LLC $600Omar Sanchez Barreras $500Lawrence Roll Up Doors, Inc. $468American Registry for Internet Numbers, LTD $450NexTec Operating Corp. $205Grand Total $26,476,146

239


I Color Printing & Mailing Inc $15,377,100SHI International Corp $8,895,102Health Dialog Services Corporation $7,000,000Ntooitive Digital LLC $6,050,000Sierra Pacific Constructors, Inc. $4,946,623Collective Medical Technologies, Inc. $4,461,840Healthx, Inc. $3,517,572Upside Crenshaw Holdings, LLC $3,325,000ePlus Technology, inc. $2,401,693Cognizant TriZetto Software Group, Inc. $2,329,245Center for the Study of Services $2,090,473Edifecs, Inc. $2,013,278Spinnaker Support, LLC $1,955,931salesforce.com, inc. $1,886,226OptumInsight, Inc. $1,746,600Imagenet LLC $1,700,000CenturyLink Communications, LLC $1,629,686Charles R. Drew University of Medicine and Science $1,474,505UCLA Foundation, The $1,474,505Safety Net Connect Inc. $1,360,000Arent Fox LLP $1,300,000Delphix Corp $1,237,074SKKN, INC. $1,206,137Gartner Inc. $1,068,220NTT America Solutions, Inc. $1,017,494Advantmed, LLC $1,012,500California Coverage and Health Initiatives $977,564Verizon Business Network Services Inc $929,548Daponde Simpson Rowe PC $900,000Martin Luther King, Jr. Community Health Foundation $900,000Canon Solutions America Inc $852,784North Star Alliances $825,000Mazars USA LLP $806,000Health Career Connection $800,000salesforce.com, inc. (Parent Company of MuleSoft, LLC) $773,336HALO BRANDED SOLUTIONS, INC. $764,902Gita Murthy $750,000Oracle America, Inc. $683,700Earth Print, Inc. $651,811NICE Systems Inc $594,159Lista Design Studio, Inc. $550,000The Children's Clinic, Serving Children and Their Families $525,000Asian Pacific Health Care Venture, Inc. $500,000Customer Motivators, LLC $500,000Benefit Express Services, LLC $455,870Change Healthcare Resources Holdings Inc. $450,000Informatica LLC $445,491SciQuest, Inc. $426,195Health Management Associates Inc. $422,166AEGIS.net, Inc. $414,500

L.A. Care Health PlanAFS-006 Authorization and Approval Limits Report

October 2020 - September 2021

240




Resources Connection Inc. $405,000Carl Andrew Botterud $400,000Charter Communications Holdings, LLC $400,000Isaacs | Friedberg LLP $400,000Microsoft Corporation $388,784Acquia, Inc $369,257Bloom Insurance Agency, LLC $345,475AltaMed Health Services Corporation $325,000JWCH Institute, Inc. $325,000St. John's Well Child & Family Center $325,000Compass Group USA, Inc. $300,000Meyers, Nave, Riback, Silver & Wilson $300,000Venice Family Clinic $300,000South Central Family Health Center $295,000PillarRx Consulting, LLC $294,000Loma Linda University $289,245SAS Institute, Inc. $277,464GHA Technologies Inc $268,816Optiv Security, Inc. $264,377Bitglass Inc. $261,990Southern California Edison Company $254,000Cerner Corporation $250,000DENTONS US LLP $250,000Lewis Brisbois Bisgaard & Smith LLP $250,000Managed Healthcare Unlimited, Inc. $250,000One Degree $249,757Wakely Consulting Group, LLC $240,724Bayard Advertising Agency, Inc. $236,800JeffersonLarsonSmith, LLC $221,700Aurora Systems Consulting, Inc $219,686Ex Novo, Inc $217,836Sonia P. Guzman $215,660DST Healthcare Holdings, Inc. $211,092The Mihalik Group, LLC $208,320Best Best & Krieger LLP $200,000Northeast Community Clinic $200,000Northeast Valley Health Corporation $200,000Orbach, Huff, Suarez & Henderson LLP $200,000Richards, Watson & Gershon A Professional Corporation $200,000Zuber Lawler & Del Duca, LLP $200,000Optum360 LLC $198,324Critical Care Training Center $196,000Fierce Software Corporation $185,932Cognisight, LLC $180,000Citrix Systems, Inc. $172,386Sovos Compliance, LLC $163,863Advent Advisory Group LLC $160,200UptoDate, Inc. $157,145Open Text Inc $156,946Ollivier Corporation $155,448

241




Arroyo Vista Family Health Foundation $150,000Buddhist Tzu Chi Medical Foundation $150,000Center for Health Care Strategies Inc. $150,000Central Neighborhood Health Foundation $150,000Clinica Msr. Oscar A. Romero $150,000Glaser Weil Fink Howard Avchen & Shapiro LLP $150,000Herald Christian Health Center $150,000National Medical Fellowships, Inc. $150,000Project Angel Food $150,000QueensCare Health Centers $150,000Tarzana Treatment Centers, Inc. $150,000Wilmington Community Clinic $150,000Advisory Board Company, The $139,984Deborah Maddis $136,750FanelliPM $130,694SAI Global Compliance, Inc. $130,356Jann Murray $125,150Bartz Altadonna Community Health Center $125,000Mallu Reddy, MD, Inc $125,000T.H.E. Clinic, Inc. $125,000Unicare Community Health Center, Inc. $125,000Uptimum Medical Group & IPA $125,000Bhive Holdings, LLC $121,000Luxor Printing Inc. $119,362Tony Lopez International $117,379Gloria S. Nuestro $117,000ABF Data Systems, Inc $115,645Kinema Fitness, Inc. $114,640Infosys Limited $111,284East Valley Community Health Center, Inc. $110,000Healthy Cooking LLC $107,710Advantage Mailing, LLC $106,803DLT Solutions, LLC. $105,526F5 Networks, Inc. $104,617Nielsen Merksamer Parrinello Gross & Leoni, LLP $102,526SmartBear Software, Inc. $100,085Andrues/Podberesky, APLC $100,000Bell & Kelly, LLP $100,000Crowell & Moring LLP $100,000Hanson Bridgett LLP $100,000Jackson Lewis P.C. $100,000Mintz, Levin, Cohn, Ferris, Glovsky and Popeo P.C. $100,000Musick, Peeler & Garrett LLP $100,000Nixon Peabody LLP $100,000Sheppard Mullin Richter & Hampton LLP $100,000Universal Community Health Center $100,000West Publishing Corporation $100,000Live Art Plantscapes, Inc. $99,799RightStar, Inc. $98,024SonBern LLC. $94,640

242




Cactus Software LLC $90,865Edmund Jung & Associates, Inc. $90,000Kimberley Carruthers $85,800Brent Powell $85,000Solarwinds, Inc. $84,868Office Depot, Inc. $81,000God's Pantry $81,000Instant InfoSystems $78,427Community Health Alliance of Pasadena $75,000Comprehensive Community Health Centers, Inc. $75,000Jemmott Rollins Group $75,000Korean Health, Education, Information and Research Center $75,000Los Angeles Christian Health Centers $75,000Los Angeles LGBT Center $75,000RDP Consulting $75,000Southern California Medical Center, Inc. $75,000University Muslim Medical Association, Inc. $75,000Via Care Community Health Center $75,000White Memorial Community Health Center $75,000PHASES INC $74,952Partners In Care Foundation Inc. $73,810University of Southern California $71,425Inland Empire Health Plan $70,000Pacific Business Group on Health $68,743RELX Inc. $67,102Jennifer Baez $66,560Aunt Bertha, a Public Benefit Corporation $66,000Skillsoft Corporation $65,600Gomez Research Inc. $60,000Safe and Sound Surveillance Solutions Inc $58,141i2i Systems, Inc. $57,600SAP America, Inc. $57,520Merito Solutions, Inc $56,601Zones, LLC (Wholly Owned by Zones IT Solutions Inc.) $53,958Clango, Inc. $53,685Ricky L. Davis $52,780Sprinklr, Inc. $50,565Liberty Hill Foundation $50,000VideoGuard, LLC $49,304Nexry LLC $48,284Uline, Inc. $48,008Brenda Sandoval $47,700Regents of the University of California at Irvine $46,500Politico LLC $44,708Agile Transformation Inc $43,600Embarcadero Technologies Inc $42,120Laura Roman Cadena $40,160Traliant Holdings, LLC $39,335Lands' End, Inc $38,406California Hospital Assessment and Reporting Task Force (CHA $35,000

243




Invent Health Inc. $35,000Franklin Covey Client Sales, Inc. $33,930Rockstar Music, Inc. $33,000FiscalNote, Inc $32,100Robert M. Taylor, Jr. $31,200Arakelian Enterprises, Inc. $30,025Amazon Capital Services, Inc. $28,440NexTec Operating Corp. $27,676Angie Gomez $27,400Health Literacy Innovations, LLC $26,904Korn Ferry Hay Group, Inc. $26,350Altec Products, Inc. $25,555Atlassian Pty Ltd $25,043IPROS Insurance Professionals Agency Inc $25,000Southern California Grantmakers $25,000VCM Technologies, Inc. $24,750Freeman-Thomas Early Education Consulting, LLC $23,520Ability Network Inc. $23,400Elisa Urbano $23,400Digicert, Inc. $22,325Elliot Scott $22,000ABMS Solutions, LLC $21,422Elizabeth Barnett $21,000Rebecca E. Lynch $20,800Costas Healthcare Solutions, LLC $20,700Mercer US Inc. $20,675Lee Hecht Harrison LLC $20,600California Medical Association $20,400NAVEX Global, Inc. $19,903iXerv Americas Inc $19,500Prevalent, Inc. $19,276GM Voices, Inc. $18,530City of El Monte $18,040Acts93, Inc. $17,910Watts Healthcare Corporation $17,290Meltwater News US Inc. $17,000Trinity Harvest $17,000Synopsys Inc. $16,500One Love Food Ministry $16,400Mayra Selene Sosa $15,750Articulate Global, Inc. $15,734Orchid Interpreting, Inc. $15,450Emin Adjemian $15,333International Business Machines Corporation $15,330Peoples Yoga $15,200Footage Firm, Inc $14,700Blackbaud, Inc. $14,580ISC Electronic Systems, Inc $14,512MEND- Meet Each Need with Dignity $14,500Pitney Bowes Inc. $14,474

244




Lakeshore Equipment Company $14,444Playcore Wisconsin, Inc. $13,231ComponentSource, Inc. $12,555Young Men's Christian Association of Metropolitan Los Angele $12,075Dual Immersion Foundation $12,000Dewey Pest Control $11,802Zena B. Meeks $11,120Comcast Holdings Corporation $10,460Muir-Chase Plumbing Co., Inc. $10,346Change Healthcare Solutions LLC $10,000PhotoShelter, Inc. $9,999Netscout Systems Inc. $9,898Plunet Inc $9,425Blue Ribbon Technologies, LLC $9,360Melissa Data Corporation $9,300America's Health Insurance Plans, Inc. $9,100McAfee Finance 2, LLC $9,000ISI Telemanagement Solutions, LLC $8,400Angela P. Ahmu $8,320Epidemic Sound US Inc $8,280Getty Images (US), Inc. $8,200Urban Voices Project $8,060Christopher Lopez $8,000Sage Software, Inc. $7,748Gallagher Benefit Services, Inc $7,500Alberto Arciniega $7,200Liberty Utilities (Park Water) Corp $7,200Worksite Wellness LA $7,200GOANIMATE, INC. $7,197Direct Technology Group, Inc. $6,800Bootstrap Software Partners, LLC $6,684Omar Sanchez Barreras $6,310Angelica Boelen $6,240Western Office Interiors $6,105RLG Enterprises, Inc $5,932EPI-USE Labs, LLC. $5,742Zoll Medical Corp $5,694Budget Holdings Inc. $5,550Michael Moldofsky $5,301American National Red Cross - CCB $5,000Martin Scholl Consulting, Inc. $4,900LMD Holdings, LTD. $4,320The Positive Results Corporation $4,200Western University of Health Sciences $4,020I.D. Systems & Supplies, Inc. $4,000Singleton Fire Protection, Inc. $4,000Datawatch Corporation $3,990BrandFuse, inc. $3,825Smartsheet.com, Inc. $3,600Metalcraft, Inc $3,056

245




Horizon DataSys Corporation $2,900Your Glass Connection, Inc. $2,505Poll Everywhere, Inc. $1,997FRASCO, Inc $1,500SK Global Software, LLC $1,428Paradise Signs, Inc. $1,400Social Chow Media Group LLC $1,200ADT US Holdings, Inc. $500Lawrence Roll Up Doors, Inc. $468American Registry for Internet Numbers, LTD $450Training Connection LLC $350Aahs Enterprises Inc. $80

Grand Total $121,823,153

246

Amended Vendor ContractsVendor Name Current Contract Total Amendment New Contract Total Term Date

Cognizant TriZetto Software Group, Inc. $44,863,569 -$26,400 $44,837,169 09/30/27C3/Customer Contact Channels, Inc $21,000,000 $4,500,000 $25,500,000 03/31/22C3/Customer Contact Channels, Inc $18,000,000 $3,000,000 $21,000,000 09/30/21Scout Exchange LLC $5,000,000 $6,100,000 $11,100,000 05/12/22Toney HealthCare Consulting, LLC $5,800,000 $4,532,000 $10,332,000 12/31/21Edifecs, Inc. $5,492,721 $772,190 $6,264,911 08/22/22Edifecs, Inc. $4,392,660 $1,100,061 $5,492,721 08/09/21OptumInsight, Inc. $5,200,000 -$80,500 $5,119,500 05/17/22Cognizant Technology Solutions U.S. Corporation $3,580,000 $540,000 $4,120,000 09/30/21Infosys Limited $3,018,384 $780,586 $3,798,970 09/30/21Cognizant Technology Solutions U.S. Corporation $3,175,000 $405,000 $3,580,000 09/30/21OptumInsight, Inc. $3,411,300 -$99,415 $3,311,885 12/28/22Infosys Limited $2,243,384 $775,000 $3,018,384 09/30/21Cognizant Technology Solutions U.S. Corporation $2,183,000 $735,000 $2,918,000 09/30/21Imagenet LLC $2,100,000 $500,000 $2,600,000 06/30/22Westfall Commercial Furniture $1,575,000 $1,000,000 $2,575,000 12/31/23Infosys Limited $1,461,384 $782,000 $2,243,384 09/30/21Cognizant Technology Solutions U.S. Corporation (separate contract) $1,208,000 $975,000 $2,183,000 03/31/21Change Healthcare Resources Holdings Inc. $892,000 $1,108,000 $2,000,000 05/31/22FirstSource Group USA Inc $1,625,000 $200,000 $1,825,000 09/30/21Language Line Services, Inc. $1,650,000 $125,000 $1,775,000 03/31/22Cognizant Technology Solutions U.S. Corporation $727,803 $949,751 $1,677,554 12/31/22HCL America Inc. $1,062,663 $317,000 $1,379,663 09/30/21Solugenix Corporation $1,038,301 $200,000 $1,238,301 03/31/22O'Neil Digital Solutions LLC $1,000,000 $150,000 $1,150,000 06/30/22Solugenix Corporation $930,067 $108,763 $1,038,830 09/30/21Lorenzo Campos $904,835 $83,671 $988,505 12/31/21North Star Alliances, LLC $875,000 $100,000 $975,000 09/30/21Lorenzo Campos $817,889 $86,944 $904,833 12/31/21Change Healthcare Resources Holdings Inc. $450,000 $442,000 $892,000 05/31/22North Star Alliances, LLC $825,000 $50,000 $875,000 09/30/21Infosys Limited $702,540 $149,955 $852,495 12/31/21Toney HealthCare Consulting, LLC $705,000 $143,925 $848,925 09/30/21Equian, LLC $455,400 $276,000 $731,400 04/22/21Quest Analytics LLC $687,385 $37,916 $725,301 12/31/21Quest Analytics LLC $413,261 $274,124 $687,385 12/31/21Infosys Limited (separate contract) $450,720 $170,490 $621,210 04/30/21Miller Geer & Associates, Inc. $298,000 $298,000 $596,000 02/28/23Edifecs, Inc. (separate contract) $693,250 -$175,000 $518,250 07/23/21AEGIS.net, Inc. $374,500 $105,000 $479,500 09/30/21Toney HealthCare Consulting, LLC $342,000 $112,832 $454,832 09/30/21Toney HealthCare Consulting, LLC $550,000 -$150,077 $399,923 09/30/21UptoDate, Inc. $195,572 $157,145 $352,717 10/14/26Cogent Communications, Inc. $283,500 $40,200 $323,700 09/17/24NexTec Operating Corp. $200,000 $100,000 $300,000 03/01/23Multnomah Group, Inc. $180,000 $108,000 $288,000 12/31/23WTI Holdings LLC $236,000 $47,520 $283,520 06/30/23UptoDate, Inc. $44,335 $97,019 $141,354 02/28/24Ex Novo, Inc $119,719 $12,186 $131,905 09/30/21Leavitt Partners, LLC $93,600 $31,200 $124,800 12/31/21Young Electric Sign Company $99,384 $10,800 $110,184 07/31/22Scott Ash $59,500 $50,000 $109,500 10/31/21WEX Health, Inc. $103,350 $2,500 $105,850 12/31/21Therma Holdings, LLC $80,420 $6,800 $87,220 10/31/21Seelig + Cussigh HCO LLC $46,631 $35,000 $81,631 10/31/21Cognizant TriZetto Software Group, Inc. $7,500 $42,500 $50,000 05/03/22UptoDate, Inc. $43,815 $521 $44,335 02/28/21Jennifer Baez $32,240 $5,115 $37,355 02/28/22FEAST $8,880 $27,840 $36,720 08/31/22Council for Affordable Quality Healthcare, Inc. $21,800 $11,000 $32,800 04/22/22NetFile, Inc. $15,000 $15,000 $30,000 01/11/24Dianne Marie V. Roquia $15,000 $10,000 $25,000 10/31/21LMD Holdings, LTD. $0 $4,320 $4,320 12/31/23Acquia, Inc $0 Term Only No Change 08/29/24Advanced Medical Reviews LLC $49,000 Term Only No Change 12/31/21Advize Health LLC $245,000 Term Only No Change 12/31/21Alejandra Martinez $0 Scope Only No Change 04/30/21Alejandra Martinez (PA) $0 Term Only No Change 04/30/23



247




ALTA Language Services, Inc. $0 Term Only No Change 05/01/22ALTA Language Services, Inc. $51,920 Price change No Change 05/01/22American Partners Insurance Mkt. Inc. $0 Term Only No Change 12/31/23Angie Gomez $36,540 Scope Only No Change 03/31/22Antelope Valley Partners for Health $26,320 Scope Only No Change 08/31/21Aon Consulting, Inc. $0 scope and Term Only No Change 12/31/22APLA Health & Wellness $175,000 Term Only No Change 03/15/22Asian Pacific Health Care Venture, Inc. $70,000 Term Only No Change 09/15/21Brenda Sandoval $21,400 Scope Only No Change 08/31/21Brent Powell $32,000 Scope Only No Change 12/31/21C3/Customer Contact Channels, Inc $0 Scope Only No Change 09/30/21California State University, Long Beach Research Foundation $70,000 Term Only No Change 10/01/21CBRE Group, Inc. $100,000 Term Only No Change 12/31/23CenturyLink Communications, LLC $76,645 Scope Only No Change 12/15/22Change Healthcare Solutions LLC $8,080,000 Scope Only No Change 06/29/25Citywide Transportation, Inc. $250,000 Term Only No Change 12/31/21Clango, Inc. $36,000 Term Only No Change 12/31/21Cognizant Technology Solutions U.S. Corporation $0 scope and Term Only No Change 12/31/23Cognizant TriZetto Software Group, Inc. $44,863,569 Scope Only No Change 09/30/21Community Health Alliance of Pasadena $125,000 Term Only No Change 04/01/22Corporate Translation Services, Inc. $440,000 Term Only No Change 02/28/22County of Los Angeles Department of Mental Health $0 term and scope No Change 08/31/22Debra R. White $23,400 Scope Only No Change 05/31/22Dickerson Employee Benefits, an Alera Group Agency, LLC (EAA) $0 Scope Only No Change 12/31/23Edmund Jung & Associates, Inc. $732,000 Term Only No Change 12/31/21Ex Novo, Inc $115,550 Term Only No Change 09/30/21Ex Novo, Inc $92,975 Term Only No Change 07/31/21Ex Novo, Inc (separate contract) $0 Term Only No Change 12/31/22FanelliPM $59,400 Term Only No Change 07/31/21FanelliPM $55,700 Term Only No Change 08/31/21FEAST $36,720 Scope Only No Change 08/31/22Garfield Health Center $125,000 Term Only No Change 09/01/22Golden Outlook Inc. (GAA) $0 Scope Only No Change 12/31/23Gomez Research Inc. $84,000 Term Only No Change 03/31/21Gomez Research Inc. $0 Scope Only No Change 02/28/23Gomez Research Inc. (separate contract) $33,400 Term Only No Change 03/31/21Health Management Associates Inc. $921,500 Term Only No Change 09/30/21Health Management Associates Inc. $54,766 Term Only No Change 09/30/21

Health Management Systems, Inc. $22,000,000Price change (rate

reduction) No Change 12/31/23Healthy Cooking LLC $29,920 Scope Only No Change 08/31/21human-I-T $0 Term Only No Change 06/16/23Imagenet LLC $1,400,000 scope and Term Only No Change 09/30/21Imagenet LLC $0 Term Only No Change 06/30/22Imagenet LLC (MSA) $0 Scope Only No Change 08/15/23Interior Office Solutions (LOS ANG) LP $3,872,000 Scope Only No Change 12/31/23JAR Insurance Services LLC (EAA) $0 Scope Only No Change 12/31/23JAR Insurance Services LLC (GAA) $0 Scope Only No Change 12/31/23Jennifer Baez $33,280 Scope Only No Change 11/30/22Jennifer Baez $32,240 Scope Only No Change 02/28/22Karen Escalante-Dalton $25,000 Term Only No Change 09/30/21KCAL Health Insurance Services (EAA) $0 Scope Only No Change 12/31/23Kimberley Carruthers $15,600 Scope Only No Change 11/30/21Klyre Payments, LLC $500,000 Term Only No Change 07/01/21Klyre Payments, LLC (separate contract) $0 Scope Only No Change 01/19/23LAC+USC Medical Center Foundation, Inc. $150,000 Term Only No Change 12/15/21Laura Roman Cadena $18,880 Scope Only No Change 05/31/21LexisNexis Risk Solutions FL Inc $77,750 Scope Only No Change 03/31/21LexisNexis Risk Solutions FL Inc $36,000 Term Only No Change 06/30/24LexisNexis Risk Solutions FL Inc $36,000 Term Only No Change 06/30/24Managed Healthcare Unlimited, Inc. $0 Scope Only No Change 08/31/23Mayra Selene Sosa $15,750 Scope Only No Change 11/30/21MG Dance Foundation $63,600 Scope Only No Change 11/30/21Mount Saint Mary's University-Los Angeles $0 Term Only No Change 07/01/24NetCentric Technologies Incorporated (MSA) $0 Term Only No Change 12/31/23New England Asset Management, Inc. $3,000,000 Price Change (rate change) No Change Until TerminatedNexTec Operating Corp. $3,280 Term Only No Change 07/01/21North Los Angeles County Regional Center, Inc. $0 Term Only No Change 06/30/22NTT America Solutions, Inc. $82,917 Term Only No Change 09/30/21

248




OptumInsight, Inc. $210,000 Term Only No Change 12/31/20OptumInsight, Inc. $7,000,000 Scope Only No Change 09/27/23OptumInsight, Inc. $500,000 Term Only No Change 12/26/24Orchid Interpreting, Inc. $15,000 Scope Only No Change 09/30/21Pacific Health Consulting Group $739,600 Term Only No Change 07/01/22Pacific Health Consulting Group $0 Term Only No Change 07/01/22Partners In Care Foundation Inc. (PA) $0 Scope Only No Change 07/31/21

Payden & Rygel $18,000,000Price Change (rate

reduction) No Change 10/31/22PaySpan, Inc $1,875,000 Scope Only No Change 12/31/23Rebecca E. Lynch $67,600 Scope Only No Change 03/31/22Rebecca E. Lynch $26,000 Scope Only No Change 08/31/21Resources Connection Inc. $405,000 Term Only No Change 12/31/21Ricky L. Davis $17,930 Scope Only No Change 07/31/21Ricky L. Davis $10,400 Scope Only No Change 03/31/22RightStar, Inc. $51,400 Term Only No Change 12/31/21Robert M. Taylor, Jr. $15,600 Scope Only No Change 06/30/21Robert M. Taylor, Jr. $33,280 Scope Only No Change 10/31/21Sarla Karan $200,000 Term Only No Change 10/31/21SHI International Corp $0 Term Only No Change 05/31/24Sierra Pacific Constructors, Inc. $2,785,972 Term Only No Change 09/30/21Sonia P. Guzman $77,440 Scope Only No Change 03/31/22Sonia P. Guzman $96,400 Scope Only No Change 08/31/21Sonia P. Guzman $77,440 Scope Only No Change 03/31/22SunGard Availability Services LP $993,751 Scope Only No Change 10/31/22The Center to Promote Healthcare Access Inc. $0 Scope Only No Change 08/01/25The Los Angeles Free Clinic $125,000 Term Only No Change 01/01/23Toney HealthCare Consulting, LLC (separate contract) $0 Scope Only No Change 12/31/21University of Southern California $0 Term Only No Change 01/31/24University of Southern California $0 Term Only No Change 06/29/24UNUM Life Insurance Company of America $50,000 Term Only No Change 12/31/21Urban Voices Project $18,060 Term Only No Change 12/31/21Valley Community Healthcare $125,000 Term Only No Change 04/01/22Wakely Consulting Group, LLC $0 Term Only No Change 11/30/21Wakely Consulting Group, LLC $0 Term Only No Change 08/31/24WebChuck Development, LLC $11,160 Term Only No Change 12/31/21Westside Family Health Center $50,000 Term Only No Change 06/15/22Woodruff-Sawyer & Co. $0 Term Only No Change 09/30/22

Total* $186,330,742*Total include totals from contracts that have been amended multiple times over FY.

249

Vendor Selection - Sole Source

Vendor Name Contract TotalPaid As Of Oct 1,

2021Vendor

SelectionGita Murthy 750,000$ 41,667$ Sole Source

L.A. Care Health PlanAFS-007 Authorization and Approval Limits Quarterly Report

July 2021 - September 2021

250

Vendor Selection - Sole Source

Vendor Name Contract TotalPaid As Of 10/01/21

Vendor Selection

California Coverage and Health Initiatives $977,564 416,454$ Sole SourceHealth Career Connection $800,000 283,200$ Sole SourceGita Murthy $750,000 41,667$ Sole SourceAEGIS.net, Inc. $394,500 449,510$ Sole SourceWTI Holdings LLC $283,520 84,179$ Sole Source

L.A. Care Health PlanAFS-007 Authorization and Approval Limits Quarterly Report


251

APPROVED

BOARD OF GOVERNORS Finance & Budget Committee Meeting Minutes – October 25, 2021 1055 W. 7th Street, Los Angeles, CA 90017

Members Management/Staff Robert H. Curry, Chairperson * John Baackes, Chief Executive Officer Stephanie Booth, MD Terry Brown, Chief Human Resources Officer Hector De La Torre Linda Greenfeld, Chief Product Officer Hilda Perez Augustavia J. Haydel, Esq., General Counsel G. Michael Roybal, MD Tom MacDougall, Chief Information & Technology Officer Marie Montgomery, Chief Financial Officer Francisco Oaxaca, Chief of Communications & Community Relations Noah Paley, Chief of Staff *Absent ** Via Teleconference Acacia Reed, Chief Operating Officer Richard Seidman, MD, MPH, Chief Medical Officer

State and local officials continue to impose or recommend measures to promote social distancing to reduce transmission of the COVID 19 virus. It is prudent to use caution in protecting the health of the public, L.A. Care’s employees and its members where adequate virtual means exist to permit the

meeting to occur by teleconference/videoconference with the public being afforded the ability to comment in real time. The Board of Governors and all legislative bodies of the L.A. Care Health Plan, and the Board of Directors and all legislative bodies of the Joint Powers Authority will continue to meet

virtually and the Boards will review that decision on an on-going basis as provided in the Brown Act. Members of the public had the opportunity to listen to the meeting via teleconference, and share their comments via voicemail, email, or text.



ACTION TAKEN

CALL TO ORDER

Hector De La Torre, Chairperson, Board of Governors, called the L.A. Care and JPA Finance & Budget Committee meetings to order at 1:01 p.m. He welcomed everyone and summarized the process for public comment during this meeting.

Board Meetings are conducted electronically so that everyone participating can be safe and practice social distancing.

Comments from anyone who would like to address the Board and its committees are welcome and there are instructions on the Agenda.

L.A. Care members need us to continue the work of the Board, and the meetings are run so that members of the public can hear the meeting and can participate by submitting comments.

Staff sends all comments received before the meeting to the Board members in writing.

252

Finance and Budget Committee Meeting Minutes October 25, 2021, Page 2 of 8

APPROVED



ACTION TAKEN

All public comment is included in the minutes of the meeting, and any comments received that were not read during the meeting are added at the end of the minutes.

Submitters of public comment must identify the Agenda item which the comment is addressing. If the submitter does not identify an agenda item for the comment to be read, the submitter’s comment will be read for three minutes at the “Public Comment” item.

At the appropriate item on the Agenda, staff will read for three minutes the public comment from each submitter. Depending on how many comments are submitted, the three-minute time could be adjusted to allow for more submitters to have their comments read.

The Board will continue reviewing and improving how public comments are received and distributed to Board members.


The Agenda for today’s meeting was approved.

Approved unanimously by roll call. 3 AYES (Booth, De La Torre and Roybal)

APPROVE CONSENT AGENDA

The Committee approved Consent Agenda items:

September 27, 2021 meeting minutes Board Member Booth amended her comments on page 3 of the September 27, 2021 meeting minutes to read: “She understands that things have to go on and noted that the Board understands circumstances change. Project leaders have technology that can inform them of a potential budget overrun. Board Member Booth said everyone should request funds as early as possible. However, if it becomes necessary for a request for funds motion to include money that has already been paid out, she hopes the requester could clarify the motion’s plans for expenditure by a separate accounting of that payment amount; and state the reason(s) it became a necessary expense.”

The meeting minutes of September 27, 2021 were approved as amended. The signed September 27, 2021 meeting minutes include the amended language.

Quest Analytics Motion FIN A.1021


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ACTION TAKEN

To authorize staff to amend a contract with Quest Analytics that will extend the term by three years to December 31, 2024, and increase the total compensation from $728,786.54 to $1,776,985.54.

PUBLIC COMMENTS There were no public comments.


There was no report from the Chairperson.

CHIEF EXECUTIVE OFFICER’S REPORT

There was no report from the CEO.

COMMITTEE ITEMS

Chief Financial Officer’s Report

Marie Montgomery, Chief Financial Officer, reported that October 1 is the beginning of the fiscal year so a written monthly financial report is not included in the meeting materials. The unaudited written September 2021 and 2021-2022 Fiscal Year End financial reports will be presented at the November 15 Committee meeting.

Approve Accounting & Finance Services Revised Policies

Policy AFS-008 (Annual Investment Review)

Policy AFS-027 (Travel Expenses)

L.A. Care’s Accounting & Financial Services policies are brought to the Board annually for update, review and approval. She summarized the updates to AFS 008 Annual Investments and AFS 027 Travel Expenses.

AFS 008 Annual Investments

Aligns requirements for investments to the California Government Code and directs Board to provide oversight.

Increases the percentage ownership limit of the overall portfolio of the total bonds from a single issuer for Commercial Paper, Corporates, Supranational Obligations, but still well below the limit allowed by the California Government Code.

Allows for negative interest rate on U.S. Government securities as per California Government Code.

Updated to reflect Securities & Exchange Commission (SEC) Rule 144A expanded definition of accredited investor to include government entities, which allows L.A. Care to buy Rule 144A securities.

AFS 027 Travel Expenses

Defines approvals and appropriate expenses related to travel.

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ACTION TAKEN

Updated with reference to the new telecommuting policy HR-220 in the References section as well as section 4.5 “Pre-employment and Telecommuting Travel”.

Motion FIN 100.1121 To approve the following Accounting & Financial Services Policies as attached:

AFS-008 (Annual Investments)

AFS-027 (Travel Expenses)


Wilshire Associates presentation by Maggie W. Ralbovsky, CFA, Managing Director

Ms. Montgomery introduced Maggie W. Ralbovsky, CFA, Managing Director, Wilshire Associates

Ms. Ralbovsky provided a current market overview and performance summary. (A copy of her report may be requested by contacting Board Services.)

There are concerns about inflation, which could affect investment returns.

Interest rates are slowly rising with increasing expectations of inflation trending higher. The market pricing currently assumes a transitory surge of near-term inflation that will gradually retreat and a long term trend level between 2-2.5% is expected for the next 10 years.

The root cause of inflation is assumed to be record high demand outpacing healthy recovery of supply. The market may be too complacent and inflation may not be transitory. Supplemental Security Income recipients will receive a 4.5% increase in benefits next year. Prices of gasoline are up 100% and natural gas up 150%.

Allocation Fiscal Year

3 Year

Annualized

Since 7/1/2016

Annualized

Payden & Rygel

Liquidity Portfolio $1,360,886,939 0.13% 1.25% 1.23%

Low Duration Portfolio $93,797,830 0.07% 3.30% 2.12%

Local Agency Investment Fund $72,827,825 0.41% 1.71% 1.71%

LA County Treasurers Pooled Investment Fund $252,869,688 0.50% 1.30% 1.30%

Bank of California CD $100,000 0.37% 0.95% 0.92%

New England Asset Management

Government and Corporate Debt $338,950,990 0.45% 4.06% 3.30%

Total Portfolio $2,119,433,272 0.27% 1.94% 1.80%

Benchmark 91 Day Treasury Bill 0.07% 1.18% 1.11%

Performance Summary as of 9/30/2021

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ACTION TAKEN

Cost Side Inflation Pressure

Transitory

Extreme Pent-Up Demand

Supply Chain Disruption

Labor Force Participation o Off the Dole o Back to School

Economics 101: Supply will increase to meet demand

Not Transitory

Government Intervention

De-Globalization/Protectionism

“Super Trends” o Infrastructure Investment o Energy Transition o ESG/Data Protection

There are some people stating that because the pandemic closed factories there is a supply shortage. But data shows this is not the case. The supply has completely recovered, and demand has gone up because consumers are flush with savings. Savings increased to 15% during the pandemic because consumers had no place to spend.

(Board Member Perez joined the meeting)

Investment Strategy Outlook

Investment policy is focused on high quality fixed income investments with 1-5 year in maturity.

Floating rate debt may help cushion short-end rate volatility, the short end is controlled by the Federal Reserve Bank.

Relatively healthy corporate and consumer balance sheet supports overweight into non-Treasury “spread” sectors.

Approve Ntooitive Contract

John Cota, Senior Director, Creative & Marketing, presented a motion to authorize a contract with Ntooitive for FY 2021-22 in the amount of $7,346,802 for work associated with digital marketing and media buying services among L.A. Care’s entire portfolio of products and services including

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ACTION TAKEN

L.A. Care Covered, Cal MediConnect, Medi-Cal, Family Resource Centers, Community Resource Centers and L.A. Care’s Brand Marketing Initiatives.

Motion FIN 101.1121 To authorize staff to execute a new statement of work with Ntooitive in the amount of $7,346,802.00 for marketing campaigns for L.A. Care’s direct lines of business, including the LACC Shop and Compare Tool, and the Community Resource Centers for the period of October 1, 2021 through September 30, 2022.

Approved unanimously by roll call. 4 AYES (Booth, De La Torre, Perez and Roybal)

Approve Change Healthcare Resources Contract Amendment

On behalf of Thomas Mapp, Chief Compliance Officer Augustavia J. Haydel, Esq. General Counsel, presented a motion requesting approval to amend the contract with Change Healthcare Resources, LLC, from June 17, 2021 to May 31, 2022 up to an amount not to exceed $4,100,000 (previously 2,000,000). The vendor will provide services around staff augmentation for the Appeals & Grievances department. L.A. Care requires these services because the current number of cases exceeds the availability of full time employees.

Motion FIN 102.1121 To authorize staff to amend a contract authorizing the expenditure of up to $4,100,000 with Change Healthcare Resources, LLC to provide Appeals and Grievances staff augmentation services from June 17, 2021 to May 31, 2022.


Approve Claris Health Contract Amendment

Acacia Reed, Chief Operations Officer, presented a motion requesting approval to amend the contract with Claris Health for Scopes of Work (SOW) #2 (workflow management and data distribution), SOW #4 (analytics module recoveries), and SOW #6 (clinical analytics module, and medical record review/management services) to increase the contract amount by $2.52 million, $1.99 million, and $2.08 million respectively and extend the term through December 31, 2024. The vendor provides services with Centralized Overpayment Repository application for workflow management, data distribution, analytics modules to support L.A. Care data mining services as well as a clinical audit workflow with an analytics module, workflow management, medical records management and review. These services are required to detect, investigate and prevent fraud, waste and abuse. The Payment Integrity team ensures that federal and state taxpayer dollars are spent appropriately on delivering quality, necessary care and in preventing fraud, waste and abuse.

L.A. Care has been contracted with this vendor since November 2017 and staff members are pleased with their work. Claris currently generates approximately $45 million in recoveries annually. No request for proposal was conducted for this vendor because of the existing contract. The sole-source justification would mitigate time, resources and initiation fees to

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ACTION TAKEN

procure and implement a new vendor. There is no commercial product available on the market for these services.

The projected recovery is approximately $220 million from July 2021 through December 2024 based on the current savings. The incremental monthly savings derive from the continued growth of the Retrospective Clinical Review Program and continuing to expand our current library of overpayment edits. Based on the associated fixed fees, licensing fees and contingency fees, $6.59 million will be the cost of the new contract.

Motion FIN 103.1121 To authorize staff to amend the contracts for three (3) Scope of Works (SOWs) in the amount of $6,587,057 (for a new total of $10,474,974 for all three SOWs) with Claris Health to provide workflow management, data distribution, analytics modules to support L.A. Care data mining services as well as a clinical audit workflow to include an analytics module, workflow management, medical records management and review through December 31, 2024.



The Joint Powers Authority Finance & Budget Committee meeting was adjourned at 1:36 p.m.

Augustavia J. Haydel, Esq., General Counsel, announced the items that the Committee will discuss in closed session. There was no public comment on the Closed Session items, and the meeting adjourned to closed session at 1:37 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: October 2023

CONFERENCE WITH REAL PROPERTY NEGOTIATORS Section 54956.8 of the Ralph M. Brown Act Property: 2140 E. Palmdale Blvd., Palmdale, California Agency Negotiator: John Baackes, Chief Executive Officer Negotiating Parties: Eric Treibatch, Ophir Management Services Inc.

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ACTION TAKEN

Landlord: Joelle Kim, Palmdale West, LLC, 8560 W. Sunset Bl. # 538, W. Hollywood, CA. 90069 Under Negotiation: Price and Terms of Payment


The meeting reconvened in open session at 1:53 pm

Ms. Haydel advised the public that no reportable actions were taken during the closed session.

ADJOURNMENT The next meeting will be held on November 15, 2021.

The meeting was adjourned at 1:54 pm

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, Board Chairperson Date Signed ________________________________

11/15/2021 | 3:09 PM PST

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APPROVED

BOARD OF GOVERNORS Compliance & Quality Committee Meeting Meeting Minutes – August 19, 2021 L.A. Care Health Plan CR 100, 1055 W. Seventh Street, Los Angeles, CA 90017

Members Senior Management Stephanie Booth, MD, Chairperson Augustavia J. Haydel, General Counsel Al Ballesteros, MBA Thomas Mapp, Chief Compliance Officer Hilda Perez Katrina Miller Parrish, MD, FAAFP, Chief Quality and Information Executive Ilan Shapiro, MD, FAAP Nina Vaccaro

Thomas Mendez, Director, Quality Performance Informatics, Quality Performance Management Cagla Ozden, Senior Director, Operational Assurance

Margaret Ngo-Lee, Senior Director, Risk Management and Operations Support, Compliance

* Absent ** Present, but doesn’t count towards quorum





CALL TO ORDER

Stephanie Booth, MD, Committee Chairperson, opened the meeting without a quorum, and a quorum was subsequently reached.

Chairperson Booth called the meeting to order for the L.A. Care Compliance & Quality Committee and the L.A. Care Joint Powers Authority Compliance & Quality Committee at 2:06 p.m.

She announced that members of the public may address the Committee on each matter listed on the agenda before the Committee’s consideration of the item by submitting their comments via text, voicemail, or email.


The Meeting Agenda was approved as submitted.

Approved unanimously by roll call. 3 AYES (Ballesteros, Booth, Vaccaro)

260

Compliance & Quality Committee


APPROVED



PUBLIC COMMENT

Submitted via text received on August 17, 2021 at 1:38 p.m. by sender not self-identified

Aug 19, 2021 meeting compliance general comment , a doctor on LA Cares board publicly discussed my adult autistic daughter Vanessa at an ECAC meeting in Nov of 2015 claiming my grievances were resolved and handled properly when in truth LA Care would not respond to my repeated requests for assistance for my daughter Vanessa Navarro and defended Synermed and retaliated because of our accurate accounts of their abuses. My daughter died less than a month after this Nov meeting . I have told LA Care to self report this abuse of my child’s rights and my rights to advocate for her and my not being notified of her being discussed at this ECAC meeting , I told LA Care I want this public record violating our privacy removed and I want written notice of this removal and LA Cares self reporting to the state privacy officer ! Submitted via text received August 19, 2021 at 10:44 a.m. by sender not self-identified

General comment for 8-19-2021 compliance meeting AND 9–2-2021 board meeting. LA Care publicly displays claims of assisting our adult autistic daughter Vanessa Navarro (I am her father) when in truth they defended Synermed and their dishonest doctors and would not return our phone calls and then claimed they assisted us at a public meeting publicaly mentioning my wife and daughter! We approached the LA Care board for help and instead got no notification to us our daughter would be publicly discussed by a board member at a public ECAC meeting violating our right to due process ! We obtained these records as proof. Now LA Care is not honoring our request that this record of our daughter being discussed without our knowledge or consent be removed from public view! (This comment is the same comment received at 10:44 but is from a different submitter, so it was read as a separate public comment) Submitted via text received August 19, 2021 at 10:55 a.m. by sender not self-identified

General comment for 8-19-2021 compliance meeting AND 9–2-2021 board meeting. LA Care publicly displays claims of assisting our adult autistic daughter Vanessa Navarro (I am her father) when in truth they defended Synermed and their dishonest doctors and would not return our phone calls and then claimed they assisted us at a public meeting publicaly mentioning my wife and daughter! We approached the LA Care board for help and instead got no notification to us our daughter would be publicly discussed by a board member at a public ECAC meeting violating our right to due process ! We obtained these records as proof. Now LA Care is not honoring our request that this record of our daughter being discussed without our knowledge or consent be removed from public view!

Chairperson Booth advised that the submitter of comments could reach out to member services to get assistance with these issues.

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APPROVED



APPROVAL OF MEETING MINUTES

(Board Members Hilda Perez and Ilan Shapiro, MD, joined the meeting).

The May 20, 2021 meeting minutes were approved as submitted.

Approved unanimously by roll call. 5 AYES (Ballesteros, Booth, Perez, Shapiro and Vaccaro)

CHAIRPERSON REPORT

There was no Chairperson’s report.



Richard Seidman, MD, MPH, Chief Medical Officer, reported: (a copy of his written report can be obtained from Board Services).

He noted that since he submitted the Chief Medical Officer report 8 days ago, the numbers have changed. COVID-19 cases have dropped from a 6.5% positivity rate down to 4%. The hospitalization rate is a more sensitive measure. People need to be sick enough to be in the hospital in order for those cases to be counted. At least 1,800 cases were reported in Los Angeles County hospitals, the rate was previously below 200 cases. Hospitalization and death rates lag behind case rates. Deaths are down to single digits per day, and yesterday there were about 30 deaths reported.

COVID-19 Update After encouraging trends before the run up to the June 15 broad reopening in California, there are increasing trends worldwide with over 200 million reported cases of COVID-19 and over 4.2 million deaths. With the combination of lagging vaccination numbers and the rapid emergence and spread of the delta variant, COVID-19 numbers are increasing nationwide as well, now reaching over 100,000 cases per day, most notably in the southern states with low vaccination rates. Los Angeles County is reporting increases in the number of cases, hospitalizations and deaths over the past 4-6 weeks, with hospitalizations still at lower rates than during the fall and winter surge, but doubling in the past two weeks to over 1,400 per day. Notably, the current surge is impacting adults under 50 at higher rates than other age cohorts, and impacting African Americans at the highest rates compared to other race/ethnic groups. The vast majority of cases are for the unvaccinated and the data continues to demonstrate the safety and efficacy of the COVID-19 vaccines, particularly in preventing serious disease and death.

Among L.A. Care members, there have been over 140,000 cases and 4,200 deaths reported since the beginning of the pandemic. Despite reporting over 950,000 L.A. Care members having received at least one dose, vaccination rates among our members are below countywide rates, consistent with what other Local Initiative Health Plans are

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reporting across the State. The California Department of Health Care Services (DHCS) announced a new program requiring health plans to submit a COVID-19 response plan to receive funding for member incentives to further encourage members to be vaccinated. L.A. Care is still learning the details of this just-announced program and will keep the Board Members informed.

COVID-19 outreach efforts by L.A. Care include the development of a robust communication plan and social media campaign. L.A. Care has mobilized its care teams and Community Health Workers, made live calls and robocalls to targeted member cohorts, shared information about the safety and efficacy of the vaccines. Information encouraging members to get vaccinated will be included in L.A. Care’s annual member mailing. L.A. Care has participated in many media requests and produced a series of L.A. Care Medical Director videos to address COVID-19 vaccination. The Communications department, in collaboration with Inland Empire Health Plan, developed a bilingual COVID-19 vaccination television and radio public service announcement campaign that will air during August. The campaign stars a well-known Hispanic actor, Jaime Camil. L.A. Care Communications also launched a separate celebrity COVID-19 vaccine billboard campaign in collaboration with the Leonard Nimoy Family Foundation and featuring the late Star Trek actor. L.A. Care is collaborating with the Los Angeles County Department of Public Health (DPH) and the California Medical Association to further expand the network of COVID-19 vaccine providers.

Board Member Shapiro asked Dr. Seidman if the recent surge in cases is changing people’s minds about the vaccine.

Chairperson Booth asked if there is a way to know who isn’t vaccinated and target certain areas. Dr. Seidman responded that L.A. Care has data that it receives from different sources. Almost one million L.A. Care members have gotten one dose, so L.A. Care has a significant number of members that are over 12 years of age that have gotten vaccinated.

Board Member Perez asked Dr. Seidman to explain more about further expanding vaccine efforts to home bound members. Dr. Seidman stated that there have been efforts at the State and County level to work closely with DPH to provide vaccinations to members that are home bound. Board Member Perez stated that in Mexico nurses go door to door in neighborhoods to administer the vaccine. John Baackes, Chief Executive Officer, said there was a program like that in the past. There were surveys taken to find those people and administer a vaccine.

Pharmacy Update The pharmacy team continues to develop and expand the Comprehensive Medication Management Program in affiliation with the USC School of Pharmacy, funded by the California Right Meds Collaborative. The program provides technical assistance and support to practices to identify and better manage members with poorly controlled diabetes, and has shown promising results in improving outcomes and reducing disparities in measures such as glycosylated hemoglobin (HgbA1c) and high blood pressure. The Clinical Pharmacy Program continues to provide an L.A. Care Pharmacist to partner with three different Federally Qualified Health Centers to date to provide care

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management services to members with Diabetes assigned to these clinics, resulting in notable reductions in A1c levels. Both programs include academic detailing to build capacity within our network to improve care and outcomes.

2020 HEDIS RESULTS

Thomas Mendez

Thomas Mendez, Director, Quality Performance Informatics, Quality Performance Management, gave a report on the 2020 HEDIS Results (A copy of the presentation can be obtained from Board Services.).

Medi-Cal Final MY2020 Rate Review Rate Review Overall Trends: Visit and Screening based measures trended behind in MY2020 from MY2019 final rate Pharmacy/Adherence measures performed better than last year, highlighting that members are getting and

following up with their medications. Telehealth Visits helped offset the drop in Office Visits.

o Next steps: continue to leverage Telehealth for HEDIS Measure Highlights: Comprehensive Diabetes Care (CDC A1C Testing): Rates Dropped (even on administrative eligible population

rates) and so did other lab related measures. In our Plan Partner debriefs we are focusing on pushing lab measures improvement.

Well-Care for Children & Adolescents: Became administration only measures (medical record review is no longer allowed). Two new measures now include all ages from 15 months up to 21 years. L.A. Care is unable to do a comparison for 16-30 months and 3-11 years old due to the measure changes. Quality Rating System Measures – L.A. Care Covered Declines: Annual Dental Visit – ~5% decrease. Low volume of dental visits can be attributed to Covid-19.

Antidepressant Medication Management – Slight decline in Continuation phase (0.30%) although the Acute phase increased slightly by ~2%.

Breast Cancer Screening – ~1% decrease. This decline is across all lines of business and screening measures (Breast, Cervical, Colon).

Chlamydia Screening in Women – ~1% decrease. This decline is across all lines of business with regards to lab measures.

Increases: Follow-Up After Hospitalization for Mental Illness (FUH) – ~5% increase for FUH 7 day follow up. This is

due to the concentrated efforts with BH department working closely with QPM. Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET) – ~10%

increase for the Initiation Phase. ~3% increase for the Continuation Phase.

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Proportion of Days Covered (PDC) – ~2-4% increase across different sub measures. This measure is trending similarly with adherence measures across all lines of business.

Appropriate Testing for Pharyngitis - ~2% increase. The increase is across all LOBs. Health Plan Rating Measures – Cal MediConnect Declines: Follow-Up After Hospitalization for Mental Illness – ~9% decrease for 30 day (FUH30) and ~2% decrease for

7 day (FUH7). FUH30 rates are below the 56% Quality Withhold benchmark. The team is currently doing root cause analysis to identify process improvement opportunities.

Pharmacotherapy Management of COPD Exacerbation – ~9% decrease for Bronchodilator and ~6% decrease

for Systemic Corticosteroids. This measure has a small denominator which can contribute to higher rate increases.

Breast Cancer Screening – Seeing declines across all lines of business with regards to screenings (Breast, Cervical, Colon).

Increases: Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET) – ~17%

increase for the Initiation Phase and ~4% increase for the Engagement Phase. The rate increase is attributed to new data source with big influx of data for substance abuse treatment. Team will continue monitoring to ensure that improvements are sustainable.

Statin Therapy for Patients with Cardiovascular Disease – ~4% increase for Statin Therapy and ~2% increase for Adherence portion. Both statin therapy and adherence highlights increase in rates year over year (YOY).

Statin Therapy for Patients with Diabetes – ~3% Increase for the Adherence sub measure. We’re seeing consistent increases in rates across Adherence based measures.

Antidepressant Medication Management – ~4% increase YOY for both Acute and Continuation Phases. This

trending highlights that members are receiving and following up with their medications.

Medical Record Review Summary

• This year’s Medical Record collection and abstraction was completed without using vendor staff which resulted in a cost savings compared to last year.

• Medical Record Review Validation passed both audits with 0 errors for the 3rd year in a row. Over the 3 years, 520 records passed with no issues.

• As expected, most of the hybrid rates for MY2020 are below last year’s rates. Of the 44 reportable Hybrid numerators, only 6 ended up above MY2019

Screening measures – Cervical Cancer Screening, Comprehensive Diabetes Care (CDC) A1c and A1c Control, CDC Eye Exams, Colorectal Cancer Screening are all significantly down for all Lines of Business

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Some of the measures are multi-year measures so rates will likely be affected for MY2021 and beyond For Controlling Blood Pressure and CDC Blood Pressure Control – nearly all visits from March to December

2020 were Telehealth visits with no Blood Pressure recorded. Weight Assessment and Counseling for Children and Adolescents – nearly all of the visits that qualified the

member for the measure were Telehealth sick visits with no Height and Weight documented and many with no Physical Activity and Nutrition Counseling.

Looking Ahead For Childhood Immunization Status (CIS) and Immunizations for Adolescents (IMA), the timeframes to get

vaccines have already passed and/or members need to catch up on vaccines. Prospective rates, especially for those measures will need to be closely monitored as there may be rate drops for MY2021. During Medical Record Review, we saw a number of members, especially those with birthdays late in the year that were missing their final doses of Dtap (Diphtheria, Tetanus, Pertussis) and PCV (Pneumococcal Conjugate Vaccine).

Telehealth visits appear to be here to stay. Provider Outreach will focus on education during Telehealth Visits, such as services that are allowed during the visits, member reported Blood Pressure readings, member/parent reported height and weight so Body Mass Index (BMI) percentiles can be calculated, providing well services during sick visits such as Counseling for Physical Activity and Nutrition, documenting history of services such as Pap Smears, Mammograms, Colonoscopies etc.

Abstraction staff is using Clinical to review records collected by Risk Adjustment (mainly CMC Annual Wellness Exams) for HEDIS gaps in care. So far approximately 700 records have been reviewed and 1,466 gaps will be closed. For MY2020 we closed 4,559 gaps.

Lead Screening for Children (LSC)

• DHCS is proposing adding the HEDIS LSC measure as an MCAS measure and not requiring custom reporting of members outside of the LSC Eligible population (members up to 6 years old). It is not yet clear when it will be added, and CAHP (California Association of Health Plans) is recommending that PIPs and sanctions be delayed until at least HEDIS MY2022 due to low rates due to COVID-19.

• Minimum Performance Level is based on the National 50th percentile, and fewer than 10% of California plans reached the 50th percentile in MY2020. LSC is a 2-year measure and the Eligible Population is the same as CIS

50th Percentile is 73.11%--L.A. Care’s final rate was 61.08% for MY2020 and 64.03% in MY2019 Rate drop due mainly to fewer in-person visits from March to Dec. 2020

Current Prospective rate as of July 19, 2021 is 49.35% which is 9.19% below the July 24, 2020 rate of 58.54%. LSC can be a Hybrid measure, however, typical improvements from medical record review are in the 2% to

5% range. If we choose to collect LSC hybrid, the sample would be for the same members as the CIS measure.

Focus should be Back to MY2019 baseline performance. Not "Improvement".

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Evaluating on-boarding new data sources strategically – better? bang for the buck. We have a quota with the auditor on how many supplemental sources to use. Exceeding the quota will result in additional fees.

MY2021 Process Improvement Tools: Non-Standard Workflow: Will accept nonstandard during the MY which will allow us to reflect the gaps and

close them more efficiently. The submitters can also prioritize ones that haven't been closed. Workflow steps have been drafted and implemented.

Submitter Impact Report: Will include accounting of their files, the impacts and if that matches to submitters’ expectations. This will help us monitor how the submitters are doing and to give them feedback accordingly.

Data Pre-Processing Report: The summarizing of these files will work in parallel to our current process and it will add insights so we can make adjustments and communicate any issues

Dr. Seidman noted that some data on disparities wasn’t included in this detailed report. The Quality Improvement annual report is about how L.A. Care is working to reduce disparities. He offered to provide information at a future meeting with details on disparities aligned with measures in HEDIS.

Chairperson Booth stated that it may be difficult to get data, but there are improvements likely over the years, not just over last year. It would be interesting to hear about disparity in healthcare.

CHIEF COMPLIANCE OFFICER REPORT Thomas Mapp

PUBLIC COMMENT Submitted via text received August 19, 2021 at 10:59 a.m. by sender not self-identified

Public comment agenda item chief compliance report, on LA Cares Yelp pg , which LA Care is obviously active on , especially flagging truthful reviews , John Baackes is listed as the “owner” of LA Care! He is not the owner , he’s a guy focused on selling “insurance “ , nothing wrong with selling a product as long as it’s a good product but stop listing him as “owning “ your agency ! Submitted via text received August 19, 2021 at 11:13 a.m. by sender not self-identified

add prior comment , stop having people on your payroll trolling Yelp and Facebook censoring public opinion just like you do at your meetings Thomas Mapp, Chief Compliance Officer, and the Compliance Department presented the Chief Compliance Officer Report (a copy of the report can be obtained from Board Services).

As L.A. Care moves into the 4th quarter of FY 2021, the compliance department is preparing to complete significant initiatives during the remainder of the year and prepare for 2022:

Annual compliance program effectiveness audit by an external auditor hired by L.A. Care as required by the

Centers for Medicare and Medicaid Services (CMS)

Annual compliance week and compliance training for all employees and members of the Board of Governors

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Complete internal evaluation of the compliance program and develop work plans for 2022 – Fraud Waste and

Abuse Program, Internal Audits, Compliance Work Plan; Risk Assessment

Preparation for annual Department of Managed Healthcare audit (January 2022)

Respond to (a) July 2021 DHCS Medical Audit; (b) January 2021 DHCS focused audit related to DHS and (c) other compliance requirements.

Regulatory Affairs Enterprise-Wide Monitoring Program

The following Monitoring Program measures were implemented in Q1 – Q2 2021.

• Initial Health Assessment

• California Children’s Services

• Sales & Marketing (Cal MediConnect only)

Compliance department staff continue to collaborate with internal business units, including Enterprise Performance Optimization (EPO), in implementation of new measures.

2021 Department of Health Services (DHCS) Medical Audit The DHCS conducted a routine Medical Audit of L.A. Care for both Medi-Cal and CMC lines of business. Review periods:

• July 1, 2019 – June, 30, 2021 (Medi-Cal)

• July 1, 2020 – June 30, 2021 (Cal MediConnect) Participating entities:

• L.A. Care;

• Allied IPA;

• L.A. County Department of Health Services (DHS);

• Health Care LA IPA;

• Optum Direct Network (DN); and

• Regal Medical Group Risk Management and Business Contintuity Risk Assessment Report – Exhibit 1 Disaster Recovery Testing:

The 2021 Disaster Recovery test (DR) will be conducted on October 30, 2021. Due to COVID-19 restrictions and to protect participants’ health, the test will be conducted remotely, similar to the remote testing that was conducted last year. Compliance will consider a hybrid model for next year’s test. The testing will include approximately 14

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Business Units and will test roughly 30 systems/applications. The test will measure if L.A. Care’s critical business units and systems can perform in a work-from home environment during a disaster. The results of the test will be presented at a future meeting. Annual Compliance Training: As part of L.A. Care’s compliance program, annual compliance training is required to be completed by employees and Board members. This year’s compliance training will be rolled out in late August and will be due by November 30, 2021. The annual compliance training will include the following:

• Compliance Program General Session

• Deficit Reduction Act: False Claims and Employee Protections Training

• Fraud and Abuse Awareness

• HIPAA: General Awareness

• Information Security

• Code of Conduct

Internal Audit Sales & Marketing Correction Action Plan (CAP) Update – Internal Audit (IA) portion

Action Status Update Responsible Party

Full-scope internal audit

• Desktop review

• Call recordings

• Report finalized and presented to Sales and Marketing to proceed with remediation efforts.

• Provided management action plan activities for Compliance to share with CMS.

• IA to plan a follow-up on closure items to start 1st week of September

Internal Audit, Compliance

Pre-Assessment to the DHCS Audit – Internal Audit portion Background: Internal Audit validates the closure of Corrective Actions from the last DHCS Medical Audit in 2019 and All Plan Letter (APL) Implementation. This will prepare for the upcoming DHCS Audit, scheduled to start in June and July.

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The focus of the internal audit will be:

• Plan’s Compliance with the DHCS contract and regulations in the area of:

• Utilization Management, Case Management, Coordination of Care, Quality Management

• Provider Availability and Accessibility,

• Member’s Rights,

• Administrative and Organizational Capacity

• All Plan Letter (APL) Implementation


Assess L.A. Care’s ability to monitor our prospective delegates activities and subcontractors, along with monitoring activities in IHA and CCS.

Draft Report was completed, however, delays in getting information pushed testing and review into actual DHCS audit which provided similar outcomes with more detailed action items.

Will work with Compliance on timing of Management Action Plans and focus on follow-up activities to ensure closure along with helping Compliance on monitoring requirements.

All related parties to the IA Project

Ongoing monitoring: Develop and implement Sales & Ensure P&Ps exist for previously released APLs in 2018 and 2019.


IT Asset Inventory – Internal Audit Background: This audit will determine whether adequate and effective IT asset management processes and controls are in place, in order to maintain the integrity of the IT assets while meeting L.A. Care’s Asset Management and Security requirements.

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The internal audit will: The scope of the audit will be limited to L.A. Care procured information technology hardware and software inventories, including IT asset management practices in place as of January 1, 2020 to July 31, 2021. The audit’s focus will be on systems and practices used in the governance, management, control and oversight of IT hardware and software assets.


1. Assess IT management governance structures are in place to provide strategic direction for IT asset management.

In process- we are targeting late August to start.


2. Assess processes are in place for planning the acquisition of IT assets, as well as the replacement and disposal of IT assets.


3. Assess processes and systems are in place to record, track, monitor, and safeguard the IT assets inventory.


Privacy HIPAA Violations (Events, Incidents, and Breaches) In June and July 2021, Privacy staff investigated nine L.A. Care HIPAA violations and 16 business associate HIPAA violations. Violations include events, incidents and breaches. Privacy violation rates for L.A. Care have remained steady. Privacy violation rates for L.A. Care’s business associates increased slightly, which can be attributed to clinical mailings by Navitus Health Solutions. There were no breaches during June or July by L.A. Care or our business associates.

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Fraud, Waste and Abuse – Delegation Oversight

• SIU staff hosted the CA Office of the Attorney General’s quarterly Healthcare Fraud Roundtable in June. This meeting was attended by representatives from the FBI, DHCS, CA-OIG, CA Dept. of Justice and several members from area SIU’s.

• SIU staff is coordinating with the Centers for Medicare & Medicaid Services (CMS) on a nationwide health care fraud scheme involving the inflammation drugs Pennsaid, Vimovo and Duexis, which are manufactured by Horizon Therapeutics. L.A. Care SIU has investigated several pharmacies based on false pre-authorizations for these drugs and has already recovered over $3 million.

Chairperson Booth asked about answers to the findings. Mr. Mapp responded that it appears as if consumer scores and HEDIS scores show mixed ratings. He noted that the sensititve risk items were separated from the open session report. He will continue to use this bifurcation in reporting in the future. Chairperson Booth asked how L.A. Care knows a fraud is occurring. Mr. Mapp responded that markers are used to evaluate the event. Even best efforts proactively to prevent fraud don’t work all the time. Chairperson Booth asked if a patient would normally be able to request a transfer. Mr Mapp responded that two notices of non compliance were received: one by Appeals & Grievances (A&G) and another with Sales & Marketing (S&M). Earlier this week L.A. Care submitted a corrective action plan (CAP) on the A&G event, with a due date at the end of August to submit a CAP for the S&M issue.

DHCS issued a Notice of Noncompliance on July 16, 2021, requesting completion of the appeals backlog by

August 1, and the grievance backlog by September 1. The appeals were not completed by August 1. L.A.

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Care continues to remediate cases and provide updates to the DHCS, California Department of Managed

Healthcare (DMHC) and CMS. A remediation plan was developed, focused on the September 1 deadline for

grievances, including engagement of external consultants, assignment of special projects to internal staff,

workflow adjustments and staff retraining in the call center and in the A&G departments.

• As of August 8, the Utilization Management (UM) backlog has been remediated, but additional focus has

been directed to the various processes to attempt to maintain compliance with an ongoing increase in

requests for services.

CMS/DHCS issued a Warning Letter on July 20, 2021, requiring updates on initiatives previously reported

and a business plan focused on future remediation activities that resulted from a 2020 complaint by a former

employee. The Warning Letter represents a second level performance notice.

• Key elements of Warning Letter/Business Plan

August 3 (completed): By March 3, 2021, we provided CMS/DHCS a summary of initiatives to improve

the S&M and compliance oversight functions.

August 31: The business plan/corrective action plan (with milestones) is due on August 31, 2021.

Margaret Ngo-Lee, Senior Director, Risk Management and Operations Support, Compliance, presented the Risk

Assessment Report and Disaster Recovery Test Update.

Provider Data (Operational)

Description of Risk: Improving accurate data that will influence regulatory reports, network associations,

network adequacy, provider directory, provider communications, timely access and enrollment and disenrollment

processes.

Description of Mitigation/Remediation: July 2021 – L.A. Care continues to work with PPGs, Specialty Health

Plans, and Plan Partners on provider data submission. Data submission that reaches an 85% passing threshold

will be moved into the production environment and will continue to correct if any errors/issues arise from

loading the file. This risk has been moved from high to medium risk pending the implementation date of the

Total Provider Management (TPM) redesign.

Disaster Recovery Test Update The 2021 Disaster Recovery Test will be conducted on October 30, 2021. Due to COVID-19 restrictions and to protect the participant’s health, the test will be conducted remotely; similar to the remote testing that was conducted last year. Compliance will consider doing a hybrid model for next year’s test. The testing will include approximately 14 Business Units participating and will be testing roughly 30 systems and/or applications. The purpose of the test is to ensure L.A. Care’s critical Business Units and systems can perform under a disaster in a work-from home environment. We will provide the results of the testing upon completion.

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PUBLIC COMMENT Submitted via text on August 17, 2021 at 1:37 p.m. by sender not self-identified

Aug 19 , 21 meeting Complaince closed session item 11 peer review, a doctor on LA Cares board publicly discussed my adult autistic daughter Vanessa at an ECAC meeting in Nov of 2015 claiming my grievances were resolved and handled properly when in truth LA Care would not respond to my repeated requests for assistance for my daughter Vanessa Navarro and defended Synermed and retaliated because of our accurate accounts of their abuses. My daughter died less than a month after this Nov meeting . I have told LA Care to self report this abuse of my child’s rights and my rights to advocate for her and my not being notified of her being discussed at this ECAC meeting , I told LA Care I want this public record violating our privacy removed and I want written notice of this removal and LA Cares self reporting to the state privacy officer !

The meeting of the Joint Powers Authority Board of Directors was adjourned. Augustavia J. Haydel, General Counsel, announced the following items to be discussed in closed session. The L.A. Care Board of Governors adjourned to closed session at 4:03 p.m.

THREAT TO PUBLIC SERVICES OR FACILITIES Consultation with Augustavia J. Haydel, JD, General Counsel

REPORT INVOLVING TRADE SECRET Pursuant to Welfare and Institutions Code Section 14087.38 (n) Discussion Concerning Program, Business Plan Estimated date of public disclosure: March 2023

CONFERENCE WITH LEGAL COUNSEL – ANTICIPATED LITIGATION Significant exposure to litigation pursuant to Section 54956.9(d) (2) of the Ralph M. Brown Act Three Potential Cases

PEER REVIEW Welfare & Institutions Code Section 14087.38(o)


The committee reconvened in open session at 4:22 p.m.

There was no report from closed session.

0ADJOURNMENT

Board Member Perez thanked L.A. Care, Mr. Baackes, Board Members, and the Communications and Community Relations, Community Resource Centers (CRC), and Family Resource Centers staff members, for the events for distributing backpacks and school supplies. She noted that there were seven events in total. She thanked Francisco Oaxaca, Chief of Communications and Community Relations, Communications, who included the Health Promoters in the

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events, as volunteers. She is really grateful that members and Mr. Baackes attended the Pomona CRC event. She noted that it was a huge success. The faces of the children who received the backpacks were beyond words. She thanked L.A. Care for allowing her to serve the community. It is an honor for her to be a part of the organization. She thanked L.A. Care on behalf of the members.

Chairperson Booth responded that there are many people that are grateful for her volunteer work.

Mr. Baackes stated that 7,000 backpacks were distributed at nine different events.

The meeting was adjourned at 4:28 p.m.

Respectfully submitted by: APPROVED BY: Victor Rodriguez, Board Specialist II, Board Services Malou Balones, Board Specialist III, Board Services _____________________________________________ Linda Merkens, Senior Manager, Board Services Stephanie Booth, MD, Chairperson Date Signed: __________________________________

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Board of Governors Meeting - L.A. Care Health Plan

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