Board Meeting Agenda - L.A. Care Health Plan 090612 Mtg Packet-public.pdf1. Legislative Update Walter A. Zelman, PhD, Chair Cherie Fields, Director of Government Affairs B. Finance

AGENDA BOARD OF GOVERNORS MEETING No. 212 Thursday, September 6, 2012, 2:00 - 5:00 PM L.A. Care Health Plan, 1055 W Seventh Street, 10th Floor, Los Angeles, CA 90017

I. Welcome

Walter A. Zelman, PhD, Chair

II. Approve today’s meeting agenda Chair

III. Approve minutes of July 12 meeting and July 19 retreat

Chair

IV. ADJOURN TO CLOSED SESSION (Est. time: 60 mins) Chair

A. CONTRACT RATES Pursuant to Welfare and Institutions Code Section 14087.38(m) • DHCS Medi-Cal Rate • Provider Rates • Plan Partner Rates • Med-Cal Managed Care Supplemental Payment

B. PROVIDER RATES – MRMIB/Healthy Families Program Welfare and Institutions Code Section 14087(p) and Government Code Section 6254 (v) Estimated date of disclosure: Contract rates: Contract Terms – Sep., 2015/Contract Rates – Sep., 2016

C. REPORT INVOLVING TRADE SECRET Pursuant to Welfare & Institutions Code Section 14087.38(n) Discussion concerning New Product Lines Estimated date of public disclosure: September 2014

D. CONFERENCE WITH LABOR NEGOTIATOR Pursuant to Section 54957 of the Ralph M. Brown Act Agency Negotiator: Howard A. Kahn Unrepresented Employee: All L.A. Care Employees

E. PUBLIC EMPLOYEE PERFORMANCE EVALUATION Section 54957 of the Ralph M. Brown Act Title: Chief Executive Officer

F. CONFERENCE WITH LABOR NEGOTIATOR Pursuant to Section 54957 of the Ralph M. Brown Act Agency Negotiator: Walter Zelman, PhD Unrepresented Employee: Howard A. Kahn

V. RECONVENE IN OPEN SESSION Chair

VI. Approve Consent Agenda Chair 1. Ratify CMO Search Contract 2. Authorize Expenditure for OMB Circular A-133 Audit 3. Authorize staff to execute Healthy Families Program contract amendments with the Managed Risk

Medical Insurance Board (MRMIB) effective October 1, 2012 – September 30, 2013 (Confidential document)

4. Authorize CEO to execute the Medicare Advantage Special Needs Plan contract with Centers for Medicare and Medicaid Services (CMS)

5. Approve 2013 Board & Committee Meeting Schedule 6. Delegate Authority to the Services Agreement Committee for sub-contracted plans

VII. Chairperson’s Report Chair

Board of Governors Meeting Agenda September 6, 2012

VIII. Motions for Consideration Chair1. Approve Health Integrated Contract Extension

John Wallace, Chief of Staff

IX. Chief Executive Officer Report

Howard A. Kahn, Chief Executive Officer

X. Chief Medical Officer Report

Elaine Batchlor, MD, Chief Medical Officer

XI. Committee Reports

A. Executive Committee 1. Legislative Update

Walter A. Zelman, PhD, Chair Cherie Fields, Director of Government Affairs

B. Finance & Budget Committee 1. Financial Summary and Investment Report

Philip L. Browning, Chair Tim Reilly, Chief Financial Officer

C. Audit Committee Jim Mangia, MPH, Chair

D. Governance Committee 1. 2013 Board Officer Nominations 2. Approve Revisions to Executive Community Advisory

Committee/Regional Advisory Community Committees Operating Rules

Mark Gamble, Chair

XII. Advisory Committee Reports

A. Children’s Health Consultant Advisory Committee Elaine Batchlor, MD

B. Technical Advisory Committee Elaine Batchlor, MD, Chair

C. Executive Community Advisory Committee Mario Ramos/Maria Guerrero

XIII. Public Comments Chair

XIV. Adjournment Chair

The order of items appearing on the agenda may change during the meeting. Please keep your comments to three minutes or less.

THE PUBLIC MAY ADDRESS THE BOARD OF GOVERNORS ON ALL MATTERS LISTED ON THE AGENDA BY FILLING OUT A “REQUEST TO ADDRESS” FORM AND SUBMITTING THE FORM TO L.A. CARE STAFF PRESENT AT THE MEETING BEFORE THE AGENDA ITEM IS

ANNOUNCED. YOUR NAME WILL BE CALLED WHEN THE ITEM YOU ARE ADDRESSING IS DISCUSSED. THE PUBLIC MAY ALSO ADDRESS THE BOARD ON L.A. CARE MATTERS DURING PUBLIC COMMENT. AN AUDIO RECORDING OF THE MEETING IS MADE TO

ASSIST IN WRITING THE MINUTES AND IS RETAINED ONLY FOR 30 DAYS.

NOTE: THE BOARD OF GOVERNORS CURRENTLY MEETS ON THE FIRST THURSDAY OF MOST MONTHS AT 2:00 P.M. POSTED AGENDA and PRINTED MEETING MATERIALS ARE AVAILABLE FOR INSPECTION AT Board Services, 1055 W. 7th Street – 10th Floor, Los Angeles, California 90017.

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 Board Services, L.A. Care Health Plan, 1055 W. 7th Street, 10th Floor, Los Angeles, CA 90017,

during regular business hours, 8:00 a.m. to 5:00 p.m., Monday – Friday.

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) 694-1250. Notification at least one (1) week before the meeting will enable us to try and make reasonable arrangements to ensure accessibility to the meetings and to the related materials.

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Board of Governors General Meeting #210 Meeting Minutes – July 12, 2012 L.A. Care Health Plan Conference Room 1018-1019 1055 W. Seventh Street, Los Angeles, CA 90017

Members Management/Staff Walter A. Zelman, PhD, Chairperson Jim Mangia, MPH Howard A. Kahn, Chief Executive Officer Thomas Horowitz, DO, Vice Chairperson Louise McCarthy, MPP* Elaine Batchlor, MD, MPH, Chief Medical Officer Philip L. Browning Treasurer* Supervisor Gloria Molina* Gene Fernandez, Chief Information Officer Mario A. Ramos, MBA, Secretary Michael A. Rembis, FACHE Augustavia J. Haydel, Esq., General Counsel Mark Gamble* G. Michael Roybal, MD, MPH Tim Reilly, Chief Financial Officer Maria Guerrero John F. Schunhoff, PhD John Wallace, Chief Operating Officer Thomas S. Klitzner, MD, PhD *absent; ** via telephone

AGENDA ITEM/PRESENTER

MOTIONS / MAJOR DISCUSSIONS

ACTION TAKEN

CALL TO ORDER

Walter A. Zelman, PhD Chairperson

Walter A. Zelman, PhD, Chairperson, called the meeting to order at 2:00 p.m.

He announced that the Public may address the Board on each matter listed on the agenda before or during the Board’s consideration of the item, or on any other topic at the Public Comment section at the end of this meeting. The public is welcome to sign the guest book and introduce themselves but may remain anonymous if they wish. He informed the Board Members that materials for the Board Retreat will be sent the following day.

Chair Zelman then introduced candidates for the two Board positions that will be elected by the members of L.A. Care’s Regional Community Advisory Committees (RCACs) on September 20: Carlos Aguirre; Alejandra Martinez, Hilda Perez, and Mary Jane Puffer. Each Candidate addressed the Board. Member Ramos and Member Guerrero, currently serving as the Member Advocate and Member Representative commented on the two positions.

APPROVAL OF MEETING AGENDA Walter A. Zelman, PhD

Item VII. A.3, approval of a Joint Exercise Powers Agreement, will be postponed to the July 19 meeting due to potential conflicts of interest. Today’s agenda was approved as amended.

Approved unanimously. 9 AYES (Guerrero, Horowitz, Klitzner, Mangia, Ramos, Rembis, Roybal, Schunhoff, Zelman).

Board of Governors Meeting Page 2 of 9 July 12, 2011

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ACTION TAKEN

ACCEPTANCE OF MINUTES OF MEETING

Walter A. Zelman, PhD

The minutes of the June 7, 2012 meeting were approved as submitted.

Approved unanimously. 9 AYES

APPROVAL OF CONSENT AGENDA

Walter Zelman, PhD

Motion COM 100.0712 Revisions to Legal Services Policy LS#006 (Gifts & Donations) Motion EXE 100.0712 Amendment to Medi-Cal Agreement 12-89150


CHAIRPERSON’S REPORT


Chair Zelman thanked the Board Members for making time in their schedules to attend this meeting as well as the Retreat on July 19.

CHIEF EXECUTIVE OFFICER’S REPORT Howard A. Kahn

Howard A. Kahn, Chief Executive Officer, encouraged Board Members to read the new RCAC Connections Newsletter showing recent activity at the Regional Community Advisory Committees (RCACs). Mr. Kahn reported: • On June 28, 2012 the Supreme Court announced its ruling which largely upheld the

Affordable Care Act, including the significant provisions for the individual mandate and allowing states to opt out of Medicaid expansion.

• The Board Retreat will be held on July 19 at the Japanese American Cultural Center. • Two speakers are scheduled for the morning session: Duane Dauner, President and CEO,

California Hospital Association, and Patrick Kapsner, CEO, Memorial/Care Medical Foundation.

• The Retreat meeting packet will be sent about a week in advance of the retreat. • The Coordinated Care Initiative requires that Medi-Cal managed care plans in Pilot

counties provide Long-Term Services and Support (LTSS) to all their Medi-Cal managed care members. L.A. County has the greatest enrollment of the pilot counties.

• L.A. Care will publish a report following implementation of the pilot project. • On July 9, DHCS announced that Medi-Cal managed care members will begin

receiving LTSS services beginning on their birth month beginning March 2013. • L.A. Care is participating extensively in statewide stakeholder work groups as well as

convening local sessions to solicit input from providers and advocates. • L.A. Care is holding focus groups to develop a new name for the pilot.


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• L.A. Care has released a joint RFP for a Health Risk Assessment with Health Net. • We are also collaborating with Health Net to evaluate building a shared infrastructure to

coordinate and manage Long Term Support Services • Current guidance from DHCS and CMS leads us to believe that enrollment in the Pilot will

not commence until June 2013, but enrollment in our D-SNP will continue throughout all of next year.

• L.A. Care is seeking to rapidly expand our D-SNP network to enhance the market attractiveness of our duals directory

• On July 9, WellPoint announced its acquisition of Amerigroup, reflecting the desire of health plans to gain a larger share of the Medicaid market following the Supreme Court ruling on health care reform and the potential future expansion of Medicaid. With this deal, WellPoint becomes a key player in the opportunities to enroll duals across the country. o Many larger health plans are not well positioned to compete for the dual eligible

enrollment due to their relatively modest Medicaid presence. • L.A. Care is listed as a partner for a CMMI grant awarded by US Health and Human

Services to SEIU for the “Care team integration of the home-based workforce” project for a total of $11,831,445. o The goal is to reduce ER visits by 23% and hospital admissions from the ER by 23%

over three years. o The program will train an estimated 6,900 In-Home Supportive Services (IHSS)

personal and home care attendants to augment their current skills to play a larger role in the patient’s health.

• L.A. Care’s contract renewal with First 5 LA for the Healthy Kids 0-5 Program takes effect July 1st. This new contract provides grant funds for July 2012 through June 2015 contract period to be distributed upfront, instead of on a yearly basis. This will allow L.A. Care to reinvest funds not used for health care premium in the community to support children 0-5 and their families, such as support for Care Harbor Event services for children 0-5 and L.A. Care’s Community Health Investment Fund’s pediatric dental program.

• Hilda Stuart will join Board Services as a Committee Liaison on July 16.

STANDING COMMITTEE REPORTS EXECUTIVE COMMITTEE

The Exec Committee met on June 27. (Minutes of the meeting can be obtained by contacting Board Services.)


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ACTION TAKEN

Walter A. Zelman, PhD Legislative Update / Actions

Cherie Fields

Cherie Fields, Director, Government Affairs, reported: • The California State Budget proposes that Medi-Cal enrollment for Healthy Families

members will begin in January 2013 according to birth date. There are 221,000 Healthy Families members in Los Angeles County. L.A. Care currently has 11,000 enrolled. Kaiser Health Plan attempted to get state regulators to contract directly and circumvent the current contract arrangements in Two-plan counties. With support from Anthem Blue Cross, L.A. Care succeeded in getting regulators to continue the current contract arrangements and preserve the two-plan system, which protects safety net providers.

• The managed care organization (MCO) premium tax will be considered when the legislature resumes August 6.

• The legislation to reinstate exceptions to the Brown Act geographical requirements for determining a quorum (SB475) sponsored by the trade organization, Local Health Plans of California, has passed the Assembly and will be taken up by the Senate.

• L.A. Care staff participated in a recent meeting organized by the health insurer’s trade organization, America’s Health Insurance Plans, to discuss development of a white paper, national disability organization.

Amendment to L.A. Care’s Medi-Cal Agreement 12-89150 with the California Department of Health Care Services

Augustavia J. Haydel, Esq.

Motion EXE 100.0712* To ratify the authorization for Howard A. Kahn, Chief Executive Officer, to execute Agreement 12-89150 (Dual Eligible Special Needs Plan Care Coordination Agreement) between the California Department of Health Care Services and L.A. Care Health Plan.

Approved unanimously under the Consent Agenda. 9 AYES

Joint Exercise Powers Agreement between L.A. Care Health Plan and Los Angeles County to Establish L.A. Care Health Plan Joint Powers Authority

Augustavia J. Haydel, Esq.

Motion BOG 100.0712 1) To approve entering into a Joint Exercise of Powers Agreement (“Agreement”)

between L.A. Care Health Plan and Los Angeles County to establish L.A. Care Health Plan Joint Powers Authority (“JPA”) to serve as a new Knox-Keene licensed health care services plan which will enroll members currently enrolled in L.A. Care’s programs other than Medi-Cal, and any new programs or lines of business which may be developed by the JPA, subject to the extension of the Managed Care Organization (MCO) Tax or similar tax beyond July 1, 2012; and

2) To authorize and delegate to Howard A. Kahn, CEO, discretionary authority to negotiate, enter into and execute the Agreement, and to take any necessary actions

Consideration of this motion was postponed to the July 19, 2012 meeting.


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ACTION TAKEN

and execute any necessary documents relating to the Agreement and the JPA.

Patient Centered Medical Home Adaptive Equipment Motion Elaine Batchlor, MD, MPH

Member Mangia may have a financial interest in Plans or Plan Participating Providers for which he might have a potential conflict of interest, and as such he refrained from participating in the discussion and vote on this item.

Elaine Batchlor, MD, MPH, Chief Medical Officer, referred to the written motion summary, and she reviewed key aspects of the program. L.A. Care has invested almost $1 million over the last few years to help more than 80 safety net clinics install adaptive medical equipment. This funding will help additional clinics ensure they can provide services to members with special needs.

Motion EXE 101.0712 To approve $120,000 to fund adaptive medical equipment for up to twelve primary care practices in L.A. Care’s first and second patient centered medical home cohorts.

Approved, 8 AYES (Guerrero, Horowitz, Klitzner, Ramos, Rembis, Roybal, Schunhoff, Zelman), 1 ABSTENTION (Mangia)

LAC+USC Foundation Wellness Center Project Elaine Batchlor, MD, MPH

Dr. Batchlor summarized the Motion Summary included in the meeting materials. A multi-purpose Wellness Center is being planned for 75,000 square foot of space located on the first floor of the historic Los Angeles County General Hospital building, which was closed in 2008. The goal of the Wellness Center, which is scheduled to open in late 2012, is to provide comprehensive preventive and connected medical and mental health services to the underserved Los Angeles County population, especially residents of Boyle Heights and East Los Angeles. The community-based planning process, led by community partner Amigos de los Rios, to date has included input from close to 450 participants through a series of seven bilingual meetings and surveys.

Some of the services that will be provided at the “one-stop shop” include health prevention programs such as education about diabetes, arthritis and hypertension, prenatal care, HIV/AIDS, and exercise programs. Patients will be referred offsite for services not covered at the facility. The offsite services will include primary health care, mental health and dental care.

Motion EXE 102.0712 To approve a one-year $150,000 ad hoc grant to the LAC+USC Medical Center Foundation to engage in a strategic planning process for the Wellness Center and Fitness Park located at the historic Los Angeles County General Hospital.

Approved unanimously. 9 AYES (Guerrero, Horowitz, Klitzner, Mangia, Ramos, Rembis, Roybal, Schunhoff, Zelman)

FINANCE & BUDGET COMMITTEE

The Committee met on June 27. (Minutes of the meeting can be obtained by contacting Board Services.)

The Committee reviewed and approved FIN-A to approve an amendment to add $130,000 to the existing agreement with Steven Krivit for consulting services through December 31, 2012,


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ACTION TAKEN

Walter Zelman, PhD for a total contract amount not to exceed $180,000.

The Committee reviewed and approved FIN-B to approve contracts with Object Health for $385,000 and E2O Health for $351,750, as Service Partners for the Safety Net eConsult Program from July 1, 2012 to June 30, 2013

Financial Report Tim Reilly

Tim Reilly, Chief Financial Officer, summarized the financial highlights addressed in the reports (a copy of the reports can be obtained by contacting Board Services): • The total healthcare expenses improved compared to the previous month because there was

a one-time adjustment done which will be discussed in closed session. • YTD is showing loss of $20 Million over $1.4 Billion revenue for the period. • The loss is still influenced by MCLA and Seniors and People with Disabilities (SPDs).

Motion FIN 100.0712 To accept the Financial Report for the eight months ended May 31, 2012, as submitted.


California Health Benefits Exchange/Basic Health Program John Wallace

John Wallace, Chief Operating Officer, reviewed the contract highlights. Based on responses to a request for qualifications (RFQ) leading candidates were invited for on-site interviews with the RFQ Steering Committee in June 2012. The Steering Committee reviewed and evaluated proposals submitted based on a set of weighted evaluation criteria and determined that Milliman was best qualified to meet L.A. Care’s business and strategic needs.

Motion FIN 101.0712 To execute a contract with Milliman not to exceed $250,000 for California Health Benefit Exchange consulting services through February 28, 2014.


COMPLIANCE & QUALITY COMMITTEE

Jim Mangia, MPH

The Committee met on June 21. (Minutes of the meeting can be obtained by contacting Board Services.)

Revisions to Legal Services Policy LS 006 (Gifts and Donations)

Augustavia J. Haydel, Esq. Ellin Davtyan, Esq.

Motion COM 100.0712* To approve revisions to Legal Services Policy and Procedure LS-006 (Gifts and Donations), as attached.

Approved unanimously under the Consent Agenda. 9 AYES


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ACTION TAKEN

Revisions to Financial Compliance Policy FC-004 (Minimum Requirements for Capitated Hospitals) Laura Jaramillo

Member Rembis may have a financial interest in Plans or Plan Participating Providers for which he might have a potential conflict of interest, and as such he refrained from participating in the discussion and vote on this item.

Laura Jaramillo, Director, Product Management, reviewed the highlights of the motion

Howard A. Kahn, Chief Executive Officer, reminded Board Members that staff received input from providers and other stakeholders and comments from plan partners over several months. A number of meetings were held with groups and hospitals. Modifications were made. This policy was written in response to concerns that were brought to L.A. Care around capitation paid to hospitals.

Concerns that a large group of providers might be negatively impacted in some way have been addressed.

Motion COM 101.0712 To approve the revisions to Financial Compliance Policy FC-004 (Minimum Requirements for Capitated Hospitals), as attached.

Approved. 8 AYES (Guerrero, Horowitz, Klitzner, Mangia, Ramos, Roybal, Schunhoff, Zelman). 1 ABSTENTION, (Rembis)

PUBLIC ADVISORY COMMITTEE REPORTS

EXECUTIVE COMMUNITY ADVISORY COMMITTEE Mario Ramos/ Maria Guerrero

Community Outreach & Education is proud to announce that an oral presentation and the “Bringing Sunshine to the Heart of the Community” video about last year’s RCAC Obesity and Nutrition Pilot project have been selected for presentation during this year’s APHA Conference in October.

On June 16 Health Promoters conducted 12 health care reform presentations (6 at the last session of the Active Steps program and at 6 RCAC meetings). Over 200 people learned about health care reform through their presentations in June. The Health Promoters have 9 presentations scheduled in July.

PUBLIC COMMENT Hilda Perez asked about sponsorship of the Care Harbor event. Mr. Wallace responded that L.A. Care sponsorship funds will support the overall event. Mr. Kahn added that there will be a special emphasis on outreach. People attending that event may become eligible for subsidy under the Affordable Care Act and potential L.A. Care members. Mr. Wallace noted that L.A. Care will work with community providers to ensure follow up care.

ADJOURN TO CLOSED SESSION

Ms. Haydel announced the following items to be discussed in closed session and indicated that a report from closed session was not anticipated.


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ACTION TAKEN

Walter A. Zelman, PhD The Board adjourned to a closed session at 3:08 p.m.

A. REPORT INVOLVING TRADE SECRET Pursuant to Welfare & Institutions Code Section 14087.38(n) Discussion concerning New Product Lines Estimated date of public disclosure for the item above: July 2014

B. CONTRACT RATES Pursuant to Welfare and Institutions Code Section 14087.38(m) • DHCS Medi-Cal Rate • Provider Rates • Plan Partner Medi-Cal Rates • Medi-Cal Managed Care Supplemental Payment not discussed

C. CONFERENCE WITH LEGAL COUNSEL – EXISTING LITIGATION Pursuant to subdivision (a) of Section 54956.9 of the Ralph M. Brown Act. Cedars-Sinai Health Systems v. L.A. Care Health Plan (Anthem Blue Cross) California Department of Health Services Office of Administrative Hearings and Appeals; Emergency Services Claim Dispute Nos. 859-06-RW, et seq. and 1599-06-RW, et seq.

D. CONFERENCE WITH LEGAL COUNSEL--EXISTING LITIGATION Pursuant to Section 54956.9(a) of the Ralph M. Brown Act Name of Case: Sanford v. L.A. Care Health Plan (Case No. BC 465697)

E. CONFERENCE WITH LABOR NEGOTIATOR Pursuant to Section 54957 of the Ralph M. Brown Act Agency Negotiator: Howard A. Kahn Unrepresented Employee: All L.A. Care Employees

F. PUBLIC EMPLOYEES DISCIPLINE/INVESTIGATION

(Member Ramos left the meeting.)

G. PUBLIC EMPLOYEE PERFORMANCE EVALUATION Section 54957 of the Ralph M. Brown Act Title: Chief Executive Officer


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ACTION TAKEN

H. CONFERENCE WITH LABOR NEGOTIATOR Pursuant to Section 54957 of the Ralph M. Brown Act Agency Negotiator: Walter Zelman, PhD Unrepresented Employee: Howard A. Kahn

RECONVENE IN OPEN SESSION Walter A. Zelman, PhD

The Board reconvened in open session at 4:10 p.m.

ADJOURNMENT

The meeting was adjourned at 4:10 p.m.

Respectfully submitted by: Linda Merkens, Manager APPROVED BY: _________________________________ Malou Balones, Committee Liaison Mario Ramos Secretary ` Date Signed _________________________________

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Board of Governors Retreat Meeting #211 Meeting Minutes –July 19, 2012 L.A. Care Health Plan Conference Room 29ABCD 555 W. Fifth Street, Los Angeles, CA 90013

Members Management/Staff Walter A. Zelman, PhD, Chairperson Jim Mangia, MPH Howard A. Kahn, Chief Executive Officer Thomas Horowitz, DO, Vice Chairperson Louise McCarthy, MPP Elaine Batchlor, MD, MPH, Chief Medical Officer Philip L. Browning Treasurer Supervisor Gloria Molina Barbara Cook, Chief, Human and Community Resources Mario A. Ramos, Secretary Michael A. Rembis, FACHE Gene Fernandez, Chief Information Officer Mark Gamble G. Michael Roybal, MD, MPH Augustavia J. Haydel, Esq., General Counsel Maria Guerrero John F. Schunhoff, PhD Tim Reilly, Chief Financial Officer Thomas S. Klitzner, MD, PhD *absent; ** via telephone John Wallace, Chief of Staff



ACTION TAKEN

CALL TO ORDER

Walter A. Zelman, PhD Chairperson

Walter A. Zelman, PhD, Chairperson, called the meeting to order at 8:35 a.m.

Chair Zelman outlined his vision for L.A. Care, which contained the elements of create, test, evaluate and promote: 1. Demonstrate value of the organization’s contributions not only to its members but to the

community 2. Aggressively address quality and access in Medi-Cal; face challenges and demand solutions. 3. While striving to control costs, maintain positive and mutually respectful relationships with

providers and collaborate on achieving bold solutions to improve access and care. 4. Become a major innovator in improvements in delivery; whenever possible collaborate with

providers. 5. Support and assist the safety net in its capacity to serve vulnerable populations and help it

transform and prepare for the approaching (likely competitive) environment. 6. Promote public health as an indispensible partner in individual insurance programs. 7. Maintain a creative and collaborative organization to attract talent to L.A. Care staff.

He noted that L.A. Care is already doing most of these, and/or has funded major initiatives to achieve them. With the growth in L.A. Care’s membership, it may become better positioned to pursue them. He also pointed out that L.A. Care is being approached by a variety of entities as a leader in innovative solutions.

Chair Zelman concluded that L.A. Care has successfully grown to a respected organization. He

Board of Governors Retreat Page 2 of 5 July 19, 2012

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cautioned that continued success may bring negativity or criticism at some point in the future.

Howard A. Kahn, Chief Executive Officer, thanked the Board Members for taking time to attend the retreat.

Mr. Kahn pointed out that there are many changes through health care reform. The Affordable Care Act (ACA) will impact the marketplace and will affect L.A. Care and its membership. This retreat is an opportunity to examine L.A. Care’s mission and structure, to maximize efficiency in the transformed environment.

Mr. Kahn introduced Bobbie Wunsch, who will facilitate the meeting.

APPROVAL OF MEETING AGENDA Walter A. Zelman, PhD

Today’s agenda was approved as submitted. Approved unanimously 12 AYES (Browning, Gamble, Guerrero, Horowitz, Klitzner, Mangia, McCarthy, Ramos, Rembis, Roybal, Schunhoff, and Zelman)

A Future Look at the Health Care System Under the Affordable Care Act (ACA)

Duane Dauner President/CEO, California Hospital Association

Patrick Kapsner CEO, MemorialCare Medical Foundation

Bobbie Wunsch introduced the goals for the first discussion. Board Members made brief remarks related to the stakeholders each represents.

Mr. Kahn introduced the two guest speakers (a brief biographical background for each of the speakers is available by contacting Board Services). Each speaker discussed the potential changes in the health care system under the ACA.

Duane Dauner, President/CEO, California Hospital Association, noted that the health care system has an opportunity to undergo significant nationwide changes to improve the health care system under ACA (a copy of Mr. Dauner’s presentation is available by contacting Board Services).

(Member Browning left the meeting.)

Patrick Kapsner, CEO, MemorialCare Medical Foundation, commented on the significant factors that will change after implementation of the ACA, the important providers in the system, possible challenges for L.A. Care throughout the transformation, and the characteristics of a successful delivery model (a copy of Mr. Kapsner’s presentation is available by contacting Board Services).

He advised that the changes for government programs can ensure that quality and patient satisfaction are embedded in the payment system, so that providers will be incentivized to


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improve efficacy in a capitated model. Comprehensive data will be needed to make decisions on risk sharing. There will be a sharp increase in utilization as the pent up needs are met at the outset of the new enrollment. It will be important to work with new members to manage their needs during the initial enrollment period.

In California, the Health Care Exchange will need to enroll a large number of members to build the shared risk pool. There may be an initial resistance among the newly enrolled when they realize the cost allocation for some coverage in the Exchange.



Augustavia Haydel, General Counsel, announced that the Committee will discuss the following items in closed session. The Board adjourned to a closed session at 11:20 a.m.

(Members Molina and Browning joined the meeting.)

REPORT INVOLVING TRADE SECRETS Pursuant to Welfare & Institutions Code 14087.38 (n) Discussion concerning New Product Lines Estimated date of public disclosure: July 2014

RECONVENE IN OPEN SESSION



No reportable actions were taken during the closed session.

The meeting adjourned to lunch.

Current and Future BoardStructure and Processes Facilitated by Bobbie Wunsch

The meeting reconvened at 1:50 p.m.

Chair Zelman reviewed the suggestions included in the materials for this meeting. Suggestions offered by the Board included: • Send materials for meetings a few days earlier to allow better time management for Board

Members, and to provide opportunity for Board Members to seek additional information or clarification from staff prior to the board meeting.

• Continue to bring more mundane items to the Consent Agenda to free up meeting time for discussion of significant issues.

• Develop robust financial tools along with operational metrics to assist Board Members with performance analysis and short and long term planning.

• Solicit nominations for Board Members with business and/or insurance industry expertise. • Encourage Board members to sit in on Committee Meetings for experience.


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• Board Members should consider attending a Regional Community Advisory Committee meeting to increase involvement with the members.

• The Board could consider holding a meeting at an alternate location to increase community participation.

• Provide meeting materials from past meetings, and suggest a mentoring program to help new Board Members with orientation.

• Provide opportunity for stakeholder groups to participate in a Board meeting to build strategic partnerships.

• Explore opportunities for expanding the advisory boards to other stakeholders. • Look for ways to increase diversity (cultural, racial, disability) on the Board through the

nominating entities. • Because membership demographics are not static, look for opportunities to engage adequate

and accurate Board and Advisory Committee representation of members, perhaps L.A. Care Board could nominate a member based on a perceived need for representation on the Board of Governors.

• Have an experienced professional with relevant expertise speak with the Board about running a large health insurance organization.



Ms. Haydel announced that the Committee will discuss the following items in closed session. The Board adjourned to a closed session at 2:55 p.m.

REPORT INVOLVING TRADE SECRETS Pursuant to Welfare & Institutions Code 14087.38 (n) Discussion concerning New Product Lines Estimated date of public disclosure: July 2014

RECONVENE IN OPEN SESSION



No reportable actions were taken during the closed session.

BUSINESS MEETING Approval of Entering into a Joint Exercise Powers Agreement between L.A.

Members Gamble, Horowitz, Klitzner, McCarthy, Mangia, Rembis, Roybal and Zelman may have financial interests in Plans or Plan Participating Providers, and as such they refrained from participating in portions of the discussion for which they might have a potential conflict of interest.

Unanimously Approved. 5 AYES (Browning, Guerrero, Molina, Ramos,


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Care Health Plan and Los Angeles County to Establish L.A. Care Health Plan Joint Powers Authority. Augustavia Haydel, Esq. General Counsel

Ms. Haydel summarized the background on this motion to create L.A. Care Health Plan Joint Powers Authority (JPA) with Los Angeles County. The establishment of the JPA will be contingent on the extension of the MCO Tax (or similar tax) beyond July 1, 2012.

Motion BOG 100.0712A 1) To approve entering into a Joint Exercise of Powers Agreement (“Agreement”) between

L.A. Care Health Plan and Los Angeles County to establish L.A. Care Health Plan Joint Powers Authority (“JPA”) to serve as a new Knox-Keene licensed health care services plan which will enroll members currently enrolled in L.A. Care’s programs other than Medi-Cal, and any new programs or lines of business which may be developed by the JPA, subject to the extension of the Managed Care Organization (MCO) Tax or similar tax beyond July 1, 2012; and

2) To authorize and delegate to Howard A. Kahn, CEO, discretionary authority to negotiate, enter into and execute the Agreement, and to take any necessary actions and execute any necessary documents relating to the Agreement and the JPA.

and Schunhoff) 8 ABSTENTIONS (Gamble, Horowitz, Klitzner, Mangia, McCarthy, Rembis, Roybal, and Zelman)

PUBLIC COMMENT There was no public comment.

ADJOURNMENT

The meeting was adjourned at 4:18 p.m.

Respectfully submitted by: Linda Merkens, Manager APPROVED BY: _________________________________ Malou Balones, Committee Liaison Mario Ramos Secretary Hilda Stuart, Committee Liaison Date Signed _________________________________

Board of Governors

MOTION SUMMARY

Date: September 6, 2012 Motion No. BOG 100.0912

Committee:

Chairperson: Walter A. Zelman, PhD

Issue: Employee Search Contract

Background: L.A. Care has been using the executive search consulting services of Spencer Stuart

to fill vacant senior management positions. Past performance by this firm has been very good. Their proposed fees are comparable to other similar firms such as Furst Group and Witt Kieffer. There was no need for competitive bidding process as the pricing was similar among qualified firms. The retained search firm fee for executive recruitment is established as a percentage of base pay plus potential bonus paid to the CMO for the first year. Included is a 10% administrative fee based on the total retainer fee. Any approved out of pocket expenses will be added to the cost for recruitment. Staff is attempting to negotiate a flat rate for this search. Staff is requesting an extension of the current consulting agreement with Spencer Stuart with the following contract deliverables.

Identify and vet qualified candidates for the Chief Medical Officer position

Manage the search process from identification of the chosen candidate through the hiring process

Because of the timing of the Board and Committee meetings and the urgency of filling senior management vacancy, the Chief Executive Officer executed this contract extension per L.A. Care Policy and Procedure and with approvals of Walter A. Zelman, PhD, Chairperson of the Board of Governors, and Philip L. Browning, Chairperson of the Finance & Budget Committee. Execution of the contract is now being presented to the Board for ratification.

Budget Impact: up to $ 153,330.00. The cost will be budgeted in Fiscal Year 2012-13.

Motion: To ratify the execution by the Chief Executive Officer of a contract with Spencer Stuart for executive search consulting services for an aggregate contract amount not to exceed $153,330.

Board of Governors

MOTION SUMMARY


Committee:


Issue: Authorize expenditures for Audit required by the Office of Management and Budget (OMB)

Circular A-133.

Background: The Audit Committee approved a motion (AUD-A.0712) at its July 12, 2012 meeting

to appoint Deloitte & Touche as L.A. Care’s independent auditors for Fiscal Year 2011-2012 as outlined in their proposal dated July 2, 2012, and to authorize audit fees not exceeding $196,000. As presented at the Audit Committee Meeting, there is a new guideline from the Centers for Medicaid & Medicare Services (CMS) regarding the Circular A-133 Audit not being required for EHR Incentive Programs but the U.S. Department of Health and Human Services (HHS) has not yet adopted a policy regarding this new guideline. Upon contacting HHS, staff was advised that federal grant awards such as HITEC-LA, which is managed by the Office of the National Coordinator for Health Information Technology, should comply with the OMB Circular A-133 and an audit is required. This motion is to approve additional expenditures for the Circular A-133 audit. .

Budget Impact: The total audit expense of $225,000 is included in the fiscal year 2012 – 2013

budget (not yet approved).

Motion: To authorize expenditures up to $29,000 for the OMB Circular A-133 Audit. The total annual cost will be $225,000 for a Fiscal Year 2011-12 financial audit.

Board of Governors

MOTION SUMMARY


Committee: Board of Governors


Issue: To ratify execution of a contract between L.A. Care Health Plan (“L.A. Care”) and the Centers for Medicare and Medicaid Services (“CMS”) for the provision of health care services to dual eligible beneficiaries, for benefit year January 1 through December 31, 2013. Background: In 2007, L.A. Care applied for and was offered a contract from the Centers for Medicare and Medicaid Services (CMS) to become a Medicare Advantage Special Needs Plan (SNP) serving dual eligible beneficiaries in (CY) 2008, with continued operations through (CY) 2012.

Medicare Advantage Organizations are required to execute new contracts annually with CMS, once approval has been granted through the annual bid submission process. L.A. Care’s latest approved bid maintained the same supplemental benefits as the previous year despite a low Star rating and a continued decrease in the 2013 Los Angeles County benchmark of 5% over the prior year. L.A. Care’s 2.5 Star rating for 2013 resulted in a decrease of $4 in rebate dollars and reduced revenue of $13 PMPM. L.A Care is able to maintain the supplemental benefits such as transportation, vision, dental, and worldwide coverage largely because of improvements in management of administrative costs and medical expenses.

Contracts and addenda for Contract Year 2013 were received and executed as required by CMS on August 31, 2012 via the electronic signature process in the Health Plan Management System (HPMS).

Budget Impact: None. Rate reductions were anticipated as a result of the decrease in county

benchmark and Star rating and are already reflected in L.A. Care’s current budget.

Motion: To ratify L.A. Care’s execution of a contract between L.A. Care Health Plan and CMS for the provision of health care services to dual eligible beneficiaries for benefit year 2013.

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Board of Governors

MOTION SUMMARY

Date: September 6, 2012 Motion No. GOV 101.0911

Committee: Governance

Chairperson: Mark Gamble

Issue: Approval of the 2013 schedule of meetings for the Board of Governors and Committees.

Background: The Governance Committee approved a schedule of meetings for the next calendar year

for consideration by the Board of Governors. The schedule proposed for 2013 is based on the same principles as past years: 1. Committee meetings occurring at the end of July are moved up one week to add flexibility for

scheduling summer vacations. The Finance & Budget and Executive Committees would meet one week earlier, on July 17, 2013.

2. A Board retreat is tentatively scheduled in place of the May meeting as has been done in recent years; urgent matters could be discussed in a shortened session during the retreat. (In 2012 the retreat was held in July because of the timing of the SCOTUS decision on the ACA.)

3. Strategic discussions are calendared for March, May, July, October and December, with staff reports in February, April, June, September and November.

4. In putting together this schedule, Board Services followed the criteria established by the Board of Governors in November, 2008 :

Four of the nine Board meetings will have a strategic focus discussion.

There are no Board meetings scheduled for January or August.

Committee meetings are scheduled at intervals established by the Board in 2009, except that the Finance & Budget continues on a monthly meeting schedule established at its March 2010 meeting.

Meetings of the Audit, Governance and Services Agreements Committees, as well as the L.A. Care Community Health Board of Directors will be added to the schedule as needed.

The attached schedule will be effective when approved by the Board at its September meeting. It should be noted that following the election of officers at the November meeting, there may be changes to committee meeting schedules based on preferences of the new members.

Budget Impact: None.

Motion: To approve the proposed schedule of meetings of the L.A. Care Board and its committees for the calendar year 2013, as attached.

Board of Governors

MOTION SUMMARY

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Proposed 2013 Board and Committee Meeting schedule

January 2013 No BoG meeting 1/17 – C&Q 1/22 - CHCAC 1/23 –F&B, Exec 1/24 - TAC

February 2013 2/7 – BoG 2/21 – C&Q 2/27 –F&B, Exec

March 2013 3/7 – BoG (strategic focus) 3/19 - CHCAC 3/21 - C&Q 3/27 – F&B, Exec 3/28 - TAC

April 2013 4/4 – BoG, LACH 4/18 – C & Q 4/24 – F&B, Exec

May 2013 5/2 – BoG Retreat (strategic focus) 5/16 – C&Q 5/21 - CHCAC 5/22 – F&B, Exec 5/23 - TAC

June 2013 6/6 – BoG 6/20 – C&Q 6/26 – F&B, Exec

July 2013 7/11 – BoG (strategic focus) 7/16 - CHCAC 7/17 – F&B, Exec 7/18 – C&Q 7/25 - TAC

August 2013 No meetings

September 2013 9/5 – BoG 9/17 - CHCAC 9/19- C&Q 9/25– F&B, Exec 9/26 - TAC

October 2013 10/3– BoG (strategic focus) 10/17 - C&Q 10/23 F&B, Exec

November 2013 11/7– BoG 11/19 - CHCAC 11/20 – F&B, Exec 11/21 - TAC 11/21– C&Q

December 2013 12/5 – BoG (strategic focus), LACH (if needed to confirm officers)

Rescheduled due to holidays / summer

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Board of Governors

MOTION SUMMARY


Committee: Governance Committee


Issue: Delegate authority to the Services Agreements Committee for approving agreements and

amendments with sub-contracted plans for services to Duals and Medicare members.

Background: This motion was approved by the Governance Committee at its July 23, 2012 meeting.

Because of the stakeholder nature of L.A. Care’s Board of Governors, there are conflicts of interest among Board Members for considering agreements between L.A. Care and certain plans who might wish to sub-contract services provided to members of L.A. Care under the Duals Demonstration project. The Services Agreements Committee typically is comprised of members who do not have these conflicts of interest. It is recommended that the Board of Governors delegate authority for approval of agreements and amendments for sub-contracted plans under the Duals Demonstration project to the Services Agreements Committee. This practice has been followed by the L.A. Care Board of Governors for the Medi-Cal health plan subcontracts for the past 15 years.

Budget Impact: None

Motion: To delegate authority to the Services Agreements Committee for

executing agreements and amendments with sub-contracted plans as necessary to maintain a full network of services to provide to members eligible for both Medicare and Medi-Cal (duals).

Board of Governors

MOTION SUMMARY

Date September 6, 2012 Motion No. BOG 103.0912

Committee:


Issue: Increase the contract expenditure with Health Integrated by $800,000 and extend the term of the

contract until February 28, 2013, based on recent data that indicates a higher volume of authorization requests.

Background: DHS is contracted with L.A. Care as a Participating Provider Group (PPG) to provide

Medi-Cal covered services to approximately 73,000 MCLA members. While most DHS enrolled members receive Medi-Cal covered services at DHS hospital and clinic sites, there are instances where DHS must authorize services to be rendered by non-DHS providers (i.e. out-of-network). Due to rising SPD enrollment and continuity of care guidelines, the volume of DHS’s out-of-network authorization activity has increased significantly, and it has outpaced internal UM workload capacity. In order to ensure L.A. Care and DHS comply with state contractual and regulatory UM processing timeliness standards, L.A. Care engaged Health Integrated, an NCQA-accredited UM company, to expand administrative capacity to respond to the increased UM workload linked to out-of-network authorizations. On July 18, 2012, the Board approved motion FIN-B.0712 to procure UM administrative services from Health Integrated to process DHS authorizations for six months at a cost of $402,400. The contract was based on DHS authorization data logs, which indicated a volume of 1,300 authorizations per month. Additional research has confirmed that the actual volume of authorizations is approximately 4,000 to 5,000 monthly. The original amount budgeted for the agreement with Health Integrated under FIN-B.0712 will be exhausted prior to expiration of the anticipated contract term.

Staff is working closely with DHS to consider options to restructure authorization responsibilities. Long-term solutions could be implemented in February 2013. Staff is requesting an additional $800,000 to align and cover the costs of the interim workload under the current contracted scope of work with Health Integrated. The revised contract budget will ensure that L.A. Care and DHS maintain compliance with all applicable state contractual and regulatory requirements in processing authorizations and ensuring timely response to providers.

Budget Impact: There will be no budget impact on L.A. Care. DHS will reimburse L.A. Care for

costs incurred in connection with the UM vendor contract with Health Integrated.

Motion: To increase the contract expenditure with Health Integrated by $800,000 and extend the term of the contract until February 2013 for UM administrative services in connection with out-of-network services provided to L.A. Care Medi-Cal members assigned to DHS.

August 29, 2012 TO: Board of Governors FROM: Howard A. Kahn, Chief Executive Officer SUBJECT: CEO Report – September 2012 I hope you all had a relaxing summer and had the opportunity to take some well deserved time off. This is our first meeting since the Board retreat in July and to follow up to the robust discussion that was started during that meeting, staff is scheduling an off-site, closed session luncheon at the L.A. Athletic Club at noon prior to the Board meeting on September 6, 2012 for Board members and Executive staff. Lunch will be served. Please find below an update on organizational activities that occurred in July and August 2012. Additional updates will be made during my CEO report at the September 6, 2012 Board meeting. 1. Elaine Batchlor, MD, Joins Martin Luther King Hospital as CEO

It is with mixed emotions that I announce this week that Elaine Batchlor, MD, our Chief Medical Officer, will be leaving L.A. Care to assume the role of CEO at the new Martin Luther King Hospital. During her 8 ½ year tenure as Chief Medical Officer with L.A. Care, Elaine has been my partner in developing this organization into what it is today. Under her leadership, she oversaw our successful National Committee for Quality Assurance (NCQA) accreditation process, creation of HITEC-LA and other HIT efforts, disease management and quality improvement programs, the distribution of millions of dollars in performance-based incentives for physicians, and millions of dollars to support community benefits programs. In recognition of several important ongoing projects, Elaine has agreed to remain at L.A. Care through mid-October to ensure a smooth transition. I hope that you will join me in wishing her farewell and great success in her new endeavor.

2. Jonathan Freedman Joins L.A. Care as Chief of Strategy, Regulatory and External Affairs Jonathan Freedman is currently the Chief Deputy Director of the Los Angeles County Department of Public Health (DPH). In his capacity as L.A. Care’s new Chief of Strategy, Regulatory and External Affairs, beginning early October, Jonathan will work closely with me and the rest of the leadership team to develop and implement strategies and initiatives that improve the programmatic impact and public image of L.A. Care. He will oversee the departments that are focused on the support of external stakeholders and selected internal activities, including

CEO Report – September 2012

Strategic Planning, Government Relations, Communications and Marketing, Regulatory Affairs and Compliance, and other functions.

3. Angela Braly Resigns as President and CEO of WellPoint Angela Braly has stepped down from her position as president and CEO of WellPoint. The move came following calls for her replacement from investors after disappointing earnings last month. John Cannon, WellPoint's executive vice president, general counsel, corporate secretary and chief public affairs officer, will serve as interim president and CEO. I have attached a copy an article published in Modern HealthCare for more information.

4. SCAN to Pay $320 Million to State SCAN health plan has agreed to pay $320 million to resolve allegations that it was overpaid by the state's Medi-Cal program going back to 1985. This is the largest settlement of its kind from a single provider in Medi-Cal. I have attached a copy an article published in the Los Angeles Times for more information.

5. Los Angeles Times Letter to the Editor

The Los Angeles Times recently published a response I authored for their Letters to the Editor section in response to "Seniors would pay the price of Ryan's plan to overhaul Medicare" On August 16, 2012. In it, I stated that cuts to the Medicaid program are shortsighted and will not solve the budget crisis. Despite assertions that California’s Medi-Cal program tries to get more money from the federal government, Medi-Cal has the lowest reimbursement rates in the country and promotes efficient use of hospital services and drugs and other cost-cutting method. I have attached a copy of the article for your reference.

6. California’s Dual Eligibles Demonstration Pilot

Staff continues to work rigorously on the Duals Demonstration Pilot. The National Committee for Quality Assurance (NCQA), on behalf of the Centers for Medicaid and Medicare Services (CMS), and the State of California have completed the initial review of L.A. Care’s model of care (MOC). The overall MOC received a score of 91.25%, based on NCQA’s scoring criteria however deficiencies were identified by the State. L.A. Care and subcontracting health plans CareMore, SCAN and Care1st passed the CMS review. Medicare Operations addressed L.A. Care’s deficiencies identified by the State and submitted corrections.

As you may recall, L.A. Care released a joint RFP with Health Net to conduct health risk assessments for dual members. The vendor selected will be responsible for telephonic and potentially in person outreach. L.A. Care and Health Net have chosen four finalists. Interviews are scheduled for August 27 and 28, with the vendor to be selected in September. In addition, L.A. Care and Health Net have released a joint RFI focused on Long Term Services and Supports (LTSS). DHCS has indicated its willingness to allow L.A. Care and Health Net to collaborate on LTSS for members enrolling in the DDP as well as those who enroll in managed care for Medi-Cal benefits.

DHCS has indicated a willingness to reconsider the suggested staggered enrollment process and allow for an integrated process for DDP or Medi-Cal enrollment for LTSS commencing in June 2013.We continue to participate in statewide work groups as well as convening local sessions to solicit input from providers and advocates. The next outreach meeting is scheduled for September 14.


7. Community Based Adult Services (CBAS) Update

The Department of Health Care Services (DHCS) has yet to define many of the specifics of the CBAS implementation, scheduled to begin October 1, 2012. We have not yet received a contract amendment to incorporate CBAS as a health plan carve-in benefit nor have rates been established. Per program requirements, L.A. Care has issued facility contracts to all CBAS centers in L.A. County as well as facilities in neighboring counties where we know current members are receiving services. Staff will be conducting on-site visits during September 2012. L.A. Care is in the process of identifying a vendor to assist with required face-to-face assessment/re-assessment of CBAS recipients.

8. Care Harbor Event – September 27-30, 2012 As approved by the Board, L.A. Care is participating in the Care Harbor event to provide free medical, dental, vision, and preventive care to thousands of people. Care Harbor is the new identity of the massive health care community clinic previously known as Remote Area Medical and Care Now. L.A. Care has sponsored this event since its inception in 2009 and this year the Board approved a $150,000 grant to be a Presenting Sponsor of the event where we will have the naming rights of the entire event as well as the Dental Clinic. The Communications and Marketing Department worked with Care Harbor to create a co-branded logo, which is now being used on all signage and collateral materials. The event will be held at the Los Angeles Sports Arena on September 27 through 30. L.A. Care is encouraging staff to volunteer at the event.

9. Healthy Families Transition Update

The transition of Health Families members into Medi-Cal managed care is contingent upon CMS approval; however plans are working with the Department of Health Care Services (DHCS), the Department of Managed Health Care (DMHC) and the Managed Risk Medical Insurance Board (MRMIB) under the assumption that CMS will approve the proposed transition. The proposed start date for the first phase of the transition is January 1, 2013. DHCS is currently facilitating weekly conference calls with the Medi-Cal managed care plans to coordinate provider network evaluations and beneficiary notifications.

10. Dave Jones, California Insurance Commissioner, to Meet with L.A. Care

Dave Jones, California Insurance Commissioner, has requested to meet with L.A. Care’s leadership regarding Medicaid expansion, health care reform, the Exchange, and other topics. The meeting is scheduled for September 19, 2012 at L.A. Care.

11. California Health Benefit Exchange Meeting

I met with Peter Lee, Executive Director of the California Health Benefit Exchange on July 13, 2012 to discuss key Qualified Health Plan (QHP) recommendations and other policy decisions pending consideration by the Health Benefit Exchange. Based on my discussion with Mr. Lee, the Exchange seems to be extremely interested in accommodating policy changes that would facilitate the participation of Local Initiative plans in the Exchange. To that end, L.A. Care submitted several recommendations on the QHP requirements to Mr. Lee on August 1, 2012. The final QHP recommendations will be presented to the Exchange Board on August 23 so that an RFP can be released for QHP applicants in October 2012. Health Plan responses to the RFP will be due by the end of December 2012.


12. Health Plan Operations Report Please find attached to my report a quarterly update on health plan operations from Chief Operating Officer, John Wallace.

13. Meetings and Events of Interest

L.A. Care provided downtown meeting space for several community activities and trainings this past month:

• July 20, 2012 – L.A. Care hosted a Duals stakeholder outreach meeting for advocates and LTSS providers

• July 25, 2012 – L.A. Care hosted a meeting on new models for organization in medical management organized by the medical directors of the Local Initiative health plans and the Community Organized Health Systems in California with over 25 meeting participants.

• August 1, 2012 – L.A. Care hosted a HITEC-LA lunch in honor of the 3,000 priority primary care providers enrolled

• August 8, 2012- School Health Centers Policy Roundtable • August 15, 2012 – L.A. Care hosted an eConsult lunch for those involved in the program

to discuss their progress. Attached to my report is a list of sponsorships and events of interest for July and August 2012.

Attachments:

• July and August sponsorship list • Angela Braly resignation, Modern HealthCare article • SCAN settlement, Los Angeles Times article • Letter to the Editor, Los Angeles Times article • Health Plan Operations report through August 2012


July and August 2012 Participation and Sponsorship List

Event Date Organization Event/Conference Location

7/19/2012 Familia Unida Wheelchair Wash Los Angeles, CA

7/19/2012 Redwood MedNet Redwood MedNet Conference Rohnert Park, CA

7/20/2012 AltaMed East L.A. Meets Napa Los Angeles, CA

7/21/2012 Saban Free Clinic Extravaganza for the Senses Hollywood, CA

8/25/12 Community Coalition Power Festival Los Angeles, CA

Angela Braly resigns as president and CEO of WellPoint – Modern HealthCare By Andis Robeznieks Posted: August 28, 2012 - 7:00 pm ET http://www.modernhealthcare.com/article/20120828/NEWS/308289937/angela-braly-resigns-as-president-and-ceo-of-wellpoint# Angela Braly has abruptly stepped down from her position as president and CEO of WellPoint, an Indianapolis-based Blue Cross Blue Shield licensee with some 34 million members covered by Blues plans in several states including California. The move came following calls for her replacement from investors. A search committee has been established to consider both internal and external candidates, and John Cannon, WellPoint's executive vice president, general counsel, corporate secretary and chief public affairs officer, will serve as interim president and CEO, a news release said. The release also noted that Cannon told the board he did not wish to be considered as Braly's permanent replacement. Also Jackie Ward, WellPoint's lead director, has been named “non-executive chair” of the board of directors, effective immediately, the release said. “Our Board continues to believe that time will prove the wisdom of potentially transformative actions taken under Angela's leadership,” Ward said in the release, citing such actions as the sale of WellPoint's pharmacy benefit management business to Express Scripts and the proposed acquisition of Amerigroup, a Virginia Beach, Va.-based managed care provider for Medicare and Medicaid recipients, for $4.9 billion. “But now is the right time for a leadership change,” Ward added. “We believe the remaining executive team is dynamic and strong, with great potential to drive WellPoint's future success, and John Cannon in particular is the right person to lead our most important initiative, which is the completion of the Amerigroup transaction.” Royal Capital Management, a New York-based hedge fund and major WellPoint stockholder, had recently called for Braly's removal. Braly has placed on Modern Healthcare's 100 Most Influential People in Healthcare List six times, most recently placing ninth. In 2011, she was named to Modern Healthcare's list of the Top 25 Women in Healthcare.

Health plan pays record settlement- Los Angeles Times

SCAN of Long Beach was accused of being overpaid for Medi-Cal services dating to '85 http://www.latimes.com/business/la-fi-medi-cal-settlement-20120824,0,4746289.story By Chad Terhune August 24, 2012

A Long Beach health plan agreed to pay $320 million to resolve allegations that it was overpaid by the state's Medi-Cal program going back to 1985, government officials said.

Federal officials called the settlement from SCAN Health Plan the largest of its kind from a single provider in Medi-Cal, the state's Medicaid program for the poor and disabled.

Separately, the United States attorney's office in Los Angeles said SCAN paid an additional $3.8 million to settle a whistle-blower's allegation that the nonprofit company was overpaid by Medicarebecause of withholding of information about patients' diagnosis codes.

Medi-Cal is a joint state-federal program. Under the settlement announced Thursday, California will receive $190.5 million and the federal government will get $129.4 million.

SCAN said it did not admit any wrongdoing in settling both the Medi-Cal and Medicare allegations. SCAN serves more than 127,000 people in the state and 3,000 in Arizona.

Susan Hershman, an assistant U.S. attorney on the case, said the state was responsible for the Medi-Cal payment errors and prosecutors didn't find any evidence SCAN was at fault in that regard.

"We did not develop any evidence that SCAN participated in the setting of the rate or that SCAN ever knew the rates exceeded the legal cap set by state statute and regulations," Hershman said. "It was a mistake by the state of California."

State officials disagreed with that characterization. They said SCAN failed to provide contractually required financial information to the Department of Health Care Services, hampering its ability to identify the errors and adjust the rates.

"This settlement is a victory for the Medi-Cal beneficiaries we serve," said Toby Douglas, director of the California Department of Health Care Services.

"We will continue our ongoing efforts to strengthen programs that protect the integrity of Medi-Cal."

Some of the overpayments were related to long-term care patients SCAN treated at their homes. Federal officials said the state mistakenly reimbursed SCAN as though those patients were in anursing home, where the cost of care is higher.

A second error involved Medi-Cal paying SCAN for certain nursing home patients even though the company wasn't obligated to continue providing services to them.

SCAN said it decided to refund the overpayments once it learned of the state's errors.

"We're pleased that we can now focus our undivided attention on our core mission and passion: serving our members," Chris Wing, SCAN's chief executive, said in a statement.

"We played no role in how the state set rates for the population at issue, and we were previously unaware

of the mistake the state made."

William Hanagami, a Woodland Hills attorney representing the company whistle-blower, James Swoben, said he disputed the notion that SCAN wasn't aware of the overpayments by Medi-Cal.

"SCAN knew about the excessive profits and failed to provide data to Medi-Cal," Hanagami said. "Had they done that, the state would have seen these rates are too high."

Swoben, a former SCAN employee, filed his whistle-blower suit in 2009.

Hershman, the federal prosecutor, said SCAN used an outside company to review the billing codes submitted to Medicare for some of its patients. But she said the company submitted information related only to higher scores and didn't pass along data indicating lower payments.

"It generated scores that were a little higher than SCAN was due," she said.

Hershman said it hasn't been determined what portion of the $3.8-million federal settlement that Swoben, the whistle-blower, may receive.

Glenn Ferry, another federal investigator, said the government will continue to probe "new ways managed healthcare organizations may attempt to game" the system.

[email protected]

Letters: Fixing Medicare the hard way. latimes.com/news/opinion/letters/la-le-0816-thursday-paul-ryan-medicare-20120816,0,4019254.story August 16, 2012

Re "A budget to reshape the nation," Aug. 14

Does anyone remember why Medicare was created? In the "good old days" before Medicare, older people could not buy health insurance after they retired. Insurance companies would not sell to them, as most people have a preexisting condition by the time they reach 65. The elderly are bad for profits. A voucher system will not change this fact.

Medicare is the most effective and efficient insurance we have. Let's not mess with success.

Catherine G. Burke

San Gabriel

Rep. Paul D. Ryan's (R-Wis.) budget plan will not balance the budget for at least another 28 years. The heart of his plan appears to be a reworking of Medicare, but his changes wouldn't apply to anyone older than 55. Why wait?

If we are going to balance the budget, reduce the debt and get this country moving again, we should end Medicare today. Let's tell Ryan not to waste time.

Tom Martin

Atascadero, Calif.

Re "Ryan plan to change Medicare is flawed," Column, Aug. 14

David Lazarus repeats all of the familiar liberal refrains about Medicare in his attack on the Ryan plan: Yes, Medicare is too expensive and unsustainable, but we shouldn't fix it without higher taxes on the wealthy, which simple math proves wouldn't fix anything.

The primary strength of the Ryan plan is that it would incentivize people to do what would really make a difference: take better care of themselves. It would help restore the concept of personal responsibility, which has been gradually replaced by a destructive entitlement mentality.

Until benefits are accompanied by an expectation of responsibility, the problems of Medicare will only get worse.

Roger Moshgat

San Diego

I respect Stanford business professor Alain Enthoven and believe that incentives are necessary for states to contain healthcare costs. I also agree that our present health system gets a failing grade. But his assertion in Lazarus' column that "Medicaid has become a great big game by states to get more and more money from the federal government" couldn't be further from the truth here in California.

Our Medi-Cal program, with reimbursement rates among the lowest in the country and efficient use of hospital services and drugs and other cost-cutting methods, is one of the cheapest health deals around.

Simply slashing the already lean Medicaid program is shortsighted. At the end of the day, protecting the healthcare of our most vulnerable citizens must be our long-term goal. This is a mission, not a game.

Howard A. Kahn

Los Angeles

The writer is chief executive of the L.A. Care Health Plan.

1

John Wallace, Chief Operating Officer

Health Plan Operations Report through August 2012

2

Claims• Daily claims receipts have risen by 65% since December 2011 due to SPD

membership. However they have remained essentially flat since February.

3

Claims• Claims inventory is arguably the most visible claims indicator for our providers. Inventory

is the number of unprocessed claims at the end of each week. Controlling this inventory, especially during a period of heavy growth, is a major goal.

• Days receipts on hand (DROH) is a standard measure of inventory relative to the volume of claims received. We have consistently met our internal goal of maintaining inventory at less than 7 days.

# = Days Receipt On Hand (DROH)

4

Claims• The cost of labor per claim is one indication of the overall efficiency of the claims

payment process. Costs have remained below the December level, when staffing increased ahead of anticipated CHP transition volume.

5

Claims• Auto adjudication (AA) measures claims processed without the intervention of a claims

examiner. AA results in improved accuracy, timeliness, and efficiency of the claims payment process. While the number of AA claims has remained constant, the AA rate has declined from the previous fiscal year due to the increased number of SPD claims, which are more complex and more costly. Since January 2012, the AA rate has stabilized around 30%.

6

Member Services• Call volume has remained consistent at or above 140,000 calls per month since

January, while the abandonment rate continued to trend downward, well within the goal rate. July’s abandonment rate was less than 1% at 0.87%.

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

‐20,000 40,000 60,000 80,000

100,000 120,000 140,000 160,000 180,000

FY 2012 Call Center MetricsCall Volume and Abandonment Rate Trend

October 2011 through July 2012

Total ACD Calls Abandonment Rate Goal

7

Member Services• Total L.A. Care membership as of July 1, 2012 is 1,061,087 an increase of 0.41% over

from the previous month. Overall membership, variance to budget, is negative at -0.44%.

8

Member Services• MCLA and Healthy Families membership has contributed to total membership being

slightly below budgeted projections for the last three months.

880,000 900,000 920,000 940,000 960,000 980,000

1,000,000 1,020,000 1,040,000 1,060,000 1,080,000

Oct‐11 Nov‐11 Dec‐11 Jan‐12 Feb‐12 Mar‐12 Apr‐12 May‐12 Jun‐12 Jul‐12

Mem

bership

FY 2012 Total MembershipActual vs. Budget

October 2011 through July 2012

Budget Actual

9

Member Services• Office of the Member Advocate

The Member Advocate was established to facilitate resolution of barriers in access to care by helping the most vulnerable members navigate and understand the managed care system and serve as the primary point of contact for external agencies such as community-based organizations, advocacy groups, public agencies, regulatory agencies, member and families with complex issues or concerns. The Member Advocate manages relationships and strengthens linkages with community-based organization and other advocacy groups by providing education and support.

10

MedicareD-SNP• Risk Adjustment

In July, L.A. Care received a mid-year risk adjustment payment of $500,000 for PY 2012 (based on 2011 DOS), a 330% improvement compared to last year’s mid-year risk adjustment which resulted in a take back of -$217,000. In August, L.A. Care received final risk adjustment payment for payment year (PY) 2011 (for 2010 DOS) of $1.342M for Part C (285% increase from last year’s $348,224) and $92,614 for Part D, surpassing projections. These funds will be allocated to providers based on their individual contract provisions.Medicare Operations has made a tremendous effort over the past 2-3 years leading, planning, and executing a foundation for a sustainable risk adjustment infrastructure, to capture, record and report hierarchical condition categories (HCC). This is an organizational effort accomplished with the contribution of many other departments and we expect the trend will continue upward as the process matures, existing processes are fine tuned, and new processes are developed.

11

MedicareD-SNP• CY2013 Bid

The initial bid submitted in June proposed the same supplemental benefits as the previous year despite a low Star rating and continued decreases in the county benchmark. In 2013 the Los Angeles County benchmark (standardized at 1.0 risk score) decreased 5% to $902 over the previous year. L.A. Care’s 2.5 Star rating for 2013 resulted in a decrease of $4 in rebate dollars and reduced revenue of $13 PMPM. Our ability to maintain supplemental benefits such as transportation, vision, dental, and worldwide coverage was largely due to our improving management of administration and medical expenses.Based on the final CMS national average bid figures released in August, L.A. Care would have a premium of $1.20 higher than the target premium of $29.88 submitted in June. L.A. Care adjusted the 2013 MA/PD bids to reflect the national averages and assume the premium overage, resulting in the following changes to the bid:

– Update the Part D national average bid amounts – Reduce margin by 70 cents (50 cent impact on premium)– Reduced transportation trips from 32 to 28

Approval of the bid is expected by the end of August and fully executed agreements are expected by mid-September.

12

CMS Duals Application• Capitated Financial Alignment Demonstration Application

L.A. Care staff is working to address deficiencies noted in the July 31 CMS determination notice, including coordinating responses with Subcontracted Plans. Understandably, one of the prominent areas of focus is the provider network including, adequate network to support delivery of LTSS. The areas noted in the CMS communication will be among the areas reviewed during the combined CMS and DHCS readiness review expected in the fall. CMS and DHCS are finalizing their MOU, with execution anticipated by 12/15/2012. The MOU will be the basis of the three-way contract between CMS, DHCS and health plans.

13

Provider Network Operations• Providers, primarily in the ancillary provider area (dialysis, home health, SNF, surgery

centers), continue to be added to serve the SPD members and the newly transitioned members in the In-Home Supportive Services (IHSS) program.

• Work continues on drafting the CBAS facilities contract template and finalizing credentialing parameters in advance of the October 1, 2012 CBAS implementation date.

• PNO and Product Management staff are discussing the C-CAP model with hospitals and IPAs. L.A. Care has identified the initial pods (approximately 10 hospitals and their partner PPGs) and will begin C-CAP contract negotiations over the next few months.

• Staff continues to develop the Duals Pilot network. Objective, measurable subcontracting plan and IPA participation criteria was finalized. Preliminary Duals Pilot contract discussions with IPAs and health plans are ongoing.

Added Ancillary Providers‐ Current Period Total Ancillary Providers(Since April 2012)

35 438

14

Family Resource Centers- FY YTD• Class participation in the Lynwood Family Resource Center has remained steady at

nearly 2,000 participants for the last three months. Class participation at the Inglewood Family Resource Center remained steady at nearly 1,000 participants for the last three months. Consistent with previous year experience, participation at both FRCs is seasonal dropping between November and February.

15

Family Resource Centers- FY YTD

16

Family Resource Centers- FY YTD• Update on Family Resource Centers #3 and #4

Staff is focused on identifying a location for the third FRC in the San Fernando Valley. Two locations have been identified as potential sites and will be presented to executive leadership for additional guidance.L.A. Care is currently exploring the possibility of establishing a fourth FRC with the Los Angeles County Wellness Center, a partnership between First District Supervisor Gloria Molina and the California Endowment. Staff will conduct further research and present a complete analysis to the Board for consideration.

August 15, 2012 To: Board of Governors From: Elaine Batchlor, MD, MPH, Chief Medical Officer Subject: CMO Report for September 2012 1. Medical and Pharmacy Management Seniors and People with Disabilities Between June 2011 and May 2012, over 89,000 seniors and people with disabilities (SPDs) enrolled in L.A. Care’s directly-contracted network (MCLA). The SPD transition was completed in May 2012, but L.A. Care has continued to enroll about 2,500 members each month since then due to the delay in identification of SPD members at enrollment by the Department of Health Care Services (DHCS). Pharmacy With the increase in SPD members and in anticipation of enrollment of complex members with the duals pilot, staff is working on new programs to manage pharmacy costs, primarily on managing expensive specialty pharmaceuticals because as they are becoming a significant driver of pharmacy costs. Some programs focus on improving medication adherence, managing potential side effects, and improving access to specialty drugs for L.A. Care members. L.A. Care is also partnering with safety net clinics to leverage 340b purchasing of pharmaceuticals, which allows clinics to purchase medications at discounted prices. We are currently using this pricing at a hemophilia clinic, and anticipate partnering with two community clinics by the end of this year. The number of pharmacy authorization requests rose significantly from 411 in June 2011 to 1,716 in June 2012, with authorizations leveling off in the last few months. Member Services has hired additional staff to respond to the increase in authorization requests, and pharmacy technicians spend more time on authorizations to meet the 24-hour response requirement. A compliance rate of 99% was reached in July. Staff will continue to monitor the volume of prior authorizations and take appropriate steps to remain compliant with authorization timelines. Regulatory Audits Health Services participated in two regulatory audits in July: the Department of Health Care Services and Department of Managed Health Care’s routine medical survey which occurs every three years, and for the first time, an on-site Managed Risk Medical Insurance Board (MRMIB) Healthy Families program audit. The audits focused on evaluating L.A. Care’s compliance with regulatory and contractual requirements for quality assurance, utilization management, provider network adequacy, access and availability, continuity of care, and member rights. Both audits included a review of the compliance program. We anticipate the preliminary findings will be presented to us at the end of August. L.A. Care will have an opportunity to review and mitigate the findings prior to the final publication of the audit results.

September CMO Report August 15, 2012 Page 2 of 5 Medical Management Conference On July 25, 2012, the Medical Management Department hosted a meeting at L.A. Care, New Models for Organization in Medical Management. The meeting was organized by the medical directors of Local Initiative health plans and Community Organized Health Systems in California. The meeting objectives were to share ideas and best practices for medical management and develop innovative solutions for common issues affecting Medicaid health plans. Long Term Services and Supports Long Term Services and Supports (LTSS) refers to a wide variety of assistance programs for older adults and individuals with disabilities, allowing them to live independently in the community. Next year, L.A. Care will be required to provide LTSS for two groups of members: • members enrolled in Medi-Cal only, as required under the Governor’s Coordinated Care Initiative • members that will enroll in the Duals Demonstration Pilot.

Both the Coordinated Care Initiative and the Duals Pilot have a primary goal to move funding away from costly institutional care and towards services that support people living independently in the community. LTSS includes a defined package of services traditionally funded by Medi-Cal as well as additional services available in the community that are not usually health plan benefits but are known to support independent living. Long Term Services and Supports include In Home Supportive Services, Multipurpose Senior Services Program, Community Based Adult Services, and Skilled Nursing Facility long term care placements. Other LTSS services include home modifications, meal delivery, medication management, social programs, housing support, and assistive technology evaluations.

There are an estimated 174,000 individuals in L.A. County receiving a variety of LTSS. Beginning in March 2013, individuals who are not yet health plan members will be mandatorily enrolled in Medi-Cal managed care and will receive LTSS through a Medi-Cal health plan. Beneficiaries who are already enrolled in Medi-Cal managed care will receive these services through their health plan instead of fee-for-service Medi-Cal. Beneficiaries who join the Duals Demonstration Pilot will get LTSS through that program. L.A. Care and Health Net are collaborating on developing a managed care LTSS network in L.A. County, as required by the State. L.A. Care and Health Net believe that greater efficiency and coordination of care and services for members can be achieved through collaboration. A joint RFP will be released to identify vendors who have the experience, expertise, local knowledge, and community partnerships required to integrate an LTSS network of care into health plan operations. The goal is to have a vendor contract in place for the March 2013 launch of the Coordinated Care Initiative. Key to the success of the LTSS program will be communication, coordination and collaboration with the care management team at the health plans, as well as between the primary care provider, the member, and the member’s family and/or caregiver. Community Based Adult Services For the past year L.A. Care has been preparing to take over the management of a new Medi-Cal managed care benefit, Community Based Adult Services (CBAS), formerly the Adult Day Health Care (ADHC) program. The Department of Health Care Services (DHCS) ended ADHC in Spring 2012 and replaced it with CBAS, a nearly identical program. CBAS is a day program for adults at risk of placement in a nursing home because of a physical or cognitive disability, serious health condition, or significant mental illness. At a CBAS center, participants receive therapies, medication supervision, nutrition services, and other important services. CBAS also provides respite for family members and caregivers who are taking care of loved ones. Currently, the Los Angeles County Department of Health Services (DHS) has been managing and paying for the CBAS benefit.

September CMO Report August 15, 2012 Page 3 of 5 On October 1, 2012, L.A. Care and Health Net will begin managing the CBAS benefit. We estimate 6,000 Medi-Cal beneficiaries currently receiving CBAS through fee-for-service Medi-Cal will join L.A. Care on or before October 1. L.A. Care’s preparations to serve these members include contracting with the 150 CBAS centers in the County, conducting education and outreach to CBAS staff, participants and families, and developing internal capacity to manage the new benefit. L.A. Care is in the process of selecting a vendor to fulfill a new DHCS mandate that health plans conduct a face-to-face assessment of any member newly referred to a CBAS center. The assessment will determine the member’s eligibility for the program. Since most of the incoming CBAS members are dually eligible (entitled to both Medi-Cal and Medicare) but will join L.A. Care only for the Medi-Cal benefits, they can continue to go to their current Medicare doctors, pharmacies and hospitals. L.A. Care will provide the services that Medi-Cal covers, which includes non-emergency transportation, incontinence supplies, some medical equipment and hearing aids, and CBAS services. This CBAS transition also applies to our Plan Partners, since the beneficiaries joining in October 1 will have a choice of plans to join. All Plan Partners must meet contracting and operational requirements. In counties with County Organized Health Systems, such as Orange County, CBAS transitioned enrollees in the Medi-Cal managed care benefit package earlier this year, and we are learning from those health plans about the challenges and successes of that transition. The CBAS transition is the state’s first effort at moving benefits known as “Long Term Services and Supports” into Medi-Cal managed care, and paves the way for the Spring 2013 transition of the remainder of these benefits into Medi-Cal managed care. 2. Health Information Technology HITEC-LA HITEC-LA has enrolled over 3,800 providers, and has reached the goal of enrolling 3,000 priority primary care providers into the program. Our Service Partners are on-site with over 2,900 providers, helping them select, implement and meaningfully use electronic health records (EHR). Over 2,300 providers are live on an electronic health record and almost 600 have achieved Meaningful Use. In April 2010, L.A. Care provided 10 percent ($1,736,212) and received $15,625,910 in federal funding for the HITEC-LA program. In June 2012, L.A. Care received additional federal funds for this grant due to HITEC-LA’s positive results that were validated by the Office of the National Coordinator (ONC) biennial evaluation. ONC increased grants for Regional Extension Centers that were performing well, and decreased grants for Centers who were underperforming. Our new total program funding of $18,749,242 includes the 90 percent Federal share ($16,874,318) and the 10 percent L.A. Care match ($1,874,924). The new amount that L.A. Care will contribute is within the amount approved by the Board in April 2010. HITEC-LA Sustainability HITEC-LA is considering a number of projects to sustain the program. Two possible projects are described here. 1. Health Center Controlled Networks Grant The Health Resources and Services Administration (HRSA) will provide 25 to 30 grants to Health Center Controlled Networks (HCCNs) for a total of $20 million over three years, to enable adoption, implementation, and meaningful use of health information technology and clinic transformation and recognition as patient centered medical homes. HCCNs are groups of safety net providers that collaborate to improve access to care, enhance quality of care, and achieve cost efficiencies. The Community Clinics Association of Los Angeles County (CCALAC) plans to apply for an award of $625,000 per year for three years, for 26 of their Federally Qualified Health Centers. As a result of HITEC-

September CMO Report August 15, 2012 Page 4 of 5 LA’s excellent reputation and history of helping CCALAC clinics achieve meaningful use of EHRs, CCALAC has asked HITEC-LA to assist them in helping these clinics continue towards Stage 2 Meaningful Use and advance towards Patient Centered Medical Home (PCMH) status. HITEC-LA will look for opportunities to collaborate with other L.A. Care departments where there may be programmatic synergy to advance L.A. Care’s mission to support the safety net. 2. Medi-Cal Specialists Program The Department of Health Care Services’ (DHCS) California Medi-Cal Health Information Technology Plan proposes a program to assist Medi-Cal specialists implement EHRs and achieve Meaningful Use. These specialists are currently eligible for the Medi-Cal EHR Incentive Program but do not qualify for HITEC-LA’s technical assistance. HITEC-LA will pursue the opportunity to assist Medi-Cal specialists when DHCS releases a request for proposals. The DHCS grant will fund 90% of the program cost, and HITEC-LA will seek board approval to fund the 10% match. Medicare and Medi-Cal EHR Incentive Programs The Medicare and Medicaid EHR incentive programs provide payments to hospitals and eligible professionals nationwide to adopt, implement, upgrade and demonstrate Meaningful Use of EHRs. According to CMS, the Medicare and Medi-Cal incentive programs have paid $469 million to 236 California hospitals and 5,661 eligible professionals. The Medi-Cal program for eligible professionals has paid approximately $62 million to 2,922 eligible professionals since mid-May. Some stakeholders and providers have expressed concerns about the slow pace of Medi-Cal payments. HITEC-LA has not heard significant complaints, which may be because of L.A. Care’s HIT incentive program. Health Information Technology Incentive Program L.A. Care’s Health Information Technology Incentive Program offers high membership L.A. Care physicians up to $5,000 for enrollment in HITEC-LA, adopting or upgrading to a certified EHR system, and achieving Stage 1 Meaningful Use. Our incentive program complements the federal program mentioned above. Since December 2010, our program has paid $2,489,500 to 670 L.A. Care physicians, with 216 enrolling in HITEC-LA, 566 adopting an EHR, and 178 achieving Meaningful Use. HITEC-LA and incentives are helping physicians meet important milestones that will improve quality of care for our members through use of EHR. Safety Net eConsult Program In June 2011, the Board approved funding for an 18-month Safety Net eConsult project to develop and implement a common eConsult system for use by providers at community clinics and in the Los Angeles County Department of Health Services (DHS) network. To date, the program has been implemented at seven clinic sites, and is on track to roll out to all 50 clinic sites by the end of this year. The eConsult team has conducted 20 trainings for 55 specialist reviewers via webinar and in various locations throughout L.A. County. We have contracted with COPE Health Solutions, e2o Health, and Object Health as service partners to provide the clinics with on-site training and technical assistance. CCALAC has been engaged to provide a forum to develop best practices among users of the program. 3. Community Benefit Programs – Update on Previous Grant In 2009, under the Tranquada II initiative, L.A. Care provided support to small community clinics for assessment, planning and implementation of projects to strengthen infrastructure. Under phase 1 of the initiative, we provided $50,000 to the Garfield Health Center to engage in planning to assess clinic systems and overall infrastructure necessary to obtain Federally Qualified Health Center (FQHC) Look-Alike status. The center is located in the San Gabriel Valley and mainly serves immigrant populations of Chinese and

September CMO Report August 15, 2012 Page 5 of 5 Latino descent who primarily speak their native languages. Under phase 2 of the initiative, we provided the clinic with $125,000 to implement the system recommendations that resulted from the planning process. Garfield received its FQHC Look-Alike status in April of this year. Our support strengthened the clinic’s infrastructure to expand services and enhance quality of care, attracted other funders to the clinic, and diversified the patient revenue source, allowing the center to become more financially sustainable. Within a two-year period, the clinic has increased its patient base from 1,700 patients to 2,300 patients (a 30% increase). The clinic serves over 2,000 Healthy Way L.A. patients. The clinic received a grant from the Blue Shield Foundation for general operating support and a grant from the California Community Foundation for three-year strategic planning. We continue to support Garfield’s efforts to expand services, and in May of this year, the clinic was awarded $150,000 under Tranquada IV to provide services to SPDs and adults with complex medical and social needs. The clinic has acknowledged L.A. Care by highlighting our support in grant applications to private and government entities, and adding L.A. Care to its “Acknowledgement Wall”, which is prominently located in the waiting room. Garfield is an example of how seed funding and staff support have helped to create a more robust system of care for an entire community. Because of our initial support the clinic has been able to secure FQCH Look-Alike status, expand and improve the quality of its system of care, and secure additional funding.

\\Barstow\public\Board Services Public Folders\BoG Mtg Docs in Process\090612 BOG\BOG 102 Financial Report.docx Page 1 of 2

Board of Governors

MOTION SUMMARY


Committee:


Issue: Acceptance of the Financial Report for the nine months ended June 30, 2012.

Background:

Budget Impact:

Motion: To accept the Financial Report for the nine months ended June 30, 2012, as submitted.

Financial Performance June 2012

Financial Performance Results Index

Description Page

Highlights (All Products) i

Financial Statements (All Products) 1

Financial Statements (MediCal Plan Partners) 2

Financial Statements (DLOB) 3

Financial Statements (MCLA) 4

Exhibit (MCLA - SPD) 4a

Financial Statements (Medicare) 5

Financial Statements (HF-CHP) 6

Financial Statements (LAHF) 7

Financial Statements (IHSS) 8

Financial Statements (HK 0-5) 9

Financial Statements (HK 6-18) 10

Financial Statements (Community Programs) 11

Financial Statements (HITEC-LA) 12

Balance Sheet Statisitcs 13

Financial Performance Results Highlights Jun-12

Overall Highlights

Plan Partners

MCLA Highlights

June performance was a surplus of $3.2 million or 1.9% on revenue of $168.3 million. Performance improved by $10.0 million from a deficit of $6.8

million in May driven by lower cost of health care which included fiscal year-to-date adjustments for provider incentives. June membership increased

by 2,654 members to reach 1,056,776.

Fiscal year-to-date performance was a deficit of $20.1 million or -1.5% on revenue of $1.4 billion and was $11.2 million unfavorable to plan. The

unfavorable variance was driven by SPD.

June performance was a surplus of $8.0 million or 8.8% on revenue of $90.9 million. Performance improved by $5.8 million compared to May driven

by a fiscal year-to-date adjustment for provider incentives. June membership increased by 2,005 to 649,132 members.

Fiscal year-to-date performance was a surplus $22.5 million or 2.7% on revenue of $831.8 million. Performance was $15.5 million favorable to plan

driven by favorable administrative expense savings.

MCLA’s performance for June was a deficit of $1.8 million or -3.0% on revenue of $61.4 million. Performance improved by $4.2 million as compared

to May, driven by reduced cost of health care expenses. June membership increased by 721 to 334,538 members.

Fiscal year-to-date performance was a deficit of $29.0 million or -6.4% on revenue of $452.7 million. Performance was $22.1 million unfavorable to

plan driven by higher than expected inpatient and outpatient expense for SPD members.

MediCal Direct SPD membership decreased by 18 members to reach 71,568 in June. The operating margin decreased by $2.4 million compared to

the prior month which reflects the fiscal year-to-date adjustment related to the transition of CHP that was recognzed in May. Fiscal year-to-date

operating margin shows a loss of $28.0 million and was $32.6 million unfavorable to the budget driven by higher than expected cost of health care.

i

Medicare Highlights

Healthy Families Highlights

IHSS Highlights

Healthy Kids Highlights

Community Programs Highlights

HITEC-LA

Healthy Kids 0-5 performance resulted in a surplus at $1,000 and deteriorated by $26,000 compared to May. Fiscal year-to-date performance was a

surplus of $202,000 and was $190,000 favorable to plan.

Healthy Kids 6-18 results show a deficit of $589,000 which deteriorated by $82,000 compared to May. Fiscal year-to-date performance was a deficit

of $5.1 million and was $659,000 favorable to plan.

Fiscal year-to-date performance was a deficit of $3.9 million which was $1.3 million favorable to the budget driven by timing of grants.

Grant revenue is drawn-down based upon expenses incurred. Fiscal year-to-date there was a deficit of $488,000 which was $50,000 favorable to

plan.

Medicare performance resulted in a surplus of $92,000 or 2.7% on revenue of $3.4 million. Performance improved by $745,000 from a deficit of

$652,000 in May driven by higher revenue, lower cost of health care, and lower administrative expenses. Membership grew by 143 to reach 3,148

members in June.

Fiscal year-to-date results show a deficit of $1.2 million or -5.1% on revenue of $24.1 million which was $758,000 unfavorable to plan driven by

higher than expected pharmacy and inpatient expenses.

HFP CHP performance was a deficit of $73,000 and declined by $43,000 compared to May driven by higher inpatient expense. Fiscal year-to-date

performance was a deficit of $57,000 which was $416,000 favorable to budget driven by lower than expected cost of health care.

HFP LAC performance was a deficit of $24,000 which declined by $69,000 from a surplus of $46,000 in May driven by higher outpatient expense.

Fiscal year-to-date results show a surplus of $112,000 which was $817,000 favorable to plan with lower than expected cost of health care.

IHSS decreased by 5 members in June to reach 40,456. June performance was a deficit of $667,000, which improved by $369,000 compared to

May driven by lower cost of health care. Fiscal year-to-date results show a deficit of $1.9 million which was $2.0 million unfavorable to plan, driven by

higher than expected cost of healthcare.

i

Combined Operations Financial Statements ($ in thousands)

($) (PMPM) ($) (PMPM) ($) (PMPM) ($) (PMPM) ($) (PMPM) ($) (PMPM)

Membership

1,056,776 1,054,122 2,654 Current Month 1,056,776 1,058,215 (1,439)

1,068,126 1,062,329 5,797 Member Months 9,226,160 9,195,151 31,009

Revenue

$159,759 $149.57 $158,572 $149.27 $1,187 $0.30 Capitation $1,300,056 $140.91 $1,317,211 $143.25 ($17,155) ($2.34)

7,896 7.39 9,014 8.48 (1,117) (1.09) Maternity Kick 75,111 8.14 70,133 7.63 4,978 0.51

604 0.57 587 0.55 18 0.01 Grants 4,846 0.53 4,841 0.53 4 (0.00)

168,259 157.53 168,173 158.31 87 (0.78) Total Revenues 1,380,013 149.58 1,392,186 151.40 (12,173) (1.83)

Healthcare Expenses

113,072 105.86 113,993 107.30 (921) (1.44) Capitation 946,642 102.60 973,295 105.85 26,653 3.24

5,052 4.73 5,735 5.40 (683) (0.67) Maternity Kick 51,091 5.54 51,374 5.59 283 0.05

(2,901) (2.72) 2,072 1.95 (4,973) (4.67) Provider Incentives 19,347 2.10 30,960 3.37 11,613 1.27

340 0.32 294 0.28 46 0.04 Shared Risk 2,149 0.23 2,738 0.30 590 0.06

15,969 14.95 18,855 17.75 (2,887) (2.80) Inpatient Claims 122,288 13.25 77,461 8.42 (44,828) (4.83)

12,148 11.37 11,199 10.54 949 0.83 Outpatient Claims 78,435 8.50 63,306 6.88 (15,129) (1.62)

0 0.00 145 0.14 (145) (0.14) Prior Period IP Exposure 2,903 0.31 0 0.00 (2,903) (0.31)

63 0.06 968 0.91 (905) (0.85) Skilled Nursing Facility 4,620 0.50 0 0.00 (4,620) (0.50)

11,907 11.15 10,555 9.94 1,352 1.21 Pharmacy 87,614 9.50 94,823 10.31 7,209 0.82

912 0.85 3,003 2.83 (2,092) (1.97) Medical Administrative Expenses 22,373 2.42 33,692 3.66 11,319 1.24

156,561 146.58 166,819 157.03 (10,258) (10.46) Total Healthcare Expenses 1,337,462 144.96 1,327,648 144.39 (9,814) (0.58)

MCR(%)

11,698 10.95 1,353 1.27 10,345 9.68 Operating Margin 42,551 4.61 64,538 7.02 (21,987) 2.41

7,337 6.87 7,837 7.38 (500) (0.51) Total Operating Expenses 61,274 6.64 72,379 7.87 11,105 1.23

Admin Ratio(%)

4,361 4.08 (6,483) (6.10) 10,845 10.19 Income from Operations (18,723) (2.03) (7,841) (0.85) (10,881) (1.18)

(1,193) (1.12) (315) (0.30) (877) (0.82) Total Non-Operating Income (Expense) (1,380) (0.15) (1,044) (0.11) (336) (0.04)

$3,169 $2.97 ($6,799) ($6.40) $9,967 $9.37 Net Surplus(Deficit) ($20,103) ($2.18) ($8,885) ($0.97) ($11,217) ($1.21)

Margin(%) -0.8%

4.4% 4.7% -0.3% 4.4% 5.2% 0.8%

1.9% -4.0% 5.9% -1.5% -0.6%

-1.6%

Month Month (Decrease) Actual Budget Budget

93.0% 99.2% -6.1% 96.9% 95.4%

June 2012

Current Prior Increase YTD YTD Fav<Unfav>

Page 1

MediCal Plan Partner Financial Statements ($ in thousands)


Membership

649,132 647,127 2,005 Current Month 649,132 640,612 8,520

657,267 653,441 3,826 Member Months 6,202,143 6,151,115 51,028

Revenue

$85,314 $129.80 $84,615 $129.49 $699 $0.31 Capitation $775,679 $125.07 $771,727 $125.46 $3,952 ($0.40)

5,558 8.46 6,302 9.64 (744) (1.19) Maternity Kick 56,147 9.05 56,454 9.18 (308) (0.13)

90,872 138.26 90,917 139.14 (45) (0.88) Total Revenues 831,825 134.12 828,181 134.64 3,644 (0.52)

Healthcare Expenses

78,059 118.76 77,429 118.49 631 0.27 Capitation 708,829 114.29 701,609 114.06 (7,220) (0.23)

5,052 7.69 5,735 8.78 (683) (1.09) Maternity Kick 51,091 8.24 51,374 8.35 283 0.11

(3,509) (5.34) 1,717 2.63 (5,227) (7.97) Provider Incentives 15,077 2.43 24,890 4.05 9,813 1.62

0 0.00 0 0.00 0 0.00 Inpatient Claims 6 0.00 0 0.00 (6) (0.00)

3 0.00 0 0.00 3 0.00 Outpatient Claims 5 0.00 0 0.00 (5) (0.00)

0 0.00 145 0.22 (145) (0.22) Prior Period IP Exposure 2,903 0.47 0 0.00 (2,903) (0.47)

1,174 1.79 1,348 2.06 (174) (0.28) Medical Administrative Expenses 11,241 1.81 11,097 1.80 (145) (0.01)

80,779 122.90 86,374 132.18 (5,595) (9.28) Total Healthcare Expenses 789,153 127.24 788,969 128.26 (184) 1.03

MCR(%)

10,093 15.36 4,543 6.95 5,550 8.40 Operating Margin 42,672 6.88 39,213 6.37 3,460 (0.51)


Admin Ratio(%)

8,015 12.19 2,237 3.42 5,778 8.77 Income from Operations 22,534 3.63 7,066 1.15 15,469 2.48

0 0.00 0 0.00 0 0.00 Total Non-Operating Income (Expense) 0 0.00 0 0.00 0 0.00

$8,015 $12.19 $2,237 $3.42 $5,778 $8.77 Net Surplus(Deficit) $22,534 $3.63 $7,066 $1.15 $15,469 $2.48

Margin(%) 1.9%

2.3% 2.5% -0.2% 2.4% 3.9% 1.5%

8.8% 2.5% 6.4% 2.7% 0.9%

0.4%


88.9% 95.0% -6.1% 94.9% 95.3%

June 2012


Page 2

Direct Lines Financial Statements ($ in thousands)


Membership

397,204 396,408 796 Current Month 397,204 407,278 (10,074)

400,398 398,287 2,111 Member Months 2,924,690 2,945,593 (20,903)

Revenue

$74,291 $185.54 $73,801 $185.30 $490 $0.25 Capitation $522,923 $178.80 $544,039 $184.70 ($21,116) ($5.90)

2,338 5.84 2,711 6.81 (374) (0.97) Maternity Kick 18,964 6.48 13,679 4.64 5,286 1.84

76,629 191.38 76,512 192.10 116 (0.72) Total Revenues 541,887 185.28 557,718 189.34 (15,831) (4.06)

Healthcare Expenses

34,696 86.65 36,244 91.00 (1,548) (4.34) Capitation 234,811 80.29 268,714 91.23 33,904 10.94

608 1.52 354 0.89 254 0.63 Provider Incentives 4,289 1.47 6,070 2.06 1,782 0.59

333 0.83 296 0.74 37 0.09 Shared Risk 2,157 0.74 2,681 0.91 525 0.17




11,847 29.59 10,501 26.37 1,346 3.22 Pharmacy 87,134 29.79 94,385 32.04 7,251 2.25

(295) (0.74) 1,618 4.06 (1,913) (4.80) Medical Administrative Expenses 10,732 3.67 21,963 7.46 11,231 3.79

75,188 187.78 79,842 200.46 (4,654) (12.68) Total Healthcare Expenses 542,597 185.52 532,936 180.93 (9,661) (4.60)

MCR(%)

1,441 3.60 (3,330) (8.36) 4,771 11.96 Operating Margin (710) (0.24) 24,782 8.41 (25,492) 8.66


Admin Ratio(%)

(2,489) (6.22) (7,664) (19.24) 5,175 13.03 Income from Operations (31,822) (10.88) (8,371) (2.84) (23,451) (8.04)

($2,489) ($6.22) ($7,664) ($19.24) $5,175 $13.03 Net Surplus(Deficit) ($31,822) ($10.88) ($8,371) ($2.84) ($23,451) ($8.04)

Margin(%)

* Direct Lines of Business include MCLA, Medicare, Healthy Families and Healthy Kids 0-5

-4.4%

5.1% 5.7% -0.5% 5.7% 5.9% 0.2%

-3.2% -10.0% 6.8% -5.9% -1.5%

-4.6%


98.1% 104.4% -6.2% 100.1% 95.6%

June 2012


Page 3

MCLA Financial Statements ($ in thousands)


Membership

334,538 333,817 721 Current Month 334,538 345,812 (11,274)

337,712 335,667 2,045 Member Months 2,525,991 2,555,912 (29,921)

Revenue

$59,019 $174.76 $58,950 $175.62 $69 ($0.86) Capitation $433,716 $171.70 $459,299 $179.70 ($25,582) ($8.00)

2,338 6.92 2,711 8.08 (374) (1.16) Maternity Kick 18,964 7.51 13,679 5.35 5,286 2.16

61,357 181.68 61,661 183.70 (304) (2.01) Total Revenues 452,681 179.21 472,977 185.05 (20,297) (5.84)

Healthcare Expenses

23,445 69.42 25,153 74.93 (1,707) (5.51) Capitation 174,146 68.94 211,780 82.86 37,633 13.92

596 1.76 316 0.94 280 0.82 Provider Incentives 4,051 1.60 5,620 2.20 1,570 0.60

232 0.69 228 0.68 4 0.01 Shared Risk 1,402 0.55 1,661 0.65 260 0.10




11,133 32.97 9,477 28.23 1,656 4.73 Pharmacy 81,974 32.45 90,213 35.30 8,239 2.84

(550) (1.63) 1,328 3.96 (1,878) (5.58) Medical Administrative Expenses 8,716 3.45 17,623 6.90 8,907 3.44

60,290 178.52 64,474 192.08 (4,184) (13.55) Total Healthcare Expenses 458,419 181.48 453,928 177.60 (4,490) (3.88)

MCR(%)

1,067 3.16 (2,813) (8.38) 3,880 11.54 Operating Margin (5,738) (2.27) 19,049 7.45 (24,787) 9.72


Admin Ratio(%)

(1,819) (5.39) (6,018) (17.93) 4,200 12.54 Income from Operations (28,967) (11.47) (6,879) (2.69) (22,088) (8.78)

($1,819) ($5.39) ($6,018) ($17.93) $4,200 $12.54 Net Surplus(Deficit) ($28,967) ($11.47) ($6,879) ($2.69) ($22,088) ($8.78)

Margin(%) -4.9%

4.7% 5.2% -0.5% 5.1% 5.5% 0.4%

-3.0% -9.8% 6.8% -6.4% -1.5%

-5.3%


98.3% 104.6% -6.3% 101.3% 96.0%

June 2012


Page 4

MCLA SPD Exhibit ($ in thousands)


Membership

71,568 71,586 (18) Current Month 71,568 77,986 (6,418)

70,714 71,070 (356) Member Months 506,940 529,430 (22,490)

Revenue

$33,114 $468.28 $33,309 $468.68 ($195) ($0.40) Capitation $237,567 $468.63 $248,451 $469.28 ($10,885) ($0.65)

33,114 468.28 33,309 468.68 (195) (0.40) Total Revenues 237,567 468.63 248,451 469.28 (10,885) (0.65)

Healthcare Expenses

11,598 164.01 11,757 165.42 (159) (1.42) Capitation 83,755 165.22 104,390 197.17 20,635 31.96

0 0.00 0 0.00 0 0.00 Quality Improvement Fee 0 0.00 0 0.00 0 0.00

0 0.00 0 0.00 0 0.00 Maternity Kick 0 0.00 0 0.00 0 0.00

124 1.76 81 1.14 44 0.62 Provider Incentives 832 1.64 2,485 4.69 1,653 3.05

813 11.50 (1,654) (23.28) 2,468 34.78 Shared Risk 3,039 5.99 868 1.64 (2,171) (4.35)



0 0.00 0 0.00 0 0.00 Prior Period IP Exposure 0 0.00 0 0.00 0 0.00


8,487 120.01 6,407 90.14 2,080 29.87 Pharmacy 60,340 119.03 67,254 127.03 6,914 8.00

(509) (7.20) 515 7.24 (1,024) (14.44) Medical Administrative Expenses 3,264 6.44 5,045 9.53 1,781 3.09

37,448 529.57 35,236 495.80 2,212 33.78 Total Healthcare Expenses 265,534 523.80 243,846 460.58 (21,688) (63.22)

MCR(%)

($4,334) ($61.29) ($1,927) ($27.11) ($2,407) ($34.18) Operating Margin ($27,967) ($55.17) $4,605 $8.70 ($32,573) $63.87

* MCLA SPD Financial Statements excluded members that have Medicare as primary.

111.8% 98.1%7.3% -13.6%113.1% 105.8%

Exhibit for information purposes only. Not a financial Statement

June 2012

Fav<Unfav>


Current Prior Increase YTD YTD

Page 4a

Medicare Financial Statements ($ in thousands)


Membership

3,148 3,005 143 Current Month 3,148 2,770 378

3,154 3,011 143 Member Months 23,808 22,061 1,747

Revenue

$3,114 $987.41 $2,685 $891.88 $429 $95.53 Part C $22,101 $928.29 $22,530 $1,021.26 ($429) ($92.97)

292 92.56 293 97.32 (1) (4.76) Part D 1,993 83.73 0 0.00 1,993 83.73

3,406 1079.97 2,978 989.19 428 90.77 Total Revenues 24,094 1012.02 22,530 1021.26 1,564 (9.24)

Healthcare Expenses

1,222 387.31 1,054 349.90 168 37.41 Capitation 8,581 360.41 8,455 383.25 (126) 22.84

11 3.60 38 12.49 (26) (8.90) Provider Incentives 209 8.78 450 20.40 241 11.62

75 23.81 31 10.27 44 13.54 Shared Risk 451 18.95 705 31.95 254 13.00

884 280.35 1,066 354.01 (182) (73.65) Inpatient Claims 7,190 301.99 5,872 266.15 (1,318) (35.84)

433 137.19 276 91.50 157 45.69 Outpatient Claims 1,896 79.62 1,875 84.97 (21) 5.35

8 2.62 102 33.99 (94) (31.36) Skilled Nursing Facility 481 20.22 0 0.00 (481) (20.22)

171 54.29 473 157.17 (302) (102.87) Pharmacy 2,269 95.29 1,627 73.75 (642) (21.54)

86 27.12 105 34.76 (19) (7.64) Medical Administrative Expenses 909 38.16 954 43.26 46 5.09

2,890 916.29 3,144 1,044.08 (254) (127.79) Total Healthcare Expenses 21,985 923.42 19,937 903.73 (2,048) (19.70)

MCR(%)

516 163.67 (165) (54.89) 681 218.56 Operating Margin 2,109 88.60 2,593 117.54 (484) 28.94

424 134.43 487 161.75 (63) (27.32) Total Operating Expenses 3,356 140.96 3,081 139.67 (275) (1.29)

Admin Ratio(%)

92 29.24 (652) (216.64) 745 245.89 Income from Operations (1,246) (52.36) (488) (22.13) (758) (30.22)

$92 $29.24 ($652) ($216.64) $745 $245.89 Net Surplus(Deficit) ($1,246) ($52.36) ($488) ($22.13) ($758) ($30.22)

Margin(%) -3.0%

12.4% 16.4% -3.9% 13.9% 13.7% -0.3%

2.7% -21.9% 24.6% -5.2% -2.2%

-2.8%


84.8% 105.5% -20.7% 91.2% 88.5%

June 2012


Page 5

CHP Healthy Families Financial Statements ($ in thousands)


Membership

6,418 6,481 (63) Current Month 6,418 6,780 (362)

6,393 6,460 (67) Member Months 59,331 61,098 (1,767)

Revenue

$434 $67.83 $438 $67.84 ($5) ($0.01) Capitation $4,020 $67.76 $4,137 $67.71 ($117) $0.05

434 67.83 438 67.84 (5) (0.01) Total Revenues 4,020 67.76 4,137 67.71 (117) 0.05

Healthcare Expenses

168 26.21 169 26.21 (2) (0.00) Capitation 1,553 26.18 1,603 26.23 50 0.06

0 0.00 0 0.00 0 0.00 Provider Incentives 2 0.04 0 0.00 (2) (0.04)

12 1.93 15 2.36 (3) (0.43) Shared Risk 139 2.34 122 2.00 (16) (0.34)

88 13.71 41 6.38 46 7.33 Inpatient Claims 454 7.66 334 5.46 (121) (2.20)

79 12.28 76 11.71 3 0.57 Outpatient Claims 687 11.58 1,013 16.58 326 5.00

0 0.00 0 0.00 0 0.00 Skilled Nursing Facility 2 0.04 0 0.00 (2) (0.04)

26 4.12 43 6.66 (17) (2.54) Pharmacy 228 3.85 232 3.80 4 (0.05)

20 3.09 19 2.90 1 0.19 Medical Administrative Expenses 169 2.85 685 11.21 515 8.35

392 61.34 363 56.22 29 5.12 Total Healthcare Expenses 3,235 54.53 3,989 65.28 753 10.75

MCR(%)

41 6.49 75 11.62 (34) (5.13) Operating Margin 785 13.23 148 2.43 636 (10.80)

115 17.94 105 16.24 10 1.70 Total Operating Expenses 842 14.19 622 10.18 (220) (4.01)

Admin Ratio(%)

(73) (11.45) (30) (4.63) (43) (6.83) Income from Operations (57) (0.96) (474) (7.75) 416 6.79

($73) ($11.45) ($30) ($4.63) ($43) ($6.83) Net Surplus(Deficit) ($57) ($0.96) ($474) ($7.75) $416 $6.79

Margin(%) 10.0%

26.4% 23.9% 2.5% 20.9% 15.0% -5.9%

-16.9% -6.8% -10.1% -1.4% -11.4%

15.9%


90.4% 82.9% 7.6% 80.5% 96.4%

June 2012


Page 6

LAC Healthy Families Financial Statements ($ in thousands)


Membership

11,073 11,031 42 Current Month 11,073 11,882 (809)

11,073 11,031 42 Member Months 97,682 101,650 (3,968)

Revenue

$802 $72.46 $801 $72.59 $2 ($0.13) Capitation $7,083 $72.51 $7,398 $72.78 ($316) ($0.28)

802 72.46 801 72.59 2 (0.13) Total Revenues 7,083 72.51 7,398 72.78 (316) (0.28)

Healthcare Expenses

288 25.98 287 25.99 1 (0.01) Capitation 2,538 25.99 2,701 26.57 162 0.58

0 0.04 0 0.04 (0) (0.00) Provider Incentives 30 0.30 0 0.00 (30) (0.30)

14 1.27 19 1.74 (5) (0.47) Shared Risk 164 1.68 182 1.79 18 0.11

66 5.95 59 5.32 7 0.63 Inpatient Claims 463 4.74 619 6.09 156 1.35

202 18.21 115 10.44 86 7.77 Outpatient Claims 1,535 15.71 1,970 19.38 435 3.66

50 4.55 52 4.72 (2) (0.17) Pharmacy 476 4.88 503 4.95 27 0.08


654 59.04 569 51.63 84 7.41 Total Healthcare Expenses 5,511 56.42 6,872 67.60 1,360 11.18

MCR(%)

149 13.42 231 20.97 (83) (7.54) Operating Margin 1,571 16.08 527 5.18 1,044 (10.90)

172 15.57 186 16.82 (13) (1.25) Total Operating Expenses 1,459 14.94 1,232 12.12 (227) (2.82)

Admin Ratio(%)

(24) (2.14) 46 4.15 (69) (6.29) Income from Operations 112 1.15 (705) (6.94) 817 8.08

($24) ($2.14) $46 $4.15 ($69) ($6.29) Net Surplus(Deficit) $112 $1.15 ($705) ($6.94) $817 $8.08

Margin(%) 11.1%

21.5% 23.2% -1.7% 20.6% 16.7% -3.9%

-3.0% 5.7% -8.7% 1.6% -9.5%

15.1%


81.5% 71.1% 10.4% 77.8% 92.9%

June 2012


Page 7

IHSS Financial Statements ($ in thousands)


Membership

40,456 40,461 (5) Current Month 40,456 38,526 1,930

40,492 40,504 (12) Member Months 202,221 189,409 12,812

Revenue

$10,441 $257.86 $10,440 $257.76 $1 $0.09 Capitation $52,140 $257.84 $48,837 $257.84 $3,303 ($0.00)

10,441 257.86 10,440 257.76 1 0.09 Total Revenues 52,140 257.84 48,837 257.84 3,303 (0.00)

Healthcare Expenses

9,527 235.27 9,533 235.35 (6) (0.08) Capitation 47,519 234.99 43,709 230.77 (3,810) (4.22)

440 10.86 521 12.86 (81) (2.00) Inpatient Claims 1,128 5.58 0 0.00 (1,128) (5.58)

315 7.79 543 13.40 (227) (5.61) Outpatient Claims 1,109 5.48 0 0.00 (1,109) (5.48)

0 0.00 30 0.75 (30) (0.75) Skilled Nursing Facility 39 0.19 0 0.00 (39) (0.19)

462 11.40 458 11.32 3 0.08 Pharmacy 2,096 10.36 1,754 9.26 (342) (1.10)

111 2.74 123 3.04 (12) (0.30) Medical Administrative Expenses 582 2.88 1,499 7.91 917 5.04

10,854 268.06 11,208 276.72 (354) (8.65) Total Healthcare Expenses 52,472 259.48 46,962 247.94 (5,510) (11.54)

MCR(%)

(413) (10.21) (768) (18.95) 354 8.75 Operating Margin (332) (1.64) 1,875 9.90 (2,207) 11.54

254 6.28 269 6.64 (15) (0.36) Total Operating Expenses 1,533 7.58 1,712 9.04 179 1.46

Admin Ratio(%)

(667) (16.48) (1,037) (25.59) 369 9.11 Income from Operations (1,865) (9.22) 163 0.86 (2,029) (10.09)

($667) ($16.48) ($1,037) ($25.59) $369 $9.11 Net Surplus(Deficit) ($1,865) ($9.22) $163 $0.86 ($2,029) ($10.09)

Margin(%) -3.9%

2.4% 2.6% -0.1% 2.9% 3.5% 0.6%

-6.4% -9.9% 3.5% -3.6% 0.3%

-4.5%


104.0% 107.4% -3.4% 100.6% 96.2%

June 2012


Page 8

Healthy Kids 0-5 Financial Statements ($ in thousands)


Membership

1,571 1,613 (42) Current Month 1,571 1,508 63

1,574 1,614 (40) Member Months 15,657 15,463 194

Revenue

$188 $119.67 $193 $119.66 ($5) $0.02 Capitation $1,870 $119.42 $1,838 $118.87 $32 $0.55

188 119.67 193 119.66 (5) 0.02 Total Revenues 1,870 119.42 1,838 118.87 32 0.55

Healthcare Expenses

48 30.20 49 30.20 (1) (0.00) Capitation 473 30.21 467 30.19 (6) (0.02)

0 0.02 0 0.02 0 0.00 Provider Incentives (3) (0.20) 0 0.00 3 0.20

(0) (0.12) 2 1.45 (3) (1.57) Shared Risk 1 0.08 11 0.73 10 0.64

11 6.71 15 9.02 (4) (2.31) Inpatient Claims 145 9.24 125 8.09 (20) (1.15)

40 25.68 16 9.64 25 16.04 Outpatient Claims 216 13.81 285 18.46 69 4.65

5 3.11 (3) (1.88) 8 4.99 Pharmacy 91 5.81 55 3.55 (36) (2.26)


108 68.67 84 52.02 24 16.65 Total Healthcare Expenses 974 62.22 1,248 80.70 274 18.48

MCR(%)

80 51.01 109 67.64 (29) (16.63) Operating Margin 896 57.20 590 38.17 305 (19.03)

79 50.08 82 50.74 (3) (0.66) Total Operating Expenses 693 44.29 579 37.42 (115) (6.87)

Admin Ratio(%)

1 0.93 27 16.90 (26) (15.97) Income from Operations 202 12.92 12 0.76 190 12.16

$1 $0.93 $27 $16.90 ($26) ($15.97) Net Surplus(Deficit) $202 $12.92 $12 $0.76 $190 $12.16

Margin(%) 10.2%

41.8% 42.4% -0.6% 37.1% 31.5% -5.6%

0.8% 14.1% -13.3% 10.8% 0.6%

15.8%


57.4% 43.5% 13.9% 52.1% 67.9%

June 2012


Page 9

Healthy Kids 6-18 Financial Statements ($ in thousands)


Membership

10,440 10,587 (147) Current Month 10,440 10,325 115

10,461 10,601 (140) Member Months 99,327 98,443 884

Revenue

$154 $14.73 $156 $14.73 ($2) ($0.00) Premiums $1,455 $14.64 $1,445 $14.68 $9 ($0.04)

0 0.00 100 9.43 (100) (9.43) CHI Grants 450 4.53 0 0.00 450 4.53

154 14.73 256 24.17 (102) (9.44) Total Revenues 1,905 19.17 1,445 14.68 459 4.49

Healthcare Expenses

316 30.22 320 30.22 (4) (0.00) Capitation 3,002 30.23 2,972 30.19 (30) (0.04)

0 0.01 0 0.01 (0) (0.00) Provider Incentives (19) (0.19) 0 0.00 19 0.19

7 0.65 (2) (0.16) 8 0.81 Shared Risk (8) (0.08) 57 0.58 65 0.66

71 6.80 94 8.83 (23) (2.04) Inpatient Claims 612 6.16 353 3.58 (259) (2.58)

107 10.26 99 9.31 9 0.95 Outpatient Claims 1,245 12.54 1,291 13.11 46 0.58

60 5.71 54 5.08 6 0.63 Pharmacy 480 4.83 439 4.46 (41) (0.38)


594 56.77 603 56.85 (9) (0.08) Total Healthcare Expenses 5,632 56.70 5,743 58.34 112 1.64

MCR(%)

(440) (42.04) (346) (32.68) (93) (9.36) Operating Margin (3,727) (37.52) (4,298) (43.66) 571 (6.14)

150 14.30 161 15.19 (11) (0.89) Total Operating Expenses 1,363 13.72 1,451 14.74 88 1.02

Admin Ratio(%)

(589) (56.34) (507) (47.87) (82) (8.47) Income from Operations (5,090) (51.24) (5,749) (58.40) 659 7.16

($589) ($56.34) ($507) ($47.87) ($82) ($8.47) Net Surplus(Deficit) ($5,090) ($51.24) ($5,749) ($58.40) $659 $7.16

Margin(%)

* Healthy Kids 6-18 Member premiums at $15 were effective July 1, 2010.

** The Healthy Kids 6-18 program is fully reserved for the current fiscal year's operations at $5.9 million.

130.6%

97.1% 62.8% 34.2% 71.5% 100.4% 28.9%

-382.4% -198.1% -184.3% -267.2% -397.8%

101.7%


385.4% 235.2% 150.1% 295.7% 397.4%

June 2012


Page 10

Community Programs Financial Statements ($ in thousands)


Revenue

$0 $0.00 $0 $0.00 $0 $0.00 Pay for Performance $0 $0.00 $0 $0.00 $0 $0.00

0 0.00 0 0.00 0 0.00 Total Revenues 0 0.00 0 0.00 0 0.00

Healthcare Expenses

0 0.00 0 0.00 0 0.00 Medical Administrative Expenses 80 80.27 0 0.00 (80) (80.27)

0 0.00 0 0.00 0 0.00 Total Healthcare Expenses 80 80.27 0 0.00 (80) (80.27)

MCR(%)

0 0.00 0 0.00 0 0.00 Operating Margin (80) (80.27) 0 0.00 (80) 80.27

267 266.57 338 337.61 (71) (71.04) Total Operating Expenses 2,269 2,269.10 2,945 2,944.91 676 675.81

(267) (266.57) (338) (337.61) 71 71.04 Income from Operations (2,349) (2,349.37) (2,945) (2,944.91) 596 595.53

(1,300) (1,300.00) (137) (136.82) (1,163) (1,163.18) Total Non-Operating Income (Expense) 1,504 1,503.82 2,250 2,250.00 (746) (746.18)

($1,567) ($1,566.57) ($474) ($474.43) ($1,092) ($1,092.14) Net Surplus(Deficit) ($846) ($845.55) ($695) ($694.91) ($151) ($150.65)

-8027.5%


0.0% 0.0% 0.0% 8027.5% 0.0%

June 2012


Page 11

HITEC-LA Financial Statements ($ in thousands)


Revenue

$604 $604.29 $487 $486.56 $118 $117.73 Pay for Performance $4,396 $4,395.54 $4,841 $4,841.16 ($446) ($445.62)

604 604.29 487 486.56 118 117.73 Total Revenues 4,396 4395.54 4,841 4841.16 (446) (445.62)

Healthcare Expenses

0 0.00 0 0.00 0 0.00 Medical Administrative Expenses 0 0.00 0 0.00 0 0.00

0 0.00 0 0.00 0 0.00 Total Healthcare Expenses 0 0.00 0 0.00 0 0.00

MCR(%)

604 604.29 487 486.56 118 117.73 Operating Margin 4,396 4,395.54 4,841 4,841.16 (446) 445.62

671 671.43 541 540.62 131 130.82 Total Operating Expenses 4,884 4,883.93 5,380 5,379.75 496 495.82

(67) (67.14) (54) (54.06) (13) (13.08) Income from Operations (488) (488.39) (539) (538.59) 50 50.19

($67) ($67.14) ($54) ($54.06) ($13) ($13.08) Net Surplus(Deficit) ($488) ($488.39) ($539) ($538.59) $50 $50.19

0.0%


0.0% 0.0% 0.0% 0.0% 0.0%

June 2012


Page 12

L.A. Care Health Plan

Balance Sheet

For the Month Ending

[Period End]

Comparative Balance Sheet (Quarterly & Unaudited)

(Dollars in thousands) Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 Dec-11 Mar-12 Jun-12

ASSETS

CURRENT ASSETS

Total Current Assets 349,134 306,199 338,276 357,464 358,188 358,903 533,625 369,264

Capitalized Assets - net 1,581 1,377 2,340 6,688 9,232 9,927 10,274 11,374

Restricted Assets $969 $966 $969 $582 $588 $329 $322 $314

TOTAL ASSETS $351,684 $308,542 $341,585 $364,734 $368,008 $369,160 $544,221 $380,953

Accounts Payable and Accrued Liabilities $12,666 $11,666 $25,667 $18,819 $17,365 $21,475 $36,113 $19,192

Subcapitation Payable $154,240 $104,746 $124,962 $145,024 $127,582 $117,078 $260,989 $114,290

Accrued Medical Expenses $20,560 $20,460 $22,623 $24,153 $35,959 $43,465 $62,266 $70,073

Deferred Capitation Revenues $591 $383 $0 $0 $2,324 $0 $3,230 $4,362

Reserve for Provider Incentives $13,405 $20,905 $23,033 $28,763 $27,906 $33,590 $35,487 $37,168

Grants Payable $4,543 $4,287 $3,860 $3,691 $5,535 $3,233 $3,160 $3,930

Long Term Liabilities $182 $144 $106 $38 $622 $1,099 $1,168 $1,325

Total Liabilities 206,186 162,591 200,251 220,489 217,293 219,941 402,413 250,340

FUND EQUITY

Invested in Capital Assets, net of related debt $1,581 $1,377 $2,340 $6,688 $9,232 $9,927 $10,274 $11,374

Restricted Equity $1,735 $1,367 $1,395 $616 $935 $499 $649 $497

Minimum Tangible Net Equity $16,880 $16,880 $17,762 $18,345 $19,370 $20,538 $22,497 $27,767

Board Designated Funds $29,991 $27,970 $66,279 $67,575 $69,080 $86,341 $108,388 $90,974

Retained Earnings (undesignated) $95,311 $98,358 $53,558 $51,020 $52,098 $31,914 ($0) $0

Total Fund Equity 145,498 145,951 141,335 144,245 150,715 149,218 141,808 130,613

TOTAL LIABILITIES AND FUND EQUITY $351,684 $308,542 $341,585 $364,734 $368,008 $369,160 $544,221 $380,953

Solvency Ratios

Working Capital 143,130 143,752 138,131 137,013 141,517 140,062 132,380 120,250

Working Capital Ratio 1.7 1.9 1.7 1.6 1.7 1.6 1.3 1.5

Average Days Cash on Hand ** 0.0 30.1 2.1 31.5 25.5 26.1 0.0 17.9

* TNE is updated quarterly based on DMHC filing.

** Payment was delayed from the state in September 2010, and March 2012.

June 2012

Page 13

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Board of Governors

MOTION SUMMARY

Date: September 6, 2012 Motion No. FIN 100.0912

Committee: Finance & Budget

Chairperson: Philip L. Browning

Issue: Acceptance of the Investment Report for the quarter ended June 30, 2012.

Background:

Budget Impact:

Motion: To accept the Investment Report for the quarter ended June 30, 2012, as submitted.

Sperry Capital Inc.

One Harbor Drive, Suite 108

Sausalito, CA 94965 Tel: 415.339.9201 Fax: 415.339.6030

[email protected]

July 10, 2012 Ms. Patricia Mowlavi Director of Finance and Accounting L.A. Care Health Plan 555 West Fifth Street, 29th Floor Los Angeles, CA 90013 Re:

L.A. Care Health Plan Quarterly Investment Report April 1 through June 30, 2012

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 April 1 through June 30, 2012. PORTFOLIO SUMMARY As of June 30, 2012 the market values of the portfolios as managed by Payden & Rygel are as follows:

Portfolios Payden & Rygel

Cash Portfolio #2365 $ 240,778,551.30

Low Duration Portfolio #2367 $ 82,504,727.31

Total $ 323,283,278.61

COMPLIANCE WITH THE ANNUAL INVESTMENT POLICY Based upon an independent compliance review performed by Sperry Capital Inc. of the monthly investment reports prepared by L.A. Care’s investment manager, Payden & Rygel, there were no investments out of compliance with LA Care’s Annual Investment Policy. The Payden & Rygel investment reports include a monthly transaction summary along with the current market values of the investments as of each month end. The Payden & Rygel investment reports for L.A. Care are available upon request.

Sperry Capital Inc.

July 10, 2012 Page 2 of 3 Compliance Verification Detail as of June 30, 2012

Compliance Verification Detail as of June 30, 2012

#2365 #2367 #2365 #2367Enhanced Cash Low Duration Enhanced Cash Low Duration Compliance

US Treasuries 5 Years 5 Years 1.3 Years 2.1 Years Yes

US Agencies 5 Years 5 Years 1.0 Years 2.5 Years Yes

Corporates (MTNs) 5 Years 5 Years 3.0 Years 3.0 Years Yes

MM & Mutual Funds NA NA 1 Day 1 Day Yes

Mortgage/Asset‐Backed 5 Years 5 Years 3.0 Years 3.0 Years Yes

Actual Maximum MaturityMaximum Permitted Maturity

Sperry Capital Inc.

July 10, 2012 Page 3 of 3 MARKET COMMENTARY The Federal Open Market Committee (FOMC) met in April and information has been received since then that suggests the economy has been expanding moderately. However, growth in employment has slowed in recent months, and the unemployment rate remains elevated. Business fixed investment has continued to advance. Household spending appears to be rising at a somewhat slower pace than earlier in the year. Despite some signs of improvement, the housing sector remains depressed. Inflation has declined, mainly reflecting lower prices of crude oil and gasoline, and longer‐term inflation expectations have remained stable. Strains in global financial markets continue to pose significant downside risks to the economic outlook. The FOMC expects economic growth to remain moderate over the coming quarters and then to pick up very gradually. Consequently, it is anticipated that the unemployment rate will decline slowly. To support a stronger economic recovery the FOMC expects to maintain a highly accommodative stance for monetary policy. In particular, the FOMC decided on March 13, 2012, to keep the target range for the federal funds rate at 0 to 1/4 percent and anticipates that economic conditions, including low rates of resource utilization and a subdued outlook for inflation over the medium run, are likely to warrant exceptionally low levels for the federal funds rate at least through late 2014. The FOMC announced a six‐month extension of its Maturity Extension Program (MEP, dubbed “Operation Twist” by the market), which entails selling short‐term Treasuries to buy longer‐term Treasuries. Market observers believe that the continuation of MEP should put downward pressure on longer‐term interest rates and help to make broader financial conditions more accommodative. The FOMC is maintaining its existing policy of reinvesting principal payments from its holdings of agency debt and agency mortgage‐backed securities in agency mortgage‐backed securities. Sincerely,

James W. Martling Principal

payden.com

Los Angeles | Boston | London | Frankfurt

LA Care Health Plan2nd Quarter 2012

July 2012

Dear Client,

As we approach the second half of 2012, many want to know, what has changed?

With the financial news media still focused on the euro area crisis and slowing global economic activity, it may seem that the second half of the year will be much like the first. Yet, outside of the noise of news, our focus is on understanding how investors will navigate uncertainties that lie ahead.

In looking back at the inception of Payden & Rygel 30 years ago, there have been many challenges, the most dramatic being the 2007-08 global credit crisis. Survival was a matter of assessing not only risks, but also discovering opportunities and deciding on the most advantageous means of protecting capital. Despite the challenges presented today in the wake of the Great Recession, we remain optimistic based on the changing nature of the global economy.

First, and nearest to our heart, is the US economy. The US is slowly improving – two million more people are employed as of the second quarter of 2012 compared to the second quarter of 2011. Although this number is still well below previous employment levels, it shows a positive trend. Also, the US remains the world leader in innovation and patent activity. These factors are the critical inputs to both our future growth levels and our future growth rate.

Second, the dangerous and precarious positions of Japan and Europe indicate that even highly developed economies are not invincible. As we have learned, the kinds of problems experienced by these economies will not be solved at a weekend summit. However, it is important to recognize the new role they play in the global economy. Fifteen years ago, these developed economies accounted for nearly 70% of the global economy. Today, they represent only about 50% of world output. Such a shift does not indicate a cyclical situation but demonstrates that we are in the midst of a major global restructuring.

This brings up a third point. With this global restructuring underway, where should we look for rapid future growth? We see opportunities in South America, parts of Eastern Europe, parts of Asia and to some degree Africa. Accelerated growth in manufacturing, consumer demand, and higher levels of education all point toward brighter economic futures in these regions. This growth will continue to exceed the levels of growth we have witnessed in many developed economies over the past half century.

What does this mean to the investor? We believe it represents an opportunity to look at choices on a global basis. The crisis exposed one big myth: the idea that to be “safe” you must confine your investments to the developed world. As we consider asset allocation, we believe it essential to avoid this fallacy by thinking hard about global structural changes. Our strategic use of diversification and liquidity in investing has allowed us not only to recognize our new globalized world, but to embrace it.

Our very best to you, your families and colleagues for the summer season.

Joan A. PaydenPresident & CEO

Payden & Rygel

-800

-600

-400

-200

0

200

400

600

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Feb-12

Cum

ulat

ive

Clai

ms/

Liab

iliti

es t

o Eu

ro S

yste

mSe

ttle

men

t Ba

lanc

es (B

illio

ns o

f Eur

os)

Germany

Greece, Italy, Ireland, Portugal, Spain

Germany Greece, Italy, Ireland, Portugal, Spain (GIIPS)

ECONOMIC HIGHLIGHTS

Sources: International Financial Statistics; Sinn and Wollmershaeuser, The ECB Rescue Facility Working Paper No. 17626 ,Payden Calculations*TARGET 2 (Trans-European Automated Real-time Gross settlement Express Transfer - Second Generation)

Global Markets Held Hostage by Euro Area

Key market-moving news spiraled out of Europe in the second quarter of 2012: Greek elections, a Spanish bank bailout, and record low levels on German Bund yields. However, few commentators trained their analytical spears on the heart of the euro area crisis—Capital Flight. The mechanism for this capital flight is TARGET2*, an interbank payment system for real-time processing of international transfers within the European Union (similar to the Fed wire).

In the euro area, cross border payments between banks in two countries automatically creates settlement balances (debits/credits) between the European Central Bank (ECB) and the national central banks involved. Prior to the Credit Crisis, these settlement balances tended to cancel each other out when, for example, German consumers bought Spanish hams and Spanish consumers bought German BMWs. Even if trade was not “balanced”, the flows tended to balance out as they also include sovereign debt and other financial assets.

More recently, the European sovereign-debt crisis has shifted the balance to stronger countries within the Euro. As depicted in the chart below, there has been a massive amount of capital flowing one-way into Germany from Greece, Italy, Ireland, Portugal and Spain (the “GIIPS”). Investors and consumers are making a clear distinction between a “German euro” and a “Greek euro”. As a result of this preference, German government bond yields have reached record lows while Spanish and Greek government bond yields continue to climb.

Crisis of Confidence: Money Moves from Periphery to Core

THE WORLD’S PULSE THROUGH WEB SEARCH TRENDS

6/11 7/11 8/11 9/11 10/11 11/11 12/11 1/12 2/12 3/12 4/12 5/12

0

20

40

60

80

100

6/11 7/11 8/11 9/11 10/11 11/11 12/11 1/12 2/12 3/12 4/12 5/12

“MONETARY POLICY”

“MONETARY POLICY”

Global central bank actions garnered market focus

The Futile Nature of Quantitative Easing - Nikkei

Central Banks Face Power Limit as Debt Persists -Bloomberg

0

20

40

60

80

100

6/11 7/11 8/11 9/11 10/11 11/11 12/11 1/12 2/12 3/12 4/12 5/12

“SPANISH BANKS”Financial sector concerns reach feverish pitch in Spain

“SPANISH BANKS”

Moody’s downgrades 16 Spanish banks- Business Line

0

20

40

60

80

100

6/11 7/11 8/11 9/11 10/11 11/11 12/11 1/12 2/12 3/12 4/12 5/12

“EURO ZONE”After fears abated in Q1, euro “break up” risk returns to the fore

Q2 2012

Euro zone Set to Boost Firewalls - Reuters

Germany Pushes EU Bank Oversight - WSJ

“EURO ZONE”

"FISCAL CLIFF"World awakens to US fiscal danger in 2013 as tax hikes and spending cuts loom

0

20

40

60

80

100 Fiscal Cliff: What You Need to Know - CNN

U.S. to Avoid Fiscal Cliff…. - Chicago Tribune

“FISCAL CLIFF“

Source: Google Trends

Crea

tive

Sea

rch

Volu

me

Search Terms

Is it possible to peer into the minds of investors and the general public? No, but using “Google Insights for Search” we can take a peek into search trends over the last year. The charts below track search volume based on key search terms. Together and separately they tell a story of the market worries in the second quarter.

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

Combined

Portfolio Market Value $ 323,283,279

Average Credit Quality AA+

Average Duration 0.4 years

Average Yield to Maturity 0.24%

Investment Objectives: Short Maturity Fixed Income

Portfolio Review – 2nd Quarter 2012

LA Care Health Plan – Combined

Sector Allocation Duration Distribution

Combined Portfolio

Percent Dollars

Cash 2.28% $7,381,639

Treasury 17.94% 58,009,874

Agency 5.37% 17,370,190

Credit 11.88% 38,406,238

Money Market 57.23% 185,016,947

Gov’t Related 2.31% 7,482,893

ABS/MBS 2.97% 9,615,498

100.00% $323,283,279

Combined Portfolio

Percent Dollars

<90 day 65.55% $211,909,944

90 days to 1 year 13.55% 43,823,576

1 - 2 years 16.77% 54,207,997

2 - 5 years 4.13% 13,341,762

100.0% $323,283,279

2nd

Qtr

Trailing

1 year

Trailing

3 years

Short-term* 0.04% 0.27% 0.35%

Money Market Index 0.01% 0.02% 0.04%

Portfolio Returns – All Periods Annualized

Periods Ended 06/30/2012

*Combined (Restricted/Unrestricted - The restricted portfolio was merged into the current unrestricted portfolio in Oct.

2009)

** Merrill Lynch 1-3 Yr Treasury Index from inception to 3/31/2010; Merrill Lynch 1-Yr Treasury Index thereafter.

Extended-term** 0.12% 0.63% 1.30%

1-year Treasury Note 0.04% 0.26% 0.64%


Short-term

Portfolio Market Value $ 240,778,551

Average Credit Quality AA+





LA Care Health Plan – Short-term


2nd

Qtr

Trailing

1 year

Trailing

3 years

Short-term* 0.04% 0.27% 0.35%

Money Market Index 0.01% 0.02% 0.04%

Portfolio Returns – Periods Over One Year Annualized


* Combined (Restricted/Unrestricted - The restricted portfolio was merged into the current unrestricted portfolio in

Oct. 2009)

Short-term Portfolio

Percent Dollars

Cash 3.01% $7,253,770

Treasury 11.52% 27,745,131

Agency 2.08% 5,004,183

Credit 6.94% 16,711,150

Money Market 72.90% 175,525,493

Gov’t Related 2.09% 5,036,768

Asset-Backed 1.45% 3,502,056

100.00% $240,778,551

Short-term Portfolio

Percent Dollars

<90 day 79.78%

$192,085,602

90 days to 1 year 10.33% 24,885,253

1 - 2 years 8.96% 21,576,097

2 - 5 years 0.93% 2,231,599

100.0% $240,778,551


The quarter began with an optimistic tone as investors were encouraged by the improving US economic landscape and

increased liquidity provided to the European banking system. The S&P 500 Index reached a 12-month high in early April, and

the 10-year Treasury yield increased to 2.3%. As the quarter unfolded, optimism diminished with disappointing US payroll

reports in April and May. In addition, investor attention turned from the funding crisis in Greece to a heightened need for bank

recapitalization in larger countries such as Spain. By the beginning of June, the yield on the 10-year Treasury declined to an

all-time low of 1.45% and half of the gains on the S&P 500 Index for the year were erased. The quarter ended on a more

optimistic note after European leaders announced progress towards financial stability.

Despite increased equity volatility, the short-term bond market performed well. Investment-grade corporate bonds, high-yield,

and emerging market debt maturing within 3-years each offered positive total return, despite modest spread widening.

LA Care Health Plan – Short-Term

Enhanced Cash Strategy Overview – 2nd Quarter 2012

U.S. Treasury Yield Curve (0-5 Years) Yields by Sector (3-Month Effective Maturity)

Source: Bloomberg

Payden & Rygel View Payden & Rygel Action Portfolio Impact

Economic

Environment

Moderate economic growth

accompanied by low inflation.

The Federal Reserve will keep

interest rates low, with potential

for additional stimulus.

Maintained an overweight

duration posture as the front-

end of the yield curve remains

steep.

Positive: Treasury Bills outperformed money markets despite front-end rates moving modestly higher.

Credit The fundamental outlook remains strong and the sector should benefit from a fairly benign supply environment. The European banking sector will remain volatile.

Targeted liquid, frequent issuers that offered appropriate yield, both in the new issue market and secondary markets.

Positive: The sector outperformed US Treasuries and government-related debt. New issue corporate bonds performed well as demand remained strong.

Backed

Securities

Asset-backed securities continue to be a source of high-quality yield.

Maintained exposure high-quality asset-backed debt.

Positive: The sector provided positive total return and outperformed US Treasuries.

Source: Bloomberg, Payden & Rygel as of 6/30/12 *Industrial A-rated


Extended-term

Portfolio Market Value $82,504,727

Average Credit Quality AA





LA Care Health Plan – Extended-Term


2nd

Qtr

Trailing

1 year

Trailing

3 years

Extended-term* 0.12% 0.63% 1.30%

1-year Treasury Note 0.04% 0.26% 0.64%

Portfolio Returns – Periods Over One Year Annualized


* Merrill Lynch 1-3 Yr Tsy Index from inception to 3/31/2010; Merrill Lynch 1-Yr Tsy Index thereafter.

Extended-term Portfolio

Percent Dollars

Cash 0.15% $ 127,869

Treasury 36.68% 30,264,743

Agency 14.99% 12,366,007

Credit 26.30% 21,695,088

Money Market 11.50% 9,491,454

Gov’t Related 2.96% 2,446,124

Asset Backed* 7.41% 6,113,442

100.00% $82,504,727

Extended-term Portfolio

Percent Dollars

<90 day 24.03% $19,824,342

90 days to 1 year 22.95% 18,938,323

1 - 2 years 39.55% 32,631,899

2 - 5 years 13.47% 11,110,163

100.0% $82,504,727

*Asset- and Mortgage-backed securities


Low Duration Strategy Overview – 2nd Quarter 2012

The quarter began with an optimistic tone as investors were encouraged by the improving US economic landscape and

increased liquidity provided to the European banking system. The S&P 500 Index reached a 12-month high in early April,

and the 10-year Treasury yield increased to 2.3%. As the quarter unfolded, optimism diminished with disappointing US

payroll reports in April and May. In addition, investor attention turned from the funding crisis in Greece to a heightened need

for bank recapitalization in larger countries such as Spain. By the beginning of June, the yield on the 10-year Treasury

declined to an all-time low of 1.45% and half of the gains on the S&P 500 Index for the year were erased. The quarter

ended on a more optimistic note after European leaders announced progress towards financial stability.

Despite increased equity volatility, the short-term bond market performed well. Investment-grade corporate bonds, high-

yield, and emerging market debt maturing within 3-years each offered positive total return, despite modest spread widening.

LA Care Health Plan – Extended -Term

Payden & Rygel View Payden & Rygel Action Portfolio Impact

Economic

Environment

Modest domestic economic growth continues while slower growth in Europe and China impacts global output. Fed keeps interest rates low, with potential for additional stimulus.

Maintained neutral interest rate

duration as Treasury yields

remain near all-time lows.

Tactically took advantage of

curve steepness as front-end

rates remain anchored.

Positive: The total return for Treasuries was positive and the account benefitted from a flattening of the yield curve.

Credit The fundamental outlook remains strong and the sector should benefit from a fairly benign supply environment. The European banking sector will remain volatile.

Targeted liquid, frequent issuers that offered appropriate yield, both in the new issue market and secondary markets.

Positive: The sector outperformed US Treasuries and government-related debt. New issue corporate bonds performed well as demand remained strong.

Mortgage- &

Asset-Backed

Securities

Mortgage- and asset-backed securities continue to be a source of high-quality yield. The US Government will continue to provide support to the agency mortgage market.

Maintained exposure to agency mortgage-backed securities and high-quality asset-backed debt.

Positive: The sector provided positive total return and outperformed US Treasuries.

Source: Bloomberg

2nd Quarter Sector Total Return U.S. Treasury Yield Curve (0-5 Years)

Source: Merrill Lynch, JP Morgan as of 6/30/12

September 6, 2012 TO: Board of Governors FROM: Mark Gamble, Chair, Governance Committee SUBJECT: SOLICITATION OF NOMINATIONS FOR 2013 BOARD OFFICERS I hereby solicit nominations for the positions of Chair, Vice-Chair, Treasurer, and Secretary of the Board for an election to be held at the October 4, 2012 Board meeting. If you are interested in nominating a fellow Board member or serving as an officer, please complete the attached nomination form and return it by September 19, 2012. Submission of nominations assists the Governance Committee in developing a slate of candidates, if appropriate. However, nominations can be made any time until the officer elections are held at the October Board meeting. A Governance Committee report on officer nominations will be presented to the Board of Governors prior to the election. New officers will be determined by a majority vote of the Board members present at the meeting. Should you have any questions about the process, please feel free to call me at (213) 538-0700 or Augie Haydel at (213) 694-1250, ext. 4226. Please return your nominations by September 19, 2012 by email to [email protected], by phone to Linda Merkens at (213) 694-1250, ext 4050, or by fax to (213) 438-5728. Attachment

I hereby nominate the following as Officers of the L.A. Care Board of Governors for 2013: Chairperson ___________________________________ Vice Chairperson ___________________________________ Treasurer ___________________________________ Secretary ___________________________________ Signed: ___________________________________ Nominating Board Member’s Name/Signature Date: ___________________________________ Please return your nominations by September 19, 2012 by email to [email protected], by phone to Linda Merkens at (213) 694-1250, ext 4050, or by fax to (213) 438-5728.

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Board of Governors

MOTION SUMMARY


Committee: Governance Committee


Issue: Approval of revisions to the Executive Community Advisory Committee (ECAC) and Regional

Community Advisory Committee (RCAC) Operating Rules.

Background: At its July 23, 2012 meeting, the Governance Committee approved a motion to post

revisions to the ECAC and RCAC Operating Rules for 30 days as required by the Bylaws. The Operating Rules have been continually posted on L.A. Care’s website and at its offices since August 1, 2012.

In October of 2011, Chairs from the ECAC expressed concern about RCAC member accountability, member conduct and member recognition.

ECAC created three (3) ad-hoc committees to address these issues.

RCAC members had an opportunity to submit written feedback at each RCAC meeting during April and May.

Overall survey participation from RCAC members was 82%, a majority consensus (83%, n=184) to move forward with the recommended changes was reached. See attachment for summarized data results.

Location in Document

Current Proposed Additions Comments

RCAC Application for new members Pg.5 of Operating Rules

New Addition 1. New members will complete an application and participate in a committee introduction prior to BOG approval.

2. New members will have a provisional status for 1 year with all rights as non-provisional members.

RCAC Attendance and Eligibility to Reapply. Pg.7 of Operating Rules

Two consecutive unexcused or 3 consecutive absences from RCAC meetings or RCAC sponsored events will be considered voluntarily removed.

1. Three absences with the exception that 1 of the 3 is medically related (for member or their child). One year waiting period for members removed for as result of absences. Exception to this rule would be for those who remove themselves for personal reasons.

Addresses members concerns regarding flexibility with medical appointments.

Board of Governors

MOTION SUMMARY

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Code of conduct. Pg.8 of Operating Rules

2. RCAC member shall be removed from the RCAC if the Member substantially violates the LAC code of conduct or the RCAC member standards of Behavior

No changes to wording only added examples of the types of conduct that will terminate a RCAC member permanently.

Changes to the Operating Rules have been approved by the Governance Committee and publicly posted for 30 days before consideration by the Board of Governors. No public comment has been received regarding the changes. If the changes are approved by the Board of Governors, the Operating Rules will be updated and republished. Each RCAC member will receive a copy of the new Operating Rules, and the changes will be reviewed at the RCAC meetings.

Budget Impact: None

Motion: To approve the revisions to the Operating Rules of the Regional

Community Advisory Committee and Executive Community Advisory Committee, as attached.

RCAC FEEDBACK SUMMARY

*RCAC # OF SIGNED TALLY # IN ATTENDANCE RESPONSE RATE # OF MEMBERS

1 12 29 41%** 33 2 11 14 79% 21 3 11 15 73% 19 4 23 23 100% 28 5 18 22 82% 29 6 12 24 50%** 28 7 31 31 100% 35 8 26 28 93% 33 9 32 33 97% 35 10 22 28 79% 29

11 24 24 100% 31

TOTAL 222 271 82% 321

83%

17%

AGREEMENT & DISAGREEMENT OF PROPOSED CHANGES

Agree Disagree

The following are written comments from RCAC members in response to recommended changes to ECAC/RCAC Operating Rules.

1. New RCAC Application and Approval Process for New RCAC Members:

Majority of RCAC members agree with the proposed changes because this will allow new members to understand the purpose of the RCAC and expectations for RCAC membership (including rights & responsibilities).

The proposed recommendations makes members more accountable, show interest/participations, and make a serious commitment.

It’s unfair that there are still members who don’t do or say anything and still get a stipend. The process needs to be more selective for becoming a RCAC member. Include a very detailed appeal process if potential member is declined.

2. Current RCAC Application and Membership Process

Current process of becoming a RCAC member is too easy, this will make it better. It’s important to identify which members are working and those who aren’t. This will help RCAC members become more responsible. It’s important to interview each RCAC member and their contribution in the RCAC. We are all volunteers, first and foremost.

RCAC FEEDBACK SUMMARY

3. Attendance and Eligibility to Reapply

A lot of questions regarding attendance, specifically the 2 absences: o Does that mean if I have a doctor’s note that will automatically count towards an

absence (whether it’s myself or my child)? o How will you be able to verify the doctor’s notes? o 1 doctors note is not fair at all, we all have unforeseen emergencies (sickness, jail,

school meetings, death, etc.) that arise. Majority likes this change since we only meet 6 times a year. This will eliminate the slackers. Children get sick many times, not only twice… this needs to be thought out more. Don’t forget about the SPD population, they see doctor’s more frequently than us so how

will this affect their representation? It is time RCAC members are more accountable, punctual, and stay for the entire duration of

the meeting. It’s not fair there are members who arrive late and leave early and still receive a stipend (80% rule).

4. Code of Conduct

Majority agrees that L.A. Care’s Code of Conduct needs to be enforced at all times. With this enforcement there will be less disruptions and interruptions during the RCAC meetings.

Members need to learn how to be adults, to behave and respect one another. Those who violate the Code of Conduct should be removed immediately and forever banned

from the RCACs. 5. RCAC Member Acknowledgement

Everybody agrees this will help encourage RCAC members to participate more often, increase motivation, increase communication, and make them feel like they are worth something.

*RCAC Region Identifiable Cities

RCAC REGION AREA/CITIES 1 Antelope Valley (Palmdale, Lancaster)

2 San Fernando Valley (Panorama City, Van Nuys, Pacoima, West Hills, North Hills, Arleta, Burbank)

3 Pasadena, Foothill, Alhambra, Rosemead 4 Central L.A. (Hollywood, Wilshire, Glendale) 5 Culver City, Santa Monica, Venice, Westchester, Malibu

6 South Central L.A. (Compton, Inglewood, Watts, Gardena, Hawthorne)

7 Huntington Park, Bellflower, Norwalk, Cudahy 8 San Pedro, Wilmington, Torrance, Carson 9 Long Beach 10 Pomona, El Monte

**Low Response Rate

• RCAC 1 and 6 o CO&E staff by due diligence administered the survey during scheduled RCAC meetings

and as a result of low response rate made a second appeal by mail on the importance of member input. The results for this effort remained low.

OPERATING RULES FOR THE REGIONAL COMMUNITY ADVISORY COMMITTEES

AND EXECUTIVE COMMUNITY ADVISORY COMMITTEE

OF L.A. CARE HEALTH PLAN (Revised on July 23, 2012 through Motion GOV 100.0912)

I. Authority and Purpose

The Regional Community Advisory Committees (“RCACs”) of L.A. Care Health Plan (“L.A. Care”)

were established to ensure community involvement in implementation of Medi-Cal managed care in

Los Angeles County, as mandated by California Welfare and Institutions Code §14087.966, and as

clarified in the Medi-Cal Managed Care Division Policy Letter 99-01 of April 2, 1999 from the

California State Department of Health Services, et seq. Rules for the RCACs are subject to the

Bylaws of the Board of Governors of L.A. Care.

The purposes of the Regional Community Advisory Committees are to:

1. Provide a vehicle for L.A. Care’s member population to be represented by product line in

its actual geographic, ethnic, linguistic and disability diversity, with a special focus on

those who are monolingual and/or disabled;

2. Provide advice and guidance to the Board of Governors and management regarding the

direction, approach and response of L.A. Care to regional and cultural issues that have

implications on member satisfaction, new product lines, health promotion and education

efforts, marketing, and outreach;

3. Inform and empower L.A. Care members to become advocates for themselves and their

communities through leadership in responding to pertinent issues raised among

members and in the community by partnering with L.A. Care to implement RCAC-

initiated projects, policy initiatives, programs supporting L.A. Care strategic health

initiatives and legislative campaigns;

4. Provide information on regional community health issues that impact large numbers of

L.A. Care members or the community at large to the Board of Governors through the

Executive Community Advisory Committee, (“ECAC”), where joint planning and

development of policy recommendations for the Board of Governors should occur, and

5. Create, promote and sustain positive and cooperative relationships among health plan

members, providers, and advocates who serve the L.A. Care population.

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II. Function and Role

RCACs shall serve in an advisory capacity and may be given opportunities by the Board of

Governors and/or the management of L.A. Care to have input into and evaluate the operation of

Medi-Cal managed care in Los Angeles County. Areas where community and especially L.A. Care

member input may be requested include:

1. improving member satisfaction with L.A. Care’s provision of services;

2. improving access to care;

3. ensuring the provision of culturally and linguistically appropriate services and programs;

4. identifying emerging needs in the community and establish programmatic responses;

5. determining and prioritize health education and outreach programs: and

6. addressing community health concerns collaboratively.

To ensure community involvement, L.A. Care staff from various departments and functions will

periodically attend meetings of the RCACs to create a meaningful and productive dialogue with

RCAC members and provide educational information. Such dialogues will seek feedback and input

from the RCAC members as well as input from the public in each region through the public

comment portions of each RCAC meeting.

The RCACs also have a responsibility to support the gathering of information about issues and

concerns that are pertinent to the health and well-being of L.A. Care members in the region. This

information will be used by the RCACs, the ECAC, and L.A. Care staff to plan, implement, and

evaluate activities to address identified concerns.

Each RCAC brings together L.A. Care members, community-based member advocates and health

care providers from the regions that have been approved to serve on a RCAC by the Board of

Governors. The committee format should assure equal participation by all RCAC members as they

discuss relevant health, managed care and access to care issues. The Chairperson of each RCAC shall

represent the region on the ECAC and shall carry issues between the RCAC and ECAC.

When the ECAC reaches consensus on specific items appropriate for action by the Board of

Governors, it shall make recommendations to the Board in the form of motions. In addition, the

L.A. Care members of the RCACs are responsible for electing the Consumer Member and Member

Advocate representatives to the L.A. Care Board of Governors.

Within a standard meeting framework for all RCACs as described below, each RCAC shall establish

its meeting agenda. ECAC can place items on each RCACs’ agenda if the ECAC determines that the

issue needs to be addressed by all the RCACs.

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RCAC activities are based on an annual work plan developed by the membership of each RCAC and

approved by L.A. Care management. The work plan identifies key projects, timelines, and evaluation

measures. At the beginning of each fiscal year, ECAC will establish a common theme for each

RCACs’ work plans.

III. Membership

Composition of the RCAC and criteria for membership shall be approved by the Board of

Governors of L.A. Care, and shall be in accordance with applicable law, regulations, and L.A. Care

Bylaws.

A. RCAC Membership Voluntary Status and Member Categories

All participants in the RCACs serve on a voluntary basis, regardless of category. RCAC

membership is not a form of employment with L.A. Care, nor is any permanent

relationship or right to serve implied or established by such membership.

1. Consumer Member

a) A “Member” as defined by these Rules is an L.A. Care member; or a parent, legal

guardian or conservator of a L.A. Care member. L.A. Care membership is

determined by reviewing L.A. Care’s member records. Proof of legal guardian or

conservator status will be requested, when applicable.

2. Provider

a) A “Provider” as defined by these Rules is a person or a representative of an entity

contracted with either L.A. Care or its plan partners to offer health care services

to L.A. Care members. L.A. Care’s Provider Network Operations Department

may assist in confirming a provider applicant’s contractual status. Providers

contracted with both L.A. Care and Health Net are permitted to serve as RCAC

members in this category.

3. Member Advocate

a) A “Member Advocate” as defined by these Rules must comply with at least one

of the following criteria:

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1. A person who, while employed by a community-based organization1,

represents the interests and brings forward the issues and concerns of the

population served by L.A. Care; or

2. A volunteer of a community-based organization who is recommended by that

organization as its representative to L.A. Care’s RCACs.

B. Committee Composition

1. Each RCAC shall have at least eight (8) and no more than thirty-five (35) members

with a target membership of twenty (20), and at least one-third of who shall be

Members, as defined above.

2. One-third of the membership of each RCAC shall consist of Consumer Members;

however, a RCAC may also include both Provider s and Member Advocates in its

membership. To maintain the one-third Member composition, new Provider or

Member Advocate applicants may be placed on a waiting list and ranked according

to the date their applications were verified. Waiting list applicants shall be added to

the RCAC membership according to their ranking as new Provider or Members

Advocates.

3. The membership of each RCAC may include up to one-third Provider members;

however, a RCAC need not have any Provider members.

4. If a RCAC falls below the minimum membership of eight (8) persons, the RCAC

must shift its energies to recruitment to achieve the minimum number of members.

The RCAC must refrain from implementing any Work Plan activities until the

minimum membership number is met.

5. The RCACs’ membership shall seek to be representative of ethnic, cultural,

linguistic, age, sexual orientation, disability and special medical needs of the Member

population in the designated region. Diversity is a desired goal for recruitment of

Members to be approved by the Board of Governors and shall not dictate any

specific membership approval decision.

1A “community-based organization” as defined by these Rules is a non-profit corporation, a public benefit agency or other public entity.

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C. Application for RCAC Membership

1. Applications for RCAC membership are accepted by the Community Outreach

and Education (CO&E) Department at any time. A RCAC candidate’s

application and category of eligibility (Consumer Member, Provider or Member

Advocate) shall be verified by L.A. Care staff. Once the application has been

verified by L.A. Care staff, a sub-committee will be established to review the new

RCAC member application. The sub-committee will consist of the Chair, Vice-

Chair of the RCAC for which member application is submitted and L.A. Care

Staff. The sub-committee will schedule a meeting with the new applicant. If the

new applicant does not show-up to the scheduled meeting this will automatically

forfeit the applicant’s application. Once the sub-committee has met with the

new applicant, their application will be submitted to ECAC for review and

consent to forward the applicants name to the Board of Governors for their

approval. The new RCAC member will enter the RCACs as a “ Provisional

Member” for a period of one year, with all the rights of a non-provisional

member, which includes being allowed to vote, receive a RCAC stipend and

eligibility to receive reimbursements, so long as other provisions of the Rules

with respect to stipend and reimbursement are complied with. “Provisional

Members” will be assessed based on attendance and participation at RCAC

meetings, Work Plan events, Community Health Improvement Project (C.H.I.P)

outreach efforts, and following L.A. Care’s Code of Conduct and the RCAC

Standards of Behavior. After successful completion of one (1) year, the

“Provisional Member” will automatically become an “Active Member”. There is

an expectation that the “Active Member” is expected to and must comply with

the Rules, Standards of Behavior, abide by L.A. Care’s Code of Conduct,

participate in and attend meetings. If a member does not meet these

expectations, this will constitute the right of ECAC to review membership in

compliance with RCAC and ECAC Operating Rules. before it is submitted for

review by the ECAC and approval by the Board of Governors. If the submitted

information cannot be verified, the applicant shall not be eligible for

consideration.

2. Any applicant who disagrees with a decision concerning their application may appeal to CO&E management, if the applicant disagrees with CO&E’s decision the applicant may then appeal to the Governance Committee if applicant

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disagrees with the Governance Committee they may appeal within (60) calendar days to the Executive Committee of the Board of Governors. The decision of the Executive Committee is final in all cases.

D. Re-certification

RCAC member re-certification by L.A. Care staff shall occur annually, typically in the

month of September and always prior to the election of the RCAC Chairpersons and

Vice Chairpersons. The purpose of re-certification shall be to confirm that RCAC

members remain eligible to continue participating in the RCAC.

E. RCAC Member Term

Since RCAC member applications are received on an on-going basis, a RCAC member’s

term of eligible service extends between the dates of his or her application until the next

recertification period. A RCAC member whose term has been less than six (6) months

will not have to complete the recertification process until the following year’s

recertification period.

1. A Consumer Member’s membership on a RCAC will end if she/he loses

eligibility for L.A. Care’s benefits program. The Consumer Member may be

removed within two months of the date of loss of eligibility unless L.A. Care

membership eligibility has been re-established.

2. No more than two (2) persons age eighteen (18) or older from the same

immediate family may serve on a RCAC at the same time in the same region.

3. Only one (1) Provider or Member Advocate member employed by or

volunteering with a particular community based organization (CBO) or provider

agency may serve on a given RCAC. In cases where the CBO or provider agency

is supporting multiple programs or projects in a specific RCAC or in multiple

RCACs, an exception may be made to allow for more than one CBO or provider

agency representative to participate in the RCAC(s).

4. Providers or Member Advocates must retain their respective eligibility status

during their term on the RCAC. If the Provider or Member Advocate member is

no longer associated with an L.A. Care provider or community based

organization, a new representative must be assigned by the respective entity.

5. If a RCAC Consumer Member moves to another region, he or she can become a

member of the RCAC of their new residence. The Consumer Member shall

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either be added to the new RCAC’s roster, or be placed on the waiting list if the

new RCAC’s membership is at the maximum of thirty–five (35).

6. A Consumer Members membership in a RCAC, or any of the privileges

associated with membership, is non-transferable. Each Member of the RCAC is

chosen, in part, for his or her unique ability to bring valuable input to the group’s

discussions, deliberations and decisions. Therefore, substitute representatives

may not vote and may not participate in discussion, except as a member of the

public.

7. New RCAC members must complete a formal new member orientation as

provided by L.A. Care staff within ninety (90) days of being approved as a RCAC

member by the Board of Governors. Such orientations may occur during

regularly scheduled RCAC meetings, or at other designated times and locations.

F. Resignation and Removal

1. Resignation: A member may resign from the RCAC upon giving written notice to

the RCAC Chairperson and/or the assigned CO&E staff person. A resignation is

effective immediately, unless stated otherwise in the letter of resignation.

2. Removal:

a. Absences

1. Consistent with the Public Advisory Committee Operating Rules, an absence

is excused when a member notifies the RCAC Chairperson or assigned

CO&E staff person of his or her impending absence prior to the meeting or

event. Notice must be in the form of a written, verbal, telephonic or

electronic communication and received within two (2) business days prior to

of the scheduled meeting.

2. RCAC members who have two (2) absences (excused or unexcused) and one

medically excused absence (with doctor’s note) from RCAC meetings, RCAC

work plan events, or other L.A. Care sponsored events in a fiscal year, will be

considered having voluntarily resigned from the RCAC, effective the date of

the last meeting or event missed.

2.3. If a RCAC member is deemed to have voluntarily resigned due to absences

as described above, he or she will be ineligible to re-apply to the RCAC for a

period of one (1) calendar year from the loss of RCAC member eligibility.

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Members who leave the RCAC because of personal reasons are excluded

from the one (1) calendar year ineligibility period. These members will be

allowed to reapply and will follow the new member application

process.RCAC members who have two (2) consecutive unexcused absences

or three (3) consecutive absences from RCAC meetings, RCAC Work Plan

or other L.A. Care-sponsored events; or have failed to attend a majority of

RCAC meetings, RCAC Work Plan or other L.A. Care-sponsored events in a

fiscal year, will be considered having voluntarily resigned from the RCAC,

effective the date of the last meeting or event missed.

3.4. In case of an emergency, a retroactive notice may be given up to seven (7)

days following the absence from the meeting and/or event.

b. Non-Compliance with the Code of Conduct or RCAC Member Standards of

Behavior

1. A RCAC member shallcan be removed from the RCAC if the member

substantially violates L.A. Care’s Code of Conduct or the RCAC Member

Standards of Behavior. RCAC members shall receive annual training on the

Code of Conduct and Standards of Behavior and are required to sign an

acknowledgement stating that the member has read and understood both the

Code of Conduct and the RCAC Member Standards of Behavior.

2. The removal process shall consist of a motion recommending removal “for

cause” by a majority of RCAC members or a petition from L.A. Care staff or

a motion recommending removal “for cause” by a majority of RCAC

members, which will be reviewed by the Legal Services Department and

forwarded to the Governance Committee of the Board of Governors for a

disposition.

3. A member removed as a result of an action by the Governance Committee

may appeal to the Executive Committee2 of the Board of Governors, within

sixty (60) calendar days of the Governance Committee action, whose

decision shall be final in all cases.

4. Any RCAC member removed for substantial violation of the Code of

Conduct or RCAC Member Standards of Behavior shall be ineligible to

2 Members serving jointly on the Executive and Governance Committee and who participated in the initial proceedings shall recuse themselves from consideration of a subsequent removal appeal.

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reapply for RCAC membership. The following, while not intended to be an

exhaustive list are examples of the kind of conduct which are not permitted

and which will subject any RCAC member to termination from Regional

Community Advisory Committee membership:

• Unlawful sexual harassment or other unlawful harassment, whether

verbal, physical or visual.

• Actual or threatened violence.

• Falsifying or making material omission on RCAC applications,

request for stipend and reimbursement forms.

• Misusing, destroying or damaging property belonging to L.A. Care, a

L.A. Care employee, a member or visitor.

• Fighting on L.A. Care property or at L.A. Care sponsored events.

• Gross misconduct (stealing, conflict of interest and other forms of

misrepresentation)

No disciplinary or retaliatory actions will be taken against anyone who reports potential

fraud or abuse in good faith.

IV. Role and Term of RCAC Chairperson and Vice-Chairperson

A. RCAC Leadership

The elected leadership of each RCAC shall be a Chairperson and a Vice-Chairperson. At

any time, the RCAC Chairperson and Vice-Chairperson may not be related by blood,

marriage or belong to the same “household” as define in the RCAC Member Handbook

and Guidelines and Procedures.

B. Duties of RCAC Chairpersons

1. The Chairperson shall preside at all meetings of his or her RCAC. In the absence of

the Chairperson, the Vice-Chairperson shall preside.

2. In partnership with the assigned CO&E staff person, the Chairperson shall develop

RCAC meeting agendas, moderate business meetings and other discussions, provide

guidance and oversight for RCAC work plan projects, maintain a respectful and

productive environment during meetings for discussion, and ensure inclusion of all

RCAC members in RCAC events and activities.

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3. The Chairperson of each RCAC shall be the official representative of that RCAC to

the ECAC. In the absence of the Chairperson, the RCAC’s Vice-Chairperson will

represent the RCAC at ECAC.

4. The RCAC Chairperson is responsible for reporting to ECAC the issues presented

by his or her RCAC and to share information gathered at ECAC with his or her

RCAC members.

C. RCAC Chairperson Term and Election

1. The RCAC Chairperson’s and Vice-Chairperson’s term shall be two (2) years. The

Chairperson or Vice-Chairperson may be re-elected for one (1) additional two (2)

year term for a maximum of four (4) consecutive years.

2. RCAC Chairperson and Vice-Chairperson regular elections shall be held in

September. Only Consumer Members and Member Advocates are eligible to be

Chairpersons or Vice-Chairpersons.

3. If a RCAC is unable to elect a Chairperson and/or a Vice-Chairperson in September,

the current Chairperson and/or Vice-Chairperson in good standing may retain their

position beyond the conclusion of their current term for a maximum of three (3)

additional months or until a Chairperson and/or a Vice-Chairperson is elected,

whichever is shorter. After three (3) months, the Chairperson and/or the Vice-

Chairperson positions will automatically become vacant and remain so until a new

Chairperson and/or Vice-Chairperson is elected.

4. The outgoing Chairperson will be encouraged to mentor the incoming Chairperson

for two (2) months following the Chairperson election.

5. The Vice-Chairperson replacing a RCAC Chairperson who was removed or resigned

prior to end of their elected term, will complete the remaining term of the departing

Chairperson with all the rights and privileges of the Chairperson as described in the

L.A. Care Bylaws, PAC Operating Rules and these RCAC Operating Rules. The

RCAC shall have the ability to have a Vice-Chairperson election to fill the vacancy

left by former Vice-Chairperson.

6. RCAC Chairpersons or Vice-Chairpersons may resign by giving written notice to the

assigned CO&E staff person responsible for that region.

7. A RCAC Chairperson or Vice-Chairperson can be removed for any one of the

following reasons:

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a) he or she no longer resides or is employed in the geographic area;

b) he or she has been convicted of a crime involving corruption, fraud or any

felony;

c) he or she fails to follow L.A. Care’s Code of Conduct or RCAC Member

Standards of Behaviors;

d) he or she has two (2) absences (excused or unexcused) and one medically

excused absence (with doctor’s note)consecutive unexcused absences or three (3)

consecutive absences from RCAC or ECAC meetings, RCAC Work Plan events,

ECAC Leadership Trainings or other L.A. Care-sponsored events; or has failed

to attend a majority of RCAC or ECAC meetings, RCAC Work Plan events,

ECAC Leadership Trainings or other L.A. Care-sponsored events in a fiscal year,

will be considered having voluntarily resigned from the RCAC, effective the date

of the last meeting, training or event missed.

e) a request for removal has been voted on by RCAC members at a scheduled

meeting and submitted by the RCAC to L.A. Care for disposition.

f) a request for removal has been voted by the ECAC members at a scheduled

meeting and submitted by the ECAC for L.A. Care disposition.

g) a request for removal has been submitted by L.A. Care staff to the L.A. Care

Board of Governors, and it is approved by the Governance Committee where a

quorum is present.

8. The RCACs shall have the ability to have a RCAC Chairperson and/or Vice-

Chairperson election at least once every two (2) years, or as needed when:

a) A Chairperson or Vice-Chairperson resigns;

b) The RCAC calls for the removal of a Chairperson or a Vice-Chairperson;

c) Other circumstances considered appropriate by the ECAC.

V. Role and Term of ECAC Leadership

The elected leadership of ECAC shall be a Chairperson and a Vice-Chairperson. At any time, the

ECAC Chairperson and Vice-Chairperson may not be related by blood, marriage or belong to the

same “household” as define in the RCAC Member Handbook and Guidelines and Procedures.

A. ECAC Chairperson and Vice Chairperson Terms

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1. The Chairperson and Vice Chairperson for ECAC will be elected by the members of

ECAC, in November of each year, to complete a one (1) year term with the

possibility of re-election for a second one (1) year term.

2. In order to be eligible for election to Chairperson or Vice Chairperson of ECAC, the

individual must have served on the ECAC for at least one (1) year and have actively

participated in leadership development training during their tenure on the ECAC.

3. ECAC Chairpersons or Vice-Chairpersons may resign by giving written notice to the

assigned CO&E staff person responsible for that region.

4. A Chairperson or Vice-Chairperson can be removed for any one of the following

reasons:


b) he or she has been convicted of a crime involving corruption, fraud or any

felony;



d) he or she has two (2) unexcused absences or three (3) consecutive absences from

RCAC or ECAC meetings, RCAC Work Plan events, ECAC Leadership

Trainings or other L.A. Care-sponsored events; or has failed to attend a majority

of RCAC or ECAC meetings, RCAC Work Plan events, ECAC Leadership

Trainings or other L.A. Care-sponsored events in a fiscal year, will be considered

having voluntarily resigned from the ECAC, effective the date of the last

meeting, training or event missed.







quorum is present.

B. ECAC At-Large Member Terms

1. The two (2) ECAC At-Large members will be selected by the members of ECAC, in

November of each year, to complete a two (2) year term with the possibility of re-

selection to a second two (2) year term.

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2. Only RCAC Consumer Members or Member Advocates in good standings are

eligible for selection for the two (2) At-Large Members to the ECAC.

3. In addition to the RCAC Chairpersons, the two (2) At-Large Members shall

comprise the ECAC.

4. At-Large Members may resign by giving written notice to the assigned CO&E staff

person responsible for that region.

5. At-Large Members can be removed for any one of the following reasons:


b) he or she has been convicted of a crime involving corruption, or any felony;



d) he or she has two (2) unexcused absences or three (3) consecutive absences from

RCAC or ECAC meetings, RCAC Work Plan events, ECAC Leadership

Trainings or other L.A. Care-sponsored events, or has failed to attend a majority

of RCAC or ECAC meetings, RCAC Work Plan events, ECAC Leadership

Trainings or other L.A. Care-sponsored events in a fiscal year, will be considered

having voluntarily resigned from the ECAC, effective the date of the last

meeting, training or event missed.







quorum is present.

6. Guidelines and procedures for role and responsibility for the ECAC and At-Large

Members can be found in the RCAC Member Handbook and Guidelines and

Procedures.

VI. Code of Conduct

L.A. Care’s Code of Conduct and the RCAC Member Standards of Behavior shall govern the

behavior of RCAC members when they are acting on behalf of L.A. Care. As part of L.A. Care’s

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Public Advisory Committee structure, each RCAC member shall receive; review and acknowledge

receipt of copy of the Code of Conduct and RCAC Member Standards of Behavior annually.

VII. RCAC Meetings

A. Public Meeting

Notice of RCAC meetings is posted 72 hours in advance of the meeting or in accordance

with the “Ralph M. Brown Act.” All RCAC meetings are open to the public. Public

discussion can be limited to the public comment portions of items appearing on the

agenda.

B. Meeting Schedule and Location

RCACs will meet every other month on a schedule and location to be determined jointly

by L.A. Care staff and the RCAC members. With guidance from the assigned CO&E

staff person, RCAC members shall set the date and time of each meeting. RCACs shall

meet at a convenient location within its regional boundaries with appropriate meeting

facilities and access to public transportation and/or parking.

C. Quorum and Voting

A majority of that month’s official RCAC membership must be present in person to

have an official RCAC meeting. All official acts of the RCAC require a majority vote of

the members present. No vote or election shall be by secret ballot.

D. Additional Meeting Guidelines

1. RCAC meetings will be conducted as informal discussion forums, in such a way that

all members have input and the opportunity to reach consensus on issues. Use of

formal communications systems such as parliamentary procedures based on the most

recent edition of “Robert’s Rules of Order Newly Revised” may be used to

supplement the informal conversation and provide structure, especially to the

disposition of motions from the members.

2. All official RCAC business (i.e., votes, consensus items, election of Chairperson and

Vice-Chairperson, recommendations to the ECAC, RCAC Work Plan project, etc.)

shall occur at a designated time and location every other month and entered into the

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public record through the meeting summary written by the assigned CO&E staff

person and then reviewed and approved at a subsequent RCAC meeting.

3. Decisions concerning work plans, events and other issues will be made by the RCAC

as a whole. Reports from the work groups shall be a regular part of the RCAC

meeting structure and shall include recommendations for consideration by the

RCAC as a whole.

4. The RCAC meeting will be conducted in accordance with the official meeting

agenda. RCAC members will be mailed the agenda by L.A. Care at least seven (7)

days prior to the meeting or as soon as practical thereafter. The Chairperson of the

RCAC with the assistance of the assigned CO&E staff person will prepare the

agenda for each general meeting based on the input of the RCAC as a whole.

Agendas will be reviewed and approved by the RCAC members at the beginning of

every meeting.

5. Only RCAC members may participate in votes on an issue and the election of a

Chairperson and Vice-Chairperson. L.A. Care staff and the public may participate in

discussion when recognized by the RCAC Chairperson. The public shall be

encouraged to share its comments during the public comment portions of the

meeting.

6. RCAC requests for information and materials should be made through the RCAC

Chairperson to the assigned CO&E staff person, who will forward the request(s) to

any appropriate departments. L.A. Care staff will make every effort to respond to

these requests in a timely manner. Copies of L.A. Care’s public documents are

available to individuals by request through L.A. Care’s Board Services or Legal

Departments.

7. Any written communication(s) the RCAC decides to send or distribute outside of

L.A. Care must first be reviewed and approved by the Director of the Community

Outreach and Education (or his or her designate) and when appropriate,

management in the Marketing Department. Certain outreach materials intended for

wide distribution (brochures, posters, etc.) may also require approval from the

California Department of Health Services.

8. Funding for support of the RCACs and ECAC is determined by the Board of

Governors each year in the annual L.A. Care budget. Completed project plan and

budget request forms shall be submitted and reviewed by the Community Outreach

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and Education staff prior to expenditure of funds. Unspent RCAC Work Plan funds

cannot be donated or carried over into the next fiscal year. Unused Work Plan funds

will be returned to L.A. Care’s general fund.

9. RCAC approved recommendations may be forwarded to the ECAC by the RCAC

Chairperson. In addition, the ECAC may request the RCACs to review and

comment on issues ECAC identifies.

10. The RCAC Chairperson is responsible for ensuring that all issues or concerns carried

to the ECAC for discussion and consideration reflect a true RCAC consensus and

diversity of opinion.

VIII. Regional Boundaries

1. RCACs shall be established within each of the regional areas as defined by L.A. Care’s

Board of Governors.

2. RCAC members are assigned to a specific RCAC based on their zip code of residence

(Consumer Members), area of community service (Member Advocates), or place of work

(Providers). Regional boundaries are for RCAC purposes only and do not affect a L.A.

Care member’s ability to access care in different regions.

IX. RCAC and ECAC Member Stipends and Reimbursement

1. RCAC members serve as volunteers and shall not be compensated for their services or

reimbursed for their out-of-pocket expenses except as provided by L.A. Care’s Policy

AFS-004 (Expense Reimbursement) or as indicated below, subject to approval by L.A.

Care’s Board of Governors.

2. Eligible RCAC Consumer Members who attend at least eighty percent (80%) of their

scheduled RCAC meeting or CO&E staff approved L.A. Care, ECAC or RCAC special

meetings or events may receive a cash stipend or grocery gift card for participating in the

meeting. The stipend amount as determined by the Governance Committee of the Board

of Governors.

3. Eligible RCAC and ECAC members may receive a cash stipend or grocery gift card for

participating in CO&E staff approved L.A. Care, ECAC or RCAC special meetings or

events.

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4. ECAC Chairpersons or Vice Chairpersons assuming the leadership role at the ECAC

monthly meeting may be eligible to receive a cash stipend or grocery gift card for leading

the ECAC meeting.

5. RCAC Chairpersons or Vice-Chairpersons assuming the leadership role at their RCAC

Meeting may be eligible to receive a cash stipend or grocery gift card, for leading their

RCAC meeting.

6. At-Large members assuming the work of the ECAC may be eligible to receive a cash

stipend or grocery gift card.

7. Details specific to RCAC and ECAC member eligibility and for determining which

meetings, events or special functions are eligible for possible receipt of a cash stipend or

grocery gift card and amount of the stipend can be found in the RCAC Member

Handbook and Guidelines and Procedures.

8. Only Consumer Members are eligible to receive a cash stipend (or grocery gift card) with

the exception of ECAC members.

9. In all cases, stipends paid shall be deemed taxable income and reported to the relevant

tax authorities in accordance with applicable law and regulations.

10. RCAC Consumer and Advocate members may be eligible for certain reimbursements to

attend other approved L.A. Care, ECAC or RCAC special meetings or events.

11. In addition, in order to be eligible to receive a stipend and/or reimbursement, each

RCAC member or ECAC member must complete RCAC Member Orientation and AB

1234 training provided by L.A. Care once every two years.

X. Election of Member and Member Advocate to the Board of Governors

The Board approved Members in each RCAC shall vote for one (1) Member and one (1) Member

Advocate to represent the interest of Members on the Board of Governors. The two (2)

representatives’ names shall be forwarded to the Los Angeles County Board of Supervisors, the

official appointing body for the Board of Governors of L.A. Care.

XI. Amendments to the RCAC and ECAC Operating Rules

These RCAC and ECAC Operating Rules are duly adopted by L A. Care’s Board of Governors and

may be amended by the Board of Governors according to L.A. Care Bylaws Article XI. The RCAC

and ECAC Operating Rules were revised on December 3, 2009 through Motion GOV 100.1209.

For information on the current month’s meetings, call L.A. Care’s Meetings Information Line at Tel. (213) 438-5408 or 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 08/30/12

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

1 2

3 4 5

6 Board of Governors

2 – 5 pm

7

8

9

10 Services Agreement

Committee 1 – 2 pm

11

12 Executive Community Advisory Committee

10 am –1 pm

13

14

15 16

17

18 Children’s Health

Consultant Advisory Committee

8:30 – 10 am

19

20 Compliance & Quality

Committee 3 – 5 pm

21

22 23

24

25 Governance Committee

10 – 11 am

26

27 Finance & Budget 1:00 – 2:30 pm

Executive 2:30 – 4:30 pm

Technical Advisory Committee 9 – 11 am

28 29 30

Schedule of Meetings September 2012

For information on the current month’s meetings, call L.A. Care’s Meetings Information Line at Tel. (213) 438-5408 or 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]. \\Barstow\board administration\BoGovernors\Meeting Files\Schedule of Meetings\2012 BoG-PACs-RCACs Mtg Schedule-0912.doc, Prepared by Malou Balones\Printed on 08/30/12, Page 1 of 6

1055 W. 7th Street, 10th Floor, Los Angeles, CA 90017 Tel. (213) 694-1250 / Fax (213) 694-1246

MEETING DAY, TIME, & LOCATION

MEETING DATES

MEMBERS

Board of Governors

General Meeting

1st Thursday 2:00 – 5:00 PM

1055 W. 7th Street, 10th Floor, Los Angeles,

CA 90017

September 6 October 4

November 1 December 6

Walter A. Zelman, PhD, Chairperson Thomas Horowitz, DO, Vice Chairperson Philip L. Browning, Treasurer Mario Ramos, MA, Secretary Mark Gamble Maria Guerrero Thomas S. Klitzner, MD, PhD Jim Mangia, MPH Louise McCarthy Honorable Gloria Molina Michael Rembis, FACHE G. Michael Roybal, MD, MPH John Schunhoff, PhD

Staff Contact: Howard A. Kahn, Chief Executive Officer, x4102 Linda Merkens, Manager, Board Services, x4050

Board of Governors - Standing Committees


MEETING DATES

2012 MEMBERS

Executive Committee 4th Wednesday of the month 2:30 - 4:30 PM


CA 90017

**moved due to holiday

September 27** October 24

November 28 No meeting in

December

Walter A. Zelman, PhD, Chairperson Thomas Horowitz, DO Philip L. Browning Mario Ramos, MA Mark Gamble Jim Mangia, MPH

Staff Contact: Linda Merkens, Manager, Board Services, x4050

Board of Governors & Public Advisory Committees 2012 Meeting Schedule / Member Listing

BOARD OF GOVERNORS & PUBLIC ADVISORY COMMITTEES 2012 MEETING SCHEDULE / MEMBER LISTING




MEETING DATES

2012 MEMBERS

Compliance & Quality Committee

3rd Thursday 3:00 PM to5:00 PM 1055 W. 7th Street,

10th Floor, Los Angeles, CA 90017



December

Jim Mangia, MPH, Chairperson Thomas Horowitz, DO Thomas S. Klitzner, MD, PhD Louise McCarthy Honorable Gloria Molina G. Michael Roybal, MD, MPH Staff Contact: Malou Balones Committee Liaison, Board Services, x 4183

Finance & Budget Committee

4th Wednesday of the month 1:00 PM to 2:30 PM 1055 W. 7th Street,


**moved due to holiday

September 27** October 24


December

Philip Browning, Chairperson Mark Gamble Michael A. Rembis, FACHE John F. Schunhoff, PhD Walter A. Zelman, PhD

Staff Contact: Malou Balones Committee Liaison, Board Services, x 4183

Governance Committee

MEETS AS NEEDED 1055 W. 7th Street,


Tuesday September 25

10 – 11 am

Mark Gamble, Chairperson Thomas S. Klitzner, MD, PhD Maria Guerrero Louise McCarthy Mario Ramos G. Michael Roybal, MD, MPH

Staff Contact: Malou Balones Committee Liaison, Board Services/x 4183

Service Agreement Committee

MEETS AS NEEDED 1055 W. 7th Street,


Monday September 10

1 – 2 pm

John F. Schunhoff, PhD, Chairperson Philip L. Browning Mark Gamble Louise McCarthy Honorable Gloria Molina Mario Ramos, MA

Staff Contact Malou Balones Committee Liaison, Board Services/x 4183

Audit Committee MEETS AS NEEDED 1055 W. 7th Street,


Jim Mangia, MPH Chairperson Maria Guerrero John Schunhoff, PhD

Staff Contact Malou Balones Committee Liaison, Board Services, x 4183





MEETING DATES

MEMBERS

L.A. Care Community

Health

Meets Annually or as needed1055 W. 7th Street,


Walter A. Zelman, PhD, Chairperson Thomas Horowitz, DO, Vice Chairperson Philip L. Browning, Treasurer Mario Ramos, MA, Secretary Mark Gamble Maria Guerrero Thomas S. Klitzner, MD, PhD Jim Mangia, MPH Louise McCarthy Honorable Gloria Molina Michael Rembis, FACHE G. Michael Roybal, MD, MPH John Schunhoff, PhD

Staff Contact: Howard A. Kahn, Chief Executive Officer, x4102 Linda Merkens, Manager, Board Services, x4050




Public Advisory Committees MEETING DAY, TIME,

& LOCATION MEETING

DATES

STAFF CONTACT Children’s Health

Consultant Advisory Committee

General Meeting

3rd Tuesday of every other month

8:30 am – 10:00 am 1055 W. 7th Street,


September 18 November 20

Tumani Coker, MD, Chairperson Staff Contact: Malou Balones Committee Liaison, Board Services, x 4183

Executive Community Advisory

Committee

2nd Wednesday of the month10:00 A.M. - 12:00 Noon


CA 90017


November 14 December 12

Hilda Perez, Chairperson Staff Contact: Idalia Chitica, Community Outreach & Education, Ext. 4420

Technical Advisory Committee

4th Thursdays every other month

9:00 – 11:00 A.M. 1055 W. 7th Street,



Elaine Batchlor, MD, MPH, Chairperson Staff Contact: Malou Balones Committee Liaison, Board Services/x 4183




REGIONAL COMMUNITY ADVISORY COMMITTEES

REGION


MEETING DATE

STAFF CONTACT

Region 1 Antelope Valley

3rd Friday of every other month

10:00 AM – 12:30 PM Chimbole Cultural Center 38350 N. Sierra Highway

Palmdale, CA 93550 Tel (661) 267-5656

October 19 December 21

Griselda Jimenez, Chairperson Staff Contact: Frank Meza, Community Outreach & Education, Ext. 4239

Region 2 San Fernando Valley

3rd Monday of every other month

10:00 AM – 12:30 PM Francis Polytechnic Senior High

School 12431 Roscoe Blvd.

Sun Valley, CA 91352


*Will meet the 4th Monday of the month*

Carlos Aguirre, Chairperson Staff Contact: Frank Meza, Community Outreach & Education, Ext. 4239

Region 3 Alhambra, Pasadena

and Foothill


9:30 AM – 12:00 noon American Legion

24 N. Stoneman Avenue Alhambra, CA 91801 Tel. (626) 458-2723


Cynthia Conteas-Wood, Chairperson Staff Contact: Judy Hsieh, Community Outreach & Education, Ext. 4199

Region 4 Hollywood-Wilshire, Central and Glendale


9:00 – 11:30 AM St. Vincent Medical Center

Mark Taper Bldg. Board Room 2200 W. 3rd Street

Los Angeles, CA 90057 Tel. (213) 484-7766


Minerva Lopez, Chairperson Staff Contact: Judy Hsieh, Community Outreach & Education, Ext. 4199

Region 5 West


2:00 – 4:30 P.M Mar Vista Housing Dev.

Multipurpose Room 4909 Marionwood Street Culver

City, CA 90230 Tel. (310) 915-9006


Maria Guadalupe Mendez, Chairperson Staff Contact: Martin Vicente Community Outreach & Education, x 4423

Region 6 South, Compton,

Inglewood

3rd Thursday of every other month

3:00 – 5:30 P.M. Saint John’s Well Child & Family Center

5701 S. Hoover Street, Los Angeles, CA 90037 Tel. (323) 541-1660


Mary Romero, Chairperson Staff Contact:




REGION


MEETING DATE

STAFF CONTACT

Region 7 San Antonio and

Bellflower


4:30 – 7:00 P.M. Old Timers Foundation Family

Center 3355 E. Gage Avenue

Huntington Park, CA 90255 Tel (323) 582-6090

September 27* November 15 *will meet the 4th

Thursday this month

Hilda Perez, Chairperson Staff Contact: Frank Meza Community Outreach & Education, x 4239

Region 8 Torrance and Harbor

3rd Friday of every other month

10:30 A.M. – 1:00 PM John Mendez Community Center

707 W. C Street Wilmington, CA 90748

Tel. (310) 549-0052


Maria Montes – Chairperson Staff Contact:

Region 9 Long Beach


9:00 – 11:30 A.M. Miller Family Health Education Center

3820 Cherry Avenue Long Beach, CA 90807

Tel. (562) 570-7987


Maria Cruz, Chairperson Staff Contact:

Region 10 East Los Angeles,

Whittier and North-East


4:00 – 6:30 P.M. Boyle Heights Technology Youth Center

1600 East 4th Street Los Angeles, CA 90033

Tel. (323) 526-0145


Aida Aguilar, Chairperson Staff Contact: Martin Vicente, Community Outreach & Education, Ext. 4423

Region 11 Pomona and El

Monte

3rd Wednesday of every other Month

9:00 AM – 11:30 AM First Christian Church

1751 North Park Avenue Pomona, CA 91768 Tel. (909) 622-1144

September 27* November 15 *will meet the 4th

Thursday this month

Alejandra Martinez, Chairperson Staff Contact: Martin Vicente, Community Outreach & Education, Ext. 4423

Documents

Board Meeting Agenda - L.A. Care Health Plan 090612 Mtg Packet-public.pdf1. Legislative Update Walter A. Zelman, PhD, Chair Cherie Fields, Director of Government Affairs B. Finance