board of governors meeting #243 bog meeting... · 2019. 8. 28. · 12. existing vendors contract...

BOARD OF GOVERNORS MEETING #243

March 5, 2015 ● 2:00 PM

L.A. Care Health Plan1055 W. 7th Street, Los Angeles, CA 90017

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www.lacare.org Facebook/lacarehealth LinkedIn/company/l.a.-care-health-plan Twitter: @lacarehealth

Mission Statement

L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-incomecommunities and residents and to support the safety net required to achieve that purpose.

Overview

Committed to the promotion of accessible, affordable and high quality health care, L.A. Care Health Plan (LocalInitiative Health Authority of Los Angeles County) is an independent local public agency created by the State ofCalifornia to provide health coverage to low-income Los Angeles County residents. With more than 1.6 millionmembers in five product lines, L.A. Care is the nation’s largest publicly operated health plan.

L.A. Care Health Plan is governed by 13 board members representing specific stakeholder groups, including consumermembers, physicians, federally qualified health centers, children’s health care providers, local hospitals and the LosAngeles County Department of Health Services.

L.A. Care advances individual and community health through a variety of targeted activities including a CommunityHealth Investment Fund that has awarded more than $132 million throughout the years to support the health caresafety net and expand health coverage. The patient-centered health plan has a robust system of consumer advisorygroups, including eleven Regional Community Advisory Committees (governed by an Executive Community AdvisoryCommittee), health promoters, and three Family Resource Centers that offer free health education and exercise classesto the community, and has made significant investments in Health Information Technology for the benefit of the morethan 10,000 doctors and other health care professionals who serve L.A. Care members.

Programs

Medi-Cal – In addition to offering a direct Medi-Cal line of business, L.A. Care works with three subcontractedhealth plans to provide coverage to Medi-Cal members. These partners are Anthem Blue Cross, Care 1st HealthPlan, and Kaiser Permanente. Since 2012, L.A. Care has enrolled more than 170,000 Seniors and Persons withDisabilities as members, and as of January 1, an additional 164,000 Healthy Way LA members transitioned toL.A. Care’s Medi-Cal program. Medi-Cal beneficiaries represent a vast majority of L.A. Care members.

L.A. Care Covered™ – As a state selected Qualified Health Plan, L.A. Care provides the opportunity for allmembers of a family to receive health coverage under one heath plan in the Covered California state exchange.

L.A. Care Cal MediConnect Plan– L.A. Care Cal MediConnect Plan provides coordinated care for Los AngelesCounty seniors and people with disabilities who are eligible for Medicare and Medi-Cal.

L.A. Care Healthy Kids (0-5) – Sponsored by First 5 LA and the Children’s Health Initiative of Greater LosAngeles, Healthy Kids (0-5) provides health coverage for children who do not qualify for Medi-Cal and HealthyFamilies.

PASC-SEIU Homecare Workers Health Care Plan – L.A. Care provides health coverage to Los Angeles County’sIn-Home Supportive Services (IHSS) workers, who enable our most vulnerable community members to remainsafely in their homes by providing services such as meal preparation and personal care services.

About L.A. Care Health Plan

Updated 2/27/2015

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2/27/2015 12:36 PM

AGENDABOARD OF GOVERNORS MEETING No. 243Thursday, March 5, 2015, 2:00 P.M.L.A. Care Health Plan, 10th Floor, 1055 W. 7th Street, Los Angeles, CA 90017

Teleconference Call In Information &Teleconference Site

Call in number: (855) 846-1604 or (213) 438-5445Participant Access code: 67163639

Michael A. Rembis44400 Indian Wells LaneIndian Wells, CA 92210

I. Welcome Thomas Horowitz, D.O., Chair

II. Approve today’s meeting agenda Chair

III. Public Comment Chair

IV. Approve February 5, 2015 and February 11, 2015 meeting minutes Chair

V. Approve Consent Agenda Items1. Contract Amendments with Salesforce and Cognizant (FIN 100)2. Revisions to the Procurement Policy (AFS-007) and Approval the Elimination of the

Contract Review Process, and Approval Process Policy (AFS-026) (FIN 101)3. Contract Amendment with Office Ally (FIN 102)4. Contract Amendment with Cornerstone Data Strategies Inc. (FIN 103)5. Contract with Civic Resource Group (CRG) (FIN 104)6. Ratify RCAC Membership (ECA 100)

Chair

VI. ADJOURN TO CLOSED SESSION (Est. time: 45 mins.) Chair

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

Plan Partner Rates

Provider Rates

DHCS Rates

Medi-Cal Managed Care Supplemental Payment

B. REPORT INVOLVING TRADE SECRETPursuant to Welfare and Institutions Code Section 14087.38(n)Discussion Concerning New Product LinesEstimated date of public disclosure: March 2017

C. CONFERENCE WITH LEGAL COUNSEL—ANTICIPATED LITIGATIONInitiation of litigation pursuant to Section 54956.9(d)(4) of the Ralph M. Brown Act: (1)

D. CONFERENCE WITH LABOR NEGOTIATORPursuant to Section 54957 of the Ralph M. Brown ActAgency Negotiator: John Wallace, Interim CEOUnrepresented Employee: Robert Turner, Tom Schwaninger

E. CONFERENCE WITH LABOR NEGOTIATORPursuant to Section 54957 of the Ralph M. Brown ActAgency Negotiator: Tom Horowitz, DOUnrepresented Employee: Chief Executive Officer

F. PUBLIC EMPLOYMENTPursuant to Section 54957 Ralph M. Brown ActTitle: Chief Executive Officer

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Board of Governors Meeting AgendaMarch 5, 2015

2/27/2015 12:36 PM

VII. RECONVENE IN OPEN SESSION Chair

VIII. Chairperson’s Report Chair

IX. Interim Chief Executive Officer Report John WallaceInterim Chief Executive Officer

X. Presentation on National Commission on Quality Assurance(NCQA) Standards for Member Connection (MEM) related toHealth Plan Accreditation

Gertrude S. Carter, MDChief Medical Officer

XI. Motions for Consideration1. Contract Related to NCQA MEM Standards – Finance & Budget

Committee Delegation (BOG 100)2. Human Resources Temporary Labor Vendors (BOG 101)

3. Contract with SafetyNet Connect Inc. (BOG 102)

John Wallace

Robert TurnerChief of Human Resources

Gertrude S. Carter, MD

XII. Committee Reports

A. Executive Committee Thomas Horowitz, D.O., Chair

1. Government Affairs Update Cherie FieldsDirector, Government Affairs

2. Consideration of Establishment of Supplemental DefinedContribution Plan Benefits, Retirement Program Changes forPart-Time Employees, and Future Costs Associated withSuch Changes. (BOG 103)

Augustavia J. Haydel, Esq.General Counsel

B. Finance & Budget Committee Michael Rembis, Chair

1. Financial Report (FIN 105) Tim Reilly

2. Monthly Investment Transactions Report Tim Reilly

XIII. Advisory Committee Reports

A. Executive Community Advisory Committee Hilda Perez/Ozzie LopezBoard Consumer member and Advocate member

XIV. Adjournment Chair

The next meeting is scheduled on Thursday, April 2, 2015.The order of items appearing on the agenda may change during the meeting. Teleconference arrangements may change prior to the meeting.Those planning to participate by telephone should confirm with L.A. Care Board Services prior to 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 BECALLED WHEN THE ITEM YOU ARE ADDRESSING IS DISCUSSED. THE PUBLIC MAY ALSO ADDRESS THE BOARD ON L.A. CARE MATTERS DURING PUBLICCOMMENT. 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 PRINTEDMEETING 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 beavailable 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.) toparticipate 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 week before the meeting will enable us to make reasonable arrangements to ensure accessibility to the meetings and to the related materials.

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DRAFT

Board of GovernorsGeneral Meeting # 242Meeting Minutes – February 5, 2015L.A. Care Health Plan Conference Room 1018-10191055 W. Seventh Street, Los Angeles, CA 90017

Members Management/StaffThomas Horowitz, DO, Chairperson Alexander K. Li, MD Jonathan Freedman, Acting Chief Executive Officer & Chief of Strategy,

Regulatory & External AffairsMark Gamble, Vice Chairperson Ozzie Lopez, MPA Gertrude S. Carter, Chief Medical OfficerMichael A. Rembis, FACHE, Treasurer ** Michael D. Antonovich Augustavia J. Haydel, Esq., General CounselLouise McCarthy, Secretary Hilda Perez Tim Reilly, Chief Financial OfficerHector De La Torre ** G. Michael Roybal, MD, MPH Tom Schwaninger, Chief Information OfficerThomas S. Klitzner, MD, PhD Sheryl Spiller Robert Turner, Chief of Human ResourcesJann Hamilton Lee *Absent ** Teleconference John Wallace, Chief Operating Officer

AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENCALL TO ORDER

Thomas Horowitz, DO,

Thomas Horowitz, DO, Chairperson, called the meeting to order at 2:04 p.m.

Chair Horowitz announced that the public may address the Board on the matters listed on theagenda before or during the Board’s consideration of the item, and on any other matters at thepublic comment section.

APPROVAL OFMEETING AGENDA

Thomas Horowitz, DO

Chair Horowitz suggested a closed session be held at the end of the meeting for discussion ofitems VI.A Contract Rates, VI.B Trade Secrets, and VI.C Conference with Legal Counsel.The meeting agenda was approved as amended.

Approved unanimouslyby roll call. 11 AYES(Gamble, Hamilton Lee,Horowitz, Klitzner, Li,Lopez, McCarthy, Perez,Rembis, Roybal andSpiller).

PUBLIC COMMENT Ms. Elizabeth Cooper stated that she would comment further later in the meeting.

ACCEPTANCE OFMINUTES OFMEETING

Thomas Horowitz, DO

The minutes of the December 4, 2014, December 11, 2014, January 8, 2015, January 22, 2015and January 28, 2015 meeting were approved as submitted.

Approved unanimouslyby roll call. 11 AYES

Board of Governors MeetingFebruary 5, 2015 DRAFTDRAFT

AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENAPPROVAL OFCONSENT AGENDA

Thomas Horowitz, DO

Chair Horowitz noted that these motions have been reviewed by a Board Committee.1. RCAC Membership (ECA 100)2. Ratification of Elected ECAC Chair and Vice Chair (ECA 101)3. Approve Legal Services Policy LS-013 (Mandatory Ethics Training for Designated Officials

and Employees) (EXE 100 )4. Ratify Amendment No. 17 to the Department of Health Care Services Contract (EXE 101)5. Approve Expenditure with Hanson & Bridgett LLP (EXE 102)6. Investment Report (FIN 100)7. Purchase of Non-Monetary Incentives with Target Inc. (FIN 101)8. Contract Amendment with Interpreting Services International (FIN 102)9. Contract with Altegra Health (FIN 103)10. Purchase of Network Equipment, Cabling, Power Supplies, Associated Maintenance and

Support with CDW Inc. (FIN 104)11. Existing Vendors Contract for L.A. Care’s Core System Operationalize Implementation

Services (FIN 105)12. Existing Vendors Contract for L.A. Care’s Data Masking and Robust Test Environment

Initiatives (FIN 106)13. Existing Vendors Contract Amendment for ICD-10 Test Environment Set Up and

Remediation Services (FIN 107)14. Procurement of New Informatica Data Replication (IDR) Software Licenses and Renewal

of Existing Products, Maintenance, and Support Fees (FIN 108)15. Existing Vendors Contract for L.A. Care’s Member and Provider Portal Strategy (FIN 109)16. Existing Vendors Contract for L.A. Care’s Provider Data Management Initiatives (FIN 110)


ADJOURN TOCLOSED SESSION

Thomas Horowitz, DO

Augustavia Haydel, Esq., General Counsel, announced the following items to be discussed in closed session. The Boardadjourned to a closed session at 2:10 p.m.

Items A., B. and C. were not discussed.A. CONTRACT RATES

Pursuant to Welfare and Institutions Code Section 14087.38(m)

Plan Partner Rates

Provider Rates

DHCS Rates

Medi-Cal Managed Care Supplemental Payment


AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN

B. REPORT INVOLVING TRADE SECRETPursuant to Welfare and Institutions Code Section 14087.38(n)Discussion Concerning New Product LinesEstimated date of public disclosure: February 2017

C. CONFERENCE WITH LEGAL COUNSEL – ANTICIPATED LITIGATIONPursuant to Section 54956.9 (d)(2) of the Ralph M. Brown ActOne (1) potential case

(Members Antonovich [in person] and De La Torre [by phone] joined the meeting.)

D. CONFERENCE WITH LABOR NEGOTIATORPursuant to Section 54957.6 of the Ralph M. Brown ActAgency Negotiator: Thomas Horowitz, DOUnrepresented Employee: Interim and new Chief Executive Officer

E. PUBLIC EMPLOYMENTPursuant to Section 54957 Ralph M. Brown ActTitle: Interim and new Chief Executive Officers

F. PUBLIC EMPLOYEE APPOINTMENTPursuant to Section 54957 Ralph M. Brown ActTitle: Interim and new Chief Executive Officers

RECONVENE INOPEN SESSIONThomas Horowitz, DO

The Board reconvened in open session at 3:28 p.m.

Ms. Haydel announced that during the closed session the Board of Governors agreed to appointJohn Baackes as Chief Executive Officer and the compensation terms as presented. (The motionwas presented and approved under Motions for Considerations.)

CHAIRPERSON’SREPORT

Thomas Horowitz, DO

Chairperson Horowitz reminded Board Members to complete the required compliance trainingas soon as possible.


AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENMOTIONS FORCONSIDERATION

Appointment of Interimand new Chief ExecutiveOfficers

Thomas Horowitz, DO

PUBLIC COMMENT:Elizabeth Cooper welcomed Supervisor Antonovich. She thanked Board members and askedthe Consumer and Consumer Advocate members to make sure that funds are available toprovide services for consumer members.

Chair Horowitz noted that the recruitment process was unique for a number of reasons.

Interviews with Board members suggested that the qualities of extensive health plan andleadership experience were a priority.

Based on their experience in recruiting CEOs to health plans, L.A. Care’s scale ofmembership (1.4 million) dwarfs most community health plans.

The outreach was extremely broad (374 people), but the yield of possible candidates wasextremely low (3%). Factors included compensation limitations, scale and politicalcomplexity.

The ad hoc Search Committee represented a broad range of L.A. Care stakeholders: clinics,providers, hospitals, the County health system, and consumers.

The Committee met numerous times to bring a recommendation to the Board ofGovernors.

Above all other candidates, John Baackes brings the following:

Deeply experienced health plan CEO in mostly not-for-profit organizations, but with somefor-profit experience that the Committee believes would prepare him to navigate theuncertainty of a changing healthcare marketplace

CEO for 14 years, seasoned profit and loss manager.

Mission driven, committed professionally and personally to serve the underserved.

Has led organizations located in highly diverse communities.

Politically and financially astute, enjoys engaging political and regulatory stakeholders.

Motion BOG 100.0215To appoint John Baackes as Chief Executive Officer of the Local Initiative HealthAuthority for Los Angeles County and to approve the compensation terms for thatindividual as indicated in the attached document, subject to Board approval of anemployment agreement that contains the approved compensation terms and is for aterm of two years. To delegate authority to Agency Negotiator/Board Chair Horowitz

Approved unanimouslyby roll call. 11 AYES(De La Torre, Gamble,Hamilton Lee, Horowitz,Klitzner, Li, Lopez,McCarthy, Perez,Rembis, and Roybal).



and Vice Chair Gamble to complete negotiation of any non-compensation terms ofemployment, and to provide the Board a completed employment agreement, executedby Mr. Baackes to be approved by the Board at an appropriately scheduled publicmeeting of the Board.

(Copy of compensation document can be obtained by contacting Board Services.)

1 NAY (Antonovich)1 ABSTENTION (Spiller)

Consideration of ChiefExecutive Officers’Compensation

Thomas Horowitz, DO

Motion BOG 101.0215To appoint John Wallace as Interim Chief Executive Officer of L.A. Care Health Plan,and to approve a temporary increase of ten percent (10%) to Mr. Wallace’s base salaryfor the duration of his service as Interim Chief Executive Officer and a permanentincrease of two percent (2%) thereafter.

Approved unanimouslyby roll call. 13 AYES(Antonovich, De LaTorre, Gamble, HamiltonLee, Horowitz, Klitzner,Li, Lopez, McCarthy,Perez, Rembis, Roybaland Spiller).

Community HealthInvestment Fund (CHIF)program, FY 2014-15

Jonathan Freedman

(Members Hamilton Lee, Horowitz, Klitzner, Lopez, Li, McCarthy, Rembis, and Roybal may have financialinterests in Plan Participating Providers or other programs and as such should consider refraining from thediscussion of this issue.)

Jonathan Freedman, Acting Chief Executive Officer and Chief of Strategy, Regulatory & External Affairs,outlined a proposal for the Community Health Investment Fund (CHIF). Staff requests that theBoard delegate and authorize the CEO and the Chief of Strategy, Regulatory and External Affairs todevelop a concept memo, release Request for Proposals (RFPs) as needed and approve grantinvestments of up to $150,000 per applicant. Adoption of this request will increase the delegatedauthority for CHIF grants not requiring Board approval from $100,000 to $150,000 per grantee peryear. All other policies and approval thresholds, noted in the Grants and Sponsorships 603 andGrant Making 603.1 policies, will remain in place.

Motion BOG 102.0215To approve the FY 2014-15 Community Health Investment Fund (CHIF) programapproach and priorities, and authorize delegated authority to implement the CHIFprogram to the CEO and Chief of Strategy, Regulatory and External Affairs to approvegrant investments of up to $150,000 per applicant. Staff will regularly report all CHIFinvestments to the Executive Committee and Board of Governors. All other policies andapprovals related to grant making investments will remain in place.

Approved by roll call.5 AYES (Antonovich, DeLa Torre, Gamble, Perezand Spiller

8 ABSTENTIONS(Hamilton Lee, Horowitz,Klitzner, Lopez, Li,McCarthy, Rembis, andRoybal)


AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENContract withWeiserMazars LLP

Tim Reilly

Tim Reilly, Chief Financial Officer, presented a motion to amend a contract with WeiserMazars LLPfor temporary Medical Payment Systems and Services department consulting services.

Motion BOG 103.0215To authorize staff to execute a contract with WeiserMazars LLP, for temporary MedicalPayment Systems and Services consulting, in the amount of $220,000, from February 1,2015 through August 31, 2015.


OFFICERS REPORT Mr. Freedman reported:

January 2015 was a very busy month; 14,000 members enrolled in Cal MediConnect (CMC);the opt-out rate was higher than expected at 55% for Los Angeles County, down from 61%in November.

L.A. Care launched Navitus as its new Pharmacy Benefit Manager (PBM) starting on January1, 2015. Several Departments at L.A. Care were involved in the planning and execution ofthe transition. The transition was generally smooth.

L.A. Care has added 2,509 new enrollees in L.A. Care Covered since the start of CoveredCalifornia’s open enrollment on November 15, 2014. Total membership for L.A. CareCovered is approximately 22,000 as of January 15, 2015. L.A. Care has retained nearly19,000 L.A. Care Covered members (90% retention rate). Open enrollment ends onFebruary 15, 2015, and L.A. Care expects that more people will enroll in February.

Jennifer Kent was appointed Director of the Department of Health Care Services (DHCS),replacing Toby Douglas. Ms. Kent will assume her position on February 9, 2015. She hasbeen Executive Director of Local Health Plans of CA (LHPC), public plan trade associationsince 2013. Ms. Kent has a long history with State government and a vast understanding ofpublic health plans.

Melanie Bella resigned her position last week as Director of the Centers for Medicare andMedicaid Services (CMS) Medicare-Medicaid Coordination Office.

Marilyn Tavenner will leave her position as Administrator of CMS in February 2015.

Last month, Cindy Mann announced her resignation as Deputy Administration and Directorof the CMS Center for Medicaid and Children’s Health Insurance Program Services.

In response to Member McCarthy’s question on how the LIHP transition members were alsoassigned to Health Net, Mr. Freedman noted that L.A. Care is not happy with the algorithmmodel and a number of factors.



In response to Member Antonovich’s inquiry about the emergency room in East San GabrielValley, John Wallace, Chief Operating Officer, informed that L.A. Care will work with the 30 daysdeadline.

Operations Report

John Wallace

Mr. Wallace thanked the Board for his appointment as Interim Chief Executive Officer.

He informed the Board that Peter Harbage passed away earlier this week.

He reviewed the Operations Report included in the meeting materials. (Copy of his report canbe obtained by contacting Board Services.)

In response to Member Antonovich’s question on the plan to come into compliance on claims,Mr. Wallace responded that L.A. Care will be in compliance by the end of February 2015.

OrganizationalPerformance Report for 1st

Quarter FY 2014-2015

Jonathan Freedman

Mr. Freedman presented the 1st Quarter Organizational Performance Report FY 2014-2015included with the materials for this meeting. (Copy of his report can be obtained by contacting BoardServices.)

L.A. Care cured the 2014 Low Performing Icon related to Medicare Stars.

L.A. Care ended its participation in the Dual Eligible Special Needs Plan (DSNP) to transitioninto CMC.

Enhancements were made to the L.A. Care Covered member portal and to the provider portalthat will help to streamline services and improve user experience.

Turnover for employees who have worked less than a year with L.A. Care is higher than thetargeted industry standard of 15.2%, with an annualized rate of 25.04% and is slightly higherfor employees with more than one year of employment (15.81%), both of which are higherthan industry standard.

Community HealthInvestment FundSummary for Fiscal Year2013-2014

Jonathan Freedman

Mr. Freedman presented the Community Health Investment Fund (CHIF) Summary for FY2013-2014. (Copy of his report can be obtained by contacting Board Services.)

The annual report summarized how the CHIF dollars were spent. The program is guided bypolicies that outline funding priorities, review procedures, approvals, and reporting. All awardsgo through a review process that includes a formal application, discussion with L.A. Care staff,site visits and review by the Chief of Strategy, Regulatory and External Affairs. All initiativeawards are also reviewed by a panel of community experts.

Annual SponsorshipReport for Fiscal Year2013-2014

Mr. Freedman presented the Annual Sponsorship Report for Fiscal Year 2013-2014. (Copy of hisreport can be obtained by contacting Board Services.)

The annual sponsorship report to the Board is required by L.A. Care policies 603 and 603.2. All


AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENJonathan Freedman sponsorships were carefully reviewed to determine if the organization and/or the event met the

requirements of these policies. Special consideration was given if the event offered considerableexposure, the organization was a CHIF grantee, or if another department showed interest inparticipating. The FY 2013-14 Budget allocated $750,000 for sponsorships, and staff reviewed143 requests from various local, state, and national organizations.

CHIEF MEDICALOFFICER REPORT


Gertrude S. Carter, MD, Chief Medical Officer, referred to her written report included in themeeting materials for this meeting and asked for questions or comments on her written report.(Copy of her report can be obtained by contacting Board Services.)

PUBLIC ADVISORY COMMITTEE REPORTS

EXECUTIVECOMMUNITYADVISORYCOMMITTEE

Hilda Perez/Ozzie Lopez

Member Lopez reported that ECAC met on January 14. (Minutes of that meeting can be obtained bycontacting Board Services.)

L.A. Care Health Promoters continue training and working with RCAC and communitymembers, providing workshops on health improvement topics and access to care.

The Interdisciplinary Committee is identifying strategies to address issues brought by RCACmembers. They are analyzing the reporting process to ensure timely and appropriate reportson the issues forwarded to them by the Committee, reviewing policies and procedures, andplanning a formal reporting and updating process.

Motion ECA 100.0215*To approve the following candidate(s) to the Regional Community AdvisoryCommittees (RCAC), and Coordinated Care Initiative Councils (CCI) as reviewed bythe Executive Community Advisory Committee (ECAC) during the January 14, 2015ECAC meeting.

Name RCAC # Type of Member(Agency, if applicable)

Ana Maria Barros CCI-Area 2 ConsumerWilma Ballew CCI-Area 2 ConsumerFrancisca Marcos Vera CCI-Area 2 ConsumerJean Walker CCI- Area 3 ConsumerBrenda White CCI-Area 3 ConsumerHelen Washington CCI-Area 3 ConsumerAna Maria Barroso RCAC 2 Consumer

Approved unanimouslyby roll call in ConsentAgenda.



Motion ECA 101.0215*To approve the election of Elda Sevilla, as Chairperson and the election of Ana Romo,as Vice-Chairperson of the Executive Community Advisory Committee (ECAC) fromFebruary 2015-December 2015.

CHILDREN’S HEALTHCONSULTANTADVISORYCOMMITTEE (CHCAC)


Dr. Carter reported that CHCAC met on January 20. (Minutes of that meeting can be obtained bycontacting Board Services.)

Clayton Chau, MD, Medical Director, Behavioral Health, noted that data is being analyzed onthe rates of pre-term births and Cesarean Sections in safety net clinics vs. privatepractitioners and more information will be provided at a future meeting.

Staff provided an update on Text4baby. A fact sheet was distributed to Committeemembers to address questions related to target population, participants’ interest in theprogram, evidence of knowledge and behavior change, and ongoing research and evaluation.

The Committee is planning to interview L.A. Care members for patient experience mappingat the next meeting scheduled on March 17, 2015.

STANDING COMMITTEE REPORTS

EXECUTIVECOMMITTEE

Thomas Horowitz, DO

The Executive Committee met on January 28. (Minutes of that meeting can be obtained by contactingBoard Services.) Other than the motions approved earlier today on the consent agenda, theCommittee approved contracts for HR consulting work with Altman & Cronin BenefitConsultants, PearlMeyers & Partners, and with Sally Kolb, dba OakQuest Advisors.

Motions approved underConsent Agenda

Motion EXE 100.0215*To approve Legal Services Policy & Procedure No. LS-013 (Mandatory Ethics TrainingFor Designated Officials And Employees), as attached.

Motion EXE 101.0215*To ratify the Chief Executive Officer’s execution of Amendment No. 17 to Contract 04-36069 between the California Department of Health Care Services and L.A. Care HealthPlan, and to ratify any non-substantive changes to Amendment No. 17 which may bemade or negotiated by the Chief Executive Officer and/or his designees.

Motion EXE 102.0215*To authorize payment of up to $350,000 to Hanson & Bridgett LLP as earned andinvoiced pursuant to the existing retainer agreement with Legal Services, for servicesthrough January 2016.



AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENGovernment AffairsUpdate

Cherie Fields

Cherie Fields, Director, Government Affairs, reported:

Federally Qualified Health Centers (FQHC) alternate payment methodology legislation hasbeen introduced – SB 147 (Hernandez). L.A. Care, California Primary Care Association,California Association of Public Hospitals.

On February 19, Government Affairs will host a forum for congressional and statelegislative staff at L.A. Care to provide updated information on L.A. Care product lines aswell as to brief them on referring constituency issues to L.A. Care.

During January and February, legislative advocate and Director of Government Affairs willhold meetings with the Los Angeles delegation members in Sacramento. L.A. Care also metwith the California Legislative Black Caucus to brief the members on the Governor’sproposal to replace the current MCO Tax with one that meets federal requirements.

Ms. Fields will travel to Washington DC next week and meet with L.A. delegation.

Jonathan Freedman, Chief of Strategy, Regulatory and External Affairs, informed the Board, IT ISNOT A COMMITTEE BUT THE “BOARD” that the Managed Care Organization (MCO) taxhas been a funding vehicle for Medi-Cal. A revised MCO tax would be applied to most healthplans in California, including plans that do not participate in Medi-Cal. The proposed revisionto the MCO tax requires a 2/3 vote of the Legislature. The Governor’s budget proposalincluded a warning about the end of the Coordinated Care Initiative (CCI) pilot program. TheGovernor ties the success of the CCI to revenue from the MCO tax and other savings. L.A.Care is interested in preserving the MCO tax without disturbing the current model of managedcare.

FINANCE & BUDGETCOMMITTEE

Michael Rembis, Treasurer, reported that the Committee met on January 28. (Minutes of the meetingcan be obtained by contacting Board Services.) In addition to the motions approved earlier on today’sconsent agenda, the Committee approved motions for contract amendments with the followingvendors that do not require Board approval:

o EvergreenRXo Edwin Chuong, MDo Bobbie Wunscho Black Box Network Serviceso Kavita Ratano Bernard Reisso OakRidge Consultantso Gomez Research


AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENMotions approved onConsent Agenda

Motion FIN 100.0215*To accept the Investment Report for the quarter ended December 31, 2014, assubmitted.

Motion FIN 101.0215*To approve the purchase of non-monetary incentives from Target, Inc. in the amount of$400,000 for member incentive programs, for the period of February 1, 2015 throughJanuary 31, 2016.

Motion FIN 102.0215*To authorize staff to amend the existing contract with Interpreting ServicesInternational in the amount of $400,000 (Total contract amount will be $838,000) toprovide translation and face-to-face interpreting services from November 1, 2014 toOctober 31, 2015.

Motion FIN 103.0215*To authorize staff to execute a contract through September 30, 2017, with AltegraHealth, in the amount of $1,419,250, for Edge Server data submission as part of theCommercial Risk Adjustment Implementation Project.

Motion FIN 104.0215*To approve the purchase of networking equipment, cabling and power supplies with theassociated maintenance and support from CDW, Inc. in the amount of $1,660,000 (totalcontract amount not to exceed $1,912,470).

Motion FIN 105.0215*To authorize staff to execute contracts with one or more existing key vendors tomaintain and support L.A. Care’s core systems, for a total amount not to exceed$2,500,000, through December 31, 2015.

Motion FIN 106.0215*To authorize staff to execute contracts with one or more existing key vendors for LACare’s Data Masking and Robust Test Environment services, for a total amount not toexceed $1,000,000, through September 30, 2015.

Motion FIN 107.0215*To authorize staff to amend contracts with one or more of L.A. Care’s existing keyvendors for professional services in ICD-10 business remediation, and test environment




setup and support, for an amount of $2,300,000 through December 31, 2015.

Motion FIN 108.0215*To approve the procurement of new Informatica Data Replication (IDR) softwarelicenses and the renewal fees of existing products with Informatica Corp. in the amountof $371,931 (total contract amount not to exceed $854,532).

Motion FIN 109.0215*To authorize staff to contract with one or more existing key vendors for L.A. Care’sMember and Provider Portal Strategic implementation services, for an amount total notto exceed $2,500,000, through September 30, 2015.

Motion FIN 110.0215*To authorize staff to execute contracts with one or more existing key vendors for L.A.Care’s Provider Data Management services, for a total amount not to exceed $1,250,000,through September 30, 2015.

Financial Report

Tim Reilly

Mr. Reilly reviewed highlights of the financial report for the period ended December 31, 2014:

L.A. Care’s current enrollment is at 1,700,000. The increased membership is driven byMedi-Cal Expansion (MCE).

L.A. Care has a surplus of $53 million.

The Plan Partner network is a positive contributor to the surplus.

Membership in the Medi-Cal directly contracted line of business (MCLA) is approximately at800,000, and produced surplus renvenue. MCE financial performance is positive and offsetslosses of the Seniors and People with Disabilities program.

Rates for MCE will be evaluated every six months. MCE rates were decreased by 13% inJanuary 2015, and a new set of rates are expected in July 2015. Continued decreases in theMCE rates will affect L.A. Care’s revenue.

Motion FIN 111.0215To accept the Financial Report for the three months ended December 31, 2014, assubmitted.

Approved unanimouslyby roll call. 12 AYES(Antonovich, Gamble,Hamilton Lee, Horowitz,Klitzner, Li, Lopez,McCarthy, Perez,Rembis, Roybal andSpiller).

Monthly InvestmentTransaction Report

Tim Reilly

Mr. Reilly referenced the Investment Transaction Report included in the meeting materials.There were no questions from Board members about the transaction report.


AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN1st Quarter FY 2014-15Prequalified VendorReport

Jonathan Freedman

Mr. Freedman referred the Board to his written report included in the meeting materials.(Copy of his report can be obtained by contacting Board Services.)

COMPLIANCE ANDQUALITYCOMMITTEE

G. Michael Roybal, MD

Committee Chairperson Roybal reported that the Committee met on January 15. (Minutes of themeeting can be obtained by contacting Board Services.)

Denise Corley, Compliance Officer, reviewed audits performed on L.A. Care and auditsperformed by L.A. Care on Plan Partners and provider groups.o The Plan Partner audits have been completed. The Care 1st preliminary findings are

under review. Kaiser’s preliminary findings have been sent and a conference call hasbeen scheduled.

o On December 4, 2014, the Centers for Medicare and Medicaid Services (CMS) issued aNotice of Non-Compliance for Prescription Drug Events (PDE). Staff is in theprocess of preparing a response to CMS.

o On December 12, 2014, the Cal MediConnect (CMC) Contract Management Team(CMT) issued a warning letter to L.A. Care that it has failed to successfully submitprescription data required for claims routing for at least 99% of its 2015 plan year CMSenrollment. Regulatory Affairs and Compliance Department is reviewing a CorrectiveAction Plan submitted by L.A. Care’s Medicare Enrollment Unit.

Ms. Corley provided updates on L.A. Care’s Compliance Programs.o Board of Governors Compliance Training is underway and scheduled for completion by

March 2.o Gorman Health Group identified areas of concern through an audit to evaluate the

effectiveness of L.A. Care’s compliance process. Staff is scheduling a due diligence audit with the new pharmacy benefit manager

(PBM). The contract allows L.A. Care to audit multiple times throughout the year. A number of required internal monitoring indicators have not been reported by the

prior PBM and L.A. Care is working with the new PBM to ensure timely andcomplete reporting.

L.A. Care’s Compliance Program Effectiveness policy will be revised to include therequirements defined in the Medicare Managed Care Manual.

Linda Lee, Director of Medicare Performance Management, reported on L.A. Care’s Medicare StarRating.



o L.A. Care has improved its rating for 2014 and has cured the Low Performing Icon.o Ms. Lee summarized the areas of focus for Part C and Part D improvements as well as

member retention/satisfaction interventions: L.A. Care keeps track of member outreach. PPGs with highest disenrollment percentage rate are being contacted to address

member retention issues and connecting members back to the PPG and L.A. Care. Customer Service training was initiated company-wide. Member disenrollment survey was conducted to identify reasons for voluntary

disenrollment.o L.A. Care will evaluate and revise breast cancer interventions based on focus group

findings.

Mary Franz, HITEC-LA Senior Executive Director, reported on L.A. Care’s Select Initiatives:o HITEC-LA has passed 90% of its goals for provider use of electronic health records.o L.A. Care will apply for a federal no-cost extension for up to 14 months.o Blue Button is a federal initiative launched late last year which allows members online

access to their prescription record. A pilot program for small practices is planned forearly 2015.

o An eConsult program for behavioral health is planned for 2015.

AUDIT COMMITTEE

G. Michael Roybal, MD

The Audit Committee met on January 23 to review the Audit Report for the fiscal year endedSeptember 30, 2014. (Minutes of the meeting can be obtained by contacting Board Services.)

Khurram Siddiqui, Partner at Deloitte & Touche (Deloitte), Mark Albrecht, Partner atDeloitte, and Angelica Kocharova, Audit Manager at Delloite, presented the results ofDeloitte’s audit of L.A. Care’s Fiscal Year 2014 financial statements.

Mr. Siddiqui reported that no material weaknesses or deficiencies were found in L.A. Care’sfinancial operations or internal controls. Overall the audit went smoothly and there were nomaterial adjustments to the financial statements reviewed and approved by the Board inDecember.

There was no recommendation letter as the Auditors did not find any deficiencies worthcommenting upon.

Deloitte’s audit findings letter may have more disclaimers this year due to increased sets ofrates in the Medi-Cal program and complicated financial risk in many programs.

The Committee also met briefly with the auditors without staff in the room as is doneannually.

Under the authority delegated by this Board, the Committee approved Motion AUD-A.0115



to accept the audit findings. (The Board does not need to approve the audit report.)

Committee members unanimously agreed to retain Deloitte & Touche for the 2015 audit.

ADJOURNMENT The meeting was adjourned at 4:30 p.m. to a teleconference meeting on February 11, 2015 at3:30 p.m.

Respectfully submitted by:Linda Merkens, Manager APPROVED BY: ______________________________Malou Balones, Committee Liaison Louise McCarthy, SecretaryHilda Stuart, Committee Liaison Date Signed ______________________________

DRAFT

Board of GovernorsGeneral Meeting # 242February 5, 2015 Adjourned Regular Meeting Minutes – February 11, 2015L.A. Care Health Plan Conference Room 1018-10191055 W. Seventh Street, Los Angeles, CA 90017

Members Management/StaffThomas Horowitz, DO, Chairperson Jann Hamilton Lee ** Augustavia J. Haydel, Esq., General CounselMark Gamble, Vice Chairperson Alexander K. Li, MDMichael A. Rembis, FACHE, Treasurer ** Ozzie Lopez, MPA **Louise McCarthy, Secretary Hilda Perez **Michael D. Antonovich ** G. Michael Roybal, MD, MPHHector De La Torre ** Sheryl Spiller **Thomas S. Klitzner, MD, PhD ** *Absent **Teleconference

AGENDAITEM/PRESENTER MOTIONS / MAJOR DISCUSSIONS ACTION TAKENCALL TO ORDER

Thomas Horowitz, DO,

Thomas Horowitz, DO, Chairperson, called the meeting to order at 3:35 p.m.

Chair Horowitz announced that the public may address the Board on the matters listed on theagenda before or during the Board’s consideration of the item, and on any other matters at thepublic comment section.

APPROVAL OFMEETING AGENDA

Thomas Horowitz, DO

The agenda was approved as submitted. Approved unanimouslyby roll call. 11 AYES(Gamble, Hamilton Lee,Horowitz, Klitzner, Li,Lopez, McCarthy, Perez,Rembis, Roybal andSpiller).

PUBLIC COMMENT There was no public comment.

ADJOURN TOCLOSED SESSION

Thomas Horowitz, DO

Augustavia Haydel, Esq., General Counsel, announced the following items to be discussed in closed session. The Boardadjourned to a closed session at 3:38 p.m.

A. CONFERENCE WITH LABOR NEGOTIATORPursuant to Section 54957.6 of the Ralph M. Brown ActAgency Negotiator: Thomas Horowitz, DOUnrepresented Employee: Interim and new Chief Executive Officer

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Board of Governors MeetingFebruary 11, 2015 Adjourned February 5, 2015 Meeting Minutes DRAFTDRAFT


B. PUBLIC EMPLOYMENTPursuant to Section 54957 Ralph M. Brown ActTitle: Interim and new Chief Executive Officers

C. PUBLIC EMPLOYEE APPOINTMENTPursuant to Section 54957 Ralph M. Brown ActTitle: Interim and new Chief Executive Officers

RECONVENE INOPEN SESSIONThomas Horowitz, DO

The Board reconvened in open session at 4:07 p.m. There was no report on actions takenduring the closed session.

Consideration of Currentand Future ChiefExecutive Officer’sCompensation (Motion)

Motion BOG 104.0215To approve an employment agreement for John Baackes that is substantially similar tothe attached agreement, to delegate authority to Agency Negotiator/Board ChairHorowitz and Vice Chair Gamble to:1. complete negotiations of outstanding non-compensation terms of employment with

any necessary non-substantive changes to the employment agreement,2. execute a final employment agreement with Mr. Baackes that is approved as to form

by L.A. Care’s General Counsel, and3. authorize staff to bring forward for the Board’s consideration at a future meeting any

technical amendments to L.A. Care’s supplemental retirement plans required tofulfill the terms of the agreement.

(Copy of compensation document can be obtained by contacting Board Services.)

Approved by roll call.9 AYES (De La Torre,Gamble, Hamilton Lee,Horowitz, Klitzner, Li, ,McCarthy, Rembis, andRoybal).

1 NAY (Antonovich)

3 ABSTENTIONS(Lopez, Perez, andSpiller)

ADJOURNMENT This meeting was adjourned at 4:10 p.m.

Respectfully submitted by:

Linda Merkens, Manager APPROVED BY: ______________________________Malou Balones, Committee Liaison Louise McCarthy, SecretaryHilda Stuart, Committee Liaison Date Signed ______________________________

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Board of Governors

MOTION SUMMARY

Date: March 5, 2015 Motion No. FIN 100.0315

Committee: Finance & Budget

Chairperson: Michael Rembis

Issue: Amend contracts with Salesforce and Cognizant, the Salesforce implementation vendor.

Background: In April 2014 the Member Outreach, Retention and Engagement (MORE) department

issued a request for proposal to identify a customer relationship management (CRM) solution. A CRM was needed to manage member communication preferences, campaigns, and touch points, consolidate many separate databases and tracking tools, and contribute to increased member satisfaction. Three vendors responded, and the evaluation team selected Salesforce because it offered the most flexible, comprehensive, scalable solution and the lowest pricing.

Based on similar needs, two other Member Services departments, the Family Resource Centers (FRC) and Member Accounting Unit (MAU), were included in the initial implementation. The current contract amount is $121,500 for 20 Salesforce Service Cloud- Enterprise Edition product licenses, upgrades and support through July 14, 2017.

Since the execution of the contract in September 2014, MORE and FRC departments have increased the number of full time staff requiring access to the CRM and MAU decided to begin migrating some of its existing databases to the more robust Salesforce platform.

Staff requests to amend the existing contract adding $188,120 (total contract not to exceed $309,620) to purchase 30 additional Salesforce Service Cloud- Enterprise Edition product licenses, upgrades and support and increased disk space capacity through July 14, 2017.

Cognizant

Salesforce implementation requires a third party vendor. In August 2014, Information Technology (IT) department solicited proposals from three existing IT vendors recognized as top tier certified Salesforce implementation partners and selected Cognizant.

Staff requests to amend the existing Master Services Agreement (MSA), adding $150,000 to continue Salesforce implementation activities for MORE, FRC and MAU departments through September 30, 2015. Vendor history is $1,891,437.00.

Budget Impact: Total amount requested of $338,120.

$211,534 is fully budgeted in FY 2014-15 IT Department budget $63,343 will be fully budgeted in FY 2015-16 IT Department budget $63,343 will be fully budgeted in FY 2016-17 IT Department budget

Motion: To authorize staff to amend the existing contract with Salesforce, adding $188,120 for additional Service Cloud- Enterprise Edition licenses, support and disk space capacity through July 14, 2017 and a Master Services Agreement with Cognizant adding $150,000 for continued Salesforce implementation activities through September 30, 2015.

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Board of Governors

MOTION SUMMARY


Committee: Finance & Budget Chairperson: Michael Rembis

Issue: Approve revisions to the Procurement Policy (AFS-007) and the elimination of the Contract

Review and Approval Process Policy (AFS-026).

Background: L.A. Care’s membership and business has increased dramatically over the recent years,

which has directly impacted our operating budget and costs associated with providing services and programs to our members. In support of L.A. Care’s commitment to the promotion of accessible, high quality health care that is driven by continuous improvement and innovation, the updated Procurement Policy combines and improves the Purchase of Products, Services, and Capital Assets policy (AFS-007) and the Contract Review and Approval Process policy (AFS-026) which both originated in 2002 and revised in 2010. The updated Procurement Policy aims to better align procurement with L.A. Care objectives and size; ensure fair and equitable procurement processes; provide better clarity and accountability; mitigate risks in the selection of vendors; and ensure effective use of L.A. Care staff resources. The new policy will replace the current policy AFS-007 and eliminate AFS-026.

Summary of changes:

The creation of a Procurement Council for better and earlier alignment with the contract and vendor selection needs of each Officer and L.A. Care.

Updated definition and use of the Preferred Vendor program.

Updated procedures of the Sole Source process.

Additional language to clarify when staff must conduct a request for proposal and or a request for quotes process from new vendors.

Updated procedures regarding formal communications to vendors on notice of award to vendors and vendor selection appeals process.

Additional language regarding deliverables as well as business ethics and confidential information responsibilities of vendor selection teams to ensure fair vendor selection processes.

New procedures and responsibilities for contract management (ie, amendments, termination, etc.) and vendor management.

The proposed changes have been fully reviewed and approved by L.A. Care’s Regulatory Affairs and Compliance and Legal Departments.

Budget Impact: None.

Motion: Approve the revisions of Procurement Policy (AFS-007) and the elimination of the Contract Review and Approval Process Policy (AFS-026).

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: PROCUREMENT POLICYTITLE

: FINANCE SERVICESSERVICE AREA

: ACCOUNTINGDEPARTMENT

SERVICES

Policy and ProcedureNumber

AFS-007

Total No. of PagesPage 1 of16

DatesEffective Date 01/10/2002Review/Revision Date ##/##/2015Supersedes PolicyNumber

AFS-026

PPSA/Mandated YES NO XNext (Annual) ReviewDate

##/##/2016

Administrative YES X NOApplies to:

Medi-Cal – PlanPartners

YES NO X

Medi-Cal – L.A. Care YES NO XPASC-SEIU Plan YES NO XHealthy Families YES NO XHealthy Kids YES NO XMedicare SNP YES NO XCal MediConnectL. A. Care

YES NO X

Cal MediConnectSubcontracted Plans

YES NO X

L.A. Care Covered YES NO X

1.0 POLICY:

1.1 Although not generally subject to the state laws and regulations pertaining tocompetitive bidding, L.A. Care Health Plan (L.A. Care) has established its own policiesand procedures relating to the purchase and procurement of products and services. I t isL.A. Care’s policy to purchase products and services on the basis of quality, delivery,and price. L.A. Care will establish purchasing procedures and processes to developqualified and reliable sources and to obtain quality products and services at fair andreasonable prices through efficient, effective, and competitive procurement methods.

1.2 This policy excludes provider network contracts, employment agreements, grantagreements, sponsorships, legal retainer agreements, and regulatory fees.

2.0 :DEFINITIONS

Whenever a word or term appears capitalized in this Policy and Procedure, the reader shouldrefer to the “Definitions” below.

2.1 Best Interest: A discretionary rationale used by the Director of Procurement or his/herdesignee in taking action most advantageous to L.A. Care when it is in L.A. Care’s bestinterest to consider award based on factors other than the lowest price for the productsor services.

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Policy and Procedure AFS-007Page 2 of 16

2.2 Bidder: A potential vendor who submits a response to an RFI, RFP, or RFQ.

2.3 Category: Commodity or category of purchase such as office supplies, temporarylabor, consulting, IT equipment, or facility services.

2.4 Contract: An agreement between two parties such as L.A. Care and a Vendor that isenforceable by law, where one party offers a product or service while the other partyaccepts the product or service and provides payment. Examples of contracts aredocuments such as Purchase Orders, Purchase Agreements, and Services Agreements –all of which include a description of the product or services, the delivery terms andcompensation, as well as terms and conditions. Master Agreements without adescription of the product or services, the delivery terms and compensation, as well asother agreements such as letters of intent, memoranda of understanding, whileagreements are not contracts in that they may not be enforceable by law.

2.5 Master Purchase Agreement (MPA): A framework document that contains legalterms and conditions to purchase products or services over a specific period of time, andgenerally includes a price list for offered products or services. Once an order forproducts or services is issued, the MPA and order, together, comprise a Contract.MPAs are used for recurring purchases.

2.6 Master Services Agreement (MSA): A framework document that contains legal termsand conditions to purchase services over a specific period of time. On its own an MSAdoes not describe any services to be delivered. Typically, it is accompanied with aSchedule that describes the services to be provided, the deliverables, a delivery scheduleand pricing. MSAs are used when it is anticipated that there will be multiplerequirements for a particular Vendor.

2.7 Preferred Vendors: Vendors selected based on a competitive bidding process toprovide products or services to support frequent or recurring requirements for aspecified period of time pursuant to the terms of an MPA or MSA. Based on the termsof the MPA or MSA and the dollar value of a specific requirement, further competitionmay be required.

2.8 Preferred Vendor Listing: Listing of Preferred Vendors located at procurementintranet that contains the Category of a purchase; name of the Preferred Vendor; anddirections on how to purchase. It is meant for frequent and recurring purchases.

2.9 Procurement Council: Formal group comprised of the Director of Procurement andL.A. Care Officers or designees charged to align procurement strategies with the goalsand objectives of L.A. Care. The group will meet on a regular basis to develop, review,and refine procurement strategies and tactics on vendor consolidation opportunities,vendor management, contract management, and process improvement.

2.10 Protected Health Information (PHI): Individually identifiable health information(essentially member information) that is transmitted and maintained in any form ormedium. PHI excludes individually identifiable health information in education records

25


covered by the Family Educational Rights and Privacy Act (FERPA), employmentrecords held by L.A. Care in its role as employer, and such information regarding aperson who has been deceased for more than 50 years.

2.11 Purchase Order/Purchase Agreement: A simplified Contract that contains standardterms and conditions and a description, pricing, and remittance information used topurchase a product or service from a vendor. It is issued and sent to a Vendor typicallyafter a Purchase Requisition has been fully approved.

2.12 Purchase Requisition: An internal document that contains the description, pricing, andtotal dollar amount of a purchase and that is routed through management for approvalbased on the dollar amount. After all approvals a Purchase Order is issued and sent to avendor.

2.13 Request for Information (RFI): An informal process for obtaining additionalinformation relative to a product or service that is needed as part of L.A. Care’s marketresearch. This helps L.A. Care identify potential sources or gain a better understandingof what products or services may be available.

2.14 Request for Proposal (RFP): A formal competitive bidding process to select aVendor(s) from a pool of vendors who provide or produce the same or similar productsor services. An RFP will have a set of requirements or specifications of what is neededand directions for the qualified vendors on how and when to submit their proposals. Forthis policy, it is typically reserved for high dollar (greater than $250,000) and morecomplex purchases that require time and resources.

2.15 Request for Quote (RFQ): An informal competitive bidding process based on price toselect a Vendor(s) from a pool of vendors who provide or produce the same or similarproduct or service. An RFQ is typically used for lower dollar (less than $250,000 butgreater than $25,000), less complex, and high transaction purchases. It can be used toget competitive pricing regardless of dollar amount when the competitive field islimited to Preferred Vendors in certain Categories like temporary labor and print.

2.16 Requestor: Designated person within a department who initiates purchase requests foreither products or services.

2.17 Service Agreement: A Contract used for the one-time purchase of services.

2.18 Short List of Bidders: A subset of the original pool of qualified Bidders participatingin an RFP who are finalists in a Vendor Selection process based on the evaluationcriteria of the RFP.

2.19 Sole Source: An exception to the Vendor Selection process when only one Vendor isconsidered, in accordance with the process outlined in this policy.

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2.20 Statement of Work (SOW): Also known as a scope of work or scope of services, thisis the portion of a contract that describes the services to be delivered, the vendor’sresponsibilities, L.A. Care’s responsibilities, timing, and pricing.

2.21 Vendor: A business entity, organization or individual who provides a product or a non-clinical service to the L.A. Care organization for payment.

2.22 Vendor Selection: A formal, value-based process by which a Vendor is selected froma pool of qualified vendors to perform services or deliver products to L.A. Care.Different Vendor selection techniques are used depending on complexity and dollarvalue of service or product in need. These techniques include RFPs, RFQs or RFIs.

2.23 Vendor Selection Team: A group of L.A. Care staff (may include consultants), led bythe Director of Procurement or designee, and a team tailored for the particular purchase,that includes appropriate procurement, business, technical and other expertise who willreview proposals to provide a comprehensive evaluation of offers and makerecommendations on the selection of vendors.

3.0 PROCEDURES:

3.1 The procedures in this policy may only be deviated from with the prior approval of boththe Chief Executive Officer (CEO) and the Chief Financial Officer (CFO), or theirdesignees.

3.2 The Procurement department is primarily responsible for aligning procurementstrategies with L.A. Care objectives, coordinating all Vendor Selection activity, andproviding efficient procurement processes and tools.

3.3 To ensure procurement strategies are aligned with L.A. Care objectives, a ProcurementCouncil comprised of the Director of Procurement and L.A. Care Officers or designeeswill meet on a regular basis to develop, review, and refine procurement strategies andtactics on vendor consolidation opportunities, vendor management, contractmanagement, and process improvement.

3.4 All requests for purchases must be reviewed and approved by the Procurementdepartment prior to submitting the request for legal review and Officer approval. Allpurchases of products, services and capital assets will only be made by authorizeddesignated management personnel and in accordance with policy AFS-006,“Authorization and Approval Limit,” as that policy may be amended from time to time.

3.5 The procurement process for products and services is outlined in this policy. TheRequestor must use the process flowchart (attachment 6.1) to determine which sectionapplies to the business situation. The Procurement department can assist the Requestorat any stage of the process.

3.6 Business Requirements Definition

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3.6.1 Before any purchase, there are pre-requisite steps to understand what is beingpurchased.

3.6.2 The Requestor must first define what they are buying; a product, service, orboth, and what Category the product/service fits into. Product examples includeCategories such as office supplies, IT equipment, promotional items, computersupplies, and print. Service examples include consulting (management ortechnical), temporary labor, facility services, construction services, mailingservices, and assessment services. It is the responsibility of the business unit toadequately define its requirements, including product requirements or scope ofwork, delivery/schedule and pricing.

3.6.3 The Requestor may contact the Procurement department for assistance inpreparing product descriptions or SOWs; however, the ultimate responsibility isthe business unit.

3.7 Review the Preferred Vendor List for Potential Sources

3.7.1 Utilizing a Preferred Vendor for frequent or recurring purchases provides thefollowing benefits:

3.7.1.1 Greatly reduces organizational expenses by ensuring L.A. Care takesadvantage of any discounts or reduced pricing that are already in aPreferred Vendor Contract.

3.7.1.2 Faster turnaround time because a Vendor and a Contract already existand a new Vendor does not have to be selected and a new Contractdoes not need to be negotiated.

3.7.1.3 Reduces financial, operational, legal, information security, andprivacy risks to L.A. Care because a Preferred Vendor is alreadyunder an approved Contract.

3.7.1.4 Saves L.A. Care resource costs associated with businessadministration, procurement processing and contracting, and legalreview that are typically utilized when new Contracts are put inplace.

3.7.2 The Requestor must check the latest Preferred Vendor Listing located at L.A.Care intranet site. The listing will contain the Category of products and services(i.e., office supplies, consulting, temporary labor, IT equipment, etc.), PreferredVendor, and directions on how to purchase. In almost all cases, a PurchaseRequisition and an executed Purchase Order will be required for each purchase.The Requestor can contact the Procurement department for assistance.

3.7.2.1 If the product or service CAN be ordered from the Preferred VendorListing, the Requestor must follow the directions outlined in thelisting. In cases such as temporary labor, consulting, or printservices, the Preferred Vendor Listing will outline when RFQsshould be done to obtain competitive bids among a subset of

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Preferred Vendors within the same Category. If competition isrequired, the Requestor must follow §3.17 below (RFQ Process). Ifthe Preferred Vendor Listing outlines that a Contract is required, thenthe Requestor must follow §3.18 below (Contracting Process).

3.7.2.2 If the product or service CANNOT be ordered from the PreferredVendor Listing, then the Requestor must follow the proceduresbelow.

3.7.3 For purchases that are Sole Source, then the Requestor must follow §3.8 below(Sole Source Justification Process). Sole Source purchases are the exceptionand should only be used when authorized. Depending on the dollar limit,pursuant to §3.8 below, Sole Source purchases are reported up to the Board ofGovernors.3.7.3.1 For purchases greater than $250,000, refer to §3.9 below (Vendor

Selection Process).3.7.3.2 For purchases greater than $25,000 up to $250,000, refer to §3.17

below (RFQ Process).3.7.3.3 For purchases up to $25,000, submit a Purchase Requisition to

Procurement department and refer to §3.18 (Contracting Process) tosee if a Contract is required.

3.8 Sole Source Purchasing Justification Process

3.8.1 Sole Source procurements may only be utilized in the circumstances and subjectto the procedures set forth below.

3.8.1.1 Only viable source for product or service, performance, and pricecompetition are not available.

3.8.1.2 Only viable source possessing specialized or unique expertise.3.8.1.3 Proposals were solicited, however no satisfactory proposals were

received or only one satisfactory proposal was received.3.8.1.4 Additional services are required to complete an ongoing task. It

would be prohibitively costly in time and money to seek a newservice provider.

3.8.1.5 Maintenance Service Agreements for equipment which must beserviced by the authorized manufacturer service representatives, andthere is only one authorized service representative in thegeographical area.

3.8.1.6 It is in the Best Interest of LA Care, e.g., administrative cost savingsoutweigh cost savings that would be realized through competition,steep learning curve for new service provider, knowledge base, etc.

3.8.1.7 It is more cost effective to obtain services by exercising an optionunder the existing contract.

3.8.1.8 Items requested are based upon previous purchases from this Vendorand are needed to match the existing product.

3.8.1.9 The requirement is within the general scope of an existing Contractand can be addressed appropriately as an amendment.

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3.8.1.10 Emergency circumstances when a product or service is necessary andthe time necessary to follow the required procurement process is notavailable.

3.8.2 Sole Source purchases must be justified before the actual purchase in sufficientdetail using the Sole Source Justification form (attachment 6.3) to explain thebasis for suspending L.A. Care’s usual Vendor Selection process and receive therequired approvals as set forth in this policy. The Sole Source Justification mustbe submitted as part of the Purchase Requisition or Board motion package if amotion is required.

3.8.3 Any proposed Sole Source purchase greater than $25,000 and up to $250,000must be approved by a Director or Officer level and the Manager ofProcurement. Sole Source purchases over $250,000 must be approved byDirector of Procurement, Officer, CFO, and CEO or designee as well as bereported to the Board of Governors or its Board Committee designee on amonthly basis.

3.8.4 Emergency Purchases:

3.8.4.1 The CEO or designee may authorize Sole Source purchases in casesthat have or could impose significant provable loss to L.A. Care;short turn-around time mandated by regulatory agencies, contractualrequirements, or changes in the law; or where human life or propertyis endangered. When an emergency condition arises and the needcannot be met through normal procurement methods, the emergencypurchase shall be made with such competition as is feasible under thecircumstances, including soliciting quotes orally. Contracts andother documents related to such emergency procurements shall beexecuted in accordance with the requirements of policy AFS-006,“Authorization and Approval Limit.” Within a reasonable time afterthe conclusion of the emergency, the Officer responsible for theemergency purchase shall provide written documentation stating thebasis for the emergency purchase and the reasoning for the selectionof the particular Vendor. A written account of the emergencycircumstances shall be sent promptly to the CEO or designee.Normal purchasing procedures shall be followed as soon as theemergency is over.

3.9 Vendor Selection Process (Purchases > $250,000)

3.9.1 Prior to starting the Vendor Selection Process, the Requestor should havealready checked the Preferred Vendor Listing and determined if Sole Source isnecessary.

3.9.2 If the Requestor’s purchase cannot be fulfilled by a Preferred Vendor and is nota Sole Source, the Requestor must contact the Procurement department toinitiate the Vendor Selection Process. The Vendor Selection Process, also

30


known as Strategic Sourcing, is utilized for purchases greater than $250,000under this policy.

3.9.3 The Vendor Selection Process consists of the steps outlined in attachment 6.2and deliverables developed by both procurement and a Vendor Selection teammade up of the Requestor and other L.A. Care staff participating in the process.

3.9.3.1 All deliverables (identified in attachment 6.2) are required wherethey are applicable.

3.9.3.2 Please refer to attachment 6.2, which includes the steps for theVendor Selection process as well as a flowchart depicting the overallprocess.

3.10 General RFP Contents

3.10.1 The most current RFP template will be maintained by Procurement departmentand tailored to fit the business need. An RFP shall include the following:

3.10.1.1 Instructions to vendors3.10.1.2 Objectives of RFP3.10.1.3 RFP schedule3.10.1.4 Business and technical requirements3.10.1.5 Pricing or total cost of operation (TCO) model template3.10.1.6 Contract performance requirements, performance standards and

guarantees, price adjustments3.10.1.7 Latest applicable Contract templates (MSA, MPA, Service

Agreement, etc.)3.10.1.8 Evaluation criteria3.10.1.9 Ability to cancel RFP or reject all proposals.

3.11 Evaluation Criteria

3.11.1 The selection of the successful Vendor will be based upon evaluation by L.A.Care in accordance with the RFP criteria considering all appropriate factors andcriteria (subjective and objective) as L.A. Care may, at its sole discretion, deemrelevant and in the Best Interest of L.A. Care. In no event will L.A. Care belimited to selecting a successful bidder based solely upon the lowest priceproposed.

3.11.2 Vendors’ responses to an RFP will be evaluated on the factors stated in the RFP,including:

3.11.2.1 Ability to meet business and technical requirements3.11.2.2 Ability to meet SOW requirements3.11.2.3 Ability to provide a comprehensive quality control plan3.11.2.4 Qualifications and experience3.11.2.5 Site visit, presentation, and/or demonstrations

31


3.11.2.6 Price or TCO3.11.2.7 Willingness to accept L.A. Care’s contractual terms and conditions

3.12 Bidders’ Conference

3.12.1 L.A. Care may conduct a bidders’ conference as it deems necessary andappropriate. In such cases, L.A. Care shall include the date, time, and locationin the RFP documents. The Vendor Selection Team and the Procurementdepartment will jointly be responsible for organizing and conducting thebidders’ conference.

3.13 Point of Contact; Notice of Award

3.13.1 The Procurement department resource working on the RFP will serve as thesingle point of contact during a Vendor Selection process. After the VendorSelection Team evaluates bidders’ proposals, the Procurement departmentresource will formally communicate to the bidders during the process. Bidderswill be notified if they have or have not made the Short List of Bidders (ifapplicable) and if they have or have not made the final award. For Bidders whodid not make the final selection, the Procurement department resource maydiscuss if necessary what requirements of the RFP the Bidders did not meet.

3.14 Vendor Selection Appeals Process

3.14.1 All appeals of a Vendor Selection must be received in writing no later than 10business days following formal communication via email to all vendors whoparticipated in the Vendor Selection process. . Appeals must be addressed anddelivered to L.A. Care, attention to the Chief Financial Officer or designee.Only appeals that are based on procedural issues will be considered for review.Procedural issues subject to review may include the following: incomplete orerroneous scoring; bid responses were not fully reviewed; other proceduralerrors or omissions. The bidder must demonstrate that the claimed error (basisfor the appeal) was prejudicial to the bidder, i.e., that but for the error, the bidderwould have been selected for award.

3.14.2 All appeal decisions made by L.A. Care will be communicated in writing to theappealing party within 20 business days of receipt of the appeal. All appealdecisions made by L.A. Care are final.

3.15 Disclosure of Proposals and L.A. Care’s Evaluation of Proposals

3.15.1 Generally, Bidders’ proposals and L.A. Care’s evaluation of the proposals,including the basis for selection, are considered to be confidential informationand should not be shared outside the Vendor Selection Team. If a request forcopies of either a Bidder’s proposal or the evaluation is received, whether orallyor in writing, the request must be treated as a request for records under theCalifornia Public Records Act (PRA). All such requests must be referred to the

32


Legal Services department immediately in order to respond to the request in thetimes mandated by the PRA.

3.16 Code of Conduct

3.16.1 L.A. Care staff and consultants participating in the Vendor Selection Processshall conduct themselves in such a manner as to foster public confidence in theintegrity of L.A. Care’s Vendor Selection process. L.A. Care staff shall performtheir duties impartially to ensure that Bidders have fair and competitive access todo business with L.A. Care. Employees and consultants are subject toapplicable state conflict of interests laws and regulations, as well as internalrequirements, including obligations of confidentiality and the use of confidentialinformation, as prescribed by L.A. Care’s Code of Conduct, the Vendor Code ofConduct and the consultant’s Contract with L.A. Care. No L.A. Care employeeor consultant shall solicit, demand, or accept from any person anything ofmonetary value for, or because of, any action taken, or to be taken in theperformance of his/her duties. Any employee or consultant failing to adhere tothe above shall be subject to any disciplinary proceeding deemed appropriate byL.A. Care, including and up to termination of employment or the consultant’sContract.

3.17 Request for Quote Process (Purchases between $25,000 and $250,000 or as defined inPreferred Vendor Listing)

3.17.1 RFQs help L.A. Care purchase products or services at fair and reasonable prices.Prior to starting the RFQ Process, the Requestor should have already checkedthe Preferred Vendor Listing and determined if Sole Source is necessary. If theRequestor’s purchase cannot be fulfilled by a Preferred Vendor and is not a SoleSource, then Requestor must follow the steps below. If there is a business needfor a competitive bid process beyond just pricing for a purchase below$250,000, the Procurement department will use its discretion to direct theRequestor to the Vendor Selection Process in §3.9.

3.17.2 The Requestor obtains at least three quotes from bidders that provide similarproduct or service within a Category and selects the vendor based on price anddelivery.

3.17.3 The Requestor submits a Purchase Requisition and all quotes received to theProcurement department.

3.17.4 A Procurement department resource will help the Requestor to determine thetype of Contract needed. The Requestor must follow §3.18 (ContractingProcess) to finish the purchase.

33


3.17.5 The Requestor will route any approvals in accordance with policy AFS-006,“Authorization and Approval Limit.”

3.17.6 The Procurement department will issue a Purchase Order number to be includedin the Contract to the Vendor after the approvals have been complete.

3.18 Contracting Process

3.18.1 Contracts are required and must be reviewed by the Procurement departmentand Legal Services department if ANY of the conditions are true:

3.18.1.1 Purchase greater than $10,000.3.18.1.2 Purchase requires PHI exchanged with the Vendor.3.18.1.3 The Vendor's performance may subject L.A. Care to liability that would

be disproportionate to the value of the Vendor's services.

3.18.2 If the conditions above are not true, then the Requestor should submit aPurchase Requisition to the Procurement department.

3.18.3 If there is a legitimate, critical business need for an expedited process, theRequestor must contact the Procurement department. This is for exceptions onlyand is not a substitute for a lack of planning by the Requestor or Requestor’sdepartment. Approvals from CEO and/or CFO maybe required.

3.18.4 New Contracts

3.18.4.1 The Requestor must submit the Purchase Requisition through theProcurement department’s procurement or contracting system andattach any pertinent information, such as applicable quotes, contractdocuments, Sole Source Justification, Board motions, cover memos,etc. The following steps and approvals are required. TheProcurement department can assist the Requestor on any of thefollowing steps.

3.18.4.2 The Requestor must acquire Contract templates from theProcurement department who will help ensure the latest L.A. Carelegally approved Contract templates are properly used for thepurchase, including whether or not an master or one-time Agreementis to be used.

3.18.4.3 The Requestor must draft business requirements to include, at aminimum, a complete and clear description of services or product;expected responsibilities of the Vendor and L.A. Care; anydeliverables; service levels; length of service/required delivery dates;purchase amount; and payment process. This is typically acollaborative, iterative review process between the Requestor,

34


Vendor, and the Procurement department if necessary in order to getto a final draft.

3.18.4.4 The Requestor must check the Vendor against the debarred andexclusion listings maintained by the U.S. General ServicesAdministration and the Office of the Inspector General, USDepartment of Health & Human Services.

3.18.4.5 The Requestor must prepare the Sole Source Justification and obtainapproval, if applicable.

3.18.4.6 The Requestor must obtain the Privacy and Information SecurityOfficer’s approval of any privacy or information security and PHIconcerns so that appropriate terms are incorporated in the Contract.

3.18.4.7 The Requestor must acquire IT approval to ensure IT-relatedpurchases such as software, hardware, cloud services, etc., meet ITstandards and are compatible with L.A. Care systems.

3.18.4.8 The Requestor must obtain approval from both Procurement and theLegal Services department for negotiation of terms, pricing, vendorperformance standards or warranties, indemnity, and insurancerequirements are finalized in the Contract.

3.18.4.9 The Requestor must obtain all approvals based on dollar amount inaccordance with policy AFS-006, “Authorization and ApprovalLimit,” including submitting any motions required for any Finance &Budget Committee or Board of Governors approvals.

3.18.4.10 After all approvals above, the Requestor or Procurement must sendtwo original copies of the final Contract to the Vendor for signatureand coordinate countersignature of the partially signed Contract.Electronic signatures are permitted.

3.18.4.11 When the final Contract is fully signed, the Requestor must send oneoriginal or electronic copy to the Vendor, the second original orelectronic copy to L.A. Care Legal Services department and aelectronic copy to the Procurement department.

3.18.5 Changes to Unexpired Contracts

3.18.5.1 If an existing and still active Contract is already in place and needs tobe changed or amended to extend the term of the Contract, increasescope, change pricing, or change any Contract provision, then theRequestor must contact the Procurement department to initiate anamendment against the Contract and then follow §3.18 (ContractingProcess).

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3.19 Contract Management

3.19.1 Once a new Contract is in place, the business owner and the Procurementdepartment have ongoing responsibilities to ensure the Vendor is fulfilling itsobligations under the Contract. Contractual terms such as fee adjustments,service levels, performance guarantees, termination rights, etc., can be unique oneach contract. Therefore, the Procurement department, the business owner ofthe Contract, and the Legal Services department (if necessary) will collaborateto determine the appropriate action and communication to a Vendor who is notfulfilling the contractual obligations. The Procurement department will maintaina Contract repository of all Contracts and manage expirations by notifying theL.A. Care business owners of the Contracts at least 90 days before they expire(unless a longer period of time is required by the Contract) in order to determineif the contract should be renewed or allowed to expire, or if an RFP needs to becompleted. In addition, the Procurement department will analyze all Contractexpirations and develop strategies that include vendor and/or contractconsolidation opportunities.

3.19.2 Procurement Responsibilities:

3.19.2.1 Monitors vendor contract expirations.3.19.2.2 Notifies business owner or designee of upcoming expirations at least

90 days prior to Contract expiration.3.19.2.3 Reviews and analyzes contract expirations for vendor and/or contract

consolidation opportunities.3.19.2.4 Monitors vendor compliance to pricing terms.3.19.2.5 Co-develop a Vendor management scorecard of key metrics and key

performance indicators (KPIs) if necessary.3.19.2.6 Participates and collaborates with Vendor in developing vendor

continuous improvement programs and corrective action plans ifnecessary.

3.19.2.7 Recommends and develops any contractual amendments with L.A.Care’s Legal Services department.

3.19.3 Business Owner or Designee Responsibilities:

3.19.3.1 Monitors vendor compliance to performance terms and deliverables.3.19.3.2 Co-develop a Vendor management scorecard of key metrics and

KPIs if necessary.3.19.3.3 Participates and collaborates with vendor in developing vendor

continuous improvement programs and corrective action plans ifnecessary.

3.19.3.4 Works with the Privacy Officer in the return or destruction of PHI ifnecessary.

36


3.20 Termination of Contracts

3.20.1 Expiring Contracts

3.20.1.1 The Procurement department will notify the business owner at least90 days prior to Contract expiration. If the business owner does notrespond after multiple documented attempts, including escalation toan Officer, then the Contract will be assumed completed. TheProcurement department will assist with Contract close outrequirements, but the Requestor and business owner will beultimately responsible for notifying the Privacy and InformationSecurity Officer if PHI needs to be formally returned to L.A. Care ordestroyed.

3.20.2 Terminating Contracts prior to Expiration

3.20.2.1 If a Contract needs to be terminated prior to the Contract expiration,the Requestor must contact the Procurement department. TheProcurement department will assist the Requestor in coordinating thetermination with L.A. Care Legal Services department. Once theContract is terminated, the Procurement department will assist withContract close out requirements, but the Requestor and businessowner will be ultimately responsible for notifying the Privacy andInformation Security Officer if PHI needs to be formally returned toL.A. Care or destroyed.

3.20.2.2 If a Contract needs to be terminated prior to the Contract expirationfor vendor issues such as non-performance or undelivered productsand/or services, then the Requestor must contact ProcurementDepartment who will coordinate with L.A. Care Legal ServicesDepartment for either a termination for breach of Contract oropportunity to cure vendor issues.

3.21 Vendor Management

3.21.1 Vendor management is applicable and typically reserved for those Vendors thatare of high impact to L.A. Care in terms of dollars paid to the Vendor and ofhigh impact to L.A. Care operations in serving its members. The intent is toproperly manage the Vendor relationship to manage and mitigate risks andensure the strategic goals and objectives of L.A. Care are being met. Vendormanagement includes all the responsibilities of Contract Management alongwith the following:

3.21.1.1 Agreed upon service levels and/or performance guarantees definedand incorporated in a fully executed Contract between L.A. Care andthe vendor.

37


3.21.1.2 A formal governance structure defined and incorporated in a fullyexecuted Contract between L.A. Care and the vendor.

3.21.1.3 A formal scorecard to measure the contractual service levels,performance guarantees, and program/project milestones.

3.21.1.4 Formal, recurring review meetings outlined in the governancestructure between the Officer or designee level and the vendor’sexecutive leadership, when the complexity and scope of the Contractwarrants. At a minimum, the meeting agenda should include:3.21.1.4.1 Review of the vendor scorecard.3.21.1.4.2 Develop and follow-up on corrective action plans for both

L.A. Care and the vendor to resolve any strategic ortactical issues.

3.21.1.4.3 Develop any new innovative strategies and tactics thatcontinuously improve the value and performance of therelationship to achieve L.A Care’s goals and objectives.

4.0 AUTHORITY:

None

5.0 REFERENCES:

5.1 Policy AFS-006, “Authorization and Approval Limit”

6.0 ATTACHMENTS:

6.1 Process Flowchart6.2 Vendor Process Selection Steps & Flowchart6.3 Sole Source Justification Form

ACCOUNTABILITY MATRIX

Responsible Department(s) Policy Section #

ELECTRONICALLY APPROVED BY THE FOLLOWING

Officer DirectorRegulatory Affairs &

ComplianceName Tim Reilly Patricia Mowlavi Denise Corley

38


DepartmentExecutive Services Accounting Services Regulatory Affairs &

ComplianceTitle Chief Financial Officer Senior Director Compliance Officer

IF APPLICABLE

Board of Governors Motion Number:

*Note: Please write “N/A” for the Name, Department, and Title of the Director if this approval is notapplicable.

POLICY HISTORY

Date DepartmentPolicy orSection #

Comment(s)Next or Annual

Review Date01/10/02 Accounting &

Financial ServicesAFS-007 New Policy 01/10/03

02/10/10 Accounting Services AFS-007 Capital Assets defined as itemswith value greater than $2,000

02/10/11

##/##/15 Accounting Services AFS-007 Annual Review; major changes. ##/##/16

39

Attachment 6.1 (AFS-007)

40


StepsKey Tasks and Responsibilities

Key DeliverableProcurement Resource Vendor Selection Team1 Kick-Off & Assess

Opportunities/Determine Goals

Collects and analyzes highlevel data

Assesses the opportunities Determine goals Identify team decision makers

Participates in the analysis ofthe data and assessment ofopportunity

Project charter

2 Develop CategoryProfile (if applicable)

Determine: What we buy Potential known vendors When we buy Estimated unit cost or fees and

expenses

Reviews and validatesdeliverables (if applicable)

List of potential vendors Vendor spend history report (if

applicable) Current procurement and

payment process (if applicable)

3 Generate MarketResearch Profile (ifapplicable)

Identify industry leadingvendors

Determine vendors value-added capabilities

Identify industry trends

Reviews and validatesdeliverables (if applicable)

Market research report (i.e.,Gartner, etc. if applicable)

Additional potential vendors

4 Develop SourcingStrategy

Develops a sourcing strategythat utilizes a Total Cost ofOwnership, (TCO) model

Assess negotiation leverage Evaluate alternative strategies

Develops a sourcing strategythat utilizes a TCO model

Assess negotiation leverage Evaluate alternative strategies

Business and technicalrequirements includingfunctional, task, quality, andservice level requirements

TCO financial model Contract strategy Vendor Management strategy

(if applicable)5 Execute Sourcing

Strategy Develops list of vendors Leads development of RFP

including evaluation criteriaand weightings

Sends RFP to qualified,

Approves final list of vendors Reviews and approves RFP

including evaluation criteriaand weightings

Participates in fielding vendor

Final list of vendors for RFP RFP Vendor Proposals RFP Scoring Report Short List of Vendors

41


approved list of vendors Serves as single point of

contact between vendors andL.A. Care

Manages and fields vendorquestions during RFP process

Moderates Bidder’sConference if necessary

Applies RFP scoringmethodology

Performs Reference Checks Issues any amendments to RFP Scores pricing component of

vendor proposals using TCOmodel

Develops Short List ofVendors from RFP scoring

Develops secondary scoringfor vendor presentations, sitevisits, and/or demos ifnecessary

questions during RFP process Participates in Bidder’s

Conference if necessary Scores vendor proposals Approves Short List of

Vendors Participates and scores

presentations, site visits,and/or demos if necessary

Additional or secondaryscoring report from Short Listof vendor presentations, sitevisits, and/or demos

6 Negotiate and SelectVendor(s)

Develops negotiation strategy Conducts negotiations

Assists in negotiations asnecessary

Final selection in the BestInterest of L.A. Care

7 Complete Contract Prepares the final Contractwith legal department

Develops procurement andpayment process

Incorporates a vendorgovernance structure ifnecessary

Implements VendorManagement if necessary

Reviews procurement andpayment process

Reviews final Contract Signs or acquires contract

signatures in accordance withAFS-006 and Sections 3.7.1.9and 3.7.1.10

Implements technical andbusiness oversight portions of

Signed Contract(s) Final procurement and

payment process Executed Purchase Order

42


Sends executed Purchase Orderto vendor

Vendor Management ifnecessary

8 Contract Management Monitors vendor compliance topricing terms.

Develops a VendorManagement scorecard of keymetrics and key performanceindicators (KPIs) if necessary.

Participates and collaborateswith vendor in developingvendor continuousimprovement programs andcorrective action plans ifnecessary.

Recommends and executes anycontractual amendments thatimprove vendor performance.

Monitors contract expirations. Performs Contract close-out

activities (final invoices,release of claims, return ofproperty or information, etc.)

Monitors vendor complianceto performance terms anddeliverables.

Develops a VendorManagement scorecard of keymetrics and KPIs if necessary.

Participates and collaborateswith vendor in developingvendor continuousimprovement programs andcorrective action plans ifnecessary.

Works with the Privacy andInformation Security Officerin the return or destruction ofPHI if necessary.

On-goingIf necessary: Vendor scorecard Vendor Correction Action

Plans Contract Amendments Return or destruction of PHI

43


Kick-Off &Assess

Opportunities/

DetermineGoals

DevelopCategory Profile

Develop MarketResearch Profile

DevelopSourcingStrategy

ExectueSourcingStrategy

Negotiate andSelect Vendor(s)

CompleteContract(s)

ContractManagement

44


Sole Source Justification

Vendor: ________________________

Contract Start/End Date: ________________________

Contract Amount: ________________________

Date:________________________

Identify applicable justification and provide documentation for each checked item.

Only viable source for product or service, performance and price competition are not

available.

Only viable source possessing specialized or unique expertise.

Proposals were solicited, however no satisfactory proposals were received or only one

satisfactory proposal was received.

Additional services are required to complete an ongoing task. It would be prohibitively

costly in time and money to seek a new service provider.

Maintenance Service Agreements for equipment which must be serviced by the

authorized manufacturer service representatives, and there is only one authorized

service representative in the geographical area.

45

It is in the Best Interest of L.A. Care, e.g., administrative cost savings outweigh cost

savings that would be realized through competition, steep learning curve for new

service provider, knowledge base, etc.

It is more cost effective to obtain services by exercising an option under the existing

contract.

Items requested are based upon previous purchases from this vendor and are needed

to match the existing product.

The requirement is within the scope of an existing Contract and can be addressed as

an amendment.

RFP previously executed. Date: ___________

Other, please explain:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Approvals for Purchases from $25,000 up to $250,000:

Director/Senior Director/Officer: _________________________

Manager of Procurement: _________________________

Approvals for Purchases greater than $250,000*:

Officer: _________________________

Director of Procurement: __________________________

CFO: __________________________

CEO: __________________________

*Sole Source purchases greater than $250,000 will be reported to Board of Governorsor its Board Committee designee on a monthly basis.

46

: PROCUREMENT TITLE

POLICYVENDOR

SELECTIONPROCUREMENT POLICY

: FINANCE SERVICES SERVICE AREA

: ACCOUNTING DEPARTMENT

SERVICES

Policy and Procedure

Number

AFS 007

Total No. of Pages Page 1 of

31

Dates

Effective Date 01/10/2002

Review/Revision Date ##/##/2015

Supersedes Policy

Number AFS-026

PPSA/Mandated YES NO X

Next (Annual) Review

Date ##/##/2016

Administrative YES X NO

Applies to:

Medi-Cal – Plan

Partners YES NO X

Medi-Cal – L.A. Care YES NO X

PASC-SEIU Plan YES NO X

Healthy Families YES NO X

Healthy Kids YES NO X

Medicare SNP YES NO X

Cal MediConnect

L. A. Care YES NO X

Cal MediConnect

Subcontracted Plans YES NO X

L.A. Care Covered YES NO X

RAC Version Control #1B (10.30.2009)

1.0 POLICY:

1.0

1.1 Although not generally subject to the state laws and regulations pertaining to

competitive bidding, L.A. Care Health Plan (L.A. Care) has established its own policies

and procedures relating to the purchase and procurement of products and services. I t is

L.A. Care’s policy to purchase products and services on the basis of quality, delivery,

and price. L.A. Care will establish purchasing procedures and processes to develop

qualified and reliable sources and to obtain quality products and services at fair and

reasonable prices through efficient, effective, and competitive procurement methods.

1.2 This policy excludes provider network contracts, employment agreements, grant

agreements, sponsorships, legal retainer agreements, and regulatory fees. Purchase

Orders can be used as a method of keeping track of payments in cases like grants and

sponsorships.

While L.A. Care, organized as a health authority, is not bound by government (State or local)

procurement Health Plan is generally not subject to the state laws and regulations.

Nevertheless, L.A. Care desires to adopt this policy to establish a fair and equitable purchasing

47

Policy and Procedure Number 1501AFS-007 Page 2 of 31


process which provides the organization with efficient, cost effective and pertaining to

competitive purchasing methods. The bid requirements as statedbidding, it has established its

own policies and procedures relating to the purchase and procurement of products and services.

It is L.A. Care’s policy to purchase products and services on the basis of quality, delivery, and

price. L.A. Care will establish purchasing procedures and processes to develop qualified and

reliable sources and to obtain quality products and services at fair and reasonable prices

through efficient, effective, and competitive procurement methods. The procedures in this

policy may only be deviated from with the prior approval of both the Chief Executive Officer

(CEO) and the Chief Financial Officer.

Products, services and capital assets in excess of established dollar amounts noted in this policy

will be purchased using competitive bid procedures. The Purchasing (CFO), or their

designees. The Procurement Department is primarily responsible foraligning procurement

strategies with L.A. Care objectives; coordinating all bid preparations, communications and

negotiations with contractors, vendors and suppliers involved in the provision of products,

services and capital assets for L.A. Care. Bid processes (RFPs etc.) may be conducted and

coordinated by other departments provided the Purchasing Department oversees the process to insure that purchasing policies and standards are adhered to during the processVendor

Selection activity; and providing efficient procurement processes and tools. To ensure

procurement strategies are aligned with L.A. Care objectives, a Procurement Council

comprised of the Director of Procurement and L.A. Care Officers or designees will meet on a

regular basis to develop, review, and refine procurement strategies and tactics on vendor

consolidation opportunities, vendor management, contract management, and process

improvement.

All requests for purchases must be reviewed and approved by the PurchasingProcurement

Department prior to submitting the request for legal review and officerOfficer approval. All

purchases of products, services and capital assets will only be made by authorized designated

management personnel and according to approved authorization limits as defined in Policy

AFS-006.

1.1 SCOPE

1.1.1 This policy covers the purchase of all products, services and capital assets

required for the administration and operational functions of L.A. Care.

1.1.2 This policy does not include contracting with Plan Partners or the purchase of,

or contracting with, healthcare providers involved in the actual delivery of

healthcare services. Additional exclusions include grant agreements,

sponsorships, employee benefits, utilities, insurance, business licenses,

regulatory fees, and payroll services.

1.2 PURCHASING GUIDELINES

1.2.1 Bid Methods and Parameters

48



1.2.1.1 Purchase Requisitions: Products, services (including professional

and technical services) and capital assets with a total value less than

$25,000 do not require a bid process and may be purchased using a

standard Purchase Requisition and/or Check Request Form.

Exception: When estimated annual purchases from one vendor

exceed this dollar limit.

1.2.1.2 Request for Quotes (RFQ): The Request for Quotes purchase

method will be used for the procurement of products and services

defined as operating expenses and costing more than $25,000, but

less than $250,000; and capital asset expenditures costing more

than $25,000, but less than $100,000.

1.2.1.2.1 If an item is a standard product or service, a minimum of

three written price and specification quotes are required.

1.2.1.2.1.1 For products of identical quality and

specifications, the lowest price responsive bidder

will be used.

1.2.1.2.1.2 For products or services which are not identical,

but may vary by vendor, the award of a purchase

contract will be given to a qualified responsive

and responsible bidder whose bid conforms to the

requirements and specifications of the RFQ, and

who is determined the most appropriate for LA

Care.

1.2.1.2.2 If an item is not a standard product or service, the selection of

the vendor need not be solely based upon the lowest price if

the vendor's experience, customer service, availability and

range of products and services, references, etc. dictate that it

would be more advantageous to L.A Care.

1.2.1.2.3 Documentation of purchase rationale is required stating the

reasons for vendor selection and discussion of significant

price differentials, if any exist.

1.2.1.2.4 A Request for Proposal must be used if the services or

product requires more detail specifications and response.

1.2.1.2.5 A RFQ may be issued to a limited number of bidders who

are known to be qualified.

1.2.1.3 Request for Proposals (RFP)

The Request for Proposal purchase method shall be used for the

procurement of capital assets and consulting services costing in

excess of $100,000; and operating expenditures in excess of

$250,000.

1.2.1.3.1 The RFP method is a competitive negotiated purchase

requiring a standard set of established purchase

specifications, contract performance requirements, standard

49



evaluation of RFP responses and an open competitive bid

process. All RFP documents will include standard L.A Care

requirements for vendor insurance coverage, performance

bonds when applicable, appropriate state or local licenses and

other requirements as deemed appropriate by L.A Care.

1.2.1.3.2 Evaluation of RFP responses will be based upon a

predetermined set of evaluation criteria, which will be

applied to all responsive bidders. Responses submitted which

are determined to be nonresponsive will not be evaluated.

Board approval of recommended contractors may be required in accordance with the

Authorization Limits as established byand Approval Limit Policy AFS-006., as that policy may

be amended from time to time.

This policy excludes provider network contracts, employment agreements, grant agreements,

sponsorships, and regulatory fees. Purchase Orders can be used as a method of keeping track

of payments in cases like grants and sponsorships.

1.2.1.3.3 :The RFP method should be used when the DEFINITIONS

selection of a vendor can be made based on the following

circumstances and criteria:

2.0 The total

Whenever a word or term appears capitalized in this Policy and Procedure, the reader should

refer to the “Definitions” below.

2.1 Best Interest: This is aA discretionary rationale used by the Director of Procurement

or his/ or her designee in taking action most advantageous to L.A. Care when it is

impossible to adequately delineate other guidance through laws, regulations, or policies

in L.A. Care’s best interest to consider award based on factors other than the lowest

price for the products or services..

2.2 Bidder: A potential vendor who submits a response to an RFI, RFP, or RFQ.

1.2.1.3.3.1 Category: Commodity or category of purchase

price (including tax and freight and installation) of

products, capital assets, or services purchased

exceeds the aforementioned limits above.

1.2.1.3.3.2 A complete purchase description and product

specification is available.

1.2.1.3.3.3 The purchase is for a standard product or service,

capital or fixed assets.

1.2.1.3.3.4 There are at least two responsible bidders who can

conform to and are willing to meet the bid

requirements, product or services specifications.

1.2.1.3.3.5 The vendor selection can be made on the basis of

price or a fixed fee contract.

50



1.2.1.3.4 For products or services which are not identical, but may vary

by contractor, the award of a contract will be given to a

qualified responsive and responsible bidder whose bid

conforms to the requirements and specifications of the

Request for Proposal and who is determined most appropriate

for L.Asuch as Care. A bidder is deemed to be responsive

and responsible when:

1.2.1.3.4.1 A responsive bidder is one whose bid meets the

specifications set forth in the RFP.

1.2.1.3.4.2 A responsible bidder is one who has the resources,

experience, expertise, service and financial

capabilities to complete, in a timely manner, the

requirements as specified in the RFP.

1.2.1.3.4.3 Contract awards will be made to the lowest priced

responsive and responsible bidder whose bid

conforms to the terms and conditions of the RFP.

Even though the RFP provides for the awarding of

a contract to the lowest priced bidder, after the

final bidder is selected, L.A Care may further

negotiate the price and terms.

1.2.1.3.4.4 A RFP may be distributed to a limited number of

potential contractors when the purchase

requirements are highly specialized and it is

reasonably known that a small number of firms or

organizations are capable of responding. Examples

would be auditing services, specialized consulting

services, specialized health education services or

projects, etc.

1.2.2 Preferred Vendors - Request for Qualifications

1.2.2.1 Preferred Vendor List

1.2.2.1.1 A "Preferred Vendor List" may be used for the purpose of

establishing ongoing contractual relationships with "Sole

Source" vendors as well as vendors and suppliers who

provide products and services to support L.A Care's

recurring business activities such as office supplies,

temporary labor, mail house fulfillment, printing, etc. L.A

Care may use multiple contractors to provide similar products

or services at equivalent or similar pricing.

1.2.2.1.2 The Request for Qualifications method essentially pre-

qualifies a potential vendor and is based upon the RFP

methodology requiring a standard set of established purchase

specifications, contract performance requirements, and a

standard evaluation of responses.

51



1.2.2.1.3 Preferred Vendors will be required to reapply for Preferred

Vendor Status at least every three years.

1.2.2.2 Request for Qualifications (RFQ) 1.12.3 The RFQ method may be used for the purchase of capital assets, and other

products,consulting, IT equipment and services, and the total purchased amount

cannot exceed the amount incorporated within the annual operating budget approved

by the Board of Governors, or facility services.

2.4 Contract: Contract is aAn agreement between two parties such as L.A. Care and a

Vendor that is enforceable by law, where one party offers a product or service while the

other party accepts the product or service and provides payment. Examples of contracts

are documents such as Purchase Orders, Purchase Agreements, and Services

Agreements – all of which include a description of the product or services, the delivery

terms and compensation, as well as terms and conditions. Master Agreements without a

description of the product or services, the delivery terms and compensation, as well as

other agreements such as Lletters of Iintent, Mmemoranda of Uunderstanding, while

agreements, are not contracts in that they may not be enforceable by law.

2.5 Master Purchase Agreement (MPA): MPA is a framework document that contains

legal terms and conditions to purchase products or services over a specific period of

time, and generally includes a price list for offered products or services. Once an order

for products or services is issued, the MPA and order, together, comprise a Contract.

MPAs are used for recurring purchases.

2.6 Master Services Agreement (MSA): MSA is aA framework document that contains

legal terms and conditions to purchase services over a specific period of time. On its

own an MSA does not describe any services to be delivered. Typically, it is

accompanied with a Schedule that describes the services to be provided, the

deliverables, a delivery schedule and pricing. MSAs are used when it is anticipated that

there will be multiple requirements for a particular vVendor.

Purchase Order/Purchase Agreement: A simplified Contract that contains standard

terms and conditions and a description, pricing, and remittance information used to

purchase a product or service from a vendor. It is issued and sent to a vendor typically

after a Purchase Requisition has been fully approved.

Purchase Requisition: An internal document that contains the description, pricing, and

total dollar amount of a purchase and that is routed through management for approval

based on the dollar amount. After all approvals a Purchase Order is issued and sent to a

vendor.

2.7 Preferred Vendors: Vendors selected based on a competitive bidding process to

provide products or services to support frequent or recurring requirements for a

specified period of time pursuant to the terms of an MPA or MSA. Based on the terms

of the MPA or MSA and the dollar value of a specific requirement, further competition

may be required.

52



2.8 Preferred Vendor Listing: Listing of Preferred Vendors located at Pprocurement

Iintranet that contains the Category of a purchase; name of the Preferred Vendor; and

directions on how to purchase. It is meant for frequent and recurring purchases.

1.2.2.2.1 Procurement Council: Formal group comprised of the

Director of Procurement and L.A. Care Officers or designees

charged to align procurement strategies with the goals and

objectives of L.A. Care. Evaluation of responses will be

based upon a predetermined set of evaluation criteria, which

will be applied to all responsive bidders. Responses submitted

determined to be non-responsive will not be evaluated.

1.2.2.2.2 The Request for Qualifications method is used to identify

firms capable of conforming to the requirements and

specifications of the product or service and who are

determined to be responsive and responsible contractors.

1.2.2.2.3 Qualified bidders will be notified that their responses

establish the bidder as a "preferred vendor", and, if necessary,

L.A Care may purchase goods or services from the contractor

from time to time. Approval of a bidder as "preferred vendor"

does not imply an award of a contract nor obligate L.A Care

to purchase goods and services from the "preferred vendor".

1.2.3 Appeals to Purchase Decisions

1.2.3.1 Scope

1.2.3.1.1 Purchase determination conducted using the following bid

methods may be appealed to L.A Care:

1.2.3.1.1.1 Request for Proposals

1.2.3.1.1.2 Request for Qualifications

1.2.3.2 Appeal Guidelines

2.9 All The group will meet on a regular basis to develop, review, and refine procurement

strategies and tactics on vendor consolidation opportunities, vendor management,

contract management, and process improvement.

2.10 Protected Health Information (PHI): Individually identifiable health information

(essentially member information) that is transmitted and maintained in any form or

medium. PHI excludes individually identifiable health information in education records

covered by the Family Educational Rights and Privacy Act (FERPA), employment

records held by L.A. Care in its role as employer, and such information regarding a

person who has been deceased for more than fifty (50) years.

2.11 Purchase Order/Purchase Agreement: A simplified Contract that contains standard

terms and conditions and a description, pricing, and remittance information used to

purchase a product or service from a vendor. It is issued and sent to a vVendor

typically after a Purchase Requisition has been fully approved.

53



2.12 Purchase Requisition: An internal document that contains the description, pricing, and

total dollar amount of a purchase and that is routed through management for approval

based on the dollar amount. After all approvals a Purchase Order is issued and sent to a

vendor.

2.13 Request for Information (RFI): An informal process for obtaining additional

information relative to a product or service that is needed as part of L.A. Care’s market

research. This helps L.A. Care identify potential sources or gain a better understanding

of what products or services may be available.

2.14 Request for Proposal (RFP): A formal competitive bidding process to select a

Vendor(s) from a pool of vendors who provide or produce the same or similar products

or services. An RFP will have a set of requirements or specifications of what is needed

and directions for the qualified vendors on how and when to submit their proposals. For

this policy, it is typically reserved for high dollar (greater than $250,000) and more

complex purchases that require time and resources.

2.15 Request for Quote (RFQ): An informal competitive bidding process based on price to

select a vVendor(s) from a pool of vendors who provide or produce the same or similar

product or service. An RFQ is typically used for lower dollar (less than $250,000 but

greater than $25,000), less complex, and high transaction purchases. It can be used to

get competitive pricing regardless of dollar amount when the competitive field is

limited to Preferred Vendors in certain Categories like temporary labor and print.

2.16 Requestor: Designated person within a department who initiates purchase requests for

either products or services.

2.17 Service Agreements: A Contract used for the one--time purchase of services.

2.18 Short List of VendorsBidders: A subset of the original pool of qualified

vendorsBidders participating in an RFP who are finalists in a Vendor Selection process

based on the evaluation criteria of the RFP.

2.19 Sole Source: An exception to the Vendor Selection process when only one Vendor is

considered, in accordance with the process in Section 3.4outlined in this policy.

2.20 Statement of Work (SOW): Also known as a scope of work or scope of services, this

is is the portion of a contract that describes the services to be delivered, the vendor’s

responsibilities, L.A. Care’s responsibilities, timing, and costspricing.

2.21 Vendor: A business entity, organization or individual who provides a product or a non-

clinical service to the L.A. Care organization for payment.

2.22 Vendor Selection: A formal, value-based process by which a Vendor is selected from

a pool of qualified vendors to perform services or deliver products to L.A. Care.

54



Different Vendor selection techniques are used depending on complexity and dollar

value of service or product in need. These techniques include RFPs, RFQs or RFIs.

Vendor Selection Team: A group of L.A. Care staff (may include consultants), led by

the Director of Procurement or designee, and a team tailored for the particular purchase,

that includes appropriate procurement, business, technical and other expertise who will

review proposals to provide a comprehensive evaluation of offers and make

reccommendations on the selection of vendors.

55



3.0 PROCEDURES::

3.1 The procedures in this policy may only be deviated from with the prior approval of both

the Chief Executive Officer (CEO) and the Chief Financial Officer (CFO), or their

designees.

3.2 The Procurement department is primarily responsible for aligning procurement

strategies with L.A. Care objectives, coordinating all Vendor Selection activity, and

providing efficient procurement processes and tools.

3.3 To ensure procurement strategies are aligned with L.A. Care objectives, a Procurement

Council comprised of the Director of Procurement and L.A. Care Officers or designees

will meet on a regular basis to develop, review, and refine procurement strategies and

tactics on vendor consolidation opportunities, vendor management, contract

management, and process improvement.

3.4 All requests for purchases must be reviewed and approved by the Procurement

department prior to submitting the request for legal review and Officer approval. All

purchases of products, services and capital assets will only be made by authorized

designated management personnel and in accordance with policy AFS-006,

“Authorization and Approval Limit,” as that policy may be amended from time to time.

The procedures in this policy may only be deviated from with the prior approval of both the Chief

Executive Officer (CEO) and the Chief Financial Officer (CFO), or their designees. The Procurement

department is primarily responsible for aligning procurement strategies with L.A. Care objectives;

coordinating all Vendor Selection activity; and providing efficient procurement processes and tools.

To ensure procurement strategies are aligned with L.A. Care objectives, a Procurement Council

comprised of the Director of Procurement and L.A. Care Officers or designees will meet on a regular

basis to develop, review, and refine procurement strategies and tactics on vendor consolidation

opportunities, vendor management, contract management, and process improvement.

The procurement process for products and services is outlined in this policy. depicted

below. TThe Requestor must use the process flowchart (attachment 6.1) diagram to

determine which section applies to the business situation. The Procurement

Ddepartment can assist the Requestor at any stage of the process.

56



3.5

3.6 Business Requirements Definition:

3.6.1 Before any purchase, there are pre-requisite steps to understand what is being

purchased.

3.6.2 The Requestor must first define what they are buying; a product, service, or

both, and what Category the product/service fits into. For example, is it a

product, service, or both and what Category does it fit into. Product examples

include Categories likesuch as office supplies, IT equipment, promotional items,

computer supplies, and print. Service examples include consulting

(management or technical), temporary labor, facility services, construction

services, mailing services, and assessment services. It is the responsibility of the

business unit to adequately define its requirements, including product

requirements or scope of work, delivery/schedule and pricing.

3.6.3 The Requestor canmay contact the Procurement Ddepartment for assistance in

preparing product descriptions or SOWs; however, the ultimate responsibility is

the business unit.

3.7 Review the Preferred Vendor List for Potential Sources:

3.7.1 Utilizing a Preferred Vendor for frequent or recurring purchases provides the

following benefits:

3.7.1.1 Greatly reduces organizational expenses by ensuring L.A. Care takes

advantage of any discounts or reduced pricing that are already in a

Preferred Vendors cContract.

57



3.7.1.2 Faster turnaround time because a vVendor and a cContract already

exists and a new vVendor does not have to be selected and a new

cContract does not need to be negotiated.

3.7.1.3 MinimizesReduces financial, operational, legal, information security,

and privacy risks to L.A. Care because a Preferred Vendor is already

under an legally approved cContract.

3.7.1.4 Saves L.A. Care resource costs associated with business

administration, procurement processing and contracting, and legal

review that are typically utilized when new cContracts are put in

place.

3.7.2 The Requestor must check the latest Preferred Vendor Listing located at L.A.

Care intranet site. The listing will contain the Category of products and services

(i.e., office supplies, consulting, temporary labor, IT equipment, etc.), Preferred

Vendor, and directions on how to purchase. In almost all cases, a Purchase

Requisition and an executed Purchase Order will be required for each purchase.

The Requestor can contact the Procurement Ddepartment for assistance.

3.7.2.1 If the product or service CAN be ordered from the Preferred Vendor

Listing, then the Requestor must follow the directions outlined in the

listing. In cases such as temporary labor, consulting, or print

services, the Preferred Vendor Listing will outline when RFQs

should be done to obtain competitive bids among a subset of

Preferred Vendors within the same Category. If competition is

required, the Requestor must follow §Section 3.17 below (6 RFQ

Process). If the Preferred Vendor Listing outlines that a Contract is

required, then the Requestor must follow §Section 3.187 below

(Contracting Process).

3.7.2.2 If the product or service CANNOT be ordered from the Preferred

Vendor Listing, then the Requestor must follow the procedures

below.:

3.7.3 For purchases that are Sole Source, then the Requestor must follow §Section

3.48 below (, Sole Source Justification Process). Sole Source purchases are the

exception and should only be used when authorized. Depending on the dollar

limit, pursuant to §Section 3.8 below4.3, Sole Source purchases are reported up

to the Board of Governors.

3.7.3.1 For purchases greater than $250,000, refer to go to Section §3.95

below (Vendor Selection Process).

3.7.3.2 For purchases greater than $25,000 up to $250,000, refer to §3.17

below (RFQ Process).

3.7.3.3 For purchases up to $25,000, submit a Purchase Requisition to

Procurement department and refer to §3.18 (Contracting Process) to

see if a Contract is required.

3.8 Sole Source Purchasing Justification Process

58



3.8.1 Sole Source procurements may only be utilized in the circumstances and subject

to the procedures set forth below.

For purchases greater than $25,000 up to $250,000, go to Section 3.6 RFQ Process

For purchases up to $25,000, submit a Purchase Requisition to Procurement Department and go to

Section 3.7 Contracting Process to see if a Contract is required.

Sole Source Purchasing Justification Process: Sole Source procurements may only be utilized in the

circumstances and subject to the procedures set forth below.

Only viable source for product or service, performance, and price competition are not available.

3.8.1.1 Only viable source for product or service, performance, and price

competition are not available.

3.8.1.2 Only viable source possessing specialized or unique expertise.

3.8.1.3 Proposals were solicited, however no satisfactory proposals were

received or only one satisfactory proposal was received.

3.8.1.4 Additional services are required to complete an ongoing task. It

would be prohibitively costly in time and money to seek a new

service provider.

3.8.1.5 Maintenance Service Agreements for equipment which must be

serviced by the authorized manufacturer service representatives, and

there is only one authorized service representative in the

geographical area.

3.8.1.6 It is in the Best Interest of LA Care, e.g., administrative cost savings

outweigh cost savings that would be realized through competition,

steep learning curve for new service provider, knowledge base, etc.

3.8.1.7 It is more cost effective to obtain services by exercising an option

under the existing contract.

3.8.1.8 Items requested are based upon previous purchases from this

vVendor and are needed to match the existing product.

3.8.1.9 The requirement is within the general scope of an existing Contract

and can be addressed appropriately as an amendment.

3.8.1.10 Emergency circumstances when a product or service is necessary and

the time necessary to follow the required procurement process is not

available.

3.8.2 Sole Source purchases must be justified before the actual purchase in sufficient

detail using the Sole Source Justification form (attachment 6.3See Attachment

A) to explain the basis for suspending L.A. Care’s usual Vendor Selection

process and receive the required approvals as set forth in this policy. The Sole

Source Justification must be submitted as part of the Purchase Requisition or

Board motion package if a motion is required.

3.8.3 Any proposed Sole Source purchase greater than $25,000 and up to $250,000

must be approved by a Director or Officer level and the Manager of

Procurement. Sole Source purchases over $250,000 must be approved by

Director of Procurement, Officer, CFO, and CEO or designee as well as be

59



reported to the Board of Governors or its Board Committee designee on a

monthly basis.

3.8.4 Emergency Purchases:

3.8.4.1 The CEO or designee may authorize Sole Source purchases in cases

that have or could impose significant provable loss to L.A. Care;

short turn-around time mandated by regulatory agencies, contractual

requirements, or changes in the law; or where human life or property

is endangered. When an emergency condition arises and the need

cannot be met through normal procurement methods, the emergency

purchase shall be made with such competition as is feasible under the

circumstances, including soliciting quotes orally. Contracts and

other documents related to such emergency procurements shall be

executed in accordance with the requirements of policy AFS-006,

“the Authorization and Approval Limit.” Policy (AFS-006). Within

a reasonable time after the conclusion of the emergency, the Officer

responsible for the emergency purchase shall provide written

documentation stating the basis for the emergency purchase and the

reasoning for the selection of the particular vVendor. A written

account of the emergency circumstances shall be sent promptly to the

CEO or designee. Normal purchasing procedures shall be followed

as soon as the emergency is over.

3.9 Vendor Selection Process (Purchases > $250,000):

3.9.1 Prior to starting the Vendor Selection Process, the Requestor should have

already checked the Preferred Vendor Listing per Section 3.3 and determined if

Sole Source is necessary per Section3.4.

3.9.2 If the Requestor’s purchase cannot be fulfilled by a Preferred Vendor and is not

a Sole Source, the Requestor must contact the Procurement Ddepartment to

initiate the Vendor Selection Process. The Vendor Selection Process, also

known as Strategic Sourcing, is utilized for purchases greater than $250,000

under this policy.

3.9.3 The Vendor Selection Process consists of the steps outlined in attachment 6.2

and deliverables developed by both procurement and a Vendor Selection team

made up of the Requestor and other L.A. Care staff participating in the process.

3.9.3.1 All deliverables (identified in attachment 6.2) are required where

they are applicable.

Please refer to attachment 6.2, which includes the steps for the

Vendor Selection Pprocess as well as a flowchart depicting the

overall process. The diagram below depicts the overall process. The

process consists of the following steps and deliverables developed by

both procurement and a Vendor Selection team made up of the

60



Requestor and other L.A. Care staff participating in the process. The

deliverables below are all required where they are applicable.

3.9.3.2

3.10 General RFP Contents:

3.10.1 The most current RFP template will be maintained by Procurement Ddepartment

and tailored to fit the business need. An RFP shall include, but not be limited to

the following:

3.10.1.1 Instructions to vendors

3.10.1.2 Objectives of RFP

3.10.1.3 RFP schedule

3.10.1.4 Business and technical requirements

3.10.1.5 Pricing or total cost of operation (TCO) model template

3.10.1.6 Contract performance requirements, performance standards and

guarantees, price adjustments

3.10.1.7 Latest applicable Contract templates (MSA, MPA, Service

Agreement, etc.)

3.10.1.8 Evaluation criteria

3.10.1.9 Ability to cancel RFP or reject all proposals.

3.11 Evaluation Criteria:

3.11.1 The selection of the successful Vendor will be based upon evaluation by L.A.

Care in accordance with the RFP criteria considering all appropriate factors and

criteria (subjective and otherwiseobjective) as L.A. Care may, at its sole

discretion, deem relevant and in the Best Interest of L.A. Care. In no event will

61



L.A. Care be limited to selecting a successful bidder based solely upon the

lowest price proposed.

3.11.2 Vendors’ responses to an RFP will be evaluated on the following factors stated

in the RFP, including, but not limited to:

3.11.2.1 Ability to meet business and technical requirements

3.11.2.2 Ability to provide a clear approach to meet SOW requirements

3.11.2.3 Ability to provide a comprehensive quality control plan

3.11.2.4 Qualifications and experience

3.11.2.5 Site visit, presentation, and/or demonstrations

3.11.2.6 Price or TCO

3.11.2.7 Willingness to accept L.A. Care’s contractual terms and conditions

3.12 Bidders’ Conference

3.12.1 : L.A. Care may conduct a bidders’ conference as it deems necessary and

appropriate. In such cases, L.A. Care shall include the date, time, and location

in the RFP documents. The Vendor Selection Team and the Procurement

Ddepartment will jointly be responsible for organizing and conducting the

bidders’ conference.

3.13 Point of Contact; Notice of Award

3.13.1 : The Procurement Ddepartment resource working on the RFP will serve as the

single point of contact during a Vendor Selection process. After the Vendor

Selection Team evaluates vendorbidders’ proposals, the Procurement

Ddepartment resource will formally communicate to the vendorbidders

alongduring the process. VendorsBidders will be notified if they have or have

not made the Short List of VendorsBidders (if applicable) and if they have or

have not made the final award. For vendorsBidders who did not make the final

selection, the Procurement Ddepartment resource canmay discuss if necessary

what requirements of the RFP the vendorsBidders did not meet in L.A. Care’s

Best Interests.

3.14 Vendor Selection Appeals Process

3.14.1 All appeals of a Vendor Selection must be received in writing no later than 10

business days following the announcementformal communication via email to

all vendors who participated in the Vendor Selection process. of the purchase

award of Contract. Appeals must be addressed and delivered to L.A. Care,

attention to the Chief Financial Officer or designee. Only appeals that are based

on procedural issues will be considered for review. Procedural issues subject to

review may include the following: incomplete or erroneous scoring; bid

responses were not fully reviewed; other procedural errors or omissions. The

bidder must demonstrate that the claimed error (basis for the appeal) was

62



prejudicial to the bidder, i.e., that but for the error, the bidder would have been

selected for award.

3.14.2 All appeal decisions made by L.A. Care will be communicated in writing to the

appealing party within 20 business days of receipt of the appeal. All appeal

decisions made by L.A. Care are final.

3.15 Disclosure of Proposals and L.A. Care’s Evaluation of Proposals

1.2 Vendor Selection Appeals Process: All appeals of purchase determinationsa Vendor

Selection must be received in writing no later than ten (10) business days following the

announcement of the purchase award of contract.

1.2.3.2.1 Contract. Appeals must be addressed and delivered to L.A.

Care, attention to the Chief Financial Officer.

1.2.3.2.2 or designee. Only appeals that are based on procedural

issues will be considered for review. Objective evaluation

criteria as established by LA Care will not be eligible for

appeal. Procedural issues subject to review wouldmay include

but would not be limited to the following:

1.2.3.2.2.1 Incomplete incomplete or erroneous scoring.

Bid; bid responses were not fully reviewed.; other 1.2.3.2.2.2 Other procedural errors or omissions.

1.2.1 All appeal decisions made by L.A. Care will be communicated in writing to the

appealing party within twenty (20) business days of receipt of the appeal. All

appeal decisions made by L.A. Care are final.

1.2.3.2.3 All appeal decisions made by LA Care will be final.

3.15.1 Disclosure of Proposals and L.A. Care’s Evaluation of Proposals. Generally,

Vendors’Bidders’ proposals and L.A. Care’s evaluation of the proposals,

including the basis for selection, are considered to be confidential information

and should not be shared outside the Vendor Selection Team. If a request for

copies of either a Vendor’sBidder’s proposal or the evaluation is received,

whether orally or in writing, the request must be treated as a request for records

under the California Public Records Act (PRA). All such requests must be

referred to the Legal Services Ddepartment immediately in order to respond to

the request in the times mandated by the PRA.

63



Kick-Off & Assess

Opportunities/

Determine Goals

Develop Market

Research Profile

Develop Sourcing Strategy

Exectue Sou

rcing Strategy

Negotiate and Select

Vendor(s)

Complete Contract(s)

Contract Management

3.16 Code of Conduct:

3.16.1 L.A. Care staff and consultants participating in the

Vendor Selection Process shall conduct themselves

in such a manner as to foster public confidence in

the integrity

of L.A.

Care’s

Vendor

Selection

process.

L.A. Care

staff shall

perform their

duties impartially to

ensure that

VendorsBidders

have fair and competitive

access to do business with

L.A. Care. Employees and

consultants are subject to applicable state conflict of interests laws and

regulations, as well as internal requirements, including obligations of

confidentiality and the use of confidential information, as prescribed by L.A.

Care’s Code of Conduct, the Vendor Code of Conduct and the consultant’s

Contract with L.A. Care. No L.A. Care employee or consultant shall solicit,

demand, or accept from any person anything of monetary value for, or because

of, any action taken, or to be taken in the performance of his/her duties. Any

employee or consultant failing to adhere to the above shall be subject to any

disciplinary proceeding deemed appropriate by L.A. Care, including and up to

termination of employment or the consultant’s Contract.

3.17 Request for Quote Process (Purchases between $25,000 and $250,000 or as defined in

Preferred Vendor Listing).

3.17.1 RFQs help L.A. Care purchase products or services at fair and reasonable prices.

Prior to starting the RFQ Process, the Requestor should have already checked

the Preferred Vendor Listing per Section 3.2 and determined if Sole Source is

64



necessary per Section 3.4. If the Requestor’s purchase cannot be fulfilled by a

Preferred Vendor and is not a Sole Source, then Requestor must follow the steps

below. If there is a business need for a competitive bid process beyond just

pricing for a purchase below $250,000, the Procurement Ddepartment will use

its discretion to direct the Requestor to the Vendor Selection Process in §Section

3.95.

3.17.2 The Requestor obtains at least three quotes from vendorsbidders that provide

similar product or service within a Category and selects the vendor based on

price and delivery.

3.17.3 The Requestor submits a Purchase Requisition and all quotes received to the

Procurement Ddepartment.

3.17.4 A Procurement Ddepartment resource will help the Requestor to determine the

type of Contract needed. The Requestor must follow Section §3.187

(Contracting Process) to finish the purchase.

3.17.5 The Requestor will route any approvals in accordance with policy AFS-006, “ to

the Authorization and Approval Limit. ”Policy (AFS-006).

3.17.6 The Procurement Ddepartment will issue a Purchase Order number to be

included in the Contract to the Vvendor after the approvals have been complete.

3.18 Contracting Process:

3.18.1 Contracts are required and must be reviewed by the Procurement Ddepartment

and Legal Services Ddepartment if ANY of the conditions are true:

3.18.1.1 Purchase greater than $10,000.

3.18.1.2 Purchase requires PHI exchanged with the Vendor.

3.18.1.3 The Vendor's performance may subject L.A. Care to liability that would

be disproportionate to the value of the vVendor's services.

3.18.2 If the conditions above are not true, then the Requestor should submit a

Purchase Requisition to the Procurement Ddepartment.

3.18.3 If there is a legitimate, critical business need for an expedited process, the

Requestor must contact the Procurement department. This is for exceptions only

and is not a substitute for a lack of planning by the Requestor or Requestor’s

department. Approvals from CEO and/or CFO maybe required.

3.18.4 New Contracts

: The Requestor must submit the Purchase Requisition through the Procurement

Ddepartment’s procurement or contracting system and attach any pertinent

information, such as applicable quotes, contract documents, Sole Source

65



Justification, Board motions, cover memos, etc. The following steps and

approvals are required. The Procurement Ddepartment can assist the Requestor

on any of the following steps.

3.18.4.1

The Requestor must acquire Contract templates from the

Procurement Ddepartment who will help ensure the latest L.A. Care

legally approved Contract templates are properly used for the

purchase, including whether or not an MSAmaster or one-time or

Service Agreement is to be used.

3.18.4.2

The Requestor must draft business requirements of the needs of the

Officer or designee that to captureinclude, at a minimum, a complete

and clear description of services or product; expected responsibilities

of the vVendor and L.A. Care; any deliverables; service levels;

length of service/required delivery dates; purchase amount; and

payment process. This is typically a collaborative, iterative review

process between the Requestor, vVendor, and the Procurement

Ddepartment if necessary iin order to get to a final draft.

3.18.4.3

The Requestor must check the Vendor against the debarred and

exclusion listings maintained by L.A. Care’s Compliance Officerthe

U.S. General Services Administration and the Office of the Inspector

General, US Department of Health & Human Services.

3.18.4.4

The Requestor must prepare the Sole Source Justification and obtain

approval, if applicable per Section 3.4.

3.18.4.5

The Requestor must acquireobtain the Privacy and Information

Security Officer’s approval to identifyof any privacy or information

security and PHI concerns so that to those appropriate terms are

incorporated in the AgreementContract.

3.18.4.6

The Requestor must acquire IT approval to ensure IT-related

purchases such as software, hardware, cloud services, etc., meet IT

standards and are compatible with L.A. Care systems.

66



3.18.4.7

The Requestor must obtain approval from both Procurement and the

Legal Services Ddepartment for negotiation of terms, pricing, vendor

performance standards or warranties, indemnity, and insurance

requirements are finalized in the Contract.

3.18.4.8

The Requestor must acquireobtain all approvals based on dollar

amount in accordance with policy AFS-006, “to the AAuthorization

and Approval Limit, Policy” (AFS-006) including filingsubmitting

any motions required for any Finance & Budget Committees or

Board of Governors approvals.

3.18.4.9 After all approvals above, the Requestor or Procurement must send

two original copies of the final Contract to the Vendor for signature

and coordinate countersignature of the partially signed Contract.

Electronic signatures are permitted.

3.18.4.10 When the final Contract is fully signed, the Requestor must send one

original or electronic copy to the vVendor, the second original or

electronic copy to L.A. Care Legal Services Ddepartment and a

electronic copy to the Procurement Ddepartment.

3.18.5 Changes to Unexpired Contracts

3.18.5.1 : If an existing and still active Contract is already in place and needs

to be changed or amended to extend the term of the Contract,

increase scope, change pricing, or change any Contract provision,

then the Requestor must contact the Procurement Ddepartment to

initiate an amendment against the Contract and then follow §Section

3.18 (Contracting Process)7.1.

3.19 Contract Management

3.19.1 : Once a new Contract is in place, the rebusiness owner and the Procurement

department have are ongoing responsibilities to ensure the vVendor is fulfilling

its obligations under the Contract. Contractual terms such as fee adjustments,

service levels, performance guarantees, termination rights, etc., can be unique on

each contract. Therefore, the Procurement Ddepartment, the business owner of

the Contract, and the Legal Services Ddepartment (if necessary) will collaborate

to determine the appropriate action and communication to a vVendor who is not

fulfilling the contractual obligations. The Procurement Ddepartment will

maintain a Contract repository of all vendor Contracts and manage expirations

67



by notifying the L.A. Care business owners of the Contracts at least 90 days

before they expire (unless a longer period of time is required by the Contract) in

order to determine if the contract should be renewed or allowed to expire, or if

an RFP needs to be completed. In addition, the Procurement Ddepartment will

analyze all Contract expirations and develop strategies that include vendor

and/or contract consolidation opportunities.

3.19.2 Procurement Responsibilities:

3.19.2.1 Monitors vendor contract expirations.

3.19.2.2 Notifies business owner or designee of upcoming expirations at least

90 days prior to Contract expiration.

3.19.2.3 Reviews and analyzes contract expirations for vendor and/or contract

consolidation opportunities.

3.19.2.4 Monitors vendor compliance to pricing terms.

3.19.2.5 Co-develop a Vendor Mmanagement scorecard of key metrics and

key performance indicators (KPIs) if necessary.

3.19.2.6 Participates and collaborates with vVendor in developing vendor

continuous improvement programs and corrective action plans if

necessary.

3.19.2.7 Recommends and develops any contractual amendments with L.A.

Care’s Legal Services department.

3.19.3 Business Owner or Designee Responsibilities:

3.19.3.1 Monitors vendor compliance to performance terms and deliverables.

3.19.3.2 Co-develop a Vendor Mmanagement scorecard of key metrics and

KPIs if necessary.

3.19.3.3 Participates and collaborates with vendor in developing vendor

continuous improvement programs and corrective action plans if

necessary.

3.19.3.4 Works with the Privacy Officer in the return or destruction of PHI if

necessary.

Procurement Responsibilities Business Owner or Designee

Responsibilities

Monitors vendor contract expirations.

Notifies business owner or designee of

upcoming expirations at least 90 days

prior to Contract expiration.

Reviews and analyzes Contract

expirations for vendor and/or contract

consolidation opportunities.

Monitors vendor compliance to pricing

terms.

Monitors vendor compliance to

performance terms and deliverables.

Co-develop a Vendor Management

scorecard of key metrics and KPIs if

necessary.

Participates and collaborates with

vendor in developing vendor

continuous improvement programs

and corrective action plans if

68



Co-develop a Vendor Management

scorecard of key metrics and KPIs if

necessary.

Participates and collaborates with vendor

in developing vendor continuous

improvement programs and corrective

action plans if necessary.

Recommends and develops any

contractual amendments with L.A. Care

legal.

necessary.

Works with Privacy Office in the

return or destruction of PHI if

necessary per Section 3.10.

3.20 Termination of Contracts:

3.20.1 Expiring Contracts

3.20.1.1 : The Procurement Ddepartment will notify the business owner at

least 90 days prior to Contract expiration. If the business owner does

not respond after multiple documented attempts, including escalation

to an Officer, then the Contract will be assumed completed. The

Procurement Ddepartment will assist with Contract close out

requirements, but the Requestor and business owner will be

ultimately responsible for notifying the Privacy and Information

Security Officer if PHI needs to be formally returned to L.A. Care or

destroyed.

3.20.2 Terminating Contracts prior to Expiration

3.20.2.1 : If a Contract needs to be terminated prior to the Contract

expiration, the Requestor must contact the Procurement

Ddepartment. The Procurement Ddepartment will assist the

Requestor in coordinating the termination with L.A. Care Legal

Services Ddepartment. Once the Contract is terminated, the

Procurement Ddepartment will assist with Contract close out

requirements, but the Requestor and business owner will be

ultimately responsible for notifying the Privacy and Information

Security Officer if PHI needs to be formally returned to L.A. Care or

destroyed.

3.20.2.2 If a Contract needs to be terminated prior to the Contract expiration

for vendor issues such as non-performance or undelivered products

and/or services, then the Requestor must contact Procurement

Department who will coordinate with L.A. Care Legal Services

Department for either a termination for breach of Contract or

opportunity to cure vendor issues.

3.21 Vendor Management

69



3.21.1 : Vendor Mmanagement is applicable and typically reserved for those Vendors

that are of high impact to L.A. Care in terms of dollars paid to the vVendor and

of high impact to L.A. Care operations in serving its members. The intent is to

properly manage the vVendor relationship to manage and mitigate risks and

ensure the strategic goals and objectives of L.A. Care are being met. Vendor

Mmanagement includes all the responsibilities of Contract Management Section

3.9 along with the following:

Agreed upon service levels and/or performance guarantees defined

and incorporated in a fully executed Contract between L.A. Care and

the vendor..

3.21.1.1

3.21.1.2 A formal governance structure defined and incorporated in a fully

executed Contract between L.A. Care and the vendor.

3.21.1.3 A formal scorecard to measure the contractual service levels,

performance guarantees, and program/project milestones.

3.21.1.4 Formal, recurring review meetings outlined in the governance

structure from Section 3.11.2 between the Officer or designee level

and the vendor’s executive leadership, when the complexity and

scope of the Contract warrants. At a minimum, the meeting agenda

should include:

3.21.1.4.1 Review of the vendor scorecard from Section 3.11.3.

3.21.1.4.2 Develop and follow-up on corrective action plans for both

L.A. Care and the vendor to resolve any strategic or

tactical issues.

3.21.1.4.3 Develop any new innovative strategies and tactics that

continuously improve the value and performance of the

relationship to achieve L.A Care’s goals and objectives.

4.0 AUTHORITY:

None

5.0 REFERENCES:

5.1 Policy AFS-006, “Authorization and Approval Limit”

6.0 ATTACHMENTS:

6.1 Process Flowchart

6.2 Vendor Process Selection Steps & Flowchart

70



6.3 Sole Source Justification Form

ACCOUNTABILITY MATRIX


ELECTRONICALLY APPROVED BY THE FOLLOWING

Officer Director

Regulatory Affairs &

Compliance

Name Tim Reilly Patricia Mowlavi Denise Corley

Department

Executive Services Accounting Services Regulatory Affairs &

Compliance

Title Chief Financial Officer Senior Director Compliance Officer

IF APPLICABLE

Board of Governors Motion Number:

*Note: Please write “N/A” for the Name, Department, and Title of the Director if this approval is not

applicable.

POLICY HISTORY

Date Department Policy or

Section # Comment(s)

Next or Annual

Review Date

01/10/02 Accounting &

Financial Services

AFS-007 New Policy 01/10/03

02/10/10 Accounting Services AFS-007 Capital Assets defined as items

with value greater than $2,000

02/10/11

##/##/15 Accounting Services AFS-007 Annual Review; major changes. ##/##/16

2.0 : DEFINITIONS

71



2.1 Products and Services: Products and services include any department supplies,

products, services and equipment used for administrative and operational purposes.

2.2 Capital Assets Furniture, Equipment and Leasehold Improvements: Capital Assets

are defined as any tangible property item with a value in excess of $2,000 including tax,

installation and freight and a useful life expectancy of one or more years.

2.3 Request For Proposal (RFP): The RFP method is an open competitive bid process that

is formalized by requiring a standard set of established specifications, contract

performance and evaluation process.

2.4 Request For Quotes (RFQ): The RFQ method is a less formal competitive bid process

than the RFP method, usually consisting of written price comparisons from vendors.

2.5 Contracts: Contracts are binding written agreements between L.A Care and an

independent party or vendor for the supply of goods and/or services at a mutually

agreed price. All contracts must be reviewed by L.A Care's Financial Services and

Legal Services Departments prior to execution, per Policy AFS-006, Section 1.1.3.

2.6 Preferred Vendor: Vendors and suppliers who provide products and services to

support L.A Care's recurring business activities such as office supplies, temporary labor,

mail house fulfillment, printing, etc.

2.7 Sole Source Vendor: Vendors and suppliers who provide specific or "one of a kind"

products and services, which are unique to L.A Care's business needs or equipment

specifications, such as IT system maintenance and support, data base management

systems, software licenses, legal services, etc.

3.0 PROCEDURE/S:

N/A

2.0 AUTHORITY: N/A

N/A

3.0 REFERENCE: N/A

N/A

72

Policy and Procedure AFS-007 Page 27 of 31

2

Accountability Matrix


73


2

APPROVAL:

APPROVAL:

Regulatory Affairs &

Compliance

Date:

Name: André G. AcostaDenise R. Corley,

R.N.

Title: Compliance Officer

Director Date:

Name: Patricia Mowlavi

Title: Senior Director, Accounting

Services

Officer Date:

Name: W. Randy StoneTim Reilly

Title: Chief Financial Officer

IF APPLICABLE

Board of Governors

Date:

Motion #:

Policy History

Date

Department

Policy or

Section #

Comment(s)

Annual

Review

02/2010 Accounting Services 2.2 Capital Assets defined as

items with value greater

than $2,000

74


2

Attachment A

Sole Source Justification

Vendor: ________________________

Contract Start/End Date: ________________________

Contract Amount: ________________________

Date:________________________

Identify applicable justification and provide documentation for each checked item.

Only viable source for product or service, performance and price competition are not

available.

Only viable source possessing specialized or unique expertise.

Proposals were solicited, however no satisfactory proposals were received or only one

satisfactory proposal was received.

Additional services are required to complete an ongoing task. It would be prohibitively

costly in time and money to seek a new service provider.

75


2

Maintenance Service Agreements for equipment which must be serviced by the

authorized manufacturer service representatives, and there is only one authorized

service representative in the geographical area.

It is in the Best Interest of LA Care, e.g., administrative cost savings outweigh cost

savings that would be realized through competition, steep learning curve for new

service provider, knowledge base, etc.

It is more cost effective to obtain services by exercising an option under the existing

contract.

Items requested are based upon previous purchases from this vendor and are needed

to match the existing product.

The requirement is within the scope of an existing Contract and can be addressed as

an amendment.

RFP previously executed. Date: ___________

Other, please explain:

__________________________________________________________ __________________________________________________________

__________________________________________________________ __________________________________________________________

Approvals for Purchases from $25,000 up to $250,000:

Director/Senior Director/Officer: _________________________ Manager of Procurement: _________________________

Approvals for Purchases greater than $250,000*:

Officer: _________________________ Director of Procurement: __________________________ CFO: __________________________ CEO: __________________________

76


2

*Sole Source purchases greater than $250,000 will be reported to Board of Governors or its Board Committee designee on a monthly basis.

77

Board of Governors

MOTION SUMMARY



Issue: Contract amendment with Office Ally to provide claims electronic data interchange (EDI)

services.

Background: L.A. Care staff requests approval to amend the contract with Office Ally in the amount

of $350,000 and extend its term through December 31, 2015, until the Emdeon conversion is implemented. L.A. Care has been using Office Ally since 2011. Given the large volume of claims, Office Ally continues to be L.A. Care’s largest electronic data interchange (EDI) claims clearinghouse and the exclusive clearinghouse for a majority of providers who submit electronic claims. Staff requests to continue to use Office Ally, as L.A. Care is currently undergoing an implementation with Emdeon as a replacement EDI vendor. Emdeon will be used for all QNXT transactions; however the Emdeon installation is not anticipated to be complete until the end of 2015. A competitive bid was conducted in May 2014 in which Emdeon was selected as the vendor of choice as it offered the lowest price per claim and the lowest real time transaction cost. The extension will allow staff to continue to utilize their services for paper claim scanning and optical recognition at a cost of $0.38 cents per claim. Additionally, Office Ally’s rate for inbound EDI transactions compares favorably at a cost of $0.25 cents per claim. The average run rate for claims during 2014 was approximately 25,000 claims per month; however the last quarter of 2014 L.A. Care experienced an increase in claims volume due to our increase in membership.

Budget Impact: Sufficient funds are budgeted in the Claims department operating budget expenses

for FY 2014-15.

Motion: To authorize staff to amend a contract with Office Ally in the amount of $350,000 (total contract not to exceed $1,028,144) for electronic data interchange services through December 31, 2015.

78

Board of Governors

UMOTION SUMMARY

UDateU: March 5, 2015 UMotion NoU. FIN 103.0315

UCommitteeU: Finance & Budget UChairpersonU: Michael Rembis

UIssueU: Contract amendment with Cornerstone Data Strategies, Inc., (Cornerstone) for core system

consulting and staffing services.

UBackgroundU: L.A. Care staff requests approval to amend a contract with Cornerstone, for core system

consulting and staffing to April 30, 2016for an additional amount of $2,774,026.

In April 2012, the Board approved a contract for $1,585,000 with Cornerstone, for core system consulting including TriZetto contract negotiations and supplemental technical program and project management. In December 2012, the Board approved an amendment for core system consulting, project management, and interim staffing services through September 30, 2013, at an additional cost up to $1,625,000. In July 2013, the Board approved an amendment for core system consulting and interim staffing services through September 30, 2014 for an additional $3,269,795, increasing the total contract amount to $6,529,795.

In July 2014, the Board approved an amendment for core system consulting and staffing from September 30, 2014 to January 31, 2015, for an additional $2,800,000 totaling $9,329,795. The request of additional funds and time extension are a result of work that still needs to be completed on the core system migration to TriZetto QNXT and Clinical Care Advance (CCA). Specifically, Cornerstone will be asked to complete the following:

Track, report and analyze the claims forwarding interfaces to satisfy L.A. Care’s requirements;

Monitor and examine enrollment and billing processes of L.A. Care Covered on QNXT;

Integrate testing support for L.A. Care surround systems;

Administer system architecture and requirements for appropriate configuration;

Implement system data conversion, integration testing, user acceptance testing and training;

Manage end-state and transitional issues

Design & deploy an enterprise wide data warehousing solution

BBBudget Impact: Sufficient funds are budgeted in the Information Technology Department budget

for FY 2014-15.

UMotionU: To authorize staff to amend a contract with Cornerstone Data

Strategies, Inc., for an additional amount of $2,774,026 (total contract amount not to exceed $12,103,821) for consulting and staffing services through April 30, 2016.

79

Board of Governors

MOTION SUMMARY



Issue: Execute a contract with Civic Resource Group (CRG) to provide technical and analytical

support for the maintenance and upgrades of L.A. Care’s websites and other digital activities.

Background: L.A. Care staff requests approval to execute a contract with CRG for $700,000 for the

period of March 1, 2015 to February 28, 2016, with two one-year extensions. The total obligation over three years is not expected to exceed $2,100,000. Annual contract amount will need to be reviewed annually as business requirements are subject to change. The vendor will provide us with technical and analytical support for the maintenance and upgrades of all web sites, including content management, web analytics, search engine optimization and web site updates. Websites include but are not limited to www.lacare.org, www.lacarecovered.org, www.calmediconnectla.org and L.A. Care’s intranet site. Staff conducted a competitive request for proposal process in September 2014. A total of six vendors responded to the request, and CRG was selected in December 2014 by the selection committee. CRG presented the most suitable experience and capabilities required of a digital agency. The next request for proposal will be conducted in September 2017. L.A. Care requires assistance with digital initiatives and a vendor to serve as our digital agency of record. CRG will strictly adhere to Section 508 Standards, the federal website accessibility guidelines. CRG will work closely with other L.A. Care vendors to ensure a consistent user experience across all external-facing platforms, and assist with the redesign of our intranet experience. Currently, L.A. Care spends approximately $500,000 annually with Sensis, the current digital agency of record. The increased cost from last year’s contract is due to L.A. Care’s higher volume of digital activities, including additional websites.

Budget Impact: Sufficient funds are budgeted in the Communications budget for

fiscal year 2014-15. We will budget the balance in future fiscal years.

Motion: To authorize staff to execute a contract with Civic Resource Group to provide assistance with digital initiatives and to serve as our digital agency of record for $700,000 between March 1, 2015 to February 28, 2016, with two one-year extensions. The total obligation over three years not to exceed $2,100,000.

80

Board of Governors

MOTION SUMMARY

Date: March 5, 2015 Motion No. ECA 100.0315

Committee: Executive Community Advisory

Chairperson: Elda Sevilla

Issue: Approval of additional member (s) to the Regional Community Advisory Committees (RCACs).

Background: Senate Bill 2092 requires that L.A. Care Health Plan ensure community involvement

through a Community Advisory Committee. L.A. Care’s Regional Community Advisory Committee (RCAC) structure is composed of 5-35 members per RCAC. RCAC member recruitment is on-going to ensure the highest possible community involvement.

Budget Impact: None.

Motion: To approve the following candidate(s) to the Regional Community Advisory Committees (RCAC), as reviewed by the Executive Community Advisory Committee (ECAC) during the February 11, 2015 ECAC meeting.

Name RCAC # Type of Member (Agency, if applicable)

David Kwong RCAC 3 Consumer

Domingo Pardo RCAC 8 Community Partner

Ana Fisette RCAC 9 Community Partner

Rosa Pastrana RCAC 11 Consumer

81

March 5, 2015

TO: Board of Governors

FROM: John Wallace, Interim Chief Executive Officer

SUBJECT: CEO Report – March 2015

Please find below an update on organizational activities that occurred in January and February 2015.

1. New CEO of L.A. Care - John BaackesL.A. Care’s new CEO, John Baackes is expected to start on March 23, 2015. He is tentativelyplanning a visit to L.A. Care on March 9. During the interim, L.A. Cares’ leadership isdeveloping a work plan to ensure a smooth transition. Introductory calls have been scheduledwith each Officer and Mr. Baackes to get him acquainted with each of their respective areas.

2. Board Member Dr. Alex LiL.A. Care is happy to announce and congratulate Board Member Alex Li in his new role asDeputy Director of Care Transitions at the L.A. County Department of Health Services. He willcontinue to work to successfully implement system wide issues.

3. Los Angeles County Auditor Controller ReviewLos Angeles County Auditor Controller conducted a financial condition review of L.A. Care. L.A.Care received an early draft of the review and agreed with the recommended areas forimprovement. Once L.A. Care receives the final review it will implement any recommendationsthat come forth from this review. Results of the final report will be shared with the Board once itbecomes available.

4. Cal MediConnect (CMC)L.A. Care’s total enrollment as of early February of this year is currently 14,836 (as of 2/13/15).The total membership is inclusive of our 2014 membership, D-SNP members that transitionedon 1/1/15, and January passive and voluntary enrollees. L.A. Care is currently averaging about150 voluntary enrollees per month. Additionally, L.A. Care is expected to receive passiveenrollment each month through June 2015.

5. Cal MediConnect Opt-Out UpdateL.A. Care is working collaboratively with the other participating plans in L.A. County to addressthe large rate of beneficiaries opting out of CMC. On Feb. 11, 2015, staff sent a letter to JenniferKent, the new Medi-Cal Director and her leadership, outlining a number of policy and

82

CEO Report – March 2015

programmatic factors that, while not originally contemplated in the design of the program, wereimplemented by the State and that have contributed to less enrollment than L.A. Care hadoriginally expected. These factors include the enrollment strategy that continued the operation ofnon-CMC DSNPs and promoted aggressive marketing of duals by Medicare Advantage plans andso-called “DSNP look-alikes”. L.A. Care recommended a number of policy/programmaticchanges to the State.

In light of ongoing enrollment challenges into CMC in L.A. County, staff is in the process ofreassessing our CMC enrollment projections for the remainder of the year. We will use this toensure our staffing and other assumptions are appropriate to program enrollment.

6. Government Accountability Office (GAO) Site Visit on CMC Care Coordination ProcessL.A. Care hosted staff of the GAO for an on-site visit the week of February 9. The site visit wasthe result of a request by the Health Subcommittee of the House Energy and CommerceCommittee to better understand how and the results of care coordination activities implementedfor dual eligibles under Cal MediConnect (the duals demonstration).

7. L.A. Care CoveredSince the start of open enrollment on November 15, L.A. Care Covered membership continuesto grow. We have added approximately 3,000 new enrollees. Although the open enrollmentclosed on February 15, the Special Enrollment Period through April 30, 2015 might allow us toobtain new members. L.A. Cares overall retention rate from 2014 to 2015 was 90%, which areapproximately 19,000 L.A. Care Covered members.

8. Martin Luther King Jr. Community HospitalL.A. Care staff met with the Martin Luther King Jr. community hospital leadership and shared adraft of the contract which both entities hope to sign to continue the ongoing relationship. L.A.Care is working with its high volume Participating Physician Groups (PPGs) in the area to directpatients to the new hospital during its opening phase which is scheduled to begin in spring of2015. Additionally, L.A. Care is working with the hospital to host an on-site meeting with highvolume Independent Practice Association’s (IPAs) in March.

9. Anthem Cyber-AttackL.A. Care’s Regulatory Affairs & Compliance (RA&C) department has been in communicationwith Anthem concerning their cyber-attack and investigation. To date it is estimated thatapproximately 78.8 million individuals were impacted; Anthem is continuing to work to identifythose individuals who were impacted, including possible L.A. Care members. During this time,Anthem has drafted a notification letter to impacted individuals. Anthem will notify impactedindividuals, including those assigned to Anthem by L.A. Care, in the coming weeks. Our RA&Cdepartment has reviewed the letter and is in draft form right now and is not available forcirculation.

Given that outside sources have reported this as an intentional attack on Anthem; L.A. Care’sInformation Technology department is taking the necessary precautions to ensure that L.A. Caredoes not become a victim of such cyber-attack. During the past several years L.A. Care hascontinued to invest in data security measures with enhanced policies, procedures, training andsecurity technology. L.A. Care has additionally been working to ensure that its data is encryptedin addition to sensitive data flows between our providers, vendors and external partners. L.A.

83

CEO Report – March 2015

Care has also made sure that the access to systems and data is now controlled on a much moregranular level to ensure that staff and vendors have access to only the data and systems they needrather than broad access rights. Additionally, within the organization, strict separation of dutieshas been established along with more rigorous change control processes to our applications andsystems.

84

Member ConnectionStandards

Gertrude S. Carter, MDChief Medical Officer

Board of Governors Meeting

March 5, 2015

Acreditación NCQA paralos programas de Medi-Cal y L.A. Care Covered.

1

85

Overview

• Focus on improving member access to healthcareinformation

• Promotes members ability to manage their own care andmake informed

• ACA calls for increased member participation andengagement in delivery of care

• Ongoing advances and access to technology

• Requirements have been in place for Commercial productsand will become effective with Medi-Cal, Medicare, andMarketplace products as of July 1, 2015

86

MEM Standards

• Health Appraisal

• Self Management Tools

• Functionality of Claims Processing

• Pharmacy Benefit Information

• Personalized Information on Health Plan Services

• Member Support

• Health Information Line

• Support for Healthy Living

• Delegation

87

MEM 1 - Health Appraisals

• Health Appraisals

– Components

• Demographics

• Personal Health History

• Self-perceived health status

• Identification of changes in behavior to reduce risk

• Special needs related to hearing, vision, languagepreference

– Disclosures

– Scope – Preventive health

– Results

• Must receive HA results in a language that is easy tounderstand

88

MEM 2 - Self-Management Tools

• Must include

– Healthy weight (BMI) maintenance

– Smoking and tobacco use cessation

– Encouraging physical activity

– Healthy eating

– Managing Stress

– Avoiding at-risk drinking

– Identifying depressive symptoms

• Usability testing every 36 months

• Review and update tools every two years

• Offered via

– Digital service

– Print or telephone

89

MEM 3 - Functionality of Claims Processing

• Information must be available on web site and by telephone

• Web exceptions may apply if:

– Member has no financial responsibility beyond flat co-pay

– Practitioner can not bill member

– 90% of claim paid by dollar amount is under capitation

Note: Based on the above expectatoins, this standard willbe applied only to L.A. Care Covered

90

MEM 4 - Pharmacy Benefit Information

• Pharmacy benefit information available both by web and by phone

• Requirements include:

– Determining financial responsibility for a drug

– Initiating exceptions process

– Ordering a refill for mail order drugs

– Finding the location of an in-network pharmacy

– Conducting a pharmacy proximity search

– Determining drug-drug interactions

– Determining common side effects and risks

– Determining availability of generic substitutes

• QI process

– Collect data on quality and accuracy

– Analyze data results

– Improve identified deficiencies

• Update member pharmacy benefit information on web and materials usedby telephone staff as changes occur

91

MEM 5 - Personalized Information on HealthPlan Services

• Web-based requirements:

– Request or reorder ID cards

– Change PCP

– How and when to obtain referrals and authorizations for specific services

– Benefit and financial responsibility for specific service from specificprovider or institution

• Phone requirements:

– How and when to obtain referrals and authorizations for specific services

– Benefit and financial responsibility for specific service from specificprovider or institution

• E-mail

– Respond to e-mail inquiry in one business day

– Evaluate quality of e-mail responses

– Collecting data on e-mail turn-around

– Collecting data on quality or responses

– Analyzing the data

– Acting to improve identified deficiencies

92

MEM 6 - Member Support

• Implement at least 4 innovative technologies

– Electronic refill reminders

– E-consult

– Calculators for HSA/FSA accounts

– E-prescribing

– E-referrals

– E-appointments

– E-enrollment in DM or wellness programs

– Online personal health record

– Smart cards containing member health or benefitinformation

• Pilots are acceptable

• PCMH initiatives can be used

93

MEM 7 - Health Information Line

• Access to Health Information Line

– Available 24 hours per day

– Provides secure transmission of electronic communication with a 24 hourturn-around

– Provides interpreter services for members by telephone

• Capabilities:

– Follow-up on specified cases and contact members

– Link member contacts to a contact history

• Monitoring

– Tracks telephone and web statistics at least monthly

– Track member use of health information line at least quarterly

– Evaluate member satisfaction with line at least annually

– Monitor call periodically

– Analyze data at least annually, identify and prioritize opportunities forimprovement

94

MEM 8 - Support for Healthy Living

• Identification of members– Claims or encounter data– Pharmacy data– HA results– Data collected through UM process

• Targeted follow-up:– Member specific reminders for need care– Member specific reminders about missed services– Information about evidenced-based guidelines and

diagnostic/treatment options– Automated member specific outreach with links to Web-

based self-management tools– Information on community resources– Information about affinity programs, if applicable

• Encouraging Member Health (optional)– Incentives for using web-based tools

95

MEM 9 - Delegation

• Delegation agreement

• Provisions for transmitting member data to delegate

• Adherence to PHI

• Pre-delegation Evaluation

• Review of program

– Semiannually evaluates regular reports

– Annually evaluates delegate performance against NCQAstandards (does not apply to NCQA certified entities)

96

Summary

• The ability to meet MEMs standards have to be in place byJuly 1, 2015

97

Board of Governors

MOTION SUMMARY

Date: March 5, 2015 Motion No. BOG 100.0315

Committee: Chairperson: Thomas Horowitz, DO

Issue: L.A. Care staff requests that the Board of Governors delegate authority to the Finance and

Budget Committee to approve contracts related to L.A. Care meeting the NCQA Standards for Member Connections (MEM) due to constraints related to timing.

Background: NCQA’s MEM standards will become effective on July 1, 2015 for L.A. Care’s Medi-

Cal, Cal MediConnect, and L.A. Care Covered lines of business. MEM standards 1, 2, and 8 require L.A. Care to implement an online health appraisal, provide access to member self-management tools, and utilize data to promote member wellness. L.A. Care’s NCQA consultant recommended contracting with a vendor with NCQA Health Information Products (HIP) certification in order to receive automatic credit for these new standards. The NCQA audit is scheduled for April 2017. Vendor Selection Various RFP’s have been conducted related to the technology and content vendors necessary to meet these new NCQA standards. However, staff is currently reassessing the most cost-effective way for L.A. Care to meet the standards within the short timeline for implementation. Budget Impact Sufficient funds are budgeted in the IT and Quality Improvement budgets for FY14-15 and will be budgeted in FY 15-16, FY 16-17 and FY 17-18.

Motion: To delegate to the Finance and Budget Committee the authority to approve agreements necessary for L.A. Care to meet the NCQA Standards for Member Connection including vendor contracts for member self-management tools, web portal and all other capabilities as deemed necessary for all lines of business with a total cost not to exceed $5,000,000, from April 1, 2015 to June 30, 2018.

98

Board of Governors

MOTION SUMMARY



Issue: Approve additional funds allocated to temporary labor vendors per Authorization and

Approval Authorization Policy (AFS-006).

Background: L.A. Care staff requests approval to increase funds allocated to temporary labor vendors listed below

through the end of FY 2015. These vendors have been approved previously and now require additional

approvals per Authorization and Approval Policy (AFS-006).

The requested funding is for 18 temporary (temp) staffing vendors at L.A. Care. These vendors have

been selected due to their high level of performance with L.A. Care. Additionally, these vendors have

agreed to new standardized contract terms for temp staffing which are more favorable to L.A. Care.

These terms include:

A reduced non-negotiable markup fee of 45%, the prior average was estimated at 55% and was as

high as 100%.

A reduced non-negotiable conversion fee at 520 hours, the prior range was 600-1000hrs.

L.A. Care currently utilizes 56 temp staff members by these vendors and anticipates an additional 24 for

a total of 80, which equates to $58,256.66 per temp employee. The estimates are inflated to

accommodate backlogs of requested temp staff, unpaid invoices, and unanticipated requests through

the current fiscal year. Below please find a table outlining each vendor’s prior history and requested

amount:

99

Board of Governors

MOTION SUMMARY

VENDOR Current Amount

Authorized

Additional Amount Requested through

FY 2015 New Total

Tentek $ 300,000 $ 300,000 $ 600,000

Accounting Principles 250,000 100,000 350,000

Admin Service Group 250,000 100,000 350,000

Aquent 250,000 100,000 350,000

Ascent Services Group 250,000 150,000 400,000

Bridgelinx (Iverson Resource Corp) 250,000 55,000 305,000

CKG GROUP, Inc. 250,000 250,000 500,000

DLT Staffing 250,000 15,000 265,000

GDN Infotech Inc 250,000 250,000 500,000

IDB Admins Inc 250,000 100,000 350,000

Maxim Staffing Solutions 250,000 150,000 400,000

Precision Professional Consultant 250,000 250,000 500,000

Talent Strategies 250,000 300,000 550,000

TCI-LA 250,000 150,000 400,000

TS-HCT1 (Payroll) 250,000 250,000 500,000

Vaco - LA 250,000 300,000 550,000

Vaco - OC 250,000 300,000 550,000

YOH 250,000 300,000 550,000

Total $ 4,550,000 $ 3,420,000 $ 7,970,000

Budget Impact: FY 2014/2015 budget did not include this expense for temporary labor, however,

budget savings, primarily from strategic projects within multiple departments, are adequate and will be repurposed to accommodate this request.

Motion: To authorize staff to allocate additional funds to the above temporary

labor vendors in the amount of $3,420,000 not to exceed an overall amount of $7,970,000.

100

Board of Governors

MOTION SUMMARY



Issue: Contract with SafetyNet Connect Inc., to provide software and technical support for the

eManagementLA program.

Background: L.A. Care is requesting approval for a contract with SafetyNet Connect Inc., for the

period of April 1, 2015 through September 30, 2016, in the amount of $700,000. One half of this requested amount will support the current econsult platform being used by 1,000 providers within the HCLA clinics, and the remaining will be used to support the eManagementLA program. The contract is funded through an approved FY 2014-2015 community Health Investment Fund (CHIF) allocation and from the HIT department’s operational budget. L.A. Care’s econsult program was developed to improve the access to quality specialty care for Los Angeles county residents focusing on low-income and vulnerable populations by allowing HIPAA secure conversations between primary care providers and specialists using a HIT software platform. A small pilot was launched in 2009. In 2011, it was expanded to the L.A. County Department of Health Services (LAC DHS) and Healthcare (HCLA) IPA clinic sites making this program the largest rollout of its type in the United States. As of December 2014, the program served over 30 specialties, 195 clinic sites, 2,500 providers and a base of up to 500,000 patients. Because of the success of the program, in 2014, LAC DHS invested over $7,000,000 of its own funds over four years and added an additional 200 clinics and health centers to the program. L.A. Care also sees significant value in the program and desires to expand it to support the Medi-Cal expansion which brings new responsibilities to the health plan, including the delivery of behavioral health services to members with mild to moderate levels of mental health and/or substance use disorders through the L.A. Care provider network which extends the scope of the primary care provider’s practice. It is estimated that around 20% of all Medi-Cal recipients experience some level of behavioral health issues, however, there are currently insufficient mental health providers to serve those in need. Thus, we are requesting a program expansion called eManagementLA to improve care delivery by enhancing collaboration between primary care providers and mental health specialists, improve co-management of complicated patients, reduce unnecessary office visits, improve medication management, and optimize the specialist visit when one is needed. This phase of the program will conduct an evaluation to measure up to eight key triple aim areas that demonstrate quality of care, cost and patient engagement. If this phase proves successful, it could be expanded in future years. SafetyNet Connect Inc. is the current vendor for the eConsult program. The requested contract for eManagementLA will build on the success of the current platform and focus on accomplishing the following goals: 1) Maintain the current platform to serve patients within HCLA clinics covering up to

101

Board of Governors

MOTION SUMMARY

Page 2 of 2

1,000 providers; and 2) develop the eManagementLA program to support the new behavioral health benefit for use by up to 200 solo providers to support up to 300,000 members.

Budget Impact: An approved FY 2014-2015 CHIF allocation not to exceed $300,000 and the HIT

department’s operational budget are sufficient to cover this request. Additional amounts will be budgeted in subsequent years.

Motion: To authorize staff to execute a contract with SafetyNet Connect Inc., to provide software and technical support for the eManagementLA program for an amount not to exceed $700,000 for the period of April 1, 2015 through September 30, 2016.

102

Board of Governors

MOTION SUMMARY

Date: March 5, 2015 Motion No: BOG 103.0315

Committee:

Chairperson: Thomas Horowitz, DO

Issue: Supplemental Retirement Plan for Management Employees of L.A. Care Health Plan

Background: The L.A. Care Health Plan Retirement Benefit Plan and Supplemental Retirement

Plan for Management Employees of L.A. Care Health Plan were amended effective January 1, 2013, to comply with the California Public Employees' Pension Reform Act of 2013 ("PEPRA"). At the time the plans were established, there were no identified participants.

This motion seeks approval to delegate authority to the Executive Committee to amend the plans to add the following participants: 1) John Baackes, 2) Thomas T. Schwaninger and 3) Robert J. Turner and to establish the contribution, interest crediting rates and vesting schedules.

Pursuant to Government Code Section 7507, the Board is hereby advised of the cost of the proposed amendments to the plans a follows: a. Mr. Baackes’ allocation will equal approximately 28% of his base salary, Mr. Schwaninger and Mr.

Turner’s contributions will equal 10% of their base salaries. b. The interest crediting rate for the Non-Qualified supplemental plan will be the rate of return on

L.A. Care’s general assets. c. Mr. Baackes’ benefits will vest at the end of two years for both plans. d. Mr. Schwaninger’s and Mr. Turner’s benefits for the Qualified Supplemental plan will vest over a

period of 3 years, however for the Non-Qualified Supplemental Plan the benefits will vest at the end of 3 years.

Budget Impact: None. Executive compensation is included in the FY 14-15 budget and will be

included in future budgets as authorized by the Board.

Motion: To delegate authority to the Executive Committee to amend the L.A. Care Qualified Supplemental Retirement Plan and the Non-Qualified Supplemental Retirement Plan to add participants John Baackes, Thomas T. Schwaninger and Robert J. Turner, to establish the contribution amounts, interest crediting rates and vesting schedules and to make other non-compensatory technical revisions as required. The Executive Committee’s authority concerning the compensatory provisions of the plans for Mr. Baackes shall be limited to the terms and conditions of his employment agreement. The Executive Committee’s authority concerning the contribution amount of the plans for Mr. Schwaninger and Mr. Turner shall be limited to no more than ten percent (10%) of their base salary.

103

Board of Governors

MOTION SUMMARY


Committee: Finance & Budget

Chairperson: Michael Rembis

Issue: Acceptance of the Financial Report for the four months ended January 31, 2015.

Background:

Budget Impact:

Motion: To accept the Financial Report for the four months ended January 31, 2015, as submitted.

111

1/31/2015

Financial Performance January 2015

112

Financial Performance Results Highlights January 2015

Overall

Plan Partners

Medi-Cal Direct (MCLA)

Cal MediConnect (CMC)

Total enrollment for January is 1,679,418 members which is 4,748 members favorable to budget. Fiscal year-to-date (four months) performance is a surplus of $68.3 million or 3.3% on revenue of $2.1 billion, and is $6.5 million favorable to plan. The favorable budget variance is driven by lower than budgeted operating and non-operating expenses.

Total enrollment for January is 825,995 members. Fiscal year-to-date performance is a surplus of $15.5 million, and is $2.2 million favorable to plan. The favorable budget variance is driven by lower than budgeted operating expenses and higher than budgeted revenue rates.

Total enrollment for January is 773,467 members. Fiscal year-to-date performance is a surplus of $64.0 million, and is $2.2 million favorable to plan driven by lower than budgeted operating expenses.

Within MCLA, Seniors and Persons with Disabilities (SPD) enrollment is 74,028. Fiscal year-to-date performance is a deficit of $10.0 million, and is $2.5 million favorable to plan driven by higher than expected revenue rates, most of which is offset by healthcare costs.

Cal MediConnect is operated as a separate line of business that launched in April 2014 with initial membership starting in May. Total enrollment for January is 14,882. Membership grew by 10,378 members in January which reflects the transition of Medicare D-SNP members selecting CMC (with the closure of L.A. Care's D-SNP product) and passive enrollment. Fiscal year-to-date performance is a deficit of $4.1 million and is $716,000 unfavorable to budget driven by higher than budgeted operating expenses.

i 113

Financial Performance Results Highlights January 2015

L.A. Care Covered

Medicare

PASC-SEIU

Healthy Kids

Community Programs

HITEC-LA

Fiscal year-to-date performance was a deficit of $3.4 million, and is $61,000 unfavorable to plan driven by timing of administrative expenses.

Total enrollment for January is 45,682 members. Fiscal year-to-date performance is a surplus of $1.8 million, and is $1.6 million favorable to plan driven by lower than expected healthcare costs. Effective December 2013, L.A. Care Health Plan Joint Powers Authority (JPA) received its Knox-Keene license and PASC-SEIU became exempt from Managed Care Organization (MCO) taxes.

Total enrollment for January is 346 members. Fiscal year-to-date performance is a surplus of $55,000, and is $42,000 favorable to plan.

The federal grant is drawn-down based upon expenses incurred. Fiscal year-to-date performance is a deficit of $65,000, and is $34,000 favorable to plan.

L.A. Care Covered began enrollment in October 2013. Total enrollment for January is 19,046 members. Fiscal year-to-date performance is a deficit of $6.9 million, and is $4.0 million unfavorable to plan driven by the capitation expense true-up which was retroactive to January 2014.

L.A. Care closed its Medicare D-SNP product line as of December 31, 2014. Fiscal year-to-date performance is a surplus of $1.0 million , and is $2.5 million favorable to plan driven by higher than budgeted revenue rates and lower than budgeted operating expenses.

i 114

Combined Operations Financial Statement ($ in thousands)

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

Membership1,679,418 1,677,406 2,012 Current Membership 1,679,418 1,674,670 4,7481,689,516 1,690,470 (954) Member Months 6,725,385 6,467,467 257,918

Revenue$528,150 312.60 $539,660 319.24 ($11,510) (6.63) Capitation $2,031,664 302.09 $1,969,437 304.51 $62,227 (2.43)

0 - 0 - 0 - DHCS MLR Risk Share 0 - 0 - 0 - 11,614 6.87 10,510 6.22 1,103 0.66 Maternity Kick 44,169 6.57 43,505 6.73 664 (0.16)

22 0.01 24 0.01 (3) (0.00) Premiums 93 0.01 163 0.03 (70) (0.01)

243 0.14 221 0.13 22 0.01 Grants/Others 742 0.11 890 0.14 (148) (0.03) 540,029 319.64 550,416 325.60 (10,387) (5.96) Total Revenues 2,076,667 308.78 2,013,995 311.40 62,673 (2.62)

Healthcare Expenses280,154 165.82 306,799 181.49 (26,645) (15.67) Capitation 1,158,922 172.32 1,114,270 172.29 (44,653) (0.03)

7,578 4.49 7,190 4.25 388 0.23 Maternity Kick 29,212 4.34 28,843 4.46 (369) 0.12 11,727 6.94 32,636 19.31 (20,910) (12.37) CBAS Centers 59,438 8.84 15,543 2.40 (43,895) (6.43) 16,077 9.52 12,275 7.26 3,802 2.25 Provider Incentives and Shared Risk 72,230 10.74 42,558 6.58 (29,671) (4.16) 86,140 50.99 59,463 35.18 26,677 15.81 Inpatient Claims 251,233 37.36 270,484 41.82 19,251 4.47 67,466 39.93 67,316 39.82 150 0.11 Outpatient Claims 232,851 34.62 255,562 39.51 22,710 4.89 28,138 16.65 29,029 17.17 (891) (0.52) Pharmacy 105,489 15.69 113,239 17.51 7,750 1.82

7,296 4.32 5,708 3.38 1,588 0.94 Medical Administrative Expenses 25,595 3.81 29,532 4.57 3,937 0.76 504,576 298.65 520,416 307.85 (15,840) (9.20) Total Healthcare Expenses 1,934,972 287.71 1,870,031 289.14 (64,941) 1.43

MCR(%)

35,453 20.98 30,000 17.75 5,453 3.24 Operating Margin 141,696 21.07 143,964 22.26 (2,268) (1.19)

19,588 11.59 19,769 11.69 (181) (0.10) Total Operating Expenses 73,163 10.88 79,094 12.23 5,930 1.35 Admin Ratio(%)

15,865 9.39 10,231 6.05 5,634 3.34 Income from Operations 68,533 10.19 64,870 10.03 3,663 0.16

(442) (0.26) 468 0.28 (911) (0.54) Total Non-Operating Income (Expense) (188) (0.03) (3,016) (0.47) 2,828 0.44

$15,423 9.13 $10,699 6.33 $4,723 2.80 Net Surplus(Deficit) $68,345 10.16 $61,854 9.56 $6,491 0.60 Margin(%)2.9% 1.9% 0.9% 3.3% 3.1% 0.2%

3.6% 3.6% 0.0% 3.5% 3.9% 0.4%

-0.3%

Month Month (Decrease) Actual Budget Budget

93.4% 94.5% -1.1% 93.2% 92.9%

January 2015Current Prior Increase YTD YTD Fav<Unfav>

115

MediCal Plan Partner Financial Statement ($ in thousands)


Membership825,995 840,393 (14,398) Current Membership 825,995 866,427 (40,432)831,660 848,948 (17,288) Member Months 3,369,274 3,373,832 (4,558)

Revenue$180,766 217.36 $226,631 266.96 ($45,865) (49.60) Capitation $764,751 226.98 $741,345 219.73 $23,406 7.24

7,218 8.68 6,571 7.74 647 0.94 Maternity Kick 27,754 8.24 27,470 8.14 284 0.10 187,984 226.04 233,202 274.70 (45,218) (48.66) Total Revenues 792,506 235.22 768,815 227.88 23,691 7.34

Healthcare Expenses161,581 194.29 190,055 223.87 (28,474) (29.58) Capitation 683,055 202.73 696,268 206.37 13,213 3.64

6,628 7.97 6,057 7.13 571 0.84 Maternity Kick 25,518 7.57 25,202 7.47 (317) (0.10) 7,373 8.87 26,489 31.20 (19,116) (22.34) CBAS Centers 38,991 11.57 0 - (38,991) (11.57) 3,195 3.84 1,772 2.09 1,422 1.75 Provider Incentives and Shared Risk 8,213 2.44 10,924 3.24 2,711 0.80

7 0.01 (0) (0.00) 7 0.01 Inpatient Claims 7 0.00 0 - (7) (0.00) 96 0.12 88 0.10 8 0.01 Outpatient Claims 345 0.10 0 - (345) (0.10)

1,113 1.34 934 1.10 178 0.24 Medical Administrative Expenses 3,924 1.16 5,060 1.50 1,136 0.34 179,993 216.43 225,396 265.50 (45,403) (49.07) Total Healthcare Expenses 760,053 225.58 737,453 218.58 (22,600) (7.00)

MCR(%)

7,991 9.61 7,807 9.20 185 0.41 Operating Margin 32,452 9.63 31,362 9.30 1,090 0.34

4,791 5.76 4,445 5.24 346 0.52 Total Operating Expenses 16,904 5.02 18,006 5.34 1,102 0.32 Admin Ratio(%)

3,200 3.85 3,361 3.96 (161) (0.11) Income from Operations 15,549 4.61 13,356 3.96 2,193 0.66

$3,200 3.85 $3,361 3.96 ($161) (0.11) Net Surplus(Deficit) $15,549 4.61 $13,356 3.96 $2,193 0.66 Margin(%) 0.2%

2.5% 1.9% 0.6% 2.1% 2.3% 0.2%

1.7% 1.4% 0.3% 2.0% 1.7%

0.0%


95.7% 96.7% -0.9% 95.9% 95.9%


116

MCLA Financial Statement ($ in thousands)


Membership773,467 756,918 16,549 Current Membership 773,467 698,113 75,354776,131 758,206 17,925 Member Months 3,018,002 2,674,385 343,617

Revenue$307,447 396.13 $279,647 368.83 $27,800 27.30 Capitation $1,122,545 371.95 $1,005,382 375.93 $117,163 (3.98)

4,395 5.66 3,939 5.20 456 0.47 Maternity Kick 16,415 5.44 16,035 6.00 380 (0.56) 311,842 401.79 283,586 374.02 28,256 27.77 Total Revenues 1,138,960 377.39 1,021,417 381.93 117,543 (4.54)

Healthcare Expenses83,740 107.89 99,659 131.44 (15,919) (23.55) Capitation 377,412 125.05 307,309 114.91 (70,103) (10.15)

950 1.22 1,133 1.49 (183) (0.27) Maternity Kick 3,694 1.22 3,641 1.36 (53) 0.14 4,219 5.44 6,015 7.93 (1,797) (2.50) CBAS Centers 19,727 6.54 13,444 5.03 (6,283) (1.51)

15,684 20.21 10,137 13.37 5,547 6.84 Provider Incentives and Shared Risk 65,514 21.71 27,095 10.13 (38,418) (11.58) 81,031 104.40 53,720 70.85 27,312 33.55 Inpatient Claims 231,451 76.69 229,822 85.93 (1,629) 9.24 63,226 81.46 66,081 87.15 (2,855) (5.69) Outpatient Claims 223,184 73.95 224,189 83.83 1,004 9.88 24,769 31.91 27,638 36.45 (2,869) (4.54) Pharmacy 99,899 33.10 94,618 35.38 (5,281) 2.28

4,128 5.32 3,558 4.69 570 0.63 Medical Administrative Expenses 14,921 4.94 16,956 6.34 2,035 1.40 277,748 357.86 267,941 353.39 9,807 4.47 Total Healthcare Expenses 1,035,802 343.21 917,074 342.91 (118,728) (0.30)

MCR(%)

34,095 43.93 15,646 20.63 18,449 23.29 Operating Margin 103,158 34.18 104,343 39.02 (1,184) (4.83)

11,588 14.93 10,498 13.85 1,090 1.08 Total Operating Expenses 39,182 12.98 42,574 15.92 3,391 2.94 Admin Ratio(%)

22,506 29.00 5,147 6.79 17,359 22.21 Income from Operations 63,976 21.20 61,769 23.10 2,207 (1.90)

$22,506 29.00 $5,147 6.79 $17,359 22.21 Net Surplus(Deficit) $63,976 21.20 $61,769 23.10 $2,207 (1.90) Margin(%) -0.4%

3.7% 3.7% 0.0% 3.4% 4.2% 0.7%

7.2% 1.8% 5.4% 5.6% 6.0%

-1.2%


89.1% 94.5% -5.4% 90.9% 89.8%


117

MCLA SPD Exhibit ($ in thousands)


Membership74,028 74,516 (488) Current Membership 74,028 89,254 (15,226)74,481 74,530 (49) Member Months 299,678 348,277 (48,599)

Revenue67,865 911.18 $70,930 951.70 ($3,065) (40.52) Capitation $294,437 982.51 $282,621 811.48 $11,816 171.03 67,865 911.18 70,930 951.70 (3,065) (40.52) Total Revenues 294,437 982.51 282,621 811.48 11,816 171.03

Healthcare Expenses12,020 161.38 12,908 173.19 (888) (11.81) Capitation 52,085 173.80 56,752 162.95 4,666 (10.85)

0 - 0 - 0 - Maternity Kick 0 - 0 - 0 - 759 10.19 1,064 14.28 (305) (4.08) CBAS Centers 3,631 12.12 6,268 18.00 2,637 5.88

0 - 173 2.33 (173) (2.33) Provider Incentives 382 1.27 797 2.29 416 1.02 0 - 0 - 0 - Shared Risk 0 - 0 - 0 -

1,430 19.20 0 - 1,430 19.20 DHS/DHCS Risk Sharing (4,566) (15.23) 0 - 4,566 15.23 17,257 231.70 19,255 258.35 (1,998) (26.65) Inpatient Claims 92,994 310.31 90,734 260.52 (2,260) (49.79) 22,907 307.56 34,121 457.82 (11,214) (150.26) Outpatient Claims 101,788 339.66 79,764 229.02 (22,024) (110.63) 10,558 141.76 12,221 163.98 (1,663) (22.22) Pharmacy 44,171 147.40 44,367 127.39 196 (20.00)

909 12.21 1,252 16.80 (342) (4.58) Medical Administrative Expenses 3,828 12.77 4,675 13.42 847 0.65 65,842 884.00 80,995 1,086.74 (15,153) (202.73) Total Healthcare Expenses 294,313 982.10 283,357 813.60 (10,956) (168.50)

MCR(%)

2,024 27.17 (10,064) (135.04) 12,088 162.21 Operating Margin 123 0.41 (737) (2.12) 860 2.53

2,522 33.86 2,626 35.23 (104) (1.37) Total Operating Expenses 10,129 33.80 11,780 33.82 1,651 0.02 Admin Ratio(%)

(498) (6.69) (12,690) (170.27) 12,192 163.58 Income from Operations (10,006) (33.39) (12,517) (35.94) 2,511 2.55

($498) (6.69) ($12,690) (170.27) $12,192 163.58 Net Surplus(Deficit) ($10,006) (33.39) ($12,517) (35.94) $2,511 2.55 Margin(%)

Note:

MCLA SPD Financial Statements exclude members that have Medicare as their primary coverage.

-0.7% -17.9% 17.2% -3.4% -4.4% 1.0%

3.7% 3.7% 0.0% 3.4% 4.2% 0.7%

0.3%


97.0% 114.2% -17.2% 100.0% 100.3%

Exhibit for information purposes only. Not a financial StatementJanuary 2015

Current Prior Increase YTD YTD Fav<Unfav>

118

CMC Financial Statement ($ in thousands)


Membership14,882 4,504 10,378 Current Membership 14,882 20,102 (5,220)14,880 4,447 10,433 Member Months 27,449 42,536 (15,087)

Revenue$21,730 1,460.37 $6,595 1,482.94 $15,136 (22.57) Capitation $39,830 1,451.06 $100,970 2,373.75 ($61,140) (922.69)

21,730 1,460.37 6,595 1,482.94 15,136 (22.57) Total Revenues 39,830 1,451.06 100,970 2,373.75 (61,140) (922.69)

Healthcare Expenses10,289 691.43 2,580 580.07 7,709 111.37 Capitation 18,226 664.01 30,609 719.61 12,383 55.60

135 9.07 132 29.73 3 (20.66) CBAS Centers 721 26.25 2,099 49.35 1,378 23.09 7 0.49 32 7.28 (25) (6.79) Provider Incentives and Shared Risk 116 4.24 613 14.41 497 10.18

5,020 337.38 1,134 254.95 3,886 82.43 Inpatient Claims 6,883 250.75 29,378 690.65 22,495 439.90 4,199 282.17 110 24.66 4,089 257.52 Outpatient Claims 6,525 237.70 21,454 504.37 14,929 266.67 3,467 232.98 142 31.90 3,325 201.08 Pharmacy 1,939 70.64 11,927 280.39 9,988 209.75 1,532 102.96 750 168.72 782 (65.76) Medical Administrative Expenses 4,460 162.48 3,838 90.24 (622) (72.24)

24,648 1,656.48 4,880 1,097.31 19,769 559.18 Total Healthcare Expenses 38,870 1,416.07 99,918 2,349.02 61,048 932.95 MCR(%)

(2,918) (196.11) 1,715 385.63 (4,633) (581.75) Operating Margin 961 35.00 1,052 24.73 (91) 10.26

1,920 129.01 1,027 230.88 893 (101.87) Total Operating Expenses 5,046 183.83 4,422 103.95 (624) (79.88) Admin Ratio(%)

(4,838) (325.12) 688 154.75 (5,526) (479.88) Income from Operations (4,085) (148.84) (3,370) (79.22) (716) (69.62)

(0) (0.00) 47 10.68 (47) (10.68) Total Non-Operating Income (Expense) 0 - 0 - - -

($4,838) (325.12) $736 165.43 ($5,574) (490.56) Net Surplus(Deficit) ($4,085) (148.84) ($3,370) (79.22) ($716) (69.62) Margin(%)-22.3% 11.2% -33.4% -10.3% -3.3% -6.9%

8.8% 15.6% -6.7% 12.7% 4.4% -8.3%

1.4%


113.4% 74.0% 39.4% 97.6% 99.0%


119

L.A. Care Covered Financial Statement ($ in thousands)


Membership19,046 20,595 (1,549) Current Membership 19,046 40,177 (21,131)21,488 24,039 (2,551) Member Months 91,847 151,708 (59,861)

Revenue$4,335 201.76 $4,557 189.55 ($221) 12.22 Capitation $18,692 203.51 $35,595 234.63 ($16,903) (31.12)

21 1.00 24 1.00 (3) - Premiums 92 1.00 152 1.00 (60) - 4,357 202.76 4,581 190.55 (224) 12.22 Total Revenues 18,784 204.51 35,747 235.63 (16,963) (31.12)

Healthcare Expenses12,177 566.70 (72) (2.99) 12,249 569.69 Capitation 20,907 227.63 18,389 121.21 (2,519) (106.42) (3,081) (143.40) 67 2.79 (3,148) (146.19) Provider Incentives and Shared Risk (2,838) (30.90) 3,005 19.81 5,843 50.71

118 5.50 1,978 82.26 (1,859) (76.77) Inpatient Claims 2,368 25.78 2,046 13.48 (322) (12.30) (50) (2.33) (125) (5.22) 75 2.88 Outpatient Claims (696) (7.58) 5,837 38.47 6,533 46.05 305 14.20 355 14.78 (50) (0.58) Pharmacy 1,359 14.80 1,435 9.46 76 (5.34) 155 7.21 115 4.79 40 2.42 Medical Administrative Expenses 523 5.69 1,620 10.68 1,097 4.99

9,624 447.87 2,318 96.41 7,306 351.46 Total Healthcare Expenses 21,623 235.42 32,331 213.11 10,708 (22.31) MCR(%)

(5,267) (245.11) 2,263 94.14 (7,530) (339.24) Operating Margin (2,839) (30.91) 3,416 22.52 (6,255) (53.43)

(488) (22.70) 1,555 64.68 (2,043) (87.38) Total Operating Expenses 3,232 35.19 4,926 32.47 1,693 (2.72) Admin Ratio(%)

(4,779) (222.41) 708 29.46 (5,487) (251.87) Income from Operations (6,071) (66.10) (1,509) (9.95) (4,562) (56.15)

(190) (8.82) (200) (8.31) 10 (0.51) Total Non-Operating Income (Expense) (798) (8.69) (1,408) (9.28) 609 0.58

($4,969) (231.23) $508 21.15 ($5,477) (252.38) Net Surplus(Deficit) ($6,870) (74.80) ($2,917) (19.23) ($3,953) (55.57) Margin(%) -28.4%

-11.2% 33.9% -45.1% 17.2% 13.8% -3.4%

-114.0% 11.1% -125.1% -36.6% -8.2%

-24.7%


220.9% 50.6% 170.3% 115.1% 90.4%


120

Medicare Financial Statement ($ in thousands)


Membership0 9,129 (9,129) Current Membership 0 0 0

(771) 8,874 (9,645) Member Months 26,732 26,052 680

Revenue($148) 192.54 $7,541 849.77 ($7,689) (657.22) Medicare Part C $24,431 913.93 $25,270 970.00 ($839) (56.07)

(109) 141.29 603 67.93 (712) 73.36 Medicare Part D 2,493 93.26 0 - 2,493 93.26 (257) 333.83 8,144 917.70 (8,401) (583.87) Total Revenues 26,924 1,007.19 25,270 970.00 1,654 37.19

Healthcare Expenses53 (69.21) 2,927 329.81 (2,873) (399.02) Capitation 9,870 369.21 9,898 379.95 29 10.73

273 (353.85) 266 30.01 7 (383.86) Provider Incentives and Shared Risk 1,215 45.47 592 22.73 (623) (22.74) (419) 542.94 2,447 275.81 (2,866) 267.13 Inpatient Claims 9,492 355.06 7,748 297.42 (1,743) (57.64) (197) 255.30 1,093 123.17 (1,290) 132.12 Outpatient Claims 2,888 108.02 2,364 90.74 (524) (17.29)

(1,124) 1,458.43 121 13.59 (1,245) 1,444.84 Pharmacy (627) (23.44) 2,214 85.00 2,841 108.44 145 (188.08) 199 22.45 (54) (210.53) Medical Administrative Expenses 1,078 40.33 1,350 51.81 272 11.48

(1,269) 1,645.53 7,053 794.83 (8,322) 850.70 Total Healthcare Expenses 23,916 894.65 24,167 927.64 251 32.99 MCR(%)

1,011 (1,311.70) 1,090 122.87 (79) (1,434.56) Operating Margin 3,008 112.54 1,104 42.36 1,905 70.18

0 - 565 63.63 (565) (63.63) Total Operating Expenses 2,004 74.97 2,570 98.65 566 23.68 Admin Ratio(%)

1,011 (1,311.70) 526 59.23 486 (1,370.93) Income from Operations 1,004 37.57 (1,466) (56.29) 2,471 93.86

$1,011 (1,311.70) $526 59.23 $486 (1,370.93) Net Surplus(Deficit) $1,004 37.57 ($1,466) (56.29) $2,471 93.86 Margin(%) 9.5%

0.0% 6.9% -6.9% 7.4% 10.2% 2.7%

-392.9% 6.5% -399.4% 3.7% -5.8%

6.8%


492.9% 86.6% 406.3% 88.8% 95.6%


121

PASC-SEIU Financial Statement ($ in thousands)


Membership45,682 45,528 154 Current Membership 45,682 49,053 (3,371)45,757 45,532 225 Member Months 190,707 195,762 (5,055)

Revenue$14,086 307.84 $14,038 308.31 $48 (0.47) Capitation $58,760 308.12 $60,316 308.11 ($1,556) 0.01

14,086 307.84 14,038 308.31 48 (0.47) Total Revenues 58,760 308.12 60,316 308.11 (1,556) 0.01

Healthcare Expenses12,301 268.84 11,636 255.55 666 13.29 Capitation 49,406 259.07 51,690 264.05 2,284 4.98

0 - 0 - 0 - Provider Incentives 0 - 3 0.02 3 0.02 389 8.50 185 4.06 204 4.45 Inpatient Claims 1,020 5.35 1,468 7.50 448 2.15 204 4.45 72 1.58 132 2.87 Outpatient Claims 636 3.33 1,664 8.50 1,028 5.17 720 15.74 772 16.95 (51) (1.21) Pharmacy 2,911 15.26 3,025 15.45 114 0.19 222 4.85 150 3.30 72 1.55 Medical Administrative Expenses 686 3.59 700 3.58 15 (0.02)

13,836 302.38 12,814 281.43 1,022 20.95 Total Healthcare Expenses 54,658 286.61 58,550 299.09 3,892 12.48 MCR(%)

250 5.45 1,224 26.88 (974) (21.42) Operating Margin 4,102 21.51 1,766 9.02 2,336 12.49

583 12.74 543 11.94 40 0.81 Total Operating Expenses 2,269 11.90 1,568 8.01 (701) (3.89) Admin Ratio(%)

(334) (7.29) 680 14.94 (1,014) (22.23) Income from Operations 1,832 9.61 198 1.01 1,634 8.60

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

($334) (7.29) $680 14.94 ($1,014) (22.23) Net Surplus(Deficit) $1,832 9.61 $198 1.01 $1,634 8.60 Margin(%)-2.4% 4.8% -7.2% 3.1% 0.3% 2.8%

4.1% 3.9% 0.3% 3.9% 2.6% -1.3%

4.1%


98.2% 91.3% 6.9% 93.0% 97.1%


122

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


Membership346 339 7 Current Membership 346 798 (452)371 424 (53) Member Months 1,374 3,192 (1,818)

Revenue$43 117.03 $50 117.12 ($6) (0.09) Capitation $161 117.05 $558 174.82 ($397) (57.77)

0 0.46 0 0.39 0 0.07 Premiums 1 0.55 11 3.42 (10) (2.87) 44 117.49 50 117.51 (6) (0.02) Total Revenues 162 117.59 569 178.24 (407) (60.65)

Healthcare Expenses12 32.54 14 31.88 (1) 0.66 Capitation 45 33.06 106 33.35 61 0.29

0 0.74 0 0.58 0 0.17 Provider Incentives and Shared Risk 10 7.03 326 102.28 317 95.25 (6) (16.24) (2) (5.14) (4) (11.10) Inpatient Claims 13 9.69 22 7.00 9 (2.69) (8) (20.53) (4) (9.53) (4) (10.99) Outpatient Claims (17) (12.73) 54 17.00 72 29.73 1 3.05 2 4.77 (1) (1.72) Pharmacy 8 5.56 21 6.43 13 0.87 1 2.81 1 2.13 0 0.68 Medical Administrative Expenses 4 2.63 8 2.44 4 (0.19) 1 2.37 10 24.68 (10) (22.31) Total Healthcare Expenses 62 45.24 538 168.50 476 123.27

MCR(%)

43 115.12 39 92.83 3 22.29 Operating Margin 99 72.36 31 9.74 68 62.62

4 9.61 4 10.23 (1) (0.62) Total Operating Expenses 44 32.07 18 5.51 (26) (26.57) Admin Ratio(%)

39 105.51 35 82.60 4 22.91 Income from Operations 55 40.28 14 4.23 42 36.05

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

$39 105.51 $35 82.60 $4 22.91 Net Surplus(Deficit) $55 40.28 $14 4.23 $42 36.05 Margin(%) 31.9%

8.2% 8.7% -0.5% 27.3% 3.1% -24.2%

89.8% 70.3% 19.5% 34.3% 2.4%

56.1%


2.0% 21.0% -19.0% 38.5% 94.5%


123

Community Programs Financial Statement ($ in thousands)


Membership0 0 0 Current Membership 0 0 00 0 0 Member Months 0 0 0

Revenue$75 - $10 - $64 - Grants/Others $154 - $0 - $154 -

0 - 0 - 0 - Capitation 0 - 0 - 0 - 75 - 10 - 64 - Total Revenues 154 - 0 - 154 -

Healthcare Expenses0 - 0 - 0 - Medical Administrative Expenses 0 - 0 - 0 - 0 - 0 - 0 - Total Healthcare Expenses 0 - 0 - 0 -

MCR(%)

75 - 10 - 64 - Operating Margin 154 - 0 - 154 -

424 - 405 - 19 - Total Operating Expenses 1,835 - 1,688 - (147) - Admin Ratio(%)

(349) - (394) - 46 - Income from Operations (1,681) - (1,688) - 7 -

0 - (360) - 360 - Total Non-Operating Income (Expense) (1,735) - (1,667) - (68) -

($349) 0.00 ($754) 0.00 $406 0.00 Net Surplus(Deficit) ($3,416) 0.00 ($3,355) 0.00 ($61) 0.00 Margin(%) 0.0%

0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

0.0% 0.0% 0.0% 0.0% 0.0%

0.0%


0.0% 0.0% 0.0% 0.0% 0.0%


124

HITEC-LA Financial Statement ($ in thousands)


Membership0 0 0 Current Membership 0 0 00 0 0 Member Months 0 0 0

Revenue$168 - $210 - ($42) - Grants/Others $588 - $890 - ($303) -

0 - 0 - 0 - Capitation 0 - 0 - 0 - 168 - 210 - (42) - Total Revenues 588 - 890 - (303) -

Healthcare Expenses0 - 0 - 0 - Medical Administrative Expenses 0 - 0 - 0 - 0 - 0 - 0 - Total Healthcare Expenses 0 - 0 - 0 -

MCR(%)

168 - 210 - (42) - Operating Margin 588 - 890 - (303) -

239 - 181 - 58 - Total Operating Expenses 653 - 989 - 336 - Admin Ratio(%)

(71) - 29 - (100) - Income from Operations (65) - (99) - 34 -

($71) 0.00 $29 0.00 ($100) 0.00 Net Surplus(Deficit) ($65) 0.00 ($99) 0.00 $34 0.00 Margin(%) 0.0%

0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

0.0% 0.0% 0.0% 0.0% 0.0%

0.0%


0.0% 0.0% 0.0% 0.0% 0.0%


125

Comparative Balance Sheet

(Dollars in thousands) Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15ASSETS

CURRENT ASSETS Total Current Assets 1,208,460 1,315,943 1,476,515 1,578,110 1,948,116 2,452,736 Capitalized Assets - net 27,427 28,654 30,437 31,328 32,159 32,190NON-CURRENT ASSETS 10,487 10,151 10,172 10,160 10,138 10,150 TOTAL ASSETS 1,246,373 1,354,749 1,517,124 1,619,598 1,990,414 2,495,077

LIABILITIES AND FUND EQUITY

CURRENT LIABILITIES Total Current Liability 1,024,596 1,131,401 1,277,838 1,353,803 1,713,835 2,203,011 Long Term Liability 3,162 3,273 3,370 3,497 3,582 3,646 Total Liabilities 1,027,758 1,134,674 1,281,208 1,357,300 1,717,417 2,206,657

FUND EQUITYInvested in Capital Assets, net of related debt 27,427 28,654 30,437 31,328 32,159 32,190 Restricted Equity 300 300 300 300 300 300 Minimum Tangible Net Equity 61,935 79,905 85,264 89,784 95,674 101,450 Board Designated Funds 128,953 111,216 119,915 140,886 144,864 154,479 Total Fund Equity 218,615 220,075 235,916 262,298 272,997 288,420

TOTAL LIABILITIES AND FUND EQUITY $1,246,373 $1,354,749 $1,517,124 $1,619,598 $1,990,414 $2,495,077

Solvency Ratios

Working Capital Ratio 1.18 1.16 1.16 1.17 1.14 1.11 Cash to Claims Ratio 0.63 0.96 1.00 0.60 1.36 1.33 Tangible Net Equity Ratio 3.53 2.75 2.77 2.92 2.85 2.84

January 2015

126

February 25, 2015

TO: Finance & Budget Committee

FROM: Timothy Reilly, Chief Financial Officer

SUBJECT: Monthly Investment Transaction Report – January 2015

In order to keep the Committee apprised of L.A. Care’s investment portfolios and to comply with

California government code section #53607, included herein are the investment transaction details

from January 1, 2015, to January 31, 2015.

As of January 31, 2015, L.A. Care's investment portfolio total market value was $1,217 million.

These funds are managed by Payden & Rygel, an external professional asset management firm, and

is divided to two separate portfolios based on investment style,

1. The Short-term Portfolio and

2. The Extended Portfolio

127

TRANSACTIONS BY TYPE

Account Name: L.A. CARE HEALTH PLAN 01/01/2015Account Number: through 01/31/2015

Trade Settlement Transaction Maturity Coupon Accrued Interest TotalDate Date Type Units Description Date Rate CUSIP Proceeds / (Cost) (Purch) or Sold Amount

01/05/15 01/06/15 Buy 50,000,000.000 FHLMC DISCOUNT NOTE 01/13/15 313396AN3 (49,999,708.33) (49,999,708.33)

01/06/15 01/06/15 Buy 50,000,000.000 U.S. TREASURY BILL 01/08/15 912796DF3 (49,999,980.56) (49,999,980.56)

01/06/15 01/06/15 Buy 50,000,000.000 U.S. TREASURY BILL 01/08/15 912796DF3 (49,999,980.56) (49,999,980.56)

01/07/15 01/07/15 Buy 25,000,000.000 FHLB DISCOUNT NOTE 01/14/15 313384AP4 (24,999,854.17) (24,999,854.17)

01/07/15 01/07/15 Buy 26,759,000.000 FHLB DISCOUNT NOTE 01/26/15 313384BB4 (26,758,364.47) (26,758,364.47)

01/07/15 01/07/15 Buy 50,000,000.000 FHLB DISCOUNT NOTE 01/28/15 313384BD0 (49,998,833.33) (49,998,833.33)

01/07/15 01/07/15 Buy 50,000,000.000 FHLMC DISCOUNT NOTE 01/27/15 313396BC6 (49,999,166.67) (49,999,166.67)

01/07/15 01/07/15 Buy 50,000,000.000 FHLMC DISCOUNT NOTE 03/13/15 313396CZ4 (49,995,486.11) (49,995,486.11)

01/07/15 01/07/15 Buy 42,900,000.000 FNMA DISCOUNT NOTE 02/02/15 313588BJ3 (42,898,450.83) (42,898,450.83)

01/07/15 01/07/15 Buy 50,000,000.000 U.S. TREASURY BILL 01/22/15 912796EQ8 (49,999,791.67) (49,999,791.67)



01/07/15 01/07/15 Buy 50,000,000.000 U.S. TREASURY BILL 02/05/15 912796DG1 (49,999,597.22) (49,999,597.22)


01/07/15 01/08/15 Buy 49,000,000.000 FHLB DISCOUNT NOTE 02/04/15 313384BL2 (48,997,978.75) (48,997,978.75)

01/07/15 01/08/15 Buy 50,000,000.000 FNMA DISCOUNT NOTE 02/02/15 313588BJ3 (49,998,263.89) (49,998,263.89)

01/07/15 01/08/15 Buy 50,000,000.000 FNMA DISCOUNT NOTE 01/20/15 313588AV7 (49,999,333.33) (49,999,333.33)

12/11/14 01/08/15 Buy 1,500,000.000 CA LOS ANGELES CCD TAXABLE 08/01/15 0.30 54438CQZ8 (1,500,000.00) (1,500,000.00)

01/13/15 01/16/15 Buy 224,000.000 JOHN DEERE CAPITAL CORP 01/16/18 1.35 24422EST7 (223,888.00) (223,888.00)

01/16/15 01/20/15 Buy 50,000,000.000 FAMC DISCOUNT NOTE 03/16/15 31315KDC1 (49,995,034.72) (49,995,034.72)

Payden & Rygel Page 1128




01/20/15 01/21/15 Buy 50,000,000.000 FHLB DISCOUNT NOTE 02/18/15 313384CA5 (49,997,666.67) (49,997,666.67)

01/21/15 01/22/15 Buy 25,000,000.000 FHLB DISCOUNT NOTE 02/18/15 313384CA5 (24,999,062.50) (24,999,062.50)


01/21/15 01/22/15 Buy 40,000,000.000 U.S. TREASURY BILL 03/05/15 912796DP1 (39,999,486.67) (39,999,486.67)

01/23/15 01/26/15 Buy 30,000,000.000 FHLB DISCOUNT NOTE 02/24/15 313384CG2 (29,999,395.83) (29,999,395.83)

01/23/15 01/26/15 Buy 50,000,000.000 U.S. TREASURY BILL 02/19/15 912796EV7 (49,999,800.00) (49,999,800.00)

01/23/15 01/26/15 Buy 20,000,000.000 U.S. TREASURY BILL 02/19/15 912796EV7 (19,999,920.00) (19,999,920.00)

01/26/15 01/27/15 Buy 15,000,000.000 FAMC DISCOUNT NOTE 02/06/15 31315KBN9 (14,999,791.67) (14,999,791.67)

01/22/15 01/27/15 Buy 500,000.000 US BANK 01/26/18 1.35 90331HMQ (499,240.00) (499,240.00)

01/27/15 01/28/15 Buy 50,000,000.000 FHLB DISCOUNT NOTE 02/25/15 313384CH0 (49,998,055.56) (49,998,055.56)

01/27/15 01/28/15 Buy 10,000,000.000 FHLB DISCOUNT NOTE 02/25/15 313384CH0 (9,999,611.11) (9,999,611.11)

01/21/15 01/28/15 Buy 1,700,000.000 HONDA 2015-1 A2 CAR 06/15/17 0.70 43814KAB7 (1,699,911.26) (1,699,911.26)

01/29/15 01/30/15 Buy 50,000,000.000 FNMA DISCOUNT NOTE 05/21/15 313588FW (49,989,208.33) (49,989,208.33) ,202,583,000.000 (1,202,544,131.37) (1,202,544,131.37)

01/02/15 01/02/15 Coupon CA GOLDEN EMPIRE SFA LEASE 05/01/15 0.22 381008AR2 235.60 235.60

01/03/15 01/03/15 Coupon FFCB FRN 10/03/16 0.19 3133ED3B6 765.31 765.31

01/07/15 01/07/15 Coupon NATL RURAL UTILITIES FRN 05/01/15 0.30 63743HEJ7 683.66 683.66

01/07/15 01/07/15 Coupon ORACLE FRN 07/07/17 0.45 68389XAT2 882.38 882.38

01/08/15 01/08/15 Coupon FFCB FRN 07/08/16 0.19 3133ED4K5 762.94 762.94

01/08/15 01/08/15 Coupon GE CAPITAL CORP 01/08/16 1.00 36962G6R0 4,650.00 4,650.00





01/11/15 01/11/15 Coupon DUKE ENERGY INDIANA FRN 07/11/16 0.60 263901AE0 458.78 458.78


01/12/15 01/12/15 Coupon JOHN DEERE CAPITAL FRN 10/11/16 0.54 24422ESE0 285.51 285.51

01/12/15 01/12/15 Coupon METLIFE GLOBAL FRN 144A 04/10/17 0.63 59217GBE8 2,385.64 2,385.64

01/13/15 01/13/15 Coupon FFCB FRN 02/13/17 0.21 3133EDFB3 864.56 864.56

01/15/15 01/15/15 Coupon EBAY 07/15/15 0.70 278642AD5 350.00 350.00

01/15/15 01/15/15 Coupon EBAY 07/15/15 0.70 278642AD5 420.00 420.00

01/15/15 01/15/15 Coupon HONDA 2014-4 A2 CAR 01/17/17 0.58 43814JAB0 596.92 596.92

01/15/15 01/15/15 Coupon U.S. TREASURY NOTE 01/15/17 0.75 912828A91 3,750.00 3,750.00

01/15/15 01/15/15 Coupon U.S. TREASURY NOTE 07/15/15 0.25 912828TD2 62,500.00 62,500.00

01/15/15 01/15/15 Coupon U.S. TREASURY NOTE 07/15/15 0.25 912828TD2 62,500.00 62,500.00

01/15/15 01/15/15 Coupon USAA 2012-1 A3 CAR 08/15/16 0.43 90327BAC6 16.24 16.24

01/15/15 01/15/15 Coupon USAA 2014-1 A2 CAR 10/17/16 0.38 90290KAB1 102.46 102.46

01/15/15 01/15/15 Coupon USAA 2014-1 A3 CAR 12/15/17 0.58 90290KAC9 512.33 512.33

01/17/15 01/17/15 Coupon FFCB FRN 04/17/17 0.22 3133EDJX1 547.67 547.67

01/20/15 01/20/15 Coupon GEDFT 2013-1 A 1MOFRN FLOO 04/20/18 0.57 36159LCF1 444.11 444.11

01/20/15 01/20/15 Coupon GEDFT 2013-1 A 1MOFRN FLOO 04/20/18 0.57 36159LCF1 223.20 223.20

01/20/15 01/20/15 Coupon WELLS FARGO FRN 07/20/16 0.79 94974BFM7 583.24 583.24

01/20/15 01/20/15 Coupon WELLS FARGO FRN 07/20/16 0.79 94974BFM7 2,332.97 2,332.97

01/22/15 01/22/15 Coupon JOHN DEERE CAPITAL 01/22/16 0.75 24422ERZ4 1,612.50 1,612.50





01/22/15 01/22/15 Coupon GEEMT 2014-1 A2 EQP 04/24/17 0.64 36163TAB9 480.00 480.00

01/23/15 01/23/15 Coupon BNY MELLON FRN 10/23/15 0.49 06406HCF4 1,177.09 1,177.09

01/23/15 01/23/15 Coupon NEW YORK LIFE GLOBAL FRN 14 05/23/16 0.61 64952WBP 741.88 741.88

01/24/15 01/24/15 Coupon GEET 2013-2 A2 EQP 06/24/16 0.61 36163GAB7 469.84 469.84

01/01/15 01/25/15 Coupon FNA 2014-M2 ASQ2 CMBS 09/25/15 0.48 3136AJDN3 403.08 403.08


01/01/15 01/25/15 Coupon FNA 2014-M5 FA 1MOFRN CMBS 01/25/17 0.52 3136AJ2A3 293.55 293.55

01/01/15 01/25/15 Coupon FNA 2014-M8 FA 1MOFRN CMBS 05/25/18 0.42 3136AKQJ5 562.87 562.87

01/27/15 01/27/15 Coupon NATL RURAL UTILITIES 01/27/17 1.10 637432MW 2,750.00 2,750.00

01/28/15 01/28/15 Coupon PNC BANK 01/28/16 0.80 69349LAH1 1,680.00 1,680.00

01/28/15 01/28/15 Coupon PNC BANK FRN 01/28/16 0.57 69349LAJ7 1,387.92 1,387.92

01/29/15 01/29/15 Coupon AMERICAN EXPRESS FRN 07/29/16 0.76 0258M0DH 1,043.77 1,043.77

01/30/15 01/30/15 Coupon MANUFACTURERS & TRADERS T 01/30/17 0.63 55279HAC4 776.38 776.38

01/30/15 01/30/15 Coupon US BANK CINCINNATI FRN 01/30/17 0.48 90331HMD 591.10 591.10

01/31/15 01/31/15 Coupon U.S. TREASURY FRN 01/31/16 0.07 912828WK 196.69 196.69

01/31/15 01/31/15 Coupon U.S. TREASURY FRN 01/31/16 0.07 912828WK 347.07 347.07 162,179.66 162,179.66

01/01/15 01/01/15 Income 139.290 STIF INT USD 139.29 139.29





Cash - cont.01/01/15 01/01/15 Income 1,051.110 ADJ NET INT USD 1,051.11 1,051.11

1,190.400 1,190.40 1,190.40

01/07/15 01/07/15 Contributn 550,000,000.000 NM USD 550,000,000.00 550,000,000.00

01/14/15 01/16/15 Sell Long 1,200,000.000 IBM 05/06/16 0.45 459200HL8 1,199,916.00 1,050.00 1,200,966.00

01/21/15 01/26/15 Sell Long 120,000.000 CATERPILLAR FINANCIAL 08/18/17 1.25 14912L6D8 120,626.40 650.00 121,276.40

01/21/15 01/26/15 Sell Long 224,000.000 JOHN DEERE CAPITAL CORP 01/16/18 1.35 24422EST7 224,331.52 84.00 224,415.52

01/21/15 01/26/15 Sell Long 660,000.000 PACCAR FINANCIAL 11/17/17 1.40 69371RM3 662,336.40 1,771.00 664,107.40 2,204,000.000 2,207,210.32 3,555.00 2,210,765.32

01/15/15 01/15/15 Pay Princpl 10,234.284 USAA 2012-1 A3 CAR 08/15/16 0.43 90327BAC6 10,234.28 10,234.28

01/15/15 01/15/15 Pay Princpl 46,694.866 USAA 2014-1 A2 CAR 10/17/16 0.38 90290KAB1 46,694.87 46,694.87

01/24/15 01/24/15 Pay Princpl 153,865.825 GEET 2013-2 A2 EQP 06/24/16 0.61 36163GAB7 153,865.83 153,865.83

01/01/15 01/25/15 Pay Princpl 12,761.730 FNA 2014-M2 ASQ2 CMBS 09/25/15 0.48 3136AJDN3 12,761.73 12,761.73


01/01/15 01/25/15 Pay Princpl 8,187.688 FNA 2014-M5 FA 1MOFRN CMBS 01/25/17 0.52 3136AJ2A3 8,187.69 8,187.69

01/01/15 01/25/15 Pay Princpl 1,361.772 FNA 2014-M8 FA 1MOFRN CMBS 05/25/18 0.42 3136AKQJ5 1,361.77 1,361.77 238,210.855 238,210.86 238,210.86

01/02/15 01/02/15 Mature Long 25,000,000.000 U.S. TREASURY BILL 01/02/15 912796EM7 24,999,875.00 125.00 25,000,000.00

01/06/15 01/06/15 Mature Long 25,000,000.000 FHLMC DISCOUNT NOTE 01/06/15 313396AF0 24,999,131.94 868.06 25,000,000.00





01/06/15 01/06/15 Mature Long 20,000,000.000 FNMA DISCOUNT NOTE 01/06/15 313588AF2 19,999,996.11 3.89 20,000,000.00

01/06/15 01/06/15 Mature Long 50,000,000.000 TVA DISCOUNT NOTE 01/06/15 880592AF7 49,997,916.67 2,083.33 50,000,000.00

01/06/15 01/06/15 Mature Long 50,000,000.000 TVA DISCOUNT NOTE 01/06/15 880592AF7 49,997,916.67 2,083.33 50,000,000.00

01/08/15 01/08/15 Mature Long 50,000,000.000 U.S. TREASURY BILL 01/08/15 912796DF3 49,999,980.56 19.44 50,000,000.00

01/08/15 01/08/15 Mature Long 50,000,000.000 U.S. TREASURY BILL 01/08/15 912796DF3 49,999,980.56 19.44 50,000,000.00

01/13/15 01/13/15 Mature Long 50,000,000.000 FHLMC DISCOUNT NOTE 01/13/15 313396AN3 49,999,708.33 291.67 50,000,000.00

01/14/15 01/14/15 Mature Long 25,000,000.000 FHLB DISCOUNT NOTE 01/14/15 313384AP4 24,999,854.17 145.83 25,000,000.00

01/20/15 01/20/15 Mature Long 50,000,000.000 FNMA DISCOUNT NOTE 01/20/15 313588AV7 49,999,333.33 666.67 50,000,000.00

01/21/15 01/21/15 Mature Long 50,000,000.000 FHLB DISCOUNT NOTE 01/21/15 313384AW 49,999,694.44 305.56 50,000,000.00

01/22/15 01/22/15 Mature Long 50,000,000.000 U.S. TREASURY BILL 01/22/15 912796EQ8 49,999,791.67 208.33 50,000,000.00



01/26/15 01/26/15 Mature Long 35,000,000.000 FHLB DISCOUNT NOTE 01/26/15 313384BB4 34,999,494.44 505.56 35,000,000.00

01/26/15 01/26/15 Mature Long 26,759,000.000 FHLB DISCOUNT NOTE 01/26/15 313384BB4 26,758,364.47 635.53 26,759,000.00

01/26/15 01/26/15 Mature Long 18,000,000.000 FHLMC DISCOUNT NOTE 01/26/15 313396BB8 17,991,450.00 8,550.00 18,000,000.00

01/27/15 01/27/15 Mature Long 50,000,000.000 FHLMC DISCOUNT NOTE 01/27/15 313396BC6 49,999,166.67 833.33 50,000,000.00

01/28/15 01/28/15 Mature Long 24,000,000.000 FHLB DISCOUNT NOTE 01/28/15 313384BD0 23,987,866.67 12,133.33 24,000,000.00

01/28/15 01/28/15 Mature Long 50,000,000.000 FHLB DISCOUNT NOTE 01/28/15 313384BD0 49,998,833.33 1,166.67 50,000,000.00 773,759,000.000 773,728,042.53 30,957.47 773,759,000.00





01/09/15 01/09/15 Withdrawal (50,000,000.000) WD USD (50,000,000.00) (50,000,000.00)

01/14/15 01/14/15 Withdrawal (75,000,000.000) WD USD (75,000,000.00) (75,000,000.00) 125,000,000.000) (125,000,000.00) (125,000,000.00)



Account Name: L.A. CARE HEALTH PLAN-LOW DURATION PORT 01/01/2015Account Number: through 01/31/2015


01/15/15 01/16/15 Buy 2,000,000.000 U.S. TREASURY NOTE 10/31/16 0.38 912828F88 (1,998,131.70) (1,595.30) (1,999,727.00)

01/28/15 01/29/15 Buy 1,456,000.000 FHLB DISCOUNT NOTE 04/15/15 313384EJ4 (1,455,735.66) (1,455,735.66) 3,456,000.000 (3,453,867.36) (1,595.30) (3,455,462.66)

01/02/15 01/02/15 Coupon CA GOLDEN EMPIRE SFA LEASE 05/01/15 0.22 381008AR2 129.27 129.27

01/07/15 01/07/15 Coupon NATL RURAL UTILITIES FRN 05/01/15 0.30 63743HEJ7 338.23 338.23

01/07/15 01/07/15 Coupon ORACLE FRN 07/07/17 0.45 68389XAT2 441.19 441.19

01/08/15 01/08/15 Coupon GE CAPITAL CORP 01/08/16 1.00 36962G6R0 750.00 750.00


01/12/15 01/12/15 Coupon GE CAPITAL CORP FRN 07/12/16 0.90 36962G7A6 1,034.00 1,034.00

01/12/15 01/12/15 Coupon METLIFE GLOBAL FRN 144A 04/10/17 0.63 59217GBE8 1,001.97 1,001.97

01/13/15 01/13/15 Coupon FFCB FRN 02/13/17 0.21 3133EDFB3 691.64 691.64

01/15/15 01/15/15 Coupon EBAY 07/15/15 0.70 278642AD5 280.00 280.00

01/15/15 01/15/15 Coupon EBAY 07/15/15 0.70 278642AD5 175.00 175.00

01/15/15 01/15/15 Coupon EBAY 07/15/15 0.70 278642AD5 175.00 175.00

01/15/15 01/15/15 Coupon HONDA 2014-4 A2 CAR 01/17/17 0.58 43814JAB0 316.58 316.58

01/15/15 01/15/15 Coupon JOHN DEERE 2014-A A3 EQP 04/16/18 0.92 47787VAC5 1,150.00 1,150.00

01/15/15 01/15/15 Coupon U.S. TREASURY NOTE 01/15/17 0.75 912828A91 5,625.00 5,625.00

01/15/15 01/15/15 Coupon TOYOTA 2013-B A3 CAR 07/17/17 0.89 89236VAC4 741.67 741.67

01/15/15 01/15/15 Coupon TOYOTA 2013-B A3 CAR 07/17/17 0.89 89236VAC4 155.75 155.75

01/15/15 01/15/15 Coupon U.S. TREASURY NOTE 01/15/15 0.25 912828RZ5 375.00 375.00





01/15/15 01/15/15 Coupon U.S. TREASURY NOTE 01/15/15 0.25 912828RZ5 1,500.00 1,500.00

01/15/15 01/15/15 Coupon USAA 2014-1 A2 CAR 10/17/16 0.38 90290KAB1 76.85 76.85

01/15/15 01/15/15 Coupon USAA 2014-1 A3 CAR 12/15/17 0.58 90290KAC9 273.08 273.08

01/17/15 01/17/15 Coupon FFCB FRN 04/17/17 0.22 3133EDJX1 273.83 273.83

01/18/15 01/18/15 Coupon HONDA 2013-4 A3 CAR 09/18/17 0.69 43814FAC6 575.00 575.00

01/20/15 01/20/15 Coupon WELLS FARGO FRN 07/20/15 0.54 94985H5G5 1,044.20 1,044.20

01/22/15 01/22/15 Coupon JOHN DEERE CAPITAL 01/22/16 0.75 24422ERZ4 1,387.50 1,387.50

01/22/15 01/22/15 Coupon GEEMT 2014-1 A2 EQP 04/24/17 0.64 36163TAB9 266.67 266.67

01/23/15 01/23/15 Coupon NEW YORK LIFE GLOBAL FRN 14 05/23/16 0.61 64952WBP 593.50 593.50

01/25/15 01/25/15 Coupon BMW 2013-A A3 CAR 11/27/17 0.67 05578XAC2 502.50 502.50

01/01/15 01/25/15 Coupon FHMS K501 A1 CMBS 06/25/16 1.34 3137ANLN3 61.86 61.86

01/01/15 01/25/15 Coupon FHMS K502 A1 CMBS 12/25/16 0.73 3137B03V4 307.45 307.45



01/01/15 01/25/15 Coupon FNA 2014-M4 ASQ2 CMBS 01/25/17 1.27 3136AJB21 715.66 715.66



01/01/15 01/25/15 Coupon FNA 2014-M8 FA 1MOFRN CMBS 05/25/18 0.42 3136AKQJ5 312.70 312.70

01/26/15 01/26/15 Coupon JPMORGAN CHASE FRN 01/25/18 1.16 46625HJF8 601.75 601.75

01/27/15 01/27/15 Coupon NATL RURAL UTILITIES 01/27/17 1.10 637432MW 2,310.00 2,310.00





01/27/15 01/27/15 Coupon PNC BANK 01/27/17 1.13 69353RCG1 2,250.00 2,250.00

01/28/15 01/28/15 Coupon PNC BANK 01/28/16 0.80 69349LAH1 1,400.00 1,400.00

01/29/15 01/29/15 Coupon FFCB FRN 08/29/17 0.21 3133EDTT9 288.64 288.64

01/30/15 01/30/15 Coupon MANUFACTURERS & TRADERS T 01/30/17 1.25 55279HAD 1,562.50 1,562.50

01/30/15 01/30/15 Coupon US BANK CINCINNATI FRN 01/30/17 0.48 90331HMD 472.88 472.88

01/31/15 01/31/15 Coupon U.S. TREASURY FRN 01/31/16 0.07 912828WK 81.38 81.38

01/31/15 01/31/15 Coupon U.S. TREASURY FRN 01/31/16 0.07 912828WK 143.63 143.63 31,371.92 31,371.92

01/01/15 01/01/15 Income 6.140 STIF INT USD 6.14 6.14

01/14/15 01/16/15 Sell Long 1,000,000.000 IBM 05/06/16 0.45 459200HL8 999,930.00 875.00 1,000,805.00

01/21/15 01/26/15 Sell Long 250,000.000 BB&T CORPORATION 10/01/17 1.35 07330NAK1 250,317.50 1,518.75 251,836.25

01/21/15 01/26/15 Sell Long 160,000.000 CATERPILLAR FINANCIAL 08/18/17 1.25 14912L6D8 160,835.20 866.67 161,701.87

01/21/15 01/26/15 Sell Long 420,000.000 WELLS FARGO 09/08/17 1.40 94974BGB0 421,411.20 2,237.67 423,648.87

01/29/15 01/30/15 Sell Long 1,000,000.000 U.S. TREASURY NOTE 05/15/15 0.25 912828SU5 1,000,625.00 524.86 1,001,149.86

01/29/15 01/30/15 Sell Long 410,000.000 U.S. TREASURY NOTE 05/15/15 0.25 912828SU5 410,256.25 215.19 410,471.44

01/29/15 01/30/15 Sell Long 750,000.000 U.S. TREASURY NOTE 05/15/15 0.25 912828SU5 750,468.75 393.65 750,862.40 3,990,000.000 3,993,843.90 6,631.79 4,000,475.69





01/15/15 01/15/15 Pay Princpl 35,021.150 USAA 2014-1 A2 CAR 10/17/16 0.38 90290KAB1 35,021.15 35,021.15

01/01/15 01/25/15 Pay Princpl 1,851.150 FHMS K501 A1 CMBS 06/25/16 1.34 3137ANLN3 1,851.15 1,851.15

01/01/15 01/25/15 Pay Princpl 99,151.060 FHMS K502 A1 CMBS 12/25/16 0.73 3137B03V4 99,151.06 99,151.06





01/01/15 01/25/15 Pay Princpl 756.540 FNA 2014-M8 FA 1MOFRN CMBS 05/25/18 0.42 3136AKQJ5 756.54 756.54 154,836.658 154,836.65 154,836.65

01/15/15 01/15/15 Mature Long 300,000.000 U.S. TREASURY NOTE 01/15/15 0.25 912828RZ5 300,000.00 300,000.00

01/15/15 01/15/15 Mature Long 1,200,000.000 U.S. TREASURY NOTE 01/15/15 0.25 912828RZ5 1,200,000.00 1,200,000.00 1,500,000.000 1,500,000.00 1,500,000.00


APPROVED

Board of GovernorsExecutive Community Advisory CommitteeMeeting Minutes – January 14, 2015L.A. Care Health Plan, 1055 West 7th Street, Los Angeles, CA 90017

ECAC Members RCAC Members/Public L.A. Care Board of Governors/StaffAlicia Flores, RCAC 1 Vice Chair,Carlos Aguirre, RCAC 2 ChairLidia Parra, RCAC 3 ChairHercilia Salvatierra, RCAC 4 ChairRomalda Meza, RCAC 5 ChairDove Savage Pinkney, RCAC 6 Chair*Dalia Cadena, RCAC 7 ChairAna Romo, RCAC 8 ChairCristina Deh- Lee, RCAC 9 ChairAida Aguilar, RCAC 10 Chair , ECAC Chair*Elda Sevilla, RCAC 11 ChairSilvia Poz, At Large Member, ECAC Vice ChairDemetria Saffore, At Large Member

* Excused Absent ** Absent*** Via teleconference

Russel Mulher, RCAC 1Maria G. Ramos, RCAC 2Rosa Ureña, RCAC 3Maria Casarrubias, RCAC 4Carmelo Salas, RCAC 5Maria Galván, RCAC 7Fátima Vázquez, RCAC 7Mariana López, RCAC 8Victoria Gramajo, PublicVonue Baker, Public

Paulina Alvira, InterpreterEduardo Kogan, InterpreterPaulina Laurent, InterpreterSina New, Interpreter

Hilda Pérez, Consumer Member, Board of GovernorsOzzie López, Member Advocate, Board of GovernorsJohn Wallace, Chief Operating OfficerGertrude S. Carter, MD, Chief Medical OfficerMaribel Ferrer, Senior Director, Member and Medi-Cal OperationsIdalia Chitica, Community Outreach Field Specialist SupervisorCO&EKristina Chung, Community Outreach Field Specialist, CO&EAuleria Eakins, Community Outreach Manager CO&EOliver Fauria, Temp, CO&EWhitney Franz, Project Manager, Quality ImprovementLaura Garcia, Health Promoter Liaison CO&EFelicia Gray, Community Outreach Liaison CO&EHilda Herrera, Community Outreach Liaison CO&EJudy Hsieh Bigman, Resource Specialist, CO&EDevina Kuo, Health Promoter Program Manager CO&ESusan Ma, CCI Field Specialist, CO&ELinda Merkens, Manager, Board ServicesFrank Meza, Community Outreach Field Specialist, CO&EPeter Prampetch, Analyst, CO&EJose Ricardo Rivas, Community Outreach Liaison CO&EMike Shook, Director, Quality and ImprovementHilda Stuart, Committee Liaison, Board ServicesPrity Thanki, Local Government Advisor, Government AffairsPaola Valdivia, Special Projects Manager to Chief Operating OfficerKenia Valle, Member Retention Unit, Member Services Dept.Martin Vicente, Community Outreach Field Specialist CO&EMaria Weaver, Member Retention Unit, Member Services Dept.

AGENDAITEM/PRESENTER

MOTIONS / MAJOR DISCUSSIONS ACTION TAKEN

CALL TO ORDER Silvia Poz, ECAC Vice Chair, called the meeting to order at 10:04 a.m.

APPROVE The Agenda for today’s meeting was approved as presented. Approved

150

Executive Community Advisory CommitteeJanuary 14, 2015 APPROVED

MEETING AGENDA unanimously asamended. 12AYES(Aguirre, Cadena,Deh-Lee, Flores,Meza, Parra, Poz,Romo, Saffore,Salvatierra, SavagePinkney, Sevilla)

APPROVEMEETING MINUTES

The December 10, 2014 meeting minutes were approved as presented.

Auleria Eakins, Manager, Community Outreach & Education Department (CO&E), addressed theCommittee to wish everyone a happy new year, and welcome Dove Savage Pinkney, RCAC 6Chair, back to the meeting. Ms. Savage Pinkney clarified that she missed some ECAC andRCAC meetings due to an accident, and not health issues. She noted appreciation for the plant,cards and phone calls that she received.

Approvedunanimously aspresented.12 AYES

STANDING ITEMSECAC CHAIRPERSONREPORT

Silvia Poz, Vice Chair

Vice Chairperson Poz presented the following motion:

Motion ECA 100: To approve the following candidate(s) to the Regional CommunityAdvisory Committees (RCAC), and Coordinated Care Initiative Councils (CCI) asreviewed by the Executive Community Advisory Committee (ECAC) during the January14, 2015 ECAC meeting.

Name RCAC # Type of MemberAna Maria Barros CCI-Area 2 ConsumerWilma Ballew CCI-Area 2 ConsumerFrancisca Marcos Vera CCI-Area 2 ConsumerJean Walker CCI- Area 3 ConsumerBrenda White CCI-Area 3 ConsumerHelen Washington CCI-Area 3 ConsumerAna Maria Barroso RCAC 2 Consumer

Motion ECA 100 wasApprovedunanimously12 AYES

Motion ECA 100 willbe forwarded to thenext Board ofGovernors meeting onFebruary 5, 2015.

L.A. CARE SENIORSTAFF REPORT

John Wallace, Chief Operating Officer, reported:

Membership

The L.A. Care Medi-Cal membership increased by 1,468 members.

The County Department of Public Social Services (DPSS) recently reinstituted the annualredetermination requirement. Mr. Wallace reminded Committee members of the importanceof completing and returning the redetermination documents.

151


L.A. Care recently received 10,000 Cal MediConnect members, including former members ofthe Dual Special Needs Plan (D-SNP).

Open enrollment for Covered California will continue until February 15, 2015. More than90% of L.A. Care Covered members renewed their coverage under L.A. Care for 2015.Maribel Ferrer, Senior Director, Senior Director, Member & Medi-Cal Services, noted that therenewal rate is at 91% and also reported that 2,000 new members have enrolled in theprogram.

Pharmacy Benefit Manager (PBM)L.A. Care has a new PBM as of January 1, 2015. The vendor’s task is to process pharmacyclaims. There were no changes to the pharmacy formulary or network. The transition wassmooth, and seamless to the members.

In response to concern from Board Member Perez, Mr. Wallace noted that the Department ofHealth Care Services (DHCS) sent an erroneous letter to all L.A. County residents under theMedi-Cal program. The letter stated that the member was due for redetermination, and this mayhave created confusion; and difficulty for members when trying to contact their eligibilityworkers.

Mr. Wallace informed the Committee that the Medi-Cal back log was due to the high number ofnew enrollments in the Medi-Cal program. Both the DHCS and the DPSS experienced somedelays in the processing of the applications therefore they decided to put the redeterminationprocess on hold while the back log was cleared.

In response to question from Board Member Lopez, Mr. Wallace informed the Committee thatthe L.A. Care Covered membership is at 22,000 and the goal is to reach 26,000, and preserve its6% market share. He noted that L.A. Care’s intent was to provide continuity of care to thoseL.A. Care Medi-Cal members that may no longer be eligible for Medi-Cal but may be eligible forCovered California.

PUBLIC COMMENT:Maria A. Lopez, RCAC 8Member, informed the Committee that a year ago, she applied for feefor service (FFS) Medi-Cal because she needs a liver transplant. Ms. Lopez noted that she wasassigned to a health plan, and that her doctor explained that liver transplant is not a coveredbenefit. Ms. Lopez reported that she has submitted numerous letters and her request to betransferred back to FFS, hasn’t been granted. She noted that she has not seen the doctor in fourmonths. Mr. Wallace informed Ms. Lopez that a case manager or care coordinator will assist herwith her issue. He Informed the Committee that organ transplant outside of kidney, and corneais not a benefit under L.A. Care however it is a covered benefit under Medi-Cal. He noted that

152


the health plan is responsible for finding a transplant center for the member, and do all thenecessary pre-tests. Once the member has their surgery, they are disenrolled from the plan andreceive health care services through the FFS Medi-Cal program.

HEALTH SERVICESREPORT

Gertrude S. Carter, MD, Chief Medical Officer, reported:

L.A. Care established a community interdisciplinary team in April 2014.

The team was established to systematically address issues forwarded by the community.

The team is comprised of L.A. Care staff from the following departments: CO&E, QualityImprovement, Provider Network Operations, Member Services, Cultural and Linguistics,Medicare Operations, and Behavioral Health.

There are two types of issues, administrative and clinical.

Individual member issues are confidential and will be addressed by Member Services staff.

Members have the right and the ability to keep their personal health care issues private.

L.A Care Member Services staff will work toward resolving each member issue. Otherdepartment staff may need to be involved in the resolution of the issue.

ECAC members should ask members to call Member Services with individual issues. Dr.Carter requested that the processes used by the Member Services Department processes bepresented to ECAC at a future meeting.

ECAC and RCAC members are asked to help L.A. Care identify problems with accessinghealth services that may affect many members in the community (for example: if a memberis unable to make an appointment because the clinic is always closed). RCAC and ECACwill forward administrative, and general clinical issues to the Interdisciplinary team tomanage.

Administrative issues include office hours, physician availability, network availability, andoffice conditions such as hazards and cleanliness.

General clinical issues affecting the entire community include access to care, quality of care,and inappropriate care.

Administrative issues managed by the Interdisciplinary team likely will be handled andresolved quickly. The Interdisciplinary team will provide a report to ECAC on the status ofadministrative issues.

Clinical issues are handled differently and have many regulatory guidelines. Once an issue isclassified as a clinical issue, it is considered as a potential quality issue (PQI). PQI areinvestigated by the PQI Committee and may be escalated for review by the QualityCommittee. A report on the status of clinical issues will not be provided to ECAC andRCACs because of regulatory restrictions.

The Interdisciplinary team will review and classify the issues, and will report on the number

153


of administrative and clinical issues received from the Committee. The Interdisciplinaryteam will update ECAC only on the administrative concerns, and will inform theCommittee when the clinical issues are forwarded to the Quality Committee.

The Interdisciplinary team will draft a message to help RCAC Chairs inform the membersof their RCACs.

In response to a question from Ms. Deh-Lee, Dr. Carter offered a future presentation aboutthe quality structure of L.A. Care to help ECAC members better understand qualityprocesses and reporting, in addition to roles and responsibilities within the department.

In response to concern from Demetria Saffore, At Large Member, Dr. Carter noted that theremay have been some confusion about reporting clinical issues, and the InterdisciplinaryCommittee will report on the status of administrative issues and will inform the Committeewhen clinical issues have been forwarded to a Quality Committee for further investigation.A report will not be given to this Committee on the status of clinical issues because ofconfidentiality restrictions. The results will only be shared with the doctor and the memberwho reported the issue. Dr. Carter assured the Committee that a dedicated group of peoplereviews, investigates, and conducts follow up on all clinical issues reported.

In response to a question from Ms. Savage Pinkney, Dr. Carter informed the Committeethat sometimes members may come to the RCACs to share their individual issues, becausethey may not know they can call member services. She noted that it is the RCAC Chairs’responsibility as volunteers representing L.A. Care, to guide the members and refer them toL.A. Care’s Member Services Department to report their issue, and to give the member thechoice, and to allow them the privacy of discussing their individual issue in a confidentialmanner.

In response to a question from Board Member Perez, Dr. Carter informed the Committeethat the composition of the Children’s Health Consultant Advisory Committee (CHCAC) isestablished in the Committee Charter. Certain organizations have been identified to be partof that Committee, and she will follow up in regards to the possible inclusion of a Memberrepresentative in that Committee.

INTERDISCIPLINARYCOMMITTEE UPDATE

Mike Shook, Director, Quality Improvement, reported:

The Interdisciplinary Committee is identifying strategies to meet the expectations of thisCommittee.

Issues brought by this Committee are important to L.A. Care and the InterdisciplinaryCommittee will ensure that the issues are heard, handled and resolved.

It is critical that ECAC members understand how to navigate the health care system, and

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the Interdisciplinary Committee will provide tools and training on how to do that.

The Interdisciplinary Committee is analyzing the reporting process to ensure timely andappropriate reports to be shared with the community. The Interdisciplinary Committee isdeveloping a formal reporting process and a grid for updates.

The Interdisciplinary Committee is also reviewing policies and procedures.

At the next meeting, Mr. Shook will provide an outline with specific examples of the twotypes of issues (administrative and clinical).

L.A. Care has limited resources and is evaluating if students or other communityrepresentatives can visit the clinics to observe the process and report back to L.A. Care.L.A. Care is also evaluating the need for customer service training at some clinics. Traininghas been done in the past but specific training can be done to address the issues reportedby ECAC.

Update on issues previously reported:

Private and Community clinics not accepting new Medi-Cal members. Ms. Eakins notedthat the Interdisciplinary Committee is in the process of identifying which clinics in theWilmington area are not accepting new members. She urged ECAC to provide the namesof the clinics as soon as possible so that this issue can be resolved.

Linden Optometry in Pasadena only seeing Medi-Cal patients Monday through Thursday.L.A. Care contracts with a vision provider to oversee all the clinics. L.A. Care is workingwith this vision provider to identify trends in increased member complaints for LindenOptometry.

Priority services given to cash paying patients-discrimination against Medi-Cal payingpatients at Pomona Valley Hospital. Mr. Shook noted the need to identify a specificlocation, as Pomona Valley Hospital has several clinics. He further noted that he, alongwith other L.A. Care staff, will visit the clinic to review their policies for access to care.

Urgent Care issue at St. Francis Medical Center. Mr. Shook asked for specific informationabout the urgent care center so he can follow up on this issue.

Long wait at East Valley Centers in West Covina. The Interdisciplinary Committee willvisit this clinic. Mr. Shook informed the Committee that some clinics double bookpatients because of a high appointment “no-show” rate. L.A. Care could work with theseclinics to develop a process to identify those patients who frequently miss appointmentsto find ways to help the member get to the clinic for the scheduled appointments.Policies and procedures will be reviewed to ensure that the clinics are following theirnetwork access and availability standards.

PUBLIC COMMENT:Rosa Urena, RCAC 3 Member, informed the Committee that after RCAC 3 members reported

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the Linden Optometry issue to the Interdisciplinary Committee and received its feedback, sheproceeded to report this issue to the Department of Public Social Services to seek assistance.Ms. Urena informed the Committee that one week ago she was able to make a Saturdayappointment at Linden Optometry, something that she couldn’t do in the past because they wereunder the Medi-Cal program. Ms. Urena noted that members bring issues to the attention ofL.A. Care because members trust that L.A. Care will take action on those issues, and assistmembers.

In response to concern from Ms. Saffore, Mr. Shook informed the Committee that theInterdisciplinary Committee will address all issues. The Interdisciplinary Committee will focuson administrative issues and forward clinical issues to the appropriate department. TheInterdisciplinary Committee will inform ECAC when clinical issues have been forwarded as aPQI. Ms. Ferrer noted that issues can be reported through this forum, and there is commitmentfrom all departments that member expectations will be met. She further noted that if an issue isnot resolved, individuals can call the Member Services Department to file a formal grievance.Ms. Ferrer asks that ECAC members use the Interdisciplinary Committee, which was created toestablish a forum where issues could be reported, reviewed and resolved. Ms. Ferrer asked thatmembers allow L.A. Care the opportunity to implement the new process discussed today. IfECAC members are dissatisfied with the process, L.A. Care will review the process again toconsider other options. Ms. Ferrer informed the Committee that members have the ability tocontact regulating agencies that oversee the health plan: Department of Health Care Services(DHCS) and the Department of Managed Health Care (DMHC). Contact information for thosestate agencies can be found on L.A. Care’s website at www.lacare.org

In response to a question from Cristina Deh-Lee, RCAC 9 Chair, Mr. Shook informed theCommittee that he will report at the next meeting. He asked for members to understand thatdue to the complexity of the health care system and need to navigate within different areas in theorganization, not all issues can be resolved in a month. He noted that a goal is to have a finalresolution within 60 days, and to provide an update by the next meeting if final resolution is notyet available.

GOVERNMENTAFFAIRS UPDATE

Prity Thanki, Local Government Advisor, reported:(A copy of the report can be requested through theCO&E department)

Legislative Update

The State Legislature resumed its session on January 5, 2015. Governor Brown took theoath of office as Governor of California.

Alex Padilla is California’s new Secretary of State.

L.A. Care continues to track health related bills, including two bills that were introduced last

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year by Senator Ricardo Lara. SB4- The Health for All Act of 2015. This bill would expand health care coverage

access to all Californians regardless of their immigration status. This was introducedbefore without success, and Senator Lara is reintroducing the bill in efforts to addressthe exclusion of undocumented Californians from Covered California.

SB10- This bill would create an Office of New Americans to assist undocumentedimmigrants with resources on education, legal services information, fraud preventionassistance, English instruction, and civics classes to help them better integrate intothe community.

Both bills seek to assist with the President’s recent Executive Order related to immigration.L.A. Care’s Government Affairs Department will closely monitor these bills and will reportback on their progress.

State Budget UpdateThe Governor’s 2015-16 budget proposal was released on January 9, 2015. Details of theproposal will be shared at the next meeting.

Covered California Update

Open enrollment began on November 15, 2014 and will end on February 15, 2015.During open enrollment, Californians will have an opportunity to renew or sign up for newhealth coverage.

More than 3.3 million Californians statewide enrolled in 2014.

As of December 31, 2014, there were 21,500 members enrolled in L.A. Care Covered.

Covered California reported that 217,000 people have new health coverage, and stateofficials also reported that about 467,000 people have enrolled in Medi-Cal sinceNovember 15, 2014.

Unlike Covered California, enrollment in Medi-Cal is available throughout the year.Committee members were asked to refer individuals to apply on line through the CoveredCalifornia web portal, or by completing an application at a county DPSS office.

HEALTH PROMOTERPROGRAM UPDATE

Devina Kuo, Health Promoter Program Manager, reported

Health Promoters (HPs) continuing education Groups A(2012 graduates) and B (2014graduates)

On December 16 and 18, HPs were trained on types of care and Health Care Reform(HCR).

On January 9, 2015, HPs received Coordinated Care Initiative (CCI) updates andconducted a stress management activity.

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HPs in group A conducted an Active Steps Program (ASP) data collection review.Group B will receive training on ASP data collection at end of January.

On January 23 and January 30, HPs will receive updates on: CCI, Mental Health, Health for All Act and How a Bill Becomes a Law. Affordable Care Act (ACA) and Tax Penalty presented by tax specialists.

HPs in the 2015 ASP

This year, the ASP will focus on RCACs 1, 6, 7.

On January 27, 2015 HPs will receive training on data collection (body measurements/surveys) at the Inglewood Family Resource Center (FRC).

Training on motivational interviewing will take place from February to May 2015.

HPs in the Community

HPs in groups A and B continue working in the community by presenting on healthrelated topics in addition to access to health care, HCR, and participating in communityevents.

On December 12, 2014 HPs participated in the Health4All Posada. Various communitymembers, organizations, and community partners gathered to support health for allCalifornians, regardless of their immigration status. HPs hosted a resource table for MyHealth LA (MHLA), they performed a song about nutrition, and performed on twotheater skits on women’s health and mental health.

On January 24, 2015, HPs will participate in the I’m All In Campaign Health Care forAll Families event. Schools, early learning centers, and after school sites will launch a 22day campaign to help all eligible families and individuals enroll in health care coveragebefore open enrollment ends. This event will target families and individuals in theMontebello area (flyers were available at the meeting). At this event HPs will perform threetheater skits on the importance of routine physical exams, women’s health and dentalhealth.

Three student interns are currently helping the HP program, including a graduate studentin public health at the University of Southern California who is responsible for enteringand analyzing the data that HPs collect.

AT-LARGE MEMBERUPDATE(MEMBERRECRUITMENT/CCI)

Demetria Saffore, and Silvia Poz, At-Large Members, reported (a copy of the reports can be requested bycontacting CO&E)(Reports can be requested through the CO&E Department).

The Coordinated Care Initiative (CCI) team continues its on-going outreach efforts in theareas of Antelope Valley, San Fernando Valley, South Los Angeles, and Long Beach.

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Member interviews continue to be conducted as applications are received by the CCI teamuntil each of the CCI Councils reaches maximum membership. All other interestedapplicants will be placed on a waiting list.

Susan Ma, CCI Field Specialist, reported:

A total of 20 consumer applications were received in December 2014; 10 were from currentRCAC members. CCI staff conducted 16 interviews based on eligibility status. Sixinterviews were in person, and 10 by phone.

Eight of the 10 RCAC members that applied for the Councils were selected. Thesemembers will have dual membership, and do not need to be approved by the Board.

Six new candidates were approved earlier on today’s Agenda. Their names will besubmitted to the Board of Governors on February 5, 2015 for final approval.

A RCAC member candidate for RCAC 2 is proposed for approval in Motion ECA 100.

In December the CO&E Department received 7 interest cards from RCACs 1, 2, 6, and 8.A total of 294 interest cards have been received to date.

L.A. Care has welcomed 47 new members into the RCACs.

Ms. Poz reminded reviewed the membership attachment (Attachment can be requested through theCO&E Department).

Out of the 294 interest cards, 47 or 16% became RCAC members.

Thirty three cards or 11% had wrong information or non-working telephone numbers.

Eighteen or 6% were no longer interested in becoming a RCAC member.

Thirty seven or 13% were ineligible, not currently active under any of L.A. Care’s productlines.

Thirty four or 12% have not been contacted yet.

Attempts to contact Eighty one or 28% of those; messages were left on their phones.

Sixteen or 5% have been invited to attend a RCAC meeting.

Twenty eight or 10% are on a waiting list due to maximum capacity for the Medi-Calproduct line in the RCAC.

COMMUNITYENGAGEMENT

Elda Sevilla, RCAC 11 Chair, informed the Committee that RCAC 11 will now meet at dACenter for the Arts in Pomona. Ms. Sevilla invited everyone to attend.

NEW BUSINESS

A. MemberStipends/Incentives

This item was deferred to the next meeting.

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B. RCAC HealthAdvocacyConference

Ms. Eakins informed that Committee that in the past RCACs held two conferences, one focusedon health, and the second one focused on advocacy. She noted that these conferences werepostponed for some time, so that RCACs and ECAC could focus on building infrastructure andget a clear understanding of their intended purpose.

Ms. Eakins informed the Committee that staff is currently looking for a venue to host the 2015health and advocacy conference. The conference will be tentatively held in March or April.This years’ conference will cover information on health and advocacy combined. More detailedinformation related to this event may be available at the next ECAC meeting.

OLD BUSINESS

A. ECAC Chair andVice ChairNominations andElections

Ms. Chitica informed the Committee that Chairperson Aguilar was not able to attend today’smeeting. Ms. Aguilar is nominated for the Chair and Vice Chair positions. Vice Chair Pozinformed the Committee that Ms. Aguilar’s name can remain on the ballot if the Committeeapproves. Carlos Aguirre, RCAC 2 Chair, expressed concerns in regards to the legality ofallowing an absent member to run for the Chair and Vice Chair position, as he noted that in thepast this has not been allowed in RCAC Chair and Vice Chair elections. Ms. Eakinsacknowledged Mr. Aguirre’s concern and noted that this has been a rule in the past howeverreceived confirmation from Board Services that is it possible to allow an absent candidate to runfor the positions if the Committee votes in favor of such action. Mr. Aguirre requested that thesame process be used throughout the RCACs.

Ana Romo, RCAC 8 Chair, made the following motion, seconded by Hercilia Salvatierra, RCAC4 Chair.

Motion ECA-A.0115To allow Aida Aguilar’s name to remain on the ballot for the 2015 ECAC Chair and ViceChair Elections.

Aida Aguilar, Demetria Saffore, and Elda Sevilla were nominated for the ECAC Chair position.Romalda Meza, RCAC 5 Chair, nominated Carlos Aguirre, RCAC 2 Chair. Mr. Aguirre declinedthe nomination. There were no additional nominations. The nominations for ECAC Chair wereclosed by consensus.

Each candidate addressed the Committee about their interest and qualifications. Committeemembers had an opportunity to ask questions of the candidates prior to the election.

The ballots were distributed, and all members voted who wished to cast a ballot. There were 12ballots cast; a candidate must receive at least 7 votes to be elected. Ms. Ferrer, Rosa Urena,

Motion ECA-A wasApprovedunanimously12 AYES

The nominations forECAC Chair wereclosed by consensus.

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RCAC 3 Member, and Laura Gonzalez, RCAC 1 Member counted the ballots.The results of the election were:

Aida Aguilar received three votesDemetria Saffore received two votesElda Sevilla received six votesThere was one abstention.

As none of the Candidates received the 7 votes required to be elected, a second set of ballotswere distributed, and all members voted who wished to cast a ballot. There were 12 ballots cast;a Candidate must receive at least 7 votes to be elected.

The results of the election were:

Aida Aguilar received one voteDemetria Saffore received one voteElda Sevilla received nine votesThere was one abstention

Elda Sevilla was elected Chair on the second ballot.

Aida Aguilar, Cristina Deh-Lee, Demetria Saffore, and Ana Romo were nominated for ECACVice Chair. There were no additional nominations. The nominations for ECAC Vice Chair wereclosed by consensus.

Each candidate addressed the Committee about their interest and qualifications. Committeemembers had an opportunity to ask questions of the candidates prior to the election.

The ballots were distributed, and all members voted who wished to cast a ballot. There were 12ballots cast; a candidate must receive at least 7 votes to be elected. Ms. Ferrer, Rosa Urena,RCAC 3 Member, and Laura Gonzalez, RCAC 1 Member counted the ballots.

The results of the election were:Aida Aguilar didn’t receive any votesDemetria Saffore received 2 votesAna Romo received 7 votesCristina Deh-Lee received 3 votes

Ana Romo was elected Vice Chair.

Elda Sevilla was electedChair on the secondballot.

The nominations forECAC Chair wereclosed by consensus.

Ana Romo was electedVice Chair

By consensus, theCommittee approved a

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By consensus, the Committee approved a motion to be forwarded to the Board of Governors toratify the elections.

Motion ECA 101:To approve the election of Elda Sevilla, as Chairperson, and the election of AnaRomo, as Vice-Chairperson, of the Executive Community Advisory Committee(ECAC) from February to December 2015.

motion to be forwardedto the Board ofGovernors on February5, 2015 to ratify theelections.

B. ECAC LeadershipTrainings

Idalia Chitica, Field Specialist Supervisor, informed the Committee that included in today’s materialsPowerPoint presentations for past ECAC Leadership Trainings (in English and Spanish), and acalendar of upcoming trainings. She reminded Committee members that attending the trainingis mandatory, and all the materials have been sent to the RCAC Vice Chairs.

Ms. Chitica requested Committee Members to remind their Vice Chairs about the next trainingon February 24 from 8:30 a.m. to 2:30 p.m.

C. ECAC Ad HocCommittee- BoardElections

Ms. Chitica reminded the Committee that an ad hoc Committee was selected at the last ECACmeeting to provide recommendations for the 2016 Board Elections. All recommendations willbe presented to ECAC for review and approval. Mr. Aguirre, Ms. Romo, Ms. Saffore and Ms.Poz volunteered to be part of the ad hoc Committee. She noted that the ad hoc Committee willmeet immediately following the February 11, 2015 ECAC meeting.

Dalia Cadena, RCAC 7 Chair, is an alternate volunteer member. Ms. Cadena will attend ifneeded.

PUBLIC COMMENTS

Alicia Flores acknowledged receipt of the new L.A. Care Member identification card, andnoted that the new plastic card is more durable.

In response to question from Ms. Urena in reference to the schools participating in the I’mAll In Campaign Health Care for All Families event, Ms. Kuo informed the Committee thattwo schools in Sacramento and one in Montebello are currently involved in this campaign.She noted that the organizers are willing to work with other schools, early child learningcenters and after school programs. Ms. Kuo asked members to call 916-844-2413 to learnmore about the steps required for potential collaborations with other schools.

Board Member Perez invited everyone to participate in all RCAC activities including workplan and member recruitment. She informed the Committee that her schedule has notpermitted her to visit the RCACs as often as she would like, but encouraged CommitteeMembers to contact her if needed.

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Ms. Sevilla noted that the 16 sessions of the Active Steps Program have proven to be moreeffective than a one day event, and asked L.A. Care to reconsider bringing the 16 sessionsback to RCAC 11. Mr. Aguirre agreed with Ms. Sevilla and requested that all RCACs bereconsidered for the 16 sessions. Ms. Eakins informed the Committee that goals for eachRCAC may differ according to several factors. She noted that if a RCAC has lowmembership, it is asked to focus on recruitment and retention. Ms. Eakins also noted thatthere will be multiple training opportunities available to build infrastructure, build strongeradvocates and partnerships, and ultimately have the best outcomes on the set goals.

Lidia Parra, RCAC 3 Chair, asked Board Member Perez why a Board meeting would be closedto the public. Board Member Perez informed the Committee that some information isconfidential, and Board Members must discuss those confidential matters in a closed session.(The Board of Governors of L.A. Care conducts its business in meetings that are open to the public. Whennecessary and allowed under the Brown Act, L.A. Care's Board of Governors meets in closed session. Theitems discussed in closed session are specifically listed on the meeting agenda. When required by the Brown Act,announcements are made in open session about actions that were taken during the closed session. The Board ofGovernors is committed to providing as much transparency in its deliberations as is possible and required. )1

ADJOURNMENTVice Chairperson Poz adjourned the meeting at 12:55 p.m.

RESPECTFULLY SUBMITTED BY: APPROVED BY:

Hilda Stuart, Committee Liaison, Board Services _________________________________________

Linda Merkens, Manager, Board Services Aida Aguilar, ECAC ChairDate _____________________________

1The italicized language is provided as an additional response or clarification to the inquiry raised at the last meeting.

163

For information on the current month’s meetings, check calendar of events at www.lacare.org. Meetings may be cancelled or rescheduled at the last

moment. To check on a particular meeting, please call (213) 694-1250 or send email to [email protected] by mhbalones/printed on 02/27/15

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

1

2 3 4 5

Board of Governors2 pm

(for approximately 2 hours)

6 7 8

9 10 11ECAC10 am


12 13 14 15

16 17CHCAC8:30 am


18 19Compliance & Quality

2:30 pm(for approximately 2 hours)

20 21 22

23 24 25Finance & Budget

1 pm(for approximately 1-1/2

hours)

Executive2:30 pm


26 27 28

Schedule of Meetings

March 2015

164

For information on the current month’s meetings, check calendar of events at www.lacare.org.

Meetings may be cancelled or rescheduled at the last moment. To check on a particular meeting,

please call (213) 694-1250 or send email to [email protected].

1055 W. 7th Street, 10th Floor, Los Angeles, CA 90017Tel. (213) 694-1250 / Fax (213) 438-5728

MEETING DAY, TIME,

& LOCATION

MEETING DATES

MEMBERS

Board ofGovernors

General Meeting

1st Thursday2:00 PM

(for approximately 3 hours)1055 W. 7th Street,

10th Floor,Los Angeles, CA 90017

March 5April 2

May 7-(All DayRetreat)June 4July 2*

No meeting in AugustSeptember 3October 1*November 5December 3*

*Strategic Focus from12:00-2:00 p.m. in

addition to regularBoard meeting from

2:00-5:00 p.m.

Thomas Horowitz, DO, ChairpersonMark Gamble, Vice ChairpersonMichael Rembis, FACHE, TreasurerLouise McCarthy, SecretaryHonorable Michael D. AntonovichHector De La TorreJann Hamilton LeeAlexander K. Li, MDOzzie LopezHilda PerezG. Michael Roybal, MD, MPHSheryl SpillerKimberly Uyeda, MD, MPH

Staff Contact:John Wallace, Interim Chief ExecutiveOfficer x4461Samantha Leewood, Interim Manager,Board Services, x4938

Board of Governors & Public Advisory Committees

2015 Meeting Schedule / Member Listing

165

BOARD OF GOVERNORS & PUBLIC ADVISORY COMMITTEES

2015 MEETING SCHEDULE / MEMBER LISTING




Board of Governors - Standing Committees

MEETING DAY,

TIME,

& LOCATION

2015

MEETING

DATES

MEMBERS

ExecutiveCommittee

4th Wednesday of themonth2:30 PM

(for approximately 2 hours)1055 W. 7th Street,

10th Floor, Los Angeles,CA 90017

*moved due to summer /holidays

March 25April 22May 27June 24July 15*

No meeting inAugust

September 23October 28

November 18*No meeting in

December

Thomas Horowitz, DO, ChairpersonMark GambleMichael RembisLouise McCarthyG. Michael Roybal, MD, MPHAlexander K Li, MD

Staff Contact:Samantha Leewood, Interim Manager,Board Services, x4938

Compliance &Quality

Committee

3rd Thursday every 2months2:30 PM


1055 W. 7th Street,10th Floor, Los Angeles,

CA 90017

March 19May 21July 16

No meeting inAugust

September 17November 19

No meeting inDecember

G. Michael Roybal, MD, MPH,ChairpersonJann Hamilton LeeAlexander Li, MDHilda Perez

Staff Contact:Malou BalonesCommittee Liaison, Board Services, x 4183

Finance &Budget

Committee

4th Wednesday of themonth1:00 PM



CA 90017

*moved due to summer /holidays

March 25April 22May 27June 24July 15*

No meeting inAugust

September 23October 28

November 18*No meeting in

December

Michael A. Rembis, FACHE, ChairpersonJann Hamilton LeeThomas Horowitz, DOOzzie LopezLouise McCarthy

Staff Contact:Hilda StuartCommittee Liaison, Board Services, x 4184

166






MEETING DAY,

TIME,

& LOCATION

2015

MEETING

DATES

MEMBERS

GovernanceCommittee

1055 W. 7th Street,10th Floor

Los Angeles, CA 90017

MEETS ASNEEDED

Alexander K Li, MD ChairpersonHector De La TorreMark GambleOzzie LopezHilda PerezSheryl Spiller

Staff Contact:Malou BalonesCommittee Liaison, Board Services/x 4183

ServiceAgreementCommittee

1055 W. 7th Street,10th Floor


MEETS ASNEEDED

Ozzie Lopez, ChairpersonLouise McCarthyHector De La TorreHilda PerezSheryl Spiller

Staff ContactMalou BalonesCommittee Liaison, Board Services/x 4183

Audit Committee 1055 W. 7th Street,10th Floor


MEETS ASNEEDED

G. Michael Roybal, MD, MPH,ChairpersonJann Hamilton LeeAlexander K. Li, MD

Staff ContactMalou BalonesCommittee Liaison, Board Services, x 4183

167






MEETING DAY,

TIME,

& LOCATION

MEETING

DATES MEMBERS

L.A. CareCommunity

Health

Meets Annually or asneeded


CA 90017



L.A. Care JointPowers Authority

Meets Quarterly or asneeded


CA 90017



168






Public Advisory Committees

MEETING DAY,

TIME,

& LOCATION

MEETING

DATES STAFF CONTACT

Children’s HealthConsultant Advisory

CommitteeGeneral Meeting

3rd Tuesday of every othermonth

8:30 AM(for approximately 2 hours)


CA 90017



Lyndee Knox, PhD, Chairperson

Staff Contact:Hilda StuartCommittee Liaison, Board Services, x 4184

ExecutiveCommunity

Advisory Committee

2nd Wednesday of themonth



CA 90017

March 11April 8May 13June 10July 8

No meeting in AugustSeptember 9October 14

November 11December 9

Elda Sevilla, Chairperson

Staff Contact:Idalia Chitica, Community Outreach &Education, Ext. 4420

Technical AdvisoryCommittee

4th Thursdays every othermonth



CA 90017



Chairperson to be elected

Staff Contact:Malou BalonesCommittee Liaison, Board Services/x 4183

169






REGIONAL COMMUNITY ADVISORY COMMITTEES

REGION

MEETING DAY,

TIME,

& LOCATION

MEETING

DATE

STAFF CONTACT

Region 1Antelope Valley

3rd Friday of every othermonth

10:00 AM(for approximately 2-1/2 hours)Chimbole Cultural Center38350 N. Sierra Highway

Palmdale, CA 93550Tel (661) 267-5656

April 17June 19

August 21October 16

December 18

Adela Guadarrama, Chairperson

Staff Contact:Judy Hsieh BigmanCommunity Outreach & Education, Ext.4199

Region 2San Fernando

Valley

3rd Monday of every othermonth

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

Family Resource Center-Pacoima

10807 San Fernando RoadPacoima, CA 91331Tel. (844) 858-9942

April 20June 15

August 17October 19

December 21

Carlos Aguirre, Chairperson

Staff Contact:Judy Hsieh BigmanCommunity Outreach & Education, Ext.4199

Region 3Alhambra,

Pasadena andFoothill


9:30 AM(for approximately 2-1/2 hours)Lake Avenue Community

Foundation500 E. Villa Street

Pasadena, CA 91101(562) 712-1551

April 21June 16

August 18October 20

December 15

Lidia Parra, Chairperson

Staff Contact:Kristina ChungCommunity Outreach & Education, Ext.5139

Region 4Hollywood-

Wilshire, Centraland Glendale


9:00 AM(for approximately 2-1/2 hours)St. Vincent Medical CenterMark Taper Building Board

Rm2200 W. Third St.

Los Angeles, CA 90057Tel. (213) 484-7766



Hercilia Salvatierra, Chairperson


170






REGION

MEETING DAY,

TIME,

& LOCATION

MEETING

DATE

STAFF CONTACT

Region 5West

3rd Monday of every othermonth2:00 PM

(for approximately 2-1/2 hours)Mar Vista Housing Dev.

Multipurpose Room4909 Marionwood StreetCulver City, CA 90230

Tel. (310) 915-9006

April 20June 15

August 17October 19

December 21

Romalda Meza, Chairperson

Staff Contact:Martin VicenteCommunity Outreach & Education, x 4423

Region 6South, Compton,

Inglewood

3rd Thursday of everyother month

3:00 PM(for approximately 2-1/2 hours)Saint John’s Well Child &

Family Center808 W. 58th Street


April 16June 18

August 20October 15

December 17

Dove Savage Pickney, Chairperson

Staff Contact:Frank MezaCommunity Outreach & Education, x 4239

Region 7San Antonio and

Bellflower


4:30 PM(for approximately 2-1/2 hours)

Old Timers FoundationFamily Center

3355 E. Gage AvenueHuntington Park, CA 90255

Tel (323) 582-6090



Dalia Cadena, Chairperson


Region 8Torrance and

Harbor

3rd Friday of every othermonth

10:30 AM(for approximately 2-1/2 hours)John Mendez Community

Center707 W. C Street

Wilmington, CA 90748Tel. (310) 549-0052



Ana Romo – Chairperson


171






REGION

MEETING DAY,

TIME,

& LOCATION

MEETING

DATE

STAFF CONTACT

Region 9Long Beach

3rd Monday of every othermonth


Miller Family HealthEducation Center

3820 Cherry AvenueLong Beach, CA 90807

Tel. (562) 570-7987** will meet the 4th Thursday of

the month

March 16May 21**

July 20September 21November 16

Christina Deh-Lee, Chairperson


Region 10East Los Angeles,

Whittier and North-East


4:00 PM(for approximately 2-1/2 hours)Boyle Heights Technology

Youth Center1600 East 4th Street


April 16June 18

August 20October 15

December 17

Aida Aguilar, Chairperson

Staff Contact:Martin Vicente, Community Outreach &Education, Ext. 4423

Region 11Pomona and El

Monte

3rd Wednesday of everyother Month


dA Center for the Arts252 D South Main Street

Pomona, CA 91766(909) 397-9716



Elda Sevilla, Chairperson

Staff Contact:Martin Vicente, Community Outreach &Education, Ext. 4423

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