AGR-7308 - CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (DHCS) - INTERGOVERNMENTAL AGREEMENT REGARDING TRANSFER OF PUBLIC FUNDSCONTRACT#21-10183
INTERGOVERNMENTAL AGREEMENT REGARDING
TRANSFER OF PUBLIC FUNDS
This Agreement is entered into between the CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES ("DHCS") and the CITY OF ORANGE ("GOVERNMENTAL
FUNDING ENTITY")with respect to the matters set forth below.
The parties agree as follows:
AGREEMENT
1. Transfer of Public Funds
1.1 The GOVERNMENTAL FUNDING ENTITY agrees to make a transfer
of funds to DHCS pursuant to sections 14164 and 14301.4 of the Welfare and Institutions Code.
The amount transferred shall be based on the sum of the applicable rate category per member per
month("PMPM") contribution increments multiplied by member months, as reflected in Exhibit
1. The GOVERNMENTAL FUNDING ENTITY agrees to initially transfer amounts that are
calculated using the Estimated Member Months in Exhibit 1, which will be reconciled to actual
enrollment for the service period of January 1, 2021 through December 31, 2021 in accordance
with Sub-Section 1.3 of this Agreement. The funds transferred shall be used as described in Sub-
Section 2.2 of this Agreement. The funds shall be transferred in accordance with the terms and
conditions, including schedule and amount, established by DHCS.
1.2 The GOVERNMENTAL FUNDING ENTITY shall certify that the funds
transferred qualify for Federal Financial Participation pursuant to 42 C.F.R. part 433,subpart B,
and are not derived from impermissible sources such as recycled Medicaid payments, Federal
money excluded from use as State match, impermissible taxes, and non-bona fide provider-
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related donations. Impermissible sources do not include patient care or other revenue received
from programs such as Medicare or Medicaid to the extent that the program revenue is not
obligated to the State as the source of funding.
1.3 DHCS shall reconcile the"Estimated Member Months,"in Exhibit 1, to
actual enrollment in HEALTH PLAN(S) for the service period of January 1, 2021 through
December 31, 2021 using actual enrollment figures taken from DHCS records. Enrollment
reconciliation will occur on an ongoing basis as updated enrollment figures become available.
Actual enrollment figures will be considered final two years after December 31, 2021. If
reconciliation results in an increase to the total amount necessary to fund the nonfederal share of
the payments described in Sub-Section 2.2, the GOVERNMENTAL FUNDING ENTITY agrees
to transfer any additional funds necessary to cover the difference. If reconciliation results in a
decrease to the total amount necessary to fund the nonfederal share of the payments described in
Sub-Section 2.2, DHCS agrees to return the unexpended funds to the GOVERNMENTAL
FUNDING ENTITY. If DHCS and the GOVERNMENTAL FUNDING ENTITY mutually
agree, amounts due to or owed by the GOVERNMENTAL FUNDING ENTITY may be offset
against future transfers.
2. Acceptance and Use of Transferred Funds
2.1 DHCS shall exercise its authority under section 14164 of the Welfare and
Institutions Code to accept funds transferred by the GOVERNMENTAL FUNDING ENTITY
pursuant to this Agreement as IGTs,to use for the purpose set forth in Sub-Section 2.2.
2.2 The funds transferred by the GOVERNMENTAL FUNDING ENTITY
pursuant to Section 1 and Exhibit 1 of this Agreement shall be used to fund the non-federal share
of Medi-Cal Managed Care actuarially sound capitation rates described in section 14301.4(b)(4)
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of the Welfare and Institutions Code as reflected in the contribution PMPM and rate categories
reflected in Exhibit 1. The funds transferred shall be paid, together with the related Federal
Financial Participation,by DHCS to HEALTH PLAN(S) as part of HEALTH PLAN(S)'
capitation rates for the service period of January 1, 2021 through December 31, 2021, in
accordance with section 14301.4 of the Welfare and Institutions Code.
2.3 DHCS shall seek Federal Financial Participation for the capitation rates
specified in Sub-Section 2.2 to the full extent permitted by federal law.
2.4 The parties acknowledge that DHCS will obtain any necessary approvals
from the Centers for Medicare and Medicaid Services.
2.5 DHCS shall not direct HEALTH PLAN(S)' expenditure of the payments
received pursuant to Sub-Section 2.2.
3. Assessment Fee
3.1 DHCS shall exercise its authority under section 14301.4 of the Welfare
and Institutions Code to assess a 20 percent fee related to the amounts transferred pursuant to
Section 1 of this Agreement, except as provided in Sub-Section 3.2. GOVERNMENTAL
FUNDING ENTITY agrees to pay the full amount of that assessment in addition to the funds
transferred pursuant to Section 1 of this Agreement.
3.2 The 20-percent assessment fee shall not be applied to any portion of funds
transferred pursuant to Section 1 that are exempt in accordance with sections 14301.4(d) or
14301.5(b)(4) of the Welfare and Institutions Code. DHCS shall have sole discretion to
determine the amount of the funds transferred pursuant to Section 1 that will not be subject to a
20 percent fee. DHCS has determined that$0.00 of the transfer amounts will not be assessed a
20 percent fee, subject to Sub-Section 3.3.
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3.3 The 20-percent assessment fee pursuant to this Agreement is non-
refundable and shall be wired to DHCS simultaneously with the transfer amounts made under
Section 1 of this Agreement. If at the time of the reconciliation performed pursuant to Sub-
Section 1.3 of this Agreement, there is a change in the amount transferred that is subject to the
20-percent assessment in accordance with Sub-Section 3.1, then a proportional adjustment to the
assessment fee will be made.
4. Amendments
4.1 No amendment or modification to this Agreement shall be binding on
either party unless made in writing and executed by both parties.
4.2 The parties shall negotiate in good faith to amend this Agreement as
necessary and appropriate to implement the requirements set forth in Section 2 of this
Agreement.
5. Notices. Any and all notices required,permitted, or desired to be given hereunder
by one party to the other shall either be sent via secure email or submitted in writing to the other
party personally or by United States First Class, Certified or Registered mail with postage
prepaid, addressed to the other party at the address as set forth below:
Any required signature(s) on any documents must be in compliance with California
Government Code section 16.5 and any other applicable state or federal regulations.
To the GOVERNMENTAL FUNDING ENTITY:
Rob Houston, City Manager
City of Orange
300 E. Chapman Ave.
Orange, CA 92866
rhouston@cityoforange.org
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Will Kolbow,Assistant City Manager
City of Orange
300 E. Chapman Ave.
Orange, CA 92866
wkolbow@cityoforange.org
With copies to:
Katrin Bandhauer, Assistant Finance Director
City of Orange
300 E. Chapman Ave.
Orange, CA 92866
kbandhauer@cityoforange.org
Michelle Kresan, Budget Manager
City of Orange
300 E. Chapman Ave.
Orange, CA 92866
mkresan@cityoforange.org
To DHCS:
Vivian Beeck
California Department of Health Care Services
Capitated Rates Development Division
1501 Capitol Ave., MS 4413
Sacramento, CA 95814
Vivian.Beeck@dhcs.ca.gov
6.Other Provisions
6.1 This Agreement contains the entire Agreement between the parties with
respect to the Medi-Cal payments described in Sub-Section 2.2 of this Agreement that are funded
by the GOVERNMENTAL FUNDING ENTITY, and supersedes any previous or
contemporaneous oral or written proposals, statements, discussions, negotiations or other
agreements between the GOVERNMENTAL FUNDING ENTITY and DHCS relating to the
subject matter of this Agreement. This Agreement is not, however, intended to be the sole
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agreement between the parties on matters relating to the funding and administration of the Medi-
Cal program. This Agreement shall not modify the terms of any other agreement, existing or
entered into in the future,between the parties.
6.2 The non-enforcement or other waiver of any provision of this Agreement
shall not be construed as a continuing waiver or as a waiver of any other provision of this
Agreement.
6.3 Sections 2 and 3 of this Agreement shall survive the expiration or
termination of this Agreement.
6.4 Nothing in this Agreement is intended to confer any rights or remedies on
any third party, including, without limitation, any provider(s) or groups of providers, or any right
to medical services for any individual(s) or groups of individuals. Accordingly, there shall be no
third party beneficiary of this Agreement.
6.5 Time is ofthe essence in this Agreement.
6.6 Each party hereby represents that the person(s) executing this Agreement
on its behalfis duly authorized to do so.
7.State Authority. Except as expressly provided herein, nothing in this Agreement
shall be construed to limit, restrict, or modify the DHCS' powers, authorities, and duties under
Federal and State law and regulations.
8. Approval. This Agreement is of no force and effect until signed by the parties.
9. Term. This Agreement shall be effective as ofJanuary 1, 2021 and shall expire as
of June 30, 2024 unless terminated earlier by mutual agreement of the parties.
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SIGNATURES
IN WITNESS WHEREOF,the parties hereto have executed this Agreement, on
the date of the last signature below.
THE CITY OF ORANGE:
By: Date: q'
Mark Murphy, Mayor,
ATTEST:_
Pamela Coleman, City Clerk
APPROVED AS TO FORM:
Mary E. inning, Assist t ity Attorney
THE STATE OF CALIFORNIA, DEPARTMENT OF HEALTH CARE SERVICES:
By: 04.45.4e r
Date: /i //r/2.Z
Rafael Davtian, Division Chief, Capitated Rates Development Division
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Exhibit 1
Health Plan: CalOptima
Rating Region: Orange
Service Period 1/2021- 12/2021
Estimated
Contribution Estimated;;. Contribution(Non-
Rate Category PMPM Member Months* `•Federal Share):
Child- non MCHIP '_ 0.03 44;432,016'`• $` • 72,42
Child- MCHIP 0.02 1;276,065 $ 25,521
Adult- non MCHIP (non CCI) $ 0.07 1,237,366 $ 86,616
Adult- MCHIP (non CCI)0.05 31,903 $ 1,595
ACA Optional Expansion 0.02 3,297,759 $ 65,955
SPD 0.16 494,384 $ 79,101 .
SPD/Full-Dual(non CCI) 0.05 24;161 $ 1,208.
LTC 1.72 17,540 $ 30,169
Whole Child Model 0.38 112,706 $ 42,828
Estimated Total 8,923,960 $ 405,955
Note that Estimated Member Months are subject to variation, and the actual total Contribution
Non-Federal Share) may differ from the amount listed here.
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