AGR-6810 - CALIFORNIA DEPARTMENT OF HEALTH SERVICES - INTERGOVERNMENTAL AGREEMENT REGARDING TRANSFER OF PUBLIC FUNDSA R B a
CONIRACT#18-95607
INTERGOVERNNI NTAL AGREEMENT REGARDING
TRANSFER OF PUBLIC FUNDS
This Agreement is entered into 6etween the CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES ("DHCS")and the C1TY OF ORANGE (GOVERNM+NTAL
FUNDING ENTITP) with respect to the matters set forth below.
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The pazties agree as follows:
AGREEMENT
1. Trinsfer of Public Funds
1.I The GOVERNMENTAL FUNDING ENTITY agrees to make a transfer
of funds to DHCS pursuant to sections 14164 and 14301.4 of the Welfare and Tnstitutions Code.
The amount transferred sbal]be based on the sum of the applicable rate category per membex per
mon[h(PMPNn contribuGon increments mulliplied 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 Exlvbit 1, which will be reconciled to ac[ual
enrollmeat for the service period of July 1,2018 through June 30,2019 in accordance with Sub- j
Secdon 13 of this Agreement. The funds transferred sh ill be used as described in Sub-Section i
2.2 of this Agreement.The funds shall be transferred in accordance with the terms and
conditions, including schedule and amount, esfablished by DHCS. i
12 The GOVERNMENTAL FUNDING ENTITY shall certify that the funds
transferred qualify for Federal Financial Participation pursuant to 42 C.F.R.pazt 433, subpart B,
and are not derived from unpermissible sourees 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 inclnde pafient care or o[her revenue received
Irom programs such as Medicare or Medicaid to the extent that the program revenue is not
obiigated to the State as the soarce of funding.
1.3 DHCS shall reconcile the"Estimated Membet Moaths," in E chibit 1, to
actual encollmen[in HEALTH PLAN(S) for[he service period of hily 1,2018 [}uough June 30,
2019 using actual enrollment£igures taken from DHCS cecords. Enrollment reconciliation will
occur on an ongoing basis as updated enrollment figures become available. Actual enrollment
figures will be considered Gnal two yeazs afrer Jnne 30,2019. If this reconcilia6on results in an
inciease[o t6e tot tl amount necessary[o fund[he nonfederal share of the payments described in
Sub-Section 2.2, [he GOVERNMENTAL FUNDING ENT7TY agrees to transfer any additional
fitnds necessazy to cover the difPerence. If this reconciliation results in a decrease to the[otal
amount necessary to fund the nonfedecal share of the pay[nents described in Sub-Section 2.2,
DHCS agrees to retum the unexpended fiands to the GOVERN'NTAL FUNDING ENTTTY.
If DHCS and the GOVERNMENTAL FUNDING ENTTI'Y mutually agree, amounts due to or
owed by the GOVERNMENTAL FLINDING ENTITY may be offset against future transfers.
2. Acceptance and Use of Transferred Funds
2.1 DHCS shall exercise its authority under secfion 14164 of the Welfue and
Institutions Code to accept funds transferred by the GOVERNMENTAL FUNDING ENTITY
pursuant to this Agceement as IGTs, to use for the purpose set forth in Sub-Sec6on 2.2.
2.2 The funds transferred by the GOVERNMENTAL FIJNDING 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 acmazially sound capitation rates described in section 14301.4@)(4)
of the Welfare and Institutions Code as reflected in the contribution PMPM and rate categories
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reflected in ExhibiY 1.The funds uansferred shall be paid, together with the related Federal
Financial Puticipation,by DHCS to HEALTH PLAN(S) as pazt of HEALTH PLAN(S)'
capitaaon ra[es for the service period of July 1,2018[luough June 30,2019,in accordance wi[h
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section 14301.4 of the Welfaze aud Institutions Code.
23 DHCS shall seek Federal Financial Participation for the capitation rates
specified in Sub-Section 2.2 to the full extent permitted by federal law. i
2.4 The parties acknowledge that DHCS will ob[ain any necessuy approvals
from the Centers for Medicare and Medicaid Services.
2.5 DHCS shall not direct HEALIT3 PLAN(S)' expenditure of the payments
received pnrsuant to Sub-Seclion 2.2.
3, Assessment Fee
3.1 DHCS shall exercise its au[hority under sec[ion 14301.4 of the Welfaze
and Institutions Code to assess a 20 peccent fee related to the amounts u ansferted pursuant to
Section 1 of this Agreement, except as provided in Sub-Section 3.2. GOVERNMENTAL
FiINDING EN1TT'Y agrees to pay[he full amount of that assessment in addition to the funds
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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 aze exempt in accordance with sections 14301.4(d) or
14301.5(b)(4) of the Welfare and InsUNtions Code.DHCS shall have sole discreUon[o I
de[erntine[he 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 aznounts wlll not be assessed a
20 peccent fee, subjec[,to Sub-Section 3.3.
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33 The 20-percent assessment fee pursuant ro this Agreement is non-
refundable and shall be wired to DHCS separately from, and simultaneous to, the transfer
amounts made under Section l of this Agreement. If,at the time of the reconciliation perFormed
pursuant to Sub-Section ]3 of[his Agreement, there is a change in [he amount transferred th t is
subject to the 20-percent assessment in accordance wi[h Sub-Secuon 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 implemenc the requirements set forth in Section 2 of this
Agreement.
5. Notices. Any and all notices required,permi[ted or desired to be given hereunder
by one party ro the other shall be in wri[ing and shall be delivered[o the other party personally or
by United States First Class, Certified or Registered mail with postage prepaid, addressed to the
other paRy a[the address set forth below:
To the GOVERNMENTAL FUNDING ENTITY:
Rick Otto, City Manager
City of Orange
300 E. Chapman Ave.
Orange,CA 92866
rotto @ c itvoforan ee.ors
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With copies [o: j
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Ka[rin Bandhauer, Assistant Finance Director ICiryofOrange
300 E. Chapman Ave.
Orange, CA 92866
kb ndhauerC cityoforan e.ore
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To DHCS: I
Sandra Dixon
California Department of Health Care Services I
Capita[ed Rates Development Division
1501 Capitol Ave., Suite 71-4002
MS 4413
Sacramento, CA 95814
Sandra.Dixon @dhcs.ca.ov
6. Other Provisions
6.1 This Agreement con[ains the en[ire Agreement between the parties with
respec[ to Ihe Medi-Cal paymen[s described in Sub-Section 2.2 of this Agreement [hat ue funded
by the GOVERNMENTAL F[JNDING ENTITY,and supersedes any previous or
contemporaneous oral or written proposals,statemen[s,discussions, negotiations or o[her
agreements between the GOVERNMENTAL FUNDING ENTITY und DHCS relating to the
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subject matter of this AgreemenL This Agreement is not,however, in[ended ro be the sole
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agreemen[between Ihe parties on matters relating to the funding and adminis[ration of the Medi-
Cal program. This Agreement shall not modify the terms of any o[her agreement, existing or I
entered into in the fiiture, between the par[ies.
6.2 The non-enforcement or other waiver of any provision of this Agreement
shall not be cons[rued as a continuing waivet or as a waiver of any other provision of this
Agreement.
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6.3 Sections 2 and 3 of this Agreement shall survive the expiratioo or
terminauon of this Agreement.
6.4 Nothing in this Agteement is intended ro confer any rights or remedies on
ny third party,including,without limitation, any providet(s) or groups of prnviders,or any right
to medical services for any individual(s) or groups of individuaLs. Accordiogly, thece shall be no
third pazty beneficiary of[his Agreement.
6.5 Time is of the essence in this Agteement.
6.6 Each party hereby represents that the person(s) executing this Agm,ement
on its behalf is duly authorized to do so.
7. State Authoritv.Except as expressly piovided herein,noching in this Agreement
shall be construed to limit,restrict, or modify the DHCS' powers, authorities, and dufies under
Federal and State law and regulations.
8. Anoroval.This Agreemeu[is of no force and effect until signed by the parties.
9. Term.This Agreemen[shall be effective as of 7uly 1,2018 and shall expire as of
December 31,2021 unless terminated eaclier hy mutual agreement of the puties.
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SIGNATURES
IN WTTNESS WHEREOF, the p rties hereto have executed this Agreement,on
the date of the last si;natnre below.
THE CITY OF ORANGE:
By; Date:
Mark A. Murphy, Mayor I
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ATTEST: j
G:/1--
Pamela Coleman, City Clerk i
APPROVED AS TO FORM: I
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Mary E. Bi ing, Sr. Asst City ttorney
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THE STATE OF CALIFORNIA, DEPARTMENT OF HEALTH CARE SERVICES:
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By: Date:
Ied iifeyLopez, Di ision Chie , Capi[ated Rates Development Division i
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Exhibit 1
Fruuliug Entity: CSty of Oraage
HealthPlan: CalOptima
Rating Region: Omnge
Fstimated
Fstimated Member Conmbution(Non-
Rate Catego ConVibution PMPM Months Federnl Share)
Child- non MCffiP 0.03 2,517,705 $ 75,531
C[ild -MCI-IIP 0.01 1,307,665 $ 13,077
Adult- non MCIIIP 0.10 1,126,289 $ 112,629
Adult-MCHII 0.02 40,055 $ 80]
SPD 0.24 482,490 $ 115,798
SPD/Pull-Dual 0.06 26,675 $ 1,601
BCCTP 036 7,396 ^ 2,663
LTC 2.14 14,780 $ 31,629
LTClFuIF Dual 1.10 36,930 $ 40,623
O tionalExpansion 0.01 2,831,403 $ 28,314
Fstimated Total 8,391,388 $ 422,666
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