HomeMy WebLinkAboutCalifornia Department of Health Services (DHCS) and Orange County Health Authority dba CalOptima Health - 2025-09-01 �011ING 2000 Main Street,
r��� Huntington Beach,CA
1:111016.4C 92648
City of Huntington Beach
APPROVED 7-0
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� �GUNTY t ✓'d
File#: 25-838 MEETING DATE: 11/4/2025
REQUEST FOR CITY COUNCIL ACTION
SUBMITTED TO: Honorable Mayor and City Council Members
SUBMITTED BY: Travis Hopkins, City Manager
VIA: Eric McCoy, Fire Chief
PREPARED BY: Kevin Justen, Senior Management Analyst
Subject:
Authorize designated City staff to execute the Intergovernmental Agreement Regarding
-Transfer of Public Funds between the California Department of Health Care Services (DHCS)
and the City of Huntington Beach and the Health Plan-Provider Agreement -
Intergovernmental Transfer Rate Range Program Agreement between CalOptima Health and
the City of Huntington Beach; and approve a payment of$722,804 to DHCS for FY 2025/26
Statement of Issue:
City Council is requested to designate and authorize the City Manager, Chief Financial Officer, and/or
Fire Chief to execute the Intergovernmental Agreement Regarding Transfer of Public Funds
between the California Department of Health Care Servies (DHCS) and the Health Plan-Provider
Agreement- Intergovernmental Transfer Rate Range Program Agreement between CalOptima
Health and the City of Huntington Beach and approve a payment of$722,804 to DHCS.
Financial Impact:
Funding in the amount of$730,816 has been included in the FY 2025/26 Budget for participation in
the program. With these agreements and the City's payment of$722,804, it is anticipated that an
estimated $1,732,305 in funds will be distributed to the City of Huntington Beach, resulting in a net
revenue of approximately $1,001,489 for additional reimbursement of Medi-Cal Managed Care
services that were incurred and unreimbursed for the service period of January 1, 2024 through
December 31, 2024.
Recommended Action:
A) Authorize the designation of the City Manager, Chief Financial Officer, and/or Fire Chief to
execute the agreement between the California Department of Health Care Servies (DHCS) and the
Health Plan-Provider Agreement - Intergovernmental Transfer Rate Range Program Agreement
between CalOptima Health and the City of Huntington Beach; and
B) Approve a payment of $722,804 to the California Department of Health Care Services for the
agreement during FY 2025/26.
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File#: 25-838 MEETING DATE: 11/4/2025
Alternative Action(s):
Do not approve the recommended action(s), and direct staff accordingly.
Analysis:
Since the 2022/23 fiscal year, the City of Huntington Beach has participated in the Voluntary Rate
Range Intergovernmental Transfer Program (VRRP IGT) through the California Department of Health
Care Services. This program allows the City to recover unreimbursed City costs for service to
CalOptima patients. DHCS distributes the funds to eligible entities through CalOptima Health.
The City's ongoing participation in the program is dependent on available funding for the program
and the City's ability to provide the upfront contribution required. The net revenue received annually
by the City is also dependent on a number of factors, including the number of program participants in
the County and the number of Medi-Cal calls for service.
If the City Council approves the recommended actions, the agreement with DHCS would require an
upfront payment of$722,804. Once paid, an estimated $1,732,305 will be disbursed to the City
within approximately 60 days through CalOptima, for a net revenue of$1,001,489. The 60-day time
estimate is based on the actual transfer dates of previous years' VRRP IGT. The required upfront
payment and subsequent disbursement from CalOptima are based on Medi-Cal managed care
services provided by the City during the January 1, 2024-December 31, 2024, period.
The agreements with DHCS and CalOptima are attached for reference, along with the funding letter
from DHCS.
Environmental Status:
This action is not subject to the California Environmental Quality Act (CEQA) pursuant to Sections
15060(c)(2) (the activity will not result in a direct or reasonably foreseeable indirect physical change
in the environment) and 15060(c)(3) (the activity is not a project as defined in Section 15378) of the
CEQA Guidelines, California Code of Regulations, Title 14, Chapter 3, because it has no potential for
resulting in physical change to the environment, directly or indirectly.
Strategic Plan Goal:
Goal 2 - Fiscal Stability, Strategy A- Consider new revenue sources and opportunities to support the
City's priority initiatives and projects.
Attachment(s):
1. Agreement between the Department of Health and Human Services (DHCS) and the City of
Huntington Beach
2. Agreement between CalOptima Health and the City of Huntington Beach
3. Funding Letter from California Department of Health Care Services
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CONTRACT.# IGT-24-0013
INTERGOVERNMENTAL AGREEMENT REGARDING
TRANSFER OF PUBLIC FUNDS
This Agreement is entered into between the CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES ("DHCS") and CITY OF HUNTINGTON BEACH
("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, 2024.through December 31, 2024.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 1,2024 through
December 31,2024 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 31,2024. 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 Intergovernmental Transfer(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
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of Medi-Cal Managed Care actuarially sound capitation rates described in section 14301.4(b)(4)
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 1,2024 through December 31, 2024, 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
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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.
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: .
To the GOVERNMENTAL FUNDING ENTITY:
Eric McCoy,Fire Chief
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CONTRACT# IGT-24-0013
2000 Main Street
Huntington Beach, CA 92648
(714) 536-5411
emccoy(isurfcity-hb.org
With copies to:
Justin Fleming, Division Chief
2000 Main Street
Huntington Beach, CA 92648
(714) 536-5411
jfleming@surfcity-hb.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@a,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
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.
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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 of the essence in this Agreement.
6.6 Each party hereby represents that the person(s) executing this Agreement
on its behalf is duly authorized to do so: 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.
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.
$. . Approval. This Agreement is of no force and effect until signed by the parties.
9. 'Term. This Agreement shall be effective as of January 1, 2024 and shall expire as
of June 30, 2027 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.
CITY OF HUNTINGTON BEACH:
DoeuSignnnedd'/�by:
rV
fric �t,abi June 11, 2025
B '--3C8D2E2A366845B Date:
y
Eric McCoy, Fire Chief
THE STATE OF CALIFORNIA, DEPARTMENT OF HEALTH CARE SERVICES:
,—S,.d by
$t a.A. bewi,t,Y' October 24, 2025
By: '-e6G019F99C13456- Date:
Authorized Representative, Department of Health Care Services
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Exhibit 1
Health Plan Funding Entity Rating Region Service Period Participation%
CalOptima City of Huntington Beach Orange . 1/2024-12/2024 1.00%
Contribution Estimated Member Estimated
Category of Aid, SIS/UIS PMPM Months* Contribution(Non
Federal Share)
Child SIS $ 0.04 3,087,562 $ 123,502.
Child. UIS $ - 189,630 $ -
Adult - SIS - $ 0.08 999,357 $ 79,949
Adult UIS. $. 0.06 614,214 $ 36,853
Adult Expansion SIS . $ 0.02 3,2E4,674 $ 65,293
Adult Expansion UIS. $ 0.01 746,598 $ 7,466
SPD SIS $ 0.27 401,788 $ 108,483
SPD UIS . $ 0.17 116,938 $ 19,879
SPD Dual SIS $ 0.10 1,241,498 $ 124,150
SPD Dual UIS $ 0.03 10,576 $ 317
LTC SIS: . $ 0.27 1,997,$ 539
LTC UIS $ 0.17 1,429,$ 243
LTC Dual SIS $ 0.11 26,935,$ 2,963
LTC Dual : UIS $ : 0.03 302 $ 9
WCM SIS . . $ 0.34 112,441 $ 38,230
WCM UIS $ 0.12 . 4;199 $ 504 ..
Est.FE Total 10,820,138 $ 608,380
*Note that Estimated Member Months are subject to variation, and the actual total Contribution
(Non-Federal Share)may differ from the amount listed here.
* FMAP is'a weighted blend of multiple FMAPs.
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INTERGOVERNMENTAL AGREEMENT REGARDING
TRANSFER OF PUBLIC FUNDS
This Agreement is entered into between the CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES ("DHCS")and CITY OF HUNTINGTON BEACH
("GOVERNMENTAL FUNDING ENTITY")with respect to the matters set forth below.
The arties(agree as follows:
p
AGREEMENT 9, '
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
;
, E
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 1,2024 through December 31,2024 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. part433, 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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{
CONTRACT#IGT-24-0013
related donations,Impermissible sources du 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 1,2024 through
December 31,2024 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 31,2024. 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 sharo 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 Intergovernmental Transfer(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
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of Medi-Cal Managed.Care actuarially sound capitation rates described in section 14301.4(b)(4)
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 1,2024 through December 31,2024, 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 1430.1..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
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CONTRACT#IGT-24-0013
20 percent fee.DHCS has determined that$0.00 of the transfer amounts will not be assessed a
20 percent fees subject to Sub-Section 3.3. •
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
st
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:
'To the GOVERNMENTAL FUNDING ENTITY:
•
Eric McCoy,Fire Chief 4
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•
CONTRACT#IGT-24-0013
2000 Main Street
Huntington Beach; CA 92648
(714) 536-5411
emccoyasurfcity hb:org
With copies to.: `
Justin Fleming,Division Chief
2000 Main Street
Huntington Beach, CA 92648
(714)536=5411
jfleming( sutfcity-hb.org
YI
To DHCS: Vivian Beeck
California Department of Health Care Services
.Capitated Rates Development Division
1501 Capitol Ave.,MS 4413
Sacramento,CA 95814
Vivian.Beeek@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
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.
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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
1 s
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 of the essence in this Agreement.
6.6 Each party hereby represents that the person(s) executing this Agreement
on its behalf is duly authorized to do so. 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.
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
{ E
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 of January 1,2024 and shall expire as
of June 30,2027unless 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,
CITY OF HUNTINGTON BEACH:
By: Date:
THE STATE OF CALIFORNIA,DEPARTMENT OF HEALTH CARE SERVICES:
By: Date:
Authorized Representative,Department of Health Care Services
APPFt VE AS JO ORM
134icHAEL J.VIGLIOTTA
CITY ATTORNEY vi
CITY OF HUNTINGTON BEAC
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f •
Exhibit 1
Health Plan, Funding Entity Rating Region, Service Period Participation
CalQptima City of Huntington Beach Orange 1j2024-12%2024 1.00%
Contribution Estimated Member Estimated
Category of Aid SIS/UIS- pMPM Months* Contribution(Non •
-
Federal Share)
Child • SIS- $ 0,04 3,087,562 $ 123,502
Child UIS $ - 189,630
Adult SIS $ 0.08 999,357 $ 79,949
Adult UIS $ 0.06 614,214 $ 36,853
Adult Expansion SIS $ 0.02 .3,264,674 $ 65,293 II ?
Adult Expansion . UIS $ 0.01 746,598 $ 7,466 i '£
SPD SIS $ 0.27 401,788 $ 108;483
SPD • UIS $ 0,17 116,938 $ 19,879•
I s
SPD Dual SIS • $ 0.10 1,241,498 $ 124,150:
SPD Dual UIS $ 0.03 10,576 $ 317 I
LTC SIS $ 0.27 1,997 $ 539 i s
LTC UIS $ 0,17 1,429 $ 243 •
LTC Dual SIS. $ 0;11 26,935 $ 2,963 � •
LTC Dual UIS $ 0,03 302 $ 9
WCM SIS $ 0.34 112,441 $ 38,230 i
WCM U1S $ 0.12 4,199 $ 504 E
Est.FETotal 10,820,138 $ 608,380
1
*Note that Estimated Member Months are subject to variation, and the'actual total Contribution
(Non-Federal Share)may differ from the amount listed here. •
*FMAP is a weighted,blend of multiple FMAPs. •
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,
HEALTH PLAN-PROVIDER INTERGOVERNMENTAL TRANSFER
RATE RANGE PROGRAM AGREEMENT
This Health Plan-Provider Intergovernmental Transfer Rate Range Program Agreement
("Agreement") is effective September 1,2025 ("Effective Date"),by and between Orange County
Health Authority, a California local agency doing business as CalOptima Health ("PLAN"), and
the City of Huntington Beach, a California municipal corporation operating through its fire
department("PROVIDER"). PLAN and PROVIDER may each be referred to herein as a"Party"
and collectively as the "Parties".
RECITALS
WHEREAS, PE AN is a county organized health system formed pursuant to California
Welfare and Institutions Code § 14087.54 and Orange County Ordinance No. 3896 (as amended
by Ordinance Nos. 00-8, 05-008, 06-012, 09-001, 11-013, 14-002 and 16-001).
WHEREAS, PLAN is party to a Medi-Cal managed care contract with the California
Department of Health Care Services ("DHCS"), entered into pursuant to Welfare and Institutions
Code § 14087.3, under which PLAN arranges and pays for the provision of covered Medi-Cal
health care services to eligible members residing in Orange County and enrolled in PLAN's Medi-
Cal program ("Members").
WHEREAS, PROVIDER is an emergency transport provider that provides transportation
on a non-contract basis, including to Members.
WHEREAS, PLAN and PROVIDER desire to enter into this Agreement to provide
Intergovernmental Transfer Medi-Cal Managed Care Rate Range Increases ("IGT Rate
Increases") from PLAN to PROVIDER to maintain the availability of Medi-Cal health care
services to Medi-Cal beneficiaries, as set forth in the Agreement.
NOW, THEREFORE, PLAN and PROVIDER, in consideration of the promises and the
mutual covenants herein stated, hereby agree as follows:
AGREEMENT
1. IGT Rate Range Increases
A. Payment
Should PLAN receive any IGT Rate Increases from DHCS where the nonfederal share is
funded by PROVIDER specifically pursuant to the provisions of the Intergovernmental Agreement
Regarding Transfer of Public Funds (Contract#IGT-24-0013)between PROVIDER AND DHCS,
("Intergovernmental Agreement")with a term of January 1,2024 through June 30,2027 for IGT
Rate Increases, PLAN shall pay to PROVIDER the amount of the IGT Rate Increases received
from DHCS, in accordance with Section 1.E below regarding the form and timing of Local Medi-
Cal Managed Care Rate Range ("Local Range") IGT payments. Local Range IGT payments paid
to PROVIDER shall not replace or supplant any other amounts paid or payable to PROVIDER by
PLAN.
B. PLAN Administrative Fee
i. PLAN shall retain two percent (2.0%) of the IGT Rate Increase payments
to PROVIDER (after reimbursing PROVIDER's initial contribution to the IGT Rate Increase
("Administrative Fee"), prior to disbursing Local Range IGT payments to PROVIDER. PLAN
will expend the Administrative Fee to cover expenses for administering the IGT payments.
PROVIDER's share of the IGT Rate Increase funds shall be calculated based on PROVIDER's
proportionate share of the Local Range IGT Payment made by PLAN in Orange County to the
respective funding entities.
ii. Any amounts referenced in this Agreement are estimates. The Parties
understand and agree that the total amount of the IGT Rate Increases paid by DHCS to PLAN may
fluctuate as a result of Member enrollment in PLAN's Medi-Cal program and the number of
entities participating in the IGT program. The Parties further understand and agree that any such
fluctuations will likewise affect the amount to be retained by PLAN and the amount payable to
PROVIDER by the same percentage as the variance in the IGT Rate Increases, if any.
iii. PLAN will ultimately not retain any other portion of the IGT Rate Increases
received from DHCS other than the Administrative Fee.
C. Conditions for PROVIDER Receiving Local Range IGT Payments
As a condition for receiving Local Range IGT payments, PROVIDER shall, as of the date
the particular Local Range IGT Payment is due:
i. continue to provide emergency transport services to Members promptly and
in a manner that ensures access to care consistent with PROVIDER's regular business practices
for providing such services; and
ii. not discriminate against Members or in any way, including based on type
of insurance, or impose limitations on the acceptance of Members for care or treatment that are
not imposed on other patients of PROVIDER.
D. Schedule and Notice of Transfer of Non-Federal Funds
i. PROVIDER shall provide PLAN with a copy of the schedule regarding the
transfer of funds to DHCS referred to in the Intergovernmental Agreement within fifteen (15)
calendar days of establishing such a schedule with DHCS. Additionally, PROVIDER shall notify
PLAN in writing within seven (7) calendar days prior to any changes to an existing schedule with
DHCS, including, but not limited to, changes to the amounts specified therein.
ii. PROVIDER shall provide PLAN with written notice of the amount and date
of the transfer within seven (7) calendar days after funds have been transferred by PROVIDER to
DHCS for use as the nonfederal share of any IGT Rate Increases.
E. Form and Timing of Payments
Page 2 of 8
PLAN agrees to pay Local Range IGT Payments owed to PROVIDER under this
Agreement in the following form and according to the following schedule:
i. PLAN agrees to pay the Local Range IGT payments to PROVIDER using
the same mechanism through which compensation and payments are normally paid by PLAN to
PROVIDER(e.g., electronic transfer).
ii. PLAN will pay the Local Range IGT payments to PROVIDER no later than
thirty (30)calendar days after receipt of the IGT Rate Increases from DHCS, unless PLAN cannot
not make the payment until a later date based on no fault of PLAN, in which case PLAN will pay
the Local Range IGT payment as soon as reasonably practicable.
F. Consideration
i. As consideration for the Local Range IGT payments,PROVIDER shall use
the Local Range IGT payments solely as follows:
a. The Local Range IGT payments are compensation for emergency
ambulance services rendered to Members by PROVIDER between January 1,2024,and December
31, 2024 ("Payment Period"), and shall be used by PROVIDER solely to fund the costs that
exceed the fee-for-service rates paid by PLAN for Medi-Cal-covered services provided to
Members during the Payment Period.
To the extent that total payments received by PROVIDER under this Agreement
exceed the cost of Medi-Cal-covered services provided to Members by PROVIDER during the
Payment Period, the remaining Local Range IGT payment amounts shall constitute an
overpayment, and PROVIDER shall return those funds to PLAN pursuant to Section 1.K.
ii. Both Parties agree that none of these funds, either originally from
PROVIDER or the federal matching funds will be recycled back to PROVIDER'S general fund,
the State of California ("State"), including DHCS, or any other intermediary organization.
Payments made by Plan to PROVIDER under the terms of this Agreement constitute patient care
revenues.
G. Oversight and Compliance Responsibilities
i. PLAN's oversight responsibilities regarding PROVIDER's use of the Local
Range IGT payments are limited to this section. PLAN shall request, within thirty (30) calendar
days after the end of each State fiscal year in which Local Range IGT payments were transferred
to PROVIDER, a written confirmation that states whether and how PROVIDER complied with
the provisions set forth in Section 1.F. In each instance, PROVIDER shall provide PLAN with
written confirmation of compliance within thirty (30) calendar days of PLAN's request.
ii. PROVIDER shall ensure at all times that its use of Local Range IGT
payments received under this Agreement complies with the terms of the Agreement, applicable
laws, and Centers for Medicare &Medicaid Services ("CMS") and DHCS requirements.
H. Cooperation Among Parties
Page 3 of 8
i. Should disputes or disagreements arise regarding the ultimate computation
or appropriateness of any aspect of the Agreement, including the Local Range IGT payments,
PROVIDER and PLAN agree to meet and confer in good faith and cooperate in all respects to
resolve the dispute and support and preserve the Local Range IGT payments to the full extent
possible on behalf of the safety net in Orange County.
ii. If the Parties are unable to resolve any dispute arising out of or relating to
this Agreement under Section 1.H.ii,either Party may submit the dispute for resolution exclusively
through confidential, binding arbitration, instead of through trial by court or jury, in Orange
County, California. The arbitration will be conducted by Judicial Arbitration and Mediation
Services ("JAMS") in accordance with the commercial dispute rules then in effect for JAMS;
provided, however, that this Agreement shall control in instances where it conflicts with JAMS's
(or the applicable arbitration service's) rules. The arbitration shall be conducted on an expedited
basis by a single arbitrator. In making decisions about discovery and case management, it is the
Parties' express agreement and intent that the arbitrator at all times promote efficiency without
denying either Party the ability to present relevant evidence. In reaching and issuing decisions,the
arbitrator shall have no jurisdiction to make errors of law and/or legal reasoning or to give a remedy
or award damages that would not be available to such prevailing Party in a court of law, nor will
the arbitrator have the authority to award punitive,exemplary,or treble damages.The Parties shall
share the costs of arbitration equally, and each Party shall bear its own attorneys' fees and costs.
iii. With the exception of any dispute that under applicable laws may not be
settled through arbitration, arbitration under Section I.H.ii is the exclusive method to resolve a
dispute between the Parties arising out of or relating to this Agreement that is not resolved through
the meet-and-confer processes. Notwithstanding the foregoing, either Party may institute
proceedings in a federal or state court of competent jurisdiction to seek temporary or preliminary
injunctive relief to enforce the status quo in any dispute relating to this Agreement pending the
resolution of that dispute through arbitration.
iv. PROVIDER acknowledges that Government Code § 911.2 requires a claim
against a government entity to be brought no later than one (1) year after the accrual of the cause
of action. As such, the Parties agree that arbitration under Section 1.H.ii must be initiated within
one (1) year of the earlier of the date the dispute arose, was discovered, or should have been
discovered with reasonable diligence; otherwise, the dispute will be deemed waived, and the
complaining Party shall be barred from initiating arbitration or other proceedings related to the
dispute, including any civil action in state or federal court.The deadline to file arbitration shall not
be subject to waiver, tolling, alteration, or modification of any kind or for any reason other than
fraud.
v. By agreeing to binding arbitration as set forth in Section 1.H.ii, the Parties
acknowledge that they are waiving certain substantial rights and protections which otherwise may
be available if a dispute between them was determined by litigation in a court, including the right
to a jury trial, attorneys' fees, and certain rights of appeal.
I. Reconciliation and Overpayment
Page 4 of 8
i. Within one hundred twenty (120)calendar days after the end of each PLAN
fiscal year in which PLAN made Local Range IGT payments to PROVIDER, PLAN shall perform
a reconciliation of the Local Range IGT payments transmitted to the PROVIDER during the
preceding fiscal year, including requesting PROVIDER to furnish proof of compliance with this
Agreement and applicable laws, to ensure that the supporting amount of IGT Rate Increases were
received by PLAN from DHCS.
ii. PROVIDER agrees to return to PLAN any overpayment of Local Range
IGT payments made in error to PROVIDER within thirty (30) calendar days after receipt from
PLAN of a written notice of the overpayment error,unless PROVIDER submits a written objection
to PLAN. Any such objection shall be resolved in accordance with the dispute resolution process
set forth in Section 1.H.
iii. PROVIDER shall report to PLAN any overpayment received under this
Agreement and identified by PROVIDER and to repay such overpayment to PLAN within sixty
(60) days of such identification by PROVIDER. PROVIDER acknowledges and agrees that, if
PLAN determines that an amount has been overpaid or paid in duplicate, or that funds were paid
which were not due under this Agreement to PROVIDER,PLAN may recover such amounts from
PROVIDER by recoupment or offset from current or future amounts due from PLAN to
PROVIDER under any contract between the Parties, after giving notice and an opportunity to
return/pay such amounts.
iv. The reconciliation process established under this section is distinct from the
indemnification provisions set forth in Section 1.J below. PLAN agrees to transmit to the
PROVIDER any underpayment of Local Range IGT payments within thirty (30) calendar days of
PLAN's identification of such underpayment.
J. DHCS Payment and Indemnification
i. PROVIDER agrees to and acknowledges the following: (1) PLAN has no
obligation to make any payments hereunder until PLAN has received IGT Rate Increases from
DHCS; (2) PLAN is not responsible for DHCS payments to PLAN, including any mathematical
calculations made by DHCS, and(3)PLAN is not responsible for the timing of the payments from
DHCS to PLAN (including the conditions precedent to the timing of such payments, which
includes the timing of DHCS submission to CMS and/or CMS review and approval). In addition,
PLAN and PROVIDER agree and acknowledge that nothing herein is intended to create an
obligation on the part of PLAN to agree to delays in capitation payment(s) from DHCS in order to
accommodate payments under this Agreement.
ii. Each Party agrees to defend, indemnify, and hold each other and DHCS
harmless with respect to any claims, costs, damages and expenses, including reasonable attorneys'
fees, that are related to or arise out of(i)the negligent or willful performance or non-performance
by the indemnifying Party of any functions, duties, or obligations of the Party under this
Agreement, or(ii) a Party's violation of applicable law.
2. Term and Termination
Page 5 of 8
A. This agreement shall commence on the Effective Date and shall expire on June
30, 2027.
B. Either Party may terminate this Agreement upon thirty (30) days' prior written
notice to the other Party if the other Party materially breaches a provision of the Agreement and
does not cure the breach within the thirty (30)-day notice period.
C. Either Party may terminate this Agreement without cause upon sixty (60) days'
prior written notice to the other Party.
3. Miscellaneous Provisions
A. Any failure of a Party to insist upon strict compliance with any provision of this
Agreement shall not be deemed a waiver of such provision or any other provision of this
Agreement. To be effective, a waiver must be in writing and signed and dated by the Parties.
B. Neither Party may assign this Agreement, either in whole or in part, without the
prior written consent of the other Party.
C. This Agreement may only be amended in a writing signed by both Parties.
D. Any notices required or permitted under this Agreement shall be in writing and
delivered to the addresses set forth below in this Section 3.D. Any notice not related to termination
of this Agreement may be sent electronically to the other Party's e-mail address listed in this
section or such other address as may be provided by a Party to the other Party from time to time.
If notice relates to termination of this Agreement,such notice shall be sent by registered or certified
mail, postage prepaid, return receipt requested, or by any other overnight delivery service that
delivers to the noticed destination and provides proof of delivery to the sender. All notices sent to
the addresses set forth in this section shall be effective (i) when first received by the Party, or (ii)
upon refusal of delivery by the Party to which it was sent.Any Party whose address changes during
the term of the Agreement shall promptly notify the other Party in writing. If PLAN cannot
complete notice under this Section 3.D because PROVIDER's addresses are incorrect and/or
PROVIDER failed to notify PLAN of the change, PLAN shall provide notice under this Section
3.D, including for Agreement termination, by making commercially reasonable efforts to deliver
notice in any manner reasonably calculated to give PROVIDER actual notice, and notice shall be
deemed delivered upon the completion of those efforts.
If to PLAN: 505 City Parkway West Orange, CA 92868
If to PROVIDER: 2000 Main Street Huntington Beach, CA 92648
E. Each Party shall be excused from performance hereunder for any period that it is
prevented from meeting the terms of this Agreement as a result of a catastrophic occurrence or
natural disaster, including an act of war and excluding labor disputes (each a "Force Majeure
Event"). A Party invoking this clause shall provide the other Party with prompt written notice of
any delay or failure to perform that occurs by reason of a Force Majeure Event. If the Force
Majeure Event continues for a period of ten (10) days, the Party unaffected by the Force Majeure
Event may terminate this Agreement upon notice to the other Party.
Page 6 of 8
F. Each Party and any of its agents or employees of PROVIDER shall act in an
independent capacity and not as officers, employees, or agents of the other Party under this
Agreement.PROVIDER's relationship with PLAN under this Agreement is that of an independent
contractor.PROVIDER's personnel performing services under this Agreement shall be at all times
under PROVIDER's exclusive direction and control and shall be employees and/or agents of
PROVIDER. PROVIDER shall pay all wages, salaries, and other amounts due its employees in
connection with this Agreement and shall be responsible for all reports and obligations respecting
them, such as social security, income tax withholding, unemployment compensation, workers'
compensation, and similar matters.
G. This Agreement shall be governed by and construed in accordance with all laws of
the State of California. Subject to the restrictions in Section 1.H, PROVIDER shall bring any and
all legal proceedings against PLAN under this Agreement in California State courts in Orange
County, California,unless mandated by law to be brought in federal court, in which case such legal
proceeding shall be brought in the Central District Court of California.
H. If any provision of this Agreement is rendered invalid or unenforceable by appliable
laws or is declared null and void by any court of competent jurisdiction, the remainder of the
provisions hereof shall remain in full force and effect as though the invalid or unenforceable parts
had not been included herein.
I. This Agreement, including its recitals and attachments, constitutes the entire
agreement between the Parties and supersedes and terminates any previous agreements between
the Parties. All prior or contemporaneous agreements, promises, negotiations or representations,
either oral or written, relating to the subject matter and period governed by this Agreement not
expressly set forth herein shall be of no further force, effect, or legal consequence after the
Effective Date.
J. This Agreement may be executed in multiple counterparts, each of which shall be
deemed an original and all of which together shall be deemed one and the same instrument.
K. The persons executing this Agreement on behalf of the Parties warrant that they are
duly authorized to execute this Agreement and that by executing this Agreement, the Parties are
formally bound.
[signature page follows]
Page 7 of 8
SIGNATURES
PLAN: CalOptima Health
Date:
By: Yunkyung Kim, Chief Operating Officer
PROVIDER: City of Huntington Beach
Yetarleis...Z......"0 Date: IP"/3- ee zs
By: Pat Burns, Mayor
ATTEST:
1/144(" d'L ('Pel‘4-7 — Date: 8_)5 2013
Lisa Lane Barnes, City Clerk
APPROVED AS TO FORM:
?a, Date:
Mike Vigliotta, City Attorney
Page 8 of 8
SIGNATURES
PLAN: CalOptima IIealth
YunkHm(Aug 27,2025 12:39:34 PDT) Date: 08/27/2025
By: Yunkyung Kim,Chief Operating Officer
PROVIDER: City of Huntington Beach
if./ 42 r Date: '/ • Ze Z
By: Pat Burns, Mayor
ATTEST:
ii/i/d4,11,v4,4_4._ leA"?‘-t--7--
Date: Y _l3 2623
Lisa Lane Barnes, City Clerk
APPROVED AS TO FORM:
z. ?til, Date:
Mike Vigliotta, City Attorney
Page 8 of 8
DocusIgn Envelope ID:83BA75AD-2403-4263-88F8-389131D03DCA
1) HCS
CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES
Michelle Saass I Director
Obtober 3, 2025
•
Eric McCoy
Fire Chief
City of Huntington Beach
2000 Main Street.
Huntington Beach, CA 92648
Dear Eric McCoy:
The Department of Health Care Services (DHCS) has completed its calculation of the
following;
1. Rating Period CY 2024 Voluntary Rate.Range Program (service period:of January 1,
2024, through December 31, 2024) payment transfer amounts for the
Intergovernmental Agreement Regarding Transfer of Public Rinds,(Agreement), No.
IGT-2440013.As stated in Section 1.8 of the Agreement, the enrollment
reconciliations Will odour an.ongOing:basis as Updated enrollment figures become
available.Actual enrollment will not be considered final until two years after
December 31, 2024.
2. Rating Period CY 2023 Voluntary Rate Range Program (service period Of January 1,
2023,through December 31., 2023) payment transfer amounts for the:reconciliation
to Intergovernmental Agreement Regarding Transfer of'Public Funds(Agreement),
No. IGT- 3-0008.As stated in Section 1.3 of the Agreement, the enrollment
reconciliations will occur on:an ongoing basis as updated enrollment figures become
available.Actual enrollment will not be considered final until two years after
December 31, 2023.
Based on the above calcUlations, and as provided in the above referenced Agreements,
DHCS is requesting that City of Huntington Beach transfer funds in the amount of
$722,804 to DHCS by no later than Friday, November 21,.2028. Detailed invoices are
attached to the email communications. Please transfer the above Total Amount td the
following:
California Department of Health CaM Seniites State of California ,7-
Capitated Rates Development Division Gavin Newsom,Governor VçJ
1501 Capitol Avenue,P.Ci.:Box 90413
Sacramento,CA,95899-7413
MS 4413 I Phone(916)345-7070 I Fax(916)650-6860
fittps:/Avww,dlIcs,ca.govi California Health and Human SerVices Agency
78
Docusign Envelope ID:53BA75AD-203-4263-86FB-389131D03DCA
s)1: -amevearo 1LS. Bank
1 California street, Suite 100
San Francisco, CA 94111
For Credit: Department of Health Care Services
AccountNumbe.k.r:
Routing Number:
For Further Credit to: Department of Health Care Services
Reference: CY 2024 Voluntary Rate Range Program Invoice.
We require Governmental Funding Entity provide a 4,8-hour adyance notice via e-mail
prior to wiring any funds over 5 million dollars.As requested by the State Treasurer's.
Office (STO), all ACH/wires must be transmitted prior to 10:00 a.m. on the date of
payment Please note: DHCS would prefer Automated Clearing House (ACH)
payments, instead of wires. Once the Governmental Funding Entity has transferred
funds to the specified account above, please email Vivian Beeck at
Vivian.Beeck(adhes.ca.goy,; and Scott Gale at ScottGaleOdhcs.casiov with the
completed transaction information.
If you have any questions regarding the Intergovernmental Transfer Agreement, please
contact Vivian Beeck via email shown above.
Sincerely,
cDocuSIgned by:
Atidua
6411197115007E40F...
Michael Jordan
Staff Services:Manager Ill
Capitated Rates Development Division
Department of Health Care Services
P.O. Box 997413, MS 4413
Sacramento, CA 95899-7413
Enclosures
cc: Vivian Beeck
Staff Services Manager I
Capitated Rates Development Division
Department of Health Care Services
P.O. Box 997413, MS.4413
Sacramento, CA 95899-7413
79
•
.City of Huntington Beach
Agreement: .IGT;24-00 i 3
.. ,
nted Estimated ,
Health Plan Rating Region Caegorief KIM 'Contilliution Satin Mernbei Aid. . S S. 'mi),iithe. CorddindienArion-
Federations)
. . _
CalOptima - Orange. - Child. $IS S. 0.04 • :3,094,165 S 123,767
CalOptirna Orange Child: UIS. 180,246 $. -
CalOptima Orange. Adult SIS '' $' 0.08 ' 1,001,505 $ .. 80,120
CalOptima• Orange. Adult' UIS $ 0.06 .612,203 S 36,732
CalOptima ' Orange. ' Adult Expansion S15 $ 0.02 . .3,265,522 $ 65,310
CalOptima Orange ' Adult Expansion UIS, $ 0.01 . 741,574 $ .7,416.
CalOptima Orange SPD SIS $. ' 0.27 405,714 $ 109,543'
CalOptima Orange SPD . UIS- ' $: 0.17 11057 $ :19,643
CalOptima ' Orange SPD Dual S1S $:: 0,10 •1,244,631. $ 124,463
CalOptima Orange SPD Dual • UIS $ 0.03 11,002 $ 330'
CalOpthe Orange .. LTC SIS $, 0.27 1,976 .$ 534
CalOptima -. Orange. LTC ' . ..' UIS $ 0.17 1,4.19 .$.. , 241
CatOptinia Orange, LTaDual SIS $ 0,11 ' 26,872 $ . •2,956.
CalOptima Orange LTC Dual UIS $.:. 0.03 309 $ .9.
CalOptime- Orange: WCM ' SIS $. 0.34 '112,547 $ 38,266
CalOpUma Orange: WCM UIS • . $' 0.12 " 4.114 $ 494
CalOptima ' 'Orange Estir FE_Tetal, . ' 10,816,756 $ 609,724
Total CY 2024.(JarinerY. p;;,1-December 2024)Sectfool Amount . $ .009,724
CY 2024(January.2024.-December2024):9ection 3 Amount under the Agreement:
......
Total CY•2024.(tanuary 20247becember2024)Section 1 Amount(above). •
$ 609,724'
Less amount not subject to fee($ectlen.3:2) $ -
Basis for 20%Assessment Fee :$ 609,724
20%.Astessment Fee(EfaSis'29%) $ 121,945
Total CY 2024 Amount(January 2024-0eceinber 2024)as of 09/2020 Estimated MemberMonths $ 731;669
Balance remaining front CV 2023)January2023-;December2023.(+/-) $: (8,865)
Total Payment Transfer Amount $ 722,804
•
•
80