BOARD OF GOVERNORS MEETING - L.A. Care Health Plan BoG Mtg Packet.pdf · BOARD OF GOVERNORS MEETING...

BOARD OF GOVERNORS MEETING

May 4, 2017 ● 2:00 PM L.A. Care Health Plan 1055 W. 7th Street, Los Angeles, CA 90017

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Mission Statement

L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities 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 (Local Initiative Health Authority of Los Angeles County) is an independent local public agency created by the State of California to provide health coverage to low-income Los Angeles County residents. Serving more than two million members 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 consumer members, physicians, federally qualified health centers, children’s health care providers, local hospitals and the Los Angeles County Department of Health Services.

L.A. Care advances individual and community health through a variety of targeted activities including a Community Health Investment Fund that has awarded more than $132 million throughout the years to support the health care safety net and expand health coverage. The patient-centered health plan has a robust system of consumer advisory groups, including 11 Regional Community Advisory Committees (governed by an Executive Community Advisory Committee), four Coordinated Care Initiative Consumer Councils, 35 health promoters and four Family Resource Centers that offer free health education and exercise classes to the community, and has made significant investments in Health Information Technology for the benefit of the more than 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 subcontracted health plans to provide coverage to Medi-Cal members. These partners are Anthem Blue Cross, Care 1st Health Plan, and Kaiser Permanente. 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 all members of a family to receive health coverage under one health plan in the Covered California state exchange.

L.A. Care Covered Direct™ – L.A. Care’s first private health plan for all members of a family.

L.A. Care Cal MediConnect Plan– L.A. Care Cal MediConnect Plan provides coordinated care for Los Angeles

County seniors and people with disabilities who are eligible for Medicare and Medi-Cal.

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

About L.A. Care Health Plan

Updated 1/10/2017

Updated January 10, 2017

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4/28/2017 1:04 PM

AGENDABOARD OF GOVERNORS MEETINGThursday, May 4, 2017, 2:00 PML.A. Care Health Plan, 1055 W. 7th Street, 10th Floor, Los Angeles, CA 90017

Teleconference Call In Information & SiteCall in number: (855) 846-1604 or (213) 438-5445

Participant Access code: 67163639

Louise McCarthyCalifornia Primary Care Association

1231 I Street, Suite 400.Sacramento, CA 95814

Welcome Louise McCarthy, Chair

1. Approve today’s Agenda Chair

2. Public Comment Chair

3. Approve April 6, 2017 meeting minutes Chair

4. Approve Consent Agenda Items

1st Quarter Investment Report CY 2017 (FIN 100)

Center for the Study of Services Contract (FIN 101)

HCL America Inc. Contract Amendment (FIN 102)

RCAC/CCI Membership (ECA 100)

Chair

5. Chairperson’s Report Chair

6. Chief Executive Officer Report

Quarterly Strategic Vision Report

Update on Availability of Accessible Examination Equipment

John BaackesChief Executive Officer

7. Election of Board Secretary Hector De La TorreGovernance Committee Chair

Advisory Committee Reports

8. Executive Community Advisory Committee Hilda Perez/Layla Gonzalez-DelgadoConsumer member and Advocate member

Standing Committee Reports

Executive Committee Chair

9. Government Affairs Update Cherie CompartoreSenior Director, Government Affairs

10. Martin Luther King Jr. Community Health Foundation Grant(BOG 100)

Richard Seidman, MD, MPHChief Medical Officer

Wendy SchifferSenior Director, Strategic Planning

Finance & Budget Committee Michael Rembis, Committee Chair

11. Chief Financial Officer’s Report

Approval of Financial Reports (FIN 103)

Monthly Investment Transactions Report

Marie MontgomeryChief Financial Officer

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Board of Governors Meeting AgendaMay 4, 2017Page 2 of 2

4/28/2017 1:04 PM

ADJOURN TO CLOSED SESSION (Estimated time: 10 minutes) Chair

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

Plan Partner Rates

Provider Rates

DHCS Rates

13. REPORT INVOLVING TRADE SECRETPursuant to Welfare and Institutions Code Section 14087.38(n)Discussion Concerning New Product Lines, FacilitiesEstimated date of public disclosure: May 2019

RECONVENE IN OPEN SESSION Chair

Adjournment Chair

The next meeting is scheduled on Thursday, June 1, 2017 at 2 pmAt the Michele Obama Neighborhood Library, 5870 Atlantic Avenue, Long Beach, CA 90805

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

If a teleconference location is listed at the top of this agenda, the public can participate in the meeting at that location.Teleconference arrangements listed at the top of this Agenda may change prior to the meeting. L.A. Care may make the teleconferencenumber available to the public. If you wish to listen to the meeting by telephone, you can confirm details with L.A. Care Board Services

staff prior to the meeting by calling (213) 694-1250, extension 4183 or 4184.

THE PUBLIC MAY ADDRESS THE BOARD OF GOVERNORS ON ALL MATTERS LISTED ON THE AGENDA BY FILLINGOUT A “REQUEST TO ADDRESS” FORM AND SUBMITTING THE FORM TO L.A. CARE STAFF PRESENT AT THE

MEETING BEFORE THE AGENDA ITEM IS ANNOUNCED. YOUR NAME WILL BE CALLED WHEN THE ITEM YOU AREADDRESSING IS DISCUSSED. THE PUBLIC MAY ALSO ADDRESS THE BOARD ON L.A. CARE MATTERS DURING

PUBLIC COMMENT. AN AUDIO RECORDING OF THE MEETING IS MADE TO ASSIST IN WRITING THE MINUTESAND IS RETAINED FOR 30 DAYS.

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

Street – 10th Floor, Los Angeles, California 90017.

Any documents distributed to a majority of the Board Members regarding any agenda item for an open session after the agenda hasbeen posted will be available for public inspection at Board Services, L.A. Care Health Plan, 1055 W. 7th Street, 10th Floor, Los Angeles,

CA 90017, during regular business hours, 8:00 a.m. to 5:00 p.m., Monday – Friday.

Meetings are accessible to people with disabilities. Individuals who may require any accommodations (alternative formats – i.e., large print, audio, translation of meetingmaterials, interpretation, etc.) to participate in this meeting and wish to request an alternative format for the agenda, meeting notice, and meeting packet may contact L.A.

Care’s Board Services Department at (213) 694-1250. Notification at least one week before the meeting will enable us to make reasonable arrangements to ensureaccessibility to the meetings and to the related materials.

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DRAFT

Board of Governors Regular & Special Supplemental Meeting Minutes #261 April 6, 2017 L.A. Care Health Plan Conference Room 1017-1018-1019 1055 W. Seventh Street, Los Angeles, CA 90017

Members Management/Staff Mark Gamble, Chair John Baackes, Chief Executive Officer Louise McCarthy, Vice Chair Phinney Ahn, Chief of Staff Michael Rembis, Treasurer* Gertrude S. Carter, MD, Chief Medical Officer Alexander Li, MD, Secretary Maribel Ferrer, Executive Director, Medicaid Coverage Expansion & TANF Alvaro Ballesteros, MBA Augustavia Haydel, General Counsel Stephanie Booth, MD Thomas Mapp, Chief Compliance Officer Hector De La Torre Marie Montgomery, Chief Financial Officer Layla Gonzalez-Delgado Bruce Pollack, Executive Director, Medi-Cal, SPD & CCI Hilda Perez Tom Schwaninger, Chief Information Officer Honorable Mark Ridley-Thomas Robert Turner, Chief of Human Resources G. Michael Roybal, MD, MPH Sheryl Spiller Kimberly Uyeda, MD, MPH *Absent **Via teleconference

AGENDA ITEM/PRESENTER

MOTIONS / MAJOR DISCUSSIONS

ACTION TAKEN

WELCOME

Mark Gamble

Mark Gamble, Chair, called the regular and supplemental special meetings to order without a quorum at 2:05 p.m. He announced that the public may address the Board on any matter at the Public Comment section at the beginning of this meeting, before or during the Board’s consideration of items listed on the Agenda. Guests are welcome to introduce themselves or can choose to remain anonymous.

APPROVAL OF MEETING AGENDA Mark Gamble

The meeting regular and special supplemental meeting agendas were approved as submitted.

Approved unanimously 7 AYES (Ballesteros, Booth, Gonzalez-Delgado, Gamble, McCarthy, Perez, Roybal).

PUBLIC COMMENT

Giselle James, RCAC 4 member, offered to play mandolin and sing at a 20th anniversary event. She also suggested L.A. Care consider music therapy at the Family Resource Centers. John

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Board of Governors Meeting April 6, 2017, Page 2 of 23 DRAFT DRAFT



ACTION TAKEN

Baackes, Chief Executive Officer, suggested she contact Francisco Oaxaca to discuss her suggestions.

(Member Uyeda joined the meeting.)

Andria McFerson, RCAC 6 member, would like to know where the health promoter program is going. She is a health promoter and it is not what she signed up to do. It has turned into a school resume program having nothing to do with health care, from her perspective. Health Promoters need education on health care, and how it pertains to low income people, and on health insurance. She has a passion to give a voice to those in the community who have no voice and can bridge the gap and improve access to healthcare for those in need. The health promoters should be providing that information to RCAC members. Chair Gamble noted that he has discussed the program with Mr. Baackes and a discussion on the health promoter program will be held at the Governance Committee. Ms. McFerson noted that health promoters are low income volunteers. Recently the volunteers are not offered food at the health promoter meetings. Chair Gamble thanked her for her remarks.

ACCEPTANCE OF MINUTES OF MEETING

Mark Gamble

The minutes of the February 2, 2017 meeting were approved as submitted.

Approved unanimously 8 AYES (Ballesteros, Booth, Gonzalez-Delgado, Gamble, McCarthy, Perez, Roybal, Uyeda).

APPROVAL OF CONSENT AGENDA

Mark Gamble

PUBLIC COMMENT: Andria McFerson advocated for increasing community involvement for advisory committee members. In the past, incentives were offered for health promoter volunteers who sought community involvement. The incentives are no longer offered.

(Member DeLaTorre joined the meeting by phone.)

1. BOG 103: Tom Schwaninger, Chief Information Officer, reported that the motion is to lease additional rack space at a cost that is comparable to the current lease cost. In addition, the voltage is being converted to increase efficiency.

2. BOG 104: Marie Montgomery, Chief Financial Officer, reported that this is an extension of time on an existing contract until new process are put in place. A competitive selection process will be conducted to implement updated payroll processes.

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ACTION TAKEN

3. BOG 105: Mr. Baackes reported that this motion is for retention of services one day per week from Jonathan Freedman, a consultant with Health Management Associates, at the same rate as prior agreements.

4. BOG 106: Mr. Baackes indicated that there are several contracts with doctors to review medical services. This motion was removed from the Consent Agenda and will be addressed later in the meeting when additional information is available.

· Amendment to L.A. Care’s Supplemental Defined Contribution Plan (BOG 100) · Approve funds for Leadership Development Sessions (BOG 101) · Revised 2017 Board meeting schedule: Offsite locations of June and September meetings

(BOG 102) · Datacenter Racks and Power Supply Upgrade 2017 (BOG 103) · Payroll Centric Contract Amendment (BOG 104) · Health Management Associates Contract Amendment (BOG 105) · Joseph Wanski, MD Contract Amendment (BOG 107) · CY 2016 4th Quarter Investment Report (FIN 100) · California Long Term Care Education Center Contract for education and training for IHSS

beneficiaries and providers (FIN 101) · Revisions to Desktop Procedure of Policy AFS 008 (Investment Policy) (FIN 102) · RCAC Membership (ECA 100)

Consent Agenda approved unanimously as amended (excluding BOG 106) by roll call. 9 AYES (Ballesteros, Booth, De La Torre, Gonzalez-Delgado, Gamble, McCarthy, Perez, Ridley-Thomas, Roybal and Uyeda).

CHAIR’S REPORT

Mark Gamble

Chair Gamble introduced the L.A. Care 20th Anniversary celebration. There are many things to celebrate since L.A. Care started operating as a health plan in 1997. As of March 1, L.A. Care has enrolled over 2 million Medi-Cal members and is the largest health insurer in Los Angeles County. Medi-Cal has become an important component of health insurance, and L.A. Care is providing quality health coverage to 1 in 5 L.A. County residents. He emphasized the unique aspect of L.A. Care that involves the members of the health plan, and he thanked the members for attending Board meetings. He acknowledged the Board and staff members for their work, and especially praised the members for their input. L.A. Care is the only public plan available on the Covered California exchange, and has been offering L.A. Care Covered since 2013. Accomplishments since L.A. Care started in 1997 include: · The Community Health Investment Fund (CHIF) was created in 2000, and has awarded

more than $160 million in grants which helps fill gaps in health care coverage and support the health care safety net in L.A. County.

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ACTION TAKEN

· A Medi-Cal program which contracts directly with providers was launched in 2006 and today serves more than 50% of L.A. Care’s Medi-Cal membership and makes L.A. Care a unique organization.

· In 2007, the first Family Resource Center (FRC) in Lynwood began serving the community and L.A. Care is expanding this program throughout L.A. County.

· He noted that the expansion of Medi-Cal benefits through the ACA should be protected. In 2014, L.A. Care enrolled more than 180,000 Medi-Cal members through Medi-Cal expansion and began enrollment in Cal MediConnect, for beneficiaries eligible for both Medi-Cal and Medicare.

· In 2016, the L.A. Care Community Access Network was launched in the Antelope Valley, increasing access to care for the members.

· He will always remember the offsite Board meeting held last year in the Antelope Valley.

Chair Gamble noted that having two million members gives L.A. Care the strength and influence to continue its important objective to ensure that members have access to high quality health care. The Board will continue to be strong advocates for the members continue the success of L.A. Care. L.A. Care is an example that California’s Medi-Cal two plan model really works.

Chair Gamble is very proud of the important work that all of us do every day. He acknowledged the work of fellow Board members, staff and members that make L.A. Care the best health plan in the country. A 20th Anniversary video was shown (the video can be accessed on www.lacare.org)

CHIEF EXECUTIVE OFFICER REPORT John Baackes

Mr. Baackes reported on the planned events to celebrate the 20th Anniversary.

Mr. Baackes thanked Chair Gamble for his leadership as Chair for the last 18 months.

Mr. Baackes reported that an attempt to repeal and replace the Affordable Care Act was not voted on because the supporters did not garner adequate votes to pass the legislation at the House of Representatives. There were significant changes in the legislation: 1. The tax penalty mandating health coverage would be eliminated, which ensured that

younger people enrolled in health care programs to help balance the risk pool. 2. The formula for determining the amount of premium subsidy for enrollment in the health

benefit exchange would have been altered so that older people would have paid more and younger people would have paid less.

3. The proposed legislation would have affected enrollment in expansion of Medi-Cal eligibility as the federal funding would be reduced from 90% to 50%, and eligibility redetermination

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ACTION TAKEN

would occur twice a year. These would create a gap in federal funding.

(Member Ridley-Thomas joined the meeting.)

There are proposals to revive legislation for government sponsored health care, and L.A. Care will continue to monitor the proposals and meet with key people to protect access for members and support for safety net providers.

Mr. Baackes reported: · L.A. Care had a net gain of 60,000 in Medi-Cal enrollment for 2016, while Health Net had a

net loss of over 50,000 lives. · As of April 1, L.A. Care’s total enrollment is 2.1 million members. · L.A. Care enrolled the two millionth Medi-Cal member for benefits beginning April 1. · There are 14,000 enrolled in L.A. Care’s Cal MediConnect program and there was a record

high number of enrollees for April 1, 2017. · Covered California enrollment is 27,000 members. The enrollment period will be shortened

in 2018 to six weeks. · There are 48,000 enrolled in the PASC/SEIU program. · People enrolled in CalMediConnect and Covered California voluntarily chose L.A. Care as

their health plan; there is no auto assignment in these programs. L.A. Care conducts advertising campaigns to appeal to potential members. That work also attracts Medi-Cal members.

· Recognition of L.A. Care is growing and L.A. Care received two awards for this year’s advertising.

· Dr. Trudy Carter will retire in May. Dr. Richard Seidman will be the new Chief Medical Officer, starting on April 18, 2017.

Chair Gamble asked that Dr. Carter be invited to a future meeting for recognition by the Board.

· The Value Initiative for IPA Performance (VIIP) program now includes provisions for pay for performance financial incentives. The provider groups have accepted the new program.

· The National Committee for Quality Assurance (NCQA) will be at L.A. Care in May. NCQA certification demonstrates that L.A. Care provides value to members. NCQA recognized L.A. Care through multicultural health care distinction and the program has been accredited for two additional years.

· A RCAC advocacy conference was held on March 24. Mr. Baackes thanked Members Ridley-Thomas, McCarthy and Gamble for their participation in the panels or spoke at that

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ACTION TAKEN

event. Mr. Baackes received notes from RCAC members that thanked him for the meeting and encouraged other similar meetings in the future.

Report on Physician Leadership Program (SNI)

John Baackes

A report on the Community Clinic Physician Leadership Program (PLP) was presented. Maria Calleros, Senior Director, Safety Net Initiatives, updated the Board on program accomplishments since it was launched in 2016. · L.A. Care Health Plan completed its first session in February 2017. · PLP model was developed in response to physician workforce education and training needs

identified by the Community Clinic Association of Los Angeles County (CCALAC) and its member clinics.

· PLP was designed to provide physicians with tangible leadership and management skills to drive change and innovation in the safety net clinics (e.g. improve clinic efficiency, quality and experience of patient care).

· Twenty physicians, representing seventeen Federally Qualified Health Centers, participated. · In addition to training, participants had two leadership coaching sessions. · Participants completed leadership enhancement projects, which focused on topics such as

improving quality measures, patient engagement, and care coordination and involved leading a team to work on a specific project to benefit their respective clinics. The projects were presented to the group.

· Given the success of the first PLP, L.A. Care intends to expand this opportunity to more community clinic physicians

Mr. Baackes commented on the excellent presentation of the leadership improvement projects. Dino Kasdagly, Chief Operations Officer, also complimented the presentations, noting that he was touched by one physician in Venice Beach who encouraged other physicians to “stop typing and start touching the patient”.

Member McCarthy thanked the team for taking an idea and need that was expressed. She noted that workforce is a capacity issue which could affect access to critical services. Developing leadership skills for providers will help beneficiaries, and staff satisfaction leads to patient satisfaction for all provider organizations.

Community Health Investment Fund (CHIF) Summary for FY 2015-16

John Baackes

A Community Health Investment Fund report was included in the packet (a copy of the report can be obtained by contacting Board Services).

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ACTION TAKEN

MOTIONS FOR CONSIDERATION

Full text of motions approved under the Consent Agenda

1. Amendment to L.A. Care’s Supplemental Defined Contribution Plan to include eligible member

Motion BOG 100.0417* To approve amendments of the L.A. Care Health Plan Qualified Supplemental Defined Contribution Plan and the L.A. Care Health Plan Nonqualified Supplemental Defined Contribution Plan, in substantially the form attached hereto, to designate Acacia Reed as an Eligible Employee, establish her entry date, allocation period, annual allocation for the first three-year period from Entry Date January 2, 2017 to December 31, 2019, and vesting schedule, and to authorize the Chief Executive Officer to execute the aforementioned amendments.

2. Approval of funds for leadership development sessions

Motion BOG 101.0417* To approve the allocation of funds for L.A. Care’s leadership development sessions by internal and external partners, in the amount of $20,000 through December 31, 2017.

3. Revisions to 2017 Board & Committee Meeting Schedule

Motion BOG 102.0417* To approve the revised 2017 Board and Committee schedule of meetings to reflect offsite meeting locations for the June 1, 2017 offsite Board meeting and September 7, 2017 All Day Board Retreat: · June 1, 2017 at the Michele Obama Neighborhood Library, 5870 Atlantic Avenue,

Long Beach, CA 90805. · September 7, 2017 Board All Day Retreat at The California Endowment, 1000 N.

Alameda Street, Los Angeles, CA 90012

4. Amendment to the lease service agreement with Alchemy Communications Inc.

Motion BOG 103.0417* To authorize staff to procure server racks and amend the lease service agreement with Alchemy Communications Inc. in an amount not to exceed $400,000 to upgrade and strengthen L.A. Care’s datacenter infrastructure.

Consent Agenda approved unanimously as amended (excluding BOG 106) by roll call. 9 AYES (Ballesteros, Booth, De La Torre, Gonzalez-Delgado, Gamble, McCarthy, Perez, Roybal and Uyeda).

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ACTION TAKEN

5. Contract Amendment with Payroll Centric

Motion BOG 104.0417* To authorize staff to amend a contract with Payroll Centric in the amount of $200,000 (total contract value not to exceed $690,000) to provide payroll and payroll tax processing services through June 30, 2018.

6. Contract with Health Management Associates for consulting services

Motion BOG 105.0417* To authorize staff to execute a contract in the amount of $200,000 (total contract not to exceed $350,000) with Health Management Associates to provide consulting services for the period of June 1, 2017 to May 31, 2018.

7. Amendment to contract with Oliver T. Brooks, MD This motion was removed from the Consent Agenda. Please see discussion of this motion later in these meeting minutes.

8. Contract with Joseph Wanski, MD

Motion BOG 107.0417* To authorize staff to execute a contract with Joseph Wanski, MD from April 1, 2017 through March 30, 2018, for a total amount not to exceed $175,000.

Contract with Health Management Systems (HMS)

Mr. Kasdagly summarized a request to approve a contract with Health Management Systems (HMS) from April 1, 2017 to December 31, 2020. As L.A. Care continues to build up its claims operation, more specifically in claims accuracy, an internal analysis on payment accuracy with goals in place. HMS is a premier data mining and payment integrity vendor that L.A. Care uses currently for other tasks. For this contract, HMS will go back approximately three years to update claims data and collect payments. The payment is on a contingency fee for overpayments recovered, up to $2 million, and 18% for recoveries over $2 million. The contract is fully contingent; fees are only paid when overpayments are recovered.

Mr. Kasdagly reported that an audit tool will be deployed on April 17 to improve claims payment accuracy to 95%.

Motion BOG 108.0417 To authorize staff to execute a contract with Health Management Systems (HMS), in the amount estimated at $3,600,000 to provide Data Mining services from April 1, 2017 to December 31, 2020.

Motions BOG 108 and 109 were approved unanimously

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ACTION TAKEN

Contract with Imagenet, LLC

Mr. Kasdagly commented that L.A. Care is currently at 70% electronic data interchange rate for claims processing, which is a significant improvement. The goal is to reach 80-85%. There will be providers that will always submit paper claims. . Today there are 10 temporary employees and outside vendors that convert the paper claims to electronic files through an inefficient two-step process. The services under this contract would simplify the process using one vendor. Payment will be made to the vendor on a per claim basis; the volume is estimated based on recent paper claims volume.

Mr. Baackes noted that the budget impact statement in Motion Summaries presented to the Board will be updated so it clearly indicates that funds for planned activities in proposed vendor contracts were anticipated and included in the annual budget approved by the Board.

Member Ballesteros asked about the types of vendors that submit paper claims, and Mr. Baackes responded that hospital claims are usually submitted electronically. Ancillary vendors and nursing homes which do not have access to electronic claims resources will send paper claims. Providers that are under capitation agreements do not submit claims.

Motion BOG 109.0417 To authorize staff to execute a contract with Imagenet, LLC in the amount of $2,100,000 to provide scanning solution services and claims transaction services from June 2017 to June 2020.

simultaneously by roll call. 10 AYES (Ballesteros, Booth, De La Torre, Gonzalez-Delgado, Gamble, McCarthy, Perez, Ridley-Thomas, Roybal and Uyeda).

STANDING COMMITTEE REPORTS Executive Committee

Mark Gamble

The Executive Committee met on March 2 (meeting minutes are available by contacting Board Services).

Government Affairs Update

Federal · L.A. Care continues efforts to educate legislators and administration on the need for

actuarially sound rates and transparency in rate setting. · Continue to aggressively discuss the need for coverage for all Medicaid enrollees and

preserve coverage in the health benefit exchange. · Promote the permanent extension of dually eligible special needs plan (D-SNP) members

and provide coordinated and integrated care for dually eligible beneficiaries. L.A. Care works independently and with trade associations.

· Mr. Baackes is the Chair of SNP Alliance, a national trade association for D-SNPs. · Senate Finance Committee reintroduced "The Chronic Care Act", bipartisan legislation for

improving care coordination for duals, including permanent authorization of SNPS.

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ACTION TAKEN

· Children’s Health Insurance Program (CHIP) needs to be reauthorized by October 1, 2017. Reauthorization of the program is expected, but L.A. Care staff remains alert for potential provisions that will reduce funding in other areas.

Member McCarthy noted that the reauthorization will include three important programs: o CHIP o Health centers program is a critical funding source for federally qualified health centers

(FQHCs), and a 70% drop in funding would occur for community health centers absent action to reauthorize this important program.

o National health service corps loan repayment program for community health center workers.

State · AB 428 (Assembly member Ridley Thomas) is sponsored by L.A. Care, and proposes an

extension of current provision of the Brown Act for an exemption of geographic limits for quorum, and allow Board members attending a meeting while outside LA County to count towards meeting the quorum requirement. The proposed legislation is moving through the process with no opposition.

· AB 1092 (Assembly member Cooley) fully restores adult vision benefits in Medi-Cal for corrective lenses and frames. Only exams are currently covered under Medi-Cal. This is a priority for advisory committee members and L.A. Care is currently the only health plan that has taken a support position on this proposed bill.

· SB 222 (Hernandez), would not terminate Medi-Cal benefits when someone becomes an inmate. Instead it suspends their eligibility so that when the beneficiary is released there is not a significant delay in obtaining Medi-Cal coverage. This is important to Los Angeles County and L.A. Care has taken a support position on this proposed bill.

· Staff is also monitoring several other legislative items for health benefit exchange and Medi-Cal programs and will continue discussions with the authors' offices as the bills transform into policy bills. Staff also continues to hold discussions with Los Angeles County lobbyists on the housing proposals and with other stakeholders. Staff may present legislation for support positions on legislation to support its stakeholders and will offer assistance as appropriate.

A list of all the bills that L.A. Care staff is tracking is included in the meeting materials (a copy can be obtained by contacting Board Services). (Member Perez left the meeting.)

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ACTION TAKEN

Amendment to contract with Oliver T. Brooks, MD (from the Consent Agenda)

Mr. Baackes reported that L.A. Care has expended the amount authorized for the contract with Dr. Brooks and is requesting approval for additional funding for this contract. For March, April and May of this year, the amount of $33,000 is owed to Dr. Brooks for his services under the contract. A contract amendment is requested for up to 100 additional hours through the end of the year for $95,000.

Mr. Gamble noted there should be a mechanism in place to prevent further spending once a contract limit has been met.

Motion BOG 106.0417 To approve an amendment to the existing contract with Oliver T. Brooks, MD extending the term through December 31, 2017 with additional fees not to exceed $128,000.

Approved unanimously simultaneously by roll call. 9 AYES (Ballesteros, Booth, De La Torre, Gonzalez-Delgado, Gamble, McCarthy, Ridley-Thomas, Roybal and Uyeda).

Finance & Budget Committee

Chair Gamble reported that the Committee met on March 2 (meeting minutes are available from Board Services). The Committee approved the following motions:

(Member Perez rejoined the meeting.)

· The Committee approved the following motions (that do not require Board approval): o 3Key Consulting Contract Amendment for professional services to support

Membership Eligibility and Clinical Care Advance strategic projects. o Bluewolf Group, LLC Contract for system implementation services. o Authorization to conduct a market analysis of Medi-Cal managed care service trends in

Los Angeles County for DHS. o Contract Amendment with Michael S. Kenny & Co. for consultant services related to

replacing Los Angeles County Department of Health Services core patient information system.

o Contract Amendment with Office Ally for electronic data interchange (EDI) claims. · The Committee received reports required by the following internal policies,

o Policies on Travel Related Expenses and Non-Travel Expenses o Policy on Authorization and Approval Limits) o Policy on Procurement

· The Committee reviewed and approved the following motions earlier approved in Consent Agenda: o The Quarterly Investment Report o Contract for California Long term Care Education Center o Revisions to Desktop Procedure of Investment Policy AFS 008

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ACTION TAKEN

Motions approved under the Consent Agenda

Motion FIN 100.0417* To accept the Quarterly Investment Report for the quarter ending December 31, 2016, as submitted.

Motion FIN 101.0417* To authorize staff to execute a contract in the amount of $2,000,000 with California Long Term Care Education Center to provide education and training for L.A. Care beneficiaries and their In Home Supportive Services (IHSS) providers for the period of April 1, 2017 through April 1, 2018.

Motion FIN 102.0417* To approve the revisions to the Desktop Procedure of Accounting & Finance Services Policy AFS-008 (Annual Investment) for the clarification of California Code for the minimum rating of issuers of Asset Backed Securities (ABS) & Mortgage Backed Securities (MBS), attached.

Approval of Financial Report

Ms. Montgomery reviewed highlights of the financial reports through February, 2017: · L.A. Care membership projections did not anticipate the impact of Medi-Cal eligibility

redetermination that occurred in January, 2017, so the actual enrollment is lower than budgeted through February. Medi-Cal expansion enrollment began in January, 2014, so a large portion of beneficiaries have an annual redetermination in January. Redetermination of eligibility was suspended for an extended period of time in L.A. County while program processes were updated. When redetermination resumed in late 2016, the members were unused to meeting to the eligibility redetermination requirements. It is expected that a portion of these members will re-enroll with L.A. Care once their eligibility for benefits has been re-established.

· Because of updated retroactive rates received late in 2016 for the Coordinated Care Initiative program and for some aid code categories, the revenues are higher than budgeted.

· Operating expenses are lower than budgeted and non-operating income is higher than expected.

· Revenue is favorable to budget, while health care cost is higher than budgeted resulting in a net surplus of more than $25 million.

· Recoupment by the Department of Health Care Services for rate reductions, that are awaiting approval from the Centers for Medicare and Medicaid Services, are expected to be implemented in July 2017.

· Because of the updated rates discussed above, operating margins are favorable for the Plan Partners, Medi-Cal Seniors and People with Disabilities (SPD) and Coordinated Care

16




ACTION TAKEN

Initiative (CCI), Medi-Cal Temporary Assistance for Needy Families (TANF) and Medi-Cal Expansion (MCE), and for Cal MediConnect (CMC) programs.

· Operating margins are negative for L.A. Care Covered, PASC/SEIU workers, and Healthy Kids programs.

· Overall, the Medical Cost Ratio (MCR) is 94.0%, slightly unfavorable to the budgeted ratio of 94.2%.

· L.A. Care continues to be cautious with administrative expenses; the administrative ratio was 4.1%, favorable to the budgeted 4.5%.

· Working Capital and Tangible Net Equity are ahead of benchmarks, while cash to claims ration was slightly below the planned rate due to a required calculation of reserves for In Home Supportive Services (IHSS) program. This unfavorable trend is expected to continue until the program administration reverts to the counties in California, as proposed in the Governor’s Budget.

· L.A. Care’s Tangible Net Equity (TNE) of 294% of required reserves reflects favorably in comparison to other public health plans in California as reported on December 31, 2016.

· L.A. Care’s TNE was calculated at 546% without the financial impact of the IHSS program. · The TNE goal of 530% is the average of eight other local initiative and county organized

health plans that have adequate financial reserves.

Member Ridley-Thomas noted that while the change proposed for administration of the IHSS program may be favorable for L.A. Care’s financial status it will have an adverse impact on Los Angeles County. The Board of Supervisors has instructed the county CEO to send workforce reduction notices to all the respective department heads, asking that curtailment scenarios are developed to gauge the potential effects for the change. This will be hugely problematic.

Mr. Baackes stated that L.A. Care staff realizes the potential negative impact and will continue to work with the Personal Assistance Services Council (PASC) and with IHSS workers to keep them involved, because they provide services to thousands of L.A. Care members. L.A. Care has continually raised the issue that with IHSS administration through L.A. Care, it impacted the financial calculations and reports even though L.A. Care had no control over the administration. L.A. Care supports the IHSS program for many reasons and it is well established on record that the organization supports the program. As a Medi-Cal plan, L.A. Care values the services provided to its members by IHSS workers and believes that the success of the IHSS program is reflected in the utilization for all of L.A. Care. However, the IHSS program is not directly connected to L.A. Care’s medical management programs.

17




ACTION TAKEN

Member Ridley Thomas noted that impacts on L.A. Care may be mixed, but impacts on LA County are not, and extend beyond the workers. There will be a compounding effect on other services, such as nursing homes, as the change in admiration of IHSS will likely drive up cost and drive down quality of care. The change is ill-advised by most standards of measurement. Los Angeles County is engaged with the Governor’s office and with other counties. Litigation is not out of reach. It is important that this Board and key staff understand that this is a major issue.

Mr. Baackes noted that the issue is not the movement of IHSS funding through L.A. Care, but is that the legislation shifts a significant cost burden to the counties.

Member Ridley-Thomas stated this is part of a pattern of the state dumping cost burdens on the counties. He notes that there are pros and cons with respect to L.A. Care. In terms of the ramifications it portends, no entity would be isolated in the dire set of circumstances. There are more than 200,000 home care workers in Los Angeles County. There are significant concerns about the compensation of the workers and care for the beneficiaries. Only three months’ notice of the change was provided. An impact as much as $220 million is expected for Los Angeles County in the first year. Other smaller counties have smaller numbers, but the impact for those smaller counties is also very severe, as well as the quality of life for the home care workers and the quality of care for the beneficiaries.

Dr. Booth asked how long it might take the state to feel the consequence of increased costs. Member Ridley-Thomas noted that it is the state’s responsibility to inspect nursing homes. In L.A. County it is done locally because the state could not handle it to the satisfaction of the Board of Supervisors. The nursing homes are where very sick, frail and elderly will be placed. There will be tremendous pressure on the state if this occurs. The notification of the change was two months ago. There is an attempt to get a longer implementation time. There will be litigation unless there is relief. There is no a calculation of the potential cost, although it is apparent that the change will have significant financial impact on the counties.

Motion BOG 110.0417 To accept the Financial Report for the periods ended December 31, 2016, January 2017 and February 2017, as submitted.

Ms. Montgomery provided an updated financial forecast, which is not presented as a revision to the approved budget. · The forecast reflects the latest membership projections and CCI/CMC rate adjustments

mention previously with the February 2017 financial results.

Approved unanimously by roll call 10 AYES (Ballesteros, Booth, De La Torre, Gonzalez-Delgado, Gamble, McCarthy, Perez, Ridley-Thomas, Roybal and Uyeda).

18




ACTION TAKEN

· Membership projection is to end the year below the budget by 36,000 members · Total revenue over budget is decreased by lower membership but increased due to recent

rate adjustments · Operating margin is slightly lower than budget · There are no significant changes to net surplus and operating expenses

Ms. Montgomery reviewed key items that could drive improvement and or could create shortfalls in the proposed budget. · Opportunities to improve results include efficiency gained through the implementation of

the Core System plus program, conversion of members from CCI and Medi-Cal to Cal MediConnect, and re-enrollment of Medi-Cal members through redetermination of eligibility

· Risks which could lead to shortfalls include enrollment reductions due to the pre-ACA aid code updates, eligibility redeterminations, and rate uncertainty for CCI.

L.A. Care staff has several initiatives to continue improvement and efficiency in 2017: · Supplier consolidation · Review risk arrangements for all programs · Identify members with disabilities who are eligible for other assistance programs such as

Supplemental Security Income or disability programs

Ms. Montgomery review the highlights of the forecast: · Membership enrollment with plan partners is projected to be lower than budget by 13,126,

primarily due to the redetermination of eligibility in January, with growth projected through the end of the fiscal year.

· Financial performance in the plan partner enrollment reflects the impact of the CCI rate increase with offsetting capitation expenses.

· SPD/CCI membership is projected to be higher than budget by 19,593, as members with fee for service benefits were transitioned into managed care plans in California.

· SPD/CCI financial performance reflects CCI rate increases with SPD rate deterioration as compared to budget. Medical expenses for SPD have been higher than budgeted for inpatient and pharmacy benefits.

· TANF/MCE membership enrollment is expected to be lower than the budget due to the eligibility redetermination in January and growth through the remaining months of the fiscal year.

19




ACTION TAKEN

· TANF/MCE financial performance reflects the lower enrollment with nominal improvement in the operating margin.

· CMC membership is projected to be slightly higher (1,823) than budget as members previously enrolled with fee for service benefits are transitioned to Medi-Cal managed care.

· CMC financial performance is forecast to improve slightly over budget due to rate increases and risk adjustment revenue for the Medicare component.

· L.A. Care’s commercial program membership projections include a strong increase during open enrollment with conservative projections through the end of the fiscal year.

· The commercial program financial performance is projected to improve through the end of the fiscal year. Performance prior to open enrollment was unfavorable to plan, and the forecast shows improving performance ending unfavorable compared to the budget.

L.A. Care’s financial performance will be measured against this forecast instead of the budget for the rest of the fiscal year since it will better reflect the expected performance by segment. L.A. Care’s overall performance is expected to be consistent with the budget.

Monthly Investment Transaction Report

Marie Montgomery

Ms. Montgomery referred to the January and February 2017 Investment Transaction Reports are included in the meeting materials. (A copy of the reports can be obtained by contacting Board Services). Total market value of the portfolio is $2.6 billion in cash and investments on February 28, 2017.

The internal quarterly and year end expenditure reports required by L.A. Care policy will be presented at the next Board meeting.

Information Technology Motions

Mr. Baackes informed the Board that as part of the FY 2016-17 approved budget for L.A. Care, strategic projects were included to support and enhance the Information Technology portfolio of applications, databases, and infrastructure. The total cost for these projects was budgeted at $48 million with approximately $34 million in the capital budget and $14 million in the expense budget. A chart showing how the next three proposed contracts tie into the budget was distributed (a copy of the chart can be obtained by contacting Board Services). Mr. Baackes informed the Board that he will be reviewing the procurement policies to assess the limits on contract expenditure requirements for approval from the Board and Committees.

Mr. Schwaninger indicated that these projects were approved in the budget. It is necessary to augment staff to meet the demands of project activities. Included on the agenda are two motions which provide professional services from vendors to provide staff and services related to the several of the budgeted projects which include: · Enhancements and release upgrades for the QNXT claims system (Infosys, $5,000,000)

20




ACTION TAKEN

· Improvements related systems supporting commercial products such as L.A. Care Covered and CalMedi-Connect (CMC) (FlexTech, $3,000,000)

Other firms are being used in addition to these two firms. In each case, the motions are for approval of funds for vendors selected through a request for proposal (RFP) process where either the vendor is new to L.A. Care or has been selected to continue work based on satisfactory performance on existing contracts in which case the contract will be amended. L.A. Care performs ongoing reviews of vendor performance and performance of resources from each vendor. Contract clauses allow for replacement of poorly performing resources and/or early termination of the contract.

Motion FIN 103.0417 To authorize staff to amend a contract with FlexTech Inc., for information technology staff augmentation resources and technical support in the amount of $3,000,000 (total contract amount not to exceed $17,200,000) through March 31, 2018.

Motion FIN 104.0417 To authorize staff to amend a contract with Infosys Public Service for member conversion services, reporting, production support, and system testing in the amount of $5,000,000 (total contract not to exceed $21,392,818) through March 31, 2018.

Motions FIN 103, 104 and 105 were simultaneously approved unanimously by roll call. 10 AYES (Ballesteros, Booth, De La Torre, Gonzalez-Delgado, Gamble, McCarthy, Perez, Ridley-Thomas, Roybal and Uyeda).

Contract Amendment with FirstSource

The Motion Summary describes the request for approval to amend the contract with FirstSource in the amount of $4,500,000 (total amount not to exceed $17,075,993.30), through December 31, 2017. The requested funds will allow processing for the portion of claims that L.A. Care is not able to process internally. FirstSource processes claim types from simple to complex and is paid on a per claim basis.

L.A. Care has used this vendor since July 2013. A request for proposal was not conducted for the extension of these services, because this vendor is considered a sole source. Off shore labor is not used by this vendor. With the transition to QNXT, staff did not anticipate needing this vendor to process claims in calendar year 2017. However, some modules of the QNXT system, such as the claims workflow, which were intended to be part of the initial implementation are scheduled for deployment in the near future. The immediate objective is to stabilize and optimize the QNXT core data system. Conversely, FirstSource services are needed to meet claims regulatory requirements, such as timeliness of claims payments.

Motion FIN 105.0417

21




ACTION TAKEN

To authorize staff to amend the contract with FirstSource in the amount of $4,500,000 (total amount not to exceed $17,075,993.30) to provide claims processing and adjudication services through December 31, 2017.

Compliance & Quality Committee G. Michael Roybal, MD

The Committee met on March 16. Trudi Carter, MD, Chief Medical Officer, reported that this was her last C&Q Committee meeting. The Committee thanked Dr. Carter for her commitment to the members and to L.A. Care. Thomas Mapp, Chief Compliance Officer, reported: · A Compliance Work Plan will accompany the Compliance Program as a tracking tool for all

Compliance related activities. This document will be changed and updated as needed. · The Compliance Department identified four compliance issues related to the

CalMediConnect line of business. One of the issues has been resolved and staff is working on will continue to monitor these issues until all are resolved.

· The 2016 Mock CMS Program Audit produced an observation that the Compliance Department has a fragmented delegation oversight program, a lack of consistency in auditing and monitoring activities, and a lack of effective communication. o Corrective action will be to develop a methodology to streamline delegation oversight,

auditing and monitoring activities, and to report all compliance issues to the Compliance Officer and other key stakeholders.

· Staff is developing an Enforcement Program by September 2017, which will include imposition of sanctions to hold contracted providers accountable for any failure to comply with contractual, regulatory and accreditation requirements. The program will include determination of actions that could be subject to sanction, a sub-committee to oversee activities, a charter, policies and procedures.

· The Committee received, reviewed and approved the following documents: o 2016 Quality Improvement Annual Report and Evaluation – All lines of business o 2016 Utilization Management Program Evaluation – All lines of business o 2017 Quality Improvement Program – All Lines of Business o 2017 Utilization Management Program – All Lines of Business

· The Committee received an overview of the annual Member Experience survey to help to measure the members’ experience with the health plan and its services.

Governance Committee

Chair Gamble reported that the Committee met on March 20. The Committee voted to recommend a slate of officers to the Board. The Secretary position is currently vacant, with Dr. Li’s resignation from the Board.

Motion GOV 100.0417

Approved unanimously by roll call. 10 AYES

22




ACTION TAKEN

To elect the following Board Officers, effective May 1, 2017, to serve until April 30, 2018. Chairperson Louise McCarthy Vice Chairperson Hector De La Torre Treasurer Michael Rembis

Chair Gamble congratulated Member McCarthy. He thanked Mr. Baackes and the Board members and indicated that it has been more rewarding then he expected to serve as Chairperson of this Board. The stakeholder members make it unique. He said it has been a great privilege and he thanked everyone for the opportunity to serve as Chair.

(Ballesteros, Booth, De La Torre, Gonzalez-Delgado, Gamble, McCarthy, Perez, Ridley-Thomas, Roybal, and Uyeda).

ADVISORY COMMITTEE REPORTS Executive Community Advisory Committee Hilda Perez Layla Gonzalez-Delgado

Member Perez recognized the members at the meeting. She thanked Mr. Gamble for his leadership and for remembering the members in his comments. She thanked him also for coming to the advisory committee member events. She invited all board members to attend the meetings and events with the advisory committee members.

Member Gonzalez-Delgado reported that ECAC met on February 8 and March 8 · Acknowledge RCAC / CCI Members here today:

RCAC Name 1 Maria Mayoral / Maria Adela Guadarrama 2 Ana Maria Barroso / Estela Lara / Wilma Ballew 3 Daniel Kwong 4 Silvia Quezada / Michael Shelton 5 Deisy Corona 6 Andria McFerson 7 Fátima Vásquez / Norma Angelica Alvarez 8 Maria Isabel Tamayo / Maria Montes 10 Marlene Paz / Leticia Navarro 11 Evangelina Candelario

CCI Councils

Area 1 Ernesto Sarmineto / Demetria Saffore / Russel Mahler Area 2 Mary Jo Fernando Area 3 Robert G. Harvey Dixon Area 4 Richard Hernandez / Deaka McClain

23




ACTION TAKEN

· In the past two meetings Mr. Baackes has provided the ECAC members with updates on proposed changes to healthcare that would impact L.A. Care members.

· L.A. Care’s General Counsel, Augustavia J. Haydel, Esq., is Chair of the Los Angeles Area Chamber of Commerce’s Healthcare Council, which supports an annual advocacy agenda, will advocate this year for accessible equipment in healthcare facilities. Mr. Oaxaca congratulated all the members for the work they have done to promote availability of accessible equipment.

· ECAC members were pleased to hear that one of L.A. Care’s Community Health Investment Fund initiatives this year is to provide a grant to help increase the availability of accessible exam equipment.

· ECAC formed an ad hoc Committee to develop an advocacy plan for this fiscal year around the vision benefit for Medi-Cal members.

· Rudy Martinez, Safety and Security Specialist, Facility Services, provided information on building and evacuation safety procedure for the public.

Motion ECA 100.0417* To approve the following candidate(s) to the Regional Community Advisory Committees (RCAC) as reviewed by the Executive Community Advisory Committee (ECAC) during the March 8, 2017 ECAC

PUBLIC COMMENT: Andria McFerson commented on the health promoter program. She and Hilda Perez attended a health care event in the community. There were over 100 people. She wants to involve ECAC members more in community activities involving many cultures. She would like more diversity in programs.

Mary Jo Fernando, CCI Council Area 2 Member, asked for clarification on the IHSS program. Mr. Baackes stated that the IHSS is not ending, rather the governor’s recent budget proposes that the state’s share of funding will shift to the counties. L.A. Care’s role does not change except that the administration will no longer be channeled through L.A. Care. The change will have deleterious effects on the budget for all counties in California. With a larger share of the cost shifting to counties, it will mean that program funding will be curtailed for this and potential other county funded programs.

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

Norma Flores RCAC 10 Consumer

Approved unanimously on the Consent Agenda as amended (excluding BOG 106) by roll call. 9 AYES (Ballesteros, Booth, De La Torre, Gonzalez-Delgado, Gamble, McCarthy, Perez, Rembis, Ridley-Thomas, Roybal and Uyeda).

24




ACTION TAKEN

Member Ridley-Thomas reported that IHSS workers are not county employees, and they constitute an entity that negotiates with the state. The situation is complex and the deleterious effects of the proposed changes need to be addressed. Continuity of care will be in question because minimum wage provisions apply to the contracts. The cost will grow over time. There are many problems, including disruption in continuity and quality of care for beneficiaries, and continuation of funding to support IHSS workers. This will lead to disruption in care and increased costs which must be borne by the state.

Member Delgado assured Ms. Fernando that the services will not be cut and the IHSS worker will still be paid. The change in funding may affect administration.

Member Ridley-Thomas reported that the proposal is not tenable. Homecare workers should be paid decently and not relegated to poverty status. Minimum wage laws were enacted based on the current arrangement with the state. This proposal will require changes in how the program is funded. There are questions about how to hold the IHSS program together in counties throughout the state.

Deaka McClain, stated that the IHSS program will be affected. Everyone needs to continue to make voices heard in advocating for the program.

ADJOURN TO CLOSED SESSION Mark Gamble

Augustavia J. Haydel, Esq., General Counsel, announced the following items to be discussed in closed session. A report is not expected in open session. The Board adjourned to closed session at 4:14 p.m.

CONTRACT RATES Pursuant to Welfare and Institutions Code Section 14087.38(m) · Plan Partner Rates · Provider Rates · DHCS Rates

REPORT INVOLVING TRADE SECRET Pursuant to Welfare and Institutions Code Section 14087.38(n) Discussion Concerning New Product Lines Estimated date of public disclosure: April 2019

(Chair Gamble left the meeting.)

CONFERENCE WITH LEGAL COUNSEL—EXISTING LITIGATION Pursuant to Section 54956.9(d)(1) of Ralph M. Brown Act

25




ACTION TAKEN

Citrus Valley Health Partners v. L.A. Care Health Plan, AAA Case No. 01-16-0001-9191

(Chair Gamble rejoined the meeting.)

CONFERENCE WITH LEGAL COUNSEL—ANTICIPATED LITIGATION Significant exposure to litigation pursuant to Section 54956.9(d)(2) of the Ralph M. Brown Act, one case

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

CONFERENCE WITH LABOR NEGOTIATOR Pursuant to Section 54957.6 of the Ralph M. Brown Act Agency Negotiator: Mark Gamble Unrepresented Employee: Chief Executive Officer

RECONVENE IN OPEN SESSION

Mark Gamble

The Board reconvened in open session at 5:35 p.m. There was no report on action taken during the closed session.

Consideration of Chief Executive Officer’s Compensation and Employment Agreement

Motion BOG 111.0417 To approve the amendment to the L.A. Care Health Plan Retirement Benefit Plan, in the form attached hereto, effective January 1, 2017.

Approved unanimously by roll call. 9 AYES (Ballesteros, Booth, Gonzalez-Delgado, Gamble, McCarthy, Perez, Ridley-Thomas, Roybal, and Uyeda).

ADJOURNMENT

The meeting was adjourned at 5:35 p.m.

Respectfully submitted by: Linda Merkens, Manager, Board Services Malou Balones, Committee Liaison Jennifer Carabali, Committee Liaison APPROVED BY: _______________________________________

26


Board Secretary Date Signed _______________________________________

27

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].

Prepared by mhbalones/printed on 04/28/17

Monday Tuesday Wednesday Thursday Friday 1 2 3 4

Board of Governors 2 pm

5

8

9

10 ECAC 10 am

(for approx. 3 hours)

11

12

15

16 RCAC 4

9 am (for approx. 2-1/2 hours)

17 RCAC 9


18 Compliance & Quality

2 pm (for approx. 2 hours)

RCAC 7 4:30 pm

(for approx. 2-1/2 hours)

RCAC 11 9:30 am


19 RCAC 8 10:30 am


22

23 CCI Area 1


24

CCI Area 2 10 am


Finance & Budget 1 pm


Executive 2 pm


25 26

29 30 31

Schedule of Meetings May 2017

28

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 90017 Tel. (213) 694-1250 / Fax (213) 438-5728

MEETING DAY, TIME, & LOCATION

MEETING DATES MEMBERS

Board of Governors

General Meeting

1st Thursday 2:00 PM

(for approximately 3 hours) 1055 W. 7th Street,

10th Floor, Los Angeles, CA 90017

* Michele Obama

Neighborhood Library, 5870 Atlantic Avenue, Long Beach,

CA 90805

**The California Endowment, 1000 N. Alameda Street, Los

Angeles, CA 90012, from 8:30 am to 4:00 pm

May 4 June 1 (offsite)*

July 6 No meetings in August September 7 (all day

retreat) ** October 5 (place holder)

November 2 December 7

Louise McCarthy, Chairperson Hector De La Torre, Vice Chairperson Michael Rembis, FACHE, Treasurer Alvaro Ballesteros, MBA Stephanie Booth, MD Layla Delgado Mark Gamble Hilda Perez Honorable Mark Ridley-Thomas G. Michael Roybal, MD, MPH Sheryl Spiller Kimberly Uyeda, MD, MPH Staff Contact: John Baackes, Chief Executive Officer x4102 Linda Merkens, Manager, Board Services, x4050

Board of Governors & Public Advisory Committees 2017 Meeting Schedule / Member Listing

29

BOARD OF GOVERNORS & PUBLIC ADVISORY COMMITTEES 2017 MEETING SCHEDULE / MEMBER LISTING



Board of Governors - Standing Committees

MEETING DAY, TIME,

& LOCATION

MEETING DATES

MEMBERS

Executive Committee

4th Wednesday of the month 2:00 PM

(for approximately 2 hours)

1055 W. 7th Street, 10th Floor, Los Angeles,

CA 90017

*Rescheduled February 22 meeting

April 26 May 24 June 28 July 26

No meetings in August

September 27 October 25

November 15 No meetings in

December

Louise McCarthy, Chairperson Hector De La Torre Michael Rembis, FACHE, Mark Gamble G. Michael Roybal, MD, MPH Staff Contact: Linda Merkens, Manager, Board Services, x4050

Compliance & Quality

Committee

3rd Thursday every 2 months 2:00 PM

(for approximately 2 hours) 1055 W. 7th Street,


May 18 July 20

September 21 November 16

G. Michael Roybal, MD, MPH, Chairperson Alvaro Ballesteros, MBA Stephanie Booth, MD Hilda Perez Kimberly Uyeda, MD

Staff Contact: Jennifer Carabali Committee Liaison, Board Services, x 4184

Finance & Budget

Committee

4th Wednesday of the month 1:00 PM

(for approximately 2 hours)


CA 90017

*Rescheduled February 22 meeting



September 27 October 25

November 15 No meetings in

December

Michael A. Rembis, FACHE, Chairperson Mark Gamble Louise McCarthy Hilda Perez Kimberly Uyeda, MD Staff Contact: Malou Balones Committee Liaison, Board Services/x 4183

30




MEETING DAY, TIME,

& LOCATION

MEETING DATES

MEMBERS

Governance Committee

1055 W. 7th Street, 10th Floor

Los Angeles, CA 90017

MEETS AS NEEDED

Hector De La Torre, Chairperson Layla Delgado Hilda Perez Michael Rembis, FACHE G. Michael Roybal, MD, MPH, Sheryl Spiller Staff Contact: Malou Balones Committee Liaison, Board Services/x 4183

Service Agreement Committee

1055 W. 7th Street, 10th Floor


MEETS AS NEEDED

Hector De La Torre, Chairperson Layla Delgado Louise McCarthy Hilda Perez Sheryl Spiller Staff Contact Malou Balones Committee Liaison, Board Services/x 4183

Audit Committee 1055 W. 7th Street, 10th Floor


MEETS AS NEEDED

Alvaro Ballesteros, MBA Hector De La Torre Staff Contact Malou Balones Committee Liaison, Board Services, x 4183

31




MEETING DAY, TIME,

& LOCATION

MEETING DATES

MEMBERS

L.A. Care Community

Health

Meets Annually or as needed


CA 90017

Mark Gamble, Chairperson Louise McCarthy, Vice Chairperson Michael Rembis, FACHE, Treasurer Alvaro Ballesteros, MBA Stephanie Booth, MD Hector De La Torre Layla Delgado Hilda Perez Honorable Mark Ridley-Thomas G. Michael Roybal, MD, MPH Sheryl Spiller Kimberly Uyeda, MD, MPH Staff Contact: John Baackes, Chief Executive Officer x4102 Linda Merkens, Manager, Board Services, x4050

L.A. Care Joint Powers Authority

Meets Quarterly or as needed


CA 90017

Mark Gamble, Chairperson Louise McCarthy, Vice Chairperson Michael Rembis, FACHE, Treasurer Alvaro Ballesteros, MBA Stephanie Booth, MD Hector De La Torre Layla Delgado Hilda Perez Honorable Mark Ridley-Thomas G. Michael Roybal, MD, MPH Sheryl Spiller Kimberly Uyeda, MD, MPH Staff Contact: John Baackes, Chief Executive Officer x4102 Linda Merkens, Manager, Board Services, x4050

Public Advisory Committees

32




MEETING DAY, TIME,

& LOCATION

MEETING DATES

STAFF CONTACT

Children’s Health Consultant Advisory

Committee General Meeting

3rd Tuesday of every other month

8:30 AM (for approximately 2 hours)

1055 W. 7th Street,


May 16 July 18


Lyndee Knox, PhD, Chairperson Staff Contact: Jennifer Carabali Committee Liaison, Board Services/x 4184

Executive Community

Advisory Committee

2nd Wednesday of the month


1055 W. 7th Street,




September 13 October 11 November 8 December 13

Christina Deh-Lee, Chairperson Staff Contact: Idalia Chitica, Community Outreach & Education, Ext. 4420

Technical Advisory Committee

4th Thursdays every other month


1055 W. 7th Street,


Placeholder meeting

dates. This Committee is under

restructure.

Chairperson to be elected Staff Contact: Jennifer Carabali Committee Liaison, Board Services/x 4184

33




REGIONAL COMMUNITY ADVISORY COMMITTEES

REGION

MEETING DAY, TIME,

& LOCATION

MEETING

DATE

STAFF CONTACT

Region 1 Antelope Valley

3rd Friday of every other month

10:00 AM (for approximately 2-1/2 hours) Chimbole Cultural Center 38350 N. Sierra Highway

Palmdale, CA 93550 (661) 267-5656

June 16 August 18 October 20

December 15

Adela Guadarrama, Chairperson Staff Contact: Courtney Nicholas Community Outreach & Education, Ext. 6583

Region 2 San Fernando

Valley

3rd Monday of every other month

10:00 AM (for approximately 2-1/2 hours)

Family Resource Center-Pacoima

10807 San Fernando Road Pacoima, CA 91331

(844) 858-9942


December 18

Ana Rodriguez, Chairperson Staff Contact: Courtney Nicholas Community Outreach & Education, Ext. 6583

Region 3 Alhambra,

Pasadena and Foothill



Rosemead Community Center

3936 N. Muscatel Avenue, Room 3

Rosemead, CA 91770 (626) 569-2160


December 19

Cynthia Conteas-Wood, Chairperson Staff Contact: Kristina Chung Community Outreach & Education, Ext. 5139

Region 4 Hollywood-

Wilshire, Central L.A. and Glendale


9:00 AM (for approximately 2-1/2 hours) Hope Street Family Center 1600 Hope Street, Rm 305

Los Angeles, CA 90015 (213) 742-6385

May 16 July 18


Michael Shelton, Chairperson Staff Contact: Kristina Chung Community Outreach & Education, Ext. 5139

34




REGION

MEETING DAY, TIME,

& LOCATION

MEETING

DATE

STAFF CONTACT

Region 5 Culver City, Venice,

Santa Monica, Malibu, Westchester

3rd Monday of every other month 2:00 PM

(for approximately 2-1/2 hours) Veterans Memorial Building

Garden Room 4117 Overland Avenue Culver City, CA 90230

(310) 253-6625


December 18

Maria Sanchez, Chairperson Staff Contact: Martin Vicente Community Outreach & Education, x 4423

Region 6 Compton,

Inglewood, Watts, Gardena,

Hawthorne

3rd Thursday of every other month

3:00 PM (for approximately 2-1/2 hours) L.A. Care Family Resource

Center - Inglewood 3111 W Century Blvd #100

Inglewood, CA 90303 (310) 330-3130


December 21

Andria McFerson, Chairperson Staff Contact: Frank Meza Community Outreach & Education, x 4239

Region 7 Huntington Park,

Bellflower, Norwalk, Cudahy


4:30 PM (for approximately 2-1/2 hours)

Old Timers Foundation Family Center

3355 E. Gage Avenue Huntington Park, CA 90255

(323) 582-6090

May 18 July 20


Fatima Vasquez, Chairperson Staff Contact: Frank Meza Community Outreach & Education, x 4239

Region 8 Carson, Torrance,

San Pedro, Wilmington

3rd Friday of every other month


Providence Community Health Wellness and

Activity Center 470 N. Hawaiian Ave. Wilmington, CA 90744

(424) 212-5699

May 19 July 21


Maria Montes – Chairperson Staff Contact: Frank Meza Community Outreach & Education, x 4239

35




REGION

MEETING DAY, TIME,

& LOCATION

MEETING

DATE

STAFF CONTACT

Region 9 Long Beach

3rd Monday of every other month


Miller Family Health Education Center

3820 Cherry Avenue Long Beach, CA 90807

(562) 570-7987

May 17 * July 17


*Will meet the 3rd Wednesday of the

Month

Christina Deh-Lee, Chairperson Staff Contact: Kristina Chung Community Outreach & Education, Ext. 5139

Region 10 East Los Angeles,

Whittier and Highland Park


1:00 PM (for approximately 2-1/2 hours) Monseñor Oscar Romero

Clinic 2032 Marengo Street

Los Angeles, CA 90033 (323) 780-6336


December 21

Leticia Navarro, Chairperson Staff Contact: Martin Vicente, Community Outreach & Education, Ext. 4423

Region 11 Pomona and El

Monte

3rd Thursday of every other Month


dA Center for the Arts 252 D South Main Street

Pomona, CA 91766 (909) 397-9716

May 18 July 20


Lluvia Salazar, Chairperson Staff Contact: Martin Vicente, Community Outreach & Education, Ext. 4423

36




COORDINATED CARE INITIATIVE (CCI) CONSUMER COUNCIL

REGION

MEETING DAY, TIME,

& LOCATION

MEETING

DATE

STAFF CONTACT

Area 1 Antelope Valley

4th Tuesday of every other month

10:00 AM (for approximately 2-1/2 hours) Antelope Valley Partners for

Health 44226 10th Street West Lancaster, CA 93534

(661) 267-5656

May 23 July 25

September 26 November 14*

*will meet the 3rd Tuesday of the month

Demetria Saffore, Chairperson Staff Contact: Mariah Walton Community Outreach & Education, Ext. 5956

Area 2 San Fernando

Valley

4th Wednesday of every other month


Family Resource Center-Pacoima

10807 San Fernando Road Pacoima, CA 91331

(877) 287-6290

May 24 July 26

September 27 November 15*

*will meet the 3rd Wednesday of the

month

Wilma Ballew, Chairperson Staff Contact: Mariah Walton Community Outreach & Education, Ext. 5956

Area 3 South Los Angeles

4th Wednesday of every other month

10:00 AM (for approximately 2-1/2 hours) Inglewood Family Resource

Center 3111 W. Century Boulevard,

Suite 100 Inglewood, CA 90303

(310) 330-3130


December 20*

will meet the 3rd Wednesday of the

month

Brenda White, Chairperson Staff Contact: Susan Ma Community Outreach & Education, Ext. 4586

Area 4 Long Beach

4th Tuesday of every other month 1:00 PM

(for approximately 2-1/2 hours) Mark Twain Branch Library

1325 E. Anaheim Street Long Beach, CA 90813

(562) 570-1046


December 19*

*will meet the 3rd Tuesday of the month

Neisma Istrefi, Chairperson Staff Contact: Susan Ma Community Outreach & Education, Ext. 4586

37

Board of Governors

MOTION SUMMARY

Date: May 4, 2017 Motion No. FIN 100.0517

Committee: Finance & Budget

Chairperson: Michael Rembis

Issue: Accept the Investment Report for the quarter ended March 31, 2017.

New Contract Amendment Sole Source RFP/RFQ was conducted

Background: Per L.A. Care’s Investment Policy, the Finance and Budget Committee is responsible for

reviewing L.A. Care’s investment portfolio to confirm compliance with the Policy, including its diversification and maturity guidelines.

Member Impact: N/A

Budget Impact: L.A. Care budgets a reasonable return on investment holdings.

Motion: To accept the Quarterly Investment Report for the quarter ending March 31, 2017, as submitted.

38

April 20, 2017

TO: Finance & Budget Committee

FROM: Marie Montgomery, Chief Financial Officer

SUBJECT: Quarterly Investment Report – March 2017 As of March 31, 2017, L.A. Care's combined investments market value was approximately $2.7 billion. Interest income, amortization, realized gains and losses was approximately $6.0 million for the quarter. Unrealized gain due to market price fluctuations was approximately $0.3 million for the quarter. Based upon an independent compliance review performed as of March 31, 2017, LA Care is in compliance with its investment policy guidelines pursuant to the California Government Code and the California Insurance Code. At quarter end $2.55 billion (or approx. 95% of total investments) were under the management of Payden and Rygel, an external professional asset management firm. The holdings of these invested funds were as follows:

U.S. Agency Securities 35% U.S. Treasury Securities 28% Corporate bonds 15% Asset Backed and Mortgage Backed Securities 11% Money Market 6% Cash 4% Other 1% 100% Average credit quality: AA+ Average duration: 0.41 years Average yield to maturity: 1.04%

These funds are managed as two separate portfolios by Payden & Rygel based on investment style – 1) the short-term portfolio and 2) the extended term portfolio. The short-term portfolio had approximately $2.47 billion invested as of March 31, 2017, and returned 0.23% for the quarter. The comparative short term money market index used as a benchmark returned 0.06% for the quarter. The extended term portfolio had approximately $84.9 million invested and returned 0.28% for the quarter. The comparative 1-year Treasury note used as a benchmark had a return of 0.16%.

39

LA Care also invests with 2 government pooled investment funds, the Local Agency Investment Fund (LAIF) and the Los Angeles County Pooled Investment Fund (LACPIF). L.A. Care’s investment balances as of March 31, 2017 were $64.5 million in LAIF and $70.7 million in LACPIF. The Local Agency Investment Fund (LAIF) yielded approximately 0.78% annualized for the quarter. The fund’s total portfolio market value as of March 31, 2017, was $71.9 billion, with a weighted average maturity of 180 days. LAIF is administered and overseen by the State Treasurer’s office. The fund’s investment holdings as of March 31, 2017, were as follows:

U.S. Treasury Securities 43% CD’s and bank notes 16% Agencies 14% Loans 11% Commercial paper 8% Time deposits 8% 100%

The Los Angeles County Pooled Investment Fund (LACPIF) yielded approximately 1.14% annualized for the quarter. The fund’s market value as of February 28, 2017, was $28.4 billion, with a weighted average maturity of 673 days. LACPIF is administered and overseen by the Los Angeles County Treasurer. The fund’s most recent published investment holdings (February 28, 2017) were as follows:

U.S. Govt. and Agency Securities 58% Commercial paper 28% CD’s 13% Other 1% 100%

Other related items: The amount placed with the Blackrock Treasury Fund Institutional Shares Money Market Fund, the daily money market fund sweep account with Bank of America, as of 3/31/2017 was $99.9 million with a net yield of approximately 0.14% annualized for the quarter.

40

Page | 1 Wilshire Associates Inc.

L.A Care Health Plan

Quarterly Investment Compliance Report

January 1, 2017 through March 31, 2017

OVERVIEW

The California Government Code requires the L.A. Care Treasurer to submit a quarterly report detailing its investment activity for the period. This investment report covers the three-month period from January 1, 2017 through March 31, 2017.

PAYDEN & RYGEL PORTFOLIO SUMMARY

As of March 31, 2017 the market values of the portfolios managed by Payden & Rygel are as follows:

PORTFOLIOS PAYDEN & RYGEL

CASH PORTFOLIO #2365 $ 2,469,888,000

LOW DURATION PORTFOLIO #2367 $ 84,894,000

TOTAL COMBINED PORTFOLIO $ 2,554,783,000

COMPLIANCE WITH ANNUAL INVESTMENT POLICY

Based on an independent compliance review of Payden & Rygel portfolios performed by Wilshire Associates (using 3rd party custodian data – BOA), L.A. Care is in compliance with the investment guidelines pursuant to the California Government Code and California Insurance Code. The Payden & Rygel investment reports for L.A. Care are available upon request. LA Care has invested funds in California’s Local Agency Investment Fund (LAIF) and the Los Angeles County Treasurer’s Pooled Investment Fund (LACPIF). In a LAIF statement dated April 14, 2017, the statement shows a March 31, 2016 balance of $64,353,752.76 with accrued interest of $123,117.81. In the LACPIF statement dated March 31, 2017, the LACPIF February 28, 2017 balance was $70,565,393.92. The LACPIF account balance does not reflect accrued interest. In the BAML report as of March 31, 2017, LA Care had a balance of $99,870,162.34 in the BAML Treasury money market sweep account.

41


California Government Code Compliance Verification Detail as of March 31, 2017

Maximum Permitted Maturity Actual Maturity

Compliance #2365 #2367 #2365 #2367

Enhanced Cash

Low Duration

Enhanced Cash

Low Duration

US Treasuries 5 Years 5 Years 1.96 Years 2.29 Years YES

Federal Agencies 5 Years 5 Years 2.90 Years 2.34 Years YES

State of CA 5 Years 5 Years 1.12 Years 1.84 Years YES

Negotiable CDs 270 Days 270 Days 160 Days 160 Days YES

MTNs 5 Years 5 Years 4.93 Years 4.93 Years YES

Money Market and Mutual Funds NA NA 1 Day 1 Day YES

Mortgage and Asset Backed Securities 5 Years 5 Years 3.57 Years 3.88 Years YES

42


California Insurance Code Compliance Verification Detail as of March 31, 2017 Compliance Verification

Combined #2365 and #2367 Portfolios as of March 31, 2017

Govt. Code

Insur. Code

Sections

Section 1170-1182

53601 1191-1202

US Treasuries YES (1)(2)(3) YES (4)(5)

Federal Agencies YES (1)(2)(3) YES (4)(5) State of CA YES (1)(2)(3) YES (4)(5) Negotiable CDs YES (1)(2)(3) YES (4)(5) MTNs YES (1)*(2)(3) YES (4)(5) Money Market and Mutual Funds YES (1)(2)(3) YES (4)(5) Mortgage and Asset Backed Securities YES (1)(2)(3) YES (4)(5)

* JP Morgan was approved to be held (Moody’s BAA) (This information was available in Payden reports)

(1) Approved security (2) Meets minimum rating (3) Meets diversification maximums (4) NAIC High Grade Obligations (5) Authorized by Insurance Code Sections 1174 and 1194.5 (6) Authorized by Insurance Code Section 1196.1 Based on an independent review of Payden & Rygel’s month-end portfolio performed by Wilshire Associates, L.A. Care’s portfolios were in compliance with its Annual Investment Guidelines and the California Government Code and the Insurance Code sections noted above. Also, based on the review of the LAIF and LACPIF March 2017 reports and their respective investment guidelines, the LAIF and LACPIF investments are in compliance with the Annual Investment Policy and the California Government Code and the California Insurance Code.

43


MARKET COMMENTARY Economic Highlights

- GDP: Real GDP growth slowed during the fourth quarter of 2016 but was solid at 2.1% annualized. Economic growth for the entire year was equal to 1.6%, the lowest since a similar figure in 2013. Both consumer and business spending contributed to growth with expanding inventories being the main driver of private investment. An increase in the trade deficit was the major detractor from growth after a spike in exports during the third quarter proved to be temporary, in part due to the strengthening U.S. dollar. Source: Dept. of Commerce (BEA)

- Interest Rates: Rates were little changed during the quarter except in the short end of the curve. While the 10-year Treasury was down just 5 basis points, finishing at 2.40%, the 1-year yield was up 0.2%. This shift was driven by the Federal Reserve’s decision to increase the Fed-funds rate by 0.25% during their March meeting, which followed a similar increase in December. Source: US

Treasury

- Inflation: Consumer price increases continue to accelerate into the first quarter of 2017. The Consumer Price Index was up 0.9% for the three months ending February and 2.8% for the one-year period. The 10-year breakeven inflation rate closed the first quarter at 1.97%, little changed from December. Breakeven did push past 2% in January, however, for the first time in more than two years. Source: Dept. of Labor (BLS), US Treasury

- Employment: Jobs growth accelerated to begin the year with total nonfarm employment increasing an average of 209,000 jobs per month during the three months ending February 2017. The unemployment rate remains below 5%, equaling 4.7% in February, a level not seen since pre-crisis 2007. Source: Dept. of Labor (BLS)

Fixed Income Markets U.S. The U.S. Treasury yield curve did not shift much during the quarter but did flatten with the six-month yield up 29 basis points and the ten-year down 5 basis points. The Federal Open Market Committee decided to increase their overnight rate by 0.25% at their March meeting, their third increase since 2008. Credit spreads continued lower during the quarter in both investment grade and high yield bonds. High yield spreads, which have averaged 6% during the past decade, fell below 4% during the quarter for the first time since mid-2014.

44

QUARTERLY PORTFOLIO REVIEWQUARTERLY PORTFOLIO REVIEW

PAYDEN.COM

LOS ANGELES | BOSTON | LONDON | PARIS

1st Quarter 2017

45

April 2017

Dear Client,

Having completed the first quarter of 2017, it is interesting to note how things have changed from just a year ago. Looking back twelve months, there were major concerns over depressed commodity prices, a possible slowdown for China, as well as a weakness in the global manufacturing sector which could impact the U.S. economy. As a result of these concerns and predictions, stocks were down more than 10% during the first quarter of 2016 and there was a great deal of anxiety about the Fed increasing interest rates rapidly.

Things changed as investors took a more positive view and realized that the U.S. economy was on the right track, showing wage growth and future GDP targeting toward 2% to 2.5%, and the fact that the Fed would take a more realistic and practical approach toward rate hikes.

Fast forward to today and there are different concerns. A degree of uncertainty as to domestic and global policies has increased volatility in all markets. The political uncertainties focus around the pending elections in Europe. We will have to wait to see if the results in the Netherlands carry through to the French and German elections. We continue to focus on the U.S. and believe it is on track for moderate wage growth and increased economic activity. The recent increase of 25 basis points by the Fed on March 15th was actually received without any disruption in the marketplace.

The one thing we believe we can take from the past twelve months is that a certain degree of volatility will continue, and the most important focus should be diversification of portfolios and keeping an eye on liquidity. These characteristics are at the core of our strategies, and we will continue to focus on them.

For 34 years we have worked with our clients to find the best solutions in a changing global investment landscape. As the firm continues to grow, we seek attractive risk-adjusted return opportunities and remain in as strong a position today as ever.

My very best wishes,

Sincerely,

Joan A. Payden

President & CEO

LETTER FROM THE CEO

46

F:\GRAPHICS\TEMPLATE\Bound Books\P&R Marketing Book\P&R Overview.pptx

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

L.A. Care Health Plan Combined Portfolio

Sector Allocation Maturity Distribution

PORTFOLIO RETURNSPeriods over one year annualized

PORTFOLIO CHARACTERISTICS (As of 3/31/17)

* iMoneyNet Instit. Money Market Avg.

Market Value $2,554,782,740 Avg Credit Quality AA+Avg Duration 0.41Avg YTM 1.04%

Periods ended 3/31/17

Sector Market Value % of Port<90 day 1,470,282,505 57.6%90 days - 1 Year 808,876,927 31.7%1 - 2 Years 260,183,492 10.2%2 - 5 years 15,439,816 0.6%Total $2,554,782,740 100.0%

PERFORMANCE 1st QtrTrailing 1 Year

Trailing 3 Year

LA Care - Short-Term Portfolio 0.23 0.74 0.42Money Market Index* 0.06 0.16 0.07

LA Care - Extended-Term Portfolio 0.28 0.87 0.65BAML 1-Year Treasury Index 0.16 0.56 0.39

LA Care - Combined Portfolio 0.23 0.74 0.43

Portfolio Review – 1st Quarter 2017

Sector Market Value % of PortCash 115,610,007 4.5%Money Market 153,662,290 6.0%Treasury 701,711,356 27.5%Agency 885,162,999 34.6%Credit 381,031,808 14.9%ABS/MBS 281,594,170 11.02%Municipal 36,010,110 1.4%Total $2,554,782,740 100.0%

47


Payden&Rygel 333 S. Grand Avenue Los Angeles, California 90071 (213) 625-1900 www.payden.com48

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L.A. Care Health Plan Short Term PortfolioPortfolio Review – 1st Quarter 2017




* iMoneyNet Institutional Money Market Average


Market Value $2,469,888,312 Avg Credit Quality AA+Avg Duration 0.40Avg YTM 1.04%

Sector Market Value % of PortCash 114,817,208 4.6%Money Market 146,314,347 5.9%Treasury 680,314,780 27.5%Agency 866,678,090 35.1%Credit 360,732,887 14.6%ABS/MBS 267,938,723 10.8%Municipal 33,092,278 1.3%Total $ 2,469,888,312 100.0%

Sector Market Value % of Port<90 day 1,440,276,492 58.3%90 days - 1 Year 778,853,466 31.5%1 - 2 Years 241,354,145 9.8%2 - 5 years 9,404,208 0.4%Total $2,469,888,312 100%


Trailing 3 Year

LA Care - Short-Term Portfolio 0.23 0.74 0.42Money Market Index* 0.06 0.16 0.07

49


Payden&Rygel 333 S. Grand Avenue Los Angeles, California 90071 (213) 625-1900 www.payden.com50

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L.A. Care Health Plan Extended Term Portfolio




Market Value $84,894,429 Avg Credit Quality AAAvg Duration 0.74Avg YTM 1.18%

Portfolio Review – 1st Quarter 2017


Sector Market Value % of Port<90 day 30,006,013 35.3%90 days - 1 Year 30,023,461 35.4%1 - 2 Years 18,829,347 22.2%2 - 5 years 6,035,608 7.1%Total $84,894,429 100%


Trailing 3 Year

LA Care - Extended-Term Portfolio 0.28 0.87 0.65BAML 1-Year Treasury Index 0.16 0.56 0.39

Sector Market Value % of PortCash 792,800 0.9%Money Market 7,347,943 8.7%Treasury 21,396,576 25.2%Agency 18,484,909 21.8%Credit 20,298,921 23.9%ABS/MBS 13,655,447 16.1%Municipal 2,917,832 3.4%Total $84,894,429 100.0%

51

Portfolio Review and Market Update - 1st Quarter 2017

MARKET THEMES

Politics moved front and center to start 2017. Donald Trump was inaugurated as the 45th President and quickly took action on deregulation, a controversial immigration ban and currency manipulators. The wave of positive market sentiment seen after his election began to falter as the failure to repeal the Affordable Care Act highlighted difficulties that lie ahead for the new president in delivering some of his promises, particularly those on tax reform. Anti-establishment parties in Europe took a hit as the Dutch election concluded with the defeat of the far right, anti-EU party, and focus has now turned to the French elections in April. In the UK, Prime Minister Teresa May triggered Article 50, officially starting the clock on Brexit.

Economic data in most major developed markets showed continued signs of improvement, and most central banks took a “wait-and-see” approach to see if the recovery in their respective economies would accelerate. Emerging markets also recovered, resulting in a much improved outlook for overall global growth. Accordingly, Federal Reserve chairwoman Janet Yellen took the opportunity to strike a more hawkish tone in her testimony to Congress in February, and the Fed hiked interest rates 0.25% at their March meeting, setting the overnight target policy interest rate corridor at 0.75-1.00%.

STRATEGY

The portfolio holds a diversified mix of credit sectors for income generation.n

Corporate bond yield premiums remain attractive, and we expect to maintain our exposure through the purchase of bonds in the new issue market.

n

We have continued to participate selectively in high-quality asset-backed and mortgage-backed security (ABS/MBS) deals with short duration profiles.

n

INTEREST RATES

Front end Treasury rates were higher with shorter maturities outpacing the longer end. Two-year maturity yields were higher by 0.06% to end the quarter at 1.25%, while the yield difference between one- and two-year maturities fell from 0.38% to 0.23%.

n

The additional carry from longer duration positions was partially offset by negative price returns from the move higher in Treasury yields.

n

Floating-rate credit and securitized holdings were positive contributors to performance as the securities had minimal price impact from higher rates.

n

SECTORS

The overweight allocation to credit securities was additive to performance. The yield difference between credit and government securities fell 0.13% during the quarter.

n

High-quality ABS continued to add positively to performance while providing reinvestment opportunities.n

The MBS allocation was additive to performance as floating-rate exposure benefited from yields resetting at higher rates.

n

Payden & Rygel • 333 South Grand Avenue • Los Angeles, California 90071 • (213) 625-1900 • www.payden.com52

MARKET PERSPECTIVEThe global economy has changed immensely in recent decades. Where once developed economies accounted for nearly 60% of total global economic activity, by 2020, estimates from the International Monetary Fund suggest that emerging economies will account for more than 60% of global economic activity.

In U.S. fi xed income markets, international investors play an increasingly important role. At the turn of the 21st century, foreign inves-tors owned only $1 trillion in U.S. corporate debt. Today, foreign investors hold more than $3 trillion of U.S. corporate debt. While some might worry, the powerful demand for dollar-denominated U.S. corporate debt provides American companies with advanta-geous borrowing terms and lower interest costs.

The same is true for the U.S. government. Currently foreign investors own just under 40% of all U.S. Treasury debt. Do foreigners buy U.S. assets out of the goodness of their hearts? We doubt it. Foreigner investors hold large quantities of dollars which need to be invested. The desire for safety and liquidity feature prominently in the investment decisions made by these foreign central banks, retirement funds and corporations, therefore guiding their savings into high quality, liquid U.S. Treasury debt.

Source: SIFMA, U.S. Treasury

Total U.S. Treasury Debt

Total U.S. Corporate Debt

02002 2004 2006 2008 2010 2012 2014 2016

2002 2004 2006 2008 2010 2012 2014 2016

12

3

4

56

7

8

910

Foreign Holdings of U.S. Corportate Debt

U.S. Corporate Debt Outstanding

$ in

Tri

llion

s

Foreign Holdings of U.S.Treasury Debt

U.S. Treasury Debt Outstanding

$ in

Tri

llion

s

0

2

4

6

8

10

12

14

16

18

53

For more information about Payden & Rygel, contact us at a location listed below.

LOS ANGELES 333 South Grand Avenue Los Angeles, California 90071 213 625-1900

BOSTON 265 Franklin StreetBoston, Massachusetts 02110617 807-1990

LONDON1 Bartholmew LaneLondon EC2N 2AX United Kingdom+ 44 (0) 20-7621-3000

PARISRepresentative Office54, 56 Avenue Hoche75008 Paris, France+ 33-607-604-441

PAYDEN.COM

LOS ANGELES | BOSTON | LONDON | PARIS

OVER 30 YEARS OF INSPIRINGC O N F I D E N C E W I T H A N UNWAVERING COMMITMENT TO OUR CLIENTS’ NEEDS.

US DOMICILED MUTUAL FUNDS

DUBLIN DOMICILED UCITS FUNDS

CASH BALANCEPayden/Kravitz Cash Balance Plan Fund

EQUITYEquity Income Fund

GLOBAL FIXED INCOMEEmerging Markets Bond FundEmerging Markets Corporate Bond FundEmerging Markets Local Bond FundGlobal Fixed Income Fund Global Low Duration Fund

TAX-EXEMPT FIXED INCOMECalifornia Municipal Income Fund

US FIXED INCOMEAbsolute Return Bond FundCash Reserves Money Market FundCore Bond FundCorporate Bond FundFloating Rate FundGNMA FundHigh Income FundLimited Maturity FundLow Duration FundStrategic Income FundUS Government Fund

EQUITYWorld Equity Fund

FIXED INCOMEAbsolute Return Bond FundGlobal Emerging Markets Bond FundGlobal Emerging Markets Corporate Bond FundGlobal Government Bond Index FundGlobal High Yield Bond FundGlobal Inflation-Linked Bond Fund

Global Bond FundGlobal Short Bond FundSterling Corporate Bond Fund – Investment GradeUS Core Bond FundUSD Low Duration Credit Fund

LIQUIDITY FUNDSEuro Liquidity FundSterling Reserve FundUS Dollar Liquidity Fund

54

Board of Governors

MOTION SUMMARY


Committee: Finance & Budget Chairperson: Michael Rembis

Issue: Execute a contract with the Center for the Study of Services (CSS) for a survey of Medi-Cal

member satisfaction with participating provider groups and community clinics.


Background: For the past several years, L.A. Care has scored in the 25th percentile on major

Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures. It is critical to capture patient experience at the provider group and clinic levels in order to identify opportunities for improvement, and to design interventions to improve the quality of services and raise Medi-Cal member satisfaction. To this end we will conduct the Clinician and Group CAHPS (CG-CAHPS) survey as part of the Value Initiative for IPA Performance + Pay-for-Performance Program (VIIP+P4P).

VIIP+P4P measures, reports, and provides financial rewards for provider group performance across multiple domains and measures. In 2014, L.A. Care established baseline measures with its first CG-CAHPS survey for participating provider groups. The 2017 CG-CAHPS survey results will measure improvement in patient experience at the provider group and clinic levels, and will be the basis for incentive payments for performance and improvements in member satisfaction for provider groups and clinics that participate in VIIP+P4P.

Staff requests authorization to contract with Center for the Study of Services (CSS) to conduct the 2017 CG-CAHPS survey. The survey will include select provider groups meeting membership requirements as part of VIIP+P4P incentive program, and clinics. The 2015 survey cost was $728,336 for 90,000 PPG- only members sampled. The 2017 survey budget is $1,151,078 for the current member sample which exceeds 128,000, and includes both PPGs and clinics. An increase in the number of supplemental questions with multiple language translations has contributed to the increase in per member pricing.

A competitive bid process was conducted for the 2015 survey in which seven firms were invited to bid. Four firms replied in sufficient detail for evaluation and CSS was selected. CSS is an NCQA-certified survey firm. A new RFP will be conducted for a 2019 survey.

Staff anticipates that at least 60 medical groups and 30 clinics will have enough L.A. Care members with office visits in the past 6 months to qualify for the survey. VIIP+P4P seeks to benefit as many members as possible by surveying and reporting and rewarding performance for as many provider groups as can be assessed in a statistically valid manner.

Member Impact: The CG-CAHPS survey positively impacts L.A. Care members by supporting

the VIIP+P4P program to improve access and quality of services through quality measures and rewards for improved performance.

Budget Impact: The cost of this agreement was anticipated and included in the approved budget

for the QI Department for FY 2016-17 and will be requested for FY 2017-18.

55

Board of Governors

MOTION SUMMARY

Motion: To authorize staff to execute a contract with Center for the Study of

Services (CSS) effective June 1, 2017 through May 31, 2018, for an amount not to exceed $1,151,078, to conduct the 2017 member satisfaction (CG-CAHPS) survey.

56

Board of Governors

MOTION SUMMARY



Issue: Amend a contract with HCL America, Inc. (HCL) to provide consulting and staffing services

for various Information Technology efforts.


Background: On June 4, 2015, the Board of Governors approved motion FIN 107.0615,

approval to negotiate a contract with HCL and three other vendors following a competitive bidding process. Since the approval of the motion, a Master Services Agreement was negotiated and executed, setting forth competitive billing rate cards and work order procedures.

L.A. Care staff requests approval to amend a contract with HCL for staff augmentation

through July 31, 2018, in the amount of $750,000. Services are needed to manage ongoing and

new strategic projects such as Clinical Care Advance and the new encounters system.

Member Impact: Will provide a standard platform for enterprise Key Performance Indicator

measurements and provide the backbone of future analytical capabilities that will facilitate improved health care outcomes and lower operational costs in addition to the improved ability to pay claims based on stable provider data and provide a robust platform to rollout the Member System of record into QNXT.

Budget Impact: The cost of this contract was anticipated and included in the approved budget for

the Information Technology Department through the Enterprise Data Warehouse and Data Integrity Initiatives/MDM (Provider MDM) strategic projects for FY 2016-17.

Motion: To authorize staff to amend a contract with HCL America, Inc., for an amount of $750,000 (total contract not to exceed $5,299,672), to provide consulting and staffing services through July 31, 2018.

57

Board of Governors

MOTION SUMMARY

Date: May 4, 2017 Motion No. ECA 100.0517

Committee: Executive Community Advisory Committee

Chairperson: Christina Deh-Lee

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.

Member Impact: None

Budget Impact: None.

Motion: To approve the following candidate(s) to the Regional Community Advisory Committees (RCAC) and Coordinated Care Initiative Councils, (CCI), as reviewed by the Executive Community Advisory Committee (ECAC) during the April 12, 2017 ECAC meeting.

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

Sonia Claudio RCAC 4 Consumer

Hugo Flores RCAC 4 Consumer

Alfonso Noriega RCAC 4 Consumer

Carrie Broadus RCAC 6 Member Advocate, Los Angeles Metropolitan Churches, Inc.

Nancy Srey CCI Area 4 Consumer

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April 27, 2017 TO: Board of Governors FROM: John Baackes, Chief Executive Officer SUBJECT: CEO Report – May 2017 On April 1, 2017, L.A. Care Health Plan celebrated its 20th Anniversary. Since the plan first began accepting members in 1997, L.A. Care has grown to become the largest publicly-operated plan in America, serving over two million members. To paint a picture of this magnitude, we insure one out of every five residents in Los Angeles County. In these 20 years, L.A. Care has expanded to include other lines of businesses outside of Medi-Cal, such as Cal MediConnect (pilot for individuals dually eligible for Medicare and Medi-Cal), and L.A. Care Covered (California’s health benefit exchange), and now employs approximately 2,000 staff members who travel from all over Los Angeles and other neighboring counties to serve our member population. L.A. Care has been a steadfast advocate for access to quality health care and a partner to community-based organizations and the safety net long before the Affordable Care Act was passed. For these reasons and countless others, I am reminded of our mission and vision, to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net. On April 4 and 5, L.A. Care held two internal events to acknowledge our “trailblazers”; staff who have been with the organization for nearly 20 years. On April 13, L.A. Care held an event for stakeholders, hosted by Martin Luther King Jr. Community Hospital, in which partners, past and present, celebrated the enrollment of L.A. Care’s two millionth Medi-Cal member, and our announcement of a $20 million commitment to the DHS Housing for Health program via Brilliant Corners, assisting many of our members who are experiencing homelessness access permanent, supportive housing. The $20 million commitment over five years is contingent on Board approval of Community Health Investment Funds annually as part of our normal budget process. This past month, L.A. Care has continued to work diligently to ensure that our presence is felt amongst lawmakers and advocates. On April 18, 2017, I had the opportunity to meet with Seema Verma, newly appointed Administrator of the Centers for Medicare and Medicaid Services and again participated in an interview by local NPR affiliate KPCC about the need to care for our homeless population in Los Angeles. KPCC article is attached to this report for your reference. L.A. Care remains vigilant in our position to maintain access to care for our members and to protect the health interests of Los Angeles County residents.

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Please find an update of organizational activities below. Additional updates will be provided at the May 4, 2017 Board meeting. 1. Louise McCarthy Instated as Chairperson of L.A. Care Board of Governors

Effective May 4, 2017, Louise McCarthy will be instated as the new Chairperson of the L.A. Care Board of Governors. Louise has served as a board member since 2011, representing as the voice of community clinics and health centers. We look forward to her continued engagement and leadership. L.A. Care would like to thank Mark Gamble who has been a member of our Board since 2011 and served as Chairperson for two years. Mark played an integral role in my onboarding and has been a steadfast partner during these past years of great membership and organizational growth. He will remain a member of our Board and continue as members of various Board Committees.

2. Membership Update

As of April 1, 2017, L.A. Care’s Medi-Cal membership, inclusive of Plan Partners and our direct line MCLA, is 2,016,872. With the addition of Cal MediConnect membership (14,151), L.A. Care Covered and L.A. Care Covered Direct membership (24,897), PASC membership (48,859), and Healthy Kids (2 remaining), total L.A. Care membership is 2,104,781.

3. Strategic Vision Progress Report

Attached to my report is the second quarter strategic vision progress update, prepared by Wendy Schiffer, Senior Director, Strategic Planning. Highlights will be discussed at the Board meeting.

4. Welcome Dr. Richard Seidman, Chief Medical Officer

Dr. Richard Seidman officially began his role as Chief Medical Officer on April 18. He is working collaboratively and cross-functionally with all internal departments in order to continue to elevate the ability of L.A. Care to provide outstanding service to our members. Again, I would like to thank Trudi Carter for her commitment to our members and support during this leadership transition. Her vision strengthened the ability of L.A. Care to serve the most vulnerable in Los Angeles County.

5. Retirement of Regina Lightner, Senior Director of Sales and Marketing

Regina Lightner, Senior Director of Sales and Marketing, is retiring after a distinguished career that has spanned over forty-six years in management and senior leadership positions, eight of which have been at L.A. Care. During her tenure, Regina was an indomitable force in leading her teams in the successful growth of L.A. Care through our D-SNP, Cal MediConnect, and L.A. Care Covered products. We will miss her forward-thinking and champion spirit, but certainly thank her for her dedication in educating Los Angeles County residents about L.A. Care and our mission.

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6. Events of Interest On April 17, 2017, L.A. Care was acknowledged at the Los Angeles Business Journal “Hall of Fame” Awards Luncheon. L.A. Care was recognized as one of the top 30 companies in Los Angeles as the top company in the health insurers category. In April, I participated in several Board meetings (listed below) for trade associations in which L.A. Care participates. Given recent efforts to alter the Affordable Care Act, it has been important to stay up to date on federal legislative issues and their impact on access to care and health coverage.

· April 21, 2017 - SNP Alliance Board meeting. · April 28, 2017 - Medicaid Health Plans of America Board Meeting.

Attachments:

· KPCC article, “Insurance Provider Wades into L.A.’s Homelessness Problem” · April 2017 Sponsorship List · Strategic Vision Progress Report

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Insurance provider wades into LA's homelessness problem

Rina Palta, April 13 2017

Jesus Torres has lived in the Arroyo Seco riverbed for almost three years. File photo by Maya Sugarman/KPCC

As part of a growing movement that looks at stable housing as a health issue, a local insurance provider is wading into Los Angeles' efforts to end homelessness.

L.A. Care, the county's largest MediCal health plan, announced Thursday it will donate $20 million over the next five years to a program that houses homeless people who have medical issues.

"The research is showing that if people don't have basic needs like food and shelter, their health-care expenses are going to be higher because you can't really get them into a routine of health prevention or consistent treatments of conditions they might have," said L.A. Care CEO John Baackes.

The money is expected to help the nonprofit Brilliant Corners house about 300 people through L.A. County's Housing for Health program. That program, started in 2013, identifies homeless persons who are frequent users of county emergency rooms and other high-cost medical services, and through nonprofits like Brilliant Corners helps them move into an apartment and pays part of their rent.

The county's Department of Health Services has invested its own money into the program over the past few years, betting that by housing these high-cost clients it will save money in the long run. Health Agency Director Mitch Katz said in a statement that L.A. Care's contribution will provide critical assistance to L.A.'s homeless persons.

“I truly applaud L.A. Care’s recognition of the importance of stable housing as a necessary component of improved health," Katz said.

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The view that stable housing and other poverty issues have a big impact on health is gaining greater acceptance in the U.S., and some of the biggest strides in linking the issues have come in Los Angeles.

Part of that effort has been through Housing for Health. In late 2016, California also announced a $1.5 billion five-year pilot program through MediCal. It targets people who use a lot of high-cost health services, but have poor health, and provides services such as social workers or case managers that normally aren't included in health plans.

L.A.'s "Whole Person Care" pilot targets people who are homeless, involved in the justice system, or who have severe mental health, substance abuse or medical issues.

"L.A. has been, frankly, visionary when figuring out ways to use health-care dollars to create supportive housing opportunities for some of their most vulnerable patients," said William Pickel, CEO of Brilliant Corners, which is headquartered in San Francisco.

L.A. Care's grant, he said, will allow the nonprofit to expand its work through the program, and will provide a way to build momentum towards more public and private health system investment in homelessness.

"To continue to show that this is a best practice," he said. "That the outcomes on both the health-care and housing side are measurable and substantial."

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April 2017 Sponsorship List

Event Date Organization Event Type Location 4/25/2017 California

Association for Adult Day Services

(CAADS)

Spring Conference Doubletree Berkeley Marina

4/27/2017 Valley Presbyterian Hospital

Foundation

Celebration of Excellence Dinner Skirball Cultural Center

4/30/2017 St. John’s Well Child and Family

Center

Moveable Feast Park Plaza Hotel

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April 26, 2017

TO: Executive Committee

FROM : John Baackes, Chief Executive Officer

SUBJECT: 2nd Quarter FY 2016-17 Organization Goals Progress Report This progress report summarizes the status of organizational goals and tactics outlined in the Strategic Vision. This is the second report for this fiscal year, which represents the second year covered by our Refreshed Strategic Vision. Among the notable activities for the second quarter are:

· The VIIP Steering Committee approved the merging of the L.A. Care P4P program and VIIP. The program documentation will be distributed to all IPAs in April 2017.

· Auto assignment to the Antelope Valley Direct Network started in March 2017 with a maximum of 200 members per month. Progress is being made in the two expansion areas, expected to be launched by September 30, 2017.

· L.A. Care Covered 2017 Open Enrollment exceeded goals. Our target for new enrollments was set at 5,000 new members. Current membership is over 26,000. Additionally, migration from Bronze to Silver was a success, with over 74% of members in Silver plans.

· Effective March 28, 2017, we revised all L.A. Care product toll-free numbers. This large undertaking changed the options for both members and providers and has positioned us to be able to spread call volume and types to broader agents with varying skills.

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Key: Green – all activities on track, Yellow – most activities on track, Red – most activities not on track

Strategic Direction 1: A highly-functioning health plan with clear lines of accountability, authority and communication, and with processes and people that drive efficiency and excellence Tactic Status Year 2 Milestones Updates 1.1 Implement the core business

transformation strategy to achieve the goal of becoming the highest quality Managed Care Organization for our members.

Lead: Dino Kasdagly

Q1, Oct-Dec 2016: Product and Cycle-time Excellence (PACE) methodology being implemented to enable and support cross-functional execution of all transformational activities. Current programs and projects underway include: 1) Beneficiary Access Line; 2) Voice of the Customer; 3) Provider Data Template Pilot. Q2, Jan-Mar 2017: Product and Cycle-time Excellence (PACE) methodology being implemented to enable and support cross-functional execution of all transformational activities. Current programs and projects underway include what was reported in Q1 and: 1) CMC InfoCrossing; 2) Direct Network Enhancement; 3) Whole-Person Care.

1.2 Build a high performance workforce through the attraction, training and retention of high quality talent, capable of meeting the evolving needs of a large and complex heath plan.

Lead: Bob Turner METRIC: Employee Engagement Baseline: 3.62 Target: 3.76

Implement fully adopted new performance management model

Q1, Oct-Dec 2016: The employer brand has been created through a partnership between HR, Marketing, Communications and Bayard Advertising. The career site has been redesigned and will debut in early 2017, along with social media strategy implementation, when HRIS Success Factors ATS goes live. The dual career ladder program has been rolled out in IT and we are conducting education sessions at IT department meetings currently. We have already educated IT management and have placed several of ITs individual contributors into the program. Kaizen on hiring process completed with assistance from PMO office, reducing hiring steps from 65 to 26. Q2, Jan-Mar 2017: The new performance management process was deployed in October 2016. This new model included an integration of enterprise goals into the annual

L.A. Care Strategic Vision (2015 – 2018)

Quarterly Progress Report January – March 2017

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Tactic Status Year 2 Milestones Updates incentive program and an alignment of organizational competencies. The 40 hour management training requirement was deployed as part of the new performance model with the goal of ensuring our managers have the right skills to build high performance teams. In partnership with the Center for Organizational Excellence, monthly management trainings have been deployed and a total of 3,125 learning hours completed. The following HRIS modules have been launched: Employee Central, Onboarding, Performance Management, Goal Management, Learning Management, Reporting, and Compensation. In addition, crucial feeds to and from SAP Success factors such as Benefits, Payroll, Sciquest, ADI time and attendance, LMS, Aduro Wellness, which are all part of HRIS, were integrated and have gone live this quarter.

1.3 Drive product line performance by establishing clear lines of accountability to support high-quality service and financial sustainability across all product lines.

Lead: John Baackes, Product Line EDs METRIC: Operating Margin Baseline: 4.1% (MCR of 95.9%) Target: 6.0% (MCR of 94.0%) FY2016-2017 Q1: 5.3% (94.7% MCR) YTD 2/28/17: 6.0% (94.0% MCR)

(Medi-Cal and Commercial/ Group) (CMC)

Service Level Agreements Implemented

Q1, Oct-Dec 2016: Completed comprehensive Service Level Agreements (SLAs) for all product lines and segments with all key departments. The SLAs cross all core functional areas and outline essential operational deliverables and metrics, as well as timeliness and key staff responsibility to support product line strategy and business objectives. Medi-Cal TANF/MCE established a monthly product retention meeting to focus on product- driven outreach, engagement and satisfaction strategies. Meeting participants represent a wide range of functional area, including QI/CAHPS that contribute to member retention. In order to improve oversight of Plan Partner non-compliance issues, the Medi-Cal Plan Partner Team is working with Regulatory Affairs & Compliance to analyze the Plan Partners 2016 Annual Audit deficiencies. The analysis will include a combined review of each PP audit deficiencies. We will begin to identify common deficiencies across the three health plans, trends, and repeat issues. Q2, Jan-Mar 2017: Medi-Cal TANF/MCE led the execution of the Human Arc Supplemental Security Income (SSI)/Social Security Disability Income (SSDI) vendor contract, which is currently being implemented with an anticipated go-live of summer 2017. This project will assist in enrolling eligible beneficiaries in the SSI or SSDI program, resulting in increased plan revenue. Medi-Cal

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Tactic Status Year 2 Milestones Updates TANF/MCE is working closely with the Enterprise Data Strategy and Analytics (EDSA) team to refine the Medi-Cal enrollment data and provide the business-related analysis in the Key Performance Indicators report. Medi-Cal Plan Partner Team and Compliance developed a draft Plan Partner Readiness process in an effort to reduce Plan Partner compliance issues. This new process aims to enhance plan relations, improve annual audit and lower deficiencies. The Cal MediConnect (CMC) product line has positive margin, indicating improved financial sustainability. The “yellow” status reflects the product’s operational efficiencies and challenges, rather than the financial. The business planning process (Pillars and Planks) has been an effective tool for departments to address strategic goals for CMC, including operational improvements and we continue to drive efforts to ensure high-quality service for our members.

1.4 Enable product line performance through operational improvements and increased functionality.

Lead: Dino Kasdagly METRIC: Encounter Accuracy (Acceptance) Baseline: 90% Target: 100% 2/28/2017: 93.9% (MCLA)

Q1, Oct-Dec 2016: Enterprise Shared Services (ESS) collaborated with Configuration and other units to correctly identify DOFR issues and increase auto-adjudication rate to 50%. ESS also completed implementation of Phase I and Phase II of Remittance Advice. Appeals & Grievances cross training completed to increase all LOB competency. Continue to refine Call Center org structure to directly support LOB uniquely. Specialty Products (L.A. Care Covered and Cal MediConnect) Manager hired and Monthly Business Reviews (MBR) scheduled with call center and EDs to ensure metric performance and processes are reported and explained. Completed the Dedicated Provider Service Unit for all providers and expanded and improved a new toll-free number for our direct contracted providers 12/22/16. Collaboration between Provider Network Management and Claims made it possible for us to expand improved service to our direct contract network. Q2, Jan-Mar 2017: Created both inbound encounter submission reporting as well as outbound reporting allowing for monitoring of encounter data flow regarding Timeliness, Quality and Quantity to mirror QMED measurements.

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Tactic Status Year 2 Milestones Updates Hired Claims Director; Reduction of Claims inventory to 60,000+ claims in late March as a result of coordination of benefits (COB) implementation. The organization is developing a risk management and operations oversight unit within the Compliance Department, including development of a risk management plan, charter, risk register and assessment of compliance risks. The risk management plan will be completed by April 30. The Customer Solution Center (CSC) has been aggressively working on hiring backfill Call Center Agent positions. We have 22 openings and only 7 filled from our hiring event. Collaborative sessions are being held with CSC, HR, and Center for Organizational Excellence to improve on rapid hiring and employee attrition. Effective 3/28/17, we revised all L.A. Care Product toll-free numbers (TFNs). This massive undertaking changed the options for both members and providers and has positioned us to be able to spread call volume and types to broader agents with varying skills. We also executed a forced transfer of misdirected calls to their proper location, ensuring the caller gets to the right place the first time. Although call volume trending continues to rise, we are seeing improvements in service levels and lower speeds of answer and abandonment rates.

1.5 Increase use of data to drive decision-making across product lines and functional areas by centralizing data governance, management, and analytics and establishing tools that facilitate access to data.

Lead: Dino Kasdagly

Organizational restructure completed; data and analytics training rolled out across the organization; initial dashboards developed; data architecture completed; additional data deployed

Q1, Oct-Dec 2016: Successfully delivered the inaugural release of the EDW on November 7th, providing the ability to easily measure and analyze inbound encounter performance and perform self-service queries on membership data. The second release was done shortly afterward on December 5th, adding the ability to drill into root causes of performance deviation for inbound encounters. The EDW functionality is already being used by the Encounters team to make operational and strategic decisions. The 2017 roadmap for the EDW was confirmed and approved by the steering committee including our COO, CMO CFO, CIO and Chief of Enterprise Integration. Q2, Jan-Mar 2017: Deployed 2 additional releases adding functionality for claims data analysis and outbound encounter performance monitoring. Tableau has been deployed as the new visualization/dashboarding tool of choice for the enterprise, enabling faster, more flexible solution development. Monthly Executive Level Metrics have already been migrated to a Tableau solution and work is underway to start sourcing data from the EDW as it becomes

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Tactic Status Year 2 Milestones Updates available. Much work is happening organizationally to train people to use the right tools, think like analysts with a business focus and instill a spirit of customer service and collaboration.

1.6 Optimize the financially responsible growth potential of Cal MediConnect (CMC) and L.A. Care Covered (LACC).

Lead: Garrison Rios; Linda Greenfeld METRIC: Membership LACC Baseline: 10,955 Target: 15,955 4/7/2017: 26,590 CMC Baseline: 12,481 Target: 17,000 2/28/2017: 13,437

(LACC) (CMC)

Implement programs to retain/grow members in CMC and LACC

Q1, Oct-Dec 2016: Open enrollment began on 11/1/2016. Through 12/31/16, LACC has 10,862 new enrollees and 9,319 renewals. The new member target of 5,000 was exceeded by 217%. Retention target is 90%, and currently it is at 85%. As of 12/31/2016, total enrolled (new & renewing) is 20,181 with 71% in Silver metal tier. We have been able to make improvements to the CMC product’s book overall, and we are working toward achieving this year’s membership and financial targets. Enrollment growth continues, we have targeted potential enrollees (age-ins to Medicare and CCI), and we continue to address reimbursement arrangements in provider contracts that we can improve upon. Retention is a challenge; there are several variables that impact the growth and retention results. As such, we are addressing the voluntary disenrollment challenges by reworking the entire onboarding process. Q2, Jan-Mar 2017: LACC: 2017 Open Enrollment was a success. Our target for new enrollments was set at 5,000 new members. The open enrollment yield more than 3x the target bringing total enrollment to almost 28,000 members enrolled inclusive of retention membership at 84% (target 90%). Our migration from Bronze to Silver plans was successful with over 74% total membership enrolled in Silver plans, Bronze shrinking to 19% with our remaining membership distributed across Platinum and Gold plans. CMC: We received a rate adjustment from the state that improved the product’s financial performance. At the same time, we are looking at our agreements from PPGs and ancillary providers to ensure clear contractual arrangements that support the product’s quality goals. Membership size is ahead of plan. Retention has been challenging due to remediation from the state and internal operational systems. We are addressing these internal issues with cross-functional teams to improve the member experience.

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Strategic Direction 2: A network that aligns reimbursement with member risk and provider performance Tactic Status Year 2 Milestones Updates 2.1 Optimize shared risk, dual risk

and full risk contracting arrangements by product segment to align reimbursement with the specific needs and risk type of the population segment.

Lead: Dino Kasdagly

Implement recommended changes to shared risk, dual risk and full risk contracting arrangements

Q1, Oct-Dec 2016: Analyzing cost and outcome information for shared risk versus dual risk contract arrangements. Currently, assessing viability and methodologies of all contracting arrangements. Q2, Jan-Mar 2017: Initiating a pilot with one hospital and two IPAs to track performance metrics for oversight of a dual risk arrangement, with the intention of expanding to other groups in the future.

2.2 Develop and implement strategies to promote quality performance in the provider network.

Lead: Trudi Carter METRIC: Average Change in VIIP Attainment Score (will report at end of fiscal year)

Full review of experience of the first year; tool revision

Q1, Oct-Dec 2016: The Value Initiative for IPA Performance (VIIP) refresh with 2015 data was completed in October and emailed to the leadership of all IPAs and DHS. The Workplan for 2017 was presented in December to the Quality Oversight Committee. Draft recommendations to coordinate VIIP with Incentives under discussion in December meetings. VIIP and Incentives will continue to be developed for all LOBs. The Medi-Cal Plan Partner team leads a weekly VIIP workgroup meeting with key participants from L.A. Care, Anthem and Care 1st. This workgroup has resulted in agreement from these two Plan Partner leadership on various topics and documents. This includes a joint Project Charter and Memorandum of Understanding (MOU) which combined, clearly outlines the purpose and objective of the new Plan Partner Collaborative for VIIP as well as the MOU which was agreed upon by the Plan Partners. On December 8th, for the first time in L.A. Care history, the leaders from L.A. Care, Anthem, and Care 1st joined together at L.A. Care Headquarters where a united approach was presented to leaders from the 6 IPAs that overlap. Resulting from this meeting with the 6 IPAs was significant feedback from IPA leaders. Q2, Jan-Mar 2017: The VIIP Steering Committee approved the merging of the L.A. Care P4P program and VIIP. The program documentation will be distributed to all IPAs in April 2017. Dr. Carter notified all L.A. Care IPAs in March 2017. Additionally, an IPA action plan will be distributed to the IPAs with the new P4P VIIP program.

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Tactic Status Year 2 Milestones Updates The Medi-Cal Plan Partner team shared draft VIIP + P4P documents, which includes VIIP Scorecard Measurements, Action Plan, and P4P description to improve performance across all IPAs, with its Plan Partners.

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Strategic Direction 3: Tailored models of care for the specific needs of our member populations Tactic Status Year 2 Milestones Updates 3.1 Develop and implement direct

networks for subpopulations within our membership to improve access and quality.

Lead: Trudi Carter METRIC: Membership in Antelope Valley Direct Network Baseline: 551 (12/31/2016) Target: 2,000 3/31/17: 921

Select new areas of focus

Q1, Oct-Dec 2016: The two new areas for Direct Network Expansion have been presented and approved by John Baackes - L.A. South and East San Gabriel Valley/Pomona. We continue to add Specialty Care Physicians throughout L.A. County. Q2, Jan-Mar 2017: Auto Assignment to the Antelope Valley Direct Network started in March 2017 with a maximum of 200 members per month. Progress is being made in the two expansion areas, expected to be launched by September 30, 2017.

3.2 Develop tailored population health management programs for the unique needs of our vulnerable, high-risk, and other subpopulations.

Lead: Trudi Carter METRIC: HbA1c Control Baseline: 42.34% Target: 76%

Review program performance and revise if necessary

Q1, Oct-Dec 2016: SPD/CCI developed a Model of Care (MOC) for its segment with the emphasis on End Stage Renal Disease. Emergency Department utilization, MLTSS utilization, and palliative care will be among its subcategories. CMC MOC pilot progressed to the implementation phase on 10/1/2016. Initiated weekly tracking of members in pilot to evaluate the HRA, ICP, and ICT process. In this quarter we launched the use of an in-home supplemental assessment to evaluate environmental safety, medication use and adherence, activities of daily living, and food security. We also re-engaged with AppleCare to test delegation of care management of high risk members. Q2, Jan-Mar 2017: The TANF/MCE Model of Care was updated in February 2017. Both data and measures were refreshed and reported to the February Quality Oversight Committee. Interventions continue to be monitored, with specific focus on the upcoming Whole Person Care Pilot in July 2017. The SPD/CCI team and Health Services continue to refine the Model of Care focusing on three target populations: 1) individuals with ESRD, 2) frequent emergency department users and 3) individuals receiving

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Tactic Status Year 2 Milestones Updates MLTSS. Concurrently, the team is working with HOA, MLTSS and Social Workers to identify initiatives to target these subcategories. CMC: Currently completing Phase 2 of the Model of Care project. Our Supplemental In Home Assessment is being fielded by two vendors and we are working with Care Managers to incorporate the data into member’s ICPs. We have developed a pre-audit tool to review metrics and assess the care management capacity of delegated entities. We have developed two communication pieces to better describe the care management experience. These are currently in the review process and will be distributed in Phase 3. Staff conducted a month-long series of training modules on the high touch model of care for CMC care managers, MLTSS, Behavioral Health, and Social Work staff.

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Strategic Direction 4: Recognized leader in improving health outcomes for low income and vulnerable populations in Los Angeles County Tactic Status Year 2 Milestones Updates 4.1 Develop an L.A. Care brand that

articulates our value proposition. Lead: R. Lightner/F. Oaxaca

Develop brand and launch new branding campaign

Q1, Oct-Dec 2016: During Q1 the Marketing Team continued to work with our agency to refine the brand creative and the associated media and employee education/engagement campaign. Q2, Jan-Mar 2017: Final versions of creative are being finalized for a public facing media campaign that will serve to reintroduce L.A. Care Health Plan to the market. Concurrently the development of a public relations strategy and plan that will employ the services of an outside agency is being finalized to help give L.A. Care more visibility and be recognized as a thought leader locally, regionally and nationally. In addition a benchmark survey is being prepared to help establish a baseline for awareness levels and perceptions of L.A. Care so that we can measure our ability to create new levels of awareness for the plan and its services one year from now.

4.2 Actively support safety net providers’ ability to perform their delegated functions and succeed in managed care environment.

Lead: Maria Calleros

Create a new performance dashboard with safety net provider partners

Q1, Oct-Dec 2016: With the new development of the EDSA department, the safety net dashboard will be incorporated into the development of the KPI overall indicator report. The timeframe for this dashboard is 3rd quarter of 2017, to allow for baseline data to be aggregated. Q2, Jan-Mar 2017: Staff have prioritized the metrics to be included in the KPI report for the 3rd quarter of 2017.

4.3 Mobilize our community resources to ensure that we are responsive and accountable to the needs of our members and constituents.

Lead: John Baackes METRIC: # Members Served through FRCs/# Total Served

Community efforts have been well-defined and support L.A. Care’s priorities

Q1, Oct-Dec 2016: The FRCs are continuing expansion efforts. Palmdale: Held community engagement forum to identify health priorities for FRC programming. Site is set to launch in March 2017. Boyle Heights at Mariachi Plaza: Site lease is being finalized and site planning will begin in January 2017. Pomona: Site visits were conducted to explore location options. Potential sites will be presented to leadership for approval. Held several meetings with state legislative and regulatory offices to discuss outcome of presidential, congressional and state elections. J. Baackes met

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Tactic Status Year 2 Milestones Updates (% L.A. Care members) Baseline: 3,506/15,799 (22%) Target: 32% Q2 - # participants served: 5,304 Q2 - # members served: 1,575 Q2 - % L.A. Care members: 30% YTD - # participants served: 8,498 YTD - # members served: 2,413 YTD - % L.A. Care members: 28%

with Senator Ed Hernandez to also discuss ACA defense issues as well as CCI issues. Senator Hernandez asked J. Baackes to sit on stakeholder workgroup he is developing to protect gains from ACA. Also, J. Baackes attended CCI meeting with DHCS and Secretary Dooley’s office on CCI policy issues and challenges. Q2, Jan-Mar 2017: The fifth FRC in Palmdale will launch in May of 2017. Boyle Heights at Mariachi Plaza was unable to negotiate a cost effective agreement. Site selection for an alternative location is currently underway in East Los Angeles. Held 52 meetings with Republican and Democratic congressional and state legislators at the national, state, and district levels to discuss health care reform proposals and issues.

4.4 Foster innovative approaches to improving health status of our members and the quality of care provided by our safety net.

Lead: John Baackes METRIC: # CHW Placed in Community Clinics Baseline: 0 Target: 10 3/31/2017: 7 in 4 clinic sites

eManagement in use by providers, homeless model of care developed

Q1, Oct-Dec 2016: HITEC-LA reached its California Technical Assistance Program enrollment goal of 2,100 Medi-Cal providers and continued meaningful use support. LANES is in negotiations with L.A. Care and several Medi-Cal hospital organizations. L.A. Care will provide LANES with its members’ prescription history. DHS went live with detailed medical record history for DHS hospitals and legally-operated clinics in December 2016. Care Navigators have been successfully deployed at participating clinics and trained on clinical and non-clinical topics, such as disease and case management, how to support patient self-care, and referral processes. L.A. County’s Whole Person Care (WPC) pilot received approval from DHCS in November 2016. L.A. Care partnered with the lead agency, L.A. County’s Department of Health Services, to participate in designing WPC programs and infrastructure. L.A. Care also led a workgroup with DHS and Health Net to provide aggregate data on potentially eligible WPC populations, which will inform program planning. Developed four CHIF priority areas for 2017: coordinated services, improving access to high-barrier services, addressing social determinants, and homeless housing. Designed the ninth oral health initiative, which will be released in early 2017.

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Tactic Status Year 2 Milestones Updates Q2, Jan-Mar 2017: HITEC-LA continues meaningful use support to 2,165 Medi-Cal providers including DHS. Over $2M of $10.8M has been earned through meaningful use milestone achievements. Two-year no-cost extension expected through 2020. The eManagement pilot is implemented with 53 providers reaching 60,000 members. Over 1,860 depression, anxiety, and substance abuse screenings and 14 eManagement consultations have been conducted for L.A. Care members. Providers were paid $35,000 in incentives. Grantors CHCF and BSCF continue to provide select support. Care Navigators have been integrated into participating clinic care teams, assigned patients caseloads and have begun to track patient touches of Care Navigator Services provided. Safety Net Initiatives (SNI) continues to work on program design for the L.A. Care homeless pilot, aka “The Bridge Program”. SNI conducted a gap analysis to understand how this pilot fit into the current L.A. Care model of care, developed draft metrics to measure success of the initiative, and researched the external landscape of services that touch our members experiencing homelessness to ensure this pilot minimized touch points and avoided duplication of services. Released Initiatives or funded Ad Hoc grants in three of the four CHIF priority areas: coordinated services, improving access to high-barrier services, and homeless housing. Released the Oral Health Initiative IX RFA and received 21 proposals of which we recommended funding for up to six projects for $600,000. Released the Robert E. Tranquada, M.D. Safety Net Infrastructure VIII initiative for $1.5 million. Funded a Brilliant Corners homeless housing grant for $4.0 million, a partnership with Los Angeles County’s Housing For Health and Whole Person Care’s programs.

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L.A. Care Legislative Matrix Updated as of April 26, 2017

The following is a list of all legislation currently tracked by Government Affairs that has been introduced during the 2017-2018 Legislative Session and is on interest to L.A. Care. If there are any questions, please contact Cherie Compartore, Senior Director of Government Affairs at [email protected] or extension 5481. Please note, we include bills that perhaps may not have a direct impact, but do have the possibility to be amended in the future to do so. Some of the bills included are spot bills, legislative place holders, in code sections that could have a policy impact on LA Care.

AB 15 AUTHOR Maienschein (R)

TITLE Denti-Cal Program: Reimbursement Rates

CODE SECTION

An act to add Section 14149.9 to the Welfare and Institutions Code, relating to Medi-Cal. Medi-Cal, and making an appropriation therefor.

SUMMARY Requires the State Department of Health Care Services to double Denti-Cal provider reimbursement rates for the 15 most common prevention, treatment, and oral evaluation services based on certain average rates. Makes an appropriation from the Healthcare Treatment Fund. To read the current text of the bill click here.

SPONSOR Author

POSITION

AB 29 AUTHOR Nazarian (D)

TITLE Pharmacy Benefit Managers

CODE SECTION

An act relating to pharmacy benefit managers. to add Division 121 (commencing with Section 152000) to the Health and Safety Code, relating to pharmacy benefit managers.

SUMMARY Requires a pharmacy benefit manager to disclose certain information to a purchaser or prospective purchaser, including the aggregate amount of rebates, retrospective utilization discounts, and other income that the pharmacy benefit manager would receive from a pharmaceutical manufacturer or labeler in connection with drug benefits related to the purchaser or prospective purchaser. To read the current text of the bill click here.

SPONSOR

POSITION

AB 40 AUTHOR Santiago (D)

TITLE CURES Database: Health Information System

CODE SECTION

An act to amend Sections 11165.1 and 11165.2 Section 11165.1 of the Health and Safety Code, relating to controlled substances, and declaring the urgency thereof, to take effect immediately.

SUMMARY Requires the Department of Justice to make the electronic history of controlled substances dispensed to an individual under a health care practitioner's care, based on data contained in the Controlled Substance Utilization Review and Evaluation System, available to the practitioner through either an online Internet Web portal or an authorized health information technology system. To read the current text of the bill click here.

SPONSOR CA Chapter of the American College of Emergency Physicians

POSITION

94

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AB 74 AUTHOR Chiu (D)

TITLE Housing

CODE SECTION

An act to add Part 14.2 (commencing with Section 53590) to Division 31 of the Health and Safety Code, relating to housing, and making an appropriation therefor, to take effect immediately, bill related to the budget.

SUMMARY Requires the Department of Housing and Community Development to establish a Housing for a Healthy California Program, and to award grants to certain grant applicants. Provides for interim and long-term rental assistance. Authorizes the department to enter into contracts on a bid or negotiated basis, exempt from specified small business procurement, personal service, and public contracting provisions. To read the current text of the bill click here.

SPONSOR Corporation for Supportive Housing and Housing California

POSITION LA County - Support

AB 148 AUTHOR Mathis (R)

TITLE California Physician Corps Program: Practice Setting

CODE SECTION

An act to amend Section 128552 of the Health and Safety Code, relating to physicians and surgeons, and making an appropriation therefor.

SUMMARY Amends existing law which establishes the Physician Corps Loan Payment program which provides financial incentives to a physician and surgeon who practices in a medically underserved area. Makes changes to the definition of practice setting. To read the current text of the bill click here.

SPONSOR

POSITION

AB 156 AUTHOR Wood (D)

TITLE Individual Market: Single Risk Pool: Index Rate

CODE SECTION

An act to amend Section 10965.3 of the Insurance Code, relating to health care coverage.

SUMMARY Relates to the federal Patient Protection and Affordable Care Act and the California Health Benefit Exchange. Deletes a reference to the federal transitional reinsurance program. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Medi-Cal

CODE SECTION

An act to amend Section 14102.5 of the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Amends an existing law which provides for the Medi-Cal program and which requires certain reports for the purpose of informing the California Health and Human Services Agency, the California Health Benefit Exchange, the Legislature, and the public about the enrollment process for insurance affordability programs. Requires a report to be issued on at least a biannual basis. To read the current text of the bill click here.

SPONSOR

POSITION

95

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TITLE Medi-Cal: Managed Care Plans

CODE SECTION

An act to amend Section 10951 of of, and to add Article 6.3 (commencing with Section 14197) to Chapter 7 of Part 3 of Division 9 of, the Welfare and Institutions Code, relating to Medi-Cal. Medi-Cal, and making an appropriation therefor.

SUMMARY Implements provisions regarding federal regulations governing Medicaid managed care plans, authorizes a person to request a hearing involving a Medi-Cal managed care plan with in a specified number of days after the order of action, requires the Department of Health Care Services to develop standards for specified provider types to ensure covered services are accessible to enrollees of Medi-Cal managed care plans, establishes rate requirements for Medi-Cal managed care plans. To read the current text of the bill click here.

SPONSOR

POSITION

AB 224 AUTHOR Thurmond (D)

TITLE Dentistry: Anesthesia and Sedation

CODE SECTION

An act to amend Sections 1646, 1646.1, 1646.2, 1646.3, 1646.4, 1646.5, 1646.8, 1646.9, 1647, 1647.1, 1647.2, 1647.3, 1647.5, 1647.6, and 1647.7 of, to amend the heading of Article 2.7 (commencing with Section 1646) of Chapter 4 of Division 2 of, to add Section 1616.1 to, and to add Article 2.87 (commencing with Section 1647.30) to Chapter 4 of Division 2 of, the Business and Professions Code, relating to dentistry.

SUMMARY Amends the Dental Practices Act. Redefines anesthesia. Extends certain licensing criteria to dentists administering deep sedation. Requires dentists to have a pediatric endorsement and to have completed specified training in order to administer certain drugs to patients under a certain age. Makes other changes concerning sedation. To read the current text of the bill click here.

SPONSOR

POSITION

AB 237 AUTHOR Gonzalez (D)

TITLE In-Home Supportive Services

CODE SECTION

An act to amend Section 12300.4 of the Welfare and Institutions Code, relating to public social services.

SUMMARY Specifies the definition of a payroll period for providers of in-home supportive services and waiver personal care services under the In-Home Supportive Services program. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Local Educational Agency Pilot for Overall Needs

CODE SECTION

An act to add Article 2.986 (commencing with Section 14094.25) to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, relating to health care services.

SUMMARY Requires the establishment of the Local Educational Agency Pilot for Overall Needs program for the purpose of improving the mental health outcomes of certain students through a whole person care approach that is accomplished by providing funding to an eligible participant for the provision of direct health services. Requires an LEA receiving funding through the program to use funds in a specified manner. Provides for health insurance reimbursement. To read the current text of the bill click here.

SPONSOR

POSITION

96

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TITLE Prescription Drugs: Prohibition on Price Discount

CODE SECTION

An act to add Article 7 (commencing with Section 111657) to Chapter 6 of Part 5 of Division 104 of the Health and Safety Code, relating to public health.

SUMMARY Prohibits a person who manufactures a prescription drug from offering any discount, repayment, product voucher, or other reduction in an individual's out-of-pocket expenses, including a copayment or deductible, for any prescription drug if a lower cost brand name or nonbrand name drug is available. To read the current text of the bill click here.

SPONSOR

POSITION

AB 286 AUTHOR Gipson (D)

TITLE Medi-Cal: Beneficiary Maintenance: Home Upkeep: Funds

CODE SECTION

An act to add Section 14005.125 to the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Establishes eligibility and other requirements for providing a home upkeep allowance or a transitional needs fund to Medi-Cal patients residing in a long-term care facility. Prescribes general requirements as well as specific requirements both for facility residents who intend to leave a facility and return to an existing home, who would receive the home upkeep allowance, and for residents who do not have a home but intend to leave the facility and establish a new home. To read the current text of the bill click here.

SPONSOR Disability Rights California

POSITION


TITLE Pharmacy Benefits Management

CODE SECTION

An act to amend Sections 4100, 4107.5, 4201, 4430, and 4400 of, and to add Sections Section 4037.5 and 4053.2 to, and to add Article 25 (commencing with Section 4427) to Chapter 9 of Division 2 of, and to add Chapter 9.6 (commencing with Section 4445) to Division 2 of, the Business and Professions Code, relating to pharmacy benefits.

SUMMARY Requires pharmacy benefit managers to be licensed by the California State Board of Pharmacy, as prescribed. Provides that a pharmacy benefit manager has a fiduciary duty to a purchaser and requires a manager to disclose any conflict of interest and certain information such as drug acquisition cost, rebates received from pharmaceutical manufacturers, and rates negotiated with pharmacies. To read the current text of the bill click here.

SPONSOR

POSITION CAHP -Oppose

97

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http://custom.statenet.com/public/resources.cgi?id=ID:bill:CA2017000A315&cuiq=42e0ef52-34dd-59ad-ac04-88401563491a&client_md=53e7bf833f670791d1cfb006cc245236&mode=current_text

AB 340 AUTHOR Arambula (D)

TITLE Early and Periodic Screening, Diagnosis, and Treatment

CODE SECTION


SUMMARY Requires that screening services under a specified Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program include screening for trauma. Requires the adoption of tools and protocols for screening children for trauma. To read the current text of the bill click here.

SPONSOR Californians for Safety and Justice

POSITION LHPC - Oppose


TITLE Medi-Cal: Asthma Preventive Services

CODE SECTION

An act to add Article 1.6 (commencing with Section 14047) to Chapter 7 of Part 3 of Division 9 to the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Requires the Department of Health Care Services to seek an amendment to its Medicaid state plan to include qualified asthma preventive services providers as providers of asthma preventive services under the Medi-Cal program. Provides for the review and approval of certain required training curricula. To read the current text of the bill click here.

SPONSOR California Pan Ethnic Health Network, Children Now, Regional Asthma Management and Prevention

POSITION

AB 401 AUTHOR Aguiar-Curry (D)

TITLE Pharmacy: Remote Dispensing Site Pharmacy: Telepharmacy

CODE SECTION

An act to amend Sections 4059.5 and 4181 Section 4059.5 of, to add Sections 4044.3, 4044.6, and 4044.7 to, and to add Article 8 (commencing with Section 4130) to Chapter 9 of Division 2 of, the Business and Professions Code, relating to pharmacy.

SUMMARY Requires the State Board of Pharmacy to issue remote dispensing site pharmacy licenses. Requires such pharmacies to be located in a medically underserved area unless approved by the Board. Authorizes a pharmacy located in the State to serve as a supervising pharmacy to provide telepharmacy services for up to a certain number of remote dispensing sites. Authorizes a licensed remote dispensing site pharmacy, as defined, to order dangerous drugs and devices and controlled substances. To read the current text of the bill click here.

SPONSOR Author

POSITION

AB 428 AUTHOR Ridley-Thomas S (D)

TITLE Local Government: the Ralph M. Brown Act

CODE SECTION

An act to amend Section 54953 of the Government Code, relating to local government.

SUMMARY Extends indefinitely, the operation of provisions relating to the establishment of a quorum for teleconferenced meetings of a health authority, under the Ralph M. Brown Act. To read the current text of the bill click here.

SPONSOR LA Care

POSITION LA Care - Support; LHPC - Support

98

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TITLE Personal Care Services

CODE SECTION

An act to amend Sections 12300.5, 12301.6, 12301.6 and 14132.97 of the Welfare and Institutions Code, relating to personal care services.

SUMMARY Authorizes a county board of supervisors to contract with a nonprofit consortium or to establish a public authority to provide waiver personal care services. Authorizes certain entities to meet and confer in good faith regarding wages, benefits, and other terms and conditions of employment with representatives of recognized employee organizations for an individual who is employed by a recipient of waiver personal care services. To read the current text of the bill click here.

SPONSOR Personal Assistance Services Council

POSITION

AB 447 AUTHOR Gray (D)

TITLE Medi-Cal: Covered Benefits: Continuous Glucose Monitors

CODE SECTION

An act to amend Section 14132 of the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Adds glucose monitors that are medically necessary for the management and treatment of diabetes to the schedule of benefits under the Medi-Cal program. To read the current text of the bill click here.

SPONSOR

POSITION

AB 470 AUTHOR Arambula (D)

TITLE Medi-Cal: Specialty Mental Health Services

CODE SECTION

An act to add Section 14719 to the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Requires the Department of Health Care Services to create a performance outcome dashboard for specialty mental health services provided to eligible Medi-Cal beneficiaries. Requires the Department to convene a stakeholder advisory committee comprised of special representatives to help create a plan for such dashboard. Requires the Department to post updated reports on its Internet Web site. To read the current text of the bill click here.

SPONSOR California Pan Ethnic Health Network

POSITION

AB 479 AUTHOR Gonzalez (D)

TITLE Sales and Use Taxes: Exemption

CODE SECTION

An act to amend Section 6369 of 32220 of, and to add Sections 6369.8 and 32221.5 to, the Revenue and Taxation Code, relating to taxation. taxation, to take effect immediately, tax levy.

SUMMARY Exempts from sales and use taxes the gross receipts from the sale of wearable incontinence supplies. Imposes an additional surtax, and a related floor stock tax, on distilled spirits at specified rates. To read the current text of the bill click here.

SPONSOR

POSITION

99

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TITLE California Mental Health Planning Council: Name Change

CODE SECTION

An act to amend Section 14132.47 of the Welfare and Institutions Code, relating to Medi-Cal. Sections 4033, 5400, 5514, 5604.2, 5610, 5614.5, 5664, 5701.1, 5750, and 14682.1 of the Welfare and Institutions Code, relating to mental health.

SUMMARY Relates to the California Mental Health Planning Council. Renames the council as the California Behavioral Health Planning Council, including for purposes of specified acts, the federal Substance Abuse and Mental Health Services Administration (SAMHSA), and mental health managed care. To read the current text of the bill click here.

SPONSOR

POSITION

AB 488 AUTHOR Kiley (R)

TITLE Mental Health Services Act

CODE SECTION

An act to amend Sections 5813.5, 5821, 5840, 5840.2, 5845, 5846, 5847, 5848, 5878.3, 5890, 5891, 5892, 5897, 5898, and 5899 of, to amend the heading of Part 3.7 (commencing with Section 5845) of Division 5 of, and to add Section 5841 to, the Welfare and Institutions Code, relating to mental health services.

SUMMARY Establishes the Mental Health Services Fund Transparency and Accountability Office within the Health and Human Services Agency. Transfers various functions of the Department of Health Care Services to the office. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Mental Health: Community Care Facilities

CODE SECTION

An act to amend Section 1502 of, and to add Sections 1562.02 and 1562.03 to, the Health and Safety Code, and to amend Sections 5848.5 and 11462.01 of, and to add Section 11462.011 to, the Welfare and Institutions Code, relating to mental health.

SUMMARY Amends the Community Care Facilities Act, which provides for the licensing and regulation of community care facilities and includes within the definition of community care facility a short-term residential therapeutic program. Authorizes the licensing of a short-term residential therapeutic program operating as a children's crisis residential center, and requires regulation of those programs. Provides for the development of a rate for certain children who are Medi-Cal beneficiaries. To read the current text of the bill click here.

SPONSOR California Alliance of Child and Family Services

POSITION

AB 508 AUTHOR Santiago (D)

TITLE Health Care Practitioners: Student Loans

CODE SECTION

An act to repeal Section 685 of the Business and Professions Code, relating to healing arts.

SUMMARY Repeals provisions relative to student loans for health care practitioners under the Department of Health and Human Services education loan and when practitioners are in default of those loans. To read the current text of the bill click here.

SPONSOR Author

POSITION

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AB 532 AUTHOR Waldron (R)

TITLE Drug Courts: Drug and Alcohol Assistance

CODE SECTION

An act to add Section 11875 to the Health and Safety Code, relating to drug and alcohol programs.

SUMMARY Authorizes a court to develop a program to offer mental health and addiction treatment services, as defined, to women who are charged with a misdemeanor offense or have a prior misdemeanor conviction. To read the current text of the bill click here.

SPONSOR California Life Sciences Association

POSITION


TITLE Emergency Medical Air Transportation

CODE SECTION

An act to amend Section 76000.10 of the Government Code, and to amend Section 10752 of the Welfare and Institutions Code, relating to emergency medical services.

SUMMARY Extends the dates of the Emergency Medical Air Transportation Act so that the assessment of the penalties will terminate January 1, 2028, and any moneys unexpended and unencumbered in the Emergency Medical Air Transportation Act Fund on June 30, 2029, will transfer to the Federal Fund. Extends the operation of the Emergency Medical Air Transportation Act. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE State Government: Pharmaceuticals: Procurement

CODE SECTION

An act to repeal and add Chapter 12 (commencing with Section 14977) of Part 5.5 of Division 3 of Title 2 of the Government Code, relating to state government.

SUMMARY Requires the Department of General Services to convene the state Pharmaceutical Collaborative to address the rising cost of pharmaceuticals, coordinate best value clinical treatment protocols, leverage governmental efficiencies to achieve best value procurement, and negotiate with manufacturers for discounts on pharmaceuticals. Requires the participation of various agencies in the collaborative. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Health Care Service Plans: Health Insurers

CODE SECTION

An act to add Article 10.2 (commencing with Section 1399.65) to Chapter 2.2 of Division 2 of the Health and Safety Code, and to add Sections 10133.61 and 10133.62 to the Insurance Code, relating to health care. care service plans.

SUMMARY Requires specified entities that intend to merge with or acquire a health care service plan doing business in this state to give notice to the Director of the Department of Managed Health Care. Requires an entity to apply for licensure as a health care service plan. Requires the Department, prior to approval, to hold a public hearing on the proposal. Requires the department to prepare an independent health care impact statement if determined that a material amount of the plan's assets are subject to merger. To read the current text of the bill click here.

SPONSOR Health Access


101

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AB 602 AUTHOR Bonta (D)

TITLE Pharmacy: Nonprescription Diabetes Test Devices

CODE SECTION

An act to amend Section 4081 Sections 4057, 4081, and 4301 of, and to add Sections 4025.2 and 4301.01 4160.5 to, the Business and Professions Code, relating to pharmacy.

SUMMARY Amends the Pharmacy Law. Specifies that it is unprofessional conduct for a licensee of the State Board of Pharmacy to submit to specified persons a claim for reimbursement for a nonprescription diabetes test device when the licensee had knowledge that the device was not purchased directly. Requires pharmacies that dispense these devices to retain records of acquisition and sale. Requires a manufacturer of these devices to publish the names of distributors on its Web site. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Pediatric Home Health Care

CODE SECTION

An act to add and repeal Section 14132.78 of the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Requires the State Department of Public Health to establish an incentive-based, supplemental payment program which would apply to licensed home health agencies that treat children who are receiving continuous nursing care or private nursing services through the Medi-Cal program. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Medi-Cal: Reimbursement Rates

CODE SECTION


SUMMARY Changes the frequency for submitting specified reports to every 3 years under the Medi-cal program. Requires the data in those reports to be based on the previous calendar year. Provide that the reimbursement rates developed pursuant to these provisions shall become effective on the specified date. To read the current text of the bill click here.

SPONSOR California Clinical Laboratory Association

POSITION

102

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TITLE In-Home Supportive Services

CODE SECTION

An act to amend Section 6531.5 of, and to add Section 110003.5 to, the Government Code, and to amend Sections 10101.1, 12300.5, 12300.6, 12300.7, 12302.6, 12306, 12306.1, 12306.15, 12330, and 14186.35 of the Welfare and Institutions Code, relating to Medi-Cal, public social services, and making an appropriation therefor.

SUMMARY Provides that a provision conditioning implementation of the Coordinated Care Initiative on an estimation of cost savings by the Director Finance does not apply to the requirement that In-Home Supportive Services be a covered service available through managed care health plans, and continues IHSS as a covered service available through Medi-Cal managed care health plans. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Mental Health Services Act: Housing Assistance

CODE SECTION

An act to amend Section 5892 of the Welfare and Institutions Code, relating to mental health.

SUMMARY Clarifies that counties may spend Mental Health Services Act moneys on housing assistance for people in the target population under the Act. To read the current text of the bill click here.

SPONSOR County Behavioral Health Directors and County of Los Angeles

POSITION LA Care - Support; LA County - Support

AB 753 AUTHOR Caballero (D)

TITLE Denti-Cal: Improved Access

CODE SECTION

An act to add Article 5.8 (commencing with Section 14187) to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, relating to Medi-Cal, and making an appropriation therefor.

SUMMARY Requires the department to implement specified initiatives designed to significantly improve access to dental services for adults and children in the Medi-Cal program, including a Dental Transformation Initiative for adults consistent with the existing goals and programmatic infrastructure and teledentistry. Requires an increase reimbursement rates of qualified providers for certain pediatric diagnostic and restorative services. To read the current text of the bill click here.

SPONSOR

POSITION

AB 834 AUTHOR O'Donnell (D)

TITLE School-Based Health Programs

CODE SECTION

An act to add Article 14 (commencing with Section 32445) to Chapter 3 of Part 19 of Division 1 of Title 1 of the Education Code, relating to school health.

SUMMARY Requires the State Department of Education to establish an Office of School-Based Health Programs for the purpose of administering health-related programs and advising on issues related to the delivery of school-based Medi-Cal services in the state. Requires the State Department of Education to make available to the office any information on other school-based dental, health, and mental health programs. To read the current text of the bill click here.

SPONSOR California School Based Health Alliance

POSITION

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AB 839 AUTHOR Garcia E (D)

TITLE Medi-Cal: Targeted Case Management

CODE SECTION

An act to amend Section 14005.28 14132.44 of the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Expands the definition of a local governmental agency for purposes of the Targeted Case Management Program to include a Native American Indian tribe, tribal organization, or subgroup of a Native American Indian tribe or trial organization. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Cannabidiol

CODE SECTION

An act to add Section 11150.2 to the Health and Safety Code, relating to controlled substances, and declaring the urgency thereof, to take effect immediately.

SUMMARY Provides if one of specified changes in federal law regarding the controlled substance cannabidiol occurs, would provide that a physician who prescribes and a pharmacist who dispenses a product composed of cannabidiol, in accordance with federal law, is in compliance with state law. Provides that the prescription, furnishing, dispensing, transfer, possession, or use of that product in accordance with federal law is for a legitimate medical purpose and is authorized pursuant to state law. To read the current text of the bill click here.

SPONSOR

POSITION

AB 904 AUTHOR Gallagher (R)

TITLE Prescription Drugs

CODE SECTION

An act relating to prescription drugs.

SUMMARY Declares the intent of the Legislature to enact legislation that would address high prescription drug costs. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Knox-Keene Health Care Service Plan Act of 1975

CODE SECTION

An act to amend Section 1374.73 of the Health and Safety Code, and to amend Section 10144.51 of the Insurance Code, relating to health care coverage.

SUMMARY Requires a qualified autism service professional or a qualified autism service paraprofessional to be supervised by a qualified autism service provider for purposes of providing behavioral health treatment. Authorizes a qualified autism service professional to supervise a qualified autism service paraprofessional. Specifies that the behavioral health treatment may include clinical case management and case supervision. To read the current text of the bill click here.

SPONSOR Center for Autism and Related Disorders (CARD), California Association for Behavior Analysis (CalABA)


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AB 1090 AUTHOR Cunningham (R)

TITLE Marijuana Use: Location Restrictions

CODE SECTION

An act relating to controlled substances. to amend Section 11362.3 of the Health and Safety Code, relating to marijuana.

SUMMARY Prohibits the possession, smoking, or ingesting of marijuana around a school, day care center, or youth center, regardless of whether children are present. To read the current text of the bill click here.

SPONSOR

POSITION

AB 1092 AUTHOR Cooley (D)

TITLE Medi-Cal: Eyeglasses

CODE SECTION


SUMMARY Relates to the Medi-Cal Program. Restores coverage of one pair of eyeglasses provided every 2 years to an individual 21 years of age or older. To read the current text of the bill click here.

SPONSOR VSP Vision Care

POSITION LA Care – Support


TITLE Oncology Clinical Pathway Act of 2017

CODE SECTION

An act to amend Section 1370 of the Health and Safety Code, relating to health care service plans. An act to add Section 1372.5 to the Health and Safety Code, and to add Section 10123.25 to the Insurance Code, relating to health care coverage.

SUMMARY Enacts the Oncology Clinical Pathway Act of 2017 which requires health care service plan or health insurer that develops and implements a clinical pathway to comply with certain requirements for cancer treatment. To read the current text of the bill click here.

SPONSOR


AB 1110 AUTHOR Burke (D)

TITLE Pupil Health: Eye and Vision Examinations

CODE SECTION

An act to amend Section 49455 of the Education Code, relating to pupil health.

SUMMARY Requires, in a pupil's kindergarten year or upon first enrollment or entry in elementary school including a charter school, the pupil's vision to be appraised in accordance with certain provisions only if the pupil's parent or guardian fails to provide the results of an eye and vision examination conducted by a physician, optometrist, or ophthalmologist in accordance with specified provisions, unless a certain waiver is submitted. To read the current text of the bill click here.

SPONSOR California State Board of Optometry


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AB 1177 AUTHOR Gray (D)

TITLE Health Care Coverage

CODE SECTION

An act to amend Section 25001 of the Welfare and Institutions Code, relating to health care coverage.

SUMMARY Makes technical, nonsubstantive changes to the existing law which states the intent of the Legislature to create a process by which the options for achieving universal health care coverage can be thoroughly examined. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Health Professions Development: Load Repayment

CODE SECTION

An act to amend Sections 2987.2, 4984.75, and 4996.65 of, and to add Section 4999.121 to, the Business and Professions Code, and to amend Section 128454 of the Health and Safety Code, relating to health professions development, and declaring the urgency thereof, to take effect immediately.

SUMMARY Adds licensed professional clinical counselors and interns to those licensed mental health service providers eligible for grants to reimburse educational loans. Requires the Board of Psychology to collect an additional fee at the time of renewal and directs the deposit of that fee into the Mental Health Practitioner Education Fund. To read the current text of the bill click here.

SPONSOR California Association of Licensed Professional Clinical Counselors

POSITION

AB 1240 AUTHOR Fong (R)

TITLE Health Care Coverage: Essential Health Benefits

CODE SECTION

An act to amend Section 1367.005 of the Health and Safety Code, relating to health care coverage.

SUMMARY Relates to the federal Patient Protection and Affordable Care Act, which provides for the California Health Benefit Exchange, to make a technical change to a provision requiring an individual or small group health care service plan contract to cover certain essential health benefits. To read the current text of the bill click here.

SPONSOR

POSITION

AB 1316 AUTHOR Quirk (D)

TITLE Public Health: Childhood Lead Poisoning: Prevention

CODE SECTION

An act to amend Sections 1367.3, 105280, 105285, 105290, and 105310 105310, and 124150 of the Health and Safety Code, relating to childhood lead poisoning.

SUMMARY Requires that standard of care under the Childhood Lead Poisoning Prevention Act to be that all children be screen for blood lead levels. Clarifies that the lead screening is not paid for by funds of the Childhood Lead Poisoning Prevention Fund. Makes conforming changes. To read the current text of the bill click here.

SPONSOR Environmental Working Group


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AB 1349 AUTHOR Daly (D)

TITLE Diabetes: Strategy for Awareness and Prevention

CODE SECTION

An act to add Section 104253 to the Health and Safety Code, relating to public health.

SUMMARY Requires the State Department of Public Health and the State Department of Health Care Services to jointly develop a strategy for diabetes awareness and prevention, and to report that strategy and related findings to the Legislature and the Governor. To read the current text of the bill click here.

SPONSOR

POSITION

AB 1353 AUTHOR Waldron (R)

TITLE Health Care Coverage: Prescription Drugs: Continuity

CODE SECTION

An act to add Sections 1367.245 and 1367.246 to the Health and Safety Code, and to add Sections 10123.203 and 10123.204 to the Insurance Code, relating to health care coverage.

SUMMARY Requires a health care service plan and health insurer that provides coverage for outpatient prescription drugs to establish an expeditious process by which enrollees and insureds or prescribing providers may obtain an exception to any prior authorization process or any other utilization management or medical management practices. Requires coverage for certain medically necessary nonformulary drugs. To read the current text of the bill click here.

SPONSOR

POSITION LHPC - Oppose: CAHP -Oppose

AB 1368 AUTHOR Calderon I (D)

TITLE Medi-Cal: Authorization Requests

CODE SECTION


SUMMARY Authorizes a physician to designate an assistant or a nurse practicioner to sign any authorization form required by the state Department of Health Care Services for benefits and services under the Medi-Cal program, provided that the physician and designated physician assistant or nurse practitioner are each enrolled as a Medi-Cal provider. To read the current text of the bill click here.

SPONSOR

POSITION

AB 1505 AUTHOR Bloom (D)

TITLE Land Use: Zoning Regulations

CODE SECTION

An act to amend Section 65850 of the Government Code, relating to land use.

SUMMARY Amends the Planning and Zoning Law to authorize the legislative body of a city or county to adopt ordinances to require, as a condition of development of residential rental units, that a development include a certain percentage of residential rental units affordable to, and occupied by, moderate-income, lower income, very low income, or extremely low income households. To read the current text of the bill click here.

SPONSOR CA Housing Consortium, CA Rural Legal Assistance Foundation, Housing CA, Non-Profit Housing Association of N. CA, Western Center on Law & Poverty

POSITION LA Care - Support; LA County - Support

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AB 1512 AUTHOR McCarty (D)

TITLE Opioid Addiction Prevention and Rehabilitation Act

CODE SECTION

An act to add Division 10.4 (commencing with Section 11740) to the Health and Safety Code, and to add Part 14.3 (commencing with Section 33001) to Division 2 of the Revenue and Taxation Code, relating to taxation. taxation, to take effect immediately, tax levy.

SUMMARY Creates the Opioid Addiction Prevention and Rehabilitation Act to impose a tax upon the distribution of opioids by every person, including a manufacturer or wholesaler, that makes the first sale in this state of opioids at a specific rate. Requires the Board of Equalization to deposit amounts collected under this Act in the Opioid Prevention and Rehabilitation Program Fund to provide critical resources for addiction prevention and rehabilitation programs. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Health Care Coverage: HIV Specialists

CODE SECTION

An act to add Section 1367.693 to the Health and Safety Code, and to add Section 10123.833 to the Insurance Code, relating to health care coverage.

SUMMARY Relates to the Department of Managed Health Care and the Insurance Commissioner. Requires a health care service plan contract to permit an HIV specialist to be an eligible primary care provider if the provider requests primary care status and meets the plan's eligibility criteria. To read the current text of the bill click here.

SPONSOR

POSITION LHPC - Oppose

AB 1601 AUTHOR Bloom (D)

TITLE Hearing Aids: Minors

CODE SECTION

An act to add and repeal Section 1367.72 of the Health and Safety Code, and to add and repeal Section 10123.72 of the Insurance Code, relating to health care coverage.

SUMMARY Requires a health care service plan contract or a health insurance policy issued, amended, or renewed on or after a specified date, to include coverage for hearing aids for an enrollee or insured under a certain age, as specified. To read the current text of the bill click here.

SPONSOR


AB 1643 AUTHOR Bonta (D)

TITLE Health Care for All Commission

CODE SECTION

An act to relating to health care coverage. add and repeal Division 122 (commencing with Section 153000) of the Health and Safety Code, relating to health care coverage.

SUMMARY Create the 9-member Health Care for All Commission in the State Department of Health Care Services, for the purpose of investigating and making recommendations on improving health care access and affordability for all Californians. Requires the Governor, the Senate Rules Committee, and the Speaker of the Assembly to each appoint 3 members of the commission, and require the commission to elect its chair from among its members. To read the current text of the bill click here.

SPONSOR Author

POSITION

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AB 1666 AUTHOR Kiley (R)

TITLE Health Care Service Plans

CODE SECTION

An act to amend Section 1341 of the Health and Safety Code, relating to health care coverage.

SUMMARY Makes a technical, nonsubstantive change to the Knox-Keene Health Care Service Plan Act of 1975, which provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Childrens Mental Health

CODE SECTION

An act to amend Section 5878.1 of the Welfare and Institutions Code, relating to mental health.

SUMMARY Makes technical, nonsubstantive changes to the Children's Mental Health Service Act which establishes an interagency system of care for children with serious emotional and behavioral disturbances that provides comprehensive, coordinated care. To read the current text of the bill click here.

SPONSOR

POSITION

ACA 11 AUTHOR Caballero (D)

TITLE Middle Class Affordable Housing and Shelter: Funding

CODE SECTION

A resolution to propose to the people of the State of California an amendment to the Constitution of the State, by adding Article XXXIV A thereto, relating to housing.

SUMMARY Creates the California Middle Class Affordable Housing and Homeless Shelter Account in the General Fund for the support of local and state programs that assist in the development or acquisition of housing. Imposes a tax upon all retailers at a percent of the gross receipts of any retailer from the sale of all tangible personal property sold at retail in this state. To read the current text of the bill click here.

SPONSOR

POSITION

SB 3 AUTHOR Beall (D)

TITLE Affordable Housing Bond Act of 2018

CODE SECTION

An act to add Part 16 (commencing with Section 54000) to Division 31 of the Health and Safety Code, relating to housing, by providing the funds necessary therefor through an election for the issuance and sale of bonds of the State of California and for the handling and disposition of those funds, and declaring the urgency thereof, to take effect immediately.

SUMMARY Enacts the Affordable Housing Bond Act of 2018 which would authorize the issuance of bonds to be used to finance various existing housing programs, as well as infill infrastructure financing and affordable housing matching grant programs. To read the current text of the bill click here.

SPONSOR

POSITION

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SB 17 AUTHOR Hernandez (D)

TITLE Health Care: Prescription Drug Costs

CODE SECTION

An act to amend Section 1385.045 of, to add Section 1367.245 to, and to add and repeal Chapter 9 (commencing with Section 127675) of to Part 2 of Division 107 of, the Health and Safety Code, and to amend Section 10181.45 of, and to add Section 10123.204 to, the Insurance Code, relating to health care.

SUMMARY Requires health care service plans or health insurers that file certain rate information to report specified cost information regarding covered prescription drugs, including generic drugs, brand name drugs, and specialty drugs. Requires the publication of a certain report. Establishes notification requirements for manufacturer of a prescription drug that is purchased or reimbursed by specified purchasers, including state agencies, health care service plans, health insurers, and pharmacy benefit managers. To read the current text of the bill click here.

SPONSOR California Labor Federation

POSITION CAHP -Support

SB 33 AUTHOR Dodd (D)

TITLE Arbitration Agreements

CODE SECTION

An act to add Section 1624.7 to the Civil Code, relating to contracts. An act to amend Section 1281.2 of the Code of Civil Procedure, relating to arbitration.

SUMMARY Amends provisions related to arbitration and determinations that allow a court to not order arbitration. Adds to these determinations instances in which a financial institution seeks to apply a written agreement to arbitrate, contained in a contract consented to by a consumer, to a relationship with that consumer created fraudulently by the petitioner without the consumer's consent or by unlawfully using the consumer's personal identifying information. To read the current text of the bill click here.

SPONSOR Author

POSITION


TITLE Individual Market: Single Risk Pool: Index Rate

CODE SECTION

An act to amend Section 1399.849 of the Health and Safety Code, relating to health care coverage.

SUMMARY Relates to the federal Patient Protection and Affordable Care Act, the California Health Benefit Exchange, and the Knox-Keene Health Care Service Plan Act. Deletes certain references to a federal transitional reinsurance program. To read the current text of the bill click here.

SPONSOR Author

POSITION

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SB 138 AUTHOR McGuire (D)

TITLE School Meal Programs: Meals: Universal Free Meal

CODE SECTION

An act to amend Section 49562 of, and to add Section 49563 49564 to, the Education Code, relating to school meals.

SUMMARY Requires a school district or county superintendent of schools that has a very high poverty school in its jurisdiction to apply to operate a universal meal service, and to begin providing breakfast and lunch free of charge through the service to all pupils at the school. Requires the State Department of Education to share participation data from the Medi-Cal program with school districts. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Medi-Cal

CODE SECTION

An act to amend Section Sections 14094.18 and 14102.5 of the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Amends an existing law which establishes the Medi-Cal program and which requires the Department of Health Care Services to develop and prepare reports for the purpose of informing the California Health and Human Services Agency, the California Health Benefit Exchange, the Legislature, and the public about the enrollment process for all insurance affordability programs. Requires a report to be issued on at least a biannual basis. Relates to an assessment on Medi-Cal managed care plan performance. To read the current text of the bill click here.

SPONSOR Author

POSITION


TITLE Medi-Cal: State Fair Hearing

CODE SECTION

An act to amend Section 10951 of of, and to add Article 6.3 (commencing with Section 14197) to Chapter 7 of Part 3 of Division 9 of, the Welfare and Institutions Code, relating to Medi-Cal. Medi-Cal, and making an appropriation therefor.

SUMMARY Implements provisions regarding federal regulations governing Medicaid managed care plans, authorizes a person to request a hearing involving a Medi-Cal managed care plan with in a specified number of days after the order of action, requires the Department of Health Care Services to develop standards for specified provider types to ensure covered services are accessible to enrollees of Medi-Cal managed care plans, establishes rate requirements for Medi-Cal managed care plans. To read the current text of the bill click here.

SPONSOR

POSITION

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SB 172 AUTHOR Portantino (D)

TITLE Health Care Coverage: Fertility Preservation

CODE SECTION

An act to add Section 1374.551 to the Health and Safety Code, and to add Section 10119.61 to the Insurance Code, relating to health care coverage.

SUMMARY Requires an individual or group health care service plan contract or health insurance policy to include coverage for evaluation and treatment of iatrogenic infertility, as specified. To read the current text of the bill click here.

SPONSOR American Society of Reproductive Medicine, Alliance for Fertility Preservation, Fertile Action

POSITION


TITLE Pupil Health: Mental Health and Substance Use Disorder

CODE SECTION

An act to add Part 5.5 (commencing with Section 5920) to Division 5 of the Welfare and Institutions Code, relating to pupil health.

SUMMARY Authorizes a county, or a qualified provider operating as part of the county mental health plan network, and a local educational agency to enter into a partnership to create a program that includes, among other things, targeted interventions for pupils with identified social-emotional, behavioral, and academic needs and an agreement to establish a Medi-Cal mental health and substance use disorder provider that is county operated or county contracted for the provision of mental health services. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Mental Health Services Act Reversion Fund

CODE SECTION

An act to amend Sections 5891, 5892, and 5892.5 of, and to add Section 5892.3 to, the Welfare and Institutions Code, relating to mental health.

SUMMARY Relates to the Mental Health Services Act, which imposes a tax on incomes above a specified sum for the purpose of financing new or expanded mental health services. Requires the counties, or counties jointly, seeking funding to demonstrate to the Mental Health Service Oversight and Accountability Commission that funding will be used to create, or expand the capacity for, services and supports to address unmet community needs. To read the current text of the bill click here.

SPONSOR

POSITION LA County - Oppose

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TITLE Health Care Cost, Quality, and Equity Atlas

CODE SECTION

An act to repeal and add Chapter 8 (commencing with Section 127670) of Part 2 of Division 107 of add Section 127672 to the Health and Safety Code, relating to health care.

SUMMARY Requires the Secretary of Health and Human Services, in furtherance of the goal of creating the Health Care Cost, Quality, and Equity Atlas, to convene an advisory committee composed of a broad spectrum of health care stakeholders and experts. Requires the advisory committee with identifying the type of data, purpose of use, and entities and individuals that are required to report to, or that may have access to, a health care cost, quality, and equity atlas, and with developing a set of recommendations. To read the current text of the bill click here.

SPONSOR

POSITION

SB 202 AUTHOR Dodd (D)

TITLE Medi-Cal: Beneficiary Maintenance Needs: Personal Needs

CODE SECTION


SUMMARY Increases the personal needs allowance amount per month under the Medi-Cal program while a person is a patient in a medical institution or nursing facility, and requires the Department of Health Care Services to annually increase this amount based on a percentage increase in the California Consumer Price Index. To read the current text of the bill click here.

SPONSOR

POSITION

SB 209 AUTHOR Cannella (R)

TITLE State Department of Health Care Services

CODE SECTION

An act relating to public health.

SUMMARY States the intent of the Legislature to enact legislation relating to the powers and duties of the State Department of Health Care Services. To read the current text of the bill click here.

SPONSOR

POSITION

SB 220 AUTHOR Pan (D)

TITLE Medi-Cal Children's Health Advisory Panel

CODE SECTION


SUMMARY Relates to the Medi-Cal Children's Health Advisory Panel. Revises the qualification criteria for panel positions filled by parent members. Provides for the terms of members. Expands the requirement to pay a per-meeting stipend to include a foster parent, relative caregiver, or legal guardian of a Medi-Cal enrollee. To read the current text of the bill click here.

SPONSOR

POSITION

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SB 221 AUTHOR Wiener (D)

TITLE Health Care Coverage: Lipodystrophy Syndrome

CODE SECTION

An act to add Section 1367.47 to the Health and Safety Code, to add Section 10123.92 to the Insurance Code, and to add Section 14132.04 to the Welfare and Institutions Code, relating to health care coverage.

SUMMARY Requires health care service plan contracts and health insurance policies issued, amended, renewed, or delivered after a specified date to include coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome, including, but not limited to, reconstructive surgery, such as suction assisted lipectomy, other restorative procedures and dermal injections or fillers for reversal of facial lipoatrophy syndrome. To read the current text of the bill click here.

SPONSOR Equality California

POSITION


TITLE Inmates: Health Care Enrollment

CODE SECTION


SUMMARY Requires the suspension of Medi-Cal benefits to end on the date he or she is no longer an inmate of a public institution or is no longer otherwise eligible for benefits under the Medi-Cal program. Requires the State Department of Health Care Services, in consultation with specified stakeholders, to develop and implement a simplified annual renewal process for individuals in a suspended eligibility status. To read the current text of the bill click here.

SPONSOR California Welfare Directors Association

POSITION LA Care - Support

SB 223 AUTHOR Atkins (D)

TITLE Health Care Language Assistance Services

CODE SECTION

An act to amend Section 1367.04 of of, and to add Sections 1367.032 and 1367.042 to, the Health and Safety Code, to amend Section 10133.8 of of, and to add Section 10133.11 to, the Insurance Code, and to amend Section 14029.91 of Sections 14029.91 and 14684 of, and to add Sections 14029.92 and 14727 to, the Welfare and Institutions Code, relating to health care coverage.

SUMMARY Requires a written notice of availability of interpretation services for health care services to be made available in the top 15 languages spoken by limited-English-proficient individuals in the state. Establishes qualifications for interpreters providing services to enrollees and insureds. Prohibits a health plan or insurer from requiring an individual to provide their own interpreter. Requires a plan or insurer to notify enrollees or insureds of language assistance and nondiscrimination protections. To read the current text of the bill click here.

SPONSOR California Pan-Ethnic Health Network


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SB 241 AUTHOR Monning (D)

TITLE Medical Records: Access

CODE SECTION

An act to amend Section 123110 of the Health and Safety Code, and to amend Section 5328 of the Welfare and Institutions Code, relating to medical records.

SUMMARY Amends an existing law which governs a patient's access to his or her health records. Changes the basis of the fee that a health care provider is authorized to charge for access to such records. Allows disclosure of information and records obtained in the course of providing mental health and developmental services to a business associate or for health care operations purposes. To read the current text of the bill click here.

SPONSOR

POSITION

SB 255 AUTHOR Mendoza (D)

TITLE California Partnership for Long-Term Care Program

CODE SECTION

An act to amend Sections 10232.1 and 10232.81 of the Insurance Code, and to amend Section 22009 of the Welfare and Institutions Code, relating to long-term care, and declaring the urgency thereof, to take effect immediately.

SUMMARY Establishes the California Partnership for Long-Term Care Program. Requires a policy, certificate, or rider to be called a home care, community-based services, and residential care facility only policy, certificate, or rider. Deletes assisted living facility services from the list of required minimum services to be provided under the program. Clarifies that those required minimum services include care in a residential care facility. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Hospices: Palliative Care

CODE SECTION

An act to amend Sections 1746 and 1749 of the Health and Safety Code, relating to palliative care.

SUMMARY Amends the California Hospice Licensure Act of 1990, which authorizes licensed hospices to provide certain services, including preliminary palliative care consultations. Expands the definition of palliative care to include relief of symptoms, pain, and stress of a serious, life threatening, or advanced illness, in addition to a terminal illness, without regard to the length of the patient's remaining period of life. Authorizes a hospice to provide the same services to a patient who is not a hospice patient. To read the current text of the bill click here.

SPONSOR CA Hospice & Palliative Care Association and Coalition for Compassionate Care of CA

POSITION

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SB 323 AUTHOR Mitchell (D)

TITLE Medi-Cal: Federally Qualified Health Centers: Drug

CODE SECTION


SUMMARY Authorizes specified entities to elect to enroll as a Drug Medi-Cal certified provider to provide Drug Medi-Cal services pursuant to the terms of a mutually agreed upon contract between those entities and the county or department and sets forth the reimbursement requirements for those services. Authorizes an federally qualified health center or rural health clinic to provide specialty mental health services to Medi-Cal beneficiaries as part of a mental health plan's provider network. Relates to contract. To read the current text of the bill click here.

SPONSOR

POSITION

SB 349 AUTHOR Lara (D)

TITLE Chronic Dialysis Clinics: Staffing Requirements

CODE SECTION

An act to amend Sections 1226 and 1228 of, to add Sections 1226.4, 1240.1, and 1266.2 to, and to repeal and add the heading of Article 5 (commencing with Section 1240) of Chapter 1 of Division 2 of, the Health and Safety Code, relating to clinics.

SUMMARY Establishes minimum staffing requirements for chronic dialysis clinics and establish a minimum transition time between patients receiving dialysis services at a treatment station. Requires chronic dialysis clinics to maintain certain information relating to minimum staffing and transition time requirements. Deletes a certain exception for end stage renal disease facilities. Provides for certain inspections. To read the current text of the bill click here.

SPONSOR

POSITION

SB 360 AUTHOR Skinner (D)

TITLE Public Social Services: Prosecution for Overpayment

CODE SECTION

An act to amend Section 10980 of the Welfare and Institutions Code, relating to public social services.

SUMMARY Prohibits a person from being subject to criminal prosecution, as specified, for an overpayment or overissuance of benefits, obtained under the CalWORKs program or the CalFresh program, for any month in which a county was in receipt of any information indicating any potential for an overpayment or an overissuance and has not provided notice of the overpayment or the overissuance to the person. To read the current text of the bill click here.

SPONSOR

POSITION

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TITLE Acquired Brain Trauma

CODE SECTION

An act to amend Sections 4353, 4354.5, 4355, 4357, and 4357.1 of, and to repeal Sections 4359 and 14132.992 of, the Welfare and Institutions Code, relating to acquired brain trauma.

SUMMARY Relates to a program of services for persons with acquired traumatic brain injury. Makes that program operative indefinitely. Requires the Department of Rehabilitation to pursue all sources of funding and by authorizing the department to require that service providers meet specified program and operational certification standards in order to receive ongoing funding. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Health Care Coverage: Pervasive Developmental Disorder

CODE SECTION


SUMMARY Relates to coverage for behavioral health treatment for pervasive developmental disorder or autism, and services of a qualified autism service professional. Provides that certain entities or groups are no longer permitted to be qualified autism service providers. Requires a review of treatment plans. Makes changes concerning reimbursement for certain school services. To read the current text of the bill click here.

SPONSOR Autism Behavior Services



TITLE Medical Practice: Pain Management

CODE SECTION

An act to add Section 2242.3 to the Business and Professions Code, relating to controlled substances. An act to amend Section 2241.6 of, and to add Section 4075.7 to, the Business and Professions Code, and to add Section 11167.7 to the Health and Safety Code, relating to healing arts.

SUMMARY Requires a specified health care practitioner, before prescribing, ordering, or furnishing specified narcotic pain medications, including controlled substances, to a minor, as defined, to educate the guardian of the minor on all other available medical treatments, specified nonopioid treatment alternatives to be tried before and alongside opioid therapy, the risks and benefits of narcotic medications and alternatives to narcotic medications, the safe storage of opioid medications, and other matters. To read the current text of the bill click here.

SPONSOR

POSITION

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SB 437 AUTHOR Atkins (D)

TITLE Health Care Coverage: Joint Senior Level Working Group

CODE SECTION

An act to amend Section 14132.01 of the Welfare and Institutions Code, relating to Medi-Cal. 1342.4 of the Health and Safety Code, and to amend Section 12923.5 of the Insurance Code, relating to health care coverage.

SUMMARY Requires the joint working group to review and examine timely access to care and network adequacy as part of its review of the grievance and consumer complaint processes, and to review and examine the state implementation of federal health care forums, including any changes in federal law, or rules, regulation, or guidance issued under federal law. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Medi-Cal Managed Care: Federally Qualified Health

CODE SECTION


SUMMARY Authorizes a federally qualified health center or rural health clinic to enter into an agreement with a public or private entity to provide services that follow a patient. Defines such services as services that promote continuity of care and contribute to overall patient wellness. Provides for compensation paid to a federally qualified health center or rural health clinics pursuant to such agreements. To read the current text of the bill click here.

SPONSOR

POSITION

SB 508 AUTHOR Roth (D)

TITLE Medi-Cal: Dental Health

CODE SECTION

An act to amend Section 14149.8 of, and to add Article 2.93 (commencing with Section 14091.40) to Chapter 7 of Part 3 of Division 9 of of, the Welfare and Institutions Code, relating to Medi-Cal.

SUMMARY Authorizes the Department of Health Care Services to authorize a Dental Health Collaboration Pilot Program for Medi-Cal beneficiaries enrolled in Medi-Cal managed care health plans that serve certain counties using a hybrid collaboration model that coordinates the efforts of participating health plans, dental managed care plans, and the department. Requires a Medi-Cal dental managed care plan to work with the department to ensure access to quality dental services to Medi-Cal beneficiaries. To read the current text of the bill click here.

SPONSOR

POSITION

118

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TITLE Health and Care Facilities: Stem Cell Clinics

CODE SECTION

An act to amend Section 14000 of the Welfare and Institutions Code, relating to Medi-Cal. add Chapter 8.4 (commencing with Section 1744) to Division 2 of the Health and Safety Code, relating to health and care facilities.

SUMMARY Requires a stem cell clinic, as defined, to post on site conspicuously in the entrance of the clinic and in at least one additional area where the clients wait to receive services, and to include in any print and digital advertising materials, a specified notice regarding the provision of stem cell therapies. To read the current text of the bill click here.

SPONSOR

POSITION

SB 515 AUTHOR Fuller (R)

TITLE Health Care Coverage: Individual Market

CODE SECTION


SUMMARY Makes technical, nonsubstantive changes to the Knox-Keene Health Care Service Plan Act, which provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and provisions relating to enrollment. To read the current text of the bill click here.

SPONSOR

POSITION

SB 516 AUTHOR Fuller (R)

TITLE Medi-Cal: Disease Management Waiver

CODE SECTION


SUMMARY Makes technical, nonsubstantive changes to an existing law which establishes the Medi-Cal program and which provides for an application for a waiver of federal law to test the efficacy of providing a disease management benefit to specified beneficiaries under the program. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Emergency Medical Transport Providers: Assurance Fee

CODE SECTION

An act to add Article 3.91 (commencing with Section 14129) to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, relating to Medi-Cal, making an appropriation therefor, and declaring the urgency thereof, to take effect immediately.

SUMMARY Amends the existing law which establishes the Medi-Cal program. Imposes a quality assurance fee for each emergency medical transport provided by an emergency medical transport provider subject to the quality assurance fee in accordance with a prescribed methodology. Increases the Medi-Cal reimbursement to emergency medical transport providers, including both fee-for-service transports paid by the Department of Health Care Services and managed care transports paid by Medi-Cal managed care health plans. To read the current text of the bill click here.

SPONSOR

POSITION

119

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TITLE Hospital Contracts

CODE SECTION

An act to add Section 513 to the Business and Professions Code, and Code, to add Section 1367.32 to the Health and Safety Code, and to add Section 10133.57 to the Insurance Code, relating to hospital contracts.

SUMMARY Prohibits contracts between hospitals and contracting agents or health care service plans from containing certain provisions, including setting payment rates or other terms for nonparticipating affiliates, requiring the agent or plan to keep payment rates secret from any payor that is or may become financially responsible for the payment, and requiring the contracting agent or plan to submit to arbitration certain claims or causes of action arising under antitrust laws. To read the current text of the bill click here.

SPONSOR Author

POSITION LA Care - Support


TITLE The Healthy California Act

CODE SECTION

An act to add Title 22.2 (commencing with Section 100600) to the Government Code, relating to health care coverage, and making an appropriation therefor.

SUMMARY Creates the Healthy California program to provide comprehensive universal single-payer health care coverage and a health care cost control system for the benefit of all residents of the state. Provides that the program incorporates benefits from existing programs. Provides for the participation of health care providers int he program. Creates the Healthy California Trust Fund for financing of the program. Authorizes providers to collectively negotiate rates of payment. To read the current text of the bill click here.

SPONSOR California Nurses Association


SB 575 AUTHOR Leyva (D)

TITLE Patient Access to Health Records

CODE SECTION

An act to amend Section 123110 of the Health and Safety Code, relating to public health.

SUMMARY Requires health care providers to provide patients with a copy of certain health records at no charge to support a claim for eligibility for a public benefit program. Specifies additional public benefit programs to which these requirements apply. Makes conforming changes. To read the current text of the bill click here.

SPONSOR Western Center on Law & Poverty

POSITION

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SB 636 AUTHOR Bradford (D)

TITLE Addiction Treatment: Advertising and Payment

CODE SECTION

An act to add Section 1371.33 Sections 1371.33, 11833.1, and 11833.2 to, and to add Chapter 15 (commencing with Section 11859) to Part 2 of Division 10.5 of, the Health and Safety Code, and to add Section 10133.75 to the Insurance Code, relating to public health.

SUMMARY Prohibits alcohol drug treatment program or certified drug counselor from offering, delivering, receiving, or accepting and rebate, refund, commission, preference, patronage dividend, discount, or other consideration as compensation or inducement for referring patients, clients, or customers to any person or certified or license program. Prohibits certain entities, including an alcoholism or drug abuse recovery and treatment program, from giving or receiving remuneration for a referral. To read the current text of the bill click here.

SPONSOR CA Consortium of Addiction Programs and Professionals



TITLE Controlled Substance Utilization

CODE SECTION

An act to amend Section 11165 of the Health and Safety Code, relating to controlled substances.

SUMMARY Amends existing law which requires the Department of Justice to maintain the Controlled Substance Utilization Review and Evaluation System (CURES) for the electronic monitoring of the prescribing and dispensing of Schedule II, Schedule III, and Schedule IV controlled substances. Prohibits the release of data obtained from CURES to a law enforcement agency except pursuant to a valid court order. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Health Care Coverage: Consumer Complaints: Reporting

CODE SECTION

An act to amend Section 511.3 of the Business and Professions Code, to amend Section 1375.7 of the Health and Safety Code, to amend Section 10178.4 of the Insurance Code, and to amend Section 4611 of the Labor Code, relating to health care providers. add Section 1348.97 to the Health and Safety Code, and to add Section 10191.7 to the Insurance Code, relating to health care coverage.

SUMMARY Requires the Department of Managed Health Care and the Department of Insurance to annually submit to the Legislature, and post on each department's Internet Web site, a record of all complaints received by each department regarding employee welfare benefit plans as defined under the federal Employee Retirement Income Security Act of 1974. To read the current text of the bill click here.

SPONSOR California Medical Association (CMA) & California Hospital Association (CHA)

POSITION

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TITLE Medi Cal: Family Planning Providers

CODE SECTION


SUMMARY Prohibits Medi-Cal Managed Care Plans from restricting the choice of a qualified provider from whom a beneficiary enrolled in the plan may receive family planning services. Requires a Medi-Cal managed care plan to reimburse an out-of-plan or out-of-network qualified provider at the applicable fee-for-service rate. To read the current text of the bill click here.

SPONSOR

POSITION


TITLE Healing Arts Licensee: License Activation Fee: Waiver

CODE SECTION

An act to amend Section 704 of the Business and Professions Code, relating to workforce development. healing arts.

SUMMARY Requires the license renewal fee to be waived for any healing arts licensee who certifies to his or her respective board that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state. To read the current text of the bill click here.

SPONSOR

POSITION

SB 792 AUTHOR Wilk (R)

TITLE Local Government: Measure B Oversight Commission

CODE SECTION

An act to add Article 19 (commencing with Section 53997.5) to Chapter 4 of Part 1 of Division 2 of Title 5 of the Government Code, relating to local government.

SUMMARY Creates the Measure B Oversight Commission and requires a certain report regarding the County of Los Angeles trauma network and the special tax levied on all improved parcels in the County to provide funding for the Countywide System of Trauma Centers, Emergency Medical Services, and Bioterrorism Response. Requires the posting of certain information on an Internet Web site. To read the current text of the bill click here.

SPONSOR

POSITION LA County - Oppose

SR 26 AUTHOR Hernandez (D)

TITLE Affordable Care Act

CODE SECTION

Relative to the Patient Protection and Affordable Care Act.

SUMMARY Affirms the Senates strong support for the Affordable Care Act and calls upon the United States Congress to reject any effort to repeal the Affordable Care Act unless it is simultaneously replaced with an alternative program that meets the standards clearly and consistently articulated by President Trump. To read the current text of the bill click here.

SPONSOR

POSITION

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Board of Governors

MOTION SUMMARY

Date: May 4, 2017

Motion No. BOG 100.0517

Committee: Executive Committee Chairperson: Mark Gamble

Issue: Award up to $500,000 to the Martin Luther King Jr. Community Health Foundation to

support an advanced care clinic in South Los Angeles.

Background: L.A. Care funds will support the initial phase of the Martin Luther King Jr.

Community Hospital affiliated advanced care clinic (Advanced Clinic) located in South Los Angeles by providing first year gap funding. The Advanced Clinic is located in Planning Area (SPA) 6 and in L.A. Care’s Regional Community Advisory Committee (RCAC) 6. The clinic will fill a gap in the continuum of care and develop higher-level medical care capacity as it is designed to serve high-risk adult patients with high-acuity, complex and chronic conditions, including patients discharged from hospitals. By the end of the 18-month grant period, the clinic is expected to serve over 1,500 unique patients with the overall goal of reducing unnecessary emergency department visits and long hospital stays.

This motion and the attached memo have been updated to include additional details as requested during discussion at the Executive Committee Meeting on April 26.

Alignment with L.A. Care Strategic Goals The Advanced Clinic project aligns with L.A. Care’s organizational goal 4.5 of fostering innovative approaches to improving health outcomes and the quality of care delivered by the safety net.

Member Impact: Community Health Investment Funds (CHIF) funds support safety net providers

and the vulnerable populations they serve, including L.A. Care members. These projects increase healthcare access and improve quality of care.

Budget Impact: In September 2016, as part of the general organizational budget, the L.A. Care Board

of Governors approved a Community Benefits CHIF funding allocation of $10 million for fiscal year 2016-17. To date $4 million has been spent to date. If this request of up to $500,000 is approved, the available remaining CHIF amount will be $5.5 million.

Motion: To approve an award of up to $500,000 to the Martin Luther King Jr.

Community Health Foundation, the fundraising entity of the Martin Luther King, Jr. Community Hospital, to support an advanced care clinic in South Los Angeles to serve high-risk and high-acuity patients with chronic and complex medical needs.

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April 26, 2017 TO: Executive Committee

FROM : Wendy Schiffer, Senior Director, Strategic Planning Roland Palencia, Director, Community Benefit SUBJECT: Martin Luther King Jr. Community Health Foundation grant of up to $500,000

to support an advanced care clinic in South Los Angeles. Introduction L.A. Care’s Community Benefits Department seeks approval to award up to $500,000 to the Martin Luther King Jr. (MLK) Community Health Foundation to support an advanced care clinic in South Los Angeles by providing first-year gap funding. The advanced care clinic (Advanced Clinic) opened in December 2016 and is located in Los Angeles County Serving Planning Area (SPA) 6, L.A. Care’s Regional Community Advisory Committee (RCAC) 6, and Coordinated Care Initiative Council Area 3. The Advanced Clinic is designed to serve high-risk adult patients with high-acuity and with complex and chronic conditions, including patients discharged from hospitals such as the Martin Luther King Jr. Community Hospital. By the end of the 18-month grant period, the clinic is expected to hire up to 12 physicians, physician assistants or nurse practitioners to serve more than 1,500 unique patients with the overall goal of reducing unnecessary emergency department visits and long hospital stays. Issue Background The Advanced Clinic will fill a gap in the continuum of care and addresses a lack of capacity among primary care clinics in the area, including federally qualified health centers, to take care of a large number of high-risk adult patients with high-acuity, complex and chronic conditions, especially those released from hospitals. In its Community Health Assessment SPA March 2014 report, the Los Angeles County Department of Public Health reported that SPA 6 experiences some of the worst health indicators in Los Angeles County. For instance, the lung cancer rate is 24% higher, the coronary heart disease death rate is 20% higher, the stroke death rate is 32% higher, and the percent of adults who are obese with a Body Mass Index of 30.0 or above is 36% higher compared to the county at large. Compared with the rest of the county, the social health disparities present a similar picture, with 38% percent of adults having less than a high school education versus 23%, 45% of adults reporting difficulty in accessing medical care versus 31%, and with 29% of 18-64 year old adults with no regular source of health care versus 23%. If these trends continue, the UCLA Center on Health Equity projects that chronic health conditions in South L.A. will increase significantly: heart disease by 25%, type II diabetes by 49% and hypertension by 21%. These are some of the health issues that the Advanced Clinic intends to address.

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April 26, 2017 Martin Luther King Jr. Community Health Foundation (MLK Health Foundation) Page 2 of 2

Organizational Background The MLK Health Foundation is a non-profit organization which serves as the fundraising entity of the Martin Luther King, Jr. (MLK) Community Hospital. The Hospital created the MLK Jr. Community Medical Group to administer the Advanced Clinic project and address outpatient complex care issues. The UCLA Department of Family Medicine and the International Medical Graduates program are key partners in this project, especially in the recruitment of physicians and other allied health professionals. MLK Hospital opened its doors in 2015, with 131 beds that serve over 6,000 patients per month in a catchment area of over 1.3 million South Los Angeles residents, including Compton, Inglewood, West Adams, Crenshaw, Watts, Willowbrook and Lynwood. The hospital features a 21-bed emergency department, a critical care unit, and labor and delivery services, among other inpatient services. The hospital is located on a campus with several other high-quality facilities that include the MLK Center for Public Health, which focuses on preventative care, and the Martin Luther King, Jr. Outpatient Center, both operated by the County of Los Angeles. The Outpatient Center provides services that include general medicine, cardiology, dermatology, dentistry, geriatrics, HIV and AIDS, neurology, orthopedics and physical therapy. Mental health services are provided through the Augustus Hawkins Mental Health Center. The total project budget for the advance care clinic development is $3.5 million. MLK Health Foundation has secured $3.0 from private funders such as the Weingart Foundation, WM Keck Foundation, Good Hope Medical Foundation, and from MLK Hospital in-kind contributions and projected patient revenue. Project Deliverables Objectives to be met by the end of the 18-month grant period include: 1. Serve over 1,500 high-acuity unique adult patients with complex and chronic health conditions. 2. Hire up to 12 physicians, physician assistants or nurse practitioners. 3. Up to 95% of patients successfully transition after discharge from the hospital to the advanced

care clinic or to an integrated community-based system of care. 4. Meet specific clinical goals such as Asthma Medication Ratio of 78%, +3% over regional

benchmark of 75%, Blood Pressure Control <140/90 of 65%, +9% over regional benchmark of 56%, and Diabetic Nephropathy Monitoring of 90%.

5. Reduce unnecessary emergency department visits and hospital stays by 1.5% over baseline.

Alignment with L.A. Care Strategic Goals This Advanced Clinic project aligns with L.A. Care’s organizational goal 4.5: foster innovative approaches to improving the health status of our members and the quality of care provided by the safety net. Evaluation and Program Monitoring Community Benefits staff will request a minimum of three program update reports on a semi-annual basis and a final one-year report after program completion.

125

Board of Governors

MOTION SUMMARY




Issue: Acceptance of the Financial Report for the period ended March 2017.

Background: Attached also is the monthly investment transactions report.

Member Impact: N/A Budget Impact: N/A

Motion: To accept the Financial Report for the period ended March 2017, as

submitted.

131

3/31/2017

Financial Performance March 2017

132

Financial Performance Results Highlights - Year-to-Date March 2017

Overall

MediCal Plan Partners

MediCal Direct SPD-CCI

MediCal Direct TANF-MCE

Cal MediConnect (CMC)

Commercial

L.A. Care Commercial consists of Covered California, PASC-SEIU and Healthy Kids. The member months is 387,152, which is 9,255

member months favorable to the forecast. The performance is a deficit of $14.0 million and is $890 thousand unfavorable to plan. The

unfavorable forecast variance is driven by higher than expected healthcare expenses, operating expenses, and non-operating expenses.

Operating expenses included a true-up to prior year LACC participation fees and marketing campaign spend for calendar year 2017 open

enrollment. Non-operating expenses includes the managed care organization tax which will be recouped through an arrangement with

DPSS by June 2017. The unfavorable variance is offset by higher revenue associated with favorable member months and higher

capitalization revenue rate.

The combined member months is 12.5 million year to date, which is 3,345 member months favorable to the forecast. The year-to-date

performance is a surplus of $79.8 million or 1.9% of revenue and is $20.8 million favorable to plan. Favorable surplus variance is primarily

driven by timing of inpatient, outpatient and skilled nursing facility paid claims and reserve adjustments. Additional favorability was

caused by timing of an $8M capitation expense accrual that will be recorded in April. Administrative expenses are higher than forecast

due, in large part, to the methodology used to forecast. Year-to-date (YTD) actuals were used through January, which discounts any YTD

favorability vs. budget. The unfavorable administrative variance for the month of March was caused by timing of the Medi-Cal provider

directory creation and mailing, Legal accruals, and professional fees related to core projects. Interest income is higher than forecast due

to timing of MCE overpayment recoupment, and overall investment portfolio is larger than anticipated.

The member months is 5.9 million, which is 2,044 member months favorable to the forecast. The performance is a surplus of $68.5

million, and is $9.2 million favorable to plan. The favorable forecast variance is driven by higher revenue associated with higher

capitation rates in revenue, timing of an $8M capitation expense accrual and investment income. Favorability is offset by higher

capitation expense.

The member months is 1.2 million, which is 28 member months unfavorable to the forecast. The performance is a deficit of $34.4 million,

and is $39.5 million favorable to plan. Favorable surplus variance is primarily driven by timing of inpatient, outpatient and skilled nursing

facility paid claims and reserve adjustments.

The member months is 4.9 million, which is 7,825 member months unfavorable to the forecast. The performance is a surplus of $65.4

million, and is $24.6 million unfavorable to plan. The unfavorable forecast variance is driven by lower than forecasted member months.

The unfavorable variance is slightly offset by lower than anticipated utilization in pharmacy, outpatient.

The member months is 78,390, which is 94 member months unfavorable to the forecast. The performance is a surplus of $3.5 million,

and is $2.4 million unfavorable to plan. The unfavorable forecast variance is driven by timing of rate adjustments and part D

reconciliations within the pharmacy expense.

133

Consolidated Operations Income Statement ($ in thousands)

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

Membership

2,109,794 2,110,171 (377) Member Months 12,464,551 12,461,206 3,345

Revenue

$692,475 328.22 $692,368 328.11 $107 0.11 Capitation $4,140,363 332.17 $4,141,571 332.36 ($1,208) (0.19)

$315 0.15 $239 0.11 $76 0.04 Pay for Performance $1,673 0.13 $1,561 0.13 $113 0.01

692,790 328.37 692,607 328.22 183 0.15 Total Revenues 4,142,036 332.31 4,143,131 332.48 (1,095) (0.18)

Healthcare Expenses

350,163 165.97 349,034 165.41 (1,129) (0.56) Capitation 2,119,086 170.01 2,109,582 169.29 (9,503) (0.72)

15,542 7.37 5,963 2.83 (9,579) (4.54) Provider Incentives and Shared Risk 51,334 4.12 43,485 3.49 (7,849) (0.63)

60,649 28.75 64,314 30.48 3,665 1.73 Inpatient Claims 370,195 29.70 379,950 30.49 9,755 0.79

128,030 60.68 137,619 65.22 9,589 4.53 Outpatient Claims 773,140 62.03 786,842 63.14 13,702 1.12

38,754 18.37 40,850 19.36 2,096 0.99 Skilled Nursing Facility 249,171 19.99 259,685 20.84 10,514 0.85

52,246 24.76 52,015 24.65 (231) (0.11) Pharmacy 305,693 24.53 310,130 24.89 4,436 0.36

4,383 2.08 4,911 2.33 528 0.25 Medical Administrative Expenses 23,687 1.90 25,006 2.01 1,318 0.11

649,766 307.98 654,705 310.26 4,939 2.29 Total Healthcare Expenses 3,892,307 312.27 3,914,679 314.15 22,372 1.88

MCR(%)

43,023 20.39 37,901 17.96 5,122 2.43 Operating Margin 249,729 20.04 228,452 18.33 21,277 1.70

30,541 14.48 29,458 13.96 (1,083) (0.52) Total Operating Expenses 172,073 13.80 168,463 13.52 (3,610) (0.29)

Admin Ratio(%)

12,483 5.92 8,444 4.00 4,039 1.92 Income (Loss) from Operations 77,656 6.23 59,989 4.81 17,667 1.42

(123) (0) (987) (0.47)$ 832 0.39$ Other Income/(Expense), net (6,726) (1) (8,410) (0.67) (1,193) (0.10)$

1,915 0.91 667 0.32 1,248 0.59 Interest Income, net 9,228 0.74 6,994 0.56 2,234 0.18

(67) (0.03) 0 - (67) (0.03) Realized Gain/Loss (151) (0.01) (106) (0.01) (45) (0.00)

(745) (0.35) 0 - (745) (0.35) Unrealized Gain/Loss (173) (0.01) 534 0.04 (707) (0.06)

981 0.46 (321) (0.15) 1,269 0.60 Total Non-Operating Income (Expense) 2,178 0.17 (987) (0.08) 288 0.02

$13,464 6.38 $8,123 3.85 $5,341 2.53 Net Surplus (Deficit) $79,834 6.40 $59,002 4.73 $20,833 1.67

Margin(%)

March 2017

Current Current Fav<Unfav> YTD YTD Fav<Unfav>

0.5%

Actual Forecast Forecast Actual Forecast Forecast

93.8% 94.5% 0.7% 94.0% 94.5%

0.5%

4.4% 4.3% -0.2% 4.2% 4.1% -0.1%

1.9% 1.2% 0.8% 1.9% 1.4%

134

MediCal Plan Partners Income Statement ($ in thousands)


Membership

998,843 996,799 2,044 Member Months 5,932,727 5,930,683 2,044

Revenue

$268,145 268.46 $259,192 260.02 $8,953 8.43 Capitation $1,596,980 269.18 $1,581,101 266.60 $15,879 2.58

268,145 268.46 259,192 260.02 8,953 8.43 Total Revenues 1,596,980 269.18 1,581,101 266.60 15,879 2.58

Healthcare Expenses

242,147 242.43 242,236 243.01 89 0.59 Capitation 1,488,055 250.82 1,480,149 249.57 (7,906) (1.25)

3,982 3.99 2,369 2.38 (1,614) (1.61) Provider Incentives and Shared Risk 14,621 2.46 14,921 2.52 300 0.05

0 - 0 - 0 - Inpatient Claims 177 0.03 180 0.03 3 0.00

275 0.27 0 - (275) (0.27) Outpatient Claims 686 0.12 156 0.03 (530) (0.09)

678 0.68 1,014 1.02 336 0.34 Medical Administrative Expenses 3,621 0.61 4,320 0.73 699 0.12

247,082 247.37 245,619 246.41 (1,463) (0.96) Total Healthcare Expenses 1,507,160 254.04 1,499,716 252.87 (7,444) (1.17)

MCR(%)

21,063 21.09 13,572 13.62 7,490 7.47 Operating Margin 89,820 15.14 81,385 13.72 8,435 1.42

4,576 4.58 4,313 4.33 (262) (0.25) Total Operating Expenses 25,813 4.35 24,972 4.21 (840) (0.14)

Admin Ratio(%)

16,487 16.51 9,259 9.29 7,228 7.22 Income (Loss) from Operations 64,008 10.79 56,413 9.51 7,595 1.28

581 0.58 0 - 581 0.58 Total Non-Operating Income (Expense) 4,484 0.76 2,836 0.48 4,484 0.28

$17,068 17.09 $9,259 9.29 $7,809 7.80 Net Surplus (Deficit) $68,492 11.54 $59,249 9.99 $9,243 1.55

Margin(%)

March 2017


0.5%


92.1% 94.8% 2.6% 94.4% 94.9%

0.5%

1.7% 1.7% 0.0% 1.6% 1.6% 0.0%

6.4% 3.6% 2.8% 4.3% 3.7%

135

MediCal Direct SPD-CCI Income Statement ($ in thousands)


Membership

208,317 208,045 272 Member Months 1,211,537 1,211,565 (28)

Revenue

$205,091 984.51 $210,749 1,013.00 ($5,658) (28.48) Capitation $1,243,279 1,026.20 $1,249,472 1,031.29 ($6,192) (5.09)

205,091 984.51 210,749 1,013.00 (5,658) (28.48) Total Revenues 1,243,279 1,026.20 1,249,472 1,031.29 (6,192) (5.09)

Healthcare Expenses

16,567 79.53 16,029 77.05 (538) (2.48) Capitation 94,655 78.13 94,513 78.01 (142) (0.12)

(7,629) (36.62) (1,929) (9.27) 5,700 27.35 Provider Incentives and Shared Risk (20,294) (16.75) (10,893) (8.99) 9,401 7.76

26,152 125.54 29,540 141.99 3,389 16.45 Inpatient Claims 166,128 137.12 177,573 146.56 11,445 9.44


33,441 160.53 36,296 174.46 2,855 13.93 Skilled Nursing Facility 218,503 180.35 231,123 190.76 12,619 10.41

17,211 82.62 17,357 83.43 146 0.81 Pharmacy 96,102 79.32 98,537 81.33 2,435 2.01

1,588 7.62 1,428 6.87 (159) (0.75) Medical Administrative Expenses 8,455 6.98 8,306 6.86 (149) (0.12)

196,183 941.75 213,539 1,026.41 17,356 84.66 Total Healthcare Expenses 1,212,668 1,000.93 1,260,476 1,040.37 47,808 39.44

MCR(%)

8,907 42.76 (2,790) (13.41) 11,698 56.17 Operating Margin 30,611 25.27 (11,004) (9.08) 41,616 34.35

13,163 63.19 11,601 55.76 (1,563) (7.43) Total Operating Expenses 68,346 56.41 65,284 53.88 (3,062) (2.53)

Admin Ratio(%)

(4,256) (20.43) (14,391) (69.17) 10,135 48.74 Income (Loss) from Operations (37,734) (31.15) (76,288) (62.97) 38,554 31.82

395 1.90 197 0.95 198 0.95 Total Non-Operating Income (Expense) 3,321 2.74 2,384 1.97 2,137 0.77

($3,861) (18.53) ($14,194) (68.22) $10,333 49.69 Net Surplus (Deficit) ($34,414) (28.41) ($73,904) (61.00) $39,490 32.59

Margin(%)

March 2017


3.3%


95.7% 101.3% 5.7% 97.5% 100.9%

3.1%

6.4% 5.5% -0.9% 5.5% 5.2% -0.3%

-1.9% -6.7% 4.9% -2.8% -5.9%

136

MediCal Direct TANF-MCE Income Statement ($ in thousands)


Membership

813,394 821,219 (7,825) Member Months 4,854,752 4,862,577 (7,825)

Revenue

$177,538 218.27 $180,666 220.00 ($3,129) (1.73) Capitation $1,062,444 218.85 $1,073,245 220.72 ($10,801) (1.87)

177,538 218.27 180,666 220.00 (3,129) (1.73) Total Revenues 1,062,444 218.85 1,073,245 220.72 (10,801) (1.87)

Healthcare Expenses

66,199 81.39 66,485 80.96 285 (0.43) Capitation 397,738 81.93 397,242 81.69 (495) (0.23)

18,397 22.62 5,209 6.34 (13,187) (16.27) Provider Incentives and Shared Risk 49,095 10.11 33,178 6.82 (15,917) (3.29)

30,365 37.33 30,654 37.33 289 (0.00) Inpatient Claims 179,780 37.03 178,884 36.79 (896) (0.24)


3,644 4.48 3,156 3.84 (487) (0.64) Skilled Nursing Facility 22,017 4.54 20,390 4.19 (1,628) (0.34)

30,334 37.29 29,851 36.35 (483) (0.94) Pharmacy 190,687 39.28 192,585 39.61 1,898 0.33

1,513 1.86 1,503 1.83 (10) (0.03) Medical Administrative Expenses 8,468 1.74 8,557 1.76 89 0.02

164,983 202.83 154,609 188.27 (10,373) (14.56) Total Healthcare Expenses 943,871 194.42 928,243 190.90 (15,628) (3.53)

MCR(%)

12,555 15.44 26,057 31.73 (13,502) (16.29) Operating Margin 118,572 24.42 145,002 29.82 (26,430) (5.40)

10,012 12.31 11,095 13.51 1,083 1.20 Total Operating Expenses 55,500 11.43 57,579 11.84 2,079 0.41

Admin Ratio(%)

2,543 3.13 14,962 18.22 (12,419) (15.09) Income (Loss) from Operations 63,072 12.99 87,423 17.98 (24,351) (4.99)

301 0.37 469 0.57 (169) (0.20) Total Non-Operating Income (Expense) 2,332 0.48 2,553 0.53 (484) (0.04)

$2,844 3.50 $15,431 18.79 ($12,587) (15.29) Net Surplus (Deficit) $65,404 13.47 $89,976 18.50 ($24,572) (5.03)

Margin(%)

March 2017


-2.4%


92.9% 85.6% -7.4% 88.8% 86.5%

-2.2%

5.6% 6.1% 0.5% 5.2% 5.4% 0.1%

1.6% 8.5% -6.9% 6.2% 8.4%

137

CMC Income Statement ($ in thousands)


Membership

13,865 13,959 (94) Member Months 78,390 78,484 (94)

Revenue

$19,439 1,402.03 $20,447 1,464.78 ($1,008) (62.76) Capitation $122,979 1,568.80 $124,064 1,580.76 ($1,085) (11.95)

19,439 1,402.03 20,447 1,464.78 (1,008) (62.76) Total Revenues 122,979 1,568.80 124,064 1,580.76 (1,085) (11.95)

Healthcare Expenses

8,753 631.30 9,008 645.29 255 13.99 Capitation 50,328 642.02 50,564 644.26 237 2.24

811 58.50 152 10.92 (659) (47.58) Provider Incentives and Shared Risk 4,330 55.24 3,437 43.79 (893) (11.45)

2,421 174.60 2,675 191.65 254 17.05 Inpatient Claims 15,099 192.62 15,472 197.14 373 4.52

3,432 247.49 4,118 294.97 686 47.48 Outpatient Claims 21,533 274.70 22,222 283.14 689 8.44

1,681 121.26 1,398 100.13 (284) (21.13) Skilled Nursing Facility 8,529 108.80 8,064 102.75 (465) (6.05)

2,294 165.44 1,740 124.68 (553) (40.76) Pharmacy 7,377 94.11 5,986 76.27 (1,391) (17.84)

517 37.25 805 57.65 288 20.40 Medical Administrative Expenses 2,727 34.78 3,261 41.55 534 6.76

19,908 1,435.85 19,895 1,425.28 (13) (10.57) Total Healthcare Expenses 109,923 1,402.26 109,006 1,388.90 (917) (13.37)

MCR(%)

(469) (33.82) 551 39.50 (1,020) (73.32) Operating Margin 13,055 166.54 15,058 191.86 (2,003) (25.32)

1,093 78.81 755 54.05 (338) (24.76) Total Operating Expenses 9,625 122.79 9,180 116.97 (445) (5.82)

Admin Ratio(%)

(1,562) (112.63) (203) (14.55) (1,359) (98.08) Income (Loss) from Operations 3,430 43.76 5,878 74.89 (2,448) (31.14)

13 0.96 0 - 13 0.96 Total Non-Operating Income (Expense) 103 1.32 70 0.89 103 0.43

($1,548) (111.68) ($203) (14.55) ($1,345) (97.13) Net Surplus (Deficit) $3,533 45.07 $5,948 75.78 ($2,414) (30.71)

Margin(%)

March 2017


-1.5%


102.4% 97.3% -5.1% 89.4% 87.9%

-1.9%

5.6% 3.7% -1.9% 7.8% 7.4% -0.4%

-8.0% -1.0% -7.0% 2.9% 4.8%

138

Commercial Income Statement ($ in thousands)


Membership

75,375 70,149 5,226 Member Months 387,152 377,897 9,255

Revenue

$22,262 295.35 $21,314 303.83 $949 (8.48) Capitation $114,689 296.24 $113,689 300.85 $999 (4.61)

22,262 295.35 21,314 303.83 949 (8.48) Total Revenues 114,689 296.24 113,689 300.85 999 (4.61)

Healthcare Expenses

16,497 218.87 15,276 217.77 (1,221) (1.10) Capitation 88,312 228.11 87,114 230.52 (1,198) 2.42

(20) (0.26) 162 2.30 181 2.57 Provider Incentives and Shared Risk 2,403 6.21 2,671 7.07 268 0.86

1,715 22.76 1,445 20.60 (270) (2.16) Inpatient Claims 9,031 23.33 7,852 20.78 (1,178) (2.55)

942 12.49 932 13.29 (9) 0.80 Outpatient Claims 5,723 14.78 5,743 15.20 20 0.41

(12) (0.15) 0 - 12 0.15 Skilled Nursing Facility 121 0.31 111 0.29 (10) (0.02)

2,406 31.92 3,066 43.71 661 11.79 Pharmacy 11,192 28.91 13,027 34.47 1,835 5.56

87 1.16 160 2.29 73 1.13 Medical Administrative Expenses 415 1.07 561 1.48 146 0.41

21,616 286.77 21,042 299.96 (574) 13.19 Total Healthcare Expenses 117,197 302.72 117,080 309.82 (117) 7.10

MCR(%)

647 8.58 272 3.87 375 4.71 Operating Margin (2,508) (6.48) (3,391) (8.97) 882 2.49

796 10.56 645 9.19 (151) (1.37) Total Operating Expenses 7,281 18.81 6,211 16.44 (1,070) (2.37)

Admin Ratio(%)

(149) (1.98) (373) (5.32) 224 3.34 Income (Loss) from Operations (9,789) (25.28) (9,602) (25.41) (187) 0.12

(506) (6.71) (154) (2.20) (384) (4.51) Total Non-Operating Income (Expense) (4,242) (10.96) (3,539) (9.36) (3,710) (1.59)

($655) (8.69) ($527) (7.51) ($128) (1.18) Net Surplus (Deficit) ($14,031) (36.24) ($13,141) (34.77) ($890) (1.47)

Margin(%)

March 2017


0.8%


97.1% 98.7% 1.6% 102.2% 103.0%

-0.7%

3.6% 3.0% -0.6% 6.3% 5.5% -0.9%

-2.9% -2.5% -0.5% -12.2% -11.6%

139

Comparative Balance Sheet

(Dollars in thousands) Mar-16 Jun-16 Sep-16 Dec-16 Jan-17 Feb-17 Mar-17

ASSETS

CURRENT ASSETS

Total Current Assets 3,419,346 3,819,961 4,070,794 4,853,489 4,670,325 4,807,703 4,655,277

Capitalized Assets - net 53,612 60,496 64,508 65,812 64,916 65,802 68,225

NON-CURRENT ASSETS $24,989 $23,465 $842 519 746 590 2,311

TOTAL ASSETS $3,497,947 $3,903,923 $4,136,144 4,919,820 4,735,987 4,874,095 4,725,813

LIABILITIES AND FUND EQUITY

CURRENT LIABILITIES

Total Current Liability $2,967,587 $3,337,041 $3,608,653 4,371,117 4,166,337 4,280,280 4,118,559

Long Term Liability $3,708 $3,695 $3,679 3,629 3,631 3,632 3,607

Total Liabilities $2,971,295 $3,340,736 $3,612,332 4,374,746 4,169,968 4,283,912 4,122,166

FUND EQUITY

Invested in Capital Assets, net of related debt $53,612 $60,496 $64,508 65,812 64,916 65,802 68,225

Restricted Equity $300 $300 $300 300 300 300 300

Minimum Tangible Net Equity $165,193 $185,931 $192,308 196,915 197,418 200,587 197,643

Board Designated Funds $307,548 $316,459 $266,696 16,252 15,237 15,042 15,042

Retained Earnings (undesignated) $0 ($0) ($0) 265,795 288,149 308,452 322,436

Total Fund Equity $526,652 $563,187 $523,812 $545,074 $566,019 $590,183 $603,646

TOTAL LIABILITIES AND FUND EQUITY $3,497,947 $3,903,923 $4,136,144 $4,919,820 $4,735,987 $4,874,095 $4,725,813

Solvency Ratios

Working Capital Ratio 1.15 1.14 1.13 1.11 1.12 1.12 1.13

Cash to Claims Ratio 0.97 0.73 0.89 0.77 0.66 0.68 0.81

Tangible Net Equity Ratio 3.19 3.03 2.72 2.77 2.87 2.94 3.05

March 2017

140

y

Cash Flows Statement ($ in thousands)

Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 YTD

Cash Flows from Operating Activities:

Capitation Revenue 585,436$ 13,957$ 591,729$ 682,666$ 717,209$ 1,157,803$ 3,748,801$

Other Income (Expense), net 17 1,071 603 1,088 1,051 2,924 6,753

Healthcare Expenses (473,840) (288,339) (736,854) (444,419) (622,572) (887,018) (3,453,041)

Operating Expenses (18,679) (24,484) (41,788) (25,939) (26,030) (26,458) (163,378)

Net Cash Provided By Operating Activities 92,934 (297,794) (186,310) 213,396 69,658 247,252 139,135

Cash Flows from Investing Activities

Net Proceeds from Sale of Investments 157,576 51,806 (331,287) 135,715 (53,507) 7,749 (31,947)

Purchase of Capital Assets (1,529) (3,331) (470) (426) (2,216) (3,737) (11,709)

Net Cash Provided By Investing Activities 156,048 48,475 (331,756) 135,289 (55,723) 4,012 (43,656)

Cash Flows from Financing Activities:

Gross Premium Tax (MCO Sales Tax) - Net (73,935) (212) 213 (34,725) 52,952 (15,749) (71,456)

Pass through transactions (AB 85, IGT, etc.) 9,102 (17,893) 414,972 (415,312) 20,667 78,788 90,325

Net Cash Provided By Financing Activities (64,833) (18,104) 415,185 (450,037) 73,619 63,039 18,868

Net Increase in Cash and Cash Equivalents 184,148 (267,424) (102,882) (101,352) 87,554 314,303 114,347

Cash and Cash Equivalents, Beginning 642,865 827,013 559,589 456,707 355,355 442,909 642,865

Cash and Cash Equivalents, Ending 827,013$ 559,589$ 456,707$ 355,355$ 442,909$ 757,212$ 757,212$

Reconciliation of Income from Operations to Net Cash Provided By (Used In) Operating Activities:

Excess of Revenues over Expenses 2,153$ 6,619$ 12,490$ 20,946$ 24,163$ 13,464$ 79,835$

Adjustments to Excess of Revenues Over Expenses:

Depreciation 1,349 1,343 1,334 1,322 1,330 1,314 7,992

Realized and Unrealized (Gain)/Loss on Investments (761) 1,132 259 (1,058) (59) 811 324

Deferred Rent (8) (21) (21) 1 1 (25) (72)

IGT - - - (331) (728) (161) (1,220)

Gross Premium Tax provision 535 547 1,519 541 702 284 4,128

Total Adjustments to Excess of Revenues over Expenses 1,113 3,002 3,091 476 1,245 2,224 11,152

Changes in Operating Assets and Liabilities:

Capitation Receivable (43,919) (641,623) (83,064) (37,740) (38,406) 445,959 (398,793)

Interest and Non-Operating Receivables (450) (417) 65 (516) (652) 809 (1,162)

Prepaids and Other Current Assets 1,613 (4,050) 212 (2,047) 1,320 202 (2,750)

Accounts Payable and Accrued Liabilities 4,646 4,527 (15,659) 5,986 1,433 2,592 3,525

Subcapitation Payable 40,741 224,293 (122,195) 254,554 125,127 (127,074) 395,446

MediCal Adult Expansion Payable 110,468 70,750 66,909 3,700 (14,742) (93,815) 143,270

Deferred Capitation Revenue (13,836) (6,833) 612 (432) 3,523 18,917 1,951

Accrued Medical Expenses (10,554) 5,043 (19,283) (6,770) 7,909 9,953 (13,701)

Reserve for Claims (3,202) 37,320 (28,171) (15,174) (24,108) (34,721) (68,055)

Reserve for Provider Incentives 3,744 3,744 (1,538) (10,098) (17,126) 8,858 (12,415)

Grants Payable 415 (170) 221 511 (30) (115) 832

Net Changes in Operating Assets and Liabilities 89,667 (307,416) (201,891) 191,974 44,250 231,564 48,148

Net Cash Provided By Operating Activities 92,934$ (297,794)$ (186,310)$ 213,396$ 69,658$ 247,252$ 139,135$

141

April 17, 2017

TO: Finance & Budget Committee

FROM: Marie Montgomery, Chief Financial Officer

SUBJECT: Monthly Investment Transaction Report for March 2017 To keep the Committee apprised of L.A. Care’s investment portfolios and to comply with California Government Code Section 53607, attached are the investment transaction details from March 1 to March 31, 2017. L.A. Care's total investment market value as of March 31, 2017 was $2.7 billion. This includes funds invested with the government pooled funds: $64 million invested with the statewide Local Agency Investment Fund (LAIF), and $71 million invested with the Los Angeles County Pooled Investment Fund (LACPIF). The remainder, $2.55 billion, is managed by Payden & Rygel, an external professional asset management firm, in two separate portfolios based on investment style:

1. Short-term Portfolio, and, 2. Extended Portfolio

Transactions within those two portfolios are included in the attached report.

142

TRANSACTIONS BY TYPE

Account Name: L.A ARE HEALTH PLAN 03/01/2017Account Number: through 03/31/2017

Tr Date St Date Transaction Accrued Interest G/L < 1 Yr G/L > 1 Yr Total

Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 02/28/17 03/03/17 Buy 4,060,000.000 AMERICAN EXPRESS FRN (4,060,000.00) 0.00 0.00 (4,060,000.00)

MAT 03/03/22 Cpn 1.79 0258M0EH8

02/28/17 03/03/17 Buy 1,915,000.000 CHEVRON (1,915,000.00) 0.00 0.00 (1,915,000.00)MAT 02/28/19 Cpn 1.69 166764BS8

03/03/17 03/03/17 Buy 50,000,000.000 FHLB DISCOUNT NOTE (49,992,479.17) 0.00 0.00 (49,992,479.17)MAT 03/22/17 Cpn 313385DJ2

03/03/17 03/03/17 Buy 10,000,000.000 FHLB DISCOUNT NOTE (9,998,495.83) 0.00 0.00 (9,998,495.83)MAT 03/22/17 Cpn 313385DJ2

03/03/17 03/03/17 Buy 50,000,000.000 FHLB DISCOUNT NOTE (49,947,111.11) 0.00 0.00 (49,947,111.11)MAT 04/28/17 Cpn 313385EX0

03/03/17 03/03/17 Buy 50,000,000.000 FHLB DISCOUNT NOTE (49,947,111.11) 0.00 0.00 (49,947,111.11)MAT 04/28/17 Cpn 313385EX0

03/03/17 03/03/17 Buy 50,000,000.000 FNMA DISCOUNT NOTE (49,962,138.89) 0.00 0.00 (49,962,138.89)MAT 04/19/17 Cpn 313589EN9

03/03/17 03/03/17 Buy 14,400,000.000 FNMA DISCOUNT NOTE (14,389,096.00) 0.00 0.00 (14,389,096.00)MAT 04/19/17 Cpn 313589EN9

03/03/17 03/03/17 Buy 49,600,000.000 FNMA DISCOUNT NOTE (49,552,384.00) 0.00 0.00 (49,552,384.00)MAT 04/26/17 Cpn 313589EV1

03/03/17 03/03/17 Buy 50,000,000.000 FNMA DISCOUNT NOTE (49,976,166.67) 0.00 0.00 (49,976,166.67)MAT 04/05/17 Cpn 313589DY6

03/01/17 03/06/17 Buy 5,015,000.000 WALT DISNEY CO FRN (5,015,000.00) 0.00 0.00 (5,015,000.00)MAT 03/04/22 Cpn 1.49 25468PDS2

03/06/17 03/06/17 Buy 25,000,000.000 FHLB DISCOUNT NOTE (24,952,638.89) 0.00 0.00 (24,952,638.89)MAT 06/02/17 Cpn 313385GJ9

02/27/17 03/06/17 Buy 2,050,000.000 INTL FINANCE CORP FRN (2,050,000.00) 0.00 0.00 (2,050,000.00)MAT 03/06/18 Cpn 0.88 45950VKP0

Payden & Rygel 143




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 02/28/17 03/06/17 Buy 50,000,000.000 U.S. TREASURY NOTE (49,863,000.00) (9,171.20) 0.00 0.00 (49,872,171.20)

MAT 02/28/19 Cpn 1.13 912828W30

03/06/17 03/07/17 Buy 7,900,000.000 MIZUHO BANK LTD YCD (7,900,000.00) 0.00 0.00 (7,900,000.00)MAT 09/06/17 Cpn 1.30 60689D5J8

03/08/17 03/13/17 Buy 3,385,000.000 BB&T CORPORATION (3,395,865.85) (16,191.58) 0.00 0.00 (3,412,057.43)MAT 06/19/18 Cpn 2.05 05531FAN3

03/10/17 03/13/17 Buy 960,000.000 FFCB 1ML FRN (964,110.88) (479.92) 0.00 0.00 (964,590.80)MAT 01/22/19 Cpn 1.15 3133EGMU

03/10/17 03/13/17 Buy 960,000.000 FHLB 3ML FRN (960,013.08) (161.47) 0.00 0.00 (960,174.55)MAT 03/06/19 Cpn 0.87 3130AAWH

03/07/17 03/15/17 Buy 10,810,000.000 TOYOTA 2017-A A2A CAR (10,808,956.84) 0.00 0.00 (10,808,956.84)MAT 09/16/19 Cpn 1.42 89238MAB4

03/15/17 03/16/17 Buy 30,000,000.000 FHLB DISCOUNT NOTE (29,964,708.33) 0.00 0.00 (29,964,708.33)MAT 05/10/17 Cpn 313385FK7

03/16/17 03/17/17 Buy 50,000,000.000 FNMA DISCOUNT NOTE (49,997,166.67) 0.00 0.00 (49,997,166.67)MAT 03/20/17 Cpn 313589DG5

03/16/17 03/17/17 Buy 30,000,000.000 FNMA DISCOUNT NOTE (29,998,300.00) 0.00 0.00 (29,998,300.00)MAT 03/20/17 Cpn 313589DG5

03/13/17 03/20/17 Buy 5,270,000.000 CITIBANK FRN (5,270,000.00) 0.00 0.00 (5,270,000.00)MAT 03/20/19 Cpn 1.49 17325FAB4

03/17/17 03/20/17 Buy 14,472,000.000 FHLB DISCOUNT NOTE (14,471,228.16) 0.00 0.00 (14,471,228.16)MAT 03/23/17 Cpn 313385DK9

03/17/17 03/20/17 Buy 40,000,000.000 FNMA DISCOUNT NOTE (39,995,022.22) 0.00 0.00 (39,995,022.22)MAT 03/27/17 Cpn 313589DP5

03/20/17 03/23/17 Buy 3,950,000.000 CATERPILLAR FINANCIAL FRN (3,950,000.00) 0.00 0.00 (3,950,000.00)MAT 03/22/19 Cpn 1.44 14912L6X4

Payden & Rygel 144




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/27/17 03/28/17 Buy 14,000,000.000 DNB NOR BANK YCD (14,000,000.00) 0.00 0.00 (14,000,000.00)

MAT 06/28/17 Cpn 1.06 23340QB28

03/21/17 03/28/17 Buy 11,120,000.000 HONDA 2017-1 A2 CAR (11,119,734.23) 0.00 0.00 (11,119,734.23)MAT 07/22/19 Cpn 1.42 43814TAB8

03/23/17 03/28/17 Buy 2,040,000.000 PNC BANK (2,039,979.60) (10,608.00) 0.00 0.00 (2,050,587.60)MAT 06/01/18 Cpn 1.60 69353REM6

03/27/17 03/28/17 Buy 13,850,000.000 SKANDINAVISKA ENSKILDA BANKE (13,850,000.00) 0.00 0.00 (13,850,000.00)MAT 06/27/17 Cpn 1.00 83050FSR3

03/28/17 03/29/17 Buy 13,900,000.000 SWEDBANK NY YCD (13,900,000.00) 0.00 0.00 (13,900,000.00)MAT 06/29/17 Cpn 0.99 87019UZG7

03/31/17 03/31/17 Buy 23,000,000.000 FAMC DISCOUNT NOTE (22,999,041.67) 0.00 0.00 (22,999,041.67)MAT 04/03/17 Cpn 31315LDW5

03/31/17 03/31/17 Buy 5,200,000.000 FHLB DISCOUNT NOTE (5,198,281.11) 0.00 0.00 (5,198,281.11)MAT 04/17/17 Cpn 313385EL6

03/31/17 03/31/17 Buy 2,365,000.000 FHLB DISCOUNT NOTE (2,364,218.24) 0.00 0.00 (2,364,218.24)MAT 04/17/17 Cpn 313385EL6

03/31/17 03/31/17 Buy 5,000,000.000 FHLB DISCOUNT NOTE (4,998,200.00) 0.00 0.00 (4,998,200.00)MAT 04/18/17 Cpn 313385EM4

03/31/17 03/31/17 Buy 6,600,000.000 FHLB DISCOUNT NOTE (6,596,496.50) 0.00 0.00 (6,596,496.50)MAT 04/26/17 Cpn 313385EV4

03/31/17 03/31/17 Buy 16,548,000.000 FHLMC DISCOUNT NOTE (16,546,072.62) 0.00 0.00 (16,546,072.62)MAT 04/07/17 Cpn 313397EA5

03/31/17 03/31/17 Buy 6,351,000.000 FHLMC DISCOUNT NOTE (6,348,900.64) 0.00 0.00 (6,348,900.64)MAT 04/17/17 Cpn 313397EL1

03/31/17 03/31/17 Buy 20,000,000.000 U.S. TREASURY BILL (19,995,161.11) 0.00 0.00 (19,995,161.11)MAT 04/13/17 Cpn 912796KS7

Payden & Rygel 145




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/31/17 03/31/17 Buy 50,000,000.000 U.S. TREASURY BILL (49,987,722.22) 0.00 0.00 (49,987,722.22)

MAT 04/13/17 Cpn 912796KS7

03/31/17 03/31/17 Buy 50,000,000.000 U.S. TREASURY BILL (49,987,722.22) 0.00 0.00 (49,987,722.22)MAT 04/13/17 Cpn 912796KS7

849,721,000.000 (849,227,523.86) (36,612.17) 0.00 0.00 (849,264,136.03)

03/01/17 03/01/17 Coupon CATERPILLAR FINANCIAL 15,418.00 0.00 0.00 15,418.00 MAT 03/01/18 Cpn 1.30 14912L5P2

03/01/17 03/01/17 Coupon CISCO SYSTEMS FRN 1,430.67 0.00 0.00 1,430.67 MAT 03/01/19 Cpn 1.55 17275RAQ5

03/01/17 03/01/17 Coupon CISCO SYSTEMS FRN 768.99 0.00 0.00 768.99 MAT 03/01/19 Cpn 1.55 17275RAQ5



03/01/17 03/01/17 Coupon CA LOS ANGELES REDEV AGY TAX 9,227.67 0.00 0.00 9,227.67 MAT 09/01/17 Cpn 0.89 54465AGH9

03/01/17 03/01/17 Coupon ELI LILLY & CO 5,000.00 0.00 0.00 5,000.00 MAT 03/01/18 Cpn 1.25 532457BK3

03/01/17 03/01/17 Coupon PNC BANK FRN 13,506.70 0.00 0.00 13,506.70 MAT 06/01/18 Cpn 1.47 69353REN4

03/01/17 03/01/17 Coupon EXXON MOBIL FRN 9,071.20 0.00 0.00 9,071.20 MAT 03/01/18 Cpn 1.10 30231GAM4

03/01/17 03/01/17 Coupon EXXON MOBIL 25,859.12 0.00 0.00 25,859.12 MAT 03/01/19 Cpn 1.71 30231GAP7

Payden & Rygel 146




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/02/17 03/02/17 Coupon CHEVRON FRN 6,901.06 0.00 0.00 6,901.06

MAT 03/02/18 Cpn 1.23 166764AW0

03/02/17 03/02/17 Coupon CHEVRON FRN 3,450.53 0.00 0.00 3,450.53 MAT 03/02/18 Cpn 1.23 166764AW0


03/02/17 03/02/17 Coupon CHEVRON 8,190.00 0.00 0.00 8,190.00 MAT 03/02/18 Cpn 1.37 166764AV2

03/02/17 03/02/17 Coupon FFCB 1ML FRN 6,947.03 0.00 0.00 6,947.03 MAT 01/02/18 Cpn 0.83 3133EEWS

03/02/17 03/02/17 Coupon FFCB 3ML FRN 4,520.85 0.00 0.00 4,520.85 MAT 03/02/18 Cpn 1.03 3133EEDP2

03/03/17 03/03/17 Coupon CATERPILLAR FINANCIAL FRN 8,592.25 0.00 0.00 8,592.25 MAT 03/03/17 Cpn 14912L5Y3



03/03/17 03/03/17 Coupon CATERPILLAR FINANCIAL FRN 819.13 0.00 0.00 819.13 MAT 03/03/17 Cpn 14912L5Y3

03/03/17 03/03/17 Coupon CATERPILLAR FINANCIAL 11,250.00 0.00 0.00 11,250.00 MAT 03/03/17 Cpn 1.00 14912L5Z0

03/03/17 03/03/17 Coupon CISCO SYSTEMS 2,915.00 0.00 0.00 2,915.00 MAT 03/03/17 Cpn 1.10 17275RAT9


Payden & Rygel 147




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/04/17 03/04/17 Coupon FFCB 1ML FRN 1,488.15 0.00 0.00 1,488.15

MAT 04/04/18 Cpn 1.01 3133EFT64

03/04/17 03/04/17 Coupon FFCB 1ML FRN 2,008.54 0.00 0.00 2,008.54 MAT 05/04/18 Cpn 0.95 3133EF5Z6

03/04/17 03/04/17 Coupon PNC BANK 4,972.50 0.00 0.00 4,972.50 MAT 03/04/19 Cpn 1.95 69353REV6

03/04/17 03/04/17 Coupon PNC BANK 48,750.00 0.00 0.00 48,750.00 MAT 03/04/19 Cpn 1.95 69353REV6

03/06/17 03/06/17 Coupon AMERICAN EXPRESS FRN 8,116.51 0.00 0.00 8,116.51 MAT 06/05/17 Cpn 1.37 0258M0DN6

03/06/17 03/06/17 Coupon BNY MELLON FRN 866.49 0.00 0.00 866.49 MAT 03/06/18 Cpn 1.54 06406HCK3

03/06/17 03/06/17 Coupon BNY MELLON FRN 1,732.99 0.00 0.00 1,732.99 MAT 03/06/18 Cpn 1.54 06406HCK3

03/06/17 03/06/17 Coupon PACCAR FINANCIAL FRN 426.15 0.00 0.00 426.15 MAT 06/06/17 Cpn 1.29 69371RL95

03/06/17 03/06/17 Coupon PACCAR FINANCIAL FRN 8,096.78 0.00 0.00 8,096.78 MAT 06/06/17 Cpn 1.29 69371RL95


03/06/17 03/06/17 Coupon PACCAR FINANCIAL FRN 8,949.07 0.00 0.00 8,949.07 MAT 06/06/17 Cpn 1.29 69371RL95

03/06/17 03/06/17 Coupon EXXON MOBIL 17,421.75 0.00 0.00 17,421.75 MAT 03/06/18 Cpn 1.31 30231GAL6


Payden & Rygel 148




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/07/17 03/07/17 Coupon BANK OF AMERICA FRN 19,002.17 0.00 0.00 19,002.17

MAT 12/07/18 Cpn 1.86 06050TMF6

03/07/17 03/07/17 Coupon BANK OF AMERICA FRN 15,159.03 0.00 0.00 15,159.03 MAT 12/07/18 Cpn 1.86 06050TMF6

03/07/17 03/07/17 Coupon BANK OF NOVA SCOTIA HOUSTON 18,100.75 0.00 0.00 18,100.75 MAT 09/07/17 Cpn 1.60 06417GPD4

03/07/17 03/07/17 Coupon BERKSHIRE HATHAWAY FRN 8,089.52 0.00 0.00 8,089.52 MAT 03/07/18 Cpn 1.65 084664CF6



03/07/17 03/07/17 Coupon MIZUHO BANK LTD YCD 1ML FRN 9,373.72 0.00 0.00 9,373.72 MAT 03/07/17 Cpn 60689DH89

03/08/17 03/08/17 Coupon STRYKER 9,900.00 0.00 0.00 9,900.00 MAT 03/08/19 Cpn 2.00 863667AK7

03/08/17 03/08/17 Coupon STRYKER 10,000.00 0.00 0.00 10,000.00 MAT 03/08/19 Cpn 2.00 863667AK7

03/09/17 03/09/17 Coupon FFCB 1ML FRN 2,518.76 0.00 0.00 2,518.76 MAT 04/09/18 Cpn 0.90 3133EFHX8

03/09/17 03/09/17 Coupon NGN 2010-R1 1A 1MOFRN NCUA G 24,258.20 0.00 0.00 24,258.20 MAT 10/07/20 Cpn 1.30 62888VAA6

03/09/17 03/09/17 Coupon NGN 2010-R2 1A 1MOFRN NCUA G 1,575.75 0.00 0.00 1,575.75 MAT 11/06/17 Cpn 1.15 62888UAA8

03/09/17 03/09/17 Coupon NGN 2010-R2 1A 1MOFRN NCUA G 1,637.42 0.00 0.00 1,637.42 MAT 11/06/17 Cpn 1.15 62888UAA8

Payden & Rygel 149




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/09/17 03/09/17 Coupon NGN 2011-R1 1A 1MOFRN NCUA G 8,337.02 0.00 0.00 8,337.02

MAT 01/08/20 Cpn 1.30 62888YAA0

03/09/17 03/09/17 Coupon NGN 2011-R1 1A 1MOFRN NCUA G 1,420.90 0.00 0.00 1,420.90 MAT 01/08/20 Cpn 1.30 62888YAA0

03/09/17 03/09/17 Coupon NGN 2011-R2 1A 1MOFRN NCUA G 1,018.84 0.00 0.00 1,018.84 MAT 02/06/20 Cpn 1.25 62889CAA7

03/09/17 03/09/17 Coupon NGN 2011-R4 1A 1MOFRN NCUA G 2,868.90 0.00 0.00 2,868.90 MAT 03/06/20 Cpn 1.23 62889FAA0

03/09/17 03/09/17 Coupon NGN 2011-R4 1A 1MOFRN NCUA G 342.35 0.00 0.00 342.35 MAT 03/06/20 Cpn 1.23 62889FAA0



03/09/17 03/09/17 Coupon PACCAR FINANCIAL 4,785.00 0.00 0.00 4,785.00 MAT 03/09/18 Cpn 1.45 69371RM45

03/10/17 03/10/17 Coupon CHARLES SCHWAB 9,000.00 0.00 0.00 9,000.00 MAT 03/10/18 Cpn 1.50 808513AK1

03/11/17 03/11/17 Coupon FFCB 1ML FRN 3,628.34 0.00 0.00 3,628.34 MAT 06/11/18 Cpn 0.93 3133EEW48

03/12/17 03/12/17 Coupon TEXAS INSTRUMENTS 2,187.50 0.00 0.00 2,187.50 MAT 03/12/17 Cpn 0.88 882508AX2


03/13/17 03/13/17 Coupon US BANK OHIO FRN 2,186.01 0.00 0.00 2,186.01 MAT 09/11/17 Cpn 1.32 90331HMJ9

Payden & Rygel 150




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/13/17 03/13/17 Coupon US BANK OHIO FRN 8,744.04 0.00 0.00 8,744.04

MAT 09/11/17 Cpn 1.32 90331HMJ9

03/14/17 03/14/17 Coupon FHLMC C 12/14/16 Q 118,956.00 0.00 0.00 118,956.00 MAT 09/14/18 Cpn 1.15 3134GAJQ8

03/14/17 03/14/17 Coupon NGN 2011-R3 1A 1MO FRN NCUA G 4,487.68 0.00 0.00 4,487.68 MAT 03/11/20 Cpn 1.29 62889EAA3

03/14/17 03/14/17 Coupon NGN 2011-R3 1A 1MO FRN NCUA G 508.60 0.00 0.00 508.60 MAT 03/11/20 Cpn 1.29 62889EAA3

03/14/17 03/14/17 Coupon NGN 2011-R3 1A 1MO FRN NCUA G 581.74 0.00 0.00 581.74 MAT 03/11/20 Cpn 1.29 62889EAA3

03/14/17 03/14/17 Coupon SVENSKA HANDELSBANKEN NY Y 12,320.16 0.00 0.00 12,320.16 MAT 03/14/17 Cpn 86958JCV9

03/14/17 03/14/17 Coupon WELLS FARGO FRN 26,495.04 0.00 0.00 26,495.04 MAT 09/14/18 Cpn 1.52 94974BGD6

03/15/17 03/15/17 Coupon BB&T CORPORATION FRN 6,837.90 0.00 0.00 6,837.90 MAT 06/15/18 Cpn 1.99 05531FAP8

03/15/17 03/15/17 Coupon BB&T CORPORATION FRN 1,367.58 0.00 0.00 1,367.58 MAT 06/15/18 Cpn 1.99 05531FAP8

03/15/17 03/15/17 Coupon CHASE 2015-A3 A CDT 1MOFRN 5,712.00 0.00 0.00 5,712.00 MAT 04/15/19 Cpn 1.16 161571GW8

03/15/17 03/15/17 Coupon CISCO SYSTEMS FRN 24,195.36 0.00 0.00 24,195.36 MAT 06/15/18 Cpn 1.44 17275RAY8


03/15/17 03/15/17 Coupon JOHN DEERE CAPITAL CORP FRN 10,710.13 0.00 0.00 10,710.13 MAT 12/15/17 Cpn 1.35 24422ESQ3

Payden & Rygel 151




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/15/17 03/15/17 Coupon DRYROCK 2014-2 A CDT 1MOFRN 8,633.33 0.00 0.00 8,633.33

MAT 03/16/20 Cpn 1.25 06742LAC7

03/15/17 03/15/17 Coupon DRYROCK 2014-2 A CDT 1MOFRN 4,316.67 0.00 0.00 4,316.67 MAT 03/16/20 Cpn 1.25 06742LAC7

03/15/17 03/15/17 Coupon DRYROCK 2014-2 A CDT 1MOFRN 133.82 0.00 0.00 133.82 MAT 03/16/20 Cpn 1.25 06742LAC7

03/01/17 03/15/17 Coupon FHLMC #G15842 15YR 25,592.88 0.00 0.00 25,592.88 MAT 04/01/19 Cpn 4.50 3128MEWB

03/15/17 03/15/17 Coupon HONDA 2016-2 A2 CAR 9,456.21 0.00 0.00 9,456.21 MAT 09/17/18 Cpn 1.13 43814QAB4

03/15/17 03/15/17 Coupon HOME DEPOT FRN 5,000.40 0.00 0.00 5,000.40 MAT 09/15/17 Cpn 1.50 437076BJ0

03/15/17 03/15/17 Coupon HOME DEPOT FRN 13,417.74 0.00 0.00 13,417.74 MAT 09/15/17 Cpn 1.50 437076BJ0

03/15/17 03/15/17 Coupon JOHN DEERE 2014-A A3 EQP 320.50 0.00 0.00 320.50 MAT 04/16/18 Cpn 0.92 47787VAC5

03/15/17 03/15/17 Coupon JOHN DEERE 2016-A A2 EQP 23.85 0.00 0.00 23.85 MAT 10/15/18 Cpn 1.15 47788MAB6

03/15/17 03/15/17 Coupon JOHN DEERE 2016-B A2 EQP 8,356.67 0.00 0.00 8,356.67 MAT 02/15/19 Cpn 1.09 47788NAB4

03/15/17 03/15/17 Coupon U.S. TREASURY NOTE 8,200.00 0.00 0.00 8,200.00 MAT 03/15/19 Cpn 1.00 912828P95

03/15/17 03/15/17 Coupon TOYOTA 2014-B A3 CAR 365.80 0.00 0.00 365.80 MAT 03/15/18 Cpn 0.76 89231RAC8

03/15/17 03/15/17 Coupon TOYOTA 2015-A A3 CAR 2,074.47 0.00 0.00 2,074.47 MAT 02/15/19 Cpn 1.12 89236WAC2

Payden & Rygel 152




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/15/17 03/15/17 Coupon TOYOTA 2015-A A3 CAR 2,077.62 0.00 0.00 2,077.62

MAT 02/15/19 Cpn 1.12 89236WAC2

03/15/17 03/15/17 Coupon TOYOTA 2015-C A2A CAR 603.04 0.00 0.00 603.04 MAT 02/15/18 Cpn 0.92 89231TAB6

03/15/17 03/15/17 Coupon TOYOTA 2016-A A2A CAR 20.19 0.00 0.00 20.19 MAT 07/16/18 Cpn 1.03 89237KAB9

03/15/17 03/15/17 Coupon TOYOTA 2016-B A2A CAR 3,453.74 0.00 0.00 3,453.74 MAT 10/15/18 Cpn 1.02 89231UAB3

03/15/17 03/15/17 Coupon TOYOTA 2016-C A2A CAR 3,833.33 0.00 0.00 3,833.33 MAT 01/15/19 Cpn 1.00 89237WAB3

03/15/17 03/15/17 Coupon U.S. TREASURY NOTE 9,800.00 0.00 0.00 9,800.00 MAT 09/15/18 Cpn 1.00 912828L40

03/15/17 03/15/17 Coupon USAA 2016-1 A2 CAR 9,451.67 0.00 0.00 9,451.67 MAT 03/15/19 Cpn 1.07 90327CAB6

03/15/17 03/15/17 Coupon WACHOVIA FRN 7,709.00 0.00 0.00 7,709.00 MAT 06/15/17 Cpn 1.40 929903DU3



03/16/17 03/16/17 Coupon FFCB 1ML FRN 4,416.61 0.00 0.00 4,416.61 MAT 04/16/18 Cpn 0.98 3133EEZC7



Payden & Rygel 153




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/16/17 03/16/17 Coupon FFCB 1ML FRN 1,275.56 0.00 0.00 1,275.56

MAT 04/16/18 Cpn 0.98 3133EEZC7

03/16/17 03/16/17 Coupon FFCB 1ML FRN 32,106.67 0.00 0.00 32,106.67 MAT 05/16/19 Cpn 1.12 3133EGAU9

03/17/17 03/17/17 Coupon FFCB 1ML FRN 6,239.49 0.00 0.00 6,239.49 MAT 01/17/18 Cpn 0.97 3133EEZM5

03/18/17 03/18/17 Coupon FFCB 1ML FRN 7,066.02 0.00 0.00 7,066.02 MAT 06/18/18 Cpn 1.18 3133EFC62

03/18/17 03/18/17 Coupon HONDA 2016-1 A2 CAR 1,562.07 0.00 0.00 1,562.07 MAT 06/18/18 Cpn 1.01 43814NAB1

03/19/17 03/19/17 Coupon FHLB 40,775.00 0.00 0.00 40,775.00 MAT 03/19/18 Cpn 0.88 3130A7CX1

03/20/17 03/20/17 Coupon BMW 2016-1 A2A LEASE 4,704.34 0.00 0.00 4,704.34 MAT 01/22/18 Cpn 1.17 05581RAB2

03/20/17 03/20/17 Coupon FFCB 1ML FRN 3,774.40 0.00 0.00 3,774.40 MAT 06/20/19 Cpn 1.17 3133EGGJ8

03/20/17 03/20/17 Coupon FFCB 1ML FRN 15,097.60 0.00 0.00 15,097.60 MAT 06/20/19 Cpn 1.17 3133EGGJ8

03/20/17 03/20/17 Coupon FNMA 152,000.00 0.00 0.00 152,000.00 MAT 09/20/17 Cpn 1.00 3135G0PP2

03/20/17 03/20/17 Coupon GEDFT 2014-2 A 1MOFRN FLOOR 3,503.90 0.00 0.00 3,503.90 MAT 10/20/19 Cpn 1.43 36159LCN4

03/20/17 03/20/17 Coupon GEDFT 2014-2 A 1MOFRN FLOOR 8,211.12 0.00 0.00 8,211.12 MAT 10/20/19 Cpn 1.43 36159LCN4

03/20/17 03/20/17 Coupon GEDFT 2014-2 A 1MOFRN FLOOR 852.92 0.00 0.00 852.92 MAT 10/20/19 Cpn 1.43 36159LCN4

Payden & Rygel 154




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/20/17 03/20/17 Coupon VOLKSWAGEN 2013-2 A3 CAR 321.50 0.00 0.00 321.50

MAT 04/20/18 Cpn 0.70 92867PAC7

03/20/17 03/20/17 Coupon VOLKSWAGEN 2013-2 A3 CAR 53.58 0.00 0.00 53.58 MAT 04/20/18 Cpn 0.70 92867PAC7

03/21/17 03/21/17 Coupon FFCB 1ML FRN 15,250.64 0.00 0.00 15,250.64 MAT 02/21/20 Cpn 1.03 3133EHAE3

03/21/17 03/21/17 Coupon FNMA 3ML FRN 94,428.00 0.00 0.00 94,428.00 MAT 03/21/18 Cpn 1.10 3135G0L35


03/21/17 03/21/17 Coupon HONDA 2015-2 A3 CAR 3,236.77 0.00 0.00 3,236.77 MAT 02/21/19 Cpn 1.04 43813NAC0

03/22/17 03/22/17 Coupon AMERICAN EXPRESS FRN 1,749.90 0.00 0.00 1,749.90 MAT 09/22/17 Cpn 1.46 0258M0DS5



03/22/17 03/22/17 Coupon FFCB 1ML FRN 707.26 0.00 0.00 707.26 MAT 01/22/19 Cpn 1.15 3133EGMU

03/23/17 03/23/17 Coupon JP MORGAN CHASE 29,616.25 0.00 0.00 29,616.25 MAT 09/21/18 Cpn 1.45 48125LRF1

03/24/17 03/24/17 Coupon CREDIT AGRICOLE NY YCD 83,556.78 0.00 0.00 83,556.78 MAT 03/24/17 Cpn 1.22 22534HRM5

03/25/17 03/25/17 Coupon BMW 2014-A A3 CAR 513.13 0.00 0.00 513.13 MAT 11/26/18 Cpn 0.97 09658UAC3

Payden & Rygel 155




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/25/17 03/25/17 Coupon BMW 2016-A A2A CAR 11,550.00 0.00 0.00 11,550.00

MAT 05/28/19 Cpn 0.99 05582QAB3

03/25/17 03/25/17 Coupon FFCB 1ML FRN 9,455.15 0.00 0.00 9,455.15 MAT 05/25/18 Cpn 1.07 3133EGCH6


03/01/17 03/25/17 Coupon FHMS K708 A2 CMBS 2,353.73 0.00 0.00 2,353.73 MAT 01/25/19 Cpn 2.13 3137AQT24

03/01/17 03/25/17 Coupon FHMS K708 A2 CMBS 1,756.52 0.00 0.00 1,756.52 MAT 01/25/19 Cpn 2.13 3137AQT24

03/01/17 03/25/17 Coupon FHMS K710 A2 CMBS 2,997.11 0.00 0.00 2,997.11 MAT 05/25/19 Cpn 1.88 3137ARPY6

03/01/17 03/25/17 Coupon FHMS K710 A2 CMBS 345.22 0.00 0.00 345.22 MAT 05/25/19 Cpn 1.88 3137ARPY6

03/01/17 03/25/17 Coupon FHMS KJ04 A1 CMBS 6,604.06 0.00 0.00 6,604.06 MAT 10/25/20 Cpn 1.38 3137BPCF4

03/25/17 03/25/17 Coupon FMPRE 2017-TK01A 1MOFRN CMBS 12,513.50 0.00 0.00 12,513.50 MAT 02/25/20 Cpn 1.09 30258EAA3

03/01/17 03/25/17 Coupon FNA 2012-M9 ASQ2 CMBS 1,337.16 0.00 0.00 1,337.16 MAT 12/25/17 Cpn 1.51 3136A7L26

03/01/17 03/25/17 Coupon FNA 2013-M7 ASQ2 CMBS 595.43 0.00 0.00 595.43 MAT 03/26/18 Cpn 1.23 3136AEGM

03/01/17 03/25/17 Coupon FNA 14-M1 ASQ2 CMBS 2,765.71 0.00 0.00 2,765.71 MAT 11/25/18 Cpn 2.32 3136AHUV0

03/01/17 03/25/17 Coupon FNA 2014-M8 FA 1MOFRN CMBS 781.37 0.00 0.00 781.37 MAT 05/25/18 Cpn 1.02 3136AKQJ5

Payden & Rygel 156




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/01/17 03/25/17 Coupon FNA 2014-M6 FA 1MOFRN CMBS 166.41 0.00 0.00 166.41

MAT 12/25/17 Cpn 1.07 3136AJ7D2

03/01/17 03/25/17 Coupon FNA 2015-M10 FA 1MOFRN CMBS 5,916.85 0.00 0.00 5,916.85 MAT 03/25/19 Cpn 1.02 3136ANA98

03/01/17 03/25/17 Coupon FNA 2015-M12 FA 1MOFRN CMBS 6,902.12 0.00 0.00 6,902.12 MAT 04/25/20 Cpn 1.11 3136AP3Z3

03/01/17 03/25/17 Coupon FNA 2015-M13 ASQ2 CMBS 5,692.74 0.00 0.00 5,692.74 MAT 09/25/19 Cpn 1.65 3136AQDQ

03/01/17 03/25/17 Coupon FNA 2015-M3 FA 1MOFRN CMBS 754.08 0.00 0.00 754.08 MAT 06/25/18 Cpn 0.99 3136AMMC

03/01/17 03/25/17 Coupon FNA 2015-M4 FA 1MOFRN CMBS 8,751.67 0.00 0.00 8,751.67 MAT 09/25/18 Cpn 0.98 3136AMTM

03/01/17 03/25/17 Coupon FNA 2015-M7 ASQ2 CMBS 4,843.75 0.00 0.00 4,843.75 MAT 04/25/18 Cpn 1.55 3136ANJY4

03/01/17 03/25/17 Coupon FNA 2015-M8 FA 1MOFRN CMBS 8,099.91 0.00 0.00 8,099.91 MAT 11/25/18 Cpn 0.94 3136ANMF1



03/01/17 03/25/17 Coupon FNA 2016-M6 ASQ2 CMBS 13,685.00 0.00 0.00 13,685.00 MAT 06/25/19 Cpn 1.79 3136ASPX8

03/01/17 03/25/17 Coupon FNMA #725046 15YR 2,394.25 0.00 0.00 2,394.25 MAT 11/01/18 Cpn 4.50 31402CP71


Payden & Rygel 157




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/01/17 03/25/17 Coupon FNMA #725046 15YR 2,394.25 0.00 0.00 2,394.25

MAT 11/01/18 Cpn 4.50 31402CP71





03/01/17 03/25/17 Coupon FNR 2003-80 LA 2,666.83 0.00 0.00 2,666.83 MAT 08/25/18 Cpn 4.50 31393DQ38




03/01/17 03/25/17 Coupon FNR 2003-80 LA 755.62 0.00 0.00 755.62 MAT 08/25/18 Cpn 4.50 31393DQ38

03/26/17 03/26/17 Coupon BANK OF AMERICA 21,862.50 0.00 0.00 21,862.50 MAT 03/26/18 Cpn 1.65 06050TLY6


03/27/17 03/27/17 Coupon SKANDINAVISKA ENSKILDA BANKE 76,175.00 0.00 0.00 76,175.00 MAT 03/27/17 Cpn 1.10 83050FLW9

Payden & Rygel 158




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/28/17 03/28/17 Coupon DNB NOR BANK YCD 76,300.00 0.00 0.00 76,300.00

MAT 03/28/17 Cpn 1.09 23340QSK0

03/29/17 03/29/17 Coupon SWEDBANK NY YCD 74,579.00 0.00 0.00 74,579.00 MAT 03/29/17 Cpn 1.07 87019URN1

03/31/17 03/31/17 Coupon U.S. TREASURY NOTE 20,078.13 0.00 0.00 20,078.13 MAT 09/30/17 Cpn 0.63 912828TS9




2,206,204.87 0.00 0.00 2,206,204.87

03/01/17 03/01/17 Income 5,376.600 ADJ NET P&I 5,376.60 0.00 0.00 5,376.60 MAT Cpn USD

03/01/17 03/01/17 Income 9,838.920 STIF INT 9,838.92 0.00 0.00 9,838.92 MAT Cpn USD

15,215.520 15,215.52 0.00 0.00 15,215.52

03/02/17 03/02/17 Contributn 100,000,000.000 NM 100,000,000.00 0.00 0.00 100,000,000.00 MAT Cpn USD


Payden & Rygel159




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount Cash - cont.


690,000,000.000 690,000,000.00 0.00 0.00 690,000,000.00

03/02/17 03/03/17 Sell Long 28,000,000.000 U.S. TREASURY BILL 27,826,991.11 96,250.00 (17,297.78) 0.00 27,923,241.11 MAT 07/20/17 Cpn 912796KB4

03/09/17 03/10/17 Sell Long 50,000,000.000 FHLB DISCOUNT NOTE 49,944,388.89 6,611.11 (2,722.22) 0.00 49,951,000.00 MAT 04/28/17 Cpn 313385EX0

03/09/17 03/10/17 Sell Long 50,000,000.000 FHLB DISCOUNT NOTE 49,944,388.89 6,611.11 (2,722.22) 0.00 49,951,000.00 MAT 04/28/17 Cpn 313385EX0

03/21/17 03/22/17 Sell Long 20,000,000.000 U.S. TREASURY NOTE 19,991,406.25 27,969.61 (12,123.49) 0.00 20,019,375.86 MAT 06/30/17 Cpn 0.63 912828XJ4

03/28/17 03/28/17 Sell Long 10,000,000.000 U.S. TREASURY BILL 9,972,304.17 17,283.33 (1,770.83) 0.00 9,989,587.50 MAT 05/18/17 Cpn 912796KZ1

03/29/17 03/30/17 Sell Long 3,365,000.000 U.S. TREASURY NOTE 3,357,507.62 6,065.37 (474.28) 0.00 3,363,572.99 MAT 01/31/19 Cpn 1.13 912828V56

161,365,000.000 161,036,986.93 160,790.53 (37,110.83) 0.00 161,197,777.46

03/09/17 03/09/17 Pay Princpl 457,458.274 NGN 2010-R1 1A 1MOFRN NCUA G 457,458.27 (742.96) 0.00 457,458.27 MAT 10/07/20 Cpn 1.30 62888VAA6

03/09/17 03/09/17 Pay Princpl 35,558.745 NGN 2010-R2 1A 1MOFRN NCUA G 35,558.74 0.00 (19.53) 35,558.74 MAT 11/06/17 Cpn 1.15 62888UAA8

03/09/17 03/09/17 Pay Princpl 36,950.383 NGN 2010-R2 1A 1MOFRN NCUA G 36,950.38 0.00 (27.07) 36,950.38 MAT 11/06/17 Cpn 1.15 62888UAA8

Payden & Rygel 160




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/09/17 03/09/17 Pay Princpl 180,890.532 NGN 2011-R1 1A 1MOFRN NCUA G 180,890.53 0.00 (690.35) 180,890.53

MAT 01/08/20 Cpn 1.30 62888YAA0

03/09/17 03/09/17 Pay Princpl 30,829.660 NGN 2011-R1 1A 1MOFRN NCUA G 30,829.66 0.00 (122.39) 30,829.66 MAT 01/08/20 Cpn 1.30 62888YAA0

03/09/17 03/09/17 Pay Princpl 18,791.091 NGN 2011-R2 1A 1MOFRN NCUA G 18,791.09 0.00 (37.82) 18,791.09 MAT 02/06/20 Cpn 1.25 62889CAA7

03/09/17 03/09/17 Pay Princpl 378,516.601 NGN 2011-R4 1A 1MOFRN NCUA G 378,516.60 0.00 (546.59) 378,516.60 MAT 03/06/20 Cpn 1.23 62889FAA0

03/09/17 03/09/17 Pay Princpl 45,169.046 NGN 2011-R4 1A 1MOFRN NCUA G 45,169.05 0.00 (74.93) 45,169.05 MAT 03/06/20 Cpn 1.23 62889FAA0

03/09/17 03/09/17 Pay Princpl 451,690.455 NGN 2011-R4 1A 1MOFRN NCUA G 451,690.46 (164.96) 0.00 451,690.46 MAT 03/06/20 Cpn 1.23 62889FAA0

03/09/17 03/09/17 Pay Princpl 195,175.446 NGN 2011-R4 1A 1MOFRN NCUA G 195,175.45 (71.28) 0.00 195,175.45 MAT 03/06/20 Cpn 1.23 62889FAA0

03/14/17 03/14/17 Pay Princpl 149,084.896 NGN 2011-R3 1A 1MO FRN NCUA G 149,084.90 0.00 (405.98) 149,084.90 MAT 03/11/20 Cpn 1.29 62889EAA3



03/01/17 03/15/17 Pay Princpl 553,647.940 FHLMC #G15842 15YR 553,647.94 (12,310.62) 0.00 553,647.94 MAT 04/01/19 Cpn 4.50 3128MEWB

03/15/17 03/15/17 Pay Princpl 1,085,593.407 HONDA 2016-2 A2 CAR 1,085,593.41 18.85 0.00 1,085,593.41 MAT 09/17/18 Cpn 1.13 43814QAB4

03/15/17 03/15/17 Pay Princpl 94,474.970 JOHN DEERE 2014-A A3 EQP 94,474.97 0.00 7.25 94,474.97 MAT 04/16/18 Cpn 0.92 47787VAC5

Payden & Rygel 161




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/15/17 03/15/17 Pay Princpl 2,826.860 JOHN DEERE 2016-A A2 EQP 2,826.86 3.15 0.00 2,826.86

MAT 10/15/18 Cpn 1.15 47788MAB6

03/15/17 03/15/17 Pay Princpl 199,831.882 TOYOTA 2014-B A3 CAR 199,831.88 0.00 6.24 199,831.88 MAT 03/15/18 Cpn 0.76 89231RAC8

03/15/17 03/15/17 Pay Princpl 196,117.694 TOYOTA 2015-A A3 CAR 196,117.69 (183.86) 0.00 196,117.69 MAT 02/15/19 Cpn 1.12 89236WAC2

03/15/17 03/15/17 Pay Princpl 196,414.842 TOYOTA 2015-A A3 CAR 196,414.84 (193.35) 0.00 196,414.84 MAT 02/15/19 Cpn 1.12 89236WAC2

03/15/17 03/15/17 Pay Princpl 524,742.920 TOYOTA 2015-C A2A CAR 524,742.92 0.00 0.00 524,742.92 MAT 02/15/18 Cpn 0.92 89231TAB6

03/15/17 03/15/17 Pay Princpl 3,174.931 TOYOTA 2016-A A2A CAR 3,174.93 4.00 0.00 3,174.93 MAT 07/16/18 Cpn 1.03 89237KAB9

03/15/17 03/15/17 Pay Princpl 449,887.425 TOYOTA 2016-B A2A CAR 449,887.43 3.87 0.00 449,887.43 MAT 10/15/18 Cpn 1.02 89231UAB3

03/18/17 03/18/17 Pay Princpl 281,994.299 HONDA 2016-1 A2 CAR 281,994.30 0.00 10.03 281,994.30 MAT 06/18/18 Cpn 1.01 43814NAB1

03/20/17 03/20/17 Pay Princpl 750,268.366 BMW 2016-1 A2A LEASE 750,268.37 0.00 25.34 750,268.37 MAT 01/22/18 Cpn 1.17 05581RAB2

03/20/17 03/20/17 Pay Princpl 551,136.773 VOLKSWAGEN 2013-2 A3 CAR 551,136.77 0.00 (0.00) 551,136.77 MAT 04/20/18 Cpn 0.70 92867PAC7

03/20/17 03/20/17 Pay Princpl 91,856.129 VOLKSWAGEN 2013-2 A3 CAR 91,856.13 0.00 0.00 91,856.13 MAT 04/20/18 Cpn 0.70 92867PAC7

03/21/17 03/21/17 Pay Princpl 326,134.179 HONDA 2015-2 A3 CAR 326,134.18 0.00 18.58 326,134.18 MAT 02/21/19 Cpn 1.04 43813NAC0

03/25/17 03/25/17 Pay Princpl 99,050.226 BMW 2014-A A3 CAR 99,050.23 0.00 22.61 99,050.23 MAT 11/26/18 Cpn 0.97 09658UAC3

Payden & Rygel 162




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/25/17 03/25/17 Pay Princpl 723,705.821 BMW 2016-A A2A CAR 723,705.82 29.43 0.00 723,705.82

MAT 05/28/19 Cpn 0.99 05582QAB3

03/01/17 03/25/17 Pay Princpl 2,771.010 FHMS K708 A2 CMBS 2,771.01 0.00 (32.48) 2,771.01 MAT 01/25/19 Cpn 2.13 3137AQT24

03/01/17 03/25/17 Pay Princpl 2,067.920 FHMS K708 A2 CMBS 2,067.92 0.00 (24.68) 2,067.92 MAT 01/25/19 Cpn 2.13 3137AQT24

03/01/17 03/25/17 Pay Princpl 19,168.000 FHMS KJ04 A1 CMBS 19,168.00 0.13 0.00 19,168.00 MAT 10/25/20 Cpn 1.38 3137BPCF4

03/01/17 03/25/17 Pay Princpl 99,629.464 FNA 2012-M9 ASQ2 CMBS 99,629.46 0.00 (223.50) 99,629.46 MAT 12/25/17 Cpn 1.51 3136A7L26

03/01/17 03/25/17 Pay Princpl 46,474.582 FNA 2013-M7 ASQ2 CMBS 46,474.58 0.00 (42.44) 46,474.58 MAT 03/26/18 Cpn 1.23 3136AEGM

03/01/17 03/25/17 Pay Princpl 27,441.200 FNA 14-M1 ASQ2 CMBS 27,441.20 0.00 (384.81) 27,441.20 MAT 11/25/18 Cpn 2.32 3136AHUV0

03/01/17 03/25/17 Pay Princpl 79,434.659 FNA 2014-M8 FA 1MOFRN CMBS 79,434.66 0.00 6.51 79,434.66 MAT 05/25/18 Cpn 1.02 3136AKQJ5

03/01/17 03/25/17 Pay Princpl 4,975.470 FNA 2014-M6 FA 1MOFRN CMBS 4,975.47 0.00 (1.86) 4,975.47 MAT 12/25/17 Cpn 1.07 3136AJ7D2

03/01/17 03/25/17 Pay Princpl 84,995.300 FNA 2015-M10 FA 1MOFRN CMBS 84,995.30 0.00 54.20 84,995.30 MAT 03/25/19 Cpn 1.02 3136ANA98

03/01/17 03/25/17 Pay Princpl 38,424.900 FNA 2015-M12 FA 1MOFRN CMBS 38,424.90 0.00 9.34 38,424.90 MAT 04/25/20 Cpn 1.11 3136AP3Z3

03/01/17 03/25/17 Pay Princpl 8,386.014 FNA 2015-M13 ASQ2 CMBS 8,386.01 0.00 (55.24) 8,386.01 MAT 09/25/19 Cpn 1.65 3136AQDQ

03/01/17 03/25/17 Pay Princpl 1,534.330 FNA 2015-M3 FA 1MOFRN CMBS 1,534.33 0.00 (0.14) 1,534.33 MAT 06/25/18 Cpn 0.99 3136AMMC

Payden & Rygel 163




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/01/17 03/25/17 Pay Princpl 372,072.680 FNA 2015-M4 FA 1MOFRN CMBS 372,072.68 0.00 42.89 372,072.68

MAT 09/25/18 Cpn 0.98 3136AMTM

03/01/17 03/25/17 Pay Princpl 456,594.950 FNA 2015-M8 FA 1MOFRN CMBS 456,594.95 0.00 53.79 456,594.95 MAT 11/25/18 Cpn 0.94 3136ANMF1



03/01/17 03/25/17 Pay Princpl 49,652.500 FNMA #725046 15YR 49,652.50 (992.30) 0.00 49,652.50 MAT 11/01/18 Cpn 4.50 31402CP71







03/01/17 03/25/17 Pay Princpl 62,473.000 FNR 2003-80 LA 62,473.00 (1,184.72) 0.00 62,473.00 MAT 08/25/18 Cpn 4.50 31393DQ38


Payden & Rygel 164




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/01/17 03/25/17 Pay Princpl 62,473.000 FNR 2003-80 LA 62,473.00 (1,184.72) 0.00 62,473.00

MAT 08/25/18 Cpn 4.50 31393DQ38


03/01/17 03/25/17 Pay Princpl 17,701.100 FNR 2003-80 LA 17,701.10 (335.68) 0.00 17,701.10 MAT 08/25/18 Cpn 4.50 31393DQ38

10,124,174.918 10,124,174.92 (25,429.82) (2,486.93) 10,124,174.92

03/01/17 03/01/17 Mature Long 50,000,000.000 FHLB DISCOUNT NOTE 49,999,513.89 486.11 0.00 0.00 50,000,000.00 MAT 03/01/17 Cpn 313385CM6



03/03/17 03/03/17 Mature Long 3,000,000.000 CATERPILLAR FINANCIAL FRN 3,000,000.00 0.00 0.00 3,000,000.00 MAT 03/03/17 Cpn 14912L5Y3

03/03/17 03/03/17 Mature Long 500,000.000 CATERPILLAR FINANCIAL FRN 500,000.00 0.00 0.00 500,000.00 MAT 03/03/17 Cpn 14912L5Y3

03/03/17 03/03/17 Mature Long 2,000,000.000 CATERPILLAR FINANCIAL FRN 2,000,000.00 0.00 0.00 2,000,000.00 MAT 03/03/17 Cpn 14912L5Y3


03/03/17 03/03/17 Mature Long 2,250,000.000 CATERPILLAR FINANCIAL 2,250,000.00 0.00 0.00 2,250,000.00 MAT 03/03/17 Cpn 1.00 14912L5Z0

03/03/17 03/03/17 Mature Long 530,000.000 CISCO SYSTEMS 530,000.00 0.00 0.00 530,000.00 MAT 03/03/17 Cpn 1.10 17275RAT9

Payden & Rygel 165




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/03/17 03/03/17 Mature Long 1,005,000.000 CISCO SYSTEMS 1,005,000.00 0.00 0.00 1,005,000.00

MAT 03/03/17 Cpn 1.10 17275RAT9

03/06/17 03/06/17 Mature Long 18,000,000.000 FHLB DISCOUNT NOTE 17,976,825.00 23,175.00 0.00 0.00 18,000,000.00 MAT 03/06/17 Cpn 313385CS3

03/07/17 03/07/17 Mature Long 7,900,000.000 MIZUHO BANK LTD YCD 1ML FRN 7,900,000.00 0.00 0.00 7,900,000.00 MAT 03/07/17 Cpn 60689DH89

03/08/17 03/08/17 Mature Long 50,000,000.000 FHLB DISCOUNT NOTE 49,979,583.33 20,416.67 0.00 0.00 50,000,000.00 MAT 03/08/17 Cpn 313385CU8

03/08/17 03/08/17 Mature Long 25,000,000.000 FHLB DISCOUNT NOTE 24,989,791.67 10,208.33 0.00 0.00 25,000,000.00 MAT 03/08/17 Cpn 313385CU8

03/12/17 03/12/17 Mature Long 500,000.000 TEXAS INSTRUMENTS 500,000.00 0.00 0.00 500,000.00 MAT 03/12/17 Cpn 0.88 882508AX2

03/12/17 03/12/17 Mature Long 4,345,000.000 TEXAS INSTRUMENTS 4,345,000.00 0.00 0.00 4,345,000.00 MAT 03/12/17 Cpn 0.88 882508AX2

03/14/17 03/14/17 Mature Long 11,900,000.000 SVENSKA HANDELSBANKEN NY Y 11,900,000.00 0.00 0.00 11,900,000.00 MAT 03/14/17 Cpn 86958JCV9

03/15/17 03/15/17 Mature Long 50,000,000.000 FNMA DISCOUNT NOTE 49,973,888.89 26,111.11 0.00 0.00 50,000,000.00 MAT 03/15/17 Cpn 313589DB6

03/15/17 03/15/17 Mature Long 50,000,000.000 FNMA DISCOUNT NOTE 49,973,888.89 26,111.11 0.00 0.00 50,000,000.00 MAT 03/15/17 Cpn 313589DB6

03/17/17 03/17/17 Mature Long 40,000,000.000 FNMA DISCOUNT NOTE 39,977,600.00 22,400.00 0.00 0.00 40,000,000.00 MAT 03/17/17 Cpn 313589DD2

03/20/17 03/20/17 Mature Long 50,000,000.000 FNMA DISCOUNT NOTE 49,997,166.67 2,833.33 0.00 0.00 50,000,000.00 MAT 03/20/17 Cpn 313589DG5

03/20/17 03/20/17 Mature Long 30,000,000.000 FNMA DISCOUNT NOTE 29,998,300.00 1,700.00 0.00 0.00 30,000,000.00 MAT 03/20/17 Cpn 313589DG5

Payden & Rygel 166




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/22/17 03/22/17 Mature Long 50,000,000.000 FHLB DISCOUNT NOTE 49,992,479.17 7,520.83 0.00 0.00 50,000,000.00

MAT 03/22/17 Cpn 313385DJ2

03/22/17 03/22/17 Mature Long 10,000,000.000 FHLB DISCOUNT NOTE 9,998,495.83 1,504.17 0.00 0.00 10,000,000.00 MAT 03/22/17 Cpn 313385DJ2

03/23/17 03/23/17 Mature Long 14,472,000.000 FHLB DISCOUNT NOTE 14,471,228.16 771.84 0.00 0.00 14,472,000.00 MAT 03/23/17 Cpn 313385DK9

03/24/17 03/24/17 Mature Long 13,930,000.000 CREDIT AGRICOLE NY YCD 13,930,000.00 0.00 0.00 13,930,000.00 MAT 03/24/17 Cpn 1.22 22534HRM5

03/27/17 03/27/17 Mature Long 40,000,000.000 FNMA DISCOUNT NOTE 39,995,022.22 4,977.78 0.00 0.00 40,000,000.00 MAT 03/27/17 Cpn 313589DP5

03/27/17 03/27/17 Mature Long 13,850,000.000 SKANDINAVISKA ENSKILDA BANKE 13,850,000.00 0.00 0.00 13,850,000.00 MAT 03/27/17 Cpn 1.10 83050FLW9

03/28/17 03/28/17 Mature Long 14,000,000.000 DNB NOR BANK YCD 14,000,000.00 0.00 0.00 14,000,000.00 MAT 03/28/17 Cpn 1.09 23340QSK0

03/29/17 03/29/17 Mature Long 10,400,000.000 FHLB DISCOUNT NOTE 10,392,044.00 7,956.00 0.00 0.00 10,400,000.00 MAT 03/29/17 Cpn 313385DR4

03/29/17 03/29/17 Mature Long 50,000,000.000 FNMA DISCOUNT NOTE 49,962,875.00 37,125.00 0.00 0.00 50,000,000.00 MAT 03/29/17 Cpn 313589DR1

03/29/17 03/29/17 Mature Long 15,000,000.000 FNMA DISCOUNT NOTE 14,988,862.50 11,137.50 0.00 0.00 15,000,000.00 MAT 03/29/17 Cpn 313589DR1

03/29/17 03/29/17 Mature Long 13,940,000.000 SWEDBANK NY YCD 13,940,000.00 0.00 0.00 13,940,000.00 MAT 03/29/17 Cpn 1.07 87019URN1

672,808,000.000 672,603,273.55 204,726.45 0.00 0.00 672,808,000.00

Payden & Rygel 167




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/01/17 03/01/17 Withdrawal (50,000,000.000) WD (50,000,000.00) (50,000,000.00) 0.00 (50,000,000.00)

MAT Cpn USD

03/01/17 03/01/17 Withdrawal (5,487.660) CUSTODY FEE (5,487.66) (5,487.66) 0.00 (5,487.66)MAT Cpn USD

03/08/17 03/08/17 Withdrawal (50,000,000.000) WD (50,000,000.00) (50,000,000.00) 0.00 (50,000,000.00)MAT Cpn USD







(575,005,487.660) (575,005,487.66) (575,005,487.66) 0.00 (575,005,487.66)

Payden & Rygel 168


Account Name: L.A ARE HEALTH PLAN-LOW DURATION PORT 03/01/2017Account Number: through 03/31/2017


Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 02/28/17 03/02/17 Buy 2,100,000.000 U.S. TREASURY BILL (2,081,102.33) 0.00 0.00 (2,081,102.33)

MAT 03/01/18 Cpn 912796LN7

02/28/17 03/03/17 Buy 245,000.000 AMERICAN EXPRESS FRN (245,000.00) 0.00 0.00 (245,000.00)MAT 03/03/22 Cpn 1.79 0258M0EH8

03/01/17 03/06/17 Buy 305,000.000 WALT DISNEY CO FRN (305,000.00) 0.00 0.00 (305,000.00)MAT 03/04/22 Cpn 1.49 25468PDS2

03/06/17 03/07/17 Buy 480,000.000 MIZUHO BANK LTD YCD (480,000.00) 0.00 0.00 (480,000.00)MAT 09/06/17 Cpn 1.30 60689D5J8

03/09/17 03/14/17 Buy 252,000.000 STRYKER (252,423.36) (84.00) 0.00 0.00 (252,507.36)MAT 03/08/19 Cpn 2.00 863667AK7

03/07/17 03/15/17 Buy 627,000.000 TOYOTA 2017-A A3 CAR (626,926.20) 0.00 0.00 (626,926.20)MAT 02/16/21 Cpn 1.73 89238MAD0

03/13/17 03/20/17 Buy 320,000.000 CITIBANK FRN (320,000.00) 0.00 0.00 (320,000.00)MAT 03/20/19 Cpn 1.49 17325FAB4

03/20/17 03/23/17 Buy 240,000.000 CATERPILLAR FINANCIAL FRN (240,000.00) 0.00 0.00 (240,000.00)MAT 03/22/19 Cpn 1.44 14912L6X4

03/21/17 03/28/17 Buy 680,000.000 HONDA 2017-1 A2 CAR (679,983.75) 0.00 0.00 (679,983.75)MAT 07/22/19 Cpn 1.42 43814TAB8

5,249,000.000 (5,230,435.64) (84.00) 0.00 0.00 (5,230,519.64)

03/01/17 03/01/17 Coupon CISCO SYSTEMS FRN 715.34 0.00 0.00 715.34 MAT 03/01/19 Cpn 1.55 17275RAQ5

03/01/17 03/01/17 Coupon JOHNSON & JOHNSON 843.75 0.00 0.00 843.75 MAT 03/01/19 Cpn 1.13 478160BR4

03/01/17 03/01/17 Coupon ELI LILLY & CO 625.00 0.00 0.00 625.00 MAT 03/01/18 Cpn 1.25 532457BK3

Payden & Rygel 169




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/01/17 03/01/17 Coupon PNC BANK FRN 1,688.34 0.00 0.00 1,688.34

MAT 06/01/18 Cpn 1.47 69353REN4

03/01/17 03/01/17 Coupon EXXON MOBIL 1,295.10 0.00 0.00 1,295.10 MAT 03/01/18 Cpn 1.44 30231GAU6


03/02/17 03/02/17 Coupon CHEVRON 1,365.00 0.00 0.00 1,365.00 MAT 03/02/18 Cpn 1.37 166764AV2



03/06/17 03/06/17 Coupon FFCB 1ML FRN 213.89 0.00 0.00 213.89 MAT 07/06/18 Cpn 0.97 3133EGJQ9



03/07/17 03/07/17 Coupon BANK OF AMERICA FRN 1,708.06 0.00 0.00 1,708.06 MAT 12/07/18 Cpn 1.86 06050TMF6

03/07/17 03/07/17 Coupon BANK OF NOVA SCOTIA HOUSTON 181.01 0.00 0.00 181.01 MAT 09/07/17 Cpn 1.60 06417GPD4

03/07/17 03/07/17 Coupon BERKSHIRE HATHAWAY 1,740.00 0.00 0.00 1,740.00 MAT 03/07/18 Cpn 1.45 084664CE9

03/07/17 03/07/17 Coupon MIZUHO BANK LTD YCD 1ML FRN 569.54 0.00 0.00 569.54 MAT 03/07/17 Cpn 60689DH89

Payden & Rygel 170




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/08/17 03/08/17 Coupon STRYKER 900.00 0.00 0.00 900.00

MAT 03/08/19 Cpn 2.00 863667AK7

03/09/17 03/09/17 Coupon PACCAR FINANCIAL 797.50 0.00 0.00 797.50 MAT 03/09/18 Cpn 1.45 69371RM45

03/10/17 03/10/17 Coupon CHARLES SCHWAB 1,500.00 0.00 0.00 1,500.00 MAT 03/10/18 Cpn 1.50 808513AK1

03/12/17 03/12/17 Coupon TEXAS INSTRUMENTS 875.00 0.00 0.00 875.00 MAT 03/12/17 Cpn 0.88 882508AX2


03/13/17 03/13/17 Coupon US BANK OHIO FRN 1,224.17 0.00 0.00 1,224.17 MAT 09/11/17 Cpn 1.32 90331HMJ9

03/14/17 03/14/17 Coupon FHLMC C 12/14/16 Q 4,853.00 0.00 0.00 4,853.00 MAT 09/14/18 Cpn 1.15 3134GAJQ8

03/14/17 03/14/17 Coupon SVENSKA HANDELSBANKEN NY Y 745.42 0.00 0.00 745.42 MAT 03/14/17 Cpn 86958JCV9

03/14/17 03/14/17 Coupon WELLS FARGO FRN 1,426.66 0.00 0.00 1,426.66 MAT 09/14/18 Cpn 1.52 94974BGD6

03/15/17 03/15/17 Coupon CHASE 2015-A3 A CDT 1MOFRN 634.67 0.00 0.00 634.67 MAT 04/15/19 Cpn 1.16 161571GW8




Payden & Rygel 171




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/01/17 03/15/17 Coupon FHLMC #G15842 15YR 1,880.29 0.00 0.00 1,880.29

MAT 04/01/19 Cpn 4.50 3128MEWB

03/15/17 03/15/17 Coupon HONDA 2016-2 A2 CAR 918.08 0.00 0.00 918.08 MAT 09/17/18 Cpn 1.13 43814QAB4

03/15/17 03/15/17 Coupon HOME DEPOT FRN 566.71 0.00 0.00 566.71 MAT 09/15/17 Cpn 1.50 437076BJ0

03/15/17 03/15/17 Coupon JOHN DEERE 2014-A A3 EQP 158.93 0.00 0.00 158.93 MAT 04/16/18 Cpn 0.92 47787VAC5

03/15/17 03/15/17 Coupon JOHN DEERE 2016-B A2 EQP 545.00 0.00 0.00 545.00 MAT 02/15/19 Cpn 1.09 47788NAB4

03/15/17 03/15/17 Coupon TOYOTA 2016-B A2A CAR 352.42 0.00 0.00 352.42 MAT 10/15/18 Cpn 1.02 89231UAB3

03/15/17 03/15/17 Coupon TOYOTA 2016-C A2A CAR 250.00 0.00 0.00 250.00 MAT 01/15/19 Cpn 1.00 89237WAB3

03/15/17 03/15/17 Coupon U.S. TREASURY NOTE 575.00 0.00 0.00 575.00 MAT 09/15/18 Cpn 1.00 912828L40

03/15/17 03/15/17 Coupon USAA 2016-1 A3 CAR 600.00 0.00 0.00 600.00 MAT 06/15/20 Cpn 1.20 90327CAC4

03/18/17 03/18/17 Coupon HONDA 2016-1 A2 CAR 151.17 0.00 0.00 151.17 MAT 06/18/18 Cpn 1.01 43814NAB1

03/19/17 03/19/17 Coupon FHLB 3,806.25 0.00 0.00 3,806.25 MAT 03/19/18 Cpn 0.88 3130A7CX1

03/20/17 03/20/17 Coupon BMW 2016-1 A2A LEASE 416.84 0.00 0.00 416.84 MAT 01/22/18 Cpn 1.17 05581RAB2

03/20/17 03/20/17 Coupon GEDFT 2014-2 A 1MOFRN FLOOR 922.08 0.00 0.00 922.08 MAT 10/20/19 Cpn 1.43 36159LCN4

Payden & Rygel 172




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/20/17 03/20/17 Coupon VOLKSWAGEN 2013-2 A3 CAR 21.43 0.00 0.00 21.43

MAT 04/20/18 Cpn 0.70 92867PAC7



03/21/17 03/21/17 Coupon HONDA 2015-2 A3 CAR 163.64 0.00 0.00 163.64 MAT 02/21/19 Cpn 1.04 43813NAC0

03/22/17 03/22/17 Coupon AMERICAN EXPRESS FRN 972.17 0.00 0.00 972.17 MAT 09/22/17 Cpn 1.46 0258M0DS5

03/25/17 03/25/17 Coupon BMW 2016-A A2A CAR 660.00 0.00 0.00 660.00 MAT 05/28/19 Cpn 0.99 05582QAB3


03/01/17 03/25/17 Coupon FHMS KJ04 A1 CMBS 619.13 0.00 0.00 619.13 MAT 10/25/20 Cpn 1.38 3137BPCF4

03/25/17 03/25/17 Coupon FMPRE 2017-TK01A 1MOFRN CMBS 761.79 0.00 0.00 761.79 MAT 02/25/20 Cpn 1.09 30258EAA3

03/01/17 03/25/17 Coupon FNA 2014-M8 FA 1MOFRN CMBS 434.10 0.00 0.00 434.10 MAT 05/25/18 Cpn 1.02 3136AKQJ5

03/01/17 03/25/17 Coupon FNA 2015-M13 ASQ2 CMBS 542.17 0.00 0.00 542.17 MAT 09/25/19 Cpn 1.65 3136AQDQ

03/01/17 03/25/17 Coupon FNA 2015-M4 FA 1MOFRN CMBS 737.64 0.00 0.00 737.64 MAT 09/25/18 Cpn 0.98 3136AMTM

03/01/17 03/25/17 Coupon FNA 2015-M4 FA 1MOFRN CMBS 256.30 0.00 0.00 256.30 MAT 09/25/18 Cpn 0.98 3136AMTM

Payden & Rygel 173




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/01/17 03/25/17 Coupon FNR 2003-80 LA 1,333.41 0.00 0.00 1,333.41

MAT 08/25/18 Cpn 4.50 31393DQ38



03/31/17 03/31/17 Coupon U.S. TREASURY NOTE 8,750.00 0.00 0.00 8,750.00 MAT 03/31/18 Cpn 0.88 912828Q45

03/31/17 03/31/17 Coupon U.S. TREASURY NOTE 9,843.75 0.00 0.00 9,843.75 MAT 03/31/18 Cpn 0.88 912828Q45

92,310.23 0.00 0.00 92,310.23

03/01/17 03/01/17 Income 303.630 STIF INT 303.63 0.00 0.00 303.63 MAT Cpn USD

03/01/17 03/02/17 Sell Long 1,400,000.000 U.S. TREASURY BILL 1,398,752.13 400.17 (47.37) 0.00 1,399,152.30 MAT 04/13/17 Cpn 912796KS7

03/22/17 03/23/17 Sell Long 900,000.000 U.S. TREASURY BILL 899,128.24 514.50 (100.01) 0.00 899,642.74 MAT 04/13/17 Cpn 912796KS7

2,300,000.000 2,297,880.37 914.67 (147.38) 0.00 2,298,795.04

03/01/17 03/15/17 Pay Princpl 40,676.180 FHLMC #G15842 15YR 40,676.18 (904.45) 0.00 40,676.18 MAT 04/01/19 Cpn 4.50 3128MEWB

03/15/17 03/15/17 Pay Princpl 105,397.418 HONDA 2016-2 A2 CAR 105,397.42 1.83 0.00 105,397.42 MAT 09/17/18 Cpn 1.13 43814QAB4

Payden & Rygel 174




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount 03/15/17 03/15/17 Pay Princpl 46,847.093 JOHN DEERE 2014-A A3 EQP 46,847.09 0.00 (2.75) 46,847.09

MAT 04/16/18 Cpn 0.92 47787VAC5

03/15/17 03/15/17 Pay Princpl 45,906.880 TOYOTA 2016-B A2A CAR 45,906.88 0.39 0.00 45,906.88 MAT 10/15/18 Cpn 1.02 89231UAB3

03/18/17 03/18/17 Pay Princpl 27,289.771 HONDA 2016-1 A2 CAR 27,289.77 0.00 0.97 27,289.77 MAT 06/18/18 Cpn 1.01 43814NAB1

03/20/17 03/20/17 Pay Princpl 66,479.476 BMW 2016-1 A2A LEASE 66,479.48 0.00 2.25 66,479.48 MAT 01/22/18 Cpn 1.17 05581RAB2

03/20/17 03/20/17 Pay Princpl 36,742.454 VOLKSWAGEN 2013-2 A3 CAR 36,742.45 0.00 (0.00) 36,742.45 MAT 04/20/18 Cpn 0.70 92867PAC7

03/21/17 03/21/17 Pay Princpl 16,488.078 HONDA 2015-2 A3 CAR 16,488.08 0.00 0.94 16,488.08 MAT 02/21/19 Cpn 1.04 43813NAC0

03/25/17 03/25/17 Pay Princpl 41,354.618 BMW 2016-A A2A CAR 41,354.62 1.68 0.00 41,354.62 MAT 05/28/19 Cpn 0.99 05582QAB3

03/01/17 03/25/17 Pay Princpl 1,797.000 FHMS KJ04 A1 CMBS 1,797.00 0.01 0.00 1,797.00 MAT 10/25/20 Cpn 1.38 3137BPCF4

03/01/17 03/25/17 Pay Princpl 44,130.366 FNA 2014-M8 FA 1MOFRN CMBS 44,130.37 0.00 3.62 44,130.37 MAT 05/25/18 Cpn 1.02 3136AKQJ5

03/01/17 03/25/17 Pay Princpl 798.668 FNA 2015-M13 ASQ2 CMBS 798.67 0.00 (5.26) 798.67 MAT 09/25/19 Cpn 1.65 3136AQDQ

03/01/17 03/25/17 Pay Princpl 31,360.410 FNA 2015-M4 FA 1MOFRN CMBS 31,360.41 0.00 3.62 31,360.41 MAT 09/25/18 Cpn 0.98 3136AMTM

03/01/17 03/25/17 Pay Princpl 10,896.410 FNA 2015-M4 FA 1MOFRN CMBS 10,896.41 0.00 0.00 10,896.41 MAT 09/25/18 Cpn 0.98 3136AMTM

Payden & Rygel175




Type Units Description Proceeds / (Cost) (Purch) or Sold Amort Cost Amort Cost Amount Fixed Income - cont.

03/01/17 03/25/17 Pay Princpl 31,236.500 FNR 2003-80 LA 31,236.50 (592.36) 0.00 31,236.50 MAT 08/25/18 Cpn 4.50 31393DQ38

547,401.322 547,401.33 (1,492.89) 3.38 547,401.33


03/03/17 03/03/17 Mature Long 290,000.000 CISCO SYSTEMS 290,000.00 0.00 0.00 290,000.00 MAT 03/03/17 Cpn 1.10 17275RAT9

03/07/17 03/07/17 Mature Long 480,000.000 MIZUHO BANK LTD YCD 1ML FRN 480,000.00 0.00 0.00 480,000.00 MAT 03/07/17 Cpn 60689DH89



03/14/17 03/14/17 Mature Long 720,000.000 SVENSKA HANDELSBANKEN NY Y 720,000.00 0.00 0.00 720,000.00 MAT 03/14/17 Cpn 86958JCV9

2,330,000.000 2,330,000.00 0.00 0.00 2,330,000.00

Payden & Rygel 176

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