ALAMEDA ALLIANCE FOR HEALTH
BOARD OF GOVERNORS MEETING/STRATEGIC PLANNING RETREAT
Minutes January 22, 2009
ALAMEDA ALLIANCE FOR HEALTH

SUMMARY OF PROCEEDINGS

Present:	Excused:	Unexcused:
Jane Garcia (Chair) Michael Mahoney (Vice-Chair) Ingrid Lamirault Wright Lassiter Pamela Gumbs Gail Steele John Norton Marty Lynch Ray Davis, Jr. MD Richard Thomason

Agenda Item (& Supporting Documents)	Speaker	Discussion Highlights	Action	Follow-Up Required
Call to Order	Jane Garcia	Meeting was called to order at 6:11 p.m. by Jane Garcia. A quorum of the members was present.	None	None
Approval of Revised Agenda Attachment 1.22.09 Agenda	Jane Garcia	J. Garcia asked for a motion to accept this month's agenda.	Motion: M. Mahoney Second: M. Lynch Vote: Unanimous	None
Approval of December Meeting Minutes Attachment 12.01.08 Meeting Minutes	Jane Garcia	J. Garcia asked for a motion to accept the December 1, 2008 meeting minutes.	Motion: M. Lynch Second: M. Mahoney Vote: Unanimous	None
Chair’s Report	Jane Garcia	Report on December 1, 2008 Closed Session: Approval of Provider Credentialing & Recredentialing Recommendations. DHCS Contract Issues Ad hoc Nominating Committee will meet to develop recommendations for expiring Board seat and other nominations.	None	None
CEO’s Report Attachment CEO Report	I. Lamirault	MEDI-CAL On November 14th, the Alliance received new Medi-Cal rates. It is an overall 6.5% increase over June 2008 rates (prior to State 10% Medi-Cal rate decreases). The Board approved budget update for your approval that reflects the changed rates. Now that we understand the new rate methodology and are somewhat confident that it considers our actual market and population profiles, the state wants to revise the methodology. Several of their proposed changes may create unacceptable risk exposure for us. Maternity / newborn Supplemental Payment Split TANF rate into adults and children Develop one county average rate for both commercial and public plan Risk Adjusted Rates	None;	None
CEO’s Report (continued)		HEALTHY FAMILIES REDUCTIONS The 5% Healthy Families reduction is now in effect AAH has no plans to reduce provider payment Last week, MRMIB Board announced it has a $17 million shortfall this fiscal year due to record high enrollment, the state budget crisis, and late passage of the FY 08-09 State budget. It is expected that at its December 17, 2008 meeting, the MRMIB Board will create a waitlist. This may result in 100,000 to 162,000 children identified as being eligible for the program, but not unable to enroll. One prominent proposal to address the $17 million shortfall is to use unallocated Prop 10 funds to offset the State budget shortfall. STATE BUDGET CRISIS Today during his 12:30 PM press conference, the Governor employed his Prop 58 authority to call the new legislature into a Special Session to deal with the Fiscal Emergency. There are several budget cutting proposals that will not impact our rates, but will impact the membership volume: Reduce income eligibility levels for new applicants under the 1931(b) program (from 100% FPL to 72 FPL) Limit eligibility for full scope Medi-Cal benefits for certain immigrants Reduce IHSS services with priority going to Medi-Cal recipients with highest needs No discussion on addressing the Healthy Families shortfall It’s expected that most of the service reductions, particularly Medi-Cal or Healthy Families will not impact current rates. The new Medi-Cal rates that the Alliance recently received are based on an assumption, made by State staff, that the State will not win their appeal of the court injunction and there will be no further reductions in Medi-Cal rates COMPLETECARE (MEDICARE SPECIAL NEEDS PLAN) The number of Completecare members increased to 850. This is below our goal. However, the Alliance is still doing well against the major competitors (AAH: 704, HealthNet: 397, Secure Horizons:184) DEVELOPMENT OF COUNTY ORGANIZED HEALTH SYSTEM (COHS) The Alliance’s federal lobbyist are still anticipating that the new Congress will work on renewing SCHIP early in 2009 and that COHS language for Alameda and Santa Clara counties can be included. The lobbyist have drafted the legislative language and it is being negotiated with the PACE programs and the State. The next major milestone is to get the draft endorsement letter approved and signed by Kim Belshe, Secretary of California Health and Human Services Agency. Everything is on track. TOPICS FOR UPCOMING STRATEGIC PLANNING MEETING CompleteCare COHS and stakeholders meetings
Finance Committee Report Two Attachments November Financial Report December Financial Report	John Volkober	J. Volkober reported on the December 31, 2008 Financial Statements. For the month, the Alliance recorded a net income of $154 thousand compared to a budgeted net loss of $807 thousand, resulting in a favorable variance from budget of $961 thousand. Year-to-date, the Alliance recorded a net loss of $1.7 million compared to a budgeted net loss of $5.5 million, resulting in a favorable variance from budget of $3.8 million. The 2009 budget included significant assumptions regarding (a) anticipated Medi-Cal revenue rate cuts, and (b) provider rate cuts – both of which did not come to fruition. Consequently, for both the current month and year-to-date, the Alliance reported significantly higher revenue, medical expense and overall profitability than budgeted. Board Voted on acceptance of December 2008 Financial Statements J. Volkober reported on the November 30, 2008 Financial Statements. For the month, the Alliance recorded a net income of $359 thousand compared to a budgeted net loss of $759 thousand, resulting in a favorable variance from budget of $1.1 million.	Motion: M. Mahoney Second: R. Davis Vote: Unanimous
CFO’s Report (continued)		For the year-to-date, the Alliance recorded a net loss of $1.8 million compared to a budgeted net loss of $4.7 million, resulting in a favorable variance from budget of $2.9 million. The 2009 budget included significant assumptions regarding (a) anticipated Medi-Cal revenue rate cuts, and (b) resulting provider rate cuts – both of which did not come to fruition. Consequently, for both the current month and year-to-date, the Alliance reported significantly higher revenue and medical expense than budgeted. Board voted on acceptance of November 2008 Finacial Statements.	Motion: M. Mahoney Second: M. Lynch Vote: Unanimous
Chief Medical Officer's Report One Attachments Resolution # 09-01	Wayne Pan, MD	W. Pan presented the Board with Resolution #09-01 - Decrease HCQC Membership	Motion: J. Norton Second: R. Davis Vote: Unanimous
Other Business	J. Garcia	The Board voted on Resolution #09-02 – CalPERS Resolution to Satisfy IRS Regulation. The Resolution was passed. The Board discussed purchasing a retirement gift for Dave Kears.	Motion: R. Thomason Second: G. Steele Vote: Unanimous None	None None
Public Comments	J. Garcia	None		None

Set Next Meeting Date
The next Board meeting will be held on Thursday, March 26, 2009

Adjournment
The meeting was adjourned at 6:56 p.m.

Respectfully Submitted By: Ingrid Lamirault, Secretary/Treasurer of the Board and CEO