AGENDA REPORT TO:Jestin D. JohnsonFROM:Sofia NavarroCity Administrator Interim Human Services Department DirectorSUBJECT:Medi-Cal Administrative Activities Memorandum of UnderstandingDATE:September 10, 2025City Administrator Approval Date:RECOMMENDATIONStaff Recommends That The City Council Adopt A Resolution: Resolution Accepting And Appropriating Three Hundred Forty-One Thousand Seventy One Dollars ($341,071) For Medi-Cal Related Activities Through The Medi-Cal Administrative Activities (MAA) Program And Accepting And Appropriating Any Additional Funds That May Come Available And Authorizing The City Administrator To Enter Into A Maa Memorandum Of Understanding With Alameda County Health To Allow For Administrative Reimbursement To The City Of Oakland For Performing Medi-Cal Administrative Activity, For Fiscal Year 2025-2026 And Every Fiscal Year Thereafter EXECUTIVE SUMMARYThe Human Services Department (HSD) has actively participated in the federal Medi-Cal Administrative Activities (MAA) Program since 2004, enabling reimbursement for key outreach -Cal eligible population. The MAA reimbursement to the HSD for Medi-Cal related outreach, policy and administration efforts is estimated to be $341,071 per year starting for fiscal year 2025-2026 and available for subsequent years as long as the City's participation is approved. Moving forward, the Human Services Department has plans to increase outreach and support for the Medi-Cal eligible population, as well as update training to ensure staff who already perform the work bill for the appropriate services.BACKGROUND / LEGISLATIVE HISTORYThe federal government sponsors the Medi-Cal Administrative Activities (MAA) Program, whichis designed to support and encourage local entities - cities, counties, and service agencies - to conduct outreach to Medi-Cal eligible individuals. These activities include informing them about the Medi-Cal program, supporting enrollment, and increasing access to medical services.
Jestin Johnson (Sep 22, 2025 09:53:51 PDT)
09/22/2025
Jestin D. Johnson, City AdministratorSubject: Medi-Cal Administrative Activities Memorandum of Understanding Date: September 30, 2025 Page 2 LEC Committee September 30, 2025
Alameda County Health Care Services Agency administers the program for the federal government.To participate in the MAA Program, agencies must submit a complex application that details specific staff positions and services, explains how they support Medi-Cal utilization, and demonstrates how this work aligns with an overall Medi-Cal outreach plan. Once approved,positions must annually implement a time-study to verify the hours which are spent in MAA eligible activities. The amount of reimbursement is further adjusted based on the localities' estimated Medi-Cal eligible population. The City of Oakland began participating in the MAA Program in 2004, when it adopted Resolution No. 78902authoring the City Administer to accept and appropriate Medi-Cal Administrative Activities (MAA) funds. While the resolution provided the authority to accept and appropriate funds, a formal Memorandum of Understanding (MOU) with Alameda County Health Care Services Agency was not executed at that time. This current resolution seeks to establish the necessary MOU to enable future participation and reimbursement under the program funds.ANALYSIS AND POLICY ALTERNATIVESBased on existing staffing levels and program participation, HSD would anticipate an annual MAA reimbursement of approximately $150,000. However, beginning in FY 2025-26, the department plans to expand its Medi-Cal outreach and administrative efforts by increasing the number of staff positions included in the MAA time study and enhancing training to improve compliance and billing accuracy. These improvements are expected to increase reimbursement amounts over time, potentially up to $341,071 annually. In effort to streamline this process and minimize the annual administrative burden on staff and the Council of this anticipated regular source of reimbursement funds, HSD is recommending that return to Council not be required unless the funding codes change.MAA reimbursements are calculated by a complex formula that considers the total staff hours and/or dollars spent on Medi-Cal related activities, but that figure is further adjusted based on Oakland's Medi-Cal eligible population. HSD is responsible for a wide array of Medi-Cal related activities -- information and referral for Medi-Cal enrollment at Senior Centers, paratransit services to Medi-Cal approved medical appointments, Medi-Cal enrollment as part of homeless outreach - which are included in the MAA application and plan and eligible for reimbursement. Adoption of this resolution will advance the Citywide priority of responsive, trustworthy governmentby helping to sustain program operations for the most vulnerable in our community. FISCAL IMPACTBased on existing staffing levels and program participation, HSD would anticipate an annual MAA reimbursement of approximately $150,000. However, beginning in Fiscal Year 2025-2026, the anticipated expansion and outreach of the program should result in a larger reimbursement amount moving forward. The resolution authorizes acceptance and appropriation of up to Jestin D. Johnson, City AdministratorSubject: Medi-Cal Administrative Activities Memorandum of Understanding Date: September 30, 2025 Page 3 LEC Committee September 30, 2025
$341,071 to accommodate the anticipated growth of the program. The funds will be appropriated to the State of California Fund (2159), Human Services Administration Organization (78111), Medi-Cal Admin Activities Project (1000323), and Empowering Seniors & People with Disability Program (YS14).PUBLIC OUTREACH / INTERESTNo outreach was deemed necessary for the proposed policy action beyond the standard City Council agenda noticing procedures.COORDINATIONThe Office of the City Attorney and the Budget Bureau have each been consulted in the development of this report and resolution.SUSTAINABLE OPPORTUNITIESEconomic: The MAA Program provides an additional funding source for staff costs associated with services for enrolling and assisting Medi-Cal eligible residents. This claiming opportunity enables the City to secure reimbursement for work already performed, improving the sustainability of funding streams that support health outreach and administrative functions. By leveraging these funds, the City can maintain and potentially expand services without increasing the general fund burden, contributing to long-term fiscal and programmatic sustainability. Environmental:The program supports healthier communities, which can reduce demand on resource-intensive emergency services and promote sustainable public health outcomes. Race & Equity:Older adults in the City of Oakland, including people facing race, age, disability, gender, and other disparities, are provided with the services and resources they need to experience overall well-being and lead full lives. They feel safe and healthy and have a sense of belonging.ACTION REQUESTED OF THE CITY COUNCILStaff Recommends That The City Council Adopt A Resolution: Resolution Accepting And Appropriating Three Hundred Forty-One Thousand Seventy One Dollars ($341,071) For Medi-Cal Related Activities Through The Medi-Cal Administrative Activities (MAA) Program And Accepting And Appropriating Any Additional Funds That May Come Available And Authorizing The City Administrator To Enter Into A Maa Memorandum Of Understanding With Alameda County Health To Allow For Jestin D. Johnson, City AdministratorSubject: Medi-Cal Administrative Activities Memorandum of Understanding Date: September 30, 2025 Page 4 LEC Committee September 30, 2025
Administrative Reimbursement To The City Of Oakland For Performing Medi-Cal Administrative Activity, For Fiscal Year 2025-2026 And Every Fiscal Year Thereafter For questions regarding this report, please contact ANA BAGTAS, AGING AND ADULT SERVICES MANAGER, at (510) 238-6794. Respectfully submitted,_____________________________SOFIA NAVARROInterim Human Services Department DirectorPrepared by: Jessi Cutter, Outreach DeveloperAging & Adult Services Division