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<br />CalOptima Health PHA MOU Page 2 of 18 <br />II. PURPOSE <br />This MOU establish es a referral framework from each PHA to CalOptima for HCV and SPV <br />program Participants to leverage the ECM and Community Support services provided through <br />CalAIM. This MOU affirms the PHAs’ and CalOptima’s roles and responsibilities regarding the <br />referral relationships and provides the framework for each PHA’s referral program and sharing of <br />information. This MOU provide s for, among other things, the disclosure of information to <br />CalOptima, in accordance with the CalAIM Housing and Health Services Voluntary Consent Form <br />to Release, Share, and Disclose Confidential Information , attached as Exhibit A to this MOU. The <br />information will include the minimum necessary to confirm the enrollment of a PHA program <br />Participant in CalOptima’s Medi-Cal program. This information may include, for example, full <br />name, date of birth, and social security number. <br /> <br />III. TERM <br />This MOU becomes effective upon the last date the Parties execute this MOU on the signature <br />page (“Effective Date”) and remains in effect until terminated under Section XI. <br />IV. POPULATION TO BE SERVED <br />This MOU applies to any household member(s) who holds or is applying to hold a HCV or SPV <br />issued by a PHA and are voluntarily interested in, or already enrolled in, CalOptima’s Medi-Cal <br />program and consent to provide their information to CalOptima by executing the “CalAIM <br />Housing and Health Services Voluntary Consent Form to Release , Share, and Disclose <br />Confidential Information.” <br /> <br />This may include: <br /> <br />• HCV or SPV applicants who have an active application in process of eligibility <br />that has been pulled off of a waiting list for an HCV or SPV; <br />• HCV or SPV applicants who are waiting to be pulled off of a waiting l ist so long <br />as they provide their written consent; <br />• HCV or SPV Participants in the Project-Based Voucher program; or <br />• Any other category of HCV or SPV applicant or participant not already listed who <br />may be served by a PHA. <br />V. SCOPE OF CALOPTIMA SERVICES <br />A. Once CalOptima receives information from a PHA of: (i) an individual or family <br />(household) member with an HCV or SPV (or who is waiting to receive their HCV or <br />SPV); and (ii) who has provided written consent to share their information with CalOptima , <br />by executing the CalAIM Housing and Health Services Vol untary Consent Form to <br />Release, Share, and Disclose Confidential Information attached as Exhibit A, CalOptima <br />shall follow this process: <br />1. If the individual or household member is unsure of their Medi-Cal status, <br />CalOptima shall either: <br />EXHIBIT 1