Oklahoma Health Care Authority §1115(a) SoonerCare Research and Demonstration Waiver Amendment Request Project Number: 11-W-00048/6 Submitted January 19, 2018 1/10/2018 3:22 PM EXECUTIVE SUMMARY Oklahoma’s single state Medicaid agency, the Oklahoma Health Care Authority (OHCA), operates the §1115(a) SoonerCare Research and Demonstration Waiver, which was initially approved in 1995. The waiver authorizes the SoonerCare Choice and Insure Oklahoma (IO) demonstrations. With this amendment request, OHCA seeks approval of the following modifications to the demonstration for the 2018 extension period: 1. Modify the Special Terms and Conditions (STC) to add qualifying supplemental payments to (a) Oklahoma public universities and/or federally recognized entities that offer qualified physician (M.D. and D.O.) Oklahoma based residency training programs in recognition of the higher cost associated with these programs for physician recruitment and training to maintain sufficient access to quality preventive, primary and specialty healthcare for SoonerCare members and (b) to offer an OHCA approved physician qualified loan repayment program; 2. Modify the waiver language to add hypothesis and evaluation criteria to test and measure the adequacy and sufficiency of the proposed program; and 3. Modify the expenditure authority to add expenditures related to services provided under the program. Background: In recognition of CMS’s commitment to assist the OHCA in identifying a path forward for critical funding that supports access and healthcare delivery for Medicaid beneficiaries, the OHCA is submitting this amendment to continue support, through supplemental payments, of physician residency training programs and physicians who practice in rural communities. Oklahoma’s two medical schools; specifically the University of Oklahoma, College of Medicine (OU) and the Oklahoma State University Center for Health Sciences (OSU) are key clinical partners with the OHCA in the delivery of Medicaid services in the state. Funding made available through the Section 1115 Medicaid waiver, will continue to enhance the healthcare provided to the Medicaid population by the schools. The schools have the unique capability and commitment to train the next generation of physicians in outpatient clinical settings that are simultaneously delivering critical services to Medicaid beneficiaries. Currently, the schools are the Accreditation Council on Graduate Medical Education (ACGME) residency program sponsoring institutions and these payments are intended to partially support and defray costs of the clinics owned and operated by the schools. These costs may include support personnel, equipment, supplies, pharmaceuticals, facility upgrades and Health Insurance Portability and Accountability Act compliance costs. These payments also provide partial salary support for physician faculty who provide clinical care and/or supervision and training of residents that serve the Medicaid population. This support may be directed toward specific physician shortages unique to Oklahoma and the Medicaid program. Additionally, these payments will help covered residency programs remain in compliance with accreditation requirements. Also, these funds support the operating costs associated with being the sponsoring institution of the graduate medical education programs. These costs include program director support, residency program coordinators, resident professional liability insurance, recruitment expenses and other program costs. 1 Page The Oklahoma loan repayment program component of this proposal is administered by a separate state agency, the Physician Manpower Training Commission (PMTC). Their website states that their mission is “to enhance medical care in rural and underserved areas of the state by administering residency, internship and scholarship incentive programs that encourage medical and nursing personnel to practice in rural and underserved areas”. The physician loan repayment program enhances the availability of health care services to Medicaid members by increasing the number of practicing physicians in rural and underserved areas of Oklahoma. Only those physicians who are Medicaid contracted providers and who establish a practice in a community located in Oklahoma are eligible to receive payment under this program. Currently, there are thirty-four (34) participants in the program and with the approval of this proposal, it is anticipated that the capacity will increase to fifty (50). Proposed Effective Date: On or after March 1, 2018 Participation Requirements • Providers participating in the residency training program must be: (1) an OHCA contracted provider for Medicaid compensable services; (2) an Oklahoma public university or federally recognized tribe that offers accredited physician (M.D. or D.O.) residency training programs that are accredited by the ACGME; (3) a sponsoring institution of an ACGME accredited residency training program; and (4) an owner and operator of teaching clinics that furnish ambulatory care services to Medicaid beneficiaries. • Providers participating in the Oklahoma Medical Loan Repayment Program (OMLR) must: (1) be an OHCA contracted provider for Medicaid compensable services; (2) be licensed to practice medicine in Oklahoma; (3) have legitimate, documented education loans; (4) not have received previous assistance from PMTC nor have any service obligation that would conflict with the proposed obligation; and (5) not be currently practicing in a rural Oklahoma community. The service obligation for the program is that participating physicians must agree to a minimum of two (2) years practice in a rural or underserved area. Financial assistance may be extended to a maximum of four years. To receive the total award, the physician is also required to (1) practice in a rural community of 10,000 or less residents for four (4) years; (2) have a caseload of at least 25% Medicaid members or in such case that the 25% threshold cannot be met, due to the demographics of the case mix, serve 100% of the Medicaid members that present for care; and (3) consult and provide referrals for all smokers to the Oklahoma tobacco hotline. Member Benefits • Member benefits under this proposal include, but are not limited to, (1) increased access to high quality, person centered care; (2) access to primary care physicians; (3) promotion of efficiencies that ensure Oklahoma Medicaid’s long-term sustainability; (4) efforts that support coordinated strategies to address certain health determinants; and (5) increased access to preventive care. • Historically, the medical schools have been major providers in the Oklahoma Patient Centered Medical Home (SoonerCare Choice (SCC)), and the Insure Oklahoma (IO), 2 Page delivery systems approved under the existing waiver. Combined, the two medical schools are the primary care medical home providers for approximately one third of SCC members. Impact of Residency Training and Loan Repayment Programs Oklahoma Medicaid contracted physicians provide direct clinical services and order many ancillary services such as: • Hospital admissions; • Laboratory • Imaging studies • Prescription drugs • Home health care • Durable Medical Equipment • Referrals to specialty care • Referrals to behavioral health Physicians provide significant medical necessary care far beyond their direct patient care in a medical clinic. This proposal addresses the needed access to immediate care and reduces barriers to other medically necessary services, which have historically been problematic for Oklahoma Medicaid. Expenditure Authority Reimbursement associated with the residency training program and the loan repayment program is based on the following methodology. Residency Training Program Reimbursement • A pool will be established to reimburse approved sponsoring institutions, university and/or federally recognized tribes, for the added cost associated with operating residency training programs. The pool amount was established by a methodology utilizing a RAND Corporation Research Report from 2013. The calculation of the pool amount is as follows: • To arrive at the total cost pool, we started with the major costs associated with running a Graduate Medical Education program within an outpatient clinical practice, which include, but are not limited to physician faculty effort, clinic costs and central support costs. The total amount of physician faculty salary & benefit costs was adjusted to reflect first, the amount attributable to the clinical effort versus education and research/scholarly efforts. These clinical effort costs were adjusted by multiplying the total amount by the Medicaid percentage of our clinical business. The adjusted figure was the basis for calculating the incremental amount attributable to the indirect cost of caring for a large Medicaid population within a learning environment. We used a 30% figure based on a 2013 RAND Corporation Study as the cost differential for outpatient clinic costs. The teaching clinic costs were adjusted by both the Medicaid percentage of our payor mix and the cost differential. The central support costs were adjusted first by the clinical mission percentage and then by the Medicaid percentage and cost differential. 3 Page Our second calculation included looking at specific residency training costs associated with being the institutional sponsor of an ACGME-accredited training program and the costs both institutions bear for training positions for which there is no offsetting federal source of support. These costs included resident and fellow positions over the Medicare caps set for each of our affiliated teaching hospitals and positions that the schools pay for, program costs including, program director support, residency program coordinators, resident professional liability insurance, recruitment expenses and other program costs. Reference Wynn, Barbara O., Smalley, Robert, and Cordasco, Kristina M., “Does It Cost More to Train Residents or to Replace Them? A Look at the Costs and Benefits of Operating Graduate Medical Education Program” RAND Corporation, 2013 Research Report pp. 22-23, 29-32 The total pool based on this methodology is approximately $104.2 million. The pool amount will be adjusted each subsequent year on January 1st by applying the most recent available Consumer Price Index (CPI)-Medical to determine the new pool amount. The annual Pool funds will be allocated based on the following: 1) Sub-Pool 1 (25%): Total resident/fellow positions filled by sponsoring institution divided by Total resident/fellow positions filled by sponsoring institutions (ratio applied to sub-pool percentage) 2) Sub-Pool 2 (20%): Total Primary Care residency positions (family medicine, internal medicine, pediatrics, OB-GYN and geriatrics) filled by sponsoring institution divided by Total Primary Care residency positions filled by sponsoring institutions (ratio applied to sub-pool percentage) 3) Sub-Pool 3 (5%): Total Psychiatry residency positions filled by sponsoring institution divided by Total Psychiatry residency positions filled by sponsoring institutions (ratio applied to sub-pool percentage) 4) Sub-Pool 4 (20%): Total Rural residency positions filled by sponsoring institution divided by Total Rural residency positions filled by sponsoring institutions (ratio applied to sub-pool percentage) 5) Sub-Pool 5 (15%): Total SCC member months for each sponsoring institution divided by the total member months for all sponsoring institutions 6) Sub-Pool 6 (15%): Specialty physicians employed by each sponsoring institution divided by total specialty physicians employed by sponsoring institutions (reflected as full-time equivalent) The sum of the Sub-Pools (Sub-Pool 1, Sub-Pool 2, Sub-Pool 3, Sub-Pool 4, Sub-Pool 5 and Sub-Pool 6) for each school is applied to the total Pool funding to be allocated. The annual Pool funds will be disbursed quarterly to Medicaid contracted providers. 4 Page Oklahoma Medical Loan Repayment Program • The OMLR program reimburses physicians a not to exceed amount of $160,000 (per physician) over a four year period allocated as Year 1 $25,000; Year 2 $35,000; Year 3 $45,000; and Year 4 $55,000. The total estimated impact for the OMLR is approximately $800,000 (per year). The total impact of the physician residency training program and the OMLR program is approximately $105,000,000 for the first year. Tribal Impact There are currently ten (10) hospitals and fifty-three (53) outpatient facilities operated by the Indian Health Service and Tribal governments, which are SoonerCare providers. The majority of these sites is rural and has enhanced challenges in recruiting and retaining medical professionals. Several federally-recognized Tribal governments have taken initiative to begin medical residency programs. Unfortunately, these programs are not authorized in federal legislation to participate in the conventional medical residency program funded by Medicare. Currently, OSU or the Osteopathic Medical Education Consortium of Oklahoma, Inc. (OMECO) is the sponsoring institution for certain federally recognized tribes that have ACGME resident training programs. One of the programs allows the residents to provide care to patients at two rural facilities; the Northeastern Health System Hospital and the Cherokee Nation Hastings Hospital. Since 2011, the program has had twenty-one (21) residents graduate. Of the 21 graduates, sixteen (16) currently practice within Oklahoma and all 16 physicians practice in rural settings where, traditionally, it has been difficult to recruit and retain physicians. In June 2018, three (3) additional residents will graduate from the program. One of the residents has signed a letter of intent to practice in the area. The other two are pursuing practices in rural Oklahoma. If they are successful in locating within rural Oklahoma as expected, 20 of the 24 (83.3%) family practice physicians that have graduated from the program will provide much needed health care to rural Oklahoma and Medicaid patients. Another Oklahoma tribal resident program is operated by the Choctaw Nation. The Choctaw Nation of Oklahoma has operated a medical residency program since 2012, accredited by ACGME and has American Osteopathic Association (AOA) recognition. OMECO serves as the sponsoring institution for this program. Of its ten (10) graduates, eight (8), or 80% continue to practice within the Choctaw Nation’s health system in rural Oklahoma, and one (1) physician practices elsewhere in rural Oklahoma, for a total of 90% continuing to work in rural Oklahoma. In addition to the above tribal run residency programs, the Chickasaw Nation will operate its own medical residency program in June of 2018. The program is an ACGME accredited Family Medicine Residency Program and has American Osteopathic Association (AOA) recognition. OSU serves as the sponsoring institution for this program. The Chickasaw Nation Family Medicine Residency Program is a 4-4-4 program for a total of twelve (12) residents possible. The residents will work in the Chickasaw facilities prior to completing their training which will 5 Page allow them to experience and witness how the Chickasaws care for their patients and gives them the opportunity to become employed. Through tribal consultation and participation in the workgroup for this proposal, the tribes have expressed interest in becoming a sponsoring institution to be an eligible participant in this program. Based on the consultation feedback, this proposal has been written to accommodate future inclusion for the tribes in this program. Public Notice and Tribal Consultation OHCA conducted tribal consultation on January 12, 2018 in the OHCA board room and conducted a public meeting with the Medical Advisory Committee (MAC) on January 18, 2018. On January 12, 2018 by a vote of 5 for and 0 against, the Inter-Tribal Council of the Five Civilized Tribes (ITC) signed Resolution No. 18-04 that states in part…the ITC understands that the Oklahoma Health Care Authority, the State Medicaid agency, must submit to CMS immediately with a wavier amendment or other mechanism to ensure that these critical and substantial health services are not lost, and we acknowledge it will require an expedited Tribal Consultation that may be shorter than the 14-days required in its State plan...Further, the resolution contained language that states “ the Inter-Tribal Council of the Five Civilized Tribes calls upon the State of Oklahoma, Congress and the Trump Administration to find a long-term solution to continue CMS funding to OSU and OU to ensure the SoonerCare participants will not face a health care gap and to safeguard the healthcare network of the state”. Additionally, OHCA published notice of the MAC meeting in several Oklahoma newspapers across the state. Finally, OHCA posted the draft amendment on the OHCA public website for the period January 15, 2018-January 19, 2018 for public comment. Comment summaries from both meetings and the website are included in this submission. Budget Neutrality The OHCA assures CMS that it is in compliance with budget neutrality requirements found at Section XIII and beginning with STC # 71. Evaluation Design To comply with the requirement to measure the effectiveness of the program, the OHCA will evaluate the physician resident training program based on the following criteria. • For the evaluation of the residency program, the following metrics will be applied. o Goal: Reduce costs associated with provision of direct services to SoonerCare beneficiaries by qualified providers.  Hypothesis: The qualifying providers will reduce their per member per month (pmpm) cost by 1% as applied to a full calendar year.  Methodology for testing: A qualifying provider’s (QP) per member per month (calculated by dividing QP’s monthly SoonerCare expenditures by the corresponding QP’s SoonerCare Choice members) will be compared to a 3-yr rolling average pmpm adjusted by the CPI-Medical (calculated by the sum of the most recent 3 yrs. expenditures divided by sum of the most recent 3 years of members in SCC) 6 Page o Goal: Maintaining access to and the availability of primary and specialty providers  Hypothesis: The number of contracted primary care and specialty providers will not decrease over a three year averaged baseline. The number will be measured annually.  Methodology for testing: Contracted provider counts will be captured by OHCA on a quarterly basis and referenced to a historical benchmark (calculated by averaging provider count for previous 3 years CY 20152017).  Hypothesis: QP’s SCC panel size will be maintained as a proportion of the total SCC population applied to a full calendar year.  Methodology for testing: Quarterly member count will be referenced to a historical benchmark (calculated by the average member months per quarter for previous 3 full calendar years). o Goal: Enhancing the state’s post-residency enrollment of SoonerCare providers.  Hypothesis: The rate of physicians completing residency training in Oklahoma and staying in state to practice will be above the current national rate for resident retention.  Methodology for testing: Association of American Medical Colleges, using the American Medical Association master file, calculates the rate of residents who stay in the state where they completed their residency program. Oklahoma’s rate will be referenced to the national average per this source. To comply with the requirement to measure the effectiveness of the program, the OHCA will evaluate the OMLR program based on the following criteria. o Goal: To encourage and incentivize Medicaid contracted physicians to practice in rural and underserved areas.  Hypothesis: The number of Medicaid contracted physicians in locating their practice in targeted high need areas will be improved by a financial incentive program.  Methodology for testing: The total number of physicians in the OMLR is measured annually and compared to the baseline.  Hypothesis: The long term retention of Medicaid contracted physicians remaining in targeted, high need areas is improved by the use of the OMLR incentive payment program.  Methodology for testing: Following the completion of the service obligation, count the number of physicians retained in targeted areas one year after OMLR participation. 7 Page SnunerEare Chaice and Insure Dklahnrna In IE I I Wawer Amendment FE JANUARY I5 JANUARY I9 Click here fur additinnal Total Cost Clinical Effort Cost of Clinical Effort Medicaid Proportionate Share Cost Differential Cost Pool Totals CLINICAL Cost Categories OKC Attending Physician Compensation Clinic Costs Central Support Costs $ 245,174,733 $ 148,214,254 $ 38,025,475 75% $ 100% $ 60% $ 183,881,050 148,214,254 22,815,285 33% 33% 33% 30% $ 30% $ 30% $ 18,452,463 14,873,300 2,289,514 Tulsa Attending Physician Compensation Clinic Costs Central Support Costs $ 38,877,283 $ 59,860,719 $ 4,403,142 80% $ 100% $ 60% $ 31,101,827 59,860,719 2,641,885 58% 58% 58% 30% $ 30% $ 30% $ 5,396,182 10,385,865 458,368 OSU Attending Physician Compensation Rural Adjunct Network Core Faculty Attending Physician Employment Costs Clinic Costs Central Support Costs $ $ $ $ $ 90% $ 70% $ $ 100% $ 100% $ 64,631,127 23,766,702 88,397,829 17,673,789 6,624,570 100% 56% 30% $ 30% $ 19,389,338 3,992,806 56% 56% 30% $ 30% $ 2,969,197 1,112,928 71,812,363 33,952,432 105,764,795 17,673,789 6,624,570 EDUCATION Cost Categories OKC Inst. Funded Resident Positions GME Program Costs GME Professional Liability $ $ $ 8,343,835 5,056,227 735,140 90% 90% 100% $ $ $ 7,509,452 4,550,604 735,140 Tulsa Inst. Funded Resident Positions GME Program Costs GME Professional Liability $ $ $ 4,441,705 3,093,235 270,599 95% 95% 100% $ $ $ 4,219,620 2,938,573 270,599 OSU Inst. Funded Resident Positions GME Program Costs $ $ 6,108,339 2,280,579 85% 85% $ $ $ 5,192,089 1,938,492 - $ 106,674,530 Combined OU and OSU Cost per resident RAND Study RAND Corporation Total Cost Cost Pool Totals $ 99,510 School % Standard CMS Financial Management Questions 1. Section 1903(a)(1) provides that federal matching funds are only available for expenditures made by states for services under the approved State Plan. a. Do providers receive and retain the total Medicaid expenditures claimed by the State(includes normal per diem, supplemental, enhanced payments, other) or is any portion of the payments returned to the State, local government entity or any other intermediary organization? If providers are required to return any portion of payments, please provide a full description of the repayment process. Include in your response a full description of the methodology for the return of any of the payments, a complete listing of providers that return a portion of their payments, the amount or Percentage of payments that are returned and the disposition and use of the funds once they are returned to the State (i.e. general fund, medical services account, etc.) Yes, providers receive and retain 100 percent of the payments. 2. Section 1902(a)(2) provides that the lack of adequate funds from local sources will not result in lowering the amount, duration, scope or quality of care and services available under the plan. a. Please describe how the state share of each type of Medicaid payment (normal per diem, supplemental, enhanced, other) is funded. The non-federal share (NFS) of the supplemental payments to Oklahoma public universities is funded through Intergovernmental Transfers (IGTs) from appropriations from the legislature. The non-federal share (NFS) of the supplemental payments to federally recognized entities is funded through Intergovernmental Transfers. The non-federal share (NFS) of the loan repayment program payments are funded through Intergovernmental Transfers (IGTs) from appropriations from the legislature. b. Please describe whether the state share is from appropriations from the legislature to the Medicaid agency, through intergovernmental transfer agreements (IGTs), certified public expenditures (CPEs) provider taxes or any other mechanism used by the State to provide state share. The non-federal share (NFS) is funded through Intergovernmental Transfers (IGTs). c. Note that, if the appropriation is not to the Medicaid agency, the source of the state share would necessarily be derived through either an IGT or CPE. In this case, please identify the agency to which the funds are appropriated. Funds are appropriated to University of Oklahoma (OU) and Oklahoma State University (OSU) Medical Schools and to the Physician Manpower Training 1 Commission for supplemental payments to Oklahoma public universities. Funds are appropriated to the Tobacco Settlement Endowment Trust for the loan repayment program. d. Please provide an estimate of total expenditure and state share amounts for each type of Medicaid payment. Type GME Payments Loan Repayment Total NFS $104,200,000 $800,000 $43,170,060 $331,440 e. If any of the non-federal share is being provided using IGTs or CPEs, please fully describe the matching arrangement including when the state agency receives the transferred amounts from the local government entity transferring the funds. The State receives the transferred amounts prior to making the payments. f. If CPEs are used, please describe the methodology used by the State to verify that the total expenditures being certified are eligible for federal matching funds in accordance with 42 CFR 433.51(b). Not applicable g. For any payment funded by CPEs or IGTs, please provide the following: i. A complete list of the names of entities transferring or certifying funds: University of Oklahoma College of Medicine Oklahoma State University College of Osteopathic Medicine P h y s i c i a n M a n p o w e r Training Commission Oklahoma Tobacco Settlement Endowment Trust ii. The operational nature of the entity (state, county, city, other): Oklahoma public universities, State Commission, State Agency iii. The total amounts transferred or certified by each entity: $43,501,500 iv. Clarify whether the certifying or transferring entity has general taxing authority: The transferring entities do not have general taxing authority. v. Whether the certifying or transferring entity receives appropriations (identify level of appropriations): The transferring entities do receive appropriations. 2 3. Section 1902(a)(30) requires that payments for services be consistent with efficiency, economy and quality of care. Section 1903(a)(1) provides for federal financial participation to states for expenditures for services under an approved State Plan. If supplemental or enhanced payments are made, please provide the total amount for each type of supplemental or enhanced payment made to each provider type. Not applicable, these payments will not be State Plan supplemental payments. 4. Please provide a detailed description of the methodology used by the State to estimate the upper payment limit (UPL) for each class of providers (state owned or operated, non-state government owned or operated, and privately owned or operated). Please provide a current (i.e. applicable to the current rate year) UPL demonstration. Not Applicable Does any governmental provider receive payments that in the aggregate (normal per diem, supplemental, enhanced, other) exceed their reasonable costs of providing services? If payments exceed the cost of services, do you recoup the excess and return the federal share of the excess to CMS on the quarterly expenditures report? No governmental provider receives payments that exceed their reasonable costs of providing services. 3 Summary of July 2016 update to Oklahoma SoonerCare Budget Neutrality Sponsor's Choice MEG The SoonerCare budget neutrality submission has been updated to include the Insure OK Sponsor's Choice Insurance (SCI) MEG. A new MEG tab has been added as Exhibit 16. The subsequent tabs have been renumbered accordingly (former Exhibit 16 is now Exhibit 17, former Exhibit 17 is now Exhibit 18, etc.). The SCI enrollment projection assumes 10,000 members will join by December 2017 and 50,000 by December 2018. The 50,000 figure is the OHCA's estimate of the total number eligible to enroll. The model assumes enrollment will begin in January 2017 with 833 members and will increase by 833 members per month, through December 2017. Enrollment in 2018 will increase by 3,333 members per month, reaching 50,000 in December 2018. The PMPM value for the SCI MEG has been set equal to the PMPM rate for the closest equivalent MEG, IOK Non-Disabled Working Adults and Spouses covered through Employer-Sponsored Insurance (NDWAESI). Costs associated with the new MEG have been incorporated into the aggregate expenditure exhibit as an offset to waiver savings. Provider Rate Reduction The SoonerCare budget neutrality forecast has been updated to account for the projected impact of a three percent across-the-board reduction in provider payment rates that took effect on January 1, 2016. The rate reduction applies to traditional Medicaid MEGs only; Insure OK, HAN and HMP MEGs are not affected. The rate reduction calculations can be found in Exhibits 3 (TANF-U), 4 (TANF-R), 5 (ABD-U), 6 (ABD-R) and 11 (TEFRA). The reductions also affect the summary budget neutrality forecast shown in Exhibit 24 (All). Completion of CY 2015 Data DY20 (CY 2015) member months and expenditures have been updated on all applicable exhibits to include a full year of historical data (previous iteration was annualized based on nine months of data). Summary of May - December updates to Oklahoma SoonerCare Budget Neutrality Savings (if applicable) Cumulative savings/(deficit) limited as follows: -Cumulative savings look back limited to the five years prior to the 2018 extension -Annual savings/(deficit) recognition limited to 25 percent of actual within cumulative savings/(deficit) calculation Updated to Reflect DY21 (CY 2016) Actual Expenditures DY21 (CY 2016) member months and expenditures have been updated on all applicable exhibits to actual expenditures as reported on Schedule C Projected PMPM Expenditures: Traditional MEGs PMPM for TANF-Urban MEG based on approved PMPM trend rate with GME and HMP trended separately PMPM for TANF-Rural, ABD-Urban and ABD-Rural based on approved PMPM trend rates with HMP trended separately at 3 percent annually Sponsors Choice MEG Enrollment for Sponsors Choice (Exhibit 16) projected to reach 10,000 members in December 2019 and 50,000 members in December 2020; enrollment will remain at 50,000 in 2021 PMPM for Sponsors Choice MEG set equal to NDWA-ESI MEG, which is the closest in terms of demographics/projected cost profile Workforce Development Expenditures Projected CY 2017 expenditures were reduced by $31 million to account for one quarter of workforce development funding deferral. Projected expenditures for subsequent years were adjusted to remove any workforce development expenditures (Adjustment made within TANF-U MEG). University Access to Care Pool Projected CY 2018 expenditure of $105 million (state and federal) included within TANF-U MEG to account for University Access to Care Pool funding. SOONERCARE 1115 BUDGET NEUTRALITY TREND FACTORS May 2017- Jan 2018 Notes/Updates: - OMB trend factors, as provided by CMS, used for 2017 - 2018 PMPM expenditure projections - OMB trend factors, as provided by CMS, used to trend 2016 base year to 2018 MEG Enrollment Trend Calculation MEG 2010 2011 2012 2013 2014 2015 2016 Annual Trend Trending Years TANF - Urban 3,333,170 3,357,000 3,620,263 3,741,817 4,001,208 4,101,736 4,023,592 3.19% 2010 - 2016 TANF - Rural 2,429,264 2,433,324 2,565,123 2,618,683 2,745,120 2,807,836 2,721,130 1.91% 2010 - 2016 ABD - Urban 327,267 344,575 348,935 360,205 365,630 362,810 373,088 2.21% 2010 - 2016 ABD - Rural 278,093 285,113 285,622 290,965 291,806 287,250 278,503 0.02% 2010 - 2016 NDWA - ESI 7.25% See IOK_ESI-IP Tab NDWA - IP 4.57% See IOK_ESI-IP Tab WDA 90 114 66 42 4,018 4,514 4,978 5,326 - - -100.00% 2010 - 2016 10.08% 2010 - 2016 College - ESI 4.20% See IOK_ESI-IP Tab College - IP 2.79% See IOK_ESI-IP Tab TEFRA 6,148 PMPM Trend Factors MEG Factor TANF-U 1.0400 TANF-R 1.0400 ABD-U 1.0360 ABD-R 1.0360 NDWA 1.0400 WDA 1.0360 TEFRA 1.0360 College Students 1.0400 Jan18-Exh1&2-Trends 6,771 7,149 July 2016 Notes/Updates: - MEG-specific actual expenditures not available for 1996 - 2003 - Historical expenditures reflect C-Report amounts - Adjustment for HAN expenditures in cells H24 - H27 (dollars removed to eliminate doublecount in 2010 - 2013 data; no doublecount in 2014-2015 data) - Historical HMP expenditures added to cells H27 - H30 - Projected HMP expenditures added to cells G31 - G32 but separately trended SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG TANF URBAN MEG May 2017 - Jan 2018 Notes/Updates: -Actual PMPM expenditures for 2016 trended forward to establish rebased PMPM budget neutrality limit for 2018 - CY 2017 projected expenditures reduced by $31 million, to reflect workforce development funding disallowance - CY 2018 projected expenditures adjusted to remove workforce development funding of $115 million per year - CY 2018 projected expenditures adjusted to add $105 million for University Access to Care Pool funding Comparison with HAN expenditures included in, and HMP expenditures excluded from, TANF-U amounts Budget Neutrality Limit Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) TANF-U with HAN and Difference (C Report without HMP minus BN table) Cumulative Deviation by Renewal Period 1 1996 1,248,591 $ 121.60 $ 151,828,666 2 1997 1,201,538 $ 129.52 $ 155,618,588 3 1998 1,299,675 $ 137.95 $ 179,287,128 4 1999 1,489,962 $ 146.93 $ 218,917,218 5 2000 1,575,250 $ 156.49 $ 246,515,710 6 2001 1,988,010 $ 166.68 $ 331,363,038 7 2002 2,159,002 $ 177.53 $ 383,291,270 8 2003 2,319,441 $ 189.09 $ 438,580,782 9 2004 2,426,341 $ 201.40 $ 488,661,911 $ 136.70 $ 331,669,473 $ 156,992,438 $ 156,992,438 $ 331,669,473 $ (331,669,473) 10 2005 2,528,654 $ 214.51 $ 542,420,938 $ 188.11 $ 475,653,511 $ 66,767,427 $ 223,759,865 $ 475,653,511 $ (475,653,511) 11 2006 2,643,157 $ 228.47 $ 603,893,538 $ 213.25 $ 563,645,766 $ 40,247,772 $ 264,007,637 $ 563,645,766 $ (563,645,766) 12 2007 2,808,278 $ 240.19 $ 674,520,293 $ 217.74 $ 611,465,158 $ 63,055,135 $ 327,062,772 $ 611,465,158 $ (611,465,158) 13 2008 2,772,622 $ 252.51 $ 700,119,625 $ 237.40 $ 658,219,711 $ 41,899,914 $ 368,962,686 $ 658,219,711 $ (658,219,711) 14 2009 3,029,870 $ 265.47 $ 804,339,589 $ 249.71 $ 756,593,334 $ 47,746,255 $ 416,708,941 $ 756,593,334 $ (756,593,334) 15 2010 3,333,170 $ 279.09 $ 930,249,786 $ 234.68 $ 782,242,482 $ 148,007,304 $ 564,716,244 $ 782,988,002 $ (782,988,002) 16 2011 3,357,000 $ 293.41 $ 984,968,363 $ 252.31 $ 847,000,007 $ 137,968,356 $ 702,684,600 $ 849,144,497 $ (849,144,497) 17 2012 3,620,263 $ 308.46 $ 1,116,703,111 $ 251.66 $ 911,062,393 $ 205,640,718 $ 908,325,319 $ 913,775,678 $ (913,775,678) 18 2013 3,741,817 $ 322.03 $ 1,204,977,329 $ 255.01 $ 954,184,381 $ 250,792,948 $ 1,159,118,266 $ 956,117,310 $ (956,117,310) $ 19 2014 4,001,208 $ 336.20 $ 1,345,206,130 $ 237.82 $ 951,550,408 $ 393,655,722 $ 1,552,773,988 20 2015 4,101,736 $ 350.99 $ 1,439,668,319 $ 240.57 $ 986,750,815 $ 452,917,504 $ 2,005,691,492 21 2016 4,023,592 $ 366.44 $ 1,474,405,052 $ 235.70 $ 948,370,039 $ 526,035,013 $ 2,531,726,505 22 2017 (proj) 4,151,834 $ 381.10 $ 1,582,254,095 $ 237.32 $ 985,294,448 $ 596,959,648 $ 3,128,686,153 23 2018 (proj) 4,284,164 $ 396.34 $ 1,697,992,025 $ 250.88 $ 1,074,791,909 $ 623,200,116 $ 3,751,886,269 Historical CY Current PMPM DY RB Member Months Actual/Projected Expenditures See Exhibit 24 (Aggregate) Jan18-Exh3-TANFU (6,899,272,440) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - MEG-specific actual expenditures not available for 1996 - 2003 - Historical expenditures reflect C-Report amounts - Historical HMP expenditures added to cells H27 - H30 - Projected PMPM HMP expenditures added to cells G31 - G32 but separately trended TANF RURAL MEG May 2017 - Jan 2018 Notes/Updates: -Actual PMPM expenditures for 2016 trended forward to establish rebased PMPM budget neutrality limit for 2018 TANF-R without HMP Difference (C Report minus BN table) 109,346,275 $ 109,346,275 $ 296,093,830 $ (296,093,830) $ 116,595,201 $ 225,941,475 $ 322,029,702 $ (322,029,702) 388,233,610 $ 83,710,191 $ 309,651,667 $ 388,233,610 $ (388,233,610) $ 417,441,223 $ 101,624,186 $ 411,275,853 $ 417,441,223 $ (417,441,223) 208.78 $ 433,930,540 $ 98,421,718 $ 509,697,571 $ 433,930,540 $ (433,930,540) $ 220.17 $ 494,500,235 $ 110,280,442 $ 619,978,012 $ 494,500,235 $ (494,500,235) 687,678,542 $ 213.70 $ 519,126,643 $ 168,551,899 $ 788,529,911 $ 519,126,643 $ (519,126,643) $ 724,164,719 $ 224.38 $ 545,999,493 $ 178,165,226 $ 966,695,137 $ 545,999,493 $ (545,999,493) 312.87 $ 802,550,338 $ 230.22 $ 590,533,873 $ 212,016,465 $ 1,178,711,602 $ 590,533,873 $ (590,533,873) $ 326.64 $ 855,366,615 $ 230.12 $ 602,610,415 $ 252,756,200 $ 1,431,467,803 $ 600,427,955 $ (600,427,955) $ 2,745,120 $ 341.01 $ 936,113,371 $ 229.99 $ 631,345,478 $ 304,767,893 $ 1,736,235,696 2015 2,807,836 $ 356.01 $ 999,617,694 $ 210.86 $ 592,057,993 $ 407,559,702 $ 2,143,795,398 21 2016 2,721,130 $ 371.67 $ 1,011,362,387 $ 208.30 $ 566,807,331 $ 444,555,056 $ 2,588,350,454 22 2017 (proj) 2,773,076 $ 386.54 $ 1,071,895,794 $ 216.58 $ 600,594,720 $ 471,301,074 $ 3,059,651,528 23 2018 (proj) 2,826,013 $ 402.00 $ 1,136,052,326 $ 225.19 $ 636,400,911 $ 499,651,415 $ 3,559,302,943 Historical Cumulative Savings/ (Deficit) Current Actual/Projected Expenditures RB Budget Neutrality Limit Comparison with HMP expenditures excluded from TANF-R amounts Member Months PMPM Aggregate PMPM Savings/ (Deficit) Aggregate DY CY 1 1996 1,088,941 $ 123.34 $ 134,309,983 2 1997 1,081,206 $ 131.37 $ 142,037,420 3 1998 1,250,830 $ 139.92 $ 175,018,115 4 1999 1,510,946 $ 149.03 $ 225,177,007 5 2000 1,522,229 $ 158.73 $ 241,627,007 6 2001 1,915,864 $ 169.07 $ 323,907,157 7 2002 2,014,674 $ 180.07 $ 362,786,430 8 2003 1,941,227 $ 191.79 $ 372,317,080 9 2004 1,984,722 $ 204.28 $ 405,440,105 $ 149.19 $ 296,093,830 $ 10 2005 2,015,932 $ 217.58 $ 438,624,903 $ 159.74 $ 322,029,702 11 2006 2,036,491 $ 231.74 $ 471,943,801 $ 190.64 $ 12 2007 2,130,548 $ 243.63 $ 519,065,409 $ 195.93 13 2008 2,078,460 $ 256.13 $ 532,352,258 $ 14 2009 2,246,021 $ 269.27 $ 604,780,677 15 2010 2,429,264 $ 283.08 $ 16 2011 2,433,324 $ 297.60 17 2012 2,565,123 $ 18 2013 2,618,683 19 2014 20 Cumulative Deviation by Renewal Period See Exhibit 24 (Aggregate) Jan18-Exh4-TANFR (2,256,087,964) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - MEG-specific actual expenditures not available for 1996 - 2003 - Historical expenditures reflect C-Report amounts - Historical HMP expenditures added to cells H27 - H30 - Projected PMPM HMP expenditures added to cells G31 - G32 but separately trended ABD URBAN MEG May 2017 - Jan 2018 Notes/Updates: -Actual PMPM expenditures for 2016 trended forward to establish rebased PMPM budget neutrality limit for 2018 Budget Neutrality Limit Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) ABD-U without HMP Difference (C Report minus BN table) Cumulative Deviation by Renewal Period CY 1 1996 2 1997 3 1998 4 1999 96,785 $ 536.14 $ 51,889,826 5 2000 190,315 $ 567.55 $ 108,013,756 6 2001 279,689 $ 600.81 $ 168,040,252 7 2002 306,526 $ 636.02 $ 194,956,243 8 2003 233,742 $ 673.29 $ 157,375,990 9 2004 244,590 $ 712.74 $ 174,330,070 $ 489.16 $ 119,644,174 $ 54,685,896 $ 54,685,896 $ 119,644,174 $ (119,644,174) 10 2005 255,066 $ 754.51 $ 192,450,068 $ 668.41 $ 170,487,472 $ 21,962,596 $ 76,648,492 $ 170,487,472 $ (170,487,472) 11 2006 259,473 $ 798.73 $ 207,247,624 $ 858.00 $ 222,627,081 $ (15,379,457) $ 61,269,036 $ 222,627,081 $ (222,627,081) 12 2007 268,332 $ 840.26 $ 225,468,646 $ 894.55 $ 240,036,203 $ (14,567,557) $ 46,701,479 $ 240,036,203 $ (240,036,203) 13 2008 283,834 $ 883.96 $ 250,898,901 $ 962.43 $ 273,171,226 $ (22,272,325) $ 24,429,154 $ 273,171,226 $ (273,171,226) 14 2009 301,034 $ 929.92 $ 279,937,423 $ 1,003.30 $ 302,026,587 $ (22,089,164) $ 2,339,990 $ 302,026,587 $ (302,026,587) 15 2010 327,267 $ 978.28 $ 320,157,269 $ 960.84 $ 314,450,856 $ 5,706,413 $ 8,046,403 $ 314,450,856 $ (314,450,856) 16 2011 344,575 $ 1,029.15 $ 354,617,902 $ 931.12 $ 320,839,827 $ 33,778,075 $ 41,824,478 $ 320,839,827 $ (320,839,827) 17 2012 348,935 $ 1,082.66 $ 377,778,436 $ 932.40 $ 325,345,676 $ 52,432,760 $ 94,257,239 $ 325,345,676 $ (325,345,676) 18 2013 360,205 $ 1,128.13 $ 406,358,067 $ 974.58 $ 351,048,325 $ 55,309,742 $ 149,566,981 $ 350,748,123 $ (350,748,123) $ 19 2014 365,630 $ 1,175.51 $ 429,801,721 $ 1,055.90 $ 386,068,587 $ 43,733,135 $ 193,300,115 20 2015 362,810 $ 1,224.89 $ 444,402,341 $ 1,089.26 $ 395,192,726 $ 49,209,615 $ 242,509,730 21 2016 373,088 $ 1,276.34 $ 476,187,138 $ 1,033.12 $ 385,443,403 $ 90,743,735 $ 333,253,465 22 2017 (proj) 381,326 $ 1,322.29 $ 504,222,545 $ 1,070.26 $ 408,119,460 $ 96,103,085 $ 429,356,550 23 2018 (proj) 389,745 $ 1,369.89 $ 533,908,531 $ 1,108.75 $ 432,130,085 $ 101,778,445 $ 531,134,995 Historical DY Current PMPM Actual/Projected Expenditures RB Member Months Comparison with HMP expenditures excluded from ABD-U amounts See Exhibit 24 (Aggregate) Jan18-Exh5-ABDU (1,311,384,482) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - MEG-specific actual expenditures not available for 1996 - 2003 - Historical expenditures reflect C-Report amounts - Historical HMP expenditures added to cells H27 - H30 - Projected PMPM HMP expenditures added to cells G31 - G32 but separately trended ABD RURAL MEG May 2017 - Jan 2018 Notes/Updates: -Actual PMPM expenditures for 2016 trended forward to establish rebased PMPM budget neutrality limit for 2018 Budget Neutrality Limit Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) ABD-R without HMP Difference (C Report minus BN table) Cumulative Deviation by Renewal Period CY 1 1996 2 1997 3 1998 4 1999 103,533 $ 427.26 $ 44,235,510 5 2000 209,188 $ 452.30 $ 94,615,196 6 2001 329,747 $ 478.80 $ 157,883,545 7 2002 343,627 $ 506.86 $ 174,170,735 8 2003 222,348 $ 536.56 $ 119,303,455 9 2004 231,151 $ 568.00 $ 131,294,780 $ 599.10 $ 138,481,478 $ (7,186,698) $ (7,186,698) $ 138,481,478 $ (138,481,478) 10 2005 238,426 $ 601.29 $ 143,363,035 $ 639.45 $ 152,460,934 $ (9,097,899) $ (16,284,596) $ 152,460,934 $ (152,460,934) 11 2006 241,661 $ 636.52 $ 153,823,267 $ 793.03 $ 191,644,246 $ (37,820,979) $ (54,105,575) $ 191,644,246 $ (191,644,246) 12 2007 244,220 $ 669.62 $ 163,534,596 $ 834.57 $ 203,819,587 $ (40,284,991) $ (94,390,566) $ 203,819,587 $ (203,819,587) 13 2008 251,088 $ 704.44 $ 176,876,491 $ 871.89 $ 218,920,196 $ (42,043,705) $ (136,434,272) $ 218,920,196 $ (218,920,196) 14 2009 262,857 $ 741.07 $ 194,795,734 $ 930.09 $ 244,480,172 $ (49,684,438) $ (186,118,709) $ 244,480,172 $ (244,480,172) 15 2010 278,093 $ 779.61 $ 216,803,202 $ 943.82 $ 262,470,486 $ (45,667,284) $ (231,785,993) $ 262,470,486 $ (262,470,486) 16 2011 285,113 $ 820.15 $ 233,834,396 $ 958.77 $ 273,358,100 $ (39,523,704) $ (271,309,697) $ 273,358,100 $ (273,358,100) 17 2012 285,622 $ 862.79 $ 246,432,947 $ 938.53 $ 268,063,880 $ (21,630,933) $ (292,940,630) $ 268,063,880 $ (268,063,880) 18 2013 290,965 $ 899.03 $ 261,586,264 $ 970.21 $ 282,298,187 $ (20,711,923) $ (313,652,553) $ 282,055,691 $ (282,055,691) $(1,085,948,157) 19 2014 291,806 $ 936.79 $ 273,360,943 $ 1,011.24 $ 295,085,785 $ (21,724,842) $ (335,377,395) 20 2015 287,250 $ 976.14 $ 280,396,215 $ 1,031.19 $ 296,210,205 $ (15,813,990) $ (351,191,386) 21 2016 278,503 $ 1,019.09 $ 283,819,622 $ 1,005.06 $ 279,910,975 $ 3,908,647 $ (347,282,739) 22 2017 (proj) 278,571 $ 1,055.78 $ 294,109,335 $ 1,041.19 $ 290,046,685 $ 4,062,650 $ (343,220,088) 23 2018 (proj) 278,640 $ 1,093.79 $ 304,772,096 $ 1,078.63 $ 300,549,779 $ 4,222,317 $ (338,997,771) Historical DY Current PMPM Actual/Projected Expenditures RB Member Months Comparison with HMP expenditures excluded from ABD-U amounts See Exhibit 24 (Aggregate) Jan18-Exh6-ABDR July 2016 Notes/Updates: - Historical expenditures reflect C-Report amounts - Adjustment for College Student (CS) expenditures in cells H23 - H27 (dollars removed to eliminate doublecount) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG NON-DISABLED WORKING ADULTS MEG - ESI & IP Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 9,744 $ 198.81 $ 1,937,239 $ (1,937,239) $ (1,937,239) 12 2007 38,417 $ 204.54 $ 7,857,843 $ (7,857,843) $ (9,795,082) 13 2008 139,822 $ 239.38 $ 33,470,013 $ (33,470,013) $ (43,265,095) 14 2009 172,594 $ 437.73 $ 75,549,419 $ (75,549,419) $ (118,814,514) 15 2010 392,065 $ 284.10 $ 111,386,167 $ (111,386,167) $ (230,200,681) 16 2011 392,772 $ 314.00 $ 123,330,328 $ (123,330,328) $ (353,531,009) 17 2012 391,031 $ 309.32 $ 120,952,327 $ (120,952,327) $ (474,483,336) 18 2013 388,005 $ 297.14 $ 115,291,324 $ (115,291,324) $ (589,774,660) 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) See Exhibit 8 for ESI 2014 and later Jan18-Exh7-NDWA_All_2013 SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - 2014 expenditure data includes C-report adjustments in order to align with C-report values, resulting in a low PMPM value for that year. PMPM trending is based on OMB rate for TANF-U and is unaffected by inclusion of the adjusted data NON-DISABLED WORKING ADULTS MEG - ESI PROJECTIONS Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 273,146 $ 72.50 $ 19,802,018 $ (19,802,018) $ (379,039,071) 20 2015 158,543 $ 277.93 $ 44,063,972 $ (44,063,972) $ (423,103,043) 21 2016 172,683 $ 299.92 $ 51,791,347 $ (51,791,347) $ (474,894,390) 22 2017 (proj) 185,206 $ 311.92 $ 57,769,167 $ (57,769,167) $ (532,663,557) 23 2018 (proj) 198,637 $ 324.40 $ 64,436,954 $ (64,436,954) $ (597,100,511) Jan18-Exh8-NDWA_ESI_2014 SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - Historical expenditures reflect C-Report amounts WORKING DISABLED ADULTS MEG - ESI & IP Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 - $ 12 2007 - $ 13 2008 - 14 2009 110 $ 15 2010 90 16 2011 17 - Cumulative Savings/ (Deficit) $ - 24 $ (24) $ (24) $ 34,024 $ (34,024) $ (34,048) 1,175.11 $ 129,262 $ (129,262) $ (163,310) $ 1,517.03 $ 136,533 $ (136,533) $ (299,843) 114 $ 907.56 $ 103,462 $ (103,462) $ (403,305) 2012 66 $ 1,429.38 $ 94,339 $ (94,339) $ (497,644) 18 2013 42 $ 1,243.31 $ 52,219 $ (52,219) $ (549,863) 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) See Exhibit 10 for ESI 2014 and later Jan18-Exh9-WDA_All_2013 $ - SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - Historical WDA enrollment has been exclusively in the IP MEG; cumulative saving/deficit amounts therefore are depicted in the WDA IP MEG - The OHCA continues to project no enrollment in this MEG for 2016 - 2018 and has requested that it be removed (continuing to show pending CMS approval) WORKING DISABLED ADULTS MEG - ESI PROJECTIONS Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 - $ - $ - $ - $ - 21 2016 - $ - $ - $ - $ - 22 2017 (proj) - $ - $ - $ - $ - 23 2018 (proj) - $ - $ - $ - $ - Jan18-Exh10-WDA_ESI_2014 SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - Historical expenditures reflect C-Report amounts TEFRA CHILDREN MEG Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 931 $ 12 2007 1,813 13 2008 14 Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) $ 5,427 $ (5,427) $ (5,427) 943.85 $ 878,723 $ (878,723) $ (884,150) $ 1,055.94 $ 1,914,413 $ (1,914,413) $ (2,798,563) 2,515 $ 914.81 $ 2,300,738 $ (2,300,738) $ (5,099,301) 2009 3,299 $ 1,393.11 $ 4,595,873 $ (4,595,873) $ (9,695,174) 15 2010 4,018 $ 1,128.02 $ 4,532,385 $ (4,532,385) $ (14,227,559) 16 2011 4,514 $ 1,007.97 $ 4,549,994 $ (4,549,994) $ (18,777,553) 17 2012 4,978 $ 1,209.69 $ 6,021,818 $ (6,021,818) $ (24,799,371) 18 2013 5,326 $ 1,038.85 $ 5,532,926 $ (5,532,926) $ (30,332,297) 19 2014 6,148 $ 1,018.70 $ 6,262,962 $ (6,262,962) $ (36,595,259) 20 2015 6,771 $ 886.04 $ 5,999,400 $ (5,999,400) $ (42,594,659) 21 2016 7,149 $ 716.07 $ 5,119,171 $ (5,119,171) $ (47,713,830) 22 2017 (proj) 7,870 $ 741.85 $ 5,838,016 $ (5,838,016) $ (53,551,846) 23 2018 (proj) 8,663 $ 768.55 $ 6,657,803 $ (6,657,803) $ (60,209,649) Jan18-Exh11-TEFRA SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - Historical expenditures reflect C-Report amounts FULL TIME COLLEGE STUDENT MEG - ESI & IP Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Cumulative Savings/ (Deficit) CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 873 $ 65.14 $ 56,867 $ (56,867) $ (56,867) 15 2010 3,972 $ 150.85 $ 599,168 $ (599,168) $ (656,035) 16 2011 5,493 $ 147.65 $ 811,060 $ (811,060) $ (1,467,095) 17 2012 6,724 $ 162.45 $ 1,092,335 $ (1,092,335) $ (2,559,430) 18 2013 5,630 $ 191.36 $ 1,077,362 $ (1,077,362) $ (3,636,792) 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) See Exhibit 13 for ESI 2014 and later Current Savings/ (Deficit) Aggregate DY Jan18-Exh12-College_All_2013 SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - Historical expenditures reflect C-Report amounts FULL TIME COLLEGE STUDENT MEG - ESI PROJECTIONS Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 3,182 $ 74.14 $ 235,903 $ (235,903) $ (1,853,302) 20 2015 1,217 $ 251.98 $ 306,659 $ (306,659) $ (2,159,961) 21 2016 1,450 $ 239.71 $ 347,579 $ (347,579) $ (2,507,540) 22 2017 (proj) 1,511 $ 249.30 $ 376,656 $ (376,656) $ (2,884,196) 23 2018 (proj) 1,574 $ 259.27 $ 408,165 $ (408,165) $ (3,292,361) Jan18-Exh13-College_ESI_2014 SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - The OHCA projects no enrollment in this MEG for 2016 - 2018 FOSTER PARENT MEG - ESI PROJECTIONS Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Jan18-Exh14-Foster_ESI Savings/ (Deficit) Cumulative Savings/ (Deficit) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - The OHCA projects no enrollment in this MEG for 2016 - 2018 EMPLOYEES OF NON-PROFIT ORGANIZATIONS MEG - ESI PROJECTIONS Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Jan18-Exh15_NonProfit_ESI Savings/ (Deficit) Cumulative Savings/ (Deficit) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG May 2017 - Jan 2018 Notes/Updates: - Member month projections assume enrollment will reach 10,000 members in December 2019 and 50,000 members in December 2020; enrollment will remain at 50,000 in 2021 - PMPM projections set equal to NDWA-ESI MEG SPONSOR'S CHOICE INSURANCE PROJECTIONS Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Jan18-Exh16-SCI Savings/ (Deficit) Cumulative Savings/ (Deficit) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - 2014 expenditure data includes C-report adjustments in order to align with C-report values, resulting in a high PMPM value. PMPM trending is based on OMB rate for TANF-U and is unaffected by inclusion of the adjusted data NON-DISABLED WORKING ADULTS MEG - IP PROJECTIONS Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 12,712 $ 4,478.15 $ 56,926,254 $ (56,926,254) $ (287,463,861) 20 2015 48,088 $ 588.04 $ 28,277,714 $ (28,277,714) $ (315,741,575) 21 2016 50,320 $ 543.92 $ 27,370,205 $ (27,370,205) $ (343,111,780) 22 2017 (proj) 52,620 $ 565.68 $ 29,766,043 $ (29,766,043) $ (372,877,823) 23 2018 (proj) 55,025 $ 588.31 $ 32,371,600 $ (32,371,600) $ (405,249,423) Jan18-Exh17-NDWA_IP_2014 SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG May 2017 - Jan 2018 Notes/Updates: -The OHCA projects no further in enrollment in this MEG for 2016 - 2018 - Historical WDA enrollment has been exclusively in the IP MEG; cumulative saving/deficit amounts therefore are depicted below WORKING DISABLED ADULTS MEG - IP PROJECTIONS Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 4 $ 1,560.75 $ 6,243 $ (6,243) $ (556,106) 20 2015 11 $ 4,187.27 $ 46,060 $ (46,060) $ (602,166) 21 2016 - $ 4,338.01 $ 17,555 $ (17,555) $ (619,721) 22 2017 (proj) - $ 4,494.18 $ - $ - $ (619,721) 23 2018 (proj) - $ 4,655.97 $ - $ - $ (619,721) Jan18-Exh18-WDA_IP_2014 SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - Historical expenditures reflect C-Report amounts - One member month entered for 2014 to prevent refference cell errors FULL TIME COLLEGE STUDENT MEG - IP PROJECTIONS Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 1 $ 293,200.00 $ 293,200 $ (293,200) $ (2,312,593) 20 2015 2,126 $ 180.09 $ 382,877 $ (382,877) $ (2,695,470) 21 2016 2,303 $ 180.93 $ 416,689 $ (416,689) $ (3,112,159) 22 2017 (proj) 2,367 $ 188.17 $ 445,430 $ (445,430) $ (3,557,589) 23 2018 (proj) 2,433 $ 195.70 $ 476,154 $ (476,154) $ (4,033,742) Jan18-Exh19-College_IP_2014 SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - The OHCA projects no enrollment in this MEG for 2016 - 2018 FOSTER PARENT MEG - IP PROJECTIONS Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Jan18-Exh20-Foster_IP Savings/ (Deficit) Cumulative Savings/ (Deficit) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - The OHCA projects no enrollment in this MEG for 2016 - 2018 EMPLOYEES OF NON-PROFIT ORGANIZATIONS MEG - IP PROJECTIONS Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Jan18-Exh21-NonProfit_IP Savings/ (Deficit) Cumulative Savings/ (Deficit) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG July 2016 Notes/Updates: - Historical expenditures reflect C-Report amounts - Member months trended at TANF-U growth rate HAN MEG Current Historical Budget Neutrality Limit Client Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 (6 mos) 149,104 $ 5.00 $ 745,520 $ (745,520) $ (745,520) 16 2011 428,898 $ 5.00 $ 2,144,490 $ (2,144,490) $ (2,890,010) 17 2012 542,657 $ 5.00 $ 2,713,285 $ (2,713,285) $ (5,603,295) 18 2013 1,010,286 $ 5.00 $ 5,051,430 $ (5,051,430) $ (10,654,725) 19 2014 1,396,342 $ 5.00 $ 6,981,710 $ (6,981,710) $ (17,636,435) 20 2015 1,426,788 $ 5.00 $ 7,133,940 $ (7,133,940) $ (24,770,375) 21 2016 1,363,486 $ 5.00 $ 6,817,430 $ (6,817,430) $ (31,587,805) 22 2017 (proj) 1,406,944 $ 5.00 $ 7,034,719 $ (7,034,719) $ (38,622,524) 23 2018 (proj) 1,451,787 $ 5.00 $ 7,258,934 $ (7,258,934) $ (45,881,458) Jan18-Exh22-HAN July 2016 Notes/Updates: - Medical match claiming for all HMP contract expenditures began in January 2013 - 2014 expenditure data includes C-Report adjustments in order to align with C-report data, resulting in a larger than historical value in cell M28 - Expenditures trended at 3 percent rate (corresponds to current contract) - Expenditures distributed across traditional MEGs based on client months (HMP participants are drawn from all four MEGs) - Expenditures are included within aggregate waiver expenditure amounts on traditional MEG worksheets SOONERCARE BUDGET NEUTRALITY HEALTH MANAGEMENT PROGRAM (HMP) EXPENDITURES - DISTRIBUTION BY MEG Current Historical Traditional MEG Client Months TANF-U TANF-R 2013 3,741,817 2,618,683 360,205 290,965 19 2014 4,001,208 2,745,120 365,630 20 2015 4,101,736 2,807,836 21 2016 4,023,592 22 2017 (proj) 23 2018 (proj) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 ABD-U ABD-R HMP Expenditures (Prorated across MEGs based on Client Months) Total Client Months ABD-U ABD-R Total Expenditures TANF-U TANF-R 7,011,670 $ 3,118,501 $ 2,182,460 $ 300,202 $ 242,496 $ 5,843,658 291,806 7,403,764 $ 8,334,149 $ 5,717,833 $ 761,574 $ 607,805 $ 15,421,361 362,810 287,250 7,559,632 $ 3,959,816 $ 2,710,685 $ 350,257 $ 277,311 $ 7,298,068 2,721,130 373,088 278,503 7,396,313 $ 5,621,545 $ 3,801,816 $ 521,258 $ 389,109 $ 10,333,729 4,151,834 2,773,076 381,326 278,571 7,584,807 $ 5,826,259 $ 3,891,450 $ 535,113 $ 390,919 $ 10,643,741 4,284,164 2,826,013 389,745 278,640 7,778,562 $ 6,038,072 $ 3,982,964 $ 549,305 $ 392,713 $ 10,963,053 Jan18-Exh23-HMP July 2016 Notes/Updates: - Member months are for traditional MEGs only (used to calculate budget neutrality limit) SOONERCARE BUDGET NEUTRALITY HISTORICAL AND PROJECTED MEMBER MONTHS AND EXPENDITURES - BY MEG May 2017 - Jan 2018 Notes/Updates - 2018 - projections reflect five-year savings look back and savings phasedown to 25%. Look back calculation is performed by resetting cumulative savings in cell J27 so as to disregard savings prior to that year Current Historical SOONERCARE CHOICE - AGGREGATE (ALL MEGS) Budget Neutrality Limit PMPM Aggregate Member Months Actual/Projected Expenditures PMPM Aggregate Savings/ (Deficit) Cumulative Savings/ (Deficit) Yearly Savings Carryforward DY CY 1 1996 2,337,532 $ 122.41 $ 286,138,649 $ 170.69 $ 398,999,423 $ (112,860,774) $ (112,860,774) N/A 2 1997 2,282,744 $ 130.39 $ 297,656,008 $ 134.54 $ 307,126,525 $ (9,470,517) $ (122,331,291) N/A 3 1998 2,550,505 $ 138.92 $ 354,305,243 $ 106.62 $ 271,927,279 $ 82,377,964 $ (39,953,328) N/A 4 1999 3,201,226 $ 168.75 $ 540,219,561 $ 144.65 $ 463,050,620 $ 77,168,941 $ 37,215,613 N/A 5 2000 3,496,982 $ 197.53 $ 690,771,669 $ 171.75 $ 600,600,099 $ 90,171,570 $ 127,387,183 N/A 6 2001 4,513,310 $ 217.40 $ 981,193,992 $ 129.19 $ 583,054,043 $ 398,139,949 $ 525,527,133 N/A 7 2002 4,823,829 $ 231.19 $ 1,115,204,678 $ 176.23 $ 850,117,611 $ 265,087,067 $ 790,614,200 N/A 8 2003 4,716,758 $ 230.58 $ 1,087,577,307 $ 194.45 $ 917,157,855 $ 170,419,452 $ 961,033,652 N/A 9 2004 4,886,804 $ 245.50 $ 1,199,726,867 $ 181.28 $ 885,888,955 $ 313,837,912 $ 1,274,871,564 N/A 10 2005 5,038,078 $ 261.38 $ 1,316,858,944 $ 222.43 $ 1,120,637,046 $ 196,221,898 $ 1,471,093,461 N/A 11 2006 5,180,782 $ 277.35 $ 1,436,908,230 $ 264.24 $ 1,368,966,665 $ 67,941,565 $ 1,539,035,027 N/A 12 2007 5,451,378 $ 290.31 $ 1,582,588,944 $ 271.96 $ 1,482,534,451 $ 100,054,493 $ 1,639,089,520 N/A 13 2008 5,386,004 $ 308.25 $ 1,660,247,275 $ 300.79 $ 1,620,046,448 $ 40,200,827 $ 1,679,290,347 N/A 14 2009 5,839,782 $ 322.59 $ 1,883,853,423 $ 321.58 $ 1,877,931,749 $ 5,921,674 $ 1,685,212,021 N/A 15 2010 6,367,794 $ 338.40 $ 2,154,888,798 $ 313.40 $ 1,995,690,240 $ 159,198,558 $ 1,844,410,579 N/A 16 2011 6,420,012 $ 357.88 $ 2,297,585,380 $ 329.93 $ 2,118,136,761 $ 179,448,619 $ 2,023,859,198 N/A 17 2012 6,819,943 $ 372.95 $ 2,543,464,833 $ 326.38 $ 2,225,879,926 $ 317,584,907 $ 2,341,444,105 N/A 18 2013 7,011,670 $ 389.11 $ 2,728,288,274 $ 330.47 $ 2,317,146,568 $ 411,141,706 $ 411,141,706 N/A 19 2014 7,403,764 $ 403.10 $ 2,984,482,165 $ 318.02 $ 2,354,558,548 $ 629,923,617 $ 1,041,065,323 N/A 20 2015 7,559,632 $ 418.55 $ 3,164,084,569 $ 311.71 $ 2,356,422,360 $ 807,662,209 $ 1,848,727,532 N/A 21 2016 7,396,313 $ 438.84 $ 3,245,774,200 $ 307.24 $ 2,272,411,725 $ 973,362,475 $ 2,822,090,007 N/A 22 2017 (proj) 7,584,807 $ 455.18 $ 3,452,481,769 $ 314.48 $ 2,385,285,344 $ 1,067,196,425 $ 3,889,286,432 N/A 23 2018 (proj) 7,778,562 $ 472.16 $ 3,672,724,979 $ 328.53 $ 2,555,482,294 $ 1,117,242,684 $ 4,084,889,896 Jan18-Exh24-ALL RB SavLim $ 195,603,464 (DIVIDER TAB - NO DATA) SOONERCARE BUDGET NEUTRALITY DOCUMENTATION OF IOK 2014 ENROLLMENT - ESI and IP July 2016 Notes/Updates: - IOK enrollment trend has been calculated based on annual percent change from January 2015 through December 2016, to take into account the opening of the program to employers 100 - 250 workers in size in 2015. Separate enrollment trends have been calculated for each IO MEG - Cumulative expenditures for years prior to 2014 have been allocated to the ESI and IO MEGs based on share of expenditures in 2013 (last year prior to separate reporting by MEG) May 2017 - Jan 2018 Notes/Updates -Student data unavailabile for April - July 2016; midpoint for March and August used NDWA ESI IP Total College Students ESI IP Total Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 13,167 4,278 17,445 13,403 4,266 17,669 13,386 4,168 17,554 13,434 4,220 17,654 13,428 4,210 17,638 13,198 4,149 17,347 105 177 282 107 179 286 96 185 281 98 189 287 99 186 285 97 167 264 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 13,067 3,991 17,058 12,993 3,883 16,876 13,025 3,814 16,839 13,417 3,742 17,159 14,161 3,702 17,863 13,263 3,564 16,827 15,171 3,745 18,916 15,169 3,820 18,989 14,842 3,872 18,714 12,223 3,908 16,131 13,263 3,854 17,117 13,878 3,994 17,872 98 171 269 92 170 262 92 167 101 178 259 279 113 176 289 101 178 279 128 188 316 133 199 332 123 200 323 113 191 304 113 191 304 ESI IP 13,518 3,920 14,274 3,878 13,364 3,742 15,299 3,933 15,302 4,019 14,965 4,072 12,336 4,099 Per Jan '16 Fas ESI IP 13,518 3,920 14,274 3,878 14,598 3,846 14,965 4,072 12,336 4,099 - - (1,234) (104) Jul-15 Totals Diff ESI IP Per Aug'16 Fas Jul-16 Allocation of Cumulative Expenditures through 2013 Dollars Percent Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 14,403 4,295 18,698 14,513 4,304 18,817 14,459 4,402 18,861 14,728 4,468 15,052 4,523 7.25% 4.57% 19,196 19,575 15,146 4,678 19,824 $ $ $ 44,063,972 28,277,714 72,341,686 60.9% 39.1% 100.0% 113 191 304 113 191 304 103 182 285 115 194 309 121 210 331 120 196 316 114 187 301 4.20% 2.79% $ $ 306,659 382,877 689,536 44.5% 55.5% 100.0% 13,376 4,045 13,991 4,185 14,516 4,486 14,616 4,486 14,574 4,596 14,849 4,678 15,172 4,719 15,260 4,865 13,376 4,045 13,991 4,185 14,516 4,367 14,616 4,486 CY16 Member Months NDWA ESI IP Total College Students ESI IP Total Fast Facts Schedule C Annual MM Trend Diff 172,847 49,863 222,710 172,683 50,320 223,003 (164) 457 293 1,409 2,320 3,729 1,450 2,303 3,753 41 (17) 24 Changed OHCA C Report AH16 from 1369 to 13669 SOONERCARE BUDGET NEUTRALITY C-REPORT DATA FOR CY 2014 through CY 2016 FFY Q 2-14 Jan-Mar 2014 T ANF Urban-Member Months 255,153,405 T ANF Rural-Member Months 159,793,700 ABD Urban-Member Months 90,366,327 ABD Rural-Member Months 71,446,936 IO ESI Non-disabled Working Adults- Member Months 5228 IO ESI College Students-Member Months 100,153,415 - 76,174,341 - - - - - 224,590 1,162 HMP Member Months - HMP Expenditures - 30,665 7,591,254 1,191 1,593,667 82,127 86,911 601,812,476 605,531,393 21,777,685.00 20,031,378.63 237,847,705 159,116,336 146,035 100,036,584 1,811,197 1,052,810 $ 75,454,096 1,158,227 647,827 $ 197,608 (56,102) $ 209,519 (152,834) $ $ 1,677,327 10,836 10,359 $ 103,265 579 651 1,914 1,058 $ 1,719,790 66,865 $ 548,217 547,024,113 $ 625,627,645 $ (2) 385,307,015 294,477,980 19,802,018 56,926,253 6,262,966 235,903 322 86,064 194 4 - 415 - 163 $ 293,200 $ 385,307,013 $ (2) $ 6,243 - 142,696,842 89,343,585 $ 294,477,980 $ (0) $ 19,802,018 $ - $ 56,926,254 $ 1 68,075,005 - 147,946,913 6,262,962 $ (4) $ 235,903 $ (0) $ 293,200 $ (0) $ 6,243 $ 0 77,871 102,046,078 189,684 78,928,228 22,474 $ 6,981,710 $ 6,981,710 $ - 598,687,292 $ 1,503,286 15,421,362 2,354,558,560 104,240,332 49,556 78,041,570 15,421,361 2,354,558,548 (12) $ (942,752) 147,287,342 128,791 99,326,257 74,385,862 41,553 10,597,292 11,150,548 11,122,787 11,193,345 12,712 12,579 11,688 11,109 6,763,237 - 1,317,574 7,524,740 684 1,692 - 7,309,719 1,460 1,705 8 1,686,136 2,367,692 6,677,293 1,035 1,387,485 294 282 333 76,879 75,480 77,656 76,644 541 542 508 535 93,942 96,372 103,685 88,878 3 4 3 1 621 13,337 20,093 12,009 - - - 1,678,515 1,277,967 532,199,289 - 1,863,344 649,437,550 (1,277,967) 1,603,180 (2,440,081) $ 2,087,924 589,424,370 281,855 982,790,995 589,347,308 (265,046) $ 394,842,471 $ 982,790,999 $ 4 295,932,895 $ 589,347,308 $ - 44,063,972 $ 394,842,469 $ (2) $ 28,277,713 $ 5,999,400 $ 295,932,894 $ (1) $ 44,063,972 $ - $ 28,277,714 $ 1 306,659 $ 5,999,400 $ - $ 306,659 $ - 2,126 $ 382,877 $ 382,877 $ - 11 $ 46,060 76,302,442 $ 46,060 $ - PQ Adj. 250,636,282 (4,151,735) 134,576,758 (14,621,434) 90,864,347 (12,331,090) 66,206,401 253,065,209 153,682,123 (5,942,064) 102,327,981 (10,568,103) 73,471,364 246,546,306 (7,514,840) 148,276,527 97,334,448 (5,435,824) 69,830,252 39,417 43,383 44,701 8,872,217 12,689,665 16,235,423 13,994,042 11,437 12,318 12,896 13,669 205 1,483,960 6,304,464 2,023 1,794 (41,508) 1,288,562 7,521,202 545 1,796 (195,164) 1,461,688 6,882,502 (249,297) 1,370,523 388 323 355 74,517 80,905 89,433 102,724 587 570 553 593 107,735 74,280 148,632 85,224 - - 16,767 656 13,008 $ $ 7,133,940 15,076 $ 7,298,068 2,356,422,358 942,748,494 $ 3 563,005,522 $ 563,005,515 $ (7) 384,922,146 $ 384,922,145 $ (1) $ 279,521,866 $ 2 $ 51,791,347 $ - $ 27,370,205 $ - $ 5,119,171 $ $ 347,579 $ - $ 416,689 $ - $ 17,555 $ - $ 6,817,430 $ - $ 10,333,729 $ - 278,503 55,125 $ 279,521,864 172,683 $ 51,791,347 50,320 319 $ 27,370,205 7,149 406 $ 5,119,170 1 1,450 $ 347,579 2,303 800 $ 416,689 - - 132 $ 17,555 - $ 7,133,940 $ - 1,527,540 1,547,370 1,638,720 2,103,800 $ 13,519 $ $ 373,088 360,061 - 942,748,491 2,721,130 1,806 384 18 $ 68,812 45,182 6,658,945 10,131 93,778 1,906,124 Diffe re nce 4,023,592 695,915 68,853 (31,956) Total Cale ndar Yr 2 Pe r Sche dule C PQ Adj. 1,030,715 93,937 69,048 (875,940) PQ Adj. 682,505 93,707 (1,840,025) FFY Q 1-17 O ct-De c 2016 1,010,027 665,888 1,753 1,217 $ (3,676,720) 71,790 6,771 (760,530) 100,256,259 FFY Q 4-16 July-Se pt 2016 987,987 91,666 48,088 580 221,356,820 150,454,771 158,543 $ PQ Adj. 676,822 287,250 (1,063,201) $ FFY Q 3-16 Apr-June 2016 994,863 362,810 - 2,068,833 Diffe re nce 2,807,836 1,725 308 3,262,272 (1,277,996) $ 71,603 (2,484,125) Pe r Sche dule C FFY Q 2-16 Jan-Mar 2016 4,101,736 91,097 38,425 1,867,940 (1) 247,041,204 39,312 $ PQ Adj. 39,253 2,260,578 154,609,360 Total 12 months 2015 690,573 71,442 1,739,820 (263,943) 90,333 71,826 - 232,621,629 FFY Q 1-16 O ct-De c 1,008,778 708,111 90,503 - PQ Adj. 1,034,531 707,838 1,649 $ PQ Adj. 294,503,825 72,379 4 5 210,088,405 FFY Q 4-15 July-Se pt 1,032,864 90,877 - 10,952,618 625,627,647 PQ Adj. 701,314 3,182 - (4) 6,148 849 - $ 12,712 1,649 8,040 943,216,259 273,146 9,558,078 7,453,929 $ 291,806 12,712 20,146 943,216,263 FFY Q 3-15 Apr-June 1,025,563 365,630 39,253 - Diffe re nce 2,745,120 72,379 143,385 Pe r Sche dule C FFY Q 2-15 Jan-Mar 2015 4,001,208 - 103,192 1,659,948 Total Cale ndar Yr 2014 90,877 1,533 835 1,731,585 478,413 - - 70,977,947 10,243,940 - 94,266,493 851 3,431 - 147,164,486 PQ Adj. Q 2-15 701,314 75,263 - - 1,790,515 Total Expe nditure s 1,497,022 684,232 73,090 - - HAN Expenditures 196,655 - 20,031,379 211,246,918 PQ Adj. 1,025,563 91,839 1,515 647 IO IP College Students-Expenditures 758,627 - PQ Adj. 687,950 78,314 1,482,747 - 965,390 72,912 1,451 IO IP College Students-Member Months HAN Client Months - 21,777,685 - IO IP Working Disabled Adults-Expenditures 156,510,031 FFY Q 1-15 O ct-De c 2014 1,006,431 91,570 - IO ESI College Students-Expenditures IO IP Working Disabled Adults-Member Months - 5229 PQ Adj. 668,292 80,316 IO IP Non-disabled Working Adults-Member Months T EFRA-Expenditures 234,454,607 73,425 ABD Rural-Expenditures T EFRA-Member Months - 91,344 ABD Urban-Expenditures FFY Q 4-14 July-Se pt 2014 975,405 687,564 T ANF Rural-Expenditures IO IP Non-disabled Working Adults- Expenditures PQ Adj. 993,809 T ANF Urban-Expenditures IO ESI Non-disabled Working Adults-Expenditures FFY Q 3-14 Apr-June 2014 6,817,430 - $ 7,298,068 2,356,422,360 $ - 2,904,340 559,430,590 1,681,964 532,831,987 4,069,403 591,849,783 1,678,022 588,299,367 $ 10,333,729 2,272,411,727 2,272,411,725 Oklahoma Health Care Authority SOONERCARE §1115(a) Research and Demonstration Waiver Demonstration Project No. 11-W-0048/6 Proposed Expenditures through December 31, 2018 Attachment B, BUDGET NEUTRALITY January 2018 Budget Neutrality This chapter contains updated enrollment and expenditure projections for the SoonerCare program through calendar year 2018. There are 24 exhibits, as delineated below and described in greater detail in this document. The exhibits also have been provided in their original worksheet format, with additional information concerning the OHCA’s methodology. Exhibit Title Page 1 Enrollment Trends by MEG 5 2 PMPM Expenditure Trends by MEG 5 3 Budget Neutrality for TANF-Urban MEG 6 4 Budget Neutrality for TANF-Rural MEG 7 5 Budget Neutrality for ABD-Urban MEG 8 6 Budget Neutrality for ABD-Rural MEG 9 7 Budget Neutrality for NDWA MEG: ESI and IP Combined through 2013 10 8 Budget Neutrality for NDWA MEG: ESI – 2014 to 2018 11 9 Budget Neutrality for WDA MEG: ESI and IP Combined through 2013 12 10 Budget Neutrality for WDA MEG: ESI – 2014 to 2018 13 11 TEFRA Children MEG 14 12 Budget Neutrality for FT College Student MEG: ESI and IP Combined through 2013 15 13 Budget Neutrality for Full-Time College Student MEG: ESI – 2014 to 2018 16 14 Budget Neutrality for Foster Parent MEG: ESI – 2014 to 2018 17 15 Not-for-Profit Employees MEG: ESI 18 16 Sponsor’s Choice Insurance MEG 19 17 NDWA MEG: IP 20 18 WDA MEG: IP – 2014 to 2018 21 19 Full-Time College Students MEG: IP – 2014 to 2018 22 20 Budget Neutrality for Foster Parent MEG: IP 23 21 Not-for-Profit Employees MEG: IP 24 22 Health Access Network Expenditures 25 23 Health Management Program Expenditures 26 24 Aggregate Budget Neutrality (All MEGs) 27 The exhibits incorporate full-year enrollment and expenditure data through calendar year 2016 (demonstration year 21). Expenditures reflect C-Report amounts. SoonerCare Budget Neutrality through CY 2018 – January 2018 1 Projections for the remainder of the current extension period are based on Medicaid Eligibility Group (MEG) specific assumptions, as described in detail throughout the chapter. Updates to worksheets previously submitted are described in text boxes included at the top of each worksheet (where applicable). Traditional MEG projections for 2018 incorporate the CMS-mandated rebasing methodology, with 1) the budget neutrality PMPM set equal to the 2016 actual PMPM, trended to 2018 and 2) savings limited to a five-year look back period. Annual aggregate savings/(deficit) projections for 2018 are capped at 25 percent of actual prior to being added to cumulative savings/(deficit) projections. The budget neutrality analysis was performed using the file reviewed and updated by CMS in December 2017. The updates addressed waiver trend factors and calculation of retained waiver savings in 2018. The trend factors inputted by OHCA for the four traditional MEGs described below also were adopted by the OHCA within the file for other MEG forecasts. Budget Neutrality Data for Individual MEGs The SoonerCare program includes four traditional MEGs that in combination provide the “without waiver” expenditure estimates for calculation of the budget neutrality cap. They are: • • • • TANF – Urban TANF – Rural ABD – Urban ABD – Rural The “with waiver” expenditure estimates also include the following demonstration populations 1: • • • • • • • • • • • • • • 1 Non-Disabled Working Adults (NDWA) – Employer Sponsored Insurance (ESI) Working Disabled Adults (WDA) – ESI TEFRA Children Full-Time College Students – ESI Foster Parents – ESI Not-for-Profit Employees – ESI Sponsor’s Choice Insurance (SCI) Non-Disabled Working Adults – Individual Plan (IP) Working Disabled Adults – IP Full-Time College Students – IP Foster Parents – IP Not-for-Profit Employees – IP Demonstration Expenses 1 – Health Access Network (HAN) Expenditures Demonstration Expenses 2 – Health Management Program (HMP) Expenditures One additional population, CHIP Medicaid Expansion, is reported separately. SoonerCare Budget Neutrality through CY 2018 – January 2018 2 Traditional MEGs Budget neutrality exhibits for the four traditional MEGs are presented starting on page 6. Each exhibit includes enrollment, expenditure and budget neutrality data. Expenditures consist of both paid claims and non-claim medical expenses. The exhibits include complete historical enrollment and expenditure data for calendar year 2004 through 2016. (MEG-specific data was not produced prior to 2004.) Member months for the remainder of the current extension period are based on the 2010 – 2016 historical member month growth trend for each MEG, as shown in exhibit 1 on the second following page. Calendar year per member per month (PMPM) expenditures are trended forward using OMB trend factors of 4.40 percent for the TANF MEGs and 4.20 percent for the ABD MEGs, as shown in exhibit 2 on the second following page. “Demonstration Expenses 2 – HMP” expenditures are included within the four traditional MEGs. Expenditures are prorated based on each MEG’s percentage of total enrollment. Traditional MEG projections for 2018 incorporate the CMS-mandated rebasing methodology, with 1) the budget neutrality PMPM set equal to the 2016 actual PMPM, trended to 2018 and 2) savings limited to a five-year look back period. TANF-U MEG projection for 2017 includes a downward adjustment of $31 million for nonrecognized Workforce Development Program expenditures; the projection for 2018 does not include any Workforce Development Program expenditures. The 2018 projection does include $105 million for the proposed University Access to Care Pool (shown within the TANF-U MEG). Budget neutrality data for the traditional MEGs is presented in exhibits 3 – 6. SoonerCare Budget Neutrality through CY 2018 – January 2018 3 Demonstration MEGs Budget neutrality data for the additional demonstration populations and for HAN and HMP expenditures is presented in exhibits 7 – 23. Member month and expenditure data for all MEGs has been prepared using the same methodology as for the traditional MEGs, with the following exceptions: • “Demonstration Expenses 1 – HAN Expenditures” and “Demonstration Expenses 2 – HMP Expenditures” relate to allowable expenditures for populations enrolled in the traditional MEGs. Treatment of these expenditures is described in more detail within their respective worksheets. • The OHCA began to report separately ESI and IP expenditures for the NDWA, WDA and Full Time College Student populations in 2014. The budget neutrality tables for these populations present aggregated data through 2013, followed by separate historical and projected data for 2014 – 2018. • The ESI component of Insure OK was opened to employers between 100 and 250 workers in size in 2015, which has resulted in enrollment growth in the program after an extended period of decline. Enrollment counts for 2016 – 2018 are based on the trend from 2014 – 2016, rather than the longer look back used for other MEGs. • Enrollment in the WDA MEG has declined to zero member months and is expected to remain at zero through 2018. • Enrollment in the Foster Parents and Not-for-Profit Employees MEGs has not begun and is not expected to occur during the extension period. ESI and IP tables are included for these MEGs but with zero enrollment or expenditures. Aggregate Budget Neutrality Data Exhibit 24 on the last page provides updated aggregate budget neutrality projections through calendar year 2018. As the exhibit illustrates, the SoonerCare demonstration is projected to continue to show cumulative savings throughout the renewal period. SoonerCare Budget Neutrality through CY 2018 – January 2018 4 Exhibit 1 – Enrollment Trends by MEG MEG 2010 2011 2013 2012 2014 2015 2016 Annual Trend Trending Years TANF - Urban 3,333,170 3,357,000 3,620,263 3,741,817 4,001,208 4,101,736 4,023,592 3.19% 2010 - 2016 TANF - Rural 2,429,264 2,433,324 2,565,123 2,618,683 2,745,120 2,807,836 2,721,130 1.91% 2010 - 2016 ABD - Urban 327,267 344,575 348,935 360,205 365,630 362,810 373,088 2.21% 2010 - 2016 ABD - Rural 278,093 285,113 285,622 290,965 291,806 287,250 278,503 0.02% 2010 - 2016 NDWA - ESI 7.25% See IOK_ESI-IP Tab NDWA - IP 4.57% See IOK_ESI-IP Tab WDA TEFRA 90 114 66 42 4,018 4,514 4,978 5,326 6,148 6,771 7,149 -100.00% 2010 - 2016 10.08% 2010 - 2016 College - ESI 4.20% See IOK_ESI-IP Tab College - IP 2.79% See IOK_ESI-IP Tab Exhibit 2 – PMPM Expenditure Trends by MEG Year 2017 2018 TANF – Urban 4.00% 4.00% TANF – Rural 4.00% 4.00% ABD – Urban 3.60% 3.60% SoonerCare Budget Neutrality through CY 2018 – January 2018 ABD – Rural 3.60% 3.60% 5 Exhibit 3 – Budget Neutrality for TANF-Urban MEG Actual/Projected Expenditures Budget Neutrality Limit Member Months PMPM Aggregate DY CY 1 1996 1,248,591 $ 121.60 $ 151,828,666 2 1997 1,201,538 $ 129.52 $ 155,618,588 3 1998 1,299,675 $ 137.95 $ 179,287,128 4 1999 1,489,962 $ 146.93 $ 218,917,218 5 2000 1,575,250 $ 156.49 $ 246,515,710 1,988,010 $ 166.68 $ 331,363,038 2,159,002 $ 177.53 $ 383,291,270 8 2003 2,319,441 $ 189.09 $ 438,580,782 Cumulative Savings/ (Deficit) See Exhibit 24 (Aggregate) 2004 2,426,341 $ 201.40 $ 488,661,911 $ 136.70 $ 331,669,473 $ 156,992,438 $ 156,992,438 2005 2,528,654 $ 214.51 $ 542,420,938 $ 188.11 $ 475,653,511 $ 66,767,427 $ 223,759,865 11 2006 2,643,157 $ 228.47 $ 603,893,538 $ 213.25 $ 563,645,766 $ 40,247,772 $ 264,007,637 12 2007 2,808,278 $ 240.19 $ 674,520,293 $ 217.74 $ 611,465,158 $ 63,055,135 $ 327,062,772 13 2008 2,772,622 $ 252.51 $ 700,119,625 $ 237.40 $ 658,219,711 $ 41,899,914 $ 368,962,686 14 2009 3,029,870 $ 265.47 $ 804,339,589 $ 249.71 $ 756,593,334 $ 47,746,255 $ 416,708,941 15 2010 3,333,170 $ 279.09 $ 930,249,786 $ 234.68 $ 782,242,482 $ 148,007,304 $ 564,716,244 16 2011 3,357,000 $ 293.41 $ 984,968,363 $ 252.31 $ 847,000,007 $ 137,968,356 $ 702,684,600 17 2012 3,620,263 $ 308.46 $ 1,116,703,111 $ 251.66 $ 911,062,393 $ 205,640,718 $ 908,325,319 18 2013 3,741,817 $ 322.03 $ 1,204,977,329 $ 255.01 $ 954,184,381 $ 250,792,948 $ 1,159,118,266 19 2014 4,001,208 $ 336.20 $ 1,345,206,130 $ 237.82 $ 951,550,408 $ 393,655,722 $ 1,552,773,988 20 2015 4,101,736 $ 350.99 $ 1,439,668,319 $ 240.57 $ 986,750,815 $ 452,917,504 $ 2,005,691,492 21 2016 4,023,592 $ 366.44 $ 1,474,405,052 $ 235.70 $ 948,370,039 $ 526,035,013 $ 2,531,726,505 22 2017 (proj) 4,151,834 $ 381.10 $ 1,582,254,095 $ 237.32 $ 985,294,448 $ 596,959,648 $ 3,128,686,153 23 2018 (proj) 4,284,164 $ 396.34 $ 1,697,992,025 $ 250.88 $ 1,074,791,909 $ 623,200,116 $ 3,751,886,269 Historical 9 10 Current 2001 2002 Savings/ (Deficit) Aggregate RB 6 7 PMPM SoonerCare Budget Neutrality through CY 2018 – January 2018 6 Exhibit 4 – Budget Neutrality for TANF-Rural MEG Actual/Projected Expenditures Member Months PMPM Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 1,088,941 $ 123.34 $ 134,309,983 2 1997 1,081,206 $ 131.37 $ 142,037,420 3 1998 1,250,830 $ 139.92 $ 175,018,115 4 1999 1,510,946 $ 149.03 $ 225,177,007 5 2000 1,522,229 $ 158.73 $ 241,627,007 6 2001 1,915,864 $ 169.07 $ 323,907,157 7 2002 2,014,674 $ 180.07 $ 362,786,430 8 2003 1,941,227 $ 191.79 $ 372,317,080 9 2004 1,984,722 $ 204.28 $ 405,440,105 $ 149.19 $ 296,093,830 $ 109,346,275 $ 109,346,275 10 2005 2,015,932 $ 217.58 $ 438,624,903 $ 159.74 $ 322,029,702 $ 116,595,201 $ 225,941,475 See Exhibit 24 (Aggregate) 2006 2,036,491 $ 231.74 $ 471,943,801 $ 190.64 $ 388,233,610 $ 83,710,191 $ 309,651,667 12 2007 2,130,548 $ 243.63 $ 519,065,409 $ 195.93 $ 417,441,223 $ 101,624,186 $ 411,275,853 13 2008 2,078,460 $ 256.13 $ 532,352,258 $ 208.78 $ 433,930,540 $ 98,421,718 $ 509,697,571 14 2009 2,246,021 $ 269.27 $ 604,780,677 $ 220.17 $ 494,500,235 $ 110,280,442 $ 619,978,012 15 2010 2,429,264 $ 283.08 $ 687,678,542 $ 213.70 $ 519,126,643 $ 168,551,899 $ 788,529,911 16 2011 2,433,324 $ 297.60 $ 724,164,719 $ 224.38 $ 545,999,493 $ 178,165,226 $ 966,695,137 17 2012 2,565,123 $ 312.87 $ 802,550,338 $ 230.22 $ 590,533,873 $ 212,016,465 $ 1,178,711,602 18 2013 2,618,683 $ 326.64 $ 855,366,615 $ 230.12 $ 602,610,415 $ 252,756,200 $ 1,431,467,803 19 2014 2,745,120 $ 341.01 $ 936,113,371 $ 229.99 $ 631,345,478 $ 304,767,893 $ 1,736,235,696 20 2015 2,807,836 $ 356.01 $ 999,617,694 $ 210.86 $ 592,057,993 $ 407,559,702 $ 2,143,795,398 Current 11 21 2016 2,721,130 $ 371.67 $ 1,011,362,387 $ 208.30 $ 566,807,331 $ 444,555,056 $ 2,588,350,454 22 2017 (proj) 2,773,076 $ 386.54 $ 1,071,895,794 $ 216.58 $ 600,594,720 $ 471,301,074 $ 3,059,651,528 RB Historical Budget Neutrality Limit 23 2018 (proj) 2,826,013 $ 402.00 $ 1,136,052,326 $ 225.19 $ 636,400,911 $ 499,651,415 $ 3,559,302,943 SoonerCare Budget Neutrality through CY 2018 – January 2018 7 Exhibit 5 – Budget Neutrality for ABD-Urban MEG DY CY 1 1996 2 1997 3 1998 4 1999 Member Months 96,785 PMPM $ 536.14 Actual/Projected Expenditures Aggregate $ PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) 51,889,826 5 2000 190,315 $ 567.55 $ 108,013,756 6 2001 279,689 $ 600.81 $ 168,040,252 7 2002 306,526 $ 636.02 $ 194,956,243 See Exhibit 24 (Aggregate) 2003 233,742 $ 673.29 $ 157,375,990 9 2004 244,590 $ 712.74 $ 174,330,070 $ 489.16 $ 119,644,174 $ 54,685,896 $ 54,685,896 10 2005 255,066 $ 754.51 $ 192,450,068 $ 668.41 $ 170,487,472 $ 21,962,596 $ 76,648,492 11 2006 259,473 $ 798.73 $ 207,247,624 $ 858.00 $ 222,627,081 $ (15,379,457) $ 61,269,036 12 2007 268,332 $ 840.26 $ 225,468,646 $ 894.55 $ 240,036,203 $ (14,567,557) $ 46,701,479 13 2008 283,834 $ 883.96 $ 250,898,901 $ 962.43 $ 273,171,226 $ (22,272,325) $ 24,429,154 14 2009 301,034 $ 929.92 $ 279,937,423 $ 1,003.30 $ 302,026,587 $ (22,089,164) $ 15 2010 327,267 $ 978.28 $ 320,157,269 $ 960.84 $ 314,450,856 $ 5,706,413 $ 8,046,403 16 2011 344,575 $ 1,029.15 $ 354,617,902 $ 931.12 $ 320,839,827 $ 33,778,075 $ 41,824,478 17 2012 348,935 $ 1,082.66 $ 377,778,436 $ 932.40 $ 325,345,676 $ 52,432,760 $ 94,257,239 18 2013 360,205 $ 1,128.13 $ 406,358,067 $ 974.58 $ 351,048,325 $ 55,309,742 $ 149,566,981 19 2014 365,630 $ 1,175.51 $ 429,801,721 $ 1,055.90 $ 386,068,587 $ 43,733,135 $ 193,300,115 20 2015 362,810 $ 1,224.89 $ 444,402,341 $ 1,089.26 $ 395,192,726 $ 49,209,615 $ 242,509,730 Current 8 21 2016 373,088 $ 1,276.34 $ 476,187,138 $ 1,033.12 $ 385,443,403 $ 90,743,735 $ 333,253,465 22 2017 (proj) 381,326 $ 1,322.29 $ 504,222,545 $ 1,070.26 $ 408,119,460 $ 96,103,085 $ 429,356,550 RB Historical Budget Neutrality Limit 23 2018 (proj) 389,745 $ 1,369.89 $ 533,908,531 $ 1,108.75 $ 432,130,085 $ 101,778,445 $ 531,134,995 SoonerCare Budget Neutrality through CY 2018 – January 2018 2,339,990 8 Exhibit 6 – Budget Neutrality for ABD-Rural MEG Budget Neutrality Limit PMPM PMPM Savings/ (Deficit) Aggregate 1 1996 2 1997 3 1998 4 1999 103,533 $ 427.26 $ 44,235,510 5 2000 209,188 $ 452.30 $ 94,615,196 6 2001 329,747 $ 478.80 $ 157,883,545 7 2002 343,627 $ 506.86 $ 174,170,735 8 2003 222,348 $ 536.56 $ 119,303,455 9 2004 231,151 $ 568.00 $ 131,294,780 $ 599.10 $ 138,481,478 $ 10 2005 238,426 $ 601.29 $ 143,363,035 $ 639.45 $ 152,460,934 11 2006 241,661 $ 636.52 $ 153,823,267 $ 793.03 $ 191,644,246 12 2007 244,220 $ 669.62 $ 163,534,596 $ 834.57 $ 13 2008 251,088 $ 704.44 $ 176,876,491 $ 871.89 14 2009 262,857 $ 741.07 $ 194,795,734 $ 15 2010 278,093 $ 779.61 $ 216,803,202 $ 16 2011 285,113 $ 820.15 $ 233,834,396 17 2012 285,622 $ 862.79 $ 18 2013 290,965 $ 899.03 $ 19 2014 291,806 $ 936.79 20 2015 287,250 $ 21 2016 278,503 22 2017 (proj) 23 2018 (proj) Historical CY Current Aggregate DY RB Member Months Actual/Projected Expenditures Cumulative Savings/ (Deficit) See Exhibit 24 (Aggregate) (7,186,698) $ (7,186,698) $ (9,097,899) $ (16,284,596) $ (37,820,979) $ (54,105,575) 203,819,587 $ (40,284,991) $ (94,390,566) $ 218,920,196 $ (42,043,705) $ (136,434,272) 930.09 $ 244,480,172 $ (49,684,438) $ (186,118,709) 943.82 $ 262,470,486 $ (45,667,284) $ (231,785,993) $ 958.77 $ 273,358,100 $ (39,523,704) $ (271,309,697) 246,432,947 $ 938.53 $ 268,063,880 $ (21,630,933) $ (292,940,630) 261,586,264 $ 970.21 $ 282,298,187 $ (20,711,923) $ (313,652,553) $ 273,360,943 $ 1,011.24 $ 295,085,785 $ (21,724,842) $ (335,377,395) 976.14 $ 280,396,215 $ 1,031.19 $ 296,210,205 $ (15,813,990) $ (351,191,386) $ 1,019.09 $ 283,819,622 $ 1,005.06 $ 279,910,975 $ 3,908,647 $ (347,282,739) 278,571 $ 1,055.78 $ 294,109,335 $ 1,041.19 $ 290,046,685 $ 4,062,650 $ (343,220,088) 278,640 $ 1,093.79 $ 304,772,096 $ 1,078.63 $ 300,549,779 $ 4,222,317 $ (338,997,771) SoonerCare Budget Neutrality through CY 2018 – January 2018 9 Exhibit 7 – Budget Neutrality for NDWA MEG: ESI and IP Combined through 2013 Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 13 14 Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate 9,744 $ 198.81 $ 2007 38,417 $ 204.54 2008 139,822 $ 239.38 2009 172,594 $ 437.73 Cumulative Savings/ (Deficit) 1,937,239 $ (1,937,239) $ $ 7,857,843 $ (7,857,843) $ (9,795,082) $ 33,470,013 $ (33,470,013) $ (43,265,095) $ 75,549,419 $ (75,549,419) $ (118,814,514) (1,937,239) 15 2010 392,065 $ 284.10 $ 111,386,167 $ (111,386,167) $ (230,200,681) 16 2011 392,772 $ 314.00 $ 123,330,328 $ (123,330,328) $ (353,531,009) 17 2012 391,031 $ 309.32 $ 120,952,327 $ (120,952,327) $ (474,483,336) 18 2013 388,005 $ 297.14 $ 115,291,324 $ (115,291,324) $ (589,774,660) 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) SoonerCare Budget Neutrality through CY 2018 – January 2018 See Exhibit 8 for ESI 2014 and later See Exhibit 17 for IP 2014 and later 10 Exhibit 8 – Budget Neutrality for NDWA MEG: ESI – 2014 to 2018 Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) 16 2011 17 2012 18 2013 19 2014 273,146 $ 72.50 $ 19,802,018 $ (19,802,018) $ (379,039,071) 20 2015 158,543 $ 277.93 $ 44,063,972 $ (44,063,972) $ (423,103,043) 21 2016 172,683 $ 299.92 $ 51,791,347 $ (51,791,347) $ (474,894,390) 22 2017 (proj) 185,206 $ 311.92 $ 57,769,167 $ (57,769,167) $ (532,663,557) 23 2018 (proj) 198,637 $ 324.40 $ 64,436,954 $ (64,436,954) $ (597,100,511) SoonerCare Budget Neutrality through CY 2018 – January 2018 11 Exhibit 9 – Budget Neutrality for WDA MEG: ESI and IP Combined through 2013 Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate 9 2004 10 2005 11 2006 - $ - $ Cumulative Savings/ (Deficit) - $ - 12 2007 - $ 24 $ (24) $ (24) 13 2008 - $ 34,024 $ (34,024) $ (34,048) 14 2009 110 $ 1,175.11 $ 129,262 $ (129,262) $ (163,310) 15 2010 90 $ 1,517.03 $ 136,533 $ (136,533) $ (299,843) 16 2011 114 $ 907.56 $ 103,462 $ (103,462) $ (403,305) 17 2012 66 $ 1,429.38 $ 94,339 $ (94,339) $ (497,644) 18 2013 42 $ 1,243.31 $ 52,219 $ (52,219) $ (549,863) 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) SoonerCare Budget Neutrality through CY 2018 – January 2018 See Exhibit 10 for ESI 2014 and later See Exhibit 18 for IP 2014 and later 12 Exhibit 10 – Budget Neutrality for WDA MEG: ESI – 2014 to 2018 2 Current Historical Budget Neutrality Limit 2 DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Cumulative Savings/ (Deficit) Savings/ (Deficit) Aggregate 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 - $ - $ - $ - $ - 21 2016 - $ - $ - $ - $ - 22 2017 (proj) - $ - $ - $ - $ - 23 2018 (proj) - $ - $ - $ - $ - All WDA enrollment has occurred within the IP component of the program. SoonerCare Budget Neutrality through CY 2018 – January 2018 13 Exhibit 11 – TEFRA Children MEG Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) 10 2005 $ 5,427 $ (5,427) $ (5,427) 11 2006 931 $ 943.85 $ 878,723 $ (878,723) $ (884,150) 12 2007 1,813 $ 1,055.94 $ 1,914,413 $ (1,914,413) $ (2,798,563) 13 2008 2,515 $ 914.81 $ 2,300,738 $ (2,300,738) $ (5,099,301) 14 2009 3,299 $ 1,393.11 $ 4,595,873 $ (4,595,873) $ (9,695,174) 15 2010 4,018 $ 1,128.02 $ 4,532,385 $ (4,532,385) $ (14,227,559) 16 2011 4,514 $ 1,007.97 $ 4,549,994 $ (4,549,994) $ (18,777,553) 17 2012 4,978 $ 1,209.69 $ 6,021,818 $ (6,021,818) $ (24,799,371) 18 2013 5,326 $ 1,038.85 $ 5,532,926 $ (5,532,926) $ (30,332,297) 19 2014 6,148 $ 1,018.70 $ 6,262,962 $ (6,262,962) $ (36,595,259) 20 2015 6,771 $ 886.04 $ 5,999,400 $ (5,999,400) $ (42,594,659) 21 2016 7,149 $ 716.07 $ 5,119,171 $ (5,119,171) $ (47,713,830) 22 2017 (proj) 7,870 $ 741.85 $ 5,838,016 $ (5,838,016) $ (53,551,846) 23 2018 (proj) 8,663 $ 768.55 $ 6,657,803 $ (6,657,803) $ (60,209,649) SoonerCare Budget Neutrality through CY 2018 – January 2018 14 Exhibit 12 – Budget Neutrality for Full-Time College Student MEG: ESI and IP Combined through 2013 Current Historical Budget Neutrality Limit Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 873 $ 65.14 $ 56,867 $ (56,867) $ (56,867) 15 2010 3,972 $ 150.85 $ 599,168 $ (599,168) $ (656,035) 16 2011 5,493 $ 147.65 $ 811,060 $ (811,060) $ (1,467,095) 17 2012 6,724 $ 162.45 $ 1,092,335 $ (1,092,335) $ (2,559,430) 18 2013 5,630 $ 191.36 $ 1,077,362 $ (1,077,362) $ (3,636,792) 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) SoonerCare Budget Neutrality through CY 2018 – January 2018 See Exhibit 13 for ESI 2014 and later See Exhibit 19 for IP 2014 and later 15 Exhibit 13– Budget Neutrality for Full-Time College Student MEG: ESI – 2014 to 2018 Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) 17 2012 18 2013 19 2014 3,182 $ 74.14 $ 235,903 $ (235,903) $ (1,853,302) 20 2015 1,217 $ 251.98 $ 306,659 $ (306,659) $ (2,159,961) 21 2016 1,450 $ 239.71 $ 347,579 $ (347,579) $ (2,507,540) 22 2017 (proj) 1,511 $ 249.30 $ 376,656 $ (376,656) $ (2,884,196) 23 2018 (proj) 1,574 $ 259.27 $ 408,165 $ (408,165) $ (3,292,361) SoonerCare Budget Neutrality through CY 2018 – January 2018 16 Exhibit 14– Budget Neutrality for Foster Parent MEG: ESI 3 Current Historical Budget Neutrality Limit 3 DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Savings/ (Deficit) Cumulative Savings/ (Deficit) The OHCA is not projecting any enrollment for this MEG during the renewal period. SoonerCare Budget Neutrality through CY 2018 – January 2018 17 Exhibit 15– Not-for-Profit Employees MEG: ESI 4 Current Historical Budget Neutrality Limit 4 DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Savings/ (Deficit) Cumulative Savings/ (Deficit) The OHCA is not projecting any enrollment for this MEG during the renewal period. SoonerCare Budget Neutrality through CY 2018 – January 2018 18 Exhibit 16 – Sponsor’s Choice Insurance (SCI) MEG – 2017 to 2018 5 Current Historical Budget Neutrality Limit 5 DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Savings/ (Deficit) Cumulative Savings/ (Deficit) The OHCA is not projecting any enrollment for this MEG during the renewal period. SoonerCare Budget Neutrality through CY 2018 – January 2018 19 Exhibit 17 – NDWA MEG: IP – 2014 to 2018 Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) 16 2011 17 2012 18 2013 19 2014 12,712 $ 4,478.15 $ 56,926,254 $ (56,926,254) $ (287,463,861) 20 2015 48,088 $ 588.04 $ 28,277,714 $ (28,277,714) $ (315,741,575) 21 2016 50,320 $ 543.92 $ 27,370,205 $ (27,370,205) $ (343,111,780) 22 2017 (proj) 52,620 $ 565.68 $ 29,766,043 $ (29,766,043) $ (372,877,823) 23 2018 (proj) 55,025 $ 588.31 $ 32,371,600 $ (32,371,600) $ (405,249,423) SoonerCare Budget Neutrality through CY 2018 – January 2018 20 Exhibit 18 – WDA MEG: IP – 2014 to 2018 6 Current Historical Budget Neutrality Limit 6 DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) 16 2011 17 2012 18 2013 19 2014 4 $ 1,560.75 $ 6,243 $ (6,243) $ (556,106) 20 2015 11 $ 4,187.27 $ 46,060 $ (46,060) $ (602,166) 21 2016 - $ 4,338.01 $ 17,555 $ (17,555) $ (619,721) 22 2017 (proj) - $ 4,494.18 $ - $ - $ (619,721) 23 2018 (proj) - $ 4,655.97 $ - $ - $ (619,721) The OHCA is not projecting any enrollment for this MEG during the renewal period. SoonerCare Budget Neutrality through CY 2018 – January 2018 21 Exhibit 19 – Full-Time College Students MEG: IP – 2014 to 2018 Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 Member Months PMPM Actual/Projected Expenditures PMPM Aggregate Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) 16 2011 17 2012 18 2013 19 2014 1 $ 293,200.00 $ 293,200 $ (293,200) $ (2,312,593) 20 2015 2,126 $ 180.09 $ 382,877 $ (382,877) $ (2,695,470) 21 2016 2,303 $ 180.93 $ 416,689 $ (416,689) $ (3,112,159) 22 2017 (proj) 2,367 $ 188.17 $ 445,430 $ (445,430) $ (3,557,589) 23 2018 (proj) 2,433 $ 195.70 $ 476,154 $ (476,154) $ (4,033,742) SoonerCare Budget Neutrality through CY 2018 – January 2018 22 Exhibit 20 – Budget Neutrality for Foster Parent MEG: IP 7 Current Historical Budget Neutrality Limit 7 DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Actual/Projected Expenditures Aggregate PMPM Aggregate Savings/ (Deficit) Cumulative Savings/ (Deficit) The OHCA is not projecting any enrollment for this MEG during the renewal period. SoonerCare Budget Neutrality through CY 2018 – January 2018 23 Exhibit 21 – Not-for-Profit Employees MEG: IP 8 Current Historical Budget Neutrality Limit 8 DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 16 2011 17 2012 18 2013 19 2014 20 2015 21 2016 22 2017 (proj) 23 2018 (proj) Member Months PMPM Aggregate Actual/Projected Expenditures PMPM Aggregate Savings/ (Deficit) Cumulative Savings/ (Deficit) The OHCA is not projecting any enrollment for this MEG during the renewal period. SoonerCare Budget Neutrality through CY 2018 – January 2018 24 Exhibit 22 – Health Access Network Expenditures Current Historical Budget Neutrality Limit DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 Client Months PMPM Actual/Projected Expenditures Aggregate PMPM Savings/ (Deficit) Aggregate Cumulative Savings/ (Deficit) 15 2010 (6 mos) 149,104 $ 5.00 $ 745,520 $ (745,520) $ (745,520) 16 2011 428,898 $ 5.00 $ 2,144,490 $ (2,144,490) $ (2,890,010) 17 2012 542,657 $ 5.00 $ 2,713,285 $ (2,713,285) $ (5,603,295) 18 2013 1,010,286 $ 5.00 $ 5,051,430 $ (5,051,430) $ (10,654,725) 19 2014 1,396,342 $ 5.00 $ 6,981,710 $ (6,981,710) $ (17,636,435) 20 2015 1,426,788 $ 5.00 $ 7,133,940 $ (7,133,940) $ (24,770,375) 21 2016 1,363,486 $ 5.00 $ 6,817,430 $ (6,817,430) $ (31,587,805) 22 2017 (proj) 1,406,944 $ 5.00 $ 7,034,719 $ (7,034,719) $ (38,622,524) 23 2018 (proj) 1,451,787 $ 5.00 $ 7,258,934 $ (7,258,934) $ (45,881,458) SoonerCare Budget Neutrality through CY 2018 – January 2018 25 Exhibit 23 – Health Management Program Expenditures 9 Current Historical Traditional MEG Client Months 9 DY CY 1 1996 2 1997 3 1998 4 1999 5 2000 6 2001 7 2002 8 2003 9 2004 10 2005 11 2006 12 2007 13 2008 14 2009 15 2010 TANF-U TANF-R ABD-U ABD-R HMP Expenditures (Prorated across MEGs based on Client Months) Total Client Months TANF-U TANF-R ABD-U Total Expenditures ABD-R 16 2011 17 2012 18 2013 3,741,817 2,618,683 360,205 290,965 7,011,670 $ 3,118,501 $ 2,182,460 $ 300,202 $ 242,496 $ 5,843,658 19 2014 4,001,208 2,745,120 365,630 291,806 7,403,764 $ 8,334,149 $ 5,717,833 $ 761,574 $ 607,805 $ 15,421,361 20 2015 4,101,736 2,807,836 362,810 287,250 7,559,632 $ 3,959,816 $ 2,710,685 $ 350,257 $ 277,311 $ 7,298,068 21 2016 4,023,592 2,721,130 373,088 278,503 7,396,313 $ 5,621,545 $ 3,801,816 $ 521,258 $ 389,109 $ 10,333,729 22 2017 (proj) 4,151,834 2,773,076 381,326 278,571 7,584,807 $ 5,826,259 $ 3,891,450 $ 535,113 $ 390,919 $ 10,643,741 23 2018 (proj) 4,284,164 2,826,013 389,745 278,640 7,778,562 $ 6,038,072 $ 3,982,964 $ 549,305 $ 392,713 $ 10,963,053 Presented for informational purposes only. Expenditures are included within the four traditional MEG exhibits. SoonerCare Budget Neutrality through CY 2018 – January 2018 26 Current Historical Exhibit 24 – Aggregate Budget Neutrality (All MEGs) Budget Neutrality Limit PMPM Aggregate Member Months Actual/Projected Expenditures PMPM Aggregate Savings/ (Deficit) Cumulative Savings/ (Deficit) Yearly Savings Carryforward DY CY 1 1996 2,337,532 $ 122.41 $ 286,138,649 $ 170.69 $ 398,999,423 $ (112,860,774) $ (112,860,774) N/A 2 1997 2,282,744 $ 130.39 $ 297,656,008 $ 134.54 $ 307,126,525 $ (9,470,517) $ (122,331,291) N/A 3 1998 2,550,505 $ 138.92 $ 354,305,243 $ 106.62 $ 271,927,279 $ 82,377,964 $ 4 1999 3,201,226 $ 168.75 $ 540,219,561 $ 144.65 $ 463,050,620 $ 77,168,941 $ 37,215,613 N/A 5 2000 3,496,982 $ 197.53 $ 690,771,669 $ 171.75 $ 600,600,099 $ 90,171,570 $ 127,387,183 N/A 6 2001 4,513,310 $ 217.40 $ 981,193,992 $ 129.19 $ 583,054,043 $ 398,139,949 $ 525,527,133 N/A 7 2002 4,823,829 $ 231.19 $ 1,115,204,678 $ 176.23 $ 850,117,611 $ 265,087,067 $ 790,614,200 N/A 8 2003 4,716,758 $ 230.58 $ 1,087,577,307 $ 194.45 $ 917,157,855 $ 170,419,452 $ 961,033,652 N/A 9 2004 4,886,804 $ 245.50 $ 1,199,726,867 $ 181.28 $ 885,888,955 $ 313,837,912 $ 1,274,871,564 N/A 10 2005 5,038,078 $ 261.38 $ 1,316,858,944 $ 222.43 $ 1,120,637,046 $ 196,221,898 $ 1,471,093,461 N/A (39,953,328) N/A 11 2006 5,180,782 $ 277.35 $ 1,436,908,230 $ 264.24 $ 1,368,966,665 $ 67,941,565 $ 1,539,035,027 N/A 12 2007 5,451,378 $ 290.31 $ 1,582,588,944 $ 271.96 $ 1,482,534,451 $ 100,054,493 $ 1,639,089,520 N/A 13 2008 5,386,004 $ 308.25 $ 1,660,247,275 $ 300.79 $ 1,620,046,448 $ 40,200,827 $ 1,679,290,347 N/A 14 2009 5,839,782 $ 322.59 $ 1,883,853,423 $ 321.58 $ 1,877,931,749 $ 5,921,674 $ 1,685,212,021 N/A 15 2010 6,367,794 $ 338.40 $ 2,154,888,798 $ 313.40 $ 1,995,690,240 $ 159,198,558 $ 1,844,410,579 N/A 16 2011 6,420,012 $ 357.88 $ 2,297,585,380 $ 329.93 $ 2,118,136,761 $ 179,448,619 $ 2,023,859,198 N/A 17 2012 6,819,943 $ 372.95 $ 2,543,464,833 $ 326.38 $ 2,225,879,926 $ 317,584,907 $ 2,341,444,105 N/A 18 2013 7,011,670 $ 389.11 $ 2,728,288,274 $ 330.47 $ 2,317,146,568 $ 411,141,706 $ 411,141,706 N/A 19 2014 7,403,764 $ 403.10 $ 2,984,482,165 $ 318.02 $ 2,354,558,548 $ 629,923,617 $ 1,041,065,323 N/A 20 2015 7,559,632 $ 418.55 $ 3,164,084,569 $ 311.71 $ 2,356,422,360 $ 807,662,209 $ 1,848,727,532 N/A 21 2016 7,396,313 $ 438.84 $ 3,245,774,200 $ 307.24 $ 2,272,411,725 $ 973,362,475 $ 2,822,090,007 N/A 22 2017 (proj) 7,584,807 $ 455.18 $ 3,452,481,769 $ 314.48 $ 2,385,285,344 $ 1,067,196,425 $ 3,889,286,432 N/A 23 2018 (proj) 7,778,562 $ 472.16 $ 3,672,724,979 $ 328.53 $ 2,555,482,294 $ 1,117,242,684 $ 4,084,889,896 SoonerCare Budget Neutrality through CY 2018 – January 2018 $ 195,603,464 27 AA Tomorrow's Doctors, Tomorrow?s Cures? 2017 State Physician Workforce Data Report Association of I November 2017 American Medicai Colleges 2017 State Physician Workforce Data Report Section 4: Retention Table 4.3. Physicians Retained from Graduate Medical Education (GME), 2016 62 1?qu I. ?"htruu smut -: II my, 4 o- United States 829,266 393,827 . Alabama 9,011 4,267 47.4% 20 Alaska 162 105 64.8% 2 Arizona 8,642 4,208 48.7% 16 Arkansas 5,019 2,802 55.8% 6 California 82,262 57,893 70.4% 1 Colorado 10,104 4,968 49.2% 14 Connecticut 14,231 4,982 35.0% 45 Delaware 1,585 453 28.6% 49 District of Columbia 16,526 2,714 16.4% N.R. Florida 24,375 14,324 58.8% 4 Georgia 15,654 7,658 48.9% 15 Hawaii 3,070 1,245 40.6% 36 ldaho 418 222 53.1% 10 Illinois 44,382 21,371 48.2% 18 Indiana 10,691 5,871 54.9% 7 lowa 6,840 2,442 35.7% 44 Kansas 5,918 2,312 39.1% 40 Kentucky 8,306 3,773 45.4% 22 Louisiana 13,699 6,511 47.5% 19 Maine 2,088 1,050 50.3% 12 Maryland 20,470 7,779 38.0% 42 Massachusetts 37,817 16,893 44.7% 27 Michigan 35,272 15,748 44.6% 28 Minnesota 18,797 8,411 44.7% 26 Mississippi 3,751 1,848 49.3% 13 Missouri 19,372 7,285 37.6% 43 Montana 125 77 61.6% 3 Nebraska 4,527 1,917 42.3% 33 Nevada 1,316 711 54.0% 8 New Hampshire 2,147 604 28.1% 50 New Jersey 19,137 8,516 44.5% 29 New Mexico 3,546 1,391 39.2% 39 New York 117,284 52,782 45.0% 25 North Carolina 20,451 8,578 41.9% 34 North Dakota 927 374 40.3% 37 Ohio 41,364 18,234 44.1% 30 Oklahoma 6,105 3.144 51.5% 11 Oregon 5,832 3,115 53.4% 9 55,255 22,452 40.6% 35 Puerto Rico 7,100 5,294 74.6% N.R. Rhode Island 4,813 1,465 30.4% 47 South Carolina 8,380 3,807 45.4% 21 South Dakota 795 359 45.2% 24 Tennessee 14,983 6,527 43.6% 31 Texas 51,026 29,942 58.7% 5 Utah 5,021 2,132 42.5% 32 Vermont 1,741 573 32.9% 46 Virginia 15,545 6,073 39.1% 41 Washington 12,632 6,138 48.6% 17 West Virginia 4,421 1,773 40.1% 38 Wisconsin 13,023 5,887 45.2% 23 Wyoming 408 121 29.7% 48 Source: AMA Physician Master?le (December 31, 2016). Note: NR. not ranked. Association of American Medical Colleges I i 2017 State Physician Workforce Data Report Section 4: Retention ?am i MC Figure 4.3. Percentage of physicians retained from graduate medical education (GME), 2016. California Alaska Montana Florida Texas Arkansas Indiana Nevada Oregon idaho Oklahoma Maine Mississippi Colorado Georgia Arizona Washington Illinois Louisiana United States Alabama South Carolina Kentucky Wisconsin South Dakota New York Minnesota Massachusetts Michigan New Jersey Ohio State Median 44.9% Tennessee Utah Nebraska North Carolina Hawaii North Dakota West Virginia New Mexico Kansas Virginia Maryland Missouri Iowa Connecticut Vermont Rhode Island Wyoming Delaware New Hampshire 0% 10% 20% 30% 40% 50% 60% 70% 80% Source: AMA Physician Master?la (December 31, 2016). 61 Association of American Medical Colleges 2017 State Physician Workforce Data Report 1 Section 4: Retention 57 United States We ran. tol??ilt "will. Y-Ilf-if"--' - -- iialga- i'lir-1 . I. I - unalil,? . .- mum I -.. 11h": 38.5% NR. 651,618 251,075 Alabama 7,895 3,873 49.1% 8 Alaska Arizona 4,639 1,960 42.3% 19 Arkansas 4,931 2,883 58.5% 3 California 42,672 28,785 62.8% 1 Colorado 5,068 2,201 43.4% 17 Connecticut 6,746 1,294 19.2% 41 Delaware District of Columbia 16,787 1,065 6.3% N.R. Florida 17,411 8,467 48.6% 9 Georgia 12,909 5,788 44.8% 13 Hawaii 2,012 1,042 51.8% 6 Idaho Illinois 43,620 13,754 31.5% 35 Indiana 10,266 5,279 51.4% 7 Iowa 12,501 2,728 21.8% 39 Kansas 6,503 2,424 37.3% 25 Kentucky 9,248 4,232 45.8% 12 Louisiana 15,706 6,315 40.2% 22 Maine 2,510 460 18.3% 42 Maryland 15,293 3,389 22.2% 38 Massachusetts 21,950 6,540 29.8% 36 Michigan 24,436 10,696 43.8% 16 Minnesota 10,393 5,396 51.9% 5 Mississippi 4,116 2,217 53.9% 4 Missouri 28,338 6,089 21.5% 40 Montana Nebraska 9,046 2,430 26.9% 37 Nevada 1,873 648 34.6% 29 New Hampshire 2,140 229 10.7% 45 New Jersey 11,997 4,003 33.4% 30 New Mexico 2,485 950 38.2% 24 New York 71,844 26,067 36.3% 27 North Carolina 15,307 5,886 38.5% 23 North Dakota 1,718 570 33.2% 31 Ohio 32,104 13,030 40.6% 21 Oklahoma 8,064 3,915 48.5% 10 Oregon 3,767 1,688 44.8% 14 50,399 16,072 31.9% 34 Puerto Rico 9,223 4,762 51.6% N.R. Rhode Island 2,653 332 12.5% 44 South Carolina 7,107 3,390 47.7% 11 South Dakota 1,611 663 41.2% 20 Tennessee 15,049 5,256 34.9% 28 Texas 41,567 24,881 59.9% 2 Utah 3,705 1,635 44.1% 15 Vermont 3,412 460 13.5% 43 Virginia 14,829 4,817 32.5% 32 Washington 6,128 2,621 42.8% 18 West Virginia 6,658 2,133 32.0% 33 Wisconsin 12,205 4,522 37.1% 26 Wyoming Source: AMA Physician Mastsr?ie (December31, 2016). Note: The University of Washington recruits students from Washington, Wyoming, Alaska, Montana, and Idaho WWAMI) for admission to its WWAMI regional medical education program. However, retention numbers for the state of Washington do not include 906 graduates from the University of Washington who are active in the other four WWAMI states. When those graduates are included, the UME retention rate for the WWAMI region is 57.7%. Note: NR. not ranked. the data are not applicable. Some states do not have a MD-granting or DO-granting institution. Association of American Medical Colleges 2017 State Physician Workforce Data Report Section 4: Retention i MC Figure 4.1. Percentage of physicians retained from undergraduate medical education (UME), 2016. California Texas Arkansas Mississippi Minnesota Hawaii Indiana Alabama Florida Oklahoma South Carolina Kentucky Georgia Oregon Utah Michigan Colorado Washington Arizona South Dakota Ohio Louisiana United States North Carolina New Mexico Kansas Wisconsin New York Tennessee Nevada Median 38.5% New Jersey North Dakota Virginia West Virginia Illinois Massachusetts Nebraska Maryland Iowa Missouri Connecticut Maine Vermont Rhode Island New Hampshire Wyoming Montana Idaho Delaware Alaska 0% 10% 20% 30% 40% 50% 60% 70% Source: AMA Physician Master?le (December 31, 2016). Note: The University of Washington recruits students from Washington. Wyoming, Alaska, Montana, and Idaho for admission to its WWAMI regional medical education program. However, retention numbers for the state of Washington do not include 906 graduates from the University of Washington who are active in the other four WWAMI states. When those graduates are included, the UME retention rate for the WWAMI region is 57.7%. 56 Association of American Medical Colleges Iv 2017 State Physician Workforce Data Report 9 A Section 4: Retention Table 4.4. Physicians Retained from Undergraduate Medical Education (UME) and Graduate Medical Education (GME) Combined, 2016 . 'v ?wirw - -- ?'tnl'Jl-United States 246,079 165,023 67.1% .R. Alabama 3,151 2,354 74.7% 11 Alaska -- Arizona 1,446 1,078 74.6% 13 Arkansas 2,383 1,928 80.9% 3 California 26,181 21,211 81.0% 2 Colorado 1,764 1,288 73.0% 16 Connecticut 1,555 806 51.8% 43 Delaware District of Columbia 3,461 716 20.7% N.R. Florida 5,768 4,511 78.2% 5 Georgia 4,327 3,143 72.6% 17 Hawaii 612 530 86.6% 1 ldaho -- Illinois 15,714 9,744 62.0% 33 Indiana 4,735 3,642 76.9% 7 lowa 2,373 1,441 60.7% 34 Kansas 2,360 1,362 57.7% 38 Kentucky 3,118 2,304 73.9% 14 Louisiana 6,224 4,297 69.0% 23 Maine 248 175 70.6% 18 Maryland 3,603 1,910 53.0% 41 Massachusetts 8,206 4,836 58.9% 36 Michigan 10,514 7,005 66.6% 27 Minnesota 5,165 3,806 73.7% 15 Mississippi 1,674 1,282 76.6% 10 Missouri 6,041 3,339 55.3% 40 Montana -- -- Nebraska 2,296 1,329 57.9% 37 Nevada 257 197 76.7% 9 New Hampshire 188 71 37.8% 45 New Jersey 3,158 1,964 62.2% 32 New Mexico 725 477 65.8% 28 New York 35,200 20,766 59.0% 35 North Carolina 4,899 3,284 67.0% 25 North Dakota 330 208 63.0% 31 Ohio 13,447 9,080 67.5% 24 Oklahoma 2,775 2,073 74.7% 12 Oregon 1,056 743 70.4% 19 19,189 10,934 57.0% 39 Puerto Rico 4,123 3,155 76.5% N.R. Rhode Island 364 181 49.7% 44 South Carolina 2,507 1,922 76.7% 8 South Dakota 258 200 77.5% 6 Tennessee 4,749 3,168 66.7% 26 Texas 21,147 17,100 80.9% 4 Utah 934 645 69.1% 22 Vermont 346 183 52.9% 42 Virginia 3,907 2,513 64.3% 29 Washington 2,053 1,438 69.9% 21 West Virginia 1,938 1,224 63.2% 30 Wisconsin 3,728 2,615 70.1% 20 Wyoming -- Source: AMA Physician Master?ie (December31, 2016). Note: NR. not ranked. -- the data are not applicable. Some states do not have an MD-granting or a DO-granting institution. 64 Association of American Medical Colleges 2017 State Physician Workforce Data Report Section 4: Retention ?am i MC 4. Physicians Retained from Undergraduate Medical Education (UME) and Graduate Medical Education (GME) Combined, 2016 Figure 4.4. Percentage of physicians retained from undergraduate medical education (UME) and graduate medical education (GME) combined, 2016. Hawaii California Arkansas Texas Florida South Dakota Indiana South Carolina Nevada Mississippi Alabama Oklahoma Arizona Kentucky Minnesota Colorado Georgia Maine Oregon Wisconsin Washington Utah Louisiana Ohio United States North Carolina Tennessee Michigan New Mexico Virginia West Virginia North Dakota New Jersey Illinois Iowa New York Massachusetts Nebraska Kansas Missouri Maryland Vermont Connecticut Rhode Island New Hampshire Wyoming Montana Idaho Delaware Alaska I State Median 69.0% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Source: AMA Physician Master?le (December 31, 2016}. 53 Association of American Medical Colleges Accessibility Report Filename: 1115 Supplemental Payment Amendmentfinal 1-19-18.pdf Report created by: Organization: [Enter personal and organization information through the Preferences > Identity dialog.] Summary The checker found no problems in this document. 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Welcome, Roll Call, and Public Comment Instructions: Chairman, Steven Crawford, M.D. II. Action Item: Approval of Minutes of the November 16th, 2017: Medical Advisory Committee Meeting III. Public Comments (2 minute limit) IV. MAC Member Comments/Discussion: V. SoonerCare Operations Update: Melissa McCully, Director of Insure Oklahoma VI. Legislative Update: Cate Jeffries, Interim Legislative Liaison VII. Financial Report: Carrie Evans, Chief Financial Officer VIII. Proposed Rule Changes: Presentation, Discussion, and Vote: Demetria Bennett, Policy Development Coordinator A. 17-15 - Student Earned Income Exclusion for Aged, Blind and Disabled (ABD) Applicants B. 17-17 - Indian Health Services, Tribal Program and Urban Indian Clinics (I/T/U) Current Procedural Terminology (CPT) Language Removal C. 17-19 - Inpatient Behavioral Health Revisions D. 17-20 - Grandfathered CHIP children E. 17-23 - Breast and Cervical Cancer (BCC) Benefit Update F. 17–24A - ADvantage Waiver Revisions G. 17–24B - ADvantage Waiver Revisions H. 17–25A - Developmental Disabilities Services (DDS) Revisions I. 17–25B - Developmental Disabilities Services (DDS) Revisions J. 17-28 - Federally Qualified Health Center Services (FQHC) Alternative Payment Methodology (APM) K. 17-33 A and B - Nursing Home Supplemental Payment Program Revisions IX. Action Item: Vote on Proposed Rule Changes: Chairman, Steven Crawford, M.D. X. Discussion Items Only: Tywanda Cox, Chief of Federal and State Policy A. 1115(a) waiver amendment for supplemental payments for residency training programs and loan repayment 1 Page January 18, 2018 MAC Meeting Agenda Oklahoma Health Care Authority MEDICAL ADVISORY COMMITTEE XI. New Business: Chairman, Steven Crawford, M.D. XII. Future Meeting: March 15th, 2018 May 17th, 2018 July 19th, 2018 September 20th, 2018 November 15th, 2018 XIII. Adjourn 2 Page January 18, 2018 MAC Meeting Agenda NEWSPAPER PUBLIC NOTICE Pursuant to 42 CFR § 431.408, the Oklahoma Health Care Authority (OHCA) is providing public notice of its plan to submit an amendment to the existing approved 2018 Section 1115(a) extension waiver for the SoonerCare Choice and Insure Oklahoma programs. The proposed amendment would add supplemental payments to qualified entities for loan repayment and residency training programs in recognition of the higher cost associated with service delivery and physician recruitment and training to maintain sufficient access to quality preventive, primary and specialty healthcare for SoonerCare members. It is the intent of the Oklahoma Health Care Authority to submit the amendment no later than January 19, 2018 with an effective date of March 1, 2018. The total estimated annual budget impact is one hundred and five million dollars ($105,000,000) of which the estimated state share is forty-three million, five hundred one thousand, five hundred dollars ($43,501,500) which is funded by participating entities. A public meeting will be held at the following location: January 18, 2018 at 1:00 p.m. Medical Advisory Committee Ed McFall Boardroom Oklahoma Health Care Authority 4345 N. Lincoln Blvd, Oklahoma City, OK. Additionally, a special tribal consultation was held January 12, 2018 at 3:00 p.m. at the above location. The OHCA welcomes comments from the public regarding the Amendment to the SoonerCare Choice and Insure Oklahoma 1115(a) Demonstration Waiver program. The application waiver will be posted online at the OHCA Public Page from January 15, 2018 through January 19, 2018. Comments and questions may be submitted online at the Policy Change Blog and the Native American Consultation Page or by contacting Bill Garrison, OHCA Federal & State Reporting Coordinator by telephone at 405-522-7914. LA SEMANA INTER NACIO NA L 17 AL 23 DE ENERO DEL 2018 www.lasemanadelsur.com A7 La realidad de Corea del Norte como potencia nuclear The Reality of North Korea as a Nuclear Power tiempo indefinido la construcción de los prometidos reactores nucleares de agua ligera. (IPS) POR THALIF DEEN NACIONES UNIDAS C on seis ensayos nucleares subterráneos entre 2006 y 2017, Corea del Norte parece desesperada por convertirse en la novena potencia nuclear, luego de Estados Unidos, Gran Bretaña, Francia, China, Rusia, India, Pakistán e Israel. Pero el reconocimiento no se vislumbra en el actual contexto de amenazas por parte de Pyongyang y de la continua guerra de palabras entre dos de los gobernantes más impredecibles del mundo: Donald Trump, de Estados Unidos, y Kim Jong-un, de Corea del Norte. Además, las cinco potencias nucleares, Estados Unidos, Gran Bretaña, Francia, China, Rusia, también miembros permanentes del Consejo de Seguridad de la Organización de las Naciones Unidas (ONU), se niegan a concederle la placa nuclear a Corea del Norte. Por su parte, ese país asiático sostiene que la invasión a Afganistán e Iraq y la expulsión del líder de Libia, Mohammar Gadafi, se facilitaron por un simple hecho: ninguno tenía armas nucleares o se habían rendido a desarrollarlas. M.V. Ramana, presidente de la Facultad de Políticas Públicas y Asuntos Globales de la Universidad de Columbia Británica, dijo que nace la esperanza tras los últimos intercambios apaciguadores entre las dos Coreas. “Creo que la situación puede regresar a la de un estado de mayor calma, aunque es totalmente posible que eso implique que Corea del Norte tenga armas nucleares. Sospecho que por ahora, el mundo tendrá que convivir con su arsenal”, añadió. Además, cualquier proceso de paz debe partir de acciones recíprocas, uno no puede esperar que Corea del Norte afloje su programa sin que Estados Unidos tome una medida en respuesta. Entonces “ahora vemos las payasadas pueriles de dos gobernantes enfrascados en reciminaciones mutuas como dos niños acosadores en el patio de la escuela ase- gurando que el botón nuclear de uno es más grande que el del otro, mientras una tensión similar a la Guerra Fría crece de forma alarmante”, añadió. El número de ojivas en el mundo disminuyó desde fines de la guerra fría, de unas 70.300, en 1986, a unas 14.550, en 2017, según la Federación de Científicos Estadounidenses (FAS). El arsenal de Corea del Norte ronda entre 20 y 50 armas o quizás un poco más, según fuentes de inteligencia de Estados Unidos. Joseph Gerson, presidente de la Campaña para la Paz, el Desarme y la Seguridad Común, dijo que los sucesivos gobiernos norcoreanos impulsaron el programa nuclear por dos motivos principales: garantizar la supervivencia de la dinastía Kim y preservar la supervivencia del Estado de Corea del Norte. Desde la guerra de Corea, Estados Unidos amenaza o se prepara para iniciar una guerra nuclear con Corea del Norte. Esas amenazas prendieron en los norcoreanos debido a que el ejército estadounidense destruyó 90 por ciento de la estructura al norte del paralelo 38. Gerson también recordó que tras la crisis de 1994 entre ambos países, Corea del Norte estaba dispuesta a canjear su programa nuclear por garantías de seguridad, normalización de relaciones y asistencia para el desarrollo económico. Estados Unidos no honró su compromiso del marco acordado entonces al negarse a entregar petróleo y demorar por NEWSPAPER PUBLIC NOTICE Pursuant to 42 CFR § 431.408, the Oklahoma Health Care Authority (OHCA) is providing public notice of its plan to submit an amendment to the existing approved 2018 Section 1115(a) extension waiver for the SoonerCare Choice and Insure Oklahoma programs. The proposed amendment would add supplemental payments to qualified entities for loan repayment and residency training programs in recognition of the higher cost associated with service delivery and physician recruitment and training to maintain sufficient access to quality preventive, primary and specialty healthcare for SoonerCare members. It is the intent of the Oklahoma Health Care Authority to submit the amendment no later than January 19, 2018 with an effective date of March 1, 2018. The total estimated annual budget impact is one hundred and five million dollars ($105,000,000) of which the estimated state share is forty-three million, five hundred one thousand, five hundred dollars (43,501,500) which is funded by participating entities. A public meeting will be held at the following location: January 18, 2018 1:00 p.m. Medical Advisory Committee Ed McFall Boardroom Oklahoma Health Care Authority 4345 N. Lincoln Blvd, Oklahoma City, OK. Additionally, a special tribal consultation was held January 12, 2018 at 11:00 a.m. at the above location. The OHCA welcomes comments from the public regarding the Amendment to the SoonerCare Choice and Insure Oklahoma 1115(a) Demonstration Waiver program. The application waiver will be posted online at http://www.okhca.org from January 15, 2018 through January 19, 2018. Comments and questions may be submitted on line at http://okhca.org/PolicyBlog.aspx or by contacting Bill Garrison, OHCA Federal & State Reporting Coordinator by Telephone 405-522-7914. ENGLISH With a track record of six underground nuclear tests between 2006 and 2017, North Korea is desperately yearning to be recognized as the world’s ninth nuclear power – trailing behind the US, UK, France, China, Russia, India, Pakistan and Israel. But that recognition seems elusive– despite the increasing nuclear threats by Pyongyang and the continued war of words between two of the world’s most unpredictable leaders: US President Donald Trump and North Korean leader Kim Jong-un. Arguing that North Koreans have little reason to give up their weapons program, the New York Times ran a story last November with a realistically arresting headline which read: “The North is a Nuclear Power Now. Get Used to it”. But the world’s five major nuclear powers, the UK, US, France, China and Russia, who are also permanent members of the UN Security Council, have refused to bestow the nuclear badge of honour to the North Koreans. North Korea, meanwhile, has pointed out that the invasion of Afghanistan and Iraq, and the ouster of Libyan leader Muammar elQaddafi, were perhaps facilitated by one fact: none of these countries had nuclear weapons or had given up developing nuclear weapons. “And that is why we will never give up ours,” a North Korean diplomat was quoted as saying. Dr M.V. Ramana, Simons Chair in Disarmament, Global and Human Security at University of British Columbia, told there is, however, hope in the recent placatory moves by North and South Korea. “I think that the situation can return to a calmer state, although it is entirely possible that this calmer state would involve North Korea holding on to nuclear weapons. I suspect that for the time being the world will have to live with North Korea’s nuclear arsenal,” he added. “Although that is not a desirable goal, there is no reason why one should presume that North Korea having nuclear weapons is any more of a problem than India, Pakistan, or Israel, or for that matter, China, France, the United Kingdom, Russia, or the United States,” said Dr Ramana. Also, any peace process should be based on reciprocal moves: one cannot simply expect North Korea to scale down its programs without corresponding moves by the United States, he declared. Jayantha Dhanapala, a former UN Under-Secretary-General for Disarmament Affairs (1998-2003), told IPS there is little doubt that North Korea, (also known as the Democratic People’s Republic of Korea), has acquired a nuclear weapon capability and the means of delivering it to the mainland of the USA. He also pointed out that the persistent efforts of the DPRK since the end of the Korean War to conclude a just and equitable peace with the USA have been rebuffed again and again. “We cannot trust to luck anymore,” he warned. “Some small steps between the two Koreas hold promise of a dialogue beginning on the eve of the Winter Olympics. This must be the opportunity for all major powers to intervene and resume negotiations. The Secretary-General of the UN must act and act now,” he added. The number of nuclear weapons in the world has declined significantly since the end of the Cold War: down from approximately 70,300 in 1986 to an estimated 14,550, according to the Federation of American Scientists (IPS) CLASSIFIED THE LAWTON CONSTITUTION 8B Legals Unfurnished Houses 275 License or 708 1/2 H: 1 bdrm., 1 ba., laundry rm., fenced yard, $325/$300. 580-512-3348. 7812 NW Morrocca Rd., 3 bdrm., 1.75 ba., $695. Tenant Special. Sundance, 580-353-3533. 90 SW 45th, 3 bdrm, 1 ba., CHA, $595. Tenant Special. Sundance, 580-353-3533. EXTRA NICE 3 bdrm., CHA, range, carpet. 248-4987/284-5300. Available NOW MOVE IN SPECIALS! NO CREDIT CHECK! Homes, apts., efficiency. Lawton & surrounding areas. Colonial Realty, 355-3222 Open Most evgs til 7. NEAR Cameron, 2 bdrm., CHA, $495/$495. New paint. 580-357-0842. NICE 2 BDRM. Duplex, Near Ft. Sill, Fenced, Hook-Ups, Gar., Extras! $450/$300. 585-7554, 713-9953. NICE 2 bdrm. redo, blinds, fans, garage, yard, $575. 536-3195. NICE 3 bdrm., fans, blinds, garage, shelter, $550. 536-3195. parksjonesrealty.com parksjonesrealty.com PROPERTY MANAGEMENT We have 2, 3 & 4 Bdrm Homes Available J*. PARKS J NES ® REALTORS REALTORS® 4301 NW Cache Rd. 580-357-0842 RENT HOUSES: 2, 3, 4 bdrm., pets allowed, Section 8 OK 1301 W. Gore 580-919-8725. SECTION 8/MILITARY, nice 3 bdrm. brick house, $695/$300. Call 580-284-2585. SECTION 8 Welcome Private Owner 400+ houses. 536-3195 Condos 280 2 BDRM. town house, MacArthur Park, completely redecorated, 2 car gar. 580-357-5083. D Announcements Legals 300 Published in The Lawton Constitution January 7, 8, 9, 14, 15, 16, 2018 WATER/WASTEWATER OPERATOR/MAINTENANCE SUPERINTENDENT: The Town of Blair is accepting applications for a full-time Water & Wastewater Operator/Maintenance Superintendent. Benefits, including paid medical, dental, vision, life insurance and retirement matched by Town. Other benefits include paid holidays, vacation, and sick time. Must have a double Class D Water/Wastewater 300 Legals ability to achieve licensing within 6 months. Applicants can have any combination of education and experience. Supervisory experience desirable. Salary range: $33,600.00 $37,200.00. Please send resumes to the Town of Blair, P.O. Box 458, Blair, OK 73526. Resumes will be accepted until the position is filled. Published in The Lawton Constitution January 15, 2018 NEWSPAPER PUBLIC NOTICE Pursuant to 42 CFR § 431.408, the Oklahoma Health Care Authority (OHCA) is providing public notice of its plan to submit an amendment to the existing approved 2018 Section 1115(a) extension waiver for the SoonerCare Choice and Insure Oklahoma programs. The proposed amendment would add supplemental payments to qualified entities for loan repayment and residency training programs in recognition of the higher cost associated with service delivery and physician recruitment and training to maintain sufficient access to quality preventive, primary and specialty healthcare for SoonerCare members. It is the intent of the Oklahoma Health Care Authority to submit the amendment no later than January 19, 2018 with an effective date of March 1, 2018. The total estimated annual budget impact is one hundred and five million dollars ($105,000,000) of which the estimated state share is forty-three million, five hundred one thousand, five hundred dollars (43,501,500) which is funded by participating entities. A public meeting will be held at the following location: January 18, 2018 1:00 p.m. Medical Advisory Committee Ed McFall Boardroom Oklahoma Health Care Authority 4345 N. Lincoln Blvd, Oklahoma City, OK. Additionally, a special tribal consultation was held January 12, 2018 at 11:00 a.m. at the above location. The OHCA welcomes comments from the public regarding the Amendment to the SoonerCare Choice and Insure Oklahoma 1115(a) Demonstration Waiver program. The application waiver will be posted online at http://www.okhca.org from January 15, 2018 through January 19, 2018. Comments and questions may be submitted on line at http://okhca.org/PolicyBlog.aspx or by contacting Bill Garrison, OHCA Federal & State Reporting Coordinator by Telephone 405-522-7914. Published in The Lawton Constitution January 15, 22, 2018 IN THE DISTRICT COURT WITHIN AND FOR COMANCHE COUNTY, STATE OF OKLAHOMA IN THE MATTER OF THE ESTATE OF FRANCISCO D. SALAS, Deceased. Case No. PB-2017-189 NOTICE OF HEARING FINAL ACCOUNT, PETITION FOR DETERMINATION OF HEIRS AT LAW, FOR DISTRIBUTION AND DISCHARGE Notice is hereby given that INGRID SANDERSON, Personal Representative of the estate of FRANCISCO D. SALAS, Deceased, has filed in this Court her Final Account of the administration of said estate and his Petition for Determination of Heirs and 300 Legals for Distribution of the estate. The hearing thereon has been fixed by the Judge of said Court for the 5th day of February, 2018, at 9:00 o´clock a.m., in Courtroom No. 507, of said Court in the County Courthouse at Lawton, Oklahoma. All persons interested in said estate are notified then and there to appear and show cause, if any they have, why the account should not be settled and allowed, the heirs, legatees and devisees of the deceased determined, and the estate distributed accordingly. DATED this, the 11th day of January, 2018. GERALD NEUWIRTH JUDGE OF THE DISTRICT COURT Michael C. Mayhall, OBA #5821 GODLOVE, MAYHALL, DZIALO, & DUTCHER, P.C. 802 “C” Avenue P.O. Box 29 Lawton, Oklahoma 73502 Phone (580) 353-6700 Fax (580) 353-2900 Attorneys for Personal Representative Published in The Lawton Constitution January 15, 2018 ORDINANCE NO. 18-01 AN ORDINANCE CHANGING T H E Z O N I N G CLASSIFICATION FROM THE EXISTING CLASSIFICATION OF R-3 MULTIPLE-FAMILY DWELLING DISTRICT TO C-1 LOCAL COMMERCIAL DISTRICT ZONING CLASSIFICATION ON THE TRACT OF LAND WHICH IS HEREINAFTER MORE PARTICULARLY DESCRIBED IN SECTION ONE (1) HEREOF; APPROVING THE SITE PLAN ATTACHED AS EXHIBIT A; AND AUTHORIZING CHANGES TO BE MADE UPON THE OFFICIAL ZONING MAP IN ACCORDANCE WITH THIS ORDINANCE. Brief Gist This ordinance changes the zoning classification of property located at 1050 SE 45th Street from R-3 Multiple-Family Dwelling District to C-1 Local Commercial District zoning classification and approves the detailed site plan for development of the tract. PASSED and APPROVED by the Council of the City of Lawton, Oklahoma, this 9th day of January, 2018. FRED L. FITCH, MAYOR ATTEST: TRACI HUSHBECK, CITY CLERK Published in The Lawton Constitution January 15, 2018 ORDINANCE NO. 18-03 A N O R D I N A N C E PERTAINING TO NONINTOXICATING BEVERAGES AMENDING DIVISION 4-2-3, ARTICLE 4-2, CHAPTER 4, LAWTON CITY CODE, 2015, ADDING PROVISIONS FOR LICENSING OF ON-PREMISE C O N S U M P T I O N NON-TAVERN RETAILER, PROVIDING FOR SEVERABILITY, AND D E C L A R I N G A N EMERGENCY. Brief Gist This ordinance adds provisions for the licensing and regulation of the sale for on-premise consumption, of low-point beer and other beverages defined by the state as nonintoxicating beverages, for businesses where 25% or less of their gross dollar sales are from such sales, and also provides specific requirements for the sale of nonintoxicating beverages at motion picture theaters. ADOPTED and APPROVED MONDAY, JANUARY 15, 2018 Help Wanted Help Wanted 300 Help Wanted General 350 General 350 Office/ Clerical 360 by the Council of the City of Lawton, Oklahoma this 9th day of January, 2018. FRED L. FITCH, MAYOR ATTEST: TRACI L. HUSHBECK, CITY CLERK Published in The Lawton Constitution January 15, 2018 ORDINANCE NO. 18-02 AN ORDINANCE AMENDING SECTIONS 7-19-1-1901 THROUGH 7-19-1-1904 AND CREATING SECTION 7-19-1-1905, ALL IN DIVISION 7-19-1, ARTICLE 7-19, CHAPTER 7, BUSINESS, LAWTON CITY CODE, 2015; BY MODIFYING THE REQUIREMENTS FOR A REFUSE HAULING LICENSE, SPECIFYING THE APPEAL PROCESS FOR A DENIED LICENSE, CLARIFYING THE RENEWAL PERIOD OF THE LICENSE, SPECIFYING HOURS THAT THE REFUSE COLLECTION CAN BE PERFORMED WITHIN A RESIDENTIAL AREA, AND PROVIDING FOR SEVERABILITY. BRIEF GIST This ordinance updates the requirements for a refuse hauling license by setting out the requirements for the vehicle inspection, setting out the appeal process for a denied application, and providing an incentive for renewal of the license prior to its expiration. This ordinance also establishes a limitation on the hours during which commercial refuse can be collected within a residential zoning district or within 300 feet of a residential dwelling. ADOPTED and APPROVED by the Council of the City of Lawton, Oklahoma this 9th day of January, 2018. FRED L. FITCH, MAYOR ATTEST: TRACI L. HUSHBECK, CITY CLERK Lost and Found 320 STRAY DOG found near Schoolhouse Slough. Medium size female with red hair and white markings. Very sweet. approx. 1-2 yrs. old. Call 971-533-4238. Instruction 330 LEARN TO FLY Chattanooga airport Tim, 580-678-9999 E Employment Help Wanted General 350 ANN´S County Kitchen now hiring Cook. Apply in person, 20602 Hwy. 58. BARTENDER NEEDED. Apply in person Glen´s Lounge, 710 SW 11th St. BEST WESTERN PLUS HOTEL AND CONVENTION CENTER 1125 E. GORE NOW HIRING! Evening Cook. Apply in person, 9am-5pm, Mon.-Fri. NO PHONE CALLS! EOE Classified: Shopping Made Easy… Looking for a TV or a Stereo? Check out the Mechandise section of the Lawton Constitution classified. EVANS AND ASSOCIATES UTILITY SERVICES, INC. Is now taking applications for full time Utility Laborers and Backhoe/ Trackhoe Operators for the installation of water, waste water and storm water utilities. MUST HAVE Valid Driver´s License. CDL preferred. Must be willing to travel. Must be able to obtain ENTRY ID Pass on Federal Installation. Full benefits avail. Drug and alcohol testing is required. Apply at 2208 SW F Ave. 7am5pm, Mon-Fri. Call 580-351-1800 for more info. FAT BOY´S PIZZA Now hiring Cook 2546 FT. Sill Blvd. Goodwill is accepting applications for an Employment Training Specialist. Will work directly with clients with disabilities. Must have a valid Oklahoma Driver´s License & vehicle insurance. Apply online @www. goodwillsont.org Drug Free Workplace/EOE. HOME DELIVERY The Lawton Constitution is now accepting applications for a full time position within the CirculationDepartment. The pay starts at $9.50 pe hour plus a benefits program that includes 401(K), medical insurance, vacation, and mileage reimbursement. You must have a reliable vehicle, a valid driver´s license, and proof of mandatory automobile insurance. The ability to lift up to 25 lbs. is also required. We will be taking applications Monday-Friday at 207 SW B Ave. (Circulation Dept.) swoknews.com from 9:00 a.m.- 4:00 p.m. HOP & SACK Now hiring all positions/ shifts. Location: Rogers Ln. Full & Part time avail. Must be able to work all rotating shifts. Apply in person at the location. Laborers and equipment operators needed. Valid driver´s lic. req. Applications can be found online, www.greenturfsod.net or call 580-353-8873 EOE Part Time Office Assistant Teen Court, a non-profit corporation, is accepting applications for a part time office assistant, 10 hours weekly. Duties include telephone, client contact and clerical duties. Must be familiar with Microsoft Word and Excel. Applicants can pick up application at Teen Court Office, 814 C Avenue, Lawton, Ok. between 1-5 pm. Closing January 17th. PART TIME INSERTER The Lawton Constitution is now accepting applications for Part Time Inserter. This is assembly line work within our distribution center with duties consisting of inserting, stacking and bundling of newspapers. Must be able to work split shifts involving afternoons, evenings, and late night hours! Approximately 20 hours per week. Applications will be taken in the Help Wanted Circulation Department at 207 SW “B” from 8:30 Professional 365 AM-4:30 PM MondayFriday. No phone calls Journeyman electricianneeded. 401k and insurplease. swoknews.com ance avail. Apply 820 SE The Kiowa Tribe is cur- 3rd., 353-4669. rently accepting applications for a full-time Help Wanted Accounting Technician, Medical 370 Salary Range: $13.00 $18.00 per hour, Closing CEDAR CREST January 26, 2018, EOE, Indian Preference apMANOR plies. If interested, please now hiring for LPNs, all visit our website at: www. shifts. Shift deferential k i o w a t r i b e . o r g / j o b - (starts upon hire), health, vacancies.html vision, dental & retirement plan offered. THE LAWTON CON- Please apply in person, STITUTION is looking for Mon.-Fri., 1700 NW Ft. Independent Contractors Sill Blvd. to deliver newspaper routes. There are over Help Wanted 1 0 0 i n d e p e n d e n t Food/ Services 375 contractors presently distributing The Lawton Constitution throughout Keystone Foodservice is Lawton & Southwest looking to fill a position Oklahoma. A large for a cook and food prep percentage of our inde- with some light cleaning. pendents have held con- This position will be at the tracts with us for many Bishop schools and will years and find they can f o l l o w t h e i r s c h o o l use the money they earn schedule. If you are from their route as either responsible, hard worktheir sole source of in- ing, dependable and a come; or an additional team player, please income on top of their full email your resume and time job. The average contact information to: tamier@ profits earned by our carriers is over $1000 keystonefoodservice.com 405-612-6116 per month. Additionally, or Kevin at many of our carriers use keving@ their routes as a way to exercise, where they ac- keystonefoodservice.com tually make money while 380 exercising. Imagine that- Jobs Wanted making money to exe r c i s e ! A p p l i c a t i o n s CAREGIVER for elderly or available at 207 SW “B handicap. 25 yrs. exp. ”Ave., 8 AM-4 PM or call Housekeeping, errands, appts., etc. Part or full 353-6397 TODAY! time. Out of rehab? I can swoknews.com help. 284-7598. Help Wanted Sales 355 Drivers D IRECTORY 170 Doors Handyman TOLER´S Garage Door NEED A HANDYMAN? ALL BRANDS, 35 yrs. SVC. Repairs only. Resi- Call 591-1371. Painting, fencing, hauling, exp., Fast Service, Low dential. Replace springs, carpentry, roofing Prices. All of Comanche cables, rollers. Operator Co. Call Ron 695-3008 Repair. 36 yrs exp. Lawn Care 580-536-4051. Brick Work Roofing SUPERIOR ROOFING by All Pro. Free Est. Roof replacements and Repairs. State Reg. #80002459. Licensed & Insured. 580-704-4444. 0 $ EST., mowing, edging, Fencing Siding bagging, cleanup. MiliABLP BRICKWORK: rock, block, patchwork. Serving $0 EST., AN AFFORDABLE tary, Sr. disc. 695-7215. GAROLD´S Siding & Lawton for over 20 yrs. Fence: FALL SPECIALS, 5 yr. warr. 14 yrs exp., lic. & Painting Windows. Installation & Call Lonnie, 483-6291. insured. 580-585-0091. repair. 25 yrs. experBiby Paint & Remodel ience. 580-620-9205. Cleaning Service Honest affordable proJones Fencing LLC, infessional residential resstall all types of fenctorations since 1983. SIDING, eaves, overing. Call 284-4494. hangs, windows, gutSteve Biby 574-0015 tering. Free est. 357-6744. Plumbing Firewood KEN Shannon´s Plumbing, Trailer Repair Seasoned split mixed drain cleaning & repair, $70, del. $20, oak $90 5 8 0 - 2 1 5 - 2 9 2 0 o r per rick. Custom cuts 405-760-1435. REPAIRS: floors, ramps, lights, and painting. H o u s e k e e p i n g , available. 536-4466, ROY´S PLUMBING, 917-0057. Crows, 580-357-2208. Caregiving, evgs. I work Heat & Air. with contract. 291-2874. 580-591-1738. Foundation CALL 355-6243 merrymaids.com Concrete CEMENT WORKS CONCRETE WORK, BACKHOE SERVICE AND TRENCHING. Floors, Safe rooms, driveways. All types. Insured 585-1225, 429-3103. MEDRANO CONCRETE floors, drives, walkways, patios. Free estimate. 580-704-4299 MEDRANO CONCRETE floors, drives, walkways, patios. Free estimate. 580-704-4299 Residential Concrete Archie Garrett, 353-9893. Free Est. Repair GOLDSTARR CONSTRUCTION Lifting, leveling houses, commercial building, trailer house. 36 yrs. experience, 536-4466 or 917-0057. Guttering GOLDEN RULE: Seamless Gutter, LLC. Free Est. 512-2966. Handyman HANDYMAN-quality work, affordable. Tree removal. 580-583-4946. HANDYMAN´S Handyman. One call does it all! Screens, Windows, Doors Doors, Cabinets, Painting, GARAGE Door Repair Roofing, Drywall, Tile, Commercial, Residential. Fencing, Hauling, Lawn Sales. Redneck Door Co. care. Free est. Call 580-284-1913 704-0229. Remodeling ALL PHASES Addns, carports, kit. & baths, concrete. 40 yrs. exp. Glen Hamiltion, 351-4037. REMODELING- Bathrooms are our speciality, also kitchens, exteriors, tiling, wood floors and much more. Free Est., J R DRAKE CONSTRUCTION LLC. 580-280-2855. Tree Service BRANCH OUT Tree Service. Removal-trimmingstump grinding. Free est. Fully insured. 580-678-9737. Tutoring Roofing CERT. teacher tutoring DC Roofing and Gutters elementary subjects. 23 Patch jobs and new roofs. yrs. exp. 512-1886. 580-704-5055. PRE-K to College LEAK & REPAIR specialist 580-351-9100 Roof replacements. Call sylvanlearning.com Jack 580-695-6057 ROOF replacement & reUpholstery pair, shingles, flat roofs. Sr., military discount. Free JOANIE´S Upholstery. est., 357-6744. Veteran Custom curtains, furniture owned, 30 yrs. business. upholstered. 357-3560. 33lines, issues forfor $54.00 per month. Each additional line $19.10 month. 1 month. lines,3434 issues $54.00 per month. Each additional lineper $19.10 per Your ad appears in The Constitution 30 days and in The Fort Sill Tribune for 4 weeks. Call 357-9545 for details. Out of town, call toll free 1-800-364-3636 m I XgjSS Cards 73505 ARES STATE ARMORY Lawton’s Only Gun & Silencer Store. Tue-Fri 10-6 Sat 10-5 2210 W. Gore. Suite 5 Lawton, OK 73501 580-699-8897 Layaway, transfers, special orders, new, and used guns. 455 STORK´S NEST. Maternity Clothes. Cribs, Baby items. 2610 NW Lee. Call 248-9999. RC GUNS AR15 & 1911 parts Call 580-647-7183 Recreational Vehicles H Auction/ Boats/ Motors/ Merchandise 500 Marine 640 BRIDGES AUCTION ´13 BassTracker, 190 & SALES CO. Pro, Merc 115, $14,500. Spring & Fall Community 580-305-2713. Consignment Auctions FRI.& SAT., April 27 & 28 I BUY *** August 24 & 25 BOATS NO FEBRUARY SALE 405-620-5760 Call for Consigning & Information bridgesauction.com (580)492-5260 J ESTATE AUCTION Transportation Mon., Jan. 15, 2018 7:00 PM King Size bdrm. suite, full size bdrm. suite, several vintage items, 3 door stainless stee refrig., washers, dryers, large upright freezer, recliner, baby bed, lots more. Several other collector items. Even an Angel collection. Merchandise can be inspected all day Monday at: Lewis Warehouse Furniture & Auction 411 SW McKinley 355-8847, 583-0833 Automobiles 07 Mazda Miata 25.6K mi;Good Condition $8500 neg. 284-5827 ´10 Toyota Corolla S, auto., well maintained, new tires, 129K mi., $7000. 678-3771. CLINTON HERRING AUTO SALES 2ND & GORE SERVING LAWTON-FT. SILL OVER FIFTY YEARS 591-1216 Musical Instruments 520 YAMAHA digital Piano, Model #P-105B, $350. Call 580-536-2023. 385 Pickups/ Vans Sport Utilities 725 ´11 TOYOTA 4 Runner, 68k, exc. cond, $19,500. 405-668-0200. ´12 DODGE Ram 2500, 4 dr., diesel, 70k, $39,900. 580-305-2713 Million tradition. Miscellaneous 575 Check Us Check Us Out On: Out On: facebook PARACORD, all colors, flags, knives, Ghillie suit, ammo boxes. Carl´s Military Surplus, 2615 NW Sheridan. 353-3100. To find us: Type “The Lawton Constitution” in the search bar on your Facebook page. Used fenced panel pricing, new #2 cedar, will install. 215-1597. Subscribe today! 353-NEWS www.swoknews.com TheLawton LawtonConstitution Constitution • www.swoknews.com The www.swoknews.com 353-NEWS 353-NEWS 39 No room at the 5 Path left behind by a mower 40 Praising 66 Rage 15 Sign after Virgo 43 Something a strawberry has on the outside 16 First word in a fairy tale 45 Wiseass 68 “Let’s a Deal" 47 Neighbor of Jordan 17 Service organization with a wheel logo 20 Get up 25 Connecticut Ivy 29 Bird of prey’s claw 58 Breadth 33 Domicile with wheels 62 Hawaiian feast ANSWER TO PREVIOUS PUZZLE L 0 C A L S E R R E 8 1 14 17 10 F R E A K 1 N G A W E S 0 M E 1 T C A E £ r' A N C E R S 1 P T E H E E T A 0 û N C A T C A R I N 0 N E S M A B A D 0 N € X [ N E T A D 0 U B E P A R A C E S M M A T A T W N E A : S E 1 33 70 Broadway award 39 12 13 30 31 32 60 61 16 1 19 22 ■ 24 23 26 ti ’ 20 27 25 26 29 34 35 36 37 44 38 41 40 42 46 45 47 48 2 Smell 54 Action taken by a company in distress 26 Wowed P 1 E D A T 7 5 69 Always telling people what to do 1 Zeus’ wife 53 Place where a mother might sing “Rock-a-Bye Baby" 21 Prison unit 1 6 3 43 50 Christmas trees S 0 N E 2 DOWN 49 Cleans, as a chalkboard 19 10:1 or 3:2 at a racetrack 5 A s A 0 N N D 1 R £ 0 R N 8 R G 0 T I T R [ E S A D D F M S B E K 1 L 1 B E L L N A P L A A R T s L T 1 E A E R F M i 67 Surmounting 42 London's Old 14 Genesis garden E R 1 C 1 D L E 63 They bring music to one's ears,,, or a hint to 17-, 21-, 33-, 45- and 54-Across No.1211 1211 65 Big vases 10 Item on a Native American moccasin 720 ´03 PT Cruiser, touring edition, 103k mi., silver, $2650. 580-574-6513. Subscribe today! Subscribe today! 38 Agatha Christie's “And Then There Were " ACROSS 635 I BUY RV´S & TRAILERS 405-620-5760 Merchandise CROSSWORD/New New YorkYork Times CROSSWORD/ Times 1 Georgetown athlete 620 isisIs the the number number number of ofofadults adults who read newspaper adultswho whoread readaaanewspaper newspaper ininIn print print or or online online In inin the the past past week. week. Million 23 Where Siberia is SULLIVAN TREE SERVICE Free local est. Since 1973. 355-6285 450 Guns THE LAWTON CONSTITUTION Classified Advertising Department offers No refunds or rain checks for Garage Sale ads affected by inclement weather. swoknews.com 115 More Readers...More Often = More Calls For Your Business. Appliance Repair 73501 Recreation 2- KITTENS, 1 male, CLASS A CDL needed. 1 female, $50 ea. Good opportunity, $500 ´98 CHEVY PICKUP, Ext 580-678-1649. sign on bonus. Cab, 3 drs., $2,500 580-695-6543. NOTICE: The City of Law- OBO. 580-647-6361. ton requires a Breeding/ Experienced Advertising/ Transfer Drivers Needed (BAT) permit number inT&G Construction cluded in unaltered pet Home nightly, EEO em- advertisements distribployer. 2 Years exper- uted within the Lawton ience required, Medical, city limit. For information Dental, Life, 401(k) call the Animal Welfare available. Call Steve Division, 581-3219. Carroll for information or fill out an application @ Pet Services/ readers 800 SE 1st Street, Supplies 560 make Lawton, OK 73501 (580) 355-6655 newspapers PET CREMATION at Rainbow Bridge. an important HIRING CDL flatbed truck 1386 SE 1st. St., part of their driver. 1K sign on bonus, Lawton, OK 73501 regional routes. Call or 580-351-8280. Sunday text 580-704-5336 Email your resume to realestate@parksjones realty.com, or come by our office at 4301 NW Cache Rd. to fill out an application. Home & Business Services Garage Sales CDL DRIVERS needed. Appliances 545 $3000 bonus after 1st MALT´S QUALITY APPLS. year. Home every night. Apply in person, Southern 811 SW LEE, 355-7514 Plains Services, US Hwy. Good used appliances. 277, Cyril, OK, Pets - Lawton 550 580-464-2503. EXPERIENCED SALES needed. Must have good driving record, and be able to pass drug and background check. SeMAINT. PERSON needed rious inquiries only. Fred for 102 unit apt. commu- Brewer Sales, 412 N. nity. Needs to be skilled Hwy. 277, Fletcher. in basic make ready, paint and texture, exper- Help Wanted ience preferred in HVAC. Apply in person at 2505 Office/ Clerical 360 NW 82nd St., between 8 Entry opportunity to learn & 5, Mon.-Fri. from the best real estate office in Lawton! 25 to 30 hours per week. Real MEERS STORE & Estate license preferred. RESTAURANT, Please bring resume to NOW HIRING Capuccio Dream Homes KITCHEN HELP, Realty, 2801 SW Lee SERIOUS Blvd. APPLICANTS ONLY. START AT $9 PER HR. TAKING PARKS JONES APPLICATIONS REALTY FOR WAITSTAFF Rental Management Dept. No Phone Calls. Apply in person. Seeking qualified (Closed on Tuesdays individual to & Wednesdays). conduct periodic THE MEERS STORE & home inspections. RESTAURANT Evaluate condition, secure 11⁄2 MILES NORTH repair estimates, competent OF THE WILDLIFE computer and good REFUGE ON HWY communication skills. 115 IN MEERS, OK. PAPA LOUIE´S PIZZERIA is now hiring full time drivers. Apply in person 2012 NW Smith. I G S E E N A S P A Y E X T R A 3 Dubious sighting in the Himalayas 4 Prehistoric Southwest culture 50 64 55 51 62 65 63 52 H .. 57 56 5 Crafty 6 Pagan religious practice 49 I a 7 Qualified PUZZLE BY BRIAN THOMAS 8 Yours (letter sign-off) 28 LIT of the funnies 9 “Se español” 30 Amours ■ 59 64 1 . . 41 Obtrusively bright 55 Mystique and showy 56 Tug sharply 44 Not concentrated, as light 10 Kind of logic in which all values are either true or false 31 In reserve 24 Notions puzzles, nytimes.com/crosswords ($39,95 a year). 26 Not quite right Read about and comment on each puzzle: nytimes.com/wordplay. 32 Long, narrow parts of bottles 46 Researcher's wear 57 Veers the other way 59 Word after lock 11 Prefix with -plasm 34 Good engine 48 Televise or glom sound 12 “Back in Black” 51 Program for rock band 60 Unpaid intern, addicts 3 5 Mae jocularly (Whoopi’s role in 52 “__ evil 13 Place for a “Ghost") laptop other than 53 Gives up, as 61 Catch sight of a lap 36 Onetime Russian territory space station 18 Flip, as a 54 Juicy fruit with a 64 Not mind one’s property pit 37 Opposite of exit own business 22 Diner sandwich, for short Online subscriptions: Today's puzzle and more than 7,000 past 27 $, € and £ LPXLP B6CLASS/MON B6 THE NORMAN TRANSCRIPT Monday, Jan. 15, 2018 LEGALS NEA Crossword Puzzle 47 Forget it! (2 wds.) 50 Command to Fido 51 Circus performer (hyph.) 54 “Do ------ say” 55 Masculine principle 56 Quaker pronoun 571-90 58 Charlotte of “Bananas” 59 Dreyfus defender ACROSS 1 Spout off 5 Drop bait on water 8 IV units 11 Proposal 12Then (2 wds.) 14 Mauve or lavender 15Self pullerupper 17 Retiree's kitty 18 Candy bar 19 Bowling target 21 Lady’s honorific 23 Get higher DOWN 24 Routine 27 Fall 1 Barbecue birthstone tidbit 29 Put a 2 Fusses dent in 3 Sign light 30 Sort of 4 Straw mat (3 wds.) 5 Football’s 34 Dinghy Mike — pair 6 Wind­ 37 Sidekick hoek’s 38 Late tennis cont. great 711th-grade 39 Compas­ exam sion 8 Junk food 41 Moonshine 9 Radium containers discoverer 43 Belgian 10 Penn or river Connery 45 Throat 13 Works feature by Puccini 1 2 6 3 11 16 15 Answer to Previous Puzzle D U S c O IVIP u N P 1 MA s T Z A P R S O U R 1N S U Y E T H E V E Z 1 R C R E L A A D E P T E L L E C 1 T B U E R R E 1 A Z O O N T E T 16 Skedaddle 20 Cairo’s river 22 Fiddle with 24 Med. plan 25 Battery size 26 Icy remark? 28 Ballet step 30 Fritz, to himself 31 “Fresh Air” station 32 Marsupial pocket 33 England’s Isle of — 35 Hangs back 36 Turn to bone 39 Ration out 40 Bogus Z 1 L M E N 1 E N C O N U R H E R S S O U S Y A M A E MO T R A E E A R D S Y E W N E A R N D R 1 V C A Y L A D E s L E D T H A E D M S C H E R E S S 41 Floor support 42 Take a bow out 44 Long bout 45 Bygone tyrant 46 Fibber 48 He overthrew Galba 49 Hull part 52 Genetic strand 53 FDR org. ■ 1 ■ 9 10 20 18 1 21 24 25 23 28 26 30 29 35 34 31 32 33 36 ■ ■ _ 39 38 41 42 43 46 45 40 44 48 49 52 50 54 53 55 56 ■ 57 58 59 © 2018 UFS, Dist. by Andrews McMeel Syndication for UFS 1-15 Alder on Bridge MONDAY, JANUARY 15, 2018 A CHOICE OF GAMES OFFERED TO PARTNER Barbara Hall, the creator and producer of “Judging Amy” and “Joan of Arcadia,” said, “You are what you are because of the conscious and subconscious choices you have made.” Bridge players usually make conscious choices, but occasionally an expert will produce a bid or play because it “felt right” at the time. In this deal, though, North had the opportunity to offer his partner a choice that worked very well. South had such a soft 18-point hand that he almost opened one no-trump. (The Kaplan-Rubens evaluation method rates it at 15 points!) However, after South showed a balanced 18 or 19, North used New Minor Forcing to find out that partner had three-card spade support. But he then made an excellent choice, continuing with three no-trump to offer partner a choice of games, North’s sequence having guaranteed five spades. South had an easy pass. Note that four spades had no chance, with one loser in each suit. Against three no-trump, West’s best lead would have been a low heart. Then declarer would have had to attack diamonds first to remove East’s entry to his long hearts. When West chose a low North 01-15-18 club, declarer won with 4J9873 V K2 dummy’s nine and played a ♦ 842 spade to his queen. West è K9 2 took the trick and shifted to a West East 4 10 heart, but South won with * K 6 4 2 ¥ A 10 6 ¥98743 dummy’s king and led a dia♦ A97 mond. East grabbed that ** A10105 37 * 8654 trick and returned a heart, South ♦ AQ5 but the contract was safe. V QJ5 In a 13-table duplicate, six ♦ KQJ6 other North-Souths reached ♦ QJ3 three no-trump, each when Dealer: North North raised two no-trump to Vulnerable: Neither three. The rest went down in South West North East Pass Pass four spades. COPYRIGHT: 2018, UNITED FEATURE SYNDICATE 14 2NT 3* l* 3* 3NT Pass Pass Pass Pass Pass All Pass Opening lead: ❖ 7 SUDOKU DIFFICULTY RATING: ★☆☆☆☆ 9 3 4 2 2 9 1 5 1 8 4 3 6 9 9 5 6 1 3 2 6 8 3 9 5 2 4 1 6 9 3 9 6 5 1 6 5 4 9 5 2018 Dist. by Andrews McMeel Syndication for UFS LPXLP Oklahoma, in Case No. CJ-2014-1050, wherein Wells Fargo Bank, NA is Plaintiff and Scott R. Esk is/are Defendant(s) to satisfy said judgment in the sum of $55,942.82 together with interest at 7.5% per annum from August 1, 2014, including late charges, $2,500.00 for attorney’s fee, $750.00 advances for title search, taxes, insurance, property preservation and all costs of this action accrued and accruing. The addresses of the Defendant(s), American National Mortgage, and her/his/their unknown successors are unknown to Plaintiff. WITNESS MY HAND this 8th day of January, 2018. BY: TODD R. GIBSON Sheriff BY: s/ C. Suttle Deputy SHAPIRO & CEJDA, LLC 770 NE 63rd St Oklahoma City, OK 73105-6431 (405)848-1819 Attorneys for Plaintiff File No. 14-120836 (Published in The Norman Transcript January 15, 2018, 1t) NEWSPAPER PUBLIC NOTICE Pursuant to 42 CFR § 431.408, the Oklahoma Health Care Authority (OHCA) is providing public notice of its plan to submit an amendment to the existing approved 2018 Section 1115(a) extension waiver for the SoonerCare Choice and Insure Oklahoma programs. The proposed amendment would add supplemental payments to qualified entities for loan repayment and residency training programs in recognition of the higher cost associated with service delivery and physician recruitment and training to maintain sufficient access to quality preventive, primary and specialty healthcare for SoonerCare members. It is the intent of the Oklahoma Health Care Authority to submit the amendment no later than January 19, 2018 with an effective date of March 1, 2018. The total estimated annual budget impact is one hundred and five million dollars ($105,000,000) of which the estimated state share is forty-three million, five hundred one thousand, five hundred dollars (43,501,500) which is funded by participating entities. A public meeting will be held at the following location: January 18, 2018 1:00 p.m. Medical Advisory Committee Ed McFall Boardroom Oklahoma Health Care Authority 4345 N. Lincoln Blvd, Oklahoma City, OK. Additionally, a special tribal consultation was held January 12, 2018 at 11:00 a.m. at the above location. The OHCA welcomes comments from the public regarding the Amendment to the SoonerCare Choice and Insure Oklahoma 1115(a) Demonstration Waiver program. The application waiver will be posted online at http://www.okhca.org from January 15, 2018 through January 19, 2018. Comments and questions may be submitted on line at http://okhca.org/PolicyBlog.aspx or by contacting Bill Garrison, OHCA Federal & State Reporting Coordinator by Telephone 405-522-7914. LEGALS LPXLP OPEN HOUSE LISTINGS Check Out The Top Selling REALTORS in Norman! NEW LISTINGS EVERY SATURDAY! TRANSCRIPTMEDIA HOW TO PLAY: Each row, column and set of 3-by-3 boxes must con­ tain the numbers 1 through 9 without repetition. 1 2 4 8 5 3 9 7 6 5 2 1 8 4 3 6 7 9 6 7 9 4 8 3 5 1 2 9 2 1 6 7 8 3 5 4 8 3 6 2 4 5 7 9 1 4 7 5 9 7 2 3 8 1 3 9 6 6 1 2 4 8 5 215 Comanche • 321-1800 Business & Service Directory 329-4726 Mike Weiner DAVID FRIES 360-4772 E Complete Remodel Handyman Service • Room Additions/Conversions • Cabinets/Refacing/Trim • Stain/Painting Doors/Windows • Decks/Pergolas/Arbors/Fences •Drywall/Plumbing/Electrical •Flooring/Wood/Ceramic Tile (All work performed by licensed contractors) 30 Yrs Exp • Refs Available Call 364-1649-550-5047 Enchantment Tree Service Trimming • Pruning • Shrubs Removal & Stump Grinding Residential & Commercial Insured 405 527-7668 No Job Too Big or Small! morrenhomeimprovement.com 5 6 4 1 2 7 9 8 3 3 1 8 5 9 4 2 7 6 AP Photo / Giovanni Auletta United States’ Lindsey Vonn gets to the finish area Sunday after completing an alpine ski women’s World Cup downhill in Bad Kleinkirchheim, Austria. Shiffrin set up as Olympics star By Howard Fendrich AP Sports Writer If Mikaela Shiffrin continues to race as well as she has been, she is setting herself up to be the biggest star of the Pyeongchang Olympics. Not just of Alpine skiing, but the entire Winter Games. To put it simply: She is about as close to unbeatable as can be right now. Shiffrin, a 22-year-old Call us at 366-3500 to reserve your spot today American, won the first five women’s World Cup races she entered in 2018, Lawn & Garden Carpet & Air Duct and seven of her past eight on the circuit, competing against the best the world Spear LAWN & GARDEN has to offer and outclassing Carpet Cleaning Mowing "Scalping them time and again. And Most Houses $QC Tree/Shrub Trim & Removal Shiffrin is not merely winSteam Cleaned Call for Firm Price You Name It! We Do It All! ning — she is overwhelmCall Red @364-8243 ing opponents, sometimes collecting victories by more than 1.5 seconds, a large margin in a sport often Lawn Care Construction decided by hundredths. Born in Colorado and raised in New Hampshire and Vermont, Shiffrin was FREDGREN 18 at the 2014 Sochi Games 25% OFF WITH THIS AD Winter Cleanup & Tree/Shrub Service when she became the QUALITY WORKS Sprinkler Systems Installed & Repaired THE BEST Small Construction Company youngest Olympic slalom in Norman, OK Res. & Com • Insured • Free Estimates champion in history. Her Juan 863-4952 fredgrenqualityworks.com 41st career World Cup race Clancy • 413-6638 Tom • 550-4505 win, which came in January, equaled the highest total for Painting a ski racer under 23. Now she heads to CRAIG- RUNKLE Pyeongchang as an over‘PAINTING- INC, whelming favorite to be pfARK SaNsSSS All Phases Interior /Exterior, Drywall Repairs, the first to win consecutive Construction Carpentry, Window Re-bronzing IBM ■ ’1 slalom golds. What’s more, w •Ceramic Tile - u 111 i * .*** 5 / •Carpentry/Trim Work \ i she will be a contender 11 g •Kitchen/Bathroom Remodels \ to win the giant slalom b f »Vinyl Replacement Windows ill” and combined, too , for a •Showers chance to match the Alpine •Backsplash & Flooring Roofing record of three titles at one Locally Owned & Operated Free Estimates • Insured w/Ref's Olympics. Call Mark @ It’s possible that she could (806) 336-3954 enter the super-G and ROOFING BY ■ «MB ■ f) downhill, too, which would faUiH make her something never seen these days: a five-event threat. “When I go to South Korea, I’m not going to be Construction Free Estimates thinking about what I did Drywall • Cabinets • Countertops • Doors • Add-on Decks • Roofs • Ceramic Tile • Wood Floors Commercial • Residential in Sochi or what I did even Other Home Improvement Ideas! Norman Area over 30 Years previously in this season,” Roofing In Norman Since 1964 Free Estimates Shiffrin said. “Hopefully, I’ll 447-0204 » 818-6442 just be thinking about the visa task at hand.” Here are some other things to watch on the MORREN Tree Trimming mountains in February: Home Improvement Norman print online mobile magazine Moore Visa / Master Card Accepted PREVIOUS SOLUTION O LYMP I CS: ALP I NE P RE VI E W (Published in The Norman Transcript January 15, 22, 2018, 2t) NOTICE OF SHERIFF’S SALE CJ-2017-598 Notice is given that on the 21st day of February, 2018, at 10:00 AM, Cleveland County Office Building, 201 S. Jones, Suite 200, in the City of Norman, Cleveland County, Oklahoma, the Sheriff of said County will offer for sale and sell, with appraisement, for cash, at public auction, to the highest and best bidder, all that certain real estate in Cleveland County, Oklahoma, to-wit: Lot Four (4), in Block Fifty-Four (54), of Winfield II Addition, Section Nine, to the City of Oklahoma City, Cleveland County, State of Oklahoma, according to the recorded plat thereof; subject to unpaid taxes, advancements by Plaintiff for taxes, insurance premiums, and expenses necessary for the preservation of the subject property, if any, said property having been duly appraised at $178,000. Sale will be made pursuant to a Special Execution And Order Of Sale issued in accordance with judgment entered in the District Court of Cleveland County, Oklahoma, in Case No. CJ-2017-598, entitled First United Bank and Trust Company, Plaintiff, vs. Dustin Bly, Heather Bly, John Doe, as occupant of the premises, and Jane Doe as occupant of the premises, being all of the Defendants and persons holding or claiming any interest or lien in the subject property. Todd Gibson, Interim Sheriff, Sheriff of Cleveland County, Oklahoma By: C. Suttle DEPUTY Done Timberlake - # 9021 BAER & TIMBERLAKE, P.C. P.O. Box 18486 Oklahoma City, OK 73154-0486 Telephone: (405) 842-7722 Facsimile: (405) 848-9349 BT File No.: 114165 TREE WIZARD “Ask a Certified Arborist” Hauling FREE ESTIMATES 850-3304 Mike’s Hauling & Lawn Care Mowing, Trees, Shrubs, Trim, Rake, Cleanup, Move/Haul, Shed Removal 360-8175 if 503-5560 www.treewizard.com Expert tree trimming, tree removals and stump grinding. Elusive gold Marcel Hirscher is as dominant among the men as Shiffrin is among the women. The Austrian has won an unprecedented six consecutive overall World Cup ti tles and appears on his way to No. 7. As of midJanuary, he put together a five-slalom winning streak. “He is just better. That’s the way it is,” said Henrik Kristoffersen, a Norwegian who perpetually ends up in second place, behind Hirscher. But for everything he’s done, Hirscher has yet to win an Olympic gold medal, despite four top-five finishes in slalom or giant slalom at Sochi and Vancouver. Remember these names Some folks to keep an eye on who could spring a surprise include Petra Vlhova of Slovakia, the last person to beat Shiffrin in a slalom race before the American’s lengthy winning streak; Sofia Goggia of Italy, who will be making her Olympic debut but won two World Cup races on the mountain in South Korea in March 2017; Michael Matt of Austria, whose older brother Mario defeated Hirscher for the gold in slalom four years ago; Andrew Weibrecht of the U.S. (nickname: War Horse), who came out of nowhere to pick up medals in 2010 and 2014 and maybe — just maybe — could do it again. Bye, Bode After a U.S.-record six Alpine medals (one gold, three silvers, two bronzes) across five Winter Games appearances, and one infamous boast about partying “at an Olympic level” at the 2006 Turin Games, Bode Miller will not be on the slopes in Pyeongchang. He will, however, be offering his thoughts on TV, which should be insightful and entertaining. Other familiar faces who’ll be absent: Tina Maze, a Slovenian who won Vonn’s return two golds four years ago; Maria Hoefl-Riesch, a Gerand farewell man medal who collected three golds and one silver at Shiffrin’s U.S. teammate Lindsey Vonn was supposed the past two Olympics; and Ivica Kostelic, a Croatian to be the one to watch at with four Olympic silvers. the Sochi Olympics but never got the chance to defend her downhill gold New event medal from Vancouver in 2010 because of a knee A team event is being injury. Back on the sport’s added at the end of the biggest stage for the last Olympic Alpine schedule time at age 33, Vonn can for the first time. Some athadd to her legacy as one letes — notably, Shiffrin — of the all-time greatest ski have said they doubt they’ll racers (she owns a women’s participate, but it could be a record 78 World Cup wins) way for ski racers who had by earning one more medal a disappointing Olympics in a speed event, downhill to make one last bid for a or super-G. medal. 4D THE OKLAHOMAN MONDAY, JANUARY 15, 2018 Lovely 3br 2ba brick home 1700sf Classy area $1035 255-4300 ¡‘ GET YOUR FIREWOOD ‘¡ ADBA Classic Bullies R. Edge Ch. Ped. 1/2 off $200! 580-237-1961 Seasoned Oak Firewood $125/rick Delivered • 405-585-7083 American Bulldog American Bulldog puppies. Registered. 8 weeks. 5M 4F. Shots $400. Call or Text 580-7910791. Call 580-623-2319 Starting at $125/rick delivered & stacked, call Ashley 405-503-2478 3bd 2ba 2car, ch/a, fp, $925 Accurate Prop 732-3939 Australian Shepherds Toy and Standard Australian Shepherds, all colors, registered, regular s/w. $500 Standard, $700 toy. Ready now. Clinton 500+ Kathy 580-695-7363 Nice 2bd 1ba carport, $625 Accurate Prop 732-3939 www.longburk.com 3bd 1ba 2car, ch/a, $600 Accurate Prop 732-3939 New & Used. Financing available. 1233 SE 44th 405-632-8954 Electric Go-Go Scooter, new batteries, easy haul, $495, 463-0693. 3bd 1.7ba 2car, ch/a, fp, $1000 Accurate Prop 732-3939 3bd 1.7ba 2car, ch/a, fp $1000 Accurate Prop 732-3939 from UKC champion bloodlines, 5F, 2M, ready now, $800, 918534-6926/918-914-3470, no texts. Poodle Standard Red Puppies AKC. Want to trade 1 puppy for Male AKC Standard 4yrs or younger. 479-394-4866 or 479-234-7210 BEAGLE PUPS » s/w, 7 weeks, 1F left, POP, black white & tan, $150 » 405-787-2111. BEAGLES AKC 10 WKS 5F 2M Blk Tan & White S/W POP Championship bloodlines $200 cash ¡ 405-659-7169 German Shepherd Puppies, AKC, 6 wks, 1st shots , healthy black & tan, $350 405-921-8761. GERMAN SHEPHERD Solid Wht AKC pups s/w $400 405-881-9844 Full length ranch mink, size medium, detachable hood, removed from storage at closing Koslows, worn once, $3000 cash, serious inquiries only, 405-209-7332. Elegant 3BR 2400sf Open Plan. Marble, granite $1645 603-4775 Pug AKC Male pug $650 cash 405-301-4473 Pug Puppies Shots, worming and papers. $500- 650 (405)756-3306 Rat Terrier Pups, small, hard to find, $125, 405-892-7512. Belgian Malinois, AKC pups, FREON R12 WANTED: Mobile Home, 2bed, 1bath, w/ appls included + W&D, storage shed, Edmond Schools, No Pets $525/mo. 348-6240 or 623-1181 Poodle Standard Puppies AKC Adorable 8 week old. Current on all vaccinations. see website. http://www.rpbarranch.net $850.-$950. Dianne 918 575-0123 BASSET HOUND PUPPIES 3bed 2bath 2car, ch/a, fireplace, $1000 Accurate Prop 732-3939 2bd & 3bd homes $600-$725 Longburk RE 732-7474 Check Our Website! GERMAN SHEPHERD AAA AKC Purebred pups + FREE food, leash, collar, training papers. Police dog parents. EXC guardians with Kids. Black/Silver/Tan, $600 972-333-4394, Pauls Valley, OK. Cert buyer will pickup, PAY CASH for cylinders and cans. (312) 2919169 or RefrigerantFinders.com both parents imported from Serbia, great for home protection 5m 4f $500 for limited registration ‘ 918-630-8678 Mens 26'' Mountain Bike $50. Bissel upright vacuum Nearly New $50 405-691-8161. Brand new in box Laminator, Model GBC H320 12.5in, very high quality $89 Johnny 405-549-5844 GOLDENDOODLE BABIES Mini & Standard sizes~MC/S/W/ DC~vet checked~no shed/ hypoallergenic~more info rubyrundoodles.com or email at rubyrunkennel@yahoo.com $1800-$2,200. 405 320-1198 Rottweiler puppies, full blood, champion bloodline, 5M, 2F, $600, sell or trade, 405-760-0360. Rottweiler German Puppies AKC reg, Beautiful, classic, Rott puppies, POP, Dew claws removed, tails docked, Great bloodlines, Weaned and paper trained, Short muzzles, nice heads, females look like males $800 male, $600 female Tony 405-370-8951 Jody 405-370-2451 Call or text Bull Mastiff Puppies, AKC, born 1/10/2018, $1,500. Now taking deposits. 918-694-9911 Rottweiler puppies, ACA registered with papers, beautiful dogs, $500 each, 405-812-1645. Flight Conditioned Bob White Quail, Newcastle, OK, $5 ea, » » » 405-426-9149 » » » OK’s largest selection of used Golf cars ¡ 800-276-0571 Small parrot found. Early Dec. Vicinity of S. Penn & SW 104th. Call to id. 405-273-2625 Bullmastiffs, AKC, 1M, 1F, 8wks, s/w, $700ea, 405-221-0881. Chihuahua puppies Adorable applehead chihuahua puppies for sale 2m 1f 6wks old parents on site $150.00 405-332-1452 CHIHUAHUAS: 2 Adorable 3/4 Chihuahuas, 1/4 Yorkie Males, 9wks old, black w/touch of white, 1st shot, $100. 405-410-9231 Chihuahuas, 2 litters, $30 each, Jack Russells, free, 414-2470. Chihuahua Teacups, TEENY TINY, 1st shot, $350 cash 405-446-4557 ROTTWIELER AKC Dad is Lab puppies AKC Black lab puppies Will make great companions/hunting dogs Vet checked and ready for pick up Jan 19 $500.00 580-618-3054 national & international champion $1500ea. 405-481-5558 Schnauzer Mini, AKC reg, F, choc, 6mos, all shots, circumstances causing to rehome, orig. $1,500 will take $1,000. 405-997-3030 Lab pups, AKC, 6M, 4F, chocolate, black & yellow, s/w/dc, vet checked, block head, otter tail, $600, 918-623-8305. Collie Puppies, AKC, sable & white DOB 11/30/17, M&F, POP, call for pics, Tulsa Area. $350ea, 918-232-0516. Financing avail. 30day-5yr warr. $125&up 1233 SE 44th 632-8954 Washer, Dryer, Freezer, Stove, Frig, $100 ea, can del, 820-8727. Corgi Pups, AKC, s/w, extra nice ready Feb. $850ea. 940-867-0931 Schnauzers Min. Schnauzers, registered, $800 & up 405-454-2836, 405-590-6562 Dachshund Puppies, red, 2M, 2F, no papers, POP, Tweenies, $300. Call or text 405-779-0266. Schnauzers AKC mchip s/w/e/t hlt grtd $500-$700 405-434-0528 LABRADOODLES 9 F1 Labradoodles.. 6 Male and 3 Female chocalte, black, champagne, and red. First round of shots and wormed. $1,200 Phone Number is 918-470-6973 Email is dustybobgene@yahoo.com W OO D S U N L I M I T E D 2604 S Portland » 405-541-5550 Lost prior #405-996-6352 due to health, but same quality service ready to warm your winter! Pecan $150 rick. Mixed Seasoned Hardwood PU $100 Rick » $125 fast del! Stovewood $75 trk load GENETIC SUPERIOR BULLS SEASONED HARD OAK $140 The Best Hardwood!!! $95 Per rick. Fast delivery & we stack It! call now! 405-314-5415. Schnauzers, Reg., champ bldln, F $500, M $400, 8wks 405-240-6941 Sheltie Puppy, AKC, 1M sable & white, s/w, $600 ¡ 405-929-0382 For more profit! Low birth wts like Angus but more muscle & growth & better disposition. Buy Now Most $2,000-$2,800. John Kusel Limousins ¡ 580-759-6038 60 black & black/white face cows, 13 new babies, balance heavy bred, $1300, 405-401-9587. 24 Black cow calf pairs 4, 5 & 6 yr old cattle, calves 2-4 months old, $2000ea 405-570-7050 Double Doodle Puppies Aussie-Goldendoodle Puppies 6 weeks old! Born 12-4-17. Ready 1-28-18. 1 Female Creamy White & 1 Male Golden Color & 1 Male Cream. Home raised, vet checked, dew claws removed. $1,500. Call/text 580-467-5305 or judylyellow@gmail.com French Bulldog 1M, brindle, registered, shots, $1500, 405-923-7801 SHIH TZU Male 14 wk pup imperial CHIH TZU imperial Chinese CKC 5 to 6pds, have pics s.e. Oklahoma $600 cash 405 830 2956 LABRADOODLE BABIES 30-40lbs sized~chocolate~MC/S/ W/DC~vet checked~no shed/ hypoallergenic~more info rubyrunkennel.com or email at rubyrunkennel@yahoo.com $1500-$2,200 405 320-1198 Labrador Retriever Puppies 2 Female Chocolate AKC Puppies. $550.00 405-802-4199 Appliance & A/C Service, 27 years exper, $40 service call, 371-3049. Home Repair & Remodel. Roofing. Siding. Free Estimate. 410-2495. Shih Tzus, mchip, $400-$450, ready to go, 405-434-0528. Siberian Husky Puppies 4 M, Born 11/15. 3 Blonde/white, 1 choc. Blue eyes, POP, S/W. $350 405/657-8443 SIBERIAN HUSKIES, AKC, 6wks, 2M R&W, 1M Blk&W, 1F Drk Red, 1F R&W, $500ea. 405-534-3377 Wirehaired Terrier Mix & German Shepherd Mix 7wks $25 414-1887 TIPTONSPLUMBING.COM Fitzpatrick Painting, 34 yrs exp, free est, lic, ins, 405-446-9882. Shih Tzus, ACA, 2M, brown & white, 8 wks, $750, 405-627-0419 Westie puppies 2F, 8 wks, s/w $300 580-334-9729 BST PLUMBING ¡ sewers, drains, residential 24hr emergency srvc. Licensed, bonded, Ins. ¡ 403-3204 A-1 Plumbing, no job to big or too small, lic, bond, 405-409-3090 Edm ¡ NW ¡ Nichols Hills Mon-Fri Good References/Transportation 30yrs Exper! 405-924-4892 lv msg LABS, AKC, 6wks on Jan 21. yellow, white & reds, blk & brown noses. Ch. Bloodlines s/w POP $600ea 405-229-4925 No Job Too Large Or Too Small Call Zach - (405) 703-2700 Bill's Painting & Home Repairs Quality Work! Free Est. 306-3087. Drives, Patios, All Types, »GENE’S TREE SERVICE» Insured-Free Est. 682-2100. Lic./Bond./Ins. Free Est. 769-3094 Tearouts/Repours, Drives, Patios, & More, Lic Ins Free Est 794-8505 BUDDY'S PLUMBING, INC. Ask about our camera special. 528-7733, buddysplumbingok.com Rural Electric Cooperative, Inc. (REC) is a distribution electric utility serving customers in southern Oklahoma. REC is soliciting bids from power line construction and debris removal contractors for storm restoration work. Interested parties should contact REC’s Engineering and Staking department at 405-7563104 ext. 302, via email at jonj@recok.coop, or visit the REC office located at 13942 Highway 76, Lindsay, OK 73052 to receive information on specific requirements and contract forms. All contractor pricing shall remain valid through calendar year 2018. REC complies with the procurement standards outlined in Federal policy 2 CFR part 215 and ensures that small businesses, minority-owned firms, and women’s business enterprises are used to the fullest extent practicable. Rural Development is an Equal Opportunity Lender. Complaints of discrimination should be sent to: Secretary of Agriculture, Washington, DC 20250. Great Dane AKC 1blk M, 1blk F, 1 merle F $750-$1500 405-476-8673 We buy GUNS Mustang Pawn & Gun. Over 1000 guns! 376-GUNS Stacked & Same Day Fast Delivery. Quality over Quantitiy :) » » » » 219-1423 » » » » NEWSOK.COM Wolf/Husky Puppies, 4F, 2M, $400 each , $100 deposit to hold, 405-273-3014/517-4344, lv msg. LaChon Hybrid- Lhasa X Bichon 7w,s/w/p $500 405-593-4714 YORKIE, ACA s/w/dc, m&f $300-$600 pics av. 580-224-1642. Yorkie AKC Female 9wks ,6-9lbs $650 405-226-0243 L&R Tree Service, Low Prices, Ins, Free Est, Firewood, 946-3369. Yorkies, 2F, 2M, ACA, s/w, $500-$700 ‘ 580-465-1571 Maltese & Morkies (ideal house pets) M & F, small, no shed, low allergy & odor, easy going, sweet & loving dogs, delivery/show room, $500-$1000, 918-694-3868. Morkies, 9 weeks, s/w/t/dc, F $450, M $400, 405-850-2110. Patterdale Terriers, 3M, 3F, excellent hunting & house dogs, vet checked, s/w, $375, 580-741-0172 Pekingese, 4F, ACA, s/w, $550 ‘ 580-465-1107 Yorkies, ACA with papers, 4 boys, 1 girl, $600ea. 405-706-3551 Yorkies, AKC M&F, s/w/dc, pretty & small, $600-$800, 919-9386. German Shepherd mix, rescued, all white, young male, loveable, great with all dogs, needs loving home, free, 405-823-7118. NEWSPAPER PUBLIC NOTICE Pursuant to 42 CFR § 431.408, the Oklahoma Health Care Authority (OHCA) is providing public notice of its plan to submit an amendment to the existing approved 2018 Section 1115(a) extension waiver for the SoonerCare Choice and Insure Oklahoma programs. The proposed amendment would add supplemental payments to qualified entities for loan repayment and residency training programs in recognition of the higher cost associated with service delivery and physician recruitment and training to maintain sufficient access to quality preventive, primary and specialty healthcare for SoonerCare members. It is the intent of the Oklahoma Health Care Authority to submit the amendment no later than January 19, 2018 with an effective date of March 1, 2018. The total estimated annual budget impact is one hundred and five million dollars ($105,000,000) of which the estimated state share is forty-three million, five hundred one thousand, five hundred dollars (43,501,500) which is funded by participating entities. A public meeting will be held at the following location: January 18, 2018 1:00 p.m. Medical Advisory Committee Ed McFall Boardroom Oklahoma Health Care Authority 4345 N. Lincoln Blvd, Oklahoma City, OK. Additionally, a special tribal consultation was held January 12, 2018 at 11:00 a.m. at the above location. The OHCA welcomes comments from the public regarding the Amendment to the SoonerCare Choice and Insure Oklahoma 1115(a) Demonstration Waiver program. The application waiver will be posted online at http://www.okhca.org from January 15, 2018 through January 19, 2018. Comments and questions may be submitted on line at http://okhca.org/PolicyBlog.aspx or by contacting Bill Garrison, OHCA Federal & State Reporting Coordinator by Telephone 405522-7914. tulsa Business & Legal news 10 Tuesday, January 16, 2018   Legal Notices LPXLP KURT GLASSCO JUDGE OF THE DISTRICT COURT JIM FEHRLE DEPUTY COURT CLERK dures and to receive Bidders' questions. RY pre-bid conference is scheduled for Tuesday, February 6, 2018. This project bond funds. is contingent the sale and receipt of right to waive any informali­ 441863 Published in the Tulsa Busi­ ness & Legal News, Tulsa County, Oklahoma, Janu­ ary 9 & 16, 2018 Published: January 16, 2018 and January 23, 2018 UNION PUBLIC SCHOOL DISTRICT INDEPENDENT SCHOOL DISTRICT NO. 9 TULSA COUNTY, OKLAHOMA 443739 Published in the Tulsa Business & Legal News, Tulsa County, Oklahoma, January 16 & 23, 2018 IN THE DISTRICT COURT IN AND FOR TULSA COUNTY STATE OF OKLAHOMA NOTICE OF SHERIFF'S SALE CJ-2017-345 S. Fred Isaacs Director of Construction Services 443399 Published in the Tulsa Business & Legal News, Tulsa County, Oklahoma, January 16, 2018 NEWSPAPER PUBLIC NOTICE IN THE MATTER OF THE ESTATE OF JERRY Y. ESTES, Deceased. Case No.: PB-2017-740 Hon Kurt G. Glassco IN THE DISTRICT COURT IN AND FOR TULSA COUNTY STATE OF OKLAHOMA ORDER AND NOTICE FOR HEARING ON FIRST AND FINAL ACCOUNT, AND PETITION TO APPROVE FINAL ACCOUNT AND DETERMINING HEIRSHIP, AND PETITION FOR FINAL DECREE OF DISTRIBUTION NOW ON January 10, 2018, Robin G. Johnson, the Per­ sonal Representative of the Estate of Jerry Y. Estes, De­ ceased, having filed in this Court her First and Final Ac­ count and Petition to Approve Final Account and Deter­ mining Heirship, and Petition for Final Decree of Distribu­ tion, the Court finds that the same should be set for hearing. IT IS THEREFORE ORDERED that the Final Account and Petition be set for hearing, and notice is hereby giv­ en of the hearing before this Court on the 28th day of February, 2018, at 9:30 o'clock a.m., when and where all persons interested in the estate may appear and contest the same, and that notice of the hearing be given by mailing copies of this Order and Notice to each heir at law, legatee, and devisee of decedent at their last known place of residence; and by publication once each week for two (2) consecutive weeks in a newspaper published in Tulsa County prior to the hearing. KURT GLASSCO JUDGE OF THE DISTRICT COURT JIM FEHRLE DEPUTY COURT CLERK /s/ Robert J. Getchell Robert J. Getchell, OBA No. 11317 GABLEGOTWALS 1100 ONEOK Plaza 100 West 5th Street Tulsa, OK 74103-4217 Telephone: (918)595-4800 Facsimile: (918)595-4990 Attorneys for the Personal Representative 443757 Published in the Tulsa Business & Legal News, Tulsa County, Oklahoma, January 16 & 23, 2018 NOTICE TO BIDDERS: Sealed proposals for a single contract for the HVAC Re­ placement Phase II @ Darnaby Elementary School will be received by the Union Public School District, Inde­ pendent School District No. 9, Tulsa County, Oklahoma (the "District"), Support Services, 8506 E. 61st Street, Tulsa, Oklahoma 74133-1926, until 2:00 p.m. CST, Tues­ day, February 20, 2018, at which time proposals will be opened and read aloud. The Instructions to Bidders, Form of Proposal, Form of Contract, Drawings, Specifications and other contract documents will be available for examination beginning Tuesday, January 16, 2018 at the office of the Support Services Department of the District by appointment be­ tween the hours of 8:00 a.m. to 5:00 p.m., Monday through Friday. Call 918-357-6183 (Support Services De­ partment) for an appointment. Additionally, copies of the contract and bidding documents, including the draw­ ings and specifications, may also be obtained from the Support Services Department beginning January 16, 2018. All Bidders for this project are required to meet all qual­ ification requirements as established in these bid docu­ ments. Furthermore, each Bidder may not withdraw his bid after the actual date of the opening of bids. Contrac­ tors are required to submit qualification statements sev­ en (7) days prior to bidding. The District will conduct a MANDATORY pre-bid confer­ ence at the place bids will be received, followed by an on-site examination of existing conditions, for the pur­ pose of review of the bidding documents, bidding proce­ 1820 South Cincinnati Ave Tulsa, OK 74119 (918) 749-0606 camille@camillequinn.com Attorney for Personal Representative The District reserves the ties, or to reject any or all bids. Prepared by: DRU R. TATE, OBA #30434 South County Law Firm/ PLLC 311 W. 7th Street Okmulgee, OK 74447 918-528-6655 - Telephone 918-917-8485-Facsimile Attorney for Petitioner upon The MANDATO­ 10:00 a.m. CST, Pursuant to 42 CFR § 431.408, the Oklahoma Health Care Authority (OHCA) is providing public notice of its plan to submit an amendment to the existing approved 2018 Section 1115(a) extension waiver for the SoonerCare Choice and Insure Oklahoma programs. The proposed amendment would add supplemental pay­ ments to qualified entities for loan repayment and resi­ dency training programs in recognition of the higher cost associated with service delivery and physician recruit­ ment and training to maintain sufficient access to quali­ ty preventive, primary and specialty healthcare for SoonerCare members. It is the intent of the Oklahoma Health Care Authority to submit the amendment no later than January 19, 2018 with an effective date of March 1, 2018. The total esti­ mated annual budget impact is one hundred and five mil­ lion dollars ($105,000,000) of which the estimated state share is forty-three million, five hundred one thousand, five hundred dollars (43,501,500) which is funded by par­ ticipating entities. A public meeting will be held at the following location: January 18, 2018 1:00 p.m. Medical Advisory Committee Ed McFall Boardroom Oklahoma Health Care Authority 4345 N. Lincoln Blvd, Oklahoma City, OK. Additionally, a special tribal consultation ary 12, 2018 at 11:00 a.m. at the above location. was held Janu­ The OHCA welcomes comments from the public regard­ ing the Amendment to the SoonerCare Choice and Insure Oklahoma 1115(a) Demonstration Waiver program. The application waiver will be posted online at http://www.ok hca.org from January 15, 2018 through January 19, 2018. Comments and questions may be submitted on line at htt p://okhca.org/PolicyBlog.aspx or by contacting Bill Gar­ rison, OHCA Federal & State Reporting Coordinator by Telephone 405-522-7914. 443688 Published in the Tulsa Business & Legal News, Tulsa County, Oklahoma, January 16, 2018 IN THE DISTRICT COURT OF TULSA COUNTY STATE OF OKLAHOMA IN THE MATTER THE ESTATE OF OF Tommie L. Blancett, Deceased. Case No. PB-2018-022 Judge: Glassco NOTICE FOR HEARING PETITION TO ADMINIS­ TER ESTATE, APPOINT­ MENT OF PERSONAL REPRESENTATIVE, AND FOR DETERMINA­ TION OF IDENTITY OF HEIRS-AT-LAW NOTICE IS HEREBY GIVEN to all persons inter­ ested in the Estate of Tom­ mie L. Blancett, Deceased, that on the 10th day of Jan­ uary, 2018, Tammie E. Blancett produced in the District Court of Tulsa County, State of Oklaho­ ma, a Petition for the Ad­ ministration of the Estate of Tommie L. Blancett, Deceased, asking that Let­ ters of Administration be issued to Tammie E. Blancett upon the estate of Tommie L. Blancett, De­ ceased, and requesting this Court determine the identi­ ty of all the heirs-at-law of the decedent. NOTICE IS ALSO GIVEN that the 6th day of Febru­ ary, 2018, at the hour of 10:30 o'clock A.M., of that day, has been appointed as the time for hearing the Petition in Courtroom 701 of the District Court, Pro­ bate Division, in the Coun­ ty Courthouse, in the Coun­ ty of Tulsa, Oklahoma, when and where all per­ sons interested may ap­ pear and contest the same by filing written opposition thereto on the ground of incompetency of the appli­ cant, or may assert their own rights to the adminis­ tration and pray the Let­ ters be issued to them. DATED this 10th day of January, 2018. KURT GLASSCO Judge of the District Court By GERI BAUHAUS Deputy Court Clerk Prepared by: Camille M. Quinn, OBA #13522 Attorney at Law Camille M. Quinn P.C. A Professional Corporation Notice is given that on the 13th day of February, 2018, at 10:00 AM, in Room 119 of the Tulsa County Court­ house, in the City of Tulsa, Tulsa County, Oklahoma, the Sheriff of said County will of­ fer for sale and sell, with ap­ praisement, for cash, at pub­ lic auction, to the highest and best bidder, all that cer­ tain real estate in Tulsa County, Oklahoma, to-wit: Lot Four (4), Block Five (5), Woodland Meadow Addition, an Addition to the City of Tulsa, Tulsa County, State of Oklaho­ ma, according to the re­ corded plat No. 3790; subject to unpaid taxes, ad­ vancements by Plaintiff for taxes, insurance premiums, and expenses necessary for the preservation of the sub­ ject property, if any, said property having been duly appraised at $111,000. Sale will be made pursuant to a Special Execution And Order Of Sale issued in accordance with judgment entered in the District Court of Tulsa Coun­ ty, Oklahoma, in Case No. CJ-2017-345, entitled Nationstar Mortgage LLC, Plaintiff, vs. Paul J. Winden, Ruth M. Winden, John Doe, as occupant of the premises a/k/a Kurt Winden, Jane Doe, as occupant of the premises and Susan Boyd, as Successor General Guardian of the person and Estate of Paul J. Winden, and as Gen­ eral Guardian of the Person and Estate of Ruth M. Winden, being all of the De­ fendants and persons holding or claiming any interest or lien in the subject property. Vic Regalado, Sheriff of Tulsa County, Oklahoma By: James Estes DEPUTY Don Timberlake - # 9021 BAER & TIMBERLAKE, P.C. P.O. Box 18486 Oklahoma City, OK 73154-0486 Telephone: (405) 842-7722 Facsimile: (405) 848-9349 BT File No.: 113381 441854 Published in the Tulsa Busi­ ness & Legal News, Tulsa County, Oklahoma, Janu­ ary 9 & 16, 2018 NOTICE OF SHERIFF'S SALE CJ-2017-3785 Notice is given that on the 13th day of February, 2018, at 10:00 AM, in Room 119 of the Tulsa County Court­ house, in the City of Tulsa, Tulsa County, Oklahoma, the Sheriff of said County will of­ fer for sale and sell, with ap­ praisement, for cash, at pub­ lic auction, to the highest and best bidder, all that cer­ tain real estate in Tulsa County, Oklahoma, to-wit: The East Half (E/2) of Lot Seven (7), Block Twenty-seven (27), in The Town of Red Fork, now an Addition to the City of Tulsa, Tulsa County, State of Oklaho­ ma, according to the re­ corded plat No. 518; subject to unpaid taxes, ad­ vancements by Plaintiff for taxes, insurance premiums, and expenses necessary for the preservation of the sub­ ject property, if any, said property having been duly appraised at $36,000. Sale will be made pursuant to a Special Execution And Order Of Sale issued in accordance with judgment entered in the District Court of Tulsa Coun­ ty, Oklahoma, in Case No. CJ-2017-3785, entitled Ditech Financial LLC, Plaintiff, vs. Shawn A. Norris, Spouse of Shawn A. Norris, if married a/k/a Judy Norris, Unifund CCR Partners and Jane Doe, as occupant of the premises a/k/a Danielle, being all of the Defendants and persons holding or claiming any in­ terest or lien in the subject property. Vic Regalado, Sheriff of Tulsa County, Oklahoma By: /s/ James Estes DEPUTY Don Timberlake - # 9021 BAER & TIMBERLAKE, P.C. P.O. Box 18486 Oklahoma City, OK 73154-0486 Telephone: (405) 842-7722 Facsimile: (405) 848-9349 BT File No.: 114851 443651 Published in the Tulsa Business & Legal News, Tulsa County, Oklaho­ ma, January 16 & 23, 2018 NOTICE OF SHERIFF'S SALE CJ-2017-2804 Notice is given that on the 20th day of February, 2018, at 10:00 AM, in Room 119 of the Tulsa County Courthouse, in the City of Tulsa, Tulsa County, Okla­ homa, the Sheriff of said County will offer for sale and sell, with appraise­ ment, for cash, at public auction, to the highest and best bidder, all that cer­ tain real estate in Tulsa County, Oklahoma, to-wit: Lot Twelve (12), Block Three (3) Amended Plat of Blocks 1,2, 3, 11 and 12 of Highland Park Estates, Tulsa County, State of Okla­ homa, according to the recorded plat No. 925; subject to unpaid taxes, advancements by Plaintiff for taxes, insurance premi­ ums, and expenses neces­ sary for the preservation of the subject property, if any, said property having been duly appraised at $378,000.00. Sale will be made pursuant to a Spe­ cial Execution And Order Of Sale issued in accord­ ance with judgment en­ tered in the District Court of Tulsa County, Oklaho­ ma, in Case No. CJ-20172804, entitled Reverse Mortgage Solutions, Inc., Plaintiff, vs. Robert Henry Thomson, Jr. and United States of America, ex rel The Secretary of Housing and Urban Development, being all of the Defendants and persons holding or claiming any interest or lien in the subject proper­ ty. Vic Regalado, Sheriff of Tulsa County, Oklahoma By /s/ James Estes DEPUTY Don Timberlake - # 9021 BAER & TIMBERLAKE, P.C. P.O. Box 18486 Oklahoma City, OK 73154-0486 Telephone: (405) 842-7722 Facsimile: (405) 848-9349 BT File No.: 114437 441852 Published in the Tulsa Busi­ ness & Legal News, Tulsa County, Oklahoma, Janu­ ary 9 & 16, 2018 NOTICE OF SHERIFF'S SALE CJ-2017-342 Notice is given that on the 13th day of February, 2018, at 10:00 AM, in Room 119 of the Tulsa County Court­ house, in the City of Tulsa, Tulsa County, Oklahoma, the Sheriff of said County will of­ fer for sale and sell, with ap­ praisement, for cash, at pub­ lic auction, to the highest and best bidder, all that cer­ tain real estate in Tulsa County, Oklahoma, to-wit: Lot Four (4), Block Two (2), HUNTINGTON PLACE, an Addition to the City of Tulsa, Tulsa County, State of Oklaho­ ma, according to the re­ corded plat thereof; subject to unpaid taxes, ad­ vancements by Plaintiff for taxes, insurance premiums, and expenses necessary for the preservation of the sub­ ject property, if any, said property having been duly appraised at $266,000. Sale will be made pursuant to a Special Execution And Order Of Sale issued in accordance with judgment entered in the District Court of Tulsa Coun­ ty, Oklahoma, in Case No. CJ-2017-342, entitled Wil­ mington Trust, NA, succes­ sor trustee, Plaintiff, vs. Ste­ phen F. Johnston, Sherlene E. Burns and State of Okla­ homa ex rel., Oklahoma Tax Commission, being all of the Defendants and persons holding or claiming any in­ terest or lien in the subject property. Vic Regalado, Sheriff of Tulsa County, Oklahoma By: /s/ James Estes DEPUTY Donald J. Timberlake - # 9021 BAER & TIMBERLAKE, P.C. P.O. Box 18486 Oklahoma City, OK 73154-0486 Telephone: (405) 842-7722 Facsimile: (405) 848-9349 BT File No.: 113171 441846 Published in the Tulsa Busi­ ness & Legal News, Tulsa County, Oklahoma, Janu­ ary 9 & 16, 2018 SECOND ALIAS NOTICE OF SHERIFF'S SALE CJ-2013-157 Notice is given that on the 13th day of February, 2018, at 10:00 AM, in Room 119 of the Tulsa County Court­ house, in the City of Tulsa, Tulsa County, Oklahoma, the Sheriff of said County will of­ fer for sale and sell, with ap­ praisement, for cash, at pub­ lic auction, to the highest and best bidder, all that cer­ tain real estate in Tulsa County, Oklahoma, to-wit: Lot Six (6), Block Two (2), Sun Meadow II, an Addition to the City of Tulsa, Tulsa County, State of Oklahoma, ac­ cording to the recorded plat No. 3605; subject to unpaid taxes, ad­ vancements by Plaintiff for taxes, insurance premiums, and expenses necessary for the preservation of the sub­ ject property, if any, said property having been duly appraised at $210,000.00. Sale will be made pursuant to a Second Alias Special Execu­ tion And Order Of Sale is­ sued in accordance with judgment entered in the Dis­ trict Court of Tulsa County, Oklahoma, in Case No. CJ2013-157, entitled GMAC Mortgage, LLC, Plaintiff, vs. Luther O. Grade, Tammy L. Grade and Mortgage Elec­ tronic Registration Systems, Inc., being all of the Defend­ ants and persons holding or claiming any interest or lien in the subject property. Vic Regalado, Sheriff of Tulsa County, Oklahoma By: /s/ James Estes DEPUTY Don Timberlake - # 9021 BAER & TIMBERLAKE, P.C. P.O. Box 18486 Oklahoma City, OK 73154-0486 Telephone: (405) 842-7722 Facsimile: (405) 848-9349 BT File No.: 111289 441868 Published in the Tulsa Busi­ ness & Legal News, Tulsa County, Oklahoma, Janu­ ary 9 & 16, 2018 NOTICE OF SHERIFF'S SALE CJ-2017-4075 Notice is given that on the 13th day of February, 2018, at 10:00 AM, in Room 119 of the Tulsa County Court­ house, in the City of Tulsa, Tulsa County, Oklahoma, the Sheriff of said County will of­ fer for sale and sell, with ap­ praisement, for cash, at pub­ lic auction, to the highest and best bidder, all that cer­ tain real estate in Tulsa County, Oklahoma, to-wit: Lot Seven (7), Block Nine (9), Magic Circle Addition, an Addition to Tulsa County, Oklaho­ ma, according to the re­ corded plat thereof; subject to unpaid taxes, ad­ vancements by Plaintiff for taxes, insurance premiums, and expenses necessary for the preservation of the sub­ ject property, if any, said property having been duly appraised at $87,000. Sale will be made pursuant to a Special Execution And Order Of Sale issued in accordance with judgment entered in the District Court of Tulsa Coun­ ty, Oklahoma, in Case No. CJ-2017-4075, entitled First Guaranty Mortgage Corpora­ tion, Plaintiff, vs. Adam L. Jennings, Jessica A. Jen­ nings and John Doe, as occu­ pant of the premises a/k/a 6 CLASSIFIED tulsamarketplace.com Monday, January 15, 2018 you feel free. What the two of you come up with might be more appropriate for you in the stage of life that you are in. Be willing to make a change. Tonight: Work late. THE STARS ★ ★ ★ ★ ★ BY JACQUELINE BIGAR JS * VIRGO (Aug. 23-Sept. 22)...................................... Whatever comes down your path forces you to tap into your dynamic energy. How you see a personal mat­ ter could change substantially after a talk with the people involved. Your imagination carries you through any problems you encounter. Tonight: Dance the night away. MONDAY, JANUARY 15,2018 Note: Bigar’s Stars is based on the degree of your sun at birth. The sign name is simply a label astrologers put on a set of degrees for convenience. For best results, readers should refer to the dates following each sign. A baby born today has a Sun and Moon in Capricorn. LIBRA (Sept. 23-Oct. 22)................................... ***» wQ You could be frightened by someone else's message and lack of clarity. You like inspiring ideas, but you need to know that there is a practical path to that end. Be willing to revise your thinking around a concept that could af­ fect your home life. Tonight: Opt for a cozy evening. II Happy birthday for Monday: This year you will want to use your natural abilities to head in the direction you want. You could be more serious-minded than you realize. If you are single, the person you choose to date today could be a lot different from the person you choose to be with three years from now. Take your time and allow this bond to evolve naturally. If you are attached, the two of you need to learn to adjust to each other's preferences. As a result, you both will be a lot happier. A fellow CAPRICORN could be demanding. fmUi Keep conver­ sations moving and open. Do not consider anyone's comment as being final. What is happening is that a process is taking place. You might adjust your ideas and feelings several times in a simple discus­ sion. Stay open to what others have to say. Tonight: Return calls. 5-Dynamic; 4-Positive; 3-Average; 2-So-so; 1-Difficult ^ SAGITTARIUS (Nov. 22-Dec. 21)...................... ARIES (March 21-April 19)............................ "i Take charge of your day. You might want to clear out some time for a personal matter. Opportunities come through a partner or associate. This person can deal with a close friend in both of your lives. Let others call the shots for now. Tonight: A discussion is animated. -jttTAURUS (April 20-May 20).................................. **** (fryi Listen to your inner voice for inspiration. A close friend could pop in and out of your day. This person might decide to share an unusual perspective on a situation. You are likely to act on this idea later in the day. Note the feedback you receive. Tonight: Mull over recent happenings. Vt vYou are full of fun. You seem to be on a more conservative path than you thought possible. How you view a personal matter could dramatically change as a result. Touch base with someone whose ideas generally prove to be beneficial. Tonight: Pay bills before heading out. • CAPRICORN (Dec. 22-Jan. 19)........................ Your imagination carries you to faraway places. Your more-practical side needs to be appeased in order to act on a risky hunch. A friend or loved one might encourage you to get past this mindset. You could find it hard to believe some news you hear. Tonight: Just be yourself. jfjL AQUARIUS (Jan. 20-Feb. 18).................................. **** Q’y'R. A lot is going GEMINI (May 21-June 20)................................. ***** AA Deal with a partner directly. You could feel overwhelmed by everything that lands on your plate. The good news is that you have the energy to meet these demands. You might have difficulty turning a situ­ ation around until you tap into your imagination. Tonight: Share news. on behind the scenes that you are not aware of. You might not be as clear as you would like to be on the details surrounding a financial matter. A deal that comes your way really could be too good to be true. Be a cynic, and you will land well. Tonight: Get some rest. You have inspired others to perform to their max. You could be driven by a long-term goal. Patience is a virtue, and you will be more comfortable if you relax and go with the flow. Honor a fast change, and embrace the mo­ ment and others' moods. Tonight: Find your friends. Your ability to connect with a loved one and others in general is highlighted. If a challenging situation arises, tap into your imagination to transform the matter more to your liking. You also might get a partner's agree­ ment. Tonight: Go along with a friend's request. BORN TODAY: Actor Lloyd Bridges (1913), actress Dove Cameron (1996), actress Regina King (1971) ¿Jfc LEO (July 23-Aug. 22)........................................ **** You might Jacqueline Bigar is on the Internet at www.jacquelinebigar.com. want to head down a different path. Brainstorm (c) 2017 by King Features Syndicate Inc. with someone who knows you well and with whom Dogs Business Property Lease Poodles home raised, 8 wks, spoiled rotten, shots & wormed, ready to go. 918-485-8200 Follow us on Twitter for breaking news. PYRENEES PUPPIES! M/F born 11/21/2017. Wormed and shots, $175 each or 2/$300. Pure blood-white Text phone: 918-716-4191 twitter.com/tulsaworld Tulsa World ROTTWEILERS, AKC Dad is National & International Champion, $1500 each. Call 405-481-5558 Pet Memorials Event Number OSUA&MRFP-000410-2018 Request for Proposal Property for lease, lease with option to purchase or straight purchase as allowed by Oklahoma law. 115-117 W. 6th Street Bell Building Okmulgee, OK 74447 AUSTRALIAN SHEPHERD PUPPIES Commercial Real Estate - Rentals YORKIE PUPPPIES 7 Wks, 1st & 2nd Worming, ACA Pedigree, 3 girls, $500 ea., 2 boys $450 ea., Cash Preffered 918-630-3273 Business Property Lease 5500 Center - 55th & Mingo 700-1600sf Retail & Warehouses Avail Starting at $510 Call 918-960-1714 Lost your Pet? Find a lost pup? Sterling Plaza 92nd & Sheridan Office spaces Available $257 to $453 Utilities included Call 918-369-1220 or 918-808-4862 Run a Classified Ad. 918-583-2121 H E ROYAL w CORGIS I m VS ] u K 0 L JG UA X QO 0 L Il ! k) C A X V H J \J T WY H E C A XV K P N ES YN G X N KN 1 \ WY 1 NL E p T GF n \ P OC T 5 o L J w V LR T R P N OM ü l- D il Q E II LE A P B A £X u A YT t It V G R Ft lK O U \I AY s K X / L nnrl Hfslhsr Mçntÿ H SR Hl.-ïé-v Crfiukers Ürakm Tulsa World Y W V V p ON F K c ,A Broken Arrow Rental tulsaworld.com/classifieds Apartments-Furnished 3/1, Bills Paid. SEC 8 ONLY! Must Already Have Voucher. Immediate Occupancy. Call 918-808-7463 or e-mail: voyagerA69@gmail.com Rivera West Apartments Great Location, lots of trees, 1 & 2 Bedrooms, all bills paid option, nice big balconies, central heat and air, move in special $350, no deposit, no app fee, pets acceptable, Immediate occupancy 918-638-0861. 918-378-6851. 4 bdrm, 2 bath, 1 car, wood/tile floors, new paint, fenced yard, near park, $925 mo., $600 deposit, 918-639-1067 Union Rental Duplex-Triplex-Quad Midtown Tulsa- Duplex 2/2, kitchen, living room, central h/a, carport, no pets. $675/mo 4318 S. MaplewoodAve. Tulsa, Ok, 74135. 918-706-2361 Victor Apartments 1st MONTH FREE with All bills paid!! in the heart of Brookside 1 Bedroom $500 & 2 Bedroom $700 Call 918-742-1840 for information and showing NO Housing Houses-Unfurnished 3504 E. King Pl., 3 Bed, 3 Bath 1850 SF, huge LR, new wd flrs & paint, lots of storage, fenced yard, pets ok, $850/mo. +$850 dep., $250 pet fee. 918-521-7717 Advertise here for results! 918-583-2121 Union School district, 3 bdrm, 1.5 bath, 2 car, covered patio, new paint, tile floor, nice neighborhood, $875/mo. Call 918-282-7594 SELLING YOUR HOUSE? Call 918-583-2121 Legal Notices LPXLP 443116 Published in the Tulsa World, Tulsa County, Oklahoma, Janu­ ary 12, 15, 16, 17, 18 & 19, 2018 443765 Published in the Tulsa World, Tulsa County, Oklahoma, January 15 & 22, 2018. REQUEST FOR BIDS: Expo Square Projects NOTICE TO BIDDERS SEALED BIDS FOR PROJECT NO. SP 16-10-1400XX BID PACKAGE #5 Notice is hereby given that pursuant to an order by the May­ or of the City of Tulsa, Oklahoma, sealed bids will be re­ ceived in Room 260 of the Office of the City Clerk, City of Tul­ sa, 175 E. 2nd Street, Tulsa, Oklahoma 74103 until 8:30 a.m. the 9th day of February, 2018 for furnishing all tools, materi­ als and labor and performing the work necessary to be done in the construction of the following: PROJECT NO. SP 16-10-1400XX EMD FACILITIES MAINTENANCE UPGRADES/PLBG, HVAC & LTG The entire cost of the improvement shall be paid from Account No. 140070.Buildings.5452101 -4051611 -541104 140080. Bui ldings.5452101-4051611-541104 A MANDATORY Pre-Bid Conference is scheduled for Mon­ day January 22, 2018 at 9:00 am in the 2nd Floor Conference Room, Room S213, South Building, 2317 South Jackson Tulsa, Oklahoma. Attendance at the Pre-Bid Conference is MANDATORY. Bids will not be received from contractors who did not attend the Pre-Bid Conference. Wholiy $h