Maricopa County Special Health Care District Board of ... BOD 090915 binder as of... · Board of Directors Strategy/Governance Meeting September 9, 2015 ... Board of Directors . Strategy/Governance

Maricopa County Special Health Care District

Board of Directors Strategy/Governance Meeting

September 9, 2015 1:00 p.m.

Agenda

Welcome We welcome your interest and hope you will often attend Maricopa County Special Health Care District Board of Directors meetings. Democracy cannot endure without an informed and involved electorate. The Board of Directors is the governing body for Maricopa Integrated Health System. Each member represents one of the five districts in Maricopa County. Members of the Board are public officials, elected by the voters of Maricopa County. The Board of Directors sets policy and the President & Chief Executive Officer, who is hired by the Board, directs staff to carry out the policies. Meetings The Board of Directors generally holds meetings at 1:00 p.m. on the second and fourth Wednesdays of the month. Please visit http://mihs.org/governing-bodies/bod-calendar or call the District Clerk at 602-344-5177 to confirm the date of the next regular meeting. The meeting may appear to proceed quickly, with important decisions reached with little discussion. However, the agenda and meeting material is available to the Board of Directors prior to the meeting, giving them the opportunity to study every item and to ask questions of District staff members. If no additional facts are presented at the meeting, action may be taken without further discussion. How Citizens Can Participate The Board of Directors values citizen comments and input. Citizens may appear before the Board of Directors to express their views. Any member of the public will be given three minutes to address the Board on issues of interest or concern to them. If you wish to address the Board, please complete a Speaker’s Slip and deliver it to the Clerk of the Board. If you have anything that you wish distributed to the Board and included in the official record, please hand it to the Clerk who will distribute the information to the Board Members and Maricopa Integrated Health System Senior Staff. Speakers will be called in the order in which requests to speak are received. Your name will be called when the Call to Public has been opened or when the Board reaches the agenda item which you wish to speak. As mandated by the Arizona Open Meeting Law, officials may not discuss items not on the agenda, but may direct staff to follow-up with the citizen.

AGENDA – Strategy/Governance Meeting


Board of Directors

Board Members Terence McMahon, Chair, District 5 Mark Dewane, Vice Chair, District 2 Mary A. Harden, R.N., Director, District 1 Susan Gerard, Director, District 3 Elbert Bicknell, Director, District 4 President & Chief Executive Officer Stephen A. Purves, FACHE Clerk of the Board Melanie Talbot Meeting Location Maricopa Medical Center Administration Building Auditoriums 1 and 2 2601 E. Roosevelt Street Phoenix, AZ 85008

Mission Statement Maricopa Integrated Health System (MIHS) is Maricopa County’s only public teaching hospital and health care system. We are committed to providing safe, comprehensive, high-quality physical and behavioral health care in a patient-centric environment to the communities we serve; and expanding the community’s available pool of physicians and other health care professionals by offering excellent academic programs.

Agendas are available within 24 hours of each meeting in the Office of the Board, Maricopa Medical Center, Administration Bldg, 2nd Floor 2601 E. Roosevelt, Phoenix, AZ 85008, Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. and on the internet at http://mihs.org/governing-bodies/bod-calendar. Accommodations for Individuals with Disabilities, alternative format materials, sign language interpretation, and assistive listening devices are available upon 72 hours advance notice through the Office of the Board, Maricopa Medical Center, Administration Bldg, 2nd Floor 2601 E. Roosevelt, Phoenix, Arizona 85008, (602) 344- 5177. To the extent possible, additional reasonable accommodations will be made available within the time constraints of the request. 9/3/2015 3:12 PM

http://mihs.org/governing-bodies/bod-calendar

http://mihs.org/governing-bodies/bod-calendar

When Speaking at the Podium Please state your name and the city in which you reside. If you reside in Maricopa County, please state the District you live in. If you have an individual concern involving the District, you are encouraged to contact your District Board member at 602-344-1241. We will do everything possible to be responsive to your individual requests. Public Rules of Conduct The Board Chair shall keep control of the meeting and require the speakers and audience to refrain from abusive or profane remarks, disruptive outbursts, applause, protests, or other conduct which disrupts or interferes with the orderly conduct of the business of the meeting. Personal attacks on Board members, staff, or members of the public are not allowed. It is inappropriate to utilize the Call to Public or other agenda item for purposes of making political speeches, including threats of political action. Engaging in such conduct, and failing to cease such conduct upon request of the Board Chair will be grounds for ending a speaker’s time at the podium or for removal of any disruptive person from the meeting room, at the direction of the Board Chair.

Terence McMahon 602-344-1241 [email protected]

Susan Gerard 602-344-1241 [email protected]

Mary A. Harden, R.N. 602-344-1241 [email protected]

Mark Dewane 602-344-1241 [email protected]

Elbert Bicknell 602-344-1241 [email protected]

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Maricopa Medical Center Administration Building Auditoriums 1 and 2

2601 E. Roosevelt Phoenix, AZ 85008

Wednesday, September 9, 2015 1:00 p.m.

One or more of the members of the Board of Directors of the Maricopa County Special Health Care District may attend telephonically. Board members attending telephonically will be announced at the meeting. Pursuant to A.R.S. § 38-431.03(A)(3), or any applicable and relevant state or federal law, the Board may vote to recess into an Executive Session for the purpose of obtaining legal advice from the Board’s attorney or attorneys on any matter listed on the agenda. The Board also may wish to discuss any items listed for Executive Session discussion in General Session, or the Board may wish to take action in General Session on any items listed for discussion in Executive Session. To do so, the Board will recess Executive Session on any particular item and reconvene General Session to discuss that item or to take action on such item.

Call to Order Roll Call Pledge of Allegiance Call to the Public This is the time for the public to comment. The Board of Directors may not discuss items that are not specifically identified on the agenda. Therefore, pursuant to A.R.S. § 38-431.01(H), action taken as a result of public comment will be limited to directing staff to study the matter, responding to any criticism or scheduling a matter for further consideration and decision at a later date.

ITEMS MAY BE DISCUSSED IN A DIFFERENT SEQUENCE General Session, Presentation, Discussion and Action: 1. Motion to Recess General Session and Convene in Executive Session 5 min

Terence M. McMahon, Chairman, Board of Directors Executive Session: E-1 Personnel Matters; A.R.S.§ 38-431.03(A)(1): Discussion or consideration of employment,

appointment, promotion, demotion, dismissal, salaries, disciplining or resignation of a public officer. Discussion or consideration of Maricopa Integrated Health System President and Chief Executive Officer, Steve Purves, Fiscal Year 2016 assignments, performance goals and strategic goals 25 min

Recess Executive Session and Reconvene in General Session

1:00

1:05

1:10

1:35

3

General Session Presentation, Discussion and Action: 2. Board Education – iProtean Online Course: Governance of Integrated Delivery Systems 30 min

Board of Directors 3. Approval of Consent Agenda: 15 min

Note: Approval of contracts, minutes, IGA’s, proclamations, etc. Any matter on the Consent Agenda will be removed from the Consent Agenda and discussed as a regular agenda item upon the request of any Board member.

a. Minutes:

i. July 22, 2015 ii. August 3, 2015 iii. August 12, 2015

b. Contracts:

i. Approve Amendment #2 to the contract (90-15-090-1-02) between Maricopa Integrated Health System and Caldwell Butler & Associates, LLC to implement LEAP 100—day Workouts 4 & 5 and to extend the agreement for one additional year

____________________End of Consent Agenda____________________

4. Maricopa Health Centers Governing Council Semi Annual Report 5 min Kathleen Rhodes, MIHS, Interim Executive Director, Maricopa Health Centers Governing

Council 5. Consideration, Discussion, and Possible Action on the President & Chief Executive Officer’s

Performance Goals for Fiscal Year 2016 5 min Board of Directors 6. Concluding Items 15 min

a. Old Business: None

b. Board Member Requests for Future Agenda Items or Reports

c. Comments i. Chairman and Member Closing Comment ii. President & Chief Executive Officer Summary of Current Events

Adjourn

1:40

2:10

2:25

2:30

2:35

2:50

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September 9, 2015

Item 1. No Handout

Recess General Session



September 9, 2015

Item 2.

iProtean Governance of Integrated Delivery Systems

Welcome to Governance of Integrated Delivery Systems

In this course, iProtean experts will cover: changes in health care, key changes in governance, changes in governance structure, best governance practices, changing how the board works, and the role of local/subsidiary boards. Barry Bader: As Yogi Berra once said, “The future is not what it used to be,” and for particularly hospital and multi-hospital system boards, a changing organization, one in which hospitals and physicians are aligned and integrated together and need to be accountable for the care that is delivered, this is a fundamentally different kind of an organization than a hospital which for generations has been primarily focused on providing acute episodic care to a defined local community. Pam Knecht: The terminology that's being used now regarding care systems and integrated delivery systems can be a little confusing, so what we'll be doing in this particular course is using those terms interchangeably. Now we tend to talk more about building care systems without necessarily referring to it as an integrated delivery system. And a care system can be any size. So it can be for a small hospital or a small system or a larger system. As we move into the era where we're going to be looking at population health management and we need to be able to take care of people within an entire population for every health issue they may have over their life, then we need to make sure that we are developing a care system that has the full continuum of care. So not just the acute care piece, but also the sub-acute and the post-acute and the long-term care and the preventative pieces and the other end of the continuum. And so, no matter what size organization you are, we need to be all thinking about, how do we make sure that we have all the components of the continuum of care? In other words, how to we create a care system? Governance: Governance of Integrated Delivery Care Description (Goal/Purpose) Governance of Integrated Delivery Systems is an advanced Governance course that examines some of the key changes for boards when their organizations move to a more integrated system for the delivery of care. It provides suggestions to the board about governance changes required, best governance practices and the relationship between the system and local/subsidiary boards. Upon completion of this course you will:

o Understand the changes in the healthcare delivery system that are pushing organizations to a more integrated model

o Understand how the new delivery system affects the board’s work

o Identify necessary changes in governance structure for boards of integrated delivery systems

o Understand the evolving role of local/subsidiary boards in an integrated delivery system



September 9, 2015

Item 3.a.i.

Minutes July 22, 2015

Present: Terence McMahon, Chairman, District 5 Mark Dewane, Vice Chairman, District 2

Mary A. Harden, R.N., Director, District 1 Susan Gerard, Director, District 3 – telephonically

Elbert Bicknell, Director, District 4 – telephonically, excused himself at 3:57 p.m. Others Present: Steve Purves, MIHS, President & Chief Executive Officer Kathy Benaquista, MIHS, Interim Chief Financial Officer Robert E. Fromm, Jr., M.D., M.P.H., MIHS, Chief Medical Officer Sherry Stotler, R.N., M.S.N., MIHS, Chief Nursing Officer

Michael Peck, M.D., MIHS, Chief of Staff Louis B. Gorman, MIHS, District Counsel Guest Presenters: Eddy Broadway, Mercy Maricopa Integrated Care, Chief Executive Officer Recorded by: Melanie Talbot, MIHS, Executive Director of Board Operations

Cynthia Cornejo, MIHS, Deputy Clerk of the Board Call to Order Chairman McMahon called the meeting to order at 12:00 noon. Roll Call Ms. Talbot called roll. Following roll call, it was noted that all five voting members of the Maricopa County Special Health Care District Board of Directors were present, which represents a quorum. Directors Gerard and Bicknell participated telephonically. For the benefit of those participating telephonically, Ms. Talbot named the individuals present and asked presenters to announce themselves prior to speaking. Pledge of Allegiance Vice Chairman Dewane led the Pledge of Allegiance. Call to the Public Chairman McMahon called for public comment. There were no comments from the public. Mission Statement Ms. Talbot read the Mission Statement aloud.

Minutes

Maricopa County Special Health Care District Board of Directors Meeting Maricopa Medical Center

Auditoriums 1 and 2 July 22, 2015 12:00 noon

Special Health Care District Board of Directors Meeting Minutes – General Session – July 22, 2015 General Session, Presentation, Discussion and Action: 1. Motion to Recess General Session and Convene in Executive Session MOTION: Vice Chairman Dewane moved to recess general session and convene in executive

session at 12:02 p.m. Director Harden seconded. Motion passed by voice vote. General Session, Presentation, Discussion and Action: Chairman McMahon reconvened general session at 3:51 p.m. 2. Approval of Consent Agenda:

a. Contracts:

i. INTENTIONALLY LEFT BLANK

b. Medical Staff:

i. Approve MIHS Medical Staff Appointments, FPPEs, Reappointments, Change of Privileges/Status, Waiver Requests, and Resignations for July 2015

ii. Approve MIHS Allied Health Professional Staff Appointments, FPPEs, Reappointments, and Resignations for July 2015

iii. Approve Affidavits Appointing Celsius Kit Gesmundo, M.D., and Maryam Hazeghazam, M.D., as Deputy Medical Directors in the Department of Psychiatry

Director Harden requested item 2.b.i. be removed from the consent agenda to be discussed and voted on separately. MOTION: Director Harden moved to approve the consent agenda minus 2.b.i. Director Gerard

seconded. Motion passed by voice vote. MOTION: Director Harden moved to approve item 2.b.i., the MIHS medical staff appointments,

FPPEs, reappointments, change of privileges/status, waiver requests, and resignations for July 2015, minus Farid Ghebleh, M.D. Director Bicknell seconded.

Director Harden requested a roll call vote. VOTE: 4 ayes; Chairman McMahon, Director Bicknell, Director Gerard, and Director Harden 1 nay; Vice Chairman Dewane Motion passed. 3. Discussion on Uncompensated Care; Discussion and Possible Action on the Development of a

Maricopa Integrated Health System Financial Assistance Program including Policies, Structure, and Implementation Process

This item was not discussed.

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Special Health Care District Board of Directors Meeting Minutes – General Session – July 22, 2015 General Session, Presentation, Discussion and Action, cont.: 4. Approve a Revised Sliding Fee Discount Schedule for the Sliding Fee Discount Program for the

Maricopa Integrated Health System’s Federally Qualified Health Center Look Alike Clinics This item was not discussed. 5. Discussion and Possible Action on the Quarterly Report from Mercy Maricopa Integrated Care

(MMIC) Mr. Broadway reviewed Mercy Maricopa Integrated Care’s (MMIC) membership statistics as of June 2015. There was a significant increase in membership, from approximately 700,000 members to 860,000 members, which was primarily Arizona Health Care Cost Containment System (AHCCCS) membership. There were 19,000 AHCCCS integrated members with serious mental illness (SMI), 420,000 adults with general mental health and substance abuse, 400,000 children, and 18,000 members whose care was funded through grant funding crisis related funding. He reviewed MMIC’s major initiatives, including the network expansion and fidelity to evidence-based practice in conjunction with the Arnold v. Arizona Department of Health Services (ADHS) settlement. The network expansion focused on assertive community treatment, supportive housing and family support, as well as general covered services. The fidelity to evidence-based practice also focused on assertive community treatment and supported houses; however, there was also an emphasis on consumer operated and supportive employment services. Additional initiatives included the integrated care for persons with serious mental illness and dual mental health substance abuse, the crisis system, children’s system of care, and value-based purchasing. The integrated care for persons with serious mental illness was improving, as providers were converting to integrated care providers. There were also contracts with providers for behavioral health and acute care to allow patients with general mental health and substance abuse to receive all services in one location. Mr. Broadway stated that there was currently an urgent psychiatric center in downtown Phoenix, however, the center would relocate in October and double the current capacity; from 25 observation chairs to 50 observation chairs. There would also be the addition of observation chairs added in the East Valley. The increase in observation chairs was expected to reduce the unnecessary use of emergency departments. There was a major movement in the children’s provider network organization by contracting directly with providers, as opposed to contracting with networks, which resulted in a savings of nearly $5 million. There was also a plan to have 3,000 children with complex and high-needs to be treated by those providers. That plan was scheduled to begin implementation in August and conclude in October. He noted that there was an increase in out of state placement for children to acute or residential institutions; however, by increasing the capability and capacity in Maricopa County, the number of out of state placements was reduced from 26 to seven. He stated that it was mandatory for all AHCCCS health plans to participate in value-based purchasing, and it would become a requirement for MMIC beginning October 1, 2015. Moving toward value-based purchasing was expected to help members reach their health goals while reducing costs and ensuring the members received the correct treatment. A pilot phase was conducted, primarily with the assertive community treatment team, using the performance incentive model. There were also other models considered, including risk adjusted case rate, shared savings, and potential sub-capitation. Mr. Broadway stated that the Division of Behavioral Health Services (DBHS) was scheduled to move from the Arizona Department of Health Services (ADHS) to AHCCCS by January 1, 2016; which was a large task to shift employees, programs, and funding from one agency to another. There was a lot of activity from a regulatory standpoint; however, it was expected that AHCCCS would accept the MMIC contract in its totality. Mr. Purves asked if the regulatory changes would affect the renewal date or contract term.

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Special Health Care District Board of Directors Meeting Minutes – General Session – July 22, 2015 General Session, Presentation, Discussion and Action, cont.: 5. Discussion and Possible Action on the Quarterly Report from Mercy Maricopa Integrated Care

(MMIC), cont. Mr. Broadway said that the contract term and renewal dates were yet to be determined. The reimbursement rates were expected to be received in the fall, the contract terms may be received at that time. Director Harden requested additional information on the urgent psychiatric centers. Mr. Broadway said Connections Arizona, which would relocate to a new location and double its capacity in October, operated the urgent psychiatric center in downtown Phoenix. Beginning August 1, 2015, Community Bridges will operate a center in the East Valley. He stated that St. Luke’s had converted a portion of their children’s unit into a respite unit for children and their families to visit during a crisis, which may have contributed to the reduction in out-of-state placements. 6. Discuss and Review June 2015 Maricopa Integrated Health System Financial Report Including

Payor Mix and Investment of Funds Information; and Key Indicator Dashboards This item was not discussed. 7. Discussion and Possible Action on Reports to the Board a. KRONOS Human Capital Management System return on investment This item was not discussed. 8. Board Education This item was not discussed. 9. Concluding Items

a. Old Business:

March 25, 2015 Uncompensated Care • In the next 60-90 days, present the Board with Financial Assistance Policy, Structure,

Philosophy and Implementation May 27, 2015 Uncompensated Care • At the July Board meeting, there will be a discussion on the Philosophy with a District

Financial Assistance Program/Policies; the following month the Board will be presented with a draft Financial Assistance Policy/Program, Structure, and Implementation Plan

Quarterly Quality Report • Include the total amount of surveys distributed to get results

Financials/Dashboard • For Fiscal Year 2015 year-to-date and Fiscal Year 2014 actual, how much bad debt

(dollar amount) came from Emergency Department admissions? 4

Special Health Care District Board of Directors Meeting Minutes – General Session – July 22, 2015

General Session, Presentation, Discussion and Action, cont.: 9. Concluding Items, cont.

b. Board Member Requests for Future Agenda Items or Reports c. Comments i. Chairman and Member Closing Comment ii. President & Chief Executive Officer Summary of Current Events

Adjourn MOTION: Director Harden moved to adjourn the July 22, 2015 Special Health Care District Board of

Directors Finance/Quality Meeting. Vice Chairman Dewane seconded. Motion passed by voice vote.

Meeting adjourned at 4:08 p.m. ______________________________ Terence M. McMahon, Chairman Special Health Care District Board of Directors

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September 9, 2015

Item 3.a.ii.

Minutes August 3, 2015

Present: Mark Dewane, Vice Chairman, District 2

Mary A. Harden, R.N., Director, District 1 Susan Gerard, Director, District 3 – arrived at 9:20 a.m.

Elbert Bicknell, Director, District 4 – telephonically Absent: Terence McMahon, Chairman, District 5 Others Present: Steve Purves, MIHS, President & Chief Executive Officer Kathy Benaquista, MIHS, Interim Chief Financial Officer Robert E. Fromm, Jr., M.D., M.P.H., MIHS, Chief Medical Officer Louis B. Gorman, MIHS, District Counsel Bill Sims, Sims Murray, Board Counsel Recorded by: Melanie Talbot, MIHS, Executive Director of Board Operations Call to Order NOTE: Due to Chairman McMahon’s absence, Vice Chairman Dewane chaired the meeting. Vice Chairman Dewane called the meeting to order at 9:01 a.m. Roll Call Ms. Talbot called roll. Following roll call, it was noted that three of the five voting members of the Maricopa County Special Health Care District Board of Directors were present, which represents a quorum. Director Bicknell participated telephonically. Director Gerard arrived shortly after roll call, during the executive session discussion. For the benefit of those participating telephonically, Ms. Talbot named the individuals present and asked presenters to announce themselves prior to speaking. Pledge of Allegiance Ms. Talbot led the Pledge of Allegiance. Call to the Public Vice Chairman Dewane called for public comment. There were no comments from the public. Mission Statement Ms. Talbot read the Mission Statement aloud.

Minutes


Auditoriums 3 and 4 August 3, 2015

9:00 a.m.

Special Health Care District Board of Directors Meeting Minutes – General Session – August 3, 2015 General Session, Presentation, Discussion and Action: 1. Motion to Recess General Session and Convene in Executive Session MOTION: Director Harden moved to recess general session and convene in executive session at

9:03 a.m. Vice Chairman Dewane seconded. Motion passed by voice vote. General Session, Presentation, Discussion and Action: Vice Chairman Dewane reconvened general session at 11:11 a.m. 2. Discuss, Review and Approve Board Resolution No. 2015-08-03-001, Resolution Providing for

the Issuance and Sale of Not Exceeding $106,000,000 Aggregate Principal Amount of Maricopa County Special Health Care District General Obligation Bonds, Taxable Series 2015, in One or More Series; Providing for the Annual Levy of a Tax for the Payment of the Bonds; Providing Terms, Covenants and Conditions Concerning the Bonds; Accepting a Proposal for the Purchase of the Bonds; Approving a Bond Purchase and Continuing Covenant Agreement; Appointing an Initial Registrar and Paying Agent for the Bonds; Approving a Bond Registrar, Transfer Agent and Paying Agent Agreement; Approving all Other Bond Purchase and Bond Issuance Related Documents; and Approving and Ratifying All Actions Taken in Furtherance of this Resolution

Vice Chairman Dewane stated that there had been lengthy discussions on the potential issuance of bonds to finance significant projects to move Maricopa Integrated Health System (MIHS) forward and to enhance the mission and strategy to support the underserved in Maricopa County. Mr. Purves acknowledged those that contributed in the progression of the transaction for their due diligence that was required. He stated that senior leadership and the bond team recommended proceeding with the first issuance of general obligation bonds related to Proposition 480. Vice Chairman Dewane thanked Mr. Purves, the senior leadership and the bond team for their hard work and dedication. He appreciated the information provided to the Board for the consideration of the bond issuance. He noted Proposition 480 was vastly supported by the voters of Maricopa County and the Board of Directors had a fiduciary obligation to move forward with the issuance.

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Special Health Care District Board of Directors Meeting Minutes – General Session – August 3, 2015 General Session, Presentation, Discussion and Action: 2. Discuss, Review and Approve Board Resolution No. 2015-08-03-001, Resolution Providing for

the Issuance and Sale of Not Exceeding $106,000,000 Aggregate Principal Amount of Maricopa County Special Health Care District General Obligation Bonds, Taxable Series 2015, in One or More Series; Providing for the Annual Levy of a Tax for the Payment of the Bonds; Providing Terms, Covenants and Conditions Concerning the Bonds; Accepting a Proposal for the Purchase of the Bonds; Approving a Bond Purchase and Continuing Covenant Agreement; Appointing an Initial Registrar and Paying Agent for the Bonds; Approving a Bond Registrar, Transfer Agent and Paying Agent Agreement; Approving all Other Bond Purchase and Bond Issuance Related Documents; and Approving and Ratifying All Actions Taken in Furtherance of this Resolution, cont.

MOTION: Director Harden moved to approve Resolution No. 2015-08-03-001, resolution providing

for the issuance and sale of not exceeding $106,000,000 aggregate principal amount of Maricopa County Special Health Care District General Obligation bonds, taxable series 2015, in one or more series; providing for the annual levy of a tax for the payment of the bonds; providing terms, covenants and conditions concerning the bonds; accepting a proposal for the purchase of the bonds; approving a bond purchase and continuing covenant agreement; appointing an initial registrar, transfer agent and paying agent for the bonds; approving all other bond purchase and bond issuance related documents; including but not limited to: - Bond Registrar, Transfer Agent and Paying Agent Agreement; - District Treasurer’s Receipt for Bond Proceeds; - Purchaser’s Receipt for Bonds; - Certificate of County Responsibility; - Certificate of County Assessor; - Certificate of Registrar and Paying Agent; - General Certificate of the District; - Arizona Department of Revenue Report of Bond and Security Issuance; - Purchaser’s Investor Letter; - Opinion of Bond Counsel; - Supplemental Opinion of Bond Counsel; - Opinion of District and Board Counsel; - List of Closing Documents; and authorizing the Chairman to execute any and all documents including but not limited to those listed above, and further authorizing and delegating to the Chief Executive Officer, the authority to execute any and all documents, including but not limited to those listed above, related to the bond purchase and bond issuance related documents; and approving and ratifying all actions taken in furtherance of this resolution. Director Gerard seconded.

Director Harden said that she had been involved with MIHS for 38 years and progressing with the first issuance of the general obligation bonds was a phenomenal move for the citizens of Maricopa County and the patients receiving care at MIHS. Director Gerard recalled the Board of Directors previously denying a request to move forward with a bond measure in 2012, which was the correct decision. The Board and MIHS senior leadership had since completed the due diligence required for such a major decision. She commended the Board staff and Board counsel for their hard work and dedication. Director Bicknell echoed the comments made by Director Gerard. He too recalled the decision, not move forward with the bond measure in 2012. He commended Mr. Purves, Board staff, and all involved in the progression of the issuance of general obligation bonds. VOTE: Motion passed by voice vote.

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Special Health Care District Board of Directors Meeting Minutes – General Session – August 3, 2015 Adjourn MOTION: Director Harden moved to adjourn the August 3, 2015 Special Health Care District Board

of Directors Special Meeting. Director Gerard seconded. Motion passed by voice vote. Meeting adjourned at 11:21 a.m. ______________________________ Terence M. McMahon, Chairman Special Health Care District Board of Directors

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September 9, 2015

Item 3.a.iii.

Minutes August 12, 2015

Present: Terence McMahon, Chairman, District 5

Mark Dewane, Vice Chairman, District 2 Mary A. Harden, R.N., Director, District 1

Susan Gerard, Director, District 3

Elbert Bicknell, Director, District 4 – telephonically, excused himself at 3:14 p.m.

Others Present: Steve Purves, MIHS, President & Chief Executive Officer – left at 2:53 p.m., returned

at 4:24 p.m. Robert E. Fromm, Jr., M.D., M.P.H., MIHS, Chief Medical Officer Kathy Benaquista, MIHS, Interim Chief Financial Officer Sherry Stotler, R.N., M.S.N., MIHS, Chief Nursing Officer Louis B. Gorman, MIHS, District Counsel Guest Presenters: Wilma Acosta, MIHS, Chief Compliance Officer Katherine Cecala, MIHS Audit and Compliance Committee, Chair Sara Wilson, Home Assist Health, President/Chief Executive Officer Recorded by: Melanie Talbot, MIHS, Executive Director of Board Operations

Cynthia Cornejo, MIHS, Deputy Clerk of the Board Call to Order Chairman McMahon called the meeting to order at 1:01 p.m. Roll Call Ms. Talbot called roll. Following roll call, it was that all five voting members of the Maricopa County Special Health Care District Board of Directors were present, which represents a quorum. Director Bicknell participated telephonically. For the benefit of those participating telephonically, Ms. Talbot named the individuals present and asked presenters to announce themselves prior to speaking. Pledge of Allegiance Chairman McMahon led the Pledge of Allegiance. Call to the Public Chairman McMahon called for public comment. There were no comments from the public.

Minutes


Auditoriums 1 and 2 August 12, 2015

1:00 p.m.

Special Health Care District Board of Directors Meeting Minutes – General Session – August 12, 2015 Mission Statement Ms. Talbot read the Mission Statement aloud. General Session, Presentation, Discussion and Action: 1. Motion to Recess General Session and Convene in Executive Session MOTION: Director Harden moved to recess general session and convene in executive session at

1:02 p.m. Vice Chairman Dewane seconded. Motion passed by voice vote. General Session, Presentation, Discussion and Action: Chairman McMahon reconvened general session at 3:05 p.m. 2. Board Education – QHR Learning Institute: Changing Times, Changing Roles: Where Should the

Board Focus? The QHR Learning Institute is an online resource that offers programs for hospital trustees, executives, physicians, and department managers. Director Harden referred to the shift in the delivery of care, with more focus on retail clinics and urgent care centers. She noted previous discussions surrounding the possibility of an urgent care center on the Maricopa Medical Center (MMC) campus and questioned the status. Dr. Fromm said that financial challenges halted the discussions, however, there was still the consideration of an urgent care center on the MMC campus; possibly utilizing the space within the infectious disease unit. Director Gerard said that there were important questions raised during the webinar, however the discussion did not provide a solution to become more policy and strategy driven. She said that there needed to be more focus on items on the agenda that were central to the District’s mission and setting policy for the future. Chairman McMahon requested the final slide be added to the Board packets to help the Board focus on the questions included. Director Gerard asked for a comparison between Accountable Care Organizations (ACO), Clinically Integrated Systems, and Patient Centered Medical Homes. Dr. Fromm explained that the different care models were very similar to one another and were not concentric, with one being better than the other. 3. Approval of Consent Agenda:

a. Minutes: i. June 18, 2015 ii. June 24, 2015 iii. July 8, 2015

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Special Health Care District Board of Directors Meeting Minutes – General Session – August 12, 2015 General Session, Presentation, Discussion and Action, cont.: 3. Approval of Consent Agenda, cont.:

b. Governance:

i. Approve the Compliance Officer’s Annual Work Plan for the 2016 Fiscal Year ii. Approve Maricopa County Special Health Care District Compliance Program iii. Approve the Internal Auditor’s Annual Work Plan for the 2016 Fiscal Year iv. Ratify Selection of Kathleen Benaquista as Chief Financial Officer of Maricopa

Integrated Health System

v. Approve Amended and Restated Intergovernmental Agreement between Maricopa County Special Health Care District and the Arizona Health Care Cost Containment System for Graduate Medical Education Programs for Fiscal Year 2015

vi. Approve registration fee, mileage, lodging, meal & incidentals per diem, and

Board per diem/stipend not to exceed rates allowable under applicable District practices or policies for Chairman McMahon to attend Arizona Hospital and Healthcare Association’s Annual Membership Conference: Healthy Communities for a Healthy Arizona, October 22–23, 2015, in Marana, Arizona

Director Harden requested items 3.b.i., 3.b.ii., 3.b.iii., 3.b.v., and 3.b.vi. be removed from the consent agenda to be discussed and voted on separately. MOTION: Director Harden moved to approve the consent agenda minus 3.b.i., 3.b.ii., 3.b.iii., 3.b.v.,

and 3.b.vi. Vice Chairman Dewane seconded. Motion passed by voice vote. Director Harden referred to the Compliance Officer’s Annual Work Plan, consent agenda item 3.b.i., and requested clarification on the reported Health Insurance Portability & Accountability Act of 1996 (HIPAA) for quarters one and two of the current calendar year. Ms. Acosta explained the reporting timeline, and reviewed the examples of the types of incidents reported. She noted that the largest type of incident reported was Patient Paperwork Switch and stated that nursing leadership was aware of the issue and that staff was provided additional education. The compliance team also conducted real-time walk-throughs on the units to ensure proper protocols were followed. There had been a slight decrease in this type of incident since the issue was identified. Director Harden referred to the District Compliance Plan, consent agenda item 3.b.ii., and stated her concerns with inconsistent language used throughout the document; in particular, the incorrect name of the Maricopa County Special Health Care District (District), the incorrect notation that the District Board was the Compliance Program under the Purpose, and the contradicting definitions for Allied Health Provider. Ms. Acosta said she would review with legal counsel and make the necessary corrections. Director Harden highlighted the language under Designation of the Compliance/Privacy Officer, which states that the Chief Compliance Officer shall report directly to the Board of Directors and asked if it was appropriate. Ms. Acosta stated that the language was correct and appropriate.

3

Special Health Care District Board of Directors Meeting Minutes – General Session – August 12, 2015 General Session, Presentation, Discussion and Action, cont.: 3. Approval of Consent Agenda, cont.: Director Harden referred to the Internal Auditor’s Annual Work Plan, consent agenda item 3.b.iii., and asked if appropriate members of staff were included in the Risk Assessment Process, including behavioral health and ambulatory services. Ms. Acosta said that input was not sought from behavioral health and ambulatory services since there were no major issues with those areas. Director Harden requested clarification on the Intergovernmental Agreement (IGA) between Arizona Health Care Cost Containment System (AHCCCS) Administration and the Maricopa County Special Health Care District (District), consent agenda item 3.b.v., with regard to the $11,481,344.22 received. Ms. Benaquista stated that the amount was the match portion received from AHCCCS for Graduate Medical Education (GME). Director Harden stated that the District experiences an approximate loss of $10 million annually with GME, even with the funds received. Ms. Benaquista said that there was a loss of nearly $10 million for fiscal year 2014; however, the GME payment included in the proposed IGA included a payment increase of approximately $2.8 million, which should reduce the loss. Director Harden addressed the request for approval of expenses for Chairman McMahon to attend the Arizona Hospital and Healthcare Association’s Annual Membership Conference, consent agenda item 3.b.vi., and stated that she could not support the expense. The District recently approved a budget with a deficit and believed the Board should lead by example. She requested a roll call vote for this item. MOTION: Director Harden moved to approve consent agenda items 3.b.i., 3.b.iii., and 3.b.v. Vice

Chairman Dewane seconded. Motion passed by voice vote. MOTION: Director Harden moved to approve consent agenda item 3.b.ii., the Maricopa County

Special Health Care District Compliance Program, with the correction of the entity to read Maricopa County Special Health Care District, the deletion of District Board from parenthesis after Compliance Program, and the deletion of Allied Health Professional from the Definitions. Director Gerard seconded. Motion passed by voice vote.

MOTION: Vice Chairman Dewane moved to approve consent agenda item 3.b.vi., the registration

fee, mileage, lodging, meal & incidentals per idem, and Board per diem/stipend not to exceed rates allowable under applicable District practices or policies for Chairman McMahon to attend Arizona Hospital and Healthcare Association’s Annual Membership Conference: Healthy Communities for a Healthy Arizona, October 22-23, 2015 in Marana, Arizona. Director Gerard seconded.

Director Gerard said she would support the vote, as it was important to have Board representation and participation in statewide organizations. Director Harden stated that she could not support due to the reasons she stated earlier. Vice Chairman Dewane concurred with Director Gerard.

4

Special Health Care District Board of Directors Meeting Minutes – General Session – August 12, 2015 General Session, Presentation, Discussion and Action, cont.: 3. Approval of Consent Agenda, cont.: VOTE: 3 ayes; Chairman McMahon, Vice Chairman Dewane, and Director Gerard 1 nay; Director Harden 1 absent: Director Bicknell Motion passed. 4. Maricopa Integrated Health System Compliance Department Report:

a. MIHS Audit and Compliance Committee b. Annual System-Wide Compliance Education Results for Fiscal year 2015

Ms. Cecala reviewed the activities of the MIHS Audit and Compliance Committee. She noted the increase in Committee members, which includes a fourth member. The Committee had also expanded its focus to include a quarterly review of the financials. The Committee reviewed all compliance matters, including the information provided in the Compliance Work Plan. Director Harden expressed her appreciation for the time and dedication from the members of the Audit and Compliance Committee. Ms. Acosta reviewed the Compliance Program activities and highlighted the improvement in the education completion rates, especially with the medical residents and District Medical Group (DMG) staff. Those improvements were achieved through improving communication throughout the organization and collaboration with the DMG Compliance Officer to capture and record the education received from other sources. Chairman McMahon asked if the education component was a requirement of regulatory agencies. Ms. Acosta stated that as a Medicaid funded system, a strong education program was a requirement of Center for Medicare and Medicaid Services (CMS), under the Deficit Reduction Act (DRA). Chairman McMahon asked if MIHS was at risk for fines or violations, since there were not 100% completion rates. Ms. Acosta stated that there would be minimal risk. Through the communication and collaboration with the DMG Compliance Officer, it was discovered that the physicians did receive the education from other sources. The next step was to develop a process to gather and record the data from those sources. Ms. Acosta mentioned an incident that was reported to the Office of Civil Rights, a device with sensitive information was misplaced. She stated that opportunities for improvement were identified, education was provided, and processes were in place to prevent such incident in the future. Chairman McMahon asked when a final resolution was expected from the Office of Civil Rights. Ms. Acosta stated that the documented requested by the Office of Civil Rights were scheduled to be submitted before the August 27, 2015 deadline. It was unknown when the documents would be reviewed by the OCR; however, MIHS had met all of the reporting requirements and the risk of monetary fines was minimal.

5

Special Health Care District Board of Directors Meeting Minutes – General Session – August 12, 2015 General Session, Presentation, Discussion and Action, cont.: 5. Reports to the Board of Directors; Discussion and Possible Action: a. Home Assist Health Year End Report – Fiscal Year 2015

b. Maricopa Integrated Health System Media Report Director Harden referred to the Home Assist Health (HAH) Year End Report and asked if there were outreach efforts to prevent falls in the home. Ms. Wilson stated that HAH conducted fall risk assessments in a client’s home and identified any potential risks and adjusted the care plan when necessary. Director Harden requested additional information on the new expense for the 2016 fiscal year budget assumptions, Hepatitis B vaccination for accepting direct care workers. Ms. Wilson explained that the vaccine was an option for caregivers, which was not previously offered. Chairman McMahon stated that according to the income statement, there was a substantial variance in the revenue from private pay. He asked if there was a reason for the shortfall. Ms. Wilson said that there was no particular reason for the variance. The original plan for private pay was aggressive and it was decided to focus on diversifying within the non-profit community. 6. Concluding Items 15 min

a. Old Business: None

b. Board Member Requests for Future Agenda Items or Reports

c. Comments i. Chairman and Member Closing Comment ii. President & Chief Executive Officer Summary of Current Events

Mr. Purves recapped a meeting he recently had with Governor Ducey and members of his staff, which he believed made progress in the discussion of supplemental funding for MIHS. Adjourn MOTION: Director Harden moved to adjourn the August 12, 2015 Special Health Care District

Board of Directors Strategy/Governance Meeting. Director Gerard seconded. Motion passed by voice vote.

Meeting adjourned at 4:38 p.m. ______________________________ Terence M. McMahon, Chairman Special Health Care District Board of Directors

6



September 9, 2015

Item 3.b.i.

Contracts Caldwell Butler

From: Compliance 360To: Melanie TalbotSubject: Contract Approval Request: Amendment #2 Caldwell Butler and Associates, LLCDate: Wednesday, September 02, 2015 3:32:53 PM

Message InformationFrom Purves, Steve

To Talbot, Melanie;

Subject Contract Approval Request: Amendment #2 CaldwellButler and Associates, LLC

Additional Information

Indicate whether you approve or reject by clicking theApprove or Reject button.

Add comments as necessary.

Approve/Reject ContractClick here to approve or reject the Contract.

Contract Information

Status Pending ApprovalTitle Amendment #2

Contract Identifier(Travel Type

Dropdown)Board - Amendment

MIHS ContractNumber 90-15-090-1-02

Primary ResponsibleParty Maness, Brian D.

Departments HOSPITAL ADMINISTRATIONProduct/Service

DescriptionLEAP 100 Day Workouts 4 & 5 and High Impact FocusArea

Action/Background

Approve Amendment #2 to the contract with CaldwellButler & Associates, LLC to:

1. Implement LEAP 100-Day Workouts 4 & 5 and HighImpact Focus Areas consulting engagement designed toprovide the Sustainability Phase of CBA's 3-phaseLeader Effectiveness & Accountability Path toSustainability (LEAP) process which is made up of twodirector-driven 100-Day Workouts and includesapprenticing of the MIHS senior team,directors/managers, and physician leaders. Estimatedexpenses for Phase 3 is $618,000 which includesprofessional fees and travel related costs.

2. Extend the agreement for an additional year throughSeptember 30, 2016.

Either party may terminate this agreement withoutcause upon ninety (90) days prior written notice.

Evaluation ProcessNotes

mailto:[email protected]




https://secure5.compliance360.com/DMZ/DmzCustomViewLoader.aspx?CD=zddgt3yRW6p%252bI2FPJ4o9ianXwL8fh81FvJjpXB2vo57EOPQHV%252bgN6A%253d%253d&PD=gewc47sikRju6syMbyrLC6BxlQP4%2fHDkLbDVWMPr3Mio%2bsXzZemLaMlnU9%2bNJpAFNaY6onQrWu1gSuAhWK9n2WVLaFASe%2bzqbyPVGDP3AyfNWMWmCqC%2fvVEl%2blGlwx%2bN2YU8WC9MOP%2b8viXPABzYNWj3U%2fjAGeKkZx7jMCD6t%2bde5OpUbXln9vNK%2fUH0ksHpuSBB8abnpq%2f4MuRtDluK1bmRkjoubzkpgBzJQglRrNpste8OF54basISPRx%2f%2bXH9VV02L25vDPY6GD9RL%2fYi2Kw3nbw7QweviCk5QhPELeXmsII8F5%2bLtw%3d%3d

CategoryEffective Date 9/9/2015

Expiration Date 9/30/2016Annual Value $618,000.00

Expense/Revenue ExpenseBudgeted (Budget Bal

Dropdown Travel) Yes

Procurement Number 90-15-090-RFQPrimary Vendor Caldwell Butler and Associates, LLC

Responses

Member Name Status CommentsDoria, Susan S. Approved

Demos, Martin C. Approved

Landas, Lito S. Approved

Purves, Steve A. Approved

Talbot, Melanie L. Current



September 9, 2015

Item 4.

Maricopa Health Centers Governing Council Semi-Annual Report

Semi-Annual Report of the Maricopa Health Centers Governing Council

Presented to:

Maricopa Special Healthcare District Board

September 2015

1

I. People

Governing Council membership: The Council added three new members, April Lynnette Kramer, Daniel Mattison and Rosalba Rubio and lost a member, Adriana Perez who resigned. FY16 officer elections occurred in June. Officers for FY16 are:

i. Chair – Gino Turrubiartes ii. Vice Chair – Simon Thomas

iii. Treasurer – Gary Tenney

Clinic management: After a nine month vacancy the Dental Manager position has been filled (Robert Winovich). Lori Lynn, Director of East Side FHC and Patient Center Medical Home resigned in May. Additionally Laurie Wood, VP Ambulatory Services and Executive Director Governing Council resigned in June. Kate Rhodes accepted Interim Vice President of Ambulatory and Executive Director Governing Council. Troy McGilvra and Patricia Stradleigh Directors of Specialty and Primary Care respectively assumed additional responsibilities during this interim period.

Provider changes: There has been several resignations and reassignment of providers

in the FHCs. This has created some scheduling challenges. Working very closely with DMG leadership to stabilize. Dr. Yuh assumed medical director responsibility of CHC Internal Medicine.

II. Service CHC Women’s Clinic has opened hours on Friday to increase capacity.

CHC Family Practice Clinic opened in August for MIHS and DMG employees and Meritus

patients. Relocated Dermatology to Med Sub Specialty Clinic area.

Participation by the majority of FHCs and the CHC Peds clinic with St. Mary’s Food Bank to provide free lunches to school age kids during the summer months, when school is out.

Avondale FHC will have Saturday hours starting Sept 12th.

All of the FHCs except South Central FHC have 10 hour shifts to increase after hours

availability.

Cardiology has a presence monthly now at five of the FHCs to better serve our patients (Avondale, El Mirage, Glendale, Mesa and Chandler).

2

III. Quality

Clinical quality indicators continue to be a focus. For patients under continuous care, trends are in the desired direction. Results that came out in June for the 2014 Uniform Data System from HRSA showed that MIHS compared better than national or other Maricopa County FQHC agencies for 7 of the 15 Clinical Quality Measures.

Visit cycle time has improved significantly. This allows greater opportunity for additional visits and increases patient satisfaction without the addition of staff or physical resources.

Patient satisfaction will be one of the major focus in FY 16. Working with DMG as part

of the initiative to engage MIHS and DMG leadership and providers.

IV. Growth

Plan to add a second mobile diabetic digital retinopathy camera. Positions posted. IT evaluating requirements related to new technology of the second camera.

Evaluating opportunity to add behavioral health services to select FHCs.

V. Finance

FY 2015 YTD was strong; visits exceeded expectation (+4.6%) primarily to the Meritus contract. Additionally there was a positive variance ytd to the budget in the amount of $344K for expenses.

The financial position of the dental department is improving. The action plan for the financial turnaround was set as a two year process. Cash collections have improved significantly, payer mix has improved, and volume targets were exceeded. Working with Marketing and the School to improve volume at Pendergast Dental.

We have worked diligently with several health plans on additional payment reform proposals that build on the medical home initiative. Mercy Care Plan, Meritus, Phoenix Health Plan and Care First all have Per Member Per Month (PMPM) and/or incentive amendments to their contract. Negotiations continue with another large AHCCCS plan for similar incentive payments.

VI. Future

Working with HMA for Governing Board education and training in preparation of the HRSA site visit (anticipated to be in 2016).

3

Pain Management Clinic for Meritus patients: Task force forming. Management of No Show patients: policy completed. Working with IT. Expansion of Open Access balanced with community/patient need for future

appointments Refinement of the phone system to improve the abandoned call rate. Continued strategic plan to expand the concept of pediatric dental and medical home

which will continue to support the payer mix shift in Dental. Sliding Fee policy to complete approval process and to be implemented. Complete 19 Core requirements in anticipation of the HRSA site visit.

i. Expand the needs assessment ii. Review and possible revision of the by-laws

iii. Review and possible need for internal and external referral agreements

4



September 9, 2015

Item 5.

President & Chief Executive Officer Performance Goals for FY16

DRAFTDRAFT - FOR BOARD DISCUSSION Maricopa Integrated Health System

CEO FY16 Performance Goals

Document date 9-2-15

9/30/2015 12/31/2015 3/31/2016 6/30/2016

YTD Results Minimum TBD Midpoint TBD

Maximum TBD

Quarter Results Minimum 65.0%

Midpoint 70.0% Maximum 75.0%

Objective 2B: Improve Adult Emergency Department throughput by decreasing patient length of stay to equal to or less than fours hours.Metric 2B: Average number of minutes for Adult ED patient length of stay as measured from registration to disposition.(Baseline: YTD June 30 2015 = 276.5 minutes. Achievement measured as YTD June 30 results.)

Quarter Results Minimum 280 minutes Midpoint 240 minutes

Maximum 210 minutes

Objective 3A: Achieve the number of Family Health Center and Comprehensive Health Center patient visits budgeted for FY16.Metric 3A: Number of actual patient visits at 12 FHCs (excludes WHH and Dental visits) and the CHC.(Baseline: FY15 FHC +CHC visits = 383,376. Minimum set at FY16 budget. Midpoint 3% above; Maximum 5% above. Achievement measured as YTD June 30 results.)

YTD Results Minimum 383,376

Midpoint 394,877 Maximum 402,545

Objective 2A: Increase percentage of patients responding favorably to HCAHPS hospital satisfaction question regarding overall rating.

Objective 1: Achieve FY16 operating expenses per adjusted discharge/admission (TBD) target for healthcare operations (excludes health plan and joint ventures).1 - FINANCIAL

2 - SERVICE

3 - GROWTH

Metric 1: FY16 medical center/ambulatory/behavioral health operating expense equal to or less than budget adjusted for volume.(Baseline: Midpoint set as budget for FY16. Minimum and Maximum 10% below and above Midpoint. Achievement measured as YTD June 30 results.)

(Baseline: YTD June 30 2015 = 66.1%. Midpoint set slightly above FY15 results. Achievement measured as YTD June 30 results.)Metric 2A: Raw score percentage for HCAHPS question "Using any number from 0 to 10, what number would you use to rate the hospital during your stay?"




9/30/2015 12/31/2015 3/31/2016 6/30/20163 - GROWTH continuedObjective 3B: Achieve FY16 budgeted net income for the combined MIHS health plans.Metric 3B: Combined fiscal year end financial results for MHP and MCA as measured by net inome.(Baseline: Midpoint set as budget for FY16. Minimum and Maximum 10% below and above Midpoint. Achievement measured as YTD June 30 results.)

YTD ResultsMinimum 6,514,652$ Midpoint 7,238,502$

Maximum 7,962,352$

Objective 3C: Increase MIHS patient activations of EPIC "MyChart" patient portal.Metric 3C: Number of unique patients enrolled and active in MyChart as a percentage of the total patient popuation.(Baseline: Current = 12%. Minimum set at EPIC client average. Maximum set at 25th percentile of EPIC clients. Achievement measured as June 30 results.)

June 30 Results Minimum 20%Midpoint 25%

Maximum 35%

YTD Results Minimum 30% Midpoint 27%

Maximum 25%

Objective 5A: Improve the Patient Safety Indicator (PSI-90) measures as reported to CMS.Metric 5A: PSI-90 cumulative average over four quarters.(Baseline: 0.38 for FY15. Achievement measured as cumulative average over four FY16 quarters.)

Quarter ResultsMinimum 0.40Midpoint 0.35

Maximum 0.30

(Baseline: FY15 first year voluntary turnover = 32%. (Note, FY15 voluntary turnover = 21%.) Achievement measured as YTD June 30 results.)

5 - QUALITY

Metric 4: Number of employees voluntarily resigning in their first year of employment as a percentage of total number of employees.

4 - PEOPLE Objective 4: Decrease first year employee turnover to improve organizational performance and reduce expenses related to turnover.




9/30/2015 12/31/2015 3/31/2016 6/30/20165 - QUALITY continuedObjective 5B: Improve the health of ambulatory diabetic patients by lowering their blood glucose to less than or equal to 8%.Metric 5B: Average HbA1c reported for diabetic patients seen at the Family Health Centers and Internal Medicine clinic.(Baseline: Midpoint set at goal of 7.6%. Minimum and Maximum 3% above and below target. Achievement measured as YTD June 30 results.)

YTD ResultsMinimum 7.8Midpoint 7.6

Maximum 7.4

6 - BOARD DISCRETIONARYObjective 6: CEO effectiveness in providing leadership, developing positive relationships, and refecting the MIHS Mission, Vision and Values.Metric 6: Board discretion used to determine whether performance needs improvement, meets expectations or exceeds expectations.

Year End Results Needs ImprovementMeets Expectations

Exceeds Expectations



September 9, 2015

Item 6. No Handout

Concluding Items