Minutes. Maricopa County Special Health Care District Board of Directors Meeting Maricopa Medical Center Auditoriums 1 and 2 June 10, :00 p.m.

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1 Minutes Maricopa County Special Health Care District Board of Directors Meeting Maricopa Medical Center Auditoriums 1 and 2 June 10, :00 p.m. 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 joined telephonically at 1:03 p.m. Elbert Bicknell, Director, District 4 Others Present: Steve Purves, MIHS, President & Chief Executive 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: Laurie Wood, MIHS, Vice President Ambulatory and Physician Services Wilma Acosta, MIHS, Chief Compliance Officer 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 1:00 p.m. Roll Call Ms. Talbot called roll. Following roll call, it was that four of the five voting members of the Maricopa County Special Health Care District Board of Directors were present, which represents a quorum. Director Gerard joined telephonically shortly after roll call, during executive session. 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.

2 General Session, Presentation, Discussion and Action: 1. Motion to Recess General Session and Convene in Executive Session 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 3:24 p.m. 2. iprotean Online Course The video was not watched or discussed. 3. Approval of Consent Agenda: a. Minutes: i. May 13, 2015 b. Governance: i. Approve Home Assist Health s Amended and Restated Articles of Incorporation. ii. iii. iv. Approve Home Assist Health s Amended and Restated Bylaws. Approve the Waiver of the Conflict of Interest with Gammage and Burnham in connection with their representation of Mountain Park Health Center in contracts with Maricopa Integrated Health System Approve the Amended and Restated Bylaws of Mercy Maricopa Integrated Care v. Approve and Ratify the Amended Mercy Maricopa Integrated Care Member Agreement, as Executed by Maricopa Integrated Health System President and Chief Executive Officer, Steve Purves vi. vii. Approve Amendment #1 to Intergovernmental Agreement (ADHS Contract #ADHS ) between the Maricopa County Special Health Care District and the Arizona Department of Health Services re: Psychiatry Residency Training Program Approve the Retention of Gammage & Burnham to Prepare an Answer and Prosecute a Counterclaim and a Third party Complaint in Maricopa County Superior Court Case # CV Director Harden requested 3.b.i., 3.b.ii., and 3.b.v. be removed from the consent agenda to be discussed and voted on separately. Director Gerard moved to approve the consent agenda minus 3.b.i., 3.b.ii., and 3.b.v. Vice Chairman Dewane seconded. Motion passed by voice vote. 2

3 3. Approval of Consent Agenda, cont. Director Harden moved to recess general session and convene in executive session for the purpose of obtaining legal advice, pursuant to A.R.S (A)(3) at 3:26 p.m. Vice Chairman Dewane seconded. Motion passed by voice vote. General Session, Presentation, Discussion and Action: Chairman McMahon reconvened general session at 3:47 p.m. 3. Approval of Consent Agenda, cont. Director Harden moved to approve consent agenda item 3.b.i., the Home Assist Health Amended and Restated Articles of Incorporation. Director Bicknell seconded. Motion passed by voice vote. Director Harden moved to approve consent agenda item 3.b.ii., the Home Assist Health Amended and Restated Bylaws, with the following changes; Article 1 Section 2, removal of either and or without. The sentence will read, The Corporation may have such offices within the State of Arizona, as may be designated from time to time by resolution of the Board of Directors, one of which may be designated as the principal office. Vice Chairman Dewane seconded. Motion passed by voice vote. Director Harden moved to approve consent agenda item 3.b.v., the Amended Mercy Maricopa Integrated Care Member Agreement, as Executed by Maricopa Integrated Health System President and Chief Executive Officer, Steve Purves. Director Bicknell seconded. Motion passed by voice vote. 4. Approve the Sliding Fee Discount Program Including its Appendices for the Maricopa Integrated Health System s Federally Qualified Health Center Look Alike Clinics Ms. Wood stated that the Maricopa Health Centers Governing Council (MHCGC) recommended the approval of the Federally Qualified Health Center Look Alike Clinics (FQHC LA) Sliding Fee Discount Program. She provided a summary of the policy and noted the discount program was a requirement of the Health Resources and Services Administration (HRSA) program. The proposed discount program addressed the specific criteria required for HRSA compliance, a schedule of discounts for services and the removal of barriers to care. She referred to the definition for family size/household and noted that HRSA grants the health centers the authority to define family size and household. The definition used within the program was consistent with Arizona Health Care Cost Containment System (AHCCCS) definition and required only those that permanently resided at the household to be included in the income calculations. She also noted the definition for nominal fee was extrapolated from the HRSA requirement. There were changes to eligibility, as HRSA does not allow discounts for patients above 200% of the federal poverty level (FPL). The change in the Sliding Fee Discount Schedule categories and eligibility was fairly profound; the opportunity for a patient to self-proclaim their income was limited and they were now required to provide documentation within 30 days. Director Harden asked if there were repercussions if that documentation was not provide. 3

4 4. Approve the Sliding Fee Discount Program Including its Appendices for the Maricopa Integrated Health System s Federally Qualified Health Center Look Alike Clinics, cont. Ms. Wood stated that the patient would default to 100% of charges if they failed to provide the required documentation. She also stated that patients are now expected to pay their portion of charges, with the expectation of full payment within 90 days. A patient could be placed on a payment plan if they did not have the payment at the time of the service. There would be no interruption of care unless the patient refused the payment plan or acknowledge the payment plan. In cases of extreme financial hardship, the clinic manager had the authority to reduce or waive the nominal fee. Those waivers would be monitored closely. She referred to Appendix C and noted the increase in nominal fee for the primary care services, including urgent care centers to $20 for patients in Category 1. The nominal fee would increase as the income for the patient increased. There were also increases in the nominal fee for dental services. The increases in the nominal fees were expected to have a $1.7 million positive impact on the fiscal year 2016 budget. Director Harden asked if MIHS charged a facility fee. Ms. Benaquista said self-pay patients were charged the co-pay or nominal fee that was required. For other payers, a facility fee was charged. Director Harden asked for the specific facility fee amount. Ms. Benaquista said she would gather the information and provide to the Board. Director Bicknell moved to approve the Sliding Fee Discount Program including its appendices for the Maricopa Integrated Health System s Federally Qualified Health Center Look Alike Clinics. Vice Chairman Dewane seconded. Motion passed by voice vote. 5. Quarterly Maricopa Integrated Health System (MIHS) Compliance Department Report Including MIHS Audit and Compliance Committee Activities Ms. Acosta reviewed the compliance department activities. The focus of the internal audit changed and there would be three or four major audits a year. There were two outstanding areas of focus; Health Insurance Portability and Accountability Act (HIPAA) Security Gap Evaluation and Security Risk Analysis. She reviewed the department assessment and goals established in 2014 and noted the progress made in the compliance department year over year. Accomplishments included the approval of a compliance work plan, the implementation of compliance committees throughout the organization, the progress with the compliance projects, the updates to the compliance hotline, and improved education and training. The compliance department implemented new procedures and practices in the organization, such as a conflict of interest renewal on an annual basis, and the exclusion provider checks, which were conducted on a monthly basis. She stated that there were 10 events reported to the Office of Civil Rights, which was reasonable for an organization the size of MIHS. She also noted MIHS was averaging a retention of approximately 83% of audited cases reviewed by CMS (Center for Medicare & Medicaid Services). Director Harden referred to the Office for Civil Rights Reportable Events and requested clarification on the YouTube video with patient protected health information (PHI). Ms. Acosta explained the radiology department developed a marketing video, in conjunction with the marketing department. Unfortunately, the X-ray film used in the video had patient information in the corner. The error was notice and the video was removed from the site within 11 minutes of being posted. 4

5 6. Quarterly Report on Home Assist Health (HAH) Ms. Wilson reported the first three quarters of fiscal year 2015 for Home Assist Health (HAH) had been successful. The current focus was furthering the brand and working on relationships within the community. The policies and procedures were reviewed to ensure the departments were interconnected and there was an assessment of personnel to ensure they were working within their capacity. A satisfaction management company conducted a survey and HAH maintained a 90 th percentile satisfaction rate with the members and caregivers. Chairman McMahon referred to the results for the members and asked for the response rate. Ms. Wilson said there was a minimum 10% response rate every month, to maintain consistency month over month. She noted that all surveys were conducted telephonically. She reviewed the financial report and stated there was financial stability. She reviewed the development activity and noted the contract with Bridgeway was executed and there were discussions for additional projects. The Division of Developmental Disabilities would add rehabilitation services component and there were other opportunities available, including the growth of referral and funding resources. Director Harden asked about the response from the community. Ms. Wilson said that the response from the community had been very positive. HAH was recently accepted by the Area Agency on Aging to be one of the sale vendors. Chairman McMahon asked if there had been an increase in utilization. Ms. Wilson said there would be a year-end report on utilization rates; however, she stated that the utilization was sustained through the transition from Complete Comfort Care to HAH. It was critical that the operations and programs be in place to sustain any growth and maintain quality. 7. Election of Board Officers for July 1, 2015 through November 30, 2015 Vice Chairman Dewane nominated Terence McMahon for Chair through November Chairman McMahon accepted the nomination. Director Harden moved to approve the appointment of Terence McMahon as Chair for a term of July 1, 2015 through November 30, Vice Chairman Dewane seconded. Motion passed by voice vote. Director Harden said that she as willing to serve as Vice Chair. Vice Chairman Dewane commented that he would be willing to continue to serve as the Vice Chairman of the Board. Chairman McMahon moved to approve the appointment of Mark Dewane as Vice Chair for term of July 1, 2015 through November 30, Director Gerard seconded. Motion passed by voice vote. Director Harden requested clarification on the term of the officers. 5

6 7. Election of Board Officers for July 1, 2015 through November 30, 2015, cont. Ms. Talbot stated that Terence McMahon and Mark Dewane would serve as officers from July 1, 2015 through November 30, In November 2015, the Board will elect officers for the term of December 1, 2015 through November 30, 2016, if Mary A. Harden, R.N., Terence McMahon and Mark Dewane are reelected in the November 2016 general election. If new members are elected to the Board of Directors in the November 2016 election, the Board would need to meet within 30 days of the election to elect officers. Due to the change in the terms, the Bylaws were scheduled to be amended to reflect the current Arizona law with regard to officers. 8. Concluding Items a. Old Business: March 11, 2015 Bond Issuance When the time is appropriate, please provide the Board with a list of needs/proposal of projects along with accompanying Board resolution to issue bonds. 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 Director Harden requested an opportunity to discuss the role of the Clerk of the Board and a possible title change. Mr. Purves reviewed the media activity for the month. He also noted that the dialysis units were undergoing a survey from CMS, which was routine. The Governor decided not to implement the reduction of Medicaid payments to providers, which was a decision that significantly affected MIHS. To express its gratitude and appreciation for the decision, Mr. Purves, along with Chairman McMahon would send a letter to the Governor, on behalf of the Special Health Care District Board of Directors, thanking him for his leadership. Adjourn Director Harden moved to adjourn the June 10, 2015 Special Health Care District Board of Directors Strategy/Governance Meeting. Vice Chairman Dewane seconded. Motion passed by voice vote. Meeting adjourned at 4:35 p.m. 6

7 Terence M. McMahon, Chairman Special Health Care District Board of Directors 7

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