Jackson Health System

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1 Jackson Health System Capital Bond Proposal Board of County Commissioners Committee of the Whole October 3, 2013

2 Mission Statement To build the health of the community by providing a single, high standard of quality care for the residents of Miami-Dade County

3 Presentation Agenda Overview New Projects Modernization Technology Finance Oversight

4 Overview Overview Need Strategy New Projects Modernization Technology Finance Oversight

5 Technology Needs Overview: Need Aging Facilities Limited Footprint Strategic Misalignment

6 Overview: Strategy Modernized ERs & ORs New Facilities Updated Accommodations Expanded Footprint Technology for Efficiency

7 New Projects Overview New Projects Children s Ambulatory Center Rehabilitation Hospital Urgent Care Centers Modernization Technology Finance Oversight

8 Children s Ambulatory Center

9 Pediatric Market Share 25% 20% 15% 10%

10 Jackson Pediatric Payer Mix 16.7% Self-Pay Medicaid Medicare Managed Care/Other

11 Children s Ambulatory Center Off Campus Checkups On Campus Dedicated Entrance Urgent Care Same-Day Surgery Specialty Clinics Child- Friendly Spaces Imaging One-Stop Clinics

12 Off-Campus Components Family-friendly lobby and waiting areas Pediatric exam rooms Child-centric imaging areas Physician offices Child-life activity center Conference spaces

13 Construction Timeline Permitting and Design Groundbreaking Planning and Zoning CAP Grand Opening (estimate months after permitting & design)

14 Rehabilitation Hospital

15 Rehabilitation Hospital

16 Attracting Patients All Miami-Dade Rehab Centers Jackson Rehab Hospital Miami-Dade Broward Other Florida Out Of State 88.9% 74.9%

17 Jackson Rehab Payer Mix 10.4% Self-Pay Medicaid Medicare Managed Care/Other

18 Cost of Inaction Projected 2013 Cases Projected 2014 Lost Cases Projected 2015 Projected 2016 Projected 2017 Projected 2018

19 Projected New Volume Projected 2013 Projected 2014 Projected 2015 Cases Lost Cases Growth Projected 2016 Projected 2017 Projected 2018

20 Construction Timeline Permitting and Design Groundbreaking Planning and Zoning New Rehab Hospital Grand Opening (estimate months after permitting & design)

21 Urgent Care Network

22 Current Footprint

23 Service Offerings All Centers Illness School Physicals Occupational Health Broken Limbs Diabetes Monitoring Employment Physicals Simple Wounds Some Locations Travel Health Geriatrics Physical Therapy Immigration Physicals Weight Loss Programs Advanced Diagnostics Routine Prenatal Care

24 Modernization Overview New Projects Modernization ERs & ORs Patient Rooms Deferred Maintenance Technology Finance Oversight

25 Operating Rooms

26 Emergency Rooms

27 Build Out Intensive Care Unit Fourth Floor Patient Unit

28 Inpatient Rooms & Units

29 Deferred Maintenance FORTY-YEAR CERTIFICATION Structure HVAC Electrical ELEVATOR REPLACEMENT PARKING

30 Technology Overview New Projects Modernization Technology Medical Equipment Information Technology Finance Oversight

31 Medical Equipment Cardiac Cath Labs Brain Scanners Oncology Equipment

32 Information Technology Electronic Health Record Network Infrastructure Bedside Computer Systems

33 Finance Overview New Projects Modernization Technology Finance Oversight

34 Project Budgets

35 Oversight Overview New Projects Modernization Technology Finance Oversight Ballot Language Oversight Structures

36 Ballot Language Shall Miami-Dade County fund modernization, improvement and equipping of Jackson Health System s facilities located throughout the county, including, but not limited to, emergency rooms, children s ambulatory pavilion and urgent care centers, by issuing, from time to time, general obligation bonds payable from the ad valorem taxes collected in Miami-Dade County in principal amount not exceeding $830,000,000, bearing interest not exceeding maximum legal rate and maturing within 30 years from issuance date?

37 Oversight Structure BCC & Mayor Financial Auditors Inspector General PHT Board Citizen Oversight Board Ethics Commission External Oversight Law Enforcement Jackson Staff

38

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