PUBLIC HEALTH TRUST BOARD OF TRUSTEES

Transcription

1 PUBLIC HEALTH TRUST BOARD OF TRUSTEES TELEVISED MEETING AGENDA Monday, July 28, :00 P.M. to 5:00 P.M Stephen P. Clark Center Board of County Commission Chambers Second Floor 111 N. W. First Street Miami, Florida 33128

2 PUBLIC HEALTH TRUST BOARD OF TRUSTEES TELEVISED MEETING AGENDA Monday, July 28, :00 p.m. to 5:00 p.m. Stephen P. Clark Center Board of County Commission Chambers Second Floor 111 N. W. First Street Miami, Florida Board of Trustees Rules Any person making impertinent or slanderous remarks or who becomes boisterous while addressing the Public Health Trust Board of Trustees, shall be barred from further audience before the board, unless permission to continue or again address the board be granted by the Chairperson. No clapping, applauding, heckling or verbal outbursts in support or opposition to a speaker or his or her remarks shall be permitted. No signs or placards shall be allowed in the Commission Chambers. Persons exiting the Commission Chambers shall do so quietly. The use of cell phones in the Commission Chambers is not permitted. Ringers must be set to silent mode to avoid disruption of proceedings. Individuals, including those seated around the board table, must exit the Commission Chambers to answer incoming cell phone calls. 1. MOMENT OF SILENCE 2. PLEDGE OF ALLEGIANCE 3. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION FLA.STAT. (CHAPTER , LAWS OF FLORIDA) 4. SWEARING IN CEREMONY - OATH OF OFFICE, PUBLIC HEALTH TRUST BOARD OF TRUSTEES Administered by Harvey Ruvin, Clerk of the Courts and Ex-Officio Clerk of the Board of County Commissioners, Miami-Dade County, Florida Irene Lipof, Incumbent Member Ralph G. Patino, New Member Page 1 of 4

3 PUBLIC HEALTH TRUST BOARD OF TRUSTEES AGENDA July 28, REPORTS (a) Public Health Trust Board of Trustees Presented by Darryl K. Sharpton, Chairperson (1) Agenda item(s) to be added or withdrawn (2) Previous meeting minutes recommended to be approved (a) Meeting minutes as of May 28, 2014 (regular televised meeting) (b) Meeting minutes as of June 26, 2014 (special meeting) (c) Meeting minutes as of July 9, 2014 (special meeting) (d) Meeting minutes as of July 17, 2014 (special meeting) Motion to approve the previous meetings minutes (b) Jackson Health System Presented by Carlos A. Migoya, President and Chief Executive Officer (c) Florida International University College of Medicine Presented by John A. Rock, M.D., Dean and Senior Vice President for Medical Affairs (d) University of Miami Miller School of Medicine Presented by Steven Falcone, M.D., Chief Executive, University of Miami at Jackson Memorial Hospital and Associate Vice President for Medical Affairs; Professor of Radiology, Neurological Surgery and Ophthalmology (e) Joint Conference and Efficiencies Committee Presented by Marcos J. Lapciuc, Chairperson (f) Fiscal Committee Presented by Mojdeh L. Khaghan, Chairperson (1) Review of Jackson Health System Combined Financial Statements as of June 30, 2014 Presented by Mark T. Knight, Executive Vice President and Chief Financial Officer (g) Strategy and Growth Committee Presented by Joe Arriola, Chairperson (h) Miami-Dade County Attorney Presented by Eugene Shy, Jr., Assistant Miami-Dade County Attorney Page 2 of 4

4 PUBLIC HEALTH TRUST BOARD OF TRUSTEES AGENDA July 28, RESOLUTIONS RECOMMENDED TO BE APPROVED (a) Resolution approving the Medical Staff and Health Professional Affiliate Staff Membership and Clinical Privileges; approving Initial Appointments, Reappointments and Clinical Privileges and Activities; approving Modifications to Medical Staff Membership Category and Clinical Privileges; accepting Resignations and Leaves of Absence July 2014 Sponsored by Kevin Andrews, Vice President, Quality and Patient Safety Division, Jackson Health System Motion to approve the resolution Darryl K. Sharpton, Chairperson (b) Resolution authorizing and approving award of bids and proposals, waiver of bids, and other purchasing actions for June 2014, in accordance with the Public Health Trust s Procurement Policy, Resolution No. PHT 10/ Sponsored by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System Motion to approve the resolution Darryl K. Sharpton, Chairperson (c) Resolution authorizing and approving award of bids and proposals, waiver of bids, and other purchasing actions for July 2014, in accordance with the Public Health Trust s Procurement Policy, Resolution No. PHT 10/ Sponsored by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System Motion to approve the resolution Darryl K. Sharpton, Chairperson (d) Resolution approving the replacement of Thornburg International Value Fund and authorizing this portion of the International Equity Portfolio of the PHT Defined Benefit Pension Plan be reallocated with 50% of the portfolio to Blackrock ishares MSCI EAFE Value Index (ETF) and 50% of the portfolio to DFA International Value (MF) Sponsored by Donald B. Jaffee, Vice President, Finance, Jackson Health System Motion to approve the resolution Darryl K. Sharpton, Chairperson Page 3 of 4

5 (e) Resolution authorizing the President or his designee to negotiate and execute a new agreement for Physician Services by and between the Public Health Trust and Variety Children s Hospital, Inc., D/B/A Miami Children s Hospital ( Variety Children s Hospital ), subject to obtaining a fair market value assessment and delegating to the President or his designee authority to exercise any options to extend contained in the new agreement; and authorizing the President or his designee to negotiate and execute a Settlement Agreement by and between the Public Health Trust And Variety Children s Hospital for compensation for services previously rendered Sponsored by Steven E. Burghart, Chief Administrative Officer, Holtz Children s Hospital and Jackson Women s Hospital, Jackson Health System Motion to approve the resolution Darryl K. Sharpton, Chairperson (f) Resolution approving acceptance of a gift in the amount of Two Million Five Hundred Thousand Dollars ($2,500,000) from the Batchelor Foundation, Inc., and authorizing the President to execute the Agreement between the Public Health Trust, Jackson Memorial Foundation, Inc., and the Batchelor Foundation, Inc. evidencing the gift Sponsored by Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System (g) Resolution recommending that the Miami-Dade County Board of County Commissioners approve and adopt the ordinance creating the Jackson Health System Capital Expedite Program; establishing policy to accelerate the processing and procurement of contracts; authorizing the Public Health Trust to advertise and award contracts for professional services and construction and design-build services; and providing for amendment of the Public Health Trust s procurement policy and implementation Sponsored by Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System Motion to approve the resolution Darryl K. Sharpton, Chairperson 7. ADJOURNMENT Page 4 of 4

6 1. MOMENT OF SILENCE

7 2. PLEDGE OF ALLEGIANCE

8 3. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION FLA.STAT. (CHAPTER , LAWS OF FLORIDA)

9 4. SWEARING IN CEREMONY PUBLIC HEALTH TRUST BOARD OF TRUSTEES, OATH OF OFFICE Administered by Harvey Ruvin, Clerk of the Courts and Ex-Officio Clerk of the Board of County Commissioners Irene Lipof, Incumbent Member Ralph G. Patino, New Member

10 5. REPORTS

11 5 (a) Public Health Trust Board of Trustees Presented by Darryl K. Sharpton, Chairperson

12 5 (a) (1) Agenda item(s) to be added or withdrawn

13 5 (a) (2) Previous meeting minutes recommended to be approved

14 PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES Wednesday, May 28, :00 p.m. to 5:00 p.m. Stephen P. Clark Center Board of County Commission Chambers Second Floor 111 N. W. First Street Miami, FL Public Health Trust Board of Trustees Darryl K. Sharpton, Chairperson Joe Arriola, Vice Chairperson Mojdeh L. Khaghan, Treasurer Irene Lipof, Secretary Michael Bileca Marcos J. Lapciuc Members Present: Member(s) Excused: Darryl K. Sharpton, Chairperson, Irene Lipof, Mojdeh L. Khaghan, and Michael Bileca Joe Arriola and Marcos J. Lapciuc In addition to the Board of Trustees, the following staff members and Miami-Dade County Attorneys were present: Carlos A. Migoya, Don S. Steigman, Esther Abolila, Donald F. Wolfe, III, and Marilyn Moss, and Jeffrey Poppel and Eugene Shy, Jr., Assistant Miami-Dade County Attorneys The Public Health Trust Board of Trustees (PHT BOT) meeting began with video reports highlighting Jackson Health System (JHS). The PHT BOT meeting was officially called to order at 3:10 p.m. by Darryl K. Sharpton, Chairperson. 1. MOMENT OF SILENCE 2. PLEDGE OF ALLEGIANCE The PHT BOT convened in a moment of silence followed by the Pledge of Allegiance. 3. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION FLA.STAT. (CHAPTER , LAWS OF FLORIDA) There were no requests from the public to be heard. Page 1 of 6

15 PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES May 28, REPORTS (a) Public Health Trust Board of Trustees Mr. Sharpton reported that JHS continues to progress; over the past several months JHS has been recognized by the community for its distinguished healthcare professionals. Mr. Sharpton requested that all JHS healthcare providers and professionals that received honors during the year be recognized. He also mentioned that he have something more ambitious in mind for the Employee Recognition Wall which is adjacent to the Jackson Memorial Cafeteria. Mr. Sharpton thanked Irene Lipof and Mojdeh L. Khaghan, members of the PHT BOT for attending various functions that recognize the efforts of JHS staff, and the PHT Board of Trustees; and recognized Michael Bileca for addressing some of the community wide healthcare issues during the 2014 Legislative Session. The PHT Nominating Council continues to move forward with the process to fill the upcoming vacancies on the PHT Board; the Nominating Council will be meeting in the month of July 2014 to advance the names of individuals selected to make up the GOB Oversight Board; and the Board of County Commissioners approved $100 million to begin the improvement process of the JHS facilities. (1) Agenda items to be added or withdrawn Eugene Shy, Jr., Assistant Miami-Dade County Attorney read into the record the following items recommended to be added to the agenda: (1) Resolution approving Public Health Trust Board of Trustees Revised Committee Assignments, effective May 28, 2014 Sponsored by Darryl K. Sharpton, Chairperson, Public Health Trust Board of Trustees (2) Resolution authorizing the President or his designee to execute a Bill of Sale to exercise exercise its option, as contained in the Physician Services Agreement entered by the Public Health Trust of Miami-Dade County, Florida ( Trust ) and Nelson Adams, M.D. and Associates, P.A. ( Practice ) on April 1, 2009, upon expiration of such agreement, to sell back to the Practice, at fair market value, certain Practice assets acquired by the Trust under the Asset Purchase Agreement entered into by the Trust and the Practice on April 1, 2009, and other additions, improvements and rights as may have accrued to the facilities and the division as defined in the aforementioned Physician Services Agreement Sponsored by Patricia Sechi, Associate Vice President, Program Development and Physician Strategies, Jackson Health System The item will also include a correction to the word to exrecise to exercise. With regards to agenda item 5 (a), Mr. Shy stated for the record that since the May 15, 2015 Joint Conference and Efficiencies Committee meeting the May 2014 Credentials Activity Report was amended to show the removal of Roberto Fogel, M.D. Motion to add add-on agenda items (1) and (2) as amended, and include the revision to the May 2014 Credentials Activity Report Darryl K. Sharpton, Chairperson Michael Bileca moved approval; seconded by Irene Lipof, and carried without dissent. Page 2 of 6

16 PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES May 28, 2014 (a) Jackson Health System (2) Previous meeting minutes recommended to be approved (a) Meeting minutes as of April 28, 2014 (regular televised meeting) Motion to approve the previous meeting minutes Darryl K. Sharpton, Chairperson (3) LifeSouth Agreement Update Michael Bileca moved approval; seconded by Mojdeh L. Khaghan, and carried without dissent. Michael Butler, M.D., Chief Medical Administrative Officer presented an update regarding the agreement between JHS and LifeSouth a 501(c)(3) non-profit community blood supplier. In 2011 the Board of County Commissioners requested that JHS explore the possibility of establishing a stem cell collection of core blood donations. Since the time of the request JHS entered into an agreement with LifeSouth to collect the stem cell from blood remaining from the placenta that could be made available for bone marrow transplants and used in a number of other diseases. Dr. Butler stated that there will be minimal to no cost to JHS which makes the service available to the community. Ms. Khaghan questioned who will collect and store the blood. Dr. Butler replied LifeSouth will collect and store the blood at its location. Ms. Khaghan questioned if families will be responsible for the cost of storing the blood. Dr. Butler replied no. He stated that the blood will be stored at the LifeSouth facility and will be available at no cost to patients who need it. Mr. Sharpton requested that at the appropriate committee meeting Dr. Butler give an estimate of the number of additional lives that JMH could save using the services provided by LifeSouth. Carlos A. Migoya, President and Chief Executive Officer announced that Darryl K. Sharpton, Chairperson, PHT Board of Trustees was honored with the 2014 NOVO Award for Outstanding Board Leader presented by the Greater Miami Chamber of Commerce, and the 2014 Thelma Gibson Community Service Award presented by United Homecare. Mr. Migoya mentioned that Zari Watkins, Esq., Director, Projects Coordination, Jackson Health System was selected by Legacy Magazine to be among the 2014 South Florida s 50 Most Powerful Black Business Leaders. Ms. Watkins joins Sandy Sears and Michael Butler, M.D. who were recognized in previous years. Mr. Migoya announced the retirement of Sandy Sears, Chief Administrative Officer, Jackson North Medical Center (JNMC). After 39 years of loyal public service, Ms. Sears s contribution to the institution will always be remembered. Mr. Migoya invited everyone to join the celebration honoring Ms. Sears on June 11, 2014 at JNMC. Mr. Migoya reported that the Joint Commission surveyors returned back to JHS to reevaluate their findings and reported that JHS was cleared of the findings noted in the original survey. During the course of their return visit three (3) findings were identified and it is anticipated that the surveyors will return in July of this year for a follow up visit. The surveyors complimented the work JHS has done and documentation gathered to demonstrate JHS commitment to compliance. Mr. Migoya also reported that this week will launch the new website dedicated to the Jackson Miracle Building Bond Program. Early stages of the website will feature basic information about the Bond Program including how to register as a vendor. Soon will be applications for membership to the Citizen Advisory Committee and other important information that will help the public better understand the Bond program. Page 3 of 6

17 PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES May 28, 2014 (c) Florida International University College of Medicine (FIUCOM) John A. Rock, M.D., Dean and Senior Vice President for Medical Affairs, FIUCOM reported that FIUCOM graduated its second class of 43 physicians. The graduates matched very well with 60% going into primary care and over 30% remaining in south Florida to complete their residency program. It is anticipated that 80 students will represent the graduating class of 2015 and 120 students will represent the graduating class of Dean Rock stated that FIUCOM have greatly appreciated the opportunity to serve Jackson North Medical Center and have worked together to improve the health of the community. Dean Rock congratulated the PHT Board of Trustees, Mr. Migoya, Mr. Steigman, JHS staff and the management team for their tremendous success in improving the financial position of the institution. He stated that clearly JHS is well positioned for future success and it is FIUCOM desire to continue to expand its partnership with JHS and University of Miami Miller School of Medicine (UMMSOM) to improve the health of the citizens of Miami-Dade County. Dean Rock expressed concern regarding the Annual Operating Agreement (AOA) between JHS and FIUCOM. The concerns are rooted in FIUCOM desire to actively participate with JHS yet no agreement has been reached. He stated that FIUCOM will work hard with Mr. Migoya and Mr. Steigman to address the concerns and remain committed to continuing negotiations for a timely establishment of an AOA that follows the intent of the resolution adopted by the Board of County Commissioners that directs the PHT to develop a plan to establish a comprehensive clinical educational program in general practice in partnership with FIUCOM and maintaining the spirit of the Memorandum of Understanding between the PHT and UMMSOM and FIUCOM. Mr. Sharpton stated that he look forward to working with Dean Rock to help insure that an effective AOA is reached. (d) University of Miami Miller School of Medicine (UMMSOM) Steven Falcone, M.D., Chief Executive and Associate Vice President of Medical Affairs reported that UMMSOM is extremely pleased that the PHT Board of Trustees approved the fiscal year 2015 AOA and MTI Agreements between JHS and UMMSOM. The Agreements along with the work of the respective teams will help solidify both parties desire to strengthen the relationship and together grow select programs. The Miller School of Medicine Dr. John T. McDonald Foundation School Health initiative was awarded a new direction for school-based health grant. The grant will allow the school health initiative to build upon its existing structure, increase program visibility and promote community awareness. The school health initiative brings free health care services to nine Miami-Dade County Public Schools. Joshua Lenchus, DO, RPh, SFHM, and President of the Medical Staff at JHS and Associate Professor of Hospital Management at UMMSOM is the recipient of the 2014 Bill Keith Humanitarian of the Year Award. Dr. Falcone congratulated Mr. Sharpton, Mr. Migoya and other JHS staff and representatives from the UMMSOM who were nominated or received award recognition for their work in healthcare in the community. (e) Joint Conference and Efficiencies Committee Irene Lipof, Vice Chairperson, Joint Conference and Efficiencies Committee reported that the Committee met on May 14, The Committee was provided with standard monthly updates, reviewed the May 2014 Credentials Activity Report, and was presented with a Joint Commission survey update, and overview of the quality scorecard. Ms. Lipof recommended for approval the May 2014 Credentials Activity Report (agenda item 5 (b)). (f) Fiscal Committee Mojdeh L. Khaghan, Chairperson, Fiscal Committee, invited Mark T. Knight, Executive Vice President and Chief Financial Officer to present an overview of the JHS combined financial statements as of April 30, (1) Financial Statements Mr. Knight presented a detailed report of the JHS combined financial statements at the May 15, 2014 Fiscal Committee meeting. Highlights of the report included a review of JHS bottom line, hospital volumes, length of stay, days cash on hand, utilization, year to date information, and projections. Page 4 of 6

18 PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES May 28, 2014 (g) Strategy and Growth Committee Ms. Khaghan, member, Strategy and Growth Committee reported that the Committee met on May 15, With regards to the outcome of the 2015 Legislative Session Ms. Khaghan invited Mr. Knight to present an update report. Mr. Knight stated that the Low Income Pool (LIP) program for JHS was extended for another year and it is anticipated that JHS will receive approximately $180 million from the program with some modifications how the dollars will be forwarded to JHS. There is a set aside for safety net hospitals totaling approximately $100 million and the dollars will continue to follow the patients through the managed care organizations as they migrate into a managed care environment. It is believed that JHS will be largely unaffected by the change for fiscal year With regards to the implementation of the new IT system, Mr. Knight stated that there is an extensive high level of anxiety for the users. Major efforts are ongoing to timely and effectively complete the training process. A review of the training process will be conducted to determine whether or not to extend the user training. (h) Miami-Dade County Attorney Eugene Shy, Jr., Assistant Miami-Dade County Attorney reminded the PHT BOT that July 1, 2014 is the deadline to submit the Financial Disclosure Forms. 5. RESOLUTIONS RECOMMENDED TO BE APPROVED ADD-ON AGENDA ITEMS (1) PHT 05/ Resolution approving Public Health Trust Board of Trustees Revised Committee Assignments, effective May 28, 2014 Sponsored by Darryl K. Sharpton, Chairperson, Public Health Trust Board of Trustees (2) PHT 05/ Resolution authorizing the President or his designee to execute a Bill of Sale to exercise exercise its option, as contained in the Physician Services Agreement entered by the Public Health Trust of Miami-Dade County, Florida ( Trust ) and Nelson Adams, M.D. and Associates, P.A. ( Practice ) on April 1, 2009, upon expiration of such agreement, to sell back to the Practice, at fair market value, certain Practice assets acquired by the Trust under the Asset Purchase Agreement entered into by the Trust and the Practice on April 1, 2009, and other additions, improvements and rights as may have accrued to the facilities and the division as defined in the aforementioned Physician Services Agreement Sponsored by Patricia Sechi, Associate Vice President, Program Development and Physician Strategies, Jackson Health System The item will also include a correction to the word to exrecise to exercise. (a) PHT 05/ Resolution approving the Annual Operating Agreement and Miami Transplant Institute (MTI) Agreement with the University of Miami and authorizing the President and Chief Executive Officer to execute such agreements Sponsored by Don S. Steigman, Executive Vice President and Chief Operating Officer, Jackson Health System Page 5 of 6

19 PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES May 28, 2014 (b) PHT 05/ Resolution approving the Medical Staff and Health Professional Affiliate Staff Membership and Clinical Privileges; approving Initial Appointments, Reappointments and Clinical Privileges and Activities; approving Modifications to Medical Staff Membership Category and Clinical Privileges; accepting Resignations and Leaves of Absence May 2014 Sponsored by Kevin Andrews, Vice President, Quality and Patient Safety Division, Jackson Health System The motion to approve the item will include the removal of Roberto Fogel, M.D. name from the May 2014 Credentials Committee Activity Report. (c) PHT 05/ Resolution authorizing and approving award of bids and proposals, waiver of bids, and other purchasing actions for May 2014, in accordance with the Public Health Trust s Procurement Policy, Resolution No. PHT 10/ Sponsored by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System (d) PHT 05/ Resolution authorizing the President to negotiate and execute a Renewal Agreement for expenditures up to $1,133,000 out of fiscal year 2014 budget for the purchase of public health services with the Miami-Dade County Health Department Sponsored by Cary Nieves, Chief Nursing Officer and Operations, Ambulatory Care Center and Primary Care Clinics, Jackson Health System Motion to approve add-on agenda items (1) and (2) as amended, and resolutions 5 (a) to 5 (d) Mojdeh L. Khaghan moved approval; seconded by Darryl K. Sharpton, and carried without dissent. 6. ADJOURNMENT Darryl K. Sharpton, Chairperson adjourned the meeting at 3:58 p.m. Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees Page 6 of 6

20 SPECIAL PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES Thursday, June 26, 2014 Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12 th Avenue Miami, FL Public Health Trust Board of Trustees Darryl K. Sharpton, Chairperson Joe Arriola, Vice Chairperson Mojdeh L. Khaghan, Treasurer Irene Lipof, Secretary Michael Bileca Marcos J. Lapciuc Members Present: Member(s) Excused: Darryl K. Sharpton, Chairperson, Joe Arriola, Marcos J. Lapciuc and Irene Lipof Joe Arriola and Michael Bileca In addition to the Board of Trustees, the following staff members and Assistant Miami-Dade County Attorneys were present: Carlos A. Migoya, Kevin Andrews, Esther Abolila, and Marilyn Moss; Christopher Kokoruda, Assistant Miami-Dade County Attorney 1. SPECIAL MEETING CALL TO ORDER Darryl K. Sharpton, Chairperson at 9:00 a.m. 2. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION FLA.STAT. (CHAPTER , LAWS OF FLORIDA) There were no requests from the public to be heard. 3. PURPOSE OF THE SPECIAL PHT BOARD OF TRUSTEES MEETING Christopher Kokoruda, Assistant Miami-Dade County Attorney stated for the record that the sole purpose of the special meeting is to consider action for the June 2014 Credentialing Activity Report. Page 1 of 2

21 SPECIAL PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES June 26, RESOLUTION RECOMMENDED TO BE APPROVED (a) PHT 06/ Resolution approving the Medical Staff and Health Professional Affiliate Staff Membership and Clinical Privileges; approving Initial Appointments, Reappointments and Clinical Privileges and Activities; approving Modifications to Medical Staff Membership Category and Clinical Privileges; accepting Resignations and Leaves of Absence June 2014 Sponsored by Kevin Andrews, Vice President, Quality and Patient Safety Division, Jackson Health System Motion to approve the resolution Darryl K. Sharpton, Chairperson 5. ADJOURNMENT Darryl K. Sharpton, Chairperson at 9:05 a.m. Marcos J. Lapciuc moved approval; seconded by Joe Arriola, and carried without dissent. Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees Page 2 of 2

22 SPECIAL PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES Wednesday, July 9, 2014 Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12 th Avenue Miami, FL Public Health Trust Board of Trustees Darryl K. Sharpton, Chairperson Joe Arriola, Vice Chairperson Mojdeh L. Khaghan, Treasurer Irene Lipof, Secretary Michael Bileca Marcos J. Lapciuc Ralph G. Patino Members Present: Member(s) Excused: Darryl K. Sharpton, Chairperson, Joe Arriola, Irene Lipof, and Ralph G. Patino, Marcos J. Lapciuc, Mojdeh L. Khaghan Michael Bileca, Mojdeh L. Khaghan, and Marcos J. Lapciuc In addition to the Board of Trustees, the following staff members and Assistant Miami-Dade County Attorneys were present: Mark T. Knight, Rosa Costanzo, Ken Robertson, and Isa Nunez; Eugene Shy, Jr., Laura Llorente and Jeffrey Poppel, Assistant Miami- Dade County Attorneys 1. SPECIAL MEETING CALL TO ORDER Darryl K. Sharpton, Chairperson at 10:36 a.m. NEW APPOINTEE AND REAPPOINTEE PHT BOARD OF TRUSTEE MEMBERS Mr. Sharpton introduced Ralph G. Patino, new appointee to the PHT Board of Trustees and welcomed back Irene Lipof who was reappointed to the PHT Board of Trustees. 2. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION FLA.STAT. (CHAPTER , LAWS OF FLORIDA) There were no requests from the public to be heard. 3. PURPOSE OF THE SPECIAL PHT BOARD OF TRUSTEES MEETING Mr. Sharpton stated that the purpose of the special PHT Board of Trustees meeting was to communicate his desire to have Jackson Health System (JHS) $1.4 billon Capital Program managed by an industry expert(s). Mr. Sharpton stated that after several drafts of an RFP in support of an industry expert(s) and after several rounds of discussion with JHS staff is of the opinion that it is in the best interest of JHS to conduct further discussions regarding the RFP and RFP process at a public meeting as it relates to reasons for delaying the next steps that are necessary to expeditiously advance the JHS Capital Program. With regards to the process surrounding the RFP, Mr. Sharpton thanked Mark T. Knight, Executive Vice President and Chief Financial Officer for his efforts to articulate the desires of the PHT BOT and taking the lead role in the RFP process. Page 1 of 4

23 SPECIAL PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES July 9, 2014 DISCUSSION The PHT BOT engaged in a detailed discussion regarding the RFP process and content of the RFP for the selection of a Program Manager for the JHS Capital Program. Much of the discussion had to do with concerns surrounding requested changes that were made to the original RFP and remaining concerns after the requested changes were made, ensuring that the policy issues previously raised by the PHT BOT are reflected in the RFP, responsibilities of a Program Manager versus the Facilities Design and Construction Department, overall accountability for the construction projects, and the continued delay of selecting an experienced Program Manager. Mr. Patino questioned if the construction projects will be managed in-house or outsourced. Mr. Knight stated that JHS Management Team is in agreement and JHS Executive Team recognizes that there is a need to bring in outside expertise on the program management component, also recognize that JHS does not have the history of spending $1.4 billion according to the magnitude of the projects. Mr. Knight further stated that the intent is to issue an RFP that would have a pricing component of 20 to 25 percent of the total score to select a Program Manager. Mr. Patino questioned if it is the intension to clearly define within the RFP the role and responsibilities of a Program Manager. Mr. Knight stated that clearly JHS Management want to insure that the document references the desires of the PHT BOT. Mr. Knight further stated that originally the RFP was structured to show that the area of responsibility would ultimately be at JHS along with the Vice President of the Facilities Design and Construction Department and the Executive of the Steering Committee. Review of the structure of the RFP could designate the responsibility of the construction projects to a Program Manager, review to determine whether the Program Manager would design the projects or whether the Program Manager would staff all of the program management functions including, design, occupancy, etc. The general consensus of the PHT BOT regarding the selection process of a Capital Program Manager is to complete the process necessary to expeditiously select through a clearly defined RFP process a Capital Program Manager who is experienced, who will be held accountable and charged with the responsibility of the Capital Program, and without further delay advance the steps to select a Capital Program Manager. Following the discussion, Mr. Arriola recommended that with the expertise, knowledge and leadership that Mr. Sharpton has that he and Mr. Knight and whomever else they may choose to create an RFP for a Capital Program Manager and present it back to the PHT BOT in two (2) weeks for action. Mr. Sharpton questioned if there is a provision in the PHT Bylaws which allow the Chairperson of the PHT BOT to hire additional personnel or personnel that may be necessary to further the goals and objectives and mission of JHS. Eugene Shy, Jr. Assistant Miami-Dade County Attorney stated that the PHT Bylaws does provide that the Chairperson have the discretion to appoint a Trust employee to assist him in performing the Chairperson s duties and any other responsibilities and the Chairperson have the discretion to appoint two additional Trust employees to assist the PHT BOT in the performance of the duties and responsibilities of the members of the PHT BOT. Mr. Sharpton questioned if the PHT Board of Trustees have the authority to direct staff to procure resources that is determined to be in the best interest of the mission of the hospital and in this case being more specifically in the best interest of advancing the JHS Capital Program. Mr. Shy replied yes. Page 2 of 4

24 SPECIAL PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES July 9, 2014 Mr. Sharpton stated that with the understanding that was explained by Mr. Shy he is prepared to meet with Mr. Knight relative to the resources required to expeditiously draft an RFP for a Capital Program Manager. And with the interpretation of the PHT Bylaws can begin to follow the appropriate direction and instruction from the PHT BOT to hire the resources necessary to assist with expeditiously completing an RFP for a Capital Program Manager. By way of a motion, Mr. Arriola moved approval directing Mr. Sharpton and Mr. Knight to create an RFP for a Capital Program Manager and present it back in two (2) weeks to the PHT BOT for action Ms. Lipof questioned if the motion include hiring additional staff to assist with creating an RFP for a Capital Program Manager. Mr. Arriola replied no. Following the discussion Mr. Patino seconded the motion with a caveat only if necessary to hire additional staff to assist with creating an RFP for a Capital Program manager. The motion carried with a caveat to hire additional staff only if necessary to assist with creating an RFP for a Capital Program Manager without dissent. Ms. Lipof requested that all of the PHT BOT receive a copy of the most recent version of the revised RFP. OTHER DISCUSSION Mr. Sharpton questioned the solicitation of an RFP by Miami-Dade County (MDC) for a Rehabilitation Hospital which was not procured through the JHS staff nor was it procured through an approval process by the PHT BOT. Mr. Knight stated that the solicitation Mr. Sharpton is referring to is the solicitation for architectural engineering purposes related to the design of a Rehabilitation Hospital which is a project that is part of the MIRACLE bond funding. As part of MDC statute or regulation requires that the MIRACLE bond funded projects be solicited through MDC. The RFP for architectural engineering services for the design has been solicited and due back later this month. To Mr. Sharpton s point the process is governed a little bit by MDC. Historically JHS have not bought these RFP s through the PHT BOT for approval and the selection does not bind JHS payment. Mr. Knight explained that the process began with an RFP posting followed by a selection process that is governed under the MDC statute or regulation which can be discussed at the PHT BOT committee day meetings. The project would be part of the JHS Capital Program Manager s responsibility. The Program Manager would be involved in the oversight selection of professional designs such as architects and engineers. Mr. Sharpton stated that he plans to discuss at the next PHT BOT One-Day Committee meetings ways the PHT BOT is included in all procurement processes that pertain to the funding set aside for the JHS Capital Program. Mr. Arriola stated for the record that it is not ok with him that the PHT BOT was not advised regarding the RFP which in his opinion is wrong, not good conduct, unacceptable, and unethical. Mr. Sharpton stated that he believes that it is only respectful to give the PHT BOT heads up in terms of when and how JHS will move forward that require significant resources. The PHT BOT was aware that a Rehabilitation Hospital was going to be built sometime in the future. The point is specifically towards the process that takes the PHT BOT out of the loop. Mr. Sharpton further stated that it is only fair to make the PHT BOT aware of whatever the process and parties are that is planning to go through MDC and not through the PHT BOT yet the public is going to hold the PHT BOT responsible for the management and oversight. It is a matter of courtesy and a matter of respect. Page 3 of 4

25 SPECIAL PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES July 9, ADJOURNMENT Darryl K. Sharpton, Chairperson at 11:28 a.m. Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees Page 4 of 4

26 SPECIAL PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES Thursday, July 17, 2014 Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12 th Avenue Miami, FL Public Health Trust Board of Trustees Darryl K. Sharpton, Chairperson Joe Arriola, Vice Chairperson Mojdeh L. Khaghan, Treasurer Irene Lipof, Secretary Michael Bileca Marcos J. Lapciuc Ralph G. Patino Members Present: Member(s) Excused: Darryl K. Sharpton, Chairperson, Irene Lipof, Marcos J. Lapciuc, Mojdeh L. Khaghan, and Ralph G. Patino Joe Arriola and Michael Bileca In addition to the Board of Trustees, the following staff members and Assistant Miami-Dade County Attorneys were present: Mark T. Knight, Peter Paige, M.D., Don S. Steigman, and Carlos A. Migoya; Eugene Shy, Jr., Laura Llorente, Jeffrey Poppel, and Christopher Kokoruda, Assistant Miami-Dade County Attorneys 1. SPECIAL MEETING CALL TO ORDER Darryl K. Sharpton, Chairperson at 9:16 a.m. 2. PURPOSE OF THE SPECIAL PHT BOARD OF TRUSTEES MEETING At the request of Mr. Sharpton, Eugene Shy, Jr., Assistant Miami-Dade County Attorney stated that the purpose of the special PHT Board of Trustees (PHT BOT) meeting was to adopt a revised 2014 PHT BOT Committee Assignments. 3. RESOLUTION RECOMMENDED TO BE APPROVED (a) PHT 07/ Resolution approving Public Health Trust Board of Trustees revised Committee Assignments, effective July 17, 2014 Motion to approve the resolution Darryl K. Sharpton, Chairperson Sponsored by Darryl K. Sharpton, Chairperson, Public Health Trust Board of Trustees Marcos J. Lapciuc moved approval; seconded by Mojdeh L. Khaghan, and carried without dissent. Page 1 of 2

27 SPECIAL PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES July 17, 2014 REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION FLA.STAT. (CHAPTER , LAWS OF FLORIDA) There were no requests from the public to be heard. 4. ADJOURNMENT Darryl K. Sharpton, Chairperson at 9:18 a.m. Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees Page 2 of 2

28 5 (b) Jackson Health System Presented by Carlos A. Migoya, President and Chief Executive Officer

29 5 (c) Florida International University College of Medicine Presented by John A. Rock, M.D., Dean and Senior Vice President for Medical Affairs

30 5 (d) University of Miami Miller School of Medicine Presented by Steven Falcone, M.D., Chief Executive, University of Miami at Jackson Memorial Hospital and Associate Vice President for Medical Affairs; Professor of Radiology, Neurological Surgery and Ophthalmology

31 5 (e) Joint Conference and Efficiencies Committee Presented by Marcos J. Lapciuc, Chairperson

32 5 (f) Fiscal Committee Presented by Mojdeh L. Khaghan, Chairperson

33 PUBLIC HEALTH TRUST JACKSON HEALTH SYSTEM COMBINED FINANCIAL STATEMENTS June 30, 2014

34 PUBLIC HEALTH TRUST JACKSON HEALTH SYSTEM COMBINED FINANCIAL STATEMENTS June 30, 2014 INDEX 1. Key Performance Indicators 2. Combined Balance Sheet 3. Combined Statement of Revenues, Expenses & Changes in Fund Net Assets 3A. Combined Statement of Revenues, Expenses & Changes in Fund Net Assets excluding Division of Managed Care 4. P &L 12 Month Trend Analysis 5. Combining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding /Month 6. Combining Statement of Revenue & Expenses Reflecting Allocated Corporate Overhead & Public Support Funding /YTD 7. Combining Statement of Revenue & Expenses by Company 8. Combined Statement of Unrestricted/Restricted Cash Flow 9. Consolidated Portfolio Inventory Summary by Security /Account Type 10. Sales Tax Monthly Income Trend Analysis 11. Payor Mix Patient Days as % of Total Fiscal Year

35 (a) (b) (e) (f) (g) (h) (i) (j) (k) NEW KEY PERFORMANCE INDICATORS Fiscal Year 2014 (Dollars in 000) (d) (e) (l) YTD Jun-14 Jun-14 Jun-13 $ Variance % Variance May-14 YTD YTD YTD $ YTD Variance % YTD Variance Benchmark Status Actual Budget Actual Budget Prior Budget Prior Actual Actual Budget 2013 Budget Prior Budget Prior JHS Financial (1) Net Patient Revenue 82,234 83,901 79,827 (1,667) 2,407 (2.0)% 3.0% 87, , , ,820 (4,702) 2,266 (0.6)% 0.3% (2) Other Operating Revenue 10,603 11,275 11,344 (672) (741) (6.0)% (6.5)% 10, , , ,164 (4,788) (32,329) (4.5)% (24.3)% (4) Total Operating Revenue 92,837 95,176 91,171 (2,339) 1,666 (2.5)% 1.8% 98, , , ,985 (9,491) (30,063) (1.1)% (3.4)% (6) Total Operating Expenses 123, , , , % 4.2% 129,078 1,126,134 1,124,854 1,132,339 (1,281) 6,204 (0.1)% 0.5% (7) Gain and (Loss) from Operations (30,749) (28,990) (27,389) (1,759) (3,361) (6.1)% (12.3)% (30,918) (279,212) (268,441) (255,354) (10,771) (23,858) (4.0)% (9.3)% (8) Total Net Non-operating Items (before GOB & Special Contributions) 32,205 30,390 30,508 1,814 1, % 5.6% 34, , , ,856 11,068 11, % 4.3% (9) Excess of Revs Over (Under) Expenses before GOB & Special Contrib. 1,456 1,400 3, (1,664) 4.0% (53.3)% 3,437 9,503 9,207 21, (11,999) 3.2% (55.8)% (10) GOB & Special Contributions 2, ,166 2, % 1,963.1% 1,286 11,966-3,981 11,966 7, % 200.6% (11) Excess of Revenues Over (Under) Expenses 3,622 1,400 3,224 2, % 12.3% 4,723 21,469 9,207 25,483 12,262 (4,014) 133.2% (15.8)% (12) Unrestricted Health Care Surtax 19,279 17,417 17,927 1,861 1, % 7.5% 20, , , ,554 11,608 8, % 5.4% (13) Miami Dade County Unrestricted Funds 11,420 11,492 11,094 (71) 327 (0.6)% 2.9% 11, , ,426 99,845 (285) 3,295 (0.3)% 3.3% (14) Discharged Not Final Billed (DNFB) HIM 36,675 21,000 9,081 (15,675) (27,594) (74.6)% (303.9)% 39,928 36,375 21,000 9,081 (15,375) (27,294) (73.2)% (300.6)% Financial Ratios (15) Net Patient Revenue per Adjusted Patient Day 1,897 1,815 1, % 13.0% 1,911 1,835 1,804 1, % 4.6% (16) Total Cost per Adjusted Patient Day 2,851 2,687 2,493 (164) (358) (6.1)% (14.4)% 2,824 2,770 2,703 2,672 (67) (98) (2.5)% (3.7)% Liquidity Indicators (17) Days Net in Receivable % 20.5% % 20.5% (18) Days (Unrestricted) Cash on Hand (0.04) 9.44 (0.1)% 53.6% (0.04) 9.44 (0.1)% 53.6% (19) Current Ratio (0.03) 2.1% (2.8)% (0.03) 2.0% (2.9)% (20) Cash (Unrestricted) to Debt Ratio % 61.2% % 63.2% Utilization (21) Admissions excl. Newborn 4,501 4,829 4,604 (328) (103) (6.8)% (2.2)% 4,668 42,232 43,477 43,535 (1,245) (1,303) (2.9)% (3.0)% (22) Observation Equivalent Days 1,068 1,179 1,389 (111) (320) (9.4)% (23.1)% 1,130 10,983 10,487 11, (177) 4.7% (1.6)% Total equivalent admissions 5,569 6,008 5,993 (439) (423) (7.3)% (7.1)% 5,798 53,215 53,964 54,696 (749) (1,480) (1.4)% (2.7)% (22) Admissions % through ED 65.76% 74.13% 66.27% (8.4)% (0.5)% (8.4)% (0.5)% 66.20% 66.57% 73.45% 67.17% (6.9)% (0.6)% (6.9)% (0.6)% (23) Hospital Patient Census Days excl. Newborn 30,646 32,743 32,974 (2,097) (2,328) (6.4)% (7.1)% 32, , , ,303 (3,811) (7,463) (1.3)% (2.5)% (24) Average Length of Stay (0.03) 0.35 (0.4)% 4.9% (0.11) (0.03) (1.6)% (0.5)% (25) Outpatient Visits 23,505 28,477 27,372 (4,972) (3,867) (17.5)% (14.1)% 25, , , ,830 (39,617) (29,365) (14.9)% (11.5)% (26) JMH Number of O/R Cases 1,091 1,129 1,175 (38) (84) (3.4)% (7.1)% 1,033 10,200 10,036 10, (273) 1.6% (2.6)% (27) Overtime % of Productive Hours 4.84% 2.31% 3.47% (2.53)% (1.37)% (109.3)% (39.4)% 4.30% 3.97% 2.30% 3.25% (1.66)% (0.72)% (72.1)% (22.1)% FTE's (28) JHS FTE per Adjusted Occupied Bed (0.60) (0.90) (9.1)% (14.3)% (0.18) (0.41) (2.8)% (6.4)% (29) Jackson Health System FTE's 10,356 10,124 9,939 (232) (417) (2.3)% (4.2)% 10,246 10,107 10,063 9,906 (44) (201) (0.4)% (2.0)% Payor Mix Self Pay Patient Days as % of Total (30) Jackson Memorial Hospital 13.77% 13.76% 13.30% -0.01% -0.47% (0.1)% (3.5)% 14.89% 15.56% 13.76% 13.73% -1.80% -1.83% (13.1)% (13.3)% (31) Jackson North 10.06% 11.25% 8.58% 1.19% -1.48% 10.6% (17.3)% 7.72% 9.67% 11.26% 10.74% 1.59% 1.07% 14.1% 10.0% (32) Jackson South 13.53% 15.51% 13.73% 1.99% 0.20% 12.8% 1.5% 14.16% 15.50% 15.51% 14.70% 0.01% -0.80% 0.1% (5.4)% (33) Inpatient Charges as Percent of Total 70.70% 70.85% 69.33% 0.15% -1.37% 0.2% (2.0)% 70.71% 71.53% 70.80% 70.38% 0.73% 1.15% 1.0% 1.6% (34) Realization Rate 25.08% 25.08% 23.97% 0.01% -1.11% 0.0% (4.6)% 25.02% 23.79% 25.05% 24.53% -1.27% -0.74% (5.1)% (3.0)%

36 Public Health Trust of Miami-Dade County (Consolidated) Combined Balance Sheet June 2014 (Amounts in thousands) Jun 14 May 14 Dollar Change Sep 13 Dollar Change ASSETS: Cash and Investments 105, , ,367 (198) Cash and Investments Restricted 8,319 27,418 (19,100) 15,774 (7,455) Cash and Investments Limited as to Use 19,449 82,456 (63,007) 7,827 11,623 Gross Patient Accounts Receivable 646, ,886 (6,156) 594,645 52,086 Allowances for Contractuals and Bad Debt (530,646) (538,026) 7,380 (464,531) (66,115) Net Accounts Receivable 116, ,860 1, ,113 (14,029) Third Party Receivable 38,355 38,587 (231) 155,606 (117,251) Due From Miami-Dade County 37,444 36,027 1,416 35,511 1,933 Other Receivables - Restricted 2,728 3,234 (506) 3,228 (500) Inventories 24,246 24, ,245 0 Prepaid Expenses and Other Current Assets 6,916 6, ,373 2,544 Total Current Assets 358, ,522 (79,811) 482,044 (123,334) Due From Restricted Funds (0) (0) 0 0 (0) Cash and Investments Limited as to Use - LT 33,106 32, ,582 4,524 Cash and Investments Restricted - LT 55,750 56,190 (440) 59,441 (3,691) Capital Assets, Net 450, ,393 2, ,744 5,509 Other Assets 6,556 6,575 (20) 6,715 (159) Total Non-Current Assets 545, ,988 2, ,481 6,182 Total Assets $ 904,374 $ 981,509 $ (77,136) $ 1,021,526 $ (117,152) Current Portion of Long Term Debt 8,005 7, , Accounts Payable and Accrued Expenses 104, ,206 (24,185) 129,944 (25,923) Accrued Salaries and Payroll Taxes Withheld 117, ,407 5, ,813 (23,992) Due to Other Third Party 63, ,969 (51,773) 139,036 (75,841) Due to Miami-Dade County 15,000 15, ,207 (207) Other Restricted 1,710 8,509 (6,799) 6,051 (4,341) Other Current Liabilities 44,827 40,893 3,934 48,046 (3,219) Total Current Liabilities 354, ,628 (73,049) 487,741 (133,163) Long Term Debts, Excluding Current Portion 335, ,356 (7,976) 343,126 (7,746) Other Liabilities 53,338 53, ,049 2,289 Total Liabilities 743, ,054 (80,757) 881,917 (138,620) NET ASSETS: Unrestricted Net Assets (6,444) (13,082) 6,638 (24,737) 18,293 Invested in Capital Assets 159, ,057 9, ,504 9,433 Restricted Net Assets 7,584 20,480 (12,896) 13,842 (6,258) Total Net Assets 161, ,455 3, ,609 21,468 Total Liabilities & Net Assets $ 904,374 $ 981,509 $ (77,136) $ 1,021,526 $ (117,152) Notes * Reserves for AR is comprised of $349 million in cont. adjustments, $45 million in charity care and $137 million in prov. for doubtful accounts. ** Amounts due to the University total $21.2 million reported in other current liab. FS-2

37 Combined Statement of Revenue, Expenses & Change in Fund Net Assets Public Health Trust of Miami-Dade County June 2014 (Amounts in thousands) Jun 14 Actual Jun 14 Budget Month of June 2014 Jun 13 Actual $ Variance Budget Prior % Variance Budget Prior Jun 14 Actual YTD Jun 14 Budget YTD 9 Months Ended June 30, 2014 Jun 13 Actual YTD Budget $ Variance Prior % Variance 79,757 81,624 78,091 (1,866) 1,667 (2)% 2 % Hospital and physician services 724, , ,582 (5,437) 67 (1)% 0 % (78) (27) (30)% (13)% Community Medical Practices 1,836 2,346 2,020 (510) (184) (22)% (9)% % 37 % Primary Care Centers 1,440 1,619 1,404 (179) 36 (11)% 3 % 2,101 1,839 1, % 52 % Continuing Care (SNF) 18,161 16,737 15,814 1,423 2,347 8 % 15 % 82,234 83,901 79,827 (1,667) 2,407 (2)% 3 % Net Patient Service Revenue 746, , ,820 (4,702) 2,266 (1)% 0 % 1,607 2,419 4,110 (812) (2,503) (34)% (61)% Division of Managed Care 25,295 25,656 59,490 (361) (34,195) (1)% (57)% 2,346 1,726 1, % 32 % Grants Revenue 17,467 15,696 15,638 1,771 1, % 12 % 6,650 7,130 5,457 (480) 1,193 (7)% 22 % Other Operating Revenue 58,074 64,272 58,037 (6,198) 37 (10)% 0 % 92,837 95,176 91,171 (2,339) 1,666 (2)% 2 % Total Operating Revenue 846, , ,985 (9,491) (30,063) (1)% (3)% 73,310 68,058 67,053 (5,252) (6,257) (8)% (9)% Salaries & Related Costs 635, , ,567 (21,872) (29,689) (4)% (5)% 26,167 29,912 27,578 3,745 1, % 5 % Contractual and Purchased Serv. 258, , ,467 11, % 0 % 1,369 2,349 3, , % 62 % Division of Managed Care - Paid Claims 22,874 25,007 60,024 2,134 37,150 9 % 62 % 16,034 16,262 15, (161) 1 % (1)% Supplies 146, , ,055 (231) (4,338) 0 % (3)% 3,860 4,542 4, % 11 % Depreciation 36,974 42,407 41,758 5,433 4, % 11 % 1,346 1,428 1, % 6 % Interest 12,464 12,856 12, % 4 % 1,500 1,615 (1,291) 115 (2,791) 7 % 216 % Other Operating Expenses 13,480 14,467 10, (2,969) 7 % (28)% 123, , , (5,026) 0 % (4)% Total Operating Expenses 1,126,134 1,124,854 1,132,339 (1,281) 6,204 0 % 1 % (30,749) (28,990) (27,389) (1,759) (3,361) (6)% (12)% Gain (Loss) From Operations (279,212) (268,441) (255,354) (10,771) (23,858) (4)% (9)% (3) 11 (6)% 31 % Investment Income (68) (61) (15)% (14)% 1,460 1,433 1, % 1 % Other Income 12,851 13,039 13,020 (187) (169) (1)% (1)% 11,420 11,492 11,094 (71) 327 (1)% 3 % Dade County Unrestricted Funds 103, ,426 99,845 (285) 3,295 0 % 3 % 19,279 17,417 17,927 1,861 1, % 8 % Unrestricted Health Care Surtax 172, , ,554 11,608 8,795 7 % 5 % 32,205 30,390 30,508 1,814 1,697 6 % 6 % Total Non-Operating Gain Net 288, , ,856 11,068 11,860 4 % 4 % 1,456 1,400 3, (1,664) 4 % (53)% Revenue & Gain in Excess of Exp. & Loss 9,503 9,207 21, (11,999) 3 % 56 % (105) 0 % (100)% Capital Contributions Grants and Other (105) 0 % (100)% % 0 % JM Foundation 1, ,163 1,215 (948) 0 % 0 % 1, ,741 1,741 0 % 0 % Miami Dade County GOB 10, ,713 10,750 9,037 0 % 0 % 3,622 1,400 3,224 2, % 12 % Revenue & Gain after Extraordinary Loss 21,469 9,207 25,483 12,262 (4,014) 133 % 16 % Budget Prior FS-3

38 Combined Statement of Revenue, Expenses & Change in Fund Net Assets Public Health Trust of Miami-Dade County excluding Division of Managed Care June 2014 (Amounts in thousands) Jun 14 Actual Jun 14 Budget Month of June 2014 Jun 13 Actual $ Variance Budget Prior % Variance Budget Prior Jun 14 Actual YTD Jun 14 Budget YTD 9 Months Ended June 30, 2014 Jun 13 Actual YTD Budget $ Variance Prior % Variance 79,757 81,624 78,091 (1,866) 1,667 (2)% 2 % Hospital and physician services 724, , ,582 (5,437) 67 (1)% 0 % (78) (27) (30)% (13)% Community Medical Practices 1,836 2,346 2,020 (510) (184) (22)% (9)% % 37 % Primary Care Centers 1,440 1,619 1,404 (179) 36 (11)% 3 % 2,101 1,839 1, % 52 % Continuing Care (SNF) 18,161 16,737 15,814 1,423 2,347 8 % 15 % 82,234 83,901 79,827 (1,667) 2,407 (2)% 3 % Net Patient Service Revenue 746, , ,820 (4,702) 2,266 (1)% 0 % 2,346 1,726 1, % 32 % Grants Revenue 17,467 15,696 15,638 1,771 1, % 12 % 6,650 7,130 5,457 (480) 1,193 (7)% 22 % Other Operating Revenue 58,074 64,272 58,037 (6,198) 37 (10)% 0 % 91,230 92,757 87,061 (1,527) 4,169 (2)% 5 % Total Operating Revenue 821, , ,495 (9,129) 4,132 (1)% 1 % 73,310 68,058 67,053 (5,252) (6,257) (8)% (9)% Salaries & Related Costs 635, , ,567 (21,872) (29,689) (4)% (5)% 26,167 29,912 27,578 3,745 1, % 5 % Contractual and Purchased Serv. 258, , ,467 11, % 0 % 16,034 16,262 15, (161) 1 % (1)% Supplies 146, , ,055 (231) (4,338) 0 % (3)% 3,860 4,536 4, % 11 % Depreciation 36,933 42,355 41,706 5,422 4, % 11 % 1,346 1,428 1, % 6 % Interest 12,464 12,856 12, % 4 % 1,500 1,615 (1,291) 115 (2,791) 7 % 216 % Other Operating Expenses 13,480 14,467 10, (2,969) 7 % (28)% 122, , ,990 (405) (7,227) 0 % (6)% Total Operating Expenses 1,103,220 1,099,795 1,072,263 (3,426) (30,958) 0 % (3)% (30,987) (29,055) (27,929) (1,933) (3,058) (7)% (11)% Gain (Loss) From Operations (281,593) (269,038) (254,768) (12,555) (26,825) (5)% (11)% (1) 11 (3)% 31 % Investment Income (54) (52) (13)% (12)% 1,460 1,433 1, % 1 % Other Income 12,851 13,039 13,020 (187) (169) (1)% (1)% 11,420 11,492 11,094 (71) 327 (1)% 3 % Dade County Unrestricted Funds 103, ,426 99,845 (285) 3,295 0 % 3 % 19,279 17,417 17,927 1,861 1, % 8 % Unrestricted Health Care Surtax 172, , ,554 11,608 8,795 7 % 5 % 32,205 30,389 30,508 1,816 1,697 6 % 6 % Total Non-Operating Gain Net 288, , ,845 11,081 11,869 4 % 4 % 1,218 1,334 2,579 (117) (1,361) (9)% 53 % Revenue & Gain in Excess of Exp. & Loss 7,120 8,594 22,077 (1,474) (14,956) (17)% 68 % (105) 0 % (100)% Capital Contributions Grants and Other (105) 0 % (100)% % 0 % JM Foundation 1, ,163 1,215 (948) 0 % 0 % 1, ,741 1,741 0 % 0 % Miami Dade County GOB 10, ,713 10,750 9,037 0 % 0 % 3,384 1,334 2,684 2, % (26)% Revenue & Gain after Extraordinary Loss 19,086 8,594 26,058 10,492 (6,972) 122 % 27 % Budget Prior FS-3A

39 P & L 12 Month Trend Analysis Public Health Trust of Miami-Dade County June 2014 Jun 14 May 14 Apr 14 Mar 14 Feb 14 Jan 14 Dec 13 Nov 13 Oct 13 Sep 13 Aug 13 Jul 13 Inpatient Services 231, , , , , , , , , , , ,423 Ambulatory Services 96, , , ,330 94,021 99,148 94,869 94, ,701 98, , ,603 Gross Patient Service Revenue 327, , , , , , , , , , , ,026 Contractual Adjustments 185, , , , , , , , , , , ,757 Charity Care 24,702 26,637 29,077 29,200 28,357 29,605 25,886 28,658 33,614 32,145 31,154 29,700 Net Patient Revenue Adjustment Provision for Doubtful Accounts 35,916 36,132 37,540 42,107 38,151 44,812 47,147 42,363 43,622 39,648 42,336 36,570 Total Deductions From Revenue 245, , , , , , , , , , , ,027 Net Patient Service Revenue 82,234 87,326 86,056 87,558 78,713 80,801 81,204 79,267 82,929 (65,270) 90,974 84,999 Division of Managed Care 1,607 2,126 2,140 3,160 2,994 3,451 3,433 3,175 3,209 4,260 7,030 6,464 Other Operating Revenue 6,650 6,756 7,188 5,696 6,045 6,386 6,294 6,319 6, ,360 6,353 6,640 Grants Revenue 2,346 1,952 1,459 2,367 1,830 1,725 1,464 1,874 2,450 4,372 1,366 2,091 Total Operating Revenue 92,837 98,160 96,843 98,781 89,581 92,362 92,395 90,636 95, , , ,194 Salaries & Related Costs 73,310 75,194 71,932 73,976 67,632 67,734 68,239 67,563 69,676 73,189 69,889 70,601 Contractual and Purchased Services 26,167 28,931 28,676 28,314 29,453 29,136 29,214 28,744 30,059 31,328 29,142 24,628 Supplies 16,034 16,158 16,038 18,697 16,339 15,413 16,134 15,609 15,971 19,884 17,489 16,665 Division of Managed Care Paid Claims 1,369 1,966 1,997 3,077 1,109 3,300 3,935 3,034 3,086 5,725 6,949 6,337 Interest 1,346 1,370 1,361 1,363 1,388 1,406 1,421 1,398 1,411 1,458 1,344 1,388 Provision for Self-Insured Claims (5,406) Public Med/Assist. Trust F. Assess ,096 Depreciation 3,860 3,959 3,917 4,095 4,123 4,242 4,312 4,327 4,137 5,140 4,484 5,386 Other Operating Expenses Total Operating Expenses 123, , , , , , , , , , , ,640 Gain (Loss) From Operations (30,749) (30,918) (28,566) (32,237) (31,966) (30,366) (32,355) (31,536) (30,518) (18,542) (24,921) (26,446) Med. Edu. and Tert. Care Fund 1,170 1,752 1,170 1,170 1,170 1,170 1,040 1,235 1,235 1,040 1,193 1,277 Interest Income - Non. Operating Unrealized Gains and Losses (1) (1) (1) (1) (1) (1) (1) (1) (1) (370) (1) (1) Other Non-Operating ,503 (3,563) 152 Dade County Unrestricted Funds 11,420 11,420 11,420 11,420 11,492 11,492 11,492 11,492 11,492 11,094 11,094 11,094 Unrestricted Health Care Surtax 19,279 20,961 18,667 18,568 22,412 18,906 17,529 19,154 16,873 17,669 17,575 17,366 TOTAL Non-Operating Gain Net 32,205 34,355 31,567 31,475 35,270 31,781 30,191 32,075 29,797 30,971 26,453 29,923 Revenue & Gain in Excess of Exp. & Loss 1,456 3,437 3,000 (762) 3,304 1,415 (2,165) 539 (721) 12,429 1,531 3,477 Capital Contributions Grants and Other (1,192) 1, JM Contributions Miami Dade Cty. GOB 1,741 1,286 1,304 2, ,186 2,573 6, Revenue & Gain after Extraordinary Loss 3,622 4,723 4,304 1,776 3,952 2,394 (963) 1, ,810 8,704 3,553 FS-4

40 Jackson Health System Jun 2014 Actual Combining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding Jackson Health S Jun 2014 YTD A Jackson Memorial Hospital Jackson South Jackson North Physician Services JHS Health Plan Nursing Homes Primary Care Corrections Health Services Jackson Medical Towers Total Total Gross Inpatient Revenue 174,861 20,222 33,652 3, ,836 Total Gross Outpatient Revenue 70,376 12,020 10,739 1, ,516 96,084 Total Gross Revenue 245,237 32,242 44,390 1,025 3,514 1, ,920 Total Deductions from Revenue -185,524-23,104-33, ,414-1, ,687 Total Net Patient Revenue 59,714 9,138 10, , ,234 Other Operating Revenue 5, ,650 Managed Care Revenue 1,607 1,607 Grant Revenue 2, ,346 Total Other Operating Revenue 7, , ,603 Total Revenue 67,037 9,450 11, ,607 1, ,837 Operating Expenses Salaries & Wages 46,392 3,830 4,289 1,245 1, , ,821 Benefits 10, ,488 Total Salaries & Benefits 56,972 4,663 5,240 1,432 1, , ,310 Purchased Services 11,312 1,257 2, ,006 Managed Care Paid Claims 1,247 1,247 UM AOA Purchased Service 9, ,284 Total Purchased Service 20,578 1,255 2, , ,537 Supplies 12,793 1,302 1, ,034 Total Direct Operating Cost 90,343 7,220 9,342 2,007 1,369 2,458 1,434 2, ,880 Depreciation 2, ,860 Interest 1, ,346 Self Insurance HCCB Assessment Other Operating Expense Total Other Operating Cost 5, ,706 Total Operating Expenses Before Allocations 95,515 8,144 9,843 2,017 1,369 2,501 1,445 2, ,586 Allocated Corporate Services: Clinical Trials Office Corporate Administration 1, ,780 Financial Services Human Resources 1, ,597 Integrity Information Technology 3, ,056 Public Safety Revenue Cycle Management 3, ,090 Strategic Sourcing ,218 Total Allocated Corporate Services 12,030 1,458 1, ,125 Total Expenses Subject to Allocation -16,125-16,125 Total Operating Expenses Including Allocations 91,420 9,601 11,793 2,134 1,385 2,706 1,620 2, ,586 Excess of Operating Revenue over (under) Operating Expenses -24, , ,216-2, ,749 Non Operating Revenue and Expenses Investment Income Unrestricted Health Care Surtax 19,279 19,279 Miami Dade County Unrestricted Funds 11,420 11,420 Other Income 1, ,459 JMH Foundation Total Non Operating Revenue 32, ,630 Redistribution of Revenue -6,172 2,993 2, Total Non Operating Revenue After Redistribution 26,173 2,992 2, ,630 Excess of Revenue over (under) Expenses before GOB and County Special Contributions 1,791 2,841 1,770-1, , ,881 Miami Dade County GOB Contributions Miami Dade County Special Contributions 1,741 1,741 Total Miami Dade GOB and Special Contributions 1,741 1,741 Excess of Revenue over (under) Expenses 3,532 2,841 1,770-1, , ,622 FS-5 FS-6

41 Jackson Health System Jun 2014 YTD Actual Combining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding Jackson Memorial Hospital Jackson South Jackson North Physician Services JHS Health Plan Nursing Homes Primary Care Corrections Health Services Jackson Medical Towers Total Total Gross Inpatient Revenue 1,721, , ,117 27,842 2,243,495 Total Gross Outpatient Revenue 651, , ,127 10,162 3,394 14, ,999 Total Gross Revenue 2,372, , ,243 10,162 31,237 14,570 3,136,494 Total Deductions from Revenue -1,821, , ,778-8,326-13,076-13, ,390,408 Total Net Patient Revenue 551,535 74,649 98,465 1,836 18,161 1, ,087 Other Operating Revenue 44,827 2,106 1,275 6, ,511 58,074 Managed Care Revenue 25,295 25,295 Grant Revenue 16, ,467 Total Other Operating Revenue 61,608 2,106 1,275 6,820 25, ,256 2, ,835 Total Revenue 613,142 76,755 99,740 8,656 25,295 18,125 2, , ,922 Operating Expenses Salaries & Wages 404,492 33,695 37,902 10,709 14,066 5,660 15, ,023 Benefits 89,917 6,633 7,125 1,704 3,707 1,279 2, ,233 Total Salaries & Benefits 494,409 40,328 45,027 12,413 17,773 6,939 17, ,256 Purchased Services 128,127 11,313 23,189 5,075 1,621 3,009 6, ,278 Managed Care Paid Claims 21,253 21,252 UM AOA Purchased Service 80, ,037 Total Purchased Service 208,292 11,310 23,187 5,075 22,874 3,062 6, ,568 Supplies 116,941 11,682 13, , , ,393 Total Direct Operating Cost 819,642 63,320 81,574 17,762 22,874 22,837 13,571 19,867 1,771 1,063,217 Depreciation 26,085 7,540 2, ,974 Interest 12, ,464 Self Insurance 3, ,965 HCCB Assessment 6, ,087 8,515 Other Operating Expense Total Other Operating Cost 48,927 8,480 4, ,917 Total Operating Expenses Before Allocations 868,569 71,800 86,097 17,852 22,914 23,219 13,678 19,878 2,127 1,126,134 Allocated Corporate Services: Clinical Trials Office Corporate Administration 18,031 2,011 2, ,651 Financial Services 3, ,012 Human Resources 10, ,357 Integrity 1, ,500 Information Technology 31,348 3,711 5, ,967 Public Safety 3, ,327 Revenue Cycle Management 29,196 3,536 5, ,082 Strategic Sourcing 8, , ,300 Total Allocated Corporate Services 106,347 11,937 16,534 1, ,814 1,581 1, ,770 Total Expenses Subject to Allocation -140, ,770 Total Operating Expenses Including Allocations 834,146 83, ,632 18,863 23,088 25,033 15,259 21,053 2,325 1,126,134 Excess of Operating Revenue over (under) Operating Expenses -221,004-6,982-2,892-10,207 2,207-6,908-12,562-21, ,212 Non Operating Revenue and Expenses Investment Income Unrestricted Health Care Surtax 172, ,349 Miami Dade County Unrestricted Funds 103, ,141 Other Income 11, ,641 12,843 JMH Foundation 1,215 1,215 Total Non Operating Revenue 288, , ,931 Redistribution of Revenue -50,154 22,059 22,350 2,534 3,210 Total Non Operating Revenue After Redistribution 238,202 22,052 22, ,534 3,210 1, ,931 Excess of Revenue over (under) Expenses before GOB and County Special Contributions 17,198 15,070 19,399-10,207 2,209-4,374-9,352-21,051 1,827 10,718 Miami Dade County GOB Contributions Miami Dade County Special Contributions 10,750 10,750 Total Miami Dade GOB and Special Contributions 10,750 10,750 Excess of Revenue over (under) Expenses 27,948 15,070 19,399-10,207 2,209-4,374-9,352-21,051 1,827 21,469 FS-6

42 Public Health Trust of Miami-Dade County Consolidated Combining Statement of Revenue & Expenses by Company Month of June 2014 (Amounts in thousands) Jackson Memorial Jackson South Jackson North Physician Services JHS Health Plan Primary Care Centers Corrections Health Services Skilled Nursing Facilities Jackson Property Management Revenue Inpatient Revenue 174,861 20,222 33, (5) 0 3, , ,876 Outpatient Revenue 70,376 12,020 10,739 1, , , ,142 Total Prior Year Actual Gross Patient Service Revenue 245,237 32,242 44,390 1, , , , ,019 Deductions From Revenue: Contractual Adjustments 135,976 18,435 28, , ,343 Provisions For Charity Care 21, ,702 28,560 Net Patient Revenue Adjustment Provision for Doubtful Accounts 27,820 3,931 4, ,916 38,290 Total Deductions From Revenue 185,524 23,104 33, , , , ,192 Net Patient Service Revenue 59,714 9,138 10, , ,234 79,827 Division of Managed Care , ,607 4,110 Other Operating Revenue 5, (207) 373 6,650 5,457 Grants Revenue 2, ,346 1,777 Total Operating Revenue 67,037 9,450 11, , , ,837 91,171 Operating Expenses Salaries & Related Costs 56,972 4,663 5,240 1, ,179 1, ,310 67,053 Contractual and Purchased Services 20,578 1,255 2, , ,537 31,143 Supplies 12,793 1,302 1, ,034 15,872 Interest 1, ,346 1,430 Depreciation 2, ,860 4,353 Other Operating Expenses 1, ,500 (1,291) Total Operating Expenses 95,515 8,144 9,843 2,017 1,369 1,445 2,487 2, , ,560 Excess of operating revenue over (under) operating expenses (28,478) 1,306 1,241 (1,029) 238 (1,041) (2,487) (607) 107 (30,749) (27,389) Other Revenues (Expenses) Investment Income 47 (1) Unrestricted Health Care Surtax 19, ,279 17,927 Miami Dade County Unrestricted Funds 11, ,420 11,094 Other Income 1, ,460 1,452 Miami Dade County Special Contributions JM Foundation Miami Dade County GOB Contributions 1, ,741 0 Total Other Revenues (expenses) 34,087 (1) ,371 30,613 Excess of revenues over (under) expenses 5,609 1,305 1,241 (1,029) 238 (1,041) (2,487) (607) 393 3,622 3,224 FS-7

43 Public Health Trust Jackson Health System Combined Statement of Unrestricted / Restricted Cash Flow As of June 30, 2014 Audited Current Month Year to Date Year to Date June 30, 2014 June 30, 2014 September 30, 2013 Cash generated (used) by operations: Funds available for working capital/facilities improvements $3,622 $21,469 $51,550 Non cash expenses: Depreciation 3,860 36,974 56,769 Loss on disposal of capital assets (10) (201) 2,482 Total 7,472 58, ,801 Cash provided (used) for current assets: Decreases (increases) in: Patient Receivable and Other Third Party payor (2,409) 129,347 14,760 Cash and Invst. Restricted Cash and Invst. Limited as to Use 63,007 (11,622) 4,261 Inventories, Prepaid Expenses and Other Receivables 410 (2,044) 948 Total 61, ,681 19,969 Cash provided (used) for current liabilities: Increases (decreases) in: Current Installment of Long Term Debt Accounts Payable and Accrued Expenses (18,772) (49,916) 491 Due to other third party (51,774) (76,048) (26,369) Other Liabilities 3,934 (3,219) 18,588 Other- Restricted (6,799) (4,341) (645) Total (73,051) (133,164) (7,615) Decreases (increases) in: Cash and Invst. Limited as to Use (277) (4,524) (4,497) Cash and Invst. Restricted 440 3,691 7,134 Long Term Investment Cash provided (used) for Other Assets Cash provided (used) for Long Term Liabilities: - Increases (decreases) in: - Long Term Debt (7,972) (7,745) (7,299) Other Liabilities 268 2,288 (25,155) Total (7,704) (5,457) (32,454) Cash provided (used) for Prop., Plant and Equipment: Purchases of Prop. Plant and Equipment (6,709) (42,281) (41,758) - - Total (6,709) (42,281) (41,758) Net Increase in Cash and Cash Equivalents (18,802) (7,653) 51,790 Cash, beginning of period 132, ,141 69,352 Cash, end of period 113, , ,142 FS-8

44 PUBLIC HEALTH TRUST CONSOLIDATED PORTFOLIO INVENTORY SUMMARY BY SECURITY/ACCOUNT TYPE June 30, 2014 # of Investments Description Par Value Avg. Interest Rate Market Value 1 Money Markets 612, % 612,283 1 Total Investments Portfolio 612,283 Wells Fargo interest bearing accts 0.250% 153,122,661 Wells Fargo Institutional Bank Deposit account 0.100% 10,121,928 Bond Proceeds Invested at Miami-Dade County 0.433% 57,935,597 Total Cash and Investments $ 221,792,469 FS-9

45 PUBLIC HEALTH TRUST SALES TAX MONTHLY INCOME STATEMENT TREND ANALYSIS FISCAL YEAR 2012 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 monthly est 14,482,634 14,779,176 17,607,553 15,330,625 15,914,413 17,395,891 15,855,155 15,355,434 15,563,007 14,907,488 15,041,626 14,844,604 mo portion of qtly est: 1,079,571 1,079,571 1,079,571 1,180,705 1,180,705 1,180,705 1,160,844 1,160,844 1,160,844 1,143,468 1,143,468 1,143,468 State revision to Sales Tax Projection 500,000 +/-est vs. actual rec'd; mo of 10,720 1,238, ,986 (106,944) (724,478) 335,025 (153,187) (295,446) (757,063) 16,220 +/-est vs. actual rec'd; qt of 257, , ,672 Monthly Revenue 15,562,205 15,858,747 18,697,844 17,750,016 18,024,509 18,469,652 16,291,521 17,251,673 16,570,664 16,255,510 15,894,703 16,004,292 FISCAL YEAR 2013 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 monthly est 15,096,482 16,870,407 15,156,957 15,600,201 15,600,201 15,600,201 15,600,201 15,600,201 15,600,201 15,600,201 15,600,201 15,600,201 mo portion of qtly est: 1,207,668 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109 State revision to Sales Tax Projection +/-est vs. actual rec'd; mo of (257,802) 981,343 3,665,869 1,457, ,194 2,964,808 1,053, , , ,814 +/-est vs. actual rec'd; qt of 338, , ,666 Monthly Revenue 16,304,150 18,143,516 16,172,264 17,854,653 20,877,588 18,331,229 17,574,504 20,369,247 17,926,959 17,365,758 17,575,066 17,177,124 FISCAL YEAR 2014 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 monthly est 15,600,201 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 mo portion of qtly est: 1,273,109 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 State revision to Sales Tax Projection 1,140,319 +/-est vs. actual rec'd; mo of (485,039) 892,399 3,943, , ,794 2,307,416 1,265,025 +/-est vs. actual rec'd; qt of 454, ,889 - Monthly Revenue 16,873,310 19,153,948 17,528,590 18,906,028 22,411,799 18,568,363 18,667,423 20,960,934 19,278, Comments: Estimate was calculated based on same month prior year adjusted for percentage change of recent receipts vs. recent estimates. FS-10

46 Jackson Health System Hospitals Payor Mix Patient Days as % of Total Fiscal Year Actual Budget % Variance Actual Actual Budget % Variance FC Group Jun-14 Jun-14 Budget May-14 YTD YTD Budget Jackson Health System Combined percentages: Commercial 1.30% 1.33% -0.03% 1.09% 1.28% 1.32% -0.04% Medicaid 20.24% 17.42% 2.82% 20.02% 19.15% 17.42% 1.73% Medicare 14.85% 16.30% -1.45% 14.37% 15.48% 16.37% -0.89% Other 4.88% 3.00% 1.88% 6.01% 5.18% 2.99% 2.19% Managed Care 30.26% 27.65% 2.61% 30.02% 28.30% 27.67% 0.63% Self Pay 13.23% 13.60% -0.37% 13.82% 14.78% 13.58% 1.20% Potential Medicaid 15.24% 20.70% -5.46% 14.67% 15.83% 20.65% -4.82% Total % % 0.00% % % % 0.00% Jackson Memorial Hospital Combined percentages: Commercial 1.60% 1.50% 0.10% 1.30% 1.52% 1.50% 0.02% Medicaid 22.47% 19.00% 3.47% 21.19% 20.85% 19.00% 1.85% Medicare 12.94% 13.82% -0.88% 12.65% 13.65% 13.82% -0.17% Other 5.58% 3.40% 2.18% 7.09% 6.02% 3.40% 2.62% Managed Care 27.17% 25.72% 1.45% 26.58% 25.57% 25.72% -0.15% Self Pay 13.77% 13.76% 0.01% 14.89% 15.56% 13.76% 1.80% Potential Medicaid 16.47% 22.80% -6.33% 16.30% 16.83% 22.80% -5.97% Total % % 0.00% % % % 0.00% Jackson South Combined percentages: Commercial 0.22% 1.10% -0.88% 0.76% 0.70% 1.09% -0.39% Medicaid 14.11% 7.40% 6.71% 11.96% 9.58% 7.41% 2.17% Medicare 23.13% 24.56% -1.43% 21.26% 23.21% 24.55% -1.34% Other 3.01% 2.10% 0.91% 2.94% 2.66% 2.13% 0.53% Managed Care 37.68% 37.84% -0.16% 43.18% 39.81% 37.82% 1.99% Self Pay 13.53% 15.51% -1.98% 14.16% 15.50% 15.51% -0.01% Potential Medicaid 8.32% 11.49% -3.17% 5.74% 8.54% 11.49% -2.95% Total % % 0.00% % % % 0.00% Jackson North Combined percentages: Commercial 0.31% 0.41% -0.10% 0.16% 0.25% 0.42% -0.17% Medicaid 11.72% 14.51% -2.79% 18.37% 15.27% 14.49% 0.78% Medicare 20.21% 26.14% -5.93% 19.75% 21.34% 26.13% -4.79% Other 2.15% 1.12% 1.03% 1.83% 1.85% 1.14% 0.71% Managed Care 42.75% 32.65% 10.10% 41.16% 37.06% 32.65% 4.41% Self Pay 10.06% 11.25% -1.19% 7.72% 9.67% 11.26% -1.59% Potential Medicaid 12.80% 13.92% -1.12% 11.01% 14.56% 13.91% 0.65% Total % % 0.00% % % % 0.00% FS-11

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92 TO: FROM: Public Health Trust Board of Trustees Rosa Costanzo Strategic Sourcing and Supply Chain Management and Chief Procurement Officer DATE: June 23, 2014 RE: Purchasing Report Recommendation The following recommendations are made in accordance with the Trust s Procurement Regulation. These items fully support our business operations and help the organization in its efforts to provide an excellent world class patient experience. Scope This report includes competitively solicited contract awards over $3,000,000, waivers of formal competition over $250,000 and other categories for Board approval as prescribed by the Procurement Regulation. Fiscal Impact/Funding Source The items included are part of the Trust s budget. Track Record/Monitor The Procurement Management Department along with the user departments and leadership support, will track and monitor the responsibilities and obligations set forth in the contracts. Background The entire report has been vetted and assembled by the Procurement Management Department with the direct participation of the Director and staff, all subject to review by the Chief Procurement Officer, consultation with the Executive Staff and the President, and reviewed for legal sufficiency by the County Attorney s Office. Request is made for approval of the Purchasing Report, consisting of the following: Vendor Amount 1 PricewaterhouseCoopers, LLP $ 321,360 Total for 1 Year Procurement completed an orderly administrative process with each item to bring the best value (cost, quality, and outcome) with each project. June 2014 PHT Board of Trustees 1

93 Agenda Item 6 (b) Public Health Trust Board of Trustees June 23, 2014 RESOLUTION NO. PHT 06/14 RESOLUTION AUTHORIZING AND APPROVING AWARD OF BIDS AND PROPOSALS, WAIVER OF BIDS, AND OTHER PURCHASING ACTIONS FOR JUNE 2014, IN ACCORDANCE WITH THE PUBLIC HEALTH TRUST S PROCUREMENT POLICY, RESOLUTION NO. PHT 10/ (Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System) WHEREAS, bids and proposals were solicited, received and reviewed by staff; and WHEREAS, the Purchasing and Facilities Subcommittee met on June 12, 2014 and reviewed staff s recommendations as submitted under the PHT s Procurement Policy, Resolution No. PHT 10/12-078; and WHEREAS, the Purchasing and Facilities Subcommittee forwarded the Purchasing Report to the Fiscal Committee with a recommendation for approval for each item under the report, which is attached hereto and hereby incorporated by reference; and WHEREAS, upon his written recommendation, the President recommends that the Public Health Trust Board of Trustees (Board of Trustees) waive competitive bidding for items under the heading of Bid Waiver and Waiver of Full and Competitive Bidding in the respective Purchasing Report, finding such action to be in the best interests of the Public Health Trust; and WHEREAS, the President and Fiscal Committee recommend various other purchasing actions, as indicated in the attached Purchasing Report. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby authorizes and approves the award of bids and proposals and all the purchasing actions as set forth in the attached Purchasing Report, under the Public Health Trust s Procurement Policy, Resolution No. PHT 10/12-078; and finds it in the best interest of the Public Health Trust to waive competitive bidding for those items listed under the heading Bid Waiver and Waiver of Full and Competitive Bidding in the respective report; and to take such action as is necessary and authorized to implement these awards and actions. June 2014 PHT Board of Trustees 2

94 PUBLIC HEALTH TRUST BOARD OF TRUSTEES PURCHASING REPORT June 23, 2014 TO: FROM: PUBLIC HEALTH TRUST BOARD OF TRUSTEES PROCUREMENT MANAGEMENT DEPARTMENT The following recommendations are made in accordance with the Trust s Procurement Policy and it s implementing Procurement Regulation. This report includes competitively solicited contract awards over $3,000,000, waivers of formal competition over $250,000 and other categories for Board approval as prescribed by the Procurement Regulation. The entire report has been screened and assembled by the Procurement Management Department with the direct participation of the Director and staff, all subject to review by the Chief Procurement Officer, consultation with the Executive Staff and the President, and reviewed for legal sufficiency by the County Attorney s Office. SECTION I. AWARDS UNDER INVITATIONS TO BID (ITB s) This section consists of awards under competitively solicited Invitations to Bid (ITB s) over $3,000,000. No items to report. SECTION II. AWARDS UNDER REQUESTS FOR PROPOSALS (RFP s) This section consists of awards under competitively solicited Requests for Proposals (RFP s) over $3,000,000. No items to report. SECTION III. AWARDS UNDER THE COMPETITIVELY SOLICITED CONTRACTS OF OTHER PUBLIC PROCUREMENT ENTITIES This section consists of awards over $3,000,000 under competitively solicited ( ITB, RFP or equivalent) contracts of other public and nonprofit entities. No items to report. SECTION IV. AWARDS UNDER GROUP PURCHASING ORGANIZATION ( GPO ) CONTRACTS This section consists of awards over $3,000,000 under Group Purchasing Organization ( GPO ) contracts. GPOs are organizations that aggregate the purchasing volume of their members consisting of hospitals and other health care providers to leverage discounts with manufacturers, distributors and other vendors to realize administrative savings and efficiencies. The Trust s GPO is MedAssets. No items to report. SECTION V. AWARDS UNDER A WAIVER OF FORMAL COMPETITION This section consists of awards over $250,000 without the formal solicitation of competitive bids or proposals. All award recommendations in this section have the approval of the President, are based on a finding that the waiver of competitive bidding is in the best interests of the Public Health Trust, and require a two-thirds affirmative vote of the Trustees present for approval. A. Sole Source No items to report. June 2014 PHT Board of Trustees 3

95 B. Physician s Preference Staff requests a waiver of formal competition for the contract items listed in this category because a physician and clinician have requested the particular item without which the physician and clinician cannot successfully and safely render patient care. No items to report. C. Standardization Items in this category have been established as the Trust standard. No items to report. D. Non-Competitive Cooperative Purchasing This subsection consists of awards under the contracts of other public entities that were not competitively solicited. No items to report. E. Miscellaneous Bid Waiver This subsection consists of awards not falling in the other categories of waiver of formal competition but where waiver is deemed to be in the best interests of the Trust. No items to report. SECTION VI. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE COMPETITIVELY SOLICITED This section refers to existing contracts that were competitively bid ( ITB or RFP ) at their origin and consists of either (a) the exercise of established options to renew or (b) the execution of contract modifications for which the Procurement Policy requires prior Board approval. No items to report. SECTION VII. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE AWARDED UNDER A WAIVER OF FORMAL COMPETITION This section refers to existing contracts that were not competitively bid at their origin and consists of either (a) the exercise of established options-to renew or (b) the execution of contract modifications for which the Procurement Policy requires prior Board approval. All contracts in this section are renewals not previously authorized by the Board have the written approval of the President, are based on a finding that the waiver of full and competitive bidding is in the best interest of the Public Health Trust, and require a two-thirds affirmative vote of the Trustees present for approval. 1. ( MAM) The Health Information Management Department ( HIM ), requests a renewal of the contract awarded to PricewaterhouseCoopers, LLP (PwC) to continue utilizing the PwC SMART Inpatient and Outpatient service for an additional one (1) year period. (Ongoing purchase) June 2014 PHT Board of Trustees 4

96 PricewaterhouseCoopers, LLP: Original Award (under CPO delegated authority January 4, 2011) No Cost (For one year) Modification # 1 $312,000 (Board Approved June 25, 2012) (For one year) Modification # 2 $321,360 (Board Approved July 3, 2013) (For one year) This request for funding: $321,360 (For one year) Total approved funding: $954,720 Background On January 4, 2011 the Trust entered into a Global License Agreement which included Outpatient SMART riders to provide access to PwC s SMART application at no cost through May 30, The Inpatient SMART rider was incorporated into the Agreement in June The automated SMART inpatient and Outpatient solutions have assisted with analyzing coding quality, corrected coding errors before billing was submitted, identified documentation improvement opportunities in reducing reimbursement risks and measured outcomes against key performance indicators. The tool has assisted and will continue to assist coding staff with appropriate coding consistent with American Hospital Association (AHA) coding guidelines. Its utilization will also ensure that the department codes efficiently in areas that are focused on the Medicare Audit Recovery Contract project (RAC) as well as other regulatory agency audits. The product was initially a component of the PwC initiative to improve the overall quality of HIM coding. HIM would otherwise be unable to manually review all of the records coded on a daily basis without the SMART system flagging potential errors for review. The system currently performs the audit three times per day. The HIM Department had performed a survey of the market and found that there is no other system currently available to perform the task required. Recommendation For the reasons stated above, the HIM Department has determined that it would be in the best interest of the Trust to continue receiving the services of PwC for an additional year and secure the assistance with daily operations required by the HIM department as well as the necessary support for the upcoming ICD-10 implementation in The original contract was reviewed and approved by the County Attorney s Office for legal sufficiency and by Risk as to Insurance and Indemnification. This contract can be terminated for convenience with a ninety (90) day notice and includes UAP and OIG provisions. In providing an evaluation of PricewaterhouseCoopers, LLP s performance during the current contract year, the Information Technology Department has reported the following: The contracted service meets the applicable standards addressed in the Joint Commission Standards. The overall service is good: There have been no complaints from patients or employees regarding this contracted service. The service has never caused delays. The vendor meets all requirements for the contracted service Vendor has demonstrated consistent responsiveness to all requests/issues/problems that might have arisen during the course of the contract period. June 2014 PHT Board of Trustees 5

97 Based on the overall contract performance evaluation, the Health Information Management Department has recommended the continuation of this contracted service. ECRI recommends that any annual cost increase by vendor should not exceed 3% or the current CPI. However, the Trust already has this cap in place, and through negotiations the vendor has agreed to maintain its current price. MD Buyline is unable to provide an analysis at this time. (M. Knight) SECTION VIII. MISCELLANEOUS This section consists of procurement actions that require Board approval not included under any other section of the Purchasing Report. No items to report. June 2014 PHT Board of Trustees 6

98 TO: FROM: Mojdeh L. Khaghan, Chairperson and Members, Fiscal Committee Rosa Costanzo, Vice President and Chief Procurement Officer Strategic Sourcing and Supply Chain Management Division DATE: July 17, 2014 RE: Purchasing Report Recommendation The following recommendations are made in accordance with the Trust s Procurement Regulation. These items fully support our business operations and help the organization in its efforts to provide an excellent world class patient experience. Scope This report includes competitively solicited contract awards over $3,000,000, waivers of formal competition over $250,000 and other categories for Board approval as prescribed by the Procurement Regulation. Fiscal Impact/Funding Source The items included are part of the Trust s budget. Track Record/Monitor The Procurement Management Department along with the user departments and leadership support, will track and monitor the responsibilities and obligations set forth in the contracts. Background The entire report has been vetted and assembled by the Procurement Management Department with the direct participation of the Director and staff, all subject to review by the Chief Procurement Officer, consultation with the Executive Staff and the President, and reviewed for legal sufficiency by the County Attorney s Office. Request is made for approval of the Purchasing Report, consisting of the following: Vendor Amount 1 Intuitive Surgical, Inc. $ 3,432,000 2 CT Mechanical Company $ 449,000 Emergency Procurement Procurement completed an orderly administrative process with each item to bring the best value (cost, quality, and outcome) with each project. July 2014 PHT Board of Trustees 1

99 Agenda Item 6 (c) Public Health Trust Board of Trustees July 28, 2014 RESOLUTION NO. PHT 07/14 RESOLUTION AUTHORIZING AND APPROVING AWARD OF BIDS AND PROPOSALS, WAIVER OF BIDS, AND OTHER PURCHASING ACTIONS FOR JULY 2014, IN ACCORDANCE WITH THE PUBLIC HEALTH TRUST S PROCUREMENT POLICY, RESOLUTION NO. PHT 10/ (Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System) WHEREAS, bids and proposals were solicited, received and reviewed by staff; and WHEREAS, the Purchasing and Facilities Subcommittee met on July 17, 2014 and reviewed staff s recommendations as submitted under the PHT s Procurement Policy, Resolution No. PHT 10/12-078; and WHEREAS, the Purchasing and Facilities Subcommittee forwarded the Purchasing Report to the Fiscal Committee with a recommendation for approval for each item under the report, which is attached hereto and hereby incorporated by reference; and WHEREAS, upon his written recommendation, the President recommends that the Public Health Trust Board of Trustees (Board of Trustees) waive competitive bidding for items under the heading of Bid Waiver and Waiver of Full and Competitive Bidding in the respective Purchasing Report, finding such action to be in the best interests of the Public Health Trust; and WHEREAS, the President and Fiscal Committee recommend various other purchasing actions, as indicated in the attached Purchasing Report. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby authorizes and approves the award of bids and proposals and all the purchasing actions as set forth in the attached Purchasing Report, under the Public Health Trust s Procurement Policy, Resolution No. PHT 10/12-078; and finds it in the best interest of the Public Health Trust to waive competitive bidding for those items listed under the heading Bid Waiver and Waiver of Full and Competitive Bidding in the respective report; and to take such action as is necessary and authorized to implement these awards and actions. July 2014 PHT Board of Trustees 2

100 PUBLIC HEALTH TRUST BOARD OF TRUSTEES PURCHASING REPORT July 28, 2014 TO: FROM: PUBLIC HEALTH TRUST BOARD OF TRUSTEES PROCUREMENT MANAGEMENT DEPARTMENT The following recommendations are made in accordance with the Trust s Procurement Policy and it s implementing Procurement Regulation. This report includes competitively solicited contract awards over $3,000,000, waivers of formal competition over $250,000 and other categories for Board approval as prescribed by the Procurement Regulation. The entire report has been screened and assembled by the Procurement Management Department with the direct participation of the Directors and staff, all subject to review by the Chief Procurement Officer, consultation with the Executive Staff and the President, and reviewed for legal sufficiency by the County Attorney s Office. SECTION I. AWARDS UNDER INVITATIONS TO BID (ITB s) This section consists of awards under competitively solicited Invitations to Bid (ITB s) over $3,000,000. No items to report. SECTION II. AWARDS UNDER REQUESTS FOR PROPOSALS (RFP s) This section consists of awards under competitively solicited Requests for Proposals (RFP s) over $3,000,000. No items to report. SECTION III. AWARDS UNDER THE COMPETITIVELY SOLICITED CONTRACTS OF OTHER PUBLIC PROCUREMENT ENTITIES This section consists of awards over $3,000,000 under competitively solicited ( ITB, RFP or equivalent) contracts of other public and nonprofit entities. No items to report. SECTION IV. AWARDS UNDER GROUP PURCHASING ORGANIZATION ( GPO ) CONTRACTS This section consists of awards over $3,000,000 under Group Purchasing Organization ( GPO ) contracts. GPOs are organizations that aggregate the purchasing volume of their members consisting of hospitals and other health care providers to leverage discounts with manufacturers, distributors and other vendors to realize administrative savings and efficiencies. The Trust s GPO is MedAssets. No items to report. SECTION V. AWARDS UNDER A WAIVER OF FORMAL COMPETITION This section consists of awards over $250,000 without the formal solicitation of competitive bids or proposals. All award recommendations in this section have the approval of the President, are based on a finding that the waiver of competitive bidding is in the best interests of the Public Health Trust, and require a two-thirds affirmative vote of the Trustees present for approval. A. Sole Source July 2014 PHT Board of Trustees 3

101 1. (CA10553; MAM) The Surgery Unit of Jackson South Community Hospital requests approval for the purchase of an upgraded surgical robotic system, the davinci Xi Surgical System from Intuitive Surgical, Inc.: Intuitive Surgical, Inc.: $ 1,615,000 (One time purchase price with trade in value included) $ 1,221,000 (Supplies and Instruments for one year) $ 596,000 (Maintenance Support years 2-5) Total approved funding: $ 3,432,000 Background Intuitive Surgical is a sole source vendor for multi-specialty and robotic surgery equipment and related service. Jackson South Community Hospital currently has a davinci SI System that was upgraded in 2011 and a successful robotic program. Jackson Health System is currently the leader in urology robotic procedures in South Florida. There are two colo-rectal surgeons that are recognized for the exceptional work they are doing on robotic cases. The new system will add the latest technology to the program and allow Jackson South to continue growing the surgery programs. The davinci Xi has broader capabilities than prior generations of the davinci System that have already been purchased by Jackson Main and Jackson South. It can be used across a wide spectrum of minimally invasive surgical procedures and has been optimized for complex, multiquadrant surgeries. For more than a decade, the da Vinci Surgical Systems have provided patients with a minimally invasive alternative to open surgery and reduces many of the costs and complications associated with open procedures. Intuitive Surgical designed the new da Vinci Xi System with the goal of further advancing the technology used in minimally invasive surgery for complex diseases and conditions in gynecology, urology, thoracic, cardiac, and general surgery. In accordance with our Contractor Due Diligence review, Intuitive Surgical, has provided a Sworn/Notarized Statement to the Trust s Procurement Management Department that: (1) No Lawsuits have been filed against the Company within the five (5) years prior to submittal of a bid or proposal to the Trust; (2) The Company has not defaulted in the five (5) years prior to bid or proposal submittal to the Trust; and, (3) the Company has not been debarred nor has the Firm received a formal notice of non-compliance or non-performance in the five (5) years prior to proposal submittal to the Trust. In providing an evaluation of Intuitive Surgical s performance during the current contract year, the Surgery Unit has reported the following: The contracted service meets the applicable standards addressed in the Joint Commission Standards. The overall service is good. There have been no complaints from patients or employees regarding this contracted service. o The service has never caused delays. o o The vendor meets all requirements for the contracted service Vendor has demonstrated consistent responsiveness to all requests/issues/problems that might have arisen during the course of the contract period. Recommendation Based on the overall contract performance evaluation, Jackson South Community Hospital Surgery Unit has recommended the continuation of this contracted service. The MDBuyline and ECRI analyses suggested a discount. However, this recommendation was based on discounts provided for an older model. So far, ECRI and MDBuyline have not seen any discounts on this newer model (the da Vinci Xi), for which the vendor holds the patent as a sole source vendor. Although a discount was not forthcoming from the vendor, Procurement aggressively negotiated the waiver of freight charges in the amount of $10,000 as well as a trade-in value of $225,000 for the existing Si model located at Jackson North. This value far July 2014 PHT Board of Trustees 4

102 exceeds the $165,000 resale figure identified by ECRI and MDBuyline. Total cost avoidance/savings to be provided by vendor for this purchase will be $235,000. With the use of the ECRI and Broadjump tool, Procurement has confirmed competitive pricing on supplies. (J. Miranda). B. Physician s Preference Staff requests a waiver of formal competition for the contract items listed in this category because a physician and clinician have requested the particular item without which the physician and clinician cannot successfully and safely render patient care. No items to report. C. Standardization Items in this category have been established as the Trust standard. No items to report. D. Non-Competitive Cooperative Purchasing This subsection consists of awards under the contracts of other public entities that were not competitively solicited. No items to report. E. Miscellaneous Bid Waiver This subsection consists of awards not falling in the other categories of waiver of formal competition but where waiver is deemed to be in the best interests of the Trust. No items to report. SECTION VI. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE COMPETITIVELY SOLICITED This section refers to existing contracts that were competitively bid ( ITB or RFP ) at their origin and consists of either (a) the exercise of established options to renew or (b) the execution of contract modifications for which the Procurement Policy requires prior Board approval. No items to report. SECTION VII. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE AWARDED UNDER A WAIVER OF FORMAL COMPETITION This section refers to existing contracts that were not competitively bid at their origin and consists of either (a) the exercise of established options-to renew or (b) the execution of contract modifications for which the Procurement Policy requires prior Board approval. All contracts in this section are renewals not previously authorized by the Board have the written approval of the President, are based on a finding that the waiver of full and competitive bidding is in the best interest of the Public Health Trust, and require a two-thirds affirmative vote of the Trustees present for approval. No items to report. SECTION VIII. MISCELLANEOUS This section consists of procurement actions that require Board approval not included under any other section of the Purchasing Report. July 2014 PHT Board of Trustees 5

103 2. ( KG) The Engineering Services and Procurement Management Departments request ratification of this one-time emergency procurement from CT Mechanical Company under the Emergency Procurement provisions of the Procurement Regulation for the replacement of Air Handler Unit (AHU) #10. CT Mechanical Company: $449,000 (One-time) Total requested funding $449,000 CT Mechanical Company is a pre-qualified mechanical contractor and has previously performed on-site work for the Trust. CT Mechanical Company was the low bidder pursuant to open-competitive Invitation to Bid (ITB) # KG for the replacement of eighteen (18) air handler units campus wide, the scope of which included the replacement of AHU #10, located at the basement of West Wing. CT Mechanical Company s price to replace AHU #10 was $421,000 including all incidental costs (bonds, etc.). The second and third lowest prices for AHU #10 were $556,000 and $600,000. All bids were rejected 4/18/14 for the subject ITB in the best interest of the Trust, and it is currently under review for CSBE Measures to be reissued. The replacement of AHU #10 was declared an emergency due to the failure of the existing unit. As a result, the Engineering Services Department, in collaboration with Procurement Management, engaged CT Mechanical Company to commence replacement of the unit. The rental of two temporary air handler units was also necessary for a two-month period in an amount not to exceed $28,000. Therefore, the total amount of the emergency purchase shall not exceed $449,000. In accordance to the Procurement Regulation, the procurement was limited to services necessary to immediately address the interruption of services and minimize operational impact compromising the delivery of services. An emergency request for the emergency replacement of AHU #10, approved by Alex Contreras, SVP CAO, Mark Knight, EVP & CFO, Don Steigman, EVP & COO, and Carlos Migoya, President & CEO, was submitted by the Engineering Services Department. The UAP and OIG provisions apply to this one-time emergency purchase (A. Contreras). July 2014 PHT Board of Trustees 6

104 TO: FROM: Public Health Trust Board of Trustees Donald B. Jaffee, Vice President, Finance DATE: June 23, 2014 RE: Thornburg International Value Fund Recommendation It is recommended that the Public Health Trust Board of Trustees (PHT) approves this resolution. Hewitt EnnisKnupp (HEK) recommended the replacement of Thornburg International Value Fund and authorization of this portion of the International Equity portfolio be reallocated with 50% of the portfolio to Blackrock ishares MSCI EAFE Value Index (ETF) and 50% of the portfolio to DFA International Value (MF) of the Public Health Trust Defined Pension Plan ( Plan ) assets. Background The Pension Plan Committee is charged with the responsibility of recommending a structure that offers the highest probability of achieving investment objectives. This item was presented to the Pension Plan Subcommittee and Fiscal Committee and changes were approved.

105 Agenda Item 6 (d) Public Health Trust Board of Trustees July 28, 2014 RESOLUTION NO. PHT 07/14 - RESOLUTION APPROVING THE REPLACEMENT OF THORNBURG INTERNATIONAL VALUE FUND AND AUTHORIZING THIS PORTION OF THE INTERNATIONAL EQUITY PORTFOLIO OF THE PHT DEFINED BENEFIT PENSION PLAN BE REALLOCATED WITH 50% OF THE PORFOLIO TO BLACKROCK ishares MSCI EAFE VALUE INDEX (ETF) AND 50% OF THE PORTFOLIO TO DFA INTERNATIONAL VALUE (MF) (Donald B. Jaffee, Vice President, Finance, Jackson Health System) WHEREAS, the Pension Plan Subcommittee held their quarterly review meeting on May 13, 2014; and WHEREAS, Hewitt EnnisKnupp (HEK) recommended the replacement of Thornburg International Value Fund and authorizing this portion of the International Equity portfolio be reallocated with 50% of the portfolio to Blackrock ishares MSCI EAFE Value Index (ETF) and 50% of the portfolio to DFA International Value (MF) of the Public Health Trust Defined Pension Plan ( Plan ) assets; and WHEREAS, the Pension Plan Subcommittee and Fiscal Committee approved these changes. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby adopts the recommendation of the Pension Plan Subcommittee and approves the replacement of Thornburg International Value Fund and authorizing this portion of the International Equity portfolio of the Plan be reallocated with 50% of the portfolio to Blackrock ishares MSCI EAFE Value Index (ETF) and 50% of the portfolio to DFA International Value (MF) and authorizes the Public Health Trust President or his designee to prepare and execute all documents to effectuate these transactions.

106 TO: FROM: Public Health Trust Board of Trustees Steven E. Burghart, Chief Administrative Officer Holtz Children s Hospital and Jackson Women s Hospital DATE: June 23, 2014 RE: Agreement With Variety Children s Hospital, Inc., d/b/a Miami Children s Pediatric Neurosurgical Services Recommendation Staff recommends that the Public Health Trust Board of Trustees authorizes the President or his designee to negotiate and execute a new agreement with Variety Children s Hospital, Inc., d/b/a Miami Children s Hospital, that is in the best interest of Jackson Health System and is in accordance with law and at a fair market rate as determined by an independent health care valuation company. Staff further recommends the Trust Board delegate authority for the President or his designee to exercise any options to extend that may be set forth in the new agreement and for the President to negotiate and execute a settlement agreement to compensate Variety for services previously rendered. Scope The agreement with Variety will cover the provision of pediatric neurological services provided at Holtz Children s Hospital. Fiscal Impact/Funding Source The amount of $625,000 is included in the Trust s adopted operating budget for FY Track Record/Monitor The Holtz Children s Hospital administrative team will track and monitor contract performance. Background In 2010, the Trust s Pediatric Neurosurgery Program direly needed to acquire the services of pediatric neurosurgeons to fully support its mission by providing pediatric neurosurgical services at Jackson Memorial Hospital, Holtz Children s Hospital, the Ryder Trauma Center, or other Jackson facilities, regardless of the patient s ability to pay for such services. Thus, on February 28, 2011, the Trust Board adopted Resolution No. PHT 02/11-038, which authorized the execution of an agreement for such physician services with Variety Children s Hospital. The agreement shall expire, and it is still in the Trust s best interest to provide these services through Variety.

107 Agenda Item 6 (e) Public Health Trust Board of Trustees July 28, 2014 RESOLUTION NO. PHT 07/14- RESOLUTION AUTHORIZING THE PRESIDENT OR HIS DESIGNEE TO NEGOTIATE AND EXECUTE A NEW AGREEMENT FOR PHYSICIAN SERVICES BY AND BETWEEN THE PUBLIC HEALTH TRUST AND VARIETY CHILDREN S HOSPITAL, INC., D/B/A MIAMI CHILDREN S HOSPITAL ( VARIETY CHILDREN S HOSPITAL ), SUBJECT TO OBTAINING A FAIR MARKET VALUE ASSESSMENT AND DELEGATING TO THE PRESIDENT OR HIS DESIGNEE AUTHORITY TO EXERCISE ANY OPTIONS TO EXTEND CONTAINED IN THE NEW AGREEMENT; AND AUTHORIZING THE PRESIDENT OR HIS DESIGNEE TO NEGOTIATE AND EXECUTE A SETTLEMENT AGREEMENT BY AND BETWEEN THE PUBLIC HEALTH TRUST AND VARIETY CHILDREN S HOSPITAL FOR COMPENSATION FOR SERVICES PREVIOUSLY RENDERED (Steven E. Burghart, Chief Administrative Officer, Holtz Children s Hospital and Jackson Women s Hospital, Jackson Health System) WHEREAS, the Public Health Trust s (the Trust ) primary mission is to provide health care to the residents of Miami-Dade County, regardless of their ability to pay, thereby serving as the safety net provider of health care services in Miami-Dade County; and WHEREAS, the Trust critically needs Pediatric Neurosurgeons to fully support its mission by providing Pediatric Neurosurgical Services to any person in need of such services who presents to Jackson Memorial Hospital, Holtz Children s Hospital, the Ryder Trauma Center, or other Trust facilities regardless of their ability to pay for such services; and WHEREAS, on February 28, 2011, the Board of Trustees adopted Resolution No. PHT 02/ authorizing the execution of an Agreement for Physician Services with Variety Children s Hospital for the Trust s acquisition of the critically needed services of Pediatric Neurosurgeons (the Agreement ); and Hospital; and WHEREAS, the Trust is in need of further services of Pediatric Neurosurgeons from Variety Children s

108 Agenda Item 6 (e) Public Health Trust Board of Trustees July 28, Page 2- WHEREAS, the President seeks authority to negotiate and execute a new agreement with Variety Children s Hospital for acquisition of Pediatric Neurosurgical services and to exercise any options to extend contained in the new agreement, and to negotiate and execute a settlement agreement with Variety Children s Hospital for compensation for Pediatric Neurosurgical services previously rendered. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby: (i) authorizes the President or his designee to negotiate and execute a new agreement with Variety Children s Hospital for the acquisition of Pediatric Neurosurgical services on such term and conditions as the President determines to be in the best interest of the Public Health Trust and, in accordance with law, at fair market rate compensation based on a valuation from an independent health care valuation company; and (ii) delegates to the President or his designee authority to exercise any options to extend contained in the new agreement. Further, this Board hereby authorizes the President or his designee to negotiate and execute a settlement agreement with Variety Children s Hospital for compensation of Pediatric Neurosurgical services previously rendered.

109 TO: FROM: Public Health Trust Board of Trustees Mark T. Knight, Executive Vice President and Chief Financial Officer DATE: June 23, 2014 RE: Monetary Gift of $2,500,000 to Public Health Trust from the Batchelor Foundation, Inc. Recommendation Staff recommends that the Public Health Trust Board of Trustees approve the acceptance of a gift of Two Million Five Hundred Thousand Dollars ($2,500,000) from the Batchelor Foundation, Inc., through the Jackson Memorial Foundation, Inc., and authorizes the President to execute the Agreement between the Trust, Jackson Memorial Foundation, Inc., and the Batchelor Foundation, Inc., evidencing the gift. Scope The gift will be used for the purpose of renovating the sixth floor at Holtz Children s Hospital which is dedicated to the care of pediatric oncology, transplant and other serious, chronic diseases. Fiscal Impact/Funding Source The monetary gift will be in the amount of Two Million Five Hundred Thousand Dollars ($2,500,000). Track Record/Monitor The Finance and Capital Projects administrative team will track and monitor the gift and performance under the Agreement. Background The Batchelor Foundation,Inc., supports non-profit organizations dedicated to the betterment of children s health. The Trust submitted a grant proposal earlier this year, and the Batchelor Foundation determined that the Trust is worthy of its support.

110 Agenda Item 6 (f) Public Health Trust Board of Trustees July 28, 2014 RESOLUTION NO. PHT 07/14 RESOLUTION APPROVING ACCEPTANCE OF A GIFT IN THE AMOUNT OF TWO MILLION FIVE HUNDRED THOUSAND DOLLARS ($2,500,000) FROM THE BATCHELOR FOUNDATION, INC., AND AUTHORIZING THE PRESIDENT TO EXECUTE THE AGREEMENT BETWEEN THE PUBLIC HEALTH TRUST, JACKSON MEMORIAL FOUNDATION, INC., AND THE BATCHELOR FOUNDATION, INC. EVIDENCING THE GIFT (Mark T. Knight, Executive Vice President and Chief Financial Officer) WHEREAS, in accordance with Section 25A-4(h) of the Code of Miami-Dade County and Section XVII of the Public Health Trust Procurement Regulation, Policy No. 248, the Public Health Trust has the authority to accept gifts of money, services, or personal property; and WHEREAS, the Procurement Regulation provides that the Board of Trustees shall approve all gifts of money, services, personal property or construction of $1,000,000 or more; and WHEREAS, the Batchelor Foundation, Inc., through the Jackson Memorial Foundation, Inc., seeks to make a gift of Two Million Five Hundred Thousand Dollars ($2,500,000) to the Public Health Trust to be used for the renovation of the sixth floor at Holtz Children s Hospital which is dedicated to the care of pediatric oncology, transplant and other serious, chronic diseases; and WHEREAS, the President recommends that the Board of Trustees approves the acceptance of the gift and authorizes the execution of the attached Agreement between the Public Health Trust, Jackson Memorial Foundation, Inc., and the Batchelor Foundation, Inc.

111 Agenda Item 6 (f) Public Health Trust Board of Trustees July 28, Page 2- NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby approves acceptance of the gift of Two Million Five Hundred Thousand Dollars ($2,500,000) from the Batchelor Foundation, Inc., through the Jackson Memorial Foundation, Inc., and authorizes the President to execute the attached Agreement between the Public Health Trust, Jackson Memorial Foundation, Inc., and the Batchelor Foundation, Inc. evidencing the gift and the terms and conditions of its use.

112 Agenda Item 6 (g) Public Health Trust Board of Trustees July 28, 2014 RESOLUTION NO. PHT 07/14 RESOLUTION RECOMMENDING THE BOARD OF COUNTY COMMISSIONER S APPROVAL AND ADOPTION OF THE ORDINANCE CREATING THE JACKSON HEALTH SYSTEM CAPITAL EXPEDITE PROGRAM; ESTABLISHING POLICY TO ACCELERATE THE PROCESSING AND PROCUREMENT OF CONTRACTS; AUTHORIZING THE PUBLIC HEALTH TRUST TO ADVERTISE AND AWARD CONTRACTS FOR PROFESSIONAL SERVICES AND CONSTRUCTION AND DESIGN-BUILD SERVICES; AND PROVIDING FOR AMENDMENT OF THE PUBLIC HEALTH TRUST S PROCUREMENT POLICY AND IMPLEMENTATION (Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System) WHEREAS, the Public Health Trust ( PHT ) is projected to spend $1.4 billion on capital projects over the next decade, including $830 million from the Jackson Miracle-Building Bond Program approved in 2013 by Miami-Dade voters; and WHEREAS, the PHT seeks, through open, competitive and transparent processes, to expedite the design, construction and improvement of the capital facilities of the Jackson Health System to enhance its delivery of health care services throughout Miami-Dade County; and WHEREAS, this Board seeks to accomplish the purposes set forth in the attached memorandum through the Board of County Commissioner s adoption of the attached ordinance. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby recommends that the Miami-Dade Board of County Commissioners approve and adopt the ordinance creating the Jackson Health System Capital Expedite Program; establishing policy to accelerate the processing and procurement of contracts; authorizing the Public Health Trust to advertise and award contracts for professional services and construction and design-build services; and providing for amendment of the Public Health Trust s procurement policy and implementation.

113 7. ADJOURNMENT