TRUST/MEDICAL SCHOOLS AOA NEGOTIATING COMMITTEE AGENDA Tuesday, May 19, 2015 9:30 a.m. to Adjournment Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12 th Avenue Miami, Florida 33136
PUBLIC HEALTH TRUST BOARD OF TRUSTEES TRUST/MEDICAL SCHOOLS AOA NEGOTIATING COMMITTEE AGENDA Tuesday, May 19, 2015 9:30 a.m. to Adjournment Jackson Memorial Hospital West Wing Board Room Trust/Medical Schools AOA Negotiating Committee Joe Arriola, Chairperson Mojdeh L. Khaghan, Vice Chairperson Marcos J. Lapciuc Carlos Trujillo Darryl K. Sharpton Mayor, Miami-Dade County Chairman, Miami-Dade County Board of County Commissioners Public Health Trust Rules Any person making impertinent or slanderous remarks or who becomes boisterous while addressing the committee, shall be barred from further audience before the committee, unless permission to continue or again address the committee 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 Board Room. Persons exiting the Board Room shall do so quietly. The use of cell phones in the Board Room 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 Board Room to answer incoming cell phone calls. 1. Meeting Call To Order (a) Reasonable Opportunity for the Public to be Heard as Required by Section 286.0114.FLA.STAT. (Chapter 2013-227, Laws of Florida) Joe Arriola, Chairperson (b) Previous committee meeting minutes (November 19, 2014) Motion to approve the previous committee meeting minutes Joe Arriola, Chairperson Page 1 of 2
TRUST/MEDICAL SCHOOLS AOA NEGOTIATING COMMITTEE AGENDA May 19, 2015 2. Report (a) University of Miami Annual Operating Agreement Presented by Don S. Steigman, Executive Vice President and Chief Operating Officer, Jackson Health System 3. Resolution Recommended To Be Accepted (a) Support Memorandum (b) Resolution approving the Annual Operating Agreement with the University of Miami in the annual base amount of $127,844,392.00, subject to increase or decrease as provided in the Agreement, which amount includes among other items an increase in the annual cap for the Transplant Program in the amount of $1,100,000.00, and authorizing the President and Chief Executive Officer, or his designee, to execute such Annual Operating Agreement and to execute an amendment to the Agreement for Solid Organ Transplant Professional Services, and to exercise any amendment or revision, modification, extension, termination or cancellation clauses provided within either the Annual Operating Agreement or the Agreement for Solid Organ Transplant Professional Services 4. Adjournment Sponsored by Don S. Steigman, Executive Vice President and Chief Operating Officer, Jackson Health System Motion to accept the resolution with a favorable recommendation to the PHT Board of Trustees Joe Arriola, Chairperson Page 2 of 2
1. Meeting Call To Order
1 (a) REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION 286.0114.FLA.STAT. (CHAPTER 2013-227, LAWS OF FLORIDA)
PUBLIC HEALTH TRUST BOARD OF TRUSTEES TRUST/MEDICAL SCHOOLS AOA NEGOTIATING COMMITTEE MEETING MINUTES Wednesday, November 19, 2014 10:30 a.m. to 11:30 a.m. Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12 th Avenue Miami, FL 33136 Trust/Medical Schools AOA Negotiating Committee Joe Arriola, Chairperson Mojdeh L. Khaghan, Vice Chairperson Marcos J. Lapciuc Carlos Trujillo Darryl K. Sharpton Mayor, Miami-Dade County Chair of Board of County Commissioners Member(s) Present: Member(s) Excused: Mojdeh L. Khaghan, Vice Chairperson, Marcos J. Lapciuc, Darryl K. Sharpton, and Alina Hudak, Deputy Mayor, Miami-Dade County, Mayor, Miami-Dade County and Chair of Board of County Commissioners PHT Board of Trustees Present: Ralph G. Patino In addition to Members of the Committee being present, the following staff members, University of Miami Miller School of Medicine (UMMSOM) Representatives, Florida International University College of Medicine (FIUCOM) Representative, and Assistant Miami-Dade County Attorneys were present: Carlos A. Migoya, Don S. Steigman, Matthew Pinzur, Peter Paige, M.D., Mark T. Knight, and Richard Klass; Michael Butler, M.D.; Steven Falcone, M.D. and Joshua Lenchus, D.O., UMMSOM Representatives; Yolangel Hernandez-Suarez, M.D., FIUCOM Representative; Laura Llorente, and Jeffrey Poppel, Assistant Miami- Dade County Attorneys 1. Meeting Call To Order Mojdeh L. Khaghan, Vice Chairperson at 10:36 a.m. (a) Reasonable Opportunity for the Public to be Heard as Required by Section 286.0114.FLA.STAT. (Chapter 2013-227, Laws of Florida) There were no requests to be heard from the public. (b) Previous committee meeting minutes (May 15, 2014) The previous committee meeting minutes of May 15, 2014 was approved as presented. Page 1 of 3
TRUST/MEDICAL SCHOOLS AOA NEGOTIATING COMMITTEE MEETING MINUTES November19, 2014 2. Annual Operating Agreement with Florida International University Don S. Steigman, Executive Vice President and Chief Operating Officer, presented a detailed overview of the proposed Annual Operating Agreement (AOA) with Florida International University (FIU). In a Basic Affiliation Agreement (BAA) both FIU and the Public Health Trust (PHT) agree to enter into an AOA which sets forth the fiscal and administrative provisions for carrying out the BAA. Within the AOA it is recommended upon approval the President is authorized to execute any amendments to the AOA and is also authorized to exercise any revision, modification, extension, termination or cancellation clauses provided within the AOA. Prior to the meeting the members of the committee were thoroughly briefed regarding the content of the AOA. A copy of the AOA was distributed at the meeting. Alina Hudak, Deputy Mayor, Miami-Dade County and the Mayor s appointment on the Trust/Medical Schools Annual Operating Agreement Negotiating Committee, questioned the reference and fiscal impact relative to the sovereign immunity and malpractice claims. Mr. Steigman stated that the arrangement is set up where for the patients that are seen in the Jackson Health System clinics which really are patients that FIU will not be billing and collecting for and really are individuals that don t have any financial resources on that. He further stated that FIU had requested JHS to indemnify them and JHS to cover them under its sovereign immunity which is acceptable to JHS and our attorneys have also worked on that. As it relates to the hospitalist services since FIU will be billing and collecting for those hospital services JHS will not indemnify FIU for the services and will be covered under FIU sovereign immunity. Ms. Khaghan questioned the difference in sovereign immunity between the University of Miami AOA from FIU AOA. Mr. Steigman explained that the University of Miami sovereign immunity covers them under the change in the state s law that happened three years ago, so basically they are covered under that statute. On any claims that happen on a university level at FIU JHS is responsible for it. Mr. Sharpton thanked Mr. Migoya, Mr. Steigman and the staff that was involved with the AOA process for getting the work done necessary to complete the AOA. Mr. Sharpton requested that a semi-annual AOA update is presented to the PHT BOT. Mr. Migoya stated that there are physician strategies that are ongoing and the PHT BOT will be regularly updated going forward. 3. Resolution Recommended To Be Approved (a) Resolution approving the Annual Operating Agreement with Florida International University and authorizing the President and Chief Executive Officer to execute such Agreement Sponsored by Don S. Steigman, Executive Vice President and Chief Operating Officer, Jackson Health System Motion to approve the resolution with a favorable recommendation to the PHT Board of Trustees Mojdeh L. Khaghan, Vice Chairperson Darryl K. Sharpton moved approval; seconded by Marcos J. Lapciuc, and carried without dissent. Yolangel Hernandez-Suarez, M.D., Chief Executive Officer, Associate Dean for General Medicine Education and Associate Professor of Obstetrics and Gynecology, FIU stated that JHS is a very important site for FIU students for training and believe that this is a very happy day for Dean Rock, who has a fundamental commitment to service to education. FIU is very grateful to be able to share JHS clinical sites. Page 2 of 3
TRUST/MEDICAL SCHOOLS AOA NEGOTIATING COMMITTEE MEETING MINUTES November19, 2014 4. Adjournment Joe Arriola, Vice Chairperson, PHT Board of Trustees at 9:40 a.m. Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees Page 3 of 3
2. Report
2 (a) University of Miami Annual Operating Agreement
3. Resolution Recommended To Be Accepted
To: Joe Arriola, Chairperson and Members, Trust/Medical Schools AOA Negotiating Committee From: Don Steigman, Executive Vice President and Chief Operating Officer, Jackson Health System Date: May 19, 2015 Subject: Resolution Approving the Annual Operating Agreement with the University of Miami and authorizing the President and Chief Executive Officer, or his designee, to execute such Agreement and to execute an amendment to the Solid Organ Transplant Professional Services Agreement RECOMMENDATION Staff recommends that the Trust/Medical Schools AOA Negotiating Committee approve and authorize the President and Chief Executive Officer, or his designee, to execute the 2015-2016 Annual Operating Agreement with the University of Miami and to also execute an Amendment to the Solid Organ Transplant Professional Services Agreement. FISCAL IMPACT/FUNDING SOURCE This item is included as part of the Trust s budget for Fiscal Year 2016. BACKGROUND The Public Health Trust (the Trust ) and the University of Miami (the University ) have been affiliated since 1952. The most recent Basic Affiliation Agreement was entered into in 2011. In the 2011 Basic Affiliation Agreement, the Trust and the University agree to enter into an Annual Operating Agreement ( AOA ) setting forth the fiscal and administrative provisions for carrying out the Basic Affiliation Agreement. Some new items included in the 2015-2016 AOA are as follows: Implementation of a pay for performance incentive/penalty pool that provides financial incentives and penalties to the University related to the achievement of specific and agreed upon clinical outcomes and other measurable outcomes. Increase in neurosurgery support to provide coverage to Jackson South Hospital and Holtz Children s Hospital. Increase in other support to improve service levels in clinical programs such as psychiatry, critical care units. Increase in support for ACGME program directors (6 FTEs). Extension of the exclusivity clause related to Trauma Services through May 31, 2018 (under the prior AOA the exclusivity clause would have expired on May 31, 2016). Extension of the exclusivity clause related to Pediatrics and Obstetrics, through May 31, 2018, provided there is continued mutual agreement on continued program support (under the prior AOA the exclusivity clause would have expired on May 31, 2016). Increase in funding to MTI by $1.1 million for the recruitment of a heart and lung transplant surgeon, a pediatric gastroenterologist, a hepatologist, and a nephrologist.
This item is being submitted to the Trust/Medical Schools AOA Negotiating Committee for approval and authorization for the Trust to enter into the aforementioned AOA with the University.
Agenda Item 3 (b) Trust/Medical Schools AOA Negotiating Committee May 19, 2015 RESOLUTION NO. PHT 05/15 RESOLUTION APPROVING THE ANNUAL OPERATING AGREEMENT WITH THE UNIVERSITY OF MIAMI IN THE ANNUAL BASE AMOUNT OF $127,844,392.00, SUBJECT TO INCREASE OR DECREASE AS PROVIDED IN THE AGREEMENT, WHICH AMOUNT INCLUDES AMONG OTHER ITEMS AN INCREASE IN THE ANNUAL CAP FOR THE TRANSPLANT PROGRAM IN THE AMOUNT OF $1,100,000.00, AND AUTHORIZING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, OR HIS DESIGNEE, TO EXECUTE SUCH ANNUAL OPERATING AGREEMENT AND TO EXECUTE AN AMENDMENT TO THE AGREEMENT FOR SOLID ORGAN TRANSPLANT PROFESSIONAL SERVICES, AND TO EXERCISE ANY AMENDMENT OR REVISION, MODIFICATON, EXTENSION, TERMINATION OR CANCELLATION CLAUSES PROVIDED WITHIN EITHER THE ANNUAL OPERATING AGREEMENT OR THE AGREEMENT FOR SOLID ORGAN TRANSPLANT PROFESSIONAL SERVICES (Don S. Steigman, Executive Vice President and Chief Operating Officer, Jackson Health System) WHEREAS, the Public Health Trust of Miami-Dade County, Florida (the PHT ) and the University of Miami (the University ) have been affiliated since 1952; and WHEREAS, the most recent Basic Affiliation Agreement (the BAA ) between the parties was entered into in 2011; and WHEREAS, in the BAA, the parties agree to enter into an Annual Operating Agreement (the AOA ) setting forth the fiscal and administrative provisions for carrying out the BAA; and WHEREAS, in May, 2014 the PHT approved an AOA for the period of June 1, 2014 to May 31, 2015; and WHEREAS, in May, 2014, the PHT also approved an agreement with the University for Solid Organ Transplant Professional Services (the MTI Agreement ) which contained an initial four (4) year term beginning on June 1, 2014 and ending on May 31, 2018; and Agenda Item 3 (b) Trust/Medical Schools AOA Negotiating Committee
May 19, 2015 -Page 2- WHEREAS, the MTI Agreement requires that the amount to be paid by the PHT during any year of the agreement (any June 1 to May 31 of the following year) be subject to at all times an annual cap; and WHEREAS, the MTI Agreement approved in May, 2014 had an annual cap of $4,500,000.00 for the year ending May 31, 2015; and WHEREAS, the 2015-2016 AOA contemplates an annual base amount of $127,844,392.00, subject to increase or decrease as provided in the Agreement, which amount includes a $1.1 million dollar increase in the annual cap for the transplant program for the year ending May 31, 2016; and WHEREAS, the 2015-2016 AOA also contains other new items, such as those delineated in the attached Memorandum; and WHEREAS, to continue to promote the continuity and quality of care delivered to its patients, the 2015-2016 AOA provides for the extension of the exclusivity clause related to Trauma Services through May 31, 2018, and the extension of the exclusivity clause related to Pediatrics and Obstetrics, through May 31, 2018, provided there is continued mutual agreement on continued program support; and WHEREAS, both the 2015-2016 AOA and the MTI Agreement contemplate that during the terms of the respective agreements, the PHT may determine that it is in the best interests of the PHT to adjust, via expansion or reduction, the level of support paid by the PHT to the University pursuant to these Agreements and that any such adjustment shall take the form of a written amendment to be executed by President and Chief Executive Officer of the PHT, or his designee; and WHEREAS, the attached 2015-2016 Annual Operating Agreement has been reviewed by the Trust/Medical Schools AOA Negotiating Committee, which recommends approval. Agenda Item 3 (b) Trust/Medical Schools AOA Negotiating Committee May 19, 2015
-Page 3- NOW, THEREFORE, BE IT RESOLVED BY THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby approves the 2015-2016 Annual Operating Agreement and authorizes the President and Chief Executive Officer, or his designee, to enter into and execute such agreement on behalf of the Public Health Trust and to execute an Amendment to the Agreement for Solid Organ Transplant Professional Services; and further the President and Chief Executive Officer, or his designee, is authorized to exercise any amendment, revision, modification, extension, termination or cancellation clauses provided within either the 2015-2016 Annual Operating Agreement or the Agreement for Solid Organ Transplant Professional Services between the Public Health Trust and the University of Miami.
4. Adjournment