HARRIS COUNTY HOSPITAL DISTRICT MINUTES OF THE BOARD OF MANAGERS MEETING

Transcription

1 HARRIS COUNTY HOSPITAL DISTRICT MINUTES OF THE BOARD OF MANAGERS MEETING Thursday, Board Room Administration Building BOARD MEMBERS PRESENT BOARD MEMBERS ABSENT Mr. Stephen DonCarlos, Chair (9:27 a.m.) Dr. George Santos Ms. Carolyn Truesdell, Vice Chair Mr. E. Dale Wortham, Secretary Dr. Atul Varadhachary Mr. Elvin Franklin, Jr. Ms. Mary Spinks (left at 12:45 p.m.) Ms. Daisy Stiner OTHERS PRESENT Mr. David Lopez, President & Chief Executive Officer Mr. George Masi, Chief Operating Officer Mr. Kelly Johnson, Harris County Purchasing Agent Ms. Vivian Groce, Harris County Assistant Purchasing Agent Attorney Mercedes Leal, County Attorney s Office Ms. Peggy Boice, Judge Ed Emmett s Office (9:21 a.m.) Mr. Mark Fury, Commissioner Steve Radack s Office (10:15 a.m.) Ms. Gloria Moreno, Commissioner Sylvia Garcia s Office (9:10 a.m.) Ms. Elizabeth Neal, Commissioner Jerry Eversole s Office (9:18 a.m.) Administrative Staff Guests (Sign-in Sheets attached to permanent record) I. Call to Order and Record of Attendance Ms. Carolyn Truesdell, Vice-Chair, called the meeting to order at 9:04 a.m. and noted that a quorum was present. The attendance was recorded. II. Approval of Minutes of Previous Meetings Motion Moved by Mr. Wortham, seconded by Ms. Spinks, and unanimously passed, that the Board approve the minutes of the April 29, 2010 Board of Managers meeting.

2 Page 2 of 14 III. Special Recognition The Board recognized Ms. Erika Harrison and Ms. Gayle McGlory for achievements in nursing. IV. Hear from Citizens No citizens signed up to speak. V. Executive Session VI. VII. Agenda Item IX.D was addressed out of order Agenda Items VII and VIII were addressed out of order. At 10:04 a.m., Ms. Truesdell stated that the Board would go into Executive Session under Chapter 551 of the Texas Government Code Section 074. Mr. DonCarlos stated that the regular meeting of the Board would reconvene at the close of Executive Session. Reconvene At 11:32 a.m., Mr. DonCarlos reconvened the meeting and stated that no action was taken in Executive Session. Discussion of the President/CEO s Evaluation pursuant to Tex. Gov t Code Ann and Possible Action regarding this Matter upon Return to Open Session Consideration of Approval of Recommendations and Acceptance of Agenda Items Identified as Consent Agenda Items Agenda item VII.G was pulled from the agenda. Motion Moved by Mr. Wortham, seconded by Ms. Spinks, and unanimously passed, that the Board approve items VII.A VII.F and VII.H VII.Y. Mr. Mark Ledman reviewed a minor change to agenda item VII.V. A. Items related to Purchasing A(1). Consideration of Purchasing Recommendations Requiring Board Approval: a. award on the basis of highest overall evaluation and authorize negotiations for Wilson Architectural Group to provide design of the Data Centers for the Holly Hall Ambulatory Specialty Clinic and Ben Taub General Hospital (If the Hospital District and Wilson Architectural Group are unable to agree on a fair and reasonable price then the Hospital District, at its sole discretion, may discontinue negotiations and proceed to negotiate with the next ranking offeror). b. approve the corrected term for Press Ganey Associates, Inc. for patient satisfaction and HCAHPS surveys, employee surveys, and physician surveys in the estimated amount of $573,473 for the corrected term of March 1, 2010 through February 28, 2011 (term as approved March 29, 2010 through March 28, 2011).

3 Page 3 of 14 c. award on the basis of best proposal meeting requirements for Milam & Co. Painting, Inc. (primary) in the estimated amount of $574,600 and Teko Contractors (secondary) in the estimated amount of $0 for paint and sheetrock maintenance services for a one year initial term with four one-year renewal options. d. award on the basis of low bid for C.F. McDonald Electric, Inc. to provide a new emergency power generator at Lyndon B. Johnson General Hospital in the amount of $1,818,669. e. approve renewal on the basis of sole source for Immucor Gamma for traditional blood bank reagents in the estimated amount of $122,360 for the term August 1, 2010 through July 31, f. approve funding for OfficeMax (PP-MM-013) for office supplies and paper products in the estimated amount of $1,743,997 for the term August 1, 2010 through May 31, g. award for The University of Texas Health Science Center at Houston to provide a faculty member, licensed in nursing, to develop and implement career coaching and custom educational programs for Hospital District nurses in the amount of $26,903 for the term March 1, 2010 through August 31, h. approve purchase on the basis of low quote for DIR through MDL Enterprise, Inc. for Hewlett Packard Server Hardware in the amount of $394,500. i. approve the guaranteed maximum price for Skanska USA Building Inc. to provide construction of the Lyndon B. Johnson General Hospital Westland Specialty Clinic Parking Garage and Site Work in the amount of $8,283,383 (construction price - $8,160,383; owner contingency - $123,000). j. approve extension for Gulf Coast Cancer & Diagnostic Southeast and St. Joseph Medical Center for imaging services for the extended term of June 1, 2010 through August 31, 2010 (Board previously approved funds in the amount of $3,000,000 for the term March 1, 2009 through February 28, 2010 and $100,000 for the term March 1, 2010 through May 31, 2010). k. ratify purchase on the basis of low quote for DIR through Business Security Solution, Inc. for maintenance and support of Pointsec Products in the amount of $100,725 for the term April 12, 2010 through April 11, l. approve corrected term for AstraZeneca LP/AstraZeneca Pharmaceutical LP for outpatient pharmaceutical products (proton pump inhibitors) in the estimated amount of $858,427 for the corrected term of March 1, 2010 through June 30, 2010 (term as approved March 1, 2010 through February 28, 2011).

4 Page 4 of 14 m. approve exemption from competitive bid requirements and renewal for The Methodist Hospital for specialized health services in the estimated amount of $460,000 for the term July 1, 2010 through June 30, n. approve the first of two renewal options for KGriff Investigations, Inc. for pre and post-employment background screenings in the estimated amount of $174,500 for the term August 15, 2010 through August 14, o. approve additional funds and an extension for Sodexho Services of Texas Limited Partnership for housekeeping services in the additional amount of $2,867,324 for the extended term July 1, 2010 through September 30, 2010 (Board previously approved funds in the amount of $11,719,445 for the term July 1, 2009 through June 30, 2010). p. rescind award for Dir through Set Solutions, Inc. (DIR-SDD-960) for maintenance and support of Pointsec Products in the amount of $100,793 for the term April 12, 2010 through April 11, q. approve renewal on the basis of sole source for Alert Logic, Inc. for maintenance of Threat Management and Active Watch Software in the estimated amount of $228,000 for the term June 1, 2010 through May 31, r. approve award for Texas Health and Human Services Commission (HHSC) for automation of equipment and software for outstationed eligibility staff ($0) effective upon execution of agreement until terminated. s. approve additional funds for Language Line Services, Inc. for language interpretation services (telephonic) in the estimated additional amount of $175,000 for the term August 1, 2009 through July 31, 2010 (Board previously approved funds in the amount of $205,000 for the term August 1, 2009 through July 31, 2010). t. approve purchase on the basis of low quote for DIR through Digital Intelligence Systems Corporation for Cisco equipment in the amount of $431,274. u. approve as an exception to the Hospital District Purchasing Manual requirements award for The American National Red Cross for blood products and components in the additional amount of $50,202 for the term March 1, 2009 through February 28, 2010 (Board previously approved funds in the amount of $1,225,000 for the term March 1, 2009 through February 28, 2010). v. approve purchase on the basis of low quote for GSA through Barcodes LLC for Topaz ClipGem Electronic Signature Pads in the amount of $108,760. w. ratify additional funds and an extension for Matheson Tri-Gas, Inc. for bulk liquid oxygen, tanks and various gases in the additional amount of $257,000 for the extended term December 1, 2009 through September 30, 2010

5 Page 5 of 14 (Board previously approved funds in the amount of $248,000 for the term December 1, 2008 through November 30, 2009). A (2). Transmittals of Completed Items (For Informational Purposes) a. transmittal of award on the basis of best proposal meeting requirements for Corporate Move Consulting, Inc. for moving/relocation consulting services in the amount of $45,013. b. transmittal of exemption from the competitive bid requirements for Methodist Radiology Associates, PLLC for physician interpretations of radiology images in the estimated amount of $75,000 for the term February 1, 2010 through February 1, c. transmittal of exemption from the competitive bid requirements and the first of two renewal options for Baylor College of Medicine for physician services at employee health clinics in the estimated amount of $68,000 for the term May 15, 2010 through May 14, d. transmittal of purchase on the basis of lowest priced contract with Medline Industries, Inc. for OR basins and laceration trays in the estimated amount of $67,302 for the term May 1, 2010 through April 30, e. transmittal of exemption from the competitive bid requirements and the first of two renewal options for Baylor College of Medicine for medical director for Riverside Dialysis Center in the estimated amount of $60,000 for the term June 1, 2010 through May 31, f. transmittal of additional funds for DMS Imaging, Inc. for mobile medical imaging systems contingency support in the additional amount of $51,000 for the term January 26, 2010 through January 25, 2011 (Board previously approved funds in the amount of $300,000 for the term January 26, 2010 through January 25, 2011). g. transmittal of purchase on the basis of low quote for DIR through Set Solutions, Inc. for network protocol analyzer hardware in the amount of $85,028. h. transmittal of award on the basis of best proposal meeting requirements for Rosetta Stone Ltd. for web-based foreign language learning system in the amount of $68,563 (625 licenses) for the term February 1, 2010 through January 31, 2011 with four one-year renewal options. i. transmittal of purchase on the basis of low quote for DIR through Mark III Systems Incorporated (DIR-SDD-952) for IBM hardware in the amount of $52,710. B. Approval of the Addition of the University of Texas M.D. Anderson Cancer Center IRB to the Harris County Hospital District s Institutional Assurances of Protection of Human Subjects with the U.S. Department of Health & Human Services Office of Human Research Protections.

6 Page 6 of 14 C. Approval of a Memorandum of Understanding between the Harris County Hospital District and The University of Texas M.D. Anderson Cancer Center regarding Review and Approval of Research by the University of Texas M.D. Anderson Cancer Center s Institutional Review Board. D. Approval of Harris County Hospital District s final affiliate indirect cost rate of 26.4% and independent indirect cost rate of 37.7% for the period 3/1/08 to 2/28/10 and affiliate indirect cost rate of 24% and independent indirect cost rate of 34% for the period 3/1/10 to 3/01/14 or until amended, and approve the execution of an agreement for these negotiated rates with the Department of Health & Human Services. E. Approval of the 2010 Medical Staff Bylaws Changes. F. Acceptance of the Revised Pediatric Gastroenterology Privileges. G. WITHDRAWN. Approval of the Conversion of the Harris County Hospital District Senior Lien Refunding Revenue Bonds, Series 2007B, from Taxable Mode to Tax-Exempt Mode. H. Approval of a Memorandum of Understanding between the Harris County Hospital District and the City of Houston, Texas to use a city indoor swimming pool to provide aquatic therapy for eligible HCHD patients in the not-toexceed amount of $ for the term June 1, 2010 through May 31, I. Approval to amend a contract award of $567,458 between the Harris County Hospital District and the Department of State Health Services for the MCH Prenatal Services for FY 2010 in the decreased amount of $467,458 for the term September 1, 2009 through August 31, J. Ratification of an amended agreement between the Harris County Hospital District and Texas Department of State Health Services to provide an HIV Perinatal Transmission Prevention Program for Hospital Labor & Delivery Units throughout Texas in the amount of $20,000 (this increases the original agreement amount of $140,000 to $160,000) for the term January 1, 2010 through December 31, K. Ratification of an amended agreement between the Harris County Hospital District and Harris County funded under Ryan White Modernization Act part A to provide primary medical care and medical case management services to eligible HIV-positive individuals in the amount of $3,222,575 (this increases the original agreement amount of $3,034,638 to $6,257,213) for the term March 1, 2010 through February 28, L. Approval of an agreement between the Harris County Hospital District and the City of Houston on behalf of its Department of Health and Human Services funded under the Centers for Disease Control and Prevention to provide HIV routine screening at District facilities in the amount of $106,898 from the date of full execution through December 31, 2010.

7 Page 7 of 14 M. Approval of an agreement between the Harris County Hospital District and the Dallas County Hospital District, The Parkland Foundation for Texas/ Oklahoma AIDS Education and Training Center funded under Ryan White Modernization Act Part F to provide state of the art education and treatment, training and consultation and support to healthcare professionals treating HIVpositive patients in the amount of $94,145 for the term July 1, 2010 through June 30, N. Approval of an agreement between the Harris County Hospital District and Baylor College of Medicine to provide medical education director services funded under Ryan White Modernization Act Part F to the AIDS Education Training Centers local performing site in the amount of $15,000 for the term July 1, 2010 through June 30, O. Ratification of a supplemental grant award from the City of Houston on behalf of its Department of Health and Human Services to the Harris County Hospital District funded under the Texas Department of State and Health Services to provide routine HIV expanded testing at District facilities in the amount of $500,000 for the term March 1, 2010 through August 31, P. Ratification of an amended agreement between the Harris County Hospital District and Baylor College of Medicine, to provide HIV perinatal transmission program education, training, consultation and evaluation services funded by the Texas Department of State Health Services to selected hospital labor & delivery units throughout Harris County in the amount of $20,000 (this increases the original agreement amount of $35,832 to $55,832) for the term January 1, 2010 through December 31, Q. Rescission of an agreement between the Harris County Hospital District and the City of Houston on behalf of its Department of Health and Human Services, BOM #10.3-4C, funded under the Texas Department of State Health Services to provide routine HIV expanded testing at District facilities in the amount of $500,000 from the date of countersignature through September 29, R. Approval of correction of a ratified agreement between the Harris County Hospital District and The Resource Group Inc., to provide primary medical care to eligible HIV-infected adolescents at District facilities funded by Ryan White Part D Modernization Act in the amount of $140,904 (BOM # A.2.C) to $141,658 for the term August 1, 2009 through July 31, S. Approval of Amendment No. 3 for Additional Services and to Expand the Current Scope of Services for the Existing Architectural/Engineering Agreement between the Harris County Hospital District and Brown, Penland, McGregor Architects, Inc. for the LBJ Emergency Center Expansion and Renovation Project in the amount of $189,650.

8 Page 8 of 14 T. Award of Contract to Centimark Corporation for the Thomas Street Clinic Roof Replacement Project in the amount of $249, (quote - $227,175, owner s contingency - $22,717.50). U. Approval of appointment of Mr. Michael Norby to the Harris County Hospital District Pension & Disability Committee. V. Acceptance of the Harris County Auditor s Hospital District Departmental Receiving Controls Report. W. Review, Discussion and Possible Action regarding the Harris County Hospital District (HCHD) Performance Improvement Plan X. Review, Discussion and Possible Action regarding the Harris County Hospital District (HCHD) Patient Safety Plan Y. Acceptance of the Harris County Hospital District (HCHD) Annual Report on Performance Improvement VIII. Reports of the Committees A. Joint Conference Committee Dr. Peter Doyle presented the credentialing changes for members of the HCHD medical staff for May. A copy of the report is available in the permanent record. 1. Motion Moved by Mr. Wortham, seconded by Ms. Spinks, and unanimously passed, that the Board approve the May credentialing changes for members of the HCHD Medical Staff. Dr. Peter Doyle presented the Medical Executive Board Report. He stated that the annual medical staff retreat will be held at the Marriott Medical Center on June 5, Ms. Truesdell addressed the report, which stated that the strategic plan would be brought to the medical staff for approval. Approval was changed to review and comment. A copy of the report is available in the permanent record. 2. Motion Moved by Mr. Wortham, seconded by Ms. Spinks, and unanimously passed, that the Board accept the Medical Executive Board Report as included in the packet. Dr. Peter Doyle presented the revised Obstetrics/Gynecology Service Privileges. 3. Motion Moved by Mr. Franklin, seconded by Ms. Stiner, and unanimously passed, that the Board accept the revised Obstetrics/Gynecology Service Privileges. B. Budget and Finance Committee Mr. Norby presented the April 2010 Financial Report. He stated that inpatient cases continue to go down. This is partially due to the shifting of inpatients to the outpatient setting. Discussion ensued. He noted that outpatient volume is up across the board. Salaries, wages, and benefits are higher for the month due to higher

9 Page 9 of 14 volume for the month. The bottom line is behind target for the month and year-todate. A copy of the report is available in the permanent record. 1. Motion Moved by Mr. Wortham, seconded by Mr. Franklin, and unanimously passed, that the Board accept the April 2010 Financial Report subject to audit. Mr. Norby presented the April 2010 Pension Plan Report. The plan is 84.2% funded as of the end of April. A copy of the report is available in the permanent record. 2. Motion Moved by Mr. Wortham, seconded by Ms. Spinks, and unanimously passed, that the Board accept the April 2010 Pension Plan Report subject to audit. 3. Presentation of the April 2010 Financial Statements of Community Health Choice, Inc. Mr. Ken Janda presented the April 2010 CHC Financial Report. He stated that CHC had another loss for the month of April. They are directionally improving, but this is still unacceptable. He stated that staff will continue to analyze this very closely. He referred to page 12 of the report, stating that this page was added to show specifics regarding where the losses were coming from (higher than expected medical claims). There has been a big spike for the cost of inpatient newborn care. Discussion ensued. Ms. Spinks asked if anything was being done to make sure babies are born healthier such as making prenatal care more intense. Mr. Janda stated that they are working on this very closely. A copy of the report is available in the permanent record. C. Planning and Operations Committee Mr. Trenschel presented agenda item VII.C.1 (entering into an agreement with the City of Houston/Harris County Area on Aging to provide selected dental services at Harris County Hospital District clinical sites). It was stated that the eight sites will be Acres, Aldine, El Franco Lee, Gulfgate, Peoples, Settegast, Strawberry, and the Dental Center. 1. Motion Moved by Dr. Varadhachary, seconded by Mr. Wortham, and unanimously passed, that the Board approve entering into an agreement with the City of Houston/Harris County Area Agency on Aging (HCAAA) to provide selected dental services for members of HCAAA at Harris County Hospital District clinical sites funded by the City of Houston/Harris County Area Agency on Aging in the not-to-exceed amount of $1,400, Motion Moved by Mr. Wortham, seconded by Ms. Spinks, and unanimously passed, that the Board approve the appointment for Michael Norby to the Harris County Hospital District 401K/457 (b) Administrative Committee.

10 Page 10 of 14 D. Performance Improvement & Patient Safety Committee Review, Discussion and Possible Action Regarding the Harris County Hospital District (HCHD) 2009 Infection Control Annual Report Ms. Truesdell addressed the 2009 Infection Control Report. Mr. Charles Schubert presented the highlights of the report. He noted that the benchmarks are not at zero, but do continue to trend downwards. He addressed central line associated infections, stating that they have continued to trend downward since July. There has been an approximate 25%-29% reduction over the previous year. Ventilator associated pneumonia was not monitored prior to 2008, but has been monitored since then. A ventilator committee has been formed to address issues in this area. Discussion ensued. Mr. Wortham addressed page 8 of the report, which stated that contractors are educated regarding infection prevention practices prior to starting a project. He asked if the District knew whether the contractor was actually relaying this information to those doing the project. Mr. Schubert stated yes, and noted that daily construction rounds are done for high level projects. Any ongoing issues require an action plan to be submitted. The program policy states that a project can be shut down if an issue becomes a constant problem. Mr. DonCarlos asked that the Board receive this report more than annually. He asked that the report be brought back in 6 months. The Infection Control Report will be scheduled for presentation at the October 2010 Board of Managers meeting. A copy of the report is available in the permanent record. Motion Moved by Mr. Wortham, seconded by Ms. Stiner, and unanimously passed, that the Board accept the Harris County Hospital District 2009 Infection Control Annual Report. E. Strategic Planning Committee Dr. Varadhachary addressed the Harris County Hospital District Strategic Plan, thanking Mr. Masi and Mr. Freitag for all of their effort over the past few months. The presented document did come up for discussion at the May 13, 2010 committee meeting. Mr. Masi addressed the plan, which shows the number of beds at 580 for Ben Taub and 258 for LBJ. These numbers will be amended for the planned and future state with the Board s approval for moving to semi-private configurations. The total approximate number of hospital acute care beds would be 670. Discussion ensued. Ms. Truesdell asked if this could be included on a footnote for each of the numbers. Mr. Masi stated that this could be added as an amendment prior to presentation at Commissioner s Court. Mr. Lopez stated that the plan will be revisited annually at a minimum to make sure they are still on target and focused on the right areas. A copy of the report is available in the permanent record. Motion Moved by Ms. Spinks, seconded by Ms. Stiner, and unanimously passed, that the Board approve the Strategic Plan for the Harris County Hospital District

11 Page 11 of 14 F. Legislative Committee Mr. Hillier presented the Legislative Committee Report. He stated that those on the state level continue to look at the impact of implementation of healthcare reform. State deficits of $18-$20 billion are also being addressed. He noted that one positive issue is the decision not to close down approximately 250 state hospital psychiatric beds. Ms. Schneider noted that there is hesitancy on both sides at the federal level to do anything that would impact the outcome of the elections in November. 1. Update, discussion and possible action regarding activities in Austin relating to regulatory issues impacting HCHD, the 81 st Legislative Session and the HCHD legislative platform 2. Update, discussion and possible action regarding pending federal legislative, line items and policy issues affecting HCHD IX. Miscellaneous Agenda Items A. Motion Moved by Mr. Franklin, seconded by Ms. Truesdell, and unanimously passed, that the Board ratify the acceptance of an additional award of $20,000 for a total award of $198,750 to the Harris County Hospital District from the Department of State Health Services for Breast and Cervical Cancer Services (BCCS) for FY for the term July 1, 2009 through June 30, B. Motion Moved by Ms. Truesdell, seconded by Mr. Franklin, and unanimously passed, that the Board approve the revised Harris County Hospital District Patient Complaint/Grievance Policy #4200 to establish effective mechanism for the reporting, prompt management, and resolution of patient complaints and grievances when the patient s expectations of care and services are not met effective May 27, C. Motion Moved by Mr. Franklin, seconded by Ms. Spinks, and unanimously passed, that the Board approve the policy to establish guidelines for employee wellness activities for Harris County Hospital District employees. D. Report on Tangible Donations to the Harris County Hospital District Foundation Mr. H. Ben Taub presented the report on tangible donations to the Harris County Hospital District Foundation. He introduced Ms. Lacey Webster and Ms. Emily Catherine Jeter, Foundation staff responsible for managing this program. Total tangible gifting in FY10 was approximately $1.974 million ($125,000 in durable medical equipment/supplies, $13,000 in facilities enhancements, $15,000 in patient amenities/hygiene items, $30,000 in patient comfort items, $1.7 million in patient incentives, and $28,000 in miscellaneous donations).

12 Page 12 of 14 X. President/Chief Executive Officer s Report to Include: 1) Staff Wellness Report; 2) Health Care Heroes Nominations; and 3) Health Reform Strategies in 2010 XI. Staff Wellness Report Mr. Lopez addressed employee wellness, stating that the organization must be able to keep medical costs down for staff. Much review has shown that less than 20% of staff account for the majority of expenses. The organization is self-insured and has challenged staff to try and improve the wellness component of who we are. Dr. Hilliard gave a presentation on staff wellness. She introduced Ms. Michelle Galindo, Ms. Jennifer Roberts, and Ms. Bianca Lopez, all have been essential to the success achieved so far. She presented a graph showing the groups of employees who have taken the heath assessment. The employees were grouped by risk categories. The goal is to grow the moderate risk group. The self-insured health care costs by fiscal year was presented and discussed. The number of employees with a risk level for lifestyle related claims was presented for two years. A summary of employee wellness physical activity programs was presented. Discussion ensued. A copy of the report is available in the permanent record. Health Care Heroes Nominations Mr. Lopez stated that the District is very privileged to have three of its staff members nominated for health care heroes by the Houston Business Journal. The three individuals nominated at an event held last week were Mr. Neal Kachalia (Director-Laboratory Services), Ms. Beth Cloyd (CNE), and Dr. Shkelzen Hoxhaj (Chief BTGH Emergency Medicine). He thanked all three individuals for their work and dedication. Health Reform Strategies in 2010 Mr. Lopez gave a presentation on health reform strategies in Health care reform must be addressed now or the District will not be ready when it occurs. There are some things that the District is aware of such as reductions in Medicare. The District does not have a lot of Medicare, but this will impact the bottom line. They have started to look at costs and service, and are reviewing readmission rates (30-60 days post discharge) very carefully. Areas of opportunity will be identified when studying readmission rates in all areas. The organization is not within the standard they need to be at the current time. Administration will need to engage with the medical staff more as bundle payments will be coming soon. Staff needs to start studying and identifying what they want to accomplish by having an Accountable Care Organization (ACO). Executive Session At 12:04 p.m., Mr. DonCarlos stated that the Board would go into Executive Session under Section of the Texas Health & Safety Code and Section of the Tex. Occupations Code and Chapter 551 of the Texas Government Code Section 071. Mr. DonCarlos stated that the regular meeting of the Board would reconvene at the close of Executive Session. Ms. Spinks left prior to reconvening from Executive Session.

13 Page 13 of 14 XII. Reconvene At 1:06 p.m., Mr. DonCarlos reconvened the meeting and stated that no action was taken in Executive Session. A. Report by the Chief Medical Officer regarding Quality of Medical and Health Care, pursuant to Tex. Health & Safety Code Ann and Tex. Occupations Code Ann to Receive Peer Review and/or Medical Committee Report in Connection with the Evaluation of the Quality of Medical and Health Care Services. No action taken. B. Report by Senior Vice President of Corporate Compliance regarding compliance with Medicare, Medicaid, HIPAA and other Federal and State Health Care Program Requirements and a Status of Fraud and Abuse Investigations, pursuant to Section of the Texas Health & Safety Code. No action taken. C. Consultation with the County Attorney regarding Cause No ; Harris County Hospital District v. Southwestern Bell Telephone Company d/b/a AT&T Texas, 333 rd Judicial District Court of Harris County, Texas, and Amending Board Motion No , pursuant to Tex. Gov t Code Ann and Possible Action regarding this Matter upon Return to Open Session. Motion Moved by Ms. Truesdell, seconded by Mr. Franklin, and unanimously passed, that the Board approve the amendment of Motion No to read: The Harris County Hospital District, by and through its Board of Managers, approves and authorizes the dismissal of Harris County Hospital District s claims in Marketing On Hold, inc., et al v. Jefferson, et al, in the U.S. District Court for the Western District of Texas, and the filing of a separate action to recover payments made by Harris County Hospital District to its telephone service provider for unauthorized municipal charges from 1991 to The Board of Managers further authorizes the County Attorney, and special counsel Thomas R. Bray, Edward J. Hennessy and J. Marcus Hill, to take such actions as they deem necessary on behalf of the District, pursuant to the terms of an Agreement for Special Counsel to represent the Harris County Hospital District dated March 25 th, 2010 and accepted by the County Attorney. The Board of Managers further authorizes David S. Lopez, President/CEO, to execute any agreement, or other necessary documents to effect these actions. D. Consultation with the County Attorney on a Claim filed by Jacqueline Smith, pursuant to Tex. Gov t Code Ann and Possible Action regarding this Matter upon Return to Open Session. No action taken. E. Consultation with the County Attorney regarding the Texas Public Hospitals for Medicaid Graduate Medical Education Coalition Reimbursement Initiative and Work

14 Page 14 of 14 Plan pursuant to Tex. Gov t Code Ann and Possible Action regarding this Matter upon Return to Open Session. No action taken. F. Consultation with the County Attorney regarding a Negotiated Settlement Agreement regarding EEOC Charge Number filed by Aurora Montecelo, pursuant to Tex. Gov t Code Ann and Possible Action regarding this Matter upon Return to Open Session. Motion Moved by Ms. Truesdell, seconded by Ms. Stiner, and unanimously passed, that the Board approve the following resolution: The Harris County Hospital District, by and through its Board of Managers, approves the settlement of EEOC Charge Number filed by Aurora Montecelo, and authorizes the President/CEO on behalf of the District to execute any necessary documents to effect this settlement. XIII. Adjournment Moved by Ms. Stiner, seconded by Dr. Varadhachary, and unanimously accepted to adjourn the meeting. There being no further business, the meeting adjourned at 1:07 p.m. I certify that the foregoing are the Minutes of the Meeting of the Board of Managers of the Harris County Hospital District held at the Administration Building in Houston, Texas on. Mr. Stephen DonCarlos, Chair Board of Managers Mr. E. Dale Wortham, Secretary Recorded by Christie Reno