SPECIAL BOARD MEETING STRATEGIC PLANNING WORKSHOP

AGENDA

WEDNESDAY, SEPTEMBER 30, 2015 PALOMAR MEDICAL CENTER 5:30 p.m. Buffet dinner for board members & invited guests RAYMOND FAMILY CONFERENCE CENTER 6:00 p.m. Meeting 2185 CITRACADO PARKWAY ESCONDIDO, CA 92029

- PLEASE TURN OFF CELL PHONES OR SET THEM TO SILENT MODE UPON ENTERING -

Form A Time Page Target

I. CALL TO ORDER…………………………………...………………………………………………….. 6:00

II. OPENING CEREMONY

A. Pledge of Allegiance ………………………………………………………………………………… …..3 6:03

III. PUBLIC COMMENTS1………………….………………….……..……………………………………. ....15 6:18

IV. INFORMATION ITEMS……………………….………………………………………………………... …5 6:23

V. * REVIEW / APPROVAL…………………………………………………………………………….

A. * Presentation of the Strategic Plan and Balanced Scorecard Metrics (ADD A-Pp3-42)…….. .…70 ...... 1 7:33

B. * Arch Health Partners: Board of Directors (ADD B-Pp43-49)..……………………………..… ….15 …..2 7:48

VI. PUBLIC COMMENTS1..…………………………………………..……………………………………. ….15 8:03

VII. ADJOURNMENT ……………………………………………………………………………………….. 8:04

NOTE: If you have a disability, please notify us by calling 760-740-6375 72 hours prior to the event so that we may provide reasonable accommodations

______ Asterisks indicate anticipated action. Action is not limited to those designated items.

1 5 minutes allowed per speaker with a cumulative total of 15 minutes per group. For further details & policy, see Request for Public Comment notices available in meeting room.

Presentation of the Strategic Plan and Balanced Scorecard Metrics

TO: Special Board Meeting - Strategic Planning Workshop

MEETING DATE: Wednesday, September 30, 2015

FROM: Della K. Shaw, EVP Strategy

Background: Presentation will include the updated Strategic Plan as well as a high level introduction to the new Balanced Scorecard. Since the regular meeting of the Board Strategy and Facilities Committee was cancelled earlier in September, Della Shaw and Bob Hemker met with Board Chair, Linda Greer, and Strategy and Facilities Committee Chair, Ray McCune, to review the strategic plan earlier in September. Based on their initial review and recommendation, we are now presenting to the special Board Workshop.

Budget Impact: N/A

Staff Recommendation: Board Approval

Committee Questions:

COMMITTEE RECOMMENDATION:

Motion:

Individual Action:

Information:

Required Time:

1

New Arch Board Members

TO: Special Board Meeting – Strategic Planning Workshop

MEETING DATE: Wednesday, September 30, 2015

FROM: Deanna Kyrimis, CEO, Arch Health Partners

Background: Ratification of new Arch Board of Director members.

Budget Impact: Zero

Staff Recommendation: Ratify Arch Board of Directors’ new members

Committee Questions:

COMMITTEE RECOMMENDATION:

Motion: X

Individual Action:

Information:

Required Time:

Form A New Arch Board Members.doc 2

ADDENDUM A

3 Palomar Health

Board of Directors Strategic Planning Update September 14, 2015

4 1 Mission - Why we exist

Values - What we believe in and how we behave

Vision - What we want to be

Strategy – Our competitive game plan

5 2 PALOMAR HEALTH

MISSION To heal, comfort, and promote health in the communities we serve. VALUES We passionately give and support heartfelt care that Patients’ Well-Being: encourages patient comfort and safety. Each of us takes pride in teamwork, self-discipline, our Professionalism: skills and trustworthiness. We are each accountable for providing the safest, most Highest Quality: effective and innovative care.

VISION Palomar will be the health system of choice for patients, physicians, and employees, recognized nationally for the highest quality of clinical care and access to comprehensive services.

STRATEGY Palomar Health will be recognized as the dominant provider of integrated health services as measured by market position and valued-based metrics of care. 6 3 Mission - Why we exist

Values - What we believe in and how we behave

Vision - What we want to be

Strategy – Our competitive game plan

Strategy Map - Translates our game plan (strategy)

Targets and Initiatives - What we will do

Balanced Scorecard - How we monitor success

7 4 TRIPLE AIM

INSTITUTE FOR HEALTHCARE IMPROVEMENT

• Improving the patient experience of care • Improving the health of populations • Reducing the per capita cost of care

8 JOURNEY TO THE SECOND CURVE

Volume to Value

Fee-for-Service reimbursement VALUE VALUE-BASED SECOND CURVE Value High quality not rewarded

Payment rewards population No shared financial risk value - quality and efficient

Acute inpatient hospital focus Quality impacts reimbursement

IT investment incentives not seen LIVING IN Partnerships with shared risk by hospital THE GAP Stand-alone care Systems can Increased patient severity thrive

Regulatory actions impede IT utilization essential for hospital-physician collaboration population health management

Scale increases in importance Value Realigned incentives, VOLUME9 VOLUME-BASED FIRST CURVE encouraged coordination Strategic Planning Timeline

Q3 FY15 Q4 FY15 Q1 FY16

) )

AND ETRIC

AP

IDE AY AR M M 26 LOSURE | FY16 | FY16 USPENDED

UGUST -W S -M -M AY -A UDGET OUNCIL PR PPROVAL AN B SWOTS SWOTS ALANCED M C J A ANAGEMENT YSTEM B A ULY RESENTATION TRATEGY S J P LANNING M S LANNING PHDC C (P CORECARD P D EVELOPMENT S

10 UNE 8 J 9- – AY

AR M LANNING LANNING AY TRATEGIC TRATEGIC ALANCED EADERSHIP EADERSHIP CORECARD S P S P M EVELOPMENT B L L M S D

10 7 Palomar Health will be recognized as the dominant Strategy provider of integrated health services as measured by market position and value based metrics of care.

Mission Sustaining Financial Performance

Customer Value

Outcomes Outcomes Quality | Cost | Experience| Brand

Operational Excellence Clinical Integration | Efficiency and Effectiveness

Process Process Hassel Free Experience | Consumerism

Organizational Capabilities World-class Workforce | Technology People People Patient First Culture 11 8 Outcomes & Targets

Mission Sustaining Financial Performance Profitable operations that enable Palomar Health to fulfill its mission to heal, comfort, and promote health in the communities we serve

Customer Value Deliver differentiated and sustainable value to patients and their families, physicians, payers, donors, and community

Quality Cost Experience Brand Utilize evidence-based High quality outcomes Create and transform the Create trust and loyalty practices to improve delivered efficiently and care experience with a through delivering quality and patient effectively ‘patent first’ focus. dependable, consistent safety. customer value.

12 9 Customer Value Quality | Cost | Experience| Brand

Palomar Health Customers

Patients and Families Physicians Payers Donors Community

13 10 Customer Value Quality | Cost | Experience| Brand

Palomar’s Value Proposition (Differentiation)

Best Total Cost Complete Customer Solution Palomar Health will offer Palomar Health Customers will

• excellent and consistent • feel understood, quality, • be provided products and • attractive prices, services that meet their needs • short lead times (access (when, where and how they and results), want it), and • ease of purchase (‘Hassle • experience completeness of Free Experience’ ), and health solutions, exceptional • good selection / choices. service - before and after care, and quality of our customer relationships.

14 11 Operational Excellence Clinical Integration | Efficiency and Effectiveness Hassel Free Experience | Consumerism

Operational Excellence Creates Customer Value

Translates to . . .

• Clinical Integration • Staff and physician effectiveness and efficiency • Hassle-free environment • Patient access where, when and how the patients want it

15 12 Organizational Capabilities World-class Workforce

Organizational Capabilities Lead to Operational Excellence

Employee & Physician Selection for Organizational Fit

Employee & Employee & Physician Physician Succession Development World-class Planning Work Place

Employee & Collaborative, Physician Performance effective teams Evaluation

Employee & Physician Reward and Recognition

16 13 Organizational Capabilities Informational Capital

Organizational Capabilities Lead to Operational Excellence

Technology supports best-practice evidence-based clinical care across the continuum

Enable IT connectivity and bi-directional information sharing between hospital and community providers

Interoperability platform that supports contiguous patient record at all points of care across the continuum

17 14 Patient First Culture

Organizational Capabilities Lead to Operational Excellence

Culture of Accountability, Aligned with Strategic Priorities, Lead to Operational Excellence and Create Customer Value

Patient First Culture

18 15 Putting it all together

• Current Strategic Goals

• FY14 – FY16 Strategic and Operational Initiatives

19 16 20 17 FY14-17 Strategic Initiative Alignment Current Strategic Initiatives Strategic Alignment

SI 1 Achieve and maintain • Mission Sustaining Financial Center of Excellence Performance (COE) status in • Customer Value orthopedics/spine, Quality rehabilitative care, Cost cardiac and Experience cardiovascular care, Brand neuroscience and • Operational Excellence women’s services. Clinical Integration Efficiency & Effectiveness Hassle Free Consumerism • World-class Workforce • Technology • Patient First Culture

21 18 FY14-17 Strategic Initiative Alignment

Current Strategic Initiatives Strategic Alignment SI 2 Become the dominant • Operational Excellence provider of primary care in Clinical Integration support of the total patient Consumerism health experience, Patient First Culture including the expansion and growth of Arch Health Partners, effective affiliations with local providers and development of a strong regional primary care network in the secondary markets.

22 19 FY14-17 Strategic Initiative Alignment

Current Strategic Initiatives Strategic Alignment SI 3 Develop a delivery model • Customer Value that supports care Quality coordination and Cost transitions across the Experience continuum, with emphasis Brand on chronic disease • Operational Excellence management, illness Clinical Integration prevention, and patient Efficiency & Effectiveness involvement. Hassle Free Consumerism • World-Class Workforce • Technology • Patient First Culture

23 20 FY14-17 Operational Initiative Alignment

Current Operational Initiatives Strategic Alignment OI 1 Build and operate a • Mission Sustaining Financial decision analytics structure Performance that supports the real time • Customer Value availability and Quality standardized use of Cost information and expertise Experience for knowledge Brand management and • Operational Excellence measurement of value- Clinical Integration based metrics of care. Efficiency & Effectiveness Hassle Free Experience • World-class Workforce • Technology

24 21 FY14-17 Operational Initiative Alignment

Current Operational Initiatives Strategic Alignment

OI 2 Create a positive • Customer Value experience for all key Quality stakeholders by improving Cost clinical and business Experience throughput and • Operational Excellence efficiency through all Efficiency & transitions of care. Effectiveness Hassle Free Consumerism

25 22 FY14-17 Operational Initiative Alignment

Current Operational Initiatives Strategic Alignment

OI 3 Develop and implement a • Customer Value strong physician Experience integration and alignment Brand model that allows for • Operational Excellence effective communication, Clinical Integration partnership and Hassle Free accountability in the • World-class Workforce management and care of • Technology patients. • Patient First Culture

26 23 Project Status Report Template

• For use by anyone leading a project or action plan • Replaces the “doughnut” status report! • Use wherever you use “doughnut” today • Simple Excel Template – Dashboard Update (traffic lighting) – Current status & risk recap – Optionally track tasks, action items, people involved, issues, etc.

27 24 FY15 Operational Initiative 1: Build and operate a decision analytics structure that supports the real time availability and standardized use of information and expertise for knowledge management and measurement of value based metrics of care.

July 14 Sept 14 Nov 14 Jan 15 Mar 15 May 15 June 15 1 2 3 4 5 6 6 6 Report Date: April 2015 Initiative Budget: To be included in FY15 Budget Reporting Committees: Board Quality Review Committee Budget Status: Executive Sponsors: Prudence August, Diane Hansen Initiative Status: Initiative Manager: Ryan Olson Physician Leader: Kolins, MD, Lee, MD, Hirsch, MD • Inventory of key reports and systems continues. Clinical inventory complete. Remaining systems and inventory Outcome Measure: Decision Support Structure in place, standardize the use of five reports from the EDW and VHA Imperative Advantage for Estimated Completion: May ongoing use and demonstrate results for a minimum of 3 quick win • Resources plan and oversight function for EDW and Truven projects tool kits in process Milestones: • Lab, Radiology & Cardiology Turn-Around-Time in progress; Operationalize the use of the Enterprise Data Warehouse (EDW) and ETC April VHA/Truven analytic tool kit • OR Efficiency Dashboard Report build in progress; ETC May 1. Create a summary of the present data analyst support for Palomar Health to include: • Create and implement education and communication plan in 1) Systems that analysts support, certifications, skills sets and any identified gaps; 2) process An inventory of our core IT systems (i.e.. Cerner, Lawson) with a brief summary of reporting functions; and 3) A listing of current reports available from source Initiative Risks: systems with a report evaluation process to avoid waste and duplication. 2. Create and implement a process and plan for resources including staff to create • Strong backlog of data needs in all areas reports, produce reports and provide analytic support. • Data analytics support resources 3. Create and implement an oversight function to assure the ongoing accuracy of the • Too broad of scope for the process data for the EDW and Truven tool kits. 4. In addition to Patient Flow and OR efficiency, the Decision Support User Groups will identify a minimum of 1-3 areas of opportunity . 5. Implement the use of at least five reports from the EDW and VHA/Truven for Outcome Measure: ongoing decision-making for clinical and operational improvement to include : • Threshold: Complete Milestones 1-3 patient population based dashboards and the conversion of physician/peer review • Target: Complete Milestones 1-5 data reporting to Truven report. • Maximum: Complete Milestones 1-6 6. Create and implement education/communication plans based on steps 1-5 to include content, participants, dates and evaluation process to enhance awareness of implementation for Operational Initiative #1. 28 25

Initiative or Project Status Report Example

Targets Status Indicators

Overall Physician & Project Project Leader/ Project Last

Project or Initiative Name Dept/Div Executive Owner(s) Sponsor(s) Manager Financial Quality Costs ExperiencePatient Brand Start Finish Status* Budg* Schd* Updated* Enterprise Data Warehouse (EDW) and VHA/Truven analyticIT F. Beirne P. August R. Olson X X X 7/1/2014 6/30/2015 G G Y 4/30/2015

Project Description Current Status/Update* Operationalize the use of the Enterprise Data Warehouse (EDW) and VHA/Truven analytic tool kit • Inventory of key reports and systems continues. Clinical inventory complete. Remaining 1. Create a summary of the present data analyst support for Palomar Health to include: 1) Systems systems and inventory Estimated Completion: May that analysts support, certifications, skills sets and any identified gaps; 2) An inventory of our core IT systems (i.e.. Cerner, Lawson) with a brief summary of reporting functions; and 3) A • Resources plan and oversight function for EDW and Truven tool kits in process listing of current reports available from source systems with a report evaluation process to avoid • Lab, Radiology & Cardiology Turn-Around-Time in progress; ETC April waste and duplication. • OR Efficiency Dashboard Report build in progress; ETC May 2. Create and implement a process and plan for resources including staff to create reports, produce reports and provide analytic support. • Create and implement education and communication plan in process 3. Create and implement an oversight function to assure the ongoing accuracy of the data for the EDW and Truven tool kits. 4. In addition to Patient Flow and OR efficiency, the Decision Support User Groups will identify a minimum of 1-3 areas of opportunity . 5. Implement the use of at least five reports from the EDW and VHA/Truven for ongoing decision- making for clinical and operational improvement to include : patient population based dashboards and the conversion of physician/peer review data reporting to Truven report. 6. Create and implement education/communication plans based on steps 1-5 to include content, participants, dates and evaluation process to enhance awareness of implementation for

Project Goals/Expected Outcomes Objectives - How will you reach the goal? Decision Support Structure in place, standardize the use of five reports from the EDW and VHA Imperative Advantage for ongoing use and demonstrate results for a minimum of 3 quick win projects

Top Risks* • Strong backlog of data needs in all areas • Data analytics support resources • Too broad of scope for the process

Key Milestones Completion Dates . Inventory of our core reporting systems, functions, and 5/31/2015 current reports . Process and plan for resources 6/30/2015 . Create and implement an oversight function 6/30/2015 . Patient Flow, Operating Room Efficiency and 1 to 3 areas of 5/15/2015 Opportunity . Implement at least five reports from the Enterprise Data 4/30/2015 Budget Status* (if applicable) Warehouse and Truven Budget Amount: Capital $ Operating $ . Create and implement education and communication plan 6/30/2015 29 Status: 26 Balanced Scorecard Targets

Mission Sustaining Financial Performance Customer Value World Class Workforce

30 27 Outcomes & Targets

Mission Sustaining Financial Performance Profitable operations that enable Palomar Health to fulfill its mission to heal, comfort, and promote health in the communities we serve Outcomes

Customer Value Deliver differentiated and sustainable value to patients and their families, physicians, payers, donors, and community

Targets Quality Cost Experience Brand Utilize evidence- High quality outcomes Create and transform Create trust and loyalty based practices to delivered efficiently and the care experience through delivering improve quality and effectively with a ‘patent first’ dependable, consistent patient safety. focus. customer value.

31 28 Mission Sustaining Financial Performance Profitable operations that enable Palomar Health to fulfill its mission to heal, comfort, and promote health in the communities we serve Expense Days Cash Operating EBIDA Reduction On Hand Margin Improvement Initiatives Customer Value Quality Cost Experience Brand Utilize evidence-based High quality outcomes Create and transform Create trust and loyalty practices to improve delivered efficiently and the care experience through delivering quality and patient effectively with a ‘patent first’ dependable, consistent safety focus. customer value. Targets

Rate Denials Clean Comm w/ Average Renewal CAUTI CLABSI Hospital 0- Rate Claims Doctors Gift Size Rate 10 Key SSI Falls Supply Professional Comm w/ Quietness of Service Volume Expense Services Nurses Hospital Line Growth Growth

Labor Outpatient C. Diff Labor Hours Expense Overall Score World-Class Workforce Timely Employee Responsiveness Develop and retain Performance Engagement to Applicants employees with Evaluations knowledge, skills, and 32 29 values required to deliver customer value. Outcome: Mission Sustaining Financial Performance

Diane Hansen, EVP, Finance

Outcome Measures FY15 FY16

Days Cash on Hand 95 Days 120 Days

Operating Margin (2.0)% 2.0%

Cost Per Adjusted Discharge $11,300 $11,000

Expense/Revenue Improvement $25 Million (EBIDA)

33 30 Targets: Customer Value Quality | Cost | Experience| Brand

Customer Value Targets

Targets Leader • Jerry Kolins, MD, VP, Patient Experience Quality • Valerie Martinez, Director, Quality and Patient Safety • Tim Nguyen, VP, Revenue Cycle Cost • Melissa Wallace, Director, Financial Planning and Decision Support • Jerry Kolins, MD, VP, Patient Experience Experience • Tina Pope, Manager, Service Excellence • Jean Larsen, VP, Philanthropy Brand • Della Shaw, EVP, Strategy

34 31 Quality Utilize evidence-based practices to improve quality and patient safety

Jerry Kolins, VP, Patient Experience Valerie Martinez, Director, Quality and Patient Safety Measures/Targets Facility Period CAUTI CLABSI C. diff SSI Falls COLO/HYST Q1 2015 0.527 0.452 1.515 COLO 2.018 HYST 0.0 PMC 75th Q2 2015 0.523 0.372 0.736 COLO 0.643 HYST 0.0 Q1 2015 0.00 0.00 0.00 COLO 0.0 HYST 0.0 75th PHDC Q2 2015 0.835 0.00 0.00 COLO 0.0 HYST 00 Q1 2015 0.338 0.00 0.991 COLO 0.0 HYST 0.0 75th POM Q2 2015 0.00 0.00 1.510 COLO 0.0 35 32 HYST 0.0 Cost High quality outcomes delivered efficiently and effectively

Tim Nguyen, VP, Revenue Cycle Management Melissa Wallace, Director, Financial Planning and Decision Support Measures Targets 835 Claims Denial Rate 6%

Clean Claim Rate 60%

Supply Expense Dollars Equal to or less than FY16 Budget Per Unit of Service (UOS)

Select Pro-Fees Dollars Equal to or less than FY16 Budget Per Unit of Service (UOS) Worked Hours Equal to or less than FY16 Budget Per Unit of Service (UOS) Labor Expense Dollars Equal to or less than FY16 Budget Per Unit of Service (UOS) 36 33 Experience Create and transform the care experience with a ‘patent first’ focus.

Jerry Kolins, VP, Patient Experience Tina Pope, Manager, Service Excellence Measures Targets HCAHPS: 90 National percentile ranking Communication with Doctors HCAHPS: 90 National percentile ranking Communication with Nurses HCAHPS: 90 National percentile ranking Quietness of Hospital Environment HCAHPS: 90 National percentile ranking Rate Hospital 0-10 Press Ganey: 90 National percentile ranking Outreach Units Overall

37 34 Brand Create trust and loyalty through delivering dependable, consistent customer value.

Jean Larsen, VP, Philanthropy Della Shaw, EVP, Strategy Measures Targets

Inpatient Volume Equal to or greater than than FY16 Budget

Outpatient Volume Equal to or greater than FY16 Budget

Donor Average Gift Size $1,414

Donor Renewal Rate 25.5%

38 35 Organizational Capabilities World-class Workforce

Brenda Turner, EVP, Human Resources Measures Targets

Timely Performance Evaluations 95%

Employee Engagement 77.0 (Quarterly) Employee Engagement 77.0 90th Percentile (Annual)

Responsiveness to Applicants 3 days

Timely Performance Evaluations 95%

39 36 The Strategic View Goal: To be recognized as the dominant provider of integrated health services

Mission Sustaining Outcome Financial Performance

Quality, Cost, Target Experience, Brand

Clinical integration Objectives Efficient & Effective Delivery Hassle Free Experience Consumerism Initiatives

Projects 40 37 Example Goal: To be recognized as the dominant provider of integrated health services

Mission-sustaining financial Outcome performance

Quality, Cost, Target Experience, Brand

Clinical integration Efficient & Effective Delivery Objectives Hassle Free Experience Consumerism Palomar Health Downtown Campus Initiatives Closure

Projects 41 38 NEXT STEPS

• August 5 Cabinet Presentation/Approval • August 7 Roundtable Presentation/Feedback • August 25 Leadership Council Presentation and Roundtable discussions • Before September 30 – Directors complete inventory of all current projects and review with their Leader. Discussions and decisions in each department: Keep, Start, or Stop Doing • September 2 – Board of Directors Leadership review • September 14 - Board of Directors – Full board review and discussion; proposed approval • September 22 - Leadership Council Balanced Scorecard presentation • October – Strategic Planning with Board, EMT, Medical Staff • October 31 – Proposed projects submitted and approved 42 39

ADDENDUM B

43

Arch Board of Director Terms

NAME TERM TERM ENDS ADDRESS PHONE NUMBER

Stuart Graham, M.D. 1 Year March, 2016

Robin Rowland, M.D. 2 Year March, 2017

*Judy Schmude 2 Year July, 2017

*Jan Jones 2 Year July, 2017

*Billy Volek 2 Year July, 2017

*Larry Winegrad 3 Year July, 2018

Bob Hemker Ex Officio With Position as Palomar CEO

Deanna Kyrimis Ex Officio, Non- With Position as Arch Health Voting Partners CEO

Vacant; under recruitment

Vacant; under recruitment

Vacant; under recruitment

*New members requiring Palomar ratification of directorship as per bylaws

44 Aaron Byzak Aaron Byzak

MBA, FACHE MBA, FACHE Director of Government & Director of Government & Community Affairs Community Affairs UC San Diego Health Sciences UC San Diego Health Sciences Arch admin phone number: Arch admin phone number: 858.673.2521 858.673.2521

Aaron Byzak serves as director of Government and Community Affairs for Aaron Byzak serves as director of Government and Community Affairs for UC San Diego Health Sciences, responsible for legislative and community UC San Diego Health Sciences, responsible for legislative and community relations for UCSD School of Medicine, Skaggs School of Pharmacy and relations for UCSD School of Medicine, Skaggs School of Pharmacy and Pharmaceutical Sciences and UCSD Health System. He joined UCSD Health Pharmaceutical Sciences and UCSD Health System. He joined UCSD Health Sciences after acting as policy advisor of Health and Human Services for Sciences after acting as policy advisor of Health and Human Services for the San Diego County Board of Supervisors. Mr. Byzak has worked as an the San Diego County Board of Supervisors. Mr. Byzak has worked as an adviser for elected officials at the state and local level, including Senator adviser for elected officials at the state and local level, including Senator Bill Morrow. He served as an assistant public affairs officer and strategic Bill Morrow. He served as an assistant public affairs officer and strategic services specialist for the Tri-City Healthcare District and served as a federal services specialist for the Tri-City Healthcare District and served as a federal health policy reform surrogate speaker for Senator John McCain’s 2008 health policy reform surrogate speaker for Senator John McCain’s 2008 presidential campaign. Mr. Byzak spent several years working for American presidential campaign. Mr. Byzak spent several years working for American Medical Response (AMR) as an Emergency Medical Technician (EMT). Medical Response (AMR) as an Emergency Medical Technician (EMT).

Mr. Byzak serves on the board of several local nonprofit agencies. He has Mr. Byzak serves on the board of several local nonprofit agencies. He has been recognized with two Emmy Awards, a Silver Bernays Award from the been recognized with two Emmy Awards, a Silver Bernays Award from the Public Relations Society of America (PRSA), The Regent’s Award for Early Public Relations Society of America (PRSA), The Regent’s Award for Early Career Healthcare Executive of the Year from the American College of Career Healthcare Executive of the Year from the American College of Healthcare Executives (ACHE) and a 40 Under 40 Award by San Diego Healthcare Executives (ACHE) and a 40 Under 40 Award by San Diego Metropolitan Magazine. Aaron was recognized by San Diego Magazine as Metropolitan Magazine. Aaron was recognized by San Diego Magazine as one of the 50 People to Watch. He earned his master of business administration one of the 50 People to Watch. He earned his master of business administration in health care management from the University of California, Irvine’s Paul in health care management from the University of California, Irvine’s Paul Merage School of Business and a bachelor’s degree in social science from Merage School of Business and a bachelor’s degree in social science from Chapman University. Mr. Byzak earned a Certificate in Executive Leadership Chapman University. Mr. Byzak earned a Certificate in Executive Leadership from Cornell University and is Board Certified in healthcare management from Cornell University and is Board Certified in healthcare management as a Fellow of the American College of Healthcare Executives (FACHE). as a Fellow of the American College of Healthcare Executives (FACHE). 45 www.ArchHealth.org www.ArchHealth.org Jan Jones Jan Jones

RN, BSN, FAAMA RN, BSN, FAAMA President/Chief Executive Officer President/Chief Executive Officer The Elizabeth Hospice The Elizabeth Hospice Arch admin phone number: Arch admin phone number: 858.673.2521 858.673.2521

Jan Jones is the President and CEO of The Elizabeth Hospice, the region’s Jan Jones is the President and CEO of The Elizabeth Hospice, the region’s oldest and largest nonprofit hospice and palliative care provider. With oldest and largest nonprofit hospice and palliative care provider. With over two decades of experience in the health care industry, Ms. Jones, over two decades of experience in the health care industry, Ms. Jones, a registered nurse, brings a strong background in the management and a registered nurse, brings a strong background in the management and growth of successful community-based hospice and palliative care growth of successful community-based hospice and palliative care programs throughout the United States. programs throughout the United States.

Ms. Jones is a well-recognized leader in the hospice and palliative care Ms. Jones is a well-recognized leader in the hospice and palliative care movement and is involved in leadership positions at the national level. movement and is involved in leadership positions at the national level. Ms. Jones currently serves as Vice Chair of the National Hospice and Ms. Jones currently serves as Vice Chair of the National Hospice and Palliative Care Organization (NHPCO) Board of Directors and serves on Palliative Care Organization (NHPCO) Board of Directors and serves on the Board of Trustees of the National Hospice Foundation. Locally, the Board of Trustees of the National Hospice Foundation. Locally, Ms. Jones is an active Board Member with the North San Diego Ms. Jones is an active Board Member with the North San Diego Business Chamber. Business Chamber.

In her role as President and CEO of The Elizabeth Hospice, Ms. Jones In her role as President and CEO of The Elizabeth Hospice, Ms. Jones overseas a workforce of more than 350 employees and 325 active overseas a workforce of more than 350 employees and 325 active volunteers serving communities throughout San Diego and the Inland volunteers serving communities throughout San Diego and the Inland Empire. Since 1978, The Elizabeth Hospice has touched the lives of Empire. Since 1978, The Elizabeth Hospice has touched the lives of more than 90,000 individuals and their families, bringing dignity, comfort more than 90,000 individuals and their families, bringing dignity, comfort and hope to those impacted by illness, grief and loss. More information and hope to those impacted by illness, grief and loss. More information is available online at www.elizabethhospice.org. is available online at www.elizabethhospice.org.

46 www.ArchHealth.org www.ArchHealth.org Judy G. Schmude Judy G. Schmude

Ph.D., FACHE® Ph.D., FACHE® Consultant Consultant Arch admin phone number: Arch admin phone number: 858.673.2521 858.673.2521

Dr. Schmude continues to support Arch Health Partners as a key consultant, Dr. Schmude continues to support Arch Health Partners as a key consultant, with many years of Executive Level experience in management for large with many years of Executive Level experience in management for large and complex healthcare organizations. From 1985 to 1995, Dr. Schmude and complex healthcare organizations. From 1985 to 1995, Dr. Schmude served as the Vice President of Patient Care for St. Joseph’s Hospital served as the Vice President of Patient Care for St. Joseph’s Hospital and Medical Center in Phoenix, AZ, a nationally recognized medical and Medical Center in Phoenix, AZ, a nationally recognized medical center for quality tertiary care, medical education and research. She center for quality tertiary care, medical education and research. She then moved into the San Diego area to accept the role of Executive then moved into the San Diego area to accept the role of Executive Director and CEO for Children’s Health Network, San Diego, leading Director and CEO for Children’s Health Network, San Diego, leading this large pediatric medical group and Independent Physician Association this large pediatric medical group and Independent Physician Association (IPA), from 1995-2001. Dr. Schmude joined Centre for HealthCare in (IPA), from 1995-2001. Dr. Schmude joined Centre for HealthCare in 2001, with administrative responsibility for all aspects of this multi- 2001, with administrative responsibility for all aspects of this multi- specialty medical group, which ultimately became Arch Health Partners. specialty medical group, which ultimately became Arch Health Partners. Dr. Schmude retired in 2008, but continues to play an active role in as Dr. Schmude retired in 2008, but continues to play an active role in as a valued member of our BOD. a valued member of our BOD.

Dr. Schmude holds a B.S. in Science Education and an M.S. in Microbiology Dr. Schmude holds a B.S. in Science Education and an M.S. in Microbiology from the University of Wisconsin, Whitewater, and a Ph.D. in Health from the University of Wisconsin, Whitewater, and a Ph.D. in Health Administration from Marquette University in Milwaukee, WI. She also Administration from Marquette University in Milwaukee, WI. She also has an MT (ASCP) certification from the Medical Technology Program has an MT (ASCP) certification from the Medical Technology Program at Kenosha Memorial Hospital, Wisconsin. at Kenosha Memorial Hospital, Wisconsin.

47 www.ArchHealth.org www.ArchHealth.org Billy Volek BillyLarry Volek Winegrad

NFL Quarterback (Retired) NFL Quarterback (Retired) San Diego Chargers San Diego Chargers Arch admin phone number: Arch admin phone number: 858.673.2521 858.673.2521

Billy Volek is a retired quarterback of the National Football League. Billy Billy Volek is a retired quarterback of the National Football League. Billy attended California State University, Fresno and majored in Economics attended California State University, Fresno and majored in Economics while also leading the Bulldogs to a Western Athletic Conference title while also leading the Bulldogs to a Western Athletic Conference title in 1999. Mr. Volek was signed by the Tennessee Titans in 2000 and in in 1999. Mr. Volek was signed by the Tennessee Titans in 2000 and in 2004. He became only the fourth quarterback in NFL history to pass for 2004. He became only the fourth quarterback in NFL history to pass for over 400 yards in two consecutive games. In 2006, Mr. Volek joined the over 400 yards in two consecutive games. In 2006, Mr. Volek joined the San Diego Chargers and retired from the NFL in 2012. Today, Billy is an San Diego Chargers and retired from the NFL in 2012. Today, Billy is an avid real estate investor and a highly respected member of the San avid real estate investor and a highly respected member of the San Diego community. He presently resides in Poway, California. Diego community. He presently resides in Poway, California.

As a professional athlete, Mr. Volek has been the recipient of many As a professional athlete, Mr. Volek has been the recipient of many health-care services and understands the consumer perspective. Arch health-care services and understands the consumer perspective. Arch Health Partners is honored to have Mr. Volek as part of its board and Health Partners is honored to have Mr. Volek as part of its board and values his strength in being our “patient voice” board member, providing values his strength in being our “patient voice” board member, providing thoughtful support to what matters most – our patients! thoughtful support to what matters most – our patients!

48 www.ArchHealth.org www.ArchHealth.org Larry Winegrad Larry Winegrad

Principal Consultant Principal Consultant L. E. Winegrad & Associates L. E. Winegrad & Associates Arch admin phone number: Arch admin phone number: 858.673.2521 858.673.2521

Larry spent his career working to improve organizational performance. Larry spent his career working to improve organizational performance. From 1973 to 2003 he held various management positions for Solar From 1973 to 2003 he held various management positions for Solar Turbines and its parent company, Caterpillar, in engineering, materials, Turbines and its parent company, Caterpillar, in engineering, materials, operations and service. Upon assuming a leadership role in quality and operations and service. Upon assuming a leadership role in quality and process improvement, Larry became interested in the Malcolm Baldrige process improvement, Larry became interested in the Malcolm Baldrige National Quality Award criteria and process and spent over fifteen years National Quality Award criteria and process and spent over fifteen years as an examiner – reviewing, site-visiting and scoring multiple applications as an examiner – reviewing, site-visiting and scoring multiple applications across manufacturing, service, education and health-care organizations. across manufacturing, service, education and health-care organizations. He was instrumental in the effort to prepare and submit an application He was instrumental in the effort to prepare and submit an application that resulted in Solar Turbines being awarded the 1998 Malcolm Baldrige that resulted in Solar Turbines being awarded the 1998 Malcolm Baldrige National Quality Award. National Quality Award.

Larry then became an independent consultant specializing in organizational Larry then became an independent consultant specializing in organizational improvement efforts. In this capacity, he assisted several organizations improvement efforts. In this capacity, he assisted several organizations using Baldrige methodologies, conducting assessments and responding using Baldrige methodologies, conducting assessments and responding to feedback reports. He has also used his experience in Six Sigma and to feedback reports. He has also used his experience in Six Sigma and Lean Thinking tools and techniques to spur institutional learning in Lean Thinking tools and techniques to spur institutional learning in companies, helping them realize breakthrough performance results. companies, helping them realize breakthrough performance results.

On a personal note, born and raised in Annapolis, Maryland, Larry has On a personal note, born and raised in Annapolis, Maryland, Larry has lived in California since receiving his Bachelor of Science degree from lived in California since receiving his Bachelor of Science degree from Drexel University in Philadelphia. He is married to Jackie, a long-time Drexel University in Philadelphia. He is married to Jackie, a long-time San Diego Zoo employee and has two children: Elaine, a 2nd grade San Diego Zoo employee and has two children: Elaine, a 2nd grade teacher in Anaheim, and Larry, Jr., an attorney in Oakland. In retirement, teacher in Anaheim, and Larry, Jr., an attorney in Oakland. In retirement, Larry has taken up golf, loves it and plays as often as he can. Larry has taken up golf, loves it and plays as often as he can. 49 www.ArchHealth.org www.ArchHealth.org