Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021 1:00 p.m.

Agenda

Board Members Mary Rose Garrido Wilcox, Chairman, District 5 AGENDA – Formal Meeting J. Woodfin Thomas, Vice Chairman, District 4 Mary A. Harden, R.N., Director, District 1 Maricopa County Special Health Care District Mark G. Dewane, Director, District 2 Board of Directors Susan Gerard, Director, District 3

President & Chief Executive Officer Stephen A. Purves, FACHE Mission Statement

Clerk of the Board The Valleywise Health’s mission is to provide exceptional care, without Melanie Talbot exception, every patient, every time.

Meeting Location Valleywise Health Medical Center 2601 East Roosevelt Street Phoenix, Arizona 85008

Welcome The Board of Directors is the governing body for the Maricopa County Special Health Care District. Each member represents one of the five districts in Maricopa County. Members of the Board are public officials, elected by the voters of Maricopa County. The Board of Directors sets policy and the President & Chief Executive Officer, who is hired by the Board, directs staff to carry out the policies.

How Citizens Can Participate Each meeting is open to the public and there is a “Call to the Public” at the beginning of each meeting. An individual may address the Board of Directors at this time or when the agenda item to be addressed is reached. If you wish to address the Board, please complete a Request to Speak form Speaker’s Slip and deliver it to the Clerk of the Board prior to the Call to the Public. If you have anything that you wish distributed to the Board and included in the official record, please hand it to the Clerk who will distribute the information to the Board members and Valleywise Health Senior Staff.

Speakers will be called in the order in which requests to speak are received. Your name will be called when the Call to the Public has been opened or when the Board reaches the agenda item which you wish to speak. As mandated by the Arizona Open Meeting Law, officials may not discuss items not on the agenda, but may direct staff to follow-up with the citizen.

Public Rules of Conduct The Board Chair shall keep control of the meeting and require the speakers and audience to refrain from abusive or profane remarks, disruptive outbursts, applause, protests, or other conduct which disrupts or interferes with the orderly conduct of the business of the meeting. Personal attacks on Board members, staff, or members of the public are not allowed. It is inappropriate to utilize the Call to the Public or other agenda item for purposes of making political speeches, including threats of political action. Engaging in such conduct and failing to cease such conduct upon request of the Board Chair will be grounds for ending a speaker’s time at the podium or for removal of any disruptive person from the meeting room, at the direction of the Board Chair.

Agendas are available within 24 hours of each meeting via the Clerk’s Office, Valleywise Health Medical Center, 2601 East Roosevelt, Phoenix, Arizona 85008, Monday through Friday between the hours of 9:00 a.m. and 4:00 p.m. and on the internet at https://valleywisehealth.org/about/board-of-directors/. Accommodations for individuals with disabilities, alternative format materials, sign language interpretation, and assistive listening devices are available upon 72 hours advance notice via the Clerk’s Office, Valleywise Health Medical Center, 2601 East Roosevelt, Phoenix, Arizona 85008, (602) 344-5177. To the extent possible, additional reasonable accommodations will be made available within the time constraints of the request.

6/15/2021 2:46 PM  Valleywise Health Medical Center   2601 East Roosevelt Street  Phoenix, Arizona 85008 

Meeting will be held remotely. Please visit https://valleywisehealth.org/event/board-of-directors- formal-meeting-june-23-2021/ for further information.

Wednesday, June 23, 2021 1:00 p.m.

One or more of the members of the Board of Directors of the Maricopa County Special Health Care District may be in attendance telephonically or by other technological means. Board members attending telephonically, or by other technological means will be announced at the meeting.

Pursuant to A.R.S. § 38-431.03(A)(3), or any applicable and relevant state or federal law, the Board may vote to recess into an Executive Session for the purpose of obtaining legal advice from the Board’s attorney or attorneys on any matter listed on the agenda. The Board also may wish to discuss any items listed for Executive Session discussion in General Session, or the Board may wish to take action in General Session on any items listed for discussion in Executive Session. To do so, the Board will recess Executive Session on any particular item and reconvene General Session to discuss that item or to take action on such item.

Please silence any cell phone, pager, computer, or other sound device to minimize disruption of the meeting.

1:00 Call to Order

Roll Call

Call to the Public This is the time for the public to comment. The Board of Directors may not discuss items that are not specifically identified on the agenda. Therefore, pursuant to A.R.S. § 38-431.01(H), action taken as a result of public comment will be limited to directing staff to study the matter, responding to any criticism or scheduling a matter for further consideration and decision at a later date.

ITEMS MAY BE DISCUSSED IN A DIFFERENT SEQUENCE

General Session, Presentation, Discussion and Action:

1:15 1. Approval of Consent Agenda: 15 min Note: Approval of contracts, minutes, IGA’s, proclamations, etc. Any matter on the Consent Agenda will be removed from the Consent Agenda and discussed as a regular agenda item upon the request of any Board member.

a. Minutes:

i. Approve Special Health Care District Board of Directors meeting minutes dated May 26, 2021 Melanie Talbot, Chief Governance Officer; and Clerk of the Board

b. Contracts:

i. Approve a new grant (90-21-337-1) between Arizona Family Health Partnership and the Maricopa County Special Health Care District dba Valleywise Health, to provide family planning and related preventative health services to eligible clients in the State of Arizona Michael White, M.D., Executive Vice President, Chief Clinical Officer

2 General Session, Presentation, Discussion and Action, cont.:

1:15 1. Approval of Consent Agenda, cont.:

b. Contracts, cont.:

ii. Approve amendment #5 to the contract (90-17-215-1-05) between Tempe Diablo, LLC and the Maricopa County Special Health Care District dba Valleywise Health, to reduce the amount of leased space and modify certain terms of the lease Warren Whitney, Senior Vice President, Government Relations

iii. Approve amendment #47 to the professional services agreement (90-12-084-1- 47) between District Medical Group (DMG) and the Maricopa County Special Health Care District dba Valleywise Health Claire Agnew, Executive Vice President, Chief Financial Officer

iv. Approve amendment #3 to the contract (90-14-074-5-03) between Prometheus Biosciences and the Maricopa County Special Health Care District dba Valleywise Health, for lab testing services Jo-el Detzel, Vice President, Ancillary and Support Services

v. Approve a new agreement (90-21-339-1) between St. Joseph's Hospital and Medical Center and the Maricopa County Special Health Care District dba Valleywise Health, for redistribution of newly generated graduate medical education funding agreement Claire Agnew, Executive Vice President, Chief Financial Officer

vi. Approve a new cooperative purchasing agreement (90-21-346-1) between Iron Mountain Information Management, LLC and the Maricopa County Special Health Care District dba Valleywise Health, for offsite records storage and management Nancy Kaminski, Senior Vice President, Revenue Cycle

vii. Approve amendment #3 to the intergovernmental agreement (IGA) (90-16-149-1- 03) between the Arizona Department of Health Services (ADHS) – Arizona State Hospital (ASH) and the Maricopa County Special Health Care District dba Valleywise Health, for the provision of comprehensive health care services Claire Agnew, Executive Vice President, Chief Financial Officer

viii. Authorize Valleywise Health President & Chief Executive Officer to enter into a professional services agreement (90-21-347-1) with District Medical Group (DMG) to permit qualified providers employed by Valleywise Health to provide professional clinical services at Valleywise Health facilities consistent with the amended and restated contract for professional services effective September 1, 2012, as amended, between the Maricopa County Special Health Care District dba Valleywise Health, and DMG Claire Agnew, Executive Vice President, Chief Financial Officer

ix. Approve amendment #10 to the contract (90-16-044-1-10) between CareFusion Solutions, LLC and the Maricopa County Special Health Care District dba Valleywise Health, to extend existing customer orders for the Valleywise Health Medical Center campus an additional two (2) years Michael White, M.D., Executive Vice President, Chief Clinical Officer

x. Approve a new customer order (90-16-044-3) between CareFusion Solutions, LLC and the Maricopa County Special Health Care District dba Valleywise Health, for updating the Pyxis station at Valleywise Behavioral Health Center-Mesa. Michael White, M.D., Executive Vice President, Chief Clinical Officer

3 General Session, Presentation, Discussion and Action, cont.:

1:15 1. Approval of Consent Agenda, cont.:

b. Contracts, cont.:

xi. Approve a new customer order (90-16-044-4) between CareFusion Solutions, LLC and the Maricopa County Special Health Care District dba Valleywise Health, to add HealthSight Inventory Optimization products to the Pyxis station at Valleywise Behavioral Health Center-Mesa Michael White, M.D., Executive Vice President, Chief Clinical Officer

c. Governance:

i. Approve Change in Scope of Service: delete site, Valleywise Community Health Center-Maryvale Barbara Harding, Senior Vice President, Ambulatory Services and Federally Qualified Health Center Clinics Chief Executive Officer

ii. Approve Change in Scope of Service: add site, Valleywise Community Health Center-West Maryvale Barbara Harding, Senior Vice President, Ambulatory Services and Federally Qualified Health Center Clinics Chief Executive Officer

iii. Approve Change in Scope of Service: delete site, Valleywise Community Health Center-Mesa, 85210 Barbara Harding, Senior Vice President, Ambulatory Services and Federally Qualified Health Center Clinics Chief Executive Officer

iv. Approve Change in Scope of Service: add site, Valleywise Community Health Center-Mesa, 85203 Barbara Harding, Senior Vice President, Ambulatory Services and Federally Qualified Health Center Clinics Chief Executive Officer

v. Approve Change in Scope of Service: add to Women’s Services: OB/GYN Infertility, OB/GYN Urology, GYN Tumor, and Perinatal Cardiology Barbara Harding, Senior Vice President, Ambulatory Services and Federally Qualified Health Center Clinics Chief Executive Officer

vi. Approve revisions to policy 06503 S; Health Resources & Services Administration Legislative Mandate Compliance Policy Barbara Harding, Senior Vice President, Ambulatory Services and Federally Qualified Health Center Clinics Chief Executive Officer

vii. Approve the grant application to Health Resources and Services Administration (HRSA) for fiscal year 2021 American Rescue Plan - Health Center Construction and Capital Improvements (C8E) funding opportunity in the amount of $1.46 million for the Federally Qualified Health Center (FQHC) Clinics Barbara Harding, Senior Vice President, Ambulatory Services and Federally Qualified Health Center Clinics Chief Executive Officer

viii. Approve amendment #1 to the purchase and sale agreement (90-21-313-1-01) between the Maricopa County Special Health Care District dba Valleywise Health, and NLW Enterprises, LLC, to extend the due diligence feasibility period Warren Whitney, Senior Vice President, Government Relations

ix. Approve the Annual Compliance Work Plan for fiscal year 2022 L.T. Slaughter, Chief Compliance Officer

x. Approve the Annual Internal Audit Work Plan for fiscal year 2022 L.T. Slaughter, Chief Compliance Officer 4 General Session, Presentation, Discussion and Action, cont.:

1:15 1. Approval of Consent Agenda, cont.:

c. Governance, cont.:

xi. Approve a new wellsite easement (90-21-350-1) between Salt River Project (SRP) and the Maricopa County Special Health Care District dba Valleywise Health, to grant SRP easement for Valleywise Health’s property located at the Northwest corner of 51st Avenue and Campbell Avenue, Phoenix, Arizona Warren Whitney, Senior Vice President, Government Relations

d. Medical Staff:

i. Approve Valleywise Health’s Medical Staff credentials for June 2021 William D. Dachman, M.D., Chief of Staff

ii. Approve Valleywise Health’s Allied Health Professional Staff credentials for June 2021 William D. Dachman, M.D., Chief of Staff

iii. Approve proposed revisions to 39026 T: Operational Credentialing Policy William D. Dachman, M.D., Chief of Staff

iv. Approve proposed revisions to 31203 T: Focused Professional Practice Evaluation (FPPE) Policy William D. Dachman, M.D., Chief of Staff

e. Care Reimagined Capital:

i. Approve a new contract (480-90-21-007) between Centrax Inc and the Maricopa County Special Health Care District dba Valleywise Health, for hardware, software and related services for a total expenditure of $1,321,227 (CER #19-947, Project # A1440) Lia Christiansen, Executive Vice President, Chief Administrative Officer

ii. Approve capital expenditure request (CER# 19-947) for the purchase of Steris booms and lights for the new acute care tower for a cost of $2,883,088 Lia Christiansen, Executive Vice President, Chief Administrative Officer

f. Capital:

i. Approve capital expenditure request (CER# 21-420) for replacement of laboratory point-of-care middleware software, for an amount not to exceed $513,000 Jo-el Detzel, Vice President, Ancillary and Support Services

______End of Consent Agenda______

1:30 2. Discuss and Review Det Norske Veritas - Germanischer Lloyd (DNV-GL) Recertification Survey Preliminary Results 15 min Crystal Garcia, Vice President, Surgical, Specialty, Quality and Safety

1:45 3. Discussion and Possible Action on Valleywise Health’s 2021 Legislative Agenda and/or the Maricopa County Special Health Care District’s Position Regarding Proposed State and Federal Legislative Items 10 min Michael Fronske, Legislative and Governmental Affairs Director 5 General Session, Presentation, Discussion and Action, cont.:

1:55 4. Discuss and Review Valleywise Health’s May 2021 Financials and Statistical Information 10 min Claire Agnew, Executive Vice President, Chief Financial Officer

2:05 5. Review and Possible Action on Reports to the Board of Directors 15 min

a. Monthly Marketing and Communications Report Lia Christiansen, Executive Vice President, Chief Administrative Officer

b. Monthly Care Reimagined Capital Purchases Report Claire Agnew, Executive Vice President, Chief Financial Officer

c. Monthly Valleywise Health Employee Turnover Report (May 2021) Jenny Marchiniak, Senior Vice President, Chief Human Resources Officer

d. Quality Management Council meeting minutes (April 2021) Crystal Garcia, Vice President, Surgical, Specialty, Quality and Safety

2:20 6. Concluding Items 10 min

a. Old Business:

February 24, 2021 Federally Qualified Health Centers (FQHC) Clinic Dashboard – December 2020  Inform the Board what Health Resources and Services Administration established for breast cancer and HIV screening benchmarks – anticipate release in August 2021

May 26, 2021 Financial and Statistical Information  Separate endoscopy from surgeries for both Valleywise Health Medical Center and Valleywise Comprehensive Health Center-Peoria  Provide date for when $2.2M reconciliation payment to District Medical Group will be paid

Issuance of General Obligation Bonds, Series D 2021  Add to August 2021 agenda a future bond authorization

Behavioral Health Initiatives  Plan for a discussion on the future of behavioral health at Valleywise Health

b. Board Member Requests for Future Agenda Items or Reports

c. Comments

i. Chairman and Member Closing Comment

ii. President and Chief Executive Officer Summary of Current Events

2:30 Adjourn

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.

Consent Agenda

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.a.i.

Minutes May 26, 2021 Minutes

Maricopa County Special Health Care District Board of Directors Meeting Valleywise Health Medical Center May 26, 2021 1:00 p.m.

Present: Mary Rose Garrido Wilcox, Chairman, District 5 – participated remotely J. Woodfin Thomas, Vice Chairman, District 4 – participated remotely Mary A. Harden, Director, District 1 – participated remotely Mark G. Dewane, Chairman, District 2 – participated remotely

Absent: Susan Gerard, Director, District 3

Others Present: Steve Purves, President & Chief Executive Officer – participated remotely Michael White, M.D., Executive Vice President, Chief Clinical Officer – participated remotely Claire Agnew, Executive Vice President, Chief Financial Officer – participated remotely Lia Christiansen, Executive Vice President, Chief Administrative Officer – participated remotely Martin C. Demos, Senior Vice President and General Counsel – participated remotely Sherry Stotler, R.N., M.S.N., Senior Vice President, Chief Nursing Officer – participated remotely William D. Dachman, M.D., Chief of Staff – participated remotely

Guest Presenters: Michael Fronske, Legislative and Government Affairs Director – participated remotely Crystal Garcia, Vice President, Surgical, Specialty, Quality and Safety – participated remotely Matthew Meier, Vice President, Financial Services – participated remotely Barbara Harding, Senior Vice President, Ambulatory Services and Federally Qualified Health Center Clinics Chief Executive Officer – participated remotely Gene Cavallo, Senior Vice President, Behavioral Health Services – participated remotely

Recorded by: Melanie Talbot, Chief Governance Officer; Clerk of the Board – participated remotely Cynthia Cornejo, Deputy Clerk of the Board – participated remotely

Call to Order:

Chairman Wilcox called the meeting to order at 1:00 p.m.

Roll Call

Ms. Talbot called roll. Following roll call, it was noted that three of the five voting members of the Maricopa County Special Health Care District Board of Directors were present, which represented a quorum. Director Harden joined the meeting shortly after roll call.

For the benefit of all participants, Ms. Talbot announced the Board members participating remotely.

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

Call to the Public

Chairman Wilcox called for public comment. There were no comments.

Mission Statement

Mr. Purves read the mission statement aloud.

General Session, Presentation, Discussion and Action:

1. Approval of Consent Agenda:

a. Minutes:

i. Approve Special Health Care District Board of Directors meeting minutes dated April 28, 2021

b. Contracts:

i. Approve amendment #2 to the Intergovernmental Agreement (IGA) (90-18-348-1-02 [ADHS18-189522]) between the Arizona Department of Health Services (ADHS) and the Maricopa County Special Health Care District dba Valleywise Health, to continue to provide funding for the Reproductive Health/Family Planning Program

ii. Approve amendment #5 to the subcontract (90-16-187-1-05) with Phoenix Children's Hospital’s Bill Holt Pediatric Infectious Disease Clinic, to extend Pediatric HIV medical care services to patients who are eligible under the Ryan White Part D services

iii. Approve amendment #4 to the subcontract (90-16-177-1-04) with Area Agency on Aging dba Care Directions, for medical case management services for women and youth infected with HIV/AIDS who are eligible for Ryan White Part D services

iv. Approve a new administrative support agreement (90-21-314-1) between the Maricopa County Special Health Care District dba Valleywise Health, and Maricopa County Clinical Services, Inc., for administrative support and oversight services

v. Approve amendment #3 to the grant (90-20-186-1-03) between Arizona Community Action Association (ACAA) dba Wildfire, and the Maricopa County Special Health Care District dba Valleywise Health, to increase funding to the Salt River Project (SRP) bill assistance fund

vi. Approve amendment #3 to the contract (90-19-192-1-03) between GE Healthcare and the Maricopa County Special Health Care District dba Valleywise Health, to add equipment to the service agreement

c. Governance:

i. Approve the property insurance policy with The Traveler’s Insurance Company, and a premium payment of $426,500, for policy period June 1, 2021 through May 31, 2022

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

1. Approval of Consent Agenda, cont.:

c. Governance, cont.:

ii. Approve the American Rescue Plan Act Award (1 H8FCS41092-01-00) submission to Health Resources and Services Administration (HRSA) for Valleywise Health’s Federally Qualified Health Center Clinics

iii. Approve application of Isaac Serna as a potential member to the Valleywise Community Health Centers Governing Council

iv. Approve a purchase and sale agreement between the Maricopa County Special Health Care District dba Valleywise Health, and NLW Enterprises, LLC, for approximately 1.063 acres located at 934 West Hatcher Road, Phoenix, AZ

v. Approve a no objection letter to the proposed property tax reclassification of real and personal property of VIAVI Solutions, Inc., to be located within foreign trade zone no. 75

d. Medical Staff:

i. Approve Valleywise Health’s Medical Staff credentials for May 2021

ii. Approve Valleywise Health’s Allied Health Professional Staff credentials for May 2021

iii. Approve proposed revisions to the Certified Nurse Midwife Privileges and Practice Prerogatives

iv. Approve proposed Physician Assistant Gastroenterology Privileges and Practice Prerogatives

v. Approve proposed Nurse Practitioner Gastroenterology Privileges and Practice Prerogatives

vi. Approve proposed revisions to 39011 T: Allied Health Professionals Policy

vii. Approve proposed revisions to policy 39020 T: Medical Staff Credentials Policy

viii. Approve proposed revisions to policy 43374: Medical Staff Glossary

e. Care Reimagined Capital:

i. Approve a new contract (480-90-21-006-1) between Cable Solutions LLC and the Maricopa County Special Health Care District dba Valleywise Health, for cabling infrastructure for a total expenditure of $5,276,567 (CER #19-947 [ACH: $4,642,016]; and CER #19-951 [SSB: $634,551])

ii. Approve amendment #41 to the contract (480-90-18-012) with Kitchell Contractors Inc. of Arizona, construction manager at risk (CMAR), for guarantee maximum price (GMP) number 4.08 for acute care hospital tenant improvements in the amount of $22,026,628 (CER #19-947 RSVT Acute Tower)

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

1. Approval of Consent Agenda, cont.:

f. Capital:

i. Approve capital expenditure request (21-419) for x-ray equipment replacement at Valleywise Community Health Center-Avondale, for a cost of $399,978

MOTION: Vice Chairman Thomas moved to approve the consent agenda. Director Dewane seconded.

VOTE: 3 Ayes: Chairman Wilcox, Vice Chairman Thomas, Director Dewane 0 Nays 2 Absent: Director Gerard, Director Harden Motion passed.

4. Discussion and Possible Action on Valleywise Health’s 2021 Legislative Agenda and/or the Maricopa County Special Health Care District’s Position Regarding Proposed State and Federal Legislative Items

Mr. Fronske reviewed the current statistics of the legislative session and noted that after 136 days in session, the budget bills were being considered. Legislators were now focused on passing a $12.8 billion budget. Upon review of the proposed budget, staff did not identify any causes for concern, however, there was a possibility that the proposed budget may change.

NOTE: Director Harden joined the meeting at 1:06 p.m.

Chairman Wilcox asked if any hospital associations had analyzed the impact of the flat tax that was included in the proposed budget.

Mr. Fronske stated that while an analysis may have been conducted, he was unsure of how the flat tax would impact hospitals, specifically.

He provided an update on the bills that were tracked by staff. House Bill (HB) 2833, related to childcare assistance pilot program had not appeared in any budget bills as of yet. The latest iteration of HB 2190, related to anti-vaccination had failed, however, the bill could be reconsidered.

Mr. Fronske updated the Board on federal issues. He informed the Board that America’s Essential Hospitals (AEH) and American Hospital Association (AHA) had requested Health and Human Services (HHS) distribute the remaining $178 billion in the provider relief funds and to extend the deadline to utilize those funds.

Chairman Wilcox inquired if Valleywise Health would receive any of the provider relief funds, should they be released.

Ms. Agnew was unaware of any funds that would be available to Valleywise Health.

2. Discuss and Review the Quarterly Quality Report and Metrics Dashboard Including but not Limited to Patient Satisfaction Survey Results/ Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Scores

Ms. Garcia provided an overview of the three quality metrics related to nursing workforce, which were within the established benchmarks.

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

Ms. Garcia outlined the quality dashboard, noting many of the metrics were within the established benchmarks. Staff would work on improving the patient experience scores within behavioral health, which had declined during the COVID-19 pandemic.

She acknowledged the patient safety indicators (PSI) metrics that did not meet the benchmarks, including the pressure ulcer rate and the Iatrogenic pneumothorax rate. Multi-disciplinary groups reviewed all occurrences and implemented action plans for those metrics. She noted that while there was an increase in death among surgical patients with serious treatable complications, the PSI was within the benchmark on a year-to-date basis. Upon review, no trends were identified. There was also one case of postoperative respiratory failure for the quarter, causing the metric to exceed the benchmark.

She outlined the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results, which had declined quarter over quarter.

Action plans were developed for the quality metrics that did not meet the benchmarks, specifically ambulatory hemoglobin A1c control. Staff would focus on optimizing opportunities to encourage patients to have their bloodwork done at the clinic, and significant improvements were made since the beginning of calendar year 2021.

Director Harden acknowledged the improvements made from the beginning of the calendar year, from 72.09% to 52.1%; however, the metric was considerably exceeding the benchmark of less than 16 percent.

Ms. Garcia said the benchmark was the organization’s stretch goal, recommended by Uniform Data System (UDS) and Health Resources and Service Administration (HRSA).

Director Harden questioned if that goal would be met by the end of the fiscal year, by encouraging patients to complete their bloodwork.

Ms. Garcia explained that UDS metrics were measured by calendar year. Significant improvements made since January 2021. Staff would continue to strive for improvement within that metric. She outlined the action plans in place to address and improve the PSI metrics, including the resumption the physician workgroups to develop specific strategies to address each metric.

Director Harden asked when the physician workgroup was paused.

Ms. Garcia stated that during the onset of the COVID-19 pandemic, the physician workgroup was halted to focus on patient care.

Director Harden asked if any patients developed the pressure ulcers required surgical intervention. If so, how many.

Ms. Garcia would investigate and report back. She outlined implemented processes that would address the decline in patient satisfaction scores.

3. Discuss and Review the Quarterly Infection Control Quality Metrics Dashboard

Ms. Garcia outlined infection prevention and control quality metrics and noted three cases of central line associated blood stream infections (CLABSI) reported in the third quarter. There were four cases of catheter associated urinary tract infections (CAUTI). There were no methicillin-resistant Staphylococcus aureus (MRSA) bacteremia occurrences in the third quarter. She outlined the action plans in place to address the metrics that did not meet the benchmarks. 5

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

3. Discuss and Review the Quarterly Infection Control Quality Metrics Dashboard, cont.

Vice Chairman Thomas asked if the equipment or the age of the current facilities contributed to the infections.

Ms. Garcia said that upon review of the cases, the facilities or equipment were not determined to be a factor.

5. Discuss and Review Valleywise Health’s April 2021 Financials and Statistical Information

Ms. Agnew reviewed statistical financial information for April 2021, noting acute admissions were near pre- pandemic levels, with an increase over the prior month. Behavioral health admissions exceeded budget by 17% for the month. The average length of stay and case mix index also continued to reach normalized levels. Emergency department visits were approaching pre-pandemic levels; however, total visits were 16% below budget. Admission rates for the emergency departments were also returning to pre-pandemic rates. While the overall ambulatory visits were not negatively impacted by the pandemic, she highlighted the moderate growth within dental services and at the Valleywise Comprehensive Health Center-Peoria. She also noted a slight decline in telehealth visits, as patients were returning to in-person visits.

She highlighted the payer mix, which would shift as emergency department visits increased and hospital admissions continued to normalize. Unusual items for the month included the final installment of surge nurse relief, as well as HRSA COVID-19 related grant revenue and reimbursement from Public Health for a vaccine point of dispensing (POD) event in December 2020.

She reviewed the income statement for April 2021, noted the net patient service revenue was below budget by 10.7% and total operating revenue exceeded budget by 5.2 percent. The total decrease in net assets was $4,697,206 compared to a budgeted gain of $1,572,660. The goal for the remainder of the fiscal year was to rebuild volumes and continue to manage expenses.

On a year-to-date basis, salaries and wages exceeded budget by $2 million. Ms. Agnew explained that approximately $3.6 million was distributed in mission critical incentives to employees working the frontline during the pandemic. Total operating revenue was one percent below budget, total operating expenses exceeded budget by 5.1%, resulting in a loss of $29,485,730 compared to a budgeted loss of $15,820,219. Staff was now focusing on the recovery process as the organization slowly resumed pre-pandemic levels.

Director Harden highlighted the negative variance within medical service fees of nearly $12 million and requested clarification.

Ms. Agnew outlined the contributing factors for that variance, including the Access to Professional Service Initiative (APSI), a supplement received that normally offset the net cost for medical service fees. However, in January 20201, staff was notified of a $8 million variance to what was budgeted.

Director Harden asked if that variance would be corrected up by the end of the fiscal year.

Ms. Agnew did not believe so. She reminded the Board of the $23 million advance received from the Centers of Medicare and Medicaid Services (CMS) at the onset of pandemic. The recoupment of that advance began in April 2021 and would continue until the full amount was repaid. She outlined the balance sheet, noting there were 131 days cash on hand and 73 days in accounts receivable.

Director Harden asked if endoscopy procedures were included within surgical center volumes reported on the financial and statistical information dashboard. If so, she recommended that endoscopy procedures be reported separately from other surgical volumes.

Ms. Agnew said that moving forward, endoscopy procedures would be reported separately for both Valleywise Health Medical Center and Valleywise Comprehensive Health Center-Peoria.

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

5. Discuss and Review Valleywise Health’s April 2021 Financials and Statistical Information, cont.

Director Harden referenced information related to accounts payable, specifically the $2.2 million due to District Medical Group (DMG) and asked if that payment would be submitted within the current fiscal year.

Ms. Agnew would review the timing of payment and report back to the Board.

6. Update on the issuance and sale of Maricopa County Special Health Care District General Obligation Bonds, Series D (2021)

Chairman Wilcox expressed her appreciation to Ms. Agnew and all that were involved in the development of the information presented related to the issuance and sale of the general obligation bonds.

Ms. Agnew was pleased to report on the completion of the bond sale, which occurred on May 20, 2021. The bonds were successfully placed with investors at extremely low yields, ranging from 0.12% in 2022 to 1.52% in 2035, which was beneficial to Maricopa County taxpayers. The final all-in true interest cost was 1.548 percent. During the order period, 40 investors submitted orders for bonds, with orders on the initial pricing totaling over $1.4 billion, oversubscribed by five times of the available bonds. Top investors included Vanguard Group, Fidelity Investments, Wells Capital Management, and Norther Trust Investment Management.

The net proceeds for the sale, approximately $303,525,000, would be available for the continuation of project upon closing, scheduled for June 10, 2021. The remaining authorization from Proposition 480 was now exhausted.

Ms. Agnew conveyed her gratitude for the finance team, senior leadership, the financial advisors, and the Board of Directors for their support throughout the process. The entire program would not be possible without the support of the taxpayers of Maricopa County.

Mr. Purves commended Ms. Agnew, who was instrumental throughout the process.

Director Dewane noted that Proposition 480 was approved by the voters in 2014, with the final bonds just now being issued. He asked if the media would be notified of the accomplishment. Due to the success of the overall project, he asked if staff would consider going back to the voters to fund additional projects at Valleywise Health and take advantage of the low interest rates.

Chairman Wilcox said that due to the success of the implementation of Proposition 480, she recommended that the focus shift to the future of Valleywise Health.

Ms. Agnew said the media was notified of the strong ratings received prior to the sale of the bonds. Upon closing, an additional release would be sent out, highlighting the tax rate was that was lower than the estimations included in the Voter Information Pamphlet for Proposition 480. The impact that Care Reimagined was having on the community exceeded original expectations. There was more work to do, and staff would determine how to address those additional projects.

Mr. Purves confirmed that staff would begin internal discussions on the framework for the organization’s next strategic plan. The plan would identify the amount of strategic capital needed to expand the organization.

Chairman Wilcox suggested the Board receive an assessment on the options available in August 2021.

Mr. Purves acknowledged the ever-changing healthcare landscape and it was time to refresh the overall analysis of the healthcare needs in the community.

Vice Chairman Thomas added that the West Valley had grown exponentially over recent years and may require additional services to meet the needs of the new population in the area. 7

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

6. Update on the issuance and sale of Maricopa County Special Health Care District General Obligation Bonds, Series D (2021)

Chairman Wilcox said that the East Valley was experiencing the same level of growth and encouraged staff to work to complete construction of the new Valleywise Community Health Center-Chandler location.

7. Discuss and Review Capital, Volumes, Revenue, Expenses, and Other Assumptions for Fiscal Year 2022

Mr. Meier provided an overview of the budget assumptions for fiscal year (FY) 2022, including patient volumes, payor mix, other operating revenue, and the preliminary capital budget plan. When developing the budget, staff focused on the COVID-19 pandemic recovery and resuming pre-pandemic volumes and managing expenses. Staff also concentrated on strategic initiatives, such as the expansion of behavioral health services at Valleywise Behavioral Health Center-Maryvale and the opening of two new facilities.

He explained that FY 2021 projections were based on volumes through February 2021, annualized. Total admissions were budgeted to increase by 7.6% in FY 2022. He reiterated that emergency department visits contributed to acute admissions and staff was monitoring the recent increase in visits to determine if budgeted volumes should be adjusted. Emergency department visits were budgeted to increase by seven percent over current year projections.

Director Harden expressed concern with the projections for emergency department visits, as the current year was below budget by approximately 25 percent. She noted that during the pandemic, many patients began utilizing other avenues to receive care, such as primary care clinics and telehealth services, instead of the emergency department. She wondered if volumes would return to pre-pandemic levels.

Ms. Agnew noted the steady growth within the emergency department over the past three months. She reiterated that staff continued to monitor the volumes and would make adjustments accordingly.

Mr. Meier outlined projections for overall ambulatory visits, which were forecasted to increase by seven percent. He highlighted the anticipated growth at Valleywise Comprehensive Health Center-Peoria, noting the transition of patients from two closed Community Health Centers. The budget anticipated increased utilization in integrated behavioral health services and dental services slowly returning to pre-pandemic levels.

He provided an overview of preliminary inpatient volume details and noted acute and behavioral health average lengths of stay were projected to decrease and normalize. The total average daily census was budgeted at 474, an increase of current year projections. There were no changes to surgery and delivery assumptions.

The payor mix was budgeted to include a two percent increase in Medicaid, Arizona Health Care Cost Containment System (AHCCCS), and a decrease in commercial insurance, due to the increase in behavioral health utilization. He highlighted the sources of other operating revenue, with a majority of the revenue received from graduate medical education (GME) and 340b pharmacy revenue.

Chairman Wilcox asked if the revenue included funds received for COVID-19 relief. Ms. Agnew said that COVID-19 relief funds were not included, as she did not anticipate those being received. However, staff was working to incorporate funds received from the American Rescue Plan, which was focused on the Federally Qualified Health Centers (FQHC), within grants and research revenue over the next three fiscal years. Those funds received would be offset by the expenses and would have no impact on the bottom line.

Mr. Meier reviewed the capital budget for FY 2022, which totaled $10 million, including emergency and contingency. Staff outlined the major investments, including the partial replacement of the roof at the Valleywise Comprehensive Health Center-Phoenix. 8

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

7. Discuss and Review Capital, Volumes, Revenue, Expenses, and Other Assumptions for Fiscal Year 2022, cont.

Director Harden noted that information technology was allocated the largest amount of capital funds and requested a solution be found to address virtual meeting capabilities. She expressed concern that the Board was not presented with projected expenses for the upcoming fiscal year. She also asked what the loss in net assets was projected to be for the current fiscal year.

Ms. Agnew understood and said staff was reevaluating volume assumptions, which would impact the assumed expenses. Staff was remaining conservative with assumptions and was using the most current information to finalize the budget projections. She acknowledged the challenges related to the recovery efforts in the next fiscal year.

Director Harden questioned if merit increases and market adjustments would be considered within the budget.

Ms. Agnew said that the budget would factor in those increases, as the organization was unable to do so in the current fiscal year.

Director Harden announced her support of that decision.

8. Discuss and Review March 2021 Valleywise Health’s Federally Qualified Health Centers Operational Dashboard

Ms. Harding provided a retrospective overview of the March 2021 operational dashboard for the FQHC clinics, as the information had been provided to the Board during the financial discussion in April 2021. She acknowledged various initiatives that contributed to increased volumes within the ambulatory setting, including but not limited to telehealth capabilities, the focus to fill appointments, and the addition of triage nurses.

In March 2021, all Valleywise Community Health Centers achieved positive variances in visits on a year-to- date basis, with Valleywise Comprehensive Health Center-Peoria improving their volumes month over month. She noted the challenges within dental services due to the additional COVID-19 requirements implemented. New equipment was purchased to reduce the cycle time and increase patient volumes.

She outlined the quality metrics and reiterated that the metrics were measured on a calendar year, as opposed to the fiscal year. To address some deficiencies, staff implemented multidisciplinary teams to focus on improving outcomes.

Director Harden asked why the data did not include March and April 2021 outcomes.

Ms. Harding noted that the information was reviewed with the Valleywise Community Health Centers Governing Council (VCHCGC) prior to the Board of Directors. Due to the timing of the reports, there was a delay in incorporating the information.

Ms. Harding inquired if the Board would be willing to receive quarterly reports with fiscal year-to-date information, as opposed to a one-month snapshot that included outdated information.

Director Harden expressed her concern that different reports provided information for various reporting timeframes.

Ms. Talbot said that due to timing of the reports, the information included differed from other reports received.

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

8. Discuss and Review March 2021 Valleywise Health’s Federally Qualified Health Centers Operational Dashboard, cont.

Director Harden requested that the Board and the VCHCGC receive the most current data available on the reports presented at the meetings. She also requested the reports included trends, to demonstrate if the metric was improving month over month.

Ms. Harding said that she would work with staff to develop an improved reporting methodology.

9. Discuss and Review the Quarterly Update on Behavioral Health Programs and Services at Valleywise Health

Mr. Cavallo highlighted the impact of Proposition 480 on the expansion of behavioral health services throughout the organization. Through the implementation of Care Reimagined, funded by Proposition 480 bonds, the inpatient capacity increased from less than 200 beds to the 434 beds that were now licensed. Valleywise Health was also able to launch various outpatient behavioral health programs, including the Assertive Community Treatment (ACT), First Episode, and integrated behavioral health.

He outlined the challenges surrounding inpatient capacity within Valleywise Health due to COVID-19 and scheduled renovations. There were processes in place to balance the need of the community while minimizing the risk of COVID-19 exposure for patients and staff. He showcased a year-over-year comparison of the impact COVID-19 had on admissions, the average daily census and average length of stay, and the improvements made over the course of that year.

Director Harden acknowledged a significant decrease in the average length of stay and questioned what factors contributed to the improvement.

Mr. Cavallo recalled that in April 2020, at the onset of the pandemic, there was an overall hesitation to accept patients into discharge facilities. There was now a process to transfer patients to a similar facility, in lieu of transferring to a step-down facility.

Chairman Wilcox asked if Valleywise Health offered COVID-19 vaccinations to behavioral health patients within the inpatient facilities.

Dr. White explained that all patients were screened upon admission and those willing to receive were administered the vaccination.

Mr. Cavallo reviewed outpatient behavioral health programs, including ACT, which had been operational for nearly five years, and noted the challenges created by the pandemic. He announced that the First Episode Center would have access to additional federal funding through the mental health block grants. Those funds would be used to implement a pilot program; iTether, to expand virtual connectivity to the patients served.

He provided an update on the progress of the Mesa Behavioral Health Specialty Clinic, formally known as the Seriously Mentally Ill (SMI) Clinic, located at the Valleywise Community Health Center-Mesa. He highlighted the significant growth of integrated behavioral health within Valleywise Community Health Centers. In March 2021, the program expanded to provide psychiatric services, which staff may need to consider expanding due to the high demand.

Moving forward, the focus was on opening the final unit at Valleywise Behavioral Health Center-Maryvale to operate at full capacity and complete renovations at Valleywise Behavioral Health Center-Phoenix.

Chairman Wilcox commended the progress made within behavioral health. She suggested that Valleywise Health develop a strategy to continue to address the unmet behavioral health needs within the community.

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

9. Discuss and Review the Quarterly Update on Behavioral Health Programs and Services at Valleywise Health, cont.

Director Harden asked how many beds were currently operational at Valleywise Behavioral Health Center- Maryvale.

Mr. Cavallo said that there were currently 150 beds available for use. One unit was closed, as it had been designated for COVID-19 positive patients. The unit would remain unavailable, as leaders recruited additional registered nurses and behavioral health technicians needed to support the unit.

10. Review and Possible Action on Reports to the Board of Directors

a. Monthly Marketing and Communications Report

b. Monthly Care Reimagined Capital Purchases Report

c. Monthly Valleywise Health Employee Turnover Report (March 2021)

d. Quality Management Council Meeting Minutes (March 2021)

e. Quarterly Compliance Officer’s Report; Valleywise Health’s Finance, Audit and Compliance Committee Activities Report

f. Quarterly Valleywise Health Foundation’s Tasks Status Report to the Valleywise Health’s President and Chief Executive Officer

Vice Chairman Thomas addressed item 10.c., Monthly Valleywise Health Employee Turnover Report, and asked if the population serviced negatively contributed to the first-year turnover rate.

Ms. Marchiniak said that she had not identified the population served as a contributing factor in the first-year turnover rate. She noted the need to focus on an overall compensation review and strategy, as well as non- monetary incentives to improve the turnover rate.

Director Harden suggested that staff emphasize the benefits of being a government employee with new hires and prospective employees.

She addressed item 10.f., Quarterly Valleywise Health Foundation’s Task Status Report, and asked if the Valleywise Health Foundation anticipated hosting an in-person fundraiser in the Fall of 2021.

Ms. Hartsock said that the Valleywise Health Foundation was planning on hosting an in-person fundraising event in October 2021.

Chairman Wilcox addressed item 10.a., Monthly Marketing and Communications Report, and asked how the availability of COVID-19 vaccinations at Valleywise Community Health Centers was marketed to the community.

Ms. Christiansen said that various outlets were used, including social media posts, facility monument signs, and grassroot efforts within each community surrounding Valleywise Community Health Centers.

Ms. Harding added that interviews were granted with Spanish-speaking media outlets. She was also coordinating efforts with various organizations and associations throughout the community to spread the word on the availability of the vaccinations.

Chairman Wilcox encouraged staff to work with newspaper publications, including Prensa and The Arizona Republic to increase awareness. 11

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

General Session, Presentation, Discussion and Action, cont.:

11. Concluding Items

a. Old Business:

February 24, 2021

Federally Qualified Health Centers (FQHC) Clinic Dashboard – December 2020  Inform the Board what Health Resources and Services Administration established for breast cancer and HIV screening benchmarks – anticipate release in August 2021

March 24, 2021

Financials  Separately track Comprehensive Health Center-Peoria outpatient surgeries from Valleywise Health Medical Center outpatient surgeries

April 28, 2021

American Rescue Plan Act Award  Provide of list of project ideas recommended by the Valleywise Community Health Centers Governing Council.

Fiscal Year 2022 Preliminary Patient Volumes  Provide the Board with data related to the all deliveries trends throughout the state of Arizona

b. Board Member Requests for Future Agenda Items or Reports

c. Comments

i. Chairman and Member Closing Comment

ii. President and Chief Executive Officer Summary of Current Events

Ms. Talbot reviewed old business, noted the items that were addressed and reiterated outstanding tasks to be addressed, and outlined requests that stemmed from the meeting.

Ms. Stotler informed the Board of a food drive event that Valleywise Health nurses participated in the prior weekend, in conjunction with St. Mary’s Food Bank. She noted that over 400 families were served throughout the day.

Adjourn

MOTION: Director Harden moved to adjourn the May 26, 2021 Special Health Care District Board of Directors Formal Meeting. Vice Chairman Thomas seconded.

VOTE: 4 Ayes: Chairman Wilcox, Vice Chairman Thomas, Director Dewane, Director Harden 0 Nays 1 Absent: Director Gerard Motion passed.

Special Health Care District Board of Directors Meeting Minutes – General Session – May 26, 2021

Meeting adjourned at 3:16 p.m.

______Mary Rose Garrido Wilcox, Chairman Special Health Care District Board of Directors

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.i.

Contracts 90-21-337-1 Melanie Talbot

From: Compliance 360 Sent: Tuesday, June 8, 2021 11:52 AM To: Melanie Talbot Subject: Contract Approval Request: (AFHP) Arizona Family Health Partnership TitleX Grant Arizona Family Health Partnership (AFHP)

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: (AFHP) Arizona Family Health Partnership TitleX Grant Arizona Family Health Partnership (AFHP) Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

Add comments as necessary.

Approve/Reject Contract

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Attachments

Name DescriptionTypeCurrent File / URL RFBA File Request for Business Action Title X FY22 - signed.pdf TitleX Grant Agreement - PENDING File Family Planning Program Contract 2021- BOARD SIGNATURE 2022 - Valleywise final.pdf SAM 2021 File Arizona Family Health Partnership thru 4.28.21.pdf OIG 2021 File Arizona Family Health Partnership.pdf COI naming AFHP File Arizona Family Health Partnership - COI.pdf

Contract Information

Division Contracts Division Folder Contracts \ Grants Status Pending Approval Title (AFHP) Arizona Family Health Partnership TitleX Grant Contract Identifier Board - New Contract MIHS Contract 90-21-337-1 Number

1 Primary Responsible Tymczyna, Katherine Party Departments GRANTS ADMINISTRATION Product/Service Arizona Family Health Partnership - TitleX GRANT Description Action/Background Approve a new contract between ARIZONA FAMILY HEALTH PARTNERSHIP and Maricopa County Special Health Care District dba Valleywise Health for a grant to provide family planning and related preventative health services to eligible clients in the State of Arizona.

Title X authorizes federally funded grants to assist in the establishment and operation of voluntary family planning projects, which shall offer a broad range of acceptable and effective family planning methods and services (including natural family planning methods, infertility services and services for adolescents. Per the Term and Statement of Work, Valleywise will provide 2,344 unduplicated clients the comprehensive sexual and reproductive services identified in the AFHP Agency Health Center Report provided.

The contract term will begin on April 1, 2021 and terminates March 31, 2022 unless terminated or amended. Valleywise Health may terminate this Contract for any reason by providing the Partnership with at least ninety (90) days written notice.

Total annual revenue is projected at $300,000. This program is 100% grant funded. All expenses equal revenue.

This Agreement is sponsored by Dr. Michael White, EVP & Chief Clinical Officer. Evaluation Process The Contractor was determined to meet the requirements of the requesting department and Valleywise Health. Procurement has been satisfied pursuant to HS-102B(2) of the Procurement Code in that any Valleywise Health compliance with the terms and conditions of a grant, gift or bequest is exempt from the solicitation requirements of the Procurement Code. Notes Program Manager - Brittney Trang [email protected] Jennifer Min [email protected] Manuel Ferreiro [email protected]

1 (BOARD) SIGNATURE REQUIRED ON THE AGREEMENT. COI, naming AFHP, pending and will be attached. Category Effective Date 4/1/2021 Expiration Date 3/31/2022 Annual Value $300,000.00 Expense/Revenue Revenue Budgeted Travel Type Yes Procurement Number Grant #5 FPHPA0064868-03-00 Primary Vendor Arizona Family Health Partnership (AFHP)

Responses

Member Name Status Comments Melton, Christopher C. Approved Reviewed and approved

2 Joiner, Jennifer L. Approved Landas, Lito S. Approved Harding, Barbara J. Approved Meier, Matthew P. Approved Demos, Martin C. Approved White, Michael Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.ii.

Contracts 90-17-215-1-05 Melanie Talbot

From: Compliance 360 Sent: Tuesday, June 8, 2021 12:21 PM To: Melanie Talbot Subject: Contract Approval Request: Amendment #5 - Reduction of Leased Space and Modification of certain terms and provisions of the Lease re: Suite D Space Tempe Diablo LLC

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Amendment #5 - Reduction of Leased Space and Modification of certain terms and provisions of the Lease re: Suite D Space Tempe Diablo LLC Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

Add comments as necessary.

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Attachments

Name DescriptionTypeCurrent File / URL (For Review) Muller - Diablo - File (For Review) Muller - Diablo - Maricopa Maricopa County Special Health Care County Special Health Care District - Fifth District - Fifth Amendment reduct Amendment reduction (4814-5340- 7212.1).pdf

Contract Information

Division Contracts Division Folder Amendments Status Pending Approval Title Amendment #5 - Reduction of Leased Space and Modification of certain terms and provisions of the Lease re: Suite D Space Contract Identifier Board - Amendment MIHS Contract 90-17-215-1-05 Number Primary Responsible Melton, Christopher C. Party Departments

1 Product/Service Amendment #5 - Reduction of Leased Space and Modification of certain Description terms and provisions of the Lease re: Suite D Space Action/Background Approve Amendment#5 to the contract between Tempe Diablo LLC and Maricopa County Special Health Care District dba Valleywise Health to i)reduce the size of the Existing Premises by deducting therefrom a portion of the Suite D Space consisting of approximately 10,415 rentable square feet (9,890 usable square feet) and ii) modify certain terms and provisions of the Lease.

Base Rent for Remaining Suite D Space Following Fifth Amendment Reduction Date: during the period from the day immediately following the Fifth Amendment Reduction Date through and including the day immediately prior to the Reduction Date, the Base Rent payable by Valleywise Health to Tempe Diablo LLC shall equal $32,354.58. An additional consideration has been agreed in that a cashier's check or wire transfer in the amount of $42,701.50 shall be delivered to Tempe Diablo LLC as a Reduction Fee, terminating the Early Reduction Suite D Space prior to previously scheduled Reduction Date.

This Amendment #5 is sponsored by Warren Whitney, SVP Government Relations.

Evaluation Process Notes Category Effective Date Expiration Date 4/30/2029 Annual Value $0.00 Expense/Revenue Expense Budgeted Travel Type Yes Procurement Number Primary Vendor Tempe Diablo LLC

Responses

Member Name Status Comments Melton, Christopher C. Approved Whitney, Warren W. Approved Harris, Ijana M. Approved Christiansen, Lia K. Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.iii.

Contracts 90-12-084-1-47

2601 E. Roosevelt D Phoenix, AZ 85008 Phone: (602) 344-8551

DATE: June 8, 2021

TO: Maricopa County Special Health Care District Board of Directors

cc: Steve Purves, President and Chief Executive Officer Martin Demos, Sr. VP & General Counsel Dr. Michael White, Executive Vice President and Chief Clinical Officer Melanie Talbot, Chief Governance Officer

FROM: Claire Agnew, Executive Vice President and Chief Financial Officer

SUBJECT: District Medical Group Contract - Amendment #47

A request for approval of Amendment #47 to the contract between District Medical Group (DMG) and Valleywise Health has been included in the June 23, 2021 Formal Meeting Consent Agenda. This amendment will be effective July 1, 2021, unless otherwise noted. The following requests are segregated by those that have or do not have a financial impact.

Amendment #47 Requests with a Financial Impact

• Remove 0.2 FTE Acupuncture Physician, Effective July 1, 2021 Valleywise Health is requesting to remove the 0.2 FTE Acupuncture Physician. The provider who had previously provided the acupuncture services is no longer working with DMG.

1 | P a g e

The total cost savings for removing the Acupuncture Physician 0.2 FTE is ($61,647) for Fiscal Year 2022.

• Remove 0.4 FTE CHC Family Practice Physician and 1.0 FTE CHC Family Practice Nurse Practitioner, Effective June 1, 2021 Valleywise Health is requesting to remove the 0.4 FTE CHC Family Practice Physician and the 1.0 CHC Family Practice Nurse Practitioner. The CHC Family Practice Clinic closed in June 2021.

The total cost savings for removing the 0.4 FTE CHC Family Practice Physician and the 1.0 CHC Family Practice Nurse Practitioner is ($20,981) for Fiscal Year 2021.

The total cost savings for removing the 0.4 FTE CHC Family Practice Physician and the 1.0 CHC Family Practice Nurse Practitioner is ($259,132) for Fiscal Year 2022.

2 | P a g e

• Add 1.0 FTE Audiologist, Effective December 1, 2020 Valleywise Health is requesting to add a 1.0 FTE Audiologist who was hired for the opening of the Peoria location.

The total added cost to Fiscal Year 2021 for the addition of the above FTE is $59,503 in staffing fees. The additional gross professional fee collections are estimated to be $21,000 and the billing fee is estimated to be $1,890.

The total net cost for the addition of the Audiologist at Peoria for Fiscal Year 2021 is: $40,393.

The total added cost to Fiscal Year 2022 for the addition of the above FTE is $119,707 in staffing fees. The additional gross professional fee collections are estimated to be $42,000 and the billing fee is estimated to be $3,780.

The total net cost for the addition of the Audiologist at Peoria for Fiscal Year 2022 is: $81,487.

• Remove the Residency Expense Payments, Effective July 1, 2021 Valleywise Health is requesting to remove the Residency Expense Payments. The Residency Expenses will be managed with the Creighton University Arizona Health Education Alliance beginning in Fiscal Year 2022.

3 | P a g e

The total cost savings for removing the Residency Expense Payments for Fiscal Year 2022 is ($597,000).

• Relocate the Department Chair Positions and Rehab Medical Director Position to the Valleywise Health -DMG Agreement, Effective July 1, 2021 Valleywise Health is requesting to relocate the Department Chair Positions and Rehab Medical Director Position to the Valleywise Health-DMG Contract. The positions were previously listed in the contract between Maricopa County Clinical Services, Inc. and DMG.

The total added cost to relocate the Department Chairs and Rehab Medical Director to the Valleywise Health-DMG Contract for FY2022 is $4,613,061.

• Revise Provider Rates to Reflect Updated Benchmarks, Effective July 1, 2021 Valleywise Health is requesting approval to add $3,094,235 to the contract to cover revised provider rates. This change will update the current rates to reflect the 2020 MGMA benchmarks and 2019-2020 AAMC benchmarks where applicable. The change also includes a decrease in overhead paid to DMG of 0.75%. The overhead percent will decrease from 30.37% to 29.62%.

The total cost to the Valleywise Health-DMG Contract for the updated provider rates is $3,094,235.

4 | P a g e

Amendment #47 Requests without a Financial Impact

The following item has no impact to the cost of the DMG contract with Valleywise Health and consists of corrections or modifications to the language of the contract:

• Revise RVU benchmarks to reflect the 2020 MGMA benchmarks, Effective July 1, 2021 • Revise Epic Department List to reflect any changes that have occurred over the past fiscal year, Effective July 1, 2021

The total Fiscal Year 2021 financial impact of Amendment #47 to the Valleywise Health-DMG Contract is: $19,412.

The total Fiscal Year 2022 financial impact of Amendment #47 to the Valleywise Health-DMG Contract is: $6,871,004

5 | P a g e

Melanie Talbot

From: Compliance 360 Sent: Wednesday, June 9, 2021 8:45 AM To: Melanie Talbot Subject: Contract Approval Request: Amendment #47 to the Professional Medical Services District Medical Group (DMG)

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Message Information

From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Amendment #47 to the Professional Medical Services District Medical Group (DMG) Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

Add comments as necessary.

Approve/Reject Contract

Click here to approve or reject the Contract.

Attachments

Name DescriptionTypeCurrent File / URL V5.Board Narrative VH-DMG Agreement- File V5.Board Narrative VH-DMG Amendment 47-June 2021.pdf Agreement-Amendment 47-June 2021.pdf

Contract Information

Division Contracts Division Folder Amendments Status Pending Approval Title Amendment #47 to the Professional Medical Services Contract Identifier Board - Amendment MIHS Contract 90-12-084-1-47 Number Primary Responsible Melton, Christopher C. Party Departments Product/Service Amendment #47 to the Professional Medical Services Description Action/Background A request for approval of Amendment #47 to the contract between District Medical Group (DMG) and Valleywise Health has been included in the June 23, 2021 Formal Meeting Consent Agenda. This amendment will be effective 1 July 1, 2021, unless otherwise noted. The following requests are segregated by those that have or do not have a financial impact.

Amendment #47 Requests with a Financial Impact • Remove 0.2 FTE Acupuncture Physician, Effective July 1, 2021 Valleywise Health is requesting to remove the 0.2 FTE Acupuncture Physician. The provider who had previously provided the acupuncture services is no longer working with DMG. The total cost savings for removing the Acupuncture Physician 0.2 FTE is ($61,647) for Fiscal Year 2022.

The total cost savings for removing the 0.4 FTE CHC Family Practice Physician and the 1.0 CHC Family Practice Nurse Practitioner is ($20,981) for Fiscal Year 2021.

The total cost savings for removing the 0.4 FTE CHC Family Practice Physician and the 1.0 CHC Family Practice Nurse Practitioner is ($259,132) for Fiscal Year 2022.

• Add 1.0 FTE Audiologist, Effective December 1, 2020 Valleywise Health is requesting to add a 1.0 FTE Audiologist who was hired for the opening of the Peoria location.

The total net cost for the addition of the Audiologist at Peoria for Fiscal Year 2021 is: $40,393.

The total net cost for the addition of the Audiologist at Peoria for Fiscal Year 2022 is: $81,487.

The total cost savings for removing the Residency Expense Payments for Fiscal Year 2022 is ($597,000).

2 The total added cost to relocate the Department Chairs and Rehab Medical Director to the Valleywise Health-DMG Contract for FY2022 is $4,613,061.

The total cost to the Valleywise Health-DMG Contract for the updated provider rates is $3,094,235.

Amendment #47 Requests without a Financial Impact

The following item has no impact to the cost of the DMG contract with Valleywise Health and consists of corrections or modifications to the language of the contract:

The total Fiscal Year 2021 financial impact of Amendment #47 to the Valleywise Health-DMG Contract is: $19,412.

The total Fiscal Year 2022 financial impact of Amendment #47 to the Valleywise Health-DMG Contract is: $6,871,004

Evaluation Process Notes Category Effective Date 7/1/2021 Expiration Date Annual Value $6,871,004.00 Expense/Revenue Expense Budgeted Travel Type Yes Procurement Number Primary Vendor District Medical Group (DMG)

Responses

Member Name Status Comments Melton, Christopher C. Approved Harris, Ijana M. Approved White, Michael Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.iv.

Contracts 90-14-074-5-03 Melanie Talbot

From: Compliance 360 Sent: Wednesday, June 9, 2021 8:45 AM To: Melanie Talbot Subject: Contract Approval Request: Amendment #3 - Extend and Price Update Prometheus Laboratories, Inc.

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Amendment #3 - Extend and Price Update Prometheus Laboratories, Inc. Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

Add comments as necessary.

Approve/Reject Contract

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Attachments

Name DescriptionTypeCurrent File / URL SAM 2021 File Prometheus Labs.pdf OIG 2021 File Prometheus Labs.pdf Amendment #3 - Exhibit A pricing eff File Valleywise Health Exhibit A_052121 8/31/21 to 7/31/22 proposed - Amendment 3 - 8.31.21 to 7.31.22.pdf Amendment #3 - Extension and updated File Valleywise Health Amendment pricing (Exhibit A) - PENDING 3_051921.pdf SIGNATURES

Contract Information

Division Contracts Division Folder Amendments Status Pending Approval Title Amendment #3 - Extend and Price Update Contract Identifier Board - Amendment MIHS Contract 90-14-074-5-03 Number Primary Responsible Tymczyna, Katherine Party Departments LAB - CLINICAL 1 Product/Service Reference Laboratory Testing Services Description Action/Background Approve Amendment #3 to the contract between Prometheus Biosciences (Contractor) and Maricopa County Special Health Care District dba Valleywise Health for Lab Testing Services to extend the contract term for one additional year and to update pricing. Pending the new interface, a new agreement will be presented to supersede this amendment and to include interface language and terms.

This Amendment #3 will extend the contract term for one additional year from August 31, 2021 to July 31, 2022 for an aggregate term of March 25, 2015 to July 31, 2022. Either party may terminate the contract, or any part thereof, at any time with 60 days notice in writing to the other party.

This Amendment #3 is sponsored by Jo-el Detzel, VP Ancillary & Support Services and reflects a current value of $350,481.00, for a new total aggregate value of $395,481.00 Evaluation Process The requesting department has determined that the Contractor is performing satisfactorily and is meeting the goals and objectives of the organization. The requesting department has elected that the contract should be continued and extended. Notes This extension is thru 7/31/22. A new agreement will be presented to include new interface with Prometheus once in progress.

Rep: Eric Lindholm 503-516-8858 Category Effective Date 8/31/2021 Expiration Date 7/31/2022 Annual Value $45,000.00 Expense/Revenue Expense Budgeted Travel Type Yes Procurement Number Primary Vendor Prometheus Laboratories, Inc.

Responses

Member Name Status Comments Melton, Christopher C. Approved Reviewed and approved Candelaria, Wesley J. Approved Landas, Lito S. Approved Detzel, Jo-El M. Approved Harris, Ijana M. Approved White, Michael Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.v.

Contracts 90-21-339-1 Melanie Talbot

From: Compliance 360 Sent: Tuesday, June 8, 2021 4:27 PM To: Melanie Talbot Subject: Contract Approval Request: Settlement Agreement St. Joseph's Hospital & Medical Center

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Settlement Agreement St. Joseph's Hospital & Medical Center Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

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Attachments

Name Description TypeCurrent File / URL 90-21-339-1 (unsigned) File 90-21-339-1 (unsigned).pdf OIG File OIG St. Joseph's 2021.pdf SAM File SAM St. Joseph's 2021.pdf RFBA File RFBA - FME Affiliation Settlement (Reimbursement).pdf

Contract Information

Division Contracts Division Folder Contracts \ Services - Consulting/Auditing & Other Status Pending Approval Title Settlement Agreement Contract Identifier Board - New Contract MIHS Contract 90-21-339-1 Number Primary Responsible Pardo, Laela N. Party Departments Reimbursement Product/Service Settlement Agreement Description

1 Action/Background Approve a new agreement between St. Joseph's Hospital and Medical Center (St. Joseph's) and Maricopa County Special Health Care District dba Valleywise Health for Redistribution of Newly Generated GME Funding Agreement. Valleywise Health and St. Joseph's jointly participate in Graduate Medical Education (GME) and Indirect Medical Education (IME), and on an annual basis agree to form a Medicare affiliated group for the purposes of sharing Medicare FTE caps which results in an increase to the level of GME funding received by both parties. As Valleywise Health is transferring a number of GME/IMEs to St. Joseph's , St. Joseph's will receive a higher GME funding. Therefore this funds flow agreement will outline the process of redistribution of GME funds from St. Joseph's to Valleywise Health in the amount of $784,223.00. This Agreement is sponsored by Claire Agnew, EVP & CFO. Evaluation Process The Contractor was determined to meet the requirements of the requesting department and Valleywise Health. Procurement has been satisfied pursuant to HS-102(B)(1) of the Procurement Code in that contracts between Valleywise Health and other political subdivisions, cooperative purchasing agreements with governmental entities or other governments are exempt from the solicitation requirements of the Procurement Code. Notes Category 0 Effective Date Expiration Date Annual Value $784,223.00 Expense/Revenue Revenue Budgeted Travel Type Procurement Number Primary Vendor St. Joseph's Hospital & Medical Center

Responses

Member Name Status Comments Melton, Christopher C. Approved Reviewed and approved Fowler, Pamela S. Approved White, Michael Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current Harris, Ijana M. Approved

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.vi.

Contracts 90-21-346-1 Melanie Talbot

From: Compliance 360 Sent: Tuesday, June 8, 2021 4:26 PM To: Melanie Talbot Subject: Contract Approval Request: Offsite Records Storage and Management Iron Mountain

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Offsite Records Storage and Management Iron Mountain Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

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Attachments

Name Description Type Current File / URL 90-21-346-1 File 90-21-346-1 (unsigned).pdf (unsigned) Omnia Partners File Contract 1325 1325_Iron_Mountain_MAD_2021_01_22_No_Pricing_Redacted.pdf OIG File OIG Iron Mountain 2021.pdf SAM File SAM Iron Mountain 2021.pdf BAA (unsigned) File BAA Iron Mountain (unsigned).pdf

Contract Information

Division Contracts Division Folder Contracts \ Services - Management/Outsourcing Status Pending Approval Title Offsite Records Storage and Management Contract Identifier Board - New Contract MIHS Contract 90-21-346-1 Number Primary Responsible Pardo, Laela N. Party Departments HEALTH INFORMATION MANAGEMENT,OFFICE OF THE CIO

1 Product/Service Offsite Records Storage and Management Description Action/Background Approve a new Cooperative Purchasing Agreement between Iron Mountain Information Management, LLC and Maricopa County Special Health Care District dba Valleywise Health for Offsite Records Storage and Management. Through this Cooperative Purchasing Agreement, Valleywise Health will be accessing Iron Mountain terms and pricing outlined in the Omnia Partners agreement. Current term of contract is to January 22, 2024 with the option to extend for two (2) additional years. The anticipated annual expense is $312,752.50 and has been budgeted for operational expenditures by the Health Information Management (HIM) and IT departments. Primary use of records management is for HIM department. This agreement is sponsored by Nancy Kaminski, SrVP Revenue Cycle. Evaluation Process The Contractor was determined to meet the requirements of the requesting department and Valleywise Health. Procurement has been satisfied pursuant to HS-102(B)(1) of the Procurement Code in that contracts between Valleywise Health and other political subdivisions, cooperative purchasing agreements with governmental entities or other governments are exempt from the solicitation requirements of the Procurement Code. Notes *Omnia Partners contract 1325* *This contract replaces contract 90-11-152-1 which customer wanted to continue. Vendor reached out to Valleywise to let them know that the Maricopa County contract we had been accessing through Cooperative Purchasing was going to expire 6/30/2021 and that they had another cooperative purchasing option with Omnia Partners. Since notification of a new contract was initiated by vendor, RFBA requirement is hereby waived* *Cost breakdown: Primarily used by HIM department with a small portion use by IT. HIM spend is based on existing usage of $177,234.92 (regular records storage) and $120,000.00 for ongoing projects. IT spend is based on existing usage of $15,517.58* *BAA reviewed/approved by Risk and Contracts* Category Co-op Effective Date 7/1/2021 Expiration Date 2/22/2024 Annual Value $312,752.50 Expense/Revenue Expense Budgeted Travel Type Yes Procurement Number Primary Vendor Iron Mountain

Responses

Member Name Status Comments Melton, Christopher C. Approved Reviewed and approved Soto-Griego, Manuel A. Approved Wynn, Diane J. Approved Kaminski, Nancy A. Approved Harris, Ijana M. Approved White, Michael Approved Agnew, Claire F. Approved Purves, Steve A. Approved

2 Talbot, Melanie L. Current

3 Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.vii.

Contracts 90-16-149-1-03 Melanie Talbot

From: Compliance 360 Sent: Thursday, June 10, 2021 1:47 PM To: Melanie Talbot Subject: Contract Approval Request: Arizona State Hospital IGA - Amendment 3 Arizona Department of Health Services (ADHS)

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From Melton, Christopher To Talbot, Melanie; Subject Contract Approval Request: Arizona State Hospital IGA - Amendment 3 Arizona Department of Health Services (ADHS) Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

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Division Contracts Division Folder Contracts \ Managed Care/Revenue Status Pending Approval Title Arizona State Hospital IGA - Amendment 3 Contract Identifier Board - Amendment MIHS Contract 90-16-149-1-03 Number Primary Responsible Tucker, Collee K. Party Departments Product/Service Description Action/Background Approve Amendment #3 to the Intergovernmental Agreement (IGA) between Arizona Department of Health Services (ADHS) – Arizona State Hospital (ASH) and the Maricopa County Special Health Care District dba Valleywise Health to extend termination date of current IGA to December 31, 2021.

Valleywise Health and Arizona State Hospital have held current IGA since 2016. ADHS has requested to complete new paper that is currently under review but was not able to be completed prior to termination date of the IGA. Amendment #3 extends current agreement through December 31, 2021, allowing for additional time to review and agree to terms for new IGA.

1 Evaluation Process Valleywise Health and Arizona State Hospital have held current IGA since 2016. ADHS has requested to complete new paper that is currently under review but was not able to be completed prior to termination date of the IGA. Amendment #3 extends current agreement through December 31, 2021 allowing for additional time to review and agree to terms for new IGA.

As an IGA, document is subject to review and approval by the District Board of Directors. Notes Category Effective Date Expiration Date 12/31/2021 Annual Value $0.00 Expense/Revenue Budgeted Travel Type Procurement Number Primary Vendor Arizona Department of Health Services (ADHS)

Responses

Member Name Status Comments Tucker, Collee K. Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Approved Tucker, Collee K. Approved Harris, Ijana M. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.viii.

Contracts 90-21-347-1 Melanie Talbot

From: Compliance 360 Sent: Wednesday, June 9, 2021 3:56 PM To: Melanie Talbot Subject: Contract Approval Request: Professional Medical Services re Interventional Cardiology Services District Medical Group (DMG)

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Professional Medical Services re Interventional Cardiology Services District Medical Group (DMG) Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

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Attachments

Name DescriptionTypeCurrent File / URL (Draft - For Review) Valleywise-DMG - File (Draft - For Review) Valleywise-DMG - Professional Services Agreement (Dr. Professional Services Agreement (Dr. White) FINAL - 6.8.21 (00 White) FINAL - 6.8.21 (002).pdf

Contract Information

Division Contracts Division Folder Contracts \ Services - Management/Outsourcing Status Pending Approval Title Professional Medical Services re Interventional Cardiology Services Contract Identifier Board - New Contract MIHS Contract 90-21-347-1 Number Primary Responsible Melton, Christopher C. Party Departments HOSPITAL ADMINISTRATION Product/Service Description Action/Background Approve a new Professional Services Agreement between District Medical Group (DMG) and Maricopa County Special Health Care District dba 1 Valleywise Health.

Valleywise Health employs certain Providers who mostly perform administrative duties but who need to maintain their credentials by periodically performing clinical services. These Valleywise Health Providers wish to furnish these professional clinical services at Valleywise Health's facilities, however, Valleywise Health operates under a closed medical staff model under the contract with DMG.

A request for approval to authorize Valleywise Health's President and Chief Executive Officer to enter into a Professional Services Agreement with DMG to permit qualified providers employed by Valleywise Health to provide professional services at Valleywise Health facilities consistent with the Amended and Restated Contract for Professional Services effective September 1, 2012, as amended, between Valleywise Health and DMG has been included in the June 23, 2021 Formal Meeting Consent Agenda.

This new Professional Services Agreement is sponsored by Claire Agnew, EVP & Chief Financial Officer. Evaluation Process Notes Category Effective Date Expiration Date Annual Value $0.00 Expense/Revenue Revenue Budgeted Travel Type Procurement Number Primary Vendor District Medical Group (DMG)

Responses

Member Name Status Comments Melton, Christopher C. Approved Harris, Ijana M. Approved Slaughter, Lanny Approved Agnew, Claire F. Approved Talbot, Melanie L. Current Purves, Steve A. Approved

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.ix.

Contracts 90-16-044-1-10 Melanie Talbot

From: Compliance 360 Sent: Thursday, June 10, 2021 8:48 AM To: Melanie Talbot Subject: Contract Approval Request: Amendment #10 - Extend the Term for Two Years Carefusion Solutions, LLC

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Amendment #10 - Extend the Term for Two Years Carefusion Solutions, LLC Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

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Attachments

Name DescriptionTypeCurrent File / URL OIG 2021 File OIG Carefusion 2021.pdf SAM 2021 File SAM Carefusion 2021.pdf 90-16-044-1-10 File 90-16-044-1 Amendment to Rental and Support (unsigned) Agreements (unsigned).pdf

Contract Information

Division Contracts Division Folder Amendments Status Pending Approval Title Amendment #10 - Extend the Term for Two Years Contract Identifier Board - Amendment MIHS Contract 90-16-044-1-10 Number Primary Responsible Pardo, Laela N. Party Departments OFFICE OF THE CIO,PHARMACY - HOSPITAL Product/Service Amendment #10 - Extend the Term for Two Years Description

1 Action/Background Approve Amendment #10 to the contract between CareFusion Solutions, LLC and Maricopa County Special Health Care District dba Valleywise Health to extend existing customer orders for the main campus an additional two (2) years to bring the End Date out to when the new Hospital will open. Various customer orders have different end dates, therefore start dates of this extension depends on each customer order listed in the Schedule A. Term End Date is extended to October 1, 2023; for an aggregate contract term of September 1, 2016 to October 31, 2023. There is an increase to support only of $1,462.00/mo. ($17,544.00/ann.); annual expense is hereby changed from $858,672.48 to be $876,216.48 and is budgeted for operational expenditures by the Pharmacy (rental) and IT (support) departments. All other terms and conditions remain the same and in full effect. This amendment is sponsored by Dr. Michael White, EVP & Chief Clinical Officer. Evaluation Process The requesting department has determined that the Contractor is performing satisfactorily and is meeting the goals and objectives of the organization. The requesting department has elected that the contract should be continued and extended. Notes *GPO #CE7136* *Cost Breakdown: Current cost is $57,901.04/mo. for rental and $13,655.00/mo. for support. New cost of term extension includes an increase to support only, from $13,655.00/mo. to 15,117.00/mo. No change in cost for rental Overall annual cost change from $858,672.48 to $876,216.48* Category GPO Effective Date Expiration Date 10/1/2023 Annual Value $876,216.48 Expense/Revenue Expense Budgeted Travel Type Yes Procurement Number Primary Vendor Carefusion Solutions, LLC

Responses

Member Name Status Comments Melton, Christopher C. Approved Reviewed and approved Wynn, Diane J. Approved Sogard, Anna V. Approved Reviewed and approve Detzel, Jo-El M. Approved Harris, Ijana M. Approved White, Michael Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.x.

Contracts 90-16-044-3 Melanie Talbot

From: Compliance 360 Sent: Wednesday, June 9, 2021 3:58 PM To: Melanie Talbot Subject: Contract Approval Request: Pyxis for Behavioral Health Center (Customer Order 1000196193) Carefusion Solutions, LLC

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Pyxis for Behavioral Health Center (Customer Order 1000196193) Carefusion Solutions, LLC Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

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Attachments

Name Description Type Current File / URL 90-16-044-3 (unsigned) File Customer Order 100196193 (unsigned).pdf OIG File OIG Carefusion 2021.pdf SAM File SAM Carefusion 2021.pdf Master Agreement File Carefusion Master Agreement.pdf

Contract Information

Division Contracts Division Folder Contracts \ Leases - Equipment Status Pending Approval Title Pyxis for Behavioral Health Center (Customer Order 1000196193) Contract Identifier Board - New Contract MIHS Contract 90-16-044-3 Number Primary Responsible Pardo, Laela N. Party Departments OFFICE OF THE CIO,PHARMACY - HOSPITAL Product/Service Pyxis for Behavioral Health Center (Customer Order 1000196193) Description

1 Action/Background Approve a new Customer Order between Carefusion Solutions, LLC and Maricopa County Special Health Care District dba Valleywise Health for updating the Pyxis station at the Valleywise Behavioral Health Center. Carefusion is aligning our Pyxis stations to be coterminous with the opening of the new Hospital and as a result some of our existing agreements need to be updated with their term. This Customer Order will have an eighty-three (83) month term so that it ends coterminously with the new lease that will accompany the Pyxis station for the new Hospital starting in 2023. Effective Date is upon signatures. There is a decrease in both the rental and support costs for an annual reduction of $2,652.12. The anticipated annual expense $111,900.00 and is budgeted for operational expenditures by the Pharmacy (rental) and IT (support) departments. This agreement is sponsored by Dr. Michael White, EVP & Chief Clinical Officer. Evaluation Process The Contractor was determined to meet the requirements of the requesting department and Valleywise Health. Procurement has been satisfied pursuant to HS-102(B)(3) of the Procurement Code in that any agreements with professional association memberships and medical research projects are exempt from the solicitation requirements of the Procurement Code. Notes *GPO #CE7136* *Customer Order 10001961930breaks down the current/new products costs as follows: Current Products is $8,138.01 for rental and $1,408.00 for support. New Products is $8,030.00 for rental and $1,295.00 for support. Reduction of $221.01/mo. = $2,652.12 Category GPO Effective Date Expiration Date Annual Value $111,900.00 Expense/Revenue Expense Budgeted Travel Type Yes Procurement Number Primary Vendor Carefusion Solutions, LLC

Responses

Member Name Status Comments Melton, Christopher C. Approved Wynn, Diane J. Approved Sogard, Anna V. Approved Reviewed and approved Detzel, Jo-El M. Approved Harris, Ijana M. Approved White, Michael Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.b.xi.

Contracts 90-16-044-4 Melanie Talbot

From: Compliance 360 Sent: Wednesday, June 9, 2021 3:57 PM To: Melanie Talbot Subject: Contract Approval Request: Pyxis HealthSight Inventory Optimization Pyxis for BH (Customer Order 1000203430) Carefusion Solutions, LLC

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From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Pyxis HealthSight Inventory Optimization Pyxis for BH (Customer Order 1000203430) Carefusion Solutions, LLC Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

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Attachments

Name Description Type Current File / URL OIG File OIG Carefusion 2021.pdf SAM File SAM Carefusion 2021.pdf Master Agreement File Carefusion Master Agreement.pdf 90-16-044-4 (unsigned) File Customer Order 1000203430 (unsigned).pdf

Contract Information

Division Contracts Division Folder Contracts \ Leases - Equipment Status Pending Approval Title Pyxis HealthSight Inventory Optimization Pyxis for BH (Customer Order 1000203430) Contract Identifier Board - New Contract MIHS Contract 90-16-044-4 Number Primary Responsible Pardo, Laela N. Party Departments PHARMACY - HOSPITAL

1 Product/Service Pyxis HealthSight Inventory Optimization Pyxis for BH (Customer Order Description 1000203430) Action/Background Approve a new Customer Order between Carefusion Solutions, LLC and Maricopa County Special Health Care District dba Valleywise Health to add HealthSight Inventory Optimization products to the Pyxis station at Behavioral Health which is a predictive analytics tool that recommends PAR levels and outcomes if changes are applied. This Customer Order will have an eighty-three (83) month term so that it ends coterminously with the new lease that will accompany the Pyxis station for the new Hospital starting in 2023. Effective Date is upon signatures. The anticipated annual expense $7,260.00 and is budgeted for operational expenditures by the Pharmacy department. This agreement is sponsored by Dr. Michael White, EVP & Chief Clinical Officer. Evaluation Process The Contractor was determined to meet the requirements of the requesting department and Valleywise Health. Procurement has been satisfied pursuant to HS-102(B)(3) of the Procurement Code in that any agreements with professional association memberships and medical research projects are exempt from the solicitation requirements of the Procurement Code. Notes *GPO #CE7136* *Customer Order 1000203430 is new cost for rental (Pharmacy) only* Category GPO Effective Date Expiration Date Annual Value $7,260.00 Expense/Revenue Expense Budgeted Travel Type Yes Procurement Number Primary Vendor Carefusion Solutions, LLC

Responses

Member Name Status Comments Melton, Christopher C. Approved Sogard, Anna V. Approved Reviewed and approve Detzel, Jo-El M. Approved Harris, Ijana M. Approved White, Michael Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.i.

Governance Change in Scope – Delete Valleywise Community Health Center-Maryvale Office of the Senior Vice President & CEO FQHC Clinics 2525 East Roosevelt Street • Phoenix • AZ• 85008

DATE: June 23, 2020

TO: Maricopa County Special Health Care District Board of Directors

FROM: Barbara Harding, BAN, RN, MPA, PAHM, CCM Sr VP Amb Services & CEO FQHC Clinics

SUBJ: Change in Scope of Service (CIS) Close Site: Valleywise Community Health Center – Maryvale

Per the Health Resources and Services Administration (HRSA), Health Center Compliance Manual, Chapter 6: Accessible Locations and Hours of Service and in accordance with 45 CFR 75.308(c)(1)(i), health centers must request prior approval from HRSA for a “Change in the scope or the objective of the project or program (even if there is no associated budget revision requiring prior written approval).” This prior approval requirement applies to the addition, deletion, or replacement of a service site. These changes require prior approval from HRSA and must be submitted by the health center as a formal change in scope request.

Staff is requesting approval of the submission of the CIS to HRSA for grant number: H80CS33644 Maricopa County Special Health Care District deleting site: Valleywise Community Health Center – Maryvale.

This Change in Scope (CIS) requests the relocation of operations from the Valleywise Community Health Center– Maryvale, currently located at 4011 N. 51st Ave, Phoenix, AZ 85031, to a new service site, Valleywise Community Health Center – West Maryvale, 7808 W. Thomas Road, Phoenix, AZ 85033.

This clinic is scheduled to close in November of 2021 with the new clinic to open immediately after.

Services at Valleywise Community Health Center– West Maryvale will continue at the new site. Adult and pediatric primary care will include: Family Medicine, Internal Medicine, Pediatrics, OB/GYN, Diabetes Outreach Education, Behavioral Health, Radiology, Pharmacy, Laboratory, and a Family Learning Center.

1 Subj: Change in Scope of Service (CIS) Close Site: Valleywise Community Health Center – Maryvale

This CIS request was presented and approved by the Valleywise Community Health Center Governing Council on June 2, 2021.

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.ii.

Governance Change in Scope – Add Valleywise Community Health Center-West Maryvale Office of the Senior Vice President & CEO FQHC Clinics 2525 East Roosevelt Street • Phoenix • AZ• 85008

DATE: June 23, 2021

TO: Maricopa County Special Health Care District Board of Directors

FROM: Barbara Harding, BAN, RN, MPA, PAHM, CCM Sr VP Amb Services & CEO FQHC Clinics

SUBJ: Change in Scope of Service (CIS) Add Site: Valleywise Community Health Center – West Maryvale

Staff is requesting approval of the submission of the CIS to HRSA for grant number: H80CS33644 Maricopa County Special Health Care District adding site: Valleywise Community Health Center – West Maryvale.

This new clinic is scheduled to open November of 2021 with the old clinic closing in conjunction.

Services at Valleywise Community Health Center– Maryvale will continue at the new site. Adult and pediatric primary care will include: Family Medicine, Internal Medicine, Pediatrics, OB/GYN, Diabetes Outreach Education, Behavioral Health, Radiology, Pharmacy, Laboratory, and a Family Learning Center.

1 Subj: Change in Scope of Service (CIS) Add Site: Valleywise Community Health Center – West Maryvale

The proposed Valleywise Community Health Center – West Maryvale site is part of Valleywise Health System (VHS) strategic plan to build an infrastructure to meet the needs of a growing population. VHS is “reimagining care” for its entire system, implementing specific initiatives, such as undertaking major renovations to the System’s aging facilities to upgrade its infrastructure and ensure providers and patients have access to quality facilities and to respond to population growth in the coming years. To operationalize the noted strategic initiatives (including replacing 7 FQHC clinic buildings) and meeting patients’ greatest needs (including access to necessary medical services), VHS reviewed the current care delivery system and identified opportunities to ensure all underserved populations have access to care. VHS is implementing a new care model at all FQHC clinics – Whole Person Care – which seeks to provide patient- centered care through fully integrated services. This model will ensure every patient has a medical home, eliminating health equity challenges by reducing barriers to care. Moreover, this new care model will allow patients to receive all care (across the continuum) at Valleywise Health.

The Maricopa County Special Health Care District completed a Community Needs Assessment in 2020. A patient survey was completed at VHS clinics to learn from clinic patients their concerns about healthcare. The population reported their 3 top health challenges: pain, diabetes, and hypertension/stroke/overweight. Self-report of wellness interventions to prevent chronic disease indicated that although patients recognized their conditions, the focus on healthy lifestyle needs to be improved. Improved access to care and wellness services to promote a healthy lifestyle will be a key component of the site. Health education classes focusing on diet, exercise and barriers created by social determinants of health are one example of service improvements to be made available.

VHS’s target population faces multiple barriers to accessing health care services, including lack of providers, financial barriers, and transportation barriers. Maricopa County has several designated Medically Underserved Areas (MUAs) and Medically Underserved Populations (MUPs), as well as numerous Health Provider Shortage Areas (HPSAs) which impact access to care and utilization across the county.

This CIS request was presented and approved by the Valleywise Community Health Center Governing Council on June 2, 2021.

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.iii.

Governance Change in Scope – Delete Valleywise Community Health Center-Mesa 85210 Office of the Senior Vice President & CEO FQHC Clinics 2525 East Roosevelt Street • Phoenix • AZ• 85008

DATE: June 23, 2020

TO: Maricopa County Special Health Care District Board of Directors

FROM: Barbara Harding, BAN, RN, MPA, PAHM, CCM Sr VP Amb Services & CEO FQHC Clinics

SUBJ: Change in Scope of Service (CIS) Close Site: Valleywise Community Health Center – Mesa

Staff is requesting approval of the submission of the CIS to HRSA for grant number: H80CS33644 Maricopa County Special Health Care District deleting site: Valleywise Community Health Center – Mesa.

This Change in Scope (CIS) requests the relocation of operations from the Valleywise Community Health Center– Mesa, currently located at 59 S. Hibbert Street, Mesa, AZ 85210 to a new service site, Valleywise Community Health Center – Mesa, 950 E. Main Street, Mesa, AZ 85034. This clinic is scheduled to close in January of 2022.

This CIS request was presented and approved by the Valleywise Community Health Center Governing Council on June 2, 2021.

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.iv.

Governance Change in Scope – Add Valleywise Community Health Center-Mesa 85203 Office of the Senior Vice President & CEO FQHC Clinics 2525 East Roosevelt Street • Phoenix • AZ• 85008

DATE: June 23, 2021

TO: Maricopa County Special Health Care District Board of Directors

FROM: Barbara Harding, BAN, RN, MPA, PAHM, CCM Sr VP Amb Services & CEO FQHC Clinics

SUBJ: Change in Scope of Service (CIS) Add Site: Valleywise Community Health Center – Mesa

Staff is requesting approval of the submission of the CIS to HRSA for grant number: H80CS33644 Maricopa County Special Health Care District adding site: Valleywise Community Health Center – Mesa.

This Change in Scope (CIS) requests the relocation of operations from the Valleywise Community Health Center– Mesa, currently located at 59 S. Hibbert Street, Mesa, AZ 85210, to a new service site, Valleywise Community Health Center – Mesa, 950 E. Mesa Street, Mesa, AZ 85034.

Services at Valleywise Community Health Center– Mesa will continue at the new site. Adult and pediatric primary care will include: Family Medicine, Internal Medicine, Pediatrics, OB/GYN, Diabetes Outreach Education, Behavioral Health, Radiology, Pharmacy, Laboratory, and a Family Learning Center. In addition to the FQHC services, there will be a clinic adjoining the FQHC for patients diagnosed with Serious Mental Illnesses (SMI).

1 Subj: Change in Scope of Service (CIS) Add Site: Valleywise Community Health Center – Mesa

The proposed Valleywise Community Health Center – Mesa site is part of Valleywise Health System (VHS) strategic plan to build an infrastructure to meet the needs of a growing population. VHS is “reimagining care” for its entire system, implementing specific initiatives, such as undertaking major renovations to the System’s aging facilities to upgrade its infrastructure and ensure providers and patients have access to quality facilities and to respond to population growth in the coming years. To operationalize the noted strategic initiatives (including replacing 7 FQHC clinic buildings) and meeting patients’ greatest needs (including access to necessary medical services), VHS reviewed the current care delivery system and identified opportunities to ensure all underserved populations have access to care. VHS is implementing a new care model at all FQHC clinics – Whole Person Care – which seeks to provide patient- centered care through fully integrated services. This model will ensure every patient has a medical home, eliminating health equity challenges by reducing barriers to care. Moreover, this new care model will allow patients to receive all care (across the continuum) at Valleywise Health.

This CIS request was presented and approved by the Valleywise Community Health Center Governing Council on June 2, 2021.

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.v.

Governance Change in Scope – Add to Women’s Services Office of the Senior Vice President & CEO FQHC Clinics 2525 East Roosevelt Street • Phoenix • AZ• 85008

DATE: June 23, 2020

TO: Maricopa County Special Health Care District Board of Directors

FROM: Barbara Harding, BAN, RN, MPA, PAHM, CCM Sr VP Amb Services & CEO FQHC Clinics

SUBJ: Correction of Form 5A & Change in Scope of Service (CIS) Add Services to Women’s Services

The Form 5A is a service descriptor outline which provides an overview of the general elements for all services, both Required and Additional, to assist in accurate recording of an approved Health Center Program under the Health Resources and Services Administration.

In review of the organizations form 5A, it was found that the following Women’s Services are provided but were not initially included:

 OB/GYN INFERTILITY  OB/GYN-Urology  GYN TUMOR

In order to modify the organization form 5A to reflect these services, a Change in Scope is necessary.

In addition to the corrections of form 5A, staff is requesting approval of the submission of the CIS to HRSA for grant number: H80CS33644 Maricopa County Special Health Care District to add Perinatal Cardiology services.

The request for a Change in Scope (CIS) for Perinatal Cardiology Services was deemed necessary after review of literature suggesting that cardiovascular disease accounts for 25% to 33% of maternal deaths making this specific cause the focus of preventative efforts. As such, a cardiologist with expertise in cardio-obstetrics and congenital health would be a part of the team care team to provide services during and after pregnancy, an especially vulnerable time for women who have cardiovascular disease.

1 Subj: Change in Scope of Service (CIS) Add Services to Women’s Services

This CIS request was presented and approved by the Valleywise Community Health Center Governing Council on June 2, 2021.

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.vi.

Governance Policy 06503 S; Health Resources & Services Administration Legislative Mandate Compliance Once Printed This Document May No Longer Be Current

Valleywise Health Administrative Policy & Procedure

Effective Date: 09/20 Reviewed Dates: 00/00 Revision Dates: 00/0005/21

Policy #: 06503 S

Policy Title: HRSA Legislative Mandate Compliance Policy

Scope: [X] District Governance (G) [X] System-Wide (S) [ ] Division (D) [ ] Multi-Division (MD) [ ] Department (T) [ ] Multi-Department (MT) [X] FQHC (F)

Purpose:

To establish a policy outlining the practices that Valleywise Health follows to comply with the legislative mandates required by the Further Consolidated Appropriations Act, 2020, for HRSA award recipients limiting the use of the funds received. Legislative mandates remain in effect until a new appropriation bill is passed setting a new list of requirements.

Definitions:

HRSA - Health Resources & Services Administration

PPAC - The Patient Protection and Affordable Care Act, Public Law 111-148

The Act - The Further Consolidation Appropriations Act, 2020 (Public Law 116-94) signed into law on December 20, 2019 which provides funding to the HRSA for the fiscal year ending September 30, 2020.

Valleywise Health - Is a “d.b.a” of Maricopa County Special Health Care District

Policy:

Valleywise Health will adhere to the provisions listed below in accordance with the Health Resources & Services Administration’s (HRSA) Legislative Mandates in Grants Management for FY 20212020. The FY 2021 list of legislative mandates for HRSA recipients is the same as the FY 2020 list.

1. Salary Limitation

Policy #06503 S HRSA Legislative Mandate Compliance Policy Page 1 of 6 09/20 Supersedes NEW Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

Valleywise Health will not use funds received through federal grants and/or contracts to pay the salary of an individual at a rate in excess of the Federal Executive Schedule Level II.

2. Gun Control Valleywise Health will not use funds received through federal grants and/or contracts, in whole or in part, to advocate for or promote gun control.

3. Anti-Lobbying a. Valleywise Health will not use funds received through federal grants and/or contracts, other than for normal and recognized executive legislative relationships, for publicity or propaganda purposes, for the preparation, distribution, or use of any kit, pamphlet, booklet, publication, electronic communication, radio, television, or video presentation designed to support or defeat the enactment of legislation before the Congress or any State or local legislature or legislative body, except in presentation to the Congress or any State or local legislature itself, or designed to support or defeat any proposed or pending regulation, administrative action, or order issued by the executive branch of any State or local government, except in presentation to the executive branch of any State or local government itself. b. Valleywise Health will not use funds received through federal grants and/or contracts, to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before the Congress or any State government, State legislature or local legislature or legislative body, other than for normal and recognized executive-legislative relationships or participation by an agency or officer of a State, local or tribal government in policymaking and administrative processes within the executive branch of that government.

The prohibitions in subsections (a) and (b) shall include any activity to advocate for or promote any proposed, pending or future Federal, State or local tax increase, or any proposed, pending, or future requirement or restriction on any legal consumer product, including its sale or marketing, including but not limited to the advocacy or promotion of gun control.

4. Acknowledgement of Federal Funding When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, as a grantee receiving Federal funds included in this Act, Valleywise Health shall clearly state (1) the percentage of the total costs of the program or project which will be financed with Federal money; (2) the dollar amount of Federal funds for the project or program; and (3) percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental sources.

5. Restriction on Abortion

Policy #06503 S HRSA Legislative Mandate Compliance Policy Page 2 of 6 09/20 Supersedes NEW Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

None of the Federal funds appropriated to Valleywise Health will be expended for any abortion or on health benefits coverage that includes coverage of abortion. The term “health coverage” means the package of services covered by a managed provider or organization pursuant to a contract or other arrangements

6. Exception to Restriction on Abortions a. The limitation established in the preceding section shall not apply to an abortion- i. If the pregnancy is the result of an act of rape or incest; or ii. In the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed. b. Nothing in the preceding section shall be construed as prohibiting the expenditure by a State, locality, entity, or private person of State, local, or private funds (other than a State’s or locality contributions of Medicaid matching funds) c. Nothing in the preceding section shall be construed as restricting ability of any managed care provider from offering abortion coverage or the ability of a State or locality to contract separately with such a provider for such coverage with State funds (other than a State’s or locality’s contribution of Medicaid matching funds) i. None of the funds made available in the Act to Valleywise Health may be made available to a Federal agency or program, or to a State or local government, if such agency, program, or government subjects any institutional or individual health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of or refer for abortions. ii. In this subsection, the term “health care entity” includes an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization or plan.

7. Ban of Funding of Human Embryo Research (Section 508) a. None of the funds made available to Valleywise Health in this Act may be used for- i. The creation of a human embryo or embryos for research purposes; or ii. Research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death greater than that allowed for research on the fetuses in utero under 45 CFR 46.204(b) and section 498 (b) of the Public Health Service Act (42 U.S.C 289g(b))

Policy #06503 S HRSA Legislative Mandate Compliance Policy Page 3 of 6 09/20 Supersedes NEW Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

b. For purposes of this section, the term “human embryo or embryos” includes any organism not protected as a human subject under 45 CFR 46 as of the date of the enactment of this Act, that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes or human diploid cells.

8. Limitation of Use of Funds for Promotion of Legalization of Controlled Substances None of the Federal funds made available to Valleywise Health will be used for any activity that promotes the legalization of any drug or other substance including Schedule I controlled substances established under section 202 of the Controlled Substances Act, except for normal and recognized executive- congressional communications. This limitation shall not apply if there is significant medical evidence of a therapeutic advantage to the use of such drug or other substance; or, if Valleywise Health is participating in a federally- sponsored clinical trial that is being conducted to determine the therapeutic advantage of a such a substance.

9. Restriction on Distribution of Sterile Needles Notwithstanding any other provision of this Act, no funds appropriated to Valleywise Health in this Act shall be used to purchase sterile needles or syringes for the hypodermic injection of any illegal drug: Provided, That such limitation does not apply to the use of funds for elements of a program other than making such purchase if the relevant State or local health department, in consultation with Center for Disease Control and Prevention, determines that the State or local jurisdiction, as applicable, is experiencing, or is at risk for significant increase in hepatitis infections or an HIV outbreak due to injection drug use, and such program is operating in accordance with State and local law.

10. Restriction on Pornography on Computer Networks (a) None of the funds made available in this Act may be used to maintain or establish a computer network unless such network blocks the viewing, downloading, and exchanging of pornography. (b) Nothing in subsection (a) shall limit the use of funds necessary for any Federal, state, tribal or local law enforcement agency or any other entity carrying out criminal investigations, prosecution, or adjudication.

11. Restrictions on Funding ACORN None of the Federal funds appropriated to Valleywise Health will be provided to the Association of Community Organization for Reform Now (ACORN), or any of its affiliates, subsidiaries, allied organizations, or successors.

12. Confidentiality Agreements Valleywise Health shall not require its employees or contractors seeking to report fraud, waste, or abuse to sign internal confidentiality agreement or statements prohibiting or otherwise restricting such employees or contractors from lawfully reporting such waste, fraud, or abuse to designated investigative or law enforcement representatives of a Federal Department or agency authorized to receive such information.

Policy #06503 S HRSA Legislative Mandate Compliance Policy Page 4 of 6 09/20 Supersedes NEW Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

The limitations in subsection (a) shall not contravene requirements applicable to standard Form 312, Form 4414, or any other form issued by a Federal department or agency governing the nondisclosure of classified information.

Procedure:

Valleywise Health will review HRSA’s Legislative Mandates annually for the passage of a new HHS Appropriations Act or issuance of HRSA guidance regarding the Legislative Mandates and ensure Valleywise Health’s policies and procedures are updated as necessary. Any modifications to Valleywise Health’s legislative mandates policies and procedures will require review and approval by the Board of Directors.

References:

External Grants Policy Bulletin Legislative Mandates in Grants Management for FY 2020 (HRSA, 2020)

The Patient Protection and Affordable Care Act, Public Law 111-148

The Further Consolidation Appropriations Act, 2020 (Public Law 116-94)

The Consolidated Appropriations Act, 2021 (Public Law 116-260)

Policy #06503 S HRSA Legislative Mandate Compliance Policy Page 5 of 6 09/20 Supersedes NEW Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

Valleywise Health Policy & Procedure - Approval Sheet (Before submitting, fill out COMPLETELY.)

Policy Responsible Party: Maricopa County Special Health Care District Board of Directors and Valleywise Community Health Centers Governing Council.

Development Team(s): Barbara Harding, Jennifer Joiner, L.T. Slaughter,

Policy #: 06503 S

Policy Title: HRSA Legislative Mandate Compliance Policy e-Signers:

Melanie Talbot, Chief Governance Officer and Board Clerk on behalf of the Maricopa County Special Health Care District Board of Directors

Barbara Harding, Senior Vice President Ambulatory Services and Chief Executive Officer of the Federally Qualified Health Center Clinics on behalf of the Valleywise Community Health Centers Governing Council

Place an X on the right side of applicable description:

New - X

Retire - Reviewed -

Revised with Minor Changes - X

Revised with Major Changes -

Please list revisions made below: (Other than grammatical changes or name and date changes)

Reviewed and Approved by in Addition to Responsible Party and E- Signer(s):

Board of Directors 09/23/20

Community Health Center Governing Council 10/07/20

Committee: Systemwide P&P 09/01/20

Other: Legal Services 09/20

Policy #06503 S HRSA Legislative Mandate Compliance Policy Page 6 of 6 09/20 Supersedes NEW Once Printed This Document May No Longer Be Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.vii.

Governance Grant Application to Health Resources & Services Administration June 23, 2021

Health Resources & Services Administration (HRSA) American Rescue Plan – Health Center Construction and Capital Improvements

Barbara Harding, SVP Ambulatory Care Services CEO FQHC Clinics

© 2019 Valleywise Health. All rights reserved. Internal use. HRSA American Rescue Plan – Health Center Construction and Capital Improvements On April 27, HRSA awarded more than $1 billion from the American Rescue Plan – Health Center Construction and Capital Improvement (ARP-Capital) to community health centers nationwide. The ARP-Capital provides one-time funding (C8E) for a 3-year period of performance for construction, expansion, alteration, renovation, and other capital improvement to modify, enhance, and expand health care infrastructure. Maricopa County Special Health Care District can apply for up to $1,461,158. The proposed budget will focus on a wide range of in-scope activities that were generated by an interdisciplinary team of staff with oversight by senior leadership. Assessments were made of current properties to determine the best use of the funds. The capital improvements will allow enhancement of accessibility of comprehensive primary care services as well as modernizing and improving the facilities.

© 2019 Valleywise Health. All rights reserved. Internal use. 2 Proposed American Rescue Plan Act Budget Facilities & Support Areas Construction & Capital Improvements Cost Avondale Clinic – Infrastructure and Plumbing Replace chilled water units and curb adaptors, mechanical controls, backflow valve, and $937,216 parking lot asphalt; design, soft costs, and contingency Guadalupe Clinic – Mechanical, Infrastructure, and Plumbing Roof-top HVAC unit; replace mechanical controls, domestic hot water system and $477,942 recirculation water pumps, and parking lot asphalt; design, soft costs, and contingency Chandler Clinic – Mechanical and Plumbing Replace chilled water and air components and backflow valve $41,000 South Central Clinic - Plumbing Replace backflow valve $5,000

Total $1,461,158

Award Facilities & Period Support Total 9/1/21 to 8/31/24 $1,461,158 $1,461,158

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.viii.

Governance Purchase and Sale Agreement Amendment #1 Melanie Talbot

From: Compliance 360 Sent: Tuesday, June 8, 2021 2:23 PM To: Melanie Talbot Subject: Contract Approval Request: Amendment #1 - Extension of Feasibility Period NLW Enterprises, LLC

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Message Information

From Melton, Christopher To Talbot, Melanie; Subject Contract Approval Request: Amendment #1 - Extension of Feasibility Period NLW Enterprises, LLC Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

Add comments as necessary.

Approve/Reject Contract

Click here to approve or reject the Contract.

Attachments

Name Description Type Current File / URL (For Review) addendum1.pdf File (For Review) addendum1.pdf

Contract Information

Division Contracts Division Folder Amendments Status Pending Approval Title Amendment #1 - Extension of Feasibility Period Contract Identifier Board - Amendment MIHS Contract 90-21-313-1-01 Number Primary Responsible Melton, Christopher C. Party Departments Product/Service Amendment #1 – Extension of Feasibility Period Description Action/Background Approve amendment#1 between NLW Enterprises, LLC (“Buyer”) and Maricopa County Special Health Care District dba Valleywise Health.

The purpose of this amendment#1 is to extend the Buyer’s due diligence “Feasibility Period”, described in Section 4.1.3 of the Purchase and Sale

1 Agreement for an additional thirty (30) days to July 10th, 2021, in order to attempt to formalize an agreement with the City of Phoenix regarding the undocumented easement across the subject property. There is no financial impact under this Amendment#1.

This Amendment #1 is sponsored by Warren Whitney, SVP Government Relations. Evaluation Process Procurement has been satisfied pursuant to HS-102B(7) of the Procurement Code in that purchase of real property is exempt from the solicitation requirements of the Procurement Code. Notes Category Effective Date Expiration Date Annual Value $0.00 Expense/Revenue Budgeted Travel Type Procurement Number Primary Vendor NLW Enterprises, LLC

Responses

Member Name Status Comments Melton, Christopher C. Approved Whitney, Warren W. Approved Harris, Ijana M. Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.ix.

Governance Annual Compliance Work Plan Fiscal Year 2022 FY2022 – Valleywise Health Compliance Work Plan - Board of Directors

Reporting Group: Compliance Person Reporting: L.T. Slaughter, Jr., CPA, CGMA, CHC, CISSP, CISA, MBA or Elena Landeros, Compliance Coordinator Reporting period: FY2022 Chief Compliance Officer/Privacy Officer

The map below depicts the highest rated risks based on feedback from interviews and other data gathering. The risks are plotted based on their individual significance to the business along with the likelihood that issues and / or improvement opportunities currently exist. The highest risk areas are shown in Quadrant 1 and generally include those risks that are inherently high for the industry or are a known concern to Valleywise Health.

R1 Revenue Cycle - (COVID, telemedicine, external referrals, etc.) Quadrant 2 Quadrant 1 R2 DMG Contract Compliance R3 Kronos and Payroll/Pay Codes/Inter-State Workers R4 Care-Reimagined Projects and Construction and Bond (Prop 480) HIGH R1 R5 Patient Violence R4 R6 Grant and Research Department (uniform guidance) Time and Effort R10 R8 R7 Privacy and IT Security of Protected Health Information R3 R2 R8 Clinical Validation and Documentation Accuracy R12 R5 R9 Quality and Internal and External Score Rating R10 GME and Resident Supervision and Controls (Creighton Alliance) R14 R7 R11 EPIC Implementation in the Locations/New Tower R20 R13 R6 R12 Compliance with Medicare and AHCCCS Regulations R9 R13 Charge Capture and Work Queues R18 R21 R17 R14 Pharmacy 340b and 797 Compliance R22 R11 R15 Procurement Process/ Supply Chain/Value Analysis/Supply Interface R16 R15 - Cost Management R23 R16 IT Disaster Recovery and Business Continuity Significance R17 Hospital Accreditation (DNV) and FQHC Licensure R19 (HRSA) R18 Managed Care Contracts/Payer Contract Management, Denied R25 R24 Reimbursement, Underpayments, Recording of Contractual Allowances – Credentialling Physicians R19 Access to and Analytical Reporting of Data R20 IMD Exclusion Compliance R21 Remote Workforce Controls R22 Vendor and Contract Management R23 General Ledger Accounting and Integrity of Data Quadrant 4 Quadrant 3 R24 Billing Accuracy Collections, Cash Application, Credit Balances

R25 Information Blocking (Cures Act) MACRA/EHR Incentive EP and EH LOW LOW HIGH Compliance Likelihood

3 Data Dictionary for the Compliance and Internal Audit Work Plan

ACN – Arizona Care Network – An Accountable Care Organization that operate in Arizona. AHCCCS – Arizona Healthcare Cost Containment System – State of Arizona’s name for the Medicaid state plan. DNV – Acute care Medicare accreditation organization Medicare PPS – Medicare Prospective Payment System – A fixed based Medicare payment model. Information Blocking – Cures Act regulation requiring medical information systems to communicate with other systems. MU – Meaningful Use – A term used in the Affordable Care Act to evaluate the implementation of Electronic Health Records and qualify for receiving incentive payments. NAP – New Access Point – A process where you receive a HRSA grant to open a new FQHC site. OSV – Operational Site Visit – The name for the HRSA audit of FQHCs at it relates to the HRSA Compliance Manual. Prop 480 (Care-Reimagined) – Referendum passed by the voters of Maricopa County to fund the re-construction of Maricopa County Special Health Care District d/b/a Valleywise Health. 340b – A HRSA sponsored discount drug program. UDS – Uniform Data System – HRSA’s quality reporting system got FQHCs.

© 2019 Valleywise Health. All rights reserved. Internal use. 4 1.1 FY2022 Compliance Work Plan The FY2022 compliance projects are listed below with proposed timing and estimated hours. Each project will, at a minimum, include a focus on the adequacy of compliance with regulations, as well as the identification of value-added recommendations. The FY2022 compliance work plan represents compliance activities based on the results of the risk assessment and may be subject to change based on changes in risk, priorities and Valleywise Health initiatives throughout the fiscal year. Initial Audit Est. Audit Post Review Project Name Current Status Completion Status Risk Timing Hours Ranking Rating Risk Assessment and Selection Q1

CQ1.1 FQHC Operational Site Visit (OSV) Q1 100 Hours Compliance Follow-up (R17) 5

CQ1.2 Violent Patients (R5) Q1 150 Hours 5 CQ1.3 Telehealth, Charge Capture, Work Queues, E&M Compliance (R1) (R13) Q1 150 Hours (R12)(R24) 5 Risk Re-assessment and Selection Q2 CQ2.1 New Facility Reviews (R4)(R5) Q2 100 Hours (R7)(R11)(R12) 5

CQ2.2 Resident Model Compliance (R10) Q2 100 Hours 5

CQ2.3 EHR Incentive Payments - (Two Q2 150 Hours Reporting Years by 12/31/2021) (R25) 5 © 2019 Valleywise Health. All rights reserved. Internal use. 5 1.2 FY2022 Compliance Work Plan The FY2022 compliance projects are listed below with proposed timing and estimated hours. Each project will, at a minimum, include a focus on the adequacy of compliance with regulations, as well as the identification of value-added recommendations. The FY2022 compliance work plan represents compliance activities based on the results of the risk assessment and may be subject to change based on changes in risk, priorities and Valleywise Health initiatives throughout the fiscal year.

Initial Audit Est. Audit Post Review Project Name Current Status Completion Status Risk Timing Hours Ranking Rating Risk Re-assessment and Selection Q3

CQ3.1) Internal and External Referral Patient Q3 150 Hours Follow-up (including Specialty referrals) (R1) 5 CQ3.2 Information Blocking Rules (R25) Q3 150 Hours 5 CQ3.3 Pharmacy 340b Compliance (R14) Q3 150 Hours 5 Risk Re-assessment and Selection Q4 CQ4.1 Clinical Documentation Improvement Q4 150 Hours Review and Quality (R8) (R9)(R24) 5 CQ4.2 HIPAA IT Security and Privacy Controls Q4 150 Hours (including remote workforce)(R7) (R21) 5 RO4 Risk Assessment and 2023 Compliance Quarterly 120 Hours Plan Development Special Projects and Other Compliance On-going TBD Requests Compliance Planning, Administration and Quarterly TBD Meetings

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.x.

Governance Annual Internal Audit Work Plan Fiscal Year 2022 FY2022 – Valleywise Health Internal Audit Work Plan - Board of Directors

Reporting Group: Internal Audit Person Reporting: L.T. Slaughter, Jr., CPA, CGMA, CHC, CISSP, CISA, MBA or Elena Landeros, Compliance Coordinator Reporting period: FY2022 Chief Compliance Officer/Privacy Officer

R1 Revenue Cycle - (COVID, telemedicine, external referrals, etc.)

Quadrant 2 Quadrant 1 R2 DMG Contract Compliance R3 Kronos and Payroll/Pay Codes/Inter-State Workers

HIGH R1 R4 Care-Reimagined Projects and Construction and Bond (Prop 480) R4 R5 Patient Violence R10 R8 R6 Grant and Research Department (uniform guidance) Time and Effort R2 R7 Privacy and IT Security of Protected Health Information R3 R8 Clinical Validation and Documentation Accuracy R12 R5 R9 Quality and Internal and External Score Rating R10 GME and Resident Supervision and Controls (Creighton Alliance) R14 R7 R11 EPIC Implementation in the Locations/New Tower R20 R13 R6 R12 Compliance with Medicare and AHCCCS Regulations R9 R13 Charge Capture and Work Queues R18 R21 R17 R14 Pharmacy 340b and 797 Compliance R22 R11 R15 Procurement Process/ Supply Chain/Value Analysis/Supply Interface - Cost Management R16 R15 R16 IT Disaster Recovery and Business Continuity R23 R17 Hospital Accreditation (DNV) and FQHC Licensure Significance (HRSA) R19 R18 Managed Care Contracts/Payer Contract Management, Denied Reimbursement, Underpayments, Recording of Contractual Allowances – Credentialling Physicians R25 R24 R19 Access to and Analytical Reporting of Data R20 IMD Exclusion Compliance R21 Remote Workforce Controls R22 Vendor and Contract Management R23 General Ledger Accounting and Integrity of Data

R24 Billing Accuracy Collections, Cash Application, Credit Balances R25 Information Blocking (Cures Act) MACRA/EHR Incentive EP and EH Quadrant 4 Quadrant 3 Compliance LOW LOW HIGH Likelihood

3 Data Dictionary for the Compliance and Internal Audit Work Plan

© 2019 Valleywise Health. All rights reserved. Internal use. 4 1.1 FY2022 Internal Audit Work Plan The FY2022 internal audit projects are listed below with proposed timing and estimated hours. Each project will, at a minimum, include a focus on the adequacy of internal controls as well as the identification of value-added recommendations. The FY2022 audit plan represents audits based on the results of the risk assessment and may be subject to change based on changes in risk, priorities and Valleywise Health initiatives throughout the fiscal year. Initial Post Audit Project Name Est. Audit Hours Current Status Completion Status Risk Review Timing Rating Ranking Risk Assessment and Selection Q1 (Current State Assessment) IQ1.1 Care Re-Imagined (Prop 480) Controls and Q1 150 Hours Monitoring Review (R4)(R23) 5

IQ1.2 Quality Reporting Barriers (R9) (R19) Q1 150 Hours 5

IQ1.3 DMG Contract Review (R2)(R23) Q1 150 Hours 5 Risk Re-assessment and Selection Q2

IQ2.1 Grants Reviews (R6)(R23) Q2 200 Hours 5 IQ2.2 Care Re-Imagined (Prop 480) Controls and Monitoring Review (A/P Procurement) Q2 100 Hours (R15)(R22) 5 IQ2.3 Managed Care Contracts and Physician Q2 150 Hours Credentialling (R18)(R20)(R12) 5 IQ2.4 Business Continuity Assessment (R16) Q1 150 Hours 5

© 2019 Valleywise Health. All rights reserved. Internal use. 5 1.1 FY2022 Internal Audit Work Plan The FY2022 internal audit projects are listed below with proposed timing and estimated hours. Each project will, at a minimum, include a focus on the adequacy of internal controls as well as the identification of value-added recommendations. The FY2022 audit plan represents audits based on the results of the risk assessment and may be subject to change based on changes in risk, priorities and Valleywise Health initiatives throughout the fiscal year. Initial Post Audit Project Name Est. Audit Hours Current Status Completion Status Risk Review Timing Rating Ranking IQ3.1 Payroll Review (R3)(R23) Q3 150 Hours 5 IQ3.2 Regulatory Sign Reviews (R12)(R17) Q3 150 Hours 5 IQ3.3 Care Re-Imagined (Prop 480) Controls and Q3 150 Hours Monitoring Review (R4) 5 Risk Re-assessment and Selection Q4 IQ4.1 Research Review (R6)(R12) Q4 150 Hours 5 IQ4.2 Revenue Cycle Controls - Back End Q4 150 Hours (R1)(R12)(R24) 5 IQ4.3 Care Re-Imagined (Prop 480) Controls and Q4 100 Hours Monitoring Review (R4) 5 Risk Assessment and 2023 Internal Audit Plan Quarterly 120 Hours Development Special Projects and Other Internal Audit On-going TBD Requests Internal Audit Planning, Administration and Quarterly TBD Meetings © 2019 Valleywise Health. All rights reserved. Internal use. 6 © 2019 Valleywise Health. All rights reserved. Internal use.

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.c.xi.

Governance Wellsite Easement with Salt River Project Melanie Talbot

From: Compliance 360 Sent: Thursday, June 10, 2021 9:57 AM To: Melanie Talbot Subject: Contract Approval Request: SRP Access Easement – APN 144-44-328 (NE ¼ Sec.20 T2N R2E) Salt River Project ("SRP")

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Message Information

From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: SRP Access Easement – APN 144-44-328 (NE ¼ Sec.20 T2N R2E) Salt River Project ("SRP") Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

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Approve/Reject Contract

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Attachments

Name DescriptionTypeCurrent File / URL (For Review Only) Wellsite Easement - File (For Review Only) Wellsite Easement - 8E-8.5NN - LJ80895 - 51st Ave & 8E-8.5NN - LJ80895 - 51st Ave & Campbell Campbell Ave.pdf Ave.pdf

Contract Information

Division Contracts Division Folder Contracts \ Leases - Property Status Pending Approval Title SRP Access Easement – APN 144-44-328 (NE ¼ Sec.20 T2N R2E) Contract Identifier Board - New Contract MIHS Contract 90-21-350-1 Number Primary Responsible Melton, Christopher C. Party Departments Product/Service Access Easement with SRP for Wellsite NE ¼ Sec.20 T2N R2E – APN 144-44- Description 328 Action/Background Approve a new Access Easement between Salt River Project (“SRP”) and Maricopa County Special Health Care District dba Valleywise Health. 1

The purpose of this easement is for Valleywise Health to grant SRP an exclusive right, privilege, and easement at the specified portion of Valleywise Health property. SRP is granted the right within the easement area to construct, reconstruct, replace, repair, operate and maintain underground electrical conduits and conductors, pipes, cables, switching equipment, transformers, pad-mounted equipment, enclosures, manholes, vaults, and all other appliances for the transmission and distribution of electricity, communication signals and data, and for all other purposes connected therewith at such locations and elevations, in, upon, over, under, across, through and along the Easement Parcel.

This Access Easement is sponsored by Warren Whitney, SVP Government Relations. Evaluation Process The Contractor was determined to meet the requirements of the requesting department and Valleywise Health. Procurement has been satisfied pursuant to HS-102B(7) of the Procurement Code in that purchase of real property is exempt from the solicitation requirements of the Procurement Code. Notes Category Effective Date Expiration Date Annual Value $10.00 Expense/Revenue Revenue Budgeted Travel Type Procurement Number Primary Vendor Salt River Project ("SRP")

Responses

Member Name Status Comments Melton, Christopher C. Approved Whitney, Warren W. Approved Harris, Ijana M. Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.d.i.

Medical Staff Medical Staff Credentials for June 2021 Recommended by Credentials Committee: June 1, 2021 Recommended by Medical Executive Committee: June 8, 2021 Submitted to MSHCDB: June 23, 2021

VALLEYWISE HEALTH CREDENTIALS AND ACTION ITEMS REPORT MEDICAL STAFF

The credentials of the following individuals including, current licensure, relevant training and experience, malpractice insurance, current competence and the ability to perform the requested privileges have been verified.

INITIAL MEDICAL STAFF APPOINTMENT NAME CATEGORY SPECIALTY/PRIVILEGES APPOINTMENT COMMENTS DATES Noha Adel Zaki Abdelkader Eltawil, M.D. Active Pediatrics 7/01/2021 to 6/30/2023 Hristo Deianov Hristov, M.D. Active Internal Medicine (Pulmonary/Critical Care Medicine) 7/01/2021 to 6/30/2023 Alpana Saini, D.O. Courtesy Anesthesiology 7/01/2021 to 6/30/2023

INITIAL/FOCUSED PROFESSIONAL PRACTICE EVALUATION

NAME SPECIALTY/PRIVILEGES RECOMMENDATION COMMENTS EXTEND or PROPOSED STATUS Chair has submitted documentation demonstrating practitioner has Meily Rosibel Arevalo Acosta, M.D. Internal Medicine FPPE successfully completed successfully completed FPPE requirement for Internal Medicine Core Privileges. Chair has submitted documentation demonstrating practitioner has Tracy Anne Contant, M.D. OB/GYN FPPE successfully completed successfully completed FPPE requirement for Ambulatory and Referral Ob/Gyn Core Privileges. Chair has submitted documentation demonstrating practitioner has Douglas R. Jones, M.D. Family and Community Medicine FPPE successfully completed successfully completed FPPE requirement for Pediatrics, Adolescent and Adult (Procedural/Cognitive) Core Privileges. Chair has submitted documentation demonstrating practitioner has Andrew Joseph Rivara, M.D. OB/GYN FPPE successfully completed successfully completed FPPE requirement for Ambulatory and Referral Ob/Gyn Core Privileges. Chair has submitted documentation demonstrating practitioner has Angela Fimbres Veesenmeyer, M.D. Pediatrics (Infectious Disease) FPPE successfully completed successfully completed FPPE requirement for Pediatric & Adolescent Core and Infectious Disease Privileges.

Page 1 of 3 Recommended by Credentials Committee: June 1, 2021 Recommended by Medical Executive Committee: June 8, 2021 Submitted to MSHCDB: June 23, 2021

REAPPOINTMENTS/ONGOING PROFESSIONAL PRACTICE EVALUATION NAME CATEGORY SPECIALTY/PRIVILEGES APPOINTMENT DATES COMMENTS Orazio L. Amabile, M.D. Courtesy Surgery (Thoracic Surgery) 7/01/2021 to 6/30/2023 Dana Meredith Chase, M.D. Courtesy Obstetrics / Gynecology 7/01/2021 to 6/30/2023 Michael Robert Collins, M.D. Active Radiology 7/01/2021 to 6/30/2023 Aaron J. Dahl, M.D. Courtesy Psychiatry 7/01/2021 to 6/30/2023 Beth Darling, D.O. Active Psychiatry 7/01/2021 to 6/30/2023 Nathan Lechae's Delafield, M.D. Active Internal Medicine 7/01/2021 to 6/30/2023 Maria Rose DiLeo, M.D. Active Obstetrics / Gynecology 7/01/2021 to 6/30/2023 Damon Brian Dixon, M.D. Courtesy Pediatrics (Cardiology) 7/01/2021 to 6/30/2023 H. Kenith Fang, M.D. Courtesy Surgery (Thoracic Surgery) 7/01/2021 to 6/30/2023 Michael David Guttenplan, M.D. Active Surgery (Otolaryngology) 7/01/2021 to 6/30/2023 Rachel Marie Haake, M.D. Courtesy Anesthesiology 7/01/2021 to 6/30/2023 Patrick K. Hitchcock, M.D. Active Radiology 7/01/2021 to 6/30/2023 Carolyn Lee Hsiao, D.D.S. Active Dentistry 7/01/2021 to 6/30/2023 Brant Marcus Jaouen, M.D. Active Emergency Medicine 7/01/2021 to 6/30/2023 Marisse Lardizabal, D.P.M. Active Surgery (Podiatry) 7/01/2021 to 6/30/2023 Gwen A. Levitt, D.O. Active Psychiatry 7/01/2021 to 6/30/2023 Rachel Frances Lusk, M.D. Active Pediatrics 7/01/2021 to 6/30/2023 Brian James Magee, D.O. Active Radiology 7/01/2021 to 6/30/2023 Elyssa Marie Metas, M.D. Active Obstetrics / Gynecology 7/01/2021 to 6/30/2023 Aris Ellann Danielle Mosley, M.D. Active Psychiatry 7/01/2021 to 6/30/2023 Carol K. Olson, M.D. Active Psychiatry 7/01/2021 to 6/30/2023 Stephen G. Pophal, M.D. Courtesy Pediatrics (Cardiology) 7/01/2021 to 6/30/2023 Paul Edwin Pugsley, M.D. Active Emergency Medicine 7/01/2021 to 6/30/2023 Robert Anthony Puntel, M.D. Courtesy Pediatrics (Cardiology) 7/01/2021 to 6/30/2023 Dany Kin Moon Quan, D.O. Active Emergency Medicine 7/01/2021 to 6/30/2023 Michelle Marie Ratkiewicz, D.O. Courtesy Pediatrics (Pulmonology) 7/01/2021 to 6/30/2023 Marie Frances Roy Babbitt, M.D. Active Psychiatry 7/01/2021 to 6/30/2023 Jimmy Youssef Saade, M.D. Active Radiology 7/01/2021 to 6/30/2023 Mark R. Tasset, M.D. Courtesy Surgery (Thoracic Surgery) 7/01/2021 to 6/30/2023 John E. Tidwell, M.D. Active Orthopaedic Surgery 7/01/2021 to 6/30/2023

Page 2 of 3 Recommended by Credentials Committee: June 1, 2021 Recommended by Medical Executive Committee: June 8, 2021 Submitted to MSHCDB: June 23, 2021

REAPPOINTMENTS/ONGOING PROFESSIONAL PRACTICE EVALUATION Benjamin Wei, M.D. Active Surgery (Hand Surgery) 7/01/2021 to 6/30/2023 Samuel Brey Weimer, M.D. Active Surgery 7/01/2021 to 6/30/2023 Thomas Trey Whiting, D.O. Active Emergency Medicine 7/01/2021 to 6/30/2023 Roscoe C. Williams, D.D.S. Active Dentistry 7/01/2021 to 6/30/2023 David Chuan-Wei Yao, M.D. Active Surgery (Plastic Surgery) 7/01/2021 to 6/30/2023

CHANGE IN PRIVILEGES

NAME DEPARTMENT/SPECIALTY ADDITION / REDUCTION / WITHDRAWAL COMMENTS Voluntary Relinquishment of Privileges due to Nicholas Baldwin, D.O. Psychiatry Withdrawal: Child Psychiatric Advanced Clinical Privileges non-utilization of privileges FPPE: Retrospective review of 5 cases with Aaron J. Dahl, M.D. Psychiatry Addition: Child Psychiatric Advanced Clinical Privileges acceptable results

FPPE: Retrospective review of the first 2 cases with Brian James Magee, D.O. Radiology Addition: Therapeutic Nuclear Medicine Privileges satisfactory performance. Voluntary Relinquishment of Privileges due to Elyssa Marie Metas, M.D. Obstetrics / Gynecology Withdrawal: Robotic Surgery Privileges non-utilization of privileges FPPE: Retrospective review of at least 5 cases in Dany Kin Moon Quan, D.O. Emergency Medicine Addition: Addiction Medicine performed in accordance with the Policy.

RESIGNATIONS Information Only NAME DEPARTMENT/SPECIALTY STATUS REASON Cortney Michelle Eakin, M.D. Obstetrics / Gynecology Active to Inactive Resigned effective June 30, 2021 Reda Ali Issa, M.D. Surgery (Ophthalmology) Courtesy to Inactive Resigned effective June 18, 2021 Meera Mahendra Mehta, M.D. Psychiatry Courtesy to Inactive Resigned effective June 30, 2021 Zhanna Shpitalnik, M.D. Psychiatry Active to Inactive Resigned effective May 14, 2021

Definitions: Active > 1,000 hours/year – Active members of the medical staff have voting rights and can serve on medical staff committees Courtesy < 1,000 hours/year – Courtesy members do not have voting rights and do not serve on medical staff committees Reappointments Renewal of appointment and privileges is for a period of two years unless otherwise specified for a shorter period of time. FPPE Focused professional practice evaluation is a process by which the organization validates current clinical competence. This process may also be used when a question arises in practice patterns.

Page 3 of 3

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.d.ii.

Medical Staff Allied Health Professional Staff Credentials for June 2021 Recommended by Credentials Committee: June 1, 2021 Recommended by Medical Executive Committee: June 8, 2021 Submitted to MSHCDB: June 23, 2021

VALLEYWISE HEALTH CREDENTIALS AND ACTION ITEMS REPORT ALLIED HEALTH PROFESSIONAL STAFF

ALLIED HEALTH PROFESSIONALS – INITIAL APPOINTMENTS NAME DEPARTMENT PRACTICE PRIVILEGES/ APPOINTMENT COMMENTS SCOPE OF SERVICE DATES Alyssa Renee Bramble, P.A.-C. Surgery Practice Prerogatives on file 7/01/2021 to 6/30/2023 Kjersten Ann Davis, F.N.P. Internal Medicine Practice Prerogatives on file 7/01/2021 to 6/30/2023 Sara Joyce Edmund, P.M.H.N.P. Psychiatry Practice Prerogatives on file 7/01/2021 to 6/30/2023 Christina Theresa Hagan, F.N.P., C.N.M. Family & Community Medicine Practice Prerogatives on file 7/01/2021 to 6/30/2023 Pooja N. Mehta, C.R.N.A. Anesthesiology Practice Prerogatives on file 7/01/2021 to 6/30/2023 Carolina Mendez, A.G.A.C.N.P. Surgery Practice Prerogatives on file 7/01/2021 to 6/30/2023 Michelle A. Obale, P.M.H.N.P. Psychiatry Practice Prerogatives on file 7/01/2021 to 6/30/2023 Karen Pine, L.C.S.W. Psychiatry Practice Prerogatives on file 7/01/2021 to 6/30/2023 Travis M. Tirk, P.A.-C. Orthopaedic Surgery Practice Prerogatives on file 7/01/2021 to 6/30/2023

ALLIED HEALTH PROFESSIONALS – REAPPOINTMENTS NAME DEPARTMENT PRACTICE PRIVILEGES/ APPOINTMENT COMMENTS SCOPE OF SERVICE DATES Tanya Ann Giorgio-Sarkisian, F.N.P. Internal Medicine Practice Prerogatives on file 7/01/2021 to 6/30/2023 Amber Norrisa Hayes, A.G.A.C.N.P. Surgery Practice Prerogatives on file 7/01/2021 to 6/30/2023 Curtis Jackson Hoopes, C.R.N.A. Anesthesiology Practice Prerogatives on file 7/01/2021 to 6/30/2023 Patricia Cardin Lilly, F.N.P. Internal Medicine Practice Prerogatives on file 7/01/2021 to 6/30/2023 Jonathan Dale Peckham, P.A.-C Surgery Practice Prerogatives on file 7/01/2021 to 6/30/2023 Madeline Irene Powers, C.N.M. Obstetrics / Gynecology Practice Prerogatives on file 7/01/2021 to 6/30/2023 Marcella C. Simpson, N.N.P. Pediatrics Practice Prerogatives on file 7/01/2021 to 6/30/2023 Erin Kristine Tisdale, P.A.-C Internal Medicine Practice Prerogatives on file 7/01/2021 to 6/30/2023

1 of 2 Recommended by Credentials Committee: June 1, 2021 Recommended by Medical Executive Committee: June 8, 2021 Submitted to MSHCDB: June 23, 2021

CHANGE IN PRIVILEGES

NAME DEPARTMENT ADDITION / REDUCTION / WITHDRAWAL COMMENTS Withdrawal: Family & Community Medicine Nurse Voluntary Relinquishment of Privileges due to Tanya Ann Giorgio-Sarkisian, F.N.P. Internal Medicine Practitioner Core Cognitive & Procedural Privileges non-utilization of privileges Addition: Insertion of Arterial/Central Venous; Amber Norrisa Hayes, A.G.A.C.N.P. Surgery Placement of Thoracostomy

RESIGNATIONS (Information Only) NAME DEPARTMENT/SPECIALTY STATUS REASON Tessa May Bowie, P.A.-C Internal Medicine Allied Health Professional to Inactive Resigned effective June 13, 2021 Claudia Caroline Cardenas, P.A.-C. Surgery Allied Health Professional to Inactive Resigned effective May 15 2021 Misty Evagene Cox, F.N.P. Family & Community Medicine Allied Health Professional to Inactive Resigned effective June 30, 2021 Sarina Otero, L.C.S.W. Psychiatry Allied Health Professional to Inactive Resigned effective June 23, 2021

General Definitions: Allied Health An Allied Health Professional (AHP) means a health care practitioner other than a Medical Staff member who is authorized by the Governing Body to provide patient care services at a MIHS facility, and who is Professional Staff permitted to initiate, modify, or terminate therapy according to their scope of practice or other applicable law or regulation. Governing Body authorized AHPs are: Certified Registered Nurse Anesthetists; Certified Registered Nurse Midwife; Naturopathic Physician; Optometrists; Physician Assistant; Psychologists (Clinical Doctorate Degree Level); Registered Nurse Practitioners. Practice Prerogatives Scopes of practice summarizing qualifications for the respective category, developed with input from the physician director of the clinical service and the observer/sponsor/responsible party of the AHP, Department Chair, and other representatives of the Medical Staff, Hospital management, and other professionals. Supervision Definitions: (1) General Supervision The procedure is furnished under the physician’s overall direction and control, but the physician’s presence is not required during the performance of the procedure or provision of the services. (2) Direct Supervision The physician must be present in the office suite or on the premises of the location and immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean that the physician must be present in the room when the procedure is performed. (3) Personal Supervision A physician must be in the room during the performance of the procedure.

2 of 2

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.d.iii.

Medical Staff 39026 T: Operational Credentialing Policy Once Printed This Document May No Longer Be Current

Valleywise Health Administrative Policy & Procedure

Effective Date: 04/10 Reviewed Dates: 03/18, 08/20 Revision Dates: 09/11, 04/12, 04/13, 04/14, 02/15, 03/16, 5/17, 06/19, 12/20, 04/21, 06/21

Policy #: 39026 T

Policy Title: Clinical Services/Medical Affairs: Operational Credentialing Policy and Procedure

Scope: [ ] District Governance (G) [ ] System-Wide (S) [ ] Division (D) [ ] Multi-Division (MD) [x] Department (T) Medical Staff Services [ ] Multi-Department (MT)

Purpose:

In accordance with Medical Staff Bylaws and Medical Staff and Allied Health Professional Credentials Policies, to further define the process for credentialing and re-credentialing members of the Medical Staff and Allied Health Professional staff in compliance with NCQA and HRSA (as used by the FQHC) standards, DNV, CMS, and health plan delegation agreements.

Definitions:

Allied Health Professional (AHP): A Licensed Independent Practitioner (LIP), a Category I provider, or an Advanced Dependent PractitionerPractice Professional, a Category II provider other than a Medical Staff member who is authorized to provide patient care services in the Hospital who has been granted clinical privileges/practice prerogatives. AMA: American Medical Association AOA: American Osteopathic Association Certifacts: An official Display Agent for the American Board of Medical Specialties (ABMS) to serve as one of the LIPs of primary source equivalent ABMS CMS: Centers for Medicare and Medicaid Services Clinical Privileges: The authorization granted by the Maricopa County Special Health Care District Board (“Board”) to render specific patient care services, for which the Medical Staff leaders and Board have developed eligibility and other privileging criteria and focused and ongoing professional practice evaluation standards with the results of the Board’s decisions communicated to the LIPs.

Policy #39026 T Title: Clinical Services/Medical Affairs: Operational Credentialing Policy Page 1 of 13 0406/21 Supersedes 12/2004/21 Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

CVO: Credentialing Verification Organization. Valleywise Health CVO is comprised of Medical Staff Services, Human Resources, Employee Health and Wellness, Center for Clinical Excellence. CVO includes the verification from a primary source. Delegation Agreement – An agreement between Valleywise Health and a health plan that allows the health plan to accept the credentialing process of Valleywise Health, provided Valleywise Health meets the health plan’s credentialing standards and successfully demonstrates compliance upon audit by the respective health plan. DNV: Det Norske Veritas – A hospital accreditation program approved by the US Centers for Medicare and Medicaid Services (CMS). DNV performs annual deemed status surveys. ECFMG: The Educational Commission for Foreign Medical Graduates for verification of a physician’s graduation from a foreign medical school. FQHC: Federally Qualified Health Center Governing Body: An organized group or individual who assumes full legal authority and responsibility for operations of the hospital, medical staff, and administrative officials. HRSA: Health Resources and Services Administration LIPs: Licensed Independent Practitioners who is permitted by law and by the Hospital to provide patient care services without direction or supervision, so long as their practice is consistent with state and federal law and/or Hospital policy, and within the scope of his, her, their license and consistent with the clinical privileges granted (e.g., are licensed, certified, or registered by the state to practice independently (without direction or supervision). Examples of LIPs include but not limited to the following: Physicians, Dentists, Nurse Practitioners, Certified Nurse Midwives, Clinical Psychologists, License Professional Counselors, and Licensed Clinical Social Workers)., and Physician Assistants (considered a LIP per the Health Resources and Services Administration (“HRSA”) Health Center Program Compliance Manual) who must have/maintain a written delegation agreement of supervision with a physician on the Valleywise Health Medical Staff in accordance with Arizona Revised Statute §32-2531. Other AHP/APP, considered a LIP per the Health Resources and Services Administration (“HRSA”) Health Center Program Compliance Manual, who may provide a medical level of care or performs surgical tasks consistent with the clinical privileges granted by the Hospital may and exercise those clinical privileges under the direction/supervision of a Supervising/Collaborating Physician pursuant to a written delegation agreement of supervision or collaborative agreement (e.g. Physician Assistant) or without direction or supervision/collaboration (e.g. Nurse Practitioner (“NP”) or Certified Nurse Midwife (“CNM”)), so long as their practice is consistent with state and federal law and/or Hospital policy. Medical Staff: All physicians, dentists, oral surgeons and podiatrists who have been appointed to the Medical Staff by the Board. MSS: Medical Staff Services NCQA: National Committee for Quality Assurance Participating Practitioners: Medical Staff and Allied Health Professional Staff as defined in the Medical Staff Credentialing Policy and Allied Health Professional Policy. Preclusion List: A list generated by CMS that contains the names of prescribers, individuals, and/or entities that are unable to receive payment for Medicare Advantage (MA) items and service and/or Part D drugs prescribed or provided to Medicare beneficiaries. Primary Source Verification: Verification by the original source of a specific credential of the accuracy of a qualification reported by an individual health care practitioner. Policy #39026 T Title: Clinical Services/Medical Affairs: Operational Credentialing Policy Page 2 of 13 0406/21 Supersedes 12/2004/21 Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

Primary source verification could include direct correspondence, telephone, fax, e-mail, or paper or online reports received from original sources (i.e., telephone confirmation from an educational institution that the individual graduated with the degree[s] listed on his or her application, confirmation through a state’s database that a LIP’s license is current, reports from credentials verification organizations). Designated examples of primary sources accepted but not limited to the following: AMA, ABMS/Certifacts, ECFMG, AOA, AAPA. Secondary Source Verification: Documented verifications of credentials obtained through a verification report from a recognized entity considered as an acceptable source of information. Virtual Meeting: A meeting conducted by way of either video or web-based conferencing with audio.

Policy #39026 T Title: Clinical Services/Medical Affairs: Operational Credentialing Policy Page 3 of 13 0406/21 Supersedes 12/2004/21 Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

Policy:

Valleywise Health which includes the Valleywise Health Medical Center and all of its affiliated inpatient, ancillary, outpatient, and licensed health services, facilities, departments and programs, including the Valleywise Behavioral Health Centers (Maryvale, Mesa, Phoenix), Valleywise Comprehensive Health Centers (Phoenix and Peoria), Arizona Burn Center, Valleywise Emergency (Maryvale), and Valleywise Community Health Centers (Federally Qualified Health Care (FQHC) Clinics) that provide services within its scope of project/services ensures that such LIPs are licensed, certified, or registered as verified through a credentialing and re-credentialing process in accordance with the Valleywise Health Medical Staff Credentials Policy and Allied Health Professional Policy; and applicable Federal, state, and local laws; and competent and fit to perform the contracted or referred services, as assessed through a privileging process; and is operationalized as set forth in this policy.

Valleywise Health will determine in its decision-making the following considerations in relation to credentialing:

➢ Staffing composition (for example, use of nurse practitioners, physician assistants, certified nurse midwives) and its staffing levels (for example, full – and/or part-time staff); ➢ Approval authority for credentialing and privileging of its clinical staff; ➢ Credentialing protocols will be implemented (for example, a health center may contract with a credentials verification organization (CVO) to perform credentialing activities or it may have its own staff conduct credentialing), including whether to have separate credentialing processes for LIPS versus other provider types; ➢ Assessment of clinical competence and fitness for duty of its staff (for example, regarding clinical competence, a health center may utilize peer review conducted by its own LIPs or may contract with another organization to conduct peer review); ➢ Consistent with established privileging criteria whether to deny, modify, or remove privileges of its staff; whether to use an appeals process in conjunction with such determinations; and whether to implement corrective action plans in conjunction with the denial, modification, or removal of privileges; ➢ Consistent with its contracts/cooperative arrangements whether to disallow individual LIPs or organizations from providing health services on the health center’s behalf.

A health care plan may delegate its credentialing function for LIPs who provide services at Valleywise Health. Health care plans, through a contractual agreement, may delegate the credentialing, re-credentialing and monitoring for adverse actions of all participating LIPs. The Delegation Agreement shall detail the delegated activities, responsibilities of the health plan and of Valleywise Health, and the process by which evaluation of the process shall occur.

Valleywise Health may sub-delegate primary source verification and, if applicable, shall conduct regular audits of all such delegated activities. The applications for initial appointment and reappointment existing now and as may be revised are incorporated by reference and made a part of the Medical Staff and Allied Health Professional Credentials Policies.

Policy #39026 T Title: Clinical Services/Medical Affairs: Operational Credentialing Policy Page 4 of 13 0406/21 Supersedes 12/2004/21 Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

Procedure:

SECTION 1 – INITIAL CREDENTIALING/APPOINTMENT PROCEDURES

1.1 Verification of Information The information that shall be collected and verified by representatives of the MSS Department working with the Credentials Committee shall include, but not be limited to:

1.1.1 Education and training will be verified using primary sources. Examples of primary sources include but not limited to the AMA/AOA profile or directly with the training program by written letter, or The Educational Commission for Foreign Medical Graduates (ECFMG) to verify a LIP’s graduation from a foreign medical school. 1.1.2 All currently unrestricted professional licensures or certifications verified using primary source verification achieved with the appropriate state agencies, by a letter, telephone verification, licensing board website, or secure electronic communication obtained from the appropriate state licensing board. Telephone and electronic communication shall be appropriately documented with the date, time, and initials of the individual performing the verification. A current copy of the Drug Enforcement Administration (DEA) registration when applicable, with the date and number of each will be primary source verified with the U.S. Department of Justice Drug Enforcement Administration Diversion Control Division. 1.1.3 Specialty or sub-specialty board certification, recertification, or active candidate status verified by Certifacts, AMA/AOA profile, or directly with the ABMS/AOA Specialty Board. 1.1.4 Continuous professional liability insurance coverage as required in the Credentialing Policy. The applicant must include names of present and past insurance carriers and complete information on malpractice claims history and experience including past and pending claims, final judgments, or settlements. The National Practitioners Data Bank (NPDB) is queried for verification of any professional liability claims. 1.1.5 Any pending or completed action involving the withdrawal of an application for or the denial, revocation, suspension, reduction, limitation, probation, non-renewal, or voluntary relinquishment (by expiration or resignation while under investigation or to avoid investigation) of: license or certificate to practice in any state or country; DEA or other controlled substances registration; specialty or sub-specialty board certification or eligibility; staff membership status, prerogatives, or clinical privileges at any hospital, clinic or health care institution; professional liability insurance coverage. The entities that shall verify this information shall include, but not be limited to the applicable state agency; health care affiliations; NPDB; and professional peer references. 1.1.6 Health Status, Fitness for Duty, Immunization, and Communicable Disease Status information provided in response to pertinent questions about a LIP’s physical and mental health status or chemical/substance dependency/abuse that may impair his/her ability to provide professional services.

Policy #39026 T Title: Clinical Services/Medical Affairs: Operational Credentialing Policy Page 5 of 13 0406/21 Supersedes 12/2004/21 Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

1.1.7 Charge, indictment, conviction, or a plea of guilty or no contest pertaining to any felony, or to any misdemeanor involving (i) controlled substances; (ii) illegal drugs; (iii) Medicare, Medicaid, or insurance or health care fraud or abuse; or (iv) violence against another shall be elicited on the application. 1.1.8 All hospitals or health care organizations where the applicant had or has any association, employment, privileges or practice to include start and end dates of each affiliation. All time gaps in practice greater than three (3) months since graduation must be accounted for and shall be verified by an individual who can attest to the validity of the activity as specified by the applicant, or re-applicant. 1.1.9 Medicare sanctions are verified directly with the OIG and SAM (Office of the Inspector General and the System for Awards Management) websites or the NPDB. 1.1.10 The Medicare Opt-Out Report will be reviewed at initial appointment. If a LIP is identified they shall be deemed to not meet the qualifications for appointment as outlined in the credentialing policies. 1.1.11 The Preclusion List will be provided by each health plan to be reviewed monthly and at time of initial appointment. 1.1.12 Clinical staff member’s (LIPs) identity is verified through government issued picture identification. 1.1.13 All Medical Staff and Allied Health Professional Staff are enrolled in the NPDB Continuous Query Program with NPDB queries reviewed at time initial appointment/reappointment, new privilege requests, and on an ongoing/real-time basis as Continuous Query enrollment reports are made available. 1.1.14 Current documentation of basic life support training will be obtained and filed in the LIP’s credential file (i.e., BLS, ACLS, PALS, NRP) if applicant is practicing in the FQHC Clinic. 1.1.15 Current Level 1 Fingerprint Clearance card issued by the Arizona Department of Public Safety at time of initial appointment/credentialing OR Record of fingerprinting application in process with the Arizona Department of Public Safety and a copy of completed/signed Arizona Department of Health Services Bureau of Child Care Licensing Criminal History Affidavit, in accordance with Arizona Revised Statute (“ARS”) §36-425.03 (Children’s Behavioral Health Programs) R9-10-1006 (11.)(c.)(vi), will be obtained and filed in the LIP’s credential file if the applicant is located or covering in a Valleywise Community Health Center or a Valleywise Comprehensive Health Center. 1.1.16 Medical Staff and Allied Health Professionals will be notified within ten (10) days of Credentialing Committee decision of either approval or denial by the Governing Body of Valleywise Health.

SECTION TWO – REAPPOINTMENT/RE-CREDENTIALING PROCEDURES 2.1 All terms, conditions, requirements, and procedures relating to initial credentialing/appointment shall apply to continued appointment and re- credentialing/reappointment. Each staff member shall be sent an application for recredentialing/reappointment and notice of the date on which the appointment will expire (not to exceed two years from the last appointment/reappointment) in

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accordance with Medical Staff and Allied Health Professional Staff Credentialing Policies. 2.2 The MSS Department shall verify information since the time of the member’s last appointment regarding professional and collegial activities, performance, clinical or technical skills and conduct. Such information will include but not be limited to: 2.2.1 At least two peer references 2.2.2 Within the last two years, any pending or completed professional action as specified in Section 1.1.5 of this policy. 2.2.3 Medical malpractice history over the past two years is required on the application and verified though NPDB. 2.2.4 All currently unrestricted professional licensures or certifications verified using primary source verification with the appropriate state agencies, and a current copy of the Drug Enforcement Administration (DEA) registration when applicable, with the date and number of each will be primary source verified with the U.S. Department of Justice Drug Enforcement Administration Diversion Control Division. 2.2.5 Primary source verification of Specialty or sub-specialty board certification, or recertification 2.2.6 All hospitals or health care organizations where the applicant had or has any association, employment, privileges or practice with the dates of each affiliation. 2.2.7 Health Status, Fitness for Duty, Immunization, and Communicable Disease Status information provided in response to pertinent questions about a LIP’s physical and mental health status or chemical/substance dependency/abuse that may impair his/her ability to provide professional services reviewed at time of reappointment. 2.2.8 Medicare/Medicaid Sanctions (i.e., OIG and SAM) and Medicare Opt- Out Report will be reviewed at reappointment. If a LIP is identified they shall be deemed to not meet the qualifications for reappointment as outlined in the credentialing policies. 2.2.9 The Preclusion List will be provided by each health plan to be reviewed monthly and at time of re-credentialing/reappointment. 2.2.10 Current documentation of basic life support training will be re-verified and filed in the LIP’s credential file (i.e., BLS, ACLS, PALS, NRP) at time of recredentialing/reappointment if applicant is practicing in the FQHC Clinic. 2.2.11 Current Level 1 Fingerprint Clearance card issued by the Arizona Department of Public Safety at time of reappointment/re-credentialing OR Record of fingerprinting clearance renewal application for an expiring fingerprint clearance card in process with the Arizona Department of Public Safety and copy of an updated Arizona Department of Health Services Bureau of Child Care Licensing Criminal History Affidavit, in accordance with Arizona Revised Statute (“ARS”) §36-425.03 (Children’s Behavioral Health Programs) R9-10-1006 (11.)(c.)(vi) in R910-1006 (11.)(c.)(vi), will be obtained and filed in LIP’s credential file if the applicant is located or covering in a Valleywise Community Health Center or a Valleywise Comprehensive Health Center. 2.2.12 Medical Staff and Allied Health Professionals will be notified within ten (10) days of Credentialing Committee decision of either approval or denial by the Governing Body of Valleywise Health.

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2.3 The sources used for verification will be the same as in the initial credentialing process.

SECTION THREE - NOTIFICATION AND STATUS OF APPLICATION 3.1 During the initial credentialing or re-credentialing process, the LIP will be given notice by the Valleywise Health credentialing staff of any conflicting information and be given an opportunity to reconcile such information in accordance with the Medical Staff and Allied Health Professional Credentials Policies. 3.2 LIPs receive a copy of the Medical Staff Bylaws, Medical Staff Credentialing Policy, or Allied Health Professional Credentialing Policy (if applicable) outlining their rights. 3.3 LIPs have the right to review information submitted to support their credentialing application in accordance with the Practitioner Access to Credentialing Files Policy.

SECTION FOUR - ONGOING VERIFICATION OF INFORMATION 4.1 Medicare/Medicaid Exclusions shall be verified on a monthly basis. Verification shall be accomplished through a sweep of the credentialing database matched against the OIG (Office of Inspector General) and SAM (System for Awards Management) websites. 4.2 Medicare/Medicaid Opt-Out Report - The Medicare Opt-Out Report will be reviewed on a quarterly basis; if a LIP is identified the health plan will be notified immediately. 4.3 Licensure - The applicant’s current professional licensure shall also be verified at the time of license renewal and revision of privileges. During the interim period between reappointment cycles, the Credentials Committee shall review disciplinary actions identified, or other issues deemed to be significant. The Credentials Committee shall make recommendations on these matters, when deemed necessary. Any licensure revocation, suspension, restriction, or probation shall result in a like limitation of clinical privileges, as of the date such action becomes effective and throughout its term. Contracted health plans shall be notified immediately of any such actions. 4.4 Patient Complaints, Adverse Events, and Medical Record Review- The collection of and review of information obtained from complaints, adverse events, and medical record review is performed on a concurrent basis. Appropriate interventions are identified from adverse events through the confidential peer review mechanism. 4.5 Immunizations and communicable disease status are verified by the Valleywise Health Employee Health and Wellness Department at time of initial appointment and on an ongoing basis in accordance with Valleywise Health policies and procedures. 4.6 Level 1 Fingerprinting Clearance cards will be verified with the Arizona Department of Public Safety.

SECTION FIVE - REPORTING TO THE NATIONAL PRACTITIONER DATA BANK (NPDB), STATE LICENSING BOARD, AHCCCS CLINICAL QUALITY MANAGEMENT UNIT, OFFICE OF THE ATTORNEY GENERAL, AND LAW ENFORCEMENT AGENCY 5.1 It is the policy of Valleywise Health to comply with the required reporting of adverse actions taken against a Participating Practitioner to all regulatory

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agencies, including the National Practitioner Data Bank (NPDB) and the appropriate State of Arizona Licensing Board. 5.2 Following a formal peer review process, and at the time that Valleywise Health denies, reduces, revokes, terminates, or suspends the privileges of a LIP for a period of longer than thirty (30) calendar days, or accepts the Participating LIP’s surrender of privileges while under investigation by Valleywise Health, Valleywise Health will notify the NPDB and the appropriate State of Arizona Licensing Board. 5.3 NPDB Reporting: 5.3.1 Valleywise Health will submit a report to the NPDB of the adverse action consistent with the NPDB timeliness requirements. 5.3.2 The NPDB report will be submitted electronically, in accordance with NPDB requirements via the NPDB website at www.npdb-hipdb.com 5.4 State of Arizona Licensing Board Reporting: The Report Verification Document that Valleywise Health received from the NPDB will be submitted to the appropriate State licensing board. 5.5 AHCCCS Clinical Quality Management Unit/Office of the Attorney General: A report shall be submitted within one business day of quality deficiencies that result in a LIP’s suspension or termination from the Valleywise Health Medical Staff or Allied Health Professional Staff. 5.6 Law Enforcement Agency: Reports will be filed in accordance with Valleywise Health Policies and Procedures.

SECTION SIX – PROTECTION AGAINST DISCRIMINATION 6.1 In accordance with the Medical Staff and Allied Health Professional Credentials Policies, No individual shall be denied appointment or reappointment at the Hospital on the basis of gender, race, ethnic/national identity, ancestry, age, health status, sexual orientation, religion, veteran’s status, marital status, handicap, or types of patients (e.g. Medicaid) in which the LIP specializes. Means used to prevent discrimination in the decision-making process includes: 6.1.1 The Credentials Committee will be comprised of a multi-disciplinary, heterogeneous group of practitioners to the degree feasible. 6.1.2 All members of the medical staff and allied health professional staff are required to attest to their willingness to abide by the Medical Staff Bylaws and associated documents. Discrimination is prohibited in the Medical Staff Credentialing Policy (section 2.A.5) and Allied Health Professional Credentialing Policy (Section 3.A.5). 6.1.3 Adverse recommendations must be supported by qualitative and quantitative data that is presented to the Credentials Committee blindly (i.e., using a numeric identifier in lieu of name, discipline, specialty, etc.). 6.1.4 All denial decisions will be handled in accordance with the Medical Staff Credentials Policy (Article 3.A.6-3.A.7) and Allied Health Professional Policy (Article 4.A.5-4.A.6) and potentials for discrimination shall be assessed through the respective (medical staff or allied health professional staff) Hearing and Appeal Process. 6.2 The Credentials Committee will conduct an annual review of credentialing decisions to ensure that practitioners are not discriminated against.

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SECTION SEVEN – GENERAL PROVISIONS

7.1 Valleywise Health shall seek to verify all the data elements as set forth in this policy and the Medical Staff and Allied Health Professional Staff Credentialing Policies. Demonstration of verification of the data elements will be achieved with each verified element dated/initialed via electronic database/audit tool sheet by the representative of the MSS Department conducting the credentialing/verification. 7.2 Valleywise Health will conduct timely verification of information, as evidenced by approval (or denial) of a LIP for initial credentialing/appointment within seventy- five (75) days of receipt of a complete application. Each applicant is required to sign and attest to the accuracy of the information provided in the application. If the signature attestation exceeds seventy-five (75) calendar days before the credentialing decision, MSS shall update it with an attestation that the information on the application remains correct and complete. 7.3 Valleywise Health will conduct timely verification of information, as evidenced by approval (or denial) of a LIP for re-credentialing/reappointment within one hundred eighty (180) days of receipt of a complete application. Each applicant is required to sign and attest to the accuracy of the information provided in the re- credentialing/reappointment application. If the signature attestation exceeds one hundred eighty (180) days before the credentialing decision, MSS shall update it with an attestation that the information on the application remains correct and complete. 7.4 All members of the Medical Staff and Allied Health Professional Staff acknowledge that they agree to respect and maintain the confidentiality of all discussions, deliberations, proceedings, and activities of Medical Staff Committees and Departments which have the responsibility of evaluating and improving the quality of care in the Hospital. Members of the Credentials Committee and other Peer Review Committees may be required to sign a confidentiality statement. 7.5 Provisionally credentialed (clean file review) and approval is permitted in accordance with the criteria and process set forth in the Medical Staff Credentialing Policy (Section 4.B) and Allied Health Professional Staff Credentialing Policy (Section 4.C). 7.6 The health care plan and Valleywise Health will identify the LIPs who will participate in this agreement in a written list updated monthly. Any published directories are based on the information provided from the Credentials Office. 7.7 Valleywise Health will conform to the current requirements established by the NCQA. 7.8 For purpose of the “Federal Quality Health Care (FQHC)” delegated credentialing arrangements, a completed application is defined as the fully verified application that has been acted on favorably by the Valleywise Health Credentials Committee. 7.9 Any meeting of the Credentials Committee by way of a virtual meeting may only be conducted by either video or web-based conferencing with audio. 7.10 Valleywise Health will review and monitor LIP adverse events and complaints on a continuous ongoing basis in accordance with our Valleywise Health Medical Staff Peer Review Policy. 7.11 Valleywise Health Medical Staff Services will conduct a review of the CMS Preclusion List, as provided by the health plan, on a monthly basis, at time of initial credentialing, and recredentialing/reappointment. If a practitioner/applicant is confirmed to be on the Preclusion List, Valleywise Health will terminate its agreement with the practitioner and provide a notification letter to the

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practitioner/applicant of said termination. Also, Valleywise Health will provide notification to the health plan (MCO).

SECTION EIGHT – CREDENTIALING SYSTEM CONTROLS

8.1 Primary Source Verification Information: Credentialing information, including application, supporting documents, and primary source verification (PSV) of license, DEA, board certification, education/training, and professional liability claims are obtained/received from the applicant or appropriate verification entity via mail, email, electronic/online portal. When PSV is printed/received and is not automatically date stamped, the MSS representative manually date stamps and initials the document to indicate when it was printed/received. All PSV documents are kept in each applicant’s individual credentialing file. All credentialing files are stored in a locked cabinet/office accessible only by the MSS representative or electronically within the credentialing database.

8.2 Tracking Modifications: Any modification(s) made to a completed application, supporting documentation, or a PSV will be documented by completion of the Application / Primary Source Verification (PSV) Update form in its entirety, which includes the applicant’s name, specialty, document to update, explanation of update, the name of the person providing the update, the date the update was obtained, and the name of the MSS representative who obtained the update. When email or fax confirmation is obtained from the applicant or applicable/primary source, the MSS representative will attach to the completed Application / Primary Source Verification (PSV) Update form.

8.3 Authorization to Modify Information: Only the MSS representative (in consultation with the Director of Medical Staff Services) will have the authority to access, modify, and/or delete information when circumstances for modification are deemed appropriate, including but not limited to discrepancies identified by the applicant, MSS representative, Department Chair, or CCO.

8.4 Securing Information: All credentialing information is protected from unauthorized modification. The MSS representative maintains a database for all credentialed applicants that is password protected. Non-electronic credentialing information is stored in a locked cabinet/office accessible only by the MSS representative or electronically within the credentialing database.

8.5 Credentialing Process Audit: The credentialing processes in place by the organization are audited on an annual basis by the Director of Medical Staff Services or designee. Credentialing files are randomly chosen and are reviewed to ensure PSV information was dated and initialed by the MSS representative, that any modified information on the credentialing application or PSV is appropriately documented, and that all information is secured in a locked cabinet/office. In addition, annual delegated credentialing audits are performed by the organization’s

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delegated entities. The organization undergoes renewal of DNV accreditation on an annual basis wherein credentialing files are reviewed by a DNV surveyor, as well as operational site visits conducted by the Health Resources & Services Administration Health Center Program within their designated project/designation period.

SECTION NINE – CLINIC SITE VISITS

9.1 Purpose: To provide a mechanism for compliance with standards in regard to clinic site visits for Primary Care, Dental, Specialist, and Obstetrics/Gynecology providers related to clinic/practice site quality.

9.2 Policy: To ensure conformance with the standards of Valleywise Health, contracted managed care organizations, Det Norske Veritas (“DNV”), National Committee of Quality Assurance (“NCQA”), as well as Federal, State, and local regulatory requirements.

9.3 Procedure: In an effort to assess the quality, safety and accessibility of clinic sites where care is delivered, the Clinic Managers in collaboration with the Medical Staff Services Department will conduct the site review, forwarding the completed audit form to the Medical Staff Services Department for evaluation to determine whether additional action is required.

9.4 Threshold: A minimum score of 80% must be achieved to pass the review. If the clinic site fails to meet the threshold, an action plan will be requested addressing implementation for improvement. Deficient clinic sites will be re-reviewed at least every six (6) months until an acceptable score is achieved.

9.5 Ongoing Review: Complaints will continually be monitored by the clinic managers for all applicable clinic sites in accordance with this policy. A site visit will be conducted when two (2) complaints within a six (6) month period occur against one clinic site in any of the areas identified (i.e., physical accessibility, physical appearance, adequacy of waiting and examining room space, availability of appointments, and adequacy of treatment record keeping) and will be conducted within sixty (60) days of the second complaint received.

9.6 If acceptable to the health plan, a site review will be conducted for only new clinics or relocated clinic sites. Clinic site reviews will not be performed on established clinic sites/practices that are accredited by DNV, NCQA or any other recognized accrediting body. Appropriate documentation of accreditation will be maintained for those sites.

References:

Valleywise Health Medical Staff Bylaws, Medical Staff Credentialing Policy, Allied Health Professional Staff Manual, Practitioner Access to Credential Files, NCQA Standards CR 1- 12, Health Care Quality Improvement Act of 1986, HRSA-Health Center Program Compliance Manual (Chapter 5), AHCCCS Medical Policy Manual, Chapter 900. Policy #39026 T Title: Clinical Services/Medical Affairs: Operational Credentialing Policy Page 12 of 13 0406/21 Supersedes 12/2004/21 Once Printed This Document May No Longer Be Current Once Printed This Document May No Longer Be Current

Valleywise Health Policy & Procedure - Approval Sheet (Before submitting, fill out COMPLETELY.)

POLICY RESPONSIBLE PARTY: Kristine Trulock, Director of Medical Staff Services

DEVELOPMENT TEAM(S): Credentialing Committee

Policy #:39026 T

Policy Title: Operational Credentialing Policy and Procedure e-Signers: Michael D. White, MD, MBA, EVP and Chief Clinical Officer

Place an X on the right side of applicable description:

New -

Retire - Reviewed -

Revised with Minor Changes - X

Revised with Major Changes -X

Please list revisions made below: (Other than grammatical changes or name and date changes)

Policy updated in accordance with CMS/DNV regulations and to align the Medical Staff Glossary as pertaining to Allied Health Professional Category One and Category Two definitions.

List associated form(s): (If applicable)

Reviewed and Approved by in Addition to Responsible Party and E- Signer(s):

Committee: Credentials Committee 04/2106/21

Committee: Medical Executive Committee 04/2106/21

Reviewed for EPIC: 00/00

Other: Maricopa County Special Health Care District Board 04/2106/21

Other: 00/00

Policy #39026 T Title: Clinical Services/Medical Affairs: Operational Credentialing Policy Page 13 of 13 0406/21 Supersedes 12/2004/21 Once Printed This Document May No Longer Be Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.d.iv.

Medical Staff 31203 T: Focused Professional Practice Evaluation (FPPE) Policy

VALLEYWISE HEALTH

FOCUSED PROFESSIONAL PRACTICE EVALUATION (FPPE) POLICY TO CONFIRM PRACTITIONER COMPETENCE

(NEW MEDICAL STAFF MEMBERS/NEW PRIVILEGES)

Approved June 26, 2019DRAFT June 2021

a 4837-0019-4536, v. 1

POLICY REGARDING FOCUSED PROFESSIONAL PRACTICE EVALUATION (FPPE) TO CONFIRM PRACTITIONER COMPETENCE (NEW MEDICAL STAFF MEMBERS/NEW PRIVILEGES)

TABLE OF CONTENTS

PAGE

1. SCOPE OF POLICY ...... 1

2. DEFINITIONS ...... 1

3. CLINICAL ACTIVITY AND PERFORMANCE REQUIREMENTS ...... 1

3.A Concurrent, Retrospective, or Otherwise-Specified Review ...... 1 3.B Time Frames ...... 1 3.C Modification of FPPEs Requirements ...... 2 3.D FPPE For Professionalism for New Practitioners ...... 2

4. GATHERING AND REVIEW OF FPPE DATA ...... 2

4.A Mechanism for FPPE Review ...... 2 4.B Questions and Concerns Identified During the FPPE Process ...... 2

5. NOTICE OF FPPE REQUIREMENTS ...... 2

6. REVIEW OF FPPE RESULTS ...... 2

6.A Review by the Department Chair ...... 2 6.B Review by Credentials Committee ...... 3 6.C Review by MEC ...... 4

7. GATHERING AND REVIEW OF FPPE DATA ...... 6

7.A General ...... 6 7.B Failure to Provide Requested Input...... 6

Appendix A: Flow Chart of FPPE Process to Confirm Competence

b 4837-0019-4536, v. 1

POLICY REGARDING FPPE TO CONFIRM PRACTITIONER COMPETENCE (NEW MEDICAL STAFF MEMBERS/NEW PRIVILEGES)

1. Scope of Policy. All practitioners who are granted clinical privileges at Valleywise Health are subject to an FPPE to confirm their:

(a) clinical competence to exercise the clinical privileges that have been granted to them; and

(b) Professionalism, which includes (i) the ability to work with others in a professional manner that promotes quality and safety; and (ii) the ability to satisfy all other responsibilities of Practitioners who are granted clinical privileges at Valleywise Health (i.e., “citizenship” responsibilities).

2. Definitions.

(a) “FPPE” means a time-limited period during which a Practitioner’s professional performance is evaluated. All initially-granted clinical privileges, whether at the time of initial appointment, reappointment, or during the term of appointment, shall be subject to FPPE. A flow chart that depicts the FPPE process to confirm practitioner competence and professionalism is attached as Appendix A.

(b) “Practitioner” means:

(1) a member of the Medical Staff; and

(2) an Allied Health Professional who has been granted clinical privileges at Valleywise Health.

3. Clinical Activity and Performance Requirements.

3.A Concurrent, Retrospective, or Otherwise-Specified ReviewDevelopment of Clinical Activity Requirements.

(a) Each Department (in consultation with Medical Staff Services, the Credentials Committee, and/or CMOCO, if necessary) is responsible for developing FPPE clinical activity requirements. In developing such recommendations, Departments should attempt to identify “index” procedures or cases that will demonstrate a practitioner’s competence to perform a bundle of privileges (i.e., the skills required to perform the index procedure or case are the same skills required to perform privileges in the bundle).

(b) For new members of the Medical Staff, the FPPE shall consist of a concurrent, retrospective, or otherwise-specified review of a cross-section of the privileges granted.

(c) For an additional privilege that is granted to an existing member during the term of his or her appointment or at reappointment, the FPPE shall consist of a concurrent, retrospective, or otherwise-specified review of the practitioner’s performance of the newly-granted privilege.

3.B Time Frames. It is expected that the FPPE for initially-granted privileges (both for new members and existing members of the staff) will be completed within six months of the date privileges are granted.

3.C Modification of FPPE Requirements. The Credentials Committee and MEC shall consider the relevant FPPE requirements when making their recommendations regarding clinical privilege requests and may modify those requirements if an applicant’s credentials indicate that an additional or different type of evaluation may be required.

3.D FPPE for Professionalism for New Practitioners at Valleywise Health. In addition to assessing clinical competence, the FPPE process will also assess every new Practitioner’s professionalism.

4. Gathering and Review of FPPE Data.

4.A Mechanism for FPPE Review. The FPPE clinical activity requirements will utilize at least one of the following review mechanisms in order to confirm competence:

(1) retrospective chart review by internal or external reviewers; and/or

(2) concurrent proctoring or direct observation of procedures or patient care practices.

In addition, review of available quality data reports, as well as discussions with other individuals also involved in the care of the Practitioner’s patients, may be used to confirm competence.

4. B Questions and Concerns Identified During the FPPE Process. Any event during the FPPE process that would trigger the Peer Review process shall be referred for review pursuant to the Medical Staff Peer Review Policy. Such a referral does not end the FPPE process, rather, it supplements the process by ensuring any questions or concerns are addressed in a timely manner. Any such case will be noted on the Practitioner’s FPPE report for review and consideration.

5. Notice of FPPE Requirements. When notified that a request for privileges has been granted, the practitioner shall also be informed of the relevant clinical activity and

performance required for the FPPE and of his or her responsibility to cooperate in satisfying those requirements. In addition, the practitioner shall be informed of the requirement of fulfilling all fundamental Medical Staff responsibilities, including completion of medical records and/or call coverage responsibilities.

6. Review of FPPE Results.

6.A Review by the Department Chair. At the conclusion of the expected time frame for completion of the FPPE, Tthe relevant Department Chair shall review the results of a practitioner’s FPPE and provide a report to the Credentials Committee. The Department Chair’s assessment and report shall address whether:

(1) the practitioner fulfilled all FPPE requirements;

(2) the results of the FPPE confirmed the practitioner’s competence and professionalism; and/or

(3) additional evaluation is required to make an appropriate determination regarding clinical competence and/or professionalism.

(4) In addition, the Department Chair may engage in a collegial discussion with a Practitioner where the FPPE indicates that competence and professionalism are confirmed, but where there is nonetheless an opportunity for the Practitioner to improve upon an aspect of his/her clinical care or citizenship responsibilities.

6.B Review by Credentials Committee. Based on the Department Chair’s assessment and report, and its own review of the FPPE results and all other relevant information, the Credentials Committee may make one of the following recommendations to the MEC:

(1) Competence and Professionalism Are Confirmed. The FPPE has confirmed clinical competence and professionalism and no changes to clinical privileges arefurther FPPE is necessary;

(2) Extend FPPE Due to Questions. sSome questions exist and additional evaluation FPPE is needed to confirm clinical competence and/or professionalism, what additional evaluationFPPE is needed, and the time frame for it (which may be coordinated by the Professional Practice Evaluation Committee (“PPEC”));

(3) Extend FPPE Due to Inactivity tThe time period for FPPE should be extended for up to six months because the individual did not fulfill the FPPE clinical activity requirements for some or all clinical privileges, thus preventing an adequate assessment of the individual’s clinical competence and/or professionalism. Although exceptions may be made for certain low volume practitioners based on a need for services in their specialties

or coverage requirements (see subsection (7) below), generally Tthe time frame for FPPE shall not extend beyond 24 12 months after the initial granting of privileges, except for practitioners who will provide back-up coverage only;

(4) Recommend Performance Improvement Plan or Other Intervention. Some concerns about the practitioner’s competence to exercise some or all of the clinical privileges granted or the Practitioner’s professionalism and the details of a Performance Improvement Plan (or other intervention) that should be pursued with the Practitioner to adequately address the concerns. Prior to making such a recommendation to the MEC, the Credentials Committee will obtain the input of the Practitioner as set forth in Section 7 of this Policy. In developing such a Performance Improvement Plan or other intervention, the Credentials Committee may request assistance from the Professional Practice Evaluation Committee (PPEC) or the Behavior Peer Review Committee (BPRC) for behavioral issues.

(5) Change to Privileges or Membership Is Necessary. More significant concerns exist about a Practitioner and the changes that should be made to some or all of the Practitioner’s clinical privileges or membership (e.g., mandatory concurring consultation requirement imposed; suspension; revocation), subject to the procedural rights outlined in the Credentials Policy. Prior to making such a recommendation to the MEC, the Credentials Committee will obtain the input of the Practitioner as set forth in Section 6.E of this Policy;

(6) Certain Privileges May Be Automatically Relinquished Due to Inactivity. The individual shall automatically relinquish specific clinical privileges for which the individual failed to meet the applicable requirements. Exceptions may be granted based on a need for services in the Practitioner’s specialty or coverage requirements. Such an automatic relinquishment shall not entitle the Practitioner to the hearing and appeals rights outlined in the Medical Staff Credentials Policy. Nor will the automatic relinquishment for failure to satisfy clinical activity requirements be considered an adverse action that must be reported to the National Practitioner Data Bank or any state licensing board. A Practitioner who automatically relinquishes certain privileges will be ineligible to apply for the clinical privileges in question for two years from the date of the relinquishment.

(7) Grant Exception to Allow Continued FPPE. Based on community need, coverage requirements, the rare nature of a given procedure or treatment, and other relevant factors, the Credentials Committee may recommend that a practitioner be granted an exception that permits the practitioner to remain subject to FPPE to confirm competence for the duration of the practitioner’s appointment term for some or all clinical privileges. If an exception is being considered, data from affiliated entities may be obtained and used for

purposes of FPPE as set forth in this Policy. The need for the exception will be reevaluated as part of the practitioner’s application for reappointment.

(78) Ongoing Safeguards Needed to Confirm Competence. If a procedure is so rarely performed that an extension will not allow for the fulfillment of the FPPE clinical activity requirements within the normal time period for FPPE, an exception may be granted based on a need for the service. In such cases, ongoing safeguards may be recommended (e.g., ongoing CME, simulation, etc.) to confirm competence. Such safeguards do not constitute a restriction of the individual’s clinical privileges.

(8) FPPE for Practitioners Who Will Provide Back-up Coverage Only. FPPEs for practitioners who are appointed to the Medical Staff solely for the purpose of providing occasional back-up coverage for members of the Medical Staff who are clinically active shall consist of a 100% retrospective review of all cases in which the practitioner providing backup coverage is involved up to five cases per year. Quality information from other hospitals where such individuals practice may also be requested and reviewed to determine that they are competent to exercise the clinical privileges granted.

6.C Review by MEC. At its next regular meeting after receipt of the written findings and recommendation of the Credentials Committee, the MEC shall:

(1) adopt the findings and recommendation of the Credentials Committee as its own; or

(2) refer the matter back to the Credentials Committee for further consideration and responses to specific questions raised by the MEC prior to its final recommendation; or

(3) state its reasons in its report and recommendation, along with supporting information, for its disagreement with the Credentials Committee’s recommendation.

As needed, the MEC may obtain additional input from the Practitioner as set forth in Section 6.E of this Policy before making a decision. If the recommendation of the MEC would entitle the applicant to request a hearing pursuant to the Medical Staff Bylaws, the MEC shall forward its recommendation to the CEO, who shall promptly send special notice to the applicant. The CEO shall then hold the application until after the applicant has completed or waived a hearing and appeal.

7 Input by Practitioner.

7.A General. The Practitioner shall provide input in writing, responding to any specific questions posed in the request. Upon the request of either the Practitioner or the committee conducting the review, the Practitioner may also provide input by meeting with appropriate individuals to discuss the issues. The committee requesting input may also ask the Practitioner to provide a copy of, or access to, medical records from the Practitioner’s office that are relevant to a review being conducted under this Policy. Failure to provide such copies or access will be viewed as a failure to provide requested input. Any records obtained from the Practitioner’s office pursuant to this section will be maintained as part of the confidential PPE/peer review file, but will not be included in Valleywise Health’s medical record.

7.B Failure to Provide Requested Input.

If the Practitioner fails to provide input within the time frame specified in the request, the Practitioner will be required to meet with the Leadership Council to discuss why the requested input was not provided. Failure of the Practitioner to either meet with the Leadership Council or provide the requested information prior to the date of that meeting will result in the automatic relinquishment of the Practitioner’s clinical privileges until the information is provided. If the Practitioner fails to provide the requested input within thirty (30) days of the automatic relinquishment, the Practitioner’s Medical Staff membership and clinical privileges will be deemed to have been automatically resigned.

8. Delegation of Functions.

(a) When a function under this Policy is to be carried out by a member of Valleywise Health management, by a Medical Staff member, or by a Medical Staff committee, the individual, or the committee through its chair, may delegate performance of the function to a qualified designee who is a practitioner or Valleywise Health employee (or a committee of such individuals). Any such designee must treat and maintain all information in a strictly confidential manner and is bound by all other terms, conditions, and requirements of this Policy. In addition, the delegating individual or committee is responsible for ensuring that the designee appropriately performs the function in question. Any documentation created by the designee are records of the committee that is ultimately responsible for the review in a particular matter.

(b) When an individual assigned a function under this Policy is unavailable or unable to perform that function, one or more Medical Staff Leaders may perform the function personally or delegate it to another appropriate individual as set forth above.

Adopted by the Medical Executive Committee on June 2021 June 11, 2019.

Adopted by the Maricopa Special Health Care District Board of Directors on June 26, 2019June 2021.

01/2013, Rev: 6/201906/2021

VALLEYWISE HEALTH Appendix A: FPPE Process to Confirm Practitioner Competence and Professionalism

1. FPPE confirmed competence and professionalism 2. Questions exist/additional FPPE needed 3. Extend time period for another six months due to insufficient clinical activity (no extension will be granted beyond 12 months FPPE unless exception is granted, as noted in #7 below) Requirements Did Practitioner fulfill all clinical activity 4. Concerns exist/develop PIP or other intervention requirements within expected time frame? 5. Concerns exist/recommend change in privileges or membership Clinical activity Did FPPE confirm competence and 6. Automatic relinquishment of some or all privileges due to insufficient clinical activity requirements professionalism? (Even if yes, Department developed by Chair may also have collegial discussion 7. Grant exception that allows FPPE to continue for duration of Departments with Practitioner to help improve appointment term based on need for services in specialty, performance.) coverage requirements, rare nature of procedure or treatment, and Professionalism other relevant factors requirements Is additional FPPE required? All requirements reviewed by MEC Credentials Results of Department Credentials Adopt findings/recommendation of Committee and MEC FPPE Credentials Committee Chair Assessment Committee Recommendation Refer matter back to Credentials Committee for further consideration FPPE may include: State reasons in its report/recommendation for chart review by internal May request input or assistance disagreement with Credentials Committee s or external reviewers; when developing a PIP Input or assistance recommendation

concurrent proctoring or Professional Practice FPPE confirmed Change in Automatic direct observation; competence and privileges relinquishment of Evaluation Committee (PPEC) professionalism that entitles privileges due to discussion with other or BPRC or extend time Practitioner insufficient clinical individuals involved in period to hearing activity the care of the Practitioner s patients; Notify Notify Notify review of available Practitioner Practitioner Practitioner quality data; and/or Right to Right to review review of concerns about hearing under under FPPE professionalism. Credentials Policy to Confirm Policy Practitioner Competence and Professionalism

Approved::June 2019June 2021 4837-0019-4536, v. 1 Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.e.i.

Care Reimagined Capital 480-90-21-007 Melanie Talbot

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Name DescriptionTypeCurrent File / URL Valleywise Asset Tracking New & File Valleywise Asset Tracking New & Recertified quipment RTLS Enterprise Recertified quipment RTLS Enterprise 02242021 Rev 1.pdf 02242021 Rev 1.pdf C102970 Valleywise Centrak Newbaby File C102970 Valleywise Centrak Newbaby Infant Tagging System 052421 Rev 3.pdf Infant Tagging System 052421 Rev 3.pdf Valleywise Software Activate for Asset File Valleywise Software Activate for Asset and Staff RTLS Enterprise 02242021 Rev and Staff RTLS Enterprise 02242021 Rev 1.pdf 1.pdf Valleywise Staff Location New & File Valleywise Staff Location New & Recertified equipment RTLS Enterprise Recertified equipment RTLS Enterprise 02242021 Rev 1.pdf 02242021 Rev 1.pdf BAA_Valleywise Health_CenTrak, Inc File BAA_Valleywise Health_CenTrak, Inc (2021.06.03).pdf (2021.06.03).pdf OIG Search Results.pdf File OIG Search Results.pdf 480-90-21-007 CenTrak - Valleywise - File 480-90-21-007 CenTrak - Valleywise Master EULA and Purchase - Master EULA and Purchase Agreement.docx Agreement.docx

Contract Information

Division Prop 480 1 Folder Contracts Status Pending Approval Title RTLS Master End User License and Purchasing Agreement Contract Identifier Board - New Contract MIHS Contract 480-90-21-007 Number Primary Responsible Benavidez, Donna Party Departments Product/Service RTLS Master End User License and Purchasing Agreement Description Action/Background Approve a new contract between Centrax Inc and Maricopa County Special Health Care District dba Valleywise Health for RTLS Master End User License and Purchasing Agreement. The purpose of this agreement is to provide RTLS Master End User License and Purchasing Agreement. This Agreement commences on the Effective Date and continues for no longer than five years, unless terminated earlier in accordance with the terms hereof. The Term will automatically renew for successive one-year periods, unless either party declines to renew this Agreement at its sole discretion by written notification to the other party at least ninety days prior to the expiration of the Term. Project: Roosevelt Campus Hospital Development Roosevelt Campus Hospital Development: $1,321,227.27 WIP 10-901000-168220 CER 19-947 The anticipated expenditure has been budgeted under Project# A1440 This Agreement is sponsored by Lia Christiansen, EVP & Chief Administrative Officer Evaluation Process The Contractor was determined to meet the requirements of the requesting department and Valleywise Health. Procurement has been satisfied pursuant to HS-102(B)(3) of the Procurement Code in that any agreements with professional association memberships and medical research projects are exempt from the solicitation requirements of the Procurement Code. Notes Master service agreement is not pertinent until 2023, vendor will provide a sample agreement for review. Category GPO Effective Date Expiration Date Annual Value $1,321,227.27 Expense/Revenue Expense Budgeted Travel Type Yes Procurement Number Primary Vendor Centrak Inc.

Responses

Member Name Status Comments Nelson, Mark E. Approved Harris, Ijana M. Approved White, Michael Approved Agnew, Claire F. Approved

2 Purves, Steve A. Approved Talbot, Melanie L. Current Melton, Christopher C. Approved Reviewed and approved

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.e.ii.

Care Reimagined Capital CER #19-947A Maricopa County Special Health Care District D

2601 E. Roosevelt Phoenix, AZ 85008 Phone: (602) 344-8551

DATE: June 8, 2021

TO: Valleywise Health Board of Directors

cc: Steve Purves, President and Chief Executive Officer Claire Agnew, EVP & Chief Financial Officer Melanie Talbot, Chief Governance Officer

FROM: Justin Storts

SUBJECT: Capital Expenditure (CER) 19-947, Medical Equipment – Acute Care Hospital

This item, CER 19-947, is for Steris Booms and Lights in multiple areas throughout the acute care tower. The IPMO team has ensured that the appropriate Clinical Workgroups have reviewed this equipment and that it meets the required needs. The below list of items has been compiled, priced, and reviewed by the IPMO project team.

Basement – Autopsy 1st Floor – ED Exam Lights, ED Trauma 2nd Floor – Endo Procedure Rooms 2nd Floor – Surgery Procedure Rooms 2nd Floor – Surgery Ortho Rooms 2nd Floor – Surgery Non-Ortho Rooms 2nd Floor – Surgical Light HD Cameras 4th Floor – Trauma Burn 4th Floor – Burn ICU 5th Floor – C Section Rooms 6th Floor – Procedure Rooms 7th Floor – ICU Rooms 1 | P a g e 7th Floor – ICU Procedure Rooms

The total cost for this CER 19-947 Steris Lights & Booms: $2,883,088.60

2 | P a g e Melanie Talbot

From: Compliance 360 Sent: Wednesday, June 9, 2021 3:56 PM To: Melanie Talbot Subject: Contract Approval Request: ACH - Steris Lights & Booms

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Message Information

From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: ACH - Steris Lights & Booms Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

Add comments as necessary.

Approve/Reject Contract

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Attachments

Name DescriptionType Current File / URL CER 19-947A - Lights & Booms File CER 19-947A - Lights & Booms memo.pdf memo.pdf CER 19-947A - Lights & Booms File CER 19-947A - Lights & Booms Quote.pdf Quote.pdf ACH - Steris Lights & Booms Contract CER 19-947A.xlsx

Contract Information

Division Capital Division Folder --- Status Pending Approval Title ACH - Steris Lights & Booms Contract Identifier Budgeted MIHS Contract 19-947A Number Primary Responsible Hixson, Jeffrey B. Party Departments Product/Service Description Action/Background

1 Evaluation Process Notes This is for Tracking Purposes and Board approval only Category Effective Date Expiration Date Annual Value $2,883,088.60 Expense/Revenue Budgeted Travel Type Yes Procurement Number Primary Vendor

Responses

Member Name Status Comments Melton, Christopher C. Approved Madhavan, Lalitha Approved Williams, Gail A. Approved Approved Pardo, Sean P. Approved White, Michael Approved Landas, Lito S. Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current Detzel, Jo-El M. Approved Nelson, Mark E. Approved Meier, Matthew P. Approved Christiansen, Lia K. Approved

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 1.f.i.

Capital CER #21-420 Melanie Talbot

From: Compliance 360 Sent: Tuesday, June 8, 2021 7:28 AM To: Melanie Talbot Subject: Contract Approval Request: Lab Point of Care Software

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Message Information

From Purves, Steve To Talbot, Melanie; Subject Contract Approval Request: Lab Point of Care Software Additional Indicate whether you approve or reject by clicking the Approve or Reject Information button.

Add comments as necessary.

Approve/Reject Contract

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Attachments

Name DescriptionType Current File / URL 420 Capital Request-Lab Point of Care File 420 Capital Request-Lab Point of Care (003).docx (003).docx Lab Point of Care Software Contract CER420.xlsx

Contract Information

Division Capital Division Folder --- Status Pending Approval Title Lab Point of Care Software Contract Identifier Budgeted MIHS Contract 21-420 Number Primary Responsible Hall, Mr. Charles E. Party Departments PMO and Governance Product/Service Description Action/Background Evaluation Process

1 Notes ***Non-Bond Capital Funding...... Clinical Funding

See CER/Memo

Capital Request for Board of Director Approval Jo-el Detzel, VP Ancillary and Support Services Kelly Summers, CHCIO, Sr VP Chief Information Officer

Submitted by: Wesley Candelaria, Director Laboratory Services Gail Williams, Director IT PMO

Title: Lab Point of Care (POC) Software

Department: Clinical Laboratory

Product/Service Description (Executive Summary for Board agenda): Valleywise Health is requesting funds to replace Lab POC middleware software. Clinical Laboratory requires middleware software to manage the incoming data feeds from the point of care devices at all Valleywise Health locations. The middleware software must meet regulatory and accreditation standards. It will enable enhanced patient care and quality, as well as increase efficiencies and throughput.

1. Background / Problem Statement: For the purposes of the remainder of this document, POC is defined as “point of care.”

The current system has multiple limitations and areas needing improvement. • New tests cannot be created quickly and efficiently within the current software It takes the current vendor approximately six weeks overall to add a new test to the system. • The number of device types currently is limited and the cost for additional device types integrations is prohibitive. • Not all devices are currently integrated. Therefore, manual entry may introduce transcription errors. • Lab charges may not be properly captured on orders. The results were entered but the actual test was not charged because there is no automatic integration. • Current vendor does not provide adequate customer service. • Regulatory requirements and reporting is very difficult.

2. Benefits / Risk Avoidance: The primary purpose of the replacement is risk avoidance, through the reduction of citations and nonconformities. Such items may be found during regulatory inspections due to non-compliance with result reporting.

The benefits include: • Future contract negotiations with affiliated vendors will provide financial benefits based on the contract awardee. • Current POC devices are not integrated with EPIC due to cost. The new software will allow integration with current non-integrated POCT devices resulting in additional revenue and improved compliance will be realized. • New system provides additional features that increase throughput efficiency and the quality and management of POCT results. • Integration of POCT devices automates the ordering and billing of results, generation of patient reports, review of instrument errors. 2 • Enhanced reporting and integration with education will ensure proper credentialing and education. • Potential increased revenue based on lab charges being captured from the additional integrations.

3. Solution Options: This project is still in the RFQ process. At the time of CER submission, a vendor has not been formally selected and awarded. Because of confidentiality restrictions, no vendor or software names are specifically referenced in this document. The following options are available: 1. Vendor Alpha 2. Vendor Beta 3. Vendor Gamma 4. Maintain current environment.

Each solution was asked to provide the following common features: • Connectivity to POC devices from various manufacturers. • Ability to review, resend, add notification, save notes, view notification actions, and print flagged results, all results, Levey-Jenning Chart, Linearity chart, and Proficiency results • Ability to review the status of applications, patient results, and devices • Ability to manage and configure devices including firmware updates, manual test setup, respiratory setup, and sessions • Ability to add, edit, remove, and restore test materials, controls, linearity, and proficiency samples • Ability to add, edit, remove, and restore operators including certifications, role management, recertification, and recertification summary. • Ability to import certification from completed modules from APEX learning center • Ability to edit, remove, add, and restore locations • Ability to add and edit evaluation criteria, patient ranges, flag configurations, and comments • Ability to compile device, operator, result, calibrator, QC, Quality improvement, usage statistics, quality check codes, and system reports • Ability to view patient ADT Events, and logs

All three solutions are similar in their approach and implementation. All options include the following elements: • Build infrastructure hardware to support solution. • Perform in-depth analysis for purposes of configuration and build. • Implement premise-based solution and integrate solution with Epic.

Option 1: Vendor Alpha This option provides the solution for integration, analyzing, compliance, and reporting as noted in the features section. There are no caveats to this option.

Option 2: Vendor Beta This option includes the four common solution elements identified previously. However, it must be noted that the following caveats apply: • Would require additional reporting build functions by Valleywise Health. • In the future, additional device types would need to be requested, added, and would incur an additional charge.

Option 3: Vendor Gamma This option provides a complete solution for integration, analyzing, compliance, and reporting. The following caveat applies: 3 • The solution will require additional emphasis on hospital-based POC (current build is directed more towards to a clinic-centric installation).

Option 4: Do nothing and maintain the environment in its current state. This approach involves VH staff maintaining the current environment. Implications include: • Additional costs as additional devices/different devices are brought on board. • Items noted in “Risks” may become issues and involve cost or regulatory consequences. • No benefits would be realized.

4. Recommendation: Option 1 Vendor Alpha is currently the top-rated solution per the RFQ scoring process.

Pros: • Top priority of risk avoidance will be achieved. • Integration of POC devices throughout the Valleywise Health campus, all clinics, and medical facilities. • Cost savings will be realized. Cost analysis indicates that the solution will essentially “pay for itself” after Year 3. • Vendor currently is independent from device manufacturers. • Provides for hospital interoperability. That means there may be instances where hospitals work together (with appropriate HIPAA and security measures) for medical cooperation.

Cons: • IT Security and Infrastructure requirements to be vetted fully; VH may require vendor adjustments to satisfy IT Security and Infrastructure needs.

5. Financial Assumptions:

Funding for this project is in the approved FY21 capital budget. There are five line items totaling $513,000. Those particular line items identified a particular vendor with additional interfaces needed. CER 21-401 was submitted in August 2020 for purchase of the software; however, it was determined that an RFQ needed to be conducted for this project.

Because the RFQ has not been officially awarded to a vendor, the CER can only reflect the highest possible amount from the three finalists. The amounts below were obtained during the quotes from the RFQ process and represent the vendor with the highest quote amounts.

Capital: Software, Services, Third Party Software $373,131.52 Additional VM infrastructure/licensing $ 75,000.00 Total Capital $448,131.52

Operating: Maintenance Support $ 52,781.75 Maintenance for Third Party Software $ 9,915.00 $ 62,696.75 Category Effective Date

4 Expiration Date Annual Value $448,131.52 Expense/Revenue Budgeted Travel Type Yes Procurement Number Primary Vendor

Responses

Member Name Status Comments Williams, Gail A. ApprovedApproved Melton, Christopher Approved. The RFQ process is still ongoing, therefore no purchase activity should be occurring Approved C. until the procurement process has been completed. Pardo, Sean P. Approved Madhavan, Lalitha Approved Candelaria, Wesley Approved J. Detzel, Jo-El M. Approved Summers, Kelly R. Approved White, Michael Approved Landas, Lito S. Approved Agnew, Claire F. Approved Purves, Steve A. Approved Talbot, Melanie L. Current

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 2.

DNV-GL Recertification Survey Preliminary DNV Recertification Survey Results

Crystal Garcia, MBA/HCM, RN VP of Specialty Services, Quality and Safety

June 23, 2021

• DNV Recertification and ISO Certification Survey was conducted onsite June 8th – June 10th. • There was a total of 9 Surveyors: • 3 Clinical • 2 Generalist • 4 Physical Environment • Offsite areas visited: • Behavioral Health – Mesa • Behavioral Health - Phoenix • Maryvale ED and Behavioral Health • Comprehensive Health Center - Phoenix • Comprehensive Health Center – Peoria • Community Health Center North Phoenix • Community Health Center – South Central • Community Health Center – South Phoenix/Laveen

© 2019 Valleywise Health. All rights reserved. Internal use. 2 Preliminary DNV Recertification Survey DNV accreditation decisions are not determined by the number of survey findings. In other words, there is no "magic number" of findings or "tipping point" that will cause a hospital to be denied accreditation. Rather, after survey, hospitals receive a preliminary report from the survey team, followed within 10 business days by a final report. The hospital will then have 10 calendar days to submit a corrective action plan, if needed. • For Category 1 nonconformities (NC-1), the hospital also submits root cause analysis to determine what led to the nonconformity, and the actions taken to correct it, including performance measure(s) data, findings, results of internal audits or other supporting documentation, and timelines to attest that correction action measures have been implemented. • For Category 2 nonconformities (NC-2), validation implementation of corrective measures occurs at the next annual survey. Upon approval of the plan, DNV accreditation committee makes a final accreditation decision, and the hospital's accreditation goes into effect on the last day of the survey.

• All Nonconformities from DNV Survey 2020 was verified as corrected. • Valleywise Health DNV findings (2021) include the following: • NC-1s • Physical Environment (2) • Patient Rights • Governing Body • NC-2s • Assessment • Patient Rights • Discharge Instructions • Emergency Management • Physical Environment (2) Corrective Action Plans are being developed to address all the Non-conformities.

Here are some of their comments: After touring Valleywise Comprehensive Health Center - Phoenix, one surveyor called the facility “very impressive” and “very quality-focused,” adding, “I could have spent the whole day going through your services." Another visited Valleywise Behavioral Health Center - Maryvale and commented, “You’re providing a great service” to the community. “That’s an amazing place. It’s very calming for your patients – we don’t see that very often.” Surveyors also applauded Valleywise Health’s VPP status, “You all have risen above for health and safety. It’s next level.” Surveyors also praised surgical services and housekeeping, “If I can see my reflection in the floors, it’s a reflection of the environmental services staff. Good job.”

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 3. Updated Information

2021 Legislative Agenda June 23, 2021 Legislative & Governmental Relations

Michael Fronske Director of Legislative and Government Affairs Current Statistics of Session

Day 164 Bills posted 1774 Bills passed 409 Bills vetoed 27 Bills signed 381 Resolutions passed 11

2 State Legislation and Issues

Legislative Deadlines Budget Process

• Budget Bills Have Been Introduced but Have Not Passed • The Governor Vetoed 22 Bills with a Veto Message That He Wants a Budget Passed Before He Will Sign any more Bills • The Flat Tax, Unemployment Insurance Increases and Other Issues Remain Unresolved • A Skinny Budget is Gaining Popularity in the House to Meet the July 1 Deadline • A 3 Day Special Session was used to Appropriate $100M to Address the Wildfires in the State

3 State Legislation and Issues

58 Bills Sent Out for Comment (30 Chaptered) 42 Bills on Monitor List Bills We Are Tracking Closely: • *HB 2454 Telehealth; Health Care Providers (Signed 5/5 Chapter 320) • HB 2575 Hospitals; Visitations (Signed 5/5 Chapter 321) • HB 2386 Crisis Standards of Care (Awaiting Vote by the Full Senate) • *HB 2833 Childcare Assistance Pilot Program (Dead) • *SB 1687 Governmental Entities; Social Media; Prohibition (Dead) • HB 2190 Vaccines; Governments; Businesses (Failed 13-16)

(* Previous Board Action)

4 Federal Issues

Recent Federal Actions: • The Supreme Court Rejected the Latest Challenge to the ACA • There are Numerous Infrastructure Bills being Worked in the Senate • The Administration announced it will invest $3B to develop an Antiviral Pill to Combat COVID and other Viruses

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 4.

Financial and Statistical Information May 2021 Financial and Statistical Information

for the month ending May 31, 2021 Financial Highlights – May 2021

Due to the COVID-19 pandemic, Patient Volume, Operating Revenues and Operating Expenses continues to be impacted during the month of May 2021.

Patient Activity Total admissions in May were 12.4% below budget, and .4% lower than the same period last year. Year-to-date total admissions were 10.9% below budget and 5.4% lower than YTD May 2020. Inpatient acute admissions for the month were 16.9% below budget and 3.1% higher than last May 2020. Behavioral health admissions were 1.6% below budget for the month and 7.0% lower than last May 2020. Emergency department visits were 10.2% below budget and 39.9% higher than last May 2020. Year- to-date visits were 24.1% below budget and 23.8% lower than YTD May 2020. Ambulatory visits were 8.6% below budget for the month and 23.6% higher than last May 2020. Year-to-date visits were 6.9% over budget and 7.7% higher than May 2020 year-to-date.

Operating Revenue Net patient service revenues were 4.2% below budget for the month and were 3.5% below budget on a year-to-date basis. Other revenues were 14.4% over budget for the month, primarily in other miscellaneous operating revenue related to the new AHCCCS healthcare investment program and the 340B program. Year- to-date total operating revenues were 1.1% below budget primarily in net patient service revenues.

Operating Expense Total operating expenses were 1.5% over budget for May. Labor expense, which includes salaries, benefits, and contract labor, were almost right on budget for the month. Majority of negative variances in contract labor were in nursing, especially the ICU/IDU units, behavioral health units and information technology. Net medical service fees were 8.5% over budget for the month due to lower collections. Supplies were 2.5% below budget primarily in pharmaceuticals, lab supplies and OR/surgery related supplies. Purchased services were 3.8% over budget primarily in legal and other professional services due to timing of invoices paid. Lastly, all other expenses excluding depreciation were 6.3% over budget for the month primarily in additional provider assessment. Year-to-date operating expenses were 4.8% over budget, primarily related to labor expense, medical service fees and provider assessment.

Non–Operating Revenue (Expense) – In total, net non-operating revenues and expenses were 19.8% over budget for the month of May. Year-to-date, net non-operating revenues and expenses were 19.9% over budget primarily due to receipt of CARES Act related grants and subsidies.

Page 1 of 35 Cash and Cash Equivalents (including investments)

May 2021 June 2020

Operating / General Fund $252.3M $256.2M Bond related – Restricted 184.3M 315.5M Total cash and cash equivalents (including investments) $436.6M $571.7M

Select Ratios 2018 FY2021 Moody’s YTD as of “A3” May Medians Liquidity Days cash on hand (unrestricted) 137.0 183.5 Days in Accounts Receivable 773.0 47.0 Current Ratio (excludes Bond 2.6 1.8 funds)

FY2021 YTD Actual YTD Budget Profitability Operating Margin (%) (22.4) (16.1) Excess Margin – normalized (%) (5.1) (3.3)

Productivity FTE/AOB w/o Residents 4.95 4.36

If you have any questions, please do not hesitate to contact Melanie Talbot or Claire Agnew, CFO.

Page 2 of 35 Fiscal Year 2021 Admissions

1,800

1,600

1,400 452 437 447 1,200 514 480 440

1,000

800

600 1,152 1,074 1,089 901 928 905 400

200

0 Actual Budget Actual Budget Actual Budget 1,381 1,604 1,442 1,511 1,345 1,536 Mar-21 Apr-21 May-21 Acute Behavioral Health

Page 3 of 35 Fiscal Year 2021 Emergency Department Visits

9,000

201 8,000 267 206 246 201 259 7,000 2,002 234 241 1,955 244 275 1,983 6,000 234 200 2,023 2,161 5,000 1,717

4,000

3,000 5,805 5,682 5,261 4,258 4,250 2,000 3,919

1,000

0 Actual Budget Actual Budget Actual Budget 6,070 8,275 6,766 8,089 6,920 7,704 Mar-21 Apr-21 May-21 Roosevelt ED Maryvale ED L&D ED Burn ED

Page 4 of 35 Fiscal Year 2021 Ambulatory Visits

45,000

40,000

5,042 4,820 5,077 35,000 5,177 5,261 1,914 2,240 2,208 2,081 2,227 4,803 2,023 30,000 2,488 2,433 2,526 1,934 2,755 2,433 25,000 15,296 13,896 14,153 13,969 20,000 13,706 12,030

15,000

10,000 15,043 14,743 14,412 14,520 13,197 13,900 5,000

0 Actual Budget Actual Budget Actual Budget 39,503 38,187 38,256 38,319 34,397 37,645 Mar-21 Apr-21 May-21 Community Health Centers Comprehensive - Phoenix Comprehensive - Peoria Dental OP Behavioral Health

* Includes Telehealth visits -- 12,240 (March 2021) || 12,065 (April 2021) || 9,648 (May 2021)

Page 5 of 35 Fiscal Year 2021 Year-to-Date Volume Summary

Admissions Emergency Department Visits 18,000 90,000 2,307 16,000 80,000 3,154 14,000 4,798 70,000 20,937 12,000 4,827 60,000 2,533 2,285 10,000 50,000 18,949 Burn ED 8,000 40,000 BH L&D ED 6,000 11,599 30,000 9,779 56,415 4,000 Acute 20,000 39,071 Maryvale ED 2,000 10,000 Roosevelt ED 0 0 Actual Budget Actual Budget 14,606 16,397 62,838 82,813 Fiscal YTD Fiscal YTD

Ambulatory Visits 450,000 400,000 OP Behavioral Health 350,000 53,159 16,051 50,329 300,000 8,921 19,418 10,313 Dental 250,000 144,767 200,000 136,100 150,000 Comprehensive Health 100,000 Center - Peoria 171,208 152,370 50,000 Comprehensive Health 0 Center - Phoenix Actual Budget Community Health 394,106 368,530 Centers Fiscal YTD * Includes 134,130 Telehealth visits in FY 2021

Page 6 of 35 Fiscal Year 2021 Patient Revenue Source by Gross Revenue

Actual Budget

18.6% 17.6%

Medicare Medicare

44.4% Other Govt. 46.0% Other Govt. 11.8% 13.0% Commercial Commercial Uninsured & Other Uninsured & Other

AHCCCS/Medicaid 11.4% AHCCCS/Medicaid 12.1%

11.9% 13.3%

Prior Year Actual

17.4% Medicare Other Govt. 45.7% 12.3% Commercial Uninsured & Other Actual Gross Revenue is 12.7% AHCCCS/Medicaid YTD as of May 31, 2021

11.9% Prior Year Gross Revenue is all of fiscal year 2020

Page 7 of 35 Fiscal Year 2021 Patient Revenue Source by Gross Revenue -- Maryvale Campus

Actual Budget

20.9% 19.8% Medicare Medicare Other Govt. Other Govt. 5.2% 5.6% Commercial Commercial 56.3% 7.9% 57.3% 7.9% Uninsured & Other Uninsured & Other AHCCCS/Medicaid AHCCCS/Medicaid 8.3% 10.8%

Prior Year Actual

17.6% Medicare

6.2% Other Govt. Commercial 7.8% 59.0% Uninsured & Other Actual Gross Revenue is 9.5% AHCCCS/Medicaid YTD as of May 31, 2021

Prior Year Gross Revenue is all of fiscal year 2020

Page 8 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) Unusual Item Report For the month ending May 31, 2021

MTD Actual

Increase (decrease) in net assets as reported $ 1,353,127

Unusual items:

HRSA COVID-19 related grant revenues $ (53,662) Valleywise Health Foundation - COVID relief (22,350) COVID-19 High Impact Areas targeted distribution (450,000) (526,012)

Normalized increase (decrease) in net assets $ 827,115

Page 9 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) STATEMENT OF REVENUES AND EXPENSES For the Period Ending May 31, 2021

Prior Year Prior Year Prior Year May-21 May-21 May-21 May-21 Same Month Same Month Same Month Actual Budget Variance % Change May-20 Variance % Change Net Patient Service Revenue $ 44,081,284 $ 46,007,051 $ (1,925,768) (4.2 %) $ 30,101,391 $ 13,979,893 46.4 %

Other Revenue 8,553,184 7,479,405 1,073,778 14.4 % 6,681,234 1,871,949 28.0 %

Total Operating Revenue 52,634,467 53,486,457 (851,989) (1.6 %) 36,782,625 15,851,842 43.1 %

OPERATING EXPENSES

Salaries and Wages 23,775,696 24,503,192 727,496 3.0 % 22,249,131 (1,526,565) (6.9 %) Contract Labor 1,966,513 1,404,759 (561,754) (40.0 %) 1,502,377 (464,136) (30.9 %) Employee Benefits 6,429,920 6,254,065 (175,854) (2.8 %) 6,130,214 (299,706) (4.9 %) Medical Service Fees 7,458,863 6,873,341 (585,522) (8.5 %) 7,190,595 (268,268) (3.7 %) Supplies 8,233,538 8,444,684 211,146 2.5 % 6,571,439 (1,662,099) (25.3 %) Purchased Services 2,501,613 2,410,821 (90,792) (3.8 %) 2,639,988 138,374 5.2 % Repair and Maintenance 1,686,830 1,705,263 18,433 1.1 % 1,632,517 (54,313) (3.3 %) Utilities 673,018 631,303 (41,715) (6.6 %) 527,716 (145,301) (27.5 %) Rent 428,054 427,057 (997) (0.2 %) 413,598 (14,456) (3.5 %) Other Expenses 1,510,908 1,884,272 373,364 19.8 % 1,945,123 434,215 22.3 % Provider Assessment 1,801,301 1,086,975 (714,326) (65.7 %) 652,033 (1,149,268) (176.3 %) Depreciation 3,422,008 3,381,891 (40,117) (1.2 %) 1,177,457 (2,244,550) (190.6 %)

Total Operating Expense 59,888,263 59,007,624 (880,639) (1.5 %) 52,632,189 (7,256,074) (13.8 %)

Operating Income (Loss) (7,253,795) (5,521,167) (1,732,628) (31.4 %) (15,849,564) 8,595,769 54.2 %

NONOPERATING REVENUES (EXPENSES)

NonCapital Grants 570,534 1,201,467 (630,933) (52.5 %) 635,825 (65,290) (10.3 %) NonCapital Transfers from County/State 295,658 295,658 0 0.0 % 295,658 0 0.0 % Investment Income 379,514 296,308 83,206 28.1 % 414,756 (35,241) (8.5 %) Other NonOperating Revenues (Expenses) 349,079 (2,173,347) 2,522,426 116.1 % 2,180,797 (1,831,718) (84.0 %) Interest Expense (1,247,384) (1,249,255) 1,872 0.1 % (1,309,179) 61,795 4.7 % Tax Levy 11,633,850 11,633,850 (0) (0.0 %) 11,941,918 (308,069) (2.6 %)

Total NonOperating Revenues (Expenses) 11,981,252 10,004,681 1,976,572 19.8 % 14,159,775 (2,178,523) (15.4 %)

Excess of Revenues over Expenses $ 4,727,457 $ 4,483,514 $ 243,944 5.4 % $ (1,689,788) $ 6,417,246 379.8 %

Page 10 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) STATEMENT OF REVENUES AND EXPENSES For the Period Ending May 31, 2021

Prior Year Prior Year Prior Year May-21 May-21 May-21 May-21 Same Month Same Month Same Month Actual Budget Variance % Change May-20 Variance % Change

Bond-Related Revenues and Expenses (3,374,331) (3,492,280) 117,950 3.4 % (4,134,997) 760,666 18.4 %

Increase in Net Assets (normalized) $ 1,353,127 $ 991,233 $ 361,893 36.5 % $ (5,824,785) $ 7,177,912 123.2 %

Page 11 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) STATEMENT OF REVENUES AND EXPENSES For the Eleven Periods Ending May 31, 2021

YTD YTD YTD YTD May-21 May-21 May-21 May-21 Prior Year Prior Year Prior Year YTD Actual YTD Budget YTD Variance % Change May-20 Variance % Change Net Patient Service Revenue $ 441,876,644 $ 458,080,102 $ (16,203,458) (3.5 %) $ 418,136,016 $ 23,740,627 5.7 %

Other Revenue 93,295,963 83,001,336 10,294,627 12.4 % 81,902,411 11,393,552 13.9 %

Total Operating Revenue 535,172,606 541,081,438 (5,908,831) (1.1 %) 500,038,427 35,134,179 7.0 %

OPERATING EXPENSES

Salaries and Wages 255,447,903 254,130,068 (1,317,835) (0.5 %) 245,715,587 (9,732,316) (4.0 %) Contract Labor 22,938,796 14,888,796 (8,050,000) (54.1 %) 21,576,335 (1,362,461) (6.3 %) Employee Benefits 76,669,553 71,985,158 (4,684,395) (6.5 %) 70,748,595 (5,920,958) (8.4 %) Medical Service Fees 80,271,466 68,020,007 (12,251,459) (18.0 %) 73,478,526 (6,792,940) (9.2 %) Supplies 85,082,105 87,950,788 2,868,683 3.3 % 83,327,225 (1,754,880) (2.1 %) Purchased Services 29,858,313 28,467,665 (1,390,648) (4.9 %) 27,135,090 (2,723,223) (10.0 %) Repair and Maintenance 18,907,243 18,768,390 (138,852) (0.7 %) 17,679,851 (1,227,392) (6.9 %) Utilities 7,691,054 7,751,320 60,266 0.8 % 6,965,650 (725,404) (10.4 %) Rent 5,270,963 5,085,224 (185,739) (3.7 %) 5,291,288 20,325 0.4 % Other Expenses 17,643,972 19,972,365 2,328,392 11.7 % 17,843,085 199,113 1.1 % Provider Assessment 17,063,605 11,343,007 (5,720,597) (50.4 %) 7,172,368 (9,891,237) (137.9 %) Depreciation 38,264,091 36,862,353 (1,401,738) (3.8 %) 30,174,324 (8,089,767) (26.8 %)

Total Operating Expense 655,109,064 625,225,142 (29,883,922) (4.8 %) 607,107,923 (48,001,141) (7.9 %)

Operating Income (Loss) (119,936,457) (84,143,704) (35,792,753) (42.5 %) (107,069,496) (12,866,962) (12.0 %)

NONOPERATING REVENUES (EXPENSES)

NonCapital Grants 5,404,325 12,439,263 (7,034,938) (56.6 %) 10,622,626 (5,218,301) (49.1 %) NonCapital Transfers from County/State 3,252,238 3,252,238 0 0.0 % 3,252,238 0 0.0 % Investment Income 1,954,635 3,259,388 (1,304,753) (40.0 %) 7,750,003 (5,795,367) (74.8 %) Other NonOperating Revenues (Expenses) 4,311,298 (25,451,628) 29,762,926 116.9 % (17,458,481) 21,769,779 124.7 % Interest Expense (13,794,985) (13,781,009) (13,976) (0.1 %) (12,429,424) (1,365,560) (11.0 %) Tax Levy 127,972,348 127,972,348 (0) (0.0 %) 131,361,102 (3,388,754) (2.6 %)

Total NonOperating Revenues (Expenses) 129,099,860 107,690,600 21,409,260 19.9 % 123,098,063 6,001,797 4.9 %

Excess of Revenues over Expenses $ 9,163,403 $ 23,546,896 $ (14,383,494) (61.1 %) $ 16,028,567 $ (6,865,165) (42.8 %)

Page 12 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) STATEMENT OF REVENUES AND EXPENSES For the Eleven Periods Ending May 31, 2021

YTD YTD YTD YTD May-21 May-21 May-21 May-21 Prior Year Prior Year Prior Year YTD Actual YTD Budget YTD Variance % Change May-20 Variance % Change

Bond-Related Revenues and Expenses (37,296,006) (38,375,883) 1,079,876 2.8 % (48,120,141) 10,824,135 22.5 %

Increase in Net Assets (normalized) $ (28,132,604) $ (14,828,986) $ (13,303,617) (89.7 %) $ (32,091,574) $ 3,958,970 12.3 %

Page 13 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) STATEMENT OF NET POSITION May 31, 2021

5/31/2021 6/30/2020 ASSETS Current Assets Cash and Cash Equivalents Cash - Care System $ 168,273,452 $ 205,329,246 Short-Term Investment - Care System 83,993,001 50,913,029 Cash and Short-Term Investment 252,266,453 256,242,275

Cash - Bond 84,498,550 245,576,963 Short-Term Investment - Bond 99,811,510 69,958,826 Cash and Short-Term Investment - Bond 184,310,061 315,535,788

Total Cash and Cash Equivalents 436,576,514 571,778,063 Patient A/R, Net of Allowances 97,427,029 92,306,976 Other Receivables and Prepaid Items 40,984,777 37,419,631 Estimated Amounts Due from Third-Party Payors 39,796,215 15,630,637 Due from Related Parties 1,643,749 1,204,159 Total Current Assets 616,428,284 718,339,467

Capital Assets, Net 585,250,029 501,967,393

Total Assets 1,201,678,313 1,220,306,860

Page 14 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) STATEMENT OF NET POSITION May 31, 2021

5/31/2021 6/30/2020

Deferred Outflows 48,799,387 48,799,387

Total Assets and Deferred Outflows $ 1,250,477,700 $ 1,269,106,247

LIABILITIES AND NET POSITION Current Liabilities Current Maturities of Long-Term Debt $ 40,848,753 $ 41,032,266 Accounts Payable 42,784,565 48,912,286 Accrued Payroll and Expenses 35,486,521 32,597,614 Medical Claims Payable 16,145,285 15,803,517 Due to Related Parties 14,631,154 5,222,959 Other Current Liabilities 56,367,125 53,207,641 Total Current Liabilities 206,263,402 196,776,282

Long-Term Debt Bonds Payable 425,891,743 463,170,813 Total Long-Term Debt 425,891,743 463,170,813

Long-Term Liabilities 311,945,423 311,945,423

Total Liabilities 944,100,568 971,892,518

Page 15 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) STATEMENT OF NET POSITION May 31, 2021

5/31/2021 6/30/2020

Deferred Inflows 23,950,283 23,950,283

Net Position Invested in Capital Assets, Net of Related Debt 544,401,276 460,935,127 Temporarily Restricted 13,432,015 13,396,825 Unrestricted (275,406,442) (201,068,506) Total Net Position 282,426,849 273,263,446

Total Liabilities, Deferred Inflows, and Net Position $ 1,250,477,700 $ 1,269,106,247

Page 16 of 35 Comprehensive Health Center – Peoria (pictured) Supplemental Information

Page 17 of 35 Valleywise Health Financial and Statistical Information 31-May-21

Current Month Fiscal Year to Date Prior Fiscal Year to Date Actual Budget Variance Var % Actual Budget Variance Var % Actual Variance Var %

Acute Admissions 905 1,089 (184) (16.9%) 9,779 11,599 (1,820) (15.7%) 11,022 (1,243) (11.3%) Length of Stay (LOS) 5.6 5.5 (0.1) (1.8%) 5.6 5.2 (0.5) (8.8%) 4.9 (0.7) (13.4%) Patient Days 5,027 5,940 (913) (15.4%) 54,883 59,832 (4,949) (8.3%) 54,535 348 0.6%

Acute - Observation Days and Admits Observation Days 512 608 (96) (15.7%) 3,827 6,035 (2,208) (36.6%) 5,620 (1,793) (31.9%)

Observation Admission - Transfer to Inpatient 175 205 (30) (14.6%) 1,707 2,021 (314) (15.5%) 2,089 (382) (18.3%) Observation Admission Only 375 443 (68) (15.3%) 2,833 4,374 (1,541) (35.2%) 4,092 (1,259) (30.8%) Total Admissions - Acute plus Observation Only 1,280 1,532 (252) (16.4%) 12,612 15,973 (3,361) (21.0%) 15,114 (2,502) (16.6%)

Behavioral Health Admissions 440 447 (7) (1.6%) 4,827 4,798 29 0.6% 4,419 408 9.2% Length of Stay (LOS) 21.0 22.5 1.4 6.4% 19.9 22.3 2.4 10.8% 22.1 2.2 10.0% Patient Days 9,251 10,041 (790) (7.9%) 96,122 107,086 (10,964) (10.2%) 97,752 (1,630) (1.7%) Valleywise Behavioral Health Center-Phoenix 2,220 2,019 201 10.0% 23,799 21,712 2,087 9.6% 28,401 (4,602) (16.2%) Valleywise Behavioral Health Center-Mesa 3,065 3,011 54 1.8% 30,778 33,356 (2,578) (7.7%) 36,900 (6,122) (16.6%) Valleywise Behavioral Health Center-Maryvale 3,966 5,011 (1,045) (20.9%) 41,545 52,018 (10,473) (20.1%) 32,451 9,094 28.0%

Combined (Acute + Behavioral Health) Adjusted Admissions 2,465 2,777 (311) (11.2%) 25,278 29,559 (4,280) (14.5%) 28,237 (2,958) (10.5%) Adjusted Patient Days 26,171 28,889 (2,718) (9.4%) 261,343 300,904 (39,561) (13.1%) 278,484 (17,140) (6.2%)

Case Mix Index Total Hospital 1.59 1.50 0.09 5.8% 1.62 1.50 0.11 7.6% 1.50 0.12 7.7% Acute (Excluding Newborns) 1.87 1.72 0.16 9.2% 1.91 1.72 0.19 11.3% 1.72 0.19 11.1% Behavioral Health 1.20 1.18 0.01 1.1% 1.20 1.18 0.01 1.2% 1.18 0.02 1.6% Medicare 2.33 2.03 0.30 15.0% 2.25 2.03 0.23 11.3% 2.02 0.23 11.6% AHCCCS 1.88 1.75 0.13 7.7% 1.91 1.75 0.16 9.3% 1.75 0.16 9.3%

Ambulatory Valleywise Community Health Centers Visits - Including WHHs 13,197 13,900 (703) (5.1%) 171,208 152,370 18,838 12.4% 171,346 (138) (0.1%) Valleywise Comprehensive Health Center-Phoenix Visits 12,030 13,706 (1,676) (12.2%) 144,767 136,100 8,667 6.4% 131,846 12,921 9.8% Valleywise Comprehensive Health Center-Peoria Visits 2,525 2,755 (230) (8.3%) 9,070 10,313 (1,243) (12.1%) 0 9,070 100.0% Dental Clinics Visits 1,934 2,023 (89) (4.4%) 16,051 19,418 (3,367) (17.3%) 18,826 (2,775) (14.7%) OP Behavioral Health Visits 4,803 5,261 (458) (8.7%) 53,159 50,329 2,830 5.6% 43,859 9,300 21.2%

Total Ambulatory Visits : 34,489 37,645 (3,156) (8.4%) 394,255 368,530 25,725 7.0% 365,877 28,378 7.8%

Page 18 of 35 Valleywise Health Financial and Statistical Information 31-May-21

Current Month Fiscal Year to Date Prior Fiscal Year to Date Actual Budget Variance Var % Actual Budget Variance Var % Actual Variance Var %

Hospital Surgical Center (SURG) - Total IP & OP Surgeries 690 777 (87) (11.2%) 6,523 6,960 (437) (6.3%) 6,542 (19) (0.3%) Surgical Center (SURG) - Total Surgical Minutes 78,240 86,285 (8,045) (9.3%) 758,880 775,684 (16,804) (2.2%) 736,770 22,110 3.0% Surgical Center (SURG) - Minutes per Case 113 111 (2.3) (2.1%) 116 111 (4.9) (4.4%) 113 (3.7) (3.3%) Operating Room Utilization 75% 70% 4.8% 6.9% 65% 70% (5.4%) (7.8%) 64% 0.1% 0.2%

Valleywise Comprehensive Health Center-Peoria Surgeries 27 14 13 92.9% 42 37 5 13.5% 0 42 100.0%

Endoscopy Cases - Roosevelt 267 275 (8) (2.9%) 2,603 2,832 (229) (8.1%) 2,436 167 6.9% Endoscopy Cases - Peoria 60 16 44 275.0% 104 40 64 160.0% 0 104 100.0%

Deliveries 127 137 (10) (7.3%) 1,511 1,698 (187) (11.0%) 1,700 (189) (11.1%)

Trauma Visits (subset of ED Visits) 165 179 (14) (7.8%) 1,460 1,850 (390) (21.1%) 1,793 (333) (18.6%)

Emergency Department (ED) 6,920 7,704 (784) (10.2%) 62,838 82,813 (19,975) (24.1%) 82,412 (19,574) (23.8%) Roosevelt ED 4,250 5,261 (1,011) (19.2%) 39,071 56,415 (17,344) (30.7%) 54,835 (15,764) (28.7%) Maryvale ED 2,161 1,983 178 9.0% 18,949 20,937 (1,988) (9.5%) 22,302 (3,353) (15.0%) L&D ED 275 259 16 6.2% 2,533 3,154 (621) (19.7%) 3,045 (512) (16.8%) Burn ED 234 201 33 16.4% 2,285 2,307 (22) (1.0%) 2,230 55 2.5%

% of Total ED Visits Resulting in Admission Roosevelt 13.0% 12.9% 0.0% 0.3% 14.6% 12.9% 1.7% 13.3% 12.3% 2.2% 18.1% % of Total ED Visits Resulting in Admission Maryvale 5.7% 5.1% 0.6% 11.6% 7.5% 5.1% 2.4% 45.9% 5.8% 1.7% 30.0% % of Acute Patients Admitted Through the ED 88.8% 84.6% 4.3% 5.0% 87.7% 86.2% 1.4% 1.7% 87.8% (0.1%) (0.1%)

Left Without Treatment (LWOT) ROOSEVELT 0.5% <3% 2.5% 82.3% 0.6% <3% 2.4% 80.0% 1.2% 0.6% 50.0% Left Without Treatment (LWOT) MARYVALE 1.8% <3% 1.2% 41.2% 1.0% <3% 2.0% 66.0% 1.3% 0.3% (20.9%)

Overall ED Median Length of Stay (minutes) ROOSEVELT 212 <240 28 11.7% 205 <240 35 14.6% 215 10 4.7% Overall ED Median Length of Stay (minutes) MARYVALE 193 <220 27 12.3% 173 <220 47 21.4% 174 1 (0.6%)

PSYCH ED Median LOS (minutes) ROOSEVELT 537 <0 (537) (100.0%) 513 <0 (513) (100.0%) 484 (29) (6.0%) PSYCH ED Median LOS (minutes) MARYVALE 654 <0 (654) (100.0%) 499 <0 (499) (100.0%) 604 105 17.4%

Median Time to Treatment (MTT) (minutes) ROOSEVELT 17 <30 13 43.3% 16 <30 14 46.7% 19 3 15.8% Median Time to Treatment (MTT) (minutes) MARYVALE 25 <30 5 16.7% 16 <30 14 46.7% 19 3 (15.8%)

Cath Lab Utilization - Room 1 24% 45% (20.6%) (45.9%) 19% 45% (26.0%) (57.8%) 18% 1.3% 7.3% Cath Lab Utilization - Room 2 31% 45% (14.0%) (31.2%) 21% 45% (24.4%) (54.1%) 31% (10.7%) (34.2%) Cath Lab Utilization - IR 116% 65% 51.3% 78.9% 94% 65% 28.6% 44.1% 71% 22.4% 31.4% CCTA/Calcium Score 11 15 (4) (26.7%) 94 165 (71) (43.0%) 87 7 8.0%

Pediatric ED Visits at Maryvale (under age 18) 308 2,195 Adult ED Visits at Maryvale (age 18 and over) 1,853 16,754 Maryvale ED to Inpatient OR 30 253

Pediatric ED Visits at Roosevelt (under age 18) 641 5,232 Adult ED Visits at Roosevelt (age 18 and over) 3,609 33,839

Page 19 of 35 Valleywise Health Financial and Statistical Information 31-May-21 Current Month Fiscal Year to Date Prior Fiscal Year to Date Actual Budget Variance Var % Actual Budget Variance Var % Actual Variance Var %

Operating Income / (Loss) in 000s Valleywise Health $ (7,254) $ (5,521) $ (1,733) (31.4%) $ (119,936) $ (84,144) $ (35,793) (42.5%) $ (107,069) $ (12,867) (12.0%)

Net Income / (Loss) in 000s Valleywise Health $ 4,727 $ 4,484 $ 244 5.4% $ 9,163 $ 23,547 $ (14,383) (61.1%) $ 16,029 $ (6,865) (42.8%)

Net Income / (Loss) in 000s Normalized Valleywise Health $ 1,353 $ 991 $ 362 36.5% $ (28,133) $ (14,829) $ (13,304) (89.7%) $ (32,092) $ 3,959 12.3%

RATIOS: Liquidity Total Cash and Investments (000s) $ 252.3 $ 233.7 $ 18.6 8.0% $ 256.0 $ (3.7) (1.5%)

Total Days Cash on Hand 137.0 183.5 (46.5) (25.3%) 146.8 (9.8) (6.7%)

Current Ratio 3.0 3.7 (0.7) (18.1%)

Current Ratio without Bond-related Assets 2.6 2.6 0.0 1.4% & Liabilities

Days in Accounts Receivable (Hospital only) 73.0 5.9 (67.1) (1147.7%) 81.0 8.0 9.9%

Capital Structure EBIDA Debt Service Coverage 15.3 (1.6) 16.9 1061.8% 14.0 1.3 9.4%

Profitability Operating Margin (13.78%) (10.32%) (3.46%) (33.5%) (22.41%) (15.55%) (6.86%) (44.1%) (21.05%) (1.36%) (6.5%)

Labor FTE/AOB WO Residents 4.57 4.40 (0.17) (3.8%) 4.95 4.36 (0.59) (13.4%) 4.65 (0.30) (6.4%)

Current Month Rolling Last Twelve Months Actual Prior Year Variance Var % Actual Prior Year Variance Var % Turnover Rate - Voluntary 1.38% 0.89% (0.49%) (55.06%) 17.17% 16.89% (0.28%) (1.66%) Turnover Rate - Involuntary 0.27% 0.18% (0.09%) (50.00%) 3.25% 4.16% 0.91% 21.88% Turnover Rate - Uncontrollable 0.60% 0.06% (0.54%) (900.00%) 4.85% 2.78% (2.07%) (74.46%) Turnover Rate - Total 2.25% 1.12% (1.13%) (100.89%) 25.27% 23.83% (1.44%) (6.04%)

Page 20 of 35 Appendix A Definition of Financial Indicators

Desired Position Relative to Indicator Definition Trend Median

Cash + Short-Term Investments Total Days Cash on Hand = Up Above (Operating Expenses Less - Depreciation) / YTD Days

Days in Accounts Net Patient Accounts Receivable (including Due/From) = Down Below Receivable Net Patient Service Revenue / YTD Days

Cash + Short-Term Investments Cushion Ratio = Up Above Principal + Interest Expenses

Cash + Short-Term Investments Cash to Debt = X 100 Up Above Long Term Debt

EBITDA Debt Service EBITDA = Up Above Coverage Principal + Interest Expenses

Long Term Debt Debt to Net Assets = X 100 Down Below Long Term Debt + Unrestricted Assets

Operating Income (Loss) Operating Margin = X 100 Up Above Operating Revenues

EBITDA EBITDA Margin = X 100 Up Above Operating Revenues + Non Operating Revenues

Net Income Excess Margin = X 100 Up Above Operating Revenues + Non Operating Revenues

All discharged accounts. Case Mix Index - = Includes normal newborns (DRG 795). Up Above Total Hospital Includes discharges with a Behavioral Health patient type.

Discharged accounts. Case Mix Index - Acute = Excludes normal newborns (DRG 795). Up Above (Excluding Newborns) Excludes discharges with a Behavioral Health patient type.

Case Mix Index - Behavioral = Discharges with a Behavioral Health patient type. Up Above Health

Discharged accounts with a financial class of Medicare or Case Mix Index - Medicare = Medicare Managed Care. Excludes normal newborns (DRG 795). Up Above Excludes discharges with a Behavioral Health patient type.

Discharged accounts with a financial class of AHCCCS or Case Mix Index - AHCCCS = Maricopa Health Plan. Excludes normal newborns (DRG 795). Up Above Excludes discharges with a Behavioral Health patient type.

For ALL Case Mix values -- only Patient Types of Inpatient, Behavioral Health and Newborn are counted (as appropriate). Patient Types of Observation, Outpatient and Emergency are excluded from all CMI calculations at all times.

New individual MS-DRG weights are issued by CMS each year, with an effective date of October 1st.

Page 21 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) VOLUMES For the Eleven Periods Ending May 31, 2021

Prior Year Prior Year YTD YTD YTD May-21 May-21 May-21 May-21 Same Month Same Month May-21 May-21 May-21 May-21 Prior Year Prior Year Actual Budget Variance % Change May-20 % Change YTD Actual YTD Budget YTD Variance % Change May-20 % Change ADMISSIONS Acute 905 1,089 (184) (16.9 %) 878 3.1 % 9,779 11,599 (1,820) (15.7 %) 11,022 (11.3 %) Behavioral Health 440 447 (7) (1.6 %) 473 (7.0 %) 4,827 4,798 29 0.6 % 4,419 9.2 % Valleywise Behavioral Health Center-Phoenix 80 79 1 1.3 % 115 (30.4 %) 916 858 58 6.8 % 1,063 (13.8 %) Valleywise Behavioral Health Center-Mesa 158 151 7 4.6 % 191 (17.3 %) 1,790 1,677 113 6.7 % 1,909 (6.2 %) Valleywise Behavioral Health Center-Maryvale 202 217 (15) (6.9 %) 167 21.0 % 2,121 2,263 (142) (6.3 %) 1,447 46.6 % Total 1,345 1,536 (191) (12.4 %) 1,351 (0.4 %) 14,606 16,397 (1,791) (10.9 %) 15,441 (5.4 %)

OBSERVATION ADMISSIONS Transferred to Inpatient * 175 205 (30) (14.6 %) 181 (3.3 %) 1,707 2,021 (314) (15.5 %) 2,089 (18.3 %) Observation Admission Only 375 443 (68) (15.3 %) 246 52.4 % 2,833 4,374 (1,541) (35.2 %) 4,092 (30.8 %) Total Observation Admissions 550 648 (98) (15.1 %) 427 28.8 % 4,540 6,395 (1,855) (29.0 %) 6,181 (26.5 %)

TOTAL ADMISSIONS AND OBSERVATION ONLY Total 1,720 1,979 (259) (13.1 %) 1,597 7.7 % 17,439 20,771 (3,332) (16.0 %) 19,533 (10.7 %)

ADJUSTED ADMISSIONS Total 2,465 2,777 (311) (11.2 %) 2,159 14.2 % 25,278 29,559 (4,280) (14.5 %) 28,237 (10.5 %)

PATIENT DAYS Acute 5,027 5,940 (913) (15.4 %) 4,136 21.5 % 54,883 59,832 (4,949) (8.3 %) 54,535 0.6 % Behavioral Health 9,251 10,041 (790) (7.9 %) 8,572 7.9 % 96,122 107,086 (10,964) (10.2 %) 97,752 (1.7 %) Valleywise Behavioral Health Center-Phoenix 2,220 2,019 201 10.0 % 2,344 (5.3 %) 23,799 21,712 2,087 9.6 % 28,401 (16.2 %) Valleywise Behavioral Health Center-Mesa 3,065 3,011 54 1.8 % 3,053 0.4 % 30,778 33,356 (2,578) (7.7 %) 36,900 (16.6 %) Valleywise Behavioral Health Center-Maryvale 3,966 5,011 (1,045) (20.9 %) 3,175 24.9 % 41,545 52,018 (10,473) (20.1 %) 32,451 28.0 % Total 14,278 15,981 (1,703) (10.7 %) 12,708 12.4 % 151,005 166,918 (15,913) (9.5 %) 152,287 (0.8 %)

AVERAGE DAILY CENSUS Acute 162 192 (29) (15.4 %) 133 21.5 % 164 179 (15) (8.3 %) 162 0.9 % Behavioral Health 298 324 (25) (7.9 %) 277 7.9 % 287 320 (33) (10.2 %) 291 (1.4 %) Valleywise Behavioral Health Center-Phoenix 72 65 6 10.0 % 76 (5.3 %) 71 65 6 9.6 % 85 (16.0 %) Valleywise Behavioral Health Center-Mesa 99 97 2 1.8 % 98 0.4 % 92 100 (8) (7.7 %) 110 (16.3 %) Valleywise Behavioral Health Center-Maryvale 128 162 (34) (20.9 %) 102 24.9 % 124 155 (31) (20.1 %) 97 28.4 % Total 461 516 (55) (10.7 %) 410 12.4 % 451 498 (48) (9.5 %) 453 (0.5 %)

ADJUSTED PATIENT DAYS Total 26,171 28,889 (2,718) (9.4 %) 20,304 28.9 % 261,343 300,904 (39,561) (13.1 %) 278,484 (6.2 %)

* Already included in 'Acute Admissions'.

Page 22 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) VOLUMES For the Eleven Periods Ending May 31, 2021

Prior Year Prior Year YTD YTD YTD May-21 May-21 May-21 May-21 Same Month Same Month May-21 May-21 May-21 May-21 Prior Year Prior Year Actual Budget Variance % Change May-20 % Change YTD Actual YTD Budget YTD Variance % Change May-20 % Change OPERATING ROOM SURGERIES - ROOSEVELT Inpatient 386 402 (16) (4.0 %) 281 37.4 % 3,793 3,674 119 3.2 % 3,629 4.5 % Outpatient 304 375 (71) (18.9 %) 129 135.7 % 2,730 3,286 (556) (16.9 %) 2,913 (6.3 %) Total 690 777 (87) (11.2 %) 410 68.3 % 6,523 6,960 (437) (6.3 %) 6,542 (0.3 %)

Inpatient Minutes 47,310 52,047 (4,737) (9.1 %) 35,085 34.8 % 473,805 475,669 (1,864) (0.4 %) 465,420 1.8 % Outpatient Minutes 30,930 34,238 (3,308) (9.7 %) 12,870 140.3 % 285,075 300,015 (14,940) (5.0 %) 271,350 5.1 % Total 78,240 86,285 (8,045) (9.3 %) 47,955 63.2 % 758,880 775,684 (16,804) (2.2 %) 736,770 3.0 %

OPERATING ROOM SURGERIES - PEORIA Outpatient 27 14 13 92.9 % 0 100.0 % 42 37 5 13.5 % 0 100.0 % Outpatient Minutes 2,460 1,457 1,003 68.8 % 0 100.0 % 3,915 3,883 32 0.8 % 0 100.0 %

ENDOSCOPY CASES - ROOSEVELT Inpatient 60 54 6 11.1 % 51 17.6 % 635 631 4 0.6 % 644 (1.4 %) Outpatient 207 221 (14) (6.3 %) 69 200.0 % 1,968 2,201 (233) (10.6 %) 1,792 9.8 % Total 267 275 (8) (2.9 %) 120 122.5 % 2,603 2,832 (229) (8.1 %) 2,436 6.9 %

ENDOSCOPY CASES - PEORIA Outpatient 60 16 44 275.0 % 0 100.0 % 104 40 64 160.0 % 0 100.0 %

DELIVERIES Total 127 137 (10) (7.3 %) 126 0.8 % 1,511 1,698 (187) (11.0 %) 1,700 (11.1 %)

ED VISITS Adult 4,250 5,261 (1,011) (19.2 %) 3,062 38.8 % 39,071 56,415 (17,344) (30.7 %) 40,922 (4.5 %) Maryvale 2,161 1,983 178 9.0 % 1,446 49.4 % 18,949 20,937 (1,988) (9.5 %) 22,302 (15.0 %) Pediatrics * 0 0 0 0.0 % 0 0.0 % 0 0 0 0.0 % 13,913 (100.0 %) Labor & Delivery 275 259 16 6.2 % 204 34.8 % 2,533 3,154 (621) (19.7 %) 3,045 (16.8 %) Burn 234 201 33 16.4 % 234 0.0 % 2,285 2,307 (22) (1.0 %) 2,230 2.5 % Total 6,920 7,704 (784) (10.2 %) 4,946 39.9 % 62,838 82,813 (19,975) (24.1 %) 82,412 (23.8 %)

AMBULATORY VISITS Valleywise Community Health Centers ** 13,197 13,900 (703) (5.1 %) 13,293 (0.7 %) 171,208 152,370 18,838 12.4 % 171,346 (0.1 %) Valleywise Comprehensive Health Center-Phoenix 12,030 13,706 (1,676) (12.2 %) 9,832 22.4 % 144,767 136,100 8,667 6.4 % 131,846 9.8 % Valleywise Comprehensive Health Center-Peoria 2,433 2,755 (322) (11.7 %) 0 100.0 % 8,921 10,313 (1,392) (13.5 %) 0 100.0 % Outpatient Behavioral Health 4,803 5,261 (458) (8.7 %) 4,481 7.2 % 53,159 50,329 2,830 5.6 % 43,859 21.2 % Dental 1,934 2,023 (89) (4.4 %) 217 791.2 % 16,051 19,418 (3,367) (17.3 %) 18,826 (14.7 %) Total 34,397 37,645 (3,248) (8.6 %) 27,823 23.6 % 394,106 368,530 25,576 6.9 % 365,877 7.7 %

* These are visits to the Pediatric Emergency Department, not ED visits under a certain age. ** Includes WHH Clinic visits when applicable

Page 23 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL INDICATORS For the Period Ending May 31, 2021

Prior Year Prior Year Prior Year May-21 May-21 May-21 May-21 Same Month Same Month Same Month Actual Budget Variance % Change May-20 Variance % Change Net Patient Service Revenue per APD $ 1,684 $ 1,593 $ 92 5.8 % $ 1,483 $ 202 13.6 %

Salaries $ 23,775,696 $ 24,503,192 $ 727,496 3.0 % $ 22,249,131 ($ 1,526,565) (6.9 %) Benefits 6,429,920 6,254,065 (175,854) (2.8 %) 6,130,214 (299,706) (4.9 %) Contract Labor 1,966,513 1,404,759 (561,754) (40.0 %) 1,502,377 (464,136) (30.9 %) Total Labor Costs $ 32,172,129 $ 32,162,017 ($ 10,112) (0.0 %) $ 29,881,722 ($ 2,290,407) (7.7 %)

Supplies $ 8,233,538 $ 8,444,684 $ 211,146 2.5 % $ 6,571,439 ($ 1,662,099) (25.3 %) Medical Service Fees 7,458,863 6,873,341 (585,522) (8.5 %) 7,190,595 (268,268) (3.7 %) All Other * 9,500,029 11,568,293 2,068,265 17.9 % 6,939,357 (2,560,672) (36.9 %) Total $ 25,192,430 $ 26,886,318 $ 1,693,888 6.3 % $ 20,701,391 ($ 4,491,039) (21.7 %)

Total Operating and Non-Operating Expenses * $ 57,364,559 $ 59,048,335 $ 1,683,776 2.9 % $ 50,583,113 ($ 6,781,446) (13.4 %) * Excludes Depreciation

Tax Levy Property Tax $ 7,020,082 $ 7,020,082 ($ 0) (0.0 %) $ 6,704,949 $ 315,133 4.7 % Bonds 4,613,768 4,613,768 0 0.0 % 5,236,969 (623,201) (11.9 %) Total Tax Levy $ 11,633,850 $ 11,633,850 ($ 0) (0.0 %) $ 11,941,918 ($ 308,069) (2.6 %)

Patient Days - Acute 5,027 5,940 (913) (15.4 %) 4,136 891 21.5 % Patient Days - Behavioral Health 9,251 10,041 (790) (7.9 %) 8,572 679 7.9 % Patient Days - Total 14,278 15,981 (1,703) (10.7 %) 12,708 1,570 12.4 %

Adjusted Patient Days 26,171 28,889 (2,718) (9.4 %) 20,304 5,867 28.9 % APD Ratio 1.83 1.81 0.03 1.4 % 1.60 0.24 14.7 %

Admissions - Acute 905 1,089 (184) (16.9 %) 878 27 3.1 % Admissions - Behavioral Health 440 447 (7) (1.6 %) 473 (33) (7.0 %) Admissions - Total 1,345 1,536 (191) (12.4 %) 1,351 (6) (0.4 %)

Adjusted Admissions 2,465 2,777 (311) (11.2 %) 2,159 307 14.2 %

Average Daily Census - Acute 162 192 (29) (15.4 %) 133 29 21.5 % Average Daily Census - Behavioral Health 298 324 (25) (7.9 %) 277 22 7.9 % Average Daily Census - Total 461 516 (55) (10.7 %) 410 51 12.4 %

Adjusted Occupied Beds - Acute 297 346 (49) (14.2 %) 213 84 39.4 %

Page 24 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL INDICATORS For the Period Ending May 31, 2021

Prior Year Prior Year Prior Year May-21 May-21 May-21 May-21 Same Month Same Month Same Month Actual Budget Variance % Change May-20 Variance % Change Adjusted Occupied Beds - Behavioral Health 547 586 (39) (6.6 %) 442 105 23.8 % Adjusted Occupied Beds - Total 844 932 (88) (9.4 %) 655 189 28.9 %

Paid FTEs - Payroll 3,723 3,986 263 6.6 % 3,573 (150) (4.2 %) Paid FTEs - Contract Labor 338 314 (24) (7.8 %) 314 (24) (7.7 %) Paid FTEs - Total 4,061 4,300 239 5.6 % 3,887 (174) (4.5 %)

FTEs per AOB 4.81 4.61 (0.20) (4.3 %) 5.93 1.12 18.9 %

FTEs per AOB (w/o Residents) 4.57 4.40 (0.17) (3.8 %) 5.63 1.06 18.9 %

Benefits as a % of Salaries 27.0 % 25.5 % (1.5 %) (6.0 %) 27.6 % 0.5 % 1.8 %

Labor Costs as a % of Net Patient Revenue 73.0 % 69.9 % (3.1 %) (4.4 %) 99.3 % 26.3 % 26.5 %

Salaries and Contract Labor per APD $ 984 $ 897 ($ 87) (9.7 %) $ 1,170 $ 186 15.9 % Benefits per APD 246 216 (29) (13.5 %) 302 56 18.6 % Supplies per APD 315 292 (22) (7.6 %) 324 9 2.8 % Medical Service Fees per APD 285 238 (47) (19.8 %) 354 69 19.5 % All Other Expenses per APD * 363 400 37 9.4 % 342 (21) (6.2 %) Total Expenses per APD * $ 2,192 $ 2,044 ($ 148) (7.2 %) $ 2,491 $ 299 12.0 %

Salaries and Contract Labor per Adj. Admission $ 10,442 $ 9,331 ($ 1,111) (11.9 %) $ 11,004 $ 562 5.1 % Benefits per Adj. Admission 2,608 2,252 (356) (15.8 %) 2,840 232 8.2 % Supplies per Adj. Admission 3,340 3,041 (298) (9.8 %) 3,044 (295) (9.7 %) Medical Service Fees per Adj. Admission 3,025 2,475 (550) (22.2 %) 3,331 306 9.2 % All Other Expenses per Adj. Admission * 3,853 4,166 313 7.5 % 3,215 (639) (19.9 %) Total Expenses per Adj. Admission * $ 23,268 $ 21,266 ($ 2,002) (9.4 %) $ 23,434 $ 166 0.7 %

* Excludes Depreciation

Page 25 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL INDICATORS For the Eleven Periods Ending May 31, 2021

YTD YTD YTD YTD May-21 May-21 May-21 May-21 Prior Year Prior Year Prior Year YTD Actual YTD Budget YTD Variance % Change May-20 Variance % Change Net Patient Service Revenue per APD $ 1,691 $ 1,522 $ 168 11.1 % $ 1,501 $ 189 12.6 %

Salaries $ 255,447,903 $ 254,130,068 ($ 1,317,835) (0.5 %) $ 245,715,587 ($ 9,732,316) (4.0 %) Benefits 76,669,553 71,985,158 (4,684,395) (6.5 %) 70,748,595 (5,920,958) (8.4 %) Contract Labor 22,938,796 14,888,796 (8,050,000) (54.1 %) 21,576,335 (1,362,461) (6.3 %) Total Labor Costs $ 355,056,252 $ 341,004,022 ($ 14,052,230) (4.1 %) $ 338,040,517 ($ 17,015,735) (5.0 %)

Supplies $ 85,082,105 $ 87,950,788 $ 2,868,683 3.3 % $ 83,327,225 ($ 1,754,880) (2.1 %) Medical Service Fees 80,271,466 68,020,007 (12,251,459) (18.0 %) 73,478,526 (6,792,940) (9.2 %) All Other * 105,918,837 130,620,608 24,701,772 18.9 % 111,975,237 6,056,400 5.4 % Total $ 271,272,407 $ 286,591,403 $ 15,318,996 5.3 % $ 268,780,988 ($ 2,491,420) (0.9 %)

Total Operating and Non-Operating Expenses * $ 626,328,659 $ 627,595,425 $ 1,266,766 0.2 % $ 606,821,505 ($ 19,507,154) (3.2 %) * Excludes Depreciation

Tax Levy Property Tax $ 77,220,897 $ 77,220,897 ($ 0) (0.0 %) $ 73,754,439 $ 3,466,458 4.7 % Bonds 50,751,451 50,751,451 0 0.0 % 57,606,664 (6,855,213) (11.9 %) Total Tax Levy $ 127,972,348 $ 127,972,348 ($ 0) (0.0 %) $ 131,361,102 ($ 3,388,754) (2.6 %)

Patient Days - Acute 54,883 59,832 (4,949) (8.3 %) 54,535 348 0.6 % Patient Days - Behavioral Health 96,122 107,086 (10,964) (10.2 %) 97,752 (1,630) (1.7 %) Patient Days - Total 151,005 166,918 (15,913) (9.5 %) 152,287 (1,282) (0.8 %)

Adjusted Patient Days 261,343 300,904 (39,561) (13.1 %) 278,484 (17,140) (6.2 %) APD Ratio 1.73 1.80 (0.07) (4.0 %) 1.83 (0.10) (5.4 %)

Admissions - Acute 9,779 11,599 (1,820) (15.7 %) 11,022 (1,243) (11.3 %) Admissions - Behavioral Health 4,827 4,798 29 0.6 % 4,419 408 9.2 % Admissions - Total 14,606 16,397 (1,791) (10.9 %) 15,441 (835) (5.4 %)

Adjusted Admissions 25,278 29,559 (4,280) (14.5 %) 28,237 (2,958) (10.5 %)

Average Daily Census - Acute 164 179 (15) (8.3 %) 162 2 0.9 % Average Daily Census - Behavioral Health 287 320 (33) (10.2 %) 291 (4) (1.4 %) Average Daily Census - Total 451 498 (48) (9.5 %) 453 (2) (0.5 %)

Adjusted Occupied Beds - Acute 284 322 (38) (11.9 %) 297 (13) (4.5 %)

Page 26 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL INDICATORS For the Eleven Periods Ending May 31, 2021

YTD YTD YTD YTD May-21 May-21 May-21 May-21 Prior Year Prior Year Prior Year YTD Actual YTD Budget YTD Variance % Change May-20 Variance % Change Adjusted Occupied Beds - Behavioral Health 497 576 (80) (13.8 %) 532 (35) (6.7 %) Adjusted Occupied Beds - Total 780 898 (118) (13.1 %) 829 (49) (5.9 %)

Paid FTEs - Payroll 3,721 3,812 91 2.4 % 3,706 (15) (0.4 %) Paid FTEs - Contract Labor 344 307 (37) (12.2 %) 350 6 1.6 % Paid FTEs - Total 4,065 4,119 54 1.3 % 4,056 (9) (0.2 %)

FTEs per AOB 5.21 4.59 (0.62) (13.6 %) 4.89 (0.32) (6.5 %)

FTEs per AOB (w/o Residents) 4.95 4.36 (0.59) (13.4 %) 4.65 (0.30) (6.4 %)

Benefits as a % of Salaries 30.0 % 28.3 % (1.7 %) (6.0 %) 28.8 % (1.2 %) (4.2 %)

Labor Costs as a % of Net Patient Revenue 80.4 % 74.4 % (5.9 %) (7.9 %) 80.8 % 0.5 % 0.6 %

Salaries and Contract Labor per APD $ 1,065 $ 894 ($ 171) (19.1 %) $ 960 ($ 105) (11.0 %) Benefits per APD 293 239 (54) (22.6 %) 254 (39) (15.5 %) Supplies per APD 326 292 (33) (11.4 %) 299 (26) (8.8 %) Medical Service Fees per APD 307 226 (81) (35.9 %) 264 (43) (16.4 %) All Other Expenses per APD * 405 434 29 6.6 % 402 (3) (0.8 %) Total Expenses per APD * $ 2,397 $ 2,086 ($ 311) (14.9 %) $ 2,179 ($ 218) (10.0 %)

Salaries and Contract Labor per Adj. Admission $ 11,013 $ 9,101 ($ 1,912) (21.0 %) $ 9,466 ($ 1,547) (16.3 %) Benefits per Adj. Admission 3,033 2,435 (598) (24.5 %) 2,506 (527) (21.1 %) Supplies per Adj. Admission 3,366 2,975 (390) (13.1 %) 2,951 (415) (14.1 %) Medical Service Fees per Adj. Admission 3,175 2,301 (874) (38.0 %) 2,602 (573) (22.0 %) All Other Expenses per Adj. Admission * 4,190 4,419 229 5.2 % 3,966 (224) (5.7 %) Total Expenses per Adj. Admission * $ 24,777 $ 21,232 ($ 3,545) (16.7 %) $ 21,491 ($ 3,287) (15.3 %)

* Excludes Depreciation

Page 27 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL STATEMENT HIGHLIGHTS For the month ending May 31, 2021

OPERATING REVENUE

Patient Days, Admissions and Adjusted Patient Days

Acute Care Actual Budget Variance %Variance MTD - Patient Days 5,027 5,940 (913) -15.4% YTD - Patient Days 54,883 59,832 (4,949) -8.3%

MTD - Admissions 905 1,089 (184) -16.9% YTD - Admissions 9,779 11,599 (1,820) -15.7%

MTD - Average Length of Stay (ALOS) 5.6 5.5 (0.1) -1.8% YTD - Average Length of Stay (ALOS) 5.6 5.2 (0.5) -8.8%

MTD - Average Daily Census (ADC) 162 192 (29) -15.4% YTD - Average Daily Census (ADC) 164 179 (15) -8.3%

Behavioral Health Actual Budget Variance %Variance MTD - Patient Days 9,251 10,041 (790) -7.9% YTD - Patient Days 96,122 107,086 (10,964) -10.2%

MTD - Admissions 440 447 (7) -1.6% YTD - Admissions 4,827 4,798 29 0.6%

MTD - Average Length of Stay (ALOS) 21.0 22.5 1.4 6.4% YTD - Average Length of Stay (ALOS) 19.9 22.3 2.4 10.8%

MTD - Average Daily Census (ADC) 298 324 (25) -7.9% YTD - Average Daily Census (ADC) 287 320 (33) -10.2%

Adjusted Patient Days (APD) Actual Budget Variance %Variance Month-to-Date 26,171 28,889 (2,718) -9.4% Year-to-Date 261,343 300,904 (39,561) -13.1%

Net patient service revenue

Actual Budget Variance %Variance Month-to-Date $ 44,081,284 $ 46,007,051 $ (1,925,768) -4.2% Year-to-Date $ 441,876,644 $ 458,080,102 $ (16,203,458) -3.5% Month-to-Date Per APD $ 1,684 $ 1,593 $ 92 5.8% Year-to-Date Per APD $ 1,691 $ 1,522 $ 168 11.1%

Other operating revenue

Actual Budget Variance %Variance Month-to-Date $ 8,553,184 $ 7,479,405 $ 1,073,778 14.4% Year-to-Date $ 93,295,963 $ 83,001,336 $ 10,294,627 12.4%

The majority of the positive variances for the month are in other miscellaneous operating revenue related to HCIA (new AHCCCS program), and 340B revenues. The negative variance for the month are primarily in cafeteria sales and retail pharmacy sales.

Total operating revenues

Actual Budget Variance %Variance Month-to-Date $ 52,634,467 $ 53,486,457 $ (851,989) -1.6% Year-to-Date $ 535,172,606 $ 541,081,438 $ (5,908,831) -1.1%

Page 28 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL STATEMENT HIGHLIGHTS For the month ending May 31, 2021

OPERATING EXPENSES

Salaries and wages

Actual Budget Variance %Variance Month-to-Date $ 23,775,696 $ 24,503,192 $ 727,496 3.0% Year-to-Date $ 255,447,903 $ 254,130,068 $ (1,317,835) -0.5%

Actual Budget Variance %Variance Paid FTE's - Payroll 3,723 3,986 263 6.6%

Actual Budget Variance %Variance Paid FTE's - Payroll (w/o Residents) 3,521 3,785 263 7.0%

Actual Budget Variance %Variance Salaries per FTE's - Payroll $ 6,386 $ 6,147 $ (239) -3.9%

Contract labor

Actual Budget Variance %Variance Month-to-Date $ 1,966,513 $ 1,404,759 $ (561,754) -40.0% Year-to-Date $ 22,938,796 $ 14,888,796 $ (8,050,000) -54.1%

Actual Budget Variance %Variance FTE's - Contract Labor incl Outsource 338 314 (24) -7.6%

FTE's - Contract Labor Actual Budget Variance %Variance Nursing operations - Acute 17 4 (13) -333.0% Revenue Cycle 4 5 2 38.5% Behavioral Health 5 - (5) 0.0% Information Technology 9 6 (3) -50.0%

FTE's - Outsource Departments Actual Budget Variance %Variance Food & Nutrition Services 127 127 - 0.0% Environmental Services 160 160 - 0.0% Laundry & Linen 7 7 - 0.0% Gift Shop 2 2 - 0.0%

Actual Budget Variance %Variance Paid FTE's - Payroll & Contract Labor 4,061 4,300 239 5.6%

Actual Budget Variance %Variance Adjusted Occupied Beds (AOB) 844 932 (88) -9.4%

Actual Budget Variance %Variance Paid FTE's per AOB 4.81 4.61 (0.20) -4.3%

Employee benefits

Actual Budget Variance %Variance Month-to-Date $ 6,429,920 $ 6,254,065 $ (175,854) -2.8% Year-to-Date $ 76,669,553 $ 71,985,158 $ (4,684,395) -6.5%

The negative variance for the month is primarily in the net self-insured expenses. The positive variances for the month are primarily in ASRS employer expense, FICA witholding.

Page 29 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL STATEMENT HIGHLIGHTS For the month ending May 31, 2021

Benefits as a % of salaries

Actual Budget Variance %Variance Month-to-Date 27.0% 25.5% -1.5% -6.0% Year-to-Date 30.0% 28.3% -1.7% -6.0%

Medical service fees

Actual Budget Variance %Variance Month-to-Date $ 7,458,863 $ 6,873,341 $ (585,522) -8.5% Year-to-Date $ 80,271,466 $ 68,020,007 $ (12,251,459) -18.0%

The negative variance for the month is primarily related to lower than anticipated DMG collections.

Supplies

Actual Budget Variance %Variance Month-to-Date $ 8,233,538 $ 8,444,684 $ 211,146 2.5% Year-to-Date $ 85,082,105 $ 87,950,788 $ 2,868,683 3.3%

The majority of the positive variance for the month is primarily in pharmaceuticals, OR related supplies (i.e. human skin, implants, devices, etc.), laboratory supplies, GPO rebates, and repairs & maintenance supplies. The negative variances for the month are primarily in software, and blood & plasma supplies.

Purchased services

Actual Budget Variance %Variance Month-to-Date $ 2,501,613 $ 2,410,821 $ (90,792) -3.8% Year-to-Date $ 29,858,313 $ 28,467,665 $ (1,390,648) -4.9%

The major negative variances for the month are in attorney/legal fees, and other professional services due to timing of invoices received. The major positive variance for the month is in other services.

Other expenses

Actual Budget Variance %Variance Month-to-Date $ 4,298,810 $ 4,647,895 $ 349,085 7.5% Year-to-Date $ 49,513,232 $ 51,577,299 $ 2,064,067 4.0%

The major positive variances for the month are in net risk management expenses, overhead costs, and organization memberships, certifications or licenses. The major negative variances for the month are in printing & duplicating, and patient transport services.

Provider Assessment

Actual Budget Variance %Variance Month-to-Date $ 1,801,301 $ 1,086,975 $ (714,326) -65.7% Year-to-Date $ 17,063,605 $ 11,343,007 $ (5,720,597) -50.4%

Negative variance for the month relates to the additional assessment from AHCCCS regarding the Healthy/HCIA program.

Depreciation

Actual Budget Variance %Variance Month-to-Date $ 3,422,008 $ 3,381,891 $ (40,117) -1.2% Year-to-Date $ 38,264,091 $ 36,862,353 $ (1,401,738) -3.8%

Page 30 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL STATEMENT HIGHLIGHTS For the month ending May 31, 2021

Total operating expenses

Actual Budget Variance %Variance Month-to-Date $ 59,888,263 $ 59,007,624 $ (880,639) -1.5% Year-to-Date $ 655,109,064 $ 625,225,142 $ (29,883,922) -4.8%

Operating income (loss)

Actual Budget Variance %Variance Month-to-Date $ (7,253,795) $ (5,521,167) $ (1,732,628) -31.4% Year-to-Date $ (119,936,457) $ (84,143,704) $ (35,792,753) -42.5%

Non-operating revenues (expenses)

Actual Budget Variance %Variance Month-to-Date $ 11,981,252 $ 10,004,681 $ 1,976,572 19.8% Year-to-Date $ 129,099,860 $ 107,690,600 $ 21,409,260 19.9%

Excess of revenues over expenses

Actual Budget Variance %Variance Month-to-Date $ 4,727,457 $ 4,483,514 $ 243,944 5.4% Year-to-Date $ 9,163,403 $ 23,546,896 $ (14,383,494) -61.1%

Page 31 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL STATEMENT HIGHLIGHTS For the month ending May 31, 2021

ASSETS

Cash and cash equivalents - Delivery system

May-21 Jun-20 Change % change $ 252,266,453 $ 256,242,275 $ (3,975,822) -1.6%

Cash and cash equivalents - Bond (restricted)

May-21 Jun-20 Change % change $ 184,310,061 $ 315,535,788 $ (131,225,727) -41.6%

Paid $40.5M in principal and interest in July 2020 related to the 2nd and 3rd bond offerings. Also paid $10.1M in interest in January 2021.

Patient A/R, net of allowances

May-21 Jun-20 Change % change $ 97,427,029 $ 92,306,976 $ 5,120,053 5.5%

Other receivables and prepaid items

May-21 Jun-20 Change % change $ 40,984,777 $ 37,419,631 $ 3,565,146 9.5%

FY21 other receivables / prepaids includes: $905K due from Home Assist Health $9.9M in inventories $1.0M in retail pharmacy receivable $3.5M due from DMG for pro-fees collections $296K in Psych subsidy $3.6M due from AHCCCS (new HCIA) program $709K due from other hospital - resident rotation $2.0M due from Wellpartner/340B program $17.2M in prepaids/deposits $2.0M receivables from grants & research sponsors $136K due from Health Foundation

Estimated amounts due from third party payors

May-21 Jun-20 Change % change $ 39,796,215 $ 15,630,637 $ 24,165,578 154.6%

FY21 due from third party payors includes: $3.9M due from AHCCCS for DSH - FY21 $554K due from First Things First $35.4M due from AHCCCS for GME - FY21

Due from related parties

May-21 Jun-20 Change % change $ 1,643,749 $ 1,204,159 $ 439,590 36.5%

FY21 due from related parties includes: $1.6M due from Public Health Ryan White Part A programs

Page 32 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL STATEMENT HIGHLIGHTS For the month ending May 31, 2021

Capital Assets, net

May-21 Jun-20 Change % change $ 585,250,029 $ 501,967,393 $ 83,282,636 16.6%

Other Assets

May-21 Jun-20 Change % change $ - $ - $ - 0.0%

Deferred outflows

May-21 Jun-20 Change % change $ 48,799,387 $ 48,799,387 $ - 0.0%

LIABILITIES AND NET POSITION

Current maturities of long-term debt

May-21 Jun-20 Change % change $ 40,848,753 $ 41,032,266 $ (183,513) -0.4%

FY21 current maturities includes: $40.9M in Bond current portion and interest payable

Accounts payable

May-21 Jun-20 Change % change $ 42,784,565 $ 48,912,286 $ (6,127,722) -12.5%

FY21 accounts payable includes: $10.7M due to DMG for annual recon and pass thru payments $20.7M in vendor related expense accruals/estimates ($2.5M related to prior year's staffing, collection & pass thru payments reconciliation) $11.4M in vendor approved payments ($8.2M related to May 2021 accrued net expenses)

Accrued payroll and expenses

May-21 Jun-20 Change % change $ 35,486,521 $ 32,597,614 $ 2,888,908 8.9%

Medical claims payable

May-21 Jun-20 Change % change $ 16,145,285 $ 15,803,517 $ 341,768 2.2%

Page 33 of 35 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT VALLEYWISE HEALTH (COMBINED CARE SYSTEM) FINANCIAL STATEMENT HIGHLIGHTS For the month ending May 31, 2021

Due to related parties

May-21 Jun-20 Change % change $ 14,631,154 $ 5,222,959 $ 9,408,195 180.1%

Timing of tax levy revenue accrual and actual collection received.

Other current liabilities

May-21 Jun-20 Change % change $ 56,367,125 $ 53,207,641 $ 3,159,484 5.9%

FY21 other current liabilities includes: $2.6M in settlement reserved for Medicare $1.1M in deferred income (Health Foundation) $2.5M in deferred income for grants, research, & study residuals $367K in unclaimed/stale dated checks $9.1M in 3rd party settlement related to SNCP, FQHC, APSI $8.4M in patient credit balance $9.9M in other deferred income (TIP, Optum, APSI) $22.2M in advanced Medicare payments $236K in other current liabilities

Bonds payable

May-21 Jun-20 Change % change $ 425,891,743 $ 463,170,813 $ (37,279,070) -8.0%

Reclassed current maturities portion of Bond payable

Long-term liabilities

May-21 Jun-20 Change % change $ 311,945,423 $ 311,945,423 $ - 0.0%

Pension liability per ASRS report - GASB68

Deferred inflows

May-21 Jun-20 Change % change $ 23,950,283 $ 23,950,283 $ - 0.0%

Net position

May-21 Jun-20 Change % change $ 282,426,849 $ 273,263,446 $ 9,163,403 3.4%

Page 34 of 35 Valleywise Health Health Plan sale proceeds

Beginning balance - February 01, 2017 $ -

ADD: Payment received from UHC for member transfer $ 33,361,499.99 Investment income 1,604,154.37 Bank interest income received - YTD 77,509.26 35,043,163.62

LESS: Consulting services expense (547,601.00) Valleywise Health Foundation Funding (3,000,000.00) Bank charges - transfer fees (50.00)

Investments - (3,547,651.00)

Ending balance as of May 31, 2021 $ 31,495,512.62

Page 35 of 35

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 5.

Reports to the Board

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 5.a.

Reports to the Board Monthly Marketing and Communications Report Valleywise Marketing Communications Snapshot MAY 2021

Marketing Communication Budget $5.1M

REQUESTS FOR APPOINTMENTS

MONTHLY TOTAL APPOINTMENT APPOINTMENT DOWNSTREAM APPOINTMENTS REVENUE POTENTIAL REVENUE POTENTIAL

5,108 $1,532,400 $4,474,608 GOAL % OF GOAL YTD GOAL YTD GOAL YTD 1,981 257% 47,757 $594,300 $14.3M $1.7M/mo $41.4M * Appointment Revenue Potential is calculated using * Downstream Revenue Potential is calculated using *Total monthly appointments are the sum of all Total $300 multiplier, which is the approximate AHCCCS the Valleywise Health Quarterly Clinic Downstream Requests by Source as listed below. payment for a per general health visit to clinic Revenue Report that shows $876,000 downstream physician/provider revenue generated by 1,000 patient visits in clinics

REQUEST FOR APPOINTMENT BREAKDOWN

TOTAL REQUEST TOTAL REQUESTS BY SOURCE BY CATEGORY PAID RESULTS BREAKDOWN

TELEHEALTH Target Audience: General market audience, including new 76 and existing patients served by the entire Valleywise ambulatory network in the Valley, with a focus on segments with intent or interest in Telehealth services. CHC Target Audience: Hyperlocal geographic targeting reaching 842 unique prospective patients based on the communities they live in and services they are looking for. CORE Target Audience: General market audience, including new 1,170 and existing patients served by the entire Valleywise ambulatory network.

Click to Call - 9973 Website - Direct PEORIA Target Audience: Prospective and Current patients in the Click to Call - VLLYWSE Net Calls 65 Peoria community, radius and household targeting surrounding the 85345 zip code. Geographic target area Telehealth Click to Call - Other includes regions previously serviced by the closing El Mirage Net Calls CHC and Glendale Health Centers. Calls from Ads Core Form Submits Peoria

EMAIL 15,458 9,020 58.35% 5.99% TOTAL EMAILS SENT TOTAL OPENED OPEN RATE CTO One Month Previous 70,676 One Month Previous 29,511 One Month Previous 41.76% One Month Previous 8.61% EARNED MEDIA AGGREGATE READERSHIP SHARE OF VOICE GRAPH 72M TOTAL MENTIONS 173 SHARE OF VOICE 29% 29% 173 AD EQUIVALENCY Valleywise Health $195K

MEDIA SCREENSHOTS

SOCIAL WEBSITE (MoM)

SHARE OF VOICE ENGAGED USERS 46,352 TOTAL WEB VISITS One Month Previous 48,221 Facebook

Instagram 99,818

Twitter TOTAL PAGE VIEWS 21.64% One Month Previous 104,563 Valleywise Health TOTAL FANS BY PLATFORM 32,561 UNIQUE VISITORS One Month Previous 33,688

Valleywise Health: 21.64% Banner Health: 55.87% 68,098 Honor Health: 2.27% Abrazo Health: 1.09% TOTAL BLOG VISITS Dignity Health: 19.13% One Month Previous 67,413 COMMUNITY OUTREACH

COMMUNITY PARTNER ENGAGEMENT EVENTS COMMUNITY BUSINESS DEVELOPMENT 13 May 12 - Virtual Family Forum 5 A third family forum was hosted for families of Pendergast Meetings (Virtual) MEETINGS (VIRTUAL) Elementary School District in Gilbert with a focus on vaccination and mental health.

249 May 22 - Food Distribution Event 375+ PARTICIPANTS PARTICIPANTS In partnership with St. Mary's Food Banks, United West Valley Human Alliance - Healthcare and Milwaukee Brewers, Valleywise hosted a Peoria Chamber of Commerce (multiple) Presentation free food distribution event for families in Maryvale. Greater Phoenix Economic Council Nurses from Valleywise volunteered of their time to Glendale Strong Family Network - make the event a success and in total more than 150 (Presentation by Steve Purves) Presentation families were provided fresh produce and dry goods to WESTMARC Association for Supportive Child Care feed more than 400 people. Glendale Chamber of Commerce Mesa Community Action Peoria Chamber of Commerce Maricopa County Public Health Greater Phoenix Chamber

AREA OF FOCUS

INTERNAL MEDIA Open Enrollment Bond Sale TOTAL EMPLOYEE EMAILS OPEN RATE Memorial Day CEO Message Employee Engagement Survey Travel Reduction Survey 26 60.38% Construction Noise (SSB) Nurses Month One Month Previous 16 One Month Previous 59.72% National Hospital Week

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 5.b.

Reports to the Board Monthly Care Reimagined Capital Purchases Report Care Reimagined – Spend report (May 2021) VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

Functional Area - Outpatient Health Facilities ABBOTT RAPID DIAGNOSTICS 19-930 $ 1,870 ADAMS AND WENDT 19-930 $ 57,101 $ 57,101 ADVANCED STERILIZATION 19-930 $ 140,587 Advanced Testing 19-930 $ 2,765 $ 3,595 Airpark Signs 19-930 $ 2,450 $ 181,111 ALLEGIANCE CORP 19-930 $ 39,577 ALTURA 19-930 $ 4,200 $ 204,410 AMICO 19-930 $ 5,097 ARC Products LLC 19-930 $ 3,510 Arizona Department of Health 19-930 $ 300 ARIZONA PUBLIC SERVICE 19-930 $ (30,357) Armstrong Medical 19-930 $ 8,955 ARTHREX 19-930 $ 64,558 $ 64,558 B BRAUN 19-930 $ 184,373 BAYER HEALTHCARE 19-930 $ 86,500 Baxter Health 19-930 $ 4,995 BONNY PIONTKOWSKI 19-930 $ 975 $ 6,270 BPG Technologies 19-921 $ 190,548 BPG Technologies 19-930 $ 16,080 $ 16,080 CAPSULE TECH 19-930 $ 166,454 CARDINAL HEALTH 19-930 $ 2,070 CAREFUSION 19-930 $ 1,074 $ 159,327 $ 34,176 $ 229,118 CDW Government 19-930 $ 528 $ 5,913 $ 9,460 $ 288,063 CHEMDAQ 19-930 $ 21,874 City of Peoria $ 80,987 CME 19-930 $ 2,329 $ 23,227 $ 2,028 $ 1,708,468 COOPER ATKINS 19-930 $ 33,041 COOPER SURGICAL 19-930 $ 87 $ 1,238 $ 11,542 COVIDIEN 19-930 $ 83,550 CROSSPOINT COMMUNICATIONS 19-930 $ 18,657 Cushman and Wakefield of Arizona $ 16,500 C-SCAN TECHNOLOGIES 19-930 $ 230 $ 230 DAAVLIN DISTRUBITING 19-930 $ 7,000 DANIELS MOVING 19-930 $ (147) $ 17,300 $ 23,133 Davis Enterprises 19-930 $ 14,807 DATA INNOVATIONS LLC $ 14,285 DATEX OHMEDA $ 8,348 $ 387,508

Page 1 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

DEPUY SYNTHES 19-930 $ 19,272 $ 19,272 DIBBLE ENGINEERING $ 12,570 ELITECHGROUP INC 19-930 $ 16,895 EXTENDATA 19-930 $ 60,844 FILLMASTER 19-930 $ 1,494 FOLLETT 19-930 $ 1,690 E3 DIAGNOSTICS 19-930 $ 7,319 $ 7,319 GE 19-930 $ 270,585 $ 16,692 $ 1,026,131 GLOBAL SURGICAL 16-930 $ 13,650 Goodmans 19-930 $ 901,835 GRAINGER $ 535 $ 55 $ 20,644 GRAYBAR ELECTRIC $ 1,045 HELMER $ 137,145 Henry Schein 19-930 $ 11,472 $ 404,003 HILL ROM 19-930 $ 53,711 Hobbs and Black Associates Inc $ 10,195 $ 3,214,559 Hologic 19-907 $ 673,682 HP INC 19-930 $ 514,051 Hye Tech Network $ 1,015,724 INTELLIGENT HEARING 19-930 $ 4,185 INTERMETRO INDUSTRIES $ 43,630 $ 2,492 $ 147,669 JRC Design 19-930 $ 148,090 KRONOS 19-930 $ 23,505 Lanmor 19-930 $ 664 LEICA MICROSYSTEMS 19-930 $ 26,779 $ 28,107 LPIT SOLUTIONS $ 10,500 Mar Cor Purification 19-930 $ 205,641 Maricopa County Environmental Services 19-930 $ 2,515 Maricopa County Planning and Development 19-930 $ 573,393 MDM COMMERCIAL 19-930 $ 43,969 MEDIVATORS $ 8,992 MEDTRONIC 19-930 $ 12,850 MIZUHO ORTHOPEDICS 19-930 $ 2,413 MONOPRICE INC 19-930 $ 757 NATUS MEDICAL 19-930 $ 346 $ 34,916 NCI INC $ 9,262 Ninyo and Moore Geotechnical and Environment $ 739 $ 132,464 NUAIER 19-930 $ 13,123 OIEC MEDICAL SYSTEMS 19-930 $ 250,893

Page 2 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

Okland Construction Company 19-930 $ 122,299 $ 43,038,874 Olympus 19-930 $ 26,151 $ 592,863 OWENS AND MINOR 19-930 $ 1,672 O&M HALYARD INC 19-930 $ 11,441 PARKS MEDICAL 19-930 $ 710 PARTS SOURCE 19-930 $ 1,726 $ 1,726 PATRIOT PURVEYORS $ 29,499 PENTAX MEDICAL 19-930 $ 122,737 Radiation Physics and Engineering $ 6,250 RICOH 19-930 $ 17,080 SIGNOSTICS INC 19-930 $ 22,020 SCRIPTPRO $ 199,244 SOFT COMPUTER 19-930 $ 32,838 $ 65,675 SMITHS MEDICAL 19-930 $ 11,582 $ 11,582 Speedie and Associates $ 1,810 $ 4,447 SPHERE COMMERCE $ 1,577 START-UP COST PEORIA 19-930 $ 131,855 Steris 19-930 $ 13,286 $ 1,508 $ 391,599 Stryker Communications 19-921 $ 15,477 $ 975,927 TBCX $ 156,758 TDINDUSTRIES 19-930 $ 54,119 THE BAKER CO. 19-930 $ 14,485 THE CBORD GROUP 19-930 $ 1,022 $ 19,021 THE CLOROX SALES 19-930 $ 44,800 THE GRAPHICS MEDICAL 19-930 $ 2,275 $ 2,275 Thomas Printworks 19-930 $ 4,200 TRANSONIC SYSTEMS $ 24,389 UTECH PRODUCTS $ 47,600 VERATHON 19-930 $ 14,620 Vizient Inc $ 379,135 West Valley Fidelity National Title - Land Purchase (Grand Ave/Cotton) $ 5,595,598 West Valley Fidelity National Title (escrow) $ 75,000 TOTAL West Valley Specialty Center (WVSC) $ 134,405 $ 808,839 $ 110,089 $ 66,085,316 Alliance Land Surveying LLC 19-942 $ 1,825 Allstare Rent A Fence 19-942 $ (1,703) $ - Great American Title (escrow/property tax) - Chandler 19-942 $ (2,320) $ 1,194,705 SPEEDIE AND ASSOC 19-942 $ 3,600 Ninyo and Moore Geotechnical and Environment 19-942 $ 70,599

Page 3 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

TOTAL Chandler FHC (CHAN) $ (4,023) $ - $ - $ 1,270,729 Fidelity National Title (escrow) - Miller&Main 19-944 $ 1,977,097 Allstare Rent A Fence 19-944 $ 407 $ 195 $ 2,847 CDW G 19-944 $ 843 $ 843 CITY OF MESA 19-944 $ 234 $ 73,756 $ 85,490 SPEEDIE AND ASSOC 19-944 $ 3,600 DAVES CONSTRUCTION 19-944 $ 72,981 DIBBLE ENGINEERING 19-944 $ 8,256 DWL ARCHITECTS + PLANNERS INC 19-944 $ 36,448 $ 870,409 Maricopa County Planning 19-944 $ 85,240 OKLAND CONSTRUCTION 19-944 $ 1,657,462 $ 2,478,445 TEMP ARMOUR 19-944 $ 6,248 SMITHS MEDICAL 19-944 $ 1,391 $ 1,391 SPEEDIE AND ASSOC 19-944 $ 3,174 $ 3,174 SPRAY SYSTEMS 19-944 $ 29,640 TRANSACT COMMERCIAL 19-944 $ 166,377 $ 166,377 Ninyo and Moore Geotechnical and Environment 19-944 $ 45,355 TOTAL Mesa FHC (MESA) $ - $ 1,866,336 $ 73,951 $ 5,837,394 Clear Title Agency (escrow) - Central Phoenix Clinic $ 2,704,752 Clear Title Agency (escrow) - Phoenix Metro $ 50,000 Cushman and Wakefield of Arizona Inc 19-945 $ 4,750 DAVES CONSTRUCTION 19-945 $ 171,254 DWL ARCHITECTS + PLANNERS INC 19-945 $ 22,693 JENSEN HUGHES 19-945 $ 2,884 MARICOPA COUNTY PLANNING 19-945 $ 30 Ninyo and Moore Geotechnical and Environment 19-945 $ 36,938 OKLAND CONSTRUCTION 19-945 $ 2,391,459 SPEEDIE AND ASSOC 19-945 $ 5,105 Spray Systems 19-945 $ 119,430 TOTAL Central Phoenix FHC (PHXM) $ - $ - $ - $ 5,509,296 DIBBLE ENGINEERING 19-929 $ 6,904 ABBOTT RAPID DIAG 19-929 $ 190 ALLEGIANCE CORP 19-929 $ 1,591 ALTURA COMMUNICATI0N 19-929 $ 52,314 BONNY PIONTKOWSKI 19-929 $ 1,645 BPG TECHNOLOGIES 19-929 $ 2,570 $ 28,099 CAPSULE TECH 19-929 $ 57,321 CITY OF PHOENIX 19-929 $ 1,274

Page 4 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

COOPER ATKINS 19-929 $ 7,474 CROSSPOINT COMMUNICATION 19-929 8,138 $ 8,138 DANIELS MOVING 19-929 2,573 $ 11,266 DWL ARCHITECTS + PLANNERS INC 19-929 $ 1,737,823 CDW G 19-929 $ 88 $ 21,797 CME 19-929 $ 120,596 $ (1,055) $ 143,944 Fidelity National Title (escrow) - North Metro 19-929 $ 2,271,759 FILLMASTER 19-929 $ 1,494 GE HEALTHCARE 19-929 $ 469,988 GOODMANS 19-929 $ 56,522 GRAINGER 19-929 $ 1,467 $ 1,658 HP INC 19-929 $ 79,129 Hye Tech Network 19-929 $ 78,618 IN GRAPHS MEDICAL PHYSIC 19-929 $ 700 INTERMETRO INDUSTRIES 19-929 $ 11,756 Jensen Hughes 19-929 $ 10,197 LOVITT & TOUCHE 19-929 $ 5,652 MARICOPA COUNTY PLANNING AND DEVELOPMENT 19-929 $ 121,093 MDM COMMERCIAL 19-929 $ 4,209 OFFSITE OFFICE EQUIPMENT STORAGE 19-929 $ 250 $ 250 OLYMPUS 19-929 $ 1,232 SCRIPTPRO 19-929 $ 104,544 SMITHCRAFT SIGNS 19-929 $ 83,980 $ 83,980 SPEEDIE AND ASSOC 19-929 $ 12,585 SALT RIVER PROJECT 19-929 $ 4,265 SPHERE COMMERCE 19-929 $ 797 Stryker Communications 19-929 $ 12,379 Sundt Construction Inv 19-929 $ 5,741,807 TEMP ARMOUR 19-929 $ 3,599 TRANSACT COMMERCIAL 19-929 $ 13,710 THE CBORD GROUP 19-929 $ 2,794 TOTAL North Phoenix FHC (19AV) $ 215,372 $ 4,290 $ (1,055) $ 11,174,496 Cox Communications 19-928 $ 4,489 ABBOTT RAPID DIAG 19-928 $ 238 ALTURA 19-928 $ 50,192 ALLEGIANCE CORP 19-928 $ 10,861 BONNY PIONTKOWSKI 19-928 $ 1,645 BPG Technologies 19-928 $ 28,048 CAPSULE TECH 19-928 $ 56,193

Page 5 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

CAREFUSION 19-928 $ 1,380 $ 1,380 CDW GOVERNMENT INC 19-928 $ 22,462 Centurylink 19-928 $ 24,539 CITY OF PHOENIX 19-928 $ 218,063 CME 19-928 $ 40 $ 194,156 COOPER ATKINS 19-928 $ 8,840 CROSSPOINT COMMUNICATION 19-928 $ 8,758 $ 8,758 Daniels Moving 19-928 $ 11,441 DIBBLE ENGINEERING 19-928 $ 7,168 DWL ARCHITECTS + PLANNERS INC 19-928 $ 1,239,124 EXTENDATA 19-928 $ 11,102 Fidelity National Title (escrow) - South Mountain 19-928 $ 743,456 FILLMASTER SYSTEMS 19-928 $ 1,494 GE HEALTHCARE 19-928 $ 502,285 GRAINGER 19-928 $ 978 HELMER 19-928 $ 20,426 HP INC 19-928 $ 88,597 Hye Tech Network 19-928 $ 169,096 INTERMETRO INDUSTRIES 19-928 $ 19,581 JENSEN HUGHES 19-928 $ 10,055 LOVITT & TOUCHE 19-928 $ 5,689 MARICOPA COUNTY PLANNING AND DEVELOPMENT 19-928 $ 51,046 MDM COMMERCIAL 19-928 $ 4,880 MONOPRICE 19-928 $ 526 NATUS 19-928 $ 2,130 OFFSITE OFFICE 19-928 $ 395 OLYMPUS AMERICA 19-928 $ 1,229 PAL-WW NORTHERN STORAGE 19-928 $ 106,121 Ricoh 19-928 $ 272 SCRIPTPRO USA INC 19-928 $ 104,544 SMITHCRAFT SIGNS 19-928 $ 83,980 $ 101,433 Speedie and Associates 19-928 $ 14,595 SPHERE COMMERCE 19-928 $ 795 SRP 19-928 $ 2,104 Sundt Construction Inc 19-928 $ 8,359,471 Stryker Communications 19-928 $ 12,379 TEMP ARMOUR 19-928 $ 12,746 THE CBORD GROUP 19-928 $ 2,794 THE GRAPHICS MEDICAL 19-928 $ 1,962

Page 6 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

TRANSACT 19-928 $ 546,908 THOMAS PRINTWORKS 19-928 $ 351 TOTAL South Phoenix FHC (SPHX) $ 92,777 $ 1,380 $ - $ 12,787,034 CDW GOVERNMENT INC 19-946 $ 81 $ 734 $ 900 CITY OF PHOENIX 19-946 $ 68,264 CME 19-946 $ 516 DIBBLE ENGINEERING 19-946 $ 6,534 DWL ARCHITECTS + PLANNERS INC 19-946 $ 23,106 $ 26,957 $ 728,270 EXTENDATA 19-946 $ 11,706 Fidelity National Title (escrow) - 79thAve&Thomas 19-946 $ 1,873,138 HYE TECH 19-946 $ 57,599 INVIVO CORP 19-946 $ 53,865 JENSEN HUGHES 19-946 $ 398 MARICOPA COUNTY PLANNING AND DEVELOPMENT 19-946 $ 50,000 Ninyo and Moore Geotechnical and Environment 19-946 $ 2,400 $ 19,600 Okland Construction Company 19-946 $ 1,877,698 $ 3,299,021 SALT RIVER PROJECT 19-946 $ 1,750 $ 1,750 SUNDT CONSTRUCTION 19-946 $ 4,155,808 SMITHCRAFT SIGNS 19-946 $ 880 SPEEDIE AND ASSOC 19-946 $ 10,018 $ 1,220 $ 810 $ 15,848 TRANSACT COMMERCIAL 19-946 $ 145,731 $ 145,731 SRP 19-946 $ 48,255 TOTAL West Maryvale FHC (WM79) $ 11,768 $ 170,138 $ 1,908,600 $ 10,538,082

$ 450,299 $ 2,850,983 $ 2,091,585 $ 113,202,348

Note: Prior months amount paid are hidden Functional Area - Behavioral Health Services Adams and WENDT $ 103,416 ADVANCED INN VATIVE SOLUTIONS $ 11,735 Airclean Systems 19-912 $ 5,064 Alliance Land Surveying LLC $ 2,400 Allscripts Healthcare 18-913 $ 240,450 Allscripts Healthcare 19-909 $ 52,560 $ 225,345 Altura Communications 19-909 $ 369,127 Altura Communications 19-939 $ 91,807 Amazon 19-909 $ 1,080 AMT Datasouth 19-912 $ 4,040 ARC Products LLC 19-912 $ 22,560

Page 7 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

ARIZONA DEPT OF HEALTH 19-939 $ 150 Arizona Lock and Safe $ 1,025 Armstrong Medical 19-912 $ 35,482 Arrington Watkins Architects $ 301,274 Arrow International 19-912 $ 598 Baxter Healthcare Corp 19-912 $ 5,368 Bayer Healthcare 18-920 $ 74,376 BEL-Aire Mechanical $ 40,215 Burlington Medical 19-912 $ 2,906 CAPSA SOLUTIONS 19-909 $ 5,936 Capsule Tech 19-912 $ 143,422 Cardinal Health 19-912 $ 102,300 CDW Government 19-909 $ 271,862 CDW Government 19-938 $ 48,448 CDW Government 19-939 $ 159,897 CME 19-912 $ 178,774 Comprehensive Risk Services $ 474,403 Coviden 19-912 $ 11,736 Crosspoint Communications $ 25,724 Datcard Systems 19-909 $ 18,500 DEC MEDICAL 18-918 $ 80,529 Delynn Consultant 19-940 $ 114,187 DLR Group Inc $ 4,222,015 EMD Millpore 19-912 $ 7,175 ENDOSCOPE SERVICES 19-912 $ 26,585 Epstexas Storage 19-912 $ 423 EQ2 LLC 19-912 $ 67,500 Ethos Evacuation 19-912 $ 10,130 ETL REPONSE 19-912 $ 29,482 EXTENDATA SOLUTIONS $ 66,659 Felix Storch Inc $ 5,796 FERGUSON ENTERPRISES 19-912 $ 3,571 First American Title - Maryvale Hospital $ 7,438,977 Follett 19-912 $ 38,837 GE Healthcare 18-915 $ 661,640 GE Healthcare 19-901 $ 14,880 GE Healthcare 18-917 $ 766,491 GE Healthcare 18-918 $ 14,000 $ 3,048,632 GE Healthcare 19-938 $ 13,999

Page 8 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

GE Medical Systems 19-912 $ 746,560 GE Medical Ultrasound 18-917 $ 139,527 General Devices 19-912 $ 47,400 Gentherm 19-912 $ 16,692 Gilbane Building CO. $ 55,096,032 Global Equipment 19-912 $ (4,635) $ 2,044 Goodmans 19-916 $ 96,476 Goodmans 19-917 $ 104,809 Goodmans 19-923 $ 518,395 Goodmans 19-926 $ 154,049 Goodmans 19-939 $ 1,570 Goodmans 18-913 $ 4,830 Grainger 19-912 $ 64,690 Graybar Electric $ 5,586 GUEST COMMUNICATIONS 19-912 $ 17,130 Haemonetics 19-912 $ 83,854 HD Supply Facilities Maintenance Ltd 19-912 $ 40,838 Helmer Inc 19-912 $ 151,587 Hill Rom $ 20,409 HP INC 19-909 $ 317,009 HP INC 19-939 $ 168,146 HUMANE RESTRAINT 19-909 $ 40,160 Hye Tech Network 19-909 $ 510,244 IMEG Corp $ 91,590 Interior Solutions 19-923 $ 238,194 Interior Solutions 19-926 $ 100,132 Intermetro Industries 19-912 $ 42,332 Intersan Manufacturing 19-912 $ 3,603 Jensen Hughes $ 1,020 Kronos Inc $ 72,000 Lanmor Services Inc $ 2,824 LOGIQUIP 19-912 $ 1,059 MARICOPA COUNTY PLANNING AND DEVELOPMENT $ 310,450 MARKETLAB 19-912 $ 10,839 MCG HEALTH LLC $ 37,017 MDM Commericial 19-909 $ 40,622 Medline 19-912 $ 3,628 Medtronic 19-912 $ 7,990 Mindray 19-912 $ 9,998

Page 9 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

Monoprice 19-909 $ 1,424 Monoprice 19-939 $ 842 MOPEC 19-912 $ 17,220 NORIX GROUP INC 19-926 $ 11,918 NANOSONICS INC 19-912 $ 22,944 Nindray DS USA Inc 19-912 $ 85,002 Ninyo and Moore Geotechnical and Environment 19-923 $ 4,570 NORIX GROUP INC $ 400,689 Olympus America $ 32,231 OEC Medical Systems 19-904 $ 80,529 OMC INVESTERS LLC $ 11,518 Owens and Minor 19-912 $ 54,193 PAC VAN $ 505 Parks Medical 19-912 $ 2,130 Philips Healthcare 18-921 $ 38,523 Physio Control 19-912 $ 19,458 Progressive Roofing 19-931 $ 84,628 PRONK TECHNOLOGIES INC $ 3,040 QRS Calibrations 19-912 $ 7,056 Radiation Physics and Engineering 18-917 $ 1,250 Radiation Physics and Engineering 18-920 $ 1,600 RAY-BAR 18-913 $ 4,905 RETAIL MANAGEMENT SOLUTIONS $ 5,961 RICOH AMERICAS CORPORATION $ 30,012 RISK CLAIM 1517 19-912 $ (901) Ruiz Custom Upholstery 19-912 $ 53,718 SCOTTSDALE RESTAURANT SUPPLY $ 5,391 Signodtics 19-912 $ 22,460 Smiths Medical 19-912 $ 9,253 SOFT COMPUTER CONSULTANT INC $ 43,038 Smithcraft Signs 18-913 $ 10,266 Speedie and Associates $ 2,189 SPEEDIE AND ASSOCIATES INC $ 15,635 SALT RIVER PROJECT 18-913 $ (23,852) Standard Textile 19-912 $ 4,380 Stryker Communications 19-910 $ 170,089 Steris Corp $ 13,950 Stryker $ 384,697 TBJ Inc 19-912 $ 5,654

Page 10 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

TD INDUSTRIES 19-924 $ 406,296 The Cbord Group 19-909 $ 26,605 THYSSENKRUPP ELEVATOR CORP 19-912 $ 587,346 Translogic 19-912 $ 3,931 Tucson Business Interiors 19-912 $ 3,000 Tucson Business Interiors 19-923 $ 34,193 Tucson Business Interiors 19-926 $ 335,704 UMF Medical 19-912 $ 11,536 Verathon 19-912 $ 14,020 VERIZON 19-909 $ 16,853 WAXIE 19-912 $ 3,002 World Wide Technology $ 701,382 Zoll Medical 19-912 $ 46,099 TOTAL Maryvale Campus (MV) $ 52,560 $ (4,635) $ 14,000 $ 82,746,340 Adams and Wendt 19-936 $ 530 $ 75,033 AIRPARK SIGNS $ 1,305 Arizona Department of Health 19-936 $ 150 $ 900 AFFILIATED ENGINEERS 19-936 $ 2,400 $ 85,852 BUREAU VERITAS 19-936 $ 14,063 Engineering Economics 19-936 $ 50,028 GOODMANS 19-936 $ 80 $ 10,210 $ 101,194 Grainger 19-936 $ 5,504 JENSEN HUGHES 19-936 $ 2,844 $ 13,287 KITCHELL 19-936 $ 397,328 $ 304,552 $ 5,204,806 MARICOPA COUNTY PLANNING AND DEVELOPMENT 19-936 $ 230 Speedie and Assoc $ 3,185 Valley Systems 19-936 $ 1,313 $ 1,223 $ 10,543 TOTAL Annex HVAC Replacement (RSVT) $ 1,393 $ 411,690 $ 307,547 $ 5,565,929

$ 53,953 $ 407,055 $ 321,547 $ 88,312,269

Note: Prior months amount paid are hidden Functional Area - Acute Care Facilities eSTF - Enterprise Strengthening the Foundation (see attached for detail) 17-900 $ 14,000,000 Client & Mobility (Phase 1) 16-934 $ 1,434,893 Client & Mobility (Phase 2) 17-906 $ 1,512,376 IPT (PBX Replacement) 16-909 $ 33,926 $ 2,789,264 Legacy Storage (DP-007) 16-910 $ 2,506,978

Page 11 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

Single Sign on 17-913 $ 81,150 Perimeter, Internal security 16-900 $ 67,213 Perimeter, Internal security 18-907 $ 151,310 Perimeter, Internal security 18-910 $ 44,235 Perimeter, Internal security 18-912 $ 51,561 Epic 2014 Monitors (Phase 1) 16-933 $ 341,470 Epic 2014 Monitors (Phase 2) 17-905 $ 474,480 LCM 16-937 $ 199,936 SEIMS 17-912 $ 235,134 SEIMS 18-911 $ 14,468 ESB Framework Enablement 18-914 $ 1,111,233 Clinical Image Repository 18-915 $ 1,271,214 Imprivata Identity 18-916 $ 576,880 Chartmaxx Infrastructure Upgrade 19-906 $ 859,682 Imprivata ConfirmID 19-911 $ 137,295 ESB (Tibco) - Infrastructure 19-918 $ 34,861 PWIM Global Monitor Software - additional funding required to support 16-924 $ 35,400 implementation of CER15-075, Cloverleaf Availability Patient monitors - High Acuity 16-908 $ 6,240,243 Stretcher replacement 16-912 $ 395,538 IVUS - intravascular ultrasound for placement of stents 16-922 $ 128,371 Vigileo Monitors (8) 16-928 $ 96,132 Balloon Pumps 16-920 $ 149,197 Zeiss - Cirrus HD opthal camera 16-919 $ 60,654 Vivid Q BT12 Ultrasound 16-931 $ 55,019 Zoll Thermoguard XP (formerly Alsius) 16-906 $ 33,230 3:1 Mesher 16-927 $ 12,870 1:1 Mesher 16-927 $ 26,190 2:1 Mesher 16-927 $ 26,190 Urodynamics machine (for surgery clinic) 16-929 $ 17,935 UltraMist System 16-925 $ 20,195 Doppler 16-935 $ 3,950 Ultrasound (for breast clinic) 16-931 $ 22,685 Biom 5 16-930 $ 8,103 Wilson Frame 18-902 $ 4,852 Medical Beds for Psych Units 16-932 $ 211,197 King Tong Pelvic fx reducer 16-926 $ 9,500 Stryker Core Power Equipment --Contract 16-904 $ 369,113

Page 12 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

Patient Monitoring (Low Acuity) - Formerly named Alarm Management 16-907 $ 347,029 AIMS Upgrade 16-901 $ 51,232 AIMS Upgrade 16-902 $ 12,000 AIMS Upgrade 16-903 $ 112,850 Temperature Monitoring - Non FQHC Depts 17-908 $ 133,615 2 Pillcams for Endo 17-911 $ 13,826 Replace 11 ultrasounds 16-931 $ 1,142,345 POC Ultrasounds (10) 16-931 $ 634,702 Ice Machine Replacement 16-911 $ 23,881 Steam Condensate Return Piping Replacement 16-914 $ 62,529 Laundry/Finance/Payroll/Facilities Roof Repairs 17-917 $ 82,955 MMC 7th Floor Roof 16-905 $ 274,582 Facility upkeep 17-910 $ 4,205 Facility upkeep 18-905 $ 69,218 Colposcopes 18-909 $ 24,607 Chandler ADA Doors 18-042 $ 5,867 Glendale Digital X-Ray unit and Sensors (Panoramic Digital AND Nomad 16-917 $ 63,217 digital) Chandler Dental Digital Radiology - Panoramic x-ray 16-915 $ 63,564 CHC - Digital Panoramic x-ray 16-916 $ 60,419 CHC Dental Replace Chairs Lights, Compressor and Deliverey Units 18-905 $ 127,642 CHC Cost for new equipment and cost of moving existing to Avondale X-Ray 16-921 $ 83,327 Avondale- Replace all flooring. 17-904 $ 72,635 Temperature Monitoring - FQHC Depts 17-909 $ 82,219 McDowell Dental 16-918 $ 15,990 CHC Internal Medicine Clinic Renovation - Increase the number of exam 18-900 $ 221,124 rooms to accommodate 1st, 2nd & 3rd yr residents as of July 1, 2017 plus the CHC Dental Autoclave Replacement including printer & Cassette rack 18-908 $ 19,122 Chandler Dental Autoclave Replacement including printer & Cassette rack 18-908 $ 6,374 Avondale Dental Autoclave Replacement including printer & Cassette rack 18-908 $ 6,374 FHC Helmer Medical Refrigerators 17-714 $ 11,110 FHC Helmer Medical Refrigerators 17-901 $ 169,399 Cabinet and Countertop Replacement South Central FHC 18-904 $ 8,419 CHC Dental Refresh 18-905 $ 96,361 POC Molecular (26 units) 19-914 $ 1,049,613 Bili Meter - Draegar (10 units) 19-927 $ 71,875 Colposcope - Guadalupe 19-925 $ 9,927 EKG machines (3 units) 19-922 $ 37,278 Bond related expenses (legal fees, etc.) N/A $ 325,646 Audiology - Astera Audiometer 16-913 $ 11,326

Page 13 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

3rd Floor Behavioral Health/Medical Unit Remodel 17-903 $ 2,570,464 22 Behavioral Health Beds for 3rd Floor MMC 17-907 $ 188,527 Replace MMC Radiology GE Fluoroscopy Imaging Equipment 17-914 $ 262,145 Endura CCTV System Replacement 18-901 $ 168,739 IT - (17-900) eSTF Project 17-900 $ 95,059 Diablo Infrastructure Costs 18-903 $ 400,721 Epic Willow - Ambulatory & Inventory 18-906 $ 428,269 Navigant - Proposition 480 planning 16-923 $ 994,000 Kaufmann Hall - Prop 480 planning 16-923 $ 370,019 IPv4Xchange (ARIN Based Transfer Escrow Payment) 16-923 $ 7,040 Vanir Construction Management (Planning Phase) 17-915 $ 749,971 Vanir Construction Management ($48M) ($48,300,501 - Entire Project) 17-916 $ 366,339 $ 771,542 $ 314,799 $ 19,517,346 IPMO Modular Building 17-902 $ 329,631 Dickenson Wright PLLC 16-923 $ 199,705 THOMAS PRINTWORKS 17-916 $ 515 $ 515 SUNDT CONSTRUCTION 19-918 $ 2,911 $ 2,911 Sims Murrary LD 16-923 $ 466 $ (466) $ 466 $ 32,654 Devenney Group LTD 16-923 $ 242,450 MTI Connect Inc 16-923 $ 181 SHI INTERNATIONAL 19-911 $ 2,577 Payroll/Supplies/Misc Expenses 16-923 $ 100,033 $ 62,987 $ 2,374,498 EPIC replatform and upgrade to 2016 (see attached for detail) 17-900 $ 7,675,491 Reimbursement for Capital Expenditures N/A $ 36,000,000 TOTAL Tranch 1 $ 366,805 $ 905,034 $ 381,677 $ 114,043,511 Atlantic Relocation Systems $ 39,819 Bond issuance costs $ 1,163,260 BPG Technologies LLC $ 116,183 Cable Solutions LLC $ 53,370 DH Pace $ 1,468 Dickinson Wright PLLC $ 306,955 Enterprise Security 16-923 $ 13,715 FC Hospitality 16-923 $ 8,376 HD Supply Facilities Maintenance Ltd $ 3,780 Hye Tech Neywork and Security Solutions $ 41,154 Innerface Architectural Signage $ 14,761 IPMO Modular Building 17-902 $ 45,466 Goodmans $ 4,790 GOODMANS 16-923 $ 19,996 JRC DESIGN 19-955 $ 134,905

Page 14 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

Lovitt & Touche Inc 19-934 $ 31,381 $ 46,382 $ 23,191 $ 3,653,878 LOVITT & TOUCHE INC 19-951 $ 505 MIHS IPMO Food - Catering 16-923 $ 104 NINYO AND MOORE 19-955 $ 2,500 OKLAND CONSTRUCTION 19-955 $ 409,488 PAC-VAN 19-955 $ 71,160 Payroll/Supplies/Misc Expenses $ 3,139,885 PHOENIX FENCE $ 2,283 Sims Murrary LD $ 30,441 Skyline Builders And Restoration Inc $ 122,769 Tempe Diablo LLC $ 33,132 Tucson Business Interiors $ 447,192 Vanir Construction Management ($48M) ($48,300,501 - Entire Project) $ 13,838,782 World Wide Technology Co Inc $ 5,978 Zurich North America 16-923 $ 47,500 TOTAL Enterprise $ 31,381 $ 46,382 $ 23,191 $ 23,773,597 Adams and Wendt 19-935 $ 1,755 $ 37,316 APS 19-935 $ 50,000 $ 45,963 Affiliated Engineers Inc 19-935 $ 2,185 $ 35,108 $ 2,146,439 Affiliated Engineers Inc 19-935 $ 2,058,558 Arnold Machinery 19-935 $ 34,209 ARIZONA DEPARTMENT OF HEALTH 19-935 $ 150 CDW GOVERNMENT INC 19-935 $ 337 CITY OF PHOENIX 19-935 $ 34,315 DP Electric 19-935 $ 6,987 ENGINEERING ECONOMICS 19-935 $ 121,763 GOODMANS 19-935 $ 3,133 HYE TECH 19-935 $ 338,411 JENSEN HUGHES 19-935 $ 11,820 KITCHELL 19-935 $ 138,025 $ 47,572,070 LANMOR 19-935 $ 23,708 Maricopa County 19-935 $ 239,965 MDM COMMERCIAL 19-935 $ 1,483 RICOH 19-935 $ 456 Soft Computer Consultants 19-935 $ 46,513 SMITHCRAFT SIGNS 19-935 $ 5,782 Speedie snd Assoc 19-935 $ 24,160 SOUTHWEST GAS 19-935 $ 121,938 THE CBORD GROUP 19-935 $ 13,022

Page 15 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

Thomas Printworks 19-935 $ 3,069 VALLEY SYSTEMS 19-935 $ 371 WESTERN STATES FIRE 19-935 $ 705 TOTAL Central Utility Plant (RSVT) $ 51,755 $ 140,210 $ 35,108 $ 52,892,643 ADAMS AND WENDT 19-949 $ 13,503 ADAMS AND WENDT 19-948 $ 22,492 $ 25,910 ADAMS AND WENDT 19-947 $ 1,685 $ 2,793 ADAMS AND WENDT 19-951 $ 12,705 $ 12,705 AFFILIATED ENGINEERS 19-948 $ 230,169 AFFILIATED ENGINEERS 19-954 $ 1,050 ANCO SANITATION 19-948 $ 1,450 $ 1,450 ARIZONA PUBLIC SERVICE 19-947 $ 1,391,892 AS SOFTWARE 19-951 $ 9,500 $ 9,500 ATLANTIC RELOCATIONS 19-948 $ 1,782 BPG TECH 19-948 $ 10,957 $ 21,304 $ 36,250 BPG TECH 19-947 $ 7,339 $ 7,339 CAPSULE TECH 19-951 $ 8,708 $ 8,708 CDW G 19-947 $ 81 $ 81 CDW G 19-951 $ (16) $ (16) CENTURY LINK 19-951 $ 6,706 $ 6,706 CITY OF PHOENIX 19-947 $ 79,102 CME 19-951 $ 1,400 $ 1,400 Cuningham Architect 19-947 $ 1,071,920 $ 26,600,453 DANIELS MOVING 19-948 $ 1,096 $ 1,096 Devenney Group LTD $ 530,623 DYNAMIC INSTALLATION 19-948 $ 3,588 $ 13,804 $ 17,392 EXCESSIVE CARTS 19-948 $ 22,782 FC HOSPITALITY 19-948 $ 173,927 Follett 16-923 $ 5,249 GOODMANS $ 4,062 $ 9,782 $ 240 $ 57,913 Innerface Architectural Signage 19-948 $ 862 Innerface Architectural Signage 19-951 $ 833 $ 833 JENSEN HUGHES 19-947 $ 2,123 $ 8,189 JENSEN HUGHES 19-951 $ 1,966 $ 892 $ 2,858 KITCHELL 19-947 $ 17,302,855 $ 9,875,444 $ 93,857,470 KITCHELL 19-937 $ 667,452 KITCHELL 19-948 $ 81,659 $ 969,115 KITCHELL 19-951 $ 813,459 $ 484,464 $ 1,535,757

Page 16 of 17 VALLEYWISE HEALTH Care Reimagined - Spend report

Description CER Number Amount Paid Amount Paid Amount Paid Amount Paid MAR 2021 APR 2021 MAY 2021 Cumulative Total

LANMOR 19-947 $ 7,056 $ 510 $ 7,566 LANMOR 19-948 $ 270 $ 270 MARICOPA COUNTY PLANNING AND DEVELOPMENT 19-951 $ 232,198 $ 7,720 $ 289,918 MARICOPA COUNTY PLANNING AND DEVELOPMENT $ 20,000 $ 22,328 $ 2,400 $ 2,018,615 NINYO AND MOORE 19-947 $ 3,200 OFFSITE EQUIPMENT STORAGE 19-948 $ 650 PAC-VAN 19-947 $ 62,185 RECLASS UTILITIES ALLOCATION TO CONSTRUCTION PROJECTS 19-951 $ 89,500 $ 89,500 RMJ Electrical Contractors $ 551 Smithcraft Signs 19-947 $ 960 $ 960 SPEEDIE AND ASSOC 19-947 $ 43,487 $ 140,777 SPEEDIE AND ASSOC 19-951 $ 670 $ 670 SWISSLOG 19-947 $ 2,500 Valley Systems 19-948 $ 320 $ 436 $ 1,716 Valley Systems 19-951 $ 698 $ 1,018 Speedie and Assoc $ 18,752 $ 49,380 SRP 19-947 $ 500 THOMAS PRINTWORKS $ 7,517 Trademark Visual 19-948 $ 2,576 ZORO TOOLS 19-948 $ 11,263 $ 11,263 TOTAL Roosevelt Campus Site Development Plan (RSVT) $ 272,310 $ 19,311,843 $ 10,646,914 $ 128,973,626

$ 722,251 $ 20,403,469 $ 11,086,890 $ 319,683,376 Bond Proceeds received to date: $631,287,454 TOTAL MONTHLY SPENT AMOUNT $ 1,226,503 $ 23,661,507 $ 13,500,022 $ 521,197,992

REMAINING Cash for disbursement $ 110,089,461

Page 17 of 17

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 5.c.

Reports to the Board Monthly Valleywise Health Employee Turnover Report Human Resources Board Turnover Analysis

June 2021

© 2019 Valleywise Health. All rights reserved. Internal use. May Turnover 2021 Summary • Overall voluntary turnover increased by 0.48% from prior month (April 16.69% to May 17.17%). We’re also up 0.28% from the same month in 2020 (May 2020 – 16.89%) Goal: 16.26%.

• 35% of overall turnover has occurred during the first 12 months of the employee's life cycle for the month of May. • Clinical (Non-Licensed) – 21.2% (Apr 20.8%) • RN – 19.4% (Apr 19.9%) • Initiatives for FY21 turnover reduction and retention: • 30 and 90 day new hire survey data. • Enhanced the leadership forum content to focus over the next 90 days on retention, effective communication, and feedback cycle for new hires on a consistent cadence. • Engagement survey trend results for FY19 and FY20. • Launch of FY21 Engagement Survey Live through 6/18/2021. • An onboarding experience that is specific for each level of position. • Turnover data by division and leader to identify areas of focus. • Realign partnership with stakeholders for research, innovation, and leadership development. • Tier 3 reporting efforts with Executive leadership to review daily metrics and execute on heightened level of accountability. • Nurse Burnout Survey work groups to identify opportunities to enhance the workforce environment to be conducive to efforts of resilience post pandemic. This directly addresses turnover of nursing staff. • First year turnover analysis:

• First year voluntary turnover has increased by 1.13% (April 34.14% to May 35.27%). • Continued burnout and changing careers during the pandemic is reflected in the data and follow up conversations with employees departing the organization. • Market analysis for position of high turnover to ensure wages are equitable and competitive with other organizations wages. • Identifying non-monetary efforts to keep medical staff engaged in healthcare has begun and is a priority. • Total reward evaluation being conducted to develop wellness packages for resilience and work/life balance. • Benchmark:

• The healthcare 2019 benchmark average for overall turnover is 18.7%.

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 5.d.

Reports to the Board Quality Management Council Meeting Minutes – April 2021 Meeting Minutes Quality Management Council 4/22/2021 • 8:00 AM – 9:30 AM • WebEx A = Absent E = Excused G = Guest P = Present CHAIR/FACILITATOR Dan Hobohm, MD MEMBERS/ATTENDEES Barbara Harding, RN Dorinne Gray, RN LT Slaughter Sherrie Beardsley, RN Carol Olson, MD Elizabeth Ferguson, MD Manuel Soto-Griego Sherry Stotler, RN Christelle Kassis, MD Gene Cavallo Mary Harden, RN Steve Purves Crystal Garcia, RN Heather Jordan, RN Michael White, MD Tony Dunnigan, MD Dale Schultz Jo-el Detzel, RN Nancy Kaminski Pat Arendt Dan Hobohm, MD Kelly Summers Nelson Silva-Craig, RN Amy Little-Hall David Wisinger, MD Lia Christiansen Paul Pugsley, MD Jeffrey Stowell, MD

PURPOSE: Quality and Patient Safety Improvement

CALL TO ORDER Topic Findings/Discussion Conclusion/Action Responsible Approval of Approval of March 25, 2021 Minutes. Minutes were approved Committee Minutes as written. Consent PCSC - committee minutes and reports; action plans; dashboards. Consent agenda items Committee Agenda were approved.

I. Action item follow-up / Loop closures / Unfinished Business Topic Findings/Discussion Conclusion/Action Responsible A Just Culture  Deferred – Sherry Stotler B Survey  DNV Findings: Improvement Updates Finding and o Utility Management (Medical Gas Booms in Operating Room and Battery backup lighting in deep sedation areas). Plan of - These were repaired shortly after DNV. Corrections - Battery backup lighting can now be found on the Vine regarding where rooms are located. – Sherry o Physician scorecards – Looking into automating process to be more robust. Stotler  As we continue to get ready for our next DNV visit; team is pushing out anything that was identified as a potential opportunity for improvement, take another look and see if there’s things that we need to touch on and to insure we are ready.  DNV survey will be our full accreditation; they will be onsite as our numbers of COVID decrease. Please use n/a if item does not apply. pg. 1 II. Standing Reports Topic Findings/Discussion Conclusion/Action Responsible A System  Next report; June 2021. Sherry Stotler Wide/CEO Goals (Quarterly) – B Quality Dashboard – Sherry Stotler

 Hand Hygiene - Hand Hygiene compliance above benchmark for all of 2020 Q2, Q3, and Q4. Increase in HH compliance since March (and start of COVID pandemic). Increase in emphasis on hand hygiene education by organization leadership since beginning of pandemic through various methods such as additional hand hygiene signage posted and video contests for best video depicting hand washing for proper length of time.  CLABSI - The overall CLABSI SIR for pediatric and adult patients with a central line in an intensive care unit, medical, and surgical units was below benchmark for all of 2018. It has been above benchmark for the first 3 quarters of 2019 but by the end of 2019 was below benchmark and was below benchmark for the first 3 quarters of 2020. Q4 2020 CLABSI SIR is above benchmark at 0.74. Benchmark and threshold values reflects CMS VBP payment adjustment thresholds.  CAUTI - CAUTI SIR was below benchmark for the first two quarters of 2020 and is above benchmark for 2020 Q3 and Q4 with an SIR of 0.91 for 2020 Q4.  PPE compliance of 100% for all isolation categories in 2020 Q3 C Patient Care  Presentation of metrics not meeting benchmark was presented and discussed to committee members. & Safety  Ambulatory – Committee - o BMI – Sherry - January: 53.54% (2,767/5,168) Stotler - February: 55.61% (5,078/9,131) Please use n/a if item does not apply. pg. 2 - Slight increase in percentage of patients meeting measurement from January to February. o Cervical Cancer Screening - January: 45.37% (3,065/6,756) - February: 45.82% (4,678/10,210) - No significant increase in percentage of patients meeting the measure between January and February. o Colorectal Cancer Screening - January: 37.71% (1,949/5,168) - February: 39.67% (3,142/7,921) - Slight increase in the percentage of patients meeting the measurement between January and February. o Controlling High Blood Pressure - January: 21.62% (962/4,450) - February: 27.23% (1,862/6,837) - Improvement in the percentage of patients meeting the measurement between January and February. o HbA1c Poor Control - January: 72.09% (2,363/3,278) - February: 62.37% (3,037/4,869) - Significant improvement in number of patients with controlled A1c from January to February.  BO - o EDI - EDI invoices as a percent of all invoices remains below the 55% benchmark. o Operative Note Compliance - Compliance is trending upward. - Top Reason: 93% Completed after transfer - By department: . 51% Surgery . 25% Gastroenterology . 13% OB . 9% ORTHO Surgery . 1% Peds GI . <1% Psychiatry . <1% Anesthesiology o POS - Improvements made in price estimator utilization, training, accountability, workflow improvements, and measurement. Looking to integrate propensity to pay tool processes and increase days out metric to contribute to POS KPI. o Net Days – Metric remains above benchmark o Clean Claim – Metric remains below benchmark  Operative & Procedural – o Room Turnover Times initially decreased as surgery volume increased o PSI-12 - PSI-12 Workgroup September 2018 through January 2019; FY21 2/3 cases were burn patients that had received preventative measures. o Post-Sedation Note Compliance - Moderate Sedation Policy (08/20) and nursing protocol (07/20) in place - Reduced variation in sedation documentation by nurses and providers - Templates improve compliance - Compliance information reported monthly to nursing leadership, department chairs, CMO, CQMO  Behavioral Health – o SCI Solutions - This measure did not meet the benchmark for 1st and 2nd QTRs FY21, January 2021 and for the rolling 12 months; the benchmark was met 2 out of the 12 rolling months. o SUB3 - This measure met the benchmark Qtr 1 FY21 but did not meet the benchmark Qtr 2 FY21; the benchmark was met 4 out of the 12 rolling months  PNC – o This measure met the benchmark in the first 6 months of the new FY (Jul through Dec). o There has been 1 elopement per month in Jan and Feb 2021. Please use n/a if item does not apply. pg. 3  SEC – o HCAHPS Reportable Would Recommend Hospital to Family - - We ended FY 2020 with an overall score of 71.5%. - We started off FY 2021 in Jul exceeding the benchmark at 79.6%. - Aug dropped to 71.1% and Sept dropped to 66.7%. Oct increased to 74.4% - Nov showed a decrease to 65.4% - Dec decreased to 61.4% - Data was pulled on 03/12/21 o HCAHPS Reportable Overall Rating of Hospital – - We ended FY 2020 with an overall score of 73.4%. - We started off FY 2021 in Jul exceeding the benchmark at 81.6%. - Aug dropped to 71.1% and Sept dropped to 64.1%. - Oct showed improvement as we exceeded our benchmark at 76.7 % - Nov dropped to 71.7% - Dec dropped to 58.1% - Data was pulled on 03/12/21. D Patient  Leapfrog – They want to change some of their scoring methodology and not use the AHA survey; currently reviewing. Crystal Garcia Safety o Will be putting out the spring grade in a couple of months. Officer  Cultural of Patient Safety Survey – Patient Safety Program Managers are currently working with leaders to come up Report – with action items. Crystal Garcia E Risk  No settlements or write-offs to report. Dale Schultz Department – Dale Schultz F Service  Service Excellence Equation Sherrie Excellence – Beardsley Sherrie Beardsley

o Service Excellence Committee received an inquiry about the applicability of the SE Committee action plan to non- patient-facing departments. We took this as an opportunity to revisit service excellence’s fit in this equation and an explanation to this inquiry. o All departments have a responsibility to the patient experience, regardless of patient-facing functions. o The SE Committee is currently committed to an action plan addressing the HCAHPS dimension of Nursing Communication. This dimension also addresses an HCAHPS question pertaining to Courtesy and Respect by staff. - If we combine this prospect of increasing our patient satisfaction scores by making the conscientious effort to Please use n/a if item does not apply. pg. 4 shape our culture focused on Courtesy and Respect with the purpose of service excellence, “how we interact with patients, community and each other at all Valleywise locations and for all encounters,” we are better situated to influence the patients perceptions. By virtue of this equation, then we are all responsible. Remember, our mission is “to provide exceptional care, without exception, every patient, every time.”  Description of Complaints/Grievances

o Number of Patients Reporting Complaints/Grievances: Count of patients alone whether they have 1-3 complaints/grievances, the individual patient is the count o Total Number of Complaints/Grievances by Patients: Count of each patients’ listed Event Types, could be as many as 3 Event Types per patient, few as 1 Event Type o Grievance Total: Includes Service Excellence Letters, Health Plan Grievances, Event Types listed as “Insurance Company” and radio button selected for “Grievance” = Y (yes) o Number of Closed Complaints/Grievances: Numerator = 220 (Number of Closed Complaints/Grievances) divided by Denominator = 234 (Number of Complaints/Grievances by Patients) - *There was a total of 14 cases that were pending as open from Q3 as of the date the report was generated, 4/12/2020. Number of closed cases include only closed cases that were opened and closed within Q3. All information presented pertains to cases that were “Received” from 01/01/2021 through 03/31/2021. o Eliminated Event Types: 1. End of Life 2. Virtual Visit 3. Seeking Information 4. Compliment 5. RDE Patient Relations Entry Error (if staff submitted PR entry when actually qualifies as PSES Risk Module entry) 6. Other not specified (EXAMPLES: at time of call back, complaint already addressed; voicemail left without indication of how to assist and no contact information; active psych patients expressing unclear thoughts)  FY21Q2 Patient Complaints/Grievances by Setting (234 Total; 33 Grievances)

Please use n/a if item does not apply. pg. 5 o Large increase from FY21-Q2 to FY21-Q3 within Behavioral setting. Last quarter = 29 and all previous quarters recorded, no more than 29 (see below). o Service Excellence recommends: - Effective point-of-service service recovery with patients - Proactive problem resolution with patients and families – promoting collaborative resolution approaches with care team, assigned nurse, etc. - Mitigate use of grievance terminology between the unit problem resolution process and referring patients to Service Excellence 1200 line o FY20-Q4: - Ambulatory combined specialty clinics and FQHC, 0 per 1000 (0.391) - ED 2 per 1000 (1.930) - Medical Center 4 per 1000 (4.196) - Behavioral 27 per 1000 (27.376) o FY21-Q1: - Specialty Clinics = 0 per 1000 (0.340) - FQHC = 0 per 1000 (0.380) - ED = 2 per 1000 (2.462) - Medical Center = 4 per 1000 (3.623) - Behavioral = 29 per 1000 (28.507) o FY21-Q2: - Specialty Clinics = 1 per 1000 (0.549) - FQHC = 0 per 1000 (0.280) - ED = 1 per 1000 (1.236) - Medical Center = 3 per 1000 (2.967) - Behavioral = 29 per 1000 (29.367) o FY21-Q3: - Specialty Clinics = 1 per 1000 (0.589) - FQHC = 1 per 1000 (0.533) - ED = 1 per 1000 (0.877) - Medical Center = 3 per 1000 (3.221) - Behavioral = 42 per 1000 (41.771) Please use n/a if item does not apply. pg. 6  Number of Complaints/Grievances by Setting

 Total number of discharges or clinic visits within each quarter at each setting is described below. The totals below are used as the denominator to determine the ultimate rate. o *Ambulatory stratified into Specialty Clinic and FQHC began FY21Q1. o In previous quarters, Ambulatory is shared with color representing FQHC and blank for Specialty Clinic.  Discharges - Behavioral o Oct – Dec = 1,213 o Jan – Mar = 1,216 o April – June = 1,315 - FY21 July – September = 1,333 - FY21 October – December = 1,328 - FY 21 Jan – Mar = 1,197  Inpatient o Jan – Mar = 14,393 (3,320-9% increase from previous qtr) o April – June = 10,964 o FY21 July – September = 14,628 o FY21 October – December = 15,502 o FY 21 Jan – Mar = 15,215  Emergency (Adult, MVE, Peds) o Jan – Mar = 16,115 (previously used 23,471 (1% increase from previous qtr)) o April – June 7,254 o FY21 July – September = 7,718 o FY21 October – December = 13,752 (each month 4,584 visits) o FY 21 Jan – Mar = 13,687  Visits o FQHC o Jan – Mar = 70,391 (previously used 70,077) o April – June = 62,782 Please use n/a if item does not apply. pg. 7 o FY21 July – September = 76,362 o FY21 October – December = 85,636 o FY 21 Jan – Mar = 73,211  Non-FQHC o Jan – Mar = 57,715 (previously used 20,326) o April – June = 48,281 o FY21 July – September = 58,833 o FY21 October – December = 58,326 o FY 21 Jan – Mar = 59,422 G Performance  100-Day Workout – Yasmine and her group are focusing on other requirements that are COVID19 reporting  Ongoing. Excellence mandated. Projects – Crystal Garcia H CMS  Reporting requirements continue to be on the forefront – Monitoring closely to ensure we are compliant with all of  Will continue to Memos – requirements. document and Sherry o Small group who reviews everything. monitor. Stotler  Mandatory reporting on data points I Infection  Discussed earlier in the dashboard section; working on action plans and continuing to monitor. Control – Crystal Garcia K Data  Deferred. Governance – Crystal Garcia

III. New Business Topic Findings/Discussion Conclusion/Action Responsible A

IV. Deferred Topic Findings/Discussion Conclusion/Action Responsible A V. Adjourn

NEXT MEETING Date Time Location May 27, 2021 11:30am WebEx

Please use n/a if item does not apply. pg. 8

Maricopa County Special Health Care District

Board of Directors Formal Meeting

June 23, 2021

Item 6. No Handout

Concluding Items