PUBLIC HEALTH TRUST BOARD OF TRUSTEES
TELEVISED MEETING AGENDA
Wednesday, January 27, 2016 3:00 p.m. to 5:00 p.m.
Stephen P. Clark Center Board of County Commission Chambers Second Floor 111 N. W. First Street Miami, Florida 33128
PUBLIC HEALTH TRUST BOARD OF TRUSTEES
TELEVISED MEETING AGENDA
Wednesday, January 27, 2016 3:00 p.m. to 5:00 p.m.
Stephen P. Clark Center Board of County Commission Chambers Second Floor 111 N. W. First Street Miami, Florida 33128
Board of Trustees Rules
Any person making impertinent or slanderous remarks or who becomes boisterous while addressing the Public Health Trust Board of Trustees, shall be barred from further audience before the board, unless permission to continue or again address the board be granted by the Chairperson. No clapping, applauding, heckling or verbal outbursts in support or opposition to a speaker or his or her remarks shall be permitted. No signs or placards shall be allowed in the Commission Chambers. Persons exiting the Commission Chambers shall do so quietly.
The use of cell phones in the Commission Chambers is not permitted. Ringers must be set to silent mode to avoid disruption of proceedings. Individuals, including those seated around the board table, must exit the Commission Chambers to answer incoming cell phone calls.
1. MOMENT OF SILENCE
Joe Arriola, Chairman
2. PLEDGE OF ALLEGIANCE
Joe Arriola, Chairman
3. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION 286.0114.FLA.STAT. (CHAPTER 2013-227, LAWS OF FLORIDA)
Joe Arriola, Chairman
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES AGENDA – January 27, 2016
4. REPORTS
(a) Public Health Trust Board of Trustees
Presented by Joe Arriola, Chairman
(1) Agenda item(s) recommended to be added, deferred, or deleted
(2) Previous meetings minutes recommended to be approved:
(a) Meeting minutes as of November 23, 2015 (regular televised meeting) (b) Meeting minutes as of December 18, 2015 (special meeting)
(b) Jackson Health System
Presented by Carlos A. Migoya, President and Chief Executive Officer
(c) Florida International University College of Medicine
Presented by John A. Rock, M.D., Dean and Senior Vice President for Medical Affairs
(d) University of Miami Miller School of Medicine
Presented by Steven Falcone, M.D., Chief Executive, University of Miami at Jackson Memorial Hospital and Associate Vice President for Medical Affairs; Professor of Radiology, Neurological Surgery and Ophthalmology
(e) Joint Conference and Efficiencies Committee
Presented by Darryl K. Sharpton, Chairman
(f) Strategy and Growth Committee
Presented by Joe Arriola, Chairman
(g) Fiscal Committee
Presented by Mojdeh L. Khaghan, Chairwoman
(1) Review of Jackson Health System Combined Financial Statements as of December 31, 2015
Presented by Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System
(h) Miami-Dade County Attorney
Presented by Eugene Shy, Jr., Assistant Miami-Dade County Attorney
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES AGENDA – January 27, 2016
5. RESOLUTIONS RECOMMENDED TO BE APPROVED
(a) Resolution approving the Medical Staff and Health Professional Affiliate Staff Membership and Clinical Privileges; approving Initial Appointments, Reappointments and Clinical Privileges and Activities; approving Modifications to Medical Staff Membership Category and Clinical Privileges; accepting Resignations and Leaves of Absences – January 2016
Motion to approve the resolution
Joe Arriola, Chairman
(b) Resolution approving the establishment of a Residency Program in Emergency Medicine under the auspices of the Accreditation Council for Graduate Medical Education and approving the ensuing funding costs associated with establishing such Residency Program, and further authorizing the President and Chief Executive Officer, or his designee, to take any actions necessary to so follow-up on establishing such residency program – January 2016
Sponsored by Peter G. Paige, MD, MMM, CPE, FACEP, FACPE, Executive Vice President and Chief Medical Officer
Motion to approve the resolution
Joe Arriola, Chairman
(c) Resolution authorizing and approving award of bids and proposals, waiver of bids, and other purchasing actions for January 2016, in accordance with the Public Health Trust’s Procurement Policy, Resolution No. PHT 10/12-078
Sponsored by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System
Motion to approve the resolution
Joe Arriola, Chairman
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES AGENDA – January 27, 2016
5. RESOLUTIONS RECOMMENDED TO BE APPROVED cont…
(d) Resolution approving the 2015-2018 Collective Bargaining Agreement by and among Miami-Dade County, the Public Health Trust, and Committee of Interns and Residents (CIR), and recommending that the Board of County Commissioners ratify the Agreement
Sponsored by Carlos A. Migoya, President and Chief Executive Officer, Jackson Health System
Motion to approve the resolution
Joe Arriola, Chairman
(e) Resolution approving use of Jackson Miracle-Building Bond funds for eight (8) projects as described in the President’s memorandum dated January 27, 2016
Sponsored by Isa M. Nunez, Vice President, Facilities Design and Construction, Jackson Health System
Motion to approve the resolution
Joe Arriola, Chairman
6. ADJOURNMENT
Joe Arriola, Chairman
Page 4 of 4
1. MOMENT OF SILENCE
Joe Arriola, Chairman
2. PLEDGE OF ALLEGIANCE
Joe Arriola, Chairman
3. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION 286.0114.FLA.STAT. (CHAPTER 2013-227, LAWS OF FLORIDA)
Joe Arriola, Chairman
4. REPORTS
4 (a) Public Health Trust Board of Trustees
Presented by Joe Arriola, Chairman
4 (a) (1) Agenda item(s) recommended to be added, deferred, or deleted
4 (a) (2) Previous meetings minutes recommended to be approved
PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES
Monday, November 23, 2015 3:00 p.m. to 5:00 p.m.
Stephen P. Clark Center Board of County Commission Chambers Second Floor 111 N. W. First Street Miami, FL 33128
Public Health Trust Board of Trustees Joe Arriola, Chairman Mojdeh L. Khaghan, Vice Chairwoman William Heffernan, Treasurer Irene Lipof, Secretary Ralph G. Patino Darryl K. Sharpton Carlos Trujillo
______
Members Present: Joe Arriola, Chairman, Mojdeh L. Khaghan, Vice Chairwoman, Ralph G. Patino, William J. Heffernan, Darryl K. Sharpton, and Irene Lipof
Member(s) Excused: Carlos Trujillo
In addition to the Board of Trustees, the following staff members and Assistant Miami-Dade County Attorneys were present: Carlos A. Migoya, Don S. Steigman, Esther Abolila, and Marilyn Moss; and Christopher Kokoruda, Laura Llorente, and Laura E. Wade, Assistant Miami-Dade County Attorneys ______
The Public Health Trust Board of Trustees meeting was called to order by Joe Arriola, Chairman at 3:03 p.m.
1. MOMENT OF SILENCE
2. PLEDGE OF ALLEGIANCE
The PHT BOT convened in a moment of silence which was followed by the Pledge of Allegiance.
3. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION 286.0114.FLA.STAT. (CHAPTER 2013-227, LAWS OF FLORIDA)
There were no requests from the public to be heard.
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES – November 23, 2015
4. SWAERING IN CEREMONY – OATH OF OFFICE, PUBLIC HEALTH TRUST BOARD OF TRUSTEES
On behalf of William J. Heffernan, new member of the Public Health Trust Board of Trustees, Harvey Ruvin, Clerk of the Courts and Ex-Officio Clerk of the Board of County Commissioners administered the Oath of Office.
5. REPORTS
(a) Public Health Trust Board of Trustees
No report.
(1) Agenda items recommended to be added, deferred, or deleted
There were no agenda items recommended to be added, deferred, or deleted.
(2) Previous meeting minutes recommended to be approved:
(a) Meeting minutes as of September 28, 2015 (regular televised meeting) (b) Meeting minutes as of October 26, 2015 (special meeting)
Motion to approve the previous meeting minutes
Joe Arriola, Chairman
Irene Lipof moved approval; seconded by William J. Heffernan, and carried without dissent.
(b) Jackson Health System
Carlos A. Migoya, President and Chief Executive Officer announced that North Dade Health Center located in Miami Gardens is the fifth proposed location for Jackson Health System (JHS) new network of Urgent Care Centers. For the first time JHS will upgrade an existing JHS facility adding urgent care services and a wide range of primary care already provided at that facility. Several physicians and executive leaders representing JHS and UHealth have been named as South Florida’s Top Black Health Care Professionals of 2015 by Legacy Magazine. The honorees are Andre Boyd, Chief Executive Officer, Jackson North Medical Center, James M. Trice, III, M.D., Assistant Professor of Medicine UHealth, Rudy Moise, D.O. and Member Jackson Foundation Board, Shyroll Morris, Chief Satellite Operations Officer, UHealth, Giovana Thomas, M.D., a head and neck surgeon and Associate Professor of Otolaryngology, University of Miami Miller School of Medicine, Gail Bouie Ward, Executive Director, Sylvester at Plantation, and Andrea Trowers, M.D., Dermatologist, University of Miami Miller School of Medicine. Thanks to Nicolette B. Tessler, Chief Executive Officer, Behavioral Health Hospital and Karina Chavarri, Internal Communications Specialist for their efforts and hard work to ensure that JHS was recognized for the fifth consecutive year as a leader in the 2015 Healthcare Quality Index. Thanks to Beverly Capasso, Chief Executive Officer, Jackson Memorial Hospital and Nicoletta Tessler, Chief Executive Officer, Behavioral Health Hospital, 2015 United Way Campaign Co-Chairs for keeping the excitement going during the campaign. The results of the 2015 United Way Campaign will be announced next month. After more than 30 years of dedicated service Maria Huot- Barrientos will resign the position as Senior Vice President and Chief Human Resources Officer. Ms. Huot-Barrientos has guided JHS through every challenge as a tireless advocate for employees and champion of service excellence. Michele Kligman, Associate Vice President, Human Resources Division will serve as Chief Human Resources Officer. Ms. Kligman will assist with the national search for a permanent Chief Human Resources Officer.
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES – November 23, 2015
5. REPORTS cont…
(c) Florida International University College of Medicine (FIUCOM)
No report
(d) University of Miami Miller School of Medicine (UMMSOM)
Steven Falcone, M.D., Chief Executive and Associate Vice President of Medical Affairs reported that U. S. Army Surgeons and a Registered Nurse who died in combat were honored on November 11, 2015 Veterans Day Ceremony at the Gordon Center for Research in Medical Education at the UMMSOM. Their photos will be added to the Gordon’s Center’s Wall of Heroes. Robert W. Irwin, M.D. was named Interim Chair of the Department of Physical Medicine and Rehabilitation. The key part of Dr. Irwin’s job will be to partner with Jackson Memorial Hospital in preparing for the opening of the Christine E. Lynn Rehabilitation Center. Jeffrey J. Goldberger, M.D. an internationally renowned electrophysiologist was named Chief of the Cardiovascular Division at UMMSOM. Dr. Goldberger will oversee all cardiac clinical care at UHealth; and his plans include integrating his disciplinary team approach into the cardiology services performed by UHealth doctors at JMH and the Miami VA Healthcare System. A clinical trial by David Roth, M.D., Nephrologist, Miami Transplant Institute is offering hope to patients with kidney disease and developed Hepatitis C virus infections. The clinical trial which is monitoring the effect of direct acting antiviral therapy has shown positive results. This is a first for patients with advanced kidney disease including those on dialysis who are at greater risk than the general population who developed Hepatitis C.
At 3:21 p.m. Mr. Arriola passed the gavel over to Mojdeh Khaghan, Vice Chairwoman.
(e) Learning and Innovation Subcommittee
Irene Lipof, Chairwoman, Learning and Innovation Subcommittee reported that the Subcommittee met on November 23, 2015. The Subcommittee was presented with updated information regarding Jackson Health System Open Enrollment activities and enhanced healthcare plans for employees, was introduced to the Achiever Award winners for this quarter, and recruitment update.
(f) Joint Conference and Efficiencies Committee
Irene Lipof, Vice Chairwoman, Joint Conference and Efficiencies Committee reported that the Committee met on November 23, 2015. There has been much progress regarding leadership hires, reduced patient wait times in various clinics, positive patient satisfaction reports, review of efforts to increase improvements, review of the Credentials Activity Report, and forwarded the Credentials Activity Report for the month of December 2015 with a favorable recommendation to the PHT BOT.
(g) Strategy and Growth Committee
In the absence of Joe Arriola, Chairman, Strategy and Growth Committee, Don S. Steigman, Executive Vice President and Chief Operating Officer reported that the Committee met on November 23, 2015. The Committee was presented with update information regarding Information Technology initiatives, and update information regarding the JHS Urgent Care Centers expansion project.
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES – November 23, 2015
5. REPORTS cont…
(h) Fiscal Committee
William J. Heffernan, Chairman, Fiscal Committee reported that the Committee met on November 23, 2015. Mr. Heffernan requested that Mark T. Knight, Executive Vice President and Chief Financial Officer present a summary of the interim year end combined financial statements as of fiscal year 2015.
Mr. Knight stated that as discussed at the November 23, 2015 Fiscal Committee meeting the performance year to date for fiscal year 2015 showed strong inpatient and outpatient volume growth which exceeded prior year budget, stronger performance on net days cash-on-hand ending fiscal year 2015 at 52 days cash-on-hand versus prior year at 41 days, days in accounts receivable remained flat at 42 days, length of stay remained flat at approximately 7 days, experienced an increase in full-time equivalence totaling approximately 700 positions over prior year, balance sheet showed improved performance with liquidity over prior year, payables remained strong with 58 days as of September 30, 2015, over all P&L bottom line performance for the year was approximately $58 million, and excess revenues over expenses prior to bond proceeds was $27 million. Despite the increases in some expense categories JHS had a strong performance from operations and at the same time improved solvency as well as working capital. As the transition process begins for fiscal year 2016 JHS is prepared to financially move forward with a healthy balance sheet. With regards to the external audit process, KPMG is in the field completing the year end field work. It is anticipated that the field work will be completed December 31, 2015, and audited financial statements will be forwarded to the PHT BOT for consideration and approval in January 2016. October 2015 began the first month of fiscal year 2016. On a budget totaling approximately $500,000 versus a bottom line totaling approximately $600,000 JHS is on budget despite being over budget in admissions and observations cases. Inpatient volumes for the month showed an increase. Despite higher volumes and increased net revenue JHS experienced an increase in expenses. Continue to struggle with specialty pharmaceutical drugs that are affecting costs per case, experienced increases in some of the operating expenses, as well as some increases in repairs and maintenance at Jackson Main as efforts continue to make improvements to the facility. FTE’s are approximately 11,200, days in accounts receivables remain flat at 42 and days cash-on-hand remain flat at 52, balance sheet remained fairly flat, and days in accounts payable is 59. There was approximately $3 million received from bond proceeds for the JHS capital expansion program.
(h) Miami-Dade County Attorney
No report.
6. RESOLUTIONS RECOMMENDED TO BE APPROVED
(a) PHT 11/15 – 090 Resolution approving the Medical Staff and Health Professional Affiliate Staff Membership and Clinical Privileges; approving Initial Appointments, Reappointments and Clinical Privileges and Activities; approving Modifications to Medical Staff Membership Category and Clinical Privileges; accepting Resignations and Leaves of Absences – November 2015
(b) PHT 11/15 – 091 Resolution authorizing and approving award of bids and proposals, waiver of bids, and other purchasing actions for November 2015, in accordance with the Public Health Trust’s Procurement Policy, Resolution No. PHT 10/12-078
Sponsored by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES – November 23, 2015
6. RESOLUTIONS RECOMMENDED TO BE APPROVED cont…
(c) PHT 11/15 – 092 Resolution authorizing the President or his designee to execute a First Amendment to that certain Au Bon Pain East Lease Agreement with Bread Partners Holdings, Inc., a Florida for-profit corporation, as tenant, for the additional rental of Seven Hundred Forty Seven (747) rentable square feet of retail space located at 901 Northwest 17th Street, Miami, Florida, commonly known as Park Plaza East, Suite Q, for a period to run concurrently with the original Lease Agreement, commencing on the effective date, for an annual rent payment of Twenty Four Thousand Two Hundred Seventy Seven and 50/100 Dollars ($24,277.50), plus operating expenses of Two Thousand Five Hundred Sixty Two and 21/100 Dollars ($2,562.21)
Sponsored by Alejandro E. Contreras-Soto, Senior Vice President for Operations, Jackson Health System
(d) PHT 11/15 – 093 Resolution authorizing the President or his designee to execute a Second Amendment to Lease Agreement with Robert C. Dann, a natural person, as Lessor, for the continued rental of Two Thousand (2,000) rentable square feet of office space located at 9275 Southwest 152nd Street, Miami, Florida, commonly known as Coral Reef Medical Park II, Suite 200, for a period of two (2) years, commencing on February 16, 2016, for an annual rent payment of Thirty Six Thousand One Hundred Eighty and No/100 Dollars ($36,180.00), plus pro-rata share of building operating expenses estimated at Fifteen Thousand Three Hundred Forty Eight and No/100 Dollars ($15,348.00)
Sponsored by Alejandro E. Contreras-Soto, Senior Vice President for Operations, Jackson Health System
(e) PHT 11/15 – 094 Resolution authorizing the President or his designee to execute an agreement with Chapman Partnership, a Florida not-for-profit corporation, for the Public Health Trust to oversee, manage, operate, and administer the provision of Primary Health Care Services at the Miami Hope Clinic Center located at 1550 N. Miami Avenue, Miami, Florida 33136
Sponsored by Caridad Nieves, Associate Vice President, Chief Administrative Officer and Chief Nursing Officer, Ambulatory Care and Primary Care Centers
(f) PHT 11/15 – 095 Resolution authorizing the President or his designee to execute an agreement with Chapman Partnership, a Florida not-for-profit corporation, for the Public Health Trust to oversee, manage, operate, and administer the provision of Primary Health Care Services at the South Dade Homeless Center located at 28205 S. W. 124th Court, Homestead, Florida 33036
Sponsored by Caridad Nieves, Associate Vice President, Chief Administrative Officer and Chief Nursing Officer, Ambulatory Care and Primary Care Centers
Motion to approve resolutions 6 (a) to (f) and add-on resolution
Mojdeh L. Khaghan, Vice Chairwoman
Darryl K. Sharpton moved approval; seconded by Irene Lipof, and carried without dissent. Page 5 of 6
PUBLIC HEALTH TRUST BOARD OF TRUSTEES MEETING MINUTES – November 23, 2015
7. ADJOURNMENT Mojdeh L. Khaghan, Vice Chairwoman adjourned the PHT BOT regular televised meeting at 3:33 p.m.
Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES SPECIAL MEETING MINUTES
Friday, December 18, 2015 Followed the PHT Board of Trustees One-Day Committee Meetings
Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12th Avenue Miami, FL 33136
Public Health Trust Board of Trustees Joe Arriola, Chairman Mojdeh L. Khaghan, Vice Chairwoman William J. Heffernan, Treasurer Irene Lipof, Secretary Ralph G. Patino Darryl K. Sharpton Carlos Trujillo
______
Members Present: Joe Arriola, Chairman, Mojdeh L. Khaghan, Vice Chairwoman, Irene Lipof, Darryl K. Sharpton, Ralph G. Patino, and William Heffernan
Member(s) Excused: Mojdeh L. Khaghan and Ralph G. Patino
In addition to the Board of Trustees, the following staff members, University of Miami Miller School of Medicine (UMMSOM) Representative and Assistant Miami-Dade County Attorneys were present: Carlos a. Migoya, Don S. Steigman, Matthew Pinzur, and Mark T. Knight; and Eugene Shy, Jr., Laura E. Wade, and Laura Llorente, Assistant Miami-Dade County Attorneys ______
1. SPECIAL MEETING CALL TO ORDER Joe Arriola, Chairman at 10:49 a.m.
2. REASONABLE OPPORTUNITY FOR THE PUBLIC TO BE HEARD AS REQUIRED BY SECTION 286.0114.FLA.STAT. (CHAPTER 2013-227, LAWS OF FLORIDA)
There were no requests from the public to be heard.
3. PURPOSE OF THE PHT BOARD OF TRUSTEES FIRST SPECIAL MEETING
Due to the cancellation of the December 18, 2015 PHT Board of Trustees (PHT BOT) televised meeting a special meeting was scheduled to consider for action the resolutions that were recommended for approval at the December 18, 2015 PHT BOT One-Day Committee Meetings.
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES SPECIAL MEETING MINUTES – December 18, 2015
4. RESOLUTIONS RECOMMENDED TO BE APPROVED
The following resolutions were forwarded to the PHT BOT from the Fiscal Committee and Joint Conference and Efficiencies Committee with a favorable recommendation for approval:
(a) PHT 12/15 – 096 Resolution authorizing the President or his designee to enter into a Lease Agreement, or series of Lease Agreements, with Healthcare Realty Services Incorporated, a Tennessee Corporation, as agent for Healthcare Realty Trust Incorporated, a Maryland Corporation, as Lessor, for the rental of up to Five Thousand Eight Hundred Two (5,802) rentable square feet of medical office space situated at 9380 Southwest 150th Street, Miami, Florida, commonly known as Deering Medical Plaza, and comprising Suites 200 and 230, for a total term not to exceed ten (10) years, with an annual rent payment not to exceed Two Hundred Seventeen Thousand Five Hundred Seventy-Five and No/100 Dollars ($217,575.00) at an annual rate of Thirty-Seven and 50/100 ($37.50) per rentable square foot being subject to increase at a fixed rate not to exceed Three and One-half (3.5%) percent per year, plus pro-rata share of increases in building operating expenses beginning in calendar year 2017
Sponsored by Alejandro E. Contreras-Soto, Senior Vice President for Operations, Jackson Health System
(b) PHT 12/15 097 Resolution authorizing the President and Chief Executive Officer of the Public Health Trust, or his designee to take any and all actions necessary to negotiate, execute, and implement an agreement between the Public Health Trust and the University of Miami and/or a public hospital system(s), to possibly also include the Florida Agency for Health Care Administration and/or Centers for Medicare and Medicaid Services, for purposes of resolving any excess low income pool payments in excess of cost limits with respect to State Fiscal Year 2012
Sponsored by Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System
(c) PHT 12/15 – 098 Resolution approving the Medical Staff and Health Professional Affiliate Staff Membership and Clinical Privileges; approving Initial Appointments, Reappointments and Clinical Privileges and Activities; approving Modifications to Medical Staff Membership Category and Clinical Privileges; accepting Resignations and Leaves of Absence – December 2015
(d) PHT 12/15 – 099 Resolution deeming the Operating Rooms at Jackson Health System as “Wet Procedure Locations”, approving the ensuing costs associated with such designation, and further authorizing the President and Chief Executive Officer, or his designee, to take any actions necessary to follow-up on such designation – December 2015
Sponsored by Peter G. Paige, MD, MMM, CPE, FACEP, FACPE, Executive Vice President and Chief Medical Officer, Jackson Health System
Motion to approve the agenda items (resolutions) 4 (a) to (d)
Joe Arriola, Chairman
William J. Heffernan moved approval; seconded by Carlos Trujillo, and carried without dissent.
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PUBLIC HEALTH TRUST BOARD OF TRUSTEES SPECIAL MEETING MINUTES – December 18, 2015
5. ADJOURNMENT Joe Arriola, Vice Chairman at 10:54 a.m.
Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees
Page 3 of 3
4 (b) Jackson Health System
Presented by Carlos A. Migoya, President and Chief Executive Officer
4 (c) Florida International University College of Medicine
Presented by John A. Rock, M.D., Dean and Senior Vice President for Medical Affairs
4 (d) University of Miami Miller School of Medicine
Presented by Steven Falcone, M.D., Chief Executive, University of Miami at Jackson Memorial Hospital and Associate Vice President for Medical Affairs; Professor of Radiology, Neurological Surgery and Ophthalmology
4 (e) Joint Conference and Efficiencies Committee
Presented by Darryl K. Sharpton, Chairman
4 (f) Strategy and Growth Committee
Presented by Joe Arriola, Chairman
4 (g) Fiscal Committee
Presented by Mojdeh L. Khaghan, Chairwoman
PUBLIC HEALTH TRUST JACKSON HEALTH SYSTEM COMBINED FINANCIAL STATEMENTS
December 31, 2015 PUBLIC HEALTH TRUST JACKSON HEALTH SYSTEM COMBINED FINANCIAL STATEMENTS
December 31, 2015
INDEX
1. Key Performance Indicators 2. Combined Balance Sheet Summary 3. Combined Statement of Revenues, Expenses & Changes in Fund Net Assets 4. P &L 12 Month Trend Analysis
5. Combining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding /Month
6. Combining Statement of Revenue & Expenses Reflecting Allocated Corporate Overhead & Public Support Funding /YTD
7. Combining Statement of Revenue & Expenses by Company 8. Combined Statement of Unrestricted/Restricted Cash Flow 9. Consolidated Portfolio Inventory Summary by Security /Account Type 10. Sales Tax Monthly Income Trend Analysis 11. Payor Mix Patient Days as % of Total Fiscal Year 2015-2016
NEW KEY PERFORMANCE INDICATORS Fiscal Year 2016 (Dollars in 000)
(a) (b) (e) (d) (e) (f) (g) (h) (i) (j) (k) (l) YTD Dec-15 Dec-15 Dec-14 $ Variance % Variance Nov-15 YTD YTD YTD $ YTD Variance % YTD Variance Benchmark Status Actual Budget Actual Budget Prior Budget Prior Actual Actual Budget 2015 Budget Prior Budget Prior JHS Financial (1) (1) Net Patient Revenue 88,916 84,722 66,675 4,193 22,241 4.9% 33.4% 84,227 259,964 252,123 204,105 7,841 55,859 3.1% 27.4% (2) (2) Other Operating Revenue 17,390 17,710 30,139 (320) (12,749) (1.8)% (42.3)% 17,091 51,840 52,288 86,906 (447) (35,065) (0.9)% (40.3)% (4) (4) Total Operating Revenue 106,305 102,432 96,814 3,873 9,491 3.8% 9.8% 101,318 311,804 304,410 291,010 7,394 20,793 2.4% 7.1% (6) (6) Total Operating Expenses 143,188 139,742 127,950 (3,446) 15,238 (2.5)% 11.9% 139,373 423,832 416,474 379,777 (7,358) (44,055) (1.8)% (11.6)% (7) (7) Gain and (Loss) from Operations (36,883) (37,309) (31,136) 426 (5,747) 1.1% (18.5)% (38,055) (112,028) (112,063) (88,766) 36 (23,261) 0.0% (26.2)% (8) (8) Total Net Non-operating Items (before GOB & Special Contributions) 38,854 37,716 32,540 1,139 6,314 3.0% 19.4% 40,034 116,599 113,314 97,648 3,285 18,951 2.9% 19.4% (9) (9) Excess of Revs Over (Under) Expenses before GOB & Special Contrib. 1,971 406 1,404 1,565 567 385.1% 40.4% 1,979 4,571 1,250 8,882 3,321 (4,310) 265.6% (48.5)% (10) (10) GOB & Special Contributions 6,648 42 1,299 6,605 5,349 15,597.3% 411.9% 4,362 14,120 126 3,747 13,994 10,372 11,134.3% 276.8% (11) (11) Excess of Revenues Over (Under) Expenses 8,619 449 2,703 8,170 5,916 1,820.6% 218.9% 6,341 18,691 1,376 12,629 17,315 6,062 1,258.3% 48.0%
(12) (12) Unrestricted Health Care Surtax 19,829 19,059 18,976 770 853 4.0% 4.5% 21,343 60,176 57,415 56,983 2,760 3,192 4.8% 5.6% (13) (13) Miami Dade County Unrestricted Funds 13,417 13,417 12,268 0 1,149 0.0% 9.4% 13,417 40,252 40,252 36,805 0 3,447 0.0% 9.4% (14) (14) Discharged Not Final Billed (DNFB) HIM 18,743 21,000 47,330 2,257 28,587 10.7% 60.4% 51,736 18,743 21,000 47,330 2,257 28,587 10.7% 60.4%
Financial Ratios (15) (15) Net Patient Revenue per Adjusted Patient Day 1,868 1,869 1,508 (1) 361 (0.0)% 23.9% 1,784 1,796 1,860 1,515 (63) 281 (3.4)% 18.6% (16) (16) Total Cost per Adjusted Patient Day 3,009 3,083 2,893 74 (115) 2.4% (4.0)% 2,952 2,929 3,072 2,819 144 (110) 4.7% (3.9)%
Liquidity Indicators (17) (17) Days Net in Receivable 45.9 44.96 41.00 38.36 (3.96) (6.60) (9.7)% (17.2)% 43.79 44.96 41.00 38.36 (3.96) (6.60) (9.7)% (17.2)% (18) (18) Days (Unrestricted) Cash on Hand 174.8 49.05 50.00 36.47 (0.95) 12.58 (1.9)% 34.5% 50.08 49.05 50.00 36.47 (0.95) 12.58 (1.9)% 34.5% (19) (19) Current Ratio 2.4 1.17 1.16 1.06 0.01 0.11 0.9% 10.2% 1.17 1.17 1.16 1.06 0.01 0.11 0.9% 10.2% (20) (20) Cash (Unrestricted) to Debt Ratio 1.29 0.60 0.65 0.41 (0.05) 0.19 (7.0)% 46.3% 0.61 0.60 0.65 0.41 (0.05) 0.19 (7.0)% 46.3%
Utilization (21) (21) Admissions excl. Newborn 5,174 4,937 4,813 237 361 4.8% 7.5% 4,961 15,304 14,684 14,133 620 1,171 4.2% 8.3% (22) (22) Observation Equivalent Days 2,917 2,180 2,454 737 463 33.8% 18.9% 2,821 8,828 6,514 6,615 2,313 2,213 35.5% 33.5% Total equivalent admissions 8,091 7,117 7,267 974 824 13.7% 11.3% 7,782 24,132 21,198 20,748 2,933 3,384 13.8% 16.3%
(22) (22) Admissions % through ED 67.55% 63.00% 64.70% 4.5% 2.8% 4.5% 2.8% 63.54% 65.11% 60.89% 63.66% 4.2% 1.4% 4.2% 1.4% (23) (23) Hospital Patient Census Days excl. Newborn 35,224 33,479 32,589 1,745 2,635 5.2% 8.1% 34,898 106,483 99,816 98,118 6,667 8,365 6.7% 8.5% (24) (24) Average Length of Stay 4.5 6.81 6.78 6.77 (0.03) (0.04) (0.4)% (0.5)% 7.03 6.96 6.80 6.94 (0.16) (0.02) (2.4)% (0.2)% (25) (25) Outpatient Visits 23,744 23,501 24,548 243 (804) 1.0% (3.3)% 23,333 73,083 76,754 79,001 (3,671) (5,918) (4.8)% (7.5)% (26) (26) JMH Number of O/R Cases 1,290 1,225 1,177 65 113 5.3% 9.6% 1,176 3,752 3,619 3,479 133 273 3.7% 7.8% (27) (27) Overtime % of Productive Hours 4.21% 2.53% 3.25% (1.68)% (0.96)% (66.5)% (29.6)% 4.64% 4.50% 2.53% 3.73% (1.98)% (0.78)% (78.3)% (20.8)%
FTE's (28) (28) JHS FTE per Adjusted Occupied Bed 6.65 7.32 7.52 7.26 0.21 (0.06) 2.7% (0.8)% 7.15 7.13 7.48 7.07 0.34 (0.07) 4.6% (0.9)% (29) (29) Jackson Health System FTE's 11,230 10,999 10,353 (232) (877) (2.1)% (8.5)% 11,256 11,221 11,017 10,349 (203) (872) (1.8)% (8.4)%
Payor Mix Self Pay Patient Days as % of Total (30) (30) Jackson Memorial Hospital 15.43% 14.65% 15.59% -0.78% 0.15% (5.3)% 1.0% 14.82% 14.65% 14.61% 15.62% -0.05% 0.97% (0.3)% 6.2% (31) (31) Jackson North 8.14% 10.38% 9.01% 2.24% 0.87% 21.6% 9.7% 7.69% 8.73% 10.36% 9.49% 1.63% 0.76% 15.8% 8.0% (32) (32) Jackson South 13.80% 12.40% 12.13% -1.40% -1.67% (11.3)% (13.7)% 13.40% 12.77% 12.40% 13.01% -0.37% 0.24% (2.9)% 1.9% (33) (33) Inpatient Charges as Percent of Total 74.01% 73.85% 73.69% -0.16% -0.32% (0.2)% (0.4)% 73.91% 73.58% 73.63% 72.83% -0.05% 0.75% (0.1)% 1.0% (34) (34) Realization Rate 21.86% 22.49% 18.21% 0.64% -3.65% 2.8% (20.0)% 21.85% 21.72% 22.51% 18.65% -0.79% 3.07% (3.5)% 16.4%
Key: Positive variance or no major concerns Year-to-date numbers are ok or explained, but concern for future trend Negative variance or area of current concern Variance are Favorable (positive number) and Unfavorable (negative number)
FS‐1 Public Health Trust of Miami-Dade County - (Consolidated) Combined Balance Sheet December 2015
(Amounts in thousands)
Dec 15 Nov 15 Dollar Change Sep 15 Dollar Change
ASSETS:
Cash and Investments 201,862 204,099 (2,237) 217,379 (15,517) Cash and Investments Restricted 10,898 15,909 (5,011) 12,121 (1,223) Cash and Investments Limited as to Use 28,805 49,804 (20,999) 2,805 26,000 Gross Patient Accounts Receivable 830,716 812,433 18,283 712,096 118,619 Allowances for Contractuals and Bad Debt (707,863) (695,448) (12,415) (608,605) (99,257) Net Accounts Receivable 122,853 116,985 5,868 103,491 19,362 Third Party Receivable 85,313 74,287 11,026 123,493 (38,180) Due From Miami-Dade County 42,233 40,382 1,851 39,633 2,600 Other Receivables - Restricted 3,902 4,003 (101) 3,809 94 Inventories 30,047 29,248 798 29,246 800 Prepaid Expenses and Other Current Assets 6,064 6,209 (145) 7,724 (1,660)
Total Current Assets 531,977 540,927 (8,950) 539,701 (7,724)
Due From Restricted Funds 00(0) 0 (0) Cash and Investments Limited as to Use - LT 36,784 36,703 80 35,278 1,506 Cash and Investments Restricted - LT 46,756 46,845 (89) 47,425 (669) Capital Assets, Net 550,982 537,489 13,493 533,174 17,809 Other Assets (25,941) (25,967) 26 (26,014) 72
Total Non-Current Assets 608,581 595,071 13,510 589,863 18,718
Total Assets $ 1,140,558 $ 1,135,997 $ 4,561 $ 1,129,564 $ 10,994
Current Portion of Long Term Debt 8,855 8,855 0 8,855 0 Accounts Payable and Accrued Expenses 112,899 108,801 4,098 111,826 1,073 Accrued Salaries and Payroll Taxes Withheld 138,108 138,536 (429) 134,019 4,088 Due to Other Third Party 130,891 128,247 2,644 145,958 (15,066) Due to Miami-Dade County 15,000 15,000 0 15,313 (313) Other Restricted 1,214 1,453 (239) 1,774 (559) Other Current Liabilities 47,404 57,557 (10,153) 45,243 2,161
Total Current Liabilities 454,371 458,450 (4,078) 462,988 (8,616)
Long Term Debts, Excluding Current Portion 233,429 233,567 (138) 233,843 (414) Other Liabilities 93,040 92,882 158 91,707 1,333
Total Liabilities 780,840 784,899 (4,059) 788,537 (7,697)
Unrestricted Net Position 101,944 90,635 11,309 88,683 13,261 Invested in Capital Assets 247,739 246,000 1,739 241,836 5,903 Restricted Net Position 10,035 14,464 (4,429) 10,508 (473)
Total Net Position 359,718 351,098 8,619 341,027 18,691
Total Liabilities & Net Position$ 1,140,558 $ 1,135,997 $ 4,561 $ 1,129,564 $ 10,994
Notes * Reserves for AR is comprised of $395.7 million in cont. adjustments, $62.0 million in charity care and $250.1 million in prov. for doubtful accounts. **Amounts due to the University total $30.4 million reported in other current liab.
FS-2 Combined Statement of Revenue, Expenses & Changes in Net Position Public Health Trust of Miami-Dade County December 2015 (Amounts in thousands)
Month of December 2015 3 Months Ended December 31, 2015 Dec 15 Dec 15 Dec 14 $ Variance % Variance Dec 15 Dec 15 Dec 14 $ Variance % Variance Actual Budget Actual Budget Prior Budget Prior Actual YTD Budget YTD Actual YTD Budget Prior Budget Prior
86,673 82,355 64,453 4,318 22,219 5 % 34 % Hospital and physician services 253,341 245,081 197,013 8,260 56,328 3 % 29 % 0 0 0 0 0 0 0 % 0 % 0 % 0 % Community Medical Practices 0 0 0 0 128 171 135 (43) (7) (25)% (5)% Primary Care Centers 396 521 422 (125) (26) (24)% (6)% 2,115 2,197 2,087 (82) 28 (4)% 1 % Continuing Care (SNF) 6,226 6,520 6,670 (294) (443) (5)% (7)%
88,916 84,722 66,675 4,193 22,241 5 % 33 % 259,964 3 % 27 % Net Patient Service Revenue 252,123 204,105 7,841 55,859 7 0 121 7 (113) 0 % (94)% Division of Managed Care 19 0 144 19 (125) 0% (87)% 2,035 1,979 2,122 55 (87) 3 % (4)% Grants Revenue 5,913 5,883 5,881 30 32 1 % 1 % 15,348 15,731 27,897 (383) (12,549) (2)% (45)% Other Operating Revenue 45,908 46,405 80,881 (496) (34,972) (1)% (43)% 7 % 106,305 102,432 96,814 3,873 9,491 4 % 10 % Total Operating Revenue 311,804 304,410 291,010 7,394 20,793 2 % 81,417 82,124 73,947 706 (7,470) 1 % (10)% Salaries & Related Costs 244,038 244,127 219,567 90 (24,471) 0 % (11)% 31,916 31,065 28,952 (851) (2,965) (3)% (10)% Contractual and Purchased Serv. 93,411 93,237 87,977 (174) (5,434) 0 % (6)% 118 80 (114) (38) (232) (48)% 203 % Division of Managed Care 351 239 119 (112) (233) (47)% (196)% 22,065 18,716 18,514 (3,348) (3,551) (18)% (19)% Supplies 63,425 55,538 52,101 (7,887) (11,324) (14)% (22)% 5,014 4,962 3,827 (52) (1,187) (1)% (31)% Depreciation 14,715 14,947 11,530 232 (3,185) 2 % (28)% 1,013 1,310 1,364 297 351 23 % 26 % Interest 3,328 3,930 4,100 602 772 15 % 19 % 1,645 1,485 1,460 (160) (185) (11)% (13)% Other Operating Expenses 4,564 4,455 4,383 (108) (180) (2)% (4)%
143,188 139,742 127,950 (3,446) (15,238) (2)% (12)% Total Operating Expenses 423,832 416,474 379,777 (7,358) (44,055) (2)% (12)%
(26)% (36,883) (37,309) (31,136) 426 (5,747) 1 % (18)% Gain (Loss) From Operations (112,028) (112,063) (88,766) 36 (23,261) 0 % 58 55 64 3 (5) 5 % (8)% Investment Income 221 165 166 56 55 34 % 33 % 5,550 5,184 1,232 366 4,318 7 % 350 % Other Income 15,951 15,482 3,694 469 12,257 3 % 332 % 13,417 13,417 12,268 0 1,149 0 % 9 % Dade County Unrestricted Funds 40,252 40,252 36,805 0 3,447 0 % 9 % 19,829 19,059 18,976 770 853 4 % 4 % Unrestricted Health Care Surtax 60,176 57,415 56,983 2,760 3,192 5 % 6 %
38,854 37,716 32,540 1,139 6,314 3 % 19 % Total Non-Operating Gain Net 116,599 113,314 97,648 3,285 18,951 3 % 19 %
406 1,404 1,565 1,971 567 385 % 40 % Revenue & Gain in Excess of Exp. & Loss 4,571 1,250 8,882 3,321 (4,310) 266 % 49 % 0 0 0 0 0 0 % 0 % Capital Contributions – Grants and Other 0 0 0 0 0 0 % 0 % 25 42 128 (17) (103) (41)% (80)% JM Foundation 25 126 128 (101) (103) (80)% (80)% 6,623 0 1,171 6,623 5,452 0 % 466 % Miami Dade County GOB 14,095 0 3,620 14,095 10,475 0 % 289 %
1258 % 8,619 449 2,703 8,170 5,916 1821 % 219 % Revenue & Gain after Extraordinary Loss 18,691 1,376 12,629 17,315 6,062 (48)%
FS-3 P & L 12 Month Trend Analysis Public Health Trust of Miami-Dade County - (Consolidated) December 2015
Dec 15 Nov 15 Oct 15 Sep 15 Aug 15 Jul 15 Jun 15 May 15 Apr 15 Mar 15 Feb 15 Jan 15 Inpatient Services 301,081 284,902 294,755 289,341 287,140 291,200 284,852 274,823 274,558 291,414 265,166 282,120 Ambulatory Services 105,719 100,565 109,965 108,670 104,741 109,136 106,945 104,629 107,173 103,676 96,030 99,876
Gross Patient Service Revenue 406,800 385,466 404,720 398,011 391,881 400,336 391,797 379,452 381,731 395,090 361,196 381,996 Contractual Adjustments 245,667 234,334 246,401 235,085 225,821 229,442 236,806 234,162 234,605 240,559 220,363 233,487 Charity Care 28,620 27,872 31,671 30,167 28,646 31,124 28,071 28,135 30,008 28,896 26,416 27,606 Net Patient Revenue Adjustment 0 0 0 0 0 0 0 0 0 0 0 0 Provision for Doubtful Accounts 43,598 39,033 39,827 42,465 46,955 48,152 42,755 39,640 42,688 44,468 50,633 47,773
Total Deductions From Revenue 317,884 301,239 317,899 307,717 301,423 308,717 307,631 301,937 307,301 313,923 297,412 308,865
Net Patient Service Revenue 88,916 84,227 86,821 90,294 90,458 91,619 84,165 77,515 74,430 81,167 63,783 73,131
Division of Managed Care 7 6 6 6 7 (3) 242 126 144 17 2 0 Other Operating Revenue 15,348 14,767 15,794 14,125 14,842 16,289 27,807 27,624 27,950 28,214 27,183 28,131 Grants Revenue 2,035 2,318 1,561 4,061 1,761 2,814 1,781 2,405 3,304 1,910 2,056 2,185
Total Operating Revenue 106,305 101,318 104,181 108,486 107,068 110,719 113,995 107,670 105,829 111,307 93,024 103,448
Salaries & Related Costs 81,417 80,165 82,455 70,592 83,175 81,123 76,883 79,609 77,418 79,456 70,313 75,384 Contractual and Purchased Services 31,916 30,807 30,688 40,676 31,413 29,798 30,586 30,803 30,858 30,231 28,492 30,751 Supplies 22,065 20,648 20,712 18,262 20,294 22,076 20,687 19,034 19,148 19,327 17,649 18,091 Division of Managed Care Paid Claims 118 117 116 129 117 373 221 111 128 127 113 111 Interest 1,013 1,162 1,154 1,233 1,150 3,487 1,261 1,330 1,325 1,330 1,326 1,290 Provision for Self-Insured Claims 592 592 578 (3,669) 576 610 570 641 570 570 576 553 Public Med/Assist. Trust F. Assess 933 933 933 893 933 933 907 907 907 907 907 907 Depreciation 5,014 4,950 4,751 9,450 4,057 3,941 3,967 3,900 3,778 3,803 3,800 3,814 Other Operating Expenses 120 0 (117) (124) (39) 39 1 0 0 0 0 0
Total Operating Expenses 143,188 139,373 141,270 137,442 141,675 142,381 135,083 136,335 134,133 135,750 123,176 130,903
Gain (Loss) From Operations (36,883) (38,055) (37,090) (28,956) (34,608) (31,662) (21,088) (28,665) (28,304) (24,443) (30,151) (27,455)
Med. Edu. and Tert. Care Fund 5,147 5,147 5,147 5,825 4,808 4,808 1,235 1,235 1,235 1,235 1,235 1,235 Interest Income - Non. Operating 59 74 90 72 85 51 89 58 52 62 52 85 Unrealized Gains and Losses (1) (1) (1) 92 (1) (1) (1) (1) (1) (1) (1) (1) Other Non-Operating 403 54 53 632 8 15 (2) 157 (12) (23) (5) 35 Dade County Unrestricted Funds 13,417 13,417 13,417 12,268 12,268 12,268 12,268 12,268 12,268 12,268 12,268 12,268 Unrestricted Health Care Surtax 19,829 21,343 19,003 21,023 18,415 19,409 20,149 22,900 19,579 19,570 24,708 19,343
TOTAL Non-Operating Gain Net 38,854 40,034 37,710 39,912 35,583 36,551 33,737 36,617 33,121 33,111 38,258 32,965
Revenue & Gain in Excess of Exp. & Loss 1,971 1,979 621 10,956 976 4,890 12,649 7,952 4,817 8,668 8,107 5,510
Capital Contributions – Grants and Other 0 0 0 0 0 0 142 0 0 0 0 0 JM Contributions 25 0 0 0 0 0 88 0 0 0 0 0 Miami Dade Cty. GOB 6,623 4,362 3,110 35,726 1,479 19,070 1,238 1,496 2,670 684 1,032 1,059
Revenue & Gain after Extraordinary Loss 8,619 6,341 3,731 46,682 2,455 23,960 14,118 9,447 7,488 9,352 9,139 6,569
FS-4 Jackson Health System Dec 2015 Actual Combining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding
Jackson Jackson West Urgent Corrections Jackson Memorial Jackson Jackson Medical Physician JHS Health Care Primary Health Nursing Property Hospital South North Center Services Plan Centers Care Services Homes Mgmt Total
Total Gross Inpatient Revenue 227,965 25,864 44,405 2,847 301,081 Total Gross Outpatient Revenue 72,744 15,085 15,654 1,817 419 105,719 Total Gross Revenue 300,709 40,949 60,059 1,817 3,266 406,800 Total Deductions from Revenue -236,386 -30,531 -48,128 -1,689 -1,151 -317,884 Total Net Patient Revenue 64,323 10,418 11,931 128 2,115 88,916 Other Operating Revenue 12,589 635 671 21 874 45 511 2 15,348 Managed Care Revenue 77 Grant Revenue 1,968 67 2,035 Total Other Operating Revenue 14,557 635 671 21 874 7 112 511 2 17,390
Total Revenue 78,880 11,054 12,602 21 874 7 240 511 2,117 106,305 Operating Expenses Salaries & Wages 49,508 4,704 5,667 1,430 9 714 2,569 61 1,685 66,348 Benefits 11,573 949 1,153 217 2 182 488 20 486 15,070
Total Salaries & Benefits 61,080 5,653 6,820 1,647 11 896 3,057 81 2,172 81,417 Purchased Services 15,470 1,430 1,773 242 111 594 89 13 477 20,198 Managed Care Paid Claims 77 UM AOA Purchased Service 11,447 302 41 23 16 11,829 Total Purchased Service 26,917 1,732 1,773 242 118 635 112 13 493 32,034 Supplies 17,337 2,159 1,831 81 48 194 24 391 22,065 Total Direct Operating Cost 105,334 9,544 10,424 1,970 118 11 1,579 3,363 118 3,056 135,516 Depreciation 3,631 858 420 11 6 12 1 38 38 5,014 Interest 1,013 1,013 Self Insurance 482 20 88 2 592 HCCB Assessment 721 88 124 933 Other Operating Expense 120 120
Total Other Operating Cost 5,847 965 632 11 6 14 1 38 159 7,672
Total Operating Expenses Before Allocations 111,181 10,509 11,055 1,980 124 11 1,593 3,363 156 3,215 143,188
Allocated Corporate Services: Clinical Trials Office 3855 1 1 2 152 Corporate Administration 2,586 317 343 61 4 48 104 5 99 3,566 Financial Services 387 47 51 9 1 7 15 1 15 531 Human Resources 801 68 83 11 11 34 2 40 1,049 Integrity 128 16 17 3 2 5 5 177 Information Technology 4,210 499 728 8 6 23 9 6 9 5,501 Public Safety 66 76 99 53 33 325 Revenue Cycle Management 2,811 383 561 17 31 3,803 Strategic Sourcing 921 101 101 9 3 18 8 1 24 1,186 Total Allocated Corporate Services 11,947 1,510 1,988 103 14 181 176 48 224 16,190 Total Expenses Subject to Allocation -16,190 -16,190 Total Operating Expenses Including Allocations 106,939 12,019 13,043 2,083 138 11 1,773 3,540 203 3,439 143,188
Excess of Operating Revenue over (under) Operating Expenses -28,059 -965 -441 21 -1,209 -130 -11 -1,533 -3,540 307 -1,321 -36,883
Non Operating Revenue and Expenses Investment Income 59 59 Unrestricted Health Care Surtax 19,829 19,829 Miami Dade County Unrestricted Funds 13,417 13,417 Other Income 5,492 57 5,549 JMH Foundation 25 25
Total Non Operating Revenue 38,822 57 38,879 Redistribution of Revenue -6,833 2,871 3,280 467 215 Total Non Operating Revenue After Redistribution 31,990 2,928 3,280 467 215 38,879 Excess of Revenue over (under) Expenses before GOB and County Special Contributions 3,931 1,962 2,839 21 -1,209 -130 -11 -1,066 -3,540 307 -1,107 1,996
Miami Dade County GOB Contributions 6,623 6,623 Miami Dade County Special Contributions Total Miami Dade GOB and Special Contributions 6,623 6,623 Excess of Revenue over (under) Expenses 10,554 1,962 2,839 21 -1,209 -130 -11 -1,066 -3,540 307 -1,107 8,619
FS-5 Jackson Health System Dec 2015 YTD Actual Combining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding
Jackson Jackson West Urgent Corrections Jackson Memorial Jackson Jackson Medical Physician JHS Health Care Primary Health Nursing Property Hospital South North Center Services Plan Centers Care Services Homes Mgmt Total
Total Gross Inpatient Revenue 668,386 78,607 125,313 8,432 880,738 Total Gross Outpatient Revenue 220,520 43,460 45,365 5,644 1,260 316,249 Total Gross Revenue 888,906 122,067 170,678 5,644 9,691 1,196,986 Total Deductions from Revenue -701,035 -91,601 -135,675 -5,248 -3,465 -937,023 Total Net Patient Revenue 187,871 30,467 35,003 396 6,226 259,964 Other Operating Revenue 37,431 1,814 2,037 63 2,877 234 58 1,396 45,908 Managed Care Revenue 19 19 Grant Revenue 5,730 183 5,913 Total Other Operating Revenue 43,161 1,814 2,037 63 2,877 19 417 58 1,396 51,840
Total Revenue 231,032 32,280 37,040 63 2,877 19 813 6,285 1,396 311,804 Operating Expenses Salaries & Wages 150,376 13,966 16,474 4,420 21 2,333 7,598 5,085 187 200,460 Benefits 33,523 2,759 3,308 633 4 513 1,394 1,384 60 43,578
Total Salaries & Benefits 183,899 16,725 19,782 5,053 25 2,846 8,992 6,469 247 244,038 Purchased Services 45,528 4,164 5,756 797 333 1,782 278 1,501 513 60,652 Managed Care Paid Claims 18 18 UM AOA Purchased Service 31,963 906 123 69 30 33,092 Total Purchased Service 77,492 5,070 5,756 797 351 1,905 347 1,531 513 93,762 Supplies 50,596 5,986 4,997 143 153 553 998 -2 63,425 Total Direct Operating Cost 311,987 27,782 30,536 5,993 351 25 4,904 9,893 8,998 757 401,225 Depreciation 10,537 2,598 1,251 33 17 42 3 121 115 14,715 Interest 3,328 3,328 Self Insurance 1,433 60 263 6 1,762 HCCB Assessment 2,164 263 372 2,799 Other Operating Expense 3 3
Total Other Operating Cost 17,465 2,920 1,886 33 17 47 3 121 115 22,607
Total Operating Expenses Before Allocations 329,452 30,702 32,421 6,026 368 25 4,952 9,895 9,119 872 423,832
Allocated Corporate Services: Clinical Trials Office 119 14 16 3 2 5 4 164 Corporate Administration 7,681 929 1,011 188 11 151 306 283 27 10,588 Financial Services 1,109 133 145 26 2 22 42 40 4 1,522 Human Resources 3,157 265 323 45 46 134 158 7 4,136 Integrity 556 67 73 14 1 11 22 21 2 766 Information Technology 12,149 1,442 2,009 24 19 69 27 26 19 15,784 Public Safety 1,142 213 278 148 93 1,874 Revenue Cycle Management 9,111 1,251 1,749 58 12,170 Strategic Sourcing 2,848 301 319 28 10 57 25 74 15 3,676 Total Allocated Corporate Services 37,871 4,617 5,923 327 42 564 561 699 75 50,679 Total Expenses Subject to Allocation -50,679 -50,679 Total Operating Expenses Including Allocations 316,644 35,319 38,344 6,353 411 25 5,516 10,456 9,818 947 423,832
Excess of Operating Revenue over (under) Operating Expenses -85,612 -3,038 -1,304 63 -3,477 -392 -25 -4,703 -10,456 -3,533 449 -112,028
Non Operating Revenue and Expenses Investment Income 224 224 Unrestricted Health Care Surtax 60,176 60,176 Miami Dade County Unrestricted Funds 40,252 40,252 Other Income 15,778 170 15,948 JMH Foundation 25 25
Total Non Operating Revenue 116,454 170 116,624 Redistribution of Revenue -19,948 8,366 9,357 1,513 712 Total Non Operating Revenue After Redistribution 96,506 8,536 9,357 1,513 712 116,624 Excess of Revenue over (under) Expenses before GOB and County Special Contributions 10,894 5,498 8,053 63 -3,477 -392 -25 -3,190 -10,456 -2,821 449 4,596
Miami Dade County GOB Contributions 14,095 14,095 Miami Dade County Special Contributions Total Miami Dade GOB and Special Contributions 14,095 14,095 Excess of Revenue over (under) Expenses 24,988 5,498 8,053 63 -3,477 -392 -25 -3,190 -10,456 -2,821 449 18,691
FS-6 Public Health Trust of Miami-Dade County Consolidated Combining Statement of Revenue & Expenses by Company Month of December 2015 (Amounts in thousands)
Jackson Jackson Jackson Jackson West Physician JHS Health Urgent Care Primary Corrections Skilled Jackson Total Prior Memorial South North Medical Center Services Plan Centers Care Health Nursing Property Year Centers Services Facilities Management Actual
Revenue Inpatient Revenue 227,965 25,864 44,405 0 0 0 0 0 0 2,847 0 301,081 269,796 Outpatient Revenue 72,744 15,085 15,654 0 0 0 0 1,817 0 419 0 105,719 96,315
Gross Patient Service Revenue 300,709 40,949 60,059 0 0 0 0 1,817 0 3,266 0 406,800 366,111
Deductions From Revenue: Contractual Adjustments 178,811 24,685 40,990 0 0 0 0 479 0 702 0 245,667 220,486 Provisions For Charity Care 24,409 1,378 1,185 0 0 0 0 1,198 0 449 0 28,620 26,103 Net Patient Revenue Adjustment 0 0 0 0 0 0 0 0 0 0 0 0 0 Provision for Doubtful Accounts 33,165 4,467 5,953 0 0 0 0 11 0 0 0 43,598 52,847
Total Deductions From Revenue 236,386 30,531 48,128 0 0 0 0 1,689 0 1,151 0 317,884 299,436 Net Patient Service Revenue 64,323 10,418 11,931 0 0 0 0 128 0 2,115 0 88,916 66,675 Division of Managed Care 0 0 0 0 0 7 0 0 0 0 0 7 121 Other Operating Revenue 12,589 635 671 21 874 0 0 45 0 2 511 15,348 27,897 Grants Revenue 1,968 0 0 0 0 0 0 67 0 0 0 2,035 2,122
Total Operating Revenue 78,880 11,054 12,602 21 874 7 0 240 0 2,117 511 106,305 96,814
Operating Expenses Salaries & Related Costs 61,080 5,653 6,820 0 1,647 0 11 896 3,057 2,172 81 81,417 73,947 Contractual and Purchased Services 26,917 1,732 1,773 0 242 118 0 635 112 493 13 32,034 28,838 Supplies 17,337 2,159 1,831 0 81 0 0 48 194 391 24 22,065 18,514 Interest 1,013 0 0 0 0 0 0 0 0 0 0 1,013 1,364 Depreciation 3,631 858 420 0 11 6 0 12 1 38 38 5,014 3,827 Other Operating Expenses 1,203 108 212 0 0 0 0 2 0 120 0 1,645 1,460
Total Operating Expenses 111,181 10,509 11,055 0 1,980 124 11 1,593 3,363 3,215 156 143,188 127,950
Excess of operating revenue over (under) (32,302) 544 1,547 21 (1,107) (116) (11) (1,353) (3,363) (1,097) 355 (36,883) (31,136) operating expenses
Other Revenues (Expenses) Investment Income 59 (1) 0 0 0 0 0 0 0 0 0 58 64 Unrestricted Health Care Surtax 19,829 0 0 0 0 0 0 0 0 0 0 19,829 18,976 Miami Dade County Unrestricted Funds 13,417 0 0 0 0 0 0 0 0 0 0 13,417 12,268 Other Income 5,492 58 0 0 0 0 0 0 0 0 0 5,550 1,232 Miami Dade County Special Contributions 0 0 0 0 0 0 0 0 0 0 0 0 0 JM Foundation 25 0 0 0 0 0 0 0 0 0 0 25 128 Miami Dade County GOB Contributions 6,623 0 0 0 0 0 0 0 0 0 0 6,623 1,171
Total Other Revenues (expenses) 45,445 57 0 0 0 0 0 0 0 0 0 45,502 33,839
Excess of revenues over (under) expenses 13,144 601 1,547 21 (1,107) (116) (11) (1,353) (3,363) (1,097) 355 8,619 2,703
FS-7
Public Health Trust Jackson Health System Combined Statement of Unrestricted / Restricted Cash Flow As of Dec 31, 2015
Audited Current Month Year to Date Year to Date December 31, 2015 December 31, 2015 September 30, 2015 Cash generated (used) by operations: Funds available for working capital/facilities improvements 8,619 $18,691 $141,839 Non cash expenses: Depreciation 5,014 14,715 52,041 Loss on disposal of capital assets - (1) (237) Total 13,633 33,405 193,643
Cash provided (used) for current assets: Decreases (increases) in: Patient Receivable and Other Third Party payor (18,745) 16,218 44,247 0- - Cash and Invst. Limited as to Use 20,999 (26,000) 200 Inventories, Prepaid Expenses and Other Receivables (553) 766 (6,130) Total 1,701 (9,016) 38,317
Cash provided (used) for current liabilities: Increases (decreases) in: Current Installment of Long Term Debt - - 850 Accounts Payable and Accrued Expenses 3,670 5,162 (13,022) Due to other third party 2,644 (15,380) (39,536) Other Liabilities (10,153) 2,162 10,923 Other- Restricted (239) (560) 345 Total (4,078) (8,616) (40,440)
Decreases (increases) in: Cash and Invst. Limited as to Use (81) (1,506) (1,633) Cash and Invst. Restricted 89 669 5,801 Long Term Investment - - - - - Cash provided (used) for Other Assets (26) (73) (5,543) - Cash provided (used) for Long Term Liabilities: - Increases (decreases) in: - Long Term Debt (136) (412) (74,363) Other Liabilities 158 1,333 63,119
Total 22 921 (11,244)
Cash provided (used) for Prop., Plant and Equipment: Purchases of Prop. Plant and Equipment (18,507) (32,524) (124,387)
- - Total (18,507) (32,524) (124,387)
- - -
Net Increase in Cash and Cash Equivalents (7,247) (16,740) 54,514 - Cash, beginning of period 220,007 229,500 174,986
Cash, end of period 212,760 212,760 229,500
FS-8 PUBLIC HEALTH TRUST CONSOLIDATED PORTFOLIO INVENTORY SUMMARY BY SECURITY/ACCOUNT TYPE December 31, 2015
# of Investments Description Par Value Avg. Interest Rate Market Value
1 Money Markets 616,876 0.060% 616,876
1 Total Investments Portfolio 616,876
Wells Fargo interest bearing accts 0.250% 254,169,110 Wells Fargo Institutional Bank Deposit account 16,291,426 0.100% 16,291,426 Bond Proceeds Invested at Miami-Dade County 0.468% 54,027,228
Total Cash and Investments $ 325,104,640
FS-9 PUBLIC HEALTH TRUST SALES TAX MONTHLY INCOME STATEMENT TREND ANALYSIS
FISCAL YEAR 2014
Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14
monthly est 15,600,201 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159 16,597,159
mo portion of qtly est: 1,273,109 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470 1,416,470
State revision to Sales Tax Projection 1,140,319
+/-est vs. actual rec'd; mo of (485,039) 892,399 3,943,238 554,734 653,794 2,307,416 1,265,025 327,211 (5,798) (221,497)
+/-est vs. actual rec'd; qt of 454,932 - 639,889 - 539,276 1,012,158
Monthly Revenue 16,873,310 19,153,948 17,528,590 18,906,028 22,411,799 18,568,363 18,667,423 20,960,934 19,278,655 18,340,840 18,547,107 18,804,290
FISCAL YEAR 2015
Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15
monthly est 17,412,313 17,378,859 17,378,859 17,378,859 17,378,859 17,378,859 17,378,859 17,378,859 17,378,859 17,378,859 17,378,859 17,378,859
mo portion of qtly est: 1,597,585 1,624,581 1,624,581 1,624,581 1,624,581 1,624,581 1,624,581 1,624,581 1,624,581 1,624,581 1,624,581 1,624,581
State revision to Sales Tax Projection (6,458) +/-est vs. actual rec'd; mo of (27,130) 339,997 4,965,715 566,716 575,989 2,828,543 1,145,334 405,485 (1,116,050) 2,213,861
+/-est vs. actual rec'd; qt of 739,219 1,068,202 527,473
Monthly Revenue 19,009,898 18,996,983 18,976,310 19,343,437 24,708,374 19,570,156 19,579,429 22,900,185 20,148,774 19,408,925 18,414,863 21,217,301
FISCAL YEAR 2016
Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16
monthly est 17,378,859 18,322,180 18,322,180
mo portion of qtly est: 1,624,581 1,851,176 1,851,176
State revision to Sales Tax Projection 1,169,916
+/-est vs. actual rec'd; mo of (344,444)
+/-est vs. actual rec'd; qt of
Monthly Revenue 19,003,440 21,343,272 19,828,912 ------
Comments:
• Estimate was calculated based on same month prior year adjusted for percentage change of recent receipts vs. recent estimates.
FS-10 Jackson Health System Hospitals Payor Mix Patient Days as % of Total Fiscal Year 2016
Actual Budget % Variance Actual Actual Budget % Variance FC Group Dec-15 Dec-15 Budget Nov-15 YTD YTD Budget Jackson Health System Combined percentages: Commercial 1.13% 1.17% ‐0.04% 1.05% 1.18% 1.17% 0.01% Medicaid 5.94% 8.26% ‐2.33% 6.73% 6.41% 8.24% ‐1.82% Medicare 14.56% 14.81% ‐0.26% 13.71% 14.22% 14.78% ‐0.56% Other 3.65% 4.04% ‐0.38% 3.72% 3.67% 4.04% ‐0.37% Managed Care Medicaid 22.23% 18.93% 3.30% 21.88% 22.07% 18.87% 3.20% Managed Care Medicare 11.39% 10.46% 0.93% 12.05% 11.50% 10.44% 1.06% Managed Care Others 12.10% 12.37% ‐0.28% 12.43% 12.64% 12.34% 0.30% Self Pay 14.28% 13.94% 0.34% 13.74% 13.73% 13.91% ‐0.18% Potential Medicaid 14.73% 16.01% ‐1.28% 14.69% 14.57% 16.22% ‐1.66% Total 100.00% 100.00% 0.00% 100.00% 100.00% 100.00% 0.00%
Jackson Memorial Hospital Combined percentages: Commercial 1.34% 1.35% ‐0.01% 1.23% 1.36% 1.34% 0.02% Medicaid 6.87% 9.45% ‐2.58% 7.53% 7.25% 9.41% ‐2.16% Medicare 12.32% 13.25% ‐0.93% 11.61% 12.22% 13.21% ‐1.00% Other 3.99% 4.66% ‐0.67% 4.10% 4.07% 4.65% ‐0.58% Managed Care Medicaid 23.23% 19.08% 4.15% 22.59% 22.83% 19.01% 3.83% Managed Care Medicare 8.51% 7.78% 0.73% 9.27% 8.85% 7.75% 1.09% Managed Care Others 12.25% 12.74% ‐0.49% 12.59% 12.80% 12.70% 0.10% Self Pay 15.43% 14.65% 0.78% 14.82% 14.65% 14.61% 0.05% Potential Medicaid 16.05% 17.03% ‐0.98% 16.26% 15.96% 17.31% ‐1.35% Total 100.00% 100.00% 0.00% 100.00% 100.00% 100.00% 0.00%
Jackson South Combined percentages: Commercial 0.47% 0.56% ‐0.09% 0.42% 0.60% 0.56% 0.03% Medicaid 1.52% 2.96% ‐1.44% 2.49% 2.46% 2.96% ‐0.50% Medicare 19.07% 22.97% ‐3.90% 18.77% 18.76% 22.97% ‐4.21% Other 2.72% 2.68% 0.04% 2.52% 2.20% 2.68% ‐0.48% Managed Care Medicaid 17.43% 17.34% 0.09% 17.97% 18.79% 17.33% 1.46% Managed Care Medicare 24.19% 20.93% 3.26% 24.34% 23.86% 20.94% 2.92% Managed Care Others 13.96% 12.16% 1.80% 12.27% 13.48% 12.15% 1.32% Self Pay 13.80% 12.40% 1.40% 13.40% 12.77% 12.40% 0.37% Potential Medicaid 6.85% 8.00% ‐1.15% 7.83% 7.09% 8.01% ‐0.92% Total 100.00% 100.00% 0.00% 100.00% 100.00% 100.00% 0.00%
Jackson North Combined percentages: Commercial 0.35% 0.42% ‐0.07% 0.45% 0.49% 0.42% 0.07% Medicaid 3.56% 4.20% ‐0.64% 5.18% 4.13% 4.20% ‐0.06% Medicare 24.12% 19.32% 4.80% 22.29% 23.28% 19.31% 3.97% Other 2.37% 0.86% 1.50% 2.36% 2.25% 0.97% 1.28% Managed Care Medicaid 19.76% 19.05% 0.71% 20.56% 19.77% 19.03% 0.74% Managed Care Medicare 19.18% 20.76% ‐1.58% 19.26% 18.86% 20.73% ‐1.87% Managed Care Others 10.05% 10.11% ‐0.05% 11.63% 11.05% 10.09% 0.96% Self Pay 8.14% 10.38% ‐2.24% 7.69% 8.73% 10.36% ‐1.63% Potential Medicaid 12.46% 14.90% ‐2.44% 10.57% 11.44% 14.89% ‐3.45% Total 100.00% 100.00% 0.00% 100.00% 100.00% 100.00% 0.00%
FS‐11
4 (h) Miami-Dade County Attorney
Presented by Eugene Shy, Jr., Assistant Miami-Dade County Attorney
5. RESOLUTIONS RECOMMENDED TO BE APPROVED
TO: Joe Arriola, Chairman and Members, Public Health Trust Board of Trustees
FROM: Peter Paige, MD, MMM, CPE, FACEP, FACPE Executive Vice President & Chief Medical Officer
DATE: January 27, 2016
RE: Emergency Medicine Residency Program
Recommendation Staff recommends that the Public Health Trust Board of Trustees establish a residency program in emergency medicine under the auspices of the Accreditation Council for Graduate Medical Education (ACGME) and provide funding for 9 PGY-1 residency positions in the 1st year and 9 PGY-1 and 10 PGY-2 residency positions in the 2nd year.
Scope The new emergency medicine residency program would be operated in partnership with the University of Miami Miller School of Medicine, with participants rotating through Jackson Memorial Hospital, the University of Miami Hospital, and Holy Cross Hospital. It would be a three-year program, with Jackson making an initial commitment to operate and fund the program for at least two years.
Fiscal Impact/Funding Source The initial two-year commitment to ACGME would have a fiscal impact of approximately $1.7 million. A larger portion of that impact would occur in the second year, when the program would have 15 first-year and 15 second- year residents.
Track Record/Monitor Jackson’s graduate medical education program is overseen by Peter Paige, executive vice president and chief medical officer. The University of Miami has defined educational responsibilities in the program as its academic partner.
Background After many years of preparation, the ACGME granted approval in 2015 for Jackson Memorial Hospital to host a residency program in emergency medicine for 15 residents. This would be the first ACGME accredited emergency medicine residency program in South Florida. This would bolster Jackson’s global reputation for emergency care and complement existing graduate medical education programs such as orthopedic trauma, surgical critical care and trauma, and head trauma. Many of our existing programs allow residents to work in Jackson’s emergency care center and learn from its clinical staff, but this would be the first to focus primarily on that specialty.
Participants would work at three sites – Jackson Memorial Hospital, the University of Miami Hospital, and Holy Cross Hospital – with Jackson and the University of Miami taking primary responsibility for administration and education.
The first cohort of 15 residents would begin training in summer 2016. Agenda Item 5 (b) Public Health Trust Board of Trustees January 27, 2016
RESOLUTION NO. PHT 01/16 –
RESOLUTION APPROVING THE ESTABLISHMENT OF A RESIDENCY PROGRAM IN EMERGENCY MEDICINE UNDER THE AUSPICES OF THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION AND APPROVING THE ENSUING FUNDING COSTS ASSOCIATED WITH ESTABLISHING SUCH RESIDENCY PROGRAM, AND FURTHER AUTHORIZING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, OR HIS DESIGNEE, TO TAKE ANY ACTIONS NECESSARY TO SO FOLLOW-UP ON ESTABLISHING SUCH A RESIDENCY PROGRAM
(Peter G. Paige, M.D., Executive Vice President and Chief Medical Officer, Jackson Health System)
WHEREAS, this Board seeks to accomplish the purposes set forth in the attached memorandum; and
WHEREAS, both the President and Joint Conference and Efficiencies Committee recommend approval.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC HEALTH
TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby approves the establishment of a residency program in emergency medicine under the auspices of the Accreditation Council for Graduate Medical Education and approves the ensuing funding costs associated with establishing such residency program and further authorizes the President or his designee to take any actions necessary to so follow-up on establishing such a residency program.
TO: Joe Arriola, Chairman and Members, Public Health Trust Board of Trustees
FROM: Rosa Costanzo Vice President and Chief Procurement Officer Strategic Sourcing and Supply Chain Management
DATE: January 27, 2016
RE: Purchasing Report
Recommendation The following recommendations are made in accordance with the Trust’s “Procurement Regulation.”
These items fully support our business operations and help the organization in its efforts to provide an excellent world class patient experience.
Scope This report includes competitively solicited contract awards over $3,000,000, waivers of formal competition over $250,000 and other categories for Board approval as prescribed by the Procurement Regulation.
Fiscal Impact/Funding Source The items included are part of the Trust’s budget.
Track Record/Monitor The Procurement Management Department along with the user departments and leadership support will track and monitor the responsibilities and obligations set forth in the contracts.
Background The entire report has been vetted and assembled by the Procurement Management Department with the direct participation of the Director and staff, all subject to review by the Chief Procurement Officer, consultation with the Executive Staff and the President, and reviewed for legal sufficiency by the County Attorney’s Office. Request is made for approval of the Purchasing Report, consisting of the following:
Vendor Amount 1. SodexoMAGIC, LLC. $32,443,389.84 For three years
2. Cohr, Inc. d/b/a Masterplan (Aramark) $10,279,709 For one year
3. Depuy/Synthes Trauma/Smith & Nephew Inc. $9,230,176 For two years 4. Leica Microsystems, Inc. $441,298.82 One-time purchase 5. Therakos $600,000 For two years 6. Cerner Corporation $9,357,556 For eight years 7. Velocity $192,279 For nine months Procurement completed an orderly administrative process with each item to bring the best value (cost, quality, and outcome) with each project.
Agenda Item 5 (c) Public Health Trust Board of Trustees January 27, 2016
RESOLUTION NO. PHT 01/16 –
RESOLUTION AUTHORIZING AND APPROVING AWARD OF BIDS AND PROPOSALS, WAIVER OF BIDS, AND OTHER PURCHASING ACTIONS FOR JANUARY 2016, IN ACCORDANCE WITH THE PUBLIC HEALTH TRUST’S PROCUREMENT POLICY, RESOLUTION NO. PHT 10/12-078
(Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System)
WHEREAS, bids and proposals were solicited, received and reviewed by staff; and
WHEREAS, the Purchasing and Facilities Subcommittee met on January 27, 2016 and reviewed staff’s recommendations as submitted under the PHT’s Procurement Policy, Resolution No. PHT 10/12-078; and
WHEREAS, the Purchasing and Facilities Subcommittee forwarded the Purchasing Report to the Fiscal
Committee with a recommendation for approval for each item under the report, which is attached hereto and hereby incorporated by reference; and
WHEREAS, upon his written recommendation, the President recommends that the Public Health Trust Board of Trustees (Board of Trustees) waive competitive bidding for items under the heading of “Bid Waiver” and “Waiver of
Full and Competitive Bidding” in the respective Purchasing Report, finding such action to be in the best interests of the
Public Health Trust; and
WHEREAS, the President and Fiscal Committee recommend various other purchasing actions, as indicated in the attached Purchasing Report.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC HEALTH
TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby authorizes and approves the award of bids and proposals and all the purchasing actions as set forth in the attached Purchasing Report, under the Public Health
Trust’s Procurement Policy, Resolution No. PHT 10/12-078; and finds it in the best interest of the Public Health Trust to waive competitive bidding for those items listed under the heading “Bid Waiver” and “Waiver of Full and
Competitive Bidding” in the respective report; and to take such action as is necessary and authorized to implement these awards and actions. PUBLIC HEALTH TRUST BOARD OF TRUSTEES PURCHASING REPORT
January 27, 2016
TO: PUBLIC HEALTH TRUST BOARD OF TRUSTEES
FROM: PROCUREMENT MANAGEMENT DEPARTMENT
The following recommendations are made in accordance with the Trust’s “Procurement Policy” and it’s implementing “Procurement Regulation.” This report includes competitively solicited contract awards over $3,000,000, waivers of formal competition over $250,000 and other categories for Board approval as prescribed by the Procurement Regulation. The entire report has been screened and assembled by the Procurement Management Department with the direct participation of the Directors and staff, all subject to review by the Chief Procurement Officer, consultation with the Executive Staff and the President, and reviewed for legal sufficiency by the County Attorney’s Office.
SECTION I. AWARDS UNDER INVITATIONS TO BID (ITB’s)
This section consists of awards under competitively solicited Invitations to Bid (ITB’s) over $3,000,000.
No items to report.
SECTION II. AWARDS UNDER REQUESTS FOR PROPOSALS (RFP’s)
This section consists of awards under competitively solicited Requests for Proposals (RFP’s) over $3,000,000.
1. (818536, 818537, 817854, 818080, 819949-CS) The Executive Office requests a contract award to SodexoMAGIC, LLC. resulting from a competitive Request for Proposals (RFP 15-13008-CS) for Hospital Nutrition Management Services (ongoing purchase).
SodexoMAGIC, LLC. $32,443,389.84 (For three years)
Total approved funding $32,443,389.84
Background This competitive procurement was solicited and administered by the Procurement Management Department through a competitive Request for Proposals (RFP # 15-13008-CS) that was publicly advertised on April 17, 2015 The RFP document was sent to eleven (11) potential Proposers including Aramark, Pride Health, Sodexo, Unidine, ILS Health, Compass USA, HHS-1, Morrison, The Palmer Group and others. The solicitation was also advertised in the Miami Review on April 24, 2015. Responses were received from three (3) firms: Morrison Healthcare, SodexoMAGIC, LLC. and Aramark Healthcare Support Services, LLC.
The RFP was comprised of three separate models as set forth below:
1. Business Model (Proposal A): This model is JHS current state of business and includes food, products, equipment and management service to operate the Food and Nutrition Services Program in JMH (main campus), Holtz Children and Women Hospitals, Jackson Memorial Perdue Medical Center, Jackson South Community Hospital, Jackson Memorial Long Term, and Jackson Mental Health. With this model, all staff will be provided by the PHT.
2. Business Model (Proposal B): This model was for "management service only". In this business model, Proposers will submit pricing for the management of the Food and Nutrition Services Program in JMH (main campus), Holtz Children and Women Hospitals, Jackson Memorial Perdue Medical Center, Jackson South Community Hospital, Jackson Memorial Long Term, and Jackson Mental Health. Proposers will exclude food, products and equipment from their price proposals.
3. Business Model (Proposal C): This was solely for JNMC and concurrent with what is provided today. This model includes all management and staff required to operate the Food and Nutrition Services Program, including the food products and equipment at JNMC.
It was determined by the Selection Committee that Models A and C were in the best interest of the Trust.
The Evaluation Criteria for this RFP comprised of 35 points for Technical Qualifications, 25 points for Vendor Qualifications and Corporate Past Performance, 25 points for Price Consideration, 5 points for Partnership Strength, and a maximum of 10 points for certified SBE subcontracting goal (20%) for total weighted points of 100.
After initial scoring, excluding pricing, the Selection Committee recommended the three (3) Proposers for oral presentations. After considering the oral presentations, the Selection Committee scored for the second time, and SodexoMAGIC, LLC. was determined to be the highest ranked Proposer.
The incumbent vendor, Sodexo, Inc., submitted their proposal for this competitive RFP as SodexoMAGIC, LLC. The negotiation team appointed by the Selection Committee negotiated the following aspects of the agreement:
1. Clear and concise Operating Procedures and Pricing Structure for each of the JHS locations including: patient meal services, cafeteria services, catering, clinical nutrition services, gift shops, doctors’ dining rooms and branded concepts such as Starbucks and Mojo Cafeteria.
2. A 20.9% reduction on General Expenses on Model C for only JNMC equivalent to $673,084 annual savings. 3. The PHT team requested the inclusion of Sodexo’s cost for hourly labor that was not part of the RFP Price Structure. Under the new contract, Contractor will provide the following management/professional positions in the Nutrition Services: General Manager, System Controller, Clinical Nutrition Services Manager, Patient Services Manager (2), Executive Chef, Production Manager, Sous Chef, Retail Operations Manager, Retail Manager and Catering Manager.
4. In addition to the above job classifications, Contractor will continue to provide the following non- management staff: a. Supervisor b. Cash-room Attendant c. Unit Clerical d. Food Service Workers (18) e. Cashier Gift Shop
The savings under the new contract compared to the previous agreement are:
Jackson Health System (First Year Savings) Proposed FY 2015 Actual Savings $10,697,460.00 $12,085,867.00 $1,388,407.00
Jackson Health System (Second Year Savings) Proposed FY 2015 Actual Savings $10,872,964.92 $12,085,867.00 $1,212,902.08
Jackson Health System (Third Year Savings) Proposed FY 2015 Actual Savings $ 10,872,965 $12,085,867.00 $1,212,902.08
Recommendation The three (3) voting members of the Selection Committee, in collaboration with Procurement Management, have prepared the final contract and this award recommendation in accordance with the Procurement Policy/Regulation.
The evaluation of proposals is as follows:
Evaluation Criteria (Average Maximum Morrison SodexoMAGIC, Aramark Items Points After Oral Available Healthcare LLC Healthcare Presentations) Points
1 Vendor Qualifications and Past 25 20.667 22.333 22.667 Performance
2 Technical Consideration 35 27.667 29.667 32.667 3 Partnership Strength 5 5.000 4.333 5.000 4 SBE Subcontracting Goal – 10% 10 4.000 6.000 0.000 5 Price Consideration 25 18.240 25.000 17.190 LOCAL PREFERENCE 0.000 0.000 0.000 TOTAL SCORES 100 75.574 87.333 77.524
* Local Preference was applied in accordance with the ordinance but not affecting the award.
The five-day protest filing period started on January 14, 2016. No reported disputes were filed.
This contract has been approved by Risk as to Insurance and Liability and by the County Attorney’s Office for Legal sufficiency.
This contract can be terminated for convenience with a ninety (90) calendar days’ notice and includes UAP and OIG provisions.
This procurement has been thoroughly reviewed for potential SBE participation. As such, SodexoMAGIC, LLC proposed a combined subcontracting SBE participation goal of 14.30% in the fulfillment of services related to the Hospital Nutrition Management. Sodexo will use the following certified SBEs throughout the entire Jackson Health System: District Healthcare & Janitorial Supply, Inc.; Casmol, LLC, dba Mi Gallito Bakery; Apex Vending, Inc.; Cafetales de Miami, Inc. dba Tu Café; and Felix Seafood Corp.
In providing an evaluation of Sodexo’s present performance as incumbent, the Executive Office has reported the following:
• The contracted service meets the applicable standards addressed in the Joint Commission Standards. • The overall service is good. o The service has never caused delays. o The vendor meets all requirements for the contracted service o Vendor has demonstrated consistent responsiveness to all requests/issues/problems that might have arisen during the course of the current contract period.
In accordance with our Contractor Due Diligence review, SodexoMAGIC, LLC has provided a Sworn/Notarized Statement to the Trust’s Procurement Management Department that: (1) No Lawsuits have been filed against the Company within the five (5) years prior to submittal of a bid or proposal to the Trust; (2) The Company has not defaulted in the five (5) years prior to bid or proposal submittal to the Trust; and, (3) the Company has not been debarred nor has the Firm received a formal notice of non-compliance or non-performance in the five (5) years prior to proposal submittal to the Trust. (G. Santorio).
SECTION III. AWARDS UNDER THE COMPETITIVELY SOLICITED CONTRACTS OF OTHER PUBLIC PROCUREMENT ENTITIES
This section consists of awards over $3,000,000 under competitively solicited (“ITB,” “RFP” or equivalent) contracts of other public and nonprofit entities.
No items to report.
SECTION IV. AWARDS UNDER GROUP PURCHASING ORGANIZATION (“GPO”) CONTRACTS
This section consists of awards over $3,000,000 under Group Purchasing Organization (“GPO”) contracts. GPOs are organizations that aggregate the purchasing volume of their members consisting of hospitals and other health care providers to leverage discounts with manufacturers, distributors and other vendors to realize administrative savings and efficiencies. The Trust’s GPO is MedAssets.
2. (938547 - MT) The Engineering Department and Jackson Main Administration is requesting a one (1) year renewal with two (2) additional one year options to renew (OTRs) and require funding for the enterprise-wide clinical biomedical engineering services agreement with Aramark under the MedAssets GPO contract. (ongoing purchase).
Cohr. Inc. d/b/a/ Masterplan (Aramark):
Previously approved funding for five year term: $47,398,548 (Total for five years)
Modification #2 (under CPO Authority) $4,000,000
This request for funding: $10,279,709 (For one year)
Total approved funding: $61,678,257
Background In October 2010, the PHT Board of Trustees approved a five-year agreement with Cohr, Inc. d/b/a Masterplan for enterprise-wide clinical biomedical engineering services to be performed at Jackson Main, North, South, and satellite locations under the MedAssets GPO contract. In March 2011, Cohr was acquired by Aramark. In October 2015, a ninety (90) day extension of the contract was executed and additional funds were added under CPO delegated authority per Procurement Regulation XI (c3). The current contract includes scheduled maintenance, remedial services, coverage, parts, emergency repair, uptime guarantees and identification and preventive maintenance of mission critical equipment. The contract also includes an equipment master list (EML) covering the equipment for which Aramark provides services.
Recommendation The contract provides parts, repair and maintenance services for all biomedical and diagnostic imaging equipment. Since the inception there has been a reduction in response time for service and repairs with an increase in customer and patient satisfaction. This additional funding and extended term will allow for the cost savings of utilizing the MedAssets Group Purchase Contract and provide for continued and uninterrupted biomedical and clinical engineering services.
This contract extension has been thoroughly reviewed for potential SBE participation. As such, Cohr. Inc. d/b/a/ Masterplan (Aramark) has agreed to an SBE participation goal of 8% based on applicable spend for the one year contract term.
The original contract was approved by Risk Management as to Insurance and Liability and by the County Attorney’s Office for legal sufficiency.
The contract can be terminated by the Trust for Convenience (without cause) upon ninety (90) calendar day’s prior written notice and includes OIG and UAP provisions. The 2% UAP fee is taken as a deduction on the invoice.
In providing an evaluation of the vendor’s performance during the current contract year, the following has been reported:
• The contracted service meets the applicable standards addressed in the Joint Commission Standards. • The overall service meets the required standards. • Timeliness of performance and safety testing of all equipment before initial use is acceptable and meets Environment of Care requirements. • Responsiveness to safety issues and standards is acceptable. • The vendor meets all of the requirements for the contracted service. • Equipment inspected within established time frames.
Based on the overall contract performance evaluations completed by the Engineering Department and various patient care areas it is recommended that the services provided by Aramark are continued. (G. Santorio).
SECTION V. AWARDS UNDER A WAIVER OF FORMAL COMPETITION
This section consists of awards over $250,000 without the formal solicitation of competitive bids or proposals. All award recommendations in this section have the approval of the President, are based on a finding that the waiver of competitive bidding is in the best interests of the Public Health Trust, and require a two-thirds affirmative vote of the Trustees present for approval.
A. Sole Source
No items to report.
B. Physician’s Preference
Staff requests a waiver of formal competition for the contract items listed in this category because a physician and clinician have requested the particular item without which the physician and clinician cannot successfully and safely render patient care.
3. (912854, 912855-JFJ) The Perioperative Services Department, Jackson Memorial Hospital, requests contract awards to Smith & Nephew Inc. (“Smith & Nephew”) and Depuy / Synthes Trauma, a Division of Johnson & Johnson Inc. (“Depuy /Synthes Trauma”) for a period of two years for the continued provision of orthopedic total joint and trauma implant products and related accessories. (ongoing purchase).
Depuy/ Synthes Trauma: $4,650,190 (For two years)
Smith & Nephew, Inc.: $4,579,986 (For two years)
Total approved funding: $9,230,176 (Total for two years)
Background Depuy/ Synthes Trauma and Smith & Nephew Inc. will continue to provide to the Trust orthopedic total joint and trauma implant products, generally used to preform trauma, total join Replacement, and General & Pediatric Orthopedic procedures. These are patient chargeable products used in the delivery of orthopedic surgeries.
Discussions with surgeons concerning their utilization of these products were conducted by Strategic Sourcing, the Value Analysis Team and the Advisory Board to identify additional saving opportunities for the Trust without limiting surgeon product choices and patient outcomes. The resulting feedback was that continued utilization of the orthopedic total joint and trauma implant products provided by these vendors was required as these products offer the physician better surgical choices. Historically, the Physicians have utilized these vendors’ products to meet the specific needs of the patient, and this has resulted in different levels of spend among the vendors. Some of the products offered by the two vendors are similar but not exactly alike. The Physicians make their choices based on different technology types (different types of instrumentation used with spinal implant products) suited to meet both the physician’s and the patient’s need. Access to varying technology types offered by these vendors have also served Jackson’s teaching mission.
The main focus of this initiative was to reduce total cost among the vendors. To this end, the team entered into negotiations with these two existing vendors, achieving line item price reductions. The negotiated price reduction is effective immediately after both contracts are executed. Depuy/ Synthes’s pricing reflects an estimated $112,502 in savings. The pricing for Smith & Nephew reflects approximately $178,542 in savings. In accordance with our standard contract terms, the estimated dollars requested for each vendor have been capped and are stated as a maximum contract value in the individual agreements.
In accordance with our Contractor Due Diligence Review, Depuy/ Synthes and Smith & Nephew have provided Sworn/ Notarized Statements to the Trust’s Procurement Management Department that: (1) No Lawsuits have been filed against the Company within the five (5) years prior to submittal of a bid or proposal to the Trust; (2) The companies have not defaulted in the five (5) years prior to bid or proposal submittal to the Trust; (3) the companies have not been debarred nor have the firms received formal notices of on-compliance or non-performance in the five (5) years prior to proposal submittals to the Trust.
ECRI and Broadjump have reported that the new pricing provided by these vendors falls within the average competitive price point of the ECRI Price Guide and Broadjump Auto Price Checker database for these products.
Recommendation All consumables within these contracts are deemed patient chargeable and are reimbursable to the organization when applicable. After reviewing and discussing the information presented, the Perioperative Services Department, in collaboration with Procurement Management, has determined that it would be in the Trust’s best interest to secure the services of Depuy/ Synthes Trauma and Smith & Nephew for the continued provision of orthopedic total joint and trauma implant products and its related accessories.
The contracts have been approved by Risk as to Insurance and Liability and by the County Attorney’s Office for Legal Sufficiency.
The underlying contracts can be terminated for convenience with a thirty (30) day notice and includes UAP and OIG fees. The 2% UAP fee is taken as a deduction on the invoice.
A Bid Waiver Justification has been provided and Conflict of Interest Declarations signed by Gregory Zych, D.O , Professor and Chief , Orthopedic Trauma, Jackson Memorial Hospital; James J. Hutson Jr. , MD, Professor of Clinical Orthopaedics & Trauma Surgeon, Jackson Memorial Hospital; Steven P. Kalandiak, M.D , Assistant Professor of Clinical Orthopaedics & Trauma Surgeon, Jackson Memorial Hospital; Stephen Quinnan, MD, Assistant Professor of Clinical Orthopaedics & Trauma Surgeon, Jackson Memorial Hospital; Fernando Vilella- Hernandez, MD, Assistant Professor of Orthopaedics & Trauma Surgeon, Jackson Memorial Hospital; Hamilton Clark, Chief Financial Officer, Jackson Memorial Hospital; Michael Goldberg, MD, Medical Director Perioperative Services, Jackson Memorial Hospital; Ana Sanchez, Administrator, Medical Hospital Center, Perioperative Services, Jackson Memorial Hospital; and Alexander Raecke, Account Director, Depuy Synthes Trauma, and Juan Carlos Junco, Area Sales Representative, Smith & Nephew ,with no reported disclosures. (B. Capasso).
4. (915923-JFJ) The Surgical Division of Jackson South Community Hospital (“JSCH”) requests a contract award to Leica Microsystems, Inc. (“Leica.”) for the acquisition of a Leica Microscope, M530 OH6 Neurovascular Fluorescence 3D Microscope System (new purchase).
Leica Microsystems, Inc.: $ 441,298.82
Total Approved Funding: $441,298.82 (One-time purchase)
Background This capital purchase is funded by Miracle Bond dollars. Neurovascular Surgical Fluorescence 3D Microscopes provide high-resolution imagery by displaying optimal visualization and increased depth of field at the desired surgical field. A clear, three dimensional, view allows Neurosurgeons to deal with delicate nerve structures, deep cavities and tiny structures with vitally important functions. Devices which display a greater depth of field, while sustaining a high resolution display, allow surgeons to see more anatomical details clearly, especially at the bottom of a deep cavity, facilitating better instrument maneuvering and exact surgical precision. JSCH’s Surgery Department, in collaboration with the Procurement Management Department, conducted market research to determine the availability of competition. The team confirmed that Leica’s offering is one of the most clinically beneficial and innovative technologies to help enhance the surgeon’s visualization for patients undergoing cranial, spinal, and endoscopic procedures.
Leica’s M530 OH6 Neurovascular Fluorescence 3D Microscope is a 4th generation system suited to improve the surgeon’s surgical field visualization while providing enhanced instrument maneuvering and exact surgical precision. It offers Leica’s FusionOptics, a patented technology which uses two different-sized openings in the optical pathways to provide high resolution display through a single 3-D impression; and, TriFluoro, a fluorescence visualization module which color-codes vascular, oncological and neurosurgical anatomical features for efficient comparison and seamless workflow integration. In addition, benefits on treatment standardization will be achieved through this acquisition as Leica’s Neurovascular Microscopes are currently in use at both Jackson Memorial Hospital and University of Miami Medical Center. Purchasing this unit will allow the continuation of treatment standardization, while also allowing for the practice of neurosurgery to continue at JSCH.
ECRI and MDBuyline have reported that the discount pricing provided by Leica Microsystems, Inc. falls within above average competitive price point for the system.
Recommendation In the best interest of the Trust, Jackson South Community Hospital recommends an award to Leica Microsystems, Inc. for the acquisition of a Leica Microscope, M530 OH6 Neurovascular Fluorescence 3D Microscope System. Through negotiations by the Procurement Management Department, Leica has agreed to provide an additional 4.5% discount on the original quoted supplement. This represents cost savings of $18,634.
In providing an evaluation of the vendor’s performance during the current contract year, Jackson South Community Hospital has reported the following:
• The contracted service meets the applicable standards addressed in the Joint Commission Standards. • The overall service is above standard. • The vendor meets all requirements for the contracted service.
The underlying contracts can be terminated for convenience with a thirty (30) day notice and includes UAP and OIG Provisions. The 2% UAP fee is taken as a deduction on the invoice.
A bid waiver justification has been provided and Conflict of Interest Declarations signed by Jonathan Jagid MD, Professor of Surgery for JHS, Ian Cote M.D., Professor of Surgery for JHS, Michael Ivan, M.D., Assistant Clinical Professor, Neurosurgery Surgery; Judith Sledge, Associate Administrator, Jackson South Community Hospital ; and Ian Prichett, Senior Territory Manager, Leica Microsystems Inc., with no reported disclosures. (G. Diaz).
5. (917445, LF) The Pediatric Dialysis Department of Holtz Children’s Hospital requests the continuation of the contact awarded to Therakos, Inc. for the acquisition of patient care consumables associated with the use of the extracorporeal photopheresis system. (ongoing purchase).
Therakos, Inc. $600,000 (Estimated consumable spend for two years)
Total approved funding: $600,000
Background The Therakos photopheresis equipment was purchased in 2014. This request will cover the purchase of proprietary consumables for a period of 2 years. Therakos develops and markets an extracorporeal photopheresis system (ECP), or immune modulation therapy, that suppresses the donor lymphocytes (type of white blood cells) that stimulate immune reactions and aid in the development of Graft-versus-host disease (GvHD). THERAKOS™ Photopheresis is a state-of- the-art treatment for the skin manifestations (appearance) of cutaneous T-cell lymphoma (CTCL) that are unresponsive to other forms of treatment. The THERAKOS™ CELLEX™ Photopheresis System is an integrated system that uses extracorporeal (outside the body) photopheresis (ECP), an innovative cellular therapy, to relieve the symptoms of CTCL. The requested consumables that will be used to provide the therapy to patients are proprietary to the Therakos equipment being utilized at JMH Holtz.
Recommendation In the best interest of the Trust, the Holtz Division, Jackson Memorial Hospital, recommends an award to Therakos for the acquisition of the proprietary consumables. The requested amount of $600,000 represents the estimated volume of supplies needed for a period of two years based on projected utilization.
The vendor has reviewed and approved the Trust’s standard contract terms and conditions, which were previously approved by Risk as to Insurance and Liability and by the County Attorney’s Office for Legal Sufficiency.
The contract can be terminated for convenience with a thirty (30) day notice and includes UAP and OIG fees. The UAP fees are deducted from the invoices.
In accordance with our Contractor Due Diligence Review, Therakos has provided Sworn/ Notarized Statements to the Trust’s Procurement Management Department that: (1) No Lawsuits have been filed against the Company within the five(5) years prior to submittal of a bid or proposal to the Trust; (2) The companies have not defaulted in the five (5) years prior to bid or proposal submittal to the Trust; (3) the companies have not been debarred not have the firms received formal notices of on-compliance or non-performance in the five (5) years prior to proposal submittals to the Trust.
A bid waiver justification has been provided and Conflict of Interest Declarations signed by Martin Andreansky, MD, Associate Professor-Pediatrics Hematology for JHS, Evel Michel, Nurse Manager for the Pediatric Dialysis Unit, and Christian Peters, CMO, for Therakos with no reported disclosures. (S. Burghart)
C. Standardization
Items in this category have been established as the Trust standard.
No items to report.
D. Non-Competitive Cooperative Purchasing
This subsection consists of awards under the contracts of other public entities that were not competitively solicited.
No items to report.
E. Miscellaneous Bid Waiver
This subsection consists of awards not falling in the other categories of waiver of formal competition but where waiver is deemed to be in the best interests of the Trust.
6. (922074, 939821-MT) The Revenue Cycle Department in conjunction with the Information Technology Department (ITD), requests approval of Schedule 204 for the legacy purchase for the Cerner implementation and maintenance of Computer Assisted Physician Documentation (CAPD); a document quality review software subscription which will increase revenue and provide Medicare case mix index (CMI) improvement. The execution of this schedule for software and professional services is crucial for the Trust to meet its implementation timeline for the project. (ongoing purchase). Cerner Corporation:
Original Award (MSA & Schedule 101) $155,105,000 (Board Approved – September 2013) (10-year term)
Workstations on Wheels Carts and Rubberized Laptops Security Locks $4,709,809 (Board Approved – May 2014) (One-time purchase)
Electronic Health Record (EHR) System and ePrescribe $21,658,800 (Schedule 102)
Electronic Health Record (EHR) System (Schedule 103) $21, 689,846 (Board Approved – September 2015)
This funding Request (Schedule 204) $9,357,556 (For eight years)
Total approved funding: $212,521,011
Background On September 23, 2013, the Board approved the execution of a new master agreement with Cerner Corporation in the amount of $155,105,000 over a ten year period. This was done under Resolution 09/13-034, for the period October 1, 2013 through September 30, 2023, for new system enhancements and essential functionality improvements, professional services and the continuation of maintenance and support under Schedule 101 of the existing “Electronic Health Record (EHR) System” pursuant to a competitively solicited RFP awarded in 2002 by the Trust. At that time the list of required equipment was an estimate only until such time that the final equipment could be identified. In May 2014, the Board ratified a letter of commitment, for the Information Technology Department between the Trust and Cerner, to provide Workstations on Wheels, Rubberized Carts, PC’s, Wall Mounts and Barcode Scanners to successfully implement Phase I of the Cerner 10-Year EHR implementation. The Trust executed a Letter of Commitment with Cerner Corporation, after extensive analysis to verify competitive pricing, for the purchase of the equipment, so as not to impact the implementation timeline. The equipment would eventually be utilized by the Trust’s medical staff to provide clinical documentation into the patient’s Electronic Health Record. On September 28, 2015 the Board approved the execution of Schedule 103, of the existing EHR System, for new system enhancements and essential functionality improvements, professional services and the continuation of maintenance and support.
Recommendation The Revenue Cycle Department, in conjunction with ITD, request approval to execute Schedule 204 between the Trust and Cerner Corporation, for the allocation of funds in the amount of $9,357,556 for the purchase of the necessary software, professional and continuing educational services under the existing Cerner Corporation contract for the Nuance Computer Assisted Physician Documentation (CAPD) Subscription and Support. Cerner is the sole reseller of the Nuance software and will be the sole point of contact and coordinator of activities and resources throughout the lifecycle of this project. The professional resources will be provided from JA Thomas and Associates (JATA), a subcontractor under this Agreement, with a proven track record. JATA will provide ongoing support and education of JHS’ medical, nursing case management staff and CDI specialists. After implementation of the software, there is a guaranteed commitment in realizing a Case Mix Index (CMI) improvement on Medicare cases reviewed, due to improved coding, as follows:
Jackson Memorial Hospital 5.5% Jackson South Community Hospital 5.3% Jackson North Medical Center 4.2%
The parties are committed to reaching these targets. After the training engagements are completed and if the targets are not met, Cerner will provide additional support staff at no additional cost to the Trust, until they are attained. This CMI improvement will represent increased revenues to the Trust.
The original contract was reviewed and approved by the CAO for legal sufficiency and by Risk as to insurance and indemnification. This contract can be terminated for convenience with a ninety (90) day notice and includes UAP and OIG provisions. In accordance with our Contractor Due Diligence review, Cerner Corporation, has provided a Sworn/Notarized Statement to the Trust’s Procurement Management Department that: (1) No Lawsuits have been filed against the Company within the five (5) years prior to submittal of a bid or proposal to the Trust; (2) The Company has not defaulted in the five (5) years prior to bid or proposal submittal to the Trust; and, (3) the Company has not been debarred nor has the Firm received a formal notice of non-compliance or non-performance in the five (5) years prior to proposal submittal to the Trust.
In providing an evaluation of Cerner Corporation’s performance during the current contract year, the Information Technology Department has reported the following:
• The contracted service meets the applicable standards addressed in the Joint Commission Standards. • The overall service is good and meets the requirements. • There have been no complaints from patients or employees regarding this contracted service.
• The service has never caused delays. • The vendor meets all requirements for the contracted service • Vendor has demonstrated consistent responsiveness to all requests/issues/problems that might have arisen during the course of the contract period.
Based on the overall contract performance evaluation, the Information Technology Department and Finance recommend the continuation of this contracted service. ECRI and MD Buyline do not track these services (M. Garcia/M.Torres).
SECTION VI. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE COMPETITIVELY SOLICITED
This section refers to existing contracts that were competitively bid (“ITB” or “RFP”) at their origin and consists of either (a) the exercise of established options to renew or (b) the execution of contract modifications for which the Procurement Policy requires prior Board approval.
No items to report.
SECTION VII. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE AWARDED UNDER A WAIVER OF FORMAL COMPETITION
This section refers to existing contracts that were not competitively bid at their origin and consists of either (a) the exercise of established options-to renew or (b) the execution of contract modifications for which the Procurement Policy requires prior Board approval. All contracts in this section are renewals not previously authorized by the Board have the written approval of the President, are based on a finding that the waiver of full and competitive bidding is in the best interest of the Public Health Trust, and require a two-thirds affirmative vote of the Trustees present for approval.
7. (940781 - MT) The Information Technology Department requests approval of the Option to Renew (OTR) the Hosting and Consulting Services Agreement for Velocity, Inc.:
Velocity Technology Solutions, Inc.:
Initial Contract Award $248,904 (CPO Delegated Authority- 10/2013) (For one year)
OTR No. 1 (Board Approved 10/2014) $248,904 (For one year) Modification #2 (CPO Delegated Authority – 11/2015) $62,226 (Ninety (90) Day Extension)
This request for funding $192,279 (OTR No. 2) (For nine (9) Months)
Total approved funding: $752,313
Background Velocity Technology Solutions presently provides hosting services for the Trust's Lawson Enterprise Resource Planning (ERP) modules. The agreement was created via a waiver of formal competition specifically for the cloud hosting services of the following, newly-procured, Lawson modules:
* Talent Management * Contract Management * Supply Order Management
The master agreement has two individual scopes of work (SOWs), or Exhibits; one for Project Stewardship (SOW#1) and the other for Hosting Services (SOW#2). This agreement is for One (1) Year with four (4) options to renew (OTRs) of One (1) Year each and has a 180 day termination for convenience clause due to the effort required to migrate any data to a new hosting environment. Pricing for this OTR No. 2 will be the same as the initial year of the contract and will increase at a fixed rate of 3% for years 3, 4 and 5.
In accordance with our Contractor Due Diligence review, Velocity Technology Solutions, has provided a Sworn/Notarized Statement to the Trust’s Procurement Management Department that: (1) No Lawsuits have been filed against the Company within the five (5) years prior to submittal of a bid or proposal to the Trust; (2) The Company has not defaulted in the five (5) years prior to bid or proposal submittal to the Trust; and, (3) the Company has not been debarred nor has the Firm received a formal notice of non-compliance or non-performance in the five (5) years prior to proposal submittal to the Trust.
In providing an evaluation of Velocity’s performance during the current contract year, the Information Technology Department has reported the following:
• The overall service is good and meets the organization requirements. • There have been no complaints from patients or employees regarding this contracted service. o The service has never caused delays. o The vendor meets all requirements for the contracted service. o Vendor has demonstrated consistent responsiveness to all requests/issues/problems that might have arisen during the course of the contract period.
Recommendation Based on the overall contract performance evaluation, the Information Technology Department has determined that it would be in the Trust’s best interest to continue this contracted service. ECRI and MD Buyline do not recommend any additional savings at this time (M. Garcia).
SECTION VIII. MISCELLANEOUS
This section consists of procurement actions that require Board approval not included under any other section of the Purchasing Report.
No items to report.
TO: Joe Arriola, Chairman and Members, Public Health Trust Board of Trustees
FROM: Carlos A. Migoya President and Chief Executive Officer
DATE: January 27, 2016
RE: 2015-2018 Collective Bargaining Agreement between the Public Health Trust and Miami-Dade County, Florida and the Committee of Interns and Residents
Recommendation It is recommended that the Public Health Trust Board of Trustees approve this resolution recommending that the Miami-Dade Board of County Commissioners (BCC) ratify the 2015-2018 Collective Bargaining Agreement between the Public Health Trust and Miami-Dade County, Florida and the Committee of Interns and Residents (CIR).
Scope The agreement would cover approximately 1,100 full-time employees of the Jackson Health System that are members of the CIR. Members of the CIR consist of all regular full-time employees employed by the PHT of Miami-Dade County in the titles of PGY-1, PGY-2, PGY-3, PGY-4, PGY-5, PGY-6, PGY-7, who are primarily interns, residents, fellow, and non-graduate assistants. The agreement would apply retroactively to October 1, 2015, through September 30, 2018.
Fiscal Impact/Funding Source The proposed agreement has a fiscal impact of approximately $4.1 million for the three-year term. It would be funded from operating revenues as documented in the PHT financial statements. In no event would capital revenues, including proceeds from any general-obligation bond, be used to fund the obligations under this agreement.
Track Record/Monitor The monitoring and implementation of all labor contracts and collective bargaining agreements is overseen by Michelle Kligman, interim Chief Human Resources Officer.
Background The proposed agreement is a product of good-faith negotiations between management and CIR. Both parties agreed to compensation changes which reflect at least the 50th percentile of the “Resident/Fellow Stipends Nationwide” as published in the most recent survey conducted by the Association of American Medical Colleges (AAMC). The other proposed changes, which are outlined below, would significantly help Jackson Health System achieve its strategic goals while rewarding employees for their remarkable professional commitment.
Terms of Agreement
This is a three (3) year Agreement covering the period of October 1, 2015 through September 30, 2018. The following represents the major provisions of the Agreement:
Article II § 2 – Pay Rates Salaries would be increased 3 percent effective February 1, 2016, to the following levels: PGY 1 $ 52,788.00 PGY 2 $ 54,537.00 PGY 3 $ 56,680.00 PGY 4 $ 58,917.00 PGY 5 $ 61,328.00 PGY 6 $ 63,608.00 PGY 7 $ 65,723.00
Effective May 1, 2017, the wages of all employees in the bargaining unit would be increased to the 50th percentile of the AAMC survey.
The parties also agreed that they shall reopen negotiations for the third year of this contract (effective October 1, 2017) solely in the area of pay rates.
Article VI § 1 – Group Health Insurance The Trust would continue to provide all new housestaff officers hired after the beginning of the 2013- 2014 academic year with the JHS/PHT Health Plan, on the same terms and conditions provided to all other PHT employees with regard to premiums, plan design, co-pays, deductibles, pharmacy, and co- insurance.
The proposed agreement also allows either party to reopen negotiations no later than six months before the end of a plan year to negotiate plan design and premium contributions.
Article X § 4 – Renewal of Appointments New language was added to better reflect current practice and to clarify the issues that arise surrounding the renewal and non-renewal of appointments. Specifically, new language added three reportable actions: (1) when housestaff officers are required to repeat a rotation that extends the required period of training; (2) electing not to advance a housestaff officer to the next PGY level; and (3) electing not to renew a residency or fellowship contract.
Article XIV – Impaired Physician New language was added to this section in order to set specific time limitations for communication from housestaff who enter rehabilitation programs through the Professionals Resource Network. The new language was added in an effort to address management’s concern of an observed lack of communication from employees while in rehabilitation programs and management’s concern surrounding the difficulties associated with employees on medical leave for several months with no clear end date.
Article XVI § 1 – On-Call Rooms New language was added to this section to require proper daily maintenance and cleaning of on-call rooms.
Article XVI § 3 – Parking New language was added to provide housestaff with one month free parking for all employees whose cars are vandalized or stolen.
Article XVI § 4 – Meal Cards New language was added to provide healthy food options in vending machines.
Article XVI § 7 – Professional Allowance New language was added to increase the housestaff officers’ allowance from $1,250 to $1,500 per residency academic year for professional/educational expenses.
Article XVI § 9 – Child Care This section is new and lays the groundwork for discussions about supporting child care for PHT employees, with ideas including on-site child care programs or subsidies for off-site care. If such a program is developed in the future, the proposed agreement reserves a portion of slots for CIR members in proportion to their segment of the overall employee population.
Article XVI § 10 – Public Service Loan Forgiveness Program This section is new but addresses services already provided in practice, such as providing paid time and room space for CIR to hold information sessions about the Public Service Loan Forgiveness Program.
Article XVII § 7 – Protective Equipment This section is new and addresses housestaff concerns regarding availability of protective equipment. The new section provides that Jackson’s Graduate Medical Education Department will work with any department that believes it has a shortage of necessary equipment or requires storage for the equipment.
Article XXI Paragraphs B&C– Housestaff Involvement, Education, & Community Outreach Fund New language was added to this section to increase the amount provided by Jackson to CIR from $125,000 per year to $175,000 per year to address Quality and Patient Safety Initiatives under the labor- management partnership.
Agenda Item 5 (d) Public Health Trust Board of Trustees January 27, 2016
RESOLUTION NO. PHT 01/16 –
RESOLUTION APPROVING THE 2015-2018 COLLECTIVE BARGAINING AGREEMENT BY AND AMONG MIAMI-DADE COUNTY, THE PUBLIC HEALTH TRUST AND COMMITTEE OF INTERNS AND RESIDENTS (CIR), AND RECOMMENDING THAT THE BOARD OF COUNTY COMMISSIONNERS RATIFY THE AGREEMENT
(Carlos A. Migoya, President and Chief Executive Officer, Jackson Health System)
WHEREAS, the President and staff of the Public Health Trust have negotiated in good faith with representatives of the Committee of Interns and Residents (hereinafter referred to as “CIR”) which is the duly certified collective bargaining agent representing bargaining unit members of the CIR employed by the Public
Health Trust; and
WHEREAS, such negotiations have resulted in a proposed Collective Bargaining Agreement, a copy of which is attached hereto and incorporated herein by reference; and
WHEREAS this Collective Bargaining Agreement was ratified by the CIR bargaining unit housestaff on
January 14, 2016; and
WHEREAS, the President and the Board of Trustees desire to accomplish the purposes outlined in the accompanying memorandum and recommend approval of the proposed Collective Bargaining Agreement; and
WHEREAS, Chapter 25A of the Code of Miami-Dade County provides that the PHT shall not be authorized to enter into a contract with a labor union or other organization representing employees without first having obtained the approval of the Board of County Commissioners (“Board”); and
Agenda Item 5 (d) Public Health Trust Board of Trustees January 27, 2016
-Page 2-
WHEREAS, in addition, Miami-Dade County and the PHT have a joint employer relationship under state public employee relations laws, Chapter 447, Florida Statutes, as determined by the Florida Public Employees
Relations Commission; and
WHEREAS, as such, the PHT does not have the independent authority to enter into labor contracts, and the County, as a matter of state law, is a party to and is bound by the contracts with the PHT’s labor unions; and
WHEREAS, the PHT Board needs the ratification of the Agreement by the Board of County
Commissioners to render it a binding labor agreement.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE PUBLIC
HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby approves the Collective
Bargaining Agreement among Miami-Dade County, the Public Health Trust, and the CIR for the period of October
1st, 2015 through September 30th, 2018 and hereby recommends that the agreement be ratified by the Board County
Commissioners of Miami-Dade County and directs the president or his designee to take such action as necessary to seek such ratification.
6. ADJOURNMENT
Joe Arriola, Chairman