Board-Packet-01.22.2014.Pdf

Board Meeting January 22, 2014

Agenda Item C1

Approve minutes for the following meetings of the Central Health Board of Managers: a. October 26, 2013; b. November 6, 2013; and c. November 20, 2013. MINUTES OF MEETING – OCTOBER 26, 2013 CENTRAL HEALTH BOARD OF MANAGERS RETREAT

On Saturday, October 26, 2013, a meeting of the Central Health Board of Managers convened in open session at 10:13 a.m. in the Training Room of the Central Health Administrative Offices located at 1111 E. Cesar Chavez Street, Austin, Texas 78702. Clerk for the meeting was Ms. Rachael Cortez. ______

Board of Managers present: Chairperson Mendoza, Vice-Chairperson Coleman-Beattie, Manager Coopwood, Manager Heidrick, and Manager Kuykendall.

REGULAR AGENDA

1. Receive and discuss a briefing on Changing Healthcare Environment – Business Drivers for Strategic Alignment and business enterprise strategy development for Central Health and affiliated entities from COPE Health Solutions.1

Clerk’s Notes: Mr. Allen Miller, President and CEO of COPE Health Solutions, discussed changes in the current healthcare environment including general assumptions regarding financial and market pressure, safety-net patients, and investments through DSRIP projects.

Manager Hudson arrived at 10:14 a.m. Treasurer Daniel arrived at 10:44 a.m.

Mr. Miller discussed population heath and managed care. Mr. Miller further discussed elements of an integrated delivery system. Mr. Miller responded to questions from the Board.

No action was taken on item 1.

2. Receive and discuss a briefing on Central Health owned property, including University Medical Center at Brackenridge and adjacent properties.1

Clerk’s Notes: Mr. John Stephens, Project Manager, discussed the steps in the planning process for Central Health owned property, including University Medical Center at Brackenridge (UMCB) and adjacent properties. Mr. Stephens reviewed the existing UMCB site use and the current understanding of site factors. Mr. Stephens discussed UMCB statistics and reuse considerations. Mr. Stephens responded to questions from the Board.

Manager Zamora arrived at 11:48 a.m.

Chairperson Mendoza announced that item 2 would also be discussed in closed session with item 3.

No action was taken on item 2.

3. Receive and discuss an agreement among Travis County Healthcare District d/b/a Central Health, Seton Family of Hospitals, the Community Care Collaborative, and the University of Texas at Austin regarding the Dell Medical School.1

Clerk’s Notes: At 12:00 p.m. Chairperson Mendoza announced that the Board is convening in closed session to discuss agenda item 2 under Section 551.071 of the Texas Government Code, Consultation with Attorney and Section 551.072 of the Texas Government Code, Deliberation

October 26, 2013 – Board of Managers Retreat Minutes

Regarding Real Property. Chairperson Mendoza also announced that the Board is convening in closed session to discuss agenda item 3 under Section 551.071 of the Texas Government Code, Consultation with Attorney and Section 551.085 of the Texas Government Code, Deliberation of Governing Board of Certain Providers of Health Care Services.

At 2:12 p.m. the Board reconvened in open session.

No action was taken on item 3.

5. Discuss and take appropriate action on the 1115 Medicaid Waiver, Delivery System Reform Incentive Payment (DSRIP) projects, the Community Care Collaborative, including health care delivery arrangements, and other interrelated community partnerships.1

Clerk’s Notes: This item was taken out of sequence. Mr. Jeff Knodel, Chief Financial Officer, reviewed the Regional Health Partnership (“RHP”) 7 three-year DSRIP projects. Mr. Knodel discussed prioritization of the DSRIP projects and constraints for Central Health. Mr. Knodel discussed the impact on Intergovernmental Transfer capacity. Ms. Sarah Cook, Medicaid Waiver Director, reviewed project details for consideration. Ms. Cook and Mr. Knodel responded to questions from the Board.

Vice-Chairperson Coleman-Beattie moved that the Board approve staff the recommendation for the Central Health funded Intergovernmental Transfer (IGT) projects, Centering Pregnancy, Telepsychiatry, and Chronic Case Management. Manager Hudson seconded the motion.

Chairperson Rosie Mendoza For Vice-Chairperson Brenda Coleman-Beattie For Treasurer Katrina Daniel For Secretary Rebecca Lightsey Absent Manager Tom Coopwood Abstain Manager Clarke Heidrick For Manager Lynne Hudson For Manager Guadalupe Zamora For Manager Kirk Kuykendall For

Following the vote, the Board discussed whether to instruct staff on moving the order of these projects. The Board did not take action to rank the projects.

4. Discuss implementation of the Affordable Care Act and its impact on the population served by the Integrated Delivery System.1

Clerk’s Notes: This item was taken out of sequence. Ms. Christie Garbe, Vice President of Planning and Communications, gave a brief overview on this item to prepare the discussion for the next Board meeting. The overview included policy assumptions for Travis County residents under 200% of the Federal Poverty Level and participants in the Medical Access Program (MAP). Ms. Garbe reviewed the timeline for decisions. Ms. Garbe responded to questions from the Board.

6. Receive and discuss a report of the September 2013 financial statements for the Community Care Collaborative.

Clerk’s Notes: Item 6 was postponed.

October 26, 2013 – Board of Managers Retreat Minutes

7. Confirm the next regular Board meeting date, time, and location.

Clerk’s Notes: Chairperson Mendoza announced the next regularly scheduled meeting of the Central Health Board of Managers will be on Wednesday, November 6, 2013 at 5:30 p.m., Central Health Administrative Offices, 1111 E. Cesar Chavez St., Austin, Texas 78702.

Treasurer Daniel moved that the Board adjourn. Manager Zamora seconded the motion.

Chairperson Rosie Mendoza For Vice-Chairperson Brenda Coleman-Beattie For Treasurer Katrina Daniel For Secretary Rebecca Lightsey Absent Manager Tom Coopwood For Manager Clarke Heidrick For Manager Lynne Hudson For Manager Guadalupe Zamora For Manager Kirk Kuykendall For

The meeting was adjourned at 3:00 p.m.

Brenda Coleman-Beattie, Chairperson Central Health Board of Managers

ATTESTED TO BY:

Lynne Hudson, Secretary Central Health Board of Managers

October 26, 2013 – Board of Managers Retreat Minutes

MINUTES OF MEETING – NOVEMBER 6, 2013 CENTRAL HEALTH BOARD OF MANAGERS

On Wednesday, November 6, 2013, a meeting of the Central Health Board of Managers convened in open session at 5:37 p.m. in the Board Room of the Central Health Administrative Offices located at 1111 E. Cesar Chavez Street, Austin, Texas 78702. Clerk for the meeting was Ms. Rachael Cortez. ______

Board of Managers present: Chairperson Mendoza, Vice-Chairperson Coleman-Beattie, Treasurer Daniel, Manager Coopwood, Manager Hudson, Manager Kuykendall, and Manager Zamora.

CITIZENS’ COMMUNICATION

Clerk’s Notes: Mr. Mike McKinnon, Communications Coordinator, introduced the speakers for Citizens’ Communication.

Ms. Cynthia Tabasco, Eligibility Senior Lead, discussed recent flooding and the impact on Central Health staff.

Ms. Claudia Lindenberg, Eligibility Services Director, discussed recent flooding and the work of Central Health staff assisting the City of Austin.

Mr. Larry Wallace, Vice President of Service Delivery, discussed coordinated efforts with Latino HealthCare Forum regarding recent flooding.

Manager Heidrick arrived at 5:42 p.m.

Ms. Rosie Mendoza, speaking in her capacity as a Travis County resident, discussed recent flooding and assisting members of the Dove Springs Community through Fiesta de Independencia Foundation.

Ms. Christie Garbe, Vice President of Planning and Communications, discussed the first anniversary of the passage of Proposition 1 and reviewed accomplishments for transforming healthcare in Travis County.

CONSENT AGENDA

C1. Approve the nomination of Ann-Marie Price, Director of Government Affairs, as Compliance Officer.

Clerk’s Notes: Item C2 was pulled from the Consent Agenda and moved to the Regular Agenda. Vice-Chairperson Coleman-Beattie moved that the Board approve Consent Agenda item C1. Manager Zamora seconded the motion.

November 6, 2013 – Board of Managers Meeting Minutes

Manager Kirk Kuykendall For REGULAR AGENDA

C2. Approve the creation of an ad hoc Women’s Health Committee to address issues related to women’s health and appoint the following Managers to serve on the committee: a. Rebecca Lightsey (Chairperson); b. Lynne Hudson; and c. Clarke Heidrick.

Clerk’s Notes: Ms. Patricia Young Brown, President and CEO, discussed the creation of an ad hoc Women’s Health Committee. Ms. Young stated that the committee would address issues related to women’s health and noted the proposed Board members that would serve on the committee. Ms. Young responded to questions from the Board.

Vice-Chairperson Coleman-Beattie moved the Board approve the creation of an ad hoc Women’s Health Committee to address issues related to women’s health and appoint the following Managers to serve on the committee: a. Rebecca Lightsey (Chairperson); b. Lynne Hudson; and c. Clarke Heidrick. Manager Zamora seconded the motion.

1. Receive and discuss a presentation on the history of the Integrated Care Collaboration (“ICC”) and the development of the community Health Information Exchange.

Clerk’s Notes: Ms. Patricia Young Brown, President and CEO, Mr. Carl Angel, Executive Director of the ICC, and Dr. Mark Hernandez, Chief Medical Officer for the Community Care Collaborative (“CCC”), discussed the history of the ICC and the development of the community Health Information Exchange. Ms. Young reviewed the development of the Medicaider software, ICare 2.0, and other projects that assist safety-net providers. The presenters discussed the data sharing and the Health Information Exchange. The presenters responded to questions from the Board.

Ms. Young proposed a meeting to further discuss and review the development of Health Information Exchanges for the CCC.

No action was taken on item 1.

2. Receive and discuss a report of the September 2013 financial statements for the Community Care Collaborative.

Clerk’s Notes: Mr. Jeff Knodel, Chief Financial Officer, presented the September 2013 financial statements for the CCC. These statements represent June 1, 2013 to September 30, 2013, the first four months of CCC operations. Mr. Knodel stated that the CCC Board of

November 6, 2013 – Board of Managers Meeting Minutes

Directors received this presentation. Mr. Knodel reviewed the statement of revenues, expenses, and changes in net assets for the CCC.

Mr. Knodel responded to questions from the Board.

No action was taken on item 2.

3. Discuss and take appropriate action on the 1115 Medicaid Waiver, Delivery System Reform Incentive Payment (DSRIP) projects, the Community Care Collaborative, including health care delivery arrangements, and other interrelated community partnerships.1

Clerk’s Notes: Ms. Sarah Cook, Medicaid Waiver Director, discussed an update on the activities of Regional Health Partnership (“RHP”) 7; the CCC Demonstration Year 2 report; and the CCC project implementation. Ms. Cook responded to questions from the Board.

No action was taken on item 3.

4. Discuss implementation of the Affordable Care Act and its impact on the population served by the Integrated Delivery System.1

Clerk’s Notes: Ms. Christie Garbe, Vice President of Planning and Communications, reviewed implementation of the Affordable Care Act. Ms. Garbe discussed the Federal Insurance Marketplace and the opportunities through open enrollment. Ms. Garbe discussed the uninsured population in Travis County. Ms. Garbe reviewed data regarding MAP patients and policy implications through the Affordable Care Act. Ms. Garbe responded to questions from the Board.

No action was taken on item 4.

5. Receive and discuss a briefing on Changing Healthcare Environment – Business Drivers for Strategic Alignment and business enterprise strategy development for Central Health and affiliated entities from COPE Health Solutions, and take appropriate action on an agreement for business enterprise strategy development for Central Health and affiliated entities with COPE Health Solutions.1

Clerk’s Notes: At 7:59 p.m. Chairperson Mendoza announced that the Board is convening in closed session to discuss agenda item 5 under Section 551.071 of the Texas Government Code, Consultation with Attorney.

At 8:54 p.m. the Board reconvened in open session.

Mr. Larry Wallace, Vice President of Service Delivery, discuss a proposal regarding business enterprise strategy development for Central Health. Mr. Wallace discussed the objectives and expected outcomes from the work by COPE Health Solutions. Mr. Wallace and Mr. Jeff Knodel responded to questions from the Board.

Manager Coopwood moved that the Board approve an agreement for business enterprise strategy development for Central Health and affiliated entities with COPE Health Solutions in an amount not to exceed $944,330 as presented by staff and authorize Central Health’s President and CEO to negotiate and execute a final agreement on terms similar to those presented or on terms more favorable to Central Health. Manager Zamora seconded the motion.

November 6, 2013 – Board of Managers Meeting Minutes

6. Confirm the next regular Board meeting date, time, and location.

Clerk’s Notes: Manager Hudson moved that Central Health convene a Special Meeting on Tuesday, November 12, 2013 at 5:30 p.m. to discuss the development of the community Health Information Exchange at Central Health Administrative Offices, 1111 E. Cesar Chavez St., Austin, Texas 78702. Manager Coopwood seconded the motion.

Chairperson Mendoza announced that the next regularly scheduled meeting of the Central Health Board of Managers would be held on Wednesday, November 20, 2013 at 5:30 p.m., Central Health Administrative Offices, 1111 E. Cesar Chavez St., Austin, Texas 78702.

Manager Coopwood moved that the Board adjourn. Manager Hudson seconded the motion.

The meeting was adjourned at 9:18 p.m.

Brenda Coleman-Beattie, Chairperson Central Health Board of Managers

ATTESTED TO BY:

Lynne Hudson, Secretary Central Health Board of Managers

November 6, 2013 – Board of Managers Meeting Minutes

MINUTES OF MEETING – NOVEMBER 20, 2013 CENTRAL HEALTH BOARD OF MANAGERS

On Wednesday, November 20, 2013, a meeting of the Central Health Board of Managers convened in open session at 5:37 p.m. in the Board Room of the Central Health Administrative Offices located at 1111 E. Cesar Chavez Street, Austin, Texas 78702. Clerk for the meeting was Ms. Rachael Cortez. ______

Board of Managers present: Chairperson Mendoza, Vice-Chairperson Coleman-Beattie, Treasurer Daniel, Secretary Lightsey, Manager Heidrick, Manager Hudson, Manager Kuykendall, and Manager Zamora.

CITIZENS’ COMMUNICATION

Clerk’s Notes: Mr. Mike McKinnon, Communications Coordinator, introduced the speakers for Citizens’ Communication.

Mr. Jim Rodriguez, TexHealth Central Texas, discussed the mission of TexHealth based on grants received from the State of Texas for the next biennium. Mr. Rodriguez expressed gratitude for Central Health’s support of TexHealth.

Manager Coopwood arrived at 5:40 p.m.

Ms. Christie Garbe, Vice President of Planning and Communication, discussed an event for the community on November 21, 2013 regarding progress one year after the passage of Proposition 1.

Mr. Adam Slosberg, Beyond Today, announced achieving advanced peer support specialist designation and discussed work on the Affordable Care Act. Mr. Slosberg discussed concerns for a system of care for mental and behavioral health patients.

Dr. Mark Hernandez, Chief Medical Officer for the Community Care Collaborative, discussed the role of the Chief Medical Officer.

CONSENT AGENDA

C1. Approve minutes for the following meetings of the Central Health Board of Managers: a. August 29, 2013 Public Hearing; and b. November 12, 2013 Special Meeting.

C2. Receive the October 2013 Investment Report and ratify Central Health investments for October 2013.

C3. Approve the adoption of a resolution regarding fund selections for the Travis County Healthcare District Retirement Plan with recommendations from Southwest Retirement Consultants and Branch Banking and Trust Company (BB&T).

Clerk’s Notes: Treasurer Daniel moved that the Board approve Consent Agenda items C1, C2, and C3. Manager Hudson seconded the motion.

Chairperson Rosie Mendoza For Vice-Chairperson Brenda Coleman-Beattie For

November 20, 2013 – Board of Managers Meeting Minutes

Treasurer Katrina Daniel For Secretary Rebecca Lightsey For Manager Tom Coopwood For Manager Clarke Heidrick For Manager Lynne Hudson For Manager Guadalupe Zamora For Manager Kirk Kuykendall For

REGULAR AGENDA

1. Receive and discuss an update on Central Health efforts related to Dove Springs and surrounding communities impacted by recent floods.

Clerk’s Notes: Mr. Larry Wallace, Vice President of Service Delivery, and Ms. Michelle Tijerina, Navigation Manager, discussed Central Health’s efforts to respond to Dove Springs and surrounding communities impacted by recent floods. Ms. Tijerina listed activities conducted by Central Health Eligibility staff, CommUnityCare, and Sendero Health Plans. Ms. Tijerina further discussed outreach to members of the community through Latino HealthCare Forum.

Mr. Wallace and Ms. Tijerina responded to questions from the Board.

No action was taken on item 1.

2. Receive and discuss an update on CommUnityCare operations for Fiscal Year 2013.

Clerk’s Notes: Chairperson Mendoza announced that item 2 was postponed. Vice- Chairperson Coleman-Beattie noted that the Budget and Finance Committee received a presentation.

3. Receive and discuss an update on behavioral health and psychiatric services for Travis County residents.1

Clerk’s Notes: Ms. Ellen Richards, Director of Planning, and Ms. Dawn Hadley, Chief Program Operations Officer for Austin Travis County Integral Care, reviewed behavioral health and psychiatric services included in Senator Watson’s 10 in 10 goals. Ms. Richard’s discussed a framework for creating a system for providing the right level of care for the patient’s needs. Ms. Hadley discussed the plan to increase capacity through DSRIP projects.

Ms. Richards and Ms. Hadley responded to questions from the Board.

No action was taken on item 3.

4. Discuss and take appropriate action on an agreement with COPE Health Solutions for Delivery System Reform Incentive Payment (DSRIP) project consulting services for the Community Care Collaborative.

Clerk’s Notes: Mr. Jeff Knodel, Chief Financial Officer, and Dr. Mark Hernandez, Chief Medical Officer for the CCC, discussed a proposed agreement between COPE Health Solutions and the CCC. Mr. Knodel reviewed the approval process for this CCC agreement. Mr. Knodel also reviewed services provided through COPE Health Solutions (COPE) and provided background information on COPE’s experience with the 1115 Medicaid Waiver and DSRIP projects. Mr. Knodel discussed the scope of work for this agreement.

November 20, 2013 – Board of Managers Meeting Minutes

Mr. Knodel and Dr. Hernandez responded to questions from the Board. Treasurer Daniel moved that the Board approve an agreement with COPE Health Solutions for Delivery System Reform Incentive Payment (DSRIP) project consulting services in an amount not to exceed $4,575,078 for the Community Care Collaborative as presented by staff. Treasurer Daniel further moved that any expenditure of greater than $100,000 of contingency funds be approved by the CCC Board. Manager Heidrick seconded the motion.

Chairperson Rosie Mendoza For Vice-Chairperson Brenda Coleman-Beattie For Treasurer Katrina Daniel For Secretary Rebecca Lightsey For Manager Tom Coopwood Abstain Manager Clarke Heidrick For Manager Lynne Hudson For Manager Guadalupe Zamora For Manager Kirk Kuykendall For

5. Discuss and take appropriate action on an agreement with Bartlett Cocke General Contractors for Construction Manager at Risk (CMAR) services for the Southeast Health and Wellness Center.

Clerk’s Notes: Mr. Larry Wallace, Vice President of Service Delivery, Mr. Bob Kallstrom, Project Manager, and Ms. Tena Southwell, Purchasing Coordinator, discussed an agreement between Bartlett Cocke General Contractors and Central Health for CMAR services. These services are for the Southeast Health and Wellness Center. Mr. Wallace noted that Latino HealthCare Forum will continue with community outreach in conjunction with this project. Mr. Kallstrom reviewed the evaluation and selection process for these services. Mr. Kallstrom discussed the scope of work for this agreement. The presenters responded to questions from the Board.

Treasurer Daniel moved that the Board approve an agreement with Bartlett Cocke General Contractors for Construction Manager at Risk (CMAR) services for the Southeast Health and Wellness Center in an amount not to exceed $659,350 as presented by staff and authorize Central Health’s President and CEO to negotiate and execute a final agreement on terms similar to those presented or on terms more favorable to Central Health. This motion is a recommendation from Budget and Finance Committee and a second is not required.

Chairperson Rosie Mendoza For Vice-Chairperson Brenda Coleman-Beattie For Treasurer Katrina Daniel For Secretary Rebecca Lightsey For Manager Tom Coopwood For Manager Clarke Heidrick For Manager Lynne Hudson For Manager Guadalupe Zamora For Manager Kirk Kuykendall For

Ms. Southwell introduced employees from Bartlett Cocke.

At 7:49 p.m., Chairperson Mendoza announced that the Board will stand in recess. At 8:00 p.m., the Board reconvened in open session.

November 20, 2013 – Board of Managers Meeting Minutes

6. Discuss and take appropriate action for the purchase of computer hardware and related services for Central Health and affiliated entities to be funded by Fiscal Year 2014 Central Health Capital Funds.

Clerk’s Notes: Mr. Jeff Knodel, Chief Financial Officer, reviewed the computer hardware shared by Central Health, CommUnityCare, and Sendero Health Plans. Mr. Knodel discussed the hardware needs of these organizations. Mr. Knodel reviewed the timelines for replacement of this infrastructure.

Treasurer Daniel moved that the Board approve the purchase of computer hardware and related services for Central Health and affiliated entities to be funded by Fiscal Year 2014 Central Health Capital Funds in an amount not to exceed $280,000 as presented by staff and authorize Central Health’s President and CEO to negotiate and execute final agreements on terms similar to those presented or on terms more favorable to Central Health. This motion is a recommendation from Budget and Finance Committee and a second is not required.

7. Receive and discuss a report of the October 2013 financial statements for Central Health.

Clerk’s Notes: Mr. Jeff Knodel, Chief Financial Officer, and Ms. Rosie Vela, Comptroller, reviewed the October 2013 financial statements for Central Health. The October 2013 financial statements were presented to the Budget and Finance Committee. Mr. Knodel reviewed the statement of revenues, expenses, and changes in net assets.

Mr. Knodel and Ms. Vela responded to questions from the Board.

No action was taken on item 7.

8. Receive and discuss the CEO’s report on the following Central Health activities: (a) procurement activity; (b) current communications/outreach statistics; (c) Eligibility Services; and (d) the Community Care Collaborative, including Medical Access Program (MAP) enrollment and activities.

Clerk’s Notes: Mr. Larry Wallace, Vice President of Service Delivery, discussed and reviewed the procurement activity for the past month. Mr. Wallace reviewed the recent meeting of the CCC Board of Directors, including DSRIP projects. Mr. Wallace noted the MAP enrollment report for the Board to review.

Ms. Christie Garbe, Vice President of Planning and Communications, reviewed the communications report and noted the events attended by Central Health staff.

Ms. Garbe and Ms. Ellen Richards, Director of Planning, discussed the CCC strategic plan.

The presenters responded to questions from the Board.

November 20, 2013 – Board of Managers Meeting Minutes

Treasurer Daniel left the meeting at 8:15 p.m.

No action was taken on item 8.

9. Receive and discuss reports from the Board committees: Budget and Finance Committee; ad hoc Nominations Committee; and Performance Improvement Subcommittee.

Clerk’s Notes: Vice-Chairperson Coleman-Beattie, reported on the Budget and Finance Committee meeting and the ad hoc Nominations Committee. Manager Hudson reported on the Performance Improvement Subcommittee.

No action was taken on item 9.

10. Discuss and take appropriate action on Central Health owned property, including University Medical Center at Brackenridge and adjacent properties.1

Clerk’s Notes: Mr. John Stephens, Director of Financial Planning, discussed innovation clusters. Mr. Stephens reviewed an innovation cluster in Massachusetts. Mr. Stephens discussed how these clusters operate and the elements required for success. Mr. Stephens discussed that Central Health owned property may play a role if an innovation cluster would happen near the medical school and teaching hospital. Mr. Stephens responded to questions from the Board.

Mr. Stephens noted that an appraisal is underway of Central Health owned property, including University Medical Center at Brackenridge and adjacent properties.

No action was taken on item 10.

11. Discuss and take appropriate action on the 1115 Medicaid Waiver, Delivery System Reform Incentive Payment (DSRIP) projects, the Community Care Collaborative, including health care delivery arrangements, and other interrelated community partnerships.1

Clerk’s Notes: Ms. Sarah Cook, Medicaid Waiver Director, discussed the Request for Application (RFA) process for the DSRIP projects. Ms. Cook discussed the contract template for these projects and the meetings providers attended to learn about the application process. Ms. Cook responded to questions from the Board.

Secretary Lightsey and Manager Hudson were not present for the vote on this item.

Vice-Chairperson Coleman-Beattie moved that the Board approve the Demonstration Year 3 Community Care Collaborative Delivery System Reform Incentive Payment (DSRIP) project implementation contract template as presented by staff. Manager Kuykendall seconded the motion.

Chairperson Rosie Mendoza For Vice-Chairperson Brenda Coleman-Beattie For Treasurer Katrina Daniel Absent Secretary Rebecca Lightsey Absent Manager Tom Coopwood Abstain Manager Clarke Heidrick For Manager Lynne Hudson Absent

November 20, 2013 – Board of Managers Meeting Minutes

Manager Guadalupe Zamora For Manager Kirk Kuykendall For

At 9:17 p.m. Chairperson Mendoza announced that the Board is convening in closed session to discuss agenda item 11 under Section 551.071 of the Texas Government Code, Consultation with Attorney and Section 551.085 of the Texas Government Code, Deliberation of Governing Board of Certain Providers of Health Care Services.

At 9:37 p.m. the Board reconvened in open session.

No action was taken on item 11.

12. Confirm the next regular Board meeting date, time, and location.

Clerk’s Notes: Chairperson Mendoza announced that the next regularly scheduled meeting of the Central Health Board of Managers would be held on Wednesday, December 11, 2013 at 11:00 a.m., Central Health Administrative Offices, 1111 E. Cesar Chavez St., Austin, Texas 78702.

Secretary Lightsey moved that Central Health convene a Special Meeting on December 18, 2013 at 5:30 p.m. to discuss waiver related matters. Manager Zamora seconded the motion.

Chairperson Rosie Mendoza For Vice-Chairperson Brenda Coleman-Beattie For Treasurer Katrina Daniel Absent Secretary Rebecca Lightsey For Manager Tom Coopwood For Manager Clarke Heidrick For Manager Lynne Hudson For Manager Guadalupe Zamora For Manager Kirk Kuykendall For

Secretary Lightsey moved that the Board adjourn. Manager Zamora seconded the motion.

The meeting was adjourned at 9:40 p.m.

Brenda Coleman-Beattie, Chairperson Central Health Board of Managers

ATTESTED TO BY:

Lynne Hudson, Secretary Central Health Board of Managers

November 20, 2013 – Board of Managers Meeting Minutes

Board Meeting January 22, 2014

Agenda Item C2

Receive the December 2013 Investment Report and ratify Central Health investments for December 2013.

Board Meeting January 22, 2014

Agenda Item C3

Approve a resolution authorizing the Travis Central Appraisal District to reappraise property with flood damage located in areas declared to be a disaster area in an Emergency Disaster Proclamation issued by the Governor of the State of Texas on December 13, 2013.

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8174 Fax: 512 978-8156 www.centralheath.net

M E M O R A N D U M

TO: Board of Managers

FROM: John Stephens, Director of Financial Planning and Management

DATE: January 15, 2014

RE: January 22, 2014 Agenda Item C3 - Reappraisal of Property Damaged by the October 31 2013 Flood

The Travis Central Appraisal District (TCAD) normally appraises property as of January 1 each year. For example, Central Health’s fiscal year 2014 tax levy is based on appraised value as of January 1, 2013. However, the Texas Property Tax Code allows local governments to authorize appraisal offices to reappraise property in areas declared by the governor as disaster areas.

There were five areas in Travis County that the governor declared as disaster areas due to the October 31, 2013 flood: Onion Creek South, Onion Creek North, Northeast Travis County, Timber Creek, and Maha Creek. The total number of parcels that TCAD estimates will be reappraised is about 700.

Travis County, the City of Austin, and Austin ISD are all considering the option to authorize property tax relief for properties in these areas damaged by the flood. However, each taxing unit must pass a resolution requesting a reappraisal to be able to provide this relief.

The reappraisal would mean that a property damaged in the flood would have a reappraisal done as of November 1, and the property owner would then pay tax on a pro-rata basis of the appraised value. The property would be taxed for January through October of 2013 based on the January 1, 2013 appraised value but would be taxed for November and December of 2013 based on the value establish by the November 1 reappraisal.

TCAD estimates that the reappraisals of the 700 parcels affected by the flood would mean a tax revenue loss of only about $21.43 per parcel, or a total loss of about $15,000.

Page 1 of 1 RESOLUTION of the CENTRAL HEALTH BOARD OF MANAGERS regarding THE REAPPRAISAL OF PROPERTIES DAMAGED BY FLOOD

WHEREAS, on December 13, 2013, Rick Perry, Governor of the State of Texas issued an Emergency Disaster Proclamation for Bell, Caldwell, Freestone, Guadalupe, Hays, Travis and Williamson counties due to severe flooding which occurred October 30,2013 and continued through November 16, 2013; and

WHEREAS, property in Travis County was damaged by floods that occurred in October 30, 2013 through November 16, 2013; and

WHEREAS, the property tax code envisions an alternate valuation scenario in Section 23.02, which states, in part: “(a) The governing body of a taxing unit that is located partly or entirely inside an area declared to be a disaster by the governor may authorize reappraisal of all property damaged in the disaster at its market value immediately after the disaster.” The code also discusses the fact that the property value would be prorated from the date of the disaster; and

WHEREAS, on December 30, 2013 the Travis County Commissioners Court authorized the Travis Central Appraisal District to reappraise property with flood damage located in areas declared to be a disaster area by the Governor,

NOW, THEREFORE BE IT RESOLVED BY THE CENTRAL HEALTH BOARD OF MANAGERS that the Travis Central Appraisal District is authorized to reappraise property with flood damage in areas declared to be a disaster area by the Governor.

ADOPTED: , 2014

______Brenda Coleman-Beattie, Chairperson

Board Meeting January 22, 2014

Agenda Item 1 (NO BACKUP)

Receive and discuss a presentation from Dr. Phil Huang, Medical Director and Health Authority for the Austin/Travis County Health and Human Services Department, regarding the state of population health in Travis County.

Board Meeting January 22, 2014

Agenda Item 2

Discuss and take appropriate action on an agreement with Wakely Consulting Group for actuarial consulting services for the Community Care Collaborative.

Central Health Budget/Finance Committee

CCC 3-Year Payment Projection

Consultant Recommendation

January 22, 2014 CCC Three-Year Payment Projection

• Required by section 4.3.2 of the Master Agreement • Actuarial consultant will project cost for the Covered Population (MAP and Charity Care) for three years • Projections will serve as starting point for discussion of next year’s budget, including any proposed changes to benefit plans or size/composition of Covered Population

www.CentralHealth.net 2

Preparation for Three-Year Study

• Central Health/Seton staff (CCC Finance Committee) began work in October • Issues addressed were: • Better defining the Covered Population • What kind of data we needed to provide consultant for the study – and how we would develop it • How we can use the study to manage the cost and quality of services we deliver

www.CentralHealth.net 3

Preparation for Three-Year Study (cont.)

• CCC Finance Committee worked with a number of people to prepare the Request for Proposals and work through study issues • CCC CMO, Dr. Mark Hernandez • Seton VP of Analytics and Health Economics, Dr. Ryan Leslie • KC Cerny, long-time consultant to both Central Health and Seton on healthcare data analytics • CCC Advisory Board – briefed on Oct. 22

www.CentralHealth.net 4

RFP Process

• RFP went out on October 25 • Preproposal conference on November 20 to address questions from potential proposers • Received four proposals on Dec. 17 • Evaluated by five-member team • Interviewed two finalists • Consensus recommendation is Wakely Consulting Group

www.CentralHealth.net 5

Wakely Consulting Group

• Leading actuarial consulting firm with offices in several U.S. cities • Leader in actuarial risk adjustment • Have done risk adjustment plans and analyses for 33 states and other entities related to the ACA, including: • State of New York • State of Illinois • Massachusetts Association of Health Plans • Robert Wood Johnson Foundation

Wakely Consulting Group, cont.

• Wakely has also recently completed a study for the St. Louis Regional Health Commission to project indigent care costs for a network of safety net providers, including Federally Qualified Health Centers • Wakely’s experience, qualifications, and work plan were the best of all proposers

Recommendation • Authorize negotiation and execution of a CCC contract with Wakely Consulting Group for an annual NTE amount of $143,000 • Base contract of $118,000 • Contingency of $25,000

• Three-year contract with two extensions

www.CentralHealth.net 8

Board Meeting January 22, 2014

Agenda Item 3 Discuss and take appropriate action on the following agreements to perform Community Care Collaborative Delivery System Reform Incentive Payment (DSRIP) projects: a. Dental services from CommUnityCare; b. Community Based Pulmonology services from CommUnityCare; c. Pregnancy Planning services from Planned Parenthood of Greater Texas; and d. Sexually Transmitted Infection Testing and Treatment services from Planned Parenthood of Greater Texas.

Request for Contract Request for Contract Negotiation Authorization Negotiation Authorization

DSRIP Project: Expanded Dental Services Provider Partner: CommUnityCare Provider Partner Site: North Central Contract Period: DY3 (through September 30th, 2014) Not To Exceed (NTE) Amount: $410,000 Deliverables: • 3500 additional dental encounters over baseline reported in DY2 • 100 additional pregnant women over baseline reported in DY2 • 750 additional chronic disease patients over baseline reported in DY2 • Participation in establishing the DY3 Category 3 baseline • Participation in required meetings • Monthly reporting

January 9, 2014

Request for Contract Request for Contract Negotiation Authorization Negotiation Authorization

DSRIP Project: Community Based Pulmonology Services Provider Partner: CommUnityCare Provider Partner Site: North Central Contract Period: DY3 (through September 30th, 2014) Not To Exceed (NTE) Amount: $518,000 Deliverables: • 1982 additional pulmonology encounters over baseline reported in DY2 • Addition of 1 FTE pulmonologist(s) • Participation in establishing the DY3 Category 3 baseline • Participation in required meetings • Monthly reporting

January 13, 2014

Board Meeting January 22, 2014

Agenda Item 4

Receive and discuss a report of the December 2013 financial statements for Central Health.

December 2013 Preliminary Monthly Financial Statements (unaudited) Page 1 of 6

Preliminary Statement of Revenues, Expenses and Changes in Net Assets December financials  3 months, 25% of the fiscal year.

Operating Revenues Lease revenue For the month of December 2013 we received $2.7 million in lease payments from Seton in accordance with the master lease agreement. Year-to-date, lease revenue received totals $8 million, or 25% of the annual budget.

Operating Expenses Healthcare delivery – For the month of December, healthcare delivery expenses totaled $6.5 million, with a year-to-date total of $27.1 million, or 17% of the $155.9 million annual budget. There were no IGTs in December, and Budgeted and Actual IGT’s for FY14 are as follows:

Type Budget (in millions) Actual (in millions) Private UC $ 27.9 0 UMCB UC $ 30.0 0 DSH $ 20.0 $16.2 CCC DSRIP $ 24.2 0 UMCB/Dell $ 20.2 $ 1.7 DSRIP Totals $122.3 $17.9

Salaries & Benefits – $450k for December, and $1.2 million year-to-date, or 23% of the $6 million annual budget.

Other Purchased Goods & Services - $467k for December and $1.2 million year-to- date, or 23% of the $5 million annual budget.

Depreciation expense - $289k for December; $866k year-to-date, or 25% of the $3.5 million annual budget. Depreciation is budgeted as a non-cash item and netted to zero in the budget presentation.

Non Operating Revenues (Expenses) Net Property Tax Revenue – Collections for December were $52.8 million, with $61 million collected year-to-date, or 44% of the $139 million budget. Typically, December and January are the highest months of property tax collections. Property taxes are now reflected at the FY2014 adopted rate of 12.9 cents per $100 valuation as

December 2013 Preliminary Monthly Financial Statements (unaudited) Page 2 of 6 approved in Proposition 1 by voters last year. At December 31, 2013, 44% of the current adjusted levy has been collected, and at December 31, 2012, 44% of the levy for that year was collected.

Tobacco Settlement – The annual tobacco settlement has not been filed and is due at the end of March 2014.

Investment Income – For the month of December, interest earnings amounted to $22k, with year-to-date interest earnings of $73k, or 18% of the $400k annual budget.

Interest expense for the $16 million Series 2011 Certificates of Obligation – $38k has been accrued for December in accordance with the debt agreements, and $114k year- to-date, or 25% of the $450k annual budget.

Change in net assets For December, the increase in net assets was $48 million, with an increase of $38 million year-to-date.

December 2013 Preliminary Monthly Financial Statements (unaudited) Page 3 of 6

Statement of Net Assets (Balance Sheet)

Current Assets Cash balance is $101k. (Operating Account)

Short-term investments – the District had $136.3 million in total short-term investments at December 31. The amount restricted for future Sendero paid-in capital is $12.9 million and the amount for capital acquisition is $10.7 million. The restriction for future Sendero paid-in capital was decreased by $2.2 million in December to reflect the cash transfer to Sendero from Risk-based Capital in accordance with the Fiscal Year 2014 adopted budget.

Ad valorem taxes receivable – $92 million balance is comprised of property taxes receivable of $77.7 million, offset by estimates of doubtful collections and adjustments of $1.3 million. In addition, $13.9 million was collected by Travis County Tax Office in the last two days of December 2013 but not received by Central Health until January 2014.

Other Receivables –Other receivables total $757k and consist of: (a) $86k – CommUnityCare intercompany receivable; (b) $275k – Sendero intercompany receivable; (c) $336k – CCC intercompany receivable for MAP claims; (d) $58k – Interest receivable; and (e) $2k - Miscellaneous accounts receivable

Prepaid expenses – major components of this $620k balance include:  $63k Seton mobile mammography van;  $16k prepaid insurance;  $178k prepaid tax appraisal fees;  $351k in prepaid tax collection fees; and  $12k in deposits.

Noncurrent assets Cash and investments restricted for capital acquisition – $10.7 million balance consists of $7.9 million in short-term securities restricted for capital acquisition and $2.8 million invested from the Series 2011 certificates of obligation construction account.

December 2013 Preliminary Monthly Financial Statements (unaudited) Page 4 of 6

Investments restricted for future Sendero paid-in capital – $12.9 million balance. The transfer of $2.2 million to Sendero Paid-in Capital was made during December 2013, as budgeted for Fiscal Year 2014, thus decreasing the Restriction by $2.2 million.

Sendero paid-in capital – $16.2 million. The transfer from Risk Based Capital for Sendero was made in December 2013, thus increasing the former $14 million balance by $2.2 million.

Working capital advance to CommUnityCare – (unchanged) – $4 million

Capital assets, net of accumulated depreciation – $115 million

Total assets - $364.9 million

December 2013 Preliminary Monthly Financial Statements (unaudited) Page 5 of 6

Liabilities Accounts payable – Major components of the $5.2 million balance are:  $2.9 million due in vendor invoices at month end;  $295k in invoices accrued at month-end;  $1.9 million in estimated costs incurred but not yet reported by healthcare providers;  $71k in outstanding checks; and  $21k for miscellaneous items

Salaries and benefits payable – $688k estimated liability for salary costs not yet paid at month end, the estimated value of accrued leave balances and various fringe benefit amounts withheld and not yet disbursed.

Other payables:  $1 million due to Seton for Fiscal Year 2013 Tobacco Settlement;  $709k due for Charity Care

Debt service payable, short term – $1.1 million balance is principal of $920k due March 2014 and interest accrued to December 2013.

Deferred Tax Revenue – $77.7 million reflects this year’s original tax levy of $139 million reduced by $136k in TCAD levy reductions and $61 million in taxes collected against this levy.

Other Deferred Revenue - $2.7 million reflects lease revenue received before December 31 which will be earned in January 2014.

Total Current Liabilities - $89.1 million

Debt service payable, long term – $13.2 million balance is $16 million in Series 2011 certificates of obligation less payments made in 2012 and 2013, and current portion due in March 2014.

Total Liabilities - $102.4 million

December 2013 Preliminary Monthly Financial Statements (unaudited) Page 6 of 6

Net assets Unrestricted net assets – $144.9 million

Series 2011 certificates of obligation construction account – $2.8 million

Investment in capital assets – $115 million

Total net assets – $262.6 million

Total liabilities and net assets - $364.9 million

Travis County Healthcare District Statement of Revenues and Expenditures From 12/1/2013 Through 12/31/2013 (In Whole Numbers)

Percent of Actual - This Actual - Fiscal Budget - Fiscal Annual Actual - Prior Month Year to Date Year Total Budget Year to Date

Operating revenues: Lease revenue 2,693,456 8,080,368 32,321,472 25.00% 1,863,317 Total Operating revenues: 2,693,456 8,080,368 32,321,472 25.00% 1,863,317

Operating expenses: Health care delivery 6,474,984 27,126,520 155,883,087 17.40% 17,007,100 Salaries and benefits 457,463 1,375,243 5,995,980 22.93% 1,350,089 Other purchased goods and services 450,133 1,178,297 5,056,768 23.30% 672,183 Depreciation 288,854 866,051 3,500,000 24.74% 668,395 Total Operating expenses: 7,671,434 30,546,112 170,435,835 17.92% 19,697,767

Operating income (loss) (4,977,978) (22,465,744) (138,114,363) 16.26% (17,834,450)

Nonoperating revenues (expenses): Ad valorem tax revenue 52,788,155 60,984,729 139,000,000 43.87% 34,926,226 Tax assessment and collection expense (73,647) (220,941) (921,723) 23.97% (201,789) Tobacco settlement revenue, net 0 0 1,200,000 0.00% 0 Investment income 21,530 72,734 400,000 18.18% 93,487 Interest expense, certificates of obligation (37,990) (113,971) (449,949) 25.32% (116,018) Intergovernmental and other revenue 0 16 0 0.00% 8,962 Total Nonoperating revenues (expenses): 52,698,048 60,722,567 139,228,328 43.61% 34,710,867

Changes in net assets 47,720,070 38,256,823 1,113,965 3,434.29% 16,876,418 Travis County Healthcare District Balance Sheet As of 12/31/2013 (In Whole Numbers)

FY 2014 FY 2013

Assets Current Assets Cash and cash equivalents 100,950 112,462 Short-term investments 112,796,099 92,035,971 Ad valorem taxes receivable 92,020,633 49,525,055 Other receivables 756,844 14,117,453 Prepaid expenses 620,465 839,542 Total Current Assets 206,294,992 156,630,482 Noncurrent or restricted cash and investments Restricted for capital acquisition 10,655,382 7,016,012 Restricted for future Sendero paid in capital 12,883,000 15,083,000 Sendero paid in capital 16,200,000 14,000,000 Working capital advance to CommUnityCare 4,000,000 4,000,000 Total Noncurrent or restricted cash and investments 43,738,382 40,099,012 Capital Assets Land 10,464,414 10,345,124 Buildings and improvements 110,938,705 95,045,672 Equipment and furniture 6,329,276 3,814,973 Construction in progress 8,613,626 26,137,542 Less accumulated depreciation (21,443,341) (17,785,779) Total Capital Assets 114,902,680 117,557,532 Total Assets 364,936,054 314,287,026

Liabilities Current Liabilities Accounts payable 5,219,512 4,098,963 Salaries and benefits payable 687,819 633,434 Other Payables 1,718,069 0 Debt service payable, short-term 1,071,961 1,064,691 Deferred tax revenue 77,744,913 44,868,399 Other deferred revenue 2,693,456 4,807,303 Total Current Liabilities 89,135,730 55,472,791 Noncurrent Liabilities Debt service payable, long-term 13,240,000 14,160,000 Total Liabilities 102,375,730 69,632,791

Net Assets Unrestricted 144,868,761 123,956,091 Series 2011 CO Construction Account 2,788,883 3,140,612 Investment in Capital Assets 114,902,680 117,557,532 Total Net Assets 262,560,324 244,654,236

Liabilities and Net Assets 364,936,054 314,287,026

Date: 1/17/14 02:17:33 PM 2014 Statement of Net Assets Page: 1 Travis County Healthcare District Comparative Budget Report - Operating Expenses From 12/1/2013 Through 12/31/2013 (In Whole Numbers)

Actual - Fiscal Budget - Fiscal Percent of Budget - Year to Date Year Total Annual Budget Remainder

Healthcare delivery Healthcare delivery (excluding service expansion) FFS-Primary Care 1,127,330 4,651,733 24.23% 3,524,403 FFS-Mental Health 1,972,300 7,925,319 24.88% 5,953,019 IGT Private Regional UC 0 27,900,000 0.00% 27,900,000 IGT UMCB UC 0 30,000,000 0.00% 30,000,000 IGT UMCB DSH 16,231,116 20,000,000 81.15% 3,768,884 IGT - CCC DSRIP 0 24,200,000 0.00% 24,200,000 IGT - Seton DSRIP 1,718,017 20,200,000 8.50% 18,481,983 Medical Administration 1,077,758 1,578,035 68.29% 500,277 Indigent Care Payment to CCC 5,000,000 15,200,000 32.89% 10,200,000 Total Healthcare delivery (excluding service expansion) 27,126,520 151,655,087 17.89% 124,528,567 Service expansion 0 4,228,000 0.00% 4,228,000 Total Healthcare delivery 27,126,520 155,883,087 17.40% 128,756,567

Salaries and benefits 1,375,243 5,995,980 22.93% 4,620,737 Total Salaries and benefits 1,375,243 5,995,980 22.94% 4,620,737 Other purchased goods and services 1,178,297 5,056,768 23.30% 3,878,471 Total Other purchased goods and services 1,178,297 5,056,768 23.30% 3,878,471 Depreciation 866,051 3,500,000 24.74% 2,633,949 Total Depreciation 866,051 3,500,000 24.74% 2,633,949

Total operating expenses 30,546,112 170,435,835 17.92% 139,889,723

Board Meeting January 22, 2014

Agenda Item 5

Receive and discuss reports on the following Central Health activities: (a) planning and communications reports and updates; (b) the Psychiatric Stakeholders’ Meeting; (c) procurement activity; (d) Eligibility Services; (e) quarterly service update; and (f) the Community Care Collaborative, including the Medical Access Program (MAP) enrollment and activities.

Communications/Outreach Report December 2013 – January 2014 Presentations ~# in Date Topic/Audience Presenter(s) Attendance (Central Health 1/14/2013 ACA & Hispanic Marketplace/Univision Presentation 75 Sponsored) 1/13/2013 ACA/Women Vote Program Christie Garbe 125 Healthcare Impact of New Medical School/UT Sage 1/13/2013 Trish Young Brown 600 Enrichment Lecture Behavioral Health Service Expansion/St. David’s Foundation 1/13/2013 Ellen Richards 20 Community Health Access Committee Southeast Health & Wellness Center Schematic Design/Dove Larry Wallace, 1/11/2013 50 Springs, Montopolis, LHCF Mark Hernandez Healthy Living for Leaders & CH Mission/Leadership Austin 12/18/2013 Christie Garbe 70 Essential Class Community Needs Press Conference/The Dove Springs Rosie Mendoza, 12/17/2013 25 Neighborhood Association & Latino HealthCare Forum Larry Wallace Prop. 1 Progress Report/The Austin Young Chamber of 12/16/2013 Trish Young Brown 50 Commerce: Speaker Series Healthcare Transformation/11th Annual Hush Blackwell Health 12/12/2013 Trish Young Brown 150 Law Conference TOTAL: 1,165 Earned Media Austin American 1/15/2014 UT medical school curriculum to emphasize discussion, research over lectures Statesman Austin American George Miller captains community health system: 1/15/2014 Statesman CEO of CommUnity Care is known as a collaborative leader Austin American 1/15/2014 Here’s how new funding will expand health programs in Travis County Statesman Austin American 1/3/2014 Austin-area health officials hope to avoid ER strain Statesman Austin American 12/21/2013 Deal with St. David’s helped Central Health quell dissent over Prop. 1 Statesman Austin Business 12/12/2013 Obamacare shift will save Travis County hundreds of thousands Journal Austin American 12/11/2013 Central Health to move 1,000 clients to ‘Obamacare’ to save money Statesman Austin American 12/8/2013 Plugging the Mental Health Care Gap in Austin Statesman Austin American 12/8/2013 Group not planning lawsuit over church-state issues with Austin medical care Statesman Community 12/5/2013 First Central Texas psychiatric ER to open at Brackenridge Impact Ongoing Projects & Events Medical School Communications Workgroup, Women’s Engagement Workgroup, CCC Communications and Strategic Plan Development, Southeast Health and Wellness Community Outreach, Strategic Plan Distribution, ACA Outreach and Education, ED Utilization Study, and Austin Area Marketplace Partnership Page 1 of 4 Eligibility Services Events & Presentations Date Event Purpose Audience Presenter 12/12/2013 Child Inc. Health To Promote Awareness of MAP, General Public Eligibility & Resource Fair Medicaid, CHIP & Health Insurance Services Staff Marketplace 12/12/2013 Child Inc. Parent To Provide Marketplace 101 Child Inc. Parents Eligibility Meeting Presentation. Services Staff

12/12/2013 Virtual Partner To Train all Virtual Application Partners Virtual Application Eligibility Meeting Partners Services Staff

Page 2 of 4 Central Health Web Site Statistics www.centralhealth.net Unique Total Mobile Page Time on Month Bounce Rate Top 3 Pages Visitors Visits Visits Views Site December 2,973 4,120 466 14,935 23% 2:09 1)centralhealth.net – 37% 2)employment – 14% 3)healthcare_services – 8% November 3,148 4,221 439 14,981 23% 1:56 1)centralhealth.net – 40% 2)employment – 12% 3)healthcare_services – 8% Change -5.56% -2.39% 6.15% -0.31% 0.00% 11.21% Eligibility Services Web Site Statistics www.cheligibility.net Unique Total Mobile Page Time on Month Bounce Rate Top 3 Pages Visitors Visits Visits Views Site December 1,527 1,948 645 6,942 26% 3:07 1)CHeligibility.net – 31% 2)am_i_eligible – 16% 3)success – 14% November 1,457 1,960 665 6,653 28% 2:56 1)CHeligibility.net – 30% 2)am_i_eligible – 16% 3)success – 16% Change 4.80% -0.61% -3.01% 4.34% -7.14% 6.25% Medical Access Program Web Site Statistics www.medicalaccessprogram.net Unique Total Mobile Page Time on Month Bounce Rate Top 3 Pages Visitors Visits Visits Views Site December 3,163 4,076 1,557 12,303 34% 2:22 1)medicalaccessprogram.net – 39% 2)do-i-quality – 21% 3)benefits – 14% November 2,871 3,733 1,322 11,666 34% 2:18 1)medicalaccessprogram.net – 39% 2)do-i-quality – 20% 3)benefits – 15%

Change 10.17% 9.19% 17.78% 5.46% 0.00% 2.90%

Page 3 of 4 Community Care Collaborative Web Site Statistics www.communitycarecollaborative.net Unique Total Mobile Page Time on Month Bounce Rate Top 3 Pages Visitors Visits Visits Views Site 1)communitycarecollaborative.net – December 206 303 15 795 39% 2:04 49% 2) dsripprojectssolicitation – 32% 3)meetings – 12% 1)communitycarecollaborative.net – November 139 188 9 512 30% 1:59 63% 2)meetings – 31%

3)dsripprojectssolicitation – 4% Change 48.20% 61.17% 66.67% 55.27% 30.00% 4.20% RHP7 Web Site Statistics www.texasregion7rhp.net Unique Total Mobile Page Time on Month Bounce Rate Top 3 Pages Visitors Visits Visits Views Site December 206 381 15 1,490 28% 4:09 1)texasregion7rhp.net – 38% 2)rhp-plan – 26% 3)dsrip-projects-proposed-for-central-

health-funding – 14% November 162 255 10 926 24% 3:14 1)texasregion7rhp.net – 52% 2)whatsnew – 19% 3)rhp-plan – 19% Change 27.16% 49.41% 50.00% 60.91% 16.67% 28.35%

1 A negative value in the Change in Bounce Rate is a positive trend. 2 Analytics for CCC and RHP7 were not collected prior to June.

Page 4 of 4

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 www.centralheath.net

M E M O R A N D U M

TO: Central Health Board of Managers

FROM: Sarah Malm, Director of Communications

DATE: January 17, 2014

RE: January Report on Public Information Awareness Campaign for the Federal Insurance Marketplace

The following memo provides the January update on the Public Information Awareness “PIA” Campaign approved by the Board of Managers on October 16, 2013. The campaign supports and expands education and outreach activities about the Federal Insurance Marketplace to uninsured, underinsured and low‐income residents in Travis County. The Campaign also complements and amplifies ongoing efforts to build awareness and encourage residents to seek more information about coverage options and eligibility.

At the next Board of Managers meeting on February 5, 2013, Central Health staff plans to present an update with a specific focus on the digital portion of the campaign.

There are two attachments to this report:

Attachment 1: “Best Practices” memo on the PIA Campaign developed by request from Marge Petty, Regional Director, Region 6, Department of Health and Humans Services Commission Attachment 2: Spanish Language Media Plan January Update

January Update

On December 23rd, Central Health staff met with Marge Petty, Regional Director, Region 6, Department of Health and Humans Services Commission to provide an update on our efforts to support the federal marketplace. At Ms. Petty’s request, we prepared a document for her to share with colleagues as an example of “Best Practices” in education and outreach with a specific emphasis on Spanish language outreach.

In the month of December 2013, Central Health ran over 800 radio spots reaching over 600,000 individual listeners. The radio schedule included spots on six local stations designed to reach the following demographic: 1

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 www.centralheath.net  Household income < $50K (= 200% of FPL for family of four)  Women 25‐54  Spanish‐speakers  Musicians and Food Workers  Uninsured and underinsured  Reach: +/‐ 400K English; +/‐ 218K Spanish

The preliminary results of this flight of radio placements are very encouraging, correlating with an approximately 400% increase in the ACA‐related call volume to 2‐1‐1. As more data comes in, Central Health and United Way are assembling a scorecard of relevant metrics for evaluating campaign performance.

We are currently rolling out the branded campaign called 211 Health Connect. The 211 Health Connect brand identity is airing on radio stations and is the focus of our digital campaign.

In January, we are increasing radio spots and broadening schedules on 11 stations including four Spanish language stations. Central Health is running over 2000 spots to reach over 1 million individual listeners each month through the end of March. These radio schedules include 30‐ second PSA‐style spots with both male and female voice talent produced in‐house by the 2‐1‐1 Health Connect team (Central Health), 60‐second produced spots and endorsements by station personalities, and vignettes featuring conversations between station talent and (actual) 2‐1‐1 referral specialists.

Digital Campaign Update

The first mock‐up of the splash pages will be completed this week, and will be live by the week of January 27th. We are working on the draft of copy for the pay‐per‐click campaign for internal approval as well advertisements that will run on for Google and Facebook immediately after the splash pages launch. In addition, we are drafting messages tailored to social media that media partners, community groups and individual influencers can publish on their digital outlets.

Outreach to Musicians

Musicians and food workers are a target audience for this campaign. We met with Don Pitts, Music Program Manager for the City of Austin, and his team is very eager to spread the word to the music and entertainment community. In addition to the digital campaign, they have requested collateral materials (posters and flyers) to distribute musicians and entertainment related workers, including food workers. We have offered to post on their social media outlets, post a promotional message on their website, and email influentials directly to share our campaign materials and messaging. They are standing by for these materials and approval from the City. We do not expect any delays in the approval process.

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 Attachment 1: PIA Campaign Update www.centralheath.net

Central Health: Public Information Awareness Campaign to Support the Federal Insurance Marketplace January 9, 2014

Central Health Central Health is the Healthcare District for Travis County, Texas. Travis County voters created Central Health in 2004 to provide eligible residents living at or below 200% of FPL access to health care services, develop innovative ways to cover the uninsured, integrate the health care delivery system and establish a long-term vision for a healthy community. Central Health is funded primarily through local taxes to ensure provision of health care services and leverages federal match opportunities, such as the 1115 Waiver, to bring additional funds for health services to Travis County.

Public Information Awareness Campaign to Support the Federal Marketplace

Overview Texas has the highest rate of uninsured in the nation. In Travis County, there are approximately 200,000 uninsured residents, many of whom are eligible to obtain coverage through the federal marketplace created by the Affordable Care Act. Despite this opportunity, many Travis County residents lacked culturally appropriate and effective information about their options under the marketplace and the local resources available to assist with enrollment.

On October 16, 2013, the Central Health Board of Managers approved $350,000 in funding for a Public Information Awareness (PIA) Campaign to promote the opportunity provided by the federal marketplace during open enrollment. The PIA Campaign targets uninsured, underinsured and low-income residents living between 100-200% FPL and promotes local resources to assist with questions and enrollment assistance. The PIA Campaign incorporates broadcast, print and digital media messages along with support for in-person education and outreach to build awareness about local resources. The PIA Campaign promotes the United Way 2-1-1 Call Center as the local resource to connect audiences with the assistance they need to enroll in the marketplace. The campaign launched on December 9th 2013 is currently underway and will run through March 31, 2014.

Campaign Objectives • Build awareness of the health insurance opportunities available in Travis County through the Affordable Care Act • Promote enrollment in the federal health marketplace exchange, using 2-1-1 as an initial point of contact

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 www.centralheath.net

Target Audience The PIA Campaign, to be branded as 2-1-1 Health Connect, targets Travis County residents who are living between 100%–200% of FPL, which is consistent with Central Health’s mission; these residents are currently eligible for sliding-fee-scale health care services funded by Central Health. Residents living at or below 100% FPL qualify for the Medical Assistance Program or MAP, a locally funded counterpart to Texas Medicaid managed by Central Health to serve lower-income residents. Central Health anticipates that the broader public engagement effort in Central Texas will reach other populations in a variety of income ranges who can and should enroll in the exchanges. The PIA Campaign also includes specific strategies to reach musicians and food service workers — two sizable groups in Travis County that represent a concentrated segment of uninsured residents living within the targeted income bracket.

Demographic and Psychographic Profile Travis County residents living between 100-200% FPL: • ± 100K under 200% FPL without health insurance or underinsured • 50% Hispanic/Latino, of which 50%+ Spanish-dominant • 15% African-American, 30% Anglo, 5% other ethnicities (mostly Asian) • Gender balance, but slight skew toward women as health decision makers • 50% of target adults under 40 • Focused outreach for musicians and food service workers • Many members of target audience are infrequent computer/Internet users, but nearly all have smartphones. • Many members of target audience will have little or no experience purchasing health insurance.

Messaging and Calls to Action The focus on 2-1-1 as a referral to in-person enrollment assistance through local agencies is intended to meet the needs of residents who are less able, willing or likely to independently enroll through healthcare.gov. Central Health is coordinating the PIA Campaign to complement rather than compete with other efforts to promote participation in the marketplace. These complementary efforts include grassroots community outreach to partner organizations funded by Central Health grants managed by United Way, enrollment assistance provided by Travis County’s two FQHCs, and marketing of ACA products by the Central Health-owned public non-profit HMO, Sendero Health Plans (The PIA campaign itself makes no reference to specific products).

Media Mix • Radio in English and Spanish • Print in English and Spanish, with a focus on community papers • Digital display advertising as an added-value extension of radio and print • Paid social media and keyword search

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 www.centralheath.net • Paid text messaging for non-Internet smartphone users

Progress to Date In the month of December 2013, Central Health ran over 800 radio spots reaching over 600,000 individual listeners. These radio schedules include spots on six local stations that reach the following demographic:

• Household income < $50K (±200% of FPL for family of four) • Women 25-54 • Spanish-speakers • Musicians and Food Workers • Uninsured and underinsured • Reach: ±400K English ±218K Spanish

The preliminary results of this flight of radio placements are very encouraging, correlating with an approximately 400% increase in the ACA-related call volume to 2-1-1 (In Travis County, 2-1-1 not only works with local agencies with marketplace enrollment programs but also manages eligibility review for Central Health’s Medical Assistance Program, allowing for a streamlined customer experience that is able to address the needs of the variety of callers who may be prompted to action by the media campaign). As more data comes in, Central Health and United Way are assembling a scorecard of relevant metrics for evaluating campaign performance.

Moving Forward: Q1 2014 • Radio: Increase radio spots and broaden schedules to a total of 11 stations (four Spanish). Central Health plans to run over 2000 spots reaching over 1 million individual listeners each month through the end of March. These radio schedules include 30-second PSA-style spots produced in-house by the PIA Campaign team, 60-second endorsements by station personalities, and vignettes featuring conversations between station talent and (actual) 2-1-1 referral specialists. • Digital: Central Health will launch its digital campaign in January. Using paid social media placements, pay-per-click search (i.e. Google AdWords), and digital display value-adds from other media schedules, the digital flights will drive users to smartphone-friendly landing pages in Spanish and English that will provide basic information about the Marketplace while promoting 2-1-1 as an initial point of contact to reach local resources for enrollment assistance. The landing pages will allow people to opt in to receive reminders to enroll and updates on deadlines. • Print: There will be a limited print placement effort that will focus on targeted publications such as community papers. Placements will start in mid-January. • Event and earned media: There are substantial added-value tie-ins with our broadcast partners including advertorial/public service programming, community events, on air interviews and access to social media platforms.

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 www.centralheath.net • Television: The campaign does not include a TV buy due to cost, but the campaign is currently identifying low- to no-cost opportunities for mentions, sponsorships, and PSA opportunities.

Since the launch of the campaign on December 9, 2013, the 211 Call Center has experienced a 400% in call volume for questions related to the federal marketplace. Metrics will be gathered and analyzed on a regular basis to determine impact. As the need for outreach continue, Central Health anticipates using the 2-1-1 Health Connect campaign identity and infrastructure to promote participation in the marketplace during future enrollment cycles.

For More Information Contact: Sarah Malm, Director of Communications Central Health [email protected]

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 www.centralheath.net Sample Scripts:

60 Second English

It’s the New Year, and it’s not too late to get health insurance. Hello this is

[PERSONALITY] from [STATION/SHOW]. Remember that, regardless of your age, gender, current health, family history, or income, you need health insurance. It’s the law, and it’s the right thing to do for the people you love and your own peace of mind. Learning how to get started is simple. Just dial 2-1-1, choose your language, then choose option 1. The 2-1-

1 referral specialists will put you in touch with the enrollment experts at local agencies near you in Travis County. Those counselors can walk you through the process and your coverage options. Don’t feel overwhelmed; this is your chance to get the health coverage you deserve, and you can find a plan that works with your budget and your lifestyle. Call 2-1-1 and choose option 1 today and you can get connected to the help you need. “This message is brought to you by Central Health, your local healthcare district.”

60 Second Spanish

Anuncio de 60 segundos – Empleado de un restaurante

DJ: ¡Bienvenidos una vez más! Estamos conversando con ____, del servicio 2-1-1 local, que conecta a las personas que llaman con proveedores locales de salud y servicios humanos. Ella nos trae un mensaje muy especial para las personas que trabajan en el negocio de los restaurantes y que no saben qué pensar acerca de la nueva Ley de Cuidados de la Salud.

MARY: Gracias John, es un placer estar de nuevo con ustedes. Independientemente de si eres cajero, cocinero, mesero, lavaplatos, anfitrión, camarero o barista, tu tienes opciones para obtener cobertura médica. La buena noticia es que el 2-1-1 te puede ayudar.

DJ: ¡Me alegra mucho oír esto! He escuchado de varios empleados de restaurantes – especialmente los que trabajan medio tiempo – que no han podido adquirir beneficios médicos a través de sus patronos. Muchos de ellos están considerando simplemente continuar sin seguro médico…

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 www.centralheath.net MARY: Por favor recuerden que todas las personas necesitamos tener seguro médico. Es la ley, y es lo correcto que debemos hacer.

DJ: Sí, es cierto, pero ¿por dónde comenzamos?

MARY: Marca 2-1-1, escoge tu lenguaje y después marca la opción 1. Uno de nuestros especialistas, aquí en el Condado de Travis, te pondrá en contacto con la persona correcta para ayudarte. Él te puede ayudar te a encontrar la cobertura médica adecuada a tu presupuesto y a tu estilo de vida.

DJ: ¿Así de simple?

MARY: ¡Exactamente John! Todas las personas merecen un seguro médico, y tu lo puedes adquirir bajo la nueva ley.

DJ: Entonces… ¿la primera cosa que hay que hacer es marcar 2-1-1?

MARY: Opción 1. Llama hoy, y te ayudaremos a empezar.

AVISO LEGAL: Este es un ejemplo de cómo se desarrollaría la conversación después de proporcionarle preguntas o puntos de discusión a la personalidad del radio y al miembro del personal de 2-1-1 siendo entrevistado. Tanto el entrevistador como el entrevistado le deben agregar su toque personal a la conversación durante la grabación.

6 ATTACHMENT 2: PIA CAMPAIGN UPDATE

Central Health: Public Information Awareness Campaign Spanish Media Plan

January 2014 Update Central Health Media Campaign Objectives

1. Build Awareness: The purpose of the Public Information Awareness campaign within Travis County for Central Health is to build awareness of and publicize the services, eligibility requirements, and enrollment procedures for the Federal Insurance Marketplace through the 211 phone line.

2. Take Action: Drive target to contact United Way's 211 phone line.

1 Hispanic Target Audience

REACH: 18+ male/female, Spanish speaking, reaching 46% of uninsured people, approximately equals to $75,900 individuals.

2 Radio Univision - 14 weeks air time total

DEC JAN FEB MARCH UNIVISION 12/9 12/16 12/23 12/30 1/6 1/13 1/20 1/27 2/3 2/10 2/17 2/24 3/3 3/10 3/17 3/24 MEDIA KLQB-FM + KLJA-FM :60 :60 :60 :60 :60 :60 :60 :60 :60 :60 :60 :60 :60 KLQB-FM + KLJA-FM :30 :30 :30 :30 :30 :30 :30 :30 :30

• Frequency 18.8 • Total Reach 218,000 Emmis - 9 weeks air time total

DEC JAN FEB MARCH Emmis 12/9 12/16 12/23 12/30 1/6 1/13 1/20 1/27 2/3 2/10 2/17 2/24 3/3 3/10 3/17 3/24 MEDIA La Z :60 :60 :60 :60 :60 :60 :60 :60 :60 :60 :60 La Z :30 :30 :30 :30 :30 :30 :30 :30 • Frequency 14.4 • Total Reach 239,000

3 Interview Opportunities Radio: Two (2) approximately 7 minute interviews with community leader at partner organization

• 1/29 Interview to be recorded with Foundation Community • 2/26 Interview pending coordination

TV: TV media buy in negotiation. Opportunity may include :30 A Su Salud vignettes recordings and 2 minutes segments on Despierta Austin. There may be opportunity to feature community partners within segments.

4 Univision Events

Date Time Location Speaker 1/5/14 complete complete Latino Healthcare Forum 2/1/14 10:00am Taco More - TBD Foundation Community 2/15/14 10:00am TBD Latino Healthcare Forum 2/22/14 10:00am Highland Mall Foundation Community/Feria 6001 Airport Blvd. Para Aprender Community Austin, TX 78752 Coffees and 3/1/14 9:00am Highland Mall Foundation Community Events 6001 Airport Blvd. Austin, TX 78752 3/15/14 10:00am TBD Community Care TBD/ Mi Familia Mi Hogar Expo 3/22/14 10:00am TBD Austin Interfaith Alliance TBD

5 Univision Social Media Posts on 104.3 Facebook page ‐ 77,530 likes

December Facebook Post January Facebook Post

Note: *Text to be distributed 2/1, 2/15, 3/1, 3/15 driving people to call https://www.facebook.com/photo.php?v=682920805 211‐1 (outside of Univision buy). 061786&set=vb.214399638580574&type=2&theater 6

1111 E. Cesar Chavez St. Austin, Texas 78702 Phone: 512 978-8155 Fax: 512 978-8156 www.centralheath.net

M E M O R A N D U M

TO: Central Health Board of Managers

FROM: Lisa Owens, Senior Healthcare Planner

DATE: January 22, 2014

RE: Psychiatric Services Stakeholders Update

Planning for 2014 The December meeting of the Psychiatric Services Stakeholders (PSS) focused on a review of the work of the committee and planning for 2014. The work done through the PSS for the “10 in 10” and DSRIP projects will fill identified system gaps and increase services in behavioral health. In the past year, PSS expanded to include members of the justice, housing and substance use disorder stakeholder groups.

Central Health Director of Planning Ellen Richards presented behavioral health projects currently being implemented in the county. Highlights of the services include:  Crisis services that are available 24/7 to address those experiencing mental health crisis from the point of intake, evaluation, then stabilization and treatment  New services coming into the system such as crisis stabilization unit and access to inpatient beds for those that need both medical and psychiatric care  Increased capacity to provide assessments, treatment and screenings  Telemedicine for psychiatric services  Permanent supported housing is part of the continuum of care

Ellen Richards presented the proposed committee structure and direction for 2014 and beyond. The Crisis Intervention Committee (CIC), Behavioral Health Advisory Committee (BHAC) working in the justice system and Substance Use Planning Group (SUPG) will each recommend policy and funding decisions to the PSS.

Objectives and Priorities for 2014 identified:  Develop a clear work plan with stakeholders and committees bringing forward issues  Sobriety Center will continue to be a high priority  Metrics and Outcomes  Health Navigation

New Business or Updates Judge Hohengarten and Ashton Cumberbatch presented a brief update on the Sobriety Center. The process includes development and vetting of the concept, development of the scope, followed by program design. Law enforcement will be a part of the discussion while planning. It was also noted that in the past, location has been an issue during discussions around the Sobriety Center.

Central Health Procurement Activity Report

Through its purchasing policy (PUR1-001), the Board of Managers has authorized Central Health President and CEO to execute Central Health contracts with a value of less than $100,000 without requiring board action or approval and to execute certain contracts on its behalf that meet the pre-authorization criteria outlined in policy.

Contract actions greater than $25,000 from December 06, 2013 through January 16, 2014

CONTRACT VENDOR NAME DESCRIPTION OF CONTRACT AMOUNT NOTES / COMMENTS ACTION

Communications and Creative Services C10397 Screamer $225,000 Pool of 12 vendors sharing the same NTE Communications and Creative Services C10404 MMI Agency $225,000 New Vendor Pool of 12 vendors sharing the same NTE

C10402 Bartlett Cocke Construction Manager at Risk - SEHWC $659,350 New Vendor

Legal Services relating to Seton lease C10401 Husch Blackwell $750,000 New Vendor agreement, DSHP, 1115 Waiver Program Construction - Minor Remodel of Central PO 1089 Ameri Trading Company $35,600 New Vendor Health for additional offices

Conflict-of-Interest Statement Information: Chapter 176 of the Local Government Code requires that local government officers file a conflict-of-interest statement disclosing certain relationships with a vendor within seven (7) days of becoming aware of facts that give rise to the conflict. Central Health has contracted with the following new vendors:  Marion Montgomery, Inc d/b/a MMI Agency*  Bartlett Cocke*  Husch Blackwell  Ameri Trading Company*

Please ensure that you have no conflict-of-interest with the vendor(s) that would require the filing of a conflict-of-interest statement. You do not need to do anything if you have no conflict. Completed conflict-of-interest statements should be filed with the Central Health Purchasing Coordinator (Tena Southwell). If you have any questions about whether you have a conflict, please contact Beth Devery.

* Denotes HUB Certified

Page 1 of 2 Central Health Procurement Activity Report

Vendor Debarment and Suspension List:

Prior to awarding any contracts, state agencies and qualified local government purchasing entities are reminded to check the list of vendors excluded from doing business at the federal and state level by utilizing the following resources:

Federal Excluded Persons List System (EPLS) at https://www.sam.gov/portal/public/SAM/

Office of Texas Comptroller at http://www.window.state.tx.us/procurement/prog/vendor_performance/debarred/

Additionally, in compliance with Executive Order #13224 - "Blocking Property and Prohibiting Transactions with Persons Who Commit, Threaten to Commit or Support Terrorism," state agencies are responsible for ensuring they do not enter into transactions or issue payments to those individuals or organizations identified in the

Office of Foreign Assets Control list of Specially Designated Nationals (SDN) and Blocked Persons. The list may be found at http://www.ustreas.gov/offices/enforcement/ofac/sdn/.

 The vendors listed on the Procurement Activity Report are not on the above-mentioned Debarment and Suspension Lists.

Page 2 of 2 Quarterly Service Report Fiscal Year 2013, Quarter 4

January 22, 2014

Larry Wallace, VP of Service Delivery Overview

✚ Call Center ✚ Eligibility Services ✚ MAP Enrollment ✚ State Application Assistance ✚ Healthcare Services ✚ Primary Care ✚ Specialty Care ✚ Emergency ✚ Inpatient ✚ Healthcare Expenditures

FY2013 Q4 Quarterly Report 2 Call Center

Call Center: United Way 40,000 100% # of Calls Handled % of Offered Calls Handled

30,000 75%

20,000 50% Calls Handled Calls 10,000 25%

0 0% FY12 Q4 FY13 Q1 FY13 Q2 FY13 Q3 FY13Q4 8:00 Average Call Handle Time Average Answer Wait Time 6:00

4:00

Time (Minutes) Time 2:00

FY12 Q4 FY13 Q1 FY13 Q2 FY13 Q3 FY13Q4 Source: United Way, reported as of September 2013

FY2013 Q4 Quarterly Report 3 Eligibility Services

Includes MAP enrollees with full benefits (Outpatient, Emergency, Inpatient, Dental, and Pharmacy). 4 Source: Network Sciences, enrollment as of 1st of each month Source: Insure-a-Kid, reported as of January 2014

FY2013 Q4 Quarterly Report Healthcare Services

Includes patients with all payor sources at CommUnityCare as well as MAP and Unfunded patients at Contracted Providers.

*Due to lag in billing and time to adjudicate claims, additional MAP claims for recent months may be received in the future.

FY2013 Q4 Quarterly Report 5 Healthcare Services

*Due to the lag in billing and time to adjudicate claims, additional MAP claims for recent months may be received in the future. Source: Unfunded claims submitted to Sendero through October 2013 Source: Valence for contracted providers and NextGen for CHC. Data pulled on 12/17/13

FY2013 Q4 Quarterly Report 6 Healthcare Services

Includes outpatient specialty care visits at UMC Brackenridge, CommUnityCare, Austin Cancer Center, and Vision providers.

*Due to the lag in billing and time to adjudicate claims, additional MAP claims for recent months may be received in the future. Source: Valence, data pulled on 12/17/13

FY2013 Q4 Quarterly Report 7 Healthcare Services

* Due to the lag in billing and time to adjudicate claims, additional MAP claims for recent months may be received in the future.

Source: Valence, data pulled on 12/17/13

FY2013 Q4 Quarterly Report 8 Healthcare Services

Includes Seton Shoal Creek, Austin Lakes Hospital, and Austin State Hospital.

Source: ATCIC, reported as of October 2013

FY2013 Q4 Quarterly Report 9 FY 2013 (10/01/12-09/30/13) CCC/Central Health Healthcare Expenditures % of Budget Provider Annual Budget Expenditures Expended Primary Care $ 49,173,035 $ 47,617,453 97% Blackstock Family Health Center (M, BH) $ 262,045 $ 221,558 85% CommUnityCare (M, BH, D) $ 38,893,751 $ 38,893,751 100% El Buen Samaritano (M, BH) $ 2,754,400 $ 2,174,949 79% LoneStar Circle of Care (M, BH) $ 4,364,995 $ 4,009,668 92% Paul Bass Internal Medicine Clinic (M, BH) $ 709,647 $ 398,937 56% People’s Community Clinic (M, BH) $ 1,398,000 $ 1,306,799 93% Planned Parenthood (M) $ 690,197 $ 515,508 75% Volunteer HealthCare (M) $ 100,000 $ 96,283 96% Specialty Care $ 1,808,788 $ 1,319,564 73% Austin Cancer Centers $ 334,000 $ 266,038 80% Dental Specialty Care $ 596,711 $ 488,154 82% Eye Disease/ Screening: Multiple Providers $ 389,077 $ 419,756 108% Multiple Specialties: Paul Bass Clinic $ 462,000 $ 108,910 24% Orthotics and Prosthetics: Multiple Providers $ 27,000 $ 36,706 136% Other Services $ 896,000 $ 1,041,056 116% Medical Services $ 100,000 $ 100,691 101% Front Steps $ 300,000 $ 362,500 121% Project Access (M) $ 330,000 $ 412,500 125% NextCare (Urgent Care) (M) $ 166,000 $ 165,365 100% Mental Health Services $ 8,360,394 $ 8,602,515 103% ATCIC $ 7,925,319 $ 8,227,395 104% SIMS Foundation (BH) $ 435,075 $ 375,120 86% Pharmacy Services $ 5,444,687 $ 4,042,113 74% MedImpact/ScriptCare $ 5,444,687 $ 4,042,113 74% Emergency Transportation $ 696,822 $ 696,822 100% City of Austin EMS $ 696,822 $ 696,822 100%

Total Healthcare Service Delivery $ 66,379,726 $ 63,319,523 95% • M=primary medical care, D=primary dental care, BH= primary behavioral health care • Project Access FY12Q4 expenses applied to FY13 resulting in $82.5K over budget • Pharmacy: ScriptCare cost savings of $80k/mo. for last 3 mos. of FY13. Mthly. invoice avg. dropped from $333k to $245k following ScriptCare effective date 8/1/13

FY2013 Q4 Quarterly Report 10

Board Meeting January 22, 2014

Agenda Item 6 (NO BACKUP)

Receive and discuss reports from the Board committees: Budget and Finance Committee; Performance Improvement Subcommittee; and ad hoc Women’s Health Committee.

Board Meeting January 22, 2014

Agenda Item 7 (NO BACKUP)

Discuss and take appropriate action on Central Health owned property, including University Medical Center at Brackenridge and adjacent properties.1

Board Meeting January 22, 2014

Agenda Item 8 (NO BACKUP)

Discuss and take appropriate action on the 1115 Medicaid Waiver, Delivery System Reform Incentive Payment (DSRIP) projects, the Community Care Collaborative, including health care delivery arrangements, and other interrelated community partnerships.1

Board Meeting January 22, 2014

Agenda Item 9 (NO BACKUP)

Receive and discuss a legal briefing regarding electronic communications and devices.1

Board Meeting January 22, 2014

Agenda Item 10 (NO BACKUP)

Receive and discuss the protocol regarding Board communications.1

Board Meeting January 22, 2014

Agenda Item 11 (NO BACKUP)

Confirm the next regular Board meeting date, time, and location.