Procurement KPI Report Card (January 2015 to December 2015)

PUBLIC HEALTH TRUST BOARD OF TRUSTEES

ONE-DAY COMMITTEE MEETINGS AGENDAS

Wednesday, January 27, 2016 10:00 a.m. to Adjournment

Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12th Avenue Miami, Florida 33136

PUBLIC HEALTH TRUST BOARD OF TRUSTEES

ONE-DAY COMMITTEE MEETINGS SCHEDULE Wednesday, January 27, 2016 10:00 a.m. to adjournment

Jackson Memorial Hospital West Wing Board Room 1611 N. W. 12th Avenue Miami, Florida 33136

The PHT Board of Trustees One-Day Committee Meetings will commence at 10:00 a.m. with the Reasonable Opportunity for the Public to be Heard as required by Section 286.0114, Fla. Stat. (Chapter 2013-227, Laws of Florida), and then followed by the Chairperson’s Remarks, Presentations and Discussion. The Purchasing and Facilities Subcommittee meeting will follow the Chairperson’s Remarks, Presentations and Discussion which will then be followed by the monthly scheduled committee meetings. The meetings will be held in the West Wing Board Room.

Reasonable Opportunity to be Heard

Please be advised that those members of the public wishing to speak on a proposition before the Board of Trustees or its committees will be called in the order in which they registered with the Secretary of the Board of Trustees. A speaker shall be limited to no more than two (2) minutes on a proposition before the Board of Trustees or its committees.

Chairperson’s Remarks, Presentations Following the Reasonable Opportunity to be and Discussion Heard

Purchasing and Facilities Subcommittee Following the Chairperson’s Remarks, Presentations and Discussion

Fiscal Committee Following the Purchasing and Facilities Subcommittee meeting

Joint Conference and Efficiencies Committee Following the Fiscal Committee meeting

Strategy and Growth Committee Following the Joint Conference and Efficiencies Committee meeting

PURCHASING AND FACILITIES SUBCOMMITTEE

AGENDA

January 27, 2016

PUBLIC HEALTH TRUST BOARD OF TRUSTEES

PURCHASING AND FACILITIES SUBCOMMITTEE AGENDA

Wednesday, January 27, 2016 Following the Chairperson’s Remarks, Presentations and Discussion

Jackson Memorial Hospital West Wing Board Room

Purchasing and Facilities Subcommittee Mojdeh L. Khaghan, Chairwoman Ralph G. Patino, Vice Chairman William J. Heffernan Irene Lipof Carlos Trujillo

Ex-Officio Member Martha Baker, RN JHS General Obligation Bond Citizens’ Advisory Committee

Public Health Trust Rules

Any person making impertinent or slanderous remarks or who becomes boisterous while addressing the committee, shall be barred from further audience before the committee, unless permission to continue or again address the committee 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 Board Room. Persons exiting the Board Room shall do so quietly.

The use of cell phones in the Board Room 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 Board Room to answer incoming cell phone calls.

1. Meeting Call To Order

(a) Previous subcommittee meeting minutes (December 18, 2015)

Motion to approve the previous subcommittee meeting minutes

Mojdeh L. Khaghan, Chairwoman

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PURCHASING AND FACILITIES SUBCOMMITTEE AGENDA – January 27, 2016

2. Reports

(a) Purchasing

(1) Purchasing Report as of January 2016

Presented by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division

(2) Competitive Contracts Awarded or Renewed Under the Chief Procurement Officer Authority as of December 2015

Presented by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System

(3) Non-Competitive Contracts Awarded or Renewed Under $250,000 and Modifications Allowed Under CPO Authority as of December 2015

Presented by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System

(4) Key Performance Indicators (KPI) for Procurement

(1) Monthly KPI as of December 2015 (2) Procurement KPI Report Card (January 2015 to December 2015)

Presented by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division

(5) Direct Payments as of December 2015

Presented by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division

(b) Facilities

(1) Jackson Miracle-Building Bond Projects – January 2016

Presented by Isa Nunez, Vice President, Facilities Design and Construction, David Clark, Corporate Director, Capital Projects, and Tom Koulouris, Senior Project Manager, URS

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PURCHASING AND FACILITIES SUBCOMMITTEE AGENDA – January 27, 2016

3. Resolutions Recommended To Be Accepted

(a) 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 accept the resolution with a favorable recommendation to the Fiscal Committee

Mojdeh L. Khaghan, Chairwoman

(b) 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 Nunez, Vice President, Facilities Design and Construction, Jackson Health System

Motion to accept the resolution with a favorable recommendation to the Fiscal Committee

Mojdeh L. Khaghan, Chairwoman

4. Adjournment

Mojdeh L. Khaghan, Chairwoman

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1. Meeting Call To Order PURCHASING AND FACILITIES SUBCOMMITTEE MEETING MINUTES

Friday, December 18, 2015 Followed the Audit and Compliance Subcommittee Meeting

Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12th Avenue Miami, FL 33136

Purchasing and Facilities Subcommittee Mojdeh L. Khaghan, Chairwoman Ralph G. Patino, Vice Chairman William J. Heffernan Irene Lipof Carlos Trujillo

Ex-Officio Member Martha Baker, RN JHS General Obligation Bond Citizens’ Advisory Committee

______

Members Present: Irene Lipof, William J. Heffernan, Carlos Trujillo, and Martha Baker, RN

Member(s) Excused: Mojdeh L. Khaghan and Ralph G. Patino

PHT Board of Trustees Present: Joe Arriola and Darryl K. Sharpton

In addition to the Subcommittee members 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, Isa Nunez, Tom Koulouris, Rosa Costanzo, Mark T. Knight, and Peter Paige, M.D.; Alan Levy, M.D. UMMSOM Representative; and Eugene Shy, Jr., Christopher Kokoruda, and Laura E. Wade, Assistant Miami-Dade County Attorneys ______

1. Meeting Call to Order Irene Lipof, Member, Purchasing and Facilities Subcommittee at 9:34 a.m.

(a) Previous subcommittee meeting minutes (November 23, 2015)

Motion to approve the previous subcommittee meeting minutes

Irene Lipof, Member, Purchasing and Facilities Subcommittee

Joe Arriola moved approval; seconded by Carlos Trujillo, and carried without dissent.

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PURCHASING AND FACILITIES SUBCOMMITTEE MEETING MINUTES – December 18, 2015

2. Reports

(a) Purchasing

(1) Purchasing Report as of December 2015

No report.

(2) Competitive Contracts Awarded or Renewed Under the Chief Procurement Officer Authority as of November 2015

(3) Non-Competitive Contracts Awarded or Renewed Under $250,000 and Modifications Allowed Under Chief Procurement Officer Authority as of November 2015

(4) Key Performance Indicators (KPI) for Procurement

(1) Monthly KPI as of November 2015 (2) Procurement KPI Report Card (December 2014 to November 2015)

(5) Direct Payments as of November 2015

Detailed information regarding the informational reports was included with the agenda.

(1) Deering Medical Plaza Suites 200 and 230 – Jackson Medical Group

Jamil S. Fraser, Director, Real Estate Services presented for acceptance with a favorable recommendation to the Fiscal Committee a Lease Agreement and/or series of Lease Agreements with the Healthcare Realty Services, Inc. for Healthcare Realty Trust, Inc. a Maryland Corporation as Lessor for the rental of up to 5,802 square feet of medical office space (Suites 200 and 230 to house the cardiology practices of the Jackson Medical Group) situated at 9380 S. W. 150th Street, Miami, FL for a total period not to exceed ten (10) years.

Mr. Fraser will track and monitor the responsibilities and obligations set forth in the Lease Agreement(s).

(b) Facilities

(1) New Rehabilitation Facility Presentation

Greg Jackson, Vice President and Chief Executive Officer, Rehabilitation Hospital presented an update regarding the new Rehabilitation Hospital design and concept. The intent of the new Rehabilitation Hospital is to oversee the movement and progression of care to the patients. Highlights of the presentation showed the proposed new location, diagrams of phase 1 and phase 2, diagrams of the floor plans (levels 1 to 7), and concept designs of the patient rooms. As part of the development process of the new Rehabilitation Facility a User Group made up of physicians, former patients and advocacy groups in the community was created. Tours of other world renowned rehabilitation facilities in the United States were conducted to see firsthand “best practice standards.”

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PURCHASING AND FACILITIES SUBCOMMITTEE MEETING MINUTES – December 18, 2015

2. Reports cont…

(b) Facilities cont…

(1) New Rehabilitation Facility Presentation cont…

As part of the presentation Tom Koulouris, Senior Project Manager presented an overview of the program stacking concept and highlighted existing conditions to be verified for connector distance and floor height coordination with Jackson Main, MEP requirements to be confirmed, and sub-surface conditions to be assessed and verified. Mr. Koulouris presented the proposed construction timeline as follows: November 2016 - Demolition of Institute and Annex; January 2017 - Completed Design; October 2018 - Ground-breaking; and December 2018 - Ribbon-cutting. The Subcommittee will be kept informed as the process continues to construct the new Rehabilitation Facility.

Ms. Lipoff questioned the hurricane preparedness plans for the new Rehabilitation Facility.

Mr. Koulouris stated that after Hurricane Andrew the State of Florida passed an amendment to House Bill 911 which changed the building codes in Florida. No structure(s) can be built in the State of Florida that doesn’t meet “Category 5” hurricane preparedness standards. Mr. Koulouris further stated that increased hurricane preparedness is being done to older facilities located on the Main Campus as well as determining how to incorporate “Category 5” hurricane preparedness standards in the Jackson Health System Master Plan.

Mr. Arriola questioned the funding requirements for the new Rehabilitation Facility.

Mr. Migoya stated that the original funding for the new Rehabilitation Facility was $120 million which includes funding from Christine E. Lynn and the Miami Project to Cure Paralysis. The costs for the new facility have increased approximately $50 million. Out of the $50 million, $25 million will be funded by JHS and the remaining $25 million will come from private donations.

Mr. Sharpton stated that he is hopeful that a strategic session is scheduled so that members of the PHT Board of Trustees can share their input, and better understand how the new facility will impact JHS.

Mr. Heffernan questioned the impact the new facility will have on JHS operations particularly as it relates to revenue.

Mark T. Knight, Executive Vice President and Chief Financial Officer stated that the facility that will be removed to create space for the new facility is not revenue producing space. The concern is displacing approximately 50,000 square feet of space in the current facility which will involve finding temporary locations for departments in order to completely demolish the old facility and begin the ground work necessary to complete the new facility. Mr. Knight further stated that a comprehensive business plan has been developed for the new Rehabilitation Facility that shows a strong rate of return.

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PURCHASING AND FACILITIES SUBCOMMITTEE MEETING MINUTES – December 18, 2015

3. Resolution Recommended To Be Accepted

(a) 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

Motion to accept the resolution with a favorable recommendation to the Fiscal Committee

Irene Lipof, Member, Purchasing and Facilities Subcommittee

Carlos Trujillo moved approval; seconded by William J. Heffernan, and carried without dissent.

Mr. Sharpton spoke about the scope of work of Jamil S. Fraser, Director, Real Estate Services and his appreciation for the work done by Mr. Fraser. Mr. Sharpton requested that at the next Subcommittee meeting Don S. Steigman, Executive Vice President and Chief Operating Officer present in the appropriate perspective the work done by Mr. Fraser.

4. Adjournment Irene Lipof, Member, Purchasing and Facilities Subcommittee at 10:03 p.m.

Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees

Page 4 of 4

2. Reports

2 (a) Purchasing

PUBLIC HEALTH TRUST BOARD OF TRUSTEES PURCHASING REPORT

January 27, 2016

TO: PURCHASING AND FACILITIES SUBCOMMITTEE

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.

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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)

January 2016 PHT Board of Trustees 2

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 Vendor Qualifications and Past 1 Performance 25 20.667 22.333 22.667

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).

January 2016 PHT Board of Trustees 3

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.

January 2016 PHT Board of Trustees 4

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.

January 2016 PHT Board of Trustees 5

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)

January 2016 PHT Board of Trustees 6

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).

January 2016 PHT Board of Trustees 7

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.

January 2016 PHT Board of Trustees 8

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:

January 2016 PHT Board of Trustees 9

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.

January 2016 PHT Board of Trustees 10

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).

January 2016 PHT Board of Trustees 11

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.

January 2016 PHT Board of Trustees 12

Monthly Report of Competitive Contracts Awarded or Renewed under the Chief Procurement Officer Authority in Accordance to Procurement Regulations December 2015 For Information Only (Greater than $100K) Cost Center & Procurement Method/ Vendor Name Description Contract Number Contract Date Contract Value Contract Term UAP Director/VP Activity Third Party Freight Management Services (Optifreight 83718 MedAssets 8201546 SERV 12/17/2015 $ 255,000 One Year Yes Logistics) for Jackson South Community Hospital Gina Diaz Contract# MS01562 Cardinal Health 200, LLC Third Party Freight Management Services (Optifreight 84610 MedAssets 8110448 SERV 12/08/2015 $ 1,917,899 Five Years Yes Logistics) for Jackson Main Rosa Costanzo Contract# MS01562 IV Admixture Services for the Pharmacy Department at 57170 MedAssets 8302358 SERV 12/10/2015 $ 200,000 One Year Yes Jackson North Medical Center Andre Boyd Contract# PH00380 Central Admixture Pharmacy IV Admixture Services for the Pharmacy Department at 73005 8110482 SERV/ MedAssets 12/15/2015 $ 2,397,852 One Year Yes Jackson Main Gino Santorio 8110491 SERV Contract# PH00380 66206 MedAssets Synergy Health North America Central Support Services Staffing Services 8110462 SERV 12/10/2015 $ 201,210 15 Weeks Yes Deborah Tedder Contract# MS01453 Endoscopic System for the Operating Room at Jackson 66207 MedAssets Olympus * 9100924 CAP 12/24/2015 $ 168,181 One Time Yes Main Deborah Tedder Contract# MS02214 866062 Philips Medical Systems * Patient Monitors for Labor and Deliver at Jackson Main 9100910 CAP 12/16/2015 $ 106,620 One Time MedAssets Contract # MS03483 Yes Steven Burghart 74406 New York City Health and Hospitals Provation Medical Inc. Licensed Software for Gastroenterology Department 8110437 SERV 12/07/2015 $ 201,925 Three Years Yes Deborah Tedder Corporation Contract# 2124 Temporary CT Scanner for the Radiology Department at 83726 Shared Imaging, LLC. 2127783 12/02/2015 $ 300,000 One Year MedAssets Contract # MS03418 Yes Jackson South Community Hospital Eddie Borrego Steam Sterilizers and Surgical Lights for the Operating 784161 MedAssets Contract Steris Corporation * 9100907 CAP 12/14/2015 $ 415,918 One Time Yes Room at Jackson Main Deborah Tedder # ES-175/BM02934 Drills and Surgical Instruments for the Trauma 83784 Stryker Instruments * 9200148 CAP 12/15/2015 $ 278,648 One Time MedAssets Contract # MS020695 Yes Department at Jackson South Community Hospital Gina Diaz Isa Nunez State of Florida Workscapes, Inc. * Patient Room Furniture for WW10 4104901 CAPS 12/10/2015 $ 119,816 One Time Yes 949143 Contract # 425-001-12-1

1. "MedAssets" is the Trust's primary "Group Purchasing Organization" (GPO) 2. "State Contract" and "Miami-Dade Contract" mean a contract competitively awarded by the State or County as a "cooperative contract". 3. "US Communities" means a contract competitively awarded by the U.S. Communities governmental purchasing alliance as a "cooperative contract". 4. "OTR" means "Option to Renew". 5. "Contract Value" corresponds to the fixed "Contract Term" that has been awarded or rewarded (not to future OTR's). 6. "RFP" means competitive Request for Proposals (or Qualifications) procurement process performed by the JHS Procurement Management Department. 7. "ITB" means competitive Invitation to Bid (or Quote) procurement process performed by the JHS Procurement Management Department. 8. "UAP" means User Access Program E – Exclusion as per UAP program: i.e., Federal Grant, etc. Yes – Incorporated into the purchase as either discount on invoice or discount upfront N/A – No, did not apply to procurement. Either an emergency purchase or contract was executed or extended before UAP was implemented

* Miracle Bond/PHT GOB Dollars Monthly Report of Non-Competitive Contracts Awarded Under 250K and Modifications Allowed Under CPO Authority December 2015 For Information Only

Cost Center & Procurement Method/ Vendor Description Contract Number Contract Date Contract Value Contract Term UAP Director/VP Activity 57060 8302353 SERV 12/01/2015 $ 15,610 Alan Goldsmith College of American Pathologists Survey for Accreditation 1 Year Sole Source N/A 71905 8110446 SERV 12/08/2015 $ 13,634 Gino Santorio Manoscan Probe for the Endoscopy Department 101 Covidien Sales, LLC * 9200147 CAP 12/10/2015 $ 14,145 One Time Sole Source Yes (Replacement of Part) Gina Diaz 66700 Kreg Therapeutics, Inc. Specialty Bed Rental 8110501 SERV 12/21/2015 $ 45,599 One Time Sole Source N/A Deborah Tedder Repair of Microscope Video Adapter by Original 66207 Leica Microsystems, Inc. 8110421 SERV 12/02/2015 $ 10,849 One Time Sole Source Yes Equipment Manufacturer (OEM) Deborah Tedder Mida Pneumatic Power Drills for the Operating 93701 Medtronic USA, Inc. * 9200146 CAP 12/04/2015 $ 160,804 One Time Sole Source Yes Room at Jackson South Gina Diaz 80105 Pantropic Power, Inc. Urgent Generator Repairs for Life Safety Requirement 4104919 CAPS 12/16/2015 $ 40,000 One Time Bid Waiver Yes Gino Santorio Graft for Oral Surgery Procedures for Jackson South 83701 Terumo BCT 2128053 12/08/2015 $ 25,400 One Time Bid Waiver Yes Community Hospital Gino Diaz Bioengineered Cultured Epidermal Auto-Graft for 66207 Vericel Corp. 15825900 12/30/2015 $ 55,765 One Time Sole Source Yes Burn Patients (Permanent Skin Replacement) Deborah Tedder

Note: "Non-competitive" procurement category includes: Sole Source, Physician's Preference, Standardization, Non-Competitive Cooperate Purchasing, and Miscellaneous Bid Waiver. UAP - User Access Program: Exempt – Exclusion as per UAP program: i.e., Federal Grant, etc. Yes – Incorporated into the purchase as either discount on invoice or discount upfront N/A – No, did not apply to procurement. Either an emergency purchase or contract was executed or extended before UAP was implemented

Legacy System Legacy system means a system including, but not limited to computer software, computer hardware, and biomedical equipment that are fully integrated into the daily operations of one or more departments or are considered strategic in nature or are unique to the provider, manufacturer, distributor, and / or provider. The Purchase of support, maintenance, upgrades, and necessary expansions of legacy systems shall not be subject to the requirements of the Procurement Regulation relating to competitive process.

Cost Center & Vendor Description Contract Number Contract Date Contract Value Contract Term Procurement Method UAP Director/VP Behavioral Health Software License Fees and 88597 Knight Software, Inc. 8110450 SERV 12/09/2015 $ 15,000 1 Year Legacy Yes Maintenance Nicoletta Tessler 92816 Legacy Data Access, Inc. Monthly Data Storage for Licenses and Support 8110424 SERV 12/03/2015 $ 151,680 1 Year Legacy Yes Mike Garcia Omnicell Cabinets for the Operating Room at Jackson 83712 Med One Capital 8201537 SERV 12/01/2015 $ 68,842 5 Years Legacy/Med Assets Yes South Community Hospital Gina Diaz Support Service Agreement for Name Connector 92820 Parlance Corporation system for the Telecommunications department 8110463 SERV 12/10/2015 $ 95,760 2 Years Legacy Yes Mike Garcia (ongoing) 92815 The Standard Register Company iMed Consent Annual Software and Maintenance 15825512 12/29/2015 $ 111,616 1 Year Legacy Yes Mike Garcia

* Miracle Bond/PHT GOB Dollars

2 (a) (4) Key Performance Indicators (KPI) for Procurement Procurement KPI I. Purchase Order Activity (Monthly) a) 2015 Purchase Orders b) 2015 Purchase Order Lines Grand Average Grand Average August September October November December August September October November December Total PO's Total Lines Optiflex & Omnicell 6,298 6,065 6,333 5,711 6,234 30,641 6,128 114,487 111,404 115,098 101,763 106,889 549,641 109,928 Activity: Total Buyers & 9,289 9,074 9,498 8,618 9,226 45,705 9,141 129,320 125,742 129,517 116,118 121,046 621,743 124,349 Omnicell: Monthly Average Number of PO's by FTE for December = 659 Monthly Average Number of PO Lines by FTE for December = 8,646 Average # of Weekdays II. Contracting Activity (Weekly) III. Previous Activity in Process with # of Pending *Approved Current Activity as of 12/31/2015 Contracts Documents Documents 31-Dec-15 147 59 20 # of Projects with Approved Documents*: 21 30-Nov-15 152 69 24 # of Projects Pending Procurement Documents: 48 30-Oct-15 194 52 21 Average # of Weekdays in 30-Sep-15 156 57 23 # of Process with 31-Aug-15 154 56 20 Contracts Pending *Approved 31-Jul-15 167 48 17 in Process Documents Documents 30-Jun-15 155 47 17 Administrative 7 175 0 29-May-15 153 51 15 Capital / Support Services 28 94 16 30-Apr-15 191 40 14 Clinical Support Services 9 192 38 31-Mar-15 178 38 13 Hospitals (JNMC/JSCH/Holtz) 12 150 48 27-Feb-15 152 41 8 Information Technology 7 63 48 31-Jan-15 158 46 12 Long Term Care / Quality / Safety 3 89 122 31-Dec-14 147 51 8 OR / Surgery / Anesthesia 3 60 0 30-Nov-14 157 47 14 Pharmacy 0 0 0 31-Oct-14 230 33 14 Revenue Cycle 0 0 0 29-Sep-14 184 57 20 Total: 69 29-Aug-14 175 58 20

IV. December 2015 Contracts Completed: 78 *Average cycle time for completed projects: 12 days Savings Approximately: $ 898,951

*Procurement process begins upon receipt of fully completed / approved documents, per Procurement Regulation Procurement KPI Report Card January 2015 - December 2015

Completed Contracts

150 111 100 106 93 95 89 80 84 86 78 100 74 66 50

0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 Average Number of Completed Contracts: 89

Average cycle time for completed projects Procurement process begins upon receipt of fully completed / approved documents, per Procurement Regulation

30 13 10 9 12 12 11 11 10 11 11 11 12

0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015

Key: 12 month average cycle time for completed projects: 11 days 15 Days Trendline • First six months average was 11 days • Last six months average was 11 days 2013 FY Trendline was 45 Days 2014 FY Trendline improved to 30 Days Savings

$824,614 Dec 2015 $898,951 $609,630 Nov 2015 $616,485 $2,729,504 Oct 2015 $5,923,786 $333,345 Sep 2015 $414,607 $2,376,275 Aug 2015 $6,051,122 $1,189,299 Jul 2015 $1,340,684 $2,303,663 Jun 2015 $2,928,160 $1,185,580 May 2015 $2,023,258 $1,232,072 Apr 2015 $2,261,703 $1,735,094 Mar 2015 $3,397,331 $749,605 Feb 2015 $763,862 $570,610 Jan 2015 $1,220,114 $0M $1M $2M $3M $4M $5M $6M $7M Annual Savings Savings For The Entire Contract Term

Total Savings for the first year of the contract: $ 15,839,294 Total Savings Approximately: $ 27,840,063 (January 2015 - December 2015) Direct Payment as Approved Pursuant to Resolution No. PHT 10/12-078 December 2015

Cost Code Vendor Description Amount VP 99301 Allen, Norton & Blue, PA Collective Bargaining Negotiations $ 35,258.25 Maria Huot-Barrientos 99301 Ballard Partners, Inc. State Lobbying Services $ 58,750.02 Mark Knight 89502 Complete Consulting Services Services for Parking Operations $ 2,500.00 Mark Aprigliano 89720 DGL and Associates Consulting Services for Real Estate Operations $ 20,600.00 Alex Contreras 99301 Greenberg Traurig, LLP Lobbying Services $ 20,000.00 Esther Abolila Emergency On-Call Physician Agreement for Jackson North Medical 58770 I and B Medical Associates, Inc. $ 1,000.00 Center Andre Boyd 86005 James H. Lowry and Associates Equity in Contracting $ 50,000.00 Rosa Costanzo 99420 John Paul Baar Sr. Services for Data Analysis and Reporting $ 4,050.00 Alex Contreras 23530 Kforce, Inc. Information Technology Staffing $ 29,760.00 Mike Garcia 95012 Kurt Salmon US, Inc. Professional Services for Jackson Health West Dade County $ 58,333.00 Laura Hunter 99301 Law Offices of Cheryl Wagonhurst Services for Corporate Compliance Program $ 28,370.82 Don Steigman 95714 Leadingstar Events and Media Services for Miami Transplant Institute Symposium $ 16,307.09 Matt Pinzur Strategic Direction and Organization of Managed Care Payor 99301 On Point Strategies, LLC $ 24,666.66 Relationships Mark Knight 90910 Otani Consulting Group, Inc. Services for Central Clearing Center Implementation Project $ 50,388.93 Myriam Torres 99301 Panza, Maurer and Maynard, PA Consulting Services Trust's/Application for Jackson West $ 314,667.79 Mark Knight 86100 Pershing, Yoakley & Associates Professional Services Agreement $ 72,373.60 Don Steigman Local, Regional, National, and International Media Relations 95714 Rebull Group, Inc. $ 4,000.00 Services Matt Pinzur 92411 RW Block Consulting, Inc. Professional Services for Internal Audit $ 3,775.00 Joseph Kuruc Consulting Services for Interim Director of Operations for Jackson 99301 Sector Strategies, Inc. $ 14,166.66 Health System Don Steigman 95714 Sivoli Consulting Corp Community Outreach Marketing Services $ 1,800.00 Matt Pinzur 99301 The Advisory Board Company Physician Education Consulting Services $ 277,459.00 Mark Knight 95714 The Weinbach Group, Inc. Advertising and Marketing Services $ 508,779.60 Matt Pinzur 99203 Veralon Partners, Inc. Fair Market Value Advisory Services $ 8,022.50 Mark Knight

2 (b) Facilities

3. Resolutions Recommended To Be Accepted

TO: Mojdeh L. Khaghan, Chairwoman and Members, Purchasing and Facilities Subcommittee

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 3 (a) Purchasing and Facilities Subcommittee January 27, 2016

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: PURCHASING AND FACILITIES SUBCOMMITTEE

FROM: PROCUREMENT MANAGEMENT DEPARTMENT

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.

SodexoMAGIC, LLC. $32,443,389.84 (For three years)

Total approved funding $32,443,389.84

The RFP was comprised of three separate models as set forth below:

It was determined by the Selection Committee that Models A and C were in the best interest of the Trust.

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

* 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.

In providing an evaluation of Sodexo’s present performance as incumbent, the Executive Office has reported the following:

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

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

The original contract was approved by Risk Management as to Insurance and Liability and by the County Attorney’s Office for legal sufficiency.

In providing an evaluation of the vendor’s performance during the current contract year, the following has been reported:

SECTION V. AWARDS UNDER A WAIVER OF FORMAL COMPETITION

A. Sole Source

No items to report.

B. Physician’s Preference

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)

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 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.

Leica Microsystems, Inc.: $ 441,298.82

Total Approved Funding: $441,298.82 (One-time purchase)

ECRI and MDBuyline have reported that the discount pricing provided by Leica Microsystems, Inc. falls within above average competitive price point for the system.

In providing an evaluation of the vendor’s performance during the current contract year, Jackson South Community Hospital has reported the following:

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.

Therakos, Inc. $600,000 (Estimated consumable spend for two years)

Total approved funding: $600,000

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.

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.

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

Jackson Memorial Hospital 5.5% Jackson South Community Hospital 5.3% Jackson North Medical Center 4.2%

In providing an evaluation of Cerner Corporation’s performance during the current contract year, the Information Technology Department has reported the following:

SECTION VI. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE COMPETITIVELY SOLICITED

No items to report.

SECTION VII. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE AWARDED UNDER A WAIVER OF FORMAL COMPETITION

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

* Talent Management * Contract Management * Supply Order Management

In providing an evaluation of Velocity’s performance during the current contract year, the Information Technology Department has reported the following:

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.

4. Adjournment

FISCAL COMMITTEE

AGENDA

January 27, 2016 PUBLIC HEALTH TRUST BOARD OF TRUSTEES

FISCAL COMMITTEE AGENDA

Wednesday, January 27, 2016 Following the Purchasing and Facilities Subcommittee Meeting

Jackson Memorial Hospital West Wing Board Room

Fiscal Committee William J. Heffernan, Chairman Mojdeh L. Khaghan, Vice Chairwoman Joe Arriola Irene Lipof Ralph G. Patino Darryl K. Sharpton Carlos Trujillo

Public Health Trust Rules

1. Meeting Call to Order

(a) Previous committee meeting minutes (December 18, 2015)

Motion to approve the previous committee meeting minutes

William J. Heffernan, Chairman

2. Reports

(a) Jackson Health System Combined Financial Statements as of December 2015

Presented by Mark T. Knight, Executive Vice President and Chief Financial Officer

(1) Accounts Receivable-All Hospitals – December 2015 (2) Financial and Budget Tracking Status Report – December 2015

(b) Purchasing and Facilities Subcommittee

Presented by Mojdeh L. Khaghan, Chairwoman, Purchasing and Facilities Subcommittee

(1) Purchasing Report as of January 2016 (2) Jackson Miracle-Building Bond Projects – January 2016

Page 1 of 2

FISCAL COMMITTEE AGENDA – January 27, 2016

3. Resolutions Recommended To Be Accepted

Sponsored by Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System

Motion to accept the resolution with a favorable recommendation to the PHT Board of Trustees

William J. Heffernan, Chairman

(b) 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 accept the resolution with a favorable recommendation to the PHT Board of Trustees

William J. Heffernan, Chairman

(c) 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 accept the resolution with a favorable recommendation to the PHT Board of Trustees

William J. Heffernan, Chairman

4. Adjournment

William J. Heffernan, Chairman

Page 2 of 2

1. Meeting Call To Order

FISCAL COMMITTEE MEETING MINUTES

Friday, December 18, 2015 Followed the Purchasing and Facilities Subcommittee Meeting

Jackson Memorial Hospital West Wing Board Room First Floor 1611 N. W. 12th Avenue Miami, FL 33136

Fiscal Committee William J. Heffernan, Chairman Mojdeh L. Khaghan, Vice Chairwoman Joe Arriola Irene Lipof Ralph G. Patino Darryl K. Sharpton Carlos Trujillo

______

Members Present: William J. Heffernan, Chairman, Joe Arriola, Irene Lipof, Darryl K. Sharpton, and Carlos Trujillo

Member(s) Excused: Mojdeh L. Khaghan and Ralph G. Patino

In addition to the Committee members, the following staff members, University of Miami Miller School of Medicine (UMMSOM) Representative, President, Medical Executive Committee of the Medical Staff, and Assistant Miami-Dade County Attorneys were present: Carlos A. Migoya, Don S. Steigman, Matthew Pinzur, Peter Paige, M.D., Mark T. Knight, and Allan D. Levi, M.D.; Steven Falcone, M.D., UMMSOM Representative; Joshua Lenchus, D.O., President, Medical Executive Committee of the Medical Staff; and Eugene Shy, Jr., Christopher Kokoruda, Laura Llorente, and Laura E. Wade, Assistant Miami- Dade County Attorneys ______

1. Fiscal Committee Meeting Call to Order William J. Heffernan, Chairman at 10:04 a.m.

(a) Previous committee meeting minutes (November 23, 2015)

Motion to approve the previous committee meeting minutes

William J. Heffernan, Chairman

Joe Arriola moved approval; seconded by Carlos Trujillo, and carried without dissent.

Page 1 of 3

FISCAL COMMITTEE MEETING MINUTES – December 18, 2015

Special Presentation

Mr. Migoya presented Mark T. Knight, Chief Executive Officer and Chief Financial Officer, Jackson Health System with a Service Award for his dedicated years of service and outstanding performance.

In recognition of Mr. Knight, Mr. Arriola stated that he realizes how valuable Mr. Knight is to the organization and it is pleasure to present him with a Service Award.

2. Reports

(a) Jackson Health System Combined Financial Statements as of November 2015

Mr. Knight reported that included in the agenda for the Fiscal Committee was a detailed overview of the JHS combined financial statements as of November 2015. Highlights of the financial statements showed that JHS continues to experience stronger than projected volumes with increases in admissions, observation cases, average daily census, combined hospital volumes, and year-over-year growth; better than projected payor mix which is attributed to funded patients, and Medicare funded patients; solid net operating revenue; increase in operating expenses which is attributed to increased specialty pharmaceuticals; overall strong performance; over the last couple of pay periods experienced significant improvement with the overtime rate; JHS hospital rate reduction plans are on target; and 50 days cash-on-hand and 44 days in accounts receivable. With regards to the month of December JHS continues to experience higher than projected volumes and stronger performance in net revenue. Mr. Knight pointed out the following: Due to process improvements and from a volume perspective JHS experienced a stronger performance in surgery cases specifically at Jackson Main. JHS continues to struggle with increased pharmaceuticals which is an industry-wide concern and is aggressively working to identify alternative pharmaceutical choices. JHS received approximately $1.8 million in additional sales tax revenue which resulted in a net gain totaling approximately $1.6 million prior to reimbursements from bond proceeds. And for the first time in several months JHS is fairly close to budget in salaries/wages/benefits. As reported last month although there is some improvement there continues to be a slowdown in cash relevant to ICD-10. It is anticipated that as the billing is made current and the users become more proficient with the new coding process the slowdown in cash will correct itself.

(b) Purchasing and Facilities Subcommittee

The Purchasing and Facilities Subcommittee (Subcommittee) met on December 18, 2015. The Subcommittee was presented with standard reports; and accepted with a favorable recommendation to the Fiscal Committee a resolution authorizing the President or his designee to enter into a Lease Agreement and/or series of Lease Agreements with Healthcare Realty Services Inc. for medical office space located at 9380 S.W. 150th Street, Miami, FL.

Page 2 of 3

FISCAL COMMITTEE MEETING MINUTES – December 18, 2015

3. Resolutions Recommended To Be Accepted

Mr. Knight presented agenda items 3 (a) and (b) with a recommendation to accept and forward with a favorable recommendation to the PHT Board of Trustees.

(a) 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

Motion to accept the resolution with a favorable recommendation to the PHT Board of Trustees

William J. Heffernan, Chairman

Carlos Trujillo moved approval; seconded by Irene Lipof, and carried without dissent.

(b) 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

Motion to accept the resolution with a favorable recommendation to the PHT Board of Trustees

William J. Heffernan, Chairman

Carlos Trujillo moved approval; seconded by Irene Lipof, and carried without dissent.

4. Adjournment William J. Heffernan, Chairman at 10:17 a.m.

Meeting Minutes Prepared by Ivenette Cobb-Black Executive Assistant Public Health Trust Board of Trustees

Page 3 of 3

2. Reports

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

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 Accounts Receivable All Hospitals December 2015 (FY16) Revenue Cycle KPI’s

Cash Collections Goal Actual

December 2015 (FY16) $85.3M $87M

KPI Best Practice /Benchmark Goal Actual Prior Month

POS Based on Table of POS Goals (Posted in PAT/DCS) $2.1M $1.8M $4.1M

Potential % of approvals compared to accepted referrals for the 90% 75% 92% Medicaid Conversion prior 90 days. AR Greater than 90 Less than 20% of discharged AR 20% 22% 19.8% Days Reduce Net denial write-offs FYTD (less Benefit Denial 5.5% 4.5% 5.2% exhausted amounts)

Benchmarks obtained by: HARA & Advisory Board ** Internal Target. No industry benchmark available Explanation for Variances • Cash goal for the month of December FY16 was surpassed by $1.7M due to increased billing for ICD10 claims (had been a slow down in October & November.)

• Potential Medicaid goal was not met by 15%, due to a slight backlog in applications for accepted referrals that occurred in the last three months with the impact of the holiday season and training for DCF staff that slowed productivity. Should see improvement next month.

• POS Cash goal for December FY16 not was reached due to patients’ annual deductibles reached and a decrease of deposits for transplants in the month.

• Denials: Goal met-still refining new denials’ identification methodology for FY16 in Revenue Cycle (likely to be additional accounts recognized next month).

• AR greater 90 days increased due to strategy recently employed to concentrate on billing for funded (insured) patients first and delaying unfunded (non-insured) patients. This has increased our cash but also negatively impacted accounts receivable-to be remedied in next couple of months.

3 JHS CBO Cash Collections Month FY-15 Cash FY-16 Cash October $76,350,606 $84,872,796 November $68,642,554 $79,417,884 December $84,192,529 $87,064,905 January $78,618,351 February $69,901,928 March $80,762,070 April $87,280,934 May $78,785,450 June $102,898,592 July $89,422,722 August $82,345,553 September $91,171,066 Total $990,372,357 $251,355,584

Source: JHS Treasury Management & Revenue Control Dept. Thank you, FINANCIAL & BUDGET TRACKING STATUS REPORT DECEMBER 2015

Capital Contribution (aka funded depreciation): The FY 2016 budget programmed $40 million of capital expenditures (both equipment and projects) to occur during the year funded with Capital Contribution dollars. For the current month end active capital projects funded with Capital Contribution dollars total $27.7 million. Of this amount, $4.8 million was spent in prior years leaving $22.9 million to be spent. Of that, $2.3 million has been spent Fiscal-Year-To-Date. The remaining $20.6 million is programmed to be spent in the current fiscal year.

Foundation: Active Foundation funded projects continue this year totaling $2.7 million of prior and current year funding commitments. Of this amount, $142 thousand was spent in prior years and an additional $13 thousand has been spent Fiscal-Year-To-Date. The remaining $2.5 million is programmed to be spent in FY 2016.

Series 2005 Revenue Bonds: Active Series 2005 projects total $19.2 million of which $8.1 million was spent in prior years, leaving $11.1 million left to spend. Of this amount, $1.6 million has been spent Fiscal-Year-To- Date. The remaining $9.5 million is programmed to be spent in FY 2016.

Series 2009 Revenue Bonds: Active Series 2009 projects total $22.6 million of which $12 million was spent in prior years leaving $10.6 million left to spend. Of this amount, $533 thousand has been spent Fiscal-Year- To-Date. An additional $8.7 and 1.4 million is programmed to be spent in FY 2016 and FY 2017 respectively.

Trust Funds and Grants: The active projects funded by grants total $6.8 million, primarily FEMA dollars allocated to the ongoing Ryder Trauma Center Hardening project. Of this amount, $5.5 million was spent in prior years leaving $1.3 million left to spend. Of that, $1.0 million has been spent Fiscal-Year- To-Date. The remaining $300 thousand is programmed to be spent in FY 2016.

Series 2015C GOB: Active Series 2015 projects total $129.7 million, of which $80 million is budgeted for the new Rehabilitation building. Of this amount, $766 thousand was spent in FY 2015 and $2.1 million has been spent Fiscal-Year-To-Date. An additional $59.1, $18.0, and $49.7 million is programmed to be spent in FY 2016, FY 2017 and FY 2018 respectively.

2 (b) Purchasing and Facilities Subcommittee

PUBLIC HEALTH TRUST BOARD OF TRUSTEES PURCHASING REPORT

January 27, 2016

TO: FISCAL COMMITTEE

FROM: PROCUREMENT MANAGEMENT DEPARTMENT

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.

SodexoMAGIC, LLC. $32,443,389.84 (For three years)

Total approved funding $32,443,389.84

The RFP was comprised of three separate models as set forth below:

January 2016 PHT Board of Trustees 1

It was determined by the Selection Committee that Models A and C were in the best interest of the Trust.

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)

January 2016 PHT Board of Trustees 2

Proposed FY 2015 Actual Savings $ 10,872,965 $12,085,867.00 $1,212,902.08

* 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.

In providing an evaluation of Sodexo’s present performance as incumbent, the Executive Office has reported the following:

January 2016 PHT Board of Trustees 3

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

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

The original contract was approved by Risk Management as to Insurance and Liability and by the County Attorney’s Office for legal sufficiency.

January 2016 PHT Board of Trustees 4

In providing an evaluation of the vendor’s performance during the current contract year, the following has been reported:

SECTION V. AWARDS UNDER A WAIVER OF FORMAL COMPETITION

A. Sole Source

No items to report.

B. Physician’s Preference

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)

January 2016 PHT Board of Trustees 5

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.

Leica Microsystems, Inc.: $ 441,298.82

Total Approved Funding: $441,298.82 (One-time purchase)

January 2016 PHT Board of Trustees 6

ECRI and MDBuyline have reported that the discount pricing provided by Leica Microsystems, Inc. falls within above average competitive price point for the system.

In providing an evaluation of the vendor’s performance during the current contract year, Jackson South Community Hospital has reported the following:

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.

January 2016 PHT Board of Trustees 7

Therakos, Inc. $600,000 (Estimated consumable spend for two years)

Total approved funding: $600,000

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.

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.

January 2016 PHT Board of Trustees 8

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.

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

January 2016 PHT Board of Trustees 9

Jackson Memorial Hospital 5.5% Jackson South Community Hospital 5.3% Jackson North Medical Center 4.2%

In providing an evaluation of Cerner Corporation’s performance during the current contract year, the Information Technology Department has reported the following:

SECTION VI. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE COMPETITIVELY SOLICITED

No items to report.

SECTION VII. OPTIONS-TO-RENEW AND CONTRACT MODIFICATIONS FOR CONTRACTS THAT WERE AWARDED UNDER A WAIVER OF FORMAL COMPETITION

January 2016 PHT Board of Trustees 10

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

* Talent Management * Contract Management * Supply Order Management

In providing an evaluation of Velocity’s performance during the current contract year, the Information Technology Department has reported the following:

January 2016 PHT Board of Trustees 11

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.

January 2016 PHT Board of Trustees 12

3. Resolutions Recommended To Be Accepted

TO: William J. Heffernan, Chairman and Members, Fiscal Committee

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.

Fiscal Impact/Funding Source The items included are part of the Trust’s budget.

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

Agenda Item 3 (a) Fiscal Committee January 27, 2016