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All right, good morning, everyone. I call the board of trustees meeting to order and note that

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a quorum is present. The time is now 8.30 a.m., the live one. While some board members are

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in the room with us today, others will participate by video conference estimates, full by state law,

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and the Harris Health video conferencing policy. Holding participants, scheduled to speak, have been

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provided dial in information for the meeting. All others who wish to do the meeting may access

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the meeting online through the HRSELF website. Please note, there are ceiling microphones in the

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boardroom and the audio may pick up background noise. As such, we ask that all individuals limit

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their side conversations during the meeting so that we can maintain the quality of the audio for

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the public. Please keep your devices on mute until it is your turn to speak. Please use the chat

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function to alert the chair. That's me. That you would like to speak. Do not put the content of your

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comments or questions in the chat. Only alert me that you would like to speak so I can acknowledge you.

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please do allow me to acknowledge and recognize you before you make comments or ask your questions.

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With that, we move to agenda item number two, the approval of our previous meeting minutes.

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Do I have a motion and a second for approval of the May 22nd, 2025, or the meeting minutes?

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So, move to the second. Thank you, Ms. Verablan. Thank you, Ms. Ferret. Any discussion?

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All in favor say aye, aye. Any opposed? Hearing none, the motions passes and the minutes are approved.

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I now, uh, turns you agenda item three, A, RCEO report, and by Dr. Porsa to say a few comments.

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Thank you, Dr. Puy. Good morning, everyone. I'll keep my comments pretty first and foremost,

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happy play that were paid by Dr. Puy. Also, I wanted to acknowledge that today is your last day

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as our board member. So, I wanted to say thank you from the bottom of my part and let you know how

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much you have meant to me personally. I do have a style. So, thank you for your service,

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your dedication, your commitment, much much appreciated. We will miss you.

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To

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brief comment, our last week we had the Texas Commission on Jail Standards visit

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at Harris County Jail. This was a suit to not stop the bottom survey of the entire Jail

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facility, including the Croatia Health Care and I'm proud to say that after one week of our survey,

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The only two technical assistance, which is what they call their findings,

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regarding the medical care instead of the Harris County jail,

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had to do a documentation of dietary referrals and the recreation

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for the folks who were admitted to our infirmary.

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Those were the only two findings after one week of serving at the Harris County jail.

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So I wanted to take this opportunity as I thank you to all of our staff

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instead of the Harris County jail and the Sheriff's Office for

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their cooperation, allowing us to do what we need to do to take care of the folks inside

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the Harris County Jail. And with that, Dr. Parker, I'll turn it back to you. Thank you.

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So next is the item 3B board member announcements. I do have a brief comment I'd like to make,

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but I want to see if any of our other board members have announcements that they'd like to make.

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I just wanted to say that since today is my last board meeting that serving on this board has been the highlight of my career and has meant so much to me but personally and professionally.

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I hope to serve on the board longer and unfortunately I'm having to leave the state because our Texas legislature decided to pass laws.

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hospital to LGBT populations that make my continued residence in the state

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untenable.

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And I want to, for anybody listening, just ask that we all recognize

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that vicious laws like that are going to cause brain drain on the state. I was

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not appointed to this board by commission of Rionis because I'm trans, although I

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was the first trans person to be appointed me because I'm a lawyer and a doctor, but

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But I'm being effectively forced off of this board by the realities of our legislature.

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I would love to continue to be on this board, but I can't because I have to do what's best

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for me, which is to get out of this state that is becoming increasingly hostile to my community.

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And so, while diversity didn't get me on the board, my diversity is what's forcing me out

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thanks to what happened in Austin, and I just want to commend this organization for always

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been committed to being on the right side of history and doing what's right and I'm going to miss

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you guys so much.

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We now move to our public life. I'd like to make a comment. Of course please.

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So I want to thank you for welcoming me when I came to the board and always being able to answer

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the question. Answer questions whatever I had them. You made sure that I understood my role

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here on the board. Your effectiveness in leading us on our governance committee and always being

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honest and finding for was right. It's important in setting a standard. So we will continue that

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that standard, even though you won't be with us,

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but I believe we've made a prayer for life.

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And so I want to thank you for your service on this floor

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and hope that at some point in the future,

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you'll be able to call it used to the home again

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because you'll always have family here.

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So thank you for your service and thank you

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for enriching my life in the patients here at Harris Health through the work that you

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have advocated for it and have done a little over your term.

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Thank you so much.

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All right, so with that, we will move before I get the FBI.

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We're going to move on to public comment, and I see we haven't speaker scheduled miss Nicarani

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from nursing point.

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That's not correct.

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Good morning.

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I didn't really get to see all of your faces on my computer screen so I'm

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fan-girling just a little bit. But my name is Nikita Theroni. I'm here on behalf of

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Precinct for Commissioner Leslie Breonez. We want to thank you Dr. Pike for your

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unravering dedication to advancing health equity to representing all of

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county residents and then advocating for the LGBTQI plus community. Your time here has made

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us very proud. Often we get to report back to Commissioner and just stand all over you and how

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you're just rocking it. So we really appreciate you. I have a certificate for you that we can

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I'll give you once we're done, and I just want to thank you.

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Thank you so much.

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Of course.

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You can get still on uncomfortable with Grace.

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All right.

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We're moving now to agenda item five, discussion regarding board governance, best practices,

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Miss Karma Bass with the Health Care Consulting.

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I turn out to Miss Bass to say a few words about the sign up.

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Good morning, everyone, and thank you for the opportunity to be here today.

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Can you all hear me okay?

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I'm sorry I can't be there in person with you today, but I appreciate the opportunity

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to see so many familiar faces again for those of you that don't know me.

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I had the privilege of facilitating this board's retreat last September and have been working

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with Harris Health for about a year now.

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I think I started my work preparing for the retreat a little bit earlier than this time

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last year. And I work nationally with hospitals and health systems, primarily other health care

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non-profits as well. My area of expertise is governance as well as strategic planning and

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leadership development. So I bring with you about 30 years of working with boards of directors

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similar to yourselves and different across the country. I do have a particular focus in public

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district hospital boards in those states across the country where they exist, similar to Texas.

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So, I am not a Texas law expert by any stretch, so I do rely on your in-house counsel Sarah quite

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a bit for that guidance. But my intention here today with you is to provide you just kind of like

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a tiny bit of updated governance best practices information and I hope that

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this information will be helpful to you. We'll keep my comments relatively short and

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would welcome any questions, comments, engagement that you would care to offer,

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either as we go along feel free to raise your hand and interrupt me if I don't see a

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raised hand but also happy to take questions at the end. So I just want to start

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out and please go to the next slide, Jennifer. I want to start out by thanking you for taking the time

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to take on this job. I know it is no small feat to be a trustee and certainly not at a public

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district organization like Harris Health, you operate in a very large context with a lot of visibility

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given to you. So I want to thank you for doing this in my opinion. Trustees play a vital and often

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under appreciated role in healthcare today and too often we see trustees kind of not given

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there do. I'm pleased to say that's not in my experience in working with or observing Harris

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Health and I'm glad to work with an organization that truly values the contribution of its board

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members and values the role that governance plays. One of the things I like about this particular

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quote and this book is old but I think the quote still stands is that it kind of shows the unique

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position. No one else can have the advantage on the organization that you are able to have

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as a trustee and so therefore your role kind of bridges that gap between the organization and

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the community. You are both of the community but you are also of the organization and so I just

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think that kind of your role providing this crucial perspective is something that provides great

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stewardship on behalf of the entire community. The next slide that I have is also one I just want

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to give you as a reminder I know that you are familiar with this you've received training on this

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but these three core fiduciary duties kind of ground your role as the stewards of the public resources

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so the way that you fulfill these means showing up being prepared asking good questions,

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maintaining confidentiality and what's interesting in Texas which I'm not

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familiar with any other state that has this requirement although there may be

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them out there but you in order to fulfill your duties as a board member you

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actually have to be in person so a quorum as you all know very well has to be

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established in person and without a quorum of course the board can't can't act

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can't do it's one of its primary functions which is to make decisions so the

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The next slide I think provides a little bit more granularity because my goal in providing

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you information is to give you something that you're able to use and maybe apply in your

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role.

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And so here are just some examples or some illustrations of how you can feel comfortable

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that you personally as a trustee and you collectively as a board are fulfilling your duties of care

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obedience and loyalty.

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So the duty of care really is about being prepared, about attending the meetings regularly,

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about having read the materials, about being thoughtful, about decisions that are being

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brought to you before you make any final decisions, and also doing the regular performance reviews

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both of yourself in the form of a board self-assessment and the president's CEO evaluation, which

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will happen, part of which will happen today in executive session.

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So, I just want to bring these to you as a way of kind of like a lot of times board members are,

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well, what are these fiduciary duties? How do I know if I'm doing them? These are the kinds of

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things that you can look for to assure yourself that you are, in fact, carrying out the duties.

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Of course, these are not the ceiling of what we hope for you to achieve. These are sort of the floor

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of kind of the entry level of, you know, kind of your ticket to ride and governance is to fulfill

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these three duties and I'll be talking a little bit more about when you go above and beyond what

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does that look like. So the next slide talks a little bit about that kind of what do excellent

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boards do because it's one of those things that having done this work as often as I have and all

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over the country there are a lot of things that are different from board to board of course but there

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There are some things that you sort of get a sense of when you work with a board.

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And one of the things that I noticed in particular is that really excellent boards are just

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obsessed with this idea of focusing on governance and not management because it is so easy

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to slide into a focus on kind of doing what management does.

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And in fact, you have very qualified, very well experienced managers and executives running

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the organization for you.

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There is no one else, however, that can do the role that you do, which is governance.

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And so that is why, for myself, I really encourage boards to be, you know, have that laser focus

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on is what we're doing governance, or is it management, and why it matters is that no one

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else can do the role of governance except you and all of the well-qualified people that

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you have in place are doing the management role.

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It's kind of like how your eyes can't simultaneously focus on a near-field of vision and a far-field

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division.

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The management is the near field division, and if you're focused there, then you're missing out on the far field division, which is governance. When I say that the board is not a legislative body, what I mean by that is that you collectively have to come together and agree on a direction for the organization. It's not 51% on a vote of some significant importance to me would be a failure on the part of most boards, depending on the or on the organization.

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and the decision because you represent the senior leadership of this entity and the people

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kind of like in a family system where the children are always watching the parents to learn how they really should behave.

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What kind of like in a family system you've got the board and with each other and with its CEO and senior leadership,

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the rest of the organization is watching you for signals.

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For signals to tell them, this organization is going in a great direction, this organization

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is one you should be proud of working with, this organization has a strong culture,

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we treat each other with respect and engagement.

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And when they see the senior leadership of the organization kind of, you know, not collectively

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moving in one direction, not agreeing on the really, really big things, not that you shouldn't

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voice differing opinions by all means you should and you should get into issues and you

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shouldn't always agree we don't want group think at the same time at the end of the day

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you should be able to find a place where you all can represent a unified perspective moving

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in a single direction that can send the signal not only to the people that work for you

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and the providers that take care of the patients but the community at large so that's kind

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of what I would say about what do excellent boards do, another thing that excellent boards

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do on the next slide is really focus on the facts that meetings are their only currency.

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So what I mean by this is that as individual board members, you have no individual authority.

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The only time that the board technically exists is when you're called together in a

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duly constituted meeting.

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And so unlike the roles that you might play in your personal or professional lives, where

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you carry the mantle of that authority, whether you're sitting in a meeting or sitting in front

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of a computer screen or out meeting with folks in the community, the only time you wear

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the mantle of the authority of this board is when you are in the meetings like today.

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And so for that reason, I recommend that these meetings be treated with an even higher

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level of seriousness of kind of the fact that this is a rare commodity for this organization.

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And so one way to do that is to make sure, and I believe that you have these things in place,

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really excellent planning for the meeting, making sure there's plenty of time for dialogue and

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discussion, making sure there's well-documented summaries through the minutes of what has actually

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happened, and taking time to make sure that you're touching base with each other and understanding each

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other's point of view well enough so that you can develop that healthy board culture.

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And one of the challenges that I believe that you face at Harris' health is that you

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do have this, the changing of your board members can happen quite frequently and from time

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to time without any kind of rhythm or rhyme.

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And so what this does, and I don't mean that as a criticism of the practice, it is written

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into state law and I greatly respect, you know, kind of the structures that drive that,

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But the inherent challenge, which is one to be addressed and overcome, is that any time

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you have a group of people working together, if you take one person out, like unfortunately,

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losing Dr. Pike after today, or you add one person in, it essentially, we know from social

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science research, it essentially becomes a whole new group. And so in order to foster that good group

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culture, particularly when you have a group like yourselves, a team like yourselves at the board

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level, who does regularly have players kind of switching in and switching out, it's important to

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focus on this board culture even more than another board might do is my recommendation. The monthly

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meetings where you have the richer conversations and the timely conversations are really important,

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I do think that because you oversee such an enormous organization with Harris South

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and so much complexity that having these monthly meetings is really critical and any time

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a monthly meeting is missed, it's quite likely that certain work in the organization grinds

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to a halt.

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So for instance, credentialing of providers is something that needs to happen on a monthly

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basis and when the board isn't meeting or doesn't have a quorum to meet, then what happens

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is there are providers out there who may be ready to come in and treat patients and aren't

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able to do so because they weren't able to get privileged and credentialed to see patients.

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And so that is why it's really important that you recognize this meeting as a currency that you

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possess and a very rare and precious one at that.

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The next slide gives you just another idea.

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And this one is one we think I have spent every.

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Oh, yes, please.

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Sorry.

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We need to take it, but just pause for just a second, please.

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Absolutely.

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I have to step out and she'll be right back.

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OK, no worries.

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Other organizations might do a presumption of quorum

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and not hear us help.

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I'm always learning.

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We don't just establish quorum and then assume

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that we have at the rest of the meeting.

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Please continue.

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Thank you.

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Wonderful.

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Thank you so much.

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Another thing that I see excellent boards do when I work with different organizations

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around the countries, they're very focused on the fact that this relationship between the

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board and the CEO is really one of primary importance.

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It should be at least to the board members and the CEO themselves.

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What I recognize in doing this work is that I've never seen a

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Board be successful by undermining the success of its CEO, and vice versa, I've never seen a CEO be successful by undermining the success of the Board.

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More importantly, the organization itself doesn't succeed.

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Now, I have often seen boards where the CEO is not the right fit for the organization and not able to deliver on what the organization needs,

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And it then becomes the board's responsibility to find a new CEO, to replace that CEO.

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So I'm not suggesting that boards in any stretch should just accept, you know, CEOs

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that aren't a good fit for their organization.

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But I would suggest that if you believe that your CEO is a good fit for your organization,

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you believe that he or she is delivering on what it is that you are looking for for the

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organization and the community, then it is incumbent on each one of you individually and collectively

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to do what you can to support each other. And again, it's that idea that your actions and the way

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that you treat each other is being very closely watched by all of the people that work for you in

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the community at large. So I think that it's like a family, you know, we have our disagreements

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and our arguments in private when you give the CEO his evaluation, those things that you

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would like to see done better, those things that you feel like are not where they need to be.

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That happens in executive session and going forward with the work that you do with the CEO,

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having each other's back is a really critical role for outstanding boards to do.

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The next two slides share a little bit of, it's a little bit tongue-in-cheek and I'll try to explain

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kind of what I'm saying here, but this idea that CEOs get frustrated by things that

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boards do and boards get frustrated by things that CEOs do and so here's the slide about

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what CEOs get frustrated by and this is what I see. A lot of times board members will

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misunderstand that their role is somehow the role of kind of to police the organization

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or to catch the organization doing something wrong and what I can share with you is that

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there are dozens, if not 100, external entities that are watching your organization all the time,

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all kinds of accreditations, regulatory oversight, laws being attended to compliance issues being

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managed, and so as a board, you can feel fairly comfortable that so long as you're not seeing any

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red flags and you're not hearing any reports that sound troubling, you can feel fairly confident

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that someone else is being the police and making sure the really bad things aren't happening.

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And your role is to kind of work together.

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So many of these bullets, as you see, have to do with that sort of cop mentality.

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The insufficient health care knowledge is a challenge for board members coming from outside.

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our field, our environment and health care is one that kind of defies logic in many cases

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and so it does require a regular resource of education and training for the trustees

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so that you can feel up-to-date and knowledgeable.

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Another thing that is very important is as you do currently to have at least a couple of folks

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who have clinical background on the board so that have an understanding of kind of

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what it's like to care for patients, either if doesn't have to be an MD, more and more

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often I see nurse practitioners or RNs, other ancillary service providers, but I do think

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that would be one thing in going forward since today, unfortunately you're losing someone

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who has that MD to, I know you are not the ones who appoint the board members, but you

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a couple, not entirely made up of clinicians, but having a board that includes clinicians

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is an important role, so that you have that grounding in understanding of what it's

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like to care for patients.

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The next slide shows what IC boards get frustrated by in their CEO or executive teams, and the

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fully baked cake is the concept that you hear about something very large for the organization

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on the first day and you're asked to act on it and you maybe didn't get a whole lot

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of information in advance and it's a very significant decision and it really wasn't something

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that just came up overnight but you're hearing about it for the first time and the management

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says, okay, we need your approval, we need your vote on this.

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That would be what I would call a fully baked cake and really outstanding executive teams

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that I work with will give the board multiple bounces on an issue before they ask for an

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action to be taken. Dr. Pike.

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You can tell us we could jump into questions.

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Yes, we did.

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This is more of a comment.

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And it's a question by way of a comment to see if that is,

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if your experience is similar to what my perception is,

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I see the fully baked cake.

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And the Board of Trustees, the trustees' duty of care

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has been closely related because if the trustee is not

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preparing, or their meeting, and for not reviewing materials, it can feel like the cake is more

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baked than it actually is. So if you're coming into the meeting without any pre-work done,

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then what you're being presented feels even more overwhelming than it already is. Is that,

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would you agree with that sentiment that the frustration of the fully baked cake can be to an extent

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offset by board members engaging in their duty of care and preparing before it?

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Yes, absolutely. I appreciate you making that connection because that is a frustration

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I have heard from executive teams at time is that, you know, they say they want information,

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we provide the information, we never hear whether that's the right information or not, and

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then we get criticized for not providing enough information. And so I do think it's important

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for board members to make sure that they're thoroughly reviewing the materials. And honestly

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I will tell you board members if you don't understand something that's in your packet and I would

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be surprised given the complexity of the information if there isn't a right because I don't understand

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everything in all the packets that I read and I've been doing it for decades. If you don't understand,

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then ask the question because your executive team I know the women and men that work with you here,

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they would love to be able to provide you information that is more targeted to what you need to

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know what you want to know. And so that engagement around the information that's being provided people have spent hours and hours if not days of their working time developing these materials they would love to know how those materials are working for you and it really is incumbent that you take that time in advance to prepare for those meetings because if you don't you are not going to be able to make an informed decision and that is really the basis of the legal obligation.

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that you have committed to doing.

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Now, one of the things that I think is really important

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to note is that, you know, as trustees,

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you are volunteers and I, again,

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that's why I commend you for this incredible service.

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And you're volunteers and that's,

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however,

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you cannot afford to be amateurs.

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This organization that you run is critically important

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to the well-being and health,

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not only of the hundreds of thousands of patients

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that you see every year through your various venues,

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but also to the community at large.

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And so it deserves your very best time and attention.

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And what I would tell you, which I tell boards all the time,

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if this is not something that, you know,

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oftentimes people are surprised.

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By what's involved in being on a board, what's they get on a board? I mean, I've asked questions in conferences of hundreds of people. How many of you, when you got on the board, found that it was what you thought it was, or how many of you found it was not what you thought it was and, you know, two thirds, three quarters of the people in the room will raise their hand. But, oh, it's funny. It raised my hand for me. It's so smart.

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But so it's not always what you think it is to get on a board, but if you get on a board and you find you just cannot meet the obligations of the board, the higher level of service is to acknowledge that and allow there to be somebody else to be on that board.

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Now I'm not saying I would encourage any of you to resign because Dr. Porsa tells me that this is the favorite board that he's worked with so far in terms of just how well people show up and engage in all of that.

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So I he would get mad at me if he thought I was suggesting you leave. However, if you find

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that the commitment is just not for you, the noble thing to do is to recognize that you're not

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able to meet the obligations. The next slide just kind of goes on what I see as the buckets of work,

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as a as a as a board member. So if you are on the board and you're wondering what is my job description

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and you've got an incredibly well-written standard operating procedures now in your board

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book and your board policies. So that's one of the legacies that Dr. Pike is leaving behind her

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is that I believe that she shepherded that and I would encourage you to read that and know it.

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The other thing that I would encourage you to do is think about these six kind of buckets of work

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being your primary areas of responsibility for boards and your monthly engagement with these

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areas, make sure that you're able to do the oversight of the organization effectively.

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And I'm not going to go into detail on them because I know my time with you this morning

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is short. The next thing I want to just talk about briefly though is that distinction between

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governance and management. And how do you know? Jennifer, if you could go to the next slide please.

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The, so a common challenge is to understand where boardwork ends and management work begins. And

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And the reason that this is a challenge is because in each organization, in each circumstance,

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it could be a little bit differently and it could be a little bit different.

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So depending on where the organization is in its life cycle, depending on what level of

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crises may be facing the organization, I have seen this line legitimately shift about where

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the distinction is.

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What the really great boards that I work with do, though, is they actually think about this

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and like I mentioned earlier they're always focused on where are we at. There was a board

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that I worked with in Southern California for many years. They had a person on a man on the board

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who was a retired medical device salesperson. He was loved governance. He loved

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he loved the fact that he could be there and make a difference for his community and he's

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really focused on quality even though he didn't have a clinical background for that.

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But one thing I will never forget is in the middle of a quality committee one time, they

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were talking about some very specific aspect of how the organization does certain things

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and he stopped the meeting because he was the chair and he said, excuse me, I just want

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to ask the question here, this is a really fascinating conversation, but are we focusing on governance

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right now or are we focusing on management detail?

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And I think that's kind of the thing is that what we do in health care I believe is really endlessly fascinating.

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And so as a board member making sure that your questions and your areas of focus have to do with kind of what your role is as a board.

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And frankly what I would share, this is my perspective of course, is that idle curiosity just doesn't have a place in the board room.

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If there is a question you're asking or information you're asking for, it should be related

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to the board's role, or it probably is not something you should be asking for or focusing

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on in your governance capacity, of course, you know, love to have you learn more about

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things in your own time.

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The next slide just gives you a little bit more granularity on that because that is what

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I was kind of wanting to do for you today is how do you know?

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So great boards are always bringing things back to the mission and vision, they're focusing on what is our strategic direction which I know you're in the midst of right now.

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So looking forward to seeing what you come up with in that regard and they're focusing on the policies and procedures.

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And so for type A people who have been really outstanding managers and executives in their own right sometimes sitting on a board feels a little bit anticlimactic and people may feel like, well, wait, I'm not quote unquote doing anything.

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But actually the higher level of governance effectiveness is to focus on that oversight and it's what one board chair that I worked with in Pennsylvania said one time we follow the NIFO rule which is nose in fingers out.

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So that's kind of the management governance distinction, and I hope that slide is helpful

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to you.

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One of the interesting nuances for you at Harris Health is that when we talk about mission

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and vision, your obligation as a board member is to serve the mission and vision of Harris

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Health itself, and while Harris Health, of course, exists to serve the community and the public,

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the duties of loyalty, care and obedience are owed to Harris health, not to the public

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at large.

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So, when you think about who do we report to, you are, you are, your selves reporting

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to yourselves, you are focused on the mission and vision of the organization and the carrying

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out of the organization's purpose in serving the community, but you are not kind of directly

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responsible to the community, you're responsible to that mission, and of course, that's my opinion.

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I know that opinions may vary on that, but that's the perspective I would bring you.

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The last slide that I have for you this morning is that, you know, just kind of these important

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notes that I will leave you with. The Board's governance, a collective body, not as individuals or

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subsets. Speaking with one voice really ensures that clarity and consistency and creates confidence

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on the part of the employees and the providers that work for you, it creates confidence on the part of the community that you all are unified in the kind of what you see as the highest and best way to provide health care to them.

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And it builds that trust which is so essential we're learning more and more in all of our areas of work and business that trust is really the underpinning of everything else.

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So, I will stop there and I think I may have just a few more minutes and I think there's

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a comment or a question that someone had mentioned in the chat.

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Thank you so much, Karma, Ms. Robinson, you had a comment?

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I do.

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So, one of ones to make sure that the presentation will be put in diligent, make sure we give

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that.

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But, second, I wanted to mention at the privilege of attending the Texas Health Care Trust,

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these governance conference with Dr. Portian, some of the staff.

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And if any of the board members get an opportunity to go in the future,

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I think that it would be, it's definitely a conference worth attending.

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I learned a lot, not only in my role as a board member, but helping me understand some

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of the challenges and that some of the challenges that we talk about are not unique to Harris

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help, but our challenges that public health systems are facing across the state until being

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able to talk to other trustees and it's meeting that I did talk to are where you guys talked about

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as being several, several years back. And so I think that it was both interesting to get

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perspectives from around the state, but to also understand some of the legislative challenges

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is that we all face and how to go about addressing those.

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So I think it's important from our role in governance

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if we have an opportunity to participate in conferences

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like that, that we make an effort to do so

414
00:38:56,940 --> 00:39:00,680
because I think that it makes us a more informed and educated

415
00:39:00,680 --> 00:39:03,600
board, especially those of us who aren't in health care

416
00:39:04,100 --> 00:39:06,780
to help us to better understand that.

417
00:39:07,720 --> 00:39:11,060
And I think I didn't have to twist his arm,

418
00:39:11,180 --> 00:39:12,820
but one of the things that Dr. Porson,

419
00:39:12,820 --> 00:39:17,460
that I spoke about at the conference was a certification

420
00:39:18,820 --> 00:39:21,940
that I suggested that we all participate in

421
00:39:21,940 --> 00:39:24,000
and then getting as a board.

422
00:39:24,620 --> 00:39:26,340
And I think that that will also elevate

423
00:39:26,900 --> 00:39:28,940
our role in the governance.

424
00:39:29,260 --> 00:39:32,840
So Dr. Porcettino, if you want to speak on that at all.

425
00:39:33,360 --> 00:39:36,040
Sure. First of all, thank you for attending the conference.

426
00:39:36,240 --> 00:39:37,960
And one of the other things I would like to add

427
00:39:37,960 --> 00:39:41,680
to the impact of attending the conference like that,

428
00:39:41,680 --> 00:39:48,380
whether they gave me an opportunity to associate with you, you know, out of the board, which was,

429
00:39:48,380 --> 00:39:56,740
which was awesome. But yes, so in speaking up with Ms. Robinson and also speaking to Dr.

430
00:39:56,920 --> 00:40:01,420
Parnayak, who's the chair of the United States health care trustees, they are actually willing to come

431
00:40:01,420 --> 00:40:10,200
to Houston to educate the board in Houston and then provide the kind of a brief

432
00:40:11,560 --> 00:40:18,700
competency check examination to get everybody certified as a trustee, which I think is

433
00:40:18,700 --> 00:40:19,680
a secret opportunity.

434
00:40:19,940 --> 00:40:22,720
And I know with Ms. Robb, I said it just elevates this sport to another level.

435
00:40:24,580 --> 00:40:26,720
And I echoed everything they just said.

436
00:40:26,780 --> 00:40:31,000
I went to the conference last year and really, really enjoyed it.

437
00:40:33,060 --> 00:40:36,600
I'm ashamed to say that I had planned on getting my certified healthcare trustee certification

438
00:40:36,600 --> 00:40:37,660
but just did not find time.

439
00:40:38,800 --> 00:40:42,120
But getting that certification, I think, would be a great idea for board members.

440
00:40:43,560 --> 00:40:48,340
I wanted to echo something that Carmen said with regard to idle curiosity

441
00:40:48,340 --> 00:40:50,660
or where you feel like there are gaps in your understanding.

442
00:40:52,140 --> 00:40:56,680
I really want to encourage board members use each other as your first resource.

443
00:40:57,420 --> 00:41:01,200
You know, Dr. Borses, our only employee, he has a very busy job.

444
00:41:01,420 --> 00:41:03,880
He doesn't need us asking him to educate us.

445
00:41:04,680 --> 00:41:10,620
And it is inappropriate for us to go around him to ask staff members directly to educate us.

446
00:41:11,560 --> 00:41:18,280
That doesn't mean that Dr. Corsa and our team isn't open to and willing to do that because they're wonderful people.

447
00:41:18,800 --> 00:41:21,280
But I would encourage you to use each other as your first line of resource.

448
00:41:22,300 --> 00:41:28,160
Ms. Robinson, you brought up that when you joined the board, I really love that you were willing to come to me and ask me questions.

449
00:41:28,820 --> 00:41:33,360
and I think that phosphorus is a really great dynamic among the board and it's respectful

450
00:41:33,360 --> 00:41:37,540
of everyone's time because that way board members are educating each other with our time

451
00:41:37,540 --> 00:41:45,020
rather than educating the board becoming a to-do list item for paid staff or for our CEO

452
00:41:45,020 --> 00:41:46,800
to add on top of their article plate.

453
00:41:47,460 --> 00:41:52,580
So I really hope we can continue that working together and educating each other because

454
00:41:52,580 --> 00:41:55,840
we all have, you know, more about housing than I could ever hope to know.

455
00:41:55,840 --> 00:42:02,320
So, Ms. Barrett knows more about, you know, healthcare finance, and I know that we all have

456
00:42:02,320 --> 00:42:06,740
our own expertise, and I think because of the complexity of healthcare, we can all lean

457
00:42:06,740 --> 00:42:07,660
on each other in that way.

458
00:42:09,220 --> 00:42:12,960
Any other comments or questions about Ms. Vast's presentation?

459
00:42:16,990 --> 00:42:17,770
Thank you for your time.

460
00:42:18,330 --> 00:42:19,610
Thank you so much.

461
00:42:20,270 --> 00:42:23,870
And we are actually four minutes ahead of schedule.

462
00:42:23,870 --> 00:42:28,910
So with that, we've come down to agenda item number six.

463
00:42:29,470 --> 00:42:34,770
The board will go into executive section for item six A through G as permitted by law

464
00:42:34,770 --> 00:42:42,590
under Texas Occupations Code, sections 151-002, 160-007 and Texas Health and Safety Code,

465
00:42:42,910 --> 00:42:52,370
one section 161-032 and Texas Government Code, sections 551-071-551-072-074-085.

466
00:42:53,050 --> 00:42:56,910
Board members and presenters scheduled to speak in executive session do not need to log

467
00:42:56,910 --> 00:42:57,210
out.

468
00:42:57,830 --> 00:43:00,250
IT will move you in and out of the executive session room.

469
00:43:00,550 --> 00:43:04,290
The public meeting will resume via live stream from the Harris Health Web site upon our

470
00:43:04,290 --> 00:43:05,790
return from executive session.

471
00:43:06,070 --> 00:43:11,650
The time is now 9.13 a.m., it will take a brief technology recess in order to transition

472
00:43:11,650 --> 00:43:13,170
to our virtual executive session.

473
00:43:19,540 --> 00:43:21,840
Let's take it and I note that the form is present.

474
00:43:22,360 --> 00:43:28,140
The time is now 10.33 a.m., this brings us to agenda item 8.

475
00:43:28,140 --> 00:43:33,380
discussion related to bent-top infrastructure and notice to the city of Houston, Texas,

476
00:43:33,820 --> 00:43:38,820
regarding chapter 26 hearing on a proposed taking by him in the domain of approximately 8.9

477
00:43:38,820 --> 00:43:44,560
acres out of Kerman Park, the adjacent to bent-top hospital for a project to expand the hospital's

478
00:43:44,560 --> 00:43:50,940
facilities. I invite Dr. Porso to say a few words about this, I am. Thank you, Dr. Biden. Good

479
00:43:50,940 --> 00:43:56,780
morning again, everyone. I try to be brief while covering the important aspects of

480
00:43:56,780 --> 00:44:04,520
conversation. As the board is aware, in November of 2023, the Harris-Kami residents overwhelmingly

481
00:44:04,520 --> 00:44:12,320
supported our $2.5 billion bond proposal. Part of that bond proposal was the construction of

482
00:44:12,320 --> 00:44:21,720
a new hospital in the LGJ campus, the vast investment in our community health clinics, but also

483
00:44:21,720 --> 00:44:28,520
So, summer, the north of $400 million in the expansion of Bentop Hospital in the form

484
00:44:28,520 --> 00:44:35,800
of a new inpatient tower added about 100 inpatient beds and procedure periods.

485
00:44:37,100 --> 00:44:43,700
The issue has always been that, at the end, they have studied the event of infrastructure

486
00:44:43,700 --> 00:44:52,440
and its location. It has been a question as to where does it make sense for us to invest

487
00:44:52,440 --> 00:44:59,940
that $400 million towards a near-term expansion event out of the hospital and ultimately replace it.

488
00:45:00,000 --> 00:45:08,760
In the future years, 20, 25 years from now. The issue is this. Ben Top Hospital is very fast

489
00:45:08,760 --> 00:45:15,640
approaching this end of his useful life, while we could potentially build on top of the

490
00:45:15,640 --> 00:45:23,260
existing mental hospital. That is not a feasible option, a practical option, and a very expensive

491
00:45:23,260 --> 00:45:31,700
option. Obviously, building a hospital that is currently serving our patients will cause

492
00:45:31,700 --> 00:45:37,740
an issue in the hospital being able to continue to provide those services. Number one, number

493
00:45:37,740 --> 00:45:44,820
two, you know, investing $400 million on a rapid-leaf aging and bail the infrastructure,

494
00:45:44,840 --> 00:45:48,720
just as not sound like a wise use of taxpayer money.

495
00:45:50,220 --> 00:45:55,560
The other issue, if we were not going to be able to build a top of the ventile hospital

496
00:45:55,560 --> 00:46:02,580
which we have studied it and the answer is no, we're not able to do that, is there an opportunity

497
00:46:02,580 --> 00:46:08,420
to build on the grants of ventile hospitals similar to what we're doing on the LVJ campus,

498
00:46:09,240 --> 00:46:15,800
build a new hospital wall to exist and the hospital continues to operate at this starting

499
00:46:15,800 --> 00:46:22,660
with the intention tower. And the answer, unfortunately, is no, because of the issue of

500
00:46:22,660 --> 00:46:30,320
ventile-based landlocked. What you see on this slide is the, as you might point out here,

501
00:46:31,200 --> 00:46:40,400
eastern zoo from the park, the memorial hermit in the light blue, ventile-based college of medicine,

502
00:46:40,400 --> 00:46:42,320
and behind Bentow Hospital here,

503
00:46:43,300 --> 00:46:45,440
and adjacent to Bentow Hospital,

504
00:46:45,440 --> 00:46:50,180
also part of the urban park, land owned by the city of Houston.

505
00:46:51,520 --> 00:46:54,880
So really, there is no space on the current footprint

506
00:46:54,880 --> 00:46:57,860
of Bentow Hospital where we could potentially begin

507
00:46:58,620 --> 00:47:01,700
with the creation of a new inpatient tower.

508
00:47:02,960 --> 00:47:06,540
And again, sometime in the future, 2020,

509
00:47:06,540 --> 00:47:11,440
25 years, it's the future once we are able to go back to the residents of Paris and

510
00:47:11,440 --> 00:47:15,600
from the bottom of the proposal to replace penthouse hospital.

511
00:47:16,800 --> 00:47:21,540
So what I'm bringing into the attention of the board, I'm the public for that matter

512
00:47:21,540 --> 00:47:32,900
today, is the idea of Harris Health requesting that Harris County on our behalf condemn the

513
00:47:32,900 --> 00:47:41,280
land that is owned by the city of Houston adjacent to ventile hospital this land is part of

514
00:47:41,280 --> 00:47:46,840
permanent park hybrid it is not contiguous with the existence of permanent park it is across

515
00:47:46,840 --> 00:47:55,080
the street on Cambridge and adjacent to ventile hospital this land represents less than 2% of the

516
00:47:55,080 --> 00:48:06,640
entirety of permanent park land. And it is the only reasonable feasible, basically responsible

517
00:48:07,320 --> 00:48:16,720
option to start the initial expansion of the hospital in the form of the investment of the

518
00:48:16,720 --> 00:48:25,880
The $400 million bond proceeds to create that 100-bit inpatient tower adjacent to Bentow

519
00:48:25,880 --> 00:48:32,540
Hospital on the Parkland and will become the first phase again of the future at the

520
00:48:32,540 --> 00:48:35,100
eventual replacement of Bentow Hospital.

521
00:48:35,700 --> 00:48:45,280
Again, 20, 25 years down the line, but studying with the new hour, which is, I'm not identified

522
00:48:45,280 --> 00:48:50,120
here in the dash yellow line. This power could be connected to the existing

523
00:48:50,120 --> 00:48:55,200
method hospital through an overpass over the Lamar Fleming street.

524
00:48:56,680 --> 00:49:02,660
This is actually very close proximity. What would be the outcome of this

525
00:49:02,660 --> 00:49:08,580
action? The existing mental hospital will be able to continue to provide uninterrupted

526
00:49:08,580 --> 00:49:13,020
service to our community throughout the entire expansion, studying with this

527
00:49:13,020 --> 00:49:20,940
in patient power and eventual replacement of ventile hospital on this parkland adjacent

528
00:49:20,940 --> 00:49:22,080
to the ventile hospital.

529
00:49:23,050 --> 00:49:28,660
The new ventile expansion tower would add that this is the needed capacity to ventile

530
00:49:28,660 --> 00:49:33,380
by adding approximately 100 more patient beds and procedure areas.

531
00:49:33,940 --> 00:49:41,520
The future ventile hospital will continue to remain an integral part of the international

532
00:49:41,520 --> 00:49:47,880
in a recognized Texas Medical Center, and the future Ben Todd will also have expanded capacity to

533
00:49:47,880 --> 00:49:54,100
better serve the level one trauma needs of Harris County. So this really becomes a win, win,

534
00:49:54,220 --> 00:50:00,820
win situation for Harris Health, whether it's the up Houston, but the residents of Harris County

535
00:50:01,570 --> 00:50:07,030
to look into the future for our ability to continue to provide the services that aren't

536
00:50:07,030 --> 00:50:16,750
book to be needed. What are the next steps? The Aristotle Court of Trustees will hold the public hearing beginning at 9 a.m.

537
00:50:17,630 --> 00:50:23,310
at our next rigorous schedule board meeting on Thursday July 24th here in this

538
00:50:23,310 --> 00:50:29,990
fourth room at 4,800 furnace place. Notice as they're going to the public hearing will appear in the Houston

539
00:50:29,990 --> 00:50:37,090
a clinical study tomorrow, Tuesday July 1st, and on a weekly basis on July 8th and again

540
00:50:37,090 --> 00:50:44,690
July 15th ahead of the public hearing, all persons interested to speak on this item

541
00:50:44,690 --> 00:50:53,310
should call 3 or 6, 4 to 6, 0 to 8, 5, 4, no later than 4 p.m. and Wednesday July 23rd

542
00:50:53,310 --> 00:50:58,710
the day before the public hearing, immediately following the public hearing, the Aristotle

543
00:50:58,710 --> 00:51:06,070
for the trustees will consider an action to request that Harris County on behalf of

544
00:51:06,070 --> 00:51:12,630
Harris Health condemned to discuss parts of land, city of Houston land, for the purposes

545
00:51:12,630 --> 00:51:20,910
of Vintal Possible Expansion and eventual replacement. But the part that is my entirety of the presentation

546
00:51:20,910 --> 00:51:24,310
I'm happy to take any questions that anyone may have at this point.

547
00:51:27,960 --> 00:51:28,900
Any questions from

548
00:51:28,900 --> 00:51:29,660
minutes of the board.

549
00:51:32,260 --> 00:51:35,320
Okay. Here you can see none. Thank you very much for your presentation.

550
00:51:35,580 --> 00:51:36,840
All right.

551
00:51:39,360 --> 00:51:44,960
That brings us now to agenda item nine. A general action items related to

552
00:51:44,960 --> 00:51:50,580
quality and medical staff. First, we have consideration of approval and credentialing changes

553
00:51:50,580 --> 00:51:54,680
for members of Harris Health Medical staff. I invite Dr. Carmen to say a few words.

554
00:51:54,960 --> 00:52:00,720
Thank you, Dr. Pike, and good morning again to the board and to the Harris Health community.

555
00:52:00,720 --> 00:52:06,440
briefly, I will present our roster changes for the medical staff credentials

556
00:52:06,440 --> 00:52:12,400
report for June of 2025. So for this month, we have a total of 13

557
00:52:12,400 --> 00:52:19,100
initial appointments, 158 reappointments, 11 change in clinical privileges,

558
00:52:19,620 --> 00:52:26,160
and a total of nine resignations. The details of which are enclosed within your packet.

559
00:52:26,340 --> 00:52:29,660
I'm happy to answer any questions, but otherwise that's my brief presentation.

560
00:52:29,660 --> 00:52:30,440
Thank you again.

561
00:52:33,270 --> 00:52:34,070
Thank you, Dr. Sharma.

562
00:52:34,230 --> 00:52:38,170
Do I have a motion and second for approval of credentialing changes for members of the

563
00:52:38,170 --> 00:52:39,870
Harris Health Medical staff as presented?

564
00:52:40,650 --> 00:52:40,970
So move.

565
00:52:41,670 --> 00:52:41,990
Thank you.

566
00:52:42,170 --> 00:52:43,510
Mr. Point, if you have a motion, thank you.

567
00:52:43,750 --> 00:52:46,190
Ms. Vera-Bland for the second on any discussion.

568
00:52:47,030 --> 00:52:48,330
All those in favor say aye.

569
00:52:48,770 --> 00:52:48,930
Aye.

570
00:52:49,310 --> 00:52:49,810
Any opposed?

571
00:52:50,010 --> 00:52:50,330
Say nay.

572
00:52:51,130 --> 00:52:51,830
The motion passes.

573
00:52:52,810 --> 00:52:53,630
Thank you, Dr. Sharma.

574
00:52:54,190 --> 00:52:54,350
Next.

575
00:52:54,730 --> 00:53:00,290
It's agenda item 9B, general action items related to quality of correctional health and

576
00:53:00,290 --> 00:53:02,310
and medical staff, consideration of approval

577
00:53:02,310 --> 00:53:03,670
and credentialing changes for members

578
00:53:03,670 --> 00:53:05,870
of the hair cell correctional health medical staff.

579
00:53:06,310 --> 00:53:07,410
Dr. Egan's, please.

580
00:53:08,710 --> 00:53:10,250
The morning, thank you, Dr. Pike,

581
00:53:10,350 --> 00:53:13,850
and thank you to the board and the public

582
00:53:13,850 --> 00:53:15,210
for this opportunity.

583
00:53:15,830 --> 00:53:17,750
The correctional health medical executive committee

584
00:53:17,750 --> 00:53:21,150
met on June 9th, and we have one application

585
00:53:21,150 --> 00:53:23,890
for initial appointment and four reappointments

586
00:53:23,890 --> 00:53:26,470
that we're asking the board to approve at this time.

587
00:53:26,870 --> 00:53:27,170
Thank you.

588
00:53:28,750 --> 00:53:33,330
Thank you Dr. Egan's. Do I have a motion and second for approval of credentialing changes

589
00:53:33,330 --> 00:53:36,990
for members of the Harris Health Correctional Health Medical staff as presented?

590
00:53:37,630 --> 00:53:42,810
Thank you, Miss Vera Blant. Thank you, Miss Perrette. Any discussion? All those in favor

591
00:53:42,810 --> 00:53:49,490
say aye. Aye. Any opposed? Say nay. The motion passes. This brings us to agenda item 10, strategic

592
00:53:49,490 --> 00:53:54,350
discussion 10a, Harris Health Strategic Plant Initiatives. A presentation regarding the

593
00:53:54,350 --> 00:53:59,230
Harris Health budget process was included in your packet for review, and I turned to Ms.

594
00:53:59,270 --> 00:54:01,690
Nikkeem and Ms. Perez to say a few words about this item.

595
00:54:02,590 --> 00:54:03,610
Thank you, Dr. Pike.

596
00:54:03,910 --> 00:54:10,850
This was requested as board education for new members who have not been through the budget

597
00:54:10,850 --> 00:54:17,870
cycle with us before, as well as a refresher when they just the process part of it and the time

598
00:54:17,870 --> 00:54:24,930
lines. The actual board workshop is going to convene very early in the month of August

599
00:54:25,240 --> 00:54:34,390
and we will cover very specific financial parameters of the budget going into fiscal 2026 with that.

600
00:54:34,950 --> 00:54:39,110
I'd like to turn over to VP of financial planning and analysis.

601
00:54:41,510 --> 00:54:47,670
Good morning, so this morning I'm going to go over the various phases of the budget cycle

602
00:54:47,670 --> 00:54:52,610
with you and then conclude with some strategies for success.

603
00:54:59,190 --> 00:55:04,070
I'm going to go over the various phases of the budget cycle with you all this morning and

604
00:55:04,070 --> 00:55:06,190
then concluded with strategies for success.

605
00:55:06,670 --> 00:55:07,410
Next slide, please.

606
00:55:09,530 --> 00:55:11,450
So we start off the budget process

607
00:55:11,450 --> 00:55:14,630
by identifying our financial goals and priorities

608
00:55:14,990 --> 00:55:15,690
for the year.

609
00:55:16,790 --> 00:55:18,450
Once that has been determined,

610
00:55:19,090 --> 00:55:21,710
we begin drafting our budget proposal.

611
00:55:23,410 --> 00:55:26,330
Once that initial draft has been developed,

612
00:55:26,550 --> 00:55:29,010
we review and consolidate that information

613
00:55:29,010 --> 00:55:31,830
and that is the phase of the cycle we're in right now.

614
00:55:31,830 --> 00:55:38,930
and we are doing that ahead of our board budget workshop scheduled for August 4th and then the

615
00:55:38,930 --> 00:55:43,930
anticipated next phase of the cycle which is the approval by the board and county commissioners.

616
00:55:44,650 --> 00:55:50,150
And then once implemented or once approved we're implementing that budget and then there's

617
00:55:50,150 --> 00:55:53,590
continuous monitoring that takes place. Next slide please.

618
00:55:56,120 --> 00:55:58,000
All right so the first phase of the budget

619
00:55:58,000 --> 00:56:03,840
process the identification of financial goals and priorities. So we actually start our budget process

620
00:56:03,840 --> 00:56:10,020
off in January of each year. So you can see it's very lengthy and extensive process here,

621
00:56:10,560 --> 00:56:15,920
but we start with the development of our budget calendar and in developing that calendar,

622
00:56:15,920 --> 00:56:22,680
we are working with our partners, the Harris County OMB, to ensure that we are aligning our deadlines

623
00:56:22,680 --> 00:56:27,240
with their timeline and expectations as well.

624
00:56:28,420 --> 00:56:31,520
So, we then worked with our executive leadership team

625
00:56:31,520 --> 00:56:34,420
again to establish those financial targets

626
00:56:34,420 --> 00:56:36,560
and priorities for the coming year.

627
00:56:37,180 --> 00:56:40,400
And then with that information we develop our budget guidance.

628
00:56:40,920 --> 00:56:43,860
So that would include what is the timeframe we're going to use

629
00:56:43,860 --> 00:56:47,420
as the baseline for our budget, what labor, efficiency,

630
00:56:48,060 --> 00:56:51,640
or cost-contain reduction expectations we have

631
00:56:51,640 --> 00:56:57,000
of, and then applying any inflationary factors or other adjustments to that baseline information.

632
00:56:57,960 --> 00:57:04,740
And then also during this phase, we are considering any new strategic initiatives that are submitted.

633
00:57:06,080 --> 00:57:06,820
Next slide, please.

634
00:57:09,200 --> 00:57:14,700
So once we've got those priorities and that guidance, we begin drafting the budget proposal

635
00:57:14,700 --> 00:57:19,940
and that is a collaborative effort with our stakeholders across the system.

636
00:57:19,940 --> 00:57:27,960
We began that process by developing volumes, so we would be developing the KVI or key volume

637
00:57:27,960 --> 00:57:34,540
indicators for various areas so that could be anything from patient days to emergency

638
00:57:34,540 --> 00:57:43,340
room visits, clinic visits, or patient's meal serves, square footage, pounds of laundry

639
00:57:43,340 --> 00:57:46,720
just depends on the area we're budgeting for.

640
00:57:46,720 --> 00:58:05,680
And so we would take that baseline information and then our stakeholders would adjust that information for any known changes in operations that could be the closure of some operating rooms temporarily for renovation.

641
00:58:06,460 --> 00:58:15,760
That could be the loss of some providers and the clinics or maybe the onboarding of some new providers as an example.

642
00:58:17,240 --> 00:58:23,480
Today, given our current capacity constraints across the system, we are projecting relatively

643
00:58:23,480 --> 00:58:25,420
stable volume for next year's school year.

644
00:58:26,740 --> 00:58:27,360
Next slide, please.

645
00:58:29,890 --> 00:58:35,270
Once we've got those volume projections developed, we move on to our expense projections.

646
00:58:36,230 --> 00:58:42,410
In projecting expenses, we categorize those expenses into two classifications.

647
00:58:42,410 --> 00:58:48,930
So, big expenses and variable expenses, so those big expenses are going to be those expenses

648
00:58:48,930 --> 00:58:55,010
that were made constant regardless of the volume of activity previously projected.

649
00:58:55,690 --> 00:59:01,410
So, think of contract maintenance expense, utilities, repairs, things that are not impacted

650
00:59:01,410 --> 00:59:02,510
by that volume.

651
00:59:03,490 --> 00:59:08,790
And then variable expenses, just the opposite, we expect that expense to increase or decrease

652
00:59:08,790 --> 00:59:13,790
on those volume projections developed in that first step.

653
00:59:14,370 --> 00:59:16,790
So that would be things like pharmaceutical expense,

654
00:59:17,150 --> 00:59:21,350
medical supplies, food purchases.

655
00:59:22,670 --> 00:59:23,790
Next slide, please.

656
00:59:27,010 --> 00:59:31,370
So building into specifically the development of FTE targets

657
00:59:31,370 --> 00:59:36,690
for those variable areas, we're going to be looking at that projected volume

658
00:59:36,690 --> 00:59:37,910
in that step one.

659
00:59:37,910 --> 00:59:44,630
Then we're going to be looking to benchmark data where available on worked hours per unit

660
00:59:44,630 --> 00:59:51,770
targets where those variable error is and then apply any productivity or labor efficiency

661
00:59:52,330 --> 00:59:54,790
goals that were established at part of that guidance.

662
00:59:56,230 --> 00:59:57,750
and then for fixed area

663
01:00:00,240 --> 01:00:29,920
Those FTEs are going to be based on our courier budgeted FTEs. We would only make changes to those based on approved strategic initiatives. So that could be any new strategic initiatives approved in that first phase. Or it could be any that were approved for this year, but maybe aren't fully reflected in that budget number. And so we're adjusting for that. All other incremental requests for FTEs happen.

664
01:00:29,920 --> 01:00:35,400
Then outside of our annual budget process, we have a very robust approval process where

665
01:00:35,400 --> 01:00:41,520
the approval of FTEs, where we have a chief staffing officer over each of our pavilions

666
01:00:41,520 --> 01:00:50,960
that works with leaders to review their request and then those requests go to the labor management

667
01:00:50,960 --> 01:00:55,380
oversight committee or LMOC for approval throughout the year as those requests come up.

668
01:00:56,420 --> 01:01:02,260
And then once those FTE targets are developed, the finance is projecting, what is the cost

669
01:01:02,260 --> 01:01:08,400
of that labor using current average allureate information at the job code level?

670
01:01:08,620 --> 01:01:14,960
We're adjusting that for anticipated or known market increases, merit adjustments, and then

671
01:01:14,960 --> 01:01:15,800
applying benefits.

672
01:01:18,560 --> 01:01:26,880
For non-labor expenses, again, for variable expenses, such as medical supply,

673
01:01:26,880 --> 01:01:32,080
As far as pharmaceuticals, we're looking at that projected volume and taking that time's

674
01:01:32,080 --> 01:01:38,760
that cost per category so that pharmaceutical expense times the projected volume and then

675
01:01:38,760 --> 01:01:44,620
applying inflationary increases and we work with our supply chain departmental leaders on

676
01:01:44,620 --> 01:01:46,000
those inflationary increases.

677
01:01:46,000 --> 01:01:52,960
We look to premier or GPO and other benchmark on an industry information to guide us on what

678
01:01:52,960 --> 01:01:54,860
those inflationary increases are.

679
01:01:54,860 --> 01:02:03,480
And then for our fixed areas, our fixed expenses, rather, we're taking into account what is

680
01:02:03,480 --> 01:02:09,240
our historical spend. So for example, repairs kind of looking at on average what do we spend on

681
01:02:09,240 --> 01:02:14,900
repairs for things such as contract maintenance, looking at what are the current contract rates

682
01:02:14,900 --> 01:02:19,680
and what are the contract terms to protect that expense. Next slide.

683
01:02:22,260 --> 01:02:23,380
All right, so now we've talked

684
01:02:23,380 --> 01:02:30,060
about our expense projections. Let's move on to our revenue projections. We start with our

685
01:02:30,060 --> 01:02:35,560
that patient revenue and that is going to be driven by those volume projections in the first step

686
01:02:35,560 --> 01:02:41,860
and then collection reimbursement rates as received from our revenue cycle team. We're not expecting

687
01:02:41,860 --> 01:02:47,220
again any significant changes in volume or those collection reimbursement rates for next year

688
01:02:47,220 --> 01:02:51,820
and so that's going to save that to be relatively stable in FY 2026.

689
01:02:53,100 --> 01:02:58,320
So Medicaid supplemental payments, so these comprise about a third of our revenue.

690
01:03:00,060 --> 01:03:06,100
When we come to you in early August, those are going to be based on our current year projections.

691
01:03:06,520 --> 01:03:11,800
We will update those as we have more current information available from the stage that that

692
01:03:11,800 --> 01:03:14,740
doesn't typically happen until the August September timeframe.

693
01:03:14,740 --> 01:03:19,560
So we may not have that at the time of the initial budget workshop.

694
01:03:20,980 --> 01:03:30,820
And then other revenue, that would include things like brands, donations, machine revenue,

695
01:03:31,360 --> 01:03:34,120
you know, all of those other sources of revenue.

696
01:03:34,460 --> 01:03:38,020
So, you know, we're going to look to the historical actions and then we'll adjust for

697
01:03:38,020 --> 01:03:38,660
known changes.

698
01:03:38,660 --> 01:03:47,720
So if we know that you know the amount of funding we're receiving for a particular grant is changing we will make that change and adjust accordingly.

699
01:03:49,120 --> 01:03:52,480
And then lastly net and alarm tax revenue.

700
01:03:53,240 --> 01:04:03,560
So again at the time we come to you in August that projection is going to be based on our car your budget and will apply some conservative inflationary adjustments to that.

701
01:04:04,460 --> 01:04:10,400
Those numbers will not be updated until we receive projections from the county, which

702
01:04:10,400 --> 01:04:15,260
won't occur until early to mid-August, and we'll talk about that a little more in the

703
01:04:15,260 --> 01:04:15,820
next slide.

704
01:04:21,140 --> 01:04:28,560
So, diving into that net-advolarm tax revenue a little more, in early to mid-August we will

705
01:04:28,560 --> 01:04:32,120
receive two projections from the county.

706
01:04:32,120 --> 01:04:37,700
that would be the no-new revenue rate and the voter approved rate, so that no-new

707
01:04:37,700 --> 01:04:42,380
revenue rate is going to be the tax rate that generates flat revenue as

708
01:04:42,380 --> 01:04:47,920
compared to the current year for the same properties. And then that voter

709
01:04:47,920 --> 01:04:52,980
approved rate would represent the maximum that we are allowed by-law without

710
01:04:52,980 --> 01:04:58,220
having to go back to the voters for approval. So think of it as the floor in the

711
01:04:58,220 --> 01:05:06,060
So the commissioners can approve either of those rights or they can approve anything in between.

712
01:05:07,040 --> 01:05:09,260
And so we will not have that.

713
01:05:09,440 --> 01:05:21,600
We won't know what that adopted tax rate is until that public hearing is held by the commissioners court and the tax rate is voted on, which is currently scheduled for September 18th.

714
01:05:22,320 --> 01:05:26,880
So we will talk about how that impacts the timeline and what we bring forward to you guys

715
01:05:26,880 --> 01:05:27,660
in just a minute.

716
01:05:28,280 --> 01:05:29,120
Next slide, please.

717
01:05:30,460 --> 01:05:34,540
So this far, everything we've talked about is how we develop our operating budget.

718
01:05:34,760 --> 01:05:43,920
So for our capital budget, we're working with our facilities team on what our equipment replacement

719
01:05:43,920 --> 01:05:49,100
needs are, what projects are upcoming, but we're just talking about routine capital.

720
01:05:49,100 --> 01:06:00,120
We come to you with and our capital budget projections does not include any of the projects related to the strategic facilities plan or the $2.5 billion bond issuance.

721
01:06:01,240 --> 01:06:09,780
One major change we are making in FY 2026 is that we're shifting from a commitment based methodology to cash.

722
01:06:09,780 --> 01:06:19,200
And what I mean by that is, you know, currently when a project is approved, the cost of that project is committed to.

723
01:06:19,700 --> 01:06:23,960
And then that would be a part of the budget that we would present to you in any given year.

724
01:06:24,960 --> 01:06:28,720
We're shifting to cash basis, which says, okay, let's look at that project.

725
01:06:29,300 --> 01:06:35,120
Let's look at when we plan to start that project, the timing, the one we're going to need, those funds.

726
01:06:35,120 --> 01:06:40,040
and then budget for that cash in the appropriate year.

727
01:06:40,740 --> 01:06:42,320
And so, as a result of that shift,

728
01:06:42,560 --> 01:06:45,420
we are expecting a decrease in the capital budget

729
01:06:45,420 --> 01:06:47,160
compared to prior fiscal years.

730
01:06:48,720 --> 01:06:49,520
Next slide, please.

731
01:06:52,100 --> 01:06:55,840
So, again, once all of those inputs are developed

732
01:06:55,840 --> 01:06:58,420
and a draft budget is complete,

733
01:06:58,680 --> 01:07:01,620
we're holding formal budget hearings with our stakeholders.

734
01:07:02,900 --> 01:07:04,830
This is where executive leadership

735
01:07:04,830 --> 01:07:13,950
Leadership provides input and feedback regarding their request, the stakeholders go back and

736
01:07:13,950 --> 01:07:17,910
they then revise their request accordingly and admits it or a trip.

737
01:07:18,070 --> 01:07:24,270
There may be, you know, multiple meetings held, you know, to revise that budget until we

738
01:07:24,270 --> 01:07:29,730
get to a place where, you know, executive leadership and finance signs off on those requests.

739
01:07:29,730 --> 01:07:36,190
Once it's been signed off on, and again, finances were doing it, making sure it appears

740
01:07:36,190 --> 01:07:42,290
to that budget guidance initially established that all of the feedback received from the

741
01:07:42,290 --> 01:07:47,930
executive leadership team has been incorporated, and then we're consolidating all of that

742
01:07:47,930 --> 01:07:49,890
information to present to you all.

743
01:07:51,050 --> 01:07:51,750
Next slide.

744
01:07:55,190 --> 01:08:01,870
And so, Phase 4, we would come to the board and the county commissioners for their approval

745
01:08:01,870 --> 01:08:07,270
and so I've outlined here some important dates and next steps for you all to be aware of

746
01:08:07,270 --> 01:08:12,870
starting with the board budget workshop. As I mentioned, we just scheduled for August 4th.

747
01:08:13,570 --> 01:08:17,850
Again, we don't expect to receive those tax revenue projections from the county until

748
01:08:17,850 --> 01:08:22,990
the first couple of weeks in August, so at the time we have to submit that data to the board

749
01:08:22,990 --> 01:08:25,850
office for y'all, we will not likely have that information.

750
01:08:27,570 --> 01:08:36,910
We'll receive that in the first couple of weeks in August ahead of our first budget presentation to the Commissioner's Court, which is scheduled for August 14th.

751
01:08:37,710 --> 01:08:51,010
And then we'll come back to you all on August 28th. We will have those no new revenue and voter approved revenue projections and we will ask you all to approve a not to exceed budget.

752
01:08:51,790 --> 01:08:59,470
Why is it not to exceed because the county commissioners have not voted on what our adopted tax rate will be yet?

753
01:09:00,210 --> 01:09:20,430
And so, again, that won't happen until tentatively September 18th, after which if there are any reconciling items, if something is approved outside of that not to exceed budget that we asked you all to approve that we'll bring that back as a reconciling item for your awareness.

754
01:09:20,430 --> 01:09:20,550
Yes.

755
01:09:21,010 --> 01:09:21,730
Real quickly.

756
01:09:22,550 --> 01:09:27,810
So we have a question from Ms. Robinson, but before we turn to that, I want to make sure

757
01:09:27,810 --> 01:09:32,670
I understand correctly with regard to Medicaid supplemental payments and Medicaid reimbursement

758
01:09:32,670 --> 01:09:33,030
rates.

759
01:09:34,210 --> 01:09:42,010
Does the state, this is HHSC, did they have a specific deadline by which they have to give

760
01:09:42,010 --> 01:09:42,870
us that information?

761
01:09:43,590 --> 01:09:45,610
You know, the state has their own schedule.

762
01:09:45,610 --> 01:10:02,910
So what the state does is simply provide us the intergovernmental transfer date and the distribution of the final payment date. So just to give you an example why this is pushing into the budget cycle and creates additional uncertainty.

763
01:10:02,910 --> 01:10:06,770
Our largest payment is uncomplensated care payment.

764
01:10:07,430 --> 01:10:13,350
It is according to the state schedule, the distribution of that payment, the schedule,

765
01:10:13,530 --> 01:10:19,310
I believe, for September 29, which is the end of our fiscal year, and the IGT call,

766
01:10:19,530 --> 01:10:26,570
which tells us exactly what that amount is going to be until which time we don't know is

767
01:10:26,570 --> 01:10:28,030
going to be the middle of August.

768
01:10:28,030 --> 01:10:36,730
So if some of you remember last year, we have to go to this body and the Commissioner's

769
01:10:36,730 --> 01:10:44,770
Court with one number, predicating it on potential updates, and then we have to change and adjust

770
01:10:44,770 --> 01:10:50,830
that number down and come back to this body and the Commissioner's Court with new information.

771
01:10:50,830 --> 01:10:58,410
So, we have been working with the state to let them know that this creates a challenge

772
01:10:59,350 --> 01:11:06,090
with this board for the administration to present our annual budget.

773
01:11:06,450 --> 01:11:12,070
They seem to be understanding, however, they are still going to stick with their schedule.

774
01:11:12,790 --> 01:11:19,450
So, we will do the absolute best that we can to provide this board the information

775
01:11:19,450 --> 01:11:24,430
that we have available to us, but I cannot guarantee that this is going to be

776
01:11:25,490 --> 01:11:30,050
something that is, you know, sent still and we can take forward.

777
01:11:30,690 --> 01:11:37,270
So, and I admittedly asked a question, I knew the answer to you, but it was because I wanted

778
01:11:37,270 --> 01:11:43,770
the board members to appreciate the amount of both work that our finance team does as well as

779
01:11:43,770 --> 01:11:48,890
the uncertainty that we have going in. So I won't be here for this upcoming budget cycle,

780
01:11:48,890 --> 01:11:54,050
But for more members who have not had the privilege of going to that process yet, it's

781
01:11:54,050 --> 01:11:55,370
going to feel a little chaotic.

782
01:11:56,210 --> 01:12:03,630
And that is a, that is a, unfortunately, a known issue because of how the various schedules

783
01:12:03,630 --> 01:12:04,210
line up.

784
01:12:04,610 --> 01:12:09,230
So our team doesn't get even what, we don't know what our main reimbursement is going

785
01:12:09,230 --> 01:12:14,570
to look like until less than six weeks before we're supposed to have voted on and published

786
01:12:14,990 --> 01:12:20,630
budget for the next fiscal year and in that six weeks we have to they have to

787
01:12:20,630 --> 01:12:24,470
calculate make projections bring it to us. We tend to really vote on the

788
01:12:24,470 --> 01:12:26,790
projection. We take that to Commissioner's Court and Commissioner Court

789
01:12:26,790 --> 01:12:30,130
deliberates on it and they might ask us to send it back and have us look at it

790
01:12:30,130 --> 01:12:33,970
again and all of that is happening without us even knowing what our tax rate is

791
01:12:33,970 --> 01:12:37,150
going to look like because Commissioner's Court oftentimes holds on voting on

792
01:12:37,150 --> 01:12:41,530
that tax rate until they've seen a proposed budget and so it's all going to feel

793
01:12:41,530 --> 01:12:49,490
very compressed. And historically, there was, I know some board members have had a perception

794
01:12:49,490 --> 01:12:53,630
that it was like there was a transparency or there wasn't good communication happening.

795
01:12:54,050 --> 01:12:57,090
And I want to reassure everyone having gone through this process twice now at least,

796
01:12:57,650 --> 01:13:01,670
that our team is incredibly transparent. It's just, we literally are sitting here,

797
01:13:01,770 --> 01:13:07,430
biting our nails, waiting for the state health services groups to tell us how much money they're

798
01:13:07,430 --> 01:13:11,130
going to give us. And then we also have to wait on commissioners court to tell us what are

799
01:13:11,130 --> 01:13:16,330
tax rate is going to be. And without those two key pieces of information, I mean, that's

800
01:13:16,330 --> 01:13:16,690
our revenue.

801
01:13:17,550 --> 01:13:21,710
Yes, that's two thirds of our revenue management, so thank you for that comment.

802
01:13:21,870 --> 01:13:28,570
So just be patient, trust the process. It's going to feel chaotic and rushed, but trust

803
01:13:28,570 --> 01:13:32,390
the process. And with that, I miss Robinson, you had a question.

804
01:13:33,950 --> 01:13:39,410
I wanted to ask, on the slide, when you talked about the capital budget and you talked about

805
01:13:39,410 --> 01:13:46,350
commitment versus cash basis to help me understand that a little bit more so the commitment is

806
01:13:46,730 --> 01:13:52,310
that we believe that we can get it done for this amount and then the cash is this is what we

807
01:13:52,310 --> 01:13:59,870
actually have on hand or no the the commitment based budgeting process. I'm sorry.

808
01:14:02,390 --> 01:14:07,890
The commitment based budgeting process we've used historically has been based on

809
01:14:07,890 --> 01:14:15,070
If we commit to a project and the estimated cost for that project is $5 million, then we

810
01:14:15,070 --> 01:14:19,870
would include that $5 million within our capital budget projection that we present to you all.

811
01:14:21,030 --> 01:14:29,370
Cash basis says, okay, this project is estimated to cost $5 million, but we're not going to

812
01:14:29,370 --> 01:14:34,430
start it until about half of the year, it has a couple of phases, really, you know, by

813
01:14:34,430 --> 01:14:41,510
time it's fully implemented it will be next fiscal year and so we only anticipate needing

814
01:14:41,510 --> 01:14:46,630
you know cash up to two and a half million dollars for the given fiscal year.

815
01:14:47,450 --> 01:14:50,670
It's really the timing, Ms. Robinson, that's the point.

816
01:14:51,250 --> 01:14:57,430
You're spending cash it's literally a little bit down the road from when you are putting in the

817
01:14:57,430 --> 01:14:59,570
purchase order in the system, so.

818
01:15:00,000 --> 01:15:28,060
Well, the timing was, it may be a different, different period. Okay. All right. Thank you very much. Any other questions for our presenters? Just a question. On the tax rate, you turn on your microphone please. On the tax rate, has there been consistency throughout the fiscal budget year, the year? No.

819
01:15:28,060 --> 01:15:35,340
Um, um, could you clarify consistency, which I mean, well, if they gave us a percentage

820
01:15:35,950 --> 01:15:41,700
from the last fiscal year to this fiscal, I mean, you know, from previous years, as

821
01:15:41,700 --> 01:15:42,880
the percentage has been the same.

822
01:15:43,120 --> 01:15:43,380
No.

823
01:15:44,140 --> 01:15:52,760
So in terms of the, I mean, how far is there's approving a particular rate, um, and stands each year

824
01:15:52,760 --> 01:16:00,640
stands on its own. So there is not a commitment or consistency to be expected. There are floors

825
01:16:00,640 --> 01:16:08,460
of the ceiling that we will know in advance but then where it lands depends on priorities of

826
01:16:08,460 --> 01:16:15,400
the county and how the commissioners decide to abortion and allocate. So we're the last five years

827
01:16:17,240 --> 01:16:27,470
We've had two non-net revenue tax rates last year was the first time in 10 plus years

828
01:16:27,710 --> 01:16:35,910
that we actually had a border improvement, but those two non-net revenue tax rates that

829
01:16:35,910 --> 01:16:43,830
we faced over the last five years has actually brought our overall tax rate so low that it

830
01:16:43,830 --> 01:16:47,390
would take several years of order of proof rate

831
01:16:47,390 --> 01:16:49,710
to just get us back to work we were at 2019.

832
01:16:53,500 --> 01:16:56,220
The rate and amount of aggregate tax receipt

833
01:16:56,220 --> 01:16:59,080
are sometimes going in different directions.

834
01:17:00,020 --> 01:17:01,640
So while the rate is low,

835
01:17:02,220 --> 01:17:06,000
the amount of aggregate revenue received from tax support

836
01:17:06,000 --> 01:17:10,160
is higher because the properties in Harris County

837
01:17:10,160 --> 01:17:13,740
have been growing for the time at a very good clip.

838
01:17:14,160 --> 01:17:14,900
And it wasn't much.

839
01:17:14,900 --> 01:17:18,060
And so, without being said, your rate may be lower,

840
01:17:18,420 --> 01:17:21,680
but the amount of tax support that you're getting is higher.

841
01:17:21,860 --> 01:17:24,380
So, that's kind of the truth of that station equation.

842
01:17:25,520 --> 01:17:26,320
Thank you.

843
01:17:27,440 --> 01:17:28,220
All right.

844
01:17:28,760 --> 01:17:29,860
Great discussion, everyone.

845
01:17:31,680 --> 01:17:37,740
So, with that, we now move to our agenda item 10B committee reports.

846
01:17:38,520 --> 01:17:43,420
We only have one committee report for the June 13th, 2025 governance committee,

847
01:17:43,420 --> 01:17:50,900
where I chaired that meeting, the governance committee met on June 13th, 2025, and we discussed

848
01:17:52,020 --> 01:17:57,160
board self-governance as well as board member meeting attendance and how it interacts with

849
01:17:57,900 --> 01:18:01,360
how board members communicate with it, one another, how it can optimize that using

850
01:18:01,360 --> 01:18:05,040
modern technology without running a file of the Texas of a meeting deck,

851
01:18:05,340 --> 01:18:11,200
and also looking at possible revisions to our standard operating procedures.

852
01:18:11,840 --> 01:18:14,540
And that includes my report for the Governance Committee.

853
01:18:14,820 --> 01:18:16,180
Any comments or questions about that?

854
01:18:17,740 --> 01:18:18,100
Okay.

855
01:18:18,940 --> 01:18:24,800
Next is new items for Board Consideration, the agenda item 11A, discussion and appropriate

856
01:18:24,800 --> 01:18:29,300
action calling an interim officer election for the current term 2025 resulting from the

857
01:18:29,300 --> 01:18:33,460
vacancy in the office of the Board Vice Chair and any other resulting vacancies required by

858
01:18:33,460 --> 01:18:37,180
Article 5 Section 3 of the Harris Health Board of Trustees by-laws.

859
01:18:37,180 --> 01:18:51,480
So because I'm unfortunately leaving or Article 5 of Section 2 of our bylaws, we must conduct an interim election to fill the vacancy of the Office of the Vice Chair, as a result of my recent resignation.

860
01:18:51,960 --> 01:18:59,840
The newly elected interim Board Vice Chair would only serve for the remainder of this calendar year until end of 2025.

861
01:18:59,840 --> 01:19:04,940
five. Prior to this meeting we received one nomination for consideration which is our

862
01:19:04,940 --> 01:19:11,300
current board secretary, Ms. Carol Perez. Now we will take nominations from the floor for

863
01:19:11,300 --> 01:19:17,240
the interim position of board vice chair. Are there any members who would like to nominate

864
01:19:17,240 --> 01:19:22,540
someone from the floor or nominate themselves to be office of interim board vice chair for the

865
01:19:22,540 --> 01:19:24,720
remainder of the calendar year of 2025?

866
01:19:28,890 --> 01:19:32,330
I have to ask you two more times. Are there any members

867
01:19:33,170 --> 01:19:41,650
We would like to nominate someone from the floor or nominate themselves to the office of Interim Board Vice Chair for the remainder of the calendar year of 2025.

868
01:19:44,960 --> 01:19:53,200
And once more, are there any members who would like to nominate someone or themselves from the floor to the office of Interim Board Vice Chair for the remainder of calendar year of 2025?

869
01:19:57,320 --> 01:20:04,060
This time, the nominations for the office of Interim Board Vice Chair for the remainder of the calendar year of 2025 are now closed.

870
01:20:04,620 --> 01:20:07,880
Our final slate of candidates for this office are Miss Perret.

871
01:20:07,880 --> 01:20:11,880
but if you would like to make any brief remarks, you may do so.

872
01:20:13,560 --> 01:20:16,560
I'll be happy to do it until the end of December.

873
01:20:16,900 --> 01:20:17,240
Thank you.

874
01:20:18,460 --> 01:20:21,620
Now that the candidates for interim board bus here have all spoken,

875
01:20:21,860 --> 01:20:23,060
we will now conduct the election.

876
01:20:23,960 --> 01:20:27,260
There's only one name to read after which I will issue a roll call

877
01:20:27,260 --> 01:20:31,580
or you will vote in favor by saying aye or nay so that we can record in the minutes

878
01:20:31,580 --> 01:20:34,120
and I will read off nominees names in the order of nations.

879
01:20:35,680 --> 01:20:42,260
So those in favor of electing Ms. Caret to the Office of Interim Board Vice Chair, please indicate.

880
01:20:42,920 --> 01:20:47,220
So by saying aye or nay, I'll start, I'm just going to go in the order I have.

881
01:20:47,760 --> 01:20:49,180
Dr. Pike, aye.

882
01:20:52,180 --> 01:20:54,200
Is Dr. Caret Costas on the call with us?

883
01:20:55,220 --> 01:20:56,220
That would be excellent.

884
01:20:57,100 --> 01:20:57,240
Okay.

885
01:20:57,580 --> 01:20:59,160
So Mark, here's an absentee.

886
01:21:00,080 --> 01:21:00,600
Absentee.

887
01:21:00,600 --> 01:21:02,180
Ms. Davis, are you on the call?

888
01:21:08,480 --> 01:21:09,020
Ms. Caret.

889
01:21:13,190 --> 01:21:14,130
Mr. Robinson,

890
01:21:16,410 --> 01:21:18,150
Mr. Puerreland, Mr.

891
01:21:20,360 --> 01:21:28,610
Puerreland, Mr. Sun, I, thank you, sir, I have Ms. Lacheladjian.

892
01:21:30,070 --> 01:21:30,990
I'll vote she's off.

893
01:21:31,130 --> 01:21:31,590
No, I'm caught.

894
01:21:32,590 --> 01:21:33,050
Okay.

895
01:21:33,770 --> 01:21:41,870
So 1, 2, 3, 4, 5, 6, they're being 6 eyes and 3 absents and 0 names, the motion passes.

896
01:21:42,150 --> 01:21:43,450
Congratulations, you have my jump.

897
01:21:51,200 --> 01:21:59,240
So, with that, we have a new officer position that is not vacant because Board Secretary

898
01:21:59,240 --> 01:22:02,260
Carol Paret has been duly elected as the interim board vice chair.

899
01:22:02,700 --> 01:22:06,740
We must now fill the new vacancy for the Office of Interim Board Secretary.

900
01:22:07,340 --> 01:22:12,940
So again, this is for the Office of Secretary until the end of the calendar year 2025.

901
01:22:13,600 --> 01:22:21,640
Are there any members who would like to nominate themselves or someone else from the floor to the Office of Interim Board Secretary?

902
01:22:23,280 --> 01:22:24,560
I'd like this up and nominate.

903
01:22:24,960 --> 01:22:27,580
Okay, let me give you a blend that is nominated.

904
01:22:34,300 --> 01:22:41,100
Anyone else would like to nominate themselves or someone else from board to serve as the Interim Board Secretary until the end of calendar year 2025?

905
01:22:44,890 --> 01:22:53,070
Once more, any members who would like to nominate themselves or someone else to the Office of Interim Board Secretary Board 2025.

906
01:22:55,210 --> 01:22:56,170
Here are the last three times.

907
01:22:58,930 --> 01:23:04,790
So nominations are now closed. Our final state of candidates for the Office of Interim Board Secretary is Ms. Yarra Blanned.

908
01:23:06,150 --> 01:23:08,410
Ms. Yarra Blanned, if you'd like to make any remarks, you may do so at this time.

909
01:23:08,930 --> 01:23:11,970
Just like to say that I'd be honored to serve the board in this capacity.

910
01:23:12,950 --> 01:23:13,590
Thank you.

911
01:23:14,170 --> 01:23:14,870
Thank you.

912
01:23:15,490 --> 01:23:20,050
Now that our candidate has spoken, we will not conduct the election after I read your name.

913
01:23:20,070 --> 01:23:22,630
I'm going to do the same thing where I go through a roll call of everyone.

914
01:23:23,350 --> 01:23:27,850
So all those in favor of electing Ms. Libby Vera Blanche, the Office of Interim Board Secretary.

915
01:23:28,190 --> 01:23:30,010
Please indicate so by saying aye or nay.

916
01:23:30,310 --> 01:23:30,750
Dr. Pike.

917
01:23:31,310 --> 01:23:31,490
Aye.

918
01:23:32,490 --> 01:23:33,890
Dr. Caracostis is absent.

919
01:23:34,590 --> 01:23:35,770
Ms. Davis is absent.

920
01:23:35,770 --> 01:23:42,570
Ms. Carrette, Ms. Robinson, Ms. Vera-Bland,

921
01:23:44,870 --> 01:23:45,550
Mr. Quentin,

922
01:23:47,700 --> 01:23:48,120
Mr. Sun,

923
01:23:51,450 --> 01:23:51,930
I think you needed

924
01:23:51,930 --> 01:23:52,170
sir.

925
01:23:52,910 --> 01:23:53,270
Thank you.

926
01:23:54,310 --> 01:23:55,810
Ms. Lutton-Baudillon is absent.

927
01:23:56,890 --> 01:24:02,110
There being six eyes, zero nays, and three absences, and congratulations to our new

928
01:24:02,110 --> 01:24:02,910
interim board secretary.

929
01:24:09,180 --> 01:24:11,360
Elections go so significantly when the following one candidate.

930
01:24:14,080 --> 01:24:14,660
All right.

931
01:24:14,660 --> 01:24:21,420
that concludes the agenda item 11A. We are now on a agenda item 11B, consideration of approval

932
01:24:21,420 --> 01:24:25,500
of resolution setting the rate of mandatory payment that has turned possible different local

933
01:24:25,500 --> 01:24:31,540
provider participation fund and notice of public hearing. I turn now to Ms. Nikita to say a few words

934
01:24:31,540 --> 01:24:37,340
about this item. Thank you, Dr. Karpai. This is an annual item that would come to the board.

935
01:24:37,340 --> 01:24:46,180
Just a quick refresher for new members and members who have heard this one year ago, local

936
01:24:46,180 --> 01:24:55,240
provider participation fund or LPPF is a financing structure enacted by the Texas legislature.

937
01:24:55,740 --> 01:24:58,460
They have existed in Texas since 2013.

938
01:24:59,340 --> 01:25:06,340
Harris County was approved in 2019, so this is year number six for us.

939
01:25:06,340 --> 01:25:34,140
And we as local government entity are administering the assessing of the taxes on the hospitals that are participating in the fund so that the state and we deposit it in the state account so that the state and uses the funds to access the federal share for the two large programs.

940
01:25:34,140 --> 01:25:44,420
One being the uncompensated care and second one is an umbrella program. It's called Comprehensive Hospital Increase Remorsement Program.

941
01:25:45,240 --> 01:25:56,540
We are asking for a mandatory payment not to exceed 6% of the net patient revenue on the hospitals that are participating in the funds.

942
01:25:56,540 --> 01:26:03,300
and we will be assessing that throughout the year as the IGT calls our send fund

943
01:26:03,300 --> 01:26:09,160
the safe and that process takes place. So asking for your approval at this time.

944
01:26:11,600 --> 01:26:13,380
Thank you Miss Nikita. Any questions?

945
01:26:15,440 --> 01:26:17,140
With that do I have a motion and a second

946
01:26:17,140 --> 01:26:20,340
to the approval of a resolution setting the rate of mandatory payment for the

947
01:26:20,340 --> 01:26:23,680
Harris County Hospital District's local provider participation fund as

948
01:26:23,680 --> 01:26:24,280
presented.

949
01:26:28,460 --> 01:26:33,580
This is Robinson, thank you for the motion, and Ms. Brett pick the second. Any discussion?

950
01:26:35,040 --> 01:26:42,340
All those in favor say aye. Aye. Any opposed? Motion passes. We're now on agenda item 11,

951
01:26:42,880 --> 01:26:48,440
Steve. Consideration of approval staffing plans and payment for the contract and services specified in

952
01:26:48,440 --> 01:26:52,120
the Harris Health Operating and Support Agreement with Fairer College of Medicine for the contract

953
01:26:52,120 --> 01:26:57,620
to your ending June 30th, 2026, Mr. Keaton, and Mr. Smith.

954
01:26:58,500 --> 01:27:03,200
Yes, thank you again. This is a funding request for the contact year.

955
01:27:03,540 --> 01:27:11,360
It's just been stated starting tomorrow for a full year ahead for faculty and resident

956
01:27:11,360 --> 01:27:17,540
physicians for Baylor College of Medicine, now to exceed $292 million.

957
01:27:17,540 --> 01:27:23,720
dollars. Thank you. Do I have a motion in a second for the approval of staffing times and payment

958
01:27:23,720 --> 01:27:27,540
for the contracted services specified in the Harris Health Operating and support agreement

959
01:27:27,540 --> 01:27:34,080
with Baylor College of Medicine, the contract year ended to June 30th, 2026 as presented.

960
01:27:35,520 --> 01:27:39,980
Thank you, Ms. Perret. Thank you, Ms. Vera-Bland. Any discussion?

961
01:27:41,120 --> 01:27:42,460
Those in favor say aye.

962
01:27:42,960 --> 01:27:43,140
Aye.

963
01:27:43,740 --> 01:27:44,160
Any opposed?

964
01:27:45,220 --> 01:27:46,020
The motion passes.

965
01:27:46,760 --> 01:27:48,480
Agenda item 11-D.

966
01:27:49,140 --> 01:28:02,640
Consideration of approval of statute of fines and payment for the contract and services specified in the Harrisville operating and support agreement with the University of Texas Health Science Center at Houston or UT Health for the contract year ended June 30th, 2026.

967
01:28:02,960 --> 01:28:03,440
Mr. Keke.

968
01:28:04,100 --> 01:28:04,460
Thank you.

969
01:28:04,460 --> 01:28:13,300
then the administration requests another funding request for UT Health, faculty and residents

970
01:28:13,300 --> 01:28:24,120
and members for the year beginning tomorrow. July 1, 2025, June 20, 2026, and they're about

971
01:28:24,120 --> 01:28:31,920
not to exceed $209 million. Thank you, Mr. Keaton. Do I have a motion and a second to the approval

972
01:28:31,920 --> 01:28:35,120
of staffing plans and payment for the contracted service is specified in the

973
01:28:35,120 --> 01:28:39,300
Harris Health Operating and support agreement with UT Health for the contract

974
01:28:39,300 --> 01:28:47,000
year ended June 30th, 2026 as presented. Thank you Ms. Libby Bearblin. Thank you

975
01:28:47,000 --> 01:28:53,500
Ms. Robinson. All those in favor say aye. Aye. Any opposed? Say nay. The motion

976
01:28:53,500 --> 01:28:59,420
passes. We're now on agenda I am 11. E is an echo in presentation of the Harris

977
01:28:59,420 --> 01:29:04,240
County Hospital District 401k and pension plan independent audit towards reports and overview for

978
01:29:04,240 --> 01:29:10,900
fiscal year end of December 31st, 2024. Mr. Ryan Singleton from Fortis, a presentation was

979
01:29:10,900 --> 01:29:15,800
included in your packet for review and I'm going to invite now Mr. Singleton to say a few words about

980
01:29:15,800 --> 01:29:22,660
this item. Thank you all board for giving us the opportunity to present. I believe also you should

981
01:29:22,660 --> 01:29:28,400
have copies of the financial statements that were provided related to each plan. As part of our

982
01:29:28,400 --> 01:29:34,980
require communications to this board to go to the next slide. Our responsibilities are outlined in

983
01:29:34,980 --> 01:29:39,900
the scope of engagement between the two parties relate to the drafting of the financial statements

984
01:29:39,900 --> 01:29:47,800
and related notes and based on the work that's been performed and presented, we are prepared to

985
01:29:47,800 --> 01:29:55,000
issue unmodified opinions on both of those reports. The accounting policies and practices that were

986
01:29:55,000 --> 01:29:56,240
You're noted during our procedure.

987
01:30:00,000 --> 01:30:29,780
Assistant with Accounting and Industry Standards. During our audit procedures and working with Jay Camp, there were no difficulties encounter between our team and his team. There were no disagreements with management. There were no contentious accounting issues. There were also no identified material weaknesses are significant deficiencies internal controls. There will be a sport of our required communication letters. You will receive an audit communication letter at the issuance

988
01:30:29,780 --> 01:30:33,380
of the audit, as well as a management representation

989
01:30:33,380 --> 01:30:35,280
letter that we provided.

990
01:30:37,880 --> 01:30:41,520
As part of our audit procedures on the next slide,

991
01:30:41,660 --> 01:30:43,740
we go through one more slide, please.

992
01:30:45,160 --> 01:30:48,080
We go through certain areas that we identify as potentially

993
01:30:48,080 --> 01:30:50,700
risked areas where we focus our procedures on.

994
01:30:51,340 --> 01:30:53,500
The first one is inherent in every audit

995
01:30:53,500 --> 01:30:55,200
as management over audit controls.

996
01:30:55,400 --> 01:30:57,420
Based on the work related forbickeries,

997
01:30:57,620 --> 01:31:00,400
journal entry testing, no matters were affordable.

998
01:31:01,100 --> 01:31:05,280
Related party disclosures, there were no issues to be reportable now.

999
01:31:05,780 --> 01:31:10,400
Any related party disclosures are properly disclosed in the financial statements.

1000
01:31:10,640 --> 01:31:12,700
Nothing significant unusual in those matters.

1001
01:31:13,540 --> 01:31:14,820
The fair value of estimates.

1002
01:31:15,220 --> 01:31:21,800
We perform a sample sent out to a third party valuation specialist, which provides those fair values back to us.

1003
01:31:22,280 --> 01:31:30,380
All of their fair values came back within reasonable expectations of what the fair values of the investments for both plans were recorded at.

1004
01:31:30,380 --> 01:31:31,820
So no matters or issues there.

1005
01:31:32,440 --> 01:31:35,160
We also, when the pension, we get the actual report,

1006
01:31:35,160 --> 01:31:38,820
go through the input, its management assumptions,

1007
01:31:39,240 --> 01:31:41,320
perform reasonable tests on those.

1008
01:31:41,540 --> 01:31:45,420
No items were noted and knows a significant differences there.

1009
01:31:46,680 --> 01:31:49,820
And that wraps up our required communications related

1010
01:31:49,820 --> 01:31:51,740
to the audit of the two benefit points.

1011
01:31:53,980 --> 01:31:55,580
Thank you very much, Mr. Singleton.

1012
01:31:56,720 --> 01:31:59,560
And Sarah, just to be clear, this presentation covers both

1013
01:31:59,560 --> 01:32:01,100
of the motions I need to make next, correct?

1014
01:32:01,100 --> 01:32:06,140
This presentation covered both the 401k and the district pension.

1015
01:32:06,560 --> 01:32:07,320
That is for credit.

1016
01:32:08,060 --> 01:32:08,480
Thank you.

1017
01:32:09,060 --> 01:32:12,200
So members, we're going to do two motions based on the presentation.

1018
01:32:12,360 --> 01:32:13,020
That was just provided.

1019
01:32:14,260 --> 01:32:15,460
Mr. Webman, sorry.

1020
01:32:19,040 --> 01:32:24,400
Ryan, were there any unfundent liabilities within the report?

1021
01:32:26,340 --> 01:32:28,320
No, sir. Nothing was noted on those.

1022
01:32:28,520 --> 01:32:33,060
The appropriate funding that was calculated was done in with regards to the pension.

1023
01:32:33,640 --> 01:32:34,820
Okay, thank you.

1024
01:32:36,840 --> 01:32:40,680
Thank you, Mr. Puente. Sorry, I got an agreement and didn't see your question on the chat.

1025
01:32:42,040 --> 01:32:47,680
So again, we have two motions. One for the 401K and one for the pension plan. So first, we'll do the 401K motion.

1026
01:32:48,440 --> 01:33:00,560
We have a motion and a second for the acceptance of the Harris County Hospital District's 401K plan. Independent auditors report and financial statements for the years ended December 31, 2024 and 2023 as presented.

1027
01:33:02,680 --> 01:33:09,680
Thank you, Mr. Puente. All those in favor say aye. Any opposed? Say nay. Motion passes.

1028
01:33:12,590 --> 01:33:13,030
Do I have

1029
01:33:13,030 --> 01:33:17,130
a motion and a second for the acceptance of the Harris County Hospital District pension plan,

1030
01:33:17,350 --> 01:33:22,030
independent auditorous report and financial statements for the years and in December 31, 2024 and 2023

1031
01:33:22,030 --> 01:33:30,670
as presented? Thank you, Mr. Puente. Thank you, Mr. Robinson. Those in favor say aye. Any opposed? Say

1032
01:33:30,670 --> 01:33:30,810
Yay!

1033
01:33:31,390 --> 01:33:32,470
The motion passes.

1034
01:33:32,750 --> 01:33:33,210
Thank you very much.

1035
01:33:33,370 --> 01:33:33,830
You're single, anyway.

1036
01:33:34,630 --> 01:33:35,190
Yes.

1037
01:33:35,190 --> 01:33:35,490
Thank you all.

1038
01:33:35,670 --> 01:33:36,030
Have a great day.

1039
01:33:36,830 --> 01:33:37,170
You as well.

1040
01:33:38,410 --> 01:33:43,630
All right, we are now moving to our consent agenda items which is agenda item raw mandu-ural

1041
01:33:43,630 --> 01:33:47,810
12 or consent purchasing recommendations.

1042
01:33:48,390 --> 01:33:51,590
We have consideration of approval of purchasing recommendations items.

1043
01:33:51,790 --> 01:33:55,130
Alpha 1 through Alpha 13 of the purchasing metrics.

1044
01:33:55,590 --> 01:33:59,250
These purchasing recommendations were included in your packet for review.

1045
01:33:59,930 --> 01:34:04,810
I turn to Mr. Kenneson, Mr. Adger, to say a few comments about these items.

1046
01:34:07,020 --> 01:34:09,260
Thank you, Dr. Pai, Jack Adger, for purchasing.

1047
01:34:10,040 --> 01:34:15,440
There are no changes or additions that we ask that the board approve as presented.

1048
01:34:17,900 --> 01:34:20,920
Thank you very much. Any questions or comments from the board members?

1049
01:34:22,800 --> 01:34:27,160
Hearing none, do I have a motion in a second for the approval of purchasing recommendations?

1050
01:34:27,160 --> 01:34:35,160
items alpha one through alpha 13 at the purchasing matrix. So thank you Mr. Whitley. Seconded. Thank you Miss Vera blend any discussion?

1051
01:34:36,380 --> 01:34:40,220
Those in favor say aye. Hi, let's say those opposed say nay.

1052
01:34:44,020 --> 01:34:45,060
Let's just do a quick.

1053
01:34:46,960 --> 01:34:49,060
Some little echo lolly is going on

1054
01:34:50,220 --> 01:34:55,200
Those in favor of the motion as presented say aye. I any opposed

1055
01:34:58,360 --> 01:35:06,680
That's it. We now move to consent agenda items B is in boy through D is in delta, and

1056
01:35:06,680 --> 01:35:10,000
the board members let me know if you'd like to pull any items for discussion.

1057
01:35:13,820 --> 01:35:14,620
Hearing no

1058
01:35:14,620 --> 01:35:19,580
items pulled for discussion, drive a motion and second for the approval of consent agenda items

1059
01:35:19,580 --> 01:35:25,880
B and C, please note that agenda item D does not require any action and is for an update

1060
01:35:25,880 --> 01:35:33,700
only. So thank you, Ms. Vera-Bland. Thank you, Mr. Pointe. Any discussion? Hearing none,

1061
01:35:33,880 --> 01:35:42,280
all those in favor say aye. Aye. And all of those say nay. The motion passes. Okay. This brings us

1062
01:35:42,280 --> 01:35:50,020
now to agenda item 13. Item is related to the health care for the homeless program. agenda item 13,

1063
01:35:50,200 --> 01:35:53,960
output review and acceptance of the following reports for the health care for the homeless program

1064
01:35:53,960 --> 01:35:57,980
As required by the United States Department of Health and Human Services, which provides

1065
01:35:57,980 --> 01:36:03,320
funding to the Harris County Hospital District to provide health services to persons experiencing

1066
01:36:03,320 --> 01:36:09,980
homelessness under Section 330H of the Public Health Service Act, Dr. Jennifer Small and

1067
01:36:09,980 --> 01:36:10,760
Mr. Tracy Bergen.

1068
01:36:11,260 --> 01:36:12,380
Good morning, everyone.

1069
01:36:13,660 --> 01:36:13,920
Okay.

1070
01:36:14,460 --> 01:36:15,340
Next slide, please.

1071
01:36:17,540 --> 01:36:23,000
Today's June War presentation will cover our patient from the Children Report, our Consumer

1072
01:36:23,000 --> 01:36:23,840
Advisory Report.

1073
01:36:23,840 --> 01:36:29,900
A revision to your ACHP bylaws, a pollite from our 2024 annual report.

1074
01:36:30,140 --> 01:36:34,000
I'm sorry, Mr. Dillon, but I think I forgot to say something before you start it.

1075
01:36:34,140 --> 01:36:34,700
Yes, ma'am.

1076
01:36:35,640 --> 01:36:40,940
So our health care for the homeless program team is going to present all items together

1077
01:36:40,940 --> 01:36:46,040
in one presentation. Afterward, we will take it along each of their items separately as required

1078
01:36:46,040 --> 01:36:51,700
by law. But before they do their combined presentation, I need to read the remaining agenda items

1079
01:36:51,700 --> 01:36:58,480
approval before that presentation, so we're going to be covering approval of the Health

1080
01:36:58,480 --> 01:37:02,760
Care for the Homeless Program Consumer Advisory Council report, the Health Care for the

1081
01:37:02,760 --> 01:37:07,320
Homeless Program revised by-laws, the Health Care for the Homeless Program 2024 annual

1082
01:37:07,320 --> 01:37:11,540
progress support, and the Health Care for the Homeless Program quality management report.

1083
01:37:12,280 --> 01:37:16,100
And we'll have to do a separate motion for each of those, but this one presentation will

1084
01:37:16,100 --> 01:37:17,640
cover all of them before we vote.

1085
01:37:18,860 --> 01:37:19,700
Thank you, please continue.

1086
01:37:19,700 --> 01:37:23,760
We will also cover our quality management report, which will be covered by our medical

1087
01:37:23,760 --> 01:37:25,220
doctor, Dr. Rich today.

1088
01:37:26,180 --> 01:37:26,840
Next slide, please.

1089
01:37:29,540 --> 01:37:29,680
Okay.

1090
01:37:29,920 --> 01:37:34,780
Year-to-date, we have served on a duplicated patient year-to-date as in May.

1091
01:37:35,440 --> 01:37:42,100
We have served 3889 on duplicated patients and completed 13,000 visits.

1092
01:37:42,520 --> 01:37:47,000
And that has put in us slightly ahead of schedule for our targeted goals, so we're happy about

1093
01:37:47,000 --> 01:37:47,260
that.

1094
01:37:47,900 --> 01:37:48,520
Next slide, please.

1095
01:37:49,980 --> 01:37:56,880
For the month of May, we've served a total of 1399 on duplicated patients, 874, which

1096
01:37:56,880 --> 01:38:03,280
were seeking family practice services, and completed 2,000, 1,2700 completed visits.

1097
01:38:04,440 --> 01:38:05,400
Next slide, please.

1098
01:38:06,840 --> 01:38:11,460
For the Consumer Advisory Council report, these activities were covered from May of 25,

1099
01:38:11,460 --> 01:38:19,980
February of 2025 to April of 2025 and the items that we discussed this month were for assessment

1100
01:38:19,980 --> 01:38:24,640
of our operational hours. We're looking at our hours at Harmony House trying to decide if we

1101
01:38:24,640 --> 01:38:31,040
need to provide services, even clinic for the individuals there that are working. We also looked at

1102
01:38:31,780 --> 01:38:37,980
updates to the Open Door renovation project, participation in our community health events,

1103
01:38:37,980 --> 01:38:44,680
and also the outcomes that our UDS report, which we'll be presenting to the board later in the year.

1104
01:38:45,600 --> 01:38:46,200
Next slide, please.

1105
01:38:48,480 --> 01:38:52,200
Okay, we've recently made some revisions to our bond laws.

1106
01:38:52,900 --> 01:38:58,040
The first one is that we changed the hair cell system to re-hair cell.

1107
01:38:58,700 --> 01:39:03,480
And the second one, due to recent updates under the new federal administration,

1108
01:39:03,480 --> 01:39:09,260
First, I have provided us with revised guidelines, and it's into concerning terminology.

1109
01:39:09,980 --> 01:39:17,360
So what we change was gender to sex, but I do want to say this, that this is only a

1110
01:39:17,360 --> 01:39:21,580
language update, and it does not impact our values or our commitment to equitable care.

1111
01:39:23,200 --> 01:39:24,100
Next slide, please.

1112
01:39:25,680 --> 01:39:30,500
Here are highlights from our annual report, and I know it won't pass, but I need that for

1113
01:39:30,500 --> 01:39:32,580
It's a comfort quality, so I'm going quick.

1114
01:39:32,940 --> 01:39:33,940
Thank you, Dr. Pry.

1115
01:39:34,360 --> 01:39:35,660
A few more on your report.

1116
01:39:36,480 --> 01:39:37,960
We're just going to show you a few highlights

1117
01:39:37,960 --> 01:39:38,640
from that report.

1118
01:39:39,300 --> 01:39:43,400
So our top five diagnosis is obesity, depression,

1119
01:39:43,960 --> 01:39:47,480
tobacco use disorder, hypertension, and diabetes.

1120
01:39:48,720 --> 01:39:50,980
Somebody of the mental health and substance use trends

1121
01:39:50,980 --> 01:39:54,240
involved, again, depression, anxiety, PTSD.

1122
01:39:54,320 --> 01:39:56,000
We actually have a lot of PTSD.

1123
01:39:56,860 --> 01:39:58,480
And we're trying to tailor our services to that.

1124
01:39:58,480 --> 01:40:01,300
and also other substance-related disorders.

1125
01:40:01,740 --> 01:40:04,200
We're going to be working on some additional treatment

1126
01:40:04,200 --> 01:40:07,460
to implement later in the years,

1127
01:40:07,480 --> 01:40:09,600
so we'll bring that to the board as we work through them.

1128
01:40:10,260 --> 01:40:10,920
Next slide, please.

1129
01:40:14,210 --> 01:40:18,710
In 2024, we served 6,684 and duplicated patients.

1130
01:40:19,130 --> 01:40:22,150
This was 89% of our targeted goal,

1131
01:40:22,910 --> 01:40:25,950
and we completed 27,000 completed visits,

1132
01:40:26,230 --> 01:40:28,330
which was 121% of our goal.

1133
01:40:28,330 --> 01:40:33,710
So we did really well and complete a business to the point where, first of all, you guys are doing a great job.

1134
01:40:33,930 --> 01:40:38,410
So they boosted that number to 30,000 businesses this year, like yes.

1135
01:40:38,830 --> 01:40:39,890
And that's why I said that.

1136
01:40:41,130 --> 01:40:48,950
Okay, a breakdown of our patients showed that we have 65% of our patients are male and 35% of them are female.

1137
01:40:49,450 --> 01:40:52,710
And they range in an age group of 25 to 64 years age.

1138
01:40:52,710 --> 01:40:59,910
So that told us that we need to continue to give dedicated care to our adult population

1139
01:40:59,910 --> 01:41:03,590
while we're still continuing to focus on women's care and our older adults.

1140
01:41:04,110 --> 01:41:06,230
We do need to kind of cater to our men's care.

1141
01:41:06,390 --> 01:41:12,690
And that included behavioral health services, preventive care services, chronic disease management as well.

1142
01:41:13,410 --> 01:41:14,290
Next slide please.

1143
01:41:15,410 --> 01:41:23,730
I find it's an overview for 2024, we received over $4.9 million in grant funding.

1144
01:41:24,170 --> 01:41:26,830
And of that funding, we utilize 71%.

1145
01:41:26,830 --> 01:41:31,510
We are lucky that we are allowed to use that funding as carryover.

1146
01:41:32,050 --> 01:41:39,090
And we're trying to do so in the limit amount of funding that Herzl has to contribute to this program by utilizing my grant funds.

1147
01:41:40,230 --> 01:41:41,050
Next slide.

1148
01:41:41,050 --> 01:41:51,150
And this is why we do what we do. This slide speaks to this young lady who was residing in the shelter at Starr Hope Cornerstone.

1149
01:41:51,810 --> 01:42:01,770
And she received services from our mobile dental unit. And that team started to reserve her as an advocate and became her support system throughout her journey.

1150
01:42:02,250 --> 01:42:05,430
And then she decided she was going to join the army.

1151
01:42:05,430 --> 01:42:11,230
Our team, the dental team, not only wrote letters until phone calls while she was in basic

1152
01:42:11,230 --> 01:42:15,490
training, they actually attended her graduation when she graduated from the basic training.

1153
01:42:16,130 --> 01:42:22,990
And I have to say that, just like the hairstyle mantra, my team truly lives this, and so I'm

1154
01:42:22,990 --> 01:42:26,490
very proud of them for staying with her throughout her journey.

1155
01:42:27,070 --> 01:42:27,730
Next slide, please.

1156
01:42:31,530 --> 01:42:34,770
I'm trying to know if the doctor reached for a positive management process.

1157
01:42:36,120 --> 01:42:37,580
Good morning, everyone.

1158
01:42:38,060 --> 01:42:38,120
All

1159
01:42:45,570 --> 01:42:46,590
right. First slide, please.

1160
01:42:49,020 --> 01:42:51,140
All right. So we have our first slide here,

1161
01:42:51,300 --> 01:42:55,780
which lists our quality goals that we have set for this quarter.

1162
01:42:56,240 --> 01:42:59,560
We're going to be talking about data from the first quarter of 2025.

1163
01:43:00,820 --> 01:43:01,660
Next slide, please.

1164
01:43:03,820 --> 01:43:10,300
So in the interest of time, we are highlighting five of the metrics that did not meet our established quality standards.

1165
01:43:10,300 --> 01:43:16,900
Childhood immunizations, diabetes, management, and early entry into prenatal care did not

1166
01:43:16,900 --> 01:43:23,440
reach the UDS benchmark measure, whereas management of intravascular disease and depression

1167
01:43:23,440 --> 01:43:28,560
screening failed to surpass our programs more aggressive internal goals.

1168
01:43:29,880 --> 01:43:35,200
I'd like to focus on those goals that are not currently meeting the UDS benchmark and provide

1169
01:43:35,200 --> 01:43:38,160
a more high level for those that are not surpassing

1170
01:43:38,160 --> 01:43:39,420
our own internal goals.

1171
01:43:40,580 --> 01:43:44,020
There are six patients in the pediatric vaccine standard

1172
01:43:44,020 --> 01:43:46,060
to them that the standard,

1173
01:43:46,460 --> 01:43:50,280
while the remaining four had either missing or refused vaccines.

1174
01:43:50,760 --> 01:43:54,160
Again, primarily is ROTA and influenza vaccines

1175
01:43:54,160 --> 01:43:56,180
which have to be given doing infancy.

1176
01:43:56,800 --> 01:43:58,480
And once that time period is passed,

1177
01:43:58,480 --> 01:44:01,140
we're not able to go back and give them those vaccines.

1178
01:44:02,120 --> 01:44:04,640
But all of the children of parents

1179
01:44:04,640 --> 01:44:10,560
to agreeable to vaccinations are enrolled in participating in a catch-up vaccine plan.

1180
01:44:12,000 --> 01:44:17,520
diabetes control continues to be challenged because patients had A1C levels, they were

1181
01:44:17,520 --> 01:44:23,100
greater than 9, or did not have A1C measurement completed during the first quarter.

1182
01:44:23,840 --> 01:44:29,200
We're addressing transportation and scheduling issues to support those patients who did not

1183
01:44:29,200 --> 01:44:35,720
have an A1C check, and we're promoting aggressive diabetes management for those with elevated levels

1184
01:44:36,240 --> 01:44:42,180
for the primary focus to address this measure. Those aggressive measures include early insulin

1185
01:44:42,180 --> 01:44:48,960
therapy, dual therapy, referral to our nutritionists, and inclusion of our clinical case nurse and

1186
01:44:48,960 --> 01:44:55,580
our health educator to help our patients. One of the challenges we face is that a lot of our patients

1187
01:44:55,580 --> 01:44:58,960
is live in facilities where they do not have control of their diets.

1188
01:45:00,000 --> 01:45:29,980
Selection, however, when you don't have much to eat, you have to eat what's given. And so we are working with our patients in understanding to try to help them make the best possible decisions in those circumstances. The early entry into prenatal care metric measures the number of patients who present for prenatal care in the first trimester. The 10 patients is quarter to met the metric, but the majority of patients presented in the second trimester.

1189
01:45:29,980 --> 01:45:36,620
semester. The drill down reveal that it was a lack of pregnancy awareness before the end of the first

1190
01:45:36,620 --> 01:45:43,020
trimester and a lack of understanding or the acceptance of need for early prenatal care.

1191
01:45:43,580 --> 01:45:51,100
We provide education for the need of early prenatal care when we do our annual family planning

1192
01:45:51,100 --> 01:45:57,840
tool and at well woman visits. So we're focusing on trying to educate patients that prenatal care

1193
01:45:57,840 --> 01:46:00,420
is necessary and is effective.

1194
01:46:02,420 --> 01:46:06,540
And then highlighting those measures that did not meet the secondary goal.

1195
01:46:07,200 --> 01:46:12,480
We are working with the epic IT team to assure appropriate identification of patients from

1196
01:46:12,480 --> 01:46:17,360
whom anti-platelets are appropriate for the intravascular disease metric.

1197
01:46:18,460 --> 01:46:24,040
And then for the depression screening and follow-up, there was a change in the metric this year

1198
01:46:24,040 --> 01:46:31,300
from HRSA previously, we were, it was considered positive if the patient scored above 10 and then we

1199
01:46:31,300 --> 01:46:37,980
would have to put in a follow up plan. However, it changed from 10 to 5. And so there was a bit of a

1200
01:46:37,980 --> 01:46:44,800
lag between when it dropped down to 5 and then we caught on to it. I submitted an SBAR to consider

1201
01:46:45,420 --> 01:46:52,260
changing it back to 10. But in the meantime, we are addressing those patients who scored above a 5.

1202
01:46:53,620 --> 01:46:55,940
And that's what we have for our presentation.

1203
01:46:56,360 --> 01:47:00,100
I thank you all for your smiles and your nods of encouragement.

1204
01:47:00,640 --> 01:47:01,800
And it's just awesome.

1205
01:47:02,300 --> 01:47:02,720
Thank you.

1206
01:47:02,800 --> 01:47:02,920
Thank you.

1207
01:47:03,720 --> 01:47:05,220
Quick question of curiosity.

1208
01:47:05,620 --> 01:47:11,920
How many FTEs of providers do you guys have on your team?

1209
01:47:12,440 --> 01:47:16,260
I'm trying to figure out how many encounters your team is having to see per day

1210
01:47:16,260 --> 01:47:19,320
to hit 27,306 in a year.

1211
01:47:20,920 --> 01:47:30,920
So there's, there's not, there's not at this, so that's why you're putting on the, you're

1212
01:47:30,920 --> 01:47:37,060
putting us on the, we'll call us to the road, but there's nine FTE and the goal is that

1213
01:47:37,060 --> 01:47:44,660
each provider should see an average of 204 patients a month, a month, yes, so if we round

1214
01:47:44,660 --> 01:47:52,100
it out to 10. That means each, I mean you're exceeding that by a lot. If we

1215
01:47:52,100 --> 01:47:56,900
rounded to 10 providers, which is one more person, then you actually have 30,000

1216
01:47:56,900 --> 01:48:01,260
would be 3,000 patients in a year, and that's what HRSA is asking for. That's what

1217
01:48:01,260 --> 01:48:06,980
they're asking for. And we just, we actually just completed our last vacancy.

1218
01:48:14,120 --> 01:48:14,640
We're

1219
01:48:14,640 --> 01:48:22,720
here. Thank you. I just want to applaud the work you guys are doing because it hit 27,000 encounters

1220
01:48:22,720 --> 01:48:31,220
with a team of nine plus minus one that's really incredible and you guys should be very, very proud.

1221
01:48:31,500 --> 01:48:33,940
Yes, ma'am. Thank you so much. Thank you.

1222
01:48:38,980 --> 01:48:42,740
Okay. Board members, we're not going to do that flurry of

1223
01:48:42,740 --> 01:48:47,180
motions that I was telling you about earlier. So first, do I have a motion and second,

1224
01:48:47,180 --> 01:48:51,400
for acceptance of the Health Care at the Homeless Program June 2025 operational update.

1225
01:48:52,480 --> 01:48:53,660
Thank you, Ms. Vera-Bland.

1226
01:48:54,020 --> 01:48:54,220
Second.

1227
01:48:54,540 --> 01:48:55,240
Thank you, Mr. Quentin.

1228
01:48:55,760 --> 01:48:56,240
Any discussion?

1229
01:48:56,980 --> 01:48:58,140
All in favor, say aye.

1230
01:48:58,620 --> 01:48:58,740
Aye.

1231
01:48:59,460 --> 01:49:00,460
Any opposed, say aye.

1232
01:49:01,580 --> 01:49:02,340
Motion passes.

1233
01:49:03,500 --> 01:49:06,660
Do I have a motion and second for the approval of the Health Care at the Homeless Program

1234
01:49:06,660 --> 01:49:08,400
Consumer Advisory Council report?

1235
01:49:09,280 --> 01:49:09,860
I have a motion.

1236
01:49:10,120 --> 01:49:14,620
Thank you, Ms. Vera-Bland, for the second.

1237
01:49:14,780 --> 01:49:15,340
Any discussion?

1238
01:49:17,120 --> 01:49:18,560
All those in favor say aye.

1239
01:49:19,400 --> 01:49:20,740
Any opposed say nay.

1240
01:49:23,030 --> 01:49:23,610
I'm sorry.

1241
01:49:23,810 --> 01:49:25,270
Was that an aye, Mr. Sun?

1242
01:49:26,970 --> 01:49:27,170
Aye.

1243
01:49:28,170 --> 01:49:29,050
Thank you.

1244
01:49:29,470 --> 01:49:30,750
All right.

1245
01:49:31,230 --> 01:49:33,630
The motion passes there with no nays.

1246
01:49:35,070 --> 01:49:40,130
Next, do I have a motion in a second for approval of the health care for the homeless program revised by loss?

1247
01:49:43,220 --> 01:49:43,880
Thank you, Ms. Robinson.

1248
01:49:44,600 --> 01:49:45,840
Thank you, Ms. Friend.

1249
01:49:45,840 --> 01:49:47,380
All those in favor say aye.

1250
01:49:48,000 --> 01:49:48,180
Aye.

1251
01:49:48,820 --> 01:49:49,580
The vote say nay.

1252
01:49:51,240 --> 01:49:51,820
No, ma'am.

1253
01:49:52,020 --> 01:49:52,440
Thank you.

1254
01:49:52,620 --> 01:49:53,360
The motion passes.

1255
01:49:54,760 --> 01:49:58,740
They have a motion and a second to the approval of the health care for the homeless program.

1256
01:49:59,520 --> 01:50:01,280
2024 annual promise work.

1257
01:50:03,110 --> 01:50:05,810
So a lot more than you could say.

1258
01:50:07,570 --> 01:50:08,790
Thank you, Mr. Vierrobland.

1259
01:50:09,010 --> 01:50:10,190
Thank you, Mr. Pundit, for the second.

1260
01:50:10,350 --> 01:50:11,210
Those in favor say aye.

1261
01:50:11,630 --> 01:50:11,770
Aye.

1262
01:50:12,410 --> 01:50:13,210
Any opposed say nay.

1263
01:50:15,550 --> 01:50:19,970
and last one, the revolution in a second-day approval of the health care for the homeless

1264
01:50:19,970 --> 01:50:21,750
program, Quality Management Report.

1265
01:50:23,170 --> 01:50:24,490
Thank you, Mr. Wednesday.

1266
01:50:24,750 --> 01:50:26,130
Thank you, Ms. Perret.

1267
01:50:26,670 --> 01:50:27,510
Any discussion?

1268
01:50:28,950 --> 01:50:30,370
Hearing none, those in favor say aye.

1269
01:50:30,770 --> 01:50:31,050
Aye.

1270
01:50:31,410 --> 01:50:32,090
Any opposed say aye.

1271
01:50:33,090 --> 01:50:33,890
Motion passes.

1272
01:50:35,070 --> 01:50:35,850
Thank you very much.

1273
01:50:38,660 --> 01:50:39,360
Lift that.

1274
01:50:40,940 --> 01:50:44,780
This brings us to Board of Gender Item, or TEAM.

1275
01:50:44,780 --> 01:50:54,200
I have a request on my room and the board will go now into executive session for items 14

1276
01:50:54,660 --> 01:51:02,800
H through Cain as permitted under law pursuant to Texas Health and Safety Code, section 161.032

1277
01:51:02,800 --> 01:51:10,480
and Texas Government Code, sections 551.071, 072, 074 and 085.

1278
01:51:11,160 --> 01:51:14,580
Board members and presenters scheduled to speak in executive session do not need to log

1279
01:51:14,580 --> 01:51:14,800
off.

1280
01:51:14,920 --> 01:51:16,920
IT will move you in and out of executive session room.

1281
01:51:17,260 --> 01:51:20,980
Public meeting will resume via live stream from the hairstyle website upon our return from

1282
01:51:20,980 --> 01:51:21,760
executive session.

1283
01:51:22,420 --> 01:51:27,760
The time is now 11.42 a.m., we will take a brief technology recess in order to transition

1284
01:51:27,760 --> 01:51:28,660
to our virtual session.

1285
01:51:29,680 --> 01:51:30,560
Recording stopped.

1286
01:51:38,500 --> 01:51:42,180
We have returned from our executive session where no action was taken and I know that a

1287
01:51:42,180 --> 01:51:53,220
is present. The time is now 114 pm. The board will now take action on item 14J and 14K

1288
01:51:53,220 --> 01:51:59,440
of the executive session agenda item 14J settlement with Texas Health and Human Services Commission.

1289
01:52:00,200 --> 01:52:04,200
Do you have a motion and a second approval of the settlement with the state of Texas Health

1290
01:52:04,200 --> 01:52:08,300
and Human Services Commission, Office of the Inspector General, related to reimbursement of Medicaid

1291
01:52:08,300 --> 01:52:15,180
It came as in the amount of $2,516,662 of $27 cents for

1292
01:52:15,180 --> 01:52:17,720
soon to the terms discussed in our executive session.

1293
01:52:20,240 --> 01:52:22,920
Thank you, Mr. Sun for the second.

1294
01:52:23,620 --> 01:52:24,600
This is in favor say aye.

1295
01:52:25,660 --> 01:52:26,520
Any of those say nay.

1296
01:52:27,400 --> 01:52:28,820
The motion passes.

1297
01:52:30,220 --> 01:52:35,920
And next agenda item 14k regarding CEO evaluation.

1298
01:52:35,920 --> 01:52:45,940
Do I have a motion and second for the approval of the review of the chief executive officer evaluation and compensation recommendations as presented in our executive session?

1299
01:52:47,080 --> 01:52:51,080
Thank you, Mr. Buendin. Thank you, Mr. Robinson. Any discussion?

1300
01:52:54,360 --> 01:52:55,340
Those in favor say aye.

1301
01:52:55,340 --> 01:53:06,440
I, all those say nay, of any abstention, Mr. Son noted as abstaining, the motion passes.

1302
01:53:08,380 --> 01:53:11,400
With that, we have completed our posted agenda.

1303
01:53:11,720 --> 01:53:14,840
If there is no, I'm going to invite this one more action.

1304
01:53:30,220 --> 01:53:44,280
Do I have a motion and a second approval of the CEO goals for the period of July 25

1305
01:53:44,280 --> 01:53:48,560
to June of 2026, as presented in our executive session?

1306
01:53:48,560 --> 01:53:54,300
Thank you, Mr. Nierbland, thank you, Ms. Robinson, all in favour say aye.

1307
01:53:55,440 --> 01:53:56,260
Any of you both say aye.

1308
01:53:58,940 --> 01:53:59,140
All right.

1309
01:53:59,260 --> 01:54:00,040
Everyone voted aye.

1310
01:54:00,240 --> 01:54:00,880
The motion passes.

1311
01:54:01,440 --> 01:54:08,360
Now, we have completed our posted event that if there is no objection, the meeting is

1312
01:54:08,360 --> 01:54:10,740
now adjourned that the time is 1.17 pm.