BOARD OF DIRECTORS MEETING MAY 9, 2017

MISSION: To Improve the health status of our diverse

communities by providing quality healthcare that is comprehensive, affordable, and culturally sensitive. VISION: North County Health Services will be the premier health care provider for diverse communities in San Diego County and the Inland Empire characterized by an exceptional patient experience, comprehensive and integrated services, and innovative approaches to clinical care, patient service and business operations.

BOARD OF DIRECTORS MEETING

MAY 9, 2017 TIME: 6:00 PM – 8:00 PM

LOCATION: WALT STEFFEN CONFERENCE ROOM

BOARD OFFICERS (APRIL 2016 - MARCH 2017) º SHEILA BROWN, CHAIR º DONALD STUMP, CHAIR ELECT º HARRIET CARTER, TREASURER º ANDREW RINDE, BOARD SECRETARY º ADRIANA ANDRÉS-PAULSON, MOST RECENT PAST CHAIR

AGENDA TIME ITEM # SUBJECT CHAIR/PRESENTER

6:00 - 6:05 pm I. CALL TO ORDER / INTRODUCTIONS SHEILA BROWN 6:05 - 6:10 pm II. APPROVALS

AGENDA MINUTES – APRIL 11, 2017 MEETING

SHEILA BROWN SHEILA BROWN

6:10 – 6:30 pm III. EDUCATION

STATE OF CALIFORNIA FQHC RATE SETTING & CHANGES IN SCOPE OF SERVICE (20 MINS)

IRMA COTA DEE ELLIOT

6:30 – 6:45 pm IV. EXECUTIVE ADMINISTRATION REPORTS

CEO REPORT – (10 MINS) PAGES 4-5 CREDENTIALING (5 MINS) PAGE 14

IRMA COTA PATRICK TELLEZ

6:45 – 7:15 pm V. BOARD COMMITTEE UPDATES & ACTIONS

GOVERNANCE COMMITTEE (10 MINS) o NEW TERM LIMITS APPROACH

PROGRAMS COMMITTEE (5 MINS)

o RESOLUTION #1837: HENRY L. Guenther Foundation - ACTION ITEM PAGE 15

FINANCE AND INVESTMENT COMMITTEE (15 MINS)

o MODIFICATION OF THE DENTAL SLIDING FEE POLICY – ACTION ITEM

ANDY RINDE

WALT STEFFEN

HARRIET CARTER

VI. CONSENT MINUTES

PROGRAMS COMMITTEE – APRIL 10 FUND DEVELOPMENT COMMITTEE – APRIL 11

VII. ADJOURN SHEILA BROWN 7:15 – 7:55 pm VIII. EXECUTIVE CLOSED SESSION

CEO SEARCH COMMITTEE (10 MINS) – INCLUDES EXECUTIVE COMMITTEE + STEVE KILDOO, CRAIG GARCIA, & VICTOR BOTELLO

EXECUTIVE BONUS METRICS (30 MINS) – INCLUDES EXECUTIVE COMMITTEE

ANDREA LEWISTON

SHEILA BROWN

June 13, 2017 Board Meeting Agenda July 11, 2017 Board Meeting Agenda 1. Follow up items from the Board Retreat

HEIDIS 1. Follow up items from the Board Retreat Provider productivity standards per HRSA Transformation care

Annual Golf Tournament – August 15

Upcoming Events

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ADMINISTRATIVE (Strategic)

Update on Healthcare National Legislative Environment and impact on NCHS

We continue to hear on the news media that there is interest on the part of some Congressional representatives to “Repeal and Replace/Repair” the Affordable Care Act. It appears that we will see an attempt to reintroduce a new and improved version of “American Health Care Act” as part of the 2017-2018 Federal budget. In addition, the Executive Order President Trump signed in February giving the Department heads in the IRS, Health Resources Services Administration (HRSA) leeway to make necessary changes to reduce the burden of the Affordable Care Act (ACA) will have an effect on HRSA. The new Administrator of Centers for Medicare and Medicaid Services (CMS) Cema Verma issued a letter with Secretary Price to Governors stating that they would work with States on changes at the State level Medicaid program. Therefore, States that want to reduce expenditures in healthcare now have a friendly and willing partner to approve requests to reduce benefits, change eligibility criteria and costs associated with this program. Each State runs their Medicaid program very differently. In California we have seen a commitment from the State Legislators and Governor to support health services for low income individuals.

While the recent AHCA efforts have been thwarted, there is still a very real chance that the GOP will come back to health reform, especially if their tax reform efforts fail. Medicaid reform would easily meet budget reconciliation criteria, and some conservative think tanks have recommended taking a more incremental approach to dismantling the ACA and safety net Desired changes to a Medicaid program take a long time to take effect, thus it may be 18-24 before we see any cuts here in California.

NCHS needs to stand tall in the wind!!

1. We do anticipate the State would want to move faster on their desire to pay based on value within this timeframe. It is imperative that NCHS continue to be an active participant with our State Association, CPCA and the State Department of Health Services in crafting the future payment methodology for “volume to value” known as “Alternative Payment Methodology” (APM).

MAY 2017 CEO BOARD REPORT

Page 4 of 22

2. It is likely that the State will use 2017 as the baseline for clinic visits/payment, thus maximizing visits this year is critical as they will use the total dollar paid on claims for the base funding

3. It is imperative that we put closure to open items with the State to establish the highest FQHC rate possible – Pending are:

a. Finalize the rate for the Perris Health Center b. Finalize the “open case” we have with the State for $2.00 per visit we are

contesting. The State disallowed some administrative costs we firmly believe are within the standard practices of the healthcare industry. Our consultants agree with us and together we are taking steps to continue to escalate the issue to the next level of review.

4. While there is continued unmet demand for our services and while we have resources to continue making investments with infrastructure to allow NCHS to create more physical space for additional providers and services we remain couscous on the capital investments as not to tie up too much of our reserves as we anticipate the headwinds of politics and healthcare policy.

5. Continue to innovate with activities that are alternative to the “face-to-face” visit or support patient care activities by clinical support team members as well as technology.

REAL ESTATE

The County Board of Supervisors approved City National Bank’s request to use TAFRA investment dollars to loan NCHS money to purchase the Ramona land. The benefit to NCHS is a lost interest rates on the mortgage.

Page 5 of 22

1-

Q2 WILL BE REPORTED IN JULY

2- PATIENT SATISFACTION/EXPERIENCE – MEDICAL (Q1 – 2017)

3- STAFF VOLUNTARY RETENTION Q2 WILL BE REPORTED IN JULY

4- PHILANTHROPIC UPDATE Q2 WILL BE REPORTED IN JULY

PRENATAL INTAKES

2.1. OVERALL SATISFACTION: 96.3% 2.2. LOYALTY: 98.6% 2.3. REFERRAL RETENTION: 96.8%

CEO KEY PERFORMANCE INDICATORS

FOR THE BOARD OF DIRECTORS MAY 2017

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Page 14 of 22

Resolution No. 1837

RESOLUTION OF THE BOARD OF DIRECTORS OF North County Health Project, Inc.

WHEREAS, North County Health Project, Inc. is a legally constituted 501(c)(3)

corporation, under the laws of the State of California, and is complete control of its affairs through its own officers and members,

NOW THEREFORE, BE IT RESOLVED, that the Board of Directors of North County Health Project, Inc. hereby approves the filing of a Letter of Intent to Apply

for a grant from the Henry L. Guenther Foundation

for support for the Oceanside Golden Years support group as a prime need within the scope and limitations of North County Health Project, Inc.'s policies.

Adopted on this __9th___ day of _May_, 2017

___________________________________________________ Signature

__Andy Rinde, Secretary___

Name, Title North County Health Project, Inc.

Page 15 of 22

Minutes of the

Board Committees Meetings

April 2017

• PROGRAMS COMMITTEE – APRIL 10 • FUND DEVELOPMENT COMMITTEE – APRIL 11

Page 16 of 22

2017 Board Committees

Summary of April Meetings

PROGRAMS COMMITTEE – APRIL 10 At the Programs meeting on 4/10/17 an overview of the Community Engagement department was presented and outlined the REACH Program, Clinical Internship/Volunteer Program and Perris efforts. The Henry L. Guenther Foundation Grant Opportunity to support the MM WHS renovation for $30,000 was discussed and it was recommended a full proposal be presented at the next Board meeting on 5/9/17. Fund Development reviewed funds received for MM WHS capital campaign as well as the upcoming Fore for Kids Golf Classic scheduled for 8/15/2017. Fund Development also discussed that this would be their last Programs meetings due to the new Fund Advisory Board Committee starting. To date, NCHS has received $349,210 in grant funding. FUND DEVELOPMENT COMMITTEE – APRIL 11 The Fund Development Committee discussed the MM WHS Capital Campaign. The Committee was pleased that NCHS will be once again introducing the ‘Buy a Brick’ fundraising opportunity. Committee members are encouraged to distribute the Case for Support via hard copies or the online link. The Committee is seeking new members to join – they discussed new potential members and coffee/lunch meetings will take place with the potential members in the near future. Additionally, the committee has been tasked with providing names of potential donors/sponsors at future meetings.

GOVERNANCE AND BOARD DEVELOPMENT COMMITTEE will meet – MAY 8 MARKETING AND COMMUNICATIONS COMMITTEE will meet – MAY 16 FINANCE AND INVESTMENT COMMITTEE will meet – MAY 9 QUALITY COMMITTEE will meet – MAY 9 AUDIT COMMITTEE will meet – MAY 15

Page 17 of 22

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ttend

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horiz

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Page 18 of 22

Pro

gra

ms

Mee

tin

g

Apri

l 10

, 2017

Doro

thy R

eno, 11:4

5am

o

Per

ris S

choo

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tric

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sica

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enta

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air

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ay 6

th

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ginn

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unity

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iana

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to g

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supp

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this

opp

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ld b

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enth

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pre

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as th

e of

ficia

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nch

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year

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aunc

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teve

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up a

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ynn

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gram

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hand

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logi

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ndat

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unity

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eetin

g ad

jour

ned

at 1

2:40

pm

Page 19 of 22

Committee Members

Present: Deborah Haydis, Steve Kildoo, and Debbie Thompson Absent: Luawanna Hallstrom, Karen Pearson, and Steve White Quorum Present: No

NCHS Staff

Present: Irma Cota, Lynn Hunter, and Jennifer Pena Proceedings

• Meeting called to order at 8:40am by Co-Chair Steve Kildoo • March 14, 2017 Meeting Notes were reviewed, no changes were recommended • CEO Report:

o Committee is still in need of one additional Board member. o Board committee members should engage the Board of Directors at the

monthly meetings. First task should be to request three (3) contacts from each director.

o Update on Ramona Health Center; next steps to create a task force in the Ramona area

• Fund Development Report: o Handouts: Fund Development Committee Report & Capital Campaign

Report o Lynn went over the YTD totals against goal; Grants are also being included

on the report to show the total philanthropic amount. o Update on Capital Campaign

MM WHC renovations will be done in phases and will stay open during renovations.

Introducing the ‘Buy a Brick’ fundraising opportunity once again. Bricks are $250.

Case for Support is complete; Committee members are encouraged to distribute. In addition to physical handouts, you can find an electronic version here.

Employee Giving kicks off tomorrow, Wednesday, April 12th. o Discussion regarding new Committee members

Three people have been recommended for the committee: Christine Lee, Linda Bailey, and Tina Pope

Lynn will reach out to Christine Lee to discuss Lynn will send Linda Bailey’s contact information to Steve and

Debbie who will meet with Linda to discuss Steve will talk to Sheila Brown regarding Tina Pope

NCHS Fund Development Committee Meeting Minutes

Tuesday, April 11, 2017

Page 20 of 22

Steve will talk to Carmen Amigon regarding the third Board seat on the committee

Deb recommended we consider Julie Nygaard. Deb will set up a meeting between Deb, Lynn, and Julie.

We will revisit the topic on next month’s agenda when more committee members are present.

o Annual Meeting Recap Over 100 people in attendance; positive feedback from event

o 13th Annual Fore for Kids Update Steve spoke with John Osborne at ATT who has asked we begin the

request process. Lynn has a robust list of targets but would like to add new

prospects to the list. We will provide the current list of targets to next month’s meeting.

o Gala Update Please keep the Gala in mind when speaking with potential

committee members and in considering sponsors/sponsorship opportunities. SAVE THE DATE: Saturday, Feb. 17, 2018!

• Other Business o Debbie suggested that when speaking with potential sponsors or in

considering potential sponsors/donors, we let them know how NCHS could be a benefit to their employees; two companies that she suggested contacting are DDH and Paramount Transportation.

o Deb suggested that committee members bring a list of three potential donors/sponsors to next month’s meeting.

Meeting adjourned at 9:30am Minutes submitted by Fund Development Specialist, Jennifer Pena

Next Meeting: May 9th, 2017

Page 21 of 22

PROGRAMS COMMITTEE MONDAY, MAY 8, 2017 11:45 AM – 1:00 PM DOROTHY RENO CONFERENCE ROOM GOVERNANCE AND BOARD DEVELOPMENT COMMITTEE MONDAY, MAY 8, 2017 1:00 PM – 2:30 PM DOROTHY RENO CONFERENCE ROOM FUND DEVELOPMENT COMMITTEE TUESDAY, MAY 9, 2017 8:30 AM – 9:30 AM WEST WING CONFERENCE ROOM QUALITY COMMITTEE TUESDAY, MAY 9, 2017 5:00 PM – 5:45 PM WEST WING CONFERENCE ROOM FINANCE AND INVESTMENT COMMITTEE TUESDAY, MAY 9, 2017 5:00 PM – 6:00 PM DOROTHY RENO CONFERENCE ROOM

AUDIT COMMITTEE MONDAY, MAY 15, 2017 4:00 PM – 5:00 PM WEST WING CONFERENCE ROOM MARKETING & COMMUNICATIONS COMMITTEE TUESDAY, MAY 16, 2017 10:00 AM – 11:15 AM DOROTHY RENO CONFERENCE ROOM

April 2017 Board Committee Meetings

Page 22 of 22