Minutes. Chairman Tenney called for public comment. There were no comments from the public.

Transcription

1 Minutes Maricopa Health Centers Governing Council Finance Committee Maricopa Medical Center Administration Building, Auditoriums 1 and 2 April 4, :00 p.m. Voting Members Present: Gary Tenney, Committee Chair Terry Benelli, Committee Vice Chair Liz McCarty, Member Melissa Kotrys, Member Joined telephonically at 4:07 pm to 5:41 pm Non-Voting Members: Barbara Harding, Chief Executive Officer, Maricopa Health Centers Governing Council (FQHC Look Alike) Richard Mutarelli, MIHS Chief Financial Officer Others/ Guest Presenters: Melanie Talbot, Chief Governance Officer Recorded by: LT Slaughter, Chief Compliance Officer Call to Order Chairman Tenney called the meeting to order at 4:00 p.m. Roll Call Ms. Talbot called roll. Following roll call, it was noted that all four voting members of the Maricopa Health Centers Governing Council Finance Committee were present, which presented a quorum. Ms. Kotrys participated telephonically from 4:07 p.m. to 5:41 p.m. Call to the Public Chairman Tenney called for public comment. There were no comments from the public. General Session, Presentation, Discussion and Action: 1. Approval of Consent Agenda: a. Minutes: i. Approve Finance Committee meeting minutes dated December 11, 2017 MOTION: Ms. McCarty moved to approve the consent agenda. Vice Chairman Benelli seconded. Motion passed by voice vote.

2 2. Discuss, Review and Make Recommendations to the Maricopa Health Centers Governing Council to Terminate the Lease and Co-Location Agreement Between Maricopa Integrated Health System and Southwest Network for the San Tan Whole Health Home (WHH) Clinic; and Terminate the Lease and Co-Location Agreement between Maricopa Integrated Health System and La Frontera for the Comunidad Whole Health Home Clinic. Ms. Harding discussed the memorandum located in the packed titled Closure of Whole Health Home Clinics. She stated that we currently have three Whole Health Homes Clinics (WHHC) currently in operation; Highland, San Tan and Comunidad. We have received notice from the owners of the San Tan facility that it has been purchased by another holding company; Assurance. She discussed that this will require us to terminate the lease due to no longer being grand-fathered into providing care in the Whole Health Home Clinic model. Ms. Harding is proposing the closure of the following two Whole Health Home Clinics associated with this lease agreement: 1) San Tan Whole Health Home Clinic: The lease and co-location agreement is up for renewal May 31, We would not renew; therefore, the clinic would close effective May 31, ) Comunidad Whole Health Home Clinic: The lease and co-location agreement is up for renewal September 30, We would not renew, therefore, the clinic would close effective September 30, 2018 She further stated that the financial impact of the loss of these clinics is minimal. The model is not sustainable given the changes in behavioral health. Moreover, Mr. Gene Cavallo, Senior Vice President of Behavioral Health Services, has been consulted and agrees with the plan as proposed. Mr. Cavalla stated that as we move forward with greater integration in the FHCs for Behavioral Health, this will provide more access of care to meet more patients needs. Bringing them into the FHC clinics (homes) would be a better location and make it easier to support this new model of care. Lastly, Dr. Lopez has also requested that we move forward with the closure, because if a provider becomes sick or is off on PTO, there is virtually no coverage for that provider. The Committee then had a detailed discussion of the PTO issues with physicians. Chairman Tenney had a question regarding contacting affected people on previous Whole Home Health Clinic closures, to see if she knows if we did contact any of them. Ms. Talbot will follow-up with Kate Rhodes to see if she contacted patients from previous Whole Health Home clinics. MOTION: Vice Chairman Benelli moved to make recommendation to the Maricopa Health Centers Governing Council to not renew the lease of co-location agreements between Maricopa Integrated Health System and Southwest Network for San Tan Whole Health Home clinic and not renew the lease and co-location agreement between Maricopa Integrated Health System and La Frontera for the Comunidad Whole Health Home clinic. Ms. McCarty seconded. Motion passed by voice vote. 3. Notification of Termination of the Lease and Co-Location Agreement Between Southwest Network and Maricopa Integrated Health System for the Highland Whole Health Home Clinic Ms. Harding continued the discussion on the closure of Whole Health Home Clinics and noted that the owner of the Highland property, SouthWest Network has sent a without cause, thirty (30) day notice of termination of lease letter. Per the letter, they invoked the termination clause due to a change in their contract with the Reginal Behavioral Health Authority. Ms. Harding states that the lease will be terminated on April 30, Ms. Harding also stated that she will contact SouthWest Network and try to extend the lease though May 31, Vice Chair Benelli asked about HRSA and if there is a 60-day notice requirement for the closure of this site. Ms. Harding replied that this is out of our control and that she will discuss the situation with our HRSA Project Officer. Chairman Tenney asked if there was a motion? Ms. Talbot stated No, it s not our choice, so there s no motion to make. Chairman Tenney said OK, and asked if there any further discussion? No one responded with any additional discussion items. 2

3 4. Discussion and Possible Action on the Federally Qualified Health Centers Look-Alike Clinics Ambulatory Financial Dashboard including but not limited to Visits and Provider Sessions Ms. Harding reviewed the Ambulatory Pillars Dashboard Finance Section and the Ambulatory Pillars Dashboard Action Plan. Ms. Harding then stated that as you can see from the dashboard we have here, we are still challenged in-regards to our visit rates at this point in time. We continue to be challenged by physician presence, PTO, during the month of February. I anticipate, within the next two months, we are going to continue to see this as a challenge because March and April had spring breaks. I believe that our PTO and our absences by physicians are impacting us. We also recognize that our Patient Service Center, who establishes our appointments and such has been challenged. There were vacancies that were occurring and on top of it they were hit really hard with the flu. That combination together has continued to present us with some challenges. We are continuing to work with our managers at the DYAD meetings. We had discussions in-regards to encourage them to plan vacation or PTO time throughout the year, and we also received an analysis that I requested from DMG. Ms. Harding stated she does not have adequate backfill when physicians are off on vacation. Even if I did know in advance it was PTO and they do have the day off, I don t have anybody to pull in from the physician pool if you will, to fill that slot or session of time to maintain those visits that I m losing. Ms. Kotrys asked at one point they talked about having some float providers. I can t remember what impact that had. Ms. Harding replied it has had a minimal impact from my estimation. It seems as if, whenever they have somebody brought into the float pool, somebody s resigning. Vice Chairman Benelli asked does the contract need to be boosted up so, there s some kind of guarantee or is it that there just aren t positions out there that are able to do this float kind of work? If they are willing to do this kind of work? Ms. Harding responded I think there are two different points. First, to find individuals that want to float because a physician likes to come into an environment and stay and get to know their panel assignments and establish relationships. I think floating means going from one place to the other. I think that presents a challenge when somebody s looking at that role. If you are somebody like a temp; you just want to go in and do it. I don t know that we ve had a population of physicians that like that kind of role. The second question is about the contract; that is a much harder question. Rich and I both, have not been here a long time. We will be coming down to look at the contract again. I certainly will try and advocate for some changes. Ms. Harding continued stating that we are in a risk-based agreement with Arizona Care Network. All of those physicians heard the ACN presentation. To me, the value of that presentation is speaking to where we are at today and is only going to continue to expand. So, where we are not meeting targets, in terms of diabetic patients, it s our quality point and they need to hear it. It s not just about us saying we want better care for our patients. The Alternative Payment Models (APM) are changing how we get paid for services. They re starting to hear these messages. Our last meeting was actually about implementing the protocol for Hemoglobin A1C, which is allowing the nurses to order Hemoglobin A1Cs as the patient is coming into the clinic; taking it out of the doctor s hands. Then monitoring the Hemoglobin AICs to really push down and see. We ve got to make some improvements in terms of our patients outcomes. Fecal cult blood testing/screening for colon cancer is an important value that we need to move forward. Chairman Tenney then asked how informed is the District Board about missed provider sessions that are bringing down our numbers? Ms. Harding replied Kris reports to them monthly. I have been before them twice, since I ve come. I am responsible for talking to them on a quarterly basis. Chairman Tenney then asked what is the status of the call center now? 3

4 4. Discussion and Possible Action on the Federally Qualified Health Centers Look-Alike Clinics Ambulatory Financial Dashboard including but not limited to Visits and Provider Sessions, cont. Mr. Mutarelli stated it has improved. Again, it s only been open since the middle of December 2018 and the amount of time on hold has improved. Actually, we need to have a report to this group. Maybe next month we can get that on the agenda from the call center for you to see some of the statistics that are tracked and the improvements that we are making. Chairman Tenney stated that we would definitely like to see how that s improving over time. Chairman Tenney then commented that Dental is fantastic right now. Chairman Tenney asked Ms. Harding are you in the DYAD meetings? Are you still having discussions on the visits per session by provider? Ms. Harding said that has not been the focus of the past two meetings, because I ve been concerned about some of our quality metrics as well as our value based agreement, as I mentioned. We ve got another DYAD coming up. It s always the third Thursday of the month. You are always welcome to that, if that is something you desire. If you would come they start at 5:30 pm with dinner and 6:00 pm is when the meeting begins. We are going to actually have a discussion about centralization of appointments and Patient Access Center and referrals. Chairman Tenney asked does anyone on the Committee have any more questions? OK, then that moves us down to item number five. 5. Discuss, Review and Possible Action on the following Finance Committee Reports: a. Year-to-Date Maricopa Health Centers Governing Council Expenditures and Budget b. Federally Qualified Health Center Look-Alike Clinics Financials and Payer Mix c. Federally Qualified Health Center Look-Alike Clinics Care Reimagined Capital Purchases Report 5a. Year-to-Date Maricopa Health Centers Governing Council Expenditures and Budget Mr. Mutarelli asked the Committee to turn to your packet under 5a. You will see the Governing Council expenditures and budget for the month. You ll see we are down some on the expenditures as we had some turnover in staff for the month. Mr. Chairman, for the YTD period we about nine percent below budget at $79K, compared to $86K. Vice Chairman Benelli asked how do we have a negative expenditure under Miscellaneous? Did we get a refund for something? Mr. Landas commented that under Miscellaneous Expenses, we did an YTD correction. It was coded under the wrong subaccount. We were correcting it and charging it to the right department with the right expense account. You can see on the back, it went from $1,257 was moved to Travel Reimbursement under the month of January. 5b. Federally Qualified Health Center Look-Alike Clinics Financials and Payer Mix Mr. Mutarelli said let s review the MTD actual vs. budget. If you ll look at the very first column, and we talked about this last month, I brought to your attention that the correction (credit of $136,000) is really driving the results for the month.. All clients combined. Again, that s a negative $135K in the revenue section. That puts us about four percent under budget for the month of February. Expenses are also four percent below budget, which is favorable. Again, staff flexing, eleven percent below budget on salaries and wages. However, because of that $135K for the current month, we are worse off than we thought from a budget standpoint on margin, after non-operating revenue and margin after the allocation of overhead. $48,000 to the negative on the margin, after non-operating revenue and about $20,000 ($19,500) on the margin after allocated overhead. 4

5 5b. Federally Qualified Health Center Look-Alike Clinics Financials and Payer Mix, cont. If you turn to the YTD period, you ll see that (like we have been discussing) visits eight percent below budget. Operating revenue is about six percent below budget. You will see where that Patient Center Medical Home revenue has corrected itself for the YTD period; it s very close to budget; $770K vs. $728K. In the other operating section, we are below budget by about $75,000 for the YTD period. We had some rents that we are no longer getting, that expired in October. We also have various health plans which have been behind on their PMPM payments to us. We need to follow-up with them. We are supposed to get an additional payment for ambulatory care management and the health plans are running behind. We need to keep after them. Vice Chairman Benelli asked if you accrued it or wait until we get it? Mr. Mutarelli replied yes, we are waiting to recognize it on a cash basis. Mr. Mutarelli continued with total operating revenues and noted they are six percent below budget. For the eight-month period, our expenses are also six percent below budget. Bottom line margin after allocations and overhead was actually $65,000 dollars better than what we budgeted. If we turn the page and look at the six-month trend visits. We have been talking about the number of patients coming off of Medicaid. You will see that we ve had a reduction in Medicaid visits. Again, those Medicaid roles are being reduced. Interesting; a bump up in commercial. We are hoping to have the discussion with our board about this. We need to verify as people come off of AHCCCS they get covered under commercial insurance. The risk of course, may also be self-pay. Interestingly enough, if you look at the chart, you see a bump in commercial and a bump in self-pay. So, it s going to be a mixed bag as we have patients coming off of AHCCCS. Mr. Mutarelli further explained that we have targets by site for collections. And as you know, as a FQHC we have to make that collection effort; collections actually improved. The same person that is responsible for the call center is also in our revenue cycle. Maybe I can bring something on collections next month to show some improvement there; if you d be interested in that. We make the effort, every patient, every time. We have to ask. It has improved and again, we have targets by location. Mr. Mutarelli continued and directed the Committee to look at the next bar graph, noting it shows more of the same. I was just talking about the four-year trend. Medicaid is down this year, Commercial is up, Other is up. On this one though, self-pay is down. This is an annual look. Again, more recent trends of patients getting off of AHCCCS. It s interesting to look at. Again, consistent with what you would expect in an FQHC in terms of payer mix. Right in that 70% percent range of Medicaid and self-pay. Chairman Tenney asked on the commercial side, is there a particular provider there that are sending them to us? Mr. Mutarelli replied it is United Health. Mr. Landas stated that United Health is the one who got a lot of the members, from the sale of the Maricopa Health Plan and United is part of commercial. Ms. Talbot noted for clarification, Maricopa Health Plan, that is an AHCCCS plan. When we sold that AHCCCS plan to United Health those patients used to show up on the payor mix under Medicaid, but they re now showing up under commercial? Mr. Landas noted that even though it s called United Health, we grouped them. There s a Commercial payer United Health and there s a Medicaid United Health. Because, if the trend continues to migrate to United Health, then I should see a bigger drop on Medicaid and then more on Commercial. I will verify that with our PFS, just to make sure on the payer mix. Chairman Tenney asked so what s the difference in the reimbursement? 5

6 5b. Federally Qualified Health Center Look-Alike Clinics Financials and Payer Mix, cont. Mr. Landas replied for the Medicaid, you are getting the FQHC rate. It s going to be $290-something. I don t know the exact. But on the Commercial, depending on the services and that line of business, what is our contracted reimbursement plan. Whether it s based on the CPT or whether it s based on the percent of charges. Mr. Landas stated he will get that clarified; about the United Health plan. How do we group them and where they fall on the payer mix. 5c. Federally Qualified Health Center Look-Alike Clinics Care Reimagined Capital Purchases Report Mr. Mutarelli started we had some expenditures during the month of February, as you can see, still well below the allocated amount. We ll be talking about that in a little bit when we talk about budget for next year. Vice Chairman Benelli asked does the allocated amount on that go through multiple years? Mr. Mutarelli replied yes, this was established and it s supposed to cover multiple years. Chairman Tenney asked if any members of the Committee have any questions or comments on number five? If not, then we will move on to Item #6, which is the volume assumptions. 6. Discuss and Review Volume Assumptions and Capital Requests for the Federally Qualified Health Center Look-Alike Clinics for Fiscal Year Mr. Mutarelli stated we are looking at the page behind the budget calendar. Ms. Harding stated I think everybody that was engaged in terms of the development of the volume really heard what you had to say, in terms of really setting the stage for this coming year and setting appropriate targets. We had very good discussions with our colleagues from DMG at my level. That would mean that we had Dr. Lopez and Stephanie Conoley, participating in those discussion with myself, Finance and others to look at what were the best options possible. As you can see, in terms of the ambulatory budget, they were calculated using the MGMA 2017 blended and counter productivity was used. We looked together, in terms of what were the projections for FY2018 and we re taking the information from the actuals and then going forward with the projections for Using the MGMA blended mediums we were able to come forth with the proposed budget numbers as you will note. You will see that the 2018 budget was listed for just the FHC clinics at 200,008 visits. As you can see in terms of the proposed budget for 2019 we have actually taken a reduction in our proposal for volumes this year. Mr. Mutarelli commented it will be an increase over the current year, but achievable. We wanted to have a stretch, but reasonable and not run into the same issues that we ran into this year. If the projections correct and we ve done our best; from 182,000 visits to 185,000 visits or a 2% increase, which is more in line with population growth. We hope we do better than that. Again, trying to be realistic and have a budget that shows growth, but is reasonable. Ms. Harding didn t point out on the previous page and it s important, because it came up earlier, you ll note the vacancy of providers was accounted for. The sessions that are missed from PTO, we given an affect for that. Vice Chairman Benelli asked if Mr. Mutarelli could explain the difference. I am trying to read through the volumes budget and how things are calculated. So, it seems like the CHC and Dental clinics are on a visit per working day basis, but there are other considerations taken into FHCs? Am I reading that right? Because the individual clinics will provide the number and type of providers they anticipate for Fiscal Year 2019? So, is it more of a clinic by clinic basis? 6

7 6. Discuss and Review Volume Assumptions and Capital Requests for the Federally Qualified Health Center Look-Alike Clinics for Fiscal Year Ms. Harding commented if you look at the first line, most CHC clinic volumes will follow the same methodology as the FHCs. Vice Chairman Benelli replied so basically the difference is, between what we have done in the past is this seems (like you said) it s more realistic in terms of what we have in providers may be different than what we re contracted to have by DMG. Mr. Mutarelli replied yes and allowing for some of that vacancy back to our float, if you will. Chairman Tenney asked how did you arrive at those variances? Mr. Landas replied basically, what it s doing is taking the column that says FY18 Budget 200,008 visits and comparing it to the proposed FY2019 Proposed Budget of 185,864 visits. Vice Chairman Benelli stated but this year, you re already up by 15.5%. Mr. Mutarelli replied yes it is up by twelve percent. Just so you know, we took the eight months actual and we took that relationship by site; eight months actual to 8 months budget. Added it to the eight months actual. Divide that ratio to the remaining budget months. Chairman Tenney asked if actuals amounts were used then? Mr. Mutarelli replied correct. Vice Chairman Benelli asked so you re not just applying a percentage across the board, you are taking into account all the different variations; clinic by clinic? Mr. Mutarelli replied that is correct. We tried to do that. And the bottom line in all this is, we think we ll end the year just under 293,000 visits and next year we ll be at 301,000, which is a three percent increase. It s a stretch given where we ve been and that s what we want. We want to stretch some, but it needs to be realistic. I am not going to be nine percent off again. At least that is the hope. Vice Chairman Benelli stated I think it seems realistic. I think the thing that we have to. Remember next year when we re looking at the numbers, is that we ve seen all the red this year, because we tried to stretch beyond what s reasonable and so then you are really trying to push the limits. If you make it very realistic, we all of a sudden start seeing green we can t just celebrate, because we all have green all of a sudden, because there s a big difference in the assumptions from one year to the next. Ms. Harding stated so on the next page, these are the capital expenditures to go forth. What I am trying to, there are a few things we are trying to deal with. We are trying to deal with end of life on some or our equipment and it has aged out and there is no further life that can be gained as a result. The next thing is that I am looking at opportunities for better care and better outcomes. I am looking at Point of Care Testing. So that means the testing would occur immediately onsite rather than waiting for a lab value to occur. I am looking for Hemoglobin A1C Point of Care Testing, flu and strep testing so we can have immediate responses. I am really excited about the Hemoglobin A1C, because I ve got somebody captive right there. I see what their Hemoglobin A1C is at that moment. I can do an immediate intervention and really start the change at that point in time. With the bili meters and jaundice meters, we re looking at the babies that are coming into the clinics. If we have challenges in terms of the patient babies here and we take the test on the baby for the bili test, we have to wait to see the results. If there are instances, if that mom leaves with that baby and results come back where the baby needs ultraviolet treatment and such, we need to go search for that mom and baby, because that is a life-threatening situation. So, this prevents that situation from occurring. That is why we wish to go forward with that. Additionally, we are talking about panic buttons, panic alarms in the FHCs. Where I came from, in terms of front desk and panic buttons, and I had them on my front desks. 7

8 6. Discuss and Review Volume Assumptions and Capital Requests for the Federally Qualified Health Center Look-Alike Clinics for Fiscal Year 2019, cont. That allows for that safety and comfort for that person at the front desk. When I push a button, I know I am getting help right away and immediately. I think that basically covers all of the work that we are looking at. Lastly, EKGs have been a challenge too. Apparently, Internal Medicine was running with one EKG that was shared with multiple clinics on the first floor. That is really dangerous. If I am coming to grab your EKG to take it down the hall to the other clinic and then somebody else comes into the clinic and we need to have an EKG right now, that s not a good situation. So that s why we are balancing out EKGs here. Ms. Kotrys asked what is the Point of Care Molecular? Is that the HBA1cs you were mentioning? Ms. Harding replied that is the Point of Care Testing. So, I am glad you pointed that out to me, because in addition to the Point of Care Testing, it also connects to the EHR. So, I don t have to deal with somebody transcribing or putting the values into the EHR. Chairman Tenney stated that personally, in the past, when we had expenditures of the size of the ultrasound machines and the POCs Molecular, we ve always had individual presentations on those. It gives us some type of proforma and a little bit more in-depth knowledge of what we re buying here. So, before we approve those. I would definitely like the Finance Committee to see a proforma on that so we know a little bit more about it. When and how it s going to pay off for us on both of those. I don t know if anyone else wants to see a proforma on anything else in here, but CCTV cameras may justify a presentation. Mr. Mutarelli replied Mr. Chairman, before we bring these for your approval and counsel. We ll have an analysis much like we do our Board. Chairman Tenney stated you can spend $100,000 without the committee s approval; unless you want to come to us. Ms. Talbot stated I want to point out that was very specific I just want to make sure we continue to have a line item on that, because that was very specific if it was budgeted and if it was part of the contingency fund. So if it is under $100,000 dollars and it is budgeted and it comes from the capital contingency, it does not need to go to this Committee. However, if it s over $100,000 dollars and it s outside the budgeted capital contingency it needs to come here. Mr. Mutarelli replied OK. So, let s talk through what we re thinking then. In terms of the budget, if we note that our Care Reimagined has almost $2mm dollars left and this was generated several years ago. Given what we are about to get into with all of our Prop 480 dollars and Care Reimagined, some of these things we are not going to be purchasing. One of the thoughts was, in particularly with this Point of Care Testing, if you would approve moving the Point of Care Testing to this list and taking it out, you can see what s left. In the contingency fund, there is about a million, one-fifty-one and at facility up keep, there s over $500,000. If we could move that to this list, we would still be within the $3M dollars. It would free up for our overall capital budget and then this capital budget would be for next year, the three million onetwenty-nine minus the million two-eighty-three. Ms. Kotrys replied so, can I ask a clarifying question? In the Care Reimagined, $3M was budgeted for FQHC capital and $1.2M was allocated, which is that third column. But, we really only spent a very minimal amount. The $89K, right? Mr. Mutarelli replied yes.. Vice Chairman Benelli asked are all the other things remaining on this still needed? Mr. Mutarelli replied they are not. 8

9 6. Discuss and Review Volume Assumptions and Capital Requests for the Federally Qualified Health Center Look-Alike Clinics for Fiscal Year 2019 Ms. Harding stated for example, you can see Glendale Dental. We closed Glendale Dental. Vice Chairman Benelli asked maybe next month can we determine which ones we could remove and then your question is, can we move some of these things from the new list, under that $3M, which makes the ask for any new bond dollars smaller. Mr. Mutarelli replied exactly and we were really only thinking of that Point of Care Testing, because I think frankly, Ms. Harding wanted to get started, if possible, this fiscal year before next. How can we approve this? May we move this Point of Care Testing to the Care Reimagined and take out the item that are no longer going to be purchased and revise this schedule and stay within that $3M dollars. That s really the question. Ms. Talbot stated so what we ll do is take the Care Reimagined report, which is 5C. Staff will bring back a revised Care Reimagined Capital Purchases report next month. The current one, which we ll say was 16, 17 & 18. We ll take from 19, the $1.3M for POC and we ll add it to this. Then it might not be a bad idea to have the Finance Committee approve the revised capital, even though I know it only goes through 2018 and it will already by May. You guys approved this to begin with and I think you should approve any changes to it. Chairman Tenney asked do we want to do any of these approvals? Would it help you Rich, if we did approve the volumes today? Mr. Mutarelli replied that would be wonderful. Ms. Talbot replied I m so sorry, we can t. It is not on here for approval. We did not ask for approval. Sorry. Chairman Tenney replied OK. Vice Chairman Benelli replied but generally we re supportive. If that is what you want to hear. Chairman Tenney asked are there any questions or comments from the Committee? Let s move onto number Chair and Committee Member Closing Comments/Announcements Chairman Tenney asked are there any comments from any members? Ms. Harding asked whether Dental needs to continue to come present to the Finance Council on a quarterly basis? I think that we have seen them move in the right direction and I would like to ask for allowing them not to come anymore, if that would be possible. Chairman Tenney replied I think we would want to see them a couple times a year probably; instead of four. Vice Chairman Benelli commented twice? Chairman Tenney stated twice a year. Maybe every six months or something. So, we don t lose what we ve built up there. OK? Ms. Harding replied agreed. Thank you. Chairman Tenney asked does everybody agree with that? 9

10 7. Chair and Committee Member Closing Comments/Announcements, cont. Vice Chairman Benelli replied yes. Chairman Tenney asked anything else? If not, then we ll go onto Melanie here on staff assignments. 8. Review Staff Assignments Follow up Items: April 4, 2018: 1) Current CEO to reach out to previous interim CEO regarding contacting patients from other closed WHHC to see where they went for primary care 2) A Patient Assistance Center Presentation and a Collection Improvement report will be on a future agenda 3) When requesting approval for POC and Ultrasound Capital equipment, ensure there is a presentation and pro forma included with materials 4) Add the revised 2018 Care Reimagined Capital Expenditures Request List to the May 2018 agenda for approval 5) Add the POC Capital equipment to the 2018 Care Reimagined Capital Expenditures Request List 6) The dental report will now be provided twice a year; next report will be in September ) When providing the profitability report to the Committee in May, also provide the cost accounting report Old Business: February 7, 2018 May 2018 quarterly referral report: add information on the top 5 services referred out for all clinics combined. If possible, also include the payer mix. May 2018 FQHC Look Alike clinic profitability report (for each FQHC): to be presented quarterly. Adjourn Chairman Tenney asked if there is nothing further, is there a motion to adjourn? MOTION: Ms. Kotrys moved to adjourn the April 4 th, 2018 Maricopa Health Centers Governing Council Finance Committee meeting. Vice Chairman Benelli seconded. Motion passed by voice vote. Meeting adjourned at 5:41 p.m. Melanie Talbot, Chief Governance Officer 10