Community Care Collaborative

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Community Care Collaborative A Central Health and Seton partnership Boardof Directors Meeting Monda~August6,2018 8:00 a.m. Central Health Administrative Offices 1111 E. Cesar Chavez St. Austin, Texas 78702 Meeting Minutes I. Call to Order and Record of Attendance On Monday, August 6, 2018, a public meeting of the CCC Board of Directors was called to order at 8:02 a.m. in the Board Room at Central Health Administrative Offices located at 1111 E. Cesar Chavez St., Austin, Texas 78702. and Vice Chairman Greg Hartman were both present The secretary for the meeting was Shannon Sefcik. Secretary Sefcik took record of attendance. Directors Present:,, Mike Geeslin, and Willie Lopez as proxy for Craig Cordola Officers Present: Jonathan Morgan (Interim Executive Director) and Shannon Sefcik (Secretary) Other Attendees Present: Randy Floyd (General Counsel)

II. Public Comments Clerk'sNotes : None. Ill. General Business A. ConsentAgenda All matters listed under the Consent Agenda will be considered by the Board of Directors to be routine and will be enacted by one motion. There will be no separate discussion of these items unless members of the Board request specific items to be moved from the Consent Agenda to the Regular Agenda for discussion prior to the time the Board of Directors votes on the motion to adopt the Consent Agenda. 1. Approve minutes from the April 5, 2018 Community Care Collaborative (CCC)Board of Directors meeting. Vice-Chairman Hartman moved that the CCC Board of Directors approve Consent Agenda item A(1). Director by Proxy Willie Lopez seconded the motion. The motion was passed on the following vote: B. Regular Agenda 1. Receive and discuss an update on the Delivery System Reform Incentive Payment (DSRIP) Program. Ms. Barbara Adams, Service Delivery Operations Manager, presented an update on the CCC DSRIP Program. Ms. Adams reviewed the incentives by category for Demonstration Years (DY) 7 and 8, including Categories A through D. She described the CCC's Category C selections, including those performed by CCC contracted providers and hospital-based measures. She also outlined the program milestones, with emphasis on performance contracting and reporting to the Texas Health and Human Services Commission. Ms. Adams responded to questions from the Board. 2. Discuss and take appropriate action on amendment to agreement with Eye Physicians of Austin.

3. Discuss and take appropriate action on amendment to agreement with Hospice Austin. Clerk 's Note s: Items 2 and 3 were taken up together. Mr. Jonathan Morgan, Interim Executive Director, presented on the amendments to the agreements with Eye Physicians of Austin and with Hospice Austin. Mr. Morgan noted that Eye Physicians of Austin provided expanded ophthalmology services to Medical Access Program (MAP) patients and required additional funding to continue working through the patient waitlist. He also explained that Hospice Austin provided a full spectrum of hospice services to MAP patients and required additional funds to continue this work. Mr. Morgan responded to questions from the Board. Vice-Chairman Hartman moved that the CCC Board of Directors authorize the CCC Executive Director to enter into an amendment to the Eye Physicians of Austin Agreement to increase the total not-to-exceed amount for Fiscal Year 2018 to $300,000. Vice-Chairman Hartman further moved that the CCC Board of Directors authorize the CCC Executive Director to enter into an amendment to the Hospice Austin Agreement to increase the total not-to-exceed amount for Fiscal Year 2018 to $725,000. Director Geeslin seconded the motion. The motion was passed on the following vote: 4. Discuss the CCC's 2016 Internal Revenue Service m 990, Return of Organization Exempt from Income Tax, Mr. Jeff Knodel, Chief Financial Officer, presented on the CCC's 2016 Internal Revenue Service m 990, Return of Organization Exempt from Income Tax. Mr. Knodel explained that the CCC, as a 50l(c)3 organization must file the 990 m no later than August 15, 2018. He distributed it in draft format to the Board for review. Mr. Knodel responded to questions from the Board.

5. Receive and discuss a presentation of the CCC Fiscal Year (FY) 2019 budget. Cler k'. Notes: Mr. Jonathan Morgan and Ms. Sarah Cook, Senior Director of Strategy, Communications & Population Health, presented the CCC Fiscal Year (FY) 2019 budget. Mr. Morgan discussed how the CCC FY 2019 budget aligned with CCC Strategic Plan for FY 2018-2020, including building an integrated delivery system, redesigning coverage programs, improving value in care, and optimizing the health of the covered population. He discussed the CCC's mission metric for patient quality of life and measuring patient experience through a 2018 Survey of Patient Access. He discussed shaping the system to allow patients a higher degree of engagement. He introduced the budget overview sources and uses of funds. He provided primary care highlights for FY 2018, including alternative visits, primary care metric set performance and care management infrastructure development, as well as FY 2019 initiatives, including DSRIP, dental service expansion and healthcare for the homeless. He discussed primary care visits and rates for the time span of FY 2015 through FY 2018 and select primary care metrics in the MAP population. He also discussed the breakdown of the primary care budget. Ms. Cook presented urgent and convenient care FY 2018 highlights, which included expanding access, and FY 2019 initiatives, which included patient outreach and digital urgent care. She also discussed the urgent and convenient care budget. Mr. Morgan presented the FY 2018 highlights for specialty care, which included ophthalmology, complex gynecology and musculoskeletal integrated practice units, ear, nose and throat service expansion, the colonoscopy pilot and palliative care. He also discussed specialty care initiatives for FY 2019, including a gastroenterology integrated practice unit, fecal immunochemical testing (FIT), rheumatology expansion and e consults. He provided dashboards demonstrating colorectal cancer screening in MAP patients and behavioral health screenings performed by the Dell Medical School. He also provided detail for the specialty care budget. Ms. Cook presented specialty behavioral health highlights for FY 2018, including the Integral Care agreement, expanded services with the SIMS Foundation and the Medication Assisted Treatment (MAT) pilot. She explained FY 2019 initiatives, which included enhancements to the Integral Care agreement and the continuation of the MAT pilot. She discussed the Integral Care agreement performance and presented detail on the specialty behavioral health budget. Mr. Morgan presented on FY 2018 post-acute care highlights, including an expanded network of skilled nursing facilities and increased hospice services. He also discussed FY 2019 initiatives, including the addition of

home health services and respite care for homeless patients. He provided detail on the post-acute care budget. Mr. Morgan ended with a discussion of health management strategy and the FY 2019 budget development timeline. Mr. Morgan and Ms. Cook responded to questions from the Board. IV. Closed Session, if necessary. V. Closing Chairperson Wallace announced that the next scheduled meeting is Friday, September 7, 2018 at 2:00 p.m. at Central Health's Administrative Offices, 1111 E. Cesar Chavez St., Austin, Texas 78702. Director by Proxy Willie Lopez motioned to adjourn the meeting. Director Geeslin seconded the motion. Clerk's Notes : The meeting adjourned at 9:45 a.m. ~QJoiN u, Larry~ 1 Chairperson Community Care Collaborative Board of Directors ATTESTED TO BY: