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MEMORANDUM
TO: Board of Managers
Patricia A. Young Brown President and CEO
FROM:
DATE: June 13, 2008
RE: Strategic Planning Retreat
This is to remind you of the strategic planning retreat to be held on Wednesday, June 18, 2008, from 1:00 p.m. to 7:00 p.m. in the Board Room of the District offices. Attached to this memorandum are three sets of documents that will help guide our work next Wednesday.
The first set of materials, identified below, are those that we will use throughout the meeting to guide our progress.
Meeting Materials • Posted agenda for retreat • Meeting agenda with specific timeframes identified for each topic • Planning document with prioritized staff recommendations for strategies by focus area
with needed resource, reason for recommended prioritization, and anticipated Return on Investment (ROI) identified for each.
The second set of materials, identified below, are those that we will refer to as needed to assist in our strategic planning discussions. The items are listed below in the order that they were completed
Back-Up Materials • SWOT Analysis • Analysis of current strategic plan • Planning document with prioritized staff recommendations by focus area without
information on needed resources or anticipated ROI • List of current District collaborations
The final set of materials is related to the Board's self-evaluation and will inform the discussion regarding the role and organizational structure of the Board.
Board Materials • Results of Board Self-Evaluation • Proposed revision to Board committee structure
Thank you in advance for your participation in this important effort. The development of a meaningful strategic plan with priorities established for FY09 and beyond along with consensus on the role and organization of the Board will be invaluable in guiding our work in the upcoming fiscal year.
TRAVIS COUNlY HEALTHCARE DISTRICT BOARD OF MANAGERS
STRATEGIC PLANNING SESSION
WEDNESOAY,JUNE1B,2DDB l:DO PM
1111 E. CESAR CHAVEZ. AUSTIN, TEXAS CESAR CHAVEZ BOARD CONFERENCE ROOM
AGENDA
I. Receive. discuss. and take appropriate action on Information related tu the development of the District's strategic plan and budget for fiscal year 2DDB-2DD9 including Items affecting the District's fiscal year 2001-2008 budget and strategic objectives.
2. Rei:eive. discuss. and take appropriate action regarding the District Board of Manager's self evaluation and organization and committee structure for fiscal year 2DDB-2D09.
3. Discuss and take appropriate action regarding the evaluation tool for the District President and CED's performance incentive pay for next formal evaluation period. including a discussion of the purpose of performance incentive pay. and the District President and CED's compensation.' ·
Note I. Section 551.074. Personnel Matters
The Board may consider any item on the agenda in Executive Session if theru are issues that require consideration in Executive Session and the Committee announces that the item will be considered during Executive Session.
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Travis County Health Care District Board of Managers Strategic Planning Retreat
June 18, 2008
Objectives • Review major accomplishments of the past 3 years • Discuss key factors and assumptions to consider in the planning process • Determine short-term priorities for 2008-2009 • Determine priority strategies for the next 3 to 5 years • Identify implications of the priorities for organizational roles, structure and
communication in the coming year ·
Agenda
1:00 Welcome (Carl)
1:05 Session Overview/Participant Expectations Facilitator reviews session objectives, agenda, discussion guidelines and roles. Participants state their goals for the session.
1:20 Where Have We Been? The group sets the context for the day's discussion by briefly reviewing the vision and mission statement. The Board then reflects upon major accomplishments and the factors that made those successes possible. Organizational limitations will also be discussed.
1:50 How Can We Align Our Purpose with the Needs of the Future? Key issues, trends and assumptions for the future will be identified and discussed. The group will clarify implications of the future for the organization's vision and m1ss10n.
2:30 Break
2:45 Where Can We Have the Most Impact? Using the discussion of future trends and organizational purpose as a context, the group discusses and reaches consensus on short- and long-term priorities.
4:00 Break
4:15 Where Can We Have the Most Impact? (Continued)
4:50 Break
5:00 How Can We Work Together to Implement the Plan?
5:50
6:15
6:15-7:00
Participants assess implications of their agreements. Topics include: • Board roles • Committee structure • Budget • Implications for organizational communication and staffing • Processes for completing a more detailed, measurable and operational
strategic plan
Agreements and Next Steps Specific agreements from the retreat are summarized, and assignments and timeframes for follow-up steps are identified.
Evaluation and Close of the Strategic Planning Meeting
Executive Session and Meeting to Discuss Incentive Program for President/CEO
Facilitator Mary Thompson, Corder/Thompson & Associates
Staff Recommendations 6/18/08
1
TCHD Strategy Considerations By Focus Area
Focus Area: Healthcare Services Network (Primary Care, Specialty Care, Mental Health)
Priority Anticipated ROI for Strategy Have To Want To Resource Rationale for FY Designation District/Community
Increase access to urgent care/convenient care centers (PC)
FY09 Current staff New staff (Provider Relations, Business Development)
Additional funds may be required to purchase additional services
Provide increased access to care for patients needing immediate services to reduce use of ER.
• Timely access to continuum of care for patients
• Increased patient satisfaction
Explore options to increase primary and specialty care capacity for target population
FY09 Current staff New staff (Provider Relations, Business Development)
Additional funds may be required to purchase additional services
Provide increased access to care to manage chronic issues and receive specialized treatment prior to needing emergency or inpatient care
• Timely access to continuum of care for patients
• Better management of patient health
Investigate feasibility of providing specialty care services within new CHC clinics as they are developed
FY09 Current staff New staff (Facilities Manager, Provider Relations)
Additional funds may be required to purchase additional services
Provide specialized treatment prior to needing emergency or inpatient care
• Timely access to continuum of care for patients
• Better management of patient health
Work with medical school and community stakeholders to define District role with graduate medical education
FY09 Current staff New staff (Governmental Relations) Additional funds may be needed to purchase services from new school
Need to define District role in relationship to any medical school in Travis County
• Manage community and stakeholder expectations
• Increased access to specialty care services
Work with stakeholders to identify level of need for full continuum of mental health services
FY09 Current staff Continue to move community forward on incremental solutions for mental health services.
• Increased access to care • Better community understanding for
need at all levels of care. Finalize and implement Phase II of mental health plan for community
FY09 Current staff Additional funds will be required to purchase additional services.
Continue to move community forward on incremental solutions for mental health services.
• Increased access to care • Better community understanding for
need at all levels of care. Contract on a pay-for-performance basis FY09 Current staff
New staff (Purchasing/Contract Manager)
Ensure accountability for District expenditures
• More transparency in use of dollars
Use JAT to establish access targets and reporting of specialty care metrics – encounters, wait times, etc.
FY09 Current staff Ensure accountability for District expenditures
• More transparency in use of dollars
Evaluate findings of UT study on E-merge program and implement recommendations based on priority and feasibility
FY09 Current staff Recommendations may require additional staff and/or dollars to implement
Ensure most efficient and effective use of District dollars for these services
• More effective program – appropriate screening of patients, access to needed care
Staff Recommendations 6/18/08
2
Focus Area: Healthcare Services Network Cont’d. Priority Anticipated ROI for
Strategy Have To Want To Resource Rationale for FY Designation District/Community Work with community providers to enhance capacity for Medicaid/Medicare population within FQHCs to maximize federal funds for community
FY09 Current staff New staff (Provider Relations, Business Development)
Maximize availability of federal funds in community
• Leverage federal funding to stretch local dollars
Investigate acquisition/addition of pediatric practices to FQHCs to increase Medicaid participation
FY10 Current staff New staff (Provider Relations & Business Development)
Additional funds and infrastructure may be required for acquisition and operation of additional practice(s)
Will be able to focus on this initiative after CHC system transition is completed and additional infrastructure is in place to implement any identified solutions.
• Leverage federal funding to stretch local dollars
• Expanded access for uninsured through maximized Medicaid funds
Collaborate with community partners, including HMOs, to evaluate opportunities to maximize specialty care resources
FY09 Current staff New staff (Governmental Relations, Business Development)
Additional funds may be required to purchase additional services
Community HMOs have expressed interest in pursuing this with us and have approached District to facilitate process
• Additional specialty care resources • Leveraged funding to support these
services
Identify, along with community partners, new funding opportunities to support increased capacity and/or integration of mental health services
FY09 Current staff New staff (Business Development, Governmental Relations)
Continue to move community forward on and supporting incremental solutions for mental health services.
• Leverage funding to stretch local dollars • Increased access to care
Focus Area: Efficiency and Integration of the Service Delivery System
Priority Anticipated ROI for Strategy Have To Want To Resource Rationale for FY Designation District/Community
Use shared data available through Medicaider, ICARE, and NexGen to inform program eligibility and care for shared safety net patients
FY09 Current staff Shared data will educate all safety net partners on available programs and allow for better care of shared clients
• Increased community understanding of available services
• Improved coordination of client care Implement NexGen software for specialty care referrals to enhance client access
FY09 Current staff Establish and implement shared standards for referrals for specialty care
• Increased understanding of level of need for specialty care services
Work with safety net providers on “virtual system of care” (shared data, standards for care, clear roles for providers, etc.) for shared clients
FY09 Current District and CHC Decision Support Staff
New staff (Provider Relations)
Create a coordinated system of care through safety net health care delivery system
• Better community and client understanding of available services
Promote concept of standard sliding fee scale for care provided at all safety net clinics
FY09 Current staff Continue work with safety net providers to stress importance of standard sliding fee scale in community and client expectations
• Increased client understanding of financial responsibilities for services
• Level playing field for providers Develop and implement standard sliding fee scale for unfunded at all safety net clinics as part of “no wrong door” approach in access to
FY10 Current staff Can only establish and implement a common sliding fee scale after safety net providers have agreed to this concept
• Increased client understanding of financial responsibilities for services
• Level playing field for providers
Staff Recommendations 6/18/08
3
healthcare for all medically underserved Focus Area: Regional Collaborations and Initiatives
Priority Anticipated ROI for Strategy Have To Want To Resource Rationale for FY Designation District/Community
Monitor legislative environment for ability to coordinate regionally and act upon opportunities as they become available.
FY09 Current staff New staff (Governmental Relations)
Legislature in session in FY09 and need to follow any relevant legislation proposed along with any other state or federal efforts. Stay abreast of potential threats to District.
• Greater leveraging of funds • More consistent provision and eligibility
for services
Participate in regional efforts for small-employer health coverage program
FY09 Current staff New staff (Business Development, Provider Relations)
Funds for initial capitalization with commitment from other community partners
Continue to influence final product and monitor effectiveness prior to commitment of additional funds.
• Greater access to affordable health care for small employers and their employees
• Reduction in unfunded within community and better health status for participants.
Support Children’s Optimal Health as charter member to enhance District access to regional planning data
FY09 Current staff Annual membership fee
On-going project to provide enhanced access to real-time (versus historical) data for coordinated community planning efforts
• Better understanding of interrelatedness of various community issues
• Maximize funds through targeted efforts Continue dialogue with Hays County to identify common interests in regional approach to healthcare services and funding
FY09 Current staff New staff (Governmental Relations)
Continue efforts to identify common areas of interest
• Greater leveraging of funds
Focus Area: Patient Coverage Programs
Priority Anticipated ROI for Strategy Have To Want To Resource Rationale for FY Designation District/Community
Complete redesign of health coverage program (currently MAP).
FY09 Current staff Complete review of accessibility to current network services
• Improve access to services • Better health outcomes for patients
Increase service contracts to expand provider network.
FY09 Current staff New staff (Provider relations)
Increase access to care through more providers
• Greater patient satisfaction, potential reduction in use of ER
Brand re-designed health coverage program and educate stakeholder son new program, name, services, limitations, etc.
FY09 Current staff Additional funds needed for printing of materials, etc.
Need to rebrand as soon as possible to move away from “MAP” which is confused with the CHC system
• Clear identification of program • Educate community, stakeholders, and
staff on District program Define target population and service provider network for pilot program to monitor total cost of care
FY10 Current staff New staff (Provider relations)
Determined to conduct pilot after program redesign has been completed.
• Better pricing and services through competing network of providers
• More comprehensive cost and service data
Deploy new program on revised terms or fully implement within available resources based on results of pilot.
FY11 Current staff New staff (Provider relations)
Need data from pilot to be conducted in FY10 to inform whether and to what extent to broaden pilot through redesigned program
• Expanded access for uninsured through maximized use of funds
Staff Recommendations 6/18/08
5
Focus Area: CHC System Transition
Priority Anticipated ROI for Strategy Have To Want To Resource Rationale for FY Designation District/Community
Finalize organizational structure (functions) for District and 501(c)3.
FY09 Current District, CHC, and transition staff
New CHC system staff (CFO, Communications, Legal)
Need to complete transition to be operational as non-profit on 3/1/09.
• Successful transition of services for community
Complete development and implementation of infrastructure to support District and CHC business, administrative, and operational functions, including the solicitation, purchase and contracting of necessary equipment, information systems and services.
FY09 Current District, CHC, and transition staff
New CHC system staff (CFO, Communications, Legal)
Need to complete transition to be operational as non-profit on 3/1/09.
• Successful transition of services for community
Complete plans with the City for close-out issues and transfer/lease of City assets.
FY09 Current District, CHC, and transition staff
New CHC system staff (CFO, Communications, Legal)
Need to complete transition to be operational as non-profit on 3/1/09.
• Successful transition of services for community
Continue process for transfer of FQHC designation and other federal requirements to TCHD.
FY09 Current staff Contracted legal support Political support
Need to complete transition to be operational as non-profit on 3/1/09.
• Successful transition of services for community
Complete and implement branding for new CHC organization.
FY09 Current District, CHC, and transition staff
New CHC system staff (CFO, Communications, Legal)
Need to complete transition to be operational as non-profit on 3/1/09.
• Successful transition of services for community
Transition CCSD staff 3/1/09 and implement HR policies and systems.
FY09 Current District, CHC, and transition staff
New CHC system staff (CFO, Communications, Legal)
Need to complete transition to be operational as non-profit on 3/1/09.
• Successful transition of services for community
Staff Recommendations 6/18/08
6
Focus Area: District Infrastructure and Resources
Priority Anticipated ROI for Strategy Have To Want To Resource Rationale for FY Designation District/Community
Protect Medicaid, DSH, UPL funding streams FY09 Current staff New staff (Governmental Relations)
Maintain sufficient funding to continue current level of services
• Reduce potential loss in access to care due to loss of funding
Sustain tax base FY09 Current staff New staff (Governmental Relations)
Maintain sufficient funding to continue current level of services
• Reduce potential loss in access to care due to loss of funding
Increase Medicaid business FY09 Current staff New staff (Governmental Relations, Business Development)
Maximize availability of federal funds in community
• Leverage funding to stretch local dollars
Explore opportunities for additional funding through grants/philanthropy, development of HMO, and other business/joint ventures
FY09 Current staff New staff (Business Development) Outside legal support, consultants to advise on process
Diversify funding for District • Good stewardship in terms of pursuing other revenue streams besides tax base
• Reduce risk in loss of access to services due to loss of funds in any one area
Identify and implement appropriate level of infrastructure for the District
FY09 Current staff Consultant report Will require new funds for new staff
Ensure “right-sizing” of District • Sustain District through effective management of staff resources
• Ability to plan and work more proactively while not being overstaffed
Manage key relationships with City of Austin, Travis County and other key partners
FY09 Current staff New staff (Governmental Relations Business Development)
Maintain effective working relationships with partners
• Leverage resources
Continue to require and ensure receipt of service performance level data from contracted providers
FY09 Current staff New staff (Purchasing/Contract Management)
On-going prudent business practice • Accountability for expenditure of taxpayer dollars
Conduct annual strategic planning process to incorporate stakeholder input, identify strengths, weaknesses, opportunities, and threats, and prioritize work for next fiscal year in sufficient time to allow plan to inform budget request
FY09 Current staff New staff (all)
Ensure that plan is well thought out to guide budget request and District purchasing decisions each year
• Identify service and resource gaps and ways to address those gaps
• Accountability for expenditure of taxpayer dollars; clarity in District philosophy and prioritized strategies
Prepare appropriate budget request within defined timeframe and including input from District
FY09 Current staff New staff (Accounting Assistant, Chief of Staff)
Required for implementation of effective tax rate
• Accountability for expenditure of taxpayer dollars
Receive approval for proposed budget from District Board of Manager and Travis County Commissioners
FY09 Current staff Need approved budget to purchase services • Accountability for expenditure of taxpayer dollars
Ensure services provided to clients are in compliance with all regulations
FY09 Current staff Ensure compliance with relevant standards and avoid penalties
• Accountability for expenditure of taxpayer dollars
SWOT Analysis for Travis County Healthcare District FY09 Planning
Strengths: What do you do well? Weaknesses: What could you improve? Governance
• Supportive, volunteer board • Strong leadership
Resources • Committed Staff • Good Teamwork • Creative – ability to think outside the box • Funding – ability to raise additional monies • Accountable –
Leverage community resources Pay-for-performance approach to purchasing
• Bringing FQHC status to District • Have established good groundwork for organization
Community Positioning • Work with collaborative partners on common goals • Able to create the organization that we want • “Controlled” community politics – do not have to be as
influenced by community input as City/County • Dedicated focus on health
Governance • Need for Board to further evolve to policy
making body Resources
• Complex relationships that support current organizational structure
• Insufficient infrastructure to plan for and respond to all issues in timely manner – need to increase efficiency to increase productivity
• Lack of strongly defined roles/career ladder for staff and corresponding performance expectations and reward system
• Lack of diversity in district funding • Low tax rate • Thin layer of investment spread over
multiple areas – little focused attention, hard to measure impact
• Facility/space issues • Inheritance of poorly defined contractual
relationships Community Positioning
• Unable to serve all eligible residents • Unable to clearly identify all eligible
residents and report on those served • District’s role still evolving – difficult for
messaging to staff, customers, community • Lack of criteria for community to request
assistance Opportunities: What trends could you take advantage of? Threats: What trends could harm you?
Access to Care • Ability develop most effective purchasing structures
(such as HMO) • Participating in innovative efforts, such as small-
employer product • Senate Bill 10 – potential to increase health coverage
across state • Expanding service availability through purchasing
services and joint ventures • Medical education in Austin – could increase access to
services Business Model
• CCSD Transition to non-profit – change to client service orientation
• Continue to create new County and regional collaborations
• Can pursue private/public partnerships to expand resources
• Build infrastructure to support core values and mission Service Efficiency/Quality
• Streamline services • Standardize costs, eligibility, services among safety net
partners • Increase access to data communitywide • Create stable organizational culture and staffing
Access to Care • Senate Bill 10 – potential to do more harm
than good if reduces local resources • Potential State/Federal health financing
reductions (Ryan White, UPL, DSH, Medicaid, etc.)
• Economy – recession/depression – will increase need (demand) and reduce ability to increase funding
• Aging population and growing uninsured • Increasing costs for care • Lack of service providers – lack of supply
(primary care, nurses), aging workforce Business Model
• Employee resistance to change and carry-over of governmental mind-set
• Turnover of CCSD staff • Medical education in Austin – could be
expensive • Staff burnout
Service Efficiency/Quality • Reviews by regulatory agencies (HRSA,
OPA, DSHS, Joint Commission, • Aging facilities and location of facilities
Initial Evaluation of TCHD Strategic Plan and FY08 Strategic Directions
4/28/08
Strategic Focus Evaluation Recommendations for Future Strategic Focus Overall Strategic Plan
1. The Strategic Plan in its current form requires updating for missing components, including: • Incomplete information regarding the
District’s current state to add context for strategic directions;
• Lack of focus on resources needed to support prioritized services/objectives;
• Lack of inclusion of the transition of the CHCs to the District, a major focus of staff work, and which impacts the safety net health care system for the District and the larger community;
• Lack of specificity regarding performance goals for each strategic direction.
2. The current format of the Strategic Plan does not allow for easy identification of all short-term (fiscal year goals) directions versus those that will be implemented on a more long-term basis.
1. Update Strategic Plan in FY09 to include the following elements: • Add and/or update the District’s Values, organizational
history (including taxing history), budget process, changing community demographics, and any additional information to provide perspective on the District’s current state and strategic directions;
• Separate Strategic Plan into 2 areas – one focused on service delivery and one focused on service resources (including organizational/staffing needs, funding/finance requirements and initiatives, revenue opportunities and growth aspirations, capital requirements;
• Addition of the CHC transition to the Service Delivery section of the strategic plan to reflect the work and goals of this initiative;
• Identification of performance measures for each prioritized short-term direction/goal.
2. List the short-term directions separately from the longer-term direction for easier identification and tracking.
Primary Care
1. Performance-based contracts have been executed with El Buen Samaritano, People’s Community Clinic, and Project Access.
2. Performance expectations are not on target for the federally qualified community health centers. However, with the FQHCs currently under City management, the District cannot directly control staff performance or project implementation.
3. Additional primary care capacity for the medically underserved is still needed within the community.
1. Continue with performance based contracts. Work with community safety net providers to increase capacity for both MAP enrollees and the unfunded to increase the capacity for Medicaid and Medicare payor mix within the FQHCs to optimize federal funds for community.
2. Review the results of the CHC technical operations consultants in implementing operational changes within the FQHCs as they transition to District sponsorship to incorporate more accountability and provide tools to support success.
3. Increase access to urgent care/convenient care centers. 4. Investigate acquisition/addition of pediatric practices to
FQHCs to substantially increase Medicaid participation.
Initial Evaluation of TCHD Strategic Plan and FY08 Strategic Directions
4/28/08
Strategic Focus Evaluation Recommendations for Future Strategic Focus Specialty Care 1. Although staff has been working with Seton
and AMEP for the majority of this fiscal year, no new contracts for increased specialty care access at Brackenridge have been implemented. Limited contracts have been implemented with private providers, and MediView™ has agreed to recruit specialty care providers to expand access.
2. JAT continues to work to establish standards for specialty care access and care.
3. Additional alternatives also need to be investigated.
1. Continue to work to expand specialty care capacity for medically underserved – • Continue to work with Brackenridge Hospital and AMEP
to expand specialty care services. • Finalize MediView™ contract and utilize specialty care
contracts to expand access for specialty care for MAP enrollees.
2. Continue work of JAT to determine access targets and establish reporting of metrics for specialty care referrals, acceptable wait times, etc.
3. Investigate the feasibility as new FQHC clinic(s) are developed to incorporate specialty care services not requiring hospital-based procedures to be offered within the FQHCs.
4. Collaborate with community HMOs, which provide health services coverage for Medicaid and Medicare recipients, to bring additional specialty care providers to our community including evaluating the feasibility of establishing a standalone FQHC for appropriate ambulatory based specialty care services.
Mental Health 1. Expanded IP capacity by funding beds at
Seton Shoal Creek; a total of 10 beds for fiscal year 2008.
2. Through community partners initiated MCOT, expanded PES, expanded integrated behavioral health, initiated expansion of residential services, and supported/coordinated MHMR and other collaborative partners in the application for competitive state crisis services funding.
1. Continue with community partners in developing a long-term plan for the full continuum of needed mental health services.
2. Finalize and implement plan for Phase II of the continuum of care.
3. As a community, foundations, local governments, and providers bring resources together.
4. Implement continuum of care based on community strategies and partnering.
Initial Evaluation of TCHD Strategic Plan and FY08 Strategic Directions
4/28/08
Strategic Focus Evaluation Recommendations for Future Strategic Focus
Integrated Healthcare Service and Information Systems
1. The FQHC System’s Medicaid/Medicare payor mix continues to be less than other systems (i.e., LSCC has a 65% Medicaid/Medicare mix and Seton’s Community Clinics have a 50% Medicaid/Medicare mix).
2. 2.Progress is being made in the implementation of a shared data system (NextGen) within the safety net clinics through the establishment of a separate 501c3 organization and commitment of community resources (CSSS). Additionally, NextGen will be used as the specialty care referral system between the Brack Specialty Clinic and the FQHCs.
1. 1.Focus efforts of FQHC on increasing Medicare and Medicaid clients – District continue/expand contracting with non-FQHC safety net providers to provide primary care for uninsured; Implement consultant recommendations that identify ways for FQHC (through new 501c3 corporation) to become more sustainable
2. Continue collaborating with community partners through support of CSSS (including collaboration with District on IT infrastructure contracting) to move toward a virtual community health record for patients.
Community Steward
1. District continues to prioritize and benefit from community collaborations in a number of areas, including: mental health, regional health care, Code Red report, specialty care, primary care, UPL, etc.
2. Additional revenue streams need to be identified to stretch taxpayer dollars.
1. Continue to assess collaborative partnerships to ensure effectiveness/value for District.
2. Continue with identifying opportunities for new revenue for TCHD, including determining the feasibility of establishing a District-affiliated HMO to serve Medicaid patients initially, and other populations later if financially appropriate.
Regional Collaborations and Initiatives
1. District continues to collaborate on Regional Health Care initiatives – current focus is development of the small employer initiative.
1. Continue to identify collaborative efforts that would benefit District, including: • Support of COH as charter member. • Continue with regional efforts for small-employer
program. • Continue work with ICC to include Hays County as a
member of the ICC. • Discuss with Hays County common interests in a
regional approach to healthcare funding.
Initial Evaluation of TCHD Strategic Plan and FY08 Strategic Directions
4/28/08
Strategic Focus Evaluation Recommendations for Future Strategic Focus
Patient Programs and Services
MAP 1. Redesign of MAP program incomplete, a
review and recommendation of the following still needs to occur – • Benefits and appropriate use of services; • Eligibility requirements; • Enrollment processes; • Cost sharing; and • Sufficiency of provider network
2. A new brand identity for the MAP program is needed.
1. Continue and/or implement the following activities: • Seek approval for UT study to determine impact of the
increase in the ER co-pay on utilization of these services and use of convenient care services within FQHC once implemented;
• Recommend a pilot of a portion of the redesigned MAP program enrollees who have eligibility up to 100% of poverty to be enrolled in a new network of providers. Set total number of enrollees based on budget. Evaluate systems of care over a two to three year period (pilot vs. public model) utilizing patient satisfaction, costs, health outcomes and utilization of services (ED /1,000, ALOS, bed days per 1,000, etc.);
• Develop eligibility plan to eliminate barriers for patients to access health services, including piloting Point of Service care at the new federally qualified health convenient care center at I-35 and William Cannon
• Evaluate MAP enrollee satisfaction with services, costs, accessing services and health outcomes;
• Expand provider network. 2. Develop new brand and implement roll-out.
CCSD Transition 1. CCSD transition is not addressed in current strategic plan.
1. Finalize organizational structure (functions) for District and 501c3.
2. Complete development and implementation of infrastructure to support District and CHC business, administrative, and operations functions (HR, administrative, IT, facilities, CHC service delivery), including the solicitation, purchase and contracting of necessary equipment, information systems, and services.
3. Complete plans with COA for close out issues and transfer/lease of City assets.
4. Continue process for transfer of FQHC designation and other requirements to TCHD.
5. Complete and implement branding for new CHC organization. 6. Transition CCSD staff March 1, 2009, and implement HR
Initial Evaluation of TCHD Strategic Plan and FY08 Strategic Directions
4/28/08
policies and systems. 7. Continue regular, timely and accurate transition communications with CCSD employees, the District Board of Managers, FQHC Board, the City and other community stakeholders.
District Infrastructure and Resources
1. Infrastructure and resources are not addressed in current strategic plan or direction for the future.
1. Establish sustainable infrastructure/resources to meet current and future business needs of the District.
1
Recommended FY09 Strategic Directions
Definitions
1. Priority Level
• “Have To” – These are service areas which the District has determined to be a core service and/or has previously committed financial, staff or Board resources to the effort. These areas can be programs, contracted services, or a means to maintain or increase resources to support the designated service areas. These areas might have to be provided at a lower level should funding become an issue but would probably not be eliminated. All strategies identified will be undertaken in FY09.
• “Want To” – These are service areas/initiatives that the District has not determined to be a core service but are an opportunity
for the District to provide a “value-added” service or resource for the community in terms of leading, facilitating, or participating in collaborative initiatives that enhance community health planning or reporting, advocate for greater health care access, leverage community resources, etc. Each “Want To” strategy has the proposed fiscal year for the
implementation of the strategy identified.
2. Desired Outcome – The ultimate goal that the District hopes to achieve. 3. Strategy – The major activities the District will undertake in the upcoming fiscal year to try to achieve the Desired Outcome. 4. Strategy Type
• Service – The main focus of the strategy is to increase access to, improve quality of, or further develop the continuum of services.
• Resource – The main focus of the strategy is to leverage funding, develop resources, or achieve financial efficiencies to assist
in purchase of services or improve business operations.
5. District Role • Control – The District has control over the outcome of a strategy if the strategy is being conducted exclusively by District staff
or the performance can be directed and monitored by District staff through a performance-based contract.
• Influence – The District is determined to have influence rather than control over the outcome of a strategy if the District is working with multiple other partner entities, requires governmental action to be able to perform, and/or does not have direct managerial or a direct contract management role over the outcome.
2
I. Focus Area – Health Care Services Network
Priority Strategy Type District Role
Desired
Outcome Have
To
Want To
Strategies Service (S) or
Resource (R)
Control or
Influence
Increase Capacity
FY09
FY09
FY09
FY09
FY09
1. Increase access to urgent care/convenient care centers. 2. Explore options to increase primary and specialty care
capacity for TCHD target population. 3. Investigate feasibility of providing specialty care services
within new CHC clinics as they are developed (SC). 4. Work with stakeholders to identify level of need for full-
continuum of mental health services. (MH) 5. Finalize and implement Phase II of the continuum of
care. (MH)
S
S
S
S
S
C & I
C & I
C I I
Ensure Accountability
FY09
FY09
FY09
1. Contract on a pay-for-performance-basis. 2. Use JAT to establish access targets and reporting of
specialty care metrics – encounters, wait times, etc. 3. Evaluate findings of UT study on E-merge Program and
implement recommendations based on priority and feasibility.
R
S
S
C
C
C
Leverage Funding
FY09
FY10
1. Work with community providers to enhance capacity for Medicaid/Medicare population within FQHCs to maximize federal funds for community (PC).
2. Investigate acquisition/addition of pediatric practices to
FQHCs to increase Medicaid participation (PC).
S & R
S & R
I I
3
FY09
FY09 3. Collaborate with community partners, including HMOs, to evaluate opportunities to maximize specialty care resources.
4. Identify, along with community partners, new funding
opportunities to support increased capacity and/or integration of mental health services.
S
R
I I
Outcome Measures for Health Care Services Network Focus Area:
Success Factor Frequency FY09 Target Rationale for Target
# of Contracted Primary Care Providers
Quarterly
# of Contracted PC Encounters Quarterly
Cost per PC Encounter Quarterly
# of Contracted Specialty Care Providers
Quarterly
# of Contracted SC Encounters Quarterly Cost per SC Encounter Quarterly # of Publicly Funded MH Slots by Service Area
Annually
Total Amount of Stakeholder Investment in MH Continuum of Care
Annually
4
II. Focus Area – Efficiency and Integration of the Service Delivery System
Priority Strategy Type District Role
Desired
Outcome
Have
To
Want To
Strategies Service or
Resource
Control or
Influence
Advance data sharing throughout service delivery system
FY09
FY09
1. Use shared data available through Medicaider, ICARE and NextGen to inform eligibility and care for shared safety net patients.
2. Implement NextGen software for specialty care referrals
to enhance client access.
Service
Service
Influence
Influence
Facilitate coordinated system of care throughout service delivery system
FY09
FY09
FY10
1. Work with safety net providers on “virtual system of care” (shared data, standards for care, clear roles for providers, etc.) for shared clients.
2. Promote concept of standard sliding fee scale for care
provided at all safety net clinics 3. Develop and implement standard sliding fee scale for
unfunded at all safety net clinics as part of “no wrong door” approach in access to healthcare for all medically underserved.
Service
Service
Service
Influence
Control
Influence
Leverage Community Resources
FY09
1. Assess collaborative partnerships to ensure effectiveness/value for District.
Service & Resource
Control
Outcome Measures for Efficiency and Integration Focus Area:
Success Factor Frequency FY09 Target Rationale for Target
# and Value of Collaborative Partnerships
Annually
5
III. Focus Area – Regional Collaborations and Initiatives
Priority Strategy Type District Role
Desired
Outcome
Have
To
Want To
Strategies Service or
Resource
Control or
Influence
Enhanced capacity for services
FY09
FY09
FY09
1. Monitor legislative environment for ability to coordinate regionally and act upon opportunities as they become available.
2. Participate in regional efforts for small-employer health
coverage program. 3. Work with Medical School and community stakeholders
to define District role with graduate medical education
Service & Resource
Service
Service
Control
Influence
Control/ Influence
Leverage Community Resources
FY09
FY09
1. Support Children’s Optimal Health as charter member to enhance District access to regional planning data.
2. Continue dialogue with Hays County to identify common
interests in regional approach to healthcare services and funding.
Service & Resource
Service &
Resource
Control
Influence
Outcome Measures for Regional Collaborations Focus Area:
Success Factor Frequency FY09 Target Rationale for Target
# and Results of Bills considered that would expand ability to coordinate/serve regionally
Annually
Implementation of Small-Employer Health Program
One-time Yes/No
6
IV. Focus Area – Patient Coverage Programs
Priority Strategy Type District Role
Desired
Outcome
Have
To
Want To
Strategies Service or
Resource
Control or
Influence
Increase access to healthcare for District-eligible clients
FY09
FY09
FY10
FY11
1. Complete redesign of health coverage program (currently MAP).
2. Increase service contracts to expand provider network. 3. Define target population and service provider network for
pilot program to monitor total cost of care. 4. Deploy new program on revised terms or fully implement
within available resources based on results of pilot.
Service
Service
Service
Service
Control
Control/ Influence
Control
Control
Establish and manage community expectations
FY09
1. Brand re-designed health coverage program and educate stakeholders on new program, name, services, limitations, etc.
Service
Control
Outcome Measures for Patient Coverage Programs Focus Area:
Success Factor Frequency FY09 Target Rationale for Target
For current MAP Program – # of District Program Enrollees Cost/Enrollee Patient Satisfaction
Quarterly Quarterly Annually
Implementation of MAP Pilot Program
One-time Yes/No
7
V. Focus Area – CHC System Transition
Priority Strategy Type District Role
Desired
Outcome Have
To
Want To
Strategies Service or
Resource
Control or
Influence
Transition occurs by March 1, 2009 with all priority systems in place and functional
FY09
FY09
FY09
FY09
FY09
FY09
1. Finalize organizational structure (functions) for District and 501(c)3.
2. Complete development and implementation of
infrastructure to support District and CHC business, administrative, and operational functions, including the solicitation, purchase and contracting of necessary equipment, information systems and services.
3. Complete plans with the City for close-out issues and
transfer/lease of City assets. 4. Continue process for transfer of FQHC designation and
other federal requirements to TCHD. 5. Complete and implement branding for new CHC
organization. 6. Transition CCSD staff 3/1/09 and implement HR policies
and systems.
Resource
Resource
Resource
Resource
Resource
Resource
Control
Control
Influence
Influence
Control
Control
Outcome Measures for CCSD Transition Focus Area:
Success Factor Frequency FY09 Target Rationale for Target
Transition occurred on time One-time Yes/No
8
VI. Focus Area – District Infrastructure and Resources
Priority Strategy
Type
District Role
Desired
Outcome Have
To
Want To
Strategies Service or
Resource
Control or
Influence
Protect current District funding
FY09
FY09
1. Protect Medicaid, DSH, UPL funding streams
2. Sustain tax base
Resource
Resource
Influence
Influence Increase/diversify Funding
FY09
FY09
1. Increase Medicaid business 2. Explore opportunities for additional funding through
grants/philanthropy, development of HMO, and other business/joint ventures
Resource
Resource
Influence
Control
Obtain and sustain appropriate infrastructure for District
FY09 1. Identify and implement appropriate level of infrastructure for District
Resource Control
Maintain support of key community stakeholders
FY09 1. Manage key relationships with City of Austin, Travis County, and other key partners.
Resource Control
Maintain fiscal, regulatory and service integrity
FY09
FY09
FY09
1. Continue to require and ensure receipt of service performance level data from contracted providers.
2. Conduct annual strategic planning process to
incorporate stakeholder input, identify strengths, weaknesses, opportunities, and threats, and prioritize work for next fiscal year in sufficient time to allow plan to inform budget request.
3. Prepare appropriate budget request within defined
timeframe and including input from District
Service
Resource
Resource
Control/ Influence
Control
Control
9
FY09
FY09
management and staff to adequately support on-going District services and proposed enhancements for next fiscal year.
4. Receive approval for proposed budget from District
Board of Managers and Travis County Commissioners 5. Ensure services provided to clients are in compliance
with all regulations
Resource
Service
Influence
Control
Outcome Measures for District Infrastructure and Resources Area:
Success Factor Frequency FY09 Target Rationale for Target
Appropriate ratio of staff Annually % of Administrative Costs to Total Costs
Annually
TCHD Current Collaborative Partnerships
Ranking by Average ScoreTCHD Role Collaboration Function TCHD Support Anticipated ROI
Influencer, Facilitator, Purchaser, Member
Psychiatric Services - Psychiatric Services Stakeholder Group
Services: Create community solutions to MH needs, prioritize needed services, & seek funding.
Staff - facilitation of group & committee
Increased access to mental health services for unfunded clients and greater community acknowledgment of shared role in solution
Services: Smaller group - Resolves operational issues with currently contracted services.
Services: Larger group - Identify needed MH resources, patient processes, and performance levels.
Influencer, Facilitator, Purchaser, Member
Regional Small Employer Health Coverage Project
Services: Create & manage a small-employer health coverage option for multi-county region.
Financial - $1,500,000 held to help capitalize project
Potentially provide an affordable health coverage option for small employers and their employees to increase access to healthcare
Facilitator, Purchaser, Member Indigent Care Collaboration (ICC)
Services: Identify & implement projects of common interest to regional safety net providers.
$500,000 - annual contract for services
Standardized, coordinated care for safety net population in Central Texasue ce ,
Facilitator, Purchaser, Participant Dental Service Planning
Services: Identify core functions for dental service providers to leverage limited funding.
Staff - coordination of planning effort
Greater leveraging of funding for dental services; focus individual resources on areas of expertise
Influencer, Facilitator, Member
Centex Systems Support Services (CSSS)
Data: Implement NextGen medical record system throughout safety net clinics.
Staff - Legal support to establish non-profit
Increased access to shared patient data to enhance patient care and better understand needs and health status of target population
Influencer, Facilitator, Participant
Regional Eligibility Determination Initiative
Services: Create a coordinated, multi-county effort to determine client eligibility for multiple programs
In the initial stages -- may consist of staff and/or financial support
Greater community understanding about eligibility for healthcare programs for unfunded and how to access; more consistency in cost-sharing for community unfunded
Influencer, Purchaser, Member Joint Action Team (JAT)
Services: Identify & implement solutions to service delivery issues for clients of TCHD & Seton.
Staff participation on on-goining projects Improved service delivery for shared clients.
Influencer, Purchaser, Member Children's Optimal Health (COH)
Data: Share & geographically map service data to inform community planning.
Financial $35,000/year for 3 years for data services
Gain access to more comprehensive service-related data to better inform District planning efforts
Influencer, Purchaser, Participant HIV Services Planning
Services: Identify HIV needs/gaps & best practices for supporting services for HIV/AIDS clients
Staff and program support - Lead on HIV screening project. Possible future facilitation role.
Gain better understanding of HIV-related healthcare needs for the community assist in identification of disease at earliest possible stage
Purchaser, Participant, Recipient E-Merge Evaluation Collaborative
Research: Evaluate the participants, effectiveness, & impact of E-merge program. Financial - $155,000
Gain better understanding of E-merge participants and successfulness of program to date and how program could be enhanced
Purchaser, Member Community Action NetworkServices: Identifies and informs community on a range of health and social service indicators
ppthrough member fees, minimal staff participation on committees
Gain access to community partners and data distributed through monthly reports
MemberPsychiatric Services - Mayor's Mental Health Taskforce
Services: Monitor & report on progress made in implementing Task Force recommendations.
Staff - monthly meeting participation
Monitor on-going non-stakeholder mental health efforts within the community and ensure District's participation as appropriate
Increased access to mental health services for unfunded clients and greater community acknowledgment of shared role in solution
Psychiatric Services - Crisis Implementation Services Committee (CIC) Staff - facilitation of committee
Influencer, Facilitator, Purchaser, Member
TCHD Current Collaborative Partnerships
Ranking by Average ScoreParticipant United Way Health Coverage ProjectServices: Recommend selection of United Way-funded healthcare grants & health planning.
Staff - monthly meeting participation
Gain better understanding of other healthcare services for the underserved being supported within the community
Board of Managers Self Assessment
Compiled responses
February 26, 2008
Responses -- Responses -- Board Self Assessment Feb 2008
1) In your opinion, do we have the right committees to perform our duties as a Board? If not, do you have suggestions for revisions to the committees to ensure that those duties are being performed?
A. For the most part – yes. B. I think we have the right type of committees to handle the district’s business. I
commend our Board officers for giving careful thought in selecting committees using a good balance of our board members’ backgrounds, expertise, and interest.
C. The committees are very useful to help us understand in more depth what will be
presented to Board and to give feedback. D. We have the right committees to perform the Board’s duties. E. I believe the committees are covering the right topics. F. Present committees seem to be performing adequately. Perhaps, it’s time to explore at
an annual planning retreat. G. I think our committee structure has been well thought out and modified whenever
appropriate.
~is county HEALTHCA ~ ~ DISTo/
Board of Managers Self Assessment
Compiled responses
February 26, 2008
Responses -- Responses -- Board Self Assessment Feb 2008
2) Are the committees functioning effectively? Do you have suggestions for improvement?
A. Yes – for the most part. B. I think the committees are functioning effectively. I appreciate that the staff tries to
accommodate everyone’s schedules in scheduling meetings. C. Attendance seems spotty. Not sure how to improve us, everyone is busy. Don’t seem
to hear much from Strategic Planning. D. The committees are functioning effectively. E. I wonder if we are spending too much time in meetings on the past or “lag” indicators. I
believe we need to spend more time on strategic planning and “lead” indicators. F. Re: Primary Care/Specialty Care/Mental Health – we need more long term
responsibilities in these three areas: (1) What are our plans to bridge our committee with FQHC 501(c)(3) Board?; (2) Where are goals initiated for decreasing uninsured?; and (3) How do stakeholders for mental health goals tie in to the TCHD Board?
I am anxious to hear about specialty care activities which have been assigned recently to this committee.
G. It seems as if the committees are fulfilling the purpose designed – dealing with issues
at a higher level of detail and reporting back to the board.
~is county HEALTHCA ~ ~ DISTo/
Board of Managers Self Assessment
Compiled responses
February 26, 2008
Responses -- Responses -- Board Self Assessment Feb 2008
3) Are financial and other reports to the Board clear and understandable? Do you have suggestions for improvement of those reports?
A. 1) Very good generally. 2) I would like to see more information and analysis with
respect to what we are paying and what we are getting from Seton and City of Austin. B. I think financial and other reports to the board are clear and understandable. The staff
are using a good executive summary type format that provides all the information needed for decision-making.
C. I have problems with the financials but [it] is just me. I’d just like to know if we are on
budget and there are no problems. D. I’m satisfied with the financial reports that we receive. E. I would like to spend a little more time reviewing progress compared to the strategic
plan. F. Mostly clear and understandable. As someone on fringe of finance, I appreciate
explanations when there are changes or unusual circumstances. G. As someone who does not deal with finances on a daily basis, it has been more of a
challenge to me, but I find now that I can keep up with the flow of ideas during Carolyn’s report.
~is county HEALTHCA ~ ~ DISTo/
Board of Managers Self Assessment
Compiled responses
February 26, 2008
Responses -- Responses -- Board Self Assessment Feb 2008
4) Do you believe you receive sufficient information to make informed decisions about the District’s mission, its strategies, its policies and funding decisions?
A. I do not think we are being as impactful or as strategic as we can be because we spend
so much time on the compulsory details. B. The staff provides sufficient information to make informed decisions. In addition to self-
education and through the committee structure we also are privy to most information that will affect the District.
C. Yes thanks to being on committees. D. Yes. E. Yes. F. Yes. G. As a committee chairman, I notice that I am not communicated with on a regular basis
between board and committee meetings.
~is county HEALTHCA ~ ~ DISTo/
Board of Managers Self Assessment
Compiled responses
February 26, 2008
Responses -- Responses -- Board Self Assessment Feb 2008
5) Do you have suggestions regarding types of board training that would be welcome or are needed?
A. No suggestions. B. I think board training and development would be useful. Some examples include:
customer perception/satisfaction; market/community awareness; access measures; and, clinical outcomes. I also think that the Board members and Executive Staff should participate in several of the Health related associations (TAPNH, TACHC, THA, and others).
C. Anything would probably be welcomed but not sure any is needed. D. Training is always good but I believe we have a very well trained and sophisticated
board. E. What does “green lights” offer? F. I believe we are to receive annual conflict of interest. Perhaps, an attorney can highlight
some gray areas from other experiences. G. We have had a lot of training over the years and I never turn any down, if I can help it,
but I would attend to the degree that I can “if” such sessions were to be deemed needed.
~is county HEALTHCA ~ ~ DISTo/
Board of Managers Self Assessment
Compiled responses
February 26, 2008
Responses -- Responses -- Board Self Assessment Feb 2008
6) Do you have other feedback would you like to provide to the other Board members concerning the Board’s functioning or suggestions to improve the functioning of the Board?
A. I think we should spend some time envisioning what success in our mission looks like
in terms of facilities, people and capability and how much that will cost and how we will accomplish that success. We are playing too much “small ball” as a Board.
B. In the May 2002 edition of Trustee, Robert E. Wilson states: “The current climate
creates an imperative for each not-for-profit health care board to reflect upon its rightful roles and duties, its current performance, and its preparedness in meeting the governance challenges of today and tomorrow.” He goes on to recommend that health care boards should undertake 5 activities immediately; the first is to conduct a critical self-assessment with an eye toward strengthening governance effectiveness. The other four activities include: enhance the content of your meetings with outside auditors; set a strong expectation of management for thoroughness, relevance, timeliness, and transparency of financial and operating performance information provided regularly to board; commit to a regimen of intensive and in-depth board education; and do not hesitate to act when a current pattern of low or negative operating margins or other early warning indicators suggest financial viability may be at risk.
C. It seems that the board functions well and I have no suggestions on how to improve. D. We have a good board that works well together. E. I value the multi-disciplinary board member view points. Actively engaged board
members help us do a better job. F. No. G. I am generally happy with the functioning of the board.
~is county HEALTHCA ~ ~ DISTo/
Travis County Healthcare District
Request for Board of Managers Consideration
June 18, 2008
Board of Managers Strategic Planning Retreat Agenda Item:
• Discuss and take appropriate action regarding a proposed revision to the Board
committee structure to become effective in FY09. Resource Impact: N/A. TCHD Proposed Board Committee Structure: Create one monthly board working session to replace the separate standing committee meetings related to service delivery and planning. Recommended Board Action: Discuss and take appropriate action to revise the current Board of Managers committee structure. Decision Statement: What is the best way to provide information to the Board of Managers that will allow for the most comprehensive discussion of issues prior to the monthly Board of Managers voting session? Background Summary:
Background: Currently, members of the Board of Managers serve on one or more committees focused on a specific issue related to District operations and/or service delivery. The table below reflects the current committee structure and Board of Managers participation.
Monthly Monthly Monthly Monthly As Needed As Needed As Needed As Needed As Needed As Needed
Board ManagersBudget &
Finance Hospital
Primary
Care/Specialty
care/Mental
Health
Strategic
Planning
Ad Hoc
Compensation
Design
Ad Hoc
Transition
Audit &
Compliance
Brackenridge
Lease Team Legislative Personnel
Bobbie Barker x x x xCarl Richie x x x x x xClarke Heidrick x x x x x xDonald Patrick x xEduardo Sanchez x x x xFrank Rodriguez x x x x x xRose Lancaster x xRosie Mendoza x x xTom Coopwood 1 x x x x
Chair Chair Chair Chair Chair Chair Chair Chair Chair Chair
Rosie Donald Rose Frank Eduardo Bobbie Clarke n/a Bobbie TomChair of the
Committee
Frequency
x
x
x
In this structure, items are considered under the most relevant committee with items
impacting the budget also considered under the Budget and Finance committee. However, since not all members of the Board of Managers attend any one committee, this results in only part of the Board being fully informed on certain issues that come before the full Board for consideration and action. Also, with the small number of Board participants on each committee, the inability of any Board participant to attend a committee meeting can result in the loss of a quorum and deny the committee the opportunity to take action on committee items.
Request: Approve a revised Board committee structure which would eliminate some of
the standing committee meetings and replace them with a second full-Board session during the month. One full-Board session would be scheduled as a working session and the Board of Managers meeting scheduled for the 4th Thursday of the month would continue as the voting
Chair of the
Committee
Frequency
session. Under this proposal, the following committees would be collapsed into the working session:
• Hospital • Primary Care/Specialty Care/Mental Health • Strategic Planning • Personnel
The following committees would be retained and would meet on a regular or periodic basis as determined by need:
• Budget and Finance (monthly) • Audit & Compliance (periodic) • Legislative (periodic)
The following committees would be retained and would meet on an as-needed basis:
• Transition • Brackenridge Lease Team
This proposal would mean that most members of the Board of Managers would have two meetings per month – the working session and the Board Meeting. Members of the Board of Managers on the Budget and Finance Committee would have a third meeting each month. Other members would have additional committee meetings on a periodic or as needed basis.
Monthly Monthly As Needed Periodic As Needed Periodic
Board ManagersBudget &
Finance Board Work
Session
Ad Hoc
Transition
Audit &
Compliance
Brackenridge
Lease Team Legislative
Total
Bobbie Barker Carl Richie Clarke Heidrick Donald Patrick Open Frank Rodriguez Rose Lancaster Rosie Mendoza Tom Coopwood
Chair Chair Chair Chair Chair Chair
Anticipated Result: The anticipated benefits of the proposed committee restructuring,
include: • Fewer meetings for Board Managers to attend and staff to prepare for,
communicate about, and support; • Better dissemination of pertinent information on service delivery, planning, and
operational issues to all Board Managers; and • More robust discussion of policy-related issues by full Board to enhance Board
decisions at the voting session.
Recommended