ALAMEDA ALLIANCE FOR HEALTH
BOARD OF GOVERNORS MEETING
September 28, 2006
6:00 p.m.

1240 South Loop Road, Alameda, CA 94502

Present: Excused: Unexcused:
Ingrid Lamirault
Michael Mahoney (Chair)
Jane Garcia (Vice-Chair)
Gail Steele
Pamela Gumbs
Ray Davis, Jr. MD
Linda Price, MD
John Norton, MD
Charlie Ridgell
Damita Davis-Howard
Wright Lassiter
Marty Lynch None

1. Call to Order:
Meeting was called to order at 6:12 p.m. by the Chair, Michael Mahoney. A quorum of the members was present.

2. Approval of Agenda & Minutes:
Motion: L. Price, MD
Second: J. Norton, MD
Results: The September 28, 2006 agenda and the July 27, 2006 minutes were approved unanimously.

AGENDA ITEM SPEAKER DISCUSSION HIGHLIGHTS ACTION FOLLOW UP
3. CHAIRS'S REPORT
Report on July 27, 2006 Closed Session

1.BOG Res 06-08 Reappointment.pdf







M. Mahoney Mr. Mahoney introduced Wright Lassiter, a new board member in Hospital Seat.

Mr. Mahoney presented the Chair's Report on the Thursday, July 27, 2006 Closed Session:

Dr. Art Chen provided an overview of the recommendations of the Peer Review and Credentialing Committee (PRCC) from the June 20 and July 18, 2006 meetings. The Board unanimously approved PRCC's recommendations for initial credentialing and recredentialing.

Mark Roche, Sr. Director of HR & Facilities, presented a report on employee benefit, bonus, and compensation options under consideration by Alliance senior staff. With the assistance of the Hay Group, management consultants, the Alliance will develop a new benefits package for its employees.


Mr. Mahoney stated that a certificate and gift were sent to retired Board Member Tony Paap in acknowledgement of his years of dedicated service.

Mr. Mahoney presented Resolution #06-08 recommending to the Board of Supervisors the following reappointments to the Board:
  • Gail Steele- Board of Supervisors seat
  • Julian Ray Davis, MD- Physician seat
  • Michael P. Mahoney - Hospital seat
  • Jane Garcia- Private or public community clinics seat
  • Gail Steele- Board of Supervisors seat
  • Julian Ray Davis, MD- Physician seat
  • Michael P. Mahoney - Hospital seat
  • Jane Garcia- Private or public community clinics seat
  • Damita Davis Howard- At-Large seat designated for labor
Motion: J. Norton, MD Second: R. Davis, MD
Result: The motion to reappoint Gail Steele, Julian Ray Davis, MD, Michael Mahoney, Jane Garcia, and Damita Davis Howard to the Board was approved unanimously.
Alliance staff: Submit resolution to Board of Supervisors for approval of reappointments to Board.
4. CEO'S REPORT
ATTACHMENT A:

2.CEO's Report 09.28.06.pdf
I. Lamirault Ingrid Lamirault, CEO, presented the attached report and informed the Board that she is on Oakland's Mayor-elect Ron Dellums' Task Force. She will update the Board on developments related to the Task Force at future meetings. None None
5. CHIEF MEDICAL OFFICER'S REPORT
Chief Medical Officer's Report

Handout:

3.CMO Report.B-1.pdf

4.Health Care Quality Committee Update.pdf

5.CMO Report.HEDIS.ppt **This is a power point presentation. To download, right click on the link and choose 'save target as.' You will need Microsoft Power Point to view the document.

6.CMO Report.B-4.pdf

7.CMO Report.B-3.pdf

8.CMO Report.B-2.pdf

9.HEDIS slides_BOG Meeting 0928061.ppt **This is a power point presentation. To download, right click on the link and choose 'save target as.' You will need Microsoft Power Point to view the document.

A. Chen, MD




















C. Mundy
Dr. Chen presented the Health Care Quality Committee Update (Attachment B):

Quality Improvement System Annual Reports and Submissions:

B-1) Evaluation of 2005-2006 QI and UM Programs
B-2) Evaluation of 2005-2006 QI Work Plan
B-3) Changes Between 2004-2005 and 2005-2006 QI Program Descriptions
B-4) 2006-2007 QI Program Description
B-5) 2006-2007 UM Program Description

Claudia Mundy, Director of Quality Management, presented the attached HEDIS 2006 results.
Motion: R. Davis, MD
Second: L. Price, MD
Result: The motion to accept the changes to the Alliance Formulary was approved unanimously.











Motion: J. Norton, MD
Second: W. Lassiter
Result: The motion to accept the QI Plan was approved unanimously.










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6. CFO'S REPORT
Financial Reports for the Month & Year-to-Date Ended July 31, 2006 and August 31, 2006

10.AAH Financial Statements Jul-06.pdf

11.AAH Financial Statements Aug-06.pdf
J. Garcia
J. Volkober
Ms. Garcia, Chair of the Finance Committee, and Mr. Volkober, CFO, presented the attached Financial Report for the Month & Year-to-Date Ended July 31, 2006 and August 31, 2006:

  • Financial Results Narrative
  • Income Statement Reports
  • Administrative Expense Detail Report
  • Balance Sheet
  • Cash Flow Statements
  • TNE Calculations
Motion: J. Garcia
Second: J. Norton, MD
Result: The motion to approve the Financial Reports for the Month & Year-to-Date Ended July 31, 2006 and August 31, 2006 was approved unanimously.
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7. DELOITTE & TOUCHE AUDITOR'S REPORT
Deloitte & Touche Audit Report for the Year Ended June 30, 2006 Mr. Volkober introduced Zain McKinney, Audit Partner, of Deloitte & Touche LLP, who presented the Fiscal Year 2006 Audit Report for Board review and approval.

Ms. McKinney presented the consolidated report for Alameda Alliance for Health and the Alameda Alliance Joint Powers Authority (JPA):
  • The Management's Discussion and Analysis as of and for the Years Ended June 30, 2006 and 2005
  • The Independent Auditor's report
  • Combined Financial Statements as of and for the Years Ended June 30, 2006 and 2005:
    • Balance Sheets
    • Statements of Revenues, Expenses, and Changes in Net Assets
    • Statements of Cash Flows
    • Notes to Combined Financial Statements
Ms. Garcia noted typos in this draft document::
  • "…for the year ended December 31, 2006" on page 58
  • "…for the year ended December 31, 2006" on page 61
Ms. McKinney stated that these errors will be fixed in the final draft of the document.
Motion: J. Garcia
Second: J. Norton, MD
Result: The motion to accept the Audit Report was approved, with the needed corrections on pages 58 and 61, unanimously.
Deloitte & Touche: Make corrections on pages 58 and 61 of the Audit Report.
8. STRATEGIC PLANNING COMMITTEE CHAIR'S REPORT
Alliance Resolution #06-10 to Approve the Establishment of a Medicare Advantage-Part D Special Needs Plan

Alliance Resolution #06-09 to Support and Endorse Proposition 86

None Ray Davis, Jr. MD presented a report on the September 25, 2006 Strategic Planning Committee meeting:

1) Medicare Business Plan
- The Alliance is planning to apply to become a Medicare Advantage Special Needs Plan to serve Alameda County residents who are eligible for both Medicare and Medi-Cal benefits (dual eligibles) effective January 1, 2008.
- The business plan assesses the financial feasibility of establishing a Medicare SNP and identifies the critical steps and considerations that would need to be addressed.

Why Alliance is Pursuing Medicare SNP:
1) Simplification of benefits and better care coordination for members.
2) Simplification of billing and enhanced revenue for providers.
3) Opportunity for revenue growth and diversification for the Alliance.

- The Strategic Planning Committee recommended approval of the plan by the full Board.

Ms. Davis-Howard requested a review of the Medicare Advantage-Part D Special Needs Plan program in 18 months.

Staff assured the Board that it will receive regular reports on the program.

2) Proposition 86: Tobacco Tax Initiative
If the proposition passes, it will:
- Allocate $371 to expand coverage.
- Provide a revenue stream to transition the Alliance's Healthy Kids program into a state funded program. The funds will be used to expand eligibility for Healthy Families to include all children, including undocumented, who live in households with incomes up to 300% of the Federal Poverty Level.
- Increase Healthy Families enrollment.
- Allow the Alliance to allocate staffing resources currently directed to Healthy Kids for other purposes.
- Make it easier for families to enroll children in coverage programs.

o The Strategic Planning Committee expressed concerns about Prop 86 and staff answered questions.
o Following the discussion, the Strategic Planning Committee voted to present Proposition 86 to the full board for further discussion.

3) Compensation of Alliance Committee Members
The committee discussed the possibility of modifying the amount of compensation that members of the Member Committee, Pharmacy & Therapeutics Committee, Peer Review & Credentialing Committee, and the Health Care Quality Committee receive per meeting that they attend.

The Strategic Planning Committee agreed to defer further discussion of the matter to the November Board meeting.

4) Bylaws Revision
Alliance staff presented a redlined draft of the revised Alliance bylaws to the Strategic Planning Committee and the Committee made recommendations for changes. Staff will incorporate the changes into the bylaws and present them to the Strategic Planning Committee prior to the November Board meeting.
Motion: C. Ridgell Second: W. Lassiter Result: The motion to accept Alliance Resolution #06-10 to Approve the Establishment of a Medicare Advantage-Part D Special Needs Plan was approved unanimously.





















Motion: R. Davis, MD Second: D. Davis-Howard Result: The motion to accept Alliance Resolution #06-09 to Support and Endorse Proposition 86 was approved unanimously.











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9. OTHER BUSINESS
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10. PUBLIC COMMENTS
None Bud Shenkin, MD, President of Bayside Medical Group, representing Children's First Medical Group, as one of its board members Dr. Shenkin stated that he had three points to make, all of which were approved by the board of CFMG:

1) Children's First Medical Group (CFMG) provides a great deal of services to the Alliance and intends to be more involved. CFMG would like to be involved in the Alliance's quality assurance.
2) Alameda County is unique in California because the safety net is mostly comprised of privately practicing primary care pediatricians. The clinics are a large part of the Alliance's constituency and should be thought of right after the patients.
3) The financial stress on the physicians under the Alliance has increased as the financial stress on the Alliance has increased. As the medical group has tried to hire physicians, reimbursement under the Alliance has declined.

Mr. Mahoney stated that when the Alliance did well financially, it benefited the provider network. When the Alliance was on the brink of financial disaster, the Board had to make difficult decisions. The Alliance invites engagement to work together toward fixing the health care system. Mr. Mahoney thanked Dr. Shenkin for his comments.
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11. Next Meeting Date
The next meeting date was set for Thursday, November 30, 2006.

12. Adjournment
Motion: L. Price, MD
Second: J. Norton, MD
The Alameda Alliance for Health Board of Governors meeting was adjourned at 7:30 p.m.

Respectfully Submitted By
Ingrid Lamirault, Secretary/Treasurer of the Board and CEO