The meeting of the Board of Trustees ("Board") of the Health and Hospital Corporation of Marion County, Indiana ("HHC"), was held on November 17, 1999 in the Administrative Conference Room "A", Fourth Floor, Ott Building, Wishard Health Services, 1001 West Tenth Street, Indianapolis, Indiana.

Philip D. Pecar, Chairman, Board of Trustees, called the meeting to order. Board members present: Dr Bock, Ms. Brougher, Ms. Journey, Mr. Roob, Mr. West, and Dr. Johnston. With all members being present, Mr. Pecar dispensed with calling the roll and proceeded with the first order of business on the agenda.

Mr. Roob moved for approval of the minutes of the October 27, 1999 Board meeting. Mr. West seconded the motion. The motion was passed unanimously.

Mr. Pecar called for the Committee Reports. Mr. Roob discussed Hospital Committee. He stated that the Committee had reviewed the Wishard Advantage numbers and found there are now over 20,000 enrolled members without including those under the age of 17. Also, they reviewed the Lockefield Village budget for the year 2000. They are projecting, after Disproportionate Share Revenue, a net operating profit of approximately $24,000. On a cash basis, they will generate next year approximately $340,000. after adding back depreciation. He said a major assumption was an increase in average daily census up to 213 from 196 today. Mr. Roob said they are expecting to receive the budgetary summaries for 2000 at the December meeting for the in-patient operation. He asked Wishard's CFO to show the in-patient operation, IUMG, and Midtown numbers. Mr. Roob said that Wishard was in the black in this month's financial report and this was partly due to Medicare Settlements. Members discussed various aspects of Mr. Roob's Hospital Committee report. Mr. Roob concluded by stating that the budget summary looked better this month, Disproportionate Share Revenue reports looked good, and that cash collections were up.

Mr. West was called on to give the Public Health/Healthy Babies Committee Report. He reported that the Committee met November 3, 1999 and decided to meet at Bell Flower Clinic next time because of the Syphilis problem. As part of the Syphilis Elimination Project, a second ancillary site will be established at the Martin Center at approximately 3500 N. College. This Center is in the midst of the three zones with the greatest outbreaks. Mr. West noted that the Syphilis Elimination Project Coordinator for the CDC visited on October 27th and 28th. Various surveillance strategies and partnerships with other community organizations and healthcare providers were discussed as part of this visit.

Mr. West noted that a meeting had been held with Judge Z. Mae Jimison to discuss screening of persons arrested on drug related charges. A meeting with Presiding Judge Patricia Gifford and the associate presiding judges is being arranged to further discuss this initiative. Dr. Caine added that the epidemic is fueled by the drug problem. She said that nearly 60% of the cases are related to drug use. She said we need to reach those 1st and 2nd time offenders in diversion programs, as well as those 3rd time offenders in drug court. She said that we currently have a voluntary screening in the jail system, but that we need to move to a mandatory screening process. Dr. Caine noted that to do so involved many legal and funding issues. They are going to talk to Judge Gifford about having judges order the screening of defendants.

Mr. West stated that the concerns of South East Community Organizations were discussed. The concerns were regarding trash and debris clean-up, citing people for violations, and fines for those in violation of the health code. He said that the public health director and the bureau chief for environmental health are looking for solutions to their concerns. He said that Mr. Elwell is looking into solutions for the inspector turnover rate.

Mr. West said they discussed Walt Disney's Friendly Access Project that helps not for profits find more customer friendly approaches. A big emphasis would be access to and quality of prenatal care and encouraging people to seek this care. Doug Elwell and Bobbie Brown, Administrator of Maternal & Child Health, have been to national meetings, and they are working on the training program. This program will start with 37 to 45 individuals working in this area. Mr. West distributed copies of the Public Health/Healthy Babies Committee meeting minutes.

Mr. Pecar then called for a report from the Planning Committee by Mr. Elwell. Mr. Elwell stated that the Planning Committee met and primarily discussed two areas. The first was the progress of funding issues, such as DSH and other methodologies that would bring more money into Health & Hospital and Wishard, specifically to continue health care for the indigent in the face of rising costs. The second was an update on the progress of the bond issue and progress on the cost containment issues.

Mr. Pecar then called for the second reading and passage of General Ordinance No. 2-1999. Ms. Journey then moved that the General Ordinance No. 2-1999 be ordered read by title, and placed upon its passage. Mr. Roob seconded the motion. Mr. Pecar asked the attorney, Ms. Murphy, to read the Ordinance by title. "General Ordinance No. 2-1999(A) an Ordinance amending the annual budget of the Health and Hospital Corporation of Marion County, Indiana, for the fiscal year beginning January 1, 1999, and ending December 31, 1999, by amending General Ordinance No. 5-1998(A) to appropriate additional funds in the amount of $15,734,954 and to reallocate funds among the Corporation departments and divisions appropriating monies for the purpose of defraying the expenses and outstanding claims and obligations of the several divisions and officials of the Corporation; and fixing a time when the same shall take effect."

Ms. Journey then moved that General Ordinance No. 2-1999(A) be substituted for General Ordinance No. 2-1999. Mr. Roob seconded the motion. Mr. Pecar stated that the Ordinance would now be considered as amended and asked public comments. Hearing none, he called for a vote. The motion passed unanimously. Ms. Journey and Mr. Roob moved and seconded, respectively, for a vote on the amended ordinance. Mr. Pecar then asked for comments on the ordinance as amended. The Board voted unanimously to pass General Ordinance No. 2-1999(A).

Mr. Pecar then announced that they were ready for a public hearing on Ordinance No. 3-1999 and Resolution No. 21-1999 and asked one of the members to move to recess this portion of the meeting until Monday, November 29, 1999 at 1:30 p.m., the Ott Building,
Wishard Health Services, 1001 West 10th Street, Conf. Rm. A. It was so moved by Mr. West and the motion was seconded by Ms. Journey. The vote was postponed to the end of the meeting.

Mr. Pecar then asked for Ms. O'Laughlin's Treasurer's report for October, 1999. She presented the Budget Revenue and Expenditure Report for October 31, 1999. Wishard Revenue categories under budget are Patient Receipts 1.7%. An 8-month program began April 1, 1999 to increase collection rate to 55% from the 1998 rate of 48.1%. October collection rate of 49.6% increased the current year rate to 47.1%. Basic/enhanced DSH will be received this year but timing and amount still are uncertain. The Miscellaneous Revenues are under budget by 3.0%. This is partly due to the Psychiatric Grant Receipts, which have declined due to discontinuance of some of the grant programs. Over Revised Budget, which is good news for this month, is revenue from Lockefield Village at 9.1%. Total revenue under budget for Wishard for October 31, 1999 was $1.7 million, a much better picture than it was a month ago. Wishard Expenditures that were over budget - none - they were 3.5 million under budget. Wishard net income is still a negative, ($33.2) million, but that also includes DSH ($25) million under budget.

In Public Health and Headquarters, revenues were $188,139 over budget. The Public Health expenditures over budget were other services and charges, 0.3% and printing and employment advertising and office furnishings for new or relocated employees accounted for that increase. Capital outlays were 2.7%. The Headquarters expenditures over budget were 1.7% for supplies.

Total expenditures for Public Health and Headquarters were under budget by $2.6 million. Public Health and Headquarters net income was $193,454 ($60,000 under budget). Corporate net income for the period ending on October 31, 1999 was a negative ($33 million) - $15 million under budget.

Ms. O'Laughlin then asked the Board's acceptance of this report. Mr. Roob made the motion, which was seconded by Dr. Johnston. It was passed unanimously.

Ms. O'Laughlin presented the Cash Disbursements Reports for two months - September and October, 1999. She stated that September Cash Disbursements are below the 1999 Adjusted Average of $21.3 M and this reflects a lower than average accounts payable at Wishard. The October Cash Disbursements total $23.6M and that is just slightly above the year to date average of $23M. Here again, that represents the continuing effort to conserve cash at Wishard. Ms. O'Laughlin asked the Board's approval of the Cash Disbursements Reports for September and October, 1999. Mr. Roob made the motion to approve this report and Dr. Johnston seconded the motion. It was unanimously approved.

Mr. Pecar asked that Dr. Braddom to present, for the Board's approval, the Medical Staff Appointments and Re-appointments, which he presented for the months of October and November, 1999. Dr. Johnston moved to approve the appointments and Dr. Bock seconded the motion. It was approved unanimously.

Dr. Braddom introduced to the Board two bids for their approval (copies were available).

The first was a bid to purchase card embossers with a total bid of $124,000. These would be replacements for the present ones being used, which are worn. The card embossers create the credit card like plastic cards used for patient identification when utilizing the services at Wishard. Ms. Journey made a motion to approve this bid and Dr. Bock seconded the motion. The bid was unanimously approved.

The second bid Dr. Braddom introduced was a bid award recommendation for generator systems modifications for $74,287.00 from the Ermco, Inc. The purpose of the generator is to offset the peak electricity requirements, especially in the summer, by generating their own electricity. Discussion ensued regarding this equipment and its connection to theY2K issue and also the Indianapolis Power and Light Company. After discussion, Ms. Journey made the motion to approve this bid and Dr. Bock seconded the motion. The bid was unanimously approved.

The Chairman called upon Dr. Caine for her report on issues with the Marion County Health Department. Dr. Caine shared her success and progress with the Walt Disney's Friendly Access Project. Indianapolis was selected as a project city by Walt Disney. Mr. Elwell and Bobbie Brown, Administrator of Maternal & Child Health, attended Disney's Friendly Access meeting in Milwaukee, Wisconsin. Dr. Caine reported that we will receive $5 million for a period of ten years. The goal of the Friendly Access program is to improve client response and compliance through working with Maternal and Child Health providers in improving customer satisfaction. Training will involve approximately 37-45 individuals going to Disney World in February for a period of one week. Mr. Pecar congratulated Dr. Caine for her efforts.

Mr. Pecar then asked for a vote on the previous motion and second to recess and reconvene the meeting to November 29, 1999 at 1:30 p.m. It was approved unanimously.

This meeting was adjourned at 2:35 p.m.

Note: The Reconvened Meeting will be held at 1:30 p.m. on Monday, November 29, 1999 in Administrative Conference Room "A", Ott Building, Wishard Health Services, 1001 West Tenth Street, Indianapolis, Indiana.