Our Vision Central Texas is a model healthy community.

Our Mission

By caring for those who need it most, Central Health improves the health of our community.

Our Values

Central Health will achieve excellence through: Stewardship - We maintain public trust through fiscal discipline and open and transparent communication.

Innovation - We create solutions to improve healthcare access. Respect - We honor our relationship with those we serve and those with whom we work.

Collaboration - We partner with others to improve the health of our community.

BOARD MEETING

June 19, 2019

REGULAR AGENDA ITEM 5

Discuss and take appropriate action to create a health care provider participation program to be administered by Central Health, which program will result in the establishment of a local provider participation fund, pursuant to Chapter 298E of the Texas Health and Safety Code.

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1111 E. Cesar Chavez St. Austin, Texas

78702 Phone: 512 978-8155

Fax: 512 978-8156 www.centralheath.net

MEMORANDUM

To: Central Health Board of Managers From: Kat ie Cobur n , Di r e c to r o f Re gional He a l thcare Par tne r sh ip CC: Mike Geeslin, President & CEO Date: June 13, 2019 Re: Item #5 Authorization of the Central Health LPPF program – ACTION ITEM

Summary – Action Requested

Consider and take appropriate action to adopt the attached resolution to establish a health care provider participation program and create a local provider participation fund (LPPF)per Chapter 298E of the Texas Health and Safety Code.

Background

Chapter 298E of the Texas Health and Safety Code grants authority to the Travis County Healthcare District, dba Central Health, to participate in a health care provider participation program and create a local provider participation fund (LPPF). Under this authority, the Central Health Board of Managers may assess a mandatory payment to hospitals required to participate in the LPPF. The payment rate must be uniform and broad based.

Payment amounts to the LPPF must be used as the local share for intergovernmental transfer (IGT) payments to draw down Federal matching funds available in authorized Medicaid supplemental payment programs. On June 11th, Central Health was notified by HHSC that any new affiliation agreements for the upcoming DY8 Uncompensated Care IGT (scheduled for September 5th) will need to be filed with HHSC no later than July 15th. Due to the revised schedule, it is necessary for Central Health to create the LPPF prior to executing the affiliation agreements. Central Health staff plan to bring an item to the Board of Managers on July 31st for consideration and action to adopt the mandatory payment rate.

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Resolution of the Travis County Healthcare District (d/b/a Central Health) Authorizing Establishment of and Participation in a Health Care Provider Participation Program and further

Authorizing Creation of a Local Provider Participation Fund

WHEREAS, the Texas Legislature enacted Senate Bill 1350, which added Chapter 298E to the Health and Safety Code (“Chapter 298E”) and went into effect immediately upon signature by the Governor on May 31, 2019;

WHEREAS, pursuant to Chapter 298E, the Central Health Board of Managers (the “Board”) may,

on an affirmative vote of a majority of the Board, authorize Central Health to participate in a health care provider participation program;

WHEREAS, once a health care provider participation program (the “Program”) is established,

Central Health, as administrator of the Program, is authorized to assess and collect mandatory payments from institutional health care providers in Travis County, which payments may be used to fund the nonfederal share of Medicaid supplemental payments as contemplated by Chapter 298E;

WHEREAS, pursuant to Chapter 298E, if Central Health requires institutional health care providers

to make mandatory payments, it is also required to create a local provider participation fund; and WHEREAS, pursuant to Chapter 298E of the Health and Safety Code, a local provider participation

fund consists of revenue from institutional health care providers’ mandatory payments and other specified public funds and may be used to fund intergovernmental transfers to the State;

NOW THEREFORE, BE IT MOVED that the Central Health Board of Managers authorizes

Central Health to:

1. Participate in a health care provider participation program;

2. Create a local provider participation fund and collect mandatory payments from each institutional health care provider required to participate;;

3. Use the funds in the local provider participation fund for the purposes specified in Chapter 298E.

Passed and adopted this 19th day of June, 2019

_________________________________________ [Name], [County/City/Hospital District Official] Attest: _______________________________ [Name], [County/City/Hospital District] Clerk Approved as to form: ________________________________ [Name], [County/City/Hospital District] legal advisor

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NOTICE: CENTRAL HEALTH BOARD OF MANAGERS OF TRAVIS COUNTY TO CONSIDER

AUTHORIZATION OF THE HEALTH CARE PROVIDER PARTICIPATION PROGRAM AND CREATION OF A LOCAL PROVIDER PARTICIPATION FUND

Notice is hereby given that the above named Central Health Board of Managers will consider action concerning the authorization of the Travis County Healthcare District (d/b/a Central Health) to participate in a Health Care Provider Participation Program and create a Local Provider Participation Fund during its scheduled Board meeting June 19,, 2019 at 5:30 p.m. or on adjournment of the 3:30 pm Special Called Meeting of the Board of Managers in the Board Room of the Central Health offices at 1111 E. Cesar Chavez St., Austin, TX, 78702. The Board of Managers will consider action pursuant to Chapter 298E of the Texas Health & Safety Code, which authorizes participation in a local provider participation program and the creation of a local provider participation fund. Representatives of local nonpublic hospitals and the public wishing to be heard on these matters may appear before the Board of Managers during citizens’ communication.

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Travis County Local Provider Participation Program (LPPF)

Item 5 – Request Creation of LPPFCentral Health Board of Managers

June 19, 2019

Jeff Knodel, CFO

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Chapter 298E, Texas Health and Safety Code

• SB 1350 by Watson signed into law May 31, 2019 by Governor Abbott, effective immediately

• Grants authority to the Central Health Board “to authorize the district to participate in a healthcare provider participation program on the affirmative vote of a majority of the board”

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Recent Developments

• June 11 - HHSC notified stakeholders that LPPF affiliation agreements are due July 15, 2019 to qualify for Sept UC payment

• LPPF program must exist in order to execute affiliation agreements

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Proposed TimelinesDate Action Decision Type

June 12 Budget and Finance: LPPF Creation and Operations Overview Informational item

June 19 Board of Managers meeting• Authorize creation of the health care provider participation program

Action requested

July 15 LPPF affiliation agreements filed with HHSC CH staff action

July 24 Budget and Finance: • Consider program rules, FY 2019 payment rate

Informational item

July 31 Public Hearing and Board of Managers meeting – discuss and adopt:• LPPF program rules• FY 2019 mandatory payment rate• Designate depository bank

Action requested

Aug 28 Public Hearing• Consider FY 2020 mandatory payment rate

Informational item

Aug 28 Board of Managers meeting• Adopt FY 2020 mandatory payment rate

Action requested

Sept 5 Transfer LPPF funds to HHSC for DY 8/FY 2019 UC payment CH staff action84

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Board Role as LPPF Administrator

• Authorize the district to create the LPPF program with a majority vote

• Hold public hearings regarding LPPF rates

• Approve the mandatory payment rate

• Board may adopt rules relating to the administration of the program: collection of mandatory payments, expenditures, audits, other administrative functions

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Administrator Functions

• Accounting

• Banking

• Legal

• Audit

• Collect payments and send IGT

• All administrative tasks are reimbursed through LPPF fund

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Next Steps

• Staff to seek board approval to establish LPPF at June 19th

board meeting in order to file timely affiliation agreements with HHSC (by July 15th) for DY 8/FY 19 UC IGT

• CH staff will collaborate with hospitals to determine an appropriate rate to recommend to the Board

• Hold public hearing on July 31st to adopt FY 2019 mandatory payment rate

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CENTRALHEALTH.NET

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