Bishop Rob to um open us in prayer.

Last night, as you were no doubt aware, Mitch Grove police officer Brian Elliott died in the line of duty.

We recognize the gravity of that loss for his family and his fellow officers as well as for his caregivers and for our broader community.

As today's meetings begin, I invite us to now observe a moment of silence together in remembrance.

As our board embarks on its work this day, may they do so in such a way that allows the many facets of community care led by the Health and Hospital Corporation to demonstrate steadiness in difficult moments, compassion among those who suffer, commitment to those who serve our community, and integrity in every decision that may be made.

May this loss remind us of the sacred trust placed in the caregiving institutions chartered for our community to preserve life, ease suffering, and serve the people of our county with purpose and with honor.

Amen.

Thank you, Ms.

Rob.

With that, I will uh do an opening uh call to order here.

Uh uh Vice person uh uh drummer present uh trustee du set is is uh is away today at a family funeral, and our prayers are with her.

Um Dr.

Dr.

Fish present trustee uh Hannafee, present.

Trustee Horn, Trustee O'Brien present, and trustee Lazard is present.

Uh the uh next item on the agenda is our consent agenda, which consists of the board minutes from the January 12th, 2026 meeting, the treasurer and CFO report for uh uh December of 2025 and January of 2026 cash disbursements, clinical privilege forms uh uh which there's a summary in your packet, as well as the medical staff appointments and the medical staff policies, which there's a summary in your uh so move, Mr.

Chairman.

It's been moved.

Is there a second?

Second.

Uh Vice Chairperson Drummer.

Yes.

Uh I'll skip trustee to set.

Uh uh Dr.

Fish.

Yes or no.

Yes, got it.

Um Trustee Hannafee.

Yes.

Trustee Horn.

Yes.

Trustee O'Brien.

Yes.

And Trustee Lazard votes yes.

So it passes uh unanimously six to zero one absent.

Uh the the next item uh on our agenda is the uh authorization uh for staff to enter into a contract, and uh this is for the uh uh SAP Cloud Migration.

And so before we have a discussion and before I introduce the staff members and talk about this, I'd ask for a uh motion uh to uh uh uh that we that the board uh approve this.

So it's been moved by trustee O'Brien.

Is there a second?

Second.

Seconded by uh uh trustee Dr.

Fish.

And I understand that we have one member who's gonna be abstaining from this, uh Trustee Drummer.

So uh and uh uh with that uh since it's been moved and seconded, I'm gonna introduce uh Scott Morris, our corporate chief information officer to uh speak on this subject uh uh so yeah, you yeah, thank you, Grant.

So we're moving SAP into the cloud.

Um that will be uh the only way that they offer the systems come 2028.

Um so we're getting ahead of that.

We performed a uh RFP uh narrowed it to two vendors.

Um happily the vendor with the best presentation had the lower price.

Uh we achieved um uh I think 23% participation from local and diverse vendors, um, eight percent WBE and the remainder uh I believe MB.

Um the uh winning bidder was V3 IT who we've done work with before.

This uh moving this into the cloud will allow us to uh leverage better AI tools and uh better analytics is the long and short of that.

So it's really not much more complex than that.

What can I say?

Thank thank you.

And and this was presented to the uh uh finance and external audit committee uh earlier this morning who uh uh advanced this to the uh for a vote of the entire board.

Are there any uh questions from any of the I think almost all the board members were present at that at that committee meeting, but are there any other questions uh that have come up uh for uh uh for Scott seeing none, um I'm uh uh we'll uh do a uh a roll call vote uh with with the uh uh exception of ice person uh uh uh uh uh uh drummer who who who is abstaining and and again trustee du set who is is at a funeral.

Uh trustee Dr.

Fish.

Um yes, the trustee Hannafee, yes, trustee Horn, yes, trustee O'Brien, yes, trustee Lazard voice, yes.

So it's uh five zero two, I guess, uh to uh uh the motion carries uh uh and uh uh thank you, Mr.

Um the uh the second resolution that's uh on our agenda is the establishment of a police department uh and we have a number of uh uh individuals with us today uh uh front from our uh in our security uh uh force uh but we so before I introduce uh our president CEO to uh talk about this resolution uh I I'd like to have a uh motion to uh uh for the board to approve the resolution uh uh one-2026, the establishment of a police department.

Is there a motion?

I'll move.

Second.

It's been moved by uh trustee Hannafee, seconded by uh Vice Chair Person Drummer.

With that, I'll turn it over to uh Paul Babcock, our uh president CEO of HHC.

Thank you, Mr.

Chair.

Uh trustees of the board, just a little background um and then if there are more specific details, um Dan Wolhelman here, director of security can answer them.

But as you know, the corporation has had their police powers um from the Marin County Sheriff a few years ago.

The sheriff decided to begin um withdrawing uh special deputy powers from the different organizations as well as entities across Marion County.

Um we were able to uh work out a little deal to extend our police powers um until sometime September of 2026.

Unfortunately, uh at the beginning of this year, the sheriff decided to pull our powers within 90 days of uh the notice that was sent.

So this resolution is asking you to approve um the creation of the police department um to allow the organization to continue to practice protect its people and its assets um as well as just to continue to provide uh steady um excuse me, steady presence uh throughout our buildings uh across Marion County.

So with that, I'm more happy to answer questions, and if there's some I can't, Dan's here to help.

Do the any of the board members have any questions for uh Paul or uh uh or or uh uh uh Dan Wilhel Wilhelm or Kelly uh uh Mr.

Sorry, Kelly, I blew the last name.

Uh Hayward, thank you.

Mr.

Chairman, once once this is approved, what's next steps?

Um what's the timeline, etc.

based on the letter that we received from the sheriff's department.

Um what are the next steps?

So I'll speak to the first next step is I have to swear in uh Dan after this, and then he's gonna swear in his deputies, and from that there's paperwork that I'll let Dan uh be able to answer the more detailed timeline.

Tomorrow hit your mic.

I'm sorry.

Tomorrow we're we will swear in the first 32 officers into the department.

Um the rest of the officers, uh the additional um 53 will be sworn in on April the 15th.

We lose our special deputy uh authority on April 16th.

Um that will allow us uh we also are going to be putting officers through a 40-hour pre-basic uh class between now and April 15th.

Everybody will receive that.

Which we have classes scheduled to get those those individuals certified.

I don't want to assume the officers that you will be swearing in are current officers.

Yes, sir.

They're all certified officers.

All certified at this particular time.

Thank you.

Okay.

If there are no other questions, and uh again, I I will simply say I've had the opportunity to do write-arounds with both the uh with with Dan, some of Dan's people uh from uh here at the hospital as well as Kelly's uh people with with HHC and and attended a training session.

It it's a very professional group.

Um with that, I'll uh do a roll call vote.

Uh uh if you're in favor of the motion, simply say yes or aye.

If you're against it, no or nay.

Uh Vice Chairperson Drummer.

Uh Mr.

Chairman, I I'd like to say this is well overdue.

This is something when another municipality can hold you hostage, and you know, use their um position to not allow you to do the things that we need.

We know that we need a police force here.

We know that we need that here, and I know that this had been discussed years, years ago, way before your time, actually, uh, as far as having a police department here.

So I'm I'm glad to be part of this.

So I adamantly vote yes.

Thank you.

Uh uh Trustee Dr.

Fish.

Uh yes.

Trustee Hannafee?

Yes.

Trustee Horn.

Yes.

Trustee O'Brien.

Yes.

Trustee Lazard uh votes yes as well.

And uh again, thank you for the opportunity to to see your folks in action and and and and on the ground as well as in the training.

It's uh uh and the assurances that uh this is gonna come off uh very well.

Thank you.

Okay, the uh the the next item uh on our agenda is the establishment of standing committees.

Uh and because of uh internal audit being formed and a few other things, uh we uh uh sitting down with uh general counsel and uh uh uh we decided we would we we would change the the standing committees just slightly so uh uh and and with that I'd be happy to make the motion that we approve the establishment of the uh standing committees as outlined uh in the resolution uh that I'll read here in a moment.

Uh is there a second to the motion?

Second, it's been seconded.

Um so the uh the the motion here is basically to to authorize health and hospital corporation as you you've seen in your board packets.

Uh we we will we will be having a uh compliance and internal audit um committee, a cultural excellence committee, an Eskenazi Health Committee, a finance and external audit committee, a long-term care committee, a nominating committee, a public health committee, a uh quality committee, and a strategic plan committee.

Um are there any uh uh uh it's been moved and seconded.

Are there any questions or any comments by any of the board members uh before we vote on the resolution?

With that, I will uh uh again do a roll call vote.

Uh again, yes or yay to uh it for for approving, nay or no for uh don't not approving.

Vice Chairperson Drummer, yes.

Uh uh Trustee Du Set is again not with us, uh Trustee Dr.

Fish, yes, Trustee Hanafe, yes, trustee Horn, yes, Trustee O'Brien, yes, trustee Lazard votes yes, it carries unanimously of those members that are here.

Uh the uh uh next resolution that that we have is the uh maintenance of a uh level one trauma center status uh for um uh Smith Level One shop trauma center at Eskenazi Health.

Uh that resolution is at is also in your packet.

Uh is there a uh a motion to approve this resolution?

I'll make a motion to approve.

It's been it's been motioned by Trustee Hannafee.

Is there a second?

Second.

Is there uh uh uh so with that I I would ask uh you're you're you're gonna have to help me with your last name, Dr.

Our Chief of Trauma Services is it's I can't remember if it's stream or stribe strike stribe, thank you.

Um I I apologize.

Uh just to comment on the resolution.

Thank you.

Yes, uh ladies and gentlemen, thank you for inviting us here today.

I'm here uh with Sidney Doyle, who is our trauma program manager, and um our level one trauma center at Eskenazzi Health and previously the Wichard Hospital was the first level one trauma center verified in the state of Indiana.

Um we are verified every three years to make sure we're in compliance with the highest standards of care.

Uh since the early 1990s, we've been successfully verified 12 times with no deficiencies.

And verification means that we have the resources for the optimal care of the injured patient, which is the name of the book of standards that we have to comply with.

Um the very first standard in the book is institutional administrative commitment, which means that we have a continuous commitment from the institution to provide resources, including equipment, personnel, administrative support, everything we need to do to care for the injured patient at a moment's notice.

And as Bishop Lyons noted at the beginning of the meeting, yesterday evening was an example of why these resources are necessary.

With only moment's notice, two police officers were brought in to the emergency department after being wounded in the line of duty.

One fatally, we were able to use the full spectrum of emergency care because we are prepared with the resources to do so.

And I'm happy to tell you that the other officer was just discharged from the hospital about an hour before this meeting.

Um and we're very uh fortunate for that outcome.

This morning, I operated on a state prison inmate who'd been stabbed uh in the chest.

And our team was up most of the night last night operating on other emergency general surgery uh cases.

So the bottom line is that we are prepared to take care of everyone uh at all times.

So injury is the leading cause of death uh for people ages one to 45 in the United States, and because those are the most productive years of one's life, uh injury is the leading cause of years of productive life lost.

Firearm injuries are now the leading cause of death for children and young adults in the United States.

And our Beyond Barriers campaign has identified and aims to address the 15-year difference in life expectancy between people living in downtown Indianapolis and those in our neighboring suburbs.

And it's important to note that some of those years of life lost are because of trauma.

And we continue to work to address this problem through injury prevention programs and caring for patients to help them recover as as well as they can.

And so again, um, I'm pleased to be here to ask for the continued support of the board and the institution to uh support our teams and all the resources that we have to provide this care for our community.

So thank you very much.

Thank you, Dr.

Stratton.

Are there any questions or comments from any of the board members on on this resolution?

Hearing none, uh we'll do a roll call vote to uh if you approve of the uh uh uh uh of the resolution uh yes or aye uh if you disapprove, no or nay.

Uh Vice Chairperson Drummer, yes.

Uh Trustee Dr.

Fish.

Yes, Trustee Hannafee, yes, trustee Horn, yes, Trustee O'Brien, yes, trustee Lazard vote yes, that's uh 601.

Um okay the uh uh it's my pleasure to uh uh bring forward a uh a nomination uh for the the board to consider uh and uh I'm gonna uh uh ask first for a uh a motion to uh nominate uh a uh a board member to the Sandra Eskenazi Mental Health Center uh board advisory board uh individual by the name of David Hudson uh and uh uh would would our current member of that advisory board like or outgoing member like to make that nomination?

Yes, I would like to make that motion with David Hudson to be uh appointed to the board.

Is there a second?

nominate uh a uh a board member to the sandra eskenazzi mental health center uh board advisory board uh individual by the name of david hudson uh and uh uh would would our current member of that advisory board like or outgoing member like to make that nomination yes i would like to make that motion to david hudson would be uh appointed to the board is there a second second it's been moved and seconded and i'll turn it over to dr overly um uh to uh to tell us a little bit about uh mr hudson whose uh bio uh very impressive bio is in our packet indeed thank you um david hudson um is currently serves as the chapter administrator for nami of greater indianapolis that's a national alliance um for mental illness um which is a really wonderful advocacy organization that provides a lot of education and support services for patients and families um he also is a veteran and previously had served a role as a veteran liaison with NAMI as well so we feel very fortunate actually for both his connection to NAMI um and his experience and knowledge as a veteran um as well um so we are very excited to have him join the board and appreciate your um support thank you are there any questions for uh Dr.

Overly hearing none uh I will uh uh uh uh do a roll call vote again yes to approve uh uh or no to to not approve uh trust uh trustee uh vice chairperson drummer yes uh trustee Dr.

Fish yes trustee Hannafee yes trustee horn yes trustee O'Brien yes trustee Lazard also votes yes so you have a new member approved okay all right that brings us to the report section uh of our meeting um and I'm I'll introduce uh for Health and Hospital Corporation our president and CEO once again uh Paul Babcock thank you Mr.

Chair uh members of the board uh my my remarks will be rather brief and they'll kind of focus on what's we think is coming forward in 26 as well as just looking back at some of the projects that have been ongoing since 25.

So first just to put on the board's radar um we're going to bring forth to the board um during the budget time uh here in the middle of the year a new debt issuance um so we're compiling a list of projects um that we want to present to the board that we would pay for with this debt issuance uh the reason we have to do this if you recall a few years ago we did issue a a small amount of debt um to do some projects across the corporation but a recent law change has really impacted the way in which municipal organizations uh do debt issuances aims to prevent um mainly you know municipalities um from issuing small amounts of debt every so many years and instead larger debt issuance um over a longer period of time it's a little wonky um and but we're looking into the amount of money that we'll be able to uh issue debt for uh the goal would be to come just short of the referendum limit and I'd be more than happy to explain in detail to any member who has questions uh about what that means or I could turn it over to trustee horn and she could help walk us through it um she probably knows it better than I do uh we'll we'll working out through that amount through the projects and so uh we'll bring that to you here part of the budget and we'll have more information every month talking through it um second the projects that we are doing construction on the public health lab the IES headquarters hasbrook renovation the new security depot and the Medic 10 bay are all on time uh on budget and we look forward to this year celebrating the opening of those facilities additionally there will be an IEMS beam signing event and that will let the trustees know and hope that you can attend uh the the paramedics are very excited about their new facility and when you drive on 38th street you can really see it coming out of the ground uh third uh in november the board authorized us to uh enter into negotiations to extend our lease with omega as well as possibly um bring in three new facilities to our portfolio we're on track with those negotiations so far they are going well uh we believe the financial analysis of those portfolios uh justifies that or those properties justifies adding them to the portfolio and we have some other strategic things that we are working on with them that we'll present to the board at a later date in time uh four speaking of strategic the planning our our strategic plan kickoff town hall meetings next week um this is when we're gonna roll out this plan that the board voted on um in January to uh staff across the organization to talk about the KPIs and the metrics that will be uh holding everyone accountable to as we try and continue to be financially sustainable here into 27 and uh onward and then finally in March we'll update the board on the impact the state house has had on the organization uh they'll be finishing up next week and we will see how what changes uh occur and which ones are positive and which ones have potential impact to us and how we operate and we'll be able to give the board a full uh assessment of what that means for us going forward.

So with that Mr.

Chairman, I'll turn it back over to you and answer any questions if there are any questions for our uh president and CEO with regard to the items he brought up not appearing.

I'll turn it over to our interim CFO and assistant uh treasurer uh James Simpson.

Thank you, Chairman Lazard and the board.

Um first I'll cover the treasure's report and then after that I'll move into the uh the finance and external audit committee report.

Uh the general fund budgetary statement of revenue and expenditures through December 31st 2025 did show a decrease in fund balance of 32.7 million.

Uh, this was attributed to taxes were unfavorable to budget by 25.4 million.

That's due to the loss of HCI, as well as IgT payments were also unfavorable by 14 million.

And this is due to our long-term care IGTs exceeded projections during 2025.

And we also had two additional physician faculty access to care settlements.

Now the additional IGTs does benefit long-term care on the the UPL payment side, but we did have to put up additional IGTs in 25.

And then also our grant revenues were unfavorable to budget by 12 million in 2025.

These unfavorable positions were partially offset by favorable positions on the headquarters revenue.

We were favorable there to budget by 7.2 million, and this is related to strong returns on cash and investment balances, and then also an overall favorable budget position on total expenditures and transfers out, and that favorite position was 13.9 million.

Within that favorable position for expenditures and transfers out, we did transfer an additional additional support payment to the hospital of 30 million dollars in December of 2025.

This support transfer increased Eskenazi's day's cash on hand position by approximately 10 days, and it keeps the hospitals cash projections above 45 days, which is the minimum we set for that target in our uh planning, our financial planning process in 2025 in the budget process.

Sorry, it keeps it above 45 days throughout 2026.

So, unless there's no if there's any questions, I can answer those now.

If not, I'll move to the committee report.

Are there any additional questions on the uh information that was just presented and was presented in more detail in the uh finance and external audit committee?

Doesn't seem don't seem to be any additional questions, sir.

So I'll let you continue on.

Thank you.

Uh this morning the finance and external audit committee met at 10 a.m.

Aside from prior meeting minute approvals, the following items were considered and reported and reportings occurred.

Um covered earlier, Scott Morris did present the SAP Cloud Migration RFP letter.

I thank the board again for the approval on that RFP uh recommendation earlier in this meeting.

For us Mazars presented the audit planning communication to the committee.

Uh the communication included in the engagement context, overview and responsibilities, timeline, scope, and confirmation of independence.

Uh, the committees, the committee members and trustee uh and trustees did have some questions around the audit and the audit process, which were answered by Forbus Mazars during the meeting.

Then myself, Tar Parchman, the uh MCPHD finance director, Nicole Harper, the Eskenazi Health CFO, and Brian Jarvis, the ASC VP of Accounting and Finance, presented the unaudited financial statements as of December 31st, 2025.

The presentation included governmental activities for both headquarters and the health department as well as Eskenazi Health and Long-Term Care.

There was one additional request from the committee for the service divisions to review patient revenue, allowance for bad debt, as well as payer mix for the last three years.

And the division leaders did acknowledge this request, and we will provide a report on that on a future committee meeting.

This would conclude my report unless there's any questions.

Are there any questions for for James?

Don't appear to be very good.

So I'm looking for our uh chief compliance officer.

He was here a minute ago.

Oh, there she is.

Hiding behind the uh camera that I couldn't see.

So I'll introduce uh Lisa Taylor, our chief compliance uh officer who's gonna uh walk us through a uh a very uh uh brief uh uh 2026 work plan for the integrity and compliance uh area.

Floor is yours.

Thank you.

There we go.

Thank you so much.

So we wanted to make sure that we brought our current work plan to the board for review and approval.

Um we essentially are presenting you with the results of a risk assessment that was completed this past year in 2025.

This is our second year completing the risk assessment.

Do you have a do you have a presentation?

No.

Okay.

It should be in your particular information.

Okay, so what we wanted you to be able to see is the difference between what we did in 2024 carrying into our 2025 year and our 2025 carrying into this year.

Essentially, the summary is we we started last year, um, did kind of a very surface level risk assessment and just got better this last year where we expanded the process.

We added 690 data points in order to inform our audit plan for this last year.

So our risk assessment process um it started in September of 2024.

It took us a year to complete and informed this this audit plan.

Um we got data inputs or received data inputs from many different places, including um surveys of the organization, many different members of the organization.

Um we had interviews across the organization, over a hundred of those, um, which included individual interviews and focus groups.

Um we also looked at where's the government going because uh we need to know where they're going so that we can check that before we get there or before they ask us for any information.

So what I was able to provide you is the top 20 risks by score.

Um of the things that I want to point out is is that we are working very diligently with internal audit, so uh with the Kodiak group, and we're also working with revenue cycle at Eskenazi to make sure that we are all utilizing our audit services effectively and efficiently.

So, what that means is is it might be on here as a high risk or an audit item, but if we identified it in red along with Kodiak, Kodiak may be auditing that, and we're gonna get to the other ones this year.

So you'll see two pages of the 20, the top 20 risk items.

Um, you'll also see a weighted score, which will demonstrate to you that again in 2024 we were doing a high, medium low, and this year we we just got better and started to do a weighted score.

So you will see that comparison next year as well.

Uh but over these top 20 risks, we have developed our 2025 audit plan.

And the last slide that you have in your packet is we've essentially parsed those out and parsed out the audits based upon our four top strategic risk category by category.

So you'll see that under health outcomes, community health, access and growth, and sustainability.

We have different audits in each of those that we're going to look at that align with the overall five-year strategic plan for HHC.

So we come to you today to ask for approval of the 2026 proposed audit plan, which you also have in your deck.

We give you a high level in the uh PowerPoint presentation, but the detail is also in there as well if you would like to review it.

We have 20 focused activities between billing and claims, HR, and quality care, and then we also have some other compliance activities for 2026 that aren't necessarily um work plan items, but they're special projects across long-term care privacy grants and some monitoring items that are within that plan.

So we ask you today to approve that plan, and I'm happy to take any questions that you might have.

So just to add what uh Lisa has said, I I took the time to go through the entire plan with Lisa.

I also took the opportunity to speak to uh our contractor who preceded Lisa and asked and ask him his thoughts, and all I got back were glowing remarks about uh uh what uh about uh what a wonderful job she's done on top of what he had been putting together and felt that this was a uh uh this was a real step forward for the organization.

So uh I I think this is uh I think this is a great first step for a person new to our organization, but somebody who has dug right in and really understood where the risks are and and and how to test those and how to work with the various groups you mentioned the internal auditors but also the external auditors, but also just the people within the departments in this.

So I I uh uh I hope you don't mind.

I took a little extra time going through all of that, but but I I think that it uh I think all the board should be confident in voting for this plan.

So are there any questions of Lisa before we uh uh before we put a motion?

I I guess we need to put a motion together to approve the plan, and then we can ask questions.

I'd make the motion to approve this plan.

Is there a second?

Sorry, it's been motioned by uh trustee Hannafee, seconded by Trustee O'Brien.

Uh, any questions of uh uh of uh uh our CO chief uh compliance officer of uh Lisa Taylor hearing none, I'll uh do a roll call vote.

Uh uh Vice Chairperson Drummer.

All right, trustee uh Dr.

Fish, yes, trustee Hannafee, yes, trustee Horn, yes, trustee O'Brien, yes, and trustee Lazard votes uh overwhelmingly uh supportive.

Yes, thank you again.

And I I know the amount of work and effort you've put into this in your first few months here, and uh thank you.

I certainly appreciate that.

I'm backed by uh a tremendous team.

So thank you.

Appreciate it.

Okay, that brings us to uh uh the Marin County Public Health Department.

Uh and we we we heard a couple of very uh actually three very nice reports uh today, and so I'll turn it over to Dr.

Virginia Kane, our director and chief medical officer to give us a summary of uh of this morning.

Uh thank you, um, and the rest of the board of trustee members.

I'm delighted to say that we're pleased to present our 2025 Marion County Health Assessment.

This is a process we do every uh five years.

And what happens is that this assessment um uh process fosters an unprecedented level of engagement of our residents and our community partners with the goal of learning about what's going on in our community.

And over 4,000 uh 700 residents took out a detailed community survey to tell us what they're experiencing in their daily lives.

Uh community members and leaders were also interviewed to ensure that we heard from people with unique experiences, needs and challenges, and over 200 partners and community leaders uh were invited to participate in this process to help us learn more about uh what we should emphasize as our priorities for our community.

And so this was this uh presentation that I presented before you today uh actually identified five priority areas for our community.

The number one by rank um was mental health well-being, number two was access to health care.

Number three, for the first time ever in any of our community health assessments, we had an issue that was a social determinant of health, and that is uh safe and affordable housing came as a number three issue for our community.

Number four was trauma, injury prevention, inclusive of gun balance, domestic balance, and other trauma injury causes, and last around our five-party uh areas was input mortality.

And so I'd like to just highlight just real quickly a perception from the community and the things that came out in this process about what do you like most about the community you live in?

So the response was the people, neighbors and friends look out for one another.

Number two, I love the community and its diversity.

Three safe, peaceful, quiet, walkable neighborhoods.

Number four, general affordability of living in Marion County, and the fifth was built environments, where sidewalks and bike lanes, trails such as the Monon, proximity to grocery stores, libraries, and faith-based institutions.

Um I'd like to thank uh my staff, a director of epidemiology, uh, Dr.

Elizabeth Bowman, and Andrew Boschinek, who's in the department of epidemiology, who really helped us spearhead this effort, and and just so many staff that participated.

And so we look to now start a community approved plan where we will address at least three of these priorities with the input from community, where we're going to have conversations, town hall meetings, listening sessions in the neighborhoods, trying to identify at least five or more events throughout the city, hoping to engage more people to help us with what are the solutions now in order to address these issues and how we engage to get.

Thank you, that's the funding.

Thank you.

Thank you, Dr.

Kane.

Are there any questions for Dr.

King?

Hearing none, we'll move to the Eskenazi Health presentation by Dr.

Lisa Harris, our CEO of Eskenazi Health.

Thank you, Chairman Lazard and members of the board.

Given the financial headwinds we're facing, I want to start by thanking Senator Jim Banks for sponsoring the Save Our Safety Net Hospitals Act of 2025, which recently passed in the Senate and was enacted into law.

This bill reverses what we have described as the Section 203 recalculation of the Medicaid Disproportionate Share Form that prohibited us and other hospitals serving large numbers of uninsured patients from counting care provided to individuals duly eligible for Medicare and Medicaid on the cost report that is used to determine our disproportionate share funding.

This bill, the again the Safety Net Hospitals Act will restore the pre-2021 Medicaid dish payment formula and distribute federal funding, which is already appropriated more fairly.

It will boost payments to Indiana hospitals by roughly 140 million annually, and it will benefit several other states as well.

It also will allow states to spend unspent disproportionate share payments against sequestered resources from earlier use with earlier years without the need for additional new appropriations.

From our discussions on the Hill earlier this month, we understand that there may be the opportunity of retroactive payments for 2024 and 2025 as part of this act, and we are awaiting guidance from the state on that.

So this is obviously good news given the multiple financial challenges that we're facing.

Nicole Harper referenced in her report to the finance committee earlier today the budget variances, variances that we experienced for 2025 relative to our changing payer and service mix.

To flesh that out just a little bit more, over the past year, while Marion County has seen a decline in Medicaid enrollment of 25%.

And a drop in our percentage of Medicaid Medicaid is a proportion of our payer mix of 8% since 2022.

This has also resulted in a change in health care utilization.

Over the past year, we've seen a 7% drop in Medicaid patients presenting for primary care, mental health care, and outpatient specialty care.

This has not been accompanied by an increase in uninsured patients presenting for these relatively low-cost outpatient services.

Rather, what we've seen is a 31% increase in uninsured patients presenting to the emergency department and a 77% increase in uninsured patients requiring hospitalization at the more expensive end of the care spectrum.

So that is the impact of decreased Medicaid enrollment and coverage.

People wait until they desperately need services.

And again, that's where the care costs a whole lot more than it does in primary care, where we're making sure people have their blood pressure medications and their insulin and everything else.

This, of course, also comes at a time when we've lost the 38 million in HCI state funding that in the past was designed to help offset the impact of uncompensated care.

So this is what makes advocacy at both the federal and state level especially important at this time, and there are several other initiatives that we're working on that we will keep the board apprised of as our efforts evolve.

So then now just moving to just a few announcements, speaking to the value of our care and services.

First of all, the Center for Quality Improvement and Innovation recognized the Eskenazi Health Infectious Diseases Clinic with a 2025 Quality Award in the category of measurable improvements in HIV care for outstanding work in raising cervical cancer screening rates.

The interdisciplinary team that is comprised of care coordinators, physicians, interpreters, nurses, nurses practitioners, pharmacists, social workers, partners with more than 1,500 Ryan White HIV AIDS program clients to deliver high quality care through individualized treatment plans, education, and access to clinical research trials.

This includes care coordination services supplied by the Indiana Department of Health and the Marion County Public Health Department, in which social workers and care coordinators help prevent interruptions in care and promote healthy living by linking clients to psychosocial and support services.

Moving on, Eskenazi Health was also recently recognized at the Indianapolis Business Journal Excellence and Health Care Celebration with Michelle Brown, Pharm D, Clinical Pharmacy Specialist at Eskenazi Health, Dr.

Claire Willard, Medical Director of Eskenazi Health Palliative Care, and Madeline Seeger, physician assistant with the Richard Fairbanks Burn Center, all being honored at the special event on February 10th.

Dr.

Brown was recognized for her passion and commitment to helping patients manage opioid prescriptions in the pharmacist category.

Dr.

Willard was recognized for her compassionate care while helping families and patients through the end of life process in the physician category.

And Madeline Singer was recognized for providing 30 years of remarkable care to burn patients in the non-physician category.

Moving from the celebratory to the somber, we have made multiple references to Officer Brian Elliott of the Beach Grove Police Department who was shot and killed last night in the line of duty.

While I think everyone across our community is aware of this tragic loss, what fewer may know is that Officer Elliott transferred from Eskenazi Health to Beach Grove in 2024 after having served as a member of our security team for six years.

So last night, as we all came together in support of Officer Elliott's family and the entire law enforcement and first responder community, our firemen and our EMS folks, and into today as some first became aware of this tragic loss, it has been a difficult time.

It's also a time for all of us to reflect on what it means that the individuals serving in these roles, protecting, providing safety and security, life-saving care for the rest of us, grieve the losses, and then with heightened awareness of all that can go terribly wrong, show up for their next shift.

We do not discount that contribution, and we are grateful for all that you do.

Thank you, Dr.

Sorry, I've got one more thing.

Oh, go ahead.

Finally, over the past month or so, we lost two individuals beloved by the Eskenazi Health family for the extraordinary compassion, generosity, and commitment to our mission that transformed the lives of countless patients, families, and caregivers.

Through their vision and philanthropy, Sid and Lois Eskenazi helped advance compassionate care, innovation, education, and hope for our community, leaving a legacy that will endure for generations.

When Sid and Lois contributed 40 million toward construction of our new hospital campus, it marked one of the greatest philanthropic gifts ever to the people of Central Indiana and the largest gift ever to a public hospital in the United States.

And the years that followed, they became part of us, engaging with our staff and physicians, regularly touring our facilities, joining joining us for our important events and celebrations, and continuing to support the Eskenazi Health Foundation's philanthropic efforts.

They shared our story with pride and purpose, encouraging others to learn about our important role in providing health care education and opportunity.

Sid's appreciation of the importance of our work was personal, rooted in his lived experience growing up on the south side of Indianapolis during the Great Depression.

The stories he shared reflected a life of hard work, humility, a deep desire to give back.

And Lois's warmth and kindness, her investment in family and community, her respect for the dignity of each individual drove to the heart of our values.

They never tired of hearing what we were doing, and they never missed an opportunity to ask what more they could do.

And the way that they live their lives, they set the example.

And we will honor their legacy by continuing to work hard and to keep caring.

Thank you.

Thank you, Dr.

Harris.

Are there any questions for Dr.

Harris on any of the topics that she addressed?

Hearing none, I'll uh turn it over to our CEO of Sandra Eskenazi Mental Health Center once again to give us an update.

Thank you, Chairman Delzar.

I have two short announcements for you today.

The first is to share new hours for our caring recovery opioid treatment program.

Um this is our methadone program for opioid use disorder.

Um, this program has historically been open seven days a week.

We are now switching to be open six days a week, Monday through Saturday.

Um we are so we are now open 5 30 a.m.

to 2 p 2 p.m.

six days a week, Monday through Saturday.

We are actually not required by regulation to be open seven days a week.

Um, and actually other local opioid treatment programs are also not open seven days a week.

Um, so we expect actually that this shift will make the clinic easier to staff, and also patients will now automatically get one take-home dose, which is actually both a privilege and patient satisfier.

Um, so we expect actually that uh patients are actually very pleased with this change.

Um, and since we do not do new patient intakes on Saturday and Sunday, um then this should have actually minimal impact to taking in new patients or really any impact to patient care.

So, overall, um, this has been going well.

This started actually at the beginning of January, um, and so just wanted to make sure to update everyone about the new hours for that program.

My next update is regarding a pilot project with crosswalk health.

Um we've actually heard about this pilot from Dan O'Donnell in this meeting before.

Um, Crosswalk Health is a nurse triage service that's working with 911 with the goal of reducing unnecessary ambulance deployments and connecting to more appropriate community resources.

Um, so we are specifically working with Crosswalk to help divert mental health crisis calls that are going to 911.

And so the goal is that a dedicated mental health resource would respond to these 911 calls and make sure that individuals in crisis are able to get connected with the right resource.

And so Crosswalk will triage the calls and send them directly to our mobile mental health crisis team 24-7.

So we're very excited.

I think this reflects an important opportunity for both crosswalk health and also part of the opportunity of the certified community behavioral health clinic because that is what is supporting our mobile mental health crisis team.

Um, so we're excited to see that get started, and I will report back as we have results from that pilot.

So thank you.

Are there any questions for Dr.

Overly?

It's my uh pleasure to introduce uh Chuck Ford, our chief of staff, and and hopefully who's filling in for hopefully uh not his boss who is we we hope not testing out emergency medical services on the ski slopes uh in uh in another state.

Chuck.

Thank you, Mr.

Chairman.

Good afternoon board.

Uh as well stated, uh Dr.

O'Donnell couldn't be here today.

Um he's in snow someplace in Wyoming.

Uh speaking of which there's not much of a left, but we had a big snowstorm about two or three weeks ago, and I wanted to thank and congratulate every member of the Indianapolis EMS for doing such a great job.

During that time, we averaged 380 responses a day.

Wow.

Um we treated over 80 people with hypothermia, bross bind.

And we delivered a baby.

So it was a little tough, but uh everything came out great.

Uh unfortunately, Indianapolis EMS was the primary responder for the event at the downtown transit center a week ago.

Um, as a result, all in all six patients were transported to area hospitals.

We're deep into planning for the upcoming NCAA 4.

It's just going to be a huge event this year.

It's going to be all over downtown.

We're looking forward to it.

But it'll be a busy weekend.

As Mr.

Babcock stated, our course is moving right along.

It's on target.

Hoping to move in end of the year or first part of next year.

And as also previously mentioned right a beam in the very near future.

So we look forward to that.

And we'd like to invite you all to come.

Our latest recruit academy is in session with 18 EMTs and paramedics.

They'll be done in about three weeks.

They'll be on to their field training after that.

I'm very excited to announce that Tom Arkans, our chief of IT and Informatics, has been selected as one of the three National Association of EMT's EMS advocates.

There's only three selected across the country every year.

He was selected because of all of his work on the national EMS advisory committee.

And he'll be presenting at EMS on the Hill in Washington, D.C.

in March.

This is to increase the awareness for blood donation.

And last week we celebrated Valentine's Day with all of our staff.

That's the end of my report.

If you have any questions, I'll be free to answer.

Are there any questions for uh for show?

Thank you very much.

Thank you.

You're welcome anytime.

That brings us to our uh uh presentation of our our long-term care uh group.

Uh Julie White, our vice president of long-term care.

Julie.

Thank you, Chairman Lazard and trustees of the board.

Um January updates include long-term care deplete completed 11 facility visits, six administrative and clinical, and five environmental and emergency preparedness.

In 2026, facility capital improvement projects totaling 19 million were finalized on January 22nd with an additional six million reserved for emergency spend.

Scopes and bids are in process.

Resident occupancy for January was 79%, an increase from 77% in January of 2025, with an average daily census of 6,064 residents that we served.

West Bend Nursing and Rehabilitation, originally acquired in 2011, will transition to a new operator on March 1st.

Revised CMS guidance for nursing homes was released January 30th, related to state up at the state operations manual or SOM in chapters five and seven regarding the following areas.

Survey team composition and procedures, examples of immediate jeopardy, plans of correction, including verification, survey revisit, and off-site revisit paper reviews, and the changes will be effective starting March 30th of 2026.

This concludes my report.

Any questions?

Any questions from Julie.

Hearing none, um brings us to our uh last report of the afternoon.

Uh I'll introduce uh our uh I don't know if this title's correct.

No, yeah.

You can be whatever title you want to eat.

The boss of the uh foundation.

Well, they certainly agree with that over in that building, but thank you.

Um happy to assume and honored to assume uh the presidency after Ernie's retirement.

I thought I would bring you up to speak today on our changes in our board of directors at the foundation and who is leading the foundation.

So our board officers for 2026, our chairperson is Deborah Daniels, our vice chair is Bart Peterson, Secretary Sharon Barner, Treasurer Mark Argula, and immediate past chair is Denny Oaklack.

I realize the font's kind of small if you're at that TV, but you can see their positions in the community, many of them serving for a long time on our board, and we're grateful for their leadership.

This is Deborah's uh first year as chairperson after the board.

We welcomed four new board members beginning in January.

Stephanie Kim, who's the chairman of the board of Telemon, and also the chair of the United Way of Central Indiana board, so that's a great connection for us.

Bill McCarthy making a return visit to the board.

He was a previous chairperson of the board, so that is a great expertise coming back to us.

Julie Quackenbush, two-time president of the St.

Margaret's Guild, and now coming on our board as a as a foundation board member, and the St.

Margaret's representative who's the president for this year, Lynn Smiley.

And then finally, we said thank you to these board members who have served their four, their full 12-year terms, uh years on our board, three terms.

So Andy Bridge, Dr.

Bridge, um, Sandro Franki, Tom Pence, Murder Pullium, Alice Schloss, and Heidi Wright, who served as the St.

Margaret's Guild liaison for the last year.

So nothing we do can happen without the terrific dedication and leadership of our board of directors.

So I'm honored to work with them and wanted to share those names with all of you.

Happy to take any questions.

Are there any questions for uh CEO President Angela White?

Thank you.

Uh did any of the board members have any unfinished business to come before the board?

Any new business hearing hearing none, I understand uh Michael that uh no one is signed up for public comment.

Our next meeting is Tuesday, March 17th.

Uh that's a uh I believe that's a holiday.

That's exactly right.

Uh and with that, uh, is there a motion to adjourn?

Or adjourn.