2. ESTABLISHMENT OF QUORUM

3. PUBLIC COMMENT - Persons wishing to comment must sign-in on the "Agenda Item Request to Speak" form provided at the entrance of the Board meeting room at least five (5) minutes prior to commencement of the Board meeting.  Commenters shall limit their comments to three (3) minutes and comments must be appropriate to the agenda item(s).  See the "Public Comment" section of the preceding General Information page for additional Public Comment-related requirements and information.

4. REAPPOINTMENTS/APPOINTMENTS TO BOARD OF MANAGERS

4.A. Introduce, recognize, and/or welcome Commissioners Court's reappointments and/or new appointments to Board of Managers; Court's reappointments and/or appointments pursuant to Texas Health and Safety Code, Sections 281.021 and 281.022:

4.A.1. Reappointments for three-year terms expiring September 30, 2017:

4.A.1.a. Van Huseman; and

4.A.1.b. Irma Caballero.

5. CONSENT AGENDA:

5.A. Board of Managers:

5.A.1. Approve minutes of Board of Managers meetings:

5.A.1.a. Regular Meeting of June 17, 2014; and

5.A.1.b. Special Meetings of:

5.A.1.b.1. July 22, 2014;

5.A.1.b.2. August 19, 2014;

5.A.1.b.3. August 26, 2014;

5.A.1.b.4. September 4, 2014;

5.A.1.b.5. September 10, 2014; and

5.A.1.b.6. September 16, 2014.

5.A.2. Receive listing of new vendors as of November 14, 2014; vendor listing provided pursuant to provisions of Board of Managers Bylaws, §2.1.B and Texas Local Government Code, Chapter 176.

5.B. Finance Committee:

5.B.1. Receive unaudited financial statements for the months and fiscal year-to-date periods ended May 31, 2014 - September 30, 2014.

5.B.2. Receive revenue report relating to CHRISTUS Spohn Health System Corporation Membership Agreement; receive Membership Revenue Report for fiscal year ended September 30, 2014 and current fiscal year-to-date.

5.B.3. Receive summary payment information for the fiscal year-to-date period ended September 30, 2014:

5.B.3.a. Medical services at Nueces County juvenile detention facility;

5.B.3.b. Emergency medical services in unincorporated areas of Nueces County;

5.B.3.c. Supplemental funding for Nueces County Mental Health and Mental Retardation Center (now known as Behavioral Health Center of Nueces County); and

5.B.3.d. Salaries, benefits, and supplies at Corpus Christi/Nueces County Public Health Department.

5.B.4. Receive summary report of intergovernmental transfers relating to the Texas Health and Human Service's Transformation and Quality Improvement 1115 Waiver Programs for fiscal year-to-date.

5.B.5. Receive investment reports and ratify related investment transactions:

5.B.5.a. Quarterly Investment Reports for fiscal quarters ended June 30, 2014 and September 30, 2014;

5.B.5.b. Annual Investment Report for fiscal year ended September 30, 2014; and

5.B.5.c. Interim Investment Transactions Report for period of October 1, 2014 - November 14, 2014.

5.B.6. Receive summary information relating to medical and hospital care provided to the Nueces Aid population consistent with the Indigent Care Agreement and the CHRISTUS Spohn Health System Corporation Membership Agreement:

5.B.6.a. Imputed Claims Experience for calendar year-to-date ended September 30, 2014.

5.C. Planning Committee:

5.C.1. Amend certain subsections of Nueces Aid Program Eligibility Guidelines Policy No. NA002, Attachment 4, Section F relating to Program Household Income Guidelines and Calculation of Income, amendments to be effective January 1, 2015; amendments to account for certain personal responsibilities under the Patient Protection and Affordable Care Act, Pub. L. 111-148 (PPACA):

5.C.1.a. Subsection 3 of Program's Eligibility Income Guidelines for Financial Assistance (Gross Household Income
Table) to add income interval of 139% to 150% of Federal Poverty Guidelines; and

5.C.1.b.  Subsection 4 relating to Eligibility Income Guidelines for Financial Assistance and PPACA hardship exemption (exemption from personal responsibility requirements) for Program applicant income levels between 139% and 150% of Federal Poverty Guidelines; hardship exemption described in PPACA, Section 1311(d)(4)(H); and accept admissible demonstration of hardship exemption from the following sources:

5.C.1.b.1. Health Insurance Marketplace Exchange website (http://www.healthcare.gov) administered by the U.S. Centers for Medicare & Medicaid Services; 

5.C.1.b.2. Subsidy Calculator for Premium Assistance for Coverage in Exchanges website (http://kff.org/interactive/subsidy-calculator/) administered by the Henry J. Kaiser Family Foundation; or

5.C.1.b.3. Other publicly-available website(s) as may be designated by the Administrator from time-to-time. (ACTION)

5.C.2. Receive hospital providers' reports relating to Indigent Care Affiliation Agreements associated with the Hospital District's participation in the Texas Healthcare Transformation and Quality Improvement Program Medicaid 1115 Waiver; receive providers' reports for calendar quarters ended June 30, 2014 and September 30, 2014:

5.C.2.a. CHRISTUS Spohn Hospitals (Joint Report): Alice, Beeville, and Kleberg;

5.C.2.b. Corpus Christi Medical Center;

5.C.2.c. DeTar Healthcare System; and

5.C.2.d. Driscoll Children's Hospital.

6. REGULAR AGENDA:

6.A. Planning Committee:

6.A.1. Receive October 16, 2014 petition requesting an election on ordered closure of Hospital District-owned hospital presently known as Christus Spohn Hospital Corpus Christi-Memorial (formerly known as Memorial Medical Center) located at 2606 Hospital Boulevard, Corpus Christi, Texas; and accept Board of Managers Secretary's certification that the petition did not meet the statutory requirement of at least 10 percent of the qualified voters of the hospital district as prescribed by Texas Health and Safety Code, §285.052(a).  (ACTION)

6.A.2. Appoint one Director to Board of City of Corpus Christi's Reinvestment Zone Number Two for two-year term to expire November 1, 2016; appointment pursuant to Texas Tax Code, §311.009(a). (ACTION)

6.A.3. Receive information relating to the interaction between the Patient Protection and Affordable Care Act, Pub. L. 111-148 and the Nueces Aid Program (indigent healthcare program):

6.A.3.a. Frequently asked questions and related answers. (INFORMATION)

6.B. Finance Committee:

6.B.1. Receive additional information and update on Centers for Medicare & Medicaid Services' (CMS) deferral of certain Texas Healthcare Transformation and Quality Improvement Program Medicaid 1115 Waiver-related payments for hospital uncompensated care expenditures. (INFORMATION)

6.B.1.a. CMS' Notice Letter of September 30, 2014 to State Medicaid Director; and

6.B.1.b. State Medicaid Director's Response Letter of October 31, 2014 to CMS.

6.C. Indigent Care Provider's Briefing:

6.C.1. Receive and discuss information from CHRISTUS Spohn Health System Corporation (Provider) relating to:

6.C.1.a. Medical aid and hospital care provided to the Nueces Aid population consistent with the Indigent Care Agreement and the CHRISTUS Spohn Health System Corporation Membership Agreement and related matters; and

6.C.1.b. Programs, projects, and/or activities at CHRISTUS Spohn Hospital Corpus Christi - Memorial and other Hospital District-owned facilities and related matters.  (INFORMATION)

6.D. Administrator's Briefing:

6.D.1. Calendar Year 2015 Meeting Schedule

6.D.2. Next Scheduled Board and Committee Meetings:

6.D.2.a. January 27, 2015 Meetings; times to be determined:

6.D.2.a.1. Quality Management Committee;

6.D.2.a.2. Planning Committee;

6.D.2.a.3. Finance Committee; and

6.D.2.a.4. Board of Managers.  (INFORMATION)

7. ADJOURN (in memory of Dan Winship)