North Texas Healthcare Coalition (NTHCC) General Membership Meeting Meeting Agenda

Time: 1430 - 1600 Date: December 7, 2017

United Regional Healthcare System – Hardeman Room 1600 11th Street Wichita Falls, TX 76301

Type of Meeting: North Texas Healthcare Coalition General Membership Meeting

Meeting Facilitator: Jeff Miller, Chair

Guest Speaker: Lee Bourgoin, Emergency Management Coordinator, Deputy Sherriff, Wichita County.

Call to order

I. Old Business

a) Coalition Budget

b) Mission & Vision Statement

II. New Business

a) Power Point Presentation: MMUs Regional Shared Assets & Equipment (Future Needs)-Lee Bourgoin

b) Governance & Funding Policy

c) CMS Update-Open Discussion

d) Redundant Communications Drill-December 11th. Primary (Cell)-Redundant (EMresource).

e) Coalition Assessment Tool

III. General Comment

IV. Adjourn

North Texas Healthcare Coalition Meeting Minutes (TSA-C) December 7, 2017 – 2:30 P.M. United Regional Health Care System-Hardeman Room

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Agenda Items Welcome and Introductions

Discussion: Mr. Miller called the meeting to order at 2:30 P.M. Mr. Comer provided an overview of the budget and noted the updated mission and vision statement. Motion to approve the mission and vision statement Kelly Second by Bruce Mr. Comer provided an overview of the new business.

HCC Equipment Discussion: (2:58- Started Recording) Mr. Lee Bourgoin, provided an overview of the mobile medical trailers, contents and the history of the project. Took out all the expired supplies. Cited which mobile medical trailers belongs to the city of WF by title. Equipment:

1) Mobile Morgue Trailer – received AC unit, deployed to Houston, did not get used. Needs to have tires update. 2) 45k generator 3) 125 K generation- purchased to support MMU 4) 75k generator 5) 4 MMU support trailers- They have been sitting. The training unit has a bunch of holes. The 4th unit has not

been blown up . Hard to move because of the need to hire movers. Paid for training to be set up and test the MMU. MMU and C2L (warehouse and storage area).

6) MCR like a AMBUS- Minus the $18k worth of emergency preparedness supplies (hpp funded supplies) and the bus is $4k in value

Shared by: County Sheriff, SWAT, City of Wichita Falls Mr. Henderson invited HCC members to come and see the equipment. Mr. Lee Bourgoin submitted quote for quote for tires for the mobile morgue unit and a quote for multiple items for a F5500 that was not purchased with HPP funds. Merits of both quotes were discussed at length. It was recommended by Mr. Comer that in accordance with bylaws the Executive Board make the decision on whether or not these items be funded.

Governance & Funding Policy

Discussion: Mr. Comer updated that the Executive Board members had been selected and introduced them to the group. Motion to Mr. Scott Norred, Mr. Bruce Sutten second the motion to approve the SOP. Mr. Comer reviewed the Funding policy. Mr. Comer updated that there may be a TTX in January. Mr. Bruce Sutten- Motion to accept Mr. Ryan Mathews to sit on the Executive Board and represent Archer County. Seconded by Mr. Kenney Hoffman

CMS Update-Open Discussion

Discussion: Mr. Comer asked if anyone was having difficulties meeting the CMS guidelines. Question was met with a positive response by membership as a whole.

North Texas Healthcare Coalition Meeting Minutes (TSA-C) December 7, 2017 – 2:30 P.M. United Regional Health Care System-Hardeman Room

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Redundant Communications Drill-December 11th. Primary (Cell)-Redundant (EMResource).

Discussion: Mr. Comer also noted that the Redundant communications drill will be held on the 11th of December.

General Public Comment Discussion: NA

Adjournment Discussion: Mr. Jeff Miller adjourned the meeting at 4:00 P.M.

Recommendation: NA

North Texas Healthcare Coalition (NTHCC) General Membership Meeting Meeting Agenda

Time: 1430 - 1600 Date: December 7, 2017

United Regional Healthcare System – Hardeman Room 1600 11th Street Wichita Falls, TX 76301

Type of Meeting: North Texas Healthcare Coalition General Membership Meeting

Meeting Facilitator: Jeff Miller, Chair

Guest Speaker: Lee Bourgoin, Emergency Management Coordinator, Deputy Sherriff, Wichita County.

Call to order

I. Old Business

a) Coalition Budget

b) Mission & Vision Statement

II. New Business

a) Power Point Presentation: MMUs Regional Shared Assets & Equipment (FutureNeeds)-Lee Bourgoin

b) Governance & Funding Policy

c) CMS Update-Open Discussion

d) Redundant Communications Drill-December 11th. Primary (Cell)-Redundant(EMresource).

e) Coalition Assessment Tool

III. General Comment

IV. Adjourn

Revenue TX DSHS (Grant Allocation to TSA-C) $164,669

Fixed Expense Personnel June Actual Variance

Salaries $50,313 0 0 0 Fringe Benefits $15,094

Total Personnel $65,407 Travel

HPP Contractors Meeting $579 Preparedness Coalition Symposium $979

Total Travel $1,558 Supplies

DIS Supplies $5,051 Office Furniture $1,500 Total Supplies $6,551

Other Office Lease $2,728

Office Phone/Internet $650 Payroll Service Fees $1,140 Insurance Premiums $891

Cell Phone Service Fees $1,680 Cisco WEBEX Service $1,647

Total Other $8,736 Indirect

Salaries-Admin $22,813 Fringe -Admin $6,844

Postage/Printer/Copier $356 Payroll & Benefits Admin $335

Bank Service Charges $190 Office Lease Indirect $729

Office Supplies $785 Office Telephones/Internet $882

Total Indirect $32,934 Total Fixed Expense $115,186

Variable Expense Regional Travel $7,000 Office Supplies $1,000

Training/Exercise/Equipment/Supplies $38,753 Conference Registration Fees $230

Mobile Medical Asset Maintenance $2,500 Total Variable Expenses $49,483

Total Expenses $164,669

The Mission of North Texas Healthcare Coalition: To support the development of cooperative partnerships in order to strengthen, promote and enhance the well-being of the community’s healthcare system through coordinated disaster preparedness training, education, public information, response/recovery activities, and sharing of resources.

The Vision Statement of Trauma Service Area-C (TSA-C) Healthcare Coalition: Envision a sustainable Healthcare Coalition supported through a collaborative network of healthcare organizations and respective public and private sector response partners. Together we serve as a multi-jurisdiction and multi-discipline coordination group that assist Emergency Management, through Emergency Support Function (ESF) 8, with preparedness, response, and recovery objectives and activities related to health and medical disaster operations. The Healthcare Coalition objectives are aimed at:

• Building a better community-based disaster healthcare system;• Strengthening the local healthcare system by fully integrating disaster preparedness into

the daily delivery of care;• Capitalizing on the links between private healthcare providers and public agencies and

groups; and,• Using an evidence informed approach to improving health and medical preparedness

and response.

.

NTHCC Executive Board Jacky Betts Al Gonzales Chris Washington Lance Liggett Lee Bourgoin Rebecca Harmel David Lee Kenny Hoffman Tim Bergman Kelley Hudson M.W. Stripling Mike Beimer Scott Norred Justin Tomlin Erick Addy

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I. The Geographic area of North Texas Healthcare Coalition (NTHCC)Trauma Service Area-C (TSA-C) served by NTHCC comprises 10 counties including:Archer, Baylor, Clay, Foard, Hardeman, Jack, Montague, Wichita, Wilbarger, and Young.

II. The Mission of North Texas Healthcare CoalitionTo support the development of cooperative partnerships in order to strengthen, promoteand enhance the well-being of the community’s healthcare system through coordinateddisaster preparedness training, education, public information, sharing of regionalresources and response/recovery activities.

III. The Vision Statement of North Texas Healthcare CoalitionA sustainable Healthcare Coalition supported through a collaborative network ofhealthcare organizations and respective public and private sector response partners.Together we serve as a multi-jurisdiction and multi-discipline coordination group thatassist Emergency Management, through Emergency Support Function (ESF) 8, withpreparedness, response, and recovery objectives and activities related to health andmedical disaster operations. The Healthcare Coalition objectives are aimed at:• Building a better community-based disaster healthcare system;• Strengthening the local healthcare system by fully integrating disaster preparedness

into the daily delivery of care;• Capitalizing on the links between private healthcare providers and public agencies

and groups; and,• Using an evidence informed approach to improving health and medical preparedness

and response.

IV. General MembershipAny entity or individual that agrees to work collaboratively for healthcare preparednessand emergency response activities may request general membership in the NTHCC.Organizations may request membership by submitting a request for membership viaemail, formal letter or by attending meetings. Requests for general membership areapproved by general consensus of the Executive Board.

i. Conditions of General Membershipa. Support the Vision and Mission of NTHCCb. Demonstrate willingness to assist and support other coalition members

during response or recovery activities.c. Actively participate NTHCC sponsored drills and exercises.d. Appoint a representative to attend and participate in meetings.

ii. General Membership CompositionIn addition to Local Public Health Departments, Hospitals, EmergencyManagement (EM) and Emergency Medical Services (EMS), many communitypartners are invited to collaborate in the Coalition; including, but not limited to,long term care (LTC) leadership, mental/behavioral health, rehabilitation centers,volunteer organizations, law enforcement, transportation, senior citizen and elderinterest groups, public schools, religious organizations, other existing strategichealth planning initiatives and other partners from every county participating inthe Coalition. Any organization that has a healthcare connection during a public

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health emergency in the geographic region of the Coalition is a potential member.

V. North Texas Healthcare Coalition Executive Board Responsibilities

North Texas Healthcare Coalition is responsible for jointly identifying and recommending plans and solutions that support improvements in Trauma Service Area-C emergency/disaster preparedness and response between medical emergency preparedness stakeholders. Additionally, North Texas Healthcare Coalition, will augment local operational readiness to meet the health and medical challenges posed by a catastrophic incidents or events within its ten county region.

VI. North Texas Healthcare Coalition Executive Board Purpose

A. Lead collaborative regional planning, formulate strategies, and make recommendations to the Coalition Membership and Partner’s to ensure that the best possible approaches to regional Healthcare Coalition planning can be achieved in TSA-C.

B. Identify and assess regional needs in order to develop possible options for strengthening the overall resiliency of regional response capabilities based upon federal and state guidance and best practices (these include the Hospital Preparedness Program, Centers for Medicare & Medicaid Services, Federal Emergency Management Agency, etc.)

C. Serve to identify the regional priorities set forth by current federal and state guidelines by utilizing input from Subject Matter Experts to set strategic planning goals and objectives.

D. Coordinate and maintain current hospital preparedness levels while enhancing disaster preparedness and resiliency in other portions of the healthcare system. Thus improving medical surge capacity and capability, further enhancing the community’s health system preparedness for disasters and public health emergencies.

VII. North Texas Healthcare Coalition Executive Board Responsibility

A. Keep informed of healthcare system objectives, activities, and funding opportunities. B. Participate in establishing priorities for the coalition. C. Educate and inform member organizations on Coalition activities. D. Participate in Coalition-Sponsored training, exercise, and drills. E. Approve funding proposals that are placed on the meeting agenda for approval.

VIII. Chair Responsibilities

The Chair serves as the principal liaison between the Coalition and the North Texas Regional Advisory Committee (NTRAC) Board of Directors with responsibilities that include, but are not limited to: A. One vote on the Board of Directors representing the collective vote of NTHCC. B. Knowledge of the NTRAC Bylaws. C. Knowledge of NTRAC programmatic obligations. D. Scheduling meetings. E. Meeting agendas and minutes. F. Coalition reports to the Board of Directors at least quarterly. G. Standard Operating Procedures. H. Serves as primary point of contact to the ESF-8 lead agency and EOC’s during an

emergency.

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I. The Coalition Chair must be a representative and a voting NTRAC member in good standing as defined in the NTRAC Bylaws.

J. The term of the Chair is two years. K. The Chair may not simultaneously hold another elected position within NTRAC. L. The Chair only votes at the NTHCC Committee meeting in the event of a tie. M. The Chair has the authority to call or postpone NTHCC meetings. N. Upon election or ascension to the NTHCC Chair position, the incumbent must vacate

their responsibility on the Executive Board.

IX. Chair Elect Responsibilities A. The Chair Elect assists the Chair with coalition functions and assumes the Chair

responsibilities for NTHCC activity and meeting management in the temporary absence of the Chair.

B. The Chair Elect must be an employee of one of the core disciplines identified in this SOP and in good standing as defined in the NTRAC Bylaws

C. The Chair Elect automatically ascends to the Chair position at the end of the current Chair’s term.

D. The NTHCC Chair Elect position will be voted on by the NTHCC membership every two years or when this position has been vacated by incumbent.

X. Secretary The Secretary is an elected member of the Executive Board and is appointed by the Coalition membership. The Secretary develops agendas, records votes, takes minutes during meetings and distributes them to members of the coalition within seven business days of the meetings; maintains documentation of all meetings and actions.

XI. Meetings, Agenda, and Minutes

A. The Healthcare Coalition and the Executive Board will meet at least every other month. B. All related meetings will be held as open meetings. C. The Coalition and Executive Board will follow a NTRAC approved format for the

meeting agenda and minutes. D. The Coalition and Executive Board will normally be provided with staff support to draft

minutes and capture attendance information following each meeting as a record of committee activities.

E. See NTRAC Bylaws for further details on standing committees Executive Board membership.

XII. Product Responsibilities (SOPs, SOGs, Protocols, Guidelines, and Plans)

A. Multi-Year Strategic Plan B. Multi-Year Training & Exercise Plan C. Develop and maintain a regional assessment of health and medical risks associated

with threats and hazards. D. Develop regional available resource report. E. Develop a gap analysis of health and medical disaster preparedness, response, or

recovery capabilities. F. Disaster planning exercise and after action reports. G. Regional Hazard Vulnerability Analysis H. Any Ad Hoc requirements set forth from the HPP

XIII. NTHCC Executive Board

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The NTHCC Board of Directors will serve as voting members of the NTHCC and are responsible for the everyday governance of the NTHCC, for representing the geographic and discipline diversity of the NTHCC members and communities, and for accepting the authority for the NTHCC. The NTHCC Board of Directors are also responsible for implementation and oversight of all NTHCC functions, including setting strategic direction, establishing plans for funding strategies, reviewing and approving the NTHCC budget, and developing, approving and implementing NTHCC policies and procedures. The membership of the Executive Board is defined in the bylaws and includes equitable representation from each of the ten member counties and will at a minimum include the four core disciplines outlined in the Health Care Preparedness and Response Capabilities: Emergency medical services, public health, emergency management, hospitals, and other key partnering agencies. In accordance with the NTRAC Bylaws, voting authority afforded to Executive Board members include those identified in this SOP except where noted. The Executive Board shall consist of the following: 1. NTHCC Chair 2. NTHCC Chair - Elect (TBA) 3. Secretary - (TBA) The NTHCC Executive Board will be comprised of one representative from each, and will provide a primary and alternate representative from the following: 4. Member Counties (10)

1) Archer (Vacant)

2) Baylor (Seymour Hospital)

3) Clay (Vacant)

4) Foard (Vacant)

5) Hardeman (Hardeman County Memorial Hospital)

6) Jack (Faith Community Hospital)

7) Montague (Vacant)

8) Wichita (Fresenius Kidney Care)

9) Wilbarger (Wilbarger General)

10) Young (Graham General Hospital)

5. Public Hospital (1) (Electra Hospital District)

6. Hospital Systems (1) (United Regional Healthcare System)

7. EMS (1) 1) Urban

(AMR) 8. Public Health (2)

1) Local Public Health (1) (Wichita Falls, Wichita County Public Health

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2) Texas DSHS Health Service Region 2/3 (Member Only-No Voting Authority) (1)

9. Emergency Management (2) 1) Wichita County, OEM 2) DDS

10. Councils of Government (1) (North Texas Regional Planning Commission)

11. Behavioral Health (1) (Red River Hospital)

12. Attendance: All Executive Board members are expected to participate in all NTHCC Executive Board meetings and NTHCC general membership meetings through attendance by their primary or alternate appointee.

13. Voting: The Chair shall manage voting issues in accordance with existing NTRAC bylaws and procedures. Each Executive Board member is entitled to one vote. Either the NTHCC Executive Board member or designated alternate shall exercise the right to vote on NTHCC matters as necessary. A simple majority vote of voting members who are present at the call for a vote (in person or online) is required to take action. Issues other than funding and changes to governance documents may be approved by consensus of the Executive Board. Approval of funding for projects and activities requires a two-thirds (2/3) vote of the Executive Board membership. Approval of changes to charter or any other organizational document requires a two-thirds (2/3) vote of the Executive Board membership. The Executive Board is encouraged to ask for input from the general membership on any issue. This option is intended to allow non-voting members to express their support or resistance to any initiative under consideration. Items that must be decided by a vote of the General Membership are:

• Bylaws • Election of Officers • Membership participating requirements.

All votes (formal or consensus reached) will be recorded in the meeting minutes. Minutes and voting activity will normally be documented by supporting staff.

14. How constituted: The NTHCC Chair shall preside over NTHCC. The membership

will elect a Chair Elect in accordance with NTRAC bylaws. The NTHCC membership will also vote to identify a Secretary as defined in the bylaws above. The NTHCC Chair, Chair Elect, and Secretary must be a representative of NTRAC and in good standing.

15. Term: NTHCC Executive Board members will be considered for continuation or rotation annually, normally in conjunction with the NTRAC fiscal year calendar. Changes to committee functional representation can be recommended by a two-thirds majority vote of the NTHCC Executive Board members, modification of this SOP, and subsequent approval by the North Texas Regional Advisory Council Board of Directors.

16. Resignation: Any representative may voluntarily withdraw from participation, with written notice to the NTHCC Chair.

17. Expulsion: Any representative can be expelled upon a two-thirds majority vote of the NTHCC Executive Board members and subsequent approval by the North Texas Regional Advisory Council Board of Directors. Any representative identified for potential expulsion has the right to present themselves to the NTRAC Executive Board members and/or the Board of Directors in consideration of such action.

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18. Meetings: Meetings shall be managed in accordance with NTRAC Bylaws. Healthcare Coalition and Executive Board meetings will be held at least 6 times per calendar year.

19. Subcommittees, Working Groups and Standing Reports: Subcommittees must be approved in conjunction with a change to the NTRAC Bylaws. Working Groups and/or and Standing Reports to NTHCC may be established at the discretion of the NTHCC Chair and will operate in due consideration of NTRAC Bylaws and this SOP.

20. Funds: The right to execute legal contracts or obligations is reserved for NTRAC staff under the direction from the North Texas Healthcare Coalition Committee and NTRAC Board of Directors.

21. Amendments: This SOP may be altered, amended or repealed in accordance with NTRAC policy and with approval of the North Texas Regional Advisory Council Board of Directors.

XIV. Funding Policy The Hospital Preparedness Program (HPP) funding purpose it to support the strengthening and preparedness capabilities of the health system. Through the collaborative development of North Texas Healthcare Coalition and its efforts to prepare and respond as an entire regional health system, rather than an individual organization, funding shall be used to advance regional, health care coalition and health care system wide priorities and will be in line with the Office of the Assistant Secretary for Preparedness and Response four health care preparedness and response capabilities. All request for funded projects/purchases will adhere to the following process; this process will ensure that the coalition activities contribute to the overarching readiness, preparedness, and resilience of the health care system.

• Funding request will be presented to the Chair who will then present the request to the Executive Board which requires a two-thirds (2/3) vote for approval on all funding request;

• If the funding request is denied it is sent back to the organization as “denied” and no other action will be taken;

• If the request for funding is approved by the Executive Board the funding request will then be turned back to the chair;

• The Chair will then submit approved funding request to the HPP Contractor North Central Texas Trauma Regional Advisory Council (NCTTRAC) via the procurement process.

XV. Procurement A. As the HPP grantee and contractor for Trauma Service Area-C (TSA-C) North

Central Texas Trauma Regional Advisory Council (NCTTRAC) has the responsibility to provide administrative support and oversight of HPP funded supplies, expendable property, equipment, and services in TSA-C.

B. NCTTRAC procurement procedures will be conducted in accordance with NCTTRAC Financial Policies and Procedures Manual.

C. NCTTRAC will address Historically Underutilized Business (HUB) requirements in accordance with all individual contract specifications.

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Table 1. Quote Requirements

DOLLAR THRESHOLD BID Up to $2,500.00 No bids required from eligible HUB vendors

$2,500.01 - $100,000.00

At least one bid from eligible vendors on the Centralized Masters Bidders List (CMBL) with 1 being a CPA/TPASS- certified HUB

$100,000.01 and up

At least two bids from eligible vendors on the Centralized Masters Bidders List (CMBL) with 2 being CPA/TPASS- certified HUBS

D. Procurement Flow / Process

1. Procurement request is submitted and routed through the approved process by the Healthcare Coalition (HCC).

2. HCC Chair signs the Asset Request Tracking Form signifying the request has been approved by HCC.

3. The HCC Chair or designee will submit the Asset Request Tracking Form to NCTTRAC via email.

4. NCTTRAC will approve or deny the request: a) Approval: Collaborate with NCTTRAC logistics office ensuring that

the purchase order is complete and routed to the proper vendor. b) Denial: If request is denied, it will be returned with reason for

denial and will be open for re-submission