The meeting of the Board of Trustees (“Board”) of The Health and Hospital Corporation of Marion County, Indiana (“HHC”), was held on August 24, 2004, at 1:30 p.m., in the Fourth Floor Administrative Conference Room “A” of the Ott Building, Wishard Health Services, 1001 West Tenth Street, Indianapolis, Indiana. Members Present: James D. Miner, M.D., Betsy L. Brougher, Jean S. Blackwell, Lula M. Journey, Marjorie H. O’Laughlin, Henry C. Bock, M.D., and Robert B. Pfeifer.

The Chairman of the Board, Dr. James D. Miner, called the meeting to order and proceeded with roll call.

Dr. Miner asked if there were any additions, corrections or deletions to the minutes for the July 27, and August 10, 2004 Board meetings. There were none. Ms. Journey made the motion to approve the minutes. Mr. Pfeifer seconded the motion. The minutes for the July 27, 2004 and August 10, 2004 Board of Trustees meetings were unanimously approved.

Dr. Miner introduced A. Scott Chinn, Corporation’s Counsel for the City of Indianapolis, who addressed the Board on a proposal entitled, “Indianapolis Works.” Also attending from the Corporation Counsel’s office was Suzanna Overholt-Wilson, Deputy Corporation Counsel. Mr. Chinn explained the Indianapolis Works’ proposal to simplify and streamline local government and tax structures in Indianapolis and handed out a detailed overview of that proposal. After the overview was provided, Dr. Miner thanked Mr. Chinn and Ms. Overholt-Wilson for taking the time to attend and present the City’s plan to the Board.

Dr. Miner then asked that Ms. Hebenstreit, Chief of Staff, present the second reading of General Ordinances No. 3 through 5-2004 and No. 6-2004(A). Ms. Hebenstreit presented for approval No. 3-2004, “Ordinance Violations Bureau;” No. 4-2004, “Administrative Searches and Notices;” No. 5-2004, “Water Study;” and No. 6-2004(A), “An Ordinance Establishing the Annual Budget of the Health and Hospital Corporation for the Year Beginning 2005.” Mrs. Journey expressed her concern regarding General Ordinance No. 4-2004, and the language and intent of Section 21-201(c) of that ordinance. After input by Mr. David Hurley and Dr. Virginia Caine regarding the proposed change in that Ordinance, and after discussion among the Board members, Ms. Blackwell asked that General Ordinance No. 4-2004 be tabled for further review and consideration by the Marion County Health Department. Ms. Journey seconded the motion. Motion carried.

Ms. Blackwell moved to approve General Ordinance No. 3-2004, No. 5-2004 and No. 6-2004(A). Mrs. Brougher seconded the motion. All three Ordinances were unanimously approved.

Dr. Miner addressed Policies and By-Laws. Mr. Pfeifer stated there were none.

Mr. Sellers presented the Treasurer’s Report. Mr. Sellers referred to Cash Disbursements for the month of July. There was $36.7 million in cash disbursements, which is above the average of $34.2 million for 2004. A quarterly payment to PERF is the primary reason for the increased cash payments. The Budget Basis Revenue and Expenditures category has been updated to include the changes to the 2004 budget. Mrs. O’Laughlin moved to accept the Treasurer’s Report. Dr. Bock seconded the motion. The Report was unanimously approved.

Mr. Sellers then presented the 2004 Revenue and Expenditure Budget Analysis. The Revenues for Taxes and Others are annualized. The other revenues are very much on track and doing better than budget. Grants and Revenues are higher than budget. The expenditures for these will be offset. The Expenditures for Personal Services are better than budget by 3%. Supplies are slightly over budget but will fall back into line by the close of the year. Other Services and Charges are currently $10 million worse than budget, but there are $6 million in open P.O.s. Capital Outlays are performing better than budget and will come in very close to budget at the end of the year. Ms. Journey moved to approve the 2004 Revenue and Expenditure Budget Analysis. Mr. Pfiefer seconded the motion. The Analysis was unanimously approved.

Dr. Harris covered Medical Staff Appointments and Reappointments. Ms. Brougher had a question about the number of physician cessations from Moderate and Deep Sedation and that question being answered by Dr. Harris, Ms. Brougher moved to approve the Medical Staff Appointments and Reappointments for August 2004. Dr. Bock seconded the motion. The appointments were approved.

Mr. Matt Matusiak from the HHC Lab presented Bid #:LAB 804, “Hasbrook Building Lab Fume Hood Project,” for the Hasbrook Laboratory’s ventilation system. It was recently determined that the Lab’s second ventilation system had a leak. The bid submitted is for reparation and replacement of parts of the ventilation system. Dr. Caine and Mr. Matusiak explained the bid process behind this project and the fact that only one bid was received. There being no further questions in regard to this bid, Mr. Pfeifer moved to approve the bid. Dr. Bock seconded the motion. Motion unanimously approved.

Dr. Miner summarized the discussions for the Hospital Committee meeting held earlier today and included the Minutes of the July 27, 2004 committee minutes in the Board packet.

The Nominating Committee did not meet. The Planning Committee is scheduled to meet following the Board meeting.

Ms. O’Laughlin stated that the Public Health/Healthy Babies Committee did not meet today at the recommendation of Dr. Caine.

The Quality Committee met after the last Board meeting and discussed the Environment of Care Report for the first quarter of 2004. Patient satisfaction reports will again be reviewed. Regulatory compliance was discussed in regard to work underway for completing the action plans identified in the JCAHO periodic performance review. The next Quality Committee meeting will occur at the completion of the September Board meeting.

Dr. Miner inquired about a report from the Board of Finance. Mr. Pfeifer stated there was none.

Dr. Miner asked about Representatives Reports. Mr. AlGhani advised the Board that Citizens Health Center has completed a corrective action plan and will be submitting it to the Board soon. Mr. AlGhani also stated that during the presentation by Citizens at the previous Board meeting, one point was omitted. That omission is that the Citizens’ Grant has been renewed for a period of two years. This is the first time in approximately eight to nine years that the cycle has been extended for more than a one-year period of time. Citizens will not have a primary care effectiveness review this year, rather, it will take place next year. Mr. AlGhani congratulated Citizens’ management for this good news.

Mr. Gutwein commended Wishard Hospital for the great work it did in connection with the police officers who were shot, one fatally, during an incident that occurred last week. He referenced the Wishard care providers at the ED, the EMS personnel, and Wishard administration for their outstanding work. Mr. Gutwein stated he had received numerous comments commending Wishard. Wishard should be very proud of the work they do in this community.

Ms. Brougher stated there was no report on Midtown.

Mr. Gutwein addressed some of the improvements, which have occurred over the last twelve months at Health and Hospital Corporation. These improvements relate to Wishard, the Marion County Health Department and Headquarters. The Wishard Advantage Program continues to grow. Forty-seven thousand people are enrolled in the program, up from 12,000 in 1999. The Pecar Center continues to expand its services. The Wishard ED has reduced diversion by 50% this year. With the new MRI and CT equipment approved by the Board, Wishard will be able to improve the waiting period for patients from two months to two weeks. The Hispanic project at Wishard has expanded. They have 15 full-time employees, 9 of whom are totally funded by grants. Mosquito Control is doing an enormous job and has sprayed 17,857 times in our community. The WIC coupon program continues to expand. Recipients can go directly to a farmer’s market and use the WIC coupons. Year-to-date our Environmental Control team has hauled away 7 million pounds of trash and their goal for the year was only 8 million pounds, so they fully expect to exceed their goal. Safety inspectors will inspect over 20,000 restaurants this year. Water Safety people will inspect over 900 public pools this year. The HazMat team has just received an award from the Department of Homeland Security for their response to bioterrorism hazards. The Indy-in-Motion program continues to expand, and between three and four thousand people are involved in the largest free fitness program in the City. Congratulations to all who are helping to achieve these goals.

Dr. Harris informed the Board that Dr. Mike Olinger has been appointed as head of the Emergency Preparedness Task Force. The Task Force has, as its primary focus, the creation of a plan to meet Federal and State Department of Health requirements to increase patient-bed capacity in the event a disaster occurs. Dr. Harris spoke to the Board about the initiatives that are taking place. Mr. Paul Dexter will fill a newly-created administrative position, as Chief Medical Information Officer. Mr. Dexter will be identifying, prioritizing and resolving clinical issues. Another initiative they have been working on over the summer is one to help the school recruit a chair of orthopedics. The top candidate is an orthotraumatologist. There is a nation-wide shortage of orthotraumatologists and there are only a handful of qualified individuals. This gentleman will do his clinical work at Wishard, and Wishard’s Chief of Orthopedics will be getting a long-awaited colleague.

Dr. Caine stated she wanted to compliment Mr. Gutwein on the recent budget presentation to the City-County Council. The budget was well received and he did a great job, along with a lot of others, to make that presentation a good one. She stated that one of the MCHD initiatives is obesity. We have received a $170,000 grant from the Fairbanks Foundation. Under the direction of Dr. P. Joseph Gibson, MCHD will be developing baseline data of obesity in our community. Some funding is being subcontracted out to a research center to do an adult assessment. Ms. Joan Trendell, who has a nutritional background, will be a heavy contributor in this project. On September 15, through an invitation from the Mayor, MCHD will gain support from the Townships to assist in doing an assessment of every child in the school systems from kindergarten through twelfth grade. This assessment will require an accurate measurement of each child’s height and weight. They will also conduct a survey of the types of food children are eating and their physical activity behaviors. The timeframe for this study is possibly January through April of 2005. With this basic information, MCHD is hoping to develop new exciting interventions.

There being no further business to discuss, Ms. Journey moved to adjourn and Dr. Bock seconded the motion. Meeting adjourned.

The next meeting of the Board of Trustees will be held on Tuesday, September 21, 2004, at 1:30 p.m., in the Fourth Floor Administrative Conference Room “A”, Ott Building, Wishard Health Services, at 1001 West Tenth Street, Indianapolis, Indiana.

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James D. Miner, M.D.

Chairman, Board of Trustees

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Matthew R. Gutwein

President and Chief Executive Officer