The meeting of the Board of Trustees (“Board”) of The Health and Hospital Corporation of Marion County, Indiana (“HHC”), was held on October 19, 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., Henry C. Bock, M.D., Lula M. Journey, Marjorie H. O’Laughlin, Robert B. Pfeifer. Members Absent: Betsy L. Brougher, Jean S. Blackwell.

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 September 21, 2004 Board meetings. Mrs. O’Laughlin stated that in the Public Health /Healthy Babies Committee section of the minutes, the word “Ordinance” was omitted from General Ordinance No. 4-2004. Ms. Journey made the motion to approve the minutes with this correction. Mr. Pfeifer seconded the motion. The minutes for the September 21, 2004 Board of Trustees meetings were unanimously approved as amended.

The next agenda item was Bylaws and Policies. Dr. Miner stated that the Hospital Committee discussed Wishard Health Services Policy No. 700-119, “Emergency Medical Treatment and Active Labor Act (EMTALA)” and recommended Board approval. There was no further discussion. Mrs. O’Laughlin made the motion to approve and Mrs. Journey seconded the motion. Policy No. 700-119 was unanimously approved.

Mr. Sellers presented the Treasurer’s Report. Mr. Sellers referred to Cash Disbursements for the month of September 2004. There were $42.2 million in cash disbursements, which is more than the average of $34.3 million for 2004. The difference is primarily due to three pay periods for Wishard Health Services employees, and a house staff payment for July through September and a settlement payment to draw down federal funds. Mrs. O’Laughlin moved to accept the Treasurer’s Report. Mr. Pfeifer seconded the motion. The report was unanimously approved.

Mr. Sellers then presented the September 2004 Revenue and Expenditure Budget Analysis. Revenues are slightly better than budget. Public Health Revenues, Headquarters Revenues and grant receipts are up. Expenditures are moving into line. Personal Services are better than budget by 2.7%. Supplies are on budget. Other Services and Charges are falling in line.

Capital Outlays are better than budget. Mr. Sellers also announced that there would be an Ordinance presented to the Board to modify the budget for year-end. The Ordinance will bring the budget expense characters in line with spending and also provided funding for come capital expenditures. He asked for approval of the report. Dr. Bock made the motion to approve and Mrs. Journey seconded the motion. The September 2004 Revenue and Expenditure Budget Analysis was unanimously approved.

Dr. Harris presented Medical Staff Appointments and Reappointments for September 2004 and requested approval. Dr. Bock made the motion to approve. Mrs. Journey seconded the motion. The appointments were unanimously approved.

The next agenda item was Bids. Dr. Miner stated that the Hospital Committee recommended that the Board accept and approve the Cabling for Telephone and Data for 1700 North Illinois Street Bid and the Disk Storage Expansion RFP Bid. Mrs. O’Laughlin made the motion to approve the Cabling for Telephone and Data for 1700 North Illinois Street Bid. Dr. Bock seconded the motion. The bid was unanimously approved. Dr. Bock made the motion to accept the Disk Storage Expansion RFP Bid. Mrs. O’Laughlin seconded the motion. The bid was unanimously approved.

Dr. Miner summarized the discussions of the Hospital Committee meeting held on October 19, 2004. The Committee approved the minutes of the September 21, 2004 meeting, discussed the Cambio Report, Wishard Health Services Financials, two Bids, and the EMTALA Policy No. 700-119.

The Planning Committee will meet today, October 19, 2004, immediately following the Board of Trustees meeting.

The Audit, Nominating Committees and Board of Finance did not meet this month.

Ms. O’Laughlin stated that the Public Health/Healthy Babies Committee met on October 19, 2004. The Committee was presented with information on the MCHD Injury Prevention Program by Serifatu Walton, the injury prevention coordinator, and the Chronic Disease Program by Sandy Cummings, program coordinator. Mrs. O’Laughlin distributed to the Board a safety seats brochure that is distributed to clients by the Injury Prevention Program. Chronic Disease focuses on six program areas: cancer control, cardiovascular disease control, diabetes control, tobacco control, and sickle cell and newborn screening. Mrs. O’Laughlin also distributed information from the Chronic Disease Program. Mrs. O’Laughlin stated that Dr. Caine gave the Committee an update on the influenza vaccine status.

Mrs. O’Laughlin also stated that Mrs. Journey was sworn-in for an additional term as member of the Board of Trustees.

Dr. Miner reported that the Quality Committee met and discussed performance improvement pertaining to cardiac diagnostics, staffing effectiveness, documentation completeness, emergency department diversion, patient complaints, infection control, Midtown core measures, Lockefield core measures, hospital core measure/heart failure, hospital core measure/pneumonia, chart teams, comprehensive performance improvement plan/patient safety plan and regulatory compliance.

Dr. Miner requested Representative Reports. Ibrahim AlGhani reported that the Citizen’s Health Center Action Plan has been submitted and will be reviewed.

In the absence of Mr. Gutwein, Patty Hebenstreit, chief of staff, reported that Dr. Virginia Caine was the recipient of the Grassroots Award at the George Rawls Scholarship Public Health Awards Dinner. She also reported that Gregory Porter represented the Health and Hospital Corporation at the annual Learning Well luncheon. Learning Well is a program that supports school- based health services. The Health and Hospital Corporation and the Board of Trustees were recipients of an award from Learning Well in appreciation of the support that the Corporation gives to the program. She concluded by announcing that the Board of local government finance is reviewing the Health and Hospital Corporation’s budget.

Dr. Harris stated that Wishard Health Services has appointed Kennilou Walker as director of medical management and Jim Fuller, director of pharmacy. Dr. Harris discussed changes in the medicine services at Wishard Health Services. A hospitalist team model is being implemented for medical services. A decision has been made to add an additional hospitalist faculty member to the team. This continues to insure around the clock in-patient medical team service at the hospital. She also stated that Wishard Health Services is adhering to the Center for Disease Control guidelines for administering influenza vaccine.

Dr. Caine reported that the Marion County Health Department (MCHD) has acquired 6000 vials of influenza vaccine and 3,000 additional vials have been ordered. MCHD will have 1500 doses of the influenza mist. A task force has been formed to include doctors, urgent care facilities representatives, visiting nurses, and hospital representatives to review the influenza situation and to educate the public and the school systems on influenza. The United States Surgeon General visited the Westside Community Health Center (WCHC) to discuss the Indiana Information Health Exchange.

Patty Hebenstreit reported that Health and Hospital Corporation representatives are meeting to respond to an Indianapolis Business Journal article comparing emergency medical services data in the city. Some of the Wishard Health Services numbers that were reported by the IBJ were not accurate.

The meeting concluded with Dr. James D. Miner presenting Dr. Virginia Caine with a twenty-year service pin.

There was no further business to discuss. Mrs. Journey made the motion to adjourn. Mr. Pfeifer seconded the motion. Meeting adjourned.

The next meeting of the Board of Trustees will be held on Tuesday, November 16, 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