Feb 25, 2025 Texas Pharmaceutical Initiative Committee

YOU. THIS TIME WE'LL CALL TO ORDER THE FEBRUARY 25TH, 2025 MEETING OF THE TEXAS

[1. Call to order, logistical announcements, and roll call]

[00:00:09]

FRANCESCA, IF YOU WOULD READ THE MEETING LOGISTICS AND THEN CALL THE ROLL, PLEASE.

THANK YOU, DOCTOR MCKINNEY. GOOD MORNING. MY NAME IS FRANCESCA COOPER WITH THE HHSC ADVISORY COMMITTEE COORDINATION OFFICE.

THIS MEETING IS BEING CONDUCTED IN COMPLIANCE WITH THE TEXAS OPEN MEETINGS ACT AND IS OPEN TO THE PUBLIC.

TODAY'S MEETING IS BEING WEBCAST LIVE AND IS BEING RECORDED AS A MATTER OF PUBLIC RECORD.

PLEASE DO NOT USE JARGON AND ACRONYMS. CONFIDENTIAL INFORMATION SHOULD NOT BE DISCUSSED IN ACCORDANCE WITH HHS POLICY.

THE USE OF ARTIFICIAL INTELLIGENCE, ALSO KNOWN AS AI NOTE TAKERS, IS EXPRESSLY PROHIBITED IN THIS MEETING, PRODUCERS WILL NOT ADMIT A BOT OR OTHER AUTONOMOUS AGENT INTO THE MEETING.

IF A BOT SHOULD INADVERTENTLY GAIN ENTRANCE, IT WILL BE REMOVED FROM THE MEETING BY ONE OF OUR PRODUCERS.

FOR THE SAKE OF THOSE VIEWING THE WEBCAST AND TO COMPLY WITH THE TEXAS OPEN MEETINGS ACT, WE ASK THAT EACH VIRTUAL ATTENDEE TURN ON THEIR VIDEO CAMERA AND STATE THEIR NAME EACH TIME PRIOR TO BEGINNING THEIR COMMENTS. WE ASK THAT YOU SPEAK DIRECTLY INTO THE MICROPHONE OF YOUR DEVICE, SO YOUR VOICE AND COMMENT CAN BE HEARD. ONCE YOU ARE FINISHED SPEAKING, WE ASK THAT YOU TURN YOUR CAMERA OFF AND MUTE YOUR MICROPHONE AND ONLY UNMUTE WHEN YOU NEED TO SPEAK. ALSO, WE RECOMMEND MEMBERS AND PRESENTERS USE HEADSETS IF POSSIBLE TO PREVENT FEEDBACK AND MINIMIZE OTHER NOISE.

WE ALSO ASK THAT MEMBERS, STAFF AND PRESENTERS PARTICIPATING VIRTUALLY TO PLEASE PUT YOUR CELL PHONE ON MUTE OR VIBRATE IF YOU NEED TO TAKE A CALL.

PLEASE TURN OFF THE VIDEO AND MICROPHONE OPTIONS FROM YOUR VIEWING DEVICE SO THE SOUND IS NOT CARRIED BACK INTO THE MEETING FOR MEMBERS, STAFF AND PRESENTERS PARTICIPATING IN PERSON, WE ASK THAT YOU SPEAK DIRECTLY INTO THE MICROPHONE SO YOUR VOICE AND COMMENT CAN BE HEARD.

THESE MICROPHONES ARE DIRECTIONAL SO THEY ONLY PICK UP SOUND DIRECTED INTO THE MIC.

YOU MAY PICK UP THE MIC BY THE BASE TO MANUALLY MOVE IT FOR YOUR COMFORT.

PLEASE PUT YOUR CELL PHONE ON MUTE OR VIBRATE IF YOU NEED TO TAKE A CALL.

PLEASE STEP OUT OF THE ROOM AND AWAY FROM THE DOORS SO THE SOUND DOES NOT CARRY BACK INTO THE MEETING.

FOR MEMBERS AND PRESENTERS WHO PLAN TO UTILIZE A POWERPOINT OR HANDOUT DURING THEIR PRESENTATION, ONE OF OUR PRODUCERS WILL PULL UP YOUR POWERPOINT OR HANDOUT AND WILL ADVANCE THE SLIDES AND PAGES BY YOU INDICATING NEXT SLIDE, NEXT PAGE. THERE'S TIME ON THE AGENDA FOR PUBLIC COMMENT.

MEMBERS OF THE PUBLIC WERE ABLE TO SUBMIT WRITTEN PUBLIC COMMENT PRIOR TO THE MEETING, AS NOTED ON THE POSTED AGENDA.

MEMBERS OF THE PUBLIC WHO ARE ATTENDING IN PERSON MAY ALSO REGISTER TO PROVIDE PUBLIC COMMENTS BY COMPLETING THE PUBLIC COMMENT FORM LOCATED AT THE REGISTRATION TABLE AT THE DOOR TO THE PUBLIC HEARING ROOM. FOR EVERYONE PARTICIPATING IN PERSON, RESTROOMS ARE LOCATED OUT THE DOORS AND DOWN THE HALL TO YOUR LEFT.

PLEASE NOTE THAT EMERGENCY EXITS ARE LOCATED AT THE BACK AND SIDE OF THE ROOM WHERE MOST OF YOU ENTERED.

IF THERE IS AN ALARM, WE WILL EVACUATE THE BUILDING AND RETURN ONLY AT THE DIRECTION OF SECURITY PERSONNEL.

IF YOU HAVE QUESTIONS OR COMMENTS REGARDING AGENDA TOPICS PRESENTED TODAY, PLEASE SEND AN EMAIL MESSAGE TO THE TEXT PHARMA INITIATIVE AT HHS DOT TEXAS GOVERNOR AT THE EMAIL ADDRESS PROVIDED IN THE CHAT SECTION AND AT THE BOTTOM OF THE POSTED PUBLIC AGENDA.

AT THIS TIME, I WOULD LIKE TO CALL ROLL MEMBERS.

WHEN I CALL YOUR NAME, PLEASE TURN ON YOUR CAMERA AND MIC AND RESPOND WITH HERE OR PRESENT AND PROVIDE A BRIEF ONE SENTENCE INTRODUCTION OF YOURSELF WHEN RESPONDING TO THE ROLL CALL. DOCTOR MIKE MCKINNEY HERE. THANK YOU. DOCTOR GODINA.

R.U.L.E. DOCTOR R.U.L.E. WILL BE JOINING US PERIODICALLY DURING THIS MEETING.

WHEN SHE DOES JOIN, SHE WILL BE MARKED AS PRESENT.

MR. TONY SHELL PRESENT. THANK YOU. I TURN THE MEETING BACK OVER TO YOU, DOCTOR MCKINNEY.

YOU DO HAVE QUORUM. THANK YOU. FRANCESCA. WELL, WELCOME TO THE FRAY.

WE APPRECIATE Y'ALL COMING AND WANT TO INTRODUCE PEOPLE TO YOU.

I'M MIKE MCKINNEY. OLD COUNTRY DOCTOR AND TONY SHELL.

I'M A PRIVATE INVESTMENT MANAGER BASED IN AUSTIN, TEXAS.

ACTUALLY, Y'ALL INTRODUCE YOURSELVES. MELISSA PATTERSON.

I'M DEPUTY EXECUTIVE DIRECTOR OF BUSINESS OPERATIONS.

I. SPEAK INTO THE MIC. WE ARE UNABLE TO HEAR YOU ON THE WEBCAST.

[00:05:05]

GOOD MORNING. I'M LAUREN BRAMBILA, DEPUTY EXECUTIVE DIRECTOR OF PROGRAM STRATEGY AND OPERATIONS FOR TPI.

GOOD MORNING, JAMES DAY, GENERAL COUNSEL FOR TPI.

GOOD MORNING. I'M KAREN WRONA, A PROGRAM SPECIALIST FOR TPI.

MIKE GEESLIN, EXECUTIVE DIRECTOR, TPI. KAYLA CATES BROWN, ADVISORY COMMITTEE COORDINATION OFFICE.

THANK YOU. THANK YOU ALL. WE WE'VE BEEN DOING A LOT OF WORK BETWEEN THE LAST THE LAST MEETING. AND WHEN I SAY WE.

THAT'S THE STAFF. I'VE. I'VE JUST BEEN LISTENING PRIMARILY.

THE FIRST ITEM THAT WE NEED TO TAKE UP IS A CONSIDERATION OF THE

[2. Consideration of December 4, 2024, draft meeting minutes]

IF YOU LOOK AT IT MINUTES. IS THERE ANY DISCUSSION ABOUT THAT? ANY CORRECTIONS, DELETIONS, ADDITIONS? IF NOT, I'LL ACCEPT A MOTION TO APPROVE THE MINUTES OF THE DECEMBER 4TH MEETING.

TONY SHELL, I'LL MAKE A MOTION TO APPROVE. AND I SECOND IT.

FRANCESCA, IF YOU WOULD CALL THE ROLL, PLEASE.

THANK YOU, DOCTOR MCKINNEY. MEMBERS. WHEN I CALL YOUR NAME, PLEASE TURN ON YOUR CAMERA AND RESPOND WITH.

YAY! NAY OR ABSTAIN. DOCTOR. MIKE MCKINNEY. YAY! THANK YOU, DOCTOR GOLDEN ROE. MR. TONY SHELL.

YAY! THANK YOU. MOTION CARRIES. I TURN THE MEETING BACK OVER TO YOU, DOCTOR MCKINNEY.

THANK YOU. FRANCESCA. THE NEXT ITEM IS A DISCUSSION ON THE IMPLEMENTATION OF THIS, OF THE INITIATIVE

[3. TPI Staff Updates and Recommendations on the Implementation of the TPI Business Plan]

AND AT THIS POINT IN TIME, RECOGNIZE MIKE GEESLIN, THE EXECUTIVE DIRECTOR, TO LEAD THIS DISCUSSION.

THANK YOU, MR. CHAIR. MIKE GEESLIN, EXECUTIVE DIRECTOR OF TEXAS PHARMACEUTICAL INITIATIVE.

MEMBERS I'LL PROVIDE SOME OVERARCHING COMMENTS TO FRAME AGENDA ITEM THREE AND THEN SOME MORE SPECIFIC COMMENTS THAT LEADS TO THE FIRST ITEM FOR DISCUSSION, AND THEN RECOGNIZE STAFF TO ALSO PRESENT. THIS IS THE SECOND BOARD MEETING.

POST BUSINESS PLAN COMPLETION AND DELIVERY OF THAT PLAN TO THE LEGISLATURE AND THE GOVERNOR AND THE LEGISLATIVE BUDGET BOARD, AS REQUIRED BY STATUTE. AND OUR STATUTORY MISSION IS COST EFFECTIVE ACCESS TO PHARMACEUTICALS AND OTHER MEDICAL SUPPLIES.

AND SO WHEN YOU THINK OF THE HUNDREDS OF BILLIONS OF DOLLARS THAT ARE SPENT ON PHARMACEUTICALS NATIONALLY, AND EVEN JUST LOOKING AT THE AT THE SUBSET OF, WE HAVE WHAT WE HAVE HERE IN TEXAS JUST BETWEEN MEDICAID AND AND THE AGENCIES THAT WE'RE WORKING WITH, WITH EMPLOYEE AND RETIREE BENEFITS, YOU KNOW, WE'RE A SUBSTANTIAL PORTION OF THAT NATIONAL SPIN.

WE STOP AND CONSIDER WHAT THAT IS. SO ALSO WE'RE SEEING SIGNIFICANT INCREASES IN PHARMACEUTICAL EXPENDITURES AND THE STATE AGENCIES THAT WE'RE WORKING WITH. YOU KNOW, AS WE'VE GONE THROUGH THE LEGISLATIVE APPROPRIATIONS REQUEST PROCESS AND HEARD WHAT SOME OF THE REQUESTS ARE AND WHAT'S DRIVING THOSE REQUESTS AND SOME OF THE PHARMACEUTICALS THAT ARE BEHIND THAT. IN TERMS OF UTILIZATION, IN TERMS OF COST, OUR MISSION HAS NEVER BEEN MORE RELEVANT THAN WHERE WE ARE TODAY. SO THE CONTEXT OF THIS MEETING IN THE AGENDA IS BUILT AROUND A FEW THINGS ONE, ACCELERATING TPI'S BUILD UP OF THE FUNCTIONALITY. AND THAT'S IMPLEMENTERS AND SUBJECT MATTER EXPERTS.

AND IT'S GETTING ALIGNED WITH AGENCIES AND SYSTEMS THAT WE WORK WITH AS MUCH AS POSSIBLE.

SO THAT WE CAN HAVE IMPLEMENTATION ON OUR ON THE PROGRAMS THAT ARE IN THE BUSINESS PLAN THAT THE BOARD ADOPTED.

NOW, WE'RE DOING ALL OF THIS AGAINST A BACKDROP OF RECRUITING KEY HIRES STARTING LATE FALL AND ONBOARDING THEM THROUGH THE EARLY PART OF DECEMBER AND THEN JANUARY, AT THE SAME TIME GETTING READY FOR A LEGISLATIVE SESSION AT THE SAME TIME, HAVING THE START OF THAT LEGISLATIVE SESSION.

SO, YOU KNOW, ALL OF THIS, WE'RE LITERALLY IT'S A GAME OF TETRIS WHERE WE'RE TRYING TO PIECE AND PUT THE THE WORK IN AS BEST WE CAN,

[00:10:06]

SO TO EXPLAIN HOW WE GOT TO WHERE WHAT YOU'RE GOING TO SEE TODAY WE WORK ON TWO WEEK CYCLES INTERNALLY.

AND SO WE HAVE WHAT WE CALL DUAL HORIZON MEETINGS WHERE WE LOOK TWO YEARS DOWN THE ROAD, USING THE BUSINESS PLAN AS THE COMPASS, AS THE MAP, AS THE NORTH STAR, IF YOU WILL. BUT THEN WE TAKE THAT TWO YEARS, TWO WEEKS AT A TIME.

AND SO WE SET WORK DELIVERABLES AT THE EXECUTIVE LEVEL THAT WE COME BACK, WE WORK ON OVER THAT TWO WEEK PERIOD, AND THEN WE COME BACK, SEE WHERE WE ARE, RESET, REASSESS.

BUT THEN WE'RE ALWAYS WORKING TOWARDS THOSE LONGER TERM OBJECTIVES THAT ARE IN THE BUSINESS PLAN. SO THAT'S THE WORK CYCLE THAT WE HAVE.

AND THEN WHAT OUR FOUNDATIONAL DOCUMENT IS THAT BEING THE TPI BUSINESS PLAN.

AND OF COURSE HOUSE BILL 4990 ARE OUR ENABLING STATUTE.

HAVING SAID THAT, THIS AGENDA HAS CONNECTED ITEMS OR HAS ITEMS THAT ARE ALL CONNECTED TOGETHER, THAT ARE PART OF THAT WORK CYCLE AND ALIGNMENT WITH THE TPI BUSINESS PLAN? THE FIRST IS DISCUSSION YOU'LL HEAR IS ON THE UT HEALTH INTELLIGENCE PLATFORM AGREEMENT, WHICH WE ALSO REFER TO INTERNALLY AS TURNKEY.

AND AS I MENTIONED EARLIER, YOU KNOW, WE'RE FOCUSED ON BUILDING UP OUR FUNCTIONALITY IN TERMS OF IMPLEMENTATION AND SUBJECT MATTER EXPERTISE.

THAT'S WHAT THAT CONTRACT OR THAT AGREEMENT IS ABOUT.

IT'S GETTING THAT FUNCTIONALITY IN A VERY COMPREHENSIVE LEVEL, IN A VERY IN-DEPTH LEVEL AS WELL, ON BOARD EARLY AND READY TO GO SO THAT WE CAN IMPLEMENT.

THE NEXT ITEM YOU'LL HEAR IS ALIGNMENT WITH THE AGENCIES ON SPECIFIC MILESTONES AND WAVE ONE OF THE BUSINESS PLAN TO ENSURE SUFFICIENT IMPLEMENTATION BY THE END OF CALENDAR YEAR 2025. THIS WAS A VERY SPECIFIC ITEM THAT WAS AMENDED TO THE BUSINESS PLAN THAT YOU ALL ADOPTED IN SEPTEMBER.

IT'S A BOARD IMPERATIVE. AND AGAIN, MUCH THANKS TO STAFF AND OUR AGENCY PARTNERS, SOME OF WHOM ARE HERE TODAY, THAT HAVE HELPED US GET THAT EARLY ALIGNMENT SO THAT WE CAN CONTINUE WORK ON THE PROGRAMS IN THE BUSINESS PLAN.

NOW, THERE ARE TWO CRITICAL PATH ITEMS THAT THE BOARD NEEDS TO BE AWARE OF, THAT WE ARE ACTIVELY WORKING WITH OUR AGENCY PARTNERS AS WELL AS THE LEGISLATURE TO RESOLVE. ONE IS ACCESS TO CLAIMS DATA AND THAT IS FULL, UNREDACTED CLAIMS DATA AND ACCESS TO CONTRACTS, PARTICULARLY THE PBM CONTRACTS, OR IF THERE'S ANY OTHER RELATED CONTRACTS THAT ALSO AFFECT PHARMACEUTICAL BENEFITS, BUT PRIMARILY AND PRINCIPALLY PBM CONTRACTS. SO WHERE WE ARE RIGHT NOW, IT'S A THE AGENCIES ARE WORKING WITH US. I THINK IT'S REALLY A MATTER IF I COULD DISTILL IT DOWN, IS THAT EACH AGENCY HAS A UNIQUE SET OF LEGAL CIRCUMSTANCES THAT NEED TO BE ADDRESSED, SOME OF WHICH ARE DRIVEN BY LAW UNDER HIPAA. AND YOU DON'T REALLY HAVE ANY LATITUDE ON THIS, SOME OF WHICH MAY BE CONTRACTUAL, THAT IS GETTING ALL THE NECESSARY PERMISSIONS TO SHARE WHAT NEEDS TO BE SHARED.

WHILE THAT IS WORKING. WE'VE ALSO GONE TO THE LEGISLATURE, WHICH I'LL ADDRESS BRIEFLY LATER ON IN THE MEETING.

BUT TO MAKE SURE THAT WE HAVE THE STATUTORY MANDATE, IF YOU WILL, OR REQUIREMENT THAT THOSE ITEMS DO BE SHARED, BECAUSE OFTENTIMES FOR LEGAL REASONS, IT IS PREFERABLE TO HAVE THAT STATUTORY MANDATE SO THAT THAT WAY THERE'S NO QUESTION THAT THEY HAVE TO BE SHARED AND NEED TO BE SHARED IN ORDER TO BE ABLE TO ADVANCE THE MISSION.

SO I WANTED TO BRING THOSE TWO CRITICAL PATH ITEMS TO YOUR ATTENTION THAT WE'RE CURRENTLY WORKING THROUGH.

SO IN THE END, IT'S A LOT OF EMAILS, A LOT OF PHONE CALLS, A LOT OF MEETINGS, SOME IN PERSON, SOME VIRTUAL, A LOT OF WORDS ON PAPER. BUT WE HAVE SOME MANTRAS THAT WE OPERATE AT TPI UNDER WHICH WE OPERATE HERE AT TPI.

SO YOU TAKE ALL THESE WORDS ON THE PAPER. WHAT DO THEY MEAN? WELL, YOU'RE NOT MAKING SUBSTANTIAL PROGRESS UNLESS YOU'RE TASKING SOMEBODY WITH A SPECIFIC JOB.

YOU'RE SIGNING A CONTRACT OR YOU'RE ELEVATING SOMETHING TO LEADERSHIP, WHICH IS A DECISION ABOVE YOUR PAY GRADE, BE IT THIS BOARD OR THE LEGISLATURE. SO THOSE ARE THREE AREAS THAT WE TEND TO FOCUS ON MAKING SUBSTANTIAL PROGRESS.

AND THE OTHER MANTRA IS DO WHAT YOU CAN, WHEN YOU CAN, WHERE YOU CAN.

WE DON'T HAVE THE LUXURY OF TIME SLACK IN OUR IMPLEMENTATION.

IT'S THAT THAT BUSINESS PLAN STARTED EFFECTIVELY OCTOBER 1ST.

AND BECAUSE WE'RE TRYING TO MAKE UP SOME LOST TIME WHEN THE BOARD WAS RIGHT TO SET THAT DATE.

BUT BY THE SAME TOKEN, STARTING THE IMPLEMENTATION DURING A LEGISLATIVE SESSION AND EVERYBODY ELSE HAS THINGS TO DO.

AND HERE WE ARE COMING ALONG SAYING, HEY, HERE'S MORE TO DO.

YOU DON'T HAVE ANY ANY TIME TO WASTE ON THIS.

AND SO YOU HAVE TO DO WHAT YOU CAN, WHEN YOU CAN, WHERE YOU CAN, YOU WORK SMARTLY, YOU BANK WORK KNOWING THAT IT'S FOUNDATIONAL FOR SOMETHING MAYBE 3 OR 4 MONTHS DOWN THE ROAD. BUT THAT WAY YOU'RE ALWAYS IMPLEMENTING AND YOU'RE ALWAYS DOING SOMETHING.

SO THAT CONCLUDES THE OPENING REMARKS TO FRAME WHAT AGENDA ITEM THREE IS ABOUT.

[00:15:02]

FIRST, WHY EVEN HAVE THIS CONSIDERATION. AND THE BOARD HAD DIRECTED STAFF TO GO WORK WITH UT HIP.

I'LL USE THAT AS AN ACRONYM. AND EVEN THOUGH I'M ADVISED NOT TO, BUT UT HEALTH INTELLIGENCE PLATFORM AND YOU ALL GAVE US A TIME FRAME TILL NOW, FEBRUARY TO COME BACK WITH SOME TERMS. AND SO WE'VE DONE THAT.

THE SECOND REASON WHY IS THE THE TEXAS STATUTES PROVIDE A PROCUREMENT PATHWAY KNOWN AS THE INTERAGENCY COOPERATION CONTRACT PROVISION, AND IT ALLOWS FOR AN EXPEDITED PROCUREMENT AND DOES A VERY SPECIFIC STATUTORY PROVISION THAT ALLOWS STATE AGENCIES TO CONTRACT WITH ONE ANOTHER, THE IDEA BEING THAT EACH AGENCY HAS DIFFERENT ASSETS AND STRENGTHS THAT THEY BRING TO THE TABLE.

AND ON AN AT COST BASIS, YOU CAN HAVE THESE CONTRACTS AND IT'S A WAY TO EXPEDITE PROCUREMENT, BUT IT'S ALSO A WAY TO HAVE AGENCY PARTNERS WITH SKIN IN THE GAME BE PART OF YOUR IMPLEMENTATION.

AND IT'S ALSO A WAY TO HAVE VERY COMPREHENSIVE AND VERY SUBJECT MATTER SPECIFIC EXPERTISE THAT'S NEEDED.

THERE ARE MANY NUMBER OF OTHER REASONS, BUT THOSE ARE THE TWO PRIMARY ONES THAT I THAT I WANTED TO POINT OUT.

THERE'S SOME BENEFITS TO THIS ONE. WE COULD GO OUT AND TRY TO STAFF UP, BUT THAT WOULD TAKE SEVERAL MONTHS AND NO GUARANTEES THAT YOU'RE ABLE TO RECRUIT THE STAFF THAT YOU NEED AND BE ABLE TO RETAIN THAT STAFF OVER A PERIOD OF LET'S JUST FOCUS ON THE FIRST THREE YEARS OF THIS, BUT BEING ABLE TO RETAIN THAT STAFF SO THAT ALL THE PIECES FIT AND WORK TOGETHER.

AND IF YOU HAVE SINGLE POINT OF KNOWLEDGE OR SKILL SET DEPARTURE 2 OR 3 PEOPLE LEAVE OUT OF, LET'S JUST SAY 45 PEOPLE OR 25 PEOPLE, WHATEVER IT IS.

WELL, THAT CAN REALLY DISRUPT AND INTERRUPT YOUR OPERATIONS.

SO THERE'S A VALUE INTO HAVING A VERY MORE COMPREHENSIVE SET OF SKILL SETS OUT THERE THAT YOU'RE CONTRACTING WITH SO THAT YOU CAN KEEP ALL OF THOSE PIECES TOGETHER AND KEEP ALL THOSE GEARS LINED UP LIKE THEY NEED TO BE. ANOTHER VALUE THAT LIES IN THIS IS WE COULD GO OUT AND AND WE MENTIONED THIS WHENEVER WE BROUGHT THIS TO THE BOARD IN DECEMBER.

IF FOR WHATEVER REASON, THIS DOES NOT WORK OUT, IT DOESN'T MEET THE BOARD'S SATISFACTION OR EVEN AFTER, IF YOU PASS THE MOTION AND WE GO AWAY AND NEGOTIATE SOMETHING AND START EXECUTING, WE'RE JUST NOT ABLE TO COME TO FINAL, FINAL TERMS, THEN YES, WE COULD GO UP FOR PROCUREMENT ON THIS, BUT YOU'RE TALKING ABOUT PROCURING MULTIPLE FIRMS, PLUS A LARGER CONTRACT MANAGEMENT FIRM TO OVERSEE ALL THESE DIFFERENT MULTIPLE FIRMS. THAT PROCUREMENT PROCESS CAN BE VERY PROLONGED, AS YOU ALL HAVE EXPERIENCED, EVEN WITH VERY SIMPLE CONSULTING CONTRACTS, THAT PROCUREMENT PROCESS WOULD TAKE, FIRST OF ALL, MULTIPLE CONTRACTS.

AND JUST LIKE STAFFING UP WOULD, IT PUTS YOU WELL INTO YOUR OWN TIMELINE AND BEHIND SCHEDULE.

SO THERE'S SOME VALUE IN THIS TYPE OF OF CONTRACT THAT GOES BEYOND JUST THE DOLLARS AND CENTS THAT YOU SEE ON, ON, ON A PIECE OF PAPER. SO HOW THIS CONTRACT WOULD WORK WE ARE PAYING FOR STAFF, THAT IS IMPLEMENTERS AND SUBJECT MATTER EXPERTS, AND I'M SIMPLIFYING THAT INTO TWO BUCKETS. LAUREN WILL GO INTO MORE DETAIL ABOUT HOW THAT BREAKS OUT.

AND AGAIN, THIS WOULD BE STAFF THAT WE OTHERWISE HIRE OR CONTRACT WITH DIRECTLY.

THE STAFF WILL WORK ON DEFINED DELIVERABLES AND THOSE DELIVERABLES WILL BE ESTABLISHED FROM THE OUTSET BY WORK PLANS AND PERIODICALLY ADJUSTED SO THAT TOGETHER WITH OUR PARTNERS, WE CAN CONTROL BY ALL PARTNERS I MEAN ALL THE AGENCIES AND SYSTEMS, BUT WITH THEIR INPUT.

BUT WE CAN CONTROL. THIS IS WHAT THE WORK PLAN WILL DO.

THIS IS WHAT THE OUTPUT IS GOING TO BE. AND HERE'S WHAT THE BUDGET IS.

AND PREFERABLY COMING IN UNDER BUDGET TOO. THESE ARE NOT GUARANTEED FIXED MINIMUMS. AND AND WHAT YOU SEE IN THIS IN THESE THESE PROPOSED BUDGETS.

AND THEN THE WORK DELIVERABLES COME BACK AND WE SEE THEM OUR AGENCY PARTNERS SEE THEM.

THIS BOARD WILL SEE THEM. AND SO THAT'S HOW THIS THIS CONTRACT WILL ESSENTIALLY WORK WITH THE SUBJECT MATTER EXPERTISE AND THE IMPLEMENTERS THAT WE BRING ON.

AS I MENTIONED, THERE ARE PERIODIC MEETINGS WHERE WE CONTROL FOR WHAT THE WORK PLAN DELIVERABLES ARE GOING TO BE, WHAT THE DATA ANALYTICS PLANS LOOK LIKE, WHICH IS REALLY IMPORTANT TO THE AGENCIES THAT ARE GOING TO BE PULLING THIS DATA, BUT ALSO BUDGET CONTROLS RELATIVE TO WHAT WE'RE SPENDING TO MAKE SURE THAT WE HAVE SUFFICIENT FUNDS TO PUSH ALL THIS ACROSS THE FINISH LINE IN THE IN THE TERM THAT'S THAT'S BEEN, YOU KNOW, THAT WE'RE CURRENTLY DISCUSSING. SO WITH THAT, I'LL TURN IT OVER TO LAUREN TO GO INTO THE UT HIP CONTRACT IN MORE DETAIL.

SHE'LL RECOGNIZE MELISSA FOR A QUICK WORD ON WHAT CONTRACT MANAGEMENT LOOKS LIKE, BECAUSE AGAIN, WE WANT TO LOOK DOWN THE ROAD A LITTLE BIT AND SAY, OKAY, LET'S ASSUME WE GET SOMETHING NEGOTIATED AND EXECUTED. HOW ARE YOU GOING TO MANAGE THIS. AND SO THERE'S SOME BIG PICTURE CONCEPTS.

WE WANT TO MAKE SURE THAT THE BOARD IS AWARE OF. AND THEN I'LL CHIME IN ON CUE TO HAVE A FEW REMARKS AROUND THE BUDGET FOR THIS.

AND THEN WE HAVE A SECOND PART OF AGENDA ITEM THREE, WHICH IS TO TALK ABOUT DASHBOARDS AND PROGRAM IMPLEMENTATION AND AGENCY ALIGNMENT THAT

[00:20:09]

SO THANK YOU FOR ALLOWING ME TO MAKE THOSE FRAMING REMARKS.

AND AT THIS POINT, I WILL TURN IT OVER TO LAUREN.

THANK YOU. MIKE. PURSUANT TO BOARD DIRECTION IN DECEMBER 2024, TPI STAFF HAS BEEN DEVELOPING AN AGREEMENT WITH THE UNIVERSITY OF TEXAS HEALTH INTELLIGENCE PLATFORM UT HIP TO PROVIDE STRATEGIC CONSULTING, DATA ANALYTICS, IMPLEMENTATION SUPPORT AND CLINICAL BASED SUBJECT MATTER EXPERTISE IN SUPPORT OF THE IMPLEMENTATION OF WAVE ONE AND WAVE TWO.

TPI BUSINESS PLAN PROGRAMS, SPECIFICALLY PROGRAM ONE BE THE CREATION OF A FACT BASE OF PBM PRACTICES.

PROGRAM ONE DIRECT CONTRACTING WITH MANUFACTURERS.

PROGRAM TWO BE PARTNERING WITH MANUFACTURERS OR NON-PROFITS TO SECURE ACCESS TO DRUGS AND SHORTAGE.

PROGRAM THREE A BUILDING CAPABILITIES FOR SHORTAGE SURVEILLANCE AND PROGRAM ONE SEE HARMONIZING FORMULARY OR CONTRACTS ACROSS THE AGENCIES AND SYSTEMS. SUBJECT TWO TPI BOARD APPROVAL TPI WILL EXECUTE AN INTERAGENCY COOPERATION CONTRACT WITH UT HIP FOR A TERM OF THREE YEARS, COMMENCING UPON CONTRACT EXECUTION TENTATIVELY IN MARCH 2025.

THE SPECIFIC TYPES OF SERVICES GENERALLY FALL INTO THE CATEGORIES OF PROJECT MANAGEMENT, STRATEGIC CONSULTATION, SUBJECT MATTER EXPERTISE, DATA ANALYSIS AND RESEARCH, ALL ORGANIZED UNDER THREE TEAMS A PROJECT TEAM WHICH INCLUDES ANALYTICS AND PROJECT MANAGEMENT. A CLINICAL TEAM INCLUDING BOTH MEDICAL AND PHARMACY EXPERTISE, AND A SUPPLY CHAIN TEAM.

AND THESE TEAMS WILL BE COORDINATED AND OVERSEEN BY US PROJECT MANAGERS UNDER THE DIRECTION OF TPA.

THE TEAMS WILL CONSIST OF EXPERTS FROM BOTH WITHIN AND EXTERNAL TO THE UNIVERSITY OF TEXAS SYSTEM, TO ENSURE A DIVERSE AND BALANCED SLATE OF PERSPECTIVES AND EXPERTISE ESSENTIAL FOR THE SUCCESSFUL, SUCCESSFUL IMPLEMENTATION OF THE TPA BUSINESS PLAN.

THE WORK WILL BE GUIDED BY WORK PLANS ALIGNED WITH MILESTONES IN THE TPA BUSINESS PLAN, AND WILL GENERALLY OCCUR IN THE FOLLOWING SEQUENCE.

WORK PLAN CREATION AND EXECUTION. FINDINGS AND DELIVERABLES THEN PRESENTED TO THE AGENCIES AND SYSTEMS AND TPA, AND THEN PRESENTATION OF OUTCOMES AND PROJECTIONS TO THE TPA BOARD.

ALL WORK AND EXPENDITURES WILL OCCUR UNDER THE DIRECTION OF TPA.

STAFF AND AGENCY AND SYSTEM PARTNERS WILL CONTINUE TO ADVISE AND PROVIDE INPUT INTO THE PROJECT WORK PURSUANT TO HOUSE BILL 4990.

THE BUDGET OUTLINED IN THE CONTRACT IS $9.45 MILLION PER YEAR FOR THREE YEARS, NOT TO EXCEED $28.3 MILLION IN TOTAL, TPA WILL BE INVOICED QUARTERLY BASED ON ACTUAL COSTS INCURRED FOR WORK PERFORMED INCLUSIVE OF SALARY, IT AND TRAVEL EXPENSES. REGARDING VALUE, THE NOT TO EXCEED AMOUNT IS APPROXIMATELY ONE FIFTH OF THE TOTAL COST TO IMPLEMENT AS ORIGINALLY ESTIMATED IN THE TPA BUSINESS PLAN, AND FOR THAT COST, WE'LL BE GETTING ACCESS TO AN ESTIMATED TOTAL OF 90 SUBJECT MATTER EXPERTS TO BE STAFFED AND COORDINATED BY UT HIP.

SEVERAL CONTROLS WILL BE ESTABLISHED AND EXERCISED IN PARTNERSHIP WITH UT HIP, INCLUDING BOARD BRIEFINGS, MONTHLY STATUS REPORTS, STANDING WORK GUIDANCE AND BUDGET MANAGEMENT MEETINGS WITH TPI PRIOR TO THE COMMENCEMENT OF WORK PLANS IN PRIOR TPI APPROVAL OF EXPENDITURES FOR TRAVEL, IT AND OUTSIDE CONSULTING CONTRACTS, IN ADDITION TO THE NOT TO EXCEED COST LIMIT CONTROL ALREADY MENTIONED.

CURRENTLY, UDT AND TPI ARE WORKING TO FINALIZE THE SCOPE OF WORK IN TERMS OF THE INTERAGENCY COOPERATION AGREEMENT TO MEET TPI BUSINESS PLAN IMPLEMENTATION AND DEVELOPMENT TIMELINES, AND THE TPI EXECUTIVE DIRECTOR WILL BE ASKING THE BOARD TODAY FOR AUTHORIZATION TO EXECUTE THE AGREEMENT.

PER THE DRAFT MOTION UNDER AGENDA ITEM NUMBER 3AI2.

BUT BEFORE THAT, ONE ADDITIONAL NOTE ON INTERAGENCY COOPERATION TPI HAS ALSO BEGUN DISCUSSIONS WITH TEXAS A&M UNIVERSITY SYSTEM WITH THE INTENT TO PARTNER WITH THE SUBSTANTIAL TALENT, EXPERTISE AND CAPABILITIES WITHIN THE A&M SYSTEM.

ON FEBRUARY 4TH, TPI BROUGHT TOGETHER LEADERSHIP FROM TEXAS A&M COLLEGE OF PHARMACY.

TEXAS A&M HEALTH SCIENCE CENTER AND UT HIP TO DISCUSS OPPORTUNITIES FOR COLLABORATION IN SUPPORT OF TBI OBJECTIVES.

SEVERAL POTENTIAL OPPORTUNITIES WERE IDENTIFIED, INCLUDING STABILITY TESTING FOR GENERIC DRUGS, MANUFACTURING OF DRUGS, AND SHORTAGE, AS WELL AS SEVERAL OPPORTUNITIES FOR THE INCLUSION OF CLINICAL AND BUSINESS EXPERTS FROM THE TEXAS A&M UNIVERSITY SYSTEM.

OVER THE COMING WEEKS, TEXAS A&M WILL REFINE THEIR LIST OF POTENTIAL AREAS OF COLLABORATION AND BRING BACK TO TPI AND UT HIP FOR CONTINUED DISCUSSION.

SO NOW I'D LIKE THE BOARD TO RECOGNIZE MISS PAT PATTERSON FOR ADDITIONAL WORDS ON THE TOPIC.

[00:25:02]

WITH THE BOARD'S PENDING DECISION REGARDING THE UT HIP CONTRACT, THE TPI BUSINESS OPERATIONS TEAM HAS BEEN FOCUSING ON COORDINATING THE SUCCESSFUL, SUCCESSFUL FINALIZATION AND SIGNING OF THIS CONTRACT FOLLOWING THE BOARD'S DECISION, AND IF APPROVED, TPI BUSINESS OPERATIONS WILL TRANSITION FROM A CONTRACT MANAGEMENT PHASE TO A CONTRACT.

I'M SORRY FROM A CONTRACT NEGOTIATION PHASE TO A CONTRACT MANAGEMENT ROLE.

DURING THIS CONTRACT MANAGEMENT ROLE, IF THE CONTRACT IS SIGNED, THE BUSINESS OPERATIONS TEAM WILL BE RESPONSIBLE FOR MANAGING ALL ASPECTS OF THE UT HIP CONTRACT, SIMILAR TO THE APPROACH THAT WE USE FOR THE MCKINSEY CONTRACT.

HOWEVER, THIS UT HIP CONTRACT IS PRESENTS GREATER COMPLEXITY DUE TO ITS LARGE DOLLAR AMOUNT, MULTIPLE AGENCY PARTNERS, AND POTENTIAL FOR SUBCONTRACTING WITH OTHER VENDORS.

AS A RESULT, THE CONTRACT MANAGEMENT TEAM WILL REQUIRE DEDICATED CONTRACT PLANNING, MANAGEMENT AND MONITORING, SO WE WILL BE FOCUSING ON COMPLIANCE AND BEST PRACTICES.

THE BUSINESS OPERATION TEAM IS COMMITTED TO MANAGING THE UT HIP CONTRACT IN FULL COMPLIANCE WITH TEXAS PROCUREMENT LAW AND WITH HHS POLICIES AND PROCEDURES. AND TO SUPPORT THIS EFFORT, WE ARE IN THE PROCESS OF EXPANDING THE CONTRACT MANAGEMENT TEAM AND DEVELOPING FORMALIZED CONTRACT MANAGEMENT PROCESSES IN COORDINATION WITH HHS GUIDELINES, AND THE CONTRACT MANAGEMENT TEAM WILL HAVE A STRATEGIC APPROACH TO CONTRACT MANAGEMENT.

WE WILL WORK TO DEVELOP STAKEHOLDER STAKEHOLDER ENGAGEMENT, FOSTERING A COLLABORATIVE RELATIONSHIP WITH ALL AGENCY PARTNERS TO ENSURE ALIGNMENT ON DELIVERABLES AND CONTRACT REQUIREMENTS.

WE WILL WORK TO CREATE PROCESS DEVELOPMENTS. WE WILL DESIGN AND IMPLEMENT STRUCTURED PROCEDURES FOR CONTRACT OVERSIGHT BY FOSTERING STRONG RELATIONSHIPS WITH OUR AGENCY PARTNERS AND STAKEHOLDERS. AND THEN WE'LL ALSO FOCUS ON CONTRACT MANAGEMENT AND MONITORING.

WITH THIS WE'LL DEVELOP A CUSTOMIZED MONITORING PLAN.

WE'LL USE THAT FOR INTERNAL TPI USE TO MAKE SURE WE'RE HITTING ALL THE CONTRACT DELIVERABLES AND MILESTONES.

WE'LL ALSO USE THAT FOR REPORTING TO THE BOARD.

AND THEN IN ADDITION, WE'LL DEVELOP A DIFFERENT CONTRACT MONITORING PLAN TO DISCUSS WITH THE VENDORS JUST TO MAKE SURE EVERYBODY IS IN ALIGNMENT.

WE'LL ALSO REFINE REPORTING AND COMMUNICATION.

WE'LL MAKE SURE THE VENDOR AND TPI STAFF ARE ALL ALIGNED WITH REPORTING TIMELINES AND REPORTING MECHANISMS, SO THAT WE CAN PROVIDE EFFECTIVE UPDATES TO THE EXECUTIVE DIRECTOR, TPI BOARD, AGENCY PARTNERS, OR ANY OTHER INQUIRIES THAT WE GET. WE'LL ALSO REVIEW THIS CONTRACT MONITORING PLAN WITH UBT STAFF ON A QUARTERLY BASIS OR AS NEEDED IF ISSUES SHOULD ARISE. AND THEN THE TPI BUSINESS OPERATIONS TEAM WILL ALSO ENHANCE ORGANIZATIONAL PROCESSES.

AND WE'LL IMPLEMENT STRUCTURED ORGANIZATIONAL PROCESSES TO ENHANCE CONTRACT MANAGEMENT CONSISTENCY ACCOUNTABILITY AND EFFECTIVENESS.

WE'LL COLLABORATE CLOSELY WITH HHS CONTRACT PROCUREMENT TEAM AND REPORT AND ENSURE ALL REPORTING REQUIREMENTS ARE MET.

AND THROUGH THESE INITIATIVES, TPI BUSINESS OPERATIONS IS COMMITTED TO ENSURING THE SUCCESSFUL EXECUTION AND OVERSIGHT OF THIS CONTRACT AND THAT WE MAINTAIN THE HIGHEST STANDARDS OF CONTRACT MANAGEMENT, FOLLOWING ALL TEXAS PROCUREMENT LAWS AND HHS HHS GUIDELINES.

AND WITH THAT, I'LL TURN IT BACK OVER TO LAUREN.

THANK YOU MELISSA. I WILL ACTUALLY TURN IT BACK OVER TO DOCTOR MCKINNEY.

YOU CAN TAKE IT FROM THERE. OKAY. THANK YOU. TONY.

YOU HAVE QUESTIONS? COMMENTS? YEAH. SO IN GENERAL, IF WE'RE LOOKING AT A THREE YEAR DEAL, WE'VE GOT A SUNSET ON TPA. I MEAN, I DON'T WANT TO ASK THE OBVIOUS, BUT THERE'S NO CONTRACT SIGNED UNTIL TPA HAS BEEN EXTENDED AND AT SOME LEVEL. AND THEN THE GENERAL QUESTION IS ALSO IN A CONTRACT LIKE THIS, IS IT CANCELABLE BY WHAT WOULD YOU EXPECT IN TERMS OF OUTS? I MEAN, BECAUSE IF THERE'S A CHANGE IN THE LEGISLATIVE BODY OR, OR WE SOLVE THE PROBLEM, ARE WE STILL BOUND TO THE ROUGHLY 28 RIGHT TERMS? SO WE'VE HAD THOSE DISCUSSIONS. AND THE ANSWER TO BOTH PARTS OF YOUR QUESTION IS THERE WILL BE PROVISIONS THAT ALLOW FOR THOSE OUTS, IF YOU WILL. AND THAT'S JUST THE NATURE OF WHERE WE ARE IN OUR LIFE CYCLE AT THIS POINT.

OKAY. AND I GUESS WE'LL HAVE ARE WE GOING TO HAVE DISCUSSIONS ABOUT THE DETAILS OF THE CONTRACT HERE ABOUT THE SERVICES PROVIDED BY YOU? YES.

[00:30:04]

AND THEN WE'VE GOT FOLKS FROM UT THAT ARE HERE THAT CAN FURTHER FURTHER ELABORATE WHAT I MEAN.

I DON'T KNOW THAT WE HAVE TO DO THAT, BUT I WOULD JUST I'LL PREACH A LITTLE BIT.

THERE IS A WE KIND OF WENT OVER THE WORD EXPERTISE, BUT THERE'S AN EXPERTISE THAT LIES IN THIS BUNCH THAT I'VE NOT SEEN ANYWHERE, PERIOD. AND I THINK THAT THAT SHOULD BE ACKNOWLEDGED THAT THIS IS THIS IS NOT FRANKLY, THIS IS NOT SOMETHING YOU CAN BUILD. YOU KNOW, WE TALKED ABOUT THAT WAS AN OPTION.

THERE'S NO WAY WE CAN'T DO THAT. WE'RE NOT CAPABLE.

THAT EXPERTISE IS SO THIN THAT WE PROBABLY ARE HIRING THE ONLY BUNCH THAT COULD DO IT.

IT'S MY OPINION. I DO HAVE SOME QUESTIONS ABOUT THE THE CONTRACTING.

JUST AGAIN, THE CLINICAL EXPERTS ARE THAT YOU CAN'T HIRE THAT EITHER.

AND IN ADDITION TO THE TO THE TECHNOLOGY EXPERTS, BUT THE WILL, THE CONTRACT, THE PAYMENTS AND ALL THAT, YOU HAD SAID THAT WE IT WAS BASICALLY THEY WOULD BILL YOU THEY WOULD FOR SALARIES AND ALL THAT.

ARE WE PAYING SOME FOR ADMINISTRATION OR ARE WE PAYING SOME FOR INDIRECTS? THERE'S A BAD WORD FOR EVERYBODY THAT'S LISTENED TO THE NEWS LATELY.

I'LL START OUT. SO YES, THERE'S COSTS IN HERE FOR OVERHEAD AS WELL AS INDIRECT COSTS BECAUSE THOSE COSTS ARE REAL.

I MEAN, IN FAIRNESS, YOU KNOW, THEY CALL THEM INDIRECT.

THAT DOESN'T MEAN THAT IT DOESN'T COST YOU. RIGHT? IS WILL A CONTRACT HAD THIS DISCUSSION WITH THE LIEUTENANT GOVERNOR BULLOCK MANY YEARS AGO.

THE ONLY TIME I EVER REMEMBER RECEIVING A COMPLIMENT FROM GOVERNOR BULLOCK.

AND I'M SURE HE'S TURNING OVER ME TALKING ABOUT IT.

BUT WE BUILT A CONTRACT, A STATE CONTRACT THAT HAD ARRANGEMENTS FOR BONUSES AND FOR PENALTIES FOR NONPERFORMANCE. WILL THIS CONTRACT HAVE ANY OF THOSE? EITHER ONE OF THOSE? SO I'LL TALK AT A HIGH LEVEL AND ASK STAFF TO ADD ANYTHING THAT I MIGHT MISS. WHAT WE DID IS WE BUILT IN A PROCESS WHERE WE MEET PERIODICALLY, BUT BEFORE THE WORK OCCURS AND IN ADVANCE, WE SIT DOWN AND WE LOOK AT EVERYTHING BECAUSE WE'RE TRYING TO AVOID THAT WHOLE LIQUIDATED DAMAGES AND PENALTIES, WHICH ONCE YOU TRIGGER THOSE DISPUTE RESOLUTIONS, EVEN IF YOU GO TO STRUCTURED MEDIATION AND THEN ARBITRATION AND THEN COURT.

IT TAKES YOU FOREVER TO WORK THOSE THINGS OUT.

IT WILL BE YEARS INTO IT. AND SO AND I'VE LIKE YOU'VE BEEN IN CONTRACTS THAT ARE EXACTLY LIKE THAT AND THEY'RE STRUCTURED LIKE THAT.

SO WHAT WE'RE DOING IS WE'RE GOING TO THE FRONT END OF THIS, AND WE'RE SAYING TO TO MINIMIZE THAT ERROR.

NOW, OBVIOUSLY, IF THERE'S A BREACH OF CONTRACT OR IF THERE'S COMPLETE NONPERFORMANCE, THEN OBVIOUSLY THERE'S THERE'S GOING TO BE PROVISIONS FOR BOTH SIDES TO THEN THEN TRIGGER THAT. BUT IN TERMS OF ANY TYPE OF STRUCTURED LIQUIDATED DAMAGES, AND WE'RE TRYING TO AVOID THAT AS MUCH AS POSSIBLE.

BUT THAT'S THE STRUCTURE OF IT. AND I'LL ASK STAFF TO, TO CHIME IN IF I MISSED SOMETHING OR IF SOMETHING NEEDS TO BE CLARIFIED, PLEASE. JAMES DADE, GENERAL COUNSEL I WOULD AGREE WITH THAT.

JUST TO THE DIRECT QUESTION, THERE ARE NO BONUSES INCENTIVES BUILT INTO THIS FOR EARLY PERFORMANCE.

IT IS NOT TO EXCEED BASED UPON WORK ACTUALLY PERFORMED.

AND THEN THERE'S NOT A PENALTY STRUCTURE OR A LIQUIDATED DAMAGES FOR FAILURE.

IT'S FOLLOWING THE STANDARD STATE OR INTERAGENCY TYPE OF COOPERATION AGREEMENT.

AND AND I WOULD SAY THAT'S ANOTHER ADVANTAGE OF HAVING THE AN INTERAGENCY AGREEMENT AS OPPOSED TO A LONG PROCUREMENT OR CONTRACTING AND A CONTRACT THAT HAS THOSE THOSE THINGS IN IT.

FIRST OFF, WE ALL HAVE THE SAME BOSS. THAT HELPS A LOT.

AND I'M TALKING ABOUT IT'S 181 PEOPLE, BUT IT'S ALSO THE OTHER 30 MILLION PEOPLE THAT THAT LIVE IN THE STATE.

SO DOCTOR MCKINNEY, IF I MAY TOO, ON THE ON THE ISSUE OF BONUS, IT THERE IS AN UPSIDE TO THIS AND THAT WE'RE GOING TO STRIVE TO COME IN UNDER BUDGET.

AGAIN. THIS IS ALSO A NOT TO EXCEED. BUT IF WE COME IN UNDER BUDGET THEN AND HOPEFULLY WE DON'T JINX THIS WHEN I SAY THIS,

[00:35:04]

BUT THAT JUST HELPS US FULFILL THE MISSION, YOU KNOW, IN THE LONG RUN.

YEAH. NO, I YOU KNOW, I, I DON'T WANT THE VALUE OF THIS CONTRACT TO BE UNDERESTIMATED BECAUSE IT'S, QUOTE, ONLY 9.45 MILLION. WE, THE PEOPLE OF TEXAS WILL GET MUCH MORE BENEFIT FROM THIS THAN 9.45 MILLION. THE A&M CONTRACT OKAY. IS THE PLAN FOR THAT TO BE A SEPARATE CONTRACT WITH, WITH US WITH TAFE OR OR TPA OR IS IT GOING TO BE PART OF THE 9.45 MILLION THAT IS THE UT CONTRACT.

I'LL ANSWER THIS FIRST. LET ME JUST START OUT BY SAYING WE'RE STILL WORKING WITH A&M AT THIS POINT.

WE JUST RECEIVED A COMMUNICATION, EVEN OVER THE WEEKEND FROM THEIR LEADERSHIP, ASKING FOR SOME MORE FOLLOW UP INFORMATION FROM US.

AND SO WE'RE NOT AS FAR ALONG WITH A&M. I WOULD SAY IT COULD BE EITHER OF THOSE.

AND I DON'T WANT TO SPEAK FOR UT, BUT IF THEY DETERMINE, WELL, THERE'S THERE'S SOME CLINICAL EXPERTISE SITTING OVER, THERE ARE SOME PHARMACOLOGICAL OR SUPPLY CHAIN, WHATEVER IT IS THAT SITS IN THE A&M SYSTEM THAT WE REALLY NEED TO PULL IN THIS.

THEN THERE IS ROOM UNDER THIS TO HAVE SUCH A SUBCONTRACT.

AND LAUREN, I'D ASK YOU TO TO, YOU KNOW, CHIME IN ON THIS, BUT BUT THEN LET'S JUST SAY THAT THAT'S NOT THE CASE.

THEN WHAT WE'RE GOING TO BE TALKING WITH A&M ABOUT IS, OKAY, WHAT WHAT ELSE DO WE NEED THAT'S NEEDED VALUE BECAUSE THEY HAVE A LOT OF VALUE TO OFFER. THE QUESTION IS WHAT VALUE LINES UP WITH OUR BUSINESS CASE, OUR BUSINESS PLAN THAT THEN WE WOULD NEED TO HAVE A SEPARATE CONTRACT FOR.

SO IT COULD VERY WELL AND MOST LIKELY WILL BE BOTH MORE TO THE FIRST PART.

IN THEORY, IF THERE'S ANYTHING WITHIN THE SCOPE OF THE WORK THAT WE'RE ENGAGING UT HIP FOR IF THERE'S EXPERTISE THAT THEY NEED TO BRING TO THE TABLE THAT CAN BE BROUGHT FROM TEXAS A&M, THEN POTENTIALLY THEY COULD SUBCONTRACT WITH TEXAS A&M THROUGH UT HIP TO PROVIDE THAT UNDER THE SCOPE OF THE AGREEMENT THAT WE'RE WORKING THROUGH WITH UT HIP RIGHT NOW. BUT BUT THEY'RE ALSO, AS MIKE WAS SAYING, COULD BE ADDITIONAL WORK OUTSIDE OF THAT THAT WE MIGHT CONTRACT WITH THEM DIRECTLY FOR. THE ANY OTHER QUESTIONS? THE I GUESS WE GO TO THE NEXT PART OF THAT SAME AGENDA ITEM, THE TPA BUSINESS PLAN, IMPLEMENTATION, DESIGN PHASE, ALIGNMENT OF WORK.

YES, SIR. IT'S THE CHAIR'S CALL ON THIS. YOU COULD.

IF YOU WANT TO WAIT FOR DOCTOR IRWELL TO TO JOIN THE MEETING BEFORE YOU TAKE THE MOTION UP.

YOU COULD CERTAINLY DO THAT. OR YOU COULD TAKE THE MOTION UP NOW. OR WE CAN GO. LAUREN'S READY TO GO TO THE NEXT. IS SHE GOING TO BE ABLE TO JOIN IN WITH DOCTOR MCKINNEY? FRANCESCA, I SAW DURING THE PROCESS. THIS IS JAMES.

I SAW THAT DOCTOR REALLY SOUGHT TO BE ADMITTED.

IS SHE STILL AVAILABLE? OKAY WHILE SHE'S CHECKING ON IF I MAY, JUST. IF I COULD, IF I COULD TROUBLESHOOT FROM THE DAIS.

MISTER CHAIR, IF YOU'LL PERMIT ME IF IF SOMEBODY COULD CHECK TO MAKE CERTAIN THAT SHE GOT THE CORRECT INVITE BECAUSE THERE WERE MULTIPLE INVITES. BUT THERE WAS ONE SPECIFICALLY FOR AGENCIES AND SYSTEMS AND BOARD MEMBERS.

THIS IS CHRISTINA WITH THE KAYLA. FRANCESCA STEPPED AWAY.

I CAN SEND DOCTOR GURLEY AN INVITE. YES, MA'AM.

PLEASE DO THAT. THANK YOU. THIS SITUATION RECTIFIED.

THANK YOU. AND, MR. CHAIR, IF I CAN JUST KIND OF, IF I MAY, JUST WANT TO KIND OF FILL OUT SOME MORE INFORMATION THAT THIS PROPOSED PLAN, AS I THINK YOU'RE ALL AWARE, WAS PRESENTED TO THE UT SYSTEM BOARD OF REGENTS LAST WEEK ON THE 19TH AND 20TH. DOCTOR ZERWAS MADE A PRESENTATION ON THE, I BELIEVE, ON THE 19TH MEETING, AND THEN IT WAS PASSED UNDER THE CONSENT AGENDA THE FOLLOWING DAY FOR UT TO PROCEED THROUGH, YOU KNOW, THEIR SIGNATORY PROCESS TO THEIR VICE CHANCELLORS AND TO THEIR OFFICE OF GENERAL COUNSEL.

SO THEY ARE A WEEK AHEAD OF US, BUT THEY'RE THEY'VE ALREADY APPROVED THIS TO MOVE FORWARD.

AND THIS IS KIND OF WHERE WE ARE WITH RESPECT TO THE TPA BOARD.

IN THE OTHER DIRECTION YOU MIGHT WANT TO GIVE US I WOULD RECOMMEND, SINCE I DID SEE DOCTOR,

[00:40:02]

THAT WE MAY BE CONSIDER WAITING ON ON THE MOTION.

IT'S YOUR CALL. AND THEN GET MORE INFORMATION FROM MISS BRAMBILLA ABOUT THE NEXT PART OF AGENDA ITEM THREE.

OKAY. THIS IS FRANCESCA COOPER WITH THE ADVISORY COMMITTEE COORDINATION OFFICE.

I'M SORRY. I STEP AWAY FOR A MOMENT. DOCTOR KELLY HAS BEEN SENT AN INVITATION.

WE EXPECT HER TO BE JOINING US MOMENTARILY. THANK YOU FOR CHECKING.

OKAY. CAN I JUST LEAVE THIS PENDING AND GO TO THE NEXT ONE AND THEN COME BACK TO IT? OR DO I HAVE TO? YOU CAN TABLE IT FOR NOW. YOU CAN LEAVE IT PENDING TILL TILL AFTER YOU GET TO.

I THINK IT'S YOUR PREROGATIVE. OKAY. ALL RIGHT, LET'S DO THAT.

ALL RIGHT. SO THAT'S ALL THERE WAS TO AGENDA.

ARE WE GOING TO GO TO THE TO THE SECOND HALF OF THREE AT THIS POINT IN TIME.

YES, SIR. IT'LL BE AGENDA ITEM THREE. A SMALL ROMAN NUMERAL TWO.

GREAT. AND THERE'S A PRESENTATION TO GO ALONG WITH THIS, IF THAT CAN BE PULLED UP AS WELL.

PASTOR COOPER WITH THE ADVISORY COMMITTEE COORDINATION OFFICE. COULD YOU PLEASE IDENTIFY THE REASON THERE ARE FIVE FOR THIS AGENDA ITEM? WE HAD THREE A UP. ARE WE GOING TO THREE BE. YES, FRANCESCA.

THREE BE THE DASHBOARD. THANK YOU. THANK YOU.

CHRISTINE, IF YOU COULD PULL UP THREE B PLEASE.

IT SAYS THE TPF BUSINESS PLAN IMPLEMENTATION, DESIGN PHASE AND ALIGNMENT OF WORK WITH AGENCIES AND.

HIGHER EDUCATION. YEAH. I'M SORRY. AND THIS IS JAMES, A GENERAL COUNSEL.

JUST FOR THOSE FOLLOWING IN THE AUDIENCE AND AT HOME, 3D IS NOT AN AGENDA ITEM.

IT IS A INTERNAL NOMENCLATURE TO DIRECT PULLING UP THE PRESENTATION.

IT'S STILL JUST IT'S PART OF AGENDA ITEM THREE.

YES, SIR. OKAY. AND DISCUSSION. FRANCESCA, WE ARE HAVING A BIT OF TECHNICAL DIFFICULTY.

RIGHT NOW WE ARE WORKING ON THIS. WE SHOULD HAVE THE PRESENTATION PULLED UP SHORTLY.

WELL, IF IT'S OKAY, I'LL GO AHEAD AND GET STARTED.

THE TEXAS PHARMACEUTICAL INITIATIVE SUBMITTED ITS BUSINESS PLAN TO THE GOVERNOR AND THE STATE LEGISLATURE AS REQUIRED ON SEPTEMBER 30TH, 2020 FOR ONE FULL MONTH INTO THE FIRST QUARTER OF THE 2025 FISCAL YEAR, AND ON NOVEMBER 15TH, TOWARD THE END OF THE FIRST QUARTER AND JUST BEFORE THE THANKSGIVING HOLIDAY, I WAS HIRED AS TPI'S DEPUTY EXECUTIVE DIRECTOR OF PROGRAM STRATEGY AND OPERATIONS, WHICH KICKED OFF THE IMPLEMENTATION OF THE TPI PROGRAMS IN EARNEST.

BUILDING UPON THE VITAL GROUNDWORK COMPLETED BY THE TPI TEAM UP TO THAT POINT, AND MATERIAL PROGRESS TOWARD IMPLEMENTATION HAS SINCE BEEN MADE IN A RELATIVELY SHORT AMOUNT OF TIME, AS ILLUSTRATED IN THE SLIDES AND IMPLEMENTATION DASHBOARDS THAT FOLLOW.

NEXT SLIDE PLEASE. ALL RIGHT. DESPITE A DELAYED START, ALL PROGRAMS ARE CURRENTLY ON TRACK.

ALIGNMENT WITH PARTICIPATING STATE AGENCIES AND UNIVERSITY SYSTEMS ON WAVE ONE PROGRAMS HAS BEEN ACHIEVED.

SPECIFICALLY, ALIGNMENT ON A DATA ANALYSIS PILOT, THE DEVELOPMENT OF A ROADMAP FOR DIRECT CONTRACTING WITH MANUFACTURERS, AND THE CREATION OF A FRAMEWORK FOR BUILDING A FACT BASED ON PBM PRACTICES, AND THE IMPLEMENTATION OF ALL WAVE ONE AND WAVE TWO PROGRAMS IS UNDERWAY WITH THE FISCAL YEAR 2027 TARGET COMPLETION TIMEFRAME. ADDITIONALLY, FOUNDATIONAL WORK FOR WAVE THREE, WHICH HAS A TARGET COMPLETION DATE OF FISCAL YEAR 2029, HAS ALSO BEGUN AHEAD OF SCHEDULE. WHILE CURRENTLY ON TRACK, ALL PROGRAMS DEPENDENT UPON REVIEW AND ANALYSIS OF PARTICIPATING STATE AGENCY AND SYSTEM PBM CONTRACTS ARE, HOWEVER, AT RISK OF FALLING BEHIND SCHEDULE, AS THE SHARING OF UNREDACTED VERSIONS OF THESE CONTRACTS HAS BEEN IDENTIFIED AS A CRITICAL PATH ITEM AND REMAINS INCOMPLETE. NEXT SLIDE PLEASE.

SO NOW LET'S LOOK AT IT PROGRAM BY PROGRAM. ON THIS FIRST DASHBOARD WE ARE SHOWING ESTIMATED COMPLETION PERCENTAGES, STATUS UPDATES AND CRITICAL PATH ITEMS FOR WAVE ONE AND WAVE TWO PROGRAMS. NOTE THAT THE VISUALS AND COMPLETION PERCENTAGES SHOWN HERE ARE ESTIMATES BASED ON COMPLETED WORK TO DATE AND EXPECTED WORK AS OF FEBRUARY 2025, AND ARE SUBJECT TO CHANGE AS WE PROCEED THROUGH IMPLEMENTATION AND GATHER NEW INFORMATION.

SO LET'S START WITH PROGRAM ONE B THE CREATION OF A FACT BASED ON PBM BEST PRACTICES.

[00:45:02]

SO FAR, WE HAVE COMPLETED A FRAMEWORK OUTLINING THE COLLABORATION AND STRUCTURE NEEDED TO BUILD THE FACT BASE.

AND WE'RE CURRENTLY IN THE PROCESS OF IDENTIFYING AND PARTNERING WITH EXPERTISE NECESSARY TO BUILD THE FACT BASE THROUGH OUR INTERAGENCY COOPERATION CONTRACT WITH UT.

HIP AT RISK IS OUR REVIEW AND COMPARISON OF UNREDACTED PBM CONTRACTS, AS OBTAINING THOSE CONTRACTS IS A CPI AND CURRENTLY AT RISK.

FUTURE WORK UNDER PROGRAM ONE B WILL INCLUDE THE ACTUARIAL AND CLINICAL ANALYSIS OF AGENCY AND SYSTEM PHARMACY CLAIM UTILIZATION AND SPEND DATA.

NEXT WE HAVE PROGRAM ONE D DIRECT CONTRACTING WITH PHARMACEUTICAL MANUFACTURERS WHICH WE ARE A BIT FURTHER ALONG WITH.

SO FAR, WE HAVE COMPLETED A ROADMAP IDENTIFYING THE PATHWAY FOR DIRECT CONTRACTING WITH MANUFACTURERS.

AND IN PROGRESS IS A PILOT DATA ANALYSIS ACROSS OUR AGENCIES AND SYSTEMS OF ANTI-INFLAMMATORY AND GLP ONE UTILIZATION AND SPEND, AS WELL AS EARLY DISCUSSIONS WITH MANUFACTURERS FOR DIRECT CONTRACTING OPPORTUNITIES.

AT RISK, AGAIN, IS OUR REVIEW AND COMPARISON OF PBM CONTRACTS, WHICH WILL BE NECESSARY TO IDENTIFY AND QUANTIFY THE IMPLICATIONS OF DIRECT TO SUPPLIER CONTRACTING ON OUR AGENCIES AND SYSTEMS. UPCOMING WORK UNDER PROGRAM ONE IS FULL ACTUARIAL AND CLINICAL ANALYSIS OF AGENCY AND SYSTEM PHARMACY CLAIM UTILIZATION AND SPEND DATA. PROGRAM TWO B IS PARTNERING WITH MANUFACTURERS OR NONPROFITS TO SECURE ACCESS TO PRIORITY DRUGS. WE ARE CURRENTLY IN THE PROCESS OF HOLDING EARLY DISCUSSIONS WITH VARIOUS POTENTIAL PARTNERS WITH CAPABILITIES TO HELP US SECURE ACCESS TO THESE DRUGS IN SHORTAGE AND FUTURE WORK FOR PROGRAM TO BE WILL BE TO CONDUCT A NEEDS ASSESSMENT BY PERFORMING ANALYSIS OF UTILIZATION DATA AND COMPARING THE RESULTS TO KNOWN SHORTAGE DRUGS.

PROGRAM THREE A IS BUILDING CAPABILITIES WITHIN THE STATE FOR SHORTAGE SURVEILLANCE.

SO FAR, WE HAVE COMPLETED INITIAL MEETINGS WITH THE FDA, AS WELL AS OTHER PHARMACEUTICAL SUPPLY CHAIN STAKEHOLDERS, TO DISCUSS EXISTING SHORTAGE SURVEILLANCE SYSTEMS AND ASSOCIATED LIMITATIONS.

UPCOMING WORK ON THIS PROGRAM WILL INCLUDE COMPILING A LIST OF ALL TEXAS PHARMACIES AND CONTACT INFORMATION, AND DISCUSSING AN APPROACH FOR ONGOING MONITORING AND COLLABORATION WITH THE VARIOUS PHARMACY ASSOCIATIONS WITHIN THE STATE.

THE LAST PROGRAM, UNDER WAVES ONE AND TWO, IS PROGRAM ONE C HARMONIZING FORMULARIES AND OR PBM CONTRACTS ACROSS THE AGENCIES AND SYSTEMS. AS MENTIONED PREVIOUSLY. PREVIOUSLY, WE ARE CURRENTLY WORKING ON AN AGREEMENT TO PARTNER WITH THE EXPERTISE NECESSARY TO BUILD THE FACT BASE ON PBM BEST PRACTICES, WHICH WILL IN TURN INFORM WHICH POTENTIAL FEATURES AND PRACTICES WE WANT TO REPLICATE OR ELIMINATE ACROSS THE AGENCIES AND SYSTEMS. ALSO IN PROGRESS IS THE COLLECTION AND REVIEW OF FORMULARIES, UTILIZATION MANAGEMENT CRITERIA AND PLAN EXCLUSIONS IN PLACE ACROSS THE PARTICIPATING STATE AGENCIES AND SYSTEMS. AND AT RISK ONCE MORE IS THE EXPERT REVIEW OF STATE AGENCY SYSTEM PBM CONTRACTS.

IN UPCOMING WORK, ONCE WE GET OUR SUBJECT MATTER EXPERTS ENGAGED, WE WILL BE PERFORMING EXPERT CLINICAL REVIEW OF STATE AGENCY FORMULARIES CRITERIA AND PLAN EXCLUSIONS. NEXT SLIDE PLEASE.

MOVING ON TO WAVES THREE AND FOUR PROGRAMS. PER THE TPI BUSINESS PLAN.

THESE PROGRAMS WILL BE THE FOCUS OF FISCAL YEARS 2028 THROUGH 2031.

HOWEVER, THERE IS PRELIMINARY WORK THAT CAN BE DONE SOONER, AND WE ARE STARTING NOW ON THAT FOR PROGRAM ONE A, WHICH IS TO MODULARIZE OR IN-SOURCE PBM FUNCTIONS.

THE WORK WE'RE DOING NOW TO IDENTIFY AND PARTNER WITH SUBJECT MATTER EXPERTS IN SUPPORT OF WAVE ONE AND WAVE TWO PROGRAMS, WILL ALSO LAY THE FOUNDATION FOR THE IMPLEMENTATION OF THIS PROGRAM.

THE SAME SUBJECT MATTER EXPERTISE WILL BE NECESSARY TO ANALYZE THE DECONSTRUCTION OF PBM FUNCTIONS AND IMPACTS OF MODULARIZATION.

AGAIN, AT RISK IS THE REVIEW AND COMPARISON OF PBM CONTRACTS NEEDED TO IDENTIFY AND QUANTIFY IMPLEMENTATION IMPLICATIONS OF PBM CARVE OUTS AND MODULARIZATION. UPCOMING ADDITIONAL PRELIMINARY WORK FOR THIS PROGRAM INCLUDES TALKING TO PRIVATE COMPANIES AND OR STATES WHO HAVE MODULARIZED PBM FUNCTIONS BEFORE AND BEGINNING RESEARCH ON ALTERNATIVE VENDORS CAPABLE OF PERFORMING VARIOUS PBM FUNCTIONS.

WORK ON THE REMAINING WAVE THREE AND WAVE FOUR PROGRAMS, AGAIN IDENTIFIED AS A FOCUS.

YEARS 2028 TO 2031 HAS NOT YET BEGUN, BUT PRELIMINARY FOUNDATIONAL WORK WILL BEGIN AS SOON AS PRACTICAL AND APPROPRIATE.

NEXT SLIDE. KEN, CAN I ASK I WANT TO ASK A QUESTION ABOUT SOMETHING.

AND IF YOU CAN MAKE US. I NEED SOMEBODY TO MAKE ME FEEL BETTER ABOUT THOSE TWO THINGS THAT SAY AT RISK.

YES, YES. AT LEAST GIVE ME AN UPDATE. AND WHAT PROBLEMS WE NEED TO OVERCOME.

[00:50:08]

WE HAVE NOT YET RECEIVED THOSE THE VARIOUS LEGAL TEAMS ARE REVIEWING WITH EACH OF THE AGENCIES.

THEY ALL HAVE THEIR OWN REVIEW PROCESSES AND THEIR OWN RULES AS FAR AS WHAT THEY'RE ABLE, WILLING TO SHARE.

AND WE'RE WORKING THROUGH THAT WITH THEM. AND MIKE, IS THERE ANYTHING YOU WANTED TO ADD? I'M SORRY TO INTERRUPT. WE WE DO HAVE ONE UNREDACTED CONTRACT FROM TRS BY VIRTUE OF NDA, SO IT IS POSSIBLE.

BUT AGAIN, AS LAUREN ALLUDED TO, IT'S DIFFERENT AGENCIES HAVE DIFFERENT LEGAL PERSPECTIVES AND INTERPRETATIONS OF CONTRACTUALLY WHAT THEY CAN DO.

BUT WE DO HAVE ONE FROM TRS. THE REST ARE ALL UNREDACTED.

AS LAUREN MENTIONED. THANK YOU FOR LETTING ME END. I'VE GOT SOME FOLLOW UP AFTER LAUREN COMPLETES HER RESPONSE.

ONE QUESTION ON THAT TOO. AND THEY'RE ALL THE PBMS THAT SERVE ALL THE AGENCIES UNDER THE PURVIEW OF TPA.

ARE ALL SCRIPTS RIGHT? IS THAT CORRECT? ON THE PBM SIDE, EXPRESS SCRIPTS.

EXPRESS SCRIPTS? YES, SIR. LAUREN, WAS THERE ADDITIONAL.

NO. THAT'S IT. SO. IF I MAY, TO ADD ON TO WHAT LAUREN JUST SAID, WE ACTUALLY WENT BACK AND FORTH ON THIS.

DO WE LIST THIS AT RISK OR NOT? BUT BECAUSE OF THESE ARE CRITICAL PATH ITEMS, YOU GOT TO HAVE DATA.

YOU GOT TO HAVE CONTRACTS. I MEAN, IF WE'RE IF WE'RE TO WORK TOGETHER AND LEVERAGE OUR STRENGTH IS IS AGENCIES AND ORGANIZATIONS, YOU HAVE TO HAVE THOSE TWO THINGS. OTHERWISE THERE IS WORK THAT YOU CAN DO WITH VARIOUS DATA SETS.

AND WE ARE DOING THAT. AND THE AGENCIES HAVE YOU KNOW, WE'RE WE'RE WORKING ON THAT RIGHT NOW WITH THIS PILOT PROJECT THAT LAUREN JUST MENTIONED.

BUT WHAT'S REALLY AT THE HEART OF IT ALL IS THE UNREDACTED CLAIMS IN SOME MEDICAL RELATED DATA, PERHAPS, AND I'LL LET DATA SCIENTISTS AND EXPERTS GET INTO WHAT ALL IS NEEDED.

BUT THE UNREDACTED CLAIMS PIECE MEANS THAT THERE IS GOING TO BE SOME PROTECTED INFORMATION THAT WE ARE GOING TO NEED TO BE ABLE TO, TO CONTINUE TO, TO DO OUR WORK. SO WITH THAT UNDERSTANDING ABOUT WHY WE'VE, WE'VE SET THIS AT RISK.

I THINK IT'S DOCTOR MCKINNEY. IN RESPONSE TO YOUR QUESTION, THE AGENCIES AND TBI WERE ALL ENGAGING WITH EACH OTHER, TRYING TO FIGURE OUT HOW IS THAT WE RESOLVE THIS PROBLEM. I WANT TO COMMEND SOME LAWYERS AND DIFFERENT AGENCIES THAT HAVE STEPPED UP TO TALK TO OTHER LAWYERS IN THE AGENCIES, ALONG WITH JAMES, TO START RESOLVING SOME OF THESE LEGAL ISSUES.

I THINK IT BOILS DOWN TO, AGAIN, EACH AGENCY HAS THEIR OWN GENERAL COUNSELS, AND THEY'VE EACH GOT DIFFERENT VIEWS OR DIFFERENT LEGAL CONCERNS OR DIFFERENT INTERPRETATIONS OF CONTRACTS AND STATUTES THAT AFFECT THIS.

AND IT'S TRYING TO GET ALL THE AGENCIES ADDRESS ALL OF THOSE CONCERNS NOW.

AND I'LL SPEAK TO THIS IN THE EXECUTIVE DIRECTOR'S REPORT. WHILE THAT WORK IS CONTINUING, AND I DO BELIEVE IT'S CONTINUING IN EARNEST.

AND WE'VE GOT SOME POSITIVE UPDATES, EVEN AS RECENTLY AS YESTERDAY FROM ONE OF THE AGENCIES IN THIS REGARD.

WE DO NEED TO GO TO THE LEGISLATURE TO SEEK LEGISLATION TO CREATE A SAFE HARBOR, IF YOU WILL, WHERE AGENCIES CAN SHARE THAT DATA AND SHARE THOSE CONTRACTS WITH US SO THAT WE CAN OPERATE AT OUR OPTIMUM STRENGTH AS A AS AN ORGANIZATION WORKING WITH OTHER AGENCIES. I THINK IN SOME INSTANCES, AND I'LL DEFER TO LEGAL COUNSEL ON THIS.

FOR EXAMPLE, THERE ARE PROVISIONS IN HIPAA WHICH IF THERE IS A STATUTORY MANDATE TO SHARE CERTAIN DATA SETS, AGAIN, THAT IS CONSIDERED A SAFE HARBOR. I'M USING THAT PHRASE AS JUST FOR MY OWN UNDERSTANDING AND ARTICULATION.

THERE MAY BE A TECHNICALLY A DIFFERENT LEGAL PHRASE TO IT, BUT HAVING THAT IN THERE PROVIDES THAT AIR COVER, IF YOU WILL, WHERE YOU CAN COME IN AND SHARE THE DATA AND WHATEVER IS NECESSARY TO BE ABLE TO PERFECT WHAT IT IS THAT YOU'RE WORKING WITH.

IT'S ALMOST SEEN AS WELL. I'M PROBABLY OVER TALKING THIS, BUT IT'S IT'S A SAFE HARBOR, IF YOU WILL.

SO I DON'T KNOW IF THAT FULLY ANSWERS THE QUESTION OR GETS YOU TO.

I WOULD SAY THAT IT GIVES MORE DEFENSE TO SHARING THE DATA, WHETHER IT CREATES A PURE SAFE HARBOR TO HAVE TO LOOK AT THE STATUTORY LANGUAGE, BUT IT DOES GIVE A MORE COMFORT IF IT'S NOT A PURE SAFE HARBOR EXCEPTION OR LACK OF A BETTER PHRASE,

[00:55:05]

THE HIPAA, HIPAA HAS TAKEN ON A LIFE OF ITS OWN FROM WHAT IT WAS ORIGINALLY DESIGNED FOR.

PORTABILITY WAS THE ORIGIN OF ALL THIS. BUT THERE'S ALWAYS BEEN A REQUIREMENT, ETHICALLY, OF NOT REVEALING PERSONALLY IDENTIFIABLE INFORMATION.

HEALTH INFORMATION. I KNOW FROM SITTING ON THE OTHER SIDE OF THIS THAT CLAIMS CLAIM SHOP OF THE MCOS GET ALL THE INFORMATION.

THAT'S THE ONLY WAY ANYBODY GETS PAID. I KNOW THAT THE INSURANCE COMPANIES HAVE ACCESS WITHOUT RELEASE. I KNOW THAT SOMEBODY WITHIN THE STATE AND THE AGENCIES OR THE UNIVERSITIES OR WHOEVER, THAT'S AN ENTITY THAT HAS ACCESS.

I'M JUST. I KEEP WONDERING WHO LET.

SOMEBODY WITHIN THE ACTUARIES GOT TO HAVE ACCESS TO IT.

IF WE'RE GOING TO SET THE PREMIUMS FOR THE NEXT GO ROUND, THE ACTUARY HAS TO SEE ALL THAT STUFF.

WE DON'T NEED TO SEE THEIR NAME. I DON'T CARE ABOUT THAT.

BUT I DO CARE ABOUT THE THE THE DEMOGRAPHICS.

IF YOU'RE GOING TO DETERMINE AN APPROPRIATE RATE FOR, FOR 4 OR 5 DIFFERENT CONSTITUENCIES OF INSURED INSURANCE COMPANIES, AND THAT'S WHAT WE'RE TALKING ABOUT.

BASICALLY, YOU'VE GOT TO BE ABLE TO IDENTIFY UTILIZATION.

YOU'VE GOT TO BE ABLE TO IDENTIFY PRESCRIBING PATTERNS, FRANKLY, RUNNING AN MCO.

I ALSO WANT TO KNOW WHAT PHYSICIAN IS WRITING, WHAT PRESCRIPTIONS.

THAT MAKES A DIFFERENCE. AND. AGAIN, I GO BACK TO WE ALL HAVE THE SAME BOSS.

I'M JUST TRYING TO FIGURE OUT WHO WOULD LET YOU SIGN A CONTRACT IF I WANTED TO PRECLUDE IF I WANTED TO EXCLUDE SOMETHING FROM THE, YOU KNOW, PUBLIC DOMAIN EVEN IN A REDACTED VERSION.

EVENTUALLY, I GUESS THE AG IS THE FINAL ARBITER OF THAT.

MAYBE THE COURTS ARE, I DON'T KNOW. BUT IF I MAY, FIRST, I AGREE, SINCE YOU KNOW THE VARIOUS RELATIONSHIPS YOU'VE IDENTIFIED THERE, THERE IS A BUSINESS RELATIONSHIP.

THERE IS EITHER A DIRECT CONTRACT BETWEEN AGENCY A AND A PBM OR A MEDICAL PROVIDER PROCESSING CLAIMS. SO THAT'S OKAY, RIGHT? WE JUST DON'T HAVE THAT DIRECT RELATIONSHIP, AND THAT'S WHAT WE'RE TRYING TO SECURE.

WITH RESPECT FROM THE VARIOUS AGENCIES AND SYSTEMS AND EITHER TPA AND OR A VENDOR PARTNER TO DO THE WORK.

SO IT'S GETTING THE DETAILS IRONED OUT OF HOW THAT RELATIONSHIP WOULD BE FRAMED.

BECAUSE TPA DOESN'T NECESSARILY WANT TO BE THE CARETAKER OF THE RAW DATA.

RIGHT. AND THEN WE'D HAVE TO PASS THE RAW DATA ON TO A THIRD PARTY, WHETHER IT'S YOU OR SOMEBODY ELSE DOWN THE ROAD.

SO IT'S GETTING THAT RELATIONSHIP THAT YOU DESCRIBE WHICH EXISTS IN THOSE OTHER CIRCUMSTANCES THAT WE DON'T HAVE RIGHT NOW.

AND THAT'S WHAT WE'RE TRYING TO TO WORK OUT. AND AGAIN, EVERY PLAN IS ENTITLED TO THEIR TO THEIR OWN ADVICE FROM THEIR LEGAL COUNSEL.

AND THEIR LEGAL COUNSEL IS TAKING CARE OF THEIR OWN CLIENTS TO MAKE SURE THAT THEY DON'T RUN AFOUL OF WHAT CAN BE VERY STRICT AND SEVERE PUNISHMENT OR PENALTIES, IF YOU DO, ARE DEEMED TO HAVE RUN AFOUL OF HIPAA AND EXPOSURE OF PHI WITHOUT THE APPROPRIATE SAFEGUARDS IN PLACE.

AND WHAT ABOUT. WHAT ABOUT THE CONTRACTS? I JUST I JUST CAN'T IMAGINE.

I FEEL A LOT BETTER ABOUT THE CONTRACT, SIR. OKAY.

THAN, YOU KNOW, AGAIN, I GO BACK TO WE HAVE 181 BOXES THAT SIT DOWNTOWN.

A LOT MORE THAN THAT, BUT 181 OF THEM THAT ARE IN TOWN A LOT.

RIGHT? YES, SIR. AND I, I JUST CAN'T IMAGINE EVER SIGNING A CONTRACT THAT SAYS SPECIFICALLY, I CAN'T TELL MY BOSS WHAT'S IN THIS CONTRACT.

IT'S KIND OF LIKE WE GOT TO PASS IT BEFORE YOU CAN KNOW WHAT'S IN IT.

[01:00:01]

AND SO IS THERE IS THERE EDITORIAL COMMENT? ARE WE AWARE OF ANYTHING? COULD EXPRESS SCRIPTS HAVE A DOG IN THE HUNT? WHY THEY DON'T WANT COMMUNICATION TO OCCUR. AND BECAUSE I KNOW WE'RE GOING TO FIND RIGHT DISCREPANCIES ACROSS THE AGENCIES IN TERMS OF PRICING.

IS THERE AN EFFORT BY THEM THAT WE'RE AWARE OF TO PREVENT THAT? I DON'T WANT TO SPEAK FOR THE AGENCIES OTHER THAN TO SAY OR EXPRESS SCRIPTS FOR THAT MATTER.

AS A MEMBER, I CAN TELL YOU WHAT I KNOW. I DO KNOW THAT THE AGENCIES WERE TALKING TO EXPRESS SCRIPTS RIGHT NOW.

THAT'S REALLY. IT'S REALLY IN EVERYBODY'S BEST INTEREST THAT WE GET TO THE POINT WHERE WE CAN SHARE THESE UNREDACTED CONTRACTS. LIKE I SAID, WE'VE GOT THE REDACTED VERSIONS, BUT TO BE ABLE TO FULLY ANALYZE, AS LAWRENCE SAID, WE WOULD NEED THAT. SO I THINK IT'S IN EVERYBODY'S BEST INTEREST TO SEE TO IT THAT THE STATUTE IS IMPLEMENTED TO THE FULLEST EXTENT POSSIBLE.

YEAH, I MEAN, EVERYBODY IT'S NOT JUST THE AGENCIES. THERE'S SOME EVERYBODY THAT'S INVOLVED IN THIS NEED TO BE WITHHELD.

I MEAN, LIKE NUMBERS. YEAH. AND PREMIUMS AND, YOU KNOW, THEIR THEIR OWN ACTUARY DETERMINATIONS IN THE NEGOTIATIONS.

BUT WHEN WE'RE SPENDING THE STATE MONEY AND THAT'S WHAT THIS IS, THAT'S ACTUALLY THE, THE, THE REASON THAT, THAT THE, THE ORIGINAL LEGISLATION WAS SO BROAD, IT WAS LOOKING AT WHAT MONEY OR WHAT PROGRAMS WERE FUNDED WITH STATE FUNDS, PARTIALLY OR COMPLETELY.

NOT TO COIN A PHRASE, BUT I BELIEVE THAT PEOPLE HAVE A RIGHT TO KNOW HOW THEY'RE SPENDING THEIR MONEY.

OKAY, WE'LL PASS THE PLATE LATER. ALL RIGHT. SHALL WE MOVE ON TO WELL, ONE LAST COMMENT ON ON THE DASHBOARDS.

AND THAT'S SIMPLY TO SAY THAT WE DO EXPECT AND INTEND FOR THESE IMPLEMENTATION DASHBOARDS TO EXPAND AND EVOLVE OVER TIME DEPENDING ON THE NEEDS OF THE PROJECT.

SO EVENTUALLY THEY WILL INCLUDE KPIS AND TRACKING OF VARIOUS PERFORMANCE MEASURES OF THE PROGRAMS THEMSELVES AS APPROPRIATE.

BUT THAT'S THAT'S IT FOR THE IMPLEMENTATION DASHBOARDS.

AND NOW IF WE CAN SWITCH OVER TO THE THE ROADMAP PROGRAM 1D AND THE FACT BASED PROGRAM 1D PRESENTATION IS THAT THE NEXT ONE TO. BE CALLED THREE C IN OUR NOMENCLATURE OKAY.

ALL RIGHT. THANK YOU. SO HERE WE'LL DIVE A LITTLE DEEPER INTO TWO PIECES OF WORK COMPLETED TO DATE THAT WE'VE WORKED WITH THE AGENCIES AND SYSTEMS TO ACHIEVE ALIGNMENT ON NEXT SLIDE PLEASE. PROGRAMS 1D DIRECT CONTRACTING WITH MANUFACTURERS AND ONE BE CREATION OF A FACT BASE ON PBM BEST PRACTICES. THESE ARE TWO PROGRAMS DESIGNATED BY THE TPI BUSINESS PLAN FOR WAVE ONE IMPLEMENTATION, BEGINNING IN FISCAL YEAR 2025, AND INITIAL PROGRESS ON THESE PROGRAMS INCLUDES PLANS OR BLUEPRINTS DETAILING HOW EACH WILL BE FRAMED OR STRUCTURED AS ILLUSTRATED IN THE SLIDES THAT FOLLOW. NEXT SLIDE PLEASE.

SO THERE ARE SEVEN MAJOR MILESTONES WITH RESPECT TO DIRECT CONTRACTING FOR PRESCRIPTION DRUGS ONBOARDING OF EXPERTISE AND FUNCTIONALITY.

DRUG TARGETING. PROCUREMENT PATHWAY TARGETING.

SOLUTION MODELING, MANUFACTURER OR SUPPLIER TARGETING, AGENCY INTEGRATION, PLANNING AND MODELING, AND FINALLY SUPPLIER NEGOTIATION AND CONTRACT EXECUTION.

AND EACH OF THESE MILESTONES HAS SEVERAL KEY STEPS NECESSARY FOR EXECUTION.

NEXT SLIDE. SO ONBOARDING OF EXPERTISE AND FUNCTIONALITY TO COMPLETE MANY OF THE SUBSEQUENT MILESTONES WHICH INVOLVE DATA, CLINICAL ANALYSIS, FINANCIAL MODELING, LEGAL ANALYSIS, ETC.

WE'LL NEED TO ONBOARD RESOURCES CAPABLE OF DOING THAT WORK, WHICH REQUIRES A HIGH DEGREE OF OFTEN VERY SPECIALIZED EXPERTISE.

WE'LL NEED DATA ANALYSTS AND ACTUARIES. WE'LL NEED FUNCTIONALITY TO STORE ALL THE DATA WE'LL NEED TO COMPILE, AND THE ABILITY TO SLICE AND DICE IT AND MODEL DIFFERENT SCENARIOS.

WE'LL ALSO NEED TO MAKE SURE WE'RE ABLE TO KEEP THIS HIGHLY SENSITIVE DATA SECURE.

AND WE'LL NEED PHARMACEUTICAL EXPERTS, EXPERTS IN PHARMACEUTICAL ECONOMICS AND PHARMACY INDUSTRY BUSINESS PRACTICES, INDIVIDUALS THAT HAVE EXPERIENCE IN AND KNOWLEDGE OF DRUG PRICING, KNOWLEDGE OF DRUG SALES AND PURCHASING AT ALL POINTS ALONG THE SUPPLY CHAIN.

[01:05:05]

PEOPLE WITH KNOWLEDGE OF RETAIL PHARMACY OPERATIONS EXPERTISE RELATED TO PBM OWNED MAIL ORDER AND SPECIALTY PHARMACY PRACTICES.

EXPERTS ON DRUGS DISPENSED VIA THE MAIL MEDICAL PLAN CHANNEL ADMINISTERED IN A HOSPITAL OR BY OUTPATIENT PHYSICIAN.

PEOPLE THAT KNOW ALL THE VARIOUS STAKEHOLDER INCENTIVES AND MOTIVATORS, AND PEOPLE THAT ARE FAMILIAR WITH ALL THE NUMEROUS DISRUPTORS AND INNOVATORS IN THE MARKET. WE MAY ALSO NEED ADDITIONAL LEGAL EXPERTISE WITH SPECIFIC EXPERTISE IN PHARMACEUTICAL INDUSTRY PRACTICES, AND WE WILL NEED CLINICAL EXPERTISE, CLINICIANS WITH BROAD EXPERTISE, AND THOSE WITH HIGHLY SPECIALIZED KNOWLEDGE ACROSS ALL MAJOR DISEASE STATES AND WILL WANT TO INCLUDE CENTERS OF EXCELLENCE CLINICIANS AS WELL AS LOCAL OR COMMUNITY PROVIDERS.

TOGETHER, THIS GROUP OF MEDICAL AND PHARMACEUTICAL CLINICIANS WILL ADVISE ON FORMULARY DECISIONS AND OTHER CLINICAL TOPICS IN ANALYSIS THROUGHOUT THE PROJECT.

NEXT SLIDE. BUT WHICH DRUGS DO WE WANT TO CONTRACT DIRECTLY FOR THEIR SAVINGS TO BE HAD IN CLINICAL VALUE TO BE OBTAINED, BUT WE WON'T KNOW EXACTLY WHAT THAT IS WITHOUT CONDUCTING IN-DEPTH ANALYSIS AND EXPERT REVIEW.

SO THE FIRST STEP NECESSARY TO BEGIN THAT ANALYSIS IS TO EXECUTE DATA SHARING AGREEMENTS.

THEN WE'LL NEED TO EXCHANGE THE DATA, GETTING IT FROM AGENCY PARTNERS TO OUR EXPERT ANALYSTS TO LOAD AND TEST WITHIN THEIR SYSTEMS AND MODELS.

THEN WE'LL RUN THE DATA ANALYTICS LOOKING AT UTILIZATION AND SPEND TO IDENTIFY POTENTIAL TARGET DRUGS FOR DIRECT CONTRACTING.

FINALLY, WE'D BRING IN OUR CLINICAL EXPERTS TO REVIEW THE UTILIZATION ANALYSIS AND APPLY THEIR CLINICAL KNOWLEDGE AND EXPERTISE TO REFINE OUR LIST OF POTENTIAL TARGET DRUGS TO PURSUE. NEXT SLIDE. SO AT THIS MILESTONE, CONSIDERS THE FOLLOWING QUESTIONS.

WHAT OPPORTUNITIES DO WE HAVE TO CONTRACT DIFFERENTLY? WHO DO WE WANT TO CONTRACT WITH AND WHAT TYPE OF CONTRACT DO WE EVEN WANT? AND TO ANSWER THESE, WE'LL NEED TO PERFORM AN EXPERT REVIEW OF CURRENT PBM AND MEDICAL CONTRACT LANGUAGE DETERMINE THE FINANCIAL AND OTHER CONTRACTUAL IMPACTS OF DIRECT CONTRACTING. EXPLORE THE VARIOUS CHANNELS FOR DIRECT CONTRACTING.

PERFORM ANALYSIS MODEL FINANCIALS OF POTENTIAL OPPORTUNITIES, AND MAKE RECOMMENDATIONS ON THE MOST ADVANTAGEOUS PATH FORWARD AND DEFINE THE CONTRACT STRUCTURE. DO WE WANT A NET COST CONTRACT? A VALUE BASED CONTRACT OR AN ACCESS CONTRACT? NEXT SLIDE. AND THIS IS WHAT WE MEAN BY EXPLORING THE VARIOUS CHANNELS FOR DIRECT CONTRACTING.

WE COULD GO RIGHT TO THE SOURCE IN DIRECT CONTRACT WITH THE MANUFACTURER.

WE COULD ALSO EXPLORE DIRECT CONTRACTING A LITTLE FURTHER DOWNSTREAM WITH THE WHOLESALER.

WE COULD ALSO CONSIDER CUTTING A DEAL WITH THE PHARMACIES.

AND FINALLY, WE HAVE THE OTHER CATEGORY. WITH A NUMBER OF THINGS LUMPED IN HERE, WE COULD CONTRACT WITH A COMBINATION OF ENTITIES TO CREATE OUR OWN SUPPLY AND DELIVERY SYSTEM. OR WE COULD LOOK AT MAKING A DEAL WITH A DISRUPTOR LIKE MARK CUBAN, COST PLUS DRUG COMPANY, OR EVEN A NONPROFIT LIKE CIVICA RX. SOMETHING TO CONSIDER, THOUGH, IS WHETHER OR NOT THE SAVINGS POTENTIAL DECREASES THE FURTHER DOWNSTREAM YOU GET, OR THE FURTHER AWAY THAT YOU GET FROM THE SOURCE.

EACH OF THE ENTITIES IN THE MIDDLE OF THE SUPPLY CHAIN TAKES PROFIT.

SO IN THEORY, THE MORE MIDDLEMEN YOU BYPASS, I.E.

IF YOU GO DIRECTLY TO THE MANUFACTURER, THE MORE SAVINGS YOU WILL GET.

BUT FOR EVERY FUNCTION IN THE MIDDLE THAT YOU CUT OUT, THE MORE YOU WILL LIKELY HAVE TO BUILD BACK OR SOURCE ON YOUR OWN, WHICH WILL COST MONEY. SO ARE WE REALLY GOING TO ACHIEVE THE SAVINGS WE'RE LOOKING FOR? MAYBE. OR MAYBE NOT. BUT JUST SOMETHING TO THINK ABOUT.

AND THESE ARE ALL THE THINGS THAT WOULD NEED TO BE MODELED BEFORE PURSUING ANY CERTAIN PATH.

SO AGAIN, OPTIONS THAT WE'LL NEED EXPERTS WITH KNOWLEDGE OF THE INS AND OUTS OF ALL THESE PATHWAYS TO ANALYSIS TO ANALYZE OUR DATA AND OUR CONTRACTS, QUANTIFY THE IMPACTS, MODEL THE FINANCIALS AND MAKE RECOMMENDATIONS.

NEXT SLIDE PLEASE. SO WHAT TYPE OF CONTRACT DO WE WANT OR NEED? AGAIN, I MENTIONED THE NET COST CONTRACT. WE COULD NEGOTIATE JUST A LOW NET LOW COST NET OF REBATES DEAL.

OR WE COULD DO A VALUE BASED CONTRACT. FINALLY, WE COULD ALSO LOOK AT AN ACCESS CONTRACT IF WE'RE LOOKING TO PROCURE A SUPPLY OF CERTAIN DRUGS IN SHORTAGE. SO AGAIN, WE HAVE OPTIONS IN THE EXPERT ANALYSIS THAT WE'LL BE DOING WILL HELP US NARROW OUR FOCUS.

NEXT SLIDE. SO ONCE WE HAVE THE SHORT LIST OF DRUGS TO TARGET AND THE SUPPLIER TYPES AT VARIOUS POINTS IN THE SUPPLY CHAIN THAT WE MAY WANT TO ENGAGE, AND WE KNOW THE TYPE OF CONTRACTS THAT WE MAY WANT TO EXECUTE.

WE'LL NEED OUR ACTUARIES AND DATA ANALYSTS TO MODEL EXPECTED UTILIZATION AND SPEND FOR EACH AGENCY UNDER THESE DIRECT CONTRACTING SOLUTIONS, AND WE'LL NEED OUR PHARMACEUTICAL ECONOMICS AND PRACTICES EXPERTS TO ADVISE ON THE FEASIBILITY,

[01:10:03]

IF WE BREAK A LINK UPSTREAM. AND WE'LL NEED OUR CLINICAL EXPERTS TO ADVISE ON CLINICAL APPROPRIATENESS OF THE SOLUTIONS AND IMPACTS ON PATIENT CARE OR PROVIDER BEHAVIORS.

THEN WE'LL NEED OUR ACTUARIES AND ANALYSTS TO COMPARE THE MODELED AGENCY SPEND AND UTILIZATION UNDER ALTERNATIVE SOLUTIONS TO THE STATUS QUO, SPEND AND UTILIZATION FOR EACH AGENCY TO DECIDE IF ANY ALTERNATIVE SOLUTION IS DESIRABLE.

NEXT SLIDE. AND IF WE DETERMINE THERE IS VALUE IN PURSUING A PARTICULAR DIRECT CONTRACTING SOLUTION, THEN WE'LL NEED TO NARROW OUR FOCUS AND TARGET SPECIFIC SUPPLIERS.

WE WILL RESEARCH AND DEVELOP A LIST OF APPROPRIATE TARGET SUPPLIERS FOR DRUGS OF INTEREST, HOLD DISCOVERY AND INTEREST SESSIONS WITH THE TARGET SUPPLIERS TO DISCUSS CAPABILITIES, LIMITATIONS, REQUIREMENTS, AND INTEREST IN PURSUING ENGAGEMENTS WITH TPI.

AND THEN WE'LL IDENTIFY AND NARROW OPPORTUNITIES WITH POTENTIAL AND BEGIN CONCEPTUAL SOLUTION CREATION AND EARLY STAGE NEGOTIATIONS.

AND NOTE THIS IS SOMETHING THAT WE CAN START SOONER, AND WE HAVE ALREADY BEGUN THESE INITIAL CONVERSATIONS.

IT'S JUST LATER IN THE IN THE PATHWAY. WE'LL NEED TO HAVE IT FINALIZED, BUT THESE THINGS ARE ALREADY IN PROGRESS.

NEXT SLIDE. AT THIS STAGE, DECISIONS WILL NEED TO BE MADE REGARDING IF, HOW AND WHEN WE WILL IMPLEMENT WITH OUR AGENCIES. SO EXPERT TEAMS WILL COORDINATE WITH OUR AGENCY PARTNERS TO SUGGEST INTEGRATION PARAMETERS.

A PHASED APPROACH AND TIMING. THE ANALYTICS TEAM, WITH SUPPORT FROM OTHER EXPERTS, WILL REMODEL THE SOLUTIONS.

SAVINGS AND IMPACTS, MAKING ANY ADJUSTMENTS DUE TO AGREED UPON AGENCY PHASE AND APPROACH AND THEN RECONFIRM DESIRABILITY AND VIABILITY.

NEXT SLIDE. FINALLY ONCE WE KNOW WHAT SUPPLIERS WE'RE CONTRACTING WITH, WHAT WE'RE IMPLEMENTING, AND WHICH PLANS WE'RE IMPLEMENTING IT FOR AND WHEN.

THEN WE'LL BE READY TO EXECUTE CONTRACTS WITH THE MANUFACTURERS OR SUPPLIERS, AND AMEND OR OTHERWISE CARE FOR THE EXISTING AGENCY CONTRACTS WITH THE PBMS OR CARRIERS AS NEEDED. ALL RIGHT. NEXT SLIDE PLEASE.

ONE QUESTION ON THAT. OKAY. KIND OF LIKE DOCTOR MCKINNEY BRINGING UP THE AT RISK.

I'M PRESUMING THAT IF WE'RE TRYING TO DO SOMETHING WITH EXPRESS SCRIPTS OR ANY PBM WILL BE AN AMENDED CONTRACT, WHY DO YOU SAY IF NECESSARY? WHAT IS. DOES THAT REALLY MEAN ANYTHING? THERE WILL LIKELY NEED TO BE CONTRACTS AMENDED DEPENDING ON WHAT WE DO.

IT'S JUST MORE OF AN UNCERTAINTY RIGHT NOW ABOUT EXACTLY WHAT THAT WILL LOOK LIKE.

UNTIL WE GET IN AND LOOK AT THE ANALYSIS AND SEE WHERE THAT LEADS US IS THE.

YES, SIR. IT'S STILL A VARIABLE THAT'S OUT THERE.

YES. THERE'S WHAT YOU'VE SEEN IN THE BULK OF THE PRESENTATION UNDER AGENDA ITEM THREE TODAY.

THESE ARE THE BUILDING BLOCKS. BUT TO EVEN ANSWER THAT QUESTION, YOU KNOW, FIRST YOU HAVE A THRESHOLD QUESTION OF, YOU KNOW, WHAT'S THE WHAT'S THE BUSINESS CASE AROUND CREATING SOMETHING VERSUS WHITE LABELING SOMETHING VERSUS SOME OTHER OPTION THAT YOU KNOW, IS HASN'T BEEN CREATED YET THAT WOULD NEED TO COME BACK TO THIS BOARD.

WE WOULD NEED TO GIVE YOU SOME IDEA ABOUT, YOU KNOW, GOING BACK TO THE ROAD MAP HERE, WHAT ROUTE WE WOULD WANT TO GO ON THAT AND THEN GET SOME DIRECTION AND THEN COME BACK AND THEN PRESENT SOME BUSINESS CASE ANALYSIS TO SHOW.

HERE'S THE PROS AND CONS OF DOING ALL THAT. WE WOULDN'T JUST FLIP A SWITCH AND SAY, YOU KNOW, WE WOULD LIKE TO GO OUT AND CONTRACT WITH A SINGLE PBM OR CREATE OUR OWN OR DO A WHITE LABEL DEAL.

WE WOULD WANT TO BRING EVERYTHING BACK TO THE BOARD FIRST.

AND IF THERE ARE NO OTHER QUESTIONS ON THAT, WE CAN GO ON TO THE NEXT SLIDE.

SO SWITCHING GEARS JUST A LITTLE BIT, THIS IS WITH REGARD TO PROGRAM ONE B BUILDING A FACT BASE.

SO A FRAMEWORK HAS BEEN CREATED TO OUTLINE THE EXPERTISE AND COORDINATION NEEDED TO DEVELOP THE FACT BASE ON PBM PRACTICES.

INCLUDED IN THIS FRAMEWORK IS A LIST OF THE VARIOUS DISCIPLINES OR CATEGORIES OF EXPERTISE THAT WOULD NEED TO BE ENGAGED TO COMPLETE A THOROUGH ANALYSIS OF EACH AGENCY'S CURRENT BASELINE STATE, INCLUDING CONTRACT PROVISIONS, UTILIZATION AND SPEND, INSIGHTS AND TRENDS,

[01:15:01]

PHARMACEUTICAL INDUSTRY LEGAL EXPERTS AND CLINICIANS, BOTH ON THE MEDICAL AND PHARMACEUTICAL SIDE AND WITHIN EACH DISCIPLINE CATEGORY, ARE THE SPECIFIC AREAS OF EXPERTISE THAT WOULD NEED TO BE ENGAGED OR ONBOARDED TO DEVELOP THE FACT BASE.

THERE ARE OVER 35 AREAS OF EXPERTISE LISTED HERE, AND THAT LIST IS LIKELY NOT ALL INCLUSIVE.

ONE THING TO NOTE IS THAT EACH ONE OF THESE IDENTIFIED AREAS OF EXPERTISE DOES NOT NECESSARILY CORRELATE TO A SINGLE INDIVIDUAL OR A SINGLE FULL TIME PERSON.

IN OTHER WORDS, ONE PERSON MIGHT HAVE SUBJECT MATTER EXPERTISE IN MULTIPLE AREAS LISTED ALSO, FULL TIME HEADCOUNT ASSOCIATED WITH EACH AREA OF EXPERTISE IS NOT ANTICIPATED.

INSTEAD, MANY OF THESE WILL LIKELY BE INDIVIDUALS WE CONTRACT WITH FOR SHORT TERM OR PROJECT SPECIFIC BASIS VERSUS FULL TIME HIRES.

SO HOW DO WE EXTRACT THE EXPERTISE CONTAINED IN THE MINDS OF ALL OF THESE EXPERTS AND INDIVIDUALS, APPLY IT TO OUR AGENCY SPECIFIC CONTRACTS AND DATA, AND SPIT OUT A FACT BASE? WELL, EACH OF THESE EXPERTS WILL BE PERFORMING ANALYSIS, SOME OF WHICH WILL LIKELY BE INDEPENDENT, WHILE SOME WILL BE COLLABORATIVE. THUS, WE ANTICIPATE A NEED FOR AN ASSIGNED LEAD FROM EACH DISCIPLINE.

WHO WOULD BE RESPONSIBLE FOR COORDINATION AND COLLABORATION BETWEEN AND WITHIN THE DISCIPLINES.

ADDITIONALLY, THERE WILL BE AN ADDED LAYER OF PROJECT MANAGERS THAT OVERSEE AND COORDINATE THE COLLABORATION ACROSS ALL THE VARIOUS DISCIPLINE GROUPS, KEEPING EVERYONE FOCUSED AND ON TRACK. AND THEN THERE WILL BE OUTPUT FROM EACH OF THESE INDIVIDUAL DISCIPLINES AND WORK STREAMS. SO THEN WE WILL NEED REVIEWS OF THAT OUTPUT FIRST, REVIEWS INTERNALLY WITHIN EACH DISCIPLINE AND THEN COLLABORATIVE REVIEW MEETINGS WITH OTHER DISCIPLINES. AND THOSE WOULD BE COORDINATED BY THE DISCIPLINARY LEADS AND THE PROJECT MANAGERS AND TPI STAFF WOULD PROVIDE OVERSIGHT ALONG THE WAY.

ATTENDING THE COLLABORATIVE REVIEW MEETINGS AS NEEDED.

AND THEY'LL NEED TO BE COLLABORATION AND PARTICIPATION WITH THE AGENCIES.

WE ANTICIPATE ONGOING REGULAR REPORT OUTS TO OUR AGENCY, PARTNERS AND SYSTEMS ALONG THE WAY, WHERE FINDINGS AND INSIGHTS FROM THE ANALYSIS AND WORK PERFORMED WILL BE SHARED AND WHERE AGENCY INPUT WILL BE COLLECTED.

THERE WILL BE DIFFERENT LEVELS OF COLLABORATIVE MEETINGS, WITH VARYING DEGREES OF ATTENDANCE AND PARTICIPATION EXPECTED FROM THE AGENCIES.

AND A KEY PURPOSE OF THIS DIFFERENTIATION IS TO MAKE THE MOST EFFICIENT USE OF OUR AGENCY PARTNERS TIME AND BANDWIDTH.

AND THE FINAL OUTPUT FROM ALL OF THIS ANALYSIS AND COLLABORATION WILL BE THE FACT BASE.

ANY QUESTIONS ON ON THAT? NO, JUST JUST A COMMENT THAT IN GOING THROUGH ALL THIS.

WELL I DO HAVE A QUESTION. I A BIG PIECE OF THAT IS GOING TO BE THE UT HIP CONTRACT OR NOT.

THAT. THAT'S RIGHT. WE WE DO EXPECT YOU KNOW, UT HIP TO BE OUR TURNKEY SOLUTION WHERE WE CAN PUT THEM IN PLACE AND THEN THEY WILL HELP SOURCE ALL OF THE VARIOUS EXPERTISE. SO THAT IS WHAT IS INTENDED, BECAUSE OTHERWISE IF WE DIDN'T THESE ARE THE, THE EXPERTS AND THINGS AND CONTRACTS THAT WE WOULD HAVE TO GO SOURCE OURSELVES. AND AGAIN, TAKE A LOT OF TIME THAT WE DON'T REALLY HAVE MY NOTE ON HERE.

I WROTE DOWN MELISSA, LAURA AND GOLDEN. I'M LOOKING FOR THE PEOPLE THAT REALLY ARE EXPERTS.

YES, ABSOLUTELY. ALL RIGHT. IF THERE ARE NO OTHER QUESTIONS, I WILL TURN IT BACK OVER TO YOU, MIKE. YES. SO THANK YOU, MEMBERS AND STAFF. LAUREN, REALLY APPRECIATE THE TIME ON THIS. THIS THIS AGENDA ITEM. YOU'LL YOU'LL SEE IT AGAIN IN FUTURE MEETINGS.

BUT WE NEED TO BRING BACK THE WORK THAT WE'VE DONE AND THE WORK THAT LIES AHEAD, AND THE PROGRAM DASHBOARD, SO YOU CAN GET A SENSE ABOUT WHERE WE ARE. IT'S ONE THING FOR US TO SAY, YEAH, WE'RE WORKING ON IT.

BUT THE QUESTION IS WHERE IN THAT TIMELINE, BECAUSE THE BUSINESS PLAN IS VERY HAS VERY DEFINITIVE TIMELINES IN PLACE.

SO WE APPRECIATE YOUR INDULGENCE ON THIS AND AS WELL AS THE QUESTIONS TOO.

SO MR. CHAIR, THAT CONCLUDES THERE IS THE MOTION THAT IS STILL PENDING RIGHT NOW OF MESSAGE WITH DOCTOR KELLY.

AND I'M LOOKING AT THE SCREEN. I HAVEN'T SEEN THAT SHE'S JOINED. SO IT'S CHAIRS THE BOARD'S PREROGATIVE.

WE WOULD ASK THAT THAT MOTION BE TAKEN UP AND DISPOSED OF THOUGH IN THIS MEETING.

YEAH. YES. YEAH THAT'S MY RECOMMENDATION I THINK YOU COULD YOU COULD VOTE ON IT NOW IF YOU SO CHOOSE.

THE TWO OF YOU HAVE MAKE A QUORUM. THE TWO OF YOU HAVE HEARD THE PRESENTATION.

IF YOU WANT TO KEEP IT PENDING UNTIL LATER IN TODAY'S MEETING, THAT'S THAT'S AVAILABLE.

BUT THE NEXT THING AFTER THIS WOULD BE AGENDA ITEM FOUR.

AND WE'RE WE'RE QUICKLY TO THE END OF THE ANTICIPATED MEETING TIME.

SO I'LL DEFER TO YOU ON YOUR DECISION TO TAKE IT UP NOW OR TAKE IT UP IN SUBSEQUENT TIME TODAY.

[01:20:04]

YEAH, I'LL MAKE A MOTION. OKAY. YEAH. TO QUOTE AND CITE SPECIFICS.

YEAH. AND IS YOUR MICROPHONE ON? IT IS. OKAY.

YES, SIR. MEMBERS. THERE'S A TAB IN YOUR BOOK THAT SAYS MOTION.

SO I'LL MAKE A MOTION REGARDING THREE A ROMAN AT TWO.

THE TPA BUSINESS PLAN IMPLEMENTATION DESIGN PHASE AND ALIGNMENT OF WORK WITH AGENCIES AND HIGHER EDUCATION.

SO IF YOU CAN IF YOU CAN GO TO THE ON BOARD BOOK PAGE 23, IF YOU CAN, IF YOU CAN GO DOWN TO THE BOTTOM THIRD AND THERE'S A BOLD SUBTITLE THERE THAT SAYS MOTION. THAT'S THE LANGUAGE OF THE MOTION THAT WE WOULD RECOMMEND.

I'LL READ IT VERBATIM. THUS I MAKE THE MOTION THAT THE TPA BOARD DELEGATE DELEGATE AUTHORITY, TO THE EXTENT NECESSARY TO THE TPA EXECUTIVE DIRECTOR, TO FINALIZE AND EXECUTE AN INTERAGENCY COOPERATION CONTRACT BETWEEN HEALTH AND HUMAN SERVICES COMMISSION ON BEHALF OF THE TPA RECEIVING AGENCY AND THE UNIVERSITY OF TEXAS SYSTEM ON BEHALF OF UT HIP FRIENDS PERFORMING AGENCY WITH SIMILAR OR BETTER TERMS. TO FURTHER TO FACILITATE THIS DELEGATED AUTHORITY, THE EXECUTIVE DIRECTOR MAY ROMANET A UTILIZE TPA STAFF TO ASSIST AND FACILITATE THIS DELEGATED AUTHORITY AS NECESSARY AND ROMANETTE B OR LOWERCASE B UTILIZE HEALTH AND HUMAN SERVICES COMMISSION STAFF AS NECESSARY.

THROUGH TPI'S ADMINISTRATIVE ATTACHMENT TO HEALTH AND HUMAN SERVICES COMMISSION UNDER CHAPTER 2177.

NUMBER THREE. FURTHER, THE AUTHORITY DELEGATED TO THE EXECUTIVE DIRECTOR ON DECEMBER 4TH, 2024, REGARDING THE TEXAS A&M UNIVERSITY SYSTEM IS RENEWED TO THE EXTENT NECESSARY AND INCLUDES CONTINUING DISCUSSIONS AND POTENTIAL NEGOTIATIONS REGARDING THE IMPLEMENTATION OF COMPONENTS OF THE BUSINESS PLAN, EITHER IN CONJUNCTION WITH UT HIP OR AS A STANDALONE AGREEMENT.

AND I WOULD SECOND THAT MOTION. IS THERE ANY DISCUSSION? ANY MORE DISCUSSION? NO DISCUSSION. FRANCESCA, IF YOU WOULD CALL THE ROLL, PLEASE.

DOCTOR MCKINNEY. MEMBERS. WHEN I CALL YOUR NAME, PLEASE TURN ON YOUR CAMERA AND RESPOND WITH YAY, NAY, OR ABSTAIN. DOCTOR MIKE MCKINNEY. THANK YOU, DOCTOR GODINA.

MR. TONY SHELL. MOTION CARRIES. I TURN THE MEETING BACK OVER TO YOU, DOCTOR MCKINNEY.

THANK YOU. THAT MOTION HAS CARRIED AND WILL BE IN THE IN THE MINUTES.

NEXT IS THE NEXT AGENDA ITEM. IS A TBI ADVISORY COUNCIL ON AGENCY DISCUSSIONS.

IF THERE ARE ANY MEMBERS OF THE ADVISORY COUNCIL OR THEIR DESIGNEE PRESENT WHO WOULD LIKE TO DISCUSS ITEMS PERTAINING TO THE IMPLEMENTATION OF THE TBI BUSINESS PLAN OR THE DUTIES OF THE TBI BOARD? IF SO, PLEASE IDENTIFY YOURSELF AND AGENCY YOU REPRESENT AND PLEASE COME FORWARD.

AND SEEING NONE. THEN WHAT WE WILL DO IS MOVE TO AGENDA ITEM NUMBER FIVE,

[5. Executive director report]

YES. WHAT YOU'RE SHOWING IS THE THE SEPTEMBER 23RD, 2024 BUSINESS PLAN.

AND THERE'S JUST POINT OF ORDER. THERE WILL BE NO SLIDE UNTIL THAT IS CALLED.

THAT'S FINE. YEAH. THAT'S PERFECT. SO, MEMBERS, THERE'S A MEMORANDUM IN THE BOOK UNDER TAB NUMBER FIVE, AS WELL AS THE MONTHLY FINANCIAL SUMMARY STATEMENT.

I'LL JUST HIT SOME HIGHLIGHTS ON THIS, BUT BUT THE EXECUTIVE DIRECTOR'S REPORT FOR THIS MEETING IS CENTERED ON LEGISLATION AND BASIC FINANCIAL REPORTS, WHICH ARE GOING TO BE A STANDING ITEM FOR THE BOARD.

[01:25:03]

AND SO THE CONTINUATION OF TPI INVOLVES THE CONTINUATION OF CHAPTER 2177, WHICH IS OUR ENABLING STATUTE, AND ADDING TWO ADDITIONAL MEMBERS TO THE TPI BOARD, TAKING IT FROM 3 TO 5 MEMBERS AND THEN REQUIRING A PERIODIC UPDATE OF THE TPI BUSINESS PLAN. AND THIS IS IMPORTANT. AND ALSO AS PART OF THAT UPDATE, LOOKING AT CHANGING THE DATES AT WHICH THINGS ARE DUE SO THAT THAT WAY IT'S DUE NOT SO CLOSE TO THE LEGISLATIVE SESSION. SO WE HAVE SOME TIME TO FOR BETTER IMPLEMENTATION AND COORDINATION BEFORE THE LEGISLATIVE APPROPRIATIONS REQUEST, START FOR THE AGENCIES IN ON THE BIENNIAL CYCLE.

SO THERE'S THERE'S THERE'S A METHOD TO THIS, BUT ALSO JUST FOR TRANSPARENCY SAKE, YOU KNOW, IF THE IF THE BOARD AMENDS THE BUSINESS PLAN OR REDIRECTS OR DECOMMISSIONS A PARTICULAR PROGRAM, MAKING CERTAIN THAT THE LEGISLATURE AND THE GOVERNOR AND LEGISLATIVE BUDGET BOARD, WHICH ARE THE RECIPIENTS OF THOSE PLANS, THE LIEUTENANT GOVERNOR'S OFFICE, ALL KNOW ABOUT WHAT THAT PLAN REVISION IS. SO THAT'S THE REASON FOR INCLUDING THAT IN THE IN THE CONTINUATION LEGISLATIVE PACKAGE.

THE SECOND THAT I MENTIONED WAS THE GENERAL APPROPRIATIONS ACT, CURRENTLY IN THE LEGISLATIVE BUDGET BOARD RECOMMENDED BUDGET BOTH IN THE HOUSE AND SENATE VERSIONS. WE HAVE UNEXPENDED BALANCE, ALSO REFERRED TO AS UB AUTHORITY.

AND THAT'S A BUDGETARY MECHANISM WHERE YOU TAKE FUNDS FROM ONE BIENNIUM AND ROLL THEM TO THE NEXT, BUT THEN IT ALSO ALLOWS YOU TO MOVE FUNDS WITHIN THE FROM ONE FISCAL YEAR TO THE NEXT WITHIN THE BIENNIUM.

SO YOU NEED BOTH. OTHERWISE, YOU CAN HAVE STRANDED FUNDS IN THE FIRST FISCAL YEAR OF THE BIENNIUM AND NOT BE ABLE TO CONDUCT BUSINESS OR WORK IN THE SECOND YEAR OF THE BIENNIUM.

BUT CURRENTLY WE HAVE THAT UNEXPENDED BALANCE AUTHORITY.

THAT'S IN THE APPROPRIATIONS ACT. BOTH THE HOUSE AND THE SENATE INTRODUCED VERSIONS.

THE NEXT MAJOR SET OF LEGISLATIVE ISSUES THAT I'LL DISCUSS INVOLVE DATA AND CONTRACT SHARING, WHICH WE'VE ALREADY TOUCHED ON. SO I'LL JUST I'LL MAYBE JUST MAKE A FEW CLARIFYING POINTS THERE.

AND THEN PROCUREMENT. SO ON THE DATA AND CONTRACT SHARING AGAIN YOU KNOW, WORKING WITH THE AGENCIES AND TRYING TO ADDRESS ALL THE DIFFERENT LEGAL ISSUES THAT ARE OUT THERE AND NUANCES AND BOTH FEDERAL, STATE AND CONTRACTUAL.

BUT THAT'S THAT'S GOING TO CONTINUE. AND WHILE WORKING WITH THE LEGAL COUNSEL'S IS IMPORTANT BECAUSE AT SOME POINT WE ARE GOING TO NEED DATA SHARING AGREEMENTS AND THEY HAVE TO BE WORDED CORRECTLY SO THAT THOSE THAT WE CONTRACT WITH TO PERFORM THE ANALYSIS OR HIRE, BUT LIKELY CONTRACT WITH CAN HAVE ACCESS TO THAT DATA.

BUT THAT ALSO THAT WE AGAIN TO WHAT JAMES WAS SAYING EARLIER, WE DON'T WANT TO BE THE CUSTODIANS OF THAT DATA, BUT WE ARE GOING TO NEED TO SEE SOME WHAT THE OUTCOME OF THE, OF THE DATA ANALYTICS ARE SO THAT THAT LEGAL WORK, IF YOU WILL, NEEDS TO CONTINUE. BUT RUNNING PARALLEL TO THAT IS DISCUSSIONS THAT WE'VE HAD WITH LEGISLATIVE OFFICES ABOUT SEEKING STATUTORY REQUIREMENTS THAT THAT BE SHARED. AGAIN, YOU KNOW, THAT IS GOING TO BE SUBJECT TO THE CALL OF THE MEMBERS THEMSELVES.

AND I ANTICIPATE HAVING SOME DISCUSSIONS BEFORE ANYTHING GETS FILED, EVEN TO MAKE CERTAIN THAT WHAT THEY'RE DOING IS THE PRUDENT COURSE OF ACTION.

BUT I JUST WANTED THE BOARD TO BE AWARE THAT WE HAVE REQUESTED THAT LEGISLATIVE DRAFTS BE DRAFTED.

BE PREPARED SO THAT WE HAVE SOMETHING TO DISCUSS, AND TO MAKE SURE THAT WE'RE HITTING ON EVERYTHING THAT WE NEED TO HIT ON SO THAT THAT WAY WE DON'T GET POST-SIGNING DIE AT THE END OF SESSION.

AND IT TURNS OUT WE DON'T HAVE THE NECESSARY STATUTORY AUTHORITY THAT WE THOUGHT WE WERE GETTING.

SO WE DON'T WANT TO WANT TO MISS ANYTHING. SO WE'RE GOING TO CONTINUE TO WORK AGAIN, THIS PARALLEL WITH THE CONTINUED COOPERATION AND COORDINATION AMONG THE AGENCIES, BUT ALSO PURSUING THE LEGISLATIVE ROUTE ON THE PROCUREMENT AGAIN, CURRENTLY IN DISCUSSIONS WITH LEGISLATIVE OFFICES ON THIS.

AND REALLY, IT'S TO TO STREAMLINE TPI'S PROCUREMENT AUTHORITY.

I MEAN, RIGHT NOW, WHAT WE'RE TALKING ABOUT SEEMS TO BE ADVANCING FAIRLY RAPIDLY FOR WHAT, YOU KNOW, WHAT IS A STATE LEVEL CONTRACT OR AN AGREEMENT, BUT WE'RE USING A VERY SPECIFIC PROVISION IN THE STATUTES THAT ALLOWS THIS TYPE OF INTERAGENCY COOPERATION CONTRACT IF WE WERE TO GO OUT FOR PRIVATE BID, LET'S JUST SAY UT AND A&M DIDN'T HAVE THE RESOURCES THAT WE'VE TALKED ABOUT, AND WE WERE TO BE GOING OUT THERE TRYING TO CONTRACT WITH CLINICAL FACILITIES, ANALYTIC SHOPS DATA MAINTENANCE AND INTEGRITY FIRM.

I MEAN, ALL OF THOSE THINGS THAT YOU NEED TO BE ABLE TO DO, THE KIND OF WORK THAT WE NEED TO DO.

WE WOULD BE ON A VERY COMPLICATED PROCUREMENT TRAJECTORY THAT YOU MIGHT AS WELL NOT HAVE A BOARD MEETING FOR THE NEXT 6 TO 8

[01:30:06]

SO LOOKING AT IS THERE A WAY TO, YOU KNOW, FOR A VERY LIMITED PERIOD OF TIME, LET'S SAY TWO, MAYBE THREE YEARS, HAVE SOME STREAMLINED, STREAMLINED PROCUREMENT AUTHORITIES SO THAT WE CAN EXPEDITE SOME OF THESE PROCUREMENTS, BUT NOT AT THE EXPENSE OF GOOD BUSINESS PRACTICE OR DUE DILIGENCE.

FIRMS STILL HAVE TO SHOW DEMONSTRATE QUALIFICATIONS, DEMONSTRATE THAT THEY'VE DONE THE WORK ON SOME SCALE THAT CAN THEN BE SCALED UP OR OUT OR OVER. HOWEVER, IT IS SO NOT ON A ON A BETA TEST, BUT ACTUALLY PRODUCED RESULTS.

MAKING CERTAIN THAT THEY'VE DONE WORK WITHIN THE PHARMACEUTICAL GREATER PHARMACEUTICAL EXPANSIVE LANDSCAPE.

SO AGAIN, THERE'S STILL SOME BUSINESS PRINCIPLES THAT WOULD STILL BE AT STAKE. SO IT'S NOT JUST THE EXECUTIVE DIRECTOR COMES TO WORK YOU KNOW, FLIPS THROUGH A COUPLE OF WEBSITES AND THEN MAKES A PHONE CALL.

IT'S STILL GOING TO BE A VERY INVOLVED PROCESS, BUT BUT WE'RE MAKING THAT REAL CLEAR TO THE LEGISLATIVE OFFICES.

AGAIN, ALL OF THAT IS SUBJECT TO LEGISLATIVE DECISION.

AND BUT YOU KNOW, YOU FIRST GOT TO HAVE THE CONVERSATIONS.

SO WE'VE HAD THOSE CONVERSATIONS WITH LEGISLATIVE OFFICES.

SO MOVING TO THE REAL QUICKLY TO THE FINANCIAL REPORTS OR DO YOU WANT TO PAUSE AND ANSWER ANY QUESTIONS ON LEGISLATIVE FRONT BEFORE I GO TO FINANCIALS? NO, JUST ANOTHER SMART ALEC COMMENT. THEY I DON'T THINK THAT THAT WE WOULD HAVE ANY PROTEST IF I REQUESTED A LIST OF FIVE THINGS THAT YOU DID THIS LAST WEEK.

IT'S FOR EVERYBODY. THE ONLY THING I THINK THEY MIGHT BE UPSET ABOUT IS THAT'S NOT ENOUGH.

THAT'S MY COMMENT. NOTED FINANCIAL REPORTS.

MEMBERS. OUR CURRENT YEAR TO DATE EXPENDED IS.

AND THIS IS THROUGH JANUARY. THE END OF JANUARY IS 1.13 MILLION ROUNDED.

AND OUR MONTHLY ADMINISTRATIVE TREND HAS INCREASED BECAUSE WE'VE ADDED ADDITIONAL STAFF.

ALL OF WHICH EXCEPT TWO ARE HERE TODAY. BUT THERE.

BUT FOR GOOD REASON. SO BUT THAT'S THAT'S WHAT'S DRIVING A LOT OF THAT.

WE'RE ASSESSING ADDITIONAL HIRES FOR THE REMAINDER OF THE YEAR.

AS I HAVE MENTIONED EARLIER, WE ARE VERY JUDICIOUS IN HOW AND WHETHER WE HIRE SOMEONE.

AND IF YOU'LL RECALL BACK TO AUGUST, WE SUBMITTED A FUNCTIONAL FRAMEWORK THAT WE WOULD USE AS OUR AS OUR GUIDEPOST TO HOW IT IS THAT WE STAFF AND FILL OUT THE AGENCY.

SO WE'RE STILL GOING BACK TO THAT FRAMEWORK. THAT WAS SOMETHING THAT THE BOARD ADOPTED, AND IT LINES UP WITH ORGANIZATION OF WHAT WE NEED TO BE TO BE ABLE TO FULFILL OUR BUSINESS PLAN. BUT WE'RE VERY JUDICIOUSLY PROCEEDING THROUGH THAT.

THERE IS A CHALLENGE, THOUGH, IN RECRUITING. AND SO, FOR EXAMPLE, CANDIDATES MAY SAY, YOU KNOW, WE WE ARE CONCERNED THAT THE CHAPTER EXPIRES IN SEPTEMBER AND THEY'LL WITHDRAW.

SO THE SOONER WE GET THROUGH THIS LEGISLATIVE SESSION, I THINK THE THE EASIER THE I DON'T WANT TO SAY IT'S NEVER EASY.

MELISSA'S LOOKING AT ME LIKE RECRUITING IS NOT EASY. BUT AND WRYLY NOTED.

BUT BUT I THINK WE WILL HAVE TAKEN AWAY A BARRIER TO FILLING OUT, YOU KNOW, THIS, THIS TEAM THAT WE NEED.

BUT AGAIN, REALLY LOOKING AT A VERY LEAN STAFFING MODEL AND CONTRACTING OUT FOR A LOT OF THE SERVICES SO THAT WE CAN SCALE THEM PROPERLY AND NOT HAVE A FULL TIME FTE. THAT, QUITE FRANKLY, IS REALLY DOING 0.25 WHERE YOU NEED 0.25.

SO KEEPING A LEAN STAFFING MODEL AND CONTRACTING OUT IS CERTAINLY ON THE HORIZON FOR US.

SO THAT'S ON. I'M KIND OF BLEEDING INTO THE PROGRAM SIDE.

SO WITH THAT ADDITIONAL PROGRAM COSTS ARE EXPECTED FOR PROJECTION PURPOSES.

WE'VE STARTED THOSE IN MARCH. THEY COULD GET PUSHED OUT TO APRIL, BUT BUT JUST TO BE ON THE SIDE OF BEING CAUTIOUS AND CONSERVATIVE.

WE STARTED THOSE IN MARCH. AND THE ATTACHED SUMMARY TABLE THAT'S IMMEDIATELY BEHIND THE REPORT.

EXCUSE ME, THE EXECUTIVE DIRECTOR'S REPORT MEMO.

IT LAYS OUT ALL THE BASIC FINANCIALS. I MEAN, NOTHING THAT IF I WERE IN YOUR SHOES, YOU KNOW, WHAT IS IT? WHAT IS IT THAT I NEED TO KNOW ABOUT HERE? NOTHING THAT STANDS OUT. OUT OF THE ORDINARY, YOU WILL SEE SOME ENCUMBRANCES AND REQUISITIONS THAT OFFSET THE BALANCE OF OUR YEAR TO DATE FUND BALANCE OF $550,703. THOSE ENCUMBRANCES ARE SET UP ANYTIME THAT THERE'S A CONTRACT AND THEY NEED TO BE RELEASED.

SO WE TEND TO HOLD THOSE OPEN FOR A WHILE. BUT THEN WE COME BACK USUALLY ABOUT 60 DAYS PRIOR, EXCUSE ME, 60 DAYS AFTER, AND THEN START WORKING TO RELEASE THOSE ENCUMBRANCES.

AND SO YOU'LL SEE THAT NUMBER ADJUST. BUT AGAIN, IT'S NOT BECAUSE THAT MONEY'S BEEN SPENT.

[01:35:01]

I MEAN, WHEN YOU GET 1 OR 2 MONTHS INTO THE FISCAL YEAR, IT'S STILL A LITTLE THIN, BUT WE'RE AT MONTH FIVE NOW.

SO THAT'S A REALLY GOOD POINT TO START A TRAJECTORY.

EXCUSE ME. PROJECTING OUT TO SEE HOW THE YEAR IS GOING TO END.

RIGHT NOW WE'RE LOOKING AT 7.3. AND I'M GOING TO ROUND THIS 7 MILLION FOR BOTH ADMINISTRATIVE AND PROGRAM COSTS.

AGAIN IT'S THE ADMINISTRATIVE SIDE OF THE COST IS US JUST THE ORGANIZATION THE STAFFING STRUCTURE.

THE PROGRAM SIDE IS EVERYTHING THAT'S OUTWARD FACING THE WE'RE COVERED IN THE PRESENTATIONS FROM FROM EARLIER TODAY.

SO RIGHT NOW WE'RE SHOWING AT 7.37 MILLION FOR THE END OF THE YEAR.

THE ADMINISTRATIVE SUBSET OF THAT IS 1.37 MILLION.

AND THOSE ARE BASIC ORGANIZATIONAL COSTS, AS I MENTIONED PREDOMINANTLY STAFFING THE ORIGINAL BUSINESS PLAN FOR THE ADMINISTRATIVE EXPENSES, BY COMPARISON, WAS 3 TO 4 MILLION A YEAR. NOW, KEEP IN MIND THAT NUMBER WAS DEVELOPED IN PROBABLY LATE EXCUSE ME, EARLY JULY TIME FRAME AND THEN WORKED THROUGH BY THE END OF JULY.

SO THAT WAS A REALLY ROUGH AND A VERY. QUICK NUMBER.

YES. IF YOU CAN. SCROLL UP ON THE SLIDE. THERE YOU GO.

THANK YOU VERY MUCH. BUT REMEMBER THAT 3 TO 4 MILLION WAS WAS DERIVED.

IT WAS YOU KNOW, WE PUT THAT BUSINESS PLAN TOGETHER IN THE THREE MONTH PERIOD. AND SO IT WAS IT WAS FAST WITH BEST KNOWLEDGE AT THE TIME.

BUT WITH EACH PASSING MONTH WE GET GET MORE KNOWLEDGE AND MORE INSIGHT.

AND SO RIGHT NOW YOU KNOW THAT THAT 1.37, I EXPECT THAT TO COME UP SOMEWHAT.

BUT RIGHT NOW I'M PEGGING THE PROJECTION THERE.

BUT AGAIN, THAT'S SIGNIFICANTLY UNDER WHAT WE HAD ESTIMATED FOR THE BUSINESS PLAN.

LASTLY ON THAT, THAT PROJECTION LINE IS THE THE END OF YEAR FUND BALANCE.

I'M SHOWING IT 141.9 MILLION. AGAIN, ALL OF THESE ARE SUBJECT TO TREND CHANGE FLUCTUATIONS.

IF THERE'S ANOTHER CONTRACT THAT WE COME BACK, WE PRESENT TO THE BOARD AND IT'S DETERMINED.

YES, WE NEED TO GO THIS ROUTE THAT COULD CHANGE ALL OF THIS.

SO BUT THAT'S FELT FAR ENOUGH ALONG IN THE FISCAL YEAR TO START PUTTING SOME PRELIMINARY SUBJECT TO REVISION PROJECTIONS FOR YOU ALL.

CONCLUDES THE REMARKS. BUT IT SEEMS LIKE EVERY TIME THAT YOU TALK TO A LEGISLATOR OR WHEN YOU HAVE TO GO OR PRESENT, LIKE RELATIVE TO THE INITIAL PLAN RE-EMPHASIZING IF WE DO THIS INTERAGENCY AGREEMENT, WE THINK WE'RE GOING TO COME IN 80% UNDER BUDGET. I MEAN, THAT'S, YOU KNOW, AND IT STAYS WITHIN THE SYSTEM, RIGHT, AS OPPOSED TO AN EXTERNAL THIRD PARTY THAT LEAVES THE STATE.

SO I THINK THIS IS AWESOME. YES, SIR. AND I WOULD POINT OUT, IF YOU'RE AND I NEED TO MAKE A NOTATION OF THIS, AND I APOLOGIZE TO THE BOARD AND THE PUBLIC FOR THIS, THAT PROJECTION END OF YEAR FUND BALANCE.

IT'S A STARTING BALANCE MINUS PROJECTED EXPENSES.

IT ALSO HAS THE THE ENCUMBRANCE THAT YOU SEE UP ABOVE THE 550,000 PULLED OUT OF THAT.

I MEAN, IT'S STILL ON THE BOOKS, SO YOU NEED TO RECOGNIZE IT UNTIL SUCH TIME THAT IT'S RELEASED.

BUT IF YOU DO THE MATH, YOU GOT TO YOU GOT TO PULL THE 550,000 OUT TO BE ABLE TO GET TO THE 141.9.

BUT I'LL, I'LL MAKE THAT NOTATION IN THE LOWER RIGHT HAND CORNER TO SHOW THAT IT'S ALSO REFLECTS ANY ENCUMBRANCES INTO YOUR TOTAL EXPENSES AFTER THE WHICH IS INCLUSIVE OF THE ADMINISTRATIVE. IT'S THE PRORATED AMOUNT FOR THE CONTRACT, ASSUMING IT'S SIGNED.

YES, SIR. YEAH. YEAH. WE DON'T FRONT LOAD IT.

THANK YOU. THAT'S. VERY COMPREHENSIVE AND I APPRECIATE THAT.

AND I THINK AGAIN, IT'S WHAT WE PROMISED FROM THE BEGINNING.

GET TO SEE WHAT WE'RE DOING. YES, SIR. AND I PUT MY ONE OF MY OLD HATS ON.

I'M REALLY GLAD TO SEE, YOU KNOW, I. I'M GLAD TO SEE THAT WE DON'T.

NUMBER ONE, WE DON'T SPEND MORE MONEY THAN WE HAVE.

IT'S AN IMPROVEMENT OVER SOME GOVERNMENTS. BUT I'M ALSO THAT WE DON'T FEEL COMPELLED TO SPEND ALL THE MONEY THAT WE HAVE ACCESS TO. AND I WANT US TO CONTINUE AND WE WILL.

BUT I APPRECIATE THAT THE THAT WE MAKE SURE THAT WE ARE SPENDING MONEY FOCUSED ON ACCOMPLISHING WHAT OUR

[01:40:03]

THAT'S THE BENEFIT OF THE STAFF AND THE CONTRACTORS AND EVERYBODY ELSE.

SO. WELL, UNFORTUNATE THAT, MR. CHAIR, THAT I'VE GOT SOME VERY TIGHT FISTED COWORKERS, SO.

THANK YOU. OKAY. THAT'S THE EXECUTIVE DIRECTOR'S REPORT.

THE THE NEXT ITEM, AGENDA ITEM IS A CLOSED SESSION SO THAT WE CAN ENTER INTO A CLOSED SESSION.

[Item 6 & 7]

CLOSED SESSION. OKAY. AND THE. IF I MAY ALSO, THE ITEM SEVEN IS A DISCUSSION OF POSSIBLE ACTIONS FROM THE CLOSED SESSION THAT WE DIDN'T HAVE.

AND SO I WOULD ENTERTAIN A MOTION TO TABLE AGENDA ITEM SIX, THE CLOSED SESSION, AND AGENDA ITEM SEVEN, THE DISCUSSION OF THAT SESSION. I'LL MAKE THAT MOTION.

SECOND. SECOND. ALL RIGHT. ANY QUESTIONS? ANY DISCUSSION ABOUT THAT? OKAY. FRANCESCA, IF YOU WOULD PLEASE CALL THE ROLL.

MR. MCKINNEY. MEMBERS. WHEN I CALL YOUR NAME, PLEASE TURN ON YOUR CAMERAS AND RESPOND WITH YAY! NAY, OR ABSTAIN. DOCTOR MIKE MCKINNEY. THANK YOU, DOCTOR GODINA.

R.U.L.E. MR. TONY SHELL. YAY! MOTION CARRIES.

I TURN THE MEETING BACK OVER TO YOU, DOCTOR MCKINNEY.

OKAY. THANK YOU. AT THIS POINT IS OPPORTUNITY FOR PUBLIC COMMENT? WE HAVE RECEIVED ANY WRITTEN COMMENTS. PUBLIC COMMENTS.

DOCTOR MCKINNEY. THIS IS FRANCESCA COOPER WITH THE ADVISORY COMMITTEE COORDINATION OFFICE. WE HAVE RECEIVED NO REQUESTS FOR PUBLIC COMMENT, WRITTEN OR ORAL FOR TODAY'S MEETING, AND I CONCUR.

TPI HAS NOT RECEIVED ANY DIRECT WRITTEN COMMENTS IN ITS MAILBOX.

OKAY. NOT HAVING OR NOT HAVING RECEIVED NOR HEARD ANY PUBLIC COMMENTS. SO WE WILL MOVE TO ITEM NUMBER NINE, WHICH IS A REVIEW OF THE ACTION

[9. Review of action items from the current meeting, and agenda items and scheduling for future meeting(s)]

MIKE. YES, SIR. SO THE KEY TAKEAWAYS FOR TODAY IS THAT WE'RE WE'LL CONTINUE WORKING ON TERMS WITH THE UT HEALTH INTELLIGENCE PLATFORM WILL CONTINUE TO COORDINATE WITH A&M, WHETHER IT'S PART OF THE OVERALL UT EFFORT.

I MEAN, EVERYTHING'S GOING TO BE COORDINATED, BUT OR IF IT'S A STANDALONE, BUT WE'LL CONTINUE THOSE THAT COORDINATION WITH THE TEXAS A&M UNIVERSITY SYSTEM. AND THAT'S THAT'S ALL I'VE PICKED UP ON IN TERMS OF BOARD DIRECTION. BUT IS THERE ANYTHING ELSE THAT HAS COME TO MIND SINCE, YOU KNOW, AS WE'VE BEEN DISCUSSING THAT YOU ALL WOULD WANT US TO TAKE DIRECTION ON? OBVIOUSLY, THE THINGS THAT THAT, THAT YOU'RE ALREADY WORKING ON, I MEAN, I DON'T WANT TO.

KNOW THAT WE'RE TRYING TO GET THE DATA. YOU'RE DOING ALL THAT ALREADY? YES, SIR. AND DULY NOTED. AND I THANK YOU, MR. CHAIR. AND AS PART OF THE WORK THAT WE'RE DOING ON IMPLEMENTING THE BUSINESS PLAN, IS ANY ANY CRITICAL PATH ITEM IS GETTING PRIORITY, BUT ESPECIALLY THOSE THAT WE MIGHT DEEM AT RISK.

AND WE'VE TAKEN CARE OF THE ABILITY TO NOT HAVE TO WAIT TILL THE NEXT MEETING TO GET THIS CONTRACT FINALIZED AND GOING. YES, SIR. GREAT. AGAIN, THANK YOU SO MUCH.

I MEAN THIS I STILL THINK THIS IS IMPORTANT WORK, AND IT'LL BE GOOD FOR YOU TO LIVE IN THIS STATE AND PROBABLY FOR OTHER STATES TO.

KEEP GOING AT THE RATE WE'RE GOING. OTHER THINGS THAT I.

LEGISLATURE. SAME THING, THE SAME UPDATES THAT WE GOT WILL NEED THOSE.

[01:45:03]

I MEAN, DO WE ANTICIPATE BY APRIL? SORRY, BY MARCH 19TH, THERE'S ENOUGH PROGRESS.

YES, SIR. WHAT I WHAT I MAY RECOMMEND, AND I HAD A PRIOR DISCUSSION WITH DOCTOR MCKINNEY ON THIS AS WELL, IS IN THE LIST OF DATES. THAT'S ON PAGE 52 OF YOUR BOARD BOOK BEHIND TAB NINE PAGE BOARD BOOK, PAGE 52 THAT WE KEEP THAT MARCH 19TH DATE. NOW THE WE WILL HAVE TO REAL QUICKLY AS IN PROBABLY TOMORROW. WELL PROBABLY AT THE END OF THIS WEEK.

FIRST PART OF NEXT WEEK. IF I COULD BEG COUNCIL TO FOR A COUPLE OF EXTRA BUSINESS DAYS, DETERMINE WHETHER OR NOT THAT MARCH 19TH MEETING IS NEEDED, BECAUSE WE'LL NEED TO POST BY THE EIGHTH AND IT MIGHT BE, YOU KNOW, PLUS OR MINUS A DAY, BUT BUT LET'S JUST SAY BY THE EIGHTH, IF WE DON'T NEED THAT, WE CAN CERTAINLY RELEASE THAT DATE JUST BY NOT POSTING.

SO THERE IS NO MEANING. BUT THEN DEFINITELY WE NEED TO COME BACK IN APRIL AND THEN EVERY OTHER MONTH IN THE WAY THAT THE WORK CYCLES ARE WORKING OUT WITH US, YOU KNOW, MENTIONED OUR INTERNAL WORK CYCLE EXTERNALLY.

YOU KNOW, WE WORK WITH AGENCIES AND WE'RE TRYING TO DO THIS IN THE MIDST OF A LEGISLATIVE SESSION IN THE INTERVENING MONTHS BETWEEN THE BOARD MEETINGS, SO THAT WHEN WE COME BACK TO THE BOARD MEETING, WE'VE GOT SOMETHING TO TALK ABOUT IN TERMS OF IMPLEMENTATION.

SO IF WE COULD ASK THE BOARD TO CONSIDER THAT EVERY OTHER MONTH CADENCE STARTING WITH THE APRIL MEETING AND THEN MOVING ON, AND THEN WE'VE GOT THAT MARCH MEETING AS A, AS A CONTINGENCY IF WE NEED IT BECAUSE OF THE CONTRACTS.

I, I THINK IT JUST THESE ARE TENTATIVE. THESE ARE DATES.

WE CAN GET A ROOM, BUT THEY FOR THE TIME BEING.

THESE ARE NOT POSTED. THESE ARE NOT I MEAN, THEY SAY WHAT THE TENTATIVE DATES ARE.

WE SHOULD TELL PEOPLE WHAT THAT IS. WELL, YEAH, THERE'S THERE'S NO PUBLIC POSTING FOR AN AGENDA FOR ANY OF THESE DATES.

THESE ARE DATES THAT HAVE BEEN SECURED BY TPD AND IN COORDINATION WITH THE ADVISORY ACOE.

SO I THINK THE RECOMMENDATION I HEARD CORRECTLY FROM THE EXECUTIVE DIRECTOR WAS TO LOOK FOR APRIL 16TH AS A, YES, DEFINITE. AND THEN MARCH 19TH AS THE CONTINGENCY IF NECESSARY.

AND I REALIZE I'M ALSO ASKING IF YOU'RE IF YOUR CALENDARS PERMIT.

AND I REALIZE I'M ASKING THIS WITH ONE BOARD MEMBER NOT PRESENT IS ESPECIALLY WITH THE LEGISLATIVE SESSION, IF WE COULD KNOW WHAT THOSE FUTURE DATES ARE EVEN BEYOND APRIL, WE WOULD GREATLY APPRECIATE THAT.

YEAH.

BY APRIL WILL HAVE THE CONTRACT GOING WITH YOU.

AND THEN WITH THE LEGISLATURE, THE UPDATE ON LEGISLATIVE STANDINGS.

AT THAT POINT IN TIME, WE SHOULD HAVE A FEEL FOR WHERE IT'S GOING.

YES, SIR. AND THEN THE ONE BY MAY 20TH. MAY NOT BE SINE DIE, BUT IT'S SINE DIE FOR. I MEAN, WE WILL KNOW BY THEN. AND SO THIS THIS IS PLANNING AND I ASSUME THAT WE WILL DO IT.

AND I DO IF, IF EVERYTHING'S GOING LIKE WE EXPECT IT TO.

I AGREE THAT THE EVERY OTHER MONTH CADENCE HAS WORKED VERY WELL.

BOARD OF REGENTS, I THINK THEY MEET WHAT, QUARTERLY OR AT CALL OF THE CHAIR.

TRYING TO HIRE A CHANCELLOR OR SOMETHING. ANY OTHER.

ANY COMMENTS AT ALL? OKAY, SO JUST TO SUM UP WHAT I'M HEARING WELL, KEEP THAT MARCH 19TH, BUT WE'LL BE IN COMMUNICATION WITH THE MEMBERS ON THE NECESSITY FOR THAT MEETING.

BUT THEN STARTING WITH APRIL WILL GO TO EVERY OTHER MONTH CADENCE.

WE'LL PROBABLY LIKELY KEEP THE ROOMS RESERVED ON THIS JUST IN CASE WE WE NEED IT FOR WHATEVER REASON, BUT WE'LL PLAN ON THAT EVERY OTHER MONTH CYCLE, AND THAT'LL HELP US STAGE OUR WORK TO BOTH INTERNALLY AS WELL AS WITH THE AGENCY PARTNERS AND THE LEGISLATURE. SO WE APPRECIATE THE CONSIDERATION.

THANK YOU. AND ONE OF THE REASONS TO DO THIS, I MEAN, IF WE'RE NOT DOING BUSY WORK, WE'RE NOT IN THAT BUSINESS.

[01:50:07]

BUT GETTING READY FOR A BOARD MEETING TAKES A WEEK'S WORTH OF TIME FROM EVERYBODY THAT'S ACTUALLY DOING THE REAL WORK.

I THINK WE NEED TO UNNECESSARILY INCREASE OUR MEETING TIGHTER.

MR. CHAIR, IF I MAY JUST A THIS WAS ADDED AFTER THIS DOCUMENT WAS PREPARED.

WE HAVE A AUGUST 25TH DATE THAT HAS BEEN SECURED AS WELL.

SO THAT THAT WOULD BE IF WE KEEP A BI MONTHLY CADENCE.

IF WE DO APRIL, JUNE, THEN IT WOULD BE AUGUST 25TH.

THAT'S THAT MONDAY BEFORE LABOR DAY. MONDAY.

OKAY. ALL RIGHT. ANYTHING ELSE? ANYBODY? IF NOT WE WILL ADJOURN THIS MEETING. NEXT MEETING TO BE DETERMINED AND BE ANNOUNCED. AT WHICH TIME? WE'LL KNOW THE NEXT ONE PRETTY QUICK. BY THE END OF THE WEEK, YOU'LL KNOW WHETHER IT'S A MARCH MEETING OR THE APRIL MEETING.

YES, SIR. AND SO THIS MEETING WILL ADJOURN. IT'S AT 11:52 A.M.

STILL. THANK YOU. THANK YOU. MEMBERS.

* This transcript was compiled from uncorrected Closed Captioning.