The Public Health Board of Trustees for today, April 29th, our first item is I Am Vocation by Dr. Kelly. Some words of wisdom, please. Good afternoon. So we'll start with John 14, verse 27. Do not let your hearts be troubled. Think about that. Maya Angelou sent a note to her daughter, and she said, you try to be the rainbow in somebody's cloud. So let's think about how does the Public Health Trust in Jackson act as a rainbow in the clouds of all the people who come here who are sad and lonely and under the weather, right? So let's pray. Dear God, we thank you for the sign of the rainbow, and we thank you that you said to not be anxious because you care about us, you listen to us, and you are with us, and will never leave or forsake us. So guide us and direct us as we go about the business of being rainbows and light in the way of darkness. Amen. Thank you, Dr. Kelly. A Pledge of Allegiance, if I may. Any members of the public that would like to be heard, this is the opportunity. Anybody in the back want to be heard? Seeing no one. And then we will proceed. I'd like a motion to set the agenda as presented. So moved. Second. Moved and second. All those in favor? We are not going to approve the minutes of the meeting. We are? Okay. I thought we were not. Oh, okay. So I would like a motion to approve the minutes of the meeting of March 25th. So moved. Second. Moved and second. All those in favor? Aye. Against? Hearing none. My comment was met because as a result of unforeseen circumstances, I was not prepared in the meeting of the whole to present the minutes this morning when we met. Those will be then presented, I apologize, at the next meeting. But that was my oversight on that. Chairman's report. I just wanted to mention that what a week here at Jackson. I had the honor and the privilege of attending the opening of the emergency room. If you haven't gone, please go. It is operational. It is impressive. And I think it's something that will be of great service to our entire community and probably to anyone who's visiting and anyone from the world. I think I was incredibly impressed, not only by the hospital, the buildings. Favorite to me was the day that the opening was presented to our team, to our employees, to our staff. That, to me, is special. Great job by the foundation. Great job by Carlos Migoya. Great job by David Zambrana. Great job by just all the team leaders that are here present and not in putting that together. So I just wanted to mention that after that. Now I'm going to give the floor to David Zambrana. Thank you, Mr. Chairman. As you were just mentioning, last Thursday we opened the doors of our new emergency department at Jackson Memorial Hospital. It was a huge milestone for our team and our organization, one that was years in the making. Witnessing the care team members' transition from our outdated emergency room into this new, beautiful facility was so impactful. Now patients are more comfortable and at ease, and our clinicians are empowered to deliver efficient, coordinated care with everything they need under one roof, and I would venture to say at their fingertips. So many Jackson team members played a critical role in the success of this project, from the construction teams who brought the building to life, to our hospital operators and the emergency department leadership, to colleagues across IT, supply chain, engineering, clinical engineering, nutrition, environmental services, public safety, and so many others. I am incredibly proud of everyone who spent so much time and energy making this transition turn into a reality. Though we've only been open for six days, we have received excellent feedback from our patients and their families. Our care team's members have acclimated to their new environment, and we're working through a few expected adjustments to the workflows and processes. We anticipate we will see gradual growth in our volume in this new facility, both from patients walking in on their own and from our EMS partners. It's too soon to call it a trend, but a comparison from last Monday in our old ED to the new one, our new facility shows a 19% increase in total patient volume and a 12% increase in our EMS volume. We're already preparing for phase two of the emergency department expansion project, which includes a remodeled emergency department for our population at our Holtz Children's Hospital and additional treatment spaces for our adult patients in our LTD. Our teams have already started with the abatement and demolition planned for May. Phase two is expected to be completed the fall of 2027. Finally, we're still reeling, as you just described, Mr. Chairman, a historic donation to our Jackson Health Foundation for this emergency room, a $100 million transformative gift made possible through a collective of community leaders and philanthropists. The gift, which was announced on One Day for Jackson a couple of weeks ago, will accelerate our ability to expand access, enhance patient care, and invest in the future of our community. We are so grateful to all of the donors who believe in Jackson and our sacred mission of serving people in Miami-Dade and beyond. And with that, Mr. Chairman, it concludes my report. Thank you. Thank you, David. Sorry I took the thunder, I guess, but I was unaware of... I've never seen your report. To team sport. There you go. But anyway, it goes without saying that it's an incredible achievement moving forward. So next in the agenda is the Compensation and Evaluation Committee met earlier today. I'm going to ask Michelle Klingman, who is our head of HR here, to help me in making a small presentation to all of you. You all have... We're members of the Compensation and Evaluation Committee, so you've heard this. We've had ample briefings, individual briefings on this, but I think it's important for Michelle to give us a presentation so that the public can also be aware of that committees and the results of that earlier today. I'm pleased to present for the board, well, formal approval, although this is already previously approved, for the three-year employment agreement for our incoming Chief Executive Officer, Dr. Zambrana. The transition of leadership at Jackson is the result of a deliberate and thoughtful six-year succession planning process. One designed to ensure that at this institution, as this institution moves forward, it does so with the right leader at the helm. That process has led us unequivocally to Dr. Zambrana. Dr. Zambrana is a doctorally prepared health care executive, holding a doctor of nursing practice and a Ph.D. in nursing and health care leadership, whose career has been defined by a commitment to clinical excellence, operational leadership, and academic medicine. He has served Jackson with distinction as President and Chief Operating Officer, earning the trust of our medical staff, our workforce, and this community. He understands the complexity of a public academic health system, the responsibility to care for our most vulnerable, while advancing education and research in partnership with the University of Miami. He has navigated that complexity with skill, integrity, and a steady hand. Simply put, he is not coming in to learn this institution. He is already leading it. With that foundation, it becomes imperative that we secure and retain this leadership in a highly competitive market. To inform that effort, Jackson engaged Gallagher to conduct an independent, third-party market analysis. Gallagher benchmarked this role across national, academic, Florida, and public health system peers. The findings were clear. To retain a leader of this caliber at an organization of this size and complexity, Jackson must compete in a national market. While remaining disciplined in how we position compensation. From a base salary perspective, Dr. Zambrana's compensation is intentionally positioned below the market median across most peer groups, generally ranging from approximately 74% to 80% of median benchmarks, depending on the comparator. This reflects a fiscally responsible starting point aligned with our role as a public health system. Importantly, a meaningful portion of this compensation is performance-based, with outcomes tied to quality, strategy, and financial priorities. The structure ensures that compensation is not only competitive, but earned through measurable results that matter to this board and to this community. When considering total direct compensation, the positioning remains near, but generally below, market median across national, academic, and Florida peers, with alignment approaching median over time through performance. Within the public health system peer group, compensation is more aligned to market, reflecting the narrow and more comparable segment. The contract has been approved and reviewed by the county attorney's office and Susan Norton, Independent Labor Counsel. Dr. Zambrana was also represented by independent counsel throughout this process, ensuring transparency and integrity on both sides. The board has been fully briefed. At its core, this agreement strikes the balance we must achieve, securing the right leadership, aligning incentives to performance, and upholding our responsibility as a public trust. I'm proud to recommend approval of this agreement. Happy to answer any questions. Thank you, Michelle. Any questions from any member of the board? So thank you. Thank you for that. And thank you to members of this board for entrusting me and leading in this process. We had this morning here at the Compensational Evaluation Committee the mayor of Miami-Dade County. She is a member of that committee, and she felt and expressed her unequivocal support for this and for the process. I think that that's important for everyone to know. I want to thank, and I thank this morning, Michelle and her team. I know that I asked more than one should in this process, but felt that it was so important. Thank you to the county and the county attorneys for their service in coordinating this agreement, making sure that it meets all of the different requirements that we have as a public hospital. And even though she's not here, thank you to Susan Norton and her counsel, which was very invaluable in making sure that the process was followed without hesitation, without a timeline, without any obstacles of any sort, and certainly to Dr. Zambrana and his attorney for being available, cooperative, and it really was a pleasure to be able to work on this. So without further comment, then, I just want to thank all for the process and for making sure that we followed it without hesitation, without interference, without any undue process, timelines, or constraints of any sort. Thank you, Mr. Chairman, for your leadership and for your support. We had several other incredible reports this morning. I'll try to be brief. When it comes to the quality reports of two departments in particular, the first one that I'll mention is our ambulatory division. They provide us with their report, and it's always incredible to see not only the volume of services that are provided and how they continue to grow. They provide and expand the access to all Miami-Dade County patients through their centers or clinics, their urgent care locations. They've seen growth, strong growth, in their patient visits, reflecting not only the demand but also the expanded services that they provide our community. The quality in each and every report that I saw was, if it could possibly say, increased better where it needed to be better and lower where it needed to be lower. So that's also an incredible for her team, for Caridad, Nieves, and her team. I think that their focus on providing access, easier access, their focus on keeping people healthy, which is really our main job that we can do in those centers is to keep them healthy and to make sure that they don't need to be hospitalized so that the hospital can concentrate their efforts and resources, the doctors, in taking care of the ones that actually do need hospitalization. So thank you for that report. That was impressive. The other report, which is one that we're probably the only ones to hear it, is the behavioral health. So as we understand that behavioral health is a growing need in this community, we are the public hospital. We are the ones that provide most of the behavioral health services at this moment within our community. Their focus on safety, whether it be patient safety, whether it be safety of their staff, patients, employees, staff members, doctors, that's important and showed great strides moving forward. They're using technology in order to help them, including the use of monitoring and observation to keep people out of harm's way. I was particularly impressed with the lowering of readmissions, which shows that, in fact, the treatment is working and allowing these people to get better. At the same time, they're constantly focusing on improvement and reducing falls and continuing to improve the overall quality of the care that they provide. I'm going to then, just to give up the microphone for now, ask Carmen Sabater to help me with the fiscal report. She certainly does it a lot better than I do. Thank you, Mr. Chair. The management team reported on the results through midway point of the year, and they were pleased to report that they're ahead of budget by approximately $3.9 million. While volume has declined in certain areas, the acuity of the patients is on the rise, contributing to some of the positive momentum. Operational efficiencies remain a key driver for performance, and we continue to see improvements in collections. The management team proposed a new line of credit to provide additional liquidity and financial flexibility for the system, and that is one of the resolutions that was passed as well, and that is basically a summary of the report. Thank you, Carmen. Last but not least was strategy and growth. In particular, we had our chief information officer, Mike Garcia, give us a detailed presentation on what is a very important project coming online, which is the transformation to EPIC as our operating system. It's a multi-year project that will touch every aspect of this hospital, including patient records, including the way we operate, including the information that we have available. It is going to EPIC, which is the recognized industry leader from the current system that we have, which is certainly outdated and been here for over 22 years, I think it is, or even more. They show a clear and very detailed plan on this transformation, including the creation of departments to look at every aspect of this hospital, with sub-workforces and involving team leaders and the different hospital, every single hospital, I think, aspect in this plan. There's dozens of teams across the system that are actively shaping the workflows and looking to ensure that we improve the patient care. That's number one in our system. Number two, that we improve what our staff and what our doctors and what our nurses and everybody can do for our patients. And three is to make sure that we can operate as efficiently and as securely and as beneficial to our community as possible. I can't possibly tell you the magnitude of this program and what it will mean, but it's certainly something that we're welcome. I used a word, which I was corrected. Well, what I should be as excited about this project. I used the word anxious, but then I'm technically challenged, as my children tell me. In any event, that's important, and I wish I pledged the support of myself as a member of this board to Mike and his team in whatever they may need in order to take this project on and bring it home safely for the county and for the patients and for the doctors and staff here. I think that exhausts my agenda, and now, if I may, I think we have some resolutions coming before you. Yes. If you want, we can look at them individually or we can do them all at once. It's at the preference of this board. Counsel, read them in. Yes, I'm happy to do that. At 10A, you have the credentialing report. At 10B, you have the purchasing report. At 10C, you have the addendum to the parking agreement between Miami-Dade College and the Ph.D. At 10D, you have the lease agreement with the Salvation Army for the installation of the OnMed care station. At 10E, you have the resolution requesting Miami-Dade County Board of County Commissioners authorize a revolving line of credit at TD Public Finance. At 10F, you have the naming interior spaces in the Jacksonville Hospital ED, including Benjamin Leon Jr. Charitable Foundation Observation Lobby, the Gorson Family Welcome Area, and the Royal Caribbean Group Foundation Physician Workrooms. And then you also have, at 10G, the resolution accepting and approving the agreement between the Public Health Trust and David Zambrana, authorizing the chairperson of the Board of Trustees to execute the same and take all necessary further actions to accomplish the purposes of this resolution. So you can entertain a motion to approve all those items as one, should you choose to. If I may have a motion. So moved. And I will second the slate. It has been moved and second. All those in favor? Aye. Against? Hearing none. The resolutions are unanimously approved. I now, unless anybody has any further comments, would like to congratulate Dr. Zambrana. And we'll welcome a motion to adjourn. So moved. Moved. Second. And second. All those in favor? Against? We are adjourned. Thank you all for coming today.