Committee information and past agendas
The Finance Committee reviews, approves, and makes recommendations to KHS' Board of Directors on all financial and contractual matters that are presented by KHS' staff in support of administrative and management operations. It ensures KHS' financial stability by providing oversight on its budget.
Friday, October 4, 2019 at 8:00 a.m
Kern Health Systems
2900 Buck Owens Boulevard
Bakersfield, CA 93308
October 4, 2019 Finance Committee Meeting Packet
Pharmacy & Therapeutics Committee
The Pharmacy & Therapeutics Committee (P&T) Committee monitors the KHS Formulary, oversees medication prescribing practices by contracting providers, assesses usage patterns by members and assists with study design and clinical guidelines development.
Physician Advisory Committee
The Physician Advisory Committee (PAC) serves as an advisor to the Board of Directors on health care issues, peer review, provider discipline and credentialing/recredentialing decisions. This committee is responsible for reviewing provider grievances and/or appeals, provider quality issues, and other peer review matters as directed by the KHS Chief Medical Officer or designee.
The QI/UMC has delegated credentialing and recredentialing functions for KHS to the PAC. The PAC is responsible for reviewing individual providers for denial or approval of participation with KHS.
The PAC is charged with the assessment of standards of health care as applied to members and providers; assist with development of indicators for studies; and regularly review guidelines that are promulgated to contracting providers and members. This committee consists of a variety of practitioners in order to represent the appropriate level of knowledge to adequately assess and adopt healthcare standards. The committee obtains an external independent review and opinion when necessary to assist with a decision regarding preventive care guidelines, disease management or coverage of a new technology as a covered benefit for members.
The PAC reviews and comments upon pertinent KHS standards and guidelines with updates, as needed. The PAC evaluates improvements in practice patterns of contracting providers and the development of local care standards. Development of educational programs includes input from the PAC. The PAC reviews and comments on other issues as requested by the Board of Directors.
Physician Advisory Committee Meeting Agenda for November 6, 2019
Public Policy/Community Advisory Committee
The Public Policy/Community Advisory Committee (PP/CAC) provides a mechanism for structured input from KHS members regarding how KHS operations impact the delivery of their care. The role of the PP/CAC is to implement and maintain community linkages.
Function – the functions of the PP/CAC are as follows:
- Culturally appropriate service or program design.
- Priorities for health education and outreach program
- Member satisfaction survey results
- Findings of health education and cultural and linguistic Group Needs Assessment.
- Plan marketing materials and campaigns.
- Communication of needs for provider network development and assessment.
- Community resources and information.
- Periodically review the KHS grievance processes;
- Review changes in policy or procedure that affects public policy;
- Advise on educational and operational issues affecting members who speak a primary language other than English;
- Advise on cultural and linguistic issues.
Structure – The PP/CAC is delegated by the Board of Directors to provide input in the development of public policy activities for KHS. The committee makes recommendations and reports findings to the Board of Directors. Appointed members include:
- 1 Public Policy Chair of the KHS Board of Directors (Chairperson) - Louis Iturriria
- 5 Subscribers/enrollees – three vacant
- 2 Community Representative
- 2 Participating Health Care Practitioner - two vacant
- 1 Kern County Health Officer or Representative
- 1 Director, Kern County Department of Human Services or Representative
Meetings - The PP/CAC meets quarterly with additional meetings as necessary.
Public Policy/Community Advisory Committee Agenda for August 13, 2019
Quality Improvement/Utilization Management Committee
With a commitment to the community of Kern County and the members of Kern Health Systems (KHS), the Quality Improvement/Utilization Management Committee (QI/UMC) is dedicated to improving the health status of members, while maintaining the medically appropriate and efficient use of available resources. The QI/UMC oversees all covered health care services delivered to members by systematic methods that develop, implement, assess and improve the integrated health delivery systems of KHS. All contracting providers of the Plan will participate in the Quality Improvement (QI) activities. The Plan's goal is to attain satisfied, healthy members and numerous collegial partners in the health care community.
The QI/UMC provides oversight for the QI and UM Programs and is composed of:
- 1 KHS Medical Director (Chairperson)
- 2 Participating Primary Care Physicians
- 2 Participating Specialty Physicians
- 1 Participating Home Health Representative
- 1 Kern County Public Health Officer
- 1 Participating Mid-Level Practitioner
- 2 Other Participating Ancillary Representatives
- 1 Participating Hospital Representative
- QI Manager and Staff (Committee staff support)
The QI/UMC meets at least quarterly but as frequently as necessary to ensure follow-up on all findings and required actions. Issues needing immediate assistance that arise prior to the next scheduled meeting are reviewed by the medical director and reported back to the QI/UMC when applicable.
Quality Improvement Utilization Management Committee Meeting Agenda and Packet - November 14, 2019