FALL 2018 DFWHC NEWS FROM THE DFW

Around DFWHCCouncil on hand for opening of St. Vincent PharmacyDFW HOSPITAL COUNCIL PRESIDENT/CEO W.STEPHEN LOVE was one of the presenters during theSeptember 25 grand opening of the St. Vincent de PaulPharmacy in Dallas. The establishment is noted for beingthe first free pharmacy open to the public in Texas.Additional presenters included Michael Pazzaglini,executive director of the pharmacy, and Dallas CountyJudge Clay Jenkins.“We are here to provide support for our neighbors inneed,” said Pazzaglini. “There are over four million peopleliving within the nine-county area served by St. Vincentde Paul of North Texas. You might be surprised that over700,000 have no health insurance and live in householdswith incomes less than 200% of the federal poverty line.”The pharmacy, located at 5750 Pineland Drive, isavailable to patients following a brief application processand proof of Texas residence. Clients will then be able togain access to health-sustaining medications like asthmainhalers, insulin and blood pressure medication.Qualifications for service at the pharmacy includeno health insurance, family below 200% of the federalW. Stephen Love (l to r), Dallas County Judge ClayJenkins and Michael Pazzaglini.poverty line, residency within the service area and one ormore valid prescriptions.“We are blessed with outstanding employees, generouspharmacists, pharmacist technicians and so many otherswho donate their precious time to make this pharmacy areality,” Love said.For information, please call 469-607-0909. nYoung healthcare executives participate in DFWHC classesTHE FUTURE OF NORTH TEXAS HEALTHCARE was atthe DFW Hospital Council (DFWHC) offices September21 for a series of classes detailing hospital governmentrelations and Lean 6 Sigma training. The gathering is apart of DFWHC’s Young Healthcare Executive Cohort, or“YHEC” for short.The group was created this year by W. Stephen Love,president/CEO of the DFWHC, and Fraser Hay, presidentof Texas Health Presbyterian Hospital Plano and DFWHC10dfwhc interlocutorboard member.YHEC is a complimentary DFWHC program to provideeducation, networking and collaboration to area hospitalexecutives 40 years of age or younger.An expert panel with David Tesmer, senior vicepresident of engagement and advocacy at Texas HealthResources; Matt Moore, vice president of governmentand community relations at Children’s Health; and CoreyDavison, vice president at Tenet Healthcare, discussedhospital government relations.Stephen Griffin, managing partner of Lean Six Sigma,provided a presentation detailing problem solvingexercises and business transformation.“The mission of the DFWHC YHEC is to engage futurehealthcare leaders and expose them to relevant topics,”Love said. “This is an effort to better prepare these futurehospital leaders to collaborate with peers and solvecommon challenges.”For information, contact DFWHC at 972-719-4900. n

DFWHC/DFW HIMSS host“Opioid Crisis” webinarMORE THAN 180 ATTENDEES participated in the October 10educational webinar “Antidote to the Opioid Crisis is Rooted in Data”hosted in coordination between the DFW Hospital Council (DFWHC)and the DFW Chapter of The Healthcare Information and ManagementSystems Society (HIMSS).Dr. Michael Petersen, physician executive with Accenture, andW. Stephen Love, president/CEO of DFWHC, served as speakers. Thecomplimentary webinar detailed both local and national perspectives.The webinar is available at https://youtu.be/er72vq28jkg.For questions, contact Chris Wilson at chrisw@dfwhc.org. nPhillips named CEO at Methodist DallasJohn PhillipsJOHN PHILLIPS was named the new CEO at Methodist Dallas in September afterserving at Methodist Mansfield over the past seven years. Phillips takes over for Dr.Martin Koonsman, who has moved up the chain to become the system’s chief medicalofficer. In Mansfield, Phillips grew the hospital to 254 beds and helped it gain a Level 3trauma designation as well as a Magnet designation, given to top performing hospitalsfor nursing. Phillips also serves on the DFW Hospital Council Board of Trustees. nKamber named CEO at Medical City WeatherfordSean KamberSEAN KAMBER was named the new CEO of Medical City Weatherford in October.Kamber has been vice president of rural and community outreach for HCA Healthcare’sGulf Coast Division for the last year and was the chief operating officer at WeatherfordRegional for three years. Kamber brings more than 12 years of health care experienceto the position, including manager for a urology group, director of operations at TexasHealth Resources and assistant administrator at Laredo Medical Center. ndfwhc interlocutor11

Around DFWHCW. Stephen Love (l to r), LaVone Arthur, Barclay Berdan and Wright Lassiter, III.DFWHC’s Love moderates panel of healthcare“maestros” during national summit in DallasDFW HOSPITAL COUNCIL PRESIDENT/CEO W. Stephen Love moderated a panel ofhealthcare “maestros” during the Oliver WymanHealth Innovation Summit on November 7 at theFairmont Dallas Hotel.The presentation “You Try Running aHospital,” included Barclay Berdan, CEO ofTexas Health Resources, LaVone Arthur, chiefstrategy officer at Baylor Scott & White Health,and Wright L. Lassiter, III, president/CEO ofthe Henry Ford Health System. The event wasbroadcast live on Facebook.12dfwhc interlocutorThis year’s sixth annual summit was themed“Health Redefined: Breaking Boundaries to Builda Better Way” and included industry leadersdiscussing a redefinition of national healthcare.“We would like to thank Barclay Berdan,LaVone Arthur and Wright Lassiter, III for theirexpert commentary yesterday,” Love said. “Itwas a great event and I appreciated their pointedcomments on the challenges of running hospitalsin today’s market.”The event was taped and will be madeavailable to DFWHC membership. n

Robotic ProcessAUTOMATIONMORE THAN 90 ATTENDEES participated in the Nov. 1 educationalwebinar “Robotic Process Automation (RPA) in Healthcare” hostedby the DFW Hospital Council (DFWHC) in coordination withAccenture.The complimentary event was introduced by DFWHCPresident/CEO W. Stephen Love, with Carol Durham,an applied intelligence director at Accenture, JamesMacDougall, a senior director at Blue Prism and FrankCatone, a senior director at Accenture’s Global IntelligentAutomation Solutions Team, serving as speakers.Topics included operational costs, data analytics,compliance, employee productivity, accuracy andcustomer satisfaction.The webinar can be viewed on DFWHC’s YouTubechannel at https://youtu.be/eObDmqEGO o. nDFWHC teams withOnPlan Healthby FlywireTHE DALLAS-FORT WORTH HOSPITALCOUNCIL (DFWHC) AND ONPLAN HEALTH BYFLYWIRE are pleased to announce a strategicpartnership effective immediately. The allianceis expected to benefit North Texas hospitalsthrough a wide range of patient friendly paymentsolutions provided by the OnPlan Health platform.OnPlan Health was co-founded by John Talagaand David King in 2014 to help providers address theincreasing patient out-of-pocket collection challengesdue to the growth in patient responsibility through highdeductible health plans (HDHP). OnPlan Health wasthe industry’s first automated patient engagement andpayment plan solution, which pioneered the proactive“offer” and “self-activation” of payment plans based onthe way patients’ have paid in the past.OnPlan Health also provides customers with a fullyintegrated suite of patient payment solutions includingconsolidated statements, online billing and payments,point-of-service payment management, merchantprocessing services, and security and compliance. Learnmore at http://onplanhealth.com/. ndfwhc interlocutor13

HealthcareMedical City Healthcare congratulatesJyric Sims, Medical City Fort WorthCEO, as the recipient of the 2018Young Healthcare Executive of the YearAward. We are honored to recognizeJyric for his leadership, dedication andcommitment to our mission of the careand improvement of human life.Jyric Sims, FACHEDallas-Fort Worth Hospital CouncilYoung Healthcare Executiveof the Year Award Winner

Jim L. TurnerTrustee and Immediate Past ChairBoard of TrusteesBaylor Scott & White HoldingsStrong Leaders Make Us BetterCongratulations to Jim L. Turner for being recognized with the Kerney Laday, Sr. Trustee of the Year Award—an honor that reflects his longtime commitment to Baylor Scott & White Health as a board member. Hehas played an instrumental role in leading Baylor Scott & White during a time of tremendous change in thehealthcare industry while also maintaining focus on the organization’s mission to promote the well-being ofindividuals, families and communities throughout Texas.BSWHealth.com 2018 Baylor Scott & White Health. BSWADMIN 140 2018 SOM

Associate MembersMARIJUANAIN THE WORKPLACELegal Issues forTexas EmployersBy Robin Sheridan, JD, MILR of Hall Render,with assistance from Law Clerk Victoire IradukundaAT LEAST 30 U.S. STATES AND D.C. HAVE LEGALIZEDMARIJUANA in some manner and nine have legalized forrecreational use. At the federal level, marijuana remainsclassified as a Schedule I drug with heroine and LSD.Caught amongst the evolving state and federal laws,employers are finding themselves left to untangle a mixedbag of contradictory directives. This article will providean overview of the laws, analyze their impact, and offerpractical takeaways for Texas employers.FEDERAL LAWThe Controlled Substances Act, Title II of theComprehensive Drug Abuse Prevention and ControlAct of 1970 (CSA) is the federal law that criminalizedmarijuana. While multiple challenges have been brought,the Supreme Court has held that the federal governmenthas a right to regulate cannabis, even for medicinalpurposes. The CSA granted the federal government,through the Drug Enforcement Agency and the Food andDrug Administration, authority to regulate controlledsubstances. To achieve this goal, the CSA provides thatdrugs shall be placed in five categories – Schedule Ithrough V – based upon the determination of the drug’s16 dfwhc interlocutorpotential for abuse, medicinal value and risk to publichealth. Marijuana is listed as Schedule I because thegovernment determined it has a high potential for abuse.Employers must comply with the American withDisabilities Act (ADA). Certain government fundedemployers must also comply with the Drug FreeWorkplace Act (DFWA) and the Federal OmnibusTransportation Employee Testing Act (FOTETA). TheADA prohibits discrimination against individuals withdisabilities. The DFWA requires federal contractors toadopt a zero-tolerance policy and comply with strictdrug-free requirements. FOTETA requires Department ofTransportation (DOT) agencies to implement drug andalcohol testing of employees who hold a “safety-sensitive”position such as truck driving.Regardless of federal laws, the government hashistorically taken a relaxed approach and has left thepolicing to the states. In August 2013, then-U.S. AttorneyGeneral James Cole stated that the DOJ would deferto states to address marijuana. However, the waterswere muddied in 2018 when current Attorney GeneralJeff Sessions shifted the federal attitude away from theObama-era “hands-off” approach and gave prosecutors

This article was submitted by DFWHC Associate MemberHall Render. For information, please contact Chris Wilsonat chrisw@dfwhc.org.free reign to crack down on marijuana. Three monthslater, Sessions released another memo urging federalprosecutors to “consider every lawful tool,” including thedeath penalty, when prosecuting drug-related crimes.Regardless of these memos, the state-legalized marijuanaindustry has not slowed. Markets continue to forecastexponential growths in sales, with Washington projecting 2.3 billion in 2020, and the national market projected toreach 24.5 billion by 2021.TEXAS LAWWhile marijuana remains federally illegal, several stateshave legalized. The Compassionate Use Act (CUA) of 2015legalized limited use in Texas. Under the law, patients canuse a “low-THC cannabis” to treat diagnosed “intractableepilepsy,” which is defined as “a disorder in which thepatient’s seizures have been treated by two or more drugsthat have failed to control the seizures.” Low-THC cannabiscannot contain more than 10% cannabidiol or more than0.5% tetrahydrocannabinol (THC). No other conditions canbe lawfully treated. Texas specifically excludes smoking,meaning a physician may not prescribe smoking foringesting medicinal marijuana.A 2017 Gallup Poll revealed that 64 percent ofAmericans support legalization, and efforts are beingmade to expand medicinal marijuana in Texas. In 2017,House Bill 81 to decriminalize possession of one ounceor less made it into the House. House Bill 2107 was alsointroduced to allow Texans suffering from terminal cancerand post-traumatic stress to use marijuana. Althoughneither bill advanced, it is clear legalization is here to stayand it is important for employers to familiarize themselveswith common laws. A few questions below.Can an employer terminate an employee for failing adrug test due to use of recreational marijuana while offduty and off premises?Historically, courts generally held that an employee couldbe terminated for failing a drug test due to off-the-clockactivities. However, Texas Administrative Law Judge (ALJ)William G. Newchurch veered from this view in 2017. InTexas Education Agency, Educatory Leadership and QualityDivision v. Maryam Roland, the ALJ ruled that a teachershouldn’t be sanctioned after testing positive. Rolandfailed a drug test after she had consumed an ediblemarijuana product in Colorado. The Texas EducationAgency requested guidance as they considered whetherto suspend Roland’s license. The ALJ held that Rolandhad not violated either law, finding that she consumedthe drug in Colorado, where marijuana was legal. The ALJheld that “possession of marijuana is a criminal offensein Texas—but so is gambling.” The ALJ reasoned that theBoard should not “find a teacher unworthy to instruct inTexas because she legally gambled in Nevada.” Similarly,the ALJ recommended that the Board should not “findRespondent unworthy to instruct because she legallyconsumed marijuana in Colorado.” The ruling serves as awarning to carefully consider termination decisions.Are employers required to make accommodations foremployees using medicinal marijuana?The ADA prohibits employers from discriminating againstpeople with disabilities. However, the ADA does notconsider individuals who use illegal drugs to be qualifiedas disabled, and marijuana is an illegal drug. Similarly, theTexas Labor and Human Resource Codes mirror the ADAwith respect to the meaning of “disability.” Therefore, noaccommodation would be required for a marijuana userunder the state fair employment law at this time.How does this impact drug test results?Because the DOT’s Medical Marijuana Notice statesthat marijuana remains illegal under the CSA, the DOTexpects all medical review officers to treat marijuanaas a Schedule I illegal drug and issue positive results totests. However, the employer’s medical review officershould not apply DOT standards to a medicinal marijuanauser and should use standard procedures to address theemployee’s claim of legality.Editor’s note: Recommendations in this article are foreducational purposes and are not to be construed asactual legal advice. Always consult with a local attorney.For additional information, contact Mac Stewart (214)615-2000 or Robin Sheridan at (414) 721-0469. ndfwhc interlocutor17

Associate MembersHUMAN MILKBy Heidi Storm,Clinical Sciences Sr. ManagerOLIGOSACCHARIDESImportant Immunological Components in mother’s milkBREASTFEEDING IS THE BEST WAY TO NOURISH AN INFANT, and it is recommended as the sole source ofnutrition for infants up to 6 months of age by the American Academy of Pediatrics (AAP).1 A recognized advantageof human milk is the immunologic support it provides the infant.2 Much activity has evolved around breastmilkhuman milk oligosaccharides, or HMOs, the 3rd most abundant solid component of human milk. HMOs are diversecarbohydrates found in breastmilk, and more than 200 different HMOs have been identified. HMOs are involved inthe development of the infant’s intestinal tract, brain, and immune system.3As much as 70-80% of the immune system resides as part of the gastrointestinal tract, where HMOs initiatetheir impact. HMOs help balance the microbiota and have at least three ways of providing immune system supportto the infant. One means is via their role as prebiotics, meaning they are utilized as food for specific types ofbacteria that are considered beneficial for the infant.3 A second function of HMOs is their ability to act as decoysagainst potentially pathogenic microorganisms.418dfwhc interlocutor

This article was provided by Gerber.For guidelines, contact Chris Wilson at chrisw@dfwhc.org.A third mechanism of HMOs is their ability to improveimmune cell communication. HMOs influence cytokines,which are proteins secreted by certain cells of the immunesystem and can help regulate immune and inflammatoryresponses of other cells. In a study where babies were fedinfant formulas with or without an HMO, cytokine levels inthe infants fed formula with HMOs were more like thoseof breastfed infants, compared to infants fed the HMOfree formula.5Another trial demonstrated that the addition of HMOsto infant formula was associated with fewer reportedepisodes of bronchitis, fewer lower respiratory tractinfections, and less use of antibiotics and medications forfever compared to infants fed formula without an HMO.6Because of the benefits that HMOs offer viabreastmilk, an HMO ingredient has also been introducedinto some infant formulas in the U.S. The first HMOselected for infant formula was 2’Fucosyllactose, or2’FL. 2’FL HMO is a prebiotic oligosaccharide, and themost prevalent human milk oligosaccharide, making upabout 30% of all HMOs. Due to its prevalence in humanmilk and its ability to be produced in a bioequivalent,structurally identical form to the 2’FL in breastmilk, 2’FLHMO, previously mentioned as studied in infant formulasis currently added to some infant formulas in the U.S.5Breastfeeding remains the best choice for nourishingan infant. For mothers unable to breastfeed, and for thosemothers who choose to use infant formula during theirinfants’ first year of life, formulas with HMO are an optionthat may provide support to their infants’ developingimmune system.REFERENCES1. American Academy of Pediatrics, Section onBreastfeeding. Breastfeeding and the Use of Human MilkPolicy Statement. Pediatrics. 2012; VOL (3): 827-841.2. Field C. The immunological components of human milkand their effect on immune development in infants. TheJournal of Nutrition. 2005; 135 (1):1–4.doi.org/10.1093/in/135.1.13. Bode L. Human milk oligosaccharides: every baby needsa sugar mama. Glycobiology 2012;22:1147-1162.4. Newberg DS. Oligosaccharides in human milk andbacterial colonization. J Pediatr Gastroenterol Nutr2000;30:S8-S17.5. Goehring KC, Marriage BJ, Oliver JS, Wilder JA, BarrettEG, Buck RH. Similar to Those Who Are Breastfed, InfantsFed a Formula Containing 2’-Fucosyllactose Have LowerInflammatory Cytokines in a Randomized Controlled Trial.J Nutr 2016;146:2559-2566.6. Puccio G, Alliet P, Cajozzo C et al. Effects of infantformula with human milk oligosaccharides on growthand morbidity: A Randomized Multicenter Trial. J PediatrGastroenterol Nutr 2017;64:624-631 ndfwhc interlocutor19

Charlie Powell:A Living Example of“Distinguished Service”“Distinguished Service” describes Charlie Powell’s penchant for serving others: Chair of Make-A-Wish Foundation RegionalCouncil Co-Chair—along with his son James—ofthe 2013 Tarrant County United Waycampaign (the first father-son combinationin its then 91-year history) Chair of John Peter Smith Health Network Recipient of the Distinguished LeadershipAward from the Boy Scouts of America Recipient of the Leadership & CommunityService Award from the Fort WorthChamber of CommerceCiera Bank honors our President and CEO for distinguishing yourselfthrough service to our community. Well done, Charlie!Banking that’s true to Texas since 1890!Member FDICEight North Texas locations www.cierabank.com

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Catapult Systems Cigna IBTX Katten Muchin Rosenman LLP Optum Propath HOSPITAL PLATINUM . the project. Nary a file cabinet went unopened during the process, with photographs discovered from events dating . relations and Lean 6 Sigma training. The gathering i