August 17, 2026

0:16 Board President not human verified

Thank you. meeting tonight. Well, then we'll start tonight with our Pledges of Allegiance.

0:34 Board President not human verified

KDIC Police Officer Lister will lead us in our Pledges of Allegiance.

0:45 Officer Lister, Katy ISD Police not human verified

I pledge allegiance to the flag of the United States of America and to the Republic for for which it stands, one nation, under God, indivisible, with liberty and justice for all. Honor the Texas flag. I pledge allegiance to thee, Texas, one state, under God, one and indivisible.

1:10 Board President not human verified

Do we have any scouts in the audience tonight? We do not. Well, then the next portion of our meeting is public comment, and we do not have anyone signed up to speak tonight. So this concludes the open forum portion of our meeting.

1:25 Board President not human verified

The board will now convene and close as authorized under section 551.001 of the Texas Government Code for the following purposes. Texas Government Code 551.071 and 551.129. The board will now reconvene in open meeting.

1:46 Board President not human verified

Today is Monday, August 17, 2026, and the time is 548 p.m. On behalf of my colleagues, I welcome everyone to this evening's work-study meeting. Each board member received the agenda and documentation for this meeting on Wednesday, August 12, 2026. The board will receive information and recommendations from staff, administration, and the superintendent on these agenda items at tonight's meeting. Board members will be able to ask questions, receive answers, and should be prepared to take action. The board has just reconvened from closed meeting in accordance with Chapter 551 of the Texas Government Code. Any action arising from discussion in a closed meeting must be taken in an open meeting. We'll now move on to our report section of our agenda, item 6.1, 2026 State Accountability Ratings.

2:28 Board President not human verified

And our presenter is Ms. Natalie Martinez, our Executive Director of School Improvement.

2:35 Natalie Martinez, Executive Director of School Improvement not human verified

Good evening, President Redman, board members, and Dr. Grogorski. Tonight I am pleased to share information about our state accountability system, which was publicly released last week. For the 25-26 school year, KDISD earned an 88 B. And to give you longitudinal perspective, here are our scores over the past four years. We have a solid track record with a high B, and of course, aiming for higher each year. To give you a different perspective, when reviewing ratings over the 10 largest districts in the state of Texas, KDISD is the highest rated now there are not many people here but I would like to give a round of applause to our staff and students who supported this effort we are proud of the work and continue to strive for more jumping into the accountability system our Texas system has three domains the first domain is student achievement which calculates students earning approaches meets and and masters, and KDISD earned an 87. Domain two is school progress, which references academic growth and relative performance. KDISD score was an 87. Finally, closing the gap, measure student groups within multiple measures, and KDISD earned an 89. To refresh everyone's memory, there are four performance standards, four-star assessment. The top three at approaches, meets, and masters are all included as passing per the state. TEA reviews these three performance levels and actually averages the percentage of each to determine what we call the AMM average. This number helps us compare our progress over time. Lots of numbers on this screen, so I want to point out that along the left-hand side, you see our content areas, which include all tested grade levels, And across the top, you'll see the performance levels comparison of 25 to 26 at approaches, meets, and masters, along with the AMM. This year, we held our own in each content area, but we did see an increase in science. I will tell you that the science test was different in 25 and 26 with the new TEKS implementation. So you'll see an asterisk there. But nonetheless, we're impressed with our science scores as well. To build in perspective, you'll see a comparison, same chart, comparison to the state. In this chart, you can see a significant difference in all three performance levels, which also shows in the AMM averages. KDISD is 14 to 18 points above the state in each of our core content areas. Although STAR is a big part of the accountability system, there are other measures that are calculated. The TELPASS progress measures are English language learners on language development. In KDISD, we are at 45%, which is 11 points higher than the state. CCMR is college career military ready. KDISD is at 82%, slightly behind the state, but I will tell you committees are already in place and have been over a year. This is a lagging indicator, so this references the class of 2025, not 2026. So the work that we've put in, you will start to see that difference in 2027 with a class of 26. Graduation rate is another lagging indicator. So you'll see the class of 2025 represented here, and KDISD is proud of our 96.5% graduation rate compared to the 91.2% at the state level. level. Tonight's data represents our district accountability, but campuses also receive accountability information and data specific to their schools. This rating distribution shows how our schools fell into the A through F system. There were more schools in 2026, so that is a difference there if you're adding up the columns. problems. Tonight, I provided details about the accountability in KDISD and context to how we review the data. But if you wanted to dig deeper, here's a TEA site that allows you to do just that. The analytic tools allow you to compare in a variety of ways. And TexasSchool.gov allows you to find a specific school or district across the state of Texas. And lastly, here are the key supports for our content areas. You'll notice that access to resources, professional development, school improvement process are all part of the ways that we support our schools and will continue to do so for this year. We celebrate our students, staff, and leaders in KDISD and I'm ready for any questions that you may have.

7:38 Board President not human verified

Board, any questions?

7:42 Unknown speaker not human verified

I would like to just make a comment. Thank you, Mr. President. As we all know, we just did a lot of training on this not long ago, Saturday before last. And I think it's always good, even though I've obviously had that training a lot of times, it's always good to know. And the updated information is so important. but one of the things I wanted, I wanted to point out two things. First of all, when you compare our district, because you gave a higher level of comparison across the state. But when you compare our district to other districts, neighboring districts were were doing. As good or better than almost every district in our surrounding area. First of all, so although that doesn't sound, you know, maybe to some people it's a B rating, it's. It's better than almost everybody else. And then Dr. Krogorski had said something, and I don't want to misquote him, but we're doing better than all large districts or something like that. You said the 88 was like the highest of, what did you say about that?

8:55 Jamey Hynds, Assistant Superintendent of Finance not human verified

That's one of the slides.

8:57 Natalie Martinez, Executive Director of School Improvement not human verified

There was a slide?

8:58 Jamey Hynds, Assistant Superintendent of Finance not human verified

Go ahead.

8:59 Natalie Martinez, Executive Director of School Improvement not human verified

Yes, on screen. So when we pull the state data, we look at enrollment first. We pull the 10 largest districts in the state of Texas, and we look at those ratings.

9:11 Unknown speaker not human verified

Sorry, I missed that, but yes.

9:12 Natalie Martinez, Executive Director of School Improvement not human verified

And we are the highest rated.

9:13 Unknown speaker not human verified

And I think, so the 88 doesn't, you know, when you compare it, you know, we had an A before, but the standards have changed, and still when you compare us to everyone else, we're still better. Yes, ma'am. Yes. Just wanted to point that out.

9:31 Unknown speaker not human verified

Mr. Shipley. Thank you. I don't have any questions, so I'm going to keep leaning on my newness up here. And while you only talked through district level, I. Being a guy that digs into data as my day job, I poured over the data and I thought I'd just kind of read a couple of the highlights if that's okay with you. MY FRIEND CLAUDE HELPED ME WITH THIS. I'M JUST GOING TO FILL FULL DISCLOSURE. BUT IT IS, YOU LOOK BACK OVER FOUR YEARS, A DISTRICT THAT IS GROWING AND IS BECOMING HIGHER ECONOMICALLY DISADVANTAGED FROM A PERCENTAGE STANDPOINT, IT'S HARD TO MAINTAIN THAT LEVEL THAT WE'RE AT. RIGHT? THOSE ARE THINGS THAT, AS SAD AS IT IS, THOSE WORK AGAINST YOU TRYING TO MAINTAIN A HIGH STANDARD. So despite those things taking place, congratulations, right, because it's stayed there. The number of campuses that are an A rating went up this year. That's impressive. I think, I don't know, it's 42 this year. I think you said it was 37 last year. That is impressive. And there is the overall summary that I took away here was that 2026 was the strongest year over the last four years of the district. So, you know, a number of campuses improved. Obviously there's always room for opportunity for other campuses, but overall the numbers to me look fantastic and so congratulations to all of you that are behind it.

10:54 Natalie Martinez, Executive Director of School Improvement not human verified

Thank you.

10:59 Unknown speaker not human verified

Mr. Davidson. Yeah, thanks Mr. President. Thanks Ms. Martinez for the presentation. Echo some of the comments here that I think are recognizing the achievement, but I appreciate I appreciate you pointing out the one metric in the presentation that you pointed out we are looking maybe and have given a little bit of special attention to, and that's the CCMR measure. measure, I wondered if you could, and I know it's a, sounds pretty complex in how it's measured, but maybe some examples, knowing it's a lagging indicator, knowing it's kind of a point in time measurement, what are some of the things that we look at to, you know, assess performance against that measure? And then, I don't know, if there's anything you wanted to highlight that you're seeing in the committees that we could look forward to a year out?

12:00 Natalie Martinez, Executive Director of School Improvement not human verified

Sure. CCMR is complex. There's a number of indicators that go along with it. And when we provide that data for campuses, it will tell you the percent of kids who earned their AP credit or earned the SAT criteria or earned all the different things. What we stress about the CCMR is that we are not trying to increase a certain indicator. I am not necessarily trying to increase our SAT scores. What I'm trying to do is find every kid in KDISD and match them with the indicator that is right for them. So whether that's an IBC because they're going that route or it's an AP because they're going that route, there are special education indicators. We're trying to find every kid in KDISD and match them with the indicator that is most helpful when they get to post-secondary. So while I could go through each of them, probably not today, but the variety of them and lends itself to when we meet about it centrally all of those departments are in the same room because we're not competing against each other we're trying to find the kids that match our program and that's the most important part of it so with school leadership with TNL with counseling with all of the departments together that's what our goal is so yes it ends up in CCMR but the idea is focused on child

13:21 Unknown speaker not human verified

Mr. President, Ms. Fox. So just to follow up on that, um, Mr. Martinez, I love when you said we're not looking at one indicator and trying to improve that one. We're trying to match every child and find every child to match them with their indicator. Can you describe indicator a little better in that regard?

13:45 Natalie Martinez, Executive Director of School Improvement not human verified

Sure. Sometimes it's an assessment, right? It's an SAT. it's an ACT, it's a TSIA. Sometimes it's under coursework where they're taking AP courses, dual credit courses. Sometimes it's the college prep courses that they're taking. Sometimes it's the IBCs that they're taking and the programs of study that align with that. I will tell you, it's gotten so complicated that over the past two years, I can't even verbalize all the pieces, especially when you get into program of study, but we have experts at the table for all of those. And so the ones that I've listed are the big ones that we have, but to be honest, we look at every single one of them. So military is in there as well. It's a CCMR. It was removed for a while back in, so we still look at that as well. So wherever the kid is trying to go, we are trying to help support that for the student.

14:37 Unknown speaker not human verified

Thank you. And for those who don't know, college, career, military, ready is CCMR. are, my heart just skipped a little beat when you said we're not trying to find like, oh, we're low on military ready or we need more college, this college or that college. No, every child where they're meant to be, where they're trying to become successful, you're looking at everyone and trying to match them and make sure that they're ready for that. Correct. It's so much more important than a percent, I mean a score, but I love that focus on that. And I know what you do is every child in every grade, how do we make sure they're successful? And it's very complex because I've seen your workings. It's incredible. May I jump to the graduation rate? KDSD is 96.5%. Is that one of the very highest in the state? Do you know?

15:42 Natalie Martinez, Executive Director of School Improvement not human verified

I have not compared the graduation rates, but I would say that's pretty high.

15:47 Unknown speaker not human verified

I remember, been a minute, when people were calling us to ask, how are you getting that graduation rate? And it's because we have people who go and seek out boys and girls who have left and bring them back. It's our Raines High School, which brings back our children who leave school thinking that's the path for them and then find out that it's, of course, not the path to success. and we bring them back to help them graduate. We had a program over at Katie Mills Mall for a while that did the same kind of thing. Like that's something that Katie ISD doesn't give up on any child, and we have that for them. So I love that. I would like to look at the domain 1, 2, and 3. Can you help me understand, like, when you're looking at those, what each of those mean? Student achievement, are those like scores on a test? Describe those for me, please.

16:41 Natalie Martinez, Executive Director of School Improvement not human verified

So student achievement is mostly about the STAR test, although when you get into high school, you'll have graduation rate and CCMR included in that. But this is aggregated for all our schools, which is where we get our district rating as well. So most of it is STAR. In domain one, it is approaches, meets, and masters. When you get into school progress, it's about growth of the child. So moving from one performance level to the next performance level, regardless of if they're passing or not, is a big piece of that. that. Relative performance is part of that as well, where they take schools and they put them on a scale with the economically disadvantaged percentage for that school, and the cut points are adjusted to level the playing field. Closing the gaps is kind of where our state and our federal mix together. This is where we look at all of these indicators, but across multiple student groups. So all of your ethnic groups are represented there, along with a high focus group, which is inclusive of special ed, EBs, mobile kids. So they put them all into a group. But that way we're looking individually at student groups to ensure that if we have a hole somewhere that we are focused on it for the following year.

17:51 Unknown speaker not human verified

Thank you. You're welcome. Mr. President. Ms. Champagne. Okay, Ms. Martinez. Thank you. I want to follow up on some things that some others have said. Mrs. Fox has made me think of this. the CCMR, I know that some years ago there's a new law that has been established where the counselors are required to meet with each student, I think, once a semester or once a year or something like that. Anyway, and so is that a time when the counselor would meet, this is at high school, if the counselor would meet with the child and they're not on, they're amongst the 15% that aren't on some kind of pathway. way you know they're not in dual credit they're not in ap they're not in any kind of miller class is does that counselor try to guide that that kid into you know something so that they can not that you're i know you're not trying to elevate your numbers you know like that but it's for the child's benefit too so it's not just about making us look good it's for that particular child child, is it part of what the counselor will try to do when they're having that meeting with the child?

19:06 Natalie Martinez, Executive Director of School Improvement not human verified

I will say we are trying to elevate our numbers because that means more kids are connected, right? The difference is we're not elevating our numbers for a specific indicator, right? But the higher number means more kids are associated with postsecondary. On the counseling side, I'm going to just watch your head. Counselors yes, do that. We also have college career facilitators at the high school that are involved in this work as well. it's massive so there are lots of people involved in the conversations but are we do lean on our counselors we work with them here centrally as well just to ensure that we all understand the pieces that are coming together for that so I know those two people for sure are those groups of people for sure work with kids at the campus to ensure that they're headed in one of these directions so I

19:48 Unknown speaker not human verified

get that right you did thank you we've really made an effort in the last few years to put the CCM are on the front end where it's in front of the kids the the counselors, the parents, and it's a part of their school links. When they go into course selection, they also see the CCMR and what indicators they have triggered or not triggered. So it's become more of the conversation, and we also have kind of front-loaded that into a physician, Marissa Adams, who works with our CCFs, our counselors, and our professional registrars, and really getting that out in front of our families and students.

20:22 Unknown speaker not human verified

Can I just say one more thing? I just want to say, because I think for some kids, probably for many kids, it's hard for them to understand, okay, I'm 14, 15, 16 years old, and what I'm doing now, I don't really care about. You know what I mean? They care about what's going to happen tomorrow or what they're going to watch on TV tonight or something like that or the friend they're going to go hang out with. And I think from a counseling point of view, you know, it is really, because I know even if the parents are over here trying to encourage their children to have that camaraderie and that community of trying to somehow explain to that young person, we need to start doing stuff now, you know, is only beneficial to them in the long run. That's a great part for a lot of young people, I think. I agree. Thank you.

21:12 Board President not human verified

Any other discussion, trustees?

21:14 Unknown speaker not human verified

Mr. President. Mr. Cross. I did a little checking on the graduation rate and for the top ten largest districts in Texas looks like we were second the top ten but the number one district has probably 20 almost 24,000 fewer students than we do too so so yeah we're but it also said and and at one point my life being in a very small school district that a lot of those little tiny school districts have amazing graduation rates because you know if you put 100 kids in the school there's a good chance you can get 100 kids through it's a lot harder to get you know 35 000 through so um but yeah the larger districts and the area and stuff it's like that's a that's another one that we we do well in so i I just thought I'd share that.

22:10 Unknown speaker not human verified

Mr. President.

22:11 Unknown speaker not human verified

Ms. Fox.

22:12 Unknown speaker not human verified

I join you, Ms. Martinez, in the praise that goes to those people in classrooms every day. Whether they have 22 students or 150 students, focusing on every student, knowing what they need, never giving up, going the extra mile, doing the extra thing, staying the extra hours. I couldn't be more grateful for them. This is evidence of how fantastic they are and everyone who supports them. Great. Thank you.

22:50 Unknown speaker not human verified

Mr. President, I would imagine it would be somewhat disheartening for your team. You all were able to pull up our D-rated schools from last year into a C or higher. What are the trends telling you all in terms of what is needed to move our schools up? Because I know we did have d schools this year. What is it that you all need? Because I know you all are spread thin, you're trying to resource every school at the level in which they need to have it resourced. What's the data telling you in terms of what you all could use to ensure none of our schools land with a D grade?

23:30 Natalie Martinez, Executive Director of School Improvement not human verified

Go ahead. It's your wish list. I'll say that currently there's the collaborative effort between school leadership and TNL is what we need, right? It takes a team effort to figure out because there never is one thing that you can fix. It's just not that easy. And so when we talk to principals and we're with our leaders all the time just listening to what the needs are, there's just a variety of them. And so with our teams together, we prioritize and figure out what we can tackle holistically, what can we tackle just for a group of schools, and we just start taking one bite at a time, to be honest. And it is helpful, but we also just have to remember, like we learned in the Saturday session, that as the standards increase, we've got to be ready for that. So one of the biggest pieces that we're working on right now is building capacity of all of our teams. And that takes all of us and all of the campus leadership working together to build a capacity and raise everybody up It takes people in the seats to make sure that kids are taken care of and that's one of the biggest things that we're working On with miss hacks team as well

24:40 Board President not human verified

This martinez the the past two years there's been several of us they've been able to go to the TA who started doing a new training for for trustees and they take this information, that relative performance data, right? Where they take our data and then they normalize it for economic disadvantage. And it's been a cool experience because they've picture 50 districts sitting in the room and they put a slide up and it's all those relative performance data slides. And you're looking at them and you're like, which one's mine? And there's four color bars and then a line. and you see one is like it's like trying to bust through the top and green like I hope that's us and last year they didn't have the names on them and he stopped and he said this one here in the middle that's Katie and this year they put the names on all of them and the one in the middle again was Katie and it's super encouraging to know like the work people have been doing in this district for years and to know like what the TEA is showing people is that right not they didn't put people's ratings up there but they were showing the relative performance data to say hey this is taking into account all of the all the social issues in the district and the size and all those kinds of things I'm so encouraged seeing this today but also knowing that you kind of hinted at it that it's still not good enough you know like like we can celebrate and at the same time we can all acknowledge like this miss taylor saying is that like we don't want any of these schools like because that that means that was an experience for a kid right that their their future and the drive to to push those schools up and provide those additional resources um it's real like it affects kids and and we're not sitting on our laurels just going like hey look look at this, we're the best large school district, but we're saying, okay, now what do we need to do to get better? And so I like celebrating it tonight and then knowing tomorrow we get back

26:49 Natalie Martinez, Executive Director of School Improvement not human verified

to work again. So yeah, my email to principals were buckle up. Let's do it again. Let's get

26:55 Unknown speaker not human verified

better. Yeah. Mr. President, can I throw one more thing? Cause I just say this because centers around everything that you just said. Cause I remember at Cinco telling our staff many times, if your kid if that parent's kid did not succeed they don't care if you're in a school they don't care if you've got blue ribbon on your thing or whatever that is they go my kid was not successful so it comes back to what you were just saying that it is it filters all the way down to the individual kid the individual family and that's what I know is happening behind the scenes and that's why I feel like we can all set up here with such confidence and and you you know, brag about the numbers, but you're right. It comes back to it's an individual kid, a family, and how they're impacted. And when we're doing the best we can do, then that family is impacted in a good way. So just wanted to share that. Thank you. Thank you very much.

27:56 Board President not human verified

We will now board. Before proceeding with our discussion items, we're going to move agenda

28:01 Board President not human verified

Agenda item 7.7 first. We have some guest presenters, and I think it's a topic we might want to talk about. So we will first do 7.7, discuss and consider the health plan options for plan year 2027. And our presenter is Mr. Brian Schuss.

28:22 Unknown speaker not human verified

All right.

28:24 Brian Schuss not human verified

Good evening. Good evening, President Remmen, members of the board, Dr. Gagorski, here tonight to present, I think, the highly anticipated 2027 health plan recommendations for our 2027 plan year. We've got a lot of help, got some folks here I'm going to introduce in a minute. But before we go on, kind of just wanted to briefly talk about the process, how we've managed it. This is my first time managing this process, first time presenting on the topic to the board. And, you know, I've managed it very much like how I have previously in my career. and that's to lean heavily on our consultants and Baldwin Group and Mr. Harris. They have been fantastic throughout this process, really appreciate everything they've done and how they've contributed. It's been a great team effort. But when I say leaning on them heavily and relying on them, it's not just as easy as saying, okay, be free. We have to have discussions. We have to talk about where does the district want to go? Do we want to see any changes? What's our comfort level with certain changes? What are we doing with employee contributions, employer contributions. There's so many discussions that have to be had so they're comfortable to then take the reins and do their job and perform. And I think what you're going to see tonight is a culmination of that and I'm excited to give the presentation. As Dr. Gorski knows, I've enjoyed it. It's something I'm very passionate about. And one thing I kind of like to foreshadow a little bit because we do have some guests that a couple things you're going to see tonight. Typically we've had three plans in KDISD. you're going to see the recommendation of a fourth plan, namely a Kelsey Seabold option. And we have some Kelsey Seabold folks with us tonight. We have Dr. Aga, which is their chief medical officer. and Kenneth Janice, which is their Chief Operations Officer. So happy to have them. Dr. Auger is going to say some words about Kelsey here in just a little bit. In addition, what you're also going to see is not just one, but two copay addition plans to our offerings. So the Kelsey Seed Bowl being one and the Memorial Hermann plan being converted to that. And I'll get to the detail on that in a little bit. So I'm going to get into it and I'm going to hit this first slide just very briefly. It's a lot of information. I'm not going to go over really much of it. But then Mr. Harris is going to come up and talk about some cost containment strategies. Then we're going to hear some information about Kelsey, which I think is very important because it's a new plan offering. And I think the board and administration and public employees need to hear what they have to say. And then I'll come up and talk about the detail. So what I want to point out in this slide, 2027 national medical cost inflation. This goes back to 2008 and you can see it's gone all across the board, but look at 26, 27 at 9%. What's important to point out there is our plan is currently trending at six and a half. You want to beat medical inflation. You always want your plan to be medical inflation and our plan trending at six and a half, at least from the claims perspective, I think points to the health of our plan. And I wanted to start out with that. I think that's very important. Now Mr. Harris, talk about some cost containment.

31:22 Mr. Harris, Baldwin Group not human verified

Sure. Absolutely. Absolutely. Good evening, President Remnen, Dr. Gorski, members of the board. So I think it's important to show what medical inflation is over the past 20 years. Currently, it is at a 20-year high, and it's going to continue to creep upward. So we have to employ cost containment strategies to try and bend this trend curve. The most, I would say the most widely used cost containment strategies are performance networks, like a Memorial Hermann ACO, direct primary care, like we have with ReadyMD, and also a well-managed pharmacy program. And so you can see here on the chart, we put the planned performance down on a per-employee, per-month basis. You can see where the Memorial Hermann ACO is achieving cost containment for us. But I will say that the one weakness of Memorial Hermann ACO is it's limited to one hospital system. So what we wanted to do is be able to bring more opportunities for members to access care by still achieving the same level of cost containment. So my team has been working very closely with the Kelsey Seabold team. We've been doing actuarially modeling and renewal projections. And through that process, we also worked on being able to add a copay to the Memorial Hermann plan. And so our goal is always to beat trend and now we're at six and a half as opposed to the rest of the markets at nine. We've seen numbers as high as ten and a half on medical inflation. Pharmacy inflation is at about 13 and that's why it's important to have a well-managed pharmacy program. But what we would like to do, if possible, is be able to present Kelsey C. Bloat adding a fourth option and then also adding co-paced mobile hermit plan, plan, which you think long term can also close gaps in care by incentivizing people without having to meet their deductible to be able to access their primary care and their specialists. There's arguments to be made for catching disease early and not turning into a much bigger claim in the future. And so is there any questions about that, how we're employing the cost containment strategies? Well, if not, I would like to introduce our friends at Kelsey Seybold. I'm sorry, Mr. President. Oh.

33:30 Unknown speaker not human verified

Say it again.

33:31 Mr. Harris, Baldwin Group not human verified

Yeah.

33:31 Unknown speaker not human verified

With regards to your cost containment strategy, you just talked about disease management or preventative care. I didn't see this in here, or maybe we'll get it later. Is there some benefit? I know there are some insurance plans where if members get their annual exam, they have a pedometer, they walk X number of steps a day, they get some kind of incentive to do that to help do preventative care. Is that what you're referencing? Is there a program like that in here?

34:03 Mr. Harris, Baldwin Group not human verified

Not specifically that yet. And if that's something that you wanted to see, then we could definitely put a solution around that. basically incentive incentivizing people annually to get their physicals done and so if that's something you would like us to work on we can definitely so this would be strictly about adding another ACO model and then adding co-pays to the

34:22 Unknown speaker not human verified

plans thank you questions I might have questions for you sure when we get through the whole presentation right like i did just yeah yes sir mr we're all quiet i've got

34:41 Brian Schuss not human verified

questions i'm not sure i want to ask them again well yeah we'll have plenty of time at the end and now i'd like to bring up dr auga from kelsey seabold their chief medical officer

34:54 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

thank you brian for the introduction and good evening and thank you for having us president President Redmond and members of the board, Superintendent, Dr. Ken Grigorski, and the KDIC leadership team. I'm Donnie Aga, I'm the Chief Medical Officer for Kelseyville Clinic. I've been with Kelsey for 30 years now, and I practice and see patients at our main campus near the Texas Medical Center, and I help lead all of our clinical teams. Before I say anything else, I do want to give a huge gratitude and a thank you to the KDISD for entertaining Kelsey as part of your health plan for next year. We know that caring for educators is also an investment in students and in the community. When teachers, staff, and their families can get care quickly and easily, they can spend less time dealing with health care and more time doing what they do best, which is in the classroom. I wanted to share, which is I often do in any presentation, a brief patient story. And this is basically I want to share what happened to me this morning. And so got up early, getting ready to come to work, got patients to see, got multiple meetings, and going through the closet, going to pick out my Sunday best because we're going to present to KDISD tonight, night and which included for me a pair of dress shoes which if you know me I never wear dress shoes it's always cowboy boots and it's so it's a pair that I had not worn very often if you get a new pair of dress shoes you know sometimes they're very slippery and so in the house I just poured my coffee walking to the kitchen slipped and fell and landed on a door gate the dog gate rather. And of course, gave me several minutes of very loud expletives. My wife was still asleep. Got myself together. Noticed that everything still seemed to be intact, but my knee was already swollen and very painful. So I sat at the table and collected myself and said, you know, what do I do now? And I'll tell you, I like to oftentimes pressure test our own system. And so we have a brand new what we call virtual urgent care. So I went on my Kelsey online app and logged in to the queue for the virtual urgent care and was seen within five minutes by a Kelsey clinician, told them what happened to me, and they ordered an X-ray for my knee. So went on to work that morning, limped around, saw patients, and the best thing about it, I could do that x-ray at any Kelsey Siebel location and at a time of convenience for me. So you guys, you know, you're very busy. You want to fit things in and not disrupt work. So finished seeing patients, slipped into x-ray, was done in five minutes, and then went on about my day. Got my results within five minutes, no fractures, just Motrin and ice, and so that's all I needed. So I think this story demonstrates what we really value, which is care that's simple, quick, and convenient. And when we're taking care of teachers or any other employees that have been given to us, we know that the best thing for them is that they can be at work to taking care of their students, and so that's important to us as well. Kelsey Seabold has been serving the Houston community for more than 75 years. We currently have around 1,100 physicians and advanced practice clinicians, and we have been growing for you. Over the last several years, we've engaged in an extensive growth plan, which has included Katie. We're now at 45 different locations serving our patients. But what I'm most proud of is not really our side, it's our experience that we create for our patients. So patient experience is very important to us. We care for more than 140,000 commercial health plan members across Houston, and our patient satisfaction scores rank among the best in health care. So for educators and school employees, convenience matters. Health care should fit your life, not disrupt it. Whether someone just needs a checkup or to see a specialist or needs surgery or, God forbid, cancer care, we want to be there for you. We want to make the access easy, and we will coordinate it all along the way. As you know, health care has become very complex, and we really also value care coordination. We have over 65 specialties. We have primary care. We have pediatrics. We have the largest OB-GYN group in Houston, Texas. And to that, we coordinate your care under one electronic medical record all the way. We know things that drive cost of care and drive frustration for patients is disconnected care, where the patient is up to their own to navigate the health care system by themselves in the fee-for-service environment, where they have to repeat their story over and over again. they get retested and no one is communicating and that's not the story that we have at Kelsey-Seybold. So we've been expanding access close to home. One of our biggest advantages for KDISD and employees is having so much care close to where they live and work. Teachers, administrators, and staff spend every day taking care of others. We want to make it easy for them to take care of themselves and their families. Their map shows several Kelsey-Seybold locations in and around Katy, including our West Campus and Katy Clinic. They're part of our 45 clinic locations across Houston and they're all connected. We expect patients to have the same experience and a consistent experience regardless of which location they go to. Our West Campus and Memorial Villages campuses are also a hub for specialty care where we represent over 65 different specialties and also have an ambulatory surgery center at our Memorial Villages location. We find that that is important for patients to have their care close to home, their surgery close to home, cancer treatment close to home, and primary care close to home without having to travel to the very complicated Texas Medical Center. The bottom line is for employees and families who receive specialty care and follow-up care in one coordinated system it's better for our patients and it's better for the healthcare system. So we have one goal that's very simple just as Katy ISD wants to bring about world-class class education we want to bring world-class care and make it close close to home. So this is a list of some of the school districts that we already take care of. We understand taking care of school districts because we've been doing it for a long time. This Kelsey is different because we also partner with our employers and we also partner with the health plan to keep our members healthy and making health care easier. We do more than treat illness. We also treat chronic conditions. We put a huge focus on prevention and annual wellness exams. And again, the coordination of care, whether it be just primary care or the complexities of specialty care, we're going to be there the whole time. For KDISD, this means that healthier employees, healthier schools, and a stronger community. In closing, as we look ahead, our commitment is simple. For example, we want every KDISD employee and family member who chooses KelseyCare to have health care that is easy to access, convenient, coordinated, and centered on their needs. We're grateful for the trust of our educators and the public servants placed in us. We will continue to work and deliver high-quality, innovative care close to where our patients live and work. Again, thank you for having us tonight. We're proud to serve Katy ISD community and looking forward to this continued relationship

43:35 Brian Schuss not human verified

Thanks, dr. Argan, mr. Harris And I want to say before we move on we actually took What I believe Kelsey calls a patient experience tour at one of their facilities and they kind of walk us through how you know how they manage care, what a patient would experience. And we got to visit with a lot of doctors and surgeons. And I tell you what, it was phenomenal. I mean, honestly, in my career, I haven't experienced anything like that. So I'm excited to bring them on board. I've got a great relationship with Memorial Hermann and looking to a great relationship with Kelsey. So, okay, these are our 2026 current plans. I've seen these plans before. And this is pretty much the way our plan's been structured for several years. uh their deductible plans uh we've tweaked out-of-pocket maximums and deductibles a little bit here and there but this has pretty much been uh the structure of our plan for uh for quite a while here's what we're recommending for 27. so still have our high deductible plan the memorial memorial herman plan on the choice plan you can see the addition of the kelsey seabold plan what i want to focus on oh and what i want to say all these plans this year we're not recommending any changes to deductibles or out-of-pocket maximums um that is something that can be tweaked year over year when you look at health plan reviews or renewals, but that is not something that we're recommending changing for the 2027 year. The big changes you can see are in green. So from Memorial Hermann and Kelsey, now to see your primary care physician, you're going to pay a $10 copay instead of paying for basically 100% of that doctor visit. Now for specialist office visits, you're going to pay $50 instead of considerably more. You can see the co-pays there for urgent care centers and emergency rooms. One thing Kelsey has, they also have a co-pay for imaging, which is a great benefit. And again, those are the major changes and I think exciting changes for this district and for our employees. Not only for our current employees, but for recruitment. I think this is a really big deal. We talk about retaining, recruiting and retaining the best. And this is one of the big pieces of the puzzle in doing that. and I'm just excited to be able to recommend this for for the district. Okay so talking about premiums. So first I want to foot what you can see we've got plan year 2026, we've got recommended increase, and we got plan year 2027. First I want to point out as I talked about earlier with Mr. Harris and these initial discussions what are we looking at with employee contributions or employer contribution. These increases include a recommendation to increase our employer contribution $385 to $427 per employee. That's at a cost, I've got it in the notes down at the bottom, but that's at a cost of about $4 million. So now let me speak, I can come back to that, but let me speak to the premium increases for the plans. Focusing on the Memorial Hermann ACO first, you can see recommended increase per month eight dollars per month for employee only I would say that's a pretty minimal increase not only when you talk about trend but also with that plan becoming a plan that is designed as a copay plan not to not just a deductible eligible plan and then you can see the other increases there as well as the high deductible plan employee only six dollars a month I think these are positive now I will say if we go back to Memorial Hermann, the employee only, if the district wasn't recommending that increase to $427 per employee, that increase on the Memorial Hermann ACO would be about $50 per month. So the district is owning quite a bit of these increases that you see in the presentation. When you look at the, oh, one thing I need to point out in those two, because I know this is going to be a question, and I'll go ahead and get it out of the way. When you see the employee spouse at zero, I know that's going to be a question, why wasn't there an increase for employee spouse? Well, for several years, the losses that were incurred from the spouse group, especially high claims costs, were a lot higher than other tiers within both of those plans. And so a decision had to be made to somehow account for that and cure that for the health of the plan as a whole. Well, the issue was a couple of years ago it got to the point where employee spouse was greater than employee family. And so that caused some concerns that caused some issues a little tough to explain. And so we had that discussion this year and thought, OK, maybe we can't completely cure that this year. But because the percentages for that group for the past three or four years have been quite a bit higher than everybody else in that plan. we thought okay for one year if we could give them a rate pass at zero help cure that a little bit get those where they're a little closer together and then next year we can review that again obviously we're going to have to review claims and see where we are and those are decisions that have to be made but get those a little bit closer together maybe next year we can get them where maybe they're equal or uh but again it's a it's going to be a multi-year process uh looking at that so that that is that is the reason for that now the the choice plan higher percentage increase on that plan the loss experience on that plan is much greater than any of our other plans and we've had to have a larger increase on that plan for the last several years again for the overall health of the the district's plan in general so that's why those create those increases are larger let's look at the Kelsey plan look at those premiums obviously then been listing the increase there because it's a new plan. But if you look at the Kelsey plan compared to Memorial Hermann, slightly higher premiums than Memorial Hermann, but quite a bit less than the Choice. And we think what we're doing this year is giving the employees in that Choice plan a pretty large incentive with the co-pays and with the addition of the Kelsey plan to migrate to one of those plans. And we're expecting, I think, about a 20 percent migration out of the Choice to the the Kelsey plan. And that is the reason for that. And we think it's a great, great option for our employees to move out of that choice plan. So again, assumes no changes to deductibles or out-of-pocket maximums. We've talked about the employer contribution increase. That equals to about $4 million. Really appreciate Mr. Smith and Dr. Kogorski in being comfortable with recommending that and let's look at that note number five so gross contribution increases plan participants so the employees contributions have gone up in total 1.9 million dollars the district's four million dollars so we're talking about six million dollars in additional contributions but the district is recommending owning four million of that and I think that's a big deal and I think that's something that we need to say publicly that we are looking at this is very important to us to take care of our employees, and I think that's the way we're showing that. Now, in the end, we're still showing an operational loss of about $12 million, and as we move forward in this process year over year, we'll continue to try to correct that. I mean, talking to Dr. Gorgorski, my goal is that one day that's at zero. You don't ever, you know, we try our best, or Baldwin tries their best to predict what claims are going to do. We don't ever know if that's exactly what's going to come true, but that would be our goal. But it's going to be a multi-year process, a long-term plan to get that down. Okay, and something that we were asked to provide, and I think this is great information. I'm really glad we have this slide in here. Oh, and I would say, Board, you have a couple of other exhibits that were in your agenda packet that weren't in the presentation just for your information. But this plan compares TRS versus Katie for $26.27, assuming the $427 employer contribution per month. And what our employees would pay, because we've heard about TRS. We've heard about folks coming from other districts that had TRS. We've heard about TRS during public comment. And so this is something I think important to show now that we've added the two copay plans. \!

52:21 Brian Schuss not human verified

or an employee is not in TRS Active Care 2 and wants that plan, you can't get that plan anymore. People are grandfathered into that plan, but the reason we compare those two is because those are apples-to-apples plans. And so we just wanted to really point that out, and I'm glad we were able to show that to the board, and I appreciate being asked to do that. So again, excited with what we've recommended. I know there's probably going to be lots of questions, and we've got a lot of folks. Oh, there's one person that I forgot to introduce you as high as Jill South. She's the director of sales for Kelsey earlier today She said I'm just a sidekick donor to do some me and I said absolutely I'm going to and then I forgot so so But of course have dr. Hill and mr. Nauman here as well, so we're open for questions Questions board

53:11 Unknown speaker not human verified

Taylor mr. President Thank you, Mr. President. Brian, you're going to have to humor me because I have quite a bit of questions. And I just want you to understand that my questions are not coming from, I'm not trying to give you a hard time, but I'm very passionate about health care. You know many of you all know my husband passed away from a cancer that probably should have taken his life in three to four Months, but because of the health care that we were fortunate to have he was with us for 14 So I know that great quality health care is something that is important to to everyone in this country particularly for Our staff here in Katy ISD So the first series of questions I want to ask you and then I will turn things over to my The rest of my board members and I'll come back is around the process How did you go about, what are the things that you investigated before you all even landed on these options? For starters, and I know our representative from Baldwin helped to walk you through this, did you all consider, given how large we are, because it looks like the numbers right now, we are insuring roughly about 8,000 staff members. That's a pretty large number, particularly to be still a self-insured organization. That's something you usually find in smaller companies. Was there a study to determine is this still the best path for us? Would we find the ROI would be better if we decided to become fully insured versus self-insured?

54:39 Mr. Harris, Baldwin Group not human verified

Let Mr. Harris speak to that. Yeah, so that's a great question there. So one thing you have to look at when you go fully insured is it's now the insurance company's money. And what we do is we do a self-insured feasibility assessment. So we take expected claims, and then we compare that in an actuarial model of what fully insured would look like. The other thing to consider is that there's also state premium tax on fully insured business, I think around 2%. You know, so when you're talking about a 60 or 70 million dollar spend, that's a pretty big number. So we did look at actuarially looking at fully insured compared to self-funding. I would say when you get over a thousand employees, probably 85% of employers are partially self-funded and we do have an individual stop loss of a million dollars and we don't have an aggregate attachment point. So that's the norm is to be partially self-funded to be able to participate in your claims experience. The other thing is when you go fully insured, you do lose some of your creativity with cost containment strategies within there. But it's something that we always look at. But for this size group, I have full confidence that being partially self-funded is the best bet.

55:46 Unknown speaker not human verified

I hear you, but was it done?

55:48 Mr. Harris, Baldwin Group not human verified

Yes.

55:48 Unknown speaker not human verified

Yes. Okay. So, and so what you all found was that it was better for us to stay self-insured.

55:54 Mr. Harris, Baldwin Group not human verified

Yes. Cause we've got in-house underwriting and actuarial modeling. So we don't actually have to go out to bid necessarily. So we can actually model, uh, like just like we, our stop-loss renewal will be coming up and we'll be modeling what a $1.25 million individual stop loss will be, what a $1.5 million stop loss would be and a 750,000 there. So we're able to do that through our systems and then we can look actuarially at the number of breaches we could possibly have and then so everything we do is data-driven

56:23 Unknown speaker not human verified

decisions so our stop-loss is currently 1 million yes on one our individual

56:28 Mr. Harris, Baldwin Group not human verified

stop-loss on any one large on one claimant and at this size group the claims are so actuarially credible that you don't need an aggregate attachment point because that mean you know once you once you get to this many members it's pretty predictable so only smaller groups when they sell fund will get an aggregate attachment point but that does cost money you're buying more insurance but it's very rare of a group this size that would have an ag it would just be individual stop loss only now the decision will be is what level of individual stop loss best fits what we're projecting for future

56:59 Unknown speaker not human verified

claims to be next year so usually with the higher stop loss you know we're able to lower the premium

57:04 Mr. Harris, Baldwin Group not human verified

but you weren't able to do that well so so this we so stop loss insurance um that that doesn't bind until about 90 days out so we always go out for our stop-loss RFP later into the year every stop-loss insurance underwriter is gonna want claims 90 days out before they'll bind it occasionally you can do it four months out so that process has started yet that process has not started yet but it will and we look at it every year just like last year so when you raise your individual stop-loss your fixed cost goes down but then you have more claims so then we have to manage out well what is this going to do to total claim spend even though the fixed cost the biggest component of that is our individual stop loss.

57:43 Unknown speaker not human verified

So you weren't able to base it on trend data like from you weren't able to base like base that on like trend data from historical data in terms of like you know what we're seeing. Oh that's what

57:53 Mr. Harris, Baldwin Group not human verified

we do we we take historical data and project that into the future so it's typically two years of claims experience you know the current large claims and then we project that into the future ACTUALLY.

58:06 Unknown speaker not human verified

AS WELL AS YOU ALL LOOKED AT PLANS AND WHAT GOES INTO THEM, I'M SURE THERE'S GOING TO BE QUESTIONS ABOUT WHAT EXACTLY GOES INTO THESE, DID WE LEVERAGE ANY KIND OF STAFF DATA TO REALLY UNDERSTAND WHERE OUR STAFF WERE USING OUR INSURANCE THE MOST, WHAT THE GREATEST NEED WAS, AND THEN ALSO WHAT ARE THE THINGS THAT WERE NICE TO HAVE THAT WE CAN TAKE AWAY? EXAMPLE, GLP-1S, WHICH YOU LISTED ON THE FIRST SLIDE, I THINK THE SECOND SLIDE IS BEING ONE one of the drivers of cost. It's a great thing to have. It is not a need, and I know it's very expensive. So did you all take that into account as well?

58:42 Mr. Harris, Baldwin Group not human verified

Yeah, so currently GLP-1s are excluded on the plan for weight loss, but they are included for diabetes and cardiovascular and those sort of things. It's just currently excluded for weight loss, but we are working on a program with ReadyMD that would be direct access for your members that do need access to GLP-1s for weight loss. So that's underway with the ReadyMD direct primary care model that we're working on.

59:06 Unknown speaker not human verified

What I'm asking more is did you all look at those things that are just very nice to have, but we probably, if we can cut them, we can also find a way to lower our premiums.

59:13 Mr. Harris, Baldwin Group not human verified

Oh, yeah. Yes, absolutely. And then when we started doing the actuarially model, first off, we do plan benchmarking. So not, you know, what do all the employers in the KD area, what kind of plans do they have? And then we started looking at, well, the majority of plans have co-pays. The majority of people in the working community around here have co-pays on their plan. So then we looked at what that cost would be. So then we took the utilization, we modeled that out of what we think it would increase in plan spend to add those co-pays. And then we did a similar thing with the Kelsey Sebold model, and they can probably speak to this for you a little bit, but their primary specialty care is a capitated rate. So basically you're paying a fixed number within there, and there's a lot of services. is you know it's about you know 40% of the cost of health care is rolled up in their cap rate. So we modeled that out to come to where we think the pricing should fit, along with adding the Memorial Harmon ACO plan. There's a lot of data going into these decisions.

1:00:12 Unknown speaker not human verified

I'll turn it over to my fellow board members, and I'll come back.

1:00:17 Unknown speaker not human verified

Mr. President? Ms. Champagne? Thank you so much. I know that this has been a lot of work, and a lot of our employees are interested in this, and I appreciate all that's gone into this. And I just have a few questions myself. But when I look at the Memorial Hermann plan and the Kelsey Siebel, and when I look at the chart, the cost is exactly the same. You know, the deductibles, everything is the same. So the person, the employee, is only choosing between which facility do they want to use more. Do they want to use Memorial? or did they want to use kelsey so but the cost is is the same what i have a question about is if you look at 2026 versus 2027 on the memorial there was a 20 copay for the primary i'm just going to use this as an example and now it's a 10 how how was that negotiated because to me that's a big difference 20 so last year or I guess so this year 20% after deductible versus only $10 now and I'm just trying to I like that I mean I'm happy about that but how is that negotiated yeah so so the way that works since we are

1:01:35 Mr. Harris, Baldwin Group not human verified

self-funded and and so when we modeled out actuarially it adds 2% to the cost of the Momoa Hermann plan to add copays on there 2% in utilization we'd go to

1:01:46 Unknown speaker not human verified

to that would go to that plan cost. So that's gonna make people a lot happier, I think. Yeah,

1:01:52 Mr. Harris, Baldwin Group not human verified

I think so. I think so. And I think getting in to get people to see their providers regularly also helps with the long-term health of people. And then can I go on? Because I have some more

1:02:02 Unknown speaker not human verified

specific questions about Kelsey Siebel. Years and years ago, 30 years ago, maybe more, I was in a terrible situation where I was in a traumatic car accident and I had I was well I actually worked for the federal government so Kelsey Siebel was one of my options but back then and I know things have changed this I quickly got out of health as soon as I could I got out of that plan because I needed to see certain specialists and I needed to have a continuous of care and back then I could you know you couldn't see the same doctor like you could just go and you would just get random whoever and you'd and like how y'all said you had to re-explain yourself explain yourself all the time and um how how has that changed is that better now i'm sure it's

1:02:55 Mr. Harris, Baldwin Group not human verified

evolved in 35 years oh it's evolved a lot and i would uh can you come up and speak to the the different practices that have been added over the years we worked at kelsey for a long time and they just expand their practice model and service model every year as well as new facilities thanks thanks

1:03:09 Unknown speaker not human verified

Hi, good evening everyone. Kenneth Janis with Kelsey. Been at Kelsey for 30 years this month, so I can go back at least that far back to 1996. So we are considerably different than we were 30 years ago. In fact, we're considerably different than we were even five years ago. We have more than double the number of locations, probably more than 60 to 70 percent, or more than double the number of providers. We're now, even about five years ago, we were about 500, 400 providers. We're now over 1,100 providers, adding specialties and adding services. I think one of the unique things about Kelsey-Seybold and our model, which is different than a fee-for-service environment, is that when you choose a PCP within Kelsey-Seybold Clinic, you can actually go to any provider primary care or specialty without a referral and so because our system is connected those notes from dr agha and his colleagues flow seamlessly through our system so i think with the added locations the added services the added number of providers and specialties were considerably different we've grown in the numbers the type and scope of services that we provide we have five ambulatory surgery centers across the city we have four or cancer centers across the city. Whereas in the past we were predominantly in the medical center located, and now we're all across the city.

1:04:33 Unknown speaker not human verified

So my question was, you would, so now versus then, you could have the same doctor and you would have to keep going into the clinic and having a different doctor every time you go. Like if you had a serious situation as Mrs. Taylor's husband or myself, you know, and you wanted to see the same doctor every time. Would you be able to do that?

1:04:57 Unknown speaker not human verified

Yes.

1:04:58 Unknown speaker not human verified

Because back then you couldn't do that, and you have to get the referrals, like you said, to be able to get any kind of special, anything else. You know, every time I wanted to go get even like a physical therapy, I'd have to get a special referral to go to this and go to that and go to this. And it just seemed like I was going to the doctor twice as often as I needed to just to get those referrals. So this is all changed is what you're saying.

1:05:21 Unknown speaker not human verified

Yeah, I'd make a difference on what type of plan you were on back then, but I would say the plan today that we're discussing within the Kelsey Care plan, yes, when you choose Kelsey Siebold, when you choose that plan offering, you're choosing to come to Kelsey Siebold for all of your care. So within Kelsey Siebold, we refer to it as open access. So you can go to any provider within Kelsey Siebold with no referral. outside of Kelsey Siebold. If you're seeing a Kelsey Siebold provider or specialist and they're recommending that you see, in most cases, it's a subspecialist, it's a pediatric neurologist or pediatric cardiologist, then we have a process of referring you out and that does

1:06:02 Unknown speaker not human verified

require a separate referral. Okay, so I'm sorry, I just want to, because this is so important to me. you so if you're going to if you have Kelsey Siebel and so in my in my situation I'm just going to use my situation I needed to see a specialist in orthopedics certain one doctor in Houston at that time could do something that I needed and I had to actually wait and switch insurances to be able to go to that doctor but are you saying now that if that particular one doctor let's say there's this one great doctor in Houston that does this one special thing, but he's not with Kelsey Siebel, he or she. Is there a possibility for the person who has Kelsey Siebel to get a

1:06:45 Unknown speaker not human verified

referral to go to that doctor? Yeah, so it does require referral that runs through a utilization review process within the medical group. Okay, so that's awesome. It does require referral.

1:06:59 Unknown speaker not human verified

But at least it's not like you're closed off and there's this one person who could save your life and it's in Houston, but it's not the case of Kelsey Siebel, possibility that if you have the Kelsey Siebel insurance, you could get to that doctor. Correct.

1:07:12 Unknown speaker not human verified

So I want to clarify just to, so there is the Kelsey Siebel physicians, over 1,100 providers that are part of the core medical group. These are employed providers. They're not contracted or affiliate. They're employed by the medical group. Then we have probably another 6,000 to 7,000 affiliate providers, and those are a group of specialists and inpatient providers. And then in rare cases, if there is a provider that is not within that network that requires a special need or specialty, then there is utilization review process to review that and approve it for a referral. Dr. Rye, would you agree?

1:07:50 Unknown speaker not human verified

Yeah.

1:07:52 Unknown speaker not human verified

Thank you so much. Most people don't think that they're going to need something like that, and most people don't. And thankfully, you know, I'm grateful that most people don't. but every once in a while something nearly tragic can happen to someone and then you do need that that care and it's awesome to know that with kelsey siebel there's a possibility of you know getting that that specialized care even if it's outside the network thank you so much

1:08:23 Unknown speaker not human verified

president mr shipley uh thank you for the presentation so i'm looking at the documents that you provided and I'm looking at the plans that were offered this calendar year so 2026 and then what is being proposed for 2027 and so if I'm wrong please correct me but there was not a plan that was offered in the current year that for example if I wanted to go to a primary care a primary office visit that was not preventative I was gonna pay some percentage of the cost up to my

1:08:56 Brian Schuss not human verified

deductible. Is that correct? You're going to pay up to your deductible for those visits in the current plan year. Yes. So if you go see your primary care physician and that office visit costs $150, you're going to be charged $150 up to your deductible. So I think for my own family,

1:09:17 Unknown speaker not human verified

there's one thing to have the amount that comes out of your paycheck every month, right? You know, it's a fixed amount and that's kind of, that's what it costs. But then all of a sudden it's January 10th and we're 10 days into the plan year and I have a sick kid or I'm sick and it's my first visit out of the year. I'm coming off of Christmas and I got to hit the deductible, which is $5,000 for one person or more. And so surprised, hey, you're 800 bucks into a primary care visit for something. And it looks like ER was the same way, 0% after deductible. Urgent care was the the same way on the current plans. And I'm calling this out because now in 2027, what you're proposing, there are two plan options where the primary office is that, as an example, would cost 10 bucks, period. Yes, sir. There's no deductible. There's no, like, there's no surprises. Yes, sir. In terms of cost. Same thing with the specialist, 50 bucks in urgent care, $75. In ER, it's 500. 500. ER is just that, right? It is an emergency room. You don't want to go, but I just did the ER with my kid on, you know, a couple of weeks ago in Florida and it was 2000 right out of pocket surprise for a cut on her leg. We're in that this case might, it would have been 500. So those are significant changes to what's being offered because again, what comes out of my paycheck is fixed. I can plan for it. It's the surprise. I get sick. My kid gets sick. I have to go to the the ER and the cost could be anything on the current plans and what's being proposed is there's some structure to it, which I think is a major change and that's a good thing.

1:10:53 Brian Schuss not human verified

Well, there's something, if it's okay, I'd like to point out, for the example you're using, the Memorial Hermann, the increase employee only $8 a month, so multiply that times 12 months, you're almost going to save that with your first primary care visit.

1:11:09 Unknown speaker not human verified

Sure. Well, and I would argue the current, if I know it's going to cost me 10 bucks, I might be more inclined to go. If it's a little bit more like, what's this going to cost me to go, maybe I can just power through, maybe I won't go, which isn't good for me. And from a business standpoint, isn't good for the district either financially, because that could lead to worse things when it comes from a medical standpoint. one. Um, so the Kelsey plan, I'm trying to put myself in the position of someone using it. So if I'm on the Kelsey plan and I need to go to the hospital, cause I'm looking at the Kelsey plans as in network, as does Memorial Harmon, they're both in network only what hospitals are considered in network for Kelsey. And I'm going to rattle off a few names. So I don't know if you want to go yes, no, but like the ones that come to mind, Memorial Herman, Methodist, Texas children's like those are the ones that come to mind where do those fall in the

1:12:03 Mr. Harris, Baldwin Group not human verified

Kelsey plan so I'm gonna introduce Jill South here she's with Kelsey and I want her to talk about the integration between the primary specialty and then that type of hospital access that's available within the Kelsey plan were

1:12:14 Unknown speaker not human verified

you the one that was trying to fly under the radar you didn't want to be introduced yes I'm sorry well sorry sorry about that no that's okay Jill

1:12:22 Unknown speaker not human verified

South thank you so much and yes I am the sidekick but Tommy and I where we've We've been working together for many, many years and yes, the employee experience is very important. If you think about Kelsey Siebel with our 1100 providers, we have that ROP network that Aetna provides that's about 6,000 other providers, which does include Texas Children's, Memorial Hermann, HCA. We deliver our babies. A lot of our babies are delivered at HCA. St. Luke's is another hospital that we use. What's HCA?

1:13:02 Unknown speaker not human verified

I'm sorry? What's HCA?

1:13:04 Unknown speaker not human verified

The Texas Women's HCA Hospital.

1:13:08 Mr. Harris, Baldwin Group not human verified

I think the local HCA hospital. It's a local hospital system.

1:13:14 Unknown speaker not human verified

Just a local. It's a smaller one. Is that a Harris County?

1:13:18 Unknown speaker not human verified

Is that what it stands for? H-C something? No? Okay. All right. Keeps having it in the dark. Houston?

1:13:27 Unknown speaker not human verified

So the nice thing is that we do have admitting rights in all of those different hospitals. So the people that choose our plan wouldn't be limited to just a Memorial Hermann. We would have access to all those different hospitals. I think I forgot one. Methodist is another one that we refer to as well.

1:13:45 Unknown speaker not human verified

Those are considered in-network.

1:13:46 Unknown speaker not human verified

Yes, it is. So an example that I use, so I do support open enrollment meetings and answer questions for employees. If a member comes to us and they have a child and they have a subspecialty that they need, a specialty that we do not serve, then we would refer to a Texas Children's. Baylor College of Medicine is another one. One of the unique things about the Kelsey plan is that we don't own hospital systems, which does add the value of driving health care costs down. There's no misalignments. We refer only to the hospital setting when needed, which is, was, we were very purposeful in building our outpatient surgical centers in and around the city. and have expanded the services like we do knee replacements and hip replacements and shoulder surgeries. And we've advanced into robotics as well. The DaVinci system, thank you. The DaVinci system is one that we invested in a couple of years ago, and it was so successful that we've brought that in-house as well. We've also developed another program called a Rapid Care Treatment Center. This is to help capture our patients that have needs greater than urgent care, but also they don't need to necessarily go into the hospital. And that's another way that, you know, another cost containment service that we provide is by capturing those members before they go into the hospital.

1:15:20 Unknown speaker not human verified

I don't know if this is the case, but I almost listen to that as another option for me as a patient as well. Is that fair to say?

1:15:28 Unknown speaker not human verified

It is fair to say, yes, sir.

1:15:29 Unknown speaker not human verified

Because, I mean, there have been times where, okay, I don't want to go to the ER and wait six hours, right? But I feel, so, okay. So where does MD Anderson fall on all of this?

1:15:42 Unknown speaker not human verified

That's a great question. So we are a nationally accredited cancer center. We have several cancer centers in and around the city. That helps our members to avoid having to go into the medical center. We have valet service. So it's very easy for our members to access care through our cancer centers. MD Anderson is also nationally accredited, so our treatment plans are the same. And one of the statistics that we have is 99% of our patients stay within the Kelsey ecosystem when they're going through cancer treatment because when they go to get their second opinion, they see that the treatment plan is the same. We have easier access and they can typically get in to see us sooner.

1:16:30 Unknown speaker not human verified

Okay. So MD Anderson is not part of the network?

1:16:33 Unknown speaker not human verified

It is. It is only if needed. So, for example, like I said, we're nationally accredited. We treat cancer. But if there's a rare cancer that is outside of our scope, we would refer our adults to MD Anderson or our children to Texas Children's, whichever makes sense. So they're one of our referring partners. Okay.

1:16:53 Unknown speaker not human verified

All right. That's good to hear. I've got two other questions for you. If I switch to the Kelsey plan, what are the chances that my current physician is going to be part of it? Or am I changing doctors?

1:17:07 Unknown speaker not human verified

Yeah, no, that's a great question. And you would know if you're a doctor's Kelsey.

1:17:12 Unknown speaker not human verified

Because they're a Kelsey doctor.

1:17:13 Unknown speaker not human verified

Yeah. You go into our...

1:17:15 Unknown speaker not human verified

Is it possible... I'm sorry, let me talk over here. Is it possible that I am on a current KDISD plan with a Kelsey physician?

1:17:20 Unknown speaker not human verified

Yes. Yeah, there is utilization already. Obviously not on the Memorial Hermann plan, but your other plans. I think we have like 300-600 members already utilizing Kelsey today. Okay One of the other things I wanted to add since we're talking about the patient experience one of the value adds that Kelsey offers our members is We call it a consult consult kind of a technical term but it kind of works in the background for our patients and the best way to explain it is again through a story like dr. Agha had mentioned before I'll just use myself as an example if I go into my primary care doctor and they see that there's something major wrong either lab work x-ray or they they identify something where it's like all right Jill Jill needs a specialist what would happen at that time is my primary care care doctor, whoever that may be, can literally pick up the phone, have my specialist visit for me with one of our Kelsey specialists, identify my next steps, and essentially get me on my treatment plan without even me having to schedule that meeting or that doctor visit with the specialist. So it just dramatically speeds up the treatment plan and improves the member experience, experience. Which you can't get that on a on a PPO plan.

1:18:50 Unknown speaker not human verified

OK, yeah, this is good stuff. I guess one question for the district. If so, if I'm considering. If I'm an employee comparing. The for for next year, the memorial Herman plan or the Kelsey Seabold plan. Why would I pick? like putting cost aside, like putting my, what comes out of my paycheck every, every two weeks or twice a month, putting that aside, just comparing the plan side by side, why would I

1:19:20 Brian Schuss not human verified

pick one over the other? Uh, I think it goes back to that patient experience and you're going to have to, you're talking about, if I'm talking about Memorial Herman versus Kelsey, those are the two that I'm comparing. Yeah. So I guess I'd answer it this way. Uh, cause they're both great organizations right and some folks are going to stay on the memorial herman plan because they want to keep their doctor and that's great right that's why we wanted to keep that as an option if approved what the district is going to see since kelsey is new is there's going to be a lot of communication going out to our employees about the options that kelsey offers and i think I think if that is appealing to folks, it is different. I mean, I have to say, not saying anything bad about any one of our other plans, but I'm just gonna say I was blown away when I went to that patient experience tour. That's how healthcare should be managed. And so I think there's gonna be communication that goes out that folks are going to look at and they're going to say, I want to be a part of that plan, right? Even if I have to change my doctor, there's going to be other folks that can't for whatever reason. Like they have surgeons that are a part of Memorial Hermann that they love, that they've been with, and they're going to stay with Memorial Hermann. And Memorial Hermann is a fantastic organization. We've got a great relationship with them. So it's going to be very personal. It's going to be that decision.

1:20:54 Unknown speaker not human verified

You're not going to be able to answer this for HIPAA reasons, But are you able to tell us the spread of what folks what plan folks are on now?

1:21:01 Brian Schuss not human verified

X% are on the choice X percent on the law Herman. Yeah choice choice is the least Memorial Herman currently, but Lance Do you want to speak to that?

1:21:09 Unknown speaker not human verified

Right now we have Right at 900 people on the POS we have about 4,000 and some change on the moral Harmon ACO and the remainder on the high deductible health point, okay Roughly off the top of my head.

1:21:28 Unknown speaker not human verified

Thank you. Mr. President. Thank you, Mr. Davidson. Yeah, thanks, team. And the phrase, I think, Kelsey Seabold ecosystem was brought up in the context of patients who are going through cancer care. So I wanted to, I guess, explore that concept a little bit because we were talking about a lot of, you know, affiliate subspecialists or kind of extension of the team specialists. Do you have information, you know, perhaps it's starting at the specialist level. If a patient's going, you know, part of the Kelsey-Seybold plan, they're needing to see specialists for one reason or another, an estimate of a percentage, what percentage of patients will stay within the Kelsey-Seybold ecosystem?

1:22:32 Unknown speaker not human verified

ecosystem?

1:22:33 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

Yeah, so we, when we refer to the ecosystem, it's like the whole offering that we do, whether it be cancer, infusion, specialty, ambulatory surgery, primary care. And today it's about 95% of patients stay within the Kelsey-Seybold system, and we can take care of 95% of the issues or problems. There are chronic conditions that we do work very closely with. The biggest one is dialysis. So we don't do any dialysis centers, but we have a very close collaborative that we've worked for for 30, 40 years that does all of our dialysis. But really it's about 95% stays within the Kelsey-Seybold system, and we can service their medical conditions there. Our cancer centers, we have five today. day, we also have equal number of radiation centers. And 95% of patients who need radiation also come to a Calcius Siebel radiation center. They don't have to go to an MD Anderson radiation center because we're strategically close to all of our patients now. And so this has been a part of our growth initiative is that we want a larger part of that medical ecosystem so that patients can stay within our system where their collaboration collaboration of care and the coordination stays really high.

1:23:52 Unknown speaker not human verified

Mr. President, Mrs. Vice President. Yes, Mrs. Fox. Okay, so a lot of these things are very exciting. I loved what you said about the Rapid Care Center. Kind of like to know how is that different from urgent care and ER?

1:24:13 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

are. So our RTCs, we have four different regional locations. We have one here at the Memorial Villages location. And you think of a rapid treatment center, these patients are a little bit too sick for primary care, but don't need to be in the hospital and need a little bit more attention than in an urgent care. And so we're able to send them to an RTC where they can get IV hydration. If they have congestive heart failure, they can get fluid taken out. I'm thinking of it as fluid in and fluid out, IV antibiotics. The other thing that the RTC will do is that they will not only, if you go to an ER, you know, it's you got treated and then go back to see your PCP. They will take care of that patient three times a week, every day until they're stable enough to go back to primary care. Then they transfer them back to primary care.

1:25:06 Unknown speaker not human verified

So they live there?

1:25:08 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

No, no, no, no, no. Yeah, you come every day and get a treatment. Sometimes like an antibiotic, you're going to get treatment every day. So you'll come in the morning.

1:25:16 Unknown speaker not human verified

Like pneumonia, those kinds of things possibly. Yeah. Okay, good. So how many of our employees' current doctors are in-network today based on what we have now, and what percentage would have to change providers with the Kelsey-Seybold plan, would you guess?

1:25:33 Mr. Harris, Baldwin Group not human verified

Good question. So the Kelsey Seabold, if you're on the point of service plan or the high deductible health plan, you do have access to Kelsey already. And there was about 600 members already utilizing Kelsey. So there will be some people that if they change from the HDHP or the point of service to Kelsey, they're already using Kelsey. On the Memorial Hermann plan, if somebody wants to go to Kelsey, like everybody would have to change their doctors because the Kelsey is a different provider network for primary specialty. specialty. And that's why I think it's important to have two different ACO models. Both are high performing networks, but it just gives people more access and more choice for the type of care

1:26:11 Unknown speaker not human verified

that they need. And I'm confident that our people will communicate all of these things thoroughly to let people know. Videos, not just written words on a page, right? Absolutely. I'm looking at Lance Nelman over there. He knows I'm going to ask that question. Okay, if employees experience experience higher than expected costs, like, okay, I'm going to go to Kelsey Seabold, I'm going to give this a try, and then this is all more than it was before. They have restricted access or provider disruption. What protections do we have to address concerns like that?

1:26:45 Mr. Harris, Baldwin Group not human verified

As far as they join the Kelsey plan and then they want off the Kelsey plan?

1:26:49 Unknown speaker not human verified

No, they're just not getting what they were promised. They're not getting the, the it's like we don't have that you can't see that doctor or that costs are much higher than they had even with the plan they didn't like before well and so

1:27:05 Mr. Harris, Baldwin Group not human verified

the costs are going to be just dictated by the payroll deductions in the plan design it's as far as what the deductible out-of-pocket and the co-pays are I think your question about that there is a subspecialty that is not part of the Kelsey network that would be then you would go to one of their referral networks or then get a pre-authorization to be referred outside of the network.

1:27:25 Unknown speaker not human verified

Okay. How does Kelsey Siebold choose providers to add? How do you choose those?

1:27:30 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

That's a good question. I'll let the good doctor answer that one. So we have a very extensive interview process. As you guys know, Houston is a high attractant for physicians across the country just because it's so international and we have tort reform form in this state. And so we get very high quality candidates. And part of how we choose is basically, are we opening a new clinic? Do we need more physicians? Is access to a certain specialty like ENT maybe is not what we want? Then we'll hire more ENT docs. But we get very good candidates and we use a lot of data as far as making sure that we're meeting our patient access needs and requirements. You realize of course that KDSD is going to bring a lot of children with them. Yep we've got a lot of pediatricians with lots of access for sure. Right

1:28:26 Unknown speaker not human verified

and so um so 1100 providers sounds like a lot but it doesn't sound like a lot knowing you know how many people are in this area already that are with so much medical access in the West Katy area. area. So Methodist Memorial Herman, Texas Children. We already have a lot of that. I'm thinking our employees are not going to like changing doctors, but I mean when they see who your doctors are, they might be able to. But that's what I think the problem would be. So one other question sent another question, not just one. Since Kelsey Seabold is owned by a group which also owns like United Healthcare. How can we be sure that the health plan that our employees get is the best for them and not just to direct people to other United Healthcare things within that?

1:29:24 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

Yeah, that's a great question. And so it's what does that division tree look like? At the very top, it's United Health Group, which is UHG. UHG has two sides to it. One is insurance, which is UnitedHealthcare, could be health insurance, life insurance, dental, whatever. The other side is care delivery, which is where Optum sits. And Optum is who owns Kelsey Seabold clinic. And so there's a huge, very dramatic firewall between the insurance and the delivery for reasons that are very... apparent and obvious. You know, who would want to do business like Aetna or Cigna if they think their information is going to United? We work with United, but we also work just as well with Cigna and Aetna and Blue Cross Blue Shield. We're in all the major health plans and all the major kind of the health hospital systems here. So we like diversity and everything we do at Kelsey Kelsey is patient centered and it's not necessarily what United Health Group stock is doing or United Health Care wants us to do.

1:30:36 Unknown speaker not human verified

So to be more specific with my question, United Health Group owns Optum, which is Kelsey.

1:30:43 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

That's correct.

1:30:44 Unknown speaker not human verified

What other groups do they own that are also health groups and might they direct our employees to other health organizations?

1:30:54 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

In the state of Texas, the only other group they own is WellMed, and WellMed is essentially a Medicare Advantage plan, and they don't do really any commercial like we do. And so in Houston, it really is Kelsey Siebel Clinic. Unless you want to go to Dallas or West Texas, that's where more WellMed is. But, yeah, in Houston, it's pretty much only Kelsey.

1:31:18 Unknown speaker not human verified

see. Okay. I know I've asked some hard questions, but I love the specialist speed plan. Love that because how many times do you have to get referred to a specialist, wait for an appointment, go to the specialist, talk back to the, it's too many things. The e-consults, we usually get

1:31:34 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

the result back the same day. Yeah. So, and we have really good data on this. An e-consult typically results 75% of the time. The patient never has to physically see the specialist. I mean, it's no copay, no taking off work, to have to go see the specialist. Because the honest truth about it, things that may be complex for a primary care doc like me are low hanging fruit and simple for a specialist. And so they can do a lot of it just electronically through our EMR.

1:32:04 Unknown speaker not human verified

Right. Like things that our PCP would know. You need an endoscopy or a colonoscopy, but you have to go to that doctor, you have to get the appointment, they have to get the, right? Is that what we're talking about?

1:32:15 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

Yeah. Yeah. Speed it through and get. That's right. Or if you do need to see the specialist, what's that testing you should have done before you go? So once you see the specialist, it's one visit instead of two visits. And then for colonoscopy, we have direct access colonoscopy. So the day you meet your doctor is the day you get your exam. So there's no pre-visit required.

1:32:36 Unknown speaker not human verified

I know some of our more mature employees are happy that I'm here asking those kinds of questions BECAUSE NONE OF Y'ALL HAD TO DO THAT YET. BUT SO I, THE THING THAT HAS ME IS, LIKE, HOUSTON, AMERICA IS KNOWN THROUGHOUT THE WORLD FOR M.D. ANDERSON. AND FOR SOME OF OUR EMPLOYEES WHO HAVE, LIKE, THEY HAVE THEIR PERSON, YOU KNOW, M.D. ANDERSON CANCER, IF, I DON'T KNOW, THEY'RE GOING TO BE, like you want me to go somewhere else when MD Anderson is the best in the world. So how do your patients handle that?

1:33:19 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

So first of all, we compete with MD Anderson. We've been doing that for many, many years. And what we compete on is patient experience. The treatment's the same. The infusion is the same. Now, if you need like a research drug, MD Anderson's the place to do, although we do some clinical trials and research now, especially in cancer. But patient experience, valet parking, go to MD Anderson and try to park. Whether you like it or not, patients see quality. Is the parking free and was it easy? And so we compete on patient experience. We have locations near our patients where you go get chemo, you're not driving three hours, you can go puke. So it's really important that we're close to our patients. And yes, some patients need to go to MD Anderson and we'll do that. Some people need to go to Baylor and we'll do that, like CAR T, a very expensive treatment that we don't do at Kelsey-Seybold. I do want the group to understand, though, that we don't ever withhold care because it's not available at Kelsey-Seybold. We have great relationships across the entire Houston area. To find that world-class specialist that might be needed for your specific condition, We just can do core, which is 95% of all the things that your employees and your teachers will need that we do have to send out on occasion. We're happy to do that.

1:34:48 Unknown speaker not human verified

So to clarify as I end up here, if once, let's say it's the bad C word and somebody has that and they go through your facilities and then it's something that only MD Anderson can do. There's a way for them to transfer into MD Anderson and do all of that. Absolutely. And that copay is all transferable into that.

1:35:11 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

We will help them do that. And by the way, we're on the same EMR as MD Anderson, so they'll see everything that's been done already.

1:35:18 Unknown speaker not human verified

EMR?

1:35:18 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

Electronic Medical Record.

1:35:20 Unknown speaker not human verified

Thank you so much for your presentation and for answering all our questions.

1:35:23 Dr. Auger, Kelsey (spelling unconfirmed) not human verified

You're welcome. Ms. Dillard?

1:35:25 Unknown speaker not human verified

Thank you, Mr. President. Donna, did you want to go first?

1:35:28 Unknown speaker not human verified

No, I just have one more question.

1:35:30 Unknown speaker not human verified

Go ahead.

1:35:30 Unknown speaker not human verified

I just have one other question. What my question is, is because this does happen. So, you know, as even Mr. Shipley was saying, his, I'm going to just use you as an example. Your child was, y'all were out of state. She had to go to the ER. So let's say something, God forbid, worse happened to somebody, and they were out of state, and they end up going to ER, but then from the ER they get transferred to some random hospital, hospital in Florida, wherever they are, and there's not Kelsey Siebel. You know, I mean, how, I mean, because you're not going to be in some kind of emergency situation and go, oh, well, you know, let me see all the different hospitals I can go to because my kid's about to die right now. You know, I'm just going to take him to the hospital, whichever one that is that's nearest. So how is that handled?

1:36:27 Unknown speaker not human verified

That's a very good question. It is one that we usually address during the open enrollment meetings with the employees because we are local to Houston. So if you're a member and you choose Kelsey Sebold and you go to Dallas, you go to California, you're traveling, usually your focus is on urgent care or emergent care. And you would have direct access to the Aetna network for all of their urgent care facilities. There's no referral required. I believe it's a $50, $50 or $75 copay. So as you travel, that's what you would mainly use. You would also have access to our virtual care if it's in Texas. So the member would pay the copay, whether it's a PCP or a specialist. If it's outside of Texas, you would rely on the Aetna, the MD Live virtual visits that members can access. And it really doesn't matter where you are in the world. You have to have access to hospitals for emergencies Also, we don't serve mental and behavioral health So we lean on the Aetna network for that as well so members can go directly to that network with again without a referral One of the things I did want to mention though And we would have to check with Aetna on this this, but if a member has children living out of state or even out of area, the Kelsey or even the Memorial Herman plan may not be the plan for them because they would need to be able to access care out of state. I believe that Aetna has an option that they can layer on for situations like that, but these are the conversations that we would have with members as they evaluate what's best for them.

1:38:12 Unknown speaker not human verified

That's good to point out because a lot of, let me just say, you know, because a lot of, since we can cover our kids now, but they're 26 and a lot of them are in- Is that a kid? I'm just kidding. Well, they can be covered and they're in college and they're in Oklahoma or Arkansas, wherever they are, you know, so that's a very good point.

1:38:29 Unknown speaker not human verified

Yeah, my daughter went to Texas State. She chose, we chose to have the Kelsey plan and it worked well for us. She didn't have any ongoing health issues. She used virtual and urgent care frequently came home for her care but if she went to Colorado she wouldn't have survived the weather but she would went to Colorado even myself working for Kelsey I wouldn't have chosen the Kelsey plan so good question that's one of my

1:38:53 Unknown speaker not human verified

questions regarding access right I want to go back so I'm just really concerned about affordability a lot that we heard an open comment from our staff members was just how expensive it is and I mean it's I mean we see how expensive this is For starters, these premiums, are they per month or are they per pay period?

1:39:11 Brian Schuss not human verified

That's per month.

1:39:12 Unknown speaker not human verified

Okay, that's per month. Okay, so it makes it feel a little bit better. As you all were doing this, what is the percentage that we carry, when I say we, administration, the district, versus what percentage of the premiums, the cost of premiums is staff carrying? Is it like a 40-50 split or 40-50?

1:39:33 Brian Schuss not human verified

Well, so if you're looking at about the $6 million increase, That would be 4.6, what's that, about 70 or so when you're talking about next year, the 1.9 compared to the 4? Is that what you're asking?

1:39:42 Unknown speaker not human verified

I'm talking in general, like was there a target split as you all were looking at the increases?

1:39:46 Brian Schuss not human verified

So it's a good question. So I'll answer it this way. In talking to Baldwin, we were having these conversations, the conversation first about, well, you have them together, or we should have them together, but employee contribution and employer contribution. but first employee contribution and and how much should those be increased and you know Baldwin says and I and I agree that You've got to increase those at least a trend which is our six and a half percent Okay, so the memorial Herman and then the high deductible plan were increased at at six and a half percent now the choice was Was about double that and that has been consistent with what we've done in the past because of the loss experience that we get from that plan. So then the discussion goes from there, okay, what about the increase from employer contribution? Because if you look at the $12 million loss, that was 16. Well, that's too much, you know, I think, to bring to the board and say this is what we're expecting as a loss. And we've got to start having those discussions about who's going to pay for that. Is that passed along to the employee or does the employer handle that? And in our discussion, with dr gorski mr smith absolutely not not going to be passed along to the employee and that's why we have four million dollars allocated in an increased employer contribution so to keep those employee premiums down and that's that's how that discussion takes place um so employer funded

1:41:14 Unknown speaker not human verified

roughly the district's around 57 like roughly um did you all consider and i know this is radical But you know we did ask you to like you know upset the apple cart When you were given this this very immense job. Did you all consider a? Model to increase a percentage by like salary band was that ever part of the conversation we didn't I mean well

1:41:37 Brian Schuss not human verified

I can say you know in I guess hypothetically or philosophically we have those conversations, but that I'd have to say that really wasn't a part of that this year. I mean you know we the The first directive that, you know, after talking to Dr. Gorski and meeting with Baldwin that we gave to Baldwin was, look, we need to be offering at least one copay plan. We know we want minimal increases. I mean, that goes without saying we want minimal increases to our employees. But we need at least one copay plan. And if we can't do that, I wanted to stand here tonight publicly and tell everybody why we couldn't do that. Okay, because our employees have been asking for that, and it's something we really, really wanted to provide. So that was a big goal this year with trying to keep increases minimal, and that dominated most of this process.

1:42:26 Unknown speaker not human verified

So that was sort of your guiding principle there. Can I ask about access for pharmacies? Are we still engaged with the HEB plan last year?

1:42:37 Brian Schuss not human verified

Yes, ma'am, and that was a three-year agreement, so that will be in our second year. Okay.

1:42:42 Unknown speaker not human verified

Okay. And then I noticed, and this may be separate, we haven't had a discussion on dental or vision. Is that TBD?

1:42:50 Brian Schuss not human verified

Well, no. So remember, that was with the voluntary. That was with the voluntary. And that was all good stuff, too, because we added that additional dental plan, the additional vision plan, the dental HMO, and the additional vision. And most of those were with decreased rates.

1:43:04 Unknown speaker not human verified

So keeping in mind, we have these premiums as well as the voluntary insurance, which most people hopefully want to take care of their teeth as well as their eyes.

1:43:12 Brian Schuss not human verified

Right. And remember, and remember, and I'm glad you brought that up because yes, there are some increases here, but with a lot of the products on the voluntary side, it wasn't a whole lot when I'm talking life changing, but there, there were decreases there. So the, the, the important story there is there weren't increases there and increases here.

1:43:32 Unknown speaker not human verified

I know we went out of order in today's meeting, so we would have heard this if we had gone in order. I know that some of our fund balance is going to be going towards health care. Is this towards this exactly?

1:43:45 Brian Schuss not human verified

So I'd like Mr. Smith to speak to this. But, again, this is right now this is just a budget projection for next year. And it is conservative, and we hope that, you know, we hope it's not that much. But yes, that is all, you know, that's all a part of that discussion. We're comfortable with 12. We've been managing healthcare this way for many years. And if you remember, Mr. Smith showed that, I believe it was last month in his budget presentation where we've had deficit budgets with underspending and then we always have added the fund balance. And this is, you know, healthcare is a part of that whole management.

1:44:22 Unknown speaker not human verified

management. So going by the logic you said at the end of the year do we settle things by leveraging the fund balance to help take care of this 12 million dollar deficit or is that generally what happens by the end of the year we look

1:44:37 Brian Schuss not human verified

at underspend and typically covered with underspending but I can let Mr. Smith speak more to that if you would like to.

1:44:45 Unknown speaker not human verified

Sorry.

1:44:46 Unknown speaker not human verified

Look, you just gave me Mr. Spence. Sorry.

1:44:50 Unknown speaker not human verified

Sure.

1:44:51 Unknown speaker not human verified

Well, I'm going to tell you what I'm getting at. What I'm getting at is, is there an opportunity, we have not finalized the budget for next year, is there an opportunity for conversation, not necessarily a decision's point, to possibly pull from that balance to help figure out a way to lower our premiums in some way for our staff members? That's the question I'm getting to. The answer may be no. I don't know. I don't know what the numbers would look like.

1:45:17 Brian Schuss not human verified

So I guess let me answer it this way, and then Mr. Smith can piggyback off of me. And I completely appreciate your question. I do. I want to go back to our premiums compared to what they would be if we were with TRS a lot more. And I know health care is expensive, and I'm not saying it's not, and I'm not trying to minimize any increase. But, you know, one of the reasons that we have a deficit, the deficit that we do, many, I think six years in a row, maybe seven, the district did make that decision to not increase contributions. And so the district just absorbed that loss year over year over year and it got to the point where okay If we're looking at a 20 million dollar loss well That that really doesn't that you know That makes the plan that makes the perception of the plan look like it's unhealthy right because man the plan is $20,000,000 or 15 or 12 or whatever it is and so we started thinking okay We we've got to write that ship because like I talked about six and a half percent trend we met with Aetna back in March or April, I believe, they're talking about our plan. Our plan, and they benchmark all their plans, they benchmark all their book of business. Our plan beats their entire book of business on almost every benchmark. So the discussion went to, okay, but these pretty big losses, we've got to right that ship. And the one way to right that ship, and I know this isn't super popular, but is to keep employee increases at a minimum, but have that discussion each year, where there's employee increase, but also have the discussion of employer contribution increase. So I appreciate your question and would love to be able to do that. But just when you're talking about, you know, protection of the plan moving forward, this is where we land.

1:47:08 Unknown speaker not human verified

Understand. But just keep in mind what you're showing us is the district is spending $4 million more, staff is spending $1.94 million more, and the fund is still $12.1 million underwater.

1:47:20 Unknown speaker not human verified

You're exactly right.

1:47:20 Unknown speaker not human verified

So the concern is, well, you know, if you're saying we want to eventually break even, et cetera, you know, are you going to come back next year, you know, with the same idea, but those numbers are going to be bigger and we're still like underwater? You know, it's a great question.

1:47:35 Brian Schuss not human verified

And, you know, looking into the crystal ball, I would hope, you know, the goal is to continue to bring that $12 million down year over year with minimal increases to our employees. The thing that we're also always going to have to keep in mind and that we will present to the board, I mean, we're trending at six and a half, and we hope we continue to beat medical inflation. But if you have a bad claims experience year, which you can have, if the next year it's nine or it's 10 or it's 11, that's where those difficult conversations come into play, where those increases are maybe not so minimal. We hope that's not the case. That's another reason we added the Kelsey plan to add another option another low-cost option and also Getting those folks to migrate from the choice plan now to a plan with a copay which will also help long-term plan health So it's a great question and you know

1:48:25 Unknown speaker not human verified

I also want to add that the goal is also to keep our staff and to also meet this district an attractive district We're just gonna come to so so there's a balance between you know, obviously wanting to break even was this a decision of being? self-funded with this medical fund balance um but also we want to be a district that you know teachers want to stay and or teachers want to come to us absolutely and there's a balance there

1:48:49 Brian Schuss not human verified

absolutely and that's and again that's why we're still showing an operational loss of 12 million dollars and didn't say hey we've got to wipe that out and pass that along to somebody you know that's why we're still showing that and i think that's why we continue to have these conversations because we don't want to be in a position where we're going to say we we can't handle the loss anymore and we're going to pass it completely under employees we don't want to be in that position you know so again that that's exactly the reason we show it this way and I appreciate that mr. president this folks may ask a question

1:49:21 Unknown speaker not human verified

here along the same line what percentage of our employees participate in health

1:49:25 Brian Schuss not human verified

care plans so there's 8100 out of about 15,000 so a little over 50% okay so I

1:49:33 Unknown speaker not human verified

agree with mrs. Taylor we want to attract the best people to Katie I see But if we're using our funds, whatever we have, to help half of them, I don't know that that would help us keep employees. So I would rather see any excess we have going towards salary so that they can choose their own plan, whether it's here or somewhere else. And so while I appreciate trying to bring the cost down and I appreciate very much what you've been doing to take take part of our budget, I mean part of our money and put it toward some people's Health care and not everyone would not make an assumption

1:50:15 Unknown speaker not human verified

We're making an assumption that the other half Chose just not to use it. They may choose not to use it because they can't afford it or they're on their spouse's insurance because that's cheaper. And I know that's the case. I understand what you're saying.

1:50:28 Unknown speaker not human verified

I understand that. I guess they probably are doing something else, but it wouldn't be fair to treat half of our employees to something. Let's just give them all a raise so everybody can use that.

1:50:40 Brian Schuss not human verified

And that is a dilemma that every organization faces. And so I do think moving forward that both of those have to fall into the equation, that we talk about employee contribution and employer contribution at the same time that we're talking about raises and increases. I do agree, but that is a dilemma, and this is what we're recommending this evening. Champagne?

1:51:08 Unknown speaker not human verified

Thank you. Okay, so I wasn't going to say anything about this, but you're right, Mr. Schultz. every organization because I talked to my husband about this a little bit and you know we get insurance through his company but every organization has this route half the people aren't on it because the other half are on their spouses or choose not to or however but it's I think it's important to offer it but that wasn't the point I was going to make but what I did want to say was and what what we hear and I'm sure that the rest of the board members of here also of hear this is kind of what Mrs. Taylor was talking about, which is the cost of the insurance, the out-of-pocket expense. So what I would hear, like walking through the grocery store just as a person who lives in the community and they know I'm on the board, they would say, well, how come an, And I don't want to say name, but an ex-ISD that's next to us, they only have to pay such and such, and we pay twice as much. So this is, so I don't know. So I've seen the charts. I know that that's not really true, but I'm not walking around with a chart, you know, in my purse and taking it out and going, look. But this is the, I don't want to say misconception, but it's the perception of people that are in our district that believe, maybe not everybody, but a lot of them believe that we're not offering the best that we could at the best price that we could. They think that in the neighboring districts, they could, you know, I could just go get another job in another district and their insurance would be less expensive. This is the problem that I hear. I'm happy about the choices. I love the $10 thing. You know, I know our teachers are happy here for the most part, but I'm just saying from the insurance point of view, this is what I hear. And so. I don't I don't know how to alleviate that that perception of people that work in the district.

1:53:20 Brian Schuss not human verified

So, yes, I understand that concern. I do think just from the conversations that I've had with folks personally, a lot of times what they're getting at is the difference between having copays and not having copays. A lot of times when I drill down in the conversation, that's really what they're getting at. And, you know, we had somebody speak in front of the board. I don't remember the district and wouldn't name the district anyways, but came from a district that had that structure to ours that didn't. And it's not all the time, but I do think this is a good step forward, and I think it's going to alleviate some of that concern. I really do.

1:54:05 Unknown speaker not human verified

Mr. President. Mr. Davis. Thank you, Mr. Schuss. You know, picking up on one of the themes anyway from the conversation that, you know, I think you and others that are listening have been able to, you know, pick up on seven individuals who, you know, we're trying to flip every rock on these plans and uncover surprise and some of those not surprises and they're being hidden but surprises and we're exploring we're trying to understand you know pros and cons of the different plans um i think it's one of the i'm a big fan of the different options that are being presented and And I think the downside, though, is it just puts more onus on, you know, all of us, really, to be able to communicate effectively what the differences are in these plans. And, you know, whether that's through, you know, different user types or journeys or stories, but being able to communicate it in a way where things that, you know, the seven of us, we couldn't even come up with a hypothetical, but we know exists, you know, during the rollout and explanation, just being as transparent as possible and communicating, as Ms. Fox said, beyond just words on a page. because that's you know that's where we'll have community members and our employees up here unhappy at some point saying you know here's my story and here's this trap I fell into and I didn't anticipate it we've we need to communicate so that those things are anticipated and we know that there are pros and cons with different plans and you know that's great as long as they're well understood.

1:56:04 Brian Schuss not human verified

I really appreciate that and you know Kelsey certainly since it's new we've already had discussions with them in preparation for the potential of board approval to get with their well they've already started but for us officially to get with their marketing team and start talking about all that communication because as an example I'll go back to it again when I was at that patient experience tour when I left I said this all needs to be communicated to our employees. But not just that. And I can say we are revamping our employee benefits guide and the information that's contained in that guide. There will be more information in that guide this year. And it's going to be good. And with the addition of the AI model, it's going to be fed all of this information so folks can ask those questions but not stuck with AI if they don't want to be. I think we are adding some options that greatly increases how we can communicate and the amount that we communicate and also the access to HR and risk management. You know, we're communicating that as well. So I completely agree. Communication is key. Over communication is key. And I think we need to be prepared to do that because I want folks to be able to make the best decision they can for themselves. Right. And it's the conversation I have with Mr. Nauman, with Mr. Harris, when we were talking about the employee benefits guide just like you said pros and cons we have as an example adding that dental plan okay within our employee benefits guide can we show kind of pros and cons and what kind of best fits you uh we're going to have folks at open enrollment with with kelsey memorial herman and the baldwin group will be there uh to answer questions so but i yes i agree over communication it's important

1:57:47 Unknown speaker not human verified

any other questions mr cross i need to join in Again, like everybody has said tonight, appreciate all of this. I mean, I know it's time-consuming and a lot of work, and our folks are certainly worth it, the people who work in this district. And so I'm grateful for that. A couple things. Mentioning AI, because I always think about this. Like in the old days when I was principal and you'd have the meetings where employees could come and get the like health care explanations and stuff. One of the old criticisms from years back was that it was almost over their heads sometimes right like where they didn't really understand and they'd sign up for a plan and go I didn't realize that and so when you mentioned AI I was thinking about and and I here's what I'll say I get it could be tricky if you open that door if you're in a room full of folks and then you get stuff like what if my cousin's brother's sister's dog is injured in you know Austin and then you're like wait wait wait we can't account for every scenario but at the same time there are more common things that might come up and I'm just wondering is the plan still to have those kinds of meetings I hate to admit I don't know if we still do those if not then I'm excited about the potential AI may be taking care of some of that stuff where you could plug in okay my child has you know these issues here's what you know I'm looking for here you know and get some kind of response that may guide them again not not relying on that solely because you you don't want to just do that and then find out later you're like well AI doesn't always get it right but at least it might be a starting place so my question is is that the kind of thing you anticipate that that ai could do was for an employee to what would be the best plan with

1:59:50 Brian Schuss not human verified

my scenario my family situation whatever well um so as soon as we approval we're going to work with Dr. Alane's team and see as far as open enrollment questions how AI could help. Trouble with getting into that deep of a scenario. It may not be an issue. Our technology team has done a phenomenal job with this stuff. We are on a little tighter schedule this year with open enrollment and leading up to open enrollment. But that, yes, that would be great if we could do something like that. The problem with that is, though, I think AI, I don't know, it's great and it blows my mind constantly, but with an employee giving very personal scenarios to AI, I'm not sure if you would be able to decipher all of that different information to say, hey, this plan is right for you. And so that's one of the reasons at open enrollment we're going to have a lot of human representatives there to answer questions that can guide people in the right direction. And there's, again, with that employee benefits guide, there's going to be plenty of communication that if you have questions, we want you to choose the plan that's right for you. If you have questions, please reach out and ask. I mean, I can't say it any more clearly than that, folks. And we'll do our absolute best to get them the answer. If we have to get them to a Kelsey rep, to a Memorial Herman rep, to somebody on Mr. Nauman's team, to a Baldwin rep, that's what we're going to do.

2:01:22 Unknown speaker not human verified

Right. I think it'll be that initial. Like you said, it will be, you know, obviously interesting, the guide that comes out, and hopefully it is super helpful for folks, and most questions can get answered. You know, there's always some people who have a unique situation, and I get that. And yes, they can call, I would say, again, for the open enrollment stuff. As much as you can, like, compliments to everybody tonight. You guys have really, and I'm just going to speak for myself, dumbed it down in the sense of, like, trying to understand how this all works, everything from actuarial tables to, you know, just the way, like, say the Kelsey Seabold plan is working and referrals and all that stuff. So I appreciate all that. I just think that, you know, after years of being in this district and one of the ongoing issues that seemed to happen was just confusion about and sometimes it's on us as employees I mean I was guilty of it too should have asked didn't ask you start the plan and you're like oh man probably should have asked that question so I'm not saying we're not guilty of that as human beings but but I think as much as it can be plain speak like it's been tonight you know in the sense of like okay those are straightforward answers and and I think if our employees can can get those kinds of answers you know through that enrollment period then that's going to be fantastic I have one last thing and it's it's gonna sound like I'm doing an ad for GLP and I'm not at all but what is what I would say is for folks like we always tend to think of folks in two categories for GLP ones GIPS that kind of thing you have people who are officially diabetic and you go okay well they get the medicine covered or whatever but as I'm sure our health folks know right research coming out daily about for a long time it was chicken and egg stuff right about GLP obviously if you lose weight that's gonna benefit you if you're an overweight person but everything I'm seeing these days is also the medicine that the peptides themselves are actually having a positive impact on people's liver kidneys sleep apnea you know cardiovascular stuff and they're starting to tie it beyond that I say all this to say that that I'd hate for there just to be a perception because some people are pre-diabetic insulin resistant you know those kinds of things and they're they are they're overweight but I think those things I'd hate to have that specific thing just taken off the table as if like oh that's just like getting Botox if you're going to your class reunion you know because I think it's a I think it's a bigger deal than that I think especially the way the research is is coming again I'm not a doctor have a couple family members who are I'm not saying this I'm not promoting it I'm just saying that I wouldn't want it automatically discounted as like it's just some I lose five pounds to go to the beach you know this summer kind of thing because I think there's much more to it than that so as that is looked at for folks For all our teachers and employees across the district, you know, I'm not saying oh this needs to be covered at this level or whatever But I hope it's it's as we learn more and more that it's not just automatically dismissed to some cosmetic

2:05:00 Brian Schuss not human verified

Cosmetic fad kind of thing well no and I think is mr. Mr. Harris said earlier, working with ReadyMD to come up with a program for those folks that are looking at it for the weight loss side of things. So I think that we're not. Yeah. Okay. That's all I have.

2:05:17 Unknown speaker not human verified

Mr. President, follow-up. So how are you going to communicate this to our employees?

2:05:24 Brian Schuss not human verified

So it'll be through, it's going to be through email blasts. It's going to be through the employee benefits guide. It's going to be through Mr. Nauman's team. and mr nalman if you want to talk you haven't talked at all if you want to talk about how

2:05:36 Unknown speaker not human verified

we're going to do that through the open enrollment process let me let me spare us some more time because i've taken too much let me just ask this so i know face to face lots of people interaction i hear all that a lot of people are really busy a lot of people put things off till the last minute hello me sometimes and it's late and i have to enroll tonight and it's 11 p.m Is there a video, a YouTube somewhere where I can go look things up? Please tell me that. Now I'm not just bringing in Dr. Alauni, who's amazing, but now I'm creeping over to Dr. Grooms, and she's like, shh, Rebecca, stop. So please tell me there will be something where they can get like an overview. Will there be like a little video of the employee, what do you call it, experience, experience, patient experience that shows some, please tell me there's some doubt in the plan.

2:06:31 Unknown speaker not human verified

Let me kind of allude to you. Once we've already started, we started back in May planning for open enrollment, assuming this all goes through, which I'm very optimistic that it will. We already have a set schedule in place. So once we get the go button, we'll be communicating via email, their their personal email, district email. We'll be sending communication pieces out. And there will also be, we've worked with the Baldwin Group to create an open enrollment video, interactive video, that will be pushed out in a schedule on a regular basis. Now, our benefit fair, where we bring in the subject matter experts, experts, is in the evening to accommodate people after work, usually from 4 to 8 in the evening. We stay there to get those questions answered. You will see historically it's procrastination. People wait until the very last. We'll be monitoring those numbers throughout open enrollment. In the last two days, it's a mad rush to the finish line. Now, we do have a period where if an employee, for whatever reason, Lance dog ate his homework and he couldn't get to his computer, whatever it may be, we have accommodations that we can work with people through appeals and make sure they get their benefits.

2:08:01 Unknown speaker not human verified

How can they compare the plans simply with pictures and a little video and what you know the drop-down menus that say what if I have this what about kids what you know the little yes that's that's YouTube that's

2:08:17 Unknown speaker not human verified

That's what I need.

2:08:22 Unknown speaker not human verified

You know, a lot of people do that and teachers do it all the time, right? They give lots of visuals to kids and interactive things and engagement and I think they'll, you know, be able to respond to those kinds of things. And if they have extensive questions or specific questions, they should come to your thing, right?

2:08:39 Unknown speaker not human verified

And even if they, and I might add too, as Mr. Cross was alluding to, we have to take some step of accountability to make that decision. We want our employees to come to this benefit fair to sit down and speak because everybody's circumstances are unique, and for us just to put a boilerplate out, this is the best, this is the best, is not, number one, not prudent, and we don't want to say, well, you told me to do this. But we want the subject matter experts to listen so they can make informed decisions about what plans they want to to do

2:09:19 Unknown speaker not human verified

But now the mr. Nama's up here and we Had talked a little bit about before that there could be a person That was a specific person in HR that would possibly in that you know be hired or I don't know, hired or trained, you know, an existing person, that this would be their specialty? Is the insurance, specialty care, customer service type person, is there a person like that?

2:09:50 Unknown speaker not human verified

We don't have a person like that. Right now we're in the very infant stages of we've rolled out the AI Abby, and we're going to see how that kind of plays out over the next few weeks and look at the data and see what questions are being asked. Is Abby responding to that? that and we're always considering how we can continually look at customer service and and I would also add I think we're all as everybody in this room we experience with AI is I want to speak to a live person I want to speak to a live person because circumstances are unique that I want to I want to strongly make it clear that risk management is there for our employees we want to hear we We don't just push you off. We want to listen, and we're there for our employees to answer and ask questions and dive into what they need. We're still a hand-holding department. Okay?

2:10:51 Unknown speaker not human verified

One more question. Sorry. We haven't really talked about pharmacy benefits much. What are we missing with that? I can rattle off some things that I've heard, right? There's the HEB thing, right? Like there's certain, what are we going to hear from our staff about the good and the bad of our current pharmacy plan?

2:11:17 Unknown speaker not human verified

There's no contemplated changes in 27 regarding pharmacy. The formulary is going to change. The drug companies sometimes will change the formulary because based on dispensing, et cetera. But we have no – this proposal to you now this evening does not contemplate any changes to pharmacy.

2:11:39 Unknown speaker not human verified

So there's deductibles that are listed that aren't changing? Yes. Copay, excuse me, 204080 on the Memorial Hermann plan and the Kelsey Seabold plan. Can I go to CVS? Can I go to Walgreens? Is it HEB only? Can you talk, like, what is the current pharmacy plan?

2:11:57 Unknown speaker not human verified

Right now, we have an exclusive. Employees must go to HEB to get their pharmacy. Okay. If Lance goes to the ER and it's after hours, he can go, and HEB is not open. There's a CVS or a Walgreens available. That is an option for the employees. There's also, if an employee is outside a 10-mile radius of an HEB, there's 65 60,000 participating pharmacies that can help support that so that would be if Lance's son is going to can't think in place in Texas if he was going to the University of Colorado let's say that option is available for them to get those medicines there as well and we're in a three-year we're in

2:12:46 Unknown speaker not human verified

12 months into a three-year contract with HEV? Correct. We will be 12 months in the end of the year. Okay, got it. Okay.

2:12:55 Board President not human verified

Thank you. Thank you. Any more questions, Board?

2:12:58 Unknown speaker not human verified

I just have a request. Ms. Taylor? I know we have to vote on this next week. I would love if myself and the Board members could get a copy of the feasibility assessment on ROI of self-insured versus fully insured that Baldwin City did. any type of staff survey data that was done regarding what staff value or needed regarding benefits, and if an RP was put out, who else bid and at what numbers and what was the scoring, if that information is available.

2:13:31 Unknown speaker not human verified

Outside of what the Baldwin Group talked about with actuarial tables, they would have to answer that for you tonight if they can give you any of that information. information but we did not do the other things that you're talking about like

2:13:47 Unknown speaker not human verified

like surveys to input so there is no I thought we didn't go out and survey

2:13:53 Unknown speaker not human verified

staff about different plans or what they're asking for or anything like that so we wouldn't have the other things you had requested the Baldwin you all would

2:14:04 Unknown speaker not human verified

be it a hi would you be able to share that information thank you all right

2:14:15 Board President not human verified

thank you very much we will now return back board to item 7.1 discuss and

2:14:23 Board President not human verified

consider board approval of the June 2026 financial reports and our presenters Jamie Hines our assistant superintendent of finance

2:15:02 Unknown speaker not human verified

Thank you.

2:15:07 Jamey Hynds, Assistant Superintendent of Finance not human verified

Good evening, President Redman, trustees, and Superintendent Grigorski. I'm here to present the financial reports through June. You'll find I have a lot of reports in front of me tonight. night so you'll find the flip to the wrong one so I apologize your financial reports through the month of June including our financial statements our tax report our construction report through the month of June as well as our check register and donation report for the month of June included with your your financial statements is going to be an analysis of our expenditures and revenues by both function and object. Just quickly, I'm going to go through these because we're going to go into final amended right after this. This is through 10 months of the year, so that's 83.3%. And, you know, in terms of looking at our taxes, our revenues for the most part, everything is directly in line with where we were at the same time last year. In terms of our spending, especially in GOF, we're at about 80, a little above 80%. Again, we're at 83% through the 10th month. And so, again, we just continue to see underspending as I've brought up in several of our prior meetings. So that's all I want to go into, unless you want me to dig deeper into it. Taxes are essentially collected. We're at about the same percentage, except for about three-tenths of a percent under where we were last year in terms of actual collections. Construction report, again, those are our capital projects. And then the check register summary is just a summary of all of our checks for the month. Can I answer any questions?

2:17:16 Board President not human verified

Any questions, Board? NEW SPEAKER No questions. We can move on to item 7.2,

2:17:23 Board President not human verified

discuss and consider board approval of the proposed 2025-2026 final amended budget.

2:17:29 Jamey Hynds, Assistant Superintendent of Finance not human verified

NEW SPEAKER Good. This is where I flipped to initially, so sorry about that. Attached, you'll find your final amended budget along with individual capital project amendments for the 2025-2026 fiscal year. The budget, as approved by you you all the board will be filed with the Texas Education Agency. This is essentially our closing document for the fiscal year in accordance with applicable law and will be included in our 2526 ACFR. Approval of this final amended budget will ensure final revenue estimates and expenditure budgets for the 2526, for 2526 are reflected in the district's financial records. Just briefly, mechanically, how we do this, we essentially go to the end of July. So at the amended budget at the end of July that you all approved last month. And then we determine what our projections are in terms of expenditures and revenue through the end of the fiscal year. So through August 31st. And that's how we come up with our final amended budget. The key to this is, and we've talked about this before, is making sure that we have enough expenditure budget available not to blow a function, not to outspend a function. and so what we do is we look at those revenue expenditure and then the amount of fund balance that we're gonna have left over and then within the expenditure budget make sure that we spread around the budget through the functions so all of our functions are gonna have enough padding not to go up not to go over and that's from TEA as well as from local policy from you all that we blow a function so I can go into a little bit of detail two things We're actually up about almost $6 million from the end of July for all three budgets. And that is a combination of two things. We're up about $1.7 million across food services. I'm sorry, we're up in revenue by about $1.7 million. And then expenditures are down by about $2.7 million. So if you look across all three funds, that kind of tells the story. but focusing in on our GOF, our general fund, we're actually at the exact same expenditure budget, but there's a little bit more revenue budget this month. And so what that's led to is going from about $600,000 add to fund balance, which is what was where we were at the end of July, to about a $4 million add to fund balance is what we're projecting now. Now, I understand this is also projecting out some of that underspending that we know is going to take place over the next, the month between July 21st and August 31st, and then we'll be continuing to have invoices and things roll in. the big thing are those payrolls though making sure those payrolls are projected correctly especially with a lump sum payment as well as we just had a TIA payment so making sure that we project on those but again with that four million we expect there will be additional fallout so additional underspending will drive that up but we won't know until we actually get to the end of the year and that's when we'll put together the annual comprehensive financial report and we'll come back here in January and present all of the final numbers for the in the ACFER and so you all will approve that at the end

2:21:10 Unknown speaker not human verified

of January or we'll bring it to you to be approved. I will say that this is one that we will continue to look at this week and what we want to do is identify where we don't want to overspend this function, but we also want to be able to, like we've done in the past, have that flexibility to maybe spend a little bit more towards our health insurance to contribute an expense that can go to cash for the health fund to keep it healthy. We've done that in the years past. It's a balancing act, but we want to be able to have that available in all functions in case we likely will use that tool. And so this could change between now and then the bottom line wouldn't but moving money from one function to another might and I doubt it at this point, but but we we could change it between now and then but I doubt it But the reason would be so we could arrange everything to to contribute and do the best financial decisions we can for that health fund

2:22:12 Jamey Hynds, Assistant Superintendent of Finance not human verified

This the separate capital projects amendment that goes back to what you all approved last month as well. That's the white fleet the AV, the turf and the tracks and the opportunity awareness center. So that's just making sure. The final amended budget only covers our general fund, our food service fund, and our debt service fund, and so those are in our capital projects funds. So we want to make sure that we're transparent with bringing those as well for your approval. I also, before we finish, just want to thank the accounting department. They are really the ones who build this and drive this entire final amended budget and put a lot of time into it. this is Brandi here and her folks are there any other any questions that I

2:22:55 Board President not human verified

can answer so what I'm hearing is we had adopted a pretty large deficit but we're

2:23:00 Jamey Hynds, Assistant Superintendent of Finance not human verified

closing at a surplus yes sir that that that is exactly true I will just bring to your memory bring back from from historical what what took place but we We had that extremely lucky, happy audit that came down because of issues that went on with the counties, the CADs, and the comptroller, and it went toward KDISD's favor. So that was a $30-plus million unanticipated increase to our revenue this year. And again, with our enrollment, our enrollment went down, which obviously drove down our state revenues so between between that audit and then you know just obviously management we were able to come out in very good shape yeah that was a

2:23:54 Board President not human verified

congratulations y'all did a great job our principals and every organization throughout our district keeping in mind being a good steward of the funds that we have and yeah congrats good job board other questions all right then we'll move on to item

2:24:15 Board President not human verified

7.3 discuss and consider board approval of a resolution to commit and assign fund balance

2:24:21 Jamey Hynds, Assistant Superintendent of Finance not human verified

all right this is um this is mostly an accounting tool that we need to use uh just to show transparency and so the governmental accounting standards board GASB 54 and TEA require the district to adopt a resolution to commit portions of its general fund unassigned fund balance and to delegate the responsibility of assigning the fund balances to the superintendent or his designee the attached resolution commits a portion of fund balance for contributions to the district's health plan health insurance plan for unanticipated expenditures and or revenue losses and for the one percent lump sum payment that was approved by you all to employees to be paid in december there's also this year 7.5 or pardon me 10 million for unanticipated expenditure and or revenue loss and those amounts are for the district's health insurance plan 5.5 million and that along with the 10 million for unanticipated expenditures has been pretty much the same thing that we've done for several years that's been an ongoing amounts this year because of the fact that we are we do have a deficit budget and and and we just want to be open about the fact that we have a deficit budget and we are putting that one percent toward our employees we still believe that we can make up that deficit budget or at least come very close to doing so but we want to make sure that we're as as open as possible as transparent as possible about what we've we've promised a fund balance so there's also a commit of a portion of the fund balance for our activity funds our four six funds and that's just a requirement of our local policy Any questions?

2:26:22 Unknown speaker not human verified

I have one question that's...

2:26:25 Board President not human verified

Ms. Hawks.

2:26:27 Unknown speaker not human verified

So one of these line items in here is the 1% lump sum payment to employees. Dr. Gorgorski, what dates will those be paid out? There'll be two of them, right?

2:26:39 Unknown speaker not human verified

That's correct. The first one comes in the next pay period coming up at the end of August. It's August 31, is that correct, Mr. Hines? And then the second one comes on which paycheck in December December 15 15

2:26:54 Unknown speaker not human verified

Thank you you bet

2:26:58 Board President not human verified

Other questions board Thank You mr. Irons, thank you. Well now move on to item 7.4 discussing consider board approval of the 2026 2027 state

2:27:08 Board President not human verified

compensatory education funding and other end of course assessment funding budget as required by House Bill 5 and our presenter will be miss Esperanza Rios director of budget and treasury we've got her for two items

2:27:28 Esperanza Rios, Director of Budget and Treasury not human verified

good evening board president Redmond Board of Trustees and dr. Gagorski agenda item 7.4 pertains to the course the end of course assessment assessment funding as required by House bill 5 the district identifies a special program budget in the amount of $80,000 called student interventions. This special program is included in the 26-27 proposed budget which will which you will see an agenda item 7.5 and is distributed by school leadership area super assistant superintendents during the second semester to campuses which are in need of additional funding for tutorials. This agenda item documents a district's compliance with the requirement to budget funds for accelerated instruction related to satisfactory performance on the end of course assessment as required for graduation any questions board no questions we can move on to 7.5 I will provide highlights of the 2627 proposed

2:28:27 Esperanza Rios, Director of Budget and Treasury not human verified

budget for the three funds which will be considered for approval by the board based on the information to be presented by mr. Smith next week the 2627 general fund revenues are budgeted at $1,140,413,942. The 26-27 proposed budget contains $1,166,088,219 in budget expenditures, which includes campus and department non-salary operating expenditures, and the majority of the expenditure budget is related to district-wide salaries and benefits for new and existing staff, including the compensation increase approved by the Board. The general operating fund is anticipated to use $25,674,277 of fund balance for the 26-27 fiscal year. The proposed food service budget revenues are budgeted at $53,173,624, with anticipated expenditures of $60,726,705. The 26-27 proposed budget includes compensation increases approved by the Board in the Summer Feeding Program. The Food Service Fund is anticipated to use $7,553,081 of fund balance for the 26-27 fiscal year. The proposed debt service budget revenues are budgeted at $259,890,321 with anticipated expenditures of $257,000. $257,250,000 for the 26-27 proposed budget. This includes the debt service principal and interest payments for outstanding debt. The debt service fund is anticipated to reflect an increase to fund balance of $2,640,321 for the 26-27 fiscal year.

2:30:21 Board President not human verified

Any questions? Any questions, Board? No questions? You all have done a good job explaining it over the past six months. Thank you.

2:30:36 Board President not human verified

We'll now move on to item 7.6, discuss and consider Board approval of the remote homebound labor. Our presenter will be Dr. Amy Brockhausen.

2:30:52 Unknown speaker not human verified

Good evening, President Redmond, Board of Trustees, and Superintendent Dr. Kogorski. I'm here to present the annual homebound requirement per board policy. Texas school boards and open enrollment charter schools are required to seek a waiver when providing remote instruction to homebound students in order to allow effective students to generate attendance-eligible days present according to the homebound funding provisions in the Student Attendance and Accounting Handbook, Homebound Funding, and Homebound Documentation requirements noted in section 4.7.2.5. Consistent with board policy, BF legal, and applicable law, the board of trustees must approve the practice for which the waiver is requested. Remote homebound waivers are submitted based on the student's individual needs. However, more than one student may be submitted on a single waiver request. I'm happy to answer any questions you may have any questions board I don't have a question I just

2:31:58 Unknown speaker not human verified

want to thank you for hanging in there absolutely my pleasure but I also I know that it's a requirement that we offer the homebound but just I will just say as a matter of fact that I've had friends whose children have been in homebound and I know that the service that they receive is excellent and it's just so important i know that legally we're required to do it but i i feel like the people in kdic go above and beyond you know the minimal requirement of just providing the service and and actually offering great customer service to those children who and families who are going through difficult time sometimes appreciate that all right thank you very much and that

2:32:51 Board President not human verified

we've already discussed item 7.7 so we'll move on to item 7.8 discuss and

2:32:56 Board President not human verified

consider approval of the board operating procedures or we had lots of discussion on August 8th during our team building as we work through our revised board operating procedures we worked on operating norms that we were all able to have a conversation in and share went through talked about some leadership requirements reformatted the operating procedures and then had the chance to dig through stuff and so tonight you've got a copy of the changes I believe that everyone was made that was requested you've got a draft that shows the changes and then kind of a final draft and so yeah if there's any discussion or questions about it there being none all right I would like to mention that that was a conversation we had that was on the agenda on on August 8th was discussing our open position that will be here in October as miss Fox retires and since since that discussion I have not had anyone come make a motion to replace the trustee position and so that being said nobody's made a motion so we'll continue on with that position open and not replace that person unless unless there's at some point that the board were to bring that motion. Is that clear? That we will not be replacing the person? Essentially, we will not be replacing the persons. All right.

2:34:40 Unknown speaker not human verified

Mr. President, just so I'm clear, by not making a motion, you have said your tenure is ending end of October, and so the position will remain open.

2:34:51 Board President not human verified

That's what will remain open. Got it. Okay. The holdover doctrine would say that Ms. Fox would still be able to come back and vote and participate. Got it.

2:34:59 Unknown speaker not human verified

But her position is up for election next May.

2:35:02 Board President not human verified

May.

2:35:03 Unknown speaker not human verified

Okay, so it would just stay open until then.

2:35:04 Board President not human verified

So essentially it will be open until our public votes to replace that position. Got it. Thank you. All right, then we have our information items that you would see.

2:35:14 Board President not human verified

This monthly, in regards to item 8.1, acquisition of new library books, this monthly posting has no new library acquisitions for the month of July. We take the month off of July for buying books. So you will see more in August when the August report is on September. We've received the certification of anticipated tax collection rates for both Fort Bend and Harris County for 2026-27. And the board has received the 2027 appraisal district budgets. And we have received the donated items list. Mr. Secretary, do we have any requests for information?

2:35:49 Unknown speaker not human verified

The only thing that... The only thing I have is, I think, Ms. Taylor's request for ROI on fully insured versus self-insured. Is that good?

2:36:03 Board President not human verified

Okay. All right. Well, then, our future meetings, there will be a regular board meeting on Monday, August 24, 2026,

2:36:12 Board President not human verified

and there being no further business before the board, this meeting is adjourned, and the time is 822 p.m.

2:36:20 Unknown speaker not human verified

Thank you.