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1990-11-28 Regular MeetingKODIAK ISLAND HOSPITAL ADVISORY BOARD MEETING NOVEMBER 28, 1990 PRESENT: Ben Ardinger, Jon Hlavinka, M.D., Gretchen Saupe, Betty Springhill, Jeannie Volker, Lorne White; John Salness, Administrator; Kate Fitzgerald, Director of Nursing; and Keith Vorachek, Accounting Manager. ABSENT: Wayne Stevens The meeting was called to order at 7:10 P.M. Lorne White moved and Gretchen Saupe seconded the motion to accept the amended agenda. Motion Carried. APPEARANCES AND COMMUNICATIONS Mr. Salness shared a letter which he had received from Mayor Selby in response to the Board's letter to the Borough regarding the interest in the Hospital's account. In his letter, Mayor Selby stated that there was over $80,000 available for the hospital's use. Mayor Selby also indicated that monthly reports would be generated for the Board's review. Lorne White moved and Gretchen Saupe seconded that the meeting minutes of November 14th be approved in their entirety except that it be noted that the Executive Session of the meeting adjourned and the Regular session reconvened at 10:32 prior to the Motion on Page Seven. Motion Carried. OI.D BUSINESS Mr. Ardinger asked if it would be possible to discuss the new business first as it directly impacted on Item A -- 1991 Budget. There was no objection. NEW A. Car Rental vs. Purchase Mr. Ardinger stated the Finance Committee, in reviewing the payables for September and October, found that over $5,400 had been spent for vehicle rentals for locum tenens physicians. The locum tenens con- tract requires that the hospital furnish housing and local transporta- tion. Advisory Board Meeting November 28, 1990 Page Two Mr. Ardinger asked if the vehicle purchased by the hospital from Neil Sargeant in February could cover the needs of both ER physicians. Mr. Salness explained that because of the geographic separation of the E.R. physicians, this would not be feasible. Dr. Henry will moving into the Administrative House on or about December 21. This will enable the hospi- tal to return one rental car. Drs. Henry and Mallender will then share the hospital's vehicle. The Hospital van is not available for use during the day; however, if the physicians wish to use the van after 5:00 p.m., it could be made available to them. Mr. Ardinger that the Finance Committee had raised the possibility of purchasing another vehicle if one is needed. B. Emergency Room Doctors During the first nine months of 24-hour coverage in the Emergency Room, the Hospital has shown a positive revenue of $48,000. This figure indicates beginning with one E.R. physician and adding physi- cians as required for coverage. Mr. Ardinger stated that he felt that if Kodiak Island Hospital & Care Center continued to provide 24-hour Emergency Room coverage utilizing locum tenens physicians, that the hospital could expend $503,000. When asked, Mr. Vorachek indicated that he did not feel a full year's projected expenditures could be made on the basis of two months' payable figures, as these may reflect prepayments, multiple billings and/or payments being made on prior billings. After full discussion, Lorne White moved that the Staff and LHS Man- agement Company be directed to recruit for a permanent E.R. Physician for Kodiak Island Hospital & Care Center. Gretchen Saupe seconded the motion. Motion Carried. Gretchen Saupe moved that Kodiak Island Hospital & Care Center reduce the number of CompHealth physicians from two and one-half to two or less physicians to provide Emergency Room coverage on a 96 -hour per week basis by January 1, 1991. Lorne White seconded the motion. Motion carried. C. sage Security System Mr. Ardinger indicated that Kodiak Island Hospital & Care Center is now paying $99,854 a year for security services. He stated that the Finance Committee felt this might be an area in which the hospital could reduce costs. Mr. Salness explained the duties of the security system and the costs. The original firm with which the hospital contracted did not provide the quality of service needed. When ser- vices were transferred to Sage, the cost rose. Advisory Board Meeting November 28, 1990 Page Three There was a discussion regarding inventory control and tagging of assets. The consensus was that this should not be a function of the security system, but would more properly be the responsibility of the material management department. Ben Ardinger moved that Kodiak Island Hospital & Care Center issue Requests for Proposals for security services during the hours of 10:00 p.m. to 4:00 a.m. Lorne White seconded the motion. Motion carried. D. Tom Mingen Mr. Mingen was weathered out. He him at 6:30 p.m. on the evening agreed to meet at this time. E. Nine Member Board asked that the Board meeting with of November 29, 1990. The Board Ms. Springhill stated at the last Borough Assembly meeting, that the Advisory Board had been asked if it would be willing to go to a nine member board. Gretchen Saupe moved that the Kodiak Island Hospital & Care Center Advisory Board be enlarged from seven to nine members. Dr. Hlavinka seconded the motion. Motion Carried. Mr. Salness indi- cated that he would prepare a letter for Ms. Springhill's signature asking that this be placed on the Assembly's agenda as an ordinance. OLD BUSINESS A. 1991 Budget During a discussion regarding the budget, it was recommended that the Borough's policy regarding recruitment and reimbursement be compared to that of Kodiak Island Hospital & Care Center. Mr. White indicated that he would obtain a copy of this policy. It was requested that this item be placed on the Board's agenda for the next regularly scheduled meeting. Lorne White moved that Kodiak Island Hospital & Care Center room rates be increased by 3% and that ancillary service charges be increased by 7.5% for fiscal year 1991. Gretchen Saupe seconded the motion. Motion Carried. Mr. Vorachek was directed by the Board to modify the proposed 1991 budget reflecting the expected decrease in housing costs, vehicle rentals, security services, etc. Advisory Board Meeting November 28, 1990 Page Four B. Certificate of Need Mr. Salness stated that the Certificate of Need was to be signed by Mayor Selby and then would be forwarded to Juneau. He indicated that the new Commissioner of Health and Social Services, Dr. Mala, seemed to be pro -hospital and pro -native services. ADA11NISTRATOR'S REPORT A. Miscellaneous Mr. Salness received information today on the procedure to get designated psychiatric treatment beds. He recommended that the board consider the feasibility of recruiting a psychiatrist at some point in the future. Ms. Saupe expressed a concern that the hospital might not be able to support a psychiatrist in private practice. She stated that Dr. Hess had told her that psychiatrists at API would be willing to travel to Kodiak. Mr. White indicated that he felt if there were a need in the community for a psychia- trist that the Mental Health Center would have come to the Assembly. Mr. Salness stated that Jeff Silva, the Material Management Department head, had told him that he was going to work for the Nicaraguan Government and that January 15, 1991 would be his last day. By utilizing the LHS purchasing system, Kodiak Island Hospital & Care Center has been able to eliminate much of the bidding processes which have been Mr. Silva's exper- tise. Kelley Phillameano will take over as head of the department, en- abling KIH to eliminate one FTE in that area. Bids have been received for the Handicapped Van. Mr. Salness stated that Mr. Silva is reviewing the specifications and is to have a recommendation to him by Friday or Monday at which time he will present the bids to the donor for her approval. Expected delivery time is six weeks to Seattle from date of order and then Kodiak delivery dependent on the barge. Representative Davidson has sent a letter stating that he will be setting appointments with community groups on December 18 to get their input for the 1991 legislative session. Mr. Salness stated he had received a letter from a Mr. Sackett, a lobbyist in Anchorage, who wished to offer his services to KIH. The Board indicated that it did not wish to utilize Mr. Sackett's services. AUDIENCE CONMENTS Mr. Vorachek stated that the internal relocations and changes required to meet the Fire Marshal's citations were nearly complete. The Board indicat ed a desire for a tour when all the changes are complete. Advisory Board Meeting November 28, 1990 Page Five Lorne White indicated that he would like to see the Board set up a work session with Karl Short and the School Board Accountant to discuss the central treasury idea. He asked that this item be placed on the agenda of the next Board meeting. Mr. White stated that he would recommend that the inventory control system of the Hospital be referred to the Finance Committee for review and recom- mendations. He stated that he would request a copy of the Borough's guidelines. Mr. White stated that he had gone before the Assembly with the possibility that the Jones bill, if passed, would fund 80% of the cost of a new hospi- tal, and 20% would fall back on the community. He indicated that he told the Assembly that if no funding was approved, that the Assembly would have determine the funding alternatives. He indicated that he did not feel that a bond proposal would be approved by the community. Mr. White asked if there was a Speaker's Bureau organized to speak for the hospital. Mr. Salness stated that he had prepared a Public Relations Proposal and had forwarded that proposal to Wayne Stevens for his review. A Speaker's Bureau is included in that proposal. Jeannie Volker stated that the furniture in the Administrative House needed to be upgraded. It was the consensus of the Board that this situation be reviewed and necessary furnishings purchased. Ms. Volker asked that if a chapel was included in the plans of the new hospital. Mr. Salness stated that if you have a room designated "chapel", then all associated costs of building and maintaining that space are excluded from any Medicare/Medicaid funding. He indicated that he believed a room called "family room" was included. Ms. Volker indicated that she felt strongly that a chapel be included and designated as such, and that funding should be obtained with which to pay the associated costs. After discussion, the consensus of the Board was that the structure of the committees would be reviewed when the number of Board members is increased. Ben Ardinger stated that he felt that a maintenance policy needed to be agreed upon between the Borough and KIH/CC which would detail the Borough's responsibilities as pertains to the maintenance of KIH. Mr. White stated that he and Wayne Stevens had talked with Jerome Selby and that the ordi- nance covering Borough responsibility includes all facilities owned by the Borough. There is currently $2,000,000 available for major maintenance. He was not sure of the limits. Mr. Salness indicated that he would request a copy of the ordinance from Mayor Selby and distribute to the Board. Advisory Board Meeting November 28, 1990 Page Six Mr. Ardinger stated that he felt the Borough should maintain the building, whatever the cost incurred, including such things as the front doors and repair of the parking lot. Mr. Ardinger expressed his desire that Dr. Hlavinka would accept another term as Chief of the Medical Staff and would stay on the Board. Dr. Hlavinka stated that he felt one of the positive aspects of being Chief of the Medical Staff was involvement on the Board. He indicated that he did not anticipate seeking another term as Chief of Staff, but that he would be interested in serving on the Board as a member at large. Ms. Saupe asked if the Smoke Shack had been closed up. Because of comple- tion of the renovation and restructuring required to meet the Fire Mar- shal's citations, Maintenance has not yet had an opportunity to board up the structure. Ms. Saupe asked about the status of mini blinds, indicating that the Director of Nursing's office windows needed some other type of covering. The blinds have been ordered. Ms. Saupe asked about the status of the Human Resource Manager position. The person hired to fill the position has not yet completed the require- ments of her current position and will report on board here on January 2, 1991. Ms. Springhill requested a progress report on surgeon recruitment. Mr. Salness indicated that Jackson & Coker had sent him one curriculum vitae, but that the applicant was not acceptable. He indicated that he had had a long discussion with the recruitment firm, stating again the hospital and board's requirements. Ms. Springhill asked if the contract with KIMHC had been rewritten to reflect the Board's desire that the hospital be billed on an hourly use basis. Mr. Salness stated that it had and that the contract would need to be reviewed after the first quarter. Responding to Ms. Springhill's request on the C/T Scan building, Mr. Salness stated that the building foundation was to have been poured on November 26; however, the weather has been too cold. Mr. Salness indicated that the contractor had indicated to him that the foundation would be poured on November 29 or 30th. Ms. Springhill asked about the status of the solarium. Mr. Salness indi- cated that the proposal is still in the office of Ray Camardello, who is preparing a design -built proposal. Advisory Board Meeting November 28, 1990 Page Seven Ms. Springhill asked Mr. Salness about the status of working with Joan Minks of the Home Health Agency. He indicated that John McEntee was working on the application to get a retail pharmacy license. This will enable the hospital to do the IV therapy for the home care agency, and to fill the prescription requirements of Care Center residents. Mr. Ardinger asked if having a retail license would adversely affect the hospital's non- profit status. Mr. Salness indicated that by maintaining separate books and a separate inventory, that this would not present a problem. He stated that the State Board of Pharmacy had approved the plan. EXECUTIVE SESSION 9:33 p.m. The meeting recessed to Executive Session to discuss personnel matters. 10:30 p.m. Executive Session recessed; Regular meeting reconvened. ADJOURNMENT Meeting adjourned at 10:35 p.m. Recorded by Debra Raper. /:s/ /`s/ Betty Springhill,.Chairperson Lorne White, Secretary