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1990-09-12 Regular MeetingKODIAK ISLAND HOSPITAL ADVISORY BOARD MEETING SEPTEMBER 12, 1990 PRESENT: Ben Ardinger, Jon Hlavinka, M.D., Gretchen Saupe, Wayne Stevens, Betty Springhill, Jeannie Volker, Lorne White; John Salness, Administrator; Mike Lockwood, Senior Alaska Administrator; June Kenyon, Registered Physical Therapist; and Jean Dickson, Speech Therapist; Keith Vorachek, Staff Accountant The meeting was called to order at 7:10 P.M. The agenda was verbally amended to move Item VII, Staff Reports, to Item II. By consensus, the Board accepted the amended agenda. STAFF REPORTS A. June Kenyon, Registered Physical Therapist Reported that her department is very busy. She is the only full-time PT, there also being a part-time PT and a part-time aide. 80% of the outpatients are referred by physicians locally and in Anchorage. Her department also works with residents in the Care Center, although no specific treatment can be performed without a physician's order. Ms. Saupe asked if there was any equipment which the department needed. Ms. Kenyon indicated that space and staffing were the limitations which she saw as more serious. She felt that long-range there were enough patients to warrant another full-time PT. This would enable the department to better manage the administrative duties, as well as provide more care to the Care Center residents. B. Jean Dickson, speech Therapist Reported that her department is the smallest at KIH, with her being the only part-time employee. Working with the Infant Learning Program, she sees patients between the ages of 1 month to 3 years. The majority of these patients are evaluated at home and if services are required, those are done at home as well. She works with patients to teach them how to stimulate their children's speech. She also works with Care Center residents when directed to do so by doctor's orders. She conducts inservice training programs for the Care Center aides to help them learn how to interact with the patients. Ms. Saupe asked if there was any equipment which her department needed. Ms. Dickson indicated that an audiometer would be very helpful, as it is more sensitive than the tymponometer she currently• uses. Ms. Dickson was directed to write up the specific Advisory Board Meeting September 12, 1990 Page Two information on the equipment and to give her request to Mr. Salness who will forward it to the Auxiliary. Ms. Dickson noted that there is now an audiologist in town and that it might be beneficial to work with her on a contractual basis. Mr. Salness noted that he has requested a proposal from the audiologist regarding working for the Care Center on a consulting basis. The minutes of the August 29, 1990 Advisory Board Meeting had been distributed to members for review. Gretchen Saupe moved and Wayne Stevens moved that the minutes be approved except that: (1) Lorne White was not listed as absent from the meeting; and (2) Dr. Hlavinka was not noted as having voted affirmatively on the motion that the Board approved the acceptance of the quotes for the patio and solarium and further, that construction begin with all haste. Motion Carried. The minutes of the August 29, 1990 Finance Meeting were moved to be accepted by Gretchen Saupe and seconded by Wayne Stevens. Motion Carried. APPEARANCES AND COMMUNICATIONS Mike Lockwood, Senior Alaska Administrator, stated that he was here on a routine visit to discuss specific issues with Mr. Salness, including staff changes, productivity systems, financial reporting systems and to help devise a way to obtain computer reports in a more immediate, accurate fashion. He reported that Tom Mingen would be at the October 20, 1990 retreat. He asked for questions. Ben Ardinger asked about the financial status of his hospital. Mr. Lockwood reported that his hospital had finished their fiscal year with an increase of $140,000. He reported, however, that July was an extremely bad month financially, being adversely impacted by the loss of tourism caused by the salmon catch and release program. There was a general discussion of the number of physicians, services available, and recruitment policies used by Mr. Lockwood at his facility. Ms. Saupe asked about the feasibility of sharing services with his facility's consultants. Mr. Lockwood said that he did feel, in theory, that it could be feasible, but did note that some physicians would be adverse to such a shared system. Advisory Board Meeting September 12, 1990 Page Three There was a general discussion of the recruitment incentives used by Mr. Lockwood. Mr. Lockwood stated that he and Mr. Salness were in the process of working on a long-term plan based on the needs of the medical staff for the community as well as strategic planning. NEW BUSINESS A. Jackson & Coker Contract Mr. Salness explained that because of the specific provisions in Dr. Alvarez' contract, KIH could not recruit for another surgeon without incurring breach of contract liability. Dr. Alvarez' contract has now expired and Mr. Salness stated that he was now seeking the direction of the board on this issue. There was a general discussion of the requirements the Board would like to see imposed on a new surgeon and of the services provided as proposed by Jackson & Coker, a recruiting firm. These services include mailing, screening and documenting materials to and about potential applicants, assistance in setting up and negotiating the employment contract, and a 90 -day guarantee of employment, during which they will replace the surgeon if not acceptable to KIH. Gretchen Saupe moved and Lorne White seconded the motion that the firm of Jackson and Coker be retained to recruit a general surgeon for Kodiak Island Hospital for a recruitment fee of $25,000 payable as follows: $5,000 down, and $5,000 per month until paid in full. The Recording Secretary called the roll: In Favor - Ardinger, Hlavinka, Springhill, Saupe, Stevens, Volker. Motion carried. Mr. Lockwood recommended that Dr. Llewellyn be contacted prior to implementing the motion. Dr. Llewellyn is a military physician married to an OB/GYN who wishes to remain in Alaska following his retirement. Mr. Salness indicated that he would do so. B. Computer Consultant Keith Vorachek, Staff Accountant, presented for the Board's review a proposal by the Medical Information Systems Committee (attached) regarding the retention of a consulting firm to research the computer needs of KIH/CC and to make recommendations as to the purchase of hardware and software to replace the IBM System 36, which will no longer be supported by the manufacturer by 1992. After discussion of the issue, Mr. Salness recommended that the Board vote to retain the consultant to review the needs and direction of, KIH. Advisory Board Meeting Setpember 12, 1990 Page Four Jeannie Volker moved and Wayne Stevens seconded the motion that the firm of Joseph Deluca and Associates be retained to research the computer needs of KIH/CC and to make recommendations as to the purchase of hardware and software to replace the current IBM System 36. Madame Chairman called the question. There was a spirited and lengthy discussion during which the following concerns were noted: Ms. Saupe was concerned that KIH would be spending funds unnecessarily when it appeared to her that other small hospitals would be using appropriate computer systems. She indicated that before hiring a consultant, that we should contact other facilities to see what systems they are using and if they would be compatible to our needs. Mr. Stevens stated that he had gone through the process of contacting various business and computer companies as Ms. Saupe was suggesting KIH do. Even with the research he did, he stated that he found that he was unable to determine which system would be best for his company. He then went to a consultant who further researched the needs of his company and make recommendations as to programming needs. Mr. Stevens recommended that we approve the proposal. Mr. White stated that he felt that LHS had been contracted with to provide services and expertise as needed in this situation. Mr. Lockwood stated that the core contract does not include computer services. Mr. Ardinger stated that he found it hard to believe that there was no LHS hospital currently utilizing a system which would be applicable to KIH. Mr. Salness stated that most LHS hospitals use the PICS system, which is paper -intensive and not desirable. Mr. Lockwood indicated that he was going through the same process as KIH. He was asked if his system would be compatible with KIH's needs. Because our needs are more basic and we utilize a different accounting and payroll package, the system he is considering would not be viable for KIH/CC. Lorne White moved and Gretchen Saupe seconded the motion that the proposal to retain a consulting firm for the purposes of determining KIH'e computer needs be tabled until a later date after further investigation into alternative solutions. The Recording Secretary, called the roll: In Favor - Hlavinka, Springhill, Saupe, White, and Stevens. Against - Volker. Motion passed by majority vote. Advisory Board Meeting September 12, 1990 Page Five C. Appointment of Auditing Firm Mr. Salness stated that the auditing firm of Charles Bailey and Company had been retained to prepare the annual audit of KIH/CC. OLD BUSINESS A. Executive Committee Mr. Salness explained his rationale for wishing to more efficiently utilize the Executive Committee structure and reduce the number of general board meetings from twice to once a month. It was the general consensus of the board that they preferred to continue meeting twice a month as a full board. Ben Ardinger moved and Lorne White seconded the motion that the Advisory Board continue to meet twice monthly until such time as the Board feels it no longer necessary. All in favor. Motion carried. B. Oil Spill Cleanup Mr. Salness reported that the Borough's Architectural Review Board has interviewed three firms to investigate the oil spill, to determine the cause and responsibility, and to recommend remediation procedures. He stated that when the final report was complete, he would bring it back to the Board. C. October 20 Board Education Noting that there five potentially new members on the Borough Assembly and the possible imminent departure of two Advisory Board members: Lorne White moved and Wayne Stevens seconded the motion that the Board Education Retreat be held after the seating of a new assembly and appointments to the Advisory Board. All in favor. Motion carried. Administrator's Report A. Administrator's Report Accepted as presented. Advisory Board Meeting September 12, 1990 Page Six B. Fire Marshall Report Mr. Salness reviewed the various violations which KIH/CC received as a result of the recent visit by the Fire Marshall. He stated that he has completed an inventory and a prioritization of storage needs as part of his plan of action. He stated that it would be the responsibility of the Borough to provide storage and reviewed some in- house options. It is the requirement of the Fire Marshall that all remediation be completed by December 4, 1990; it is Mr. Salness' objective to have everything completed by November 15, 1990. C. Funding Feasibility Update Mr. Salness reported that the letter for the Feasibility Update had been completed and that Ms. Springhill had them for her signature. The company with whom KIH contracted for the study will be contacting the companies receiving the letters. D. Contract Negotiations with KAVA Mr. Salness reported that in a meeting with KANA this morning, they had expressed a strong interest in building a clinic and outpatient facilities as part of the new hospital. A proposed contract for expanded services between KANA and KIH is now under review. Ben Ardinger: Regarding Keith Hediger's letters in the newspaper, Mr. Ardinger reported that he had contacted Dr. Hediger regarding discrepancies, especially that no Borough monies run the hospital. Mr. Ardinger does not feel that Dr. Hediger will retract any part of his letters. Mr. Salness has written a letter to the editor in response to Dr. Hediger's letters. Lorne White: Mr. White expressed some confusion regarding the minutes of the Financial Committee meeting on August 29th. Keith Vorachek will review the minutes and provide clarification to Mr. White. The article in Newsweek stating that Alaska is the worst state in which to live could be turned to an advantage to get funding for the new hospital. Advisory Board Meeting September 12, 1990 Page Seven Mr. White would like the candidates running for Council seats to attend the next Board meeting and address their stands on hospital funding and other issues. Mr. Salness will invite them to the next board meeting. Wayne Stevens: Target date for the Business Opportunity Tour is October 8 and 9th. Sought the Board's approval and funding of Mr. Salness' participation in the event. Consensus of the Board was favorable. Audience Comments None. The next meeting dates are: Finance Committee Meeting September 19, 1990 12:00 noon Quality Assurance Committee Meeting September 20, 1990 12:00 noon Advisory Board Meeting September 26, 1990 7:00 p.m. By general consensus the meeting adjourned at 10:10 p.m. Recorded by Debra Raper. 46& �or e White, Secretary