1990-04-11 Regular MeetingC , RECEIVE®
,03.0 _01 IAYoa N
KODIAK ISLAND ADVISORY BOARD
REGULAR MEETING, APRIL 11, 1990 )DIAKISLAND BOROUGH
I. CALL TO ORDER: 7:04 p.m. CLERK'S OFFICE
PRESENT: Gretchen Saupe, Jeannie Volker, Ben Ardinger, Chairperson Betty
Springhill, Dr. Hlavinka (7:15p), Lonnie White (7:15p); unexcused, Wayne
Stevens. Also present: Mike Lockwood, Sr. Administrator-Ak; Kate
Fitzgerald, DON -Acute; Keith Vorachek, Staff Accountant; John Salness,
Administrator.
II. AGENDA: Additions: IX. E. -Relocate DON Office; F.- Management by
Objectives; G.- Apartment Lease. Chairperson asked members consent to move
item VIII. C. to first item of business since Lorne White had to leave
early; agreed.
III. MINUTES
A. March 28, 1990. Gretchen Saupe moved, Lorne White seconded to approve
minutes. ALL IN FAVOR. MOTION PASSED.
B. Finance Meetings, 2/28/90, 3/28/90: Gretchen motioned to approved,
Jeannie Volker seconded. ALL IN FAVOR. MOTION PASSED. Ben Ardinger
commented on $17,000 insurance expense referred to in 3/28/90 minutes (to
be discussed under Board Comments).
IV. REPORT ON C.A.T. SCAN
(Item VIII C. moved up.) Mr. Salness gave an update: Mr. Camardella went
to Assembly looking for permission to proceed with planning of C.A.T. scan
location, requesting monies. The Assembly took the position the KIH Board
needed to approve his request first. The request was to develop plans to
house C.A.T. scan in present storeroom plus an addition to replace present
storeroom, needed storage to remove clutter from halls, and office space.
Mr. Salness stated KIH must remove items stored in hall. He has
received a verbal warning from local fire marshall deputy, which was
confirmed by fire marshall in Anchorage, if items are still in hall at
inspection, KIH would be turned Into Medicare/Medicaid to revoke our
certification. This is in violation of federal life safety and fire code.
A violation that has been cited for 5 years -- the federal government will
not tolerate any longer. Losing the Medicaid coverage will virtually shut
down the Care Center. When in violation of federal regulation, there are
90 days to comply. Mr. Lockwood also informed the Board revocation of
certification is a very real possibility and citations should be dealt with
in order to prevent this.
Mr. Salness also reported it has now been discovered the present
storeroom cannot house C.A.T. scan due to shaking from washer when it's
extracting in adjacent laundry room. This could throw off calibration of
C.A.T. scan. He called Borough and put plans "on hold."
Members expressed concern over not providing the C.A.T. scan service
promptly. Lorne White stated the Assembly is 100% behind the service.
That the Assembly needed Board approval of these plans and there was
concern over cost of storage building. Mr. Camardella contends the
building must be attached to the hospital due to weather. Board does not
agree with this and cited examples in Anchorage of an outside, unattached,
trailer at Providence for a medical service. Board expressed discontent
at Borough "blocking" the availability of C.A.T. service due to housing.
MOTION: DR. HLAVINKA MOVED, GRETCHEN SAUPE SECONDED, WE, THE ADVISORY
BOARD REITERATE ITS DECISION TO HAVE THE C.A.T. SCAN LOCATION IN A MOBILE
OR NON -PERMANENT STRUCTURE NOT ATTACHED TO THE HOSPITAL BUILDING ASAP. ALL
IN FAVOR. MOTION PASSED.
. Advisory Board, April 11, 1990 c
01
V. PRESENTATIONS
A. Radiology, Randy Packard. Radiology department is more a medical
imaging service providing xray, floroscopy, mammography, and ultrasound.
We just recently received one of the best ultrasound machines on the
market. Discussion - would there be a mammography month? This is a
possibility during cancer month. Changes in hospital drawings for
radiology discussed. The present ultrasound tech will be trained in
mammography to keep service available when tech aide is absent.
B. Sharron Reno, Emergency Room. ER has been departmentalized with 4
designated nurses, a positive change. Also have designated ER physicians.
Sharron shared the results of ER patient surveys sent out in January &
February; majority of comments were positive. Discussion on use of ER vs.
clinics. Sharron expressed concern we offer new services but are not
covering expenses -- our ER charges are very low. She cited research
conducted on this. Our ER rates were discussed. Mr. Salness stated we are
barely covering costs.
MOTION: BEN ARDINGER MOTIONED, GRETCHEN SAUPE SECONDED TO ACCEPT PROPOSED
NEW EMERGENCY RATES FOR KIH. ROLL CALL VOTE.
Yes: Gretchen Saupe, Jeannie Volker, Dr. Hlavinka, Ben Ardinger, Betty
Springhill.
No: None. ALL IN FAVOR. MOTION PASSED.
Sharron is leaving KIH for a position with the state.
VII. GUEST. Mike Lockwood.
Mr. Lockwood stated he enjoyed his day here, and Mr. Salness has exceeded
his expectations for learning the KIH issues. He stated the productivity
hours/adjusted patient day has gone down 3.2 hours for KIH, meaning a large
annual savings. Brief discussion on LHS facility sizes; fiance directors -
are employees of LHS at all facility except KIH. Asked Board to
participate in Mr. Salness' 6 month evaluation.
VIII. OLD BUSINESS
A. New Hospital Update. Met with many senators in Juneau. 4/1-2. Funding
looks more secure than ever. Mayors conference held in Juneau that same
time and called upon the Governor to assist the three communities get
hospitals. He may entertain direct appropriation, as he is not in favor
of general obligation bonds. Between the governor, new revenue forecast,
and oil spill funds, funding could be close to 1006. It will not be known
until the end of the session.
In talking to Mayor Selby and Mr. Camardella the ordinal hospital
plans should be built w/some minor revisions. Such as xray being
redesigned for the C.A.T. scan. Funds requested -14.465 million.
B. Fire Marshall Visit. Citations for violations of stored items has been
historical at KIH. We have to have a plan of action before the inspectors
come (this summer?). A copy of fire marshal report will be sent to Cliff
and Fred.
C. C.A.T. Scan - was discussed earlier.
D. Washer. Our machines can be programmed to wash fragiles. Trainer from
Anchorage coining to inservice laundry staff.
E. Funds to KIB. Ordinance is legal document for transfer which occurred
Thursday, April 5th, - $1,516,870. KIH kept a reserve for self insurance
and C.A.T. scan.
Advisory Board, April 11, 1990 3
X. ADMINISTRATOR REPORT
A. ER Physician. Dr. Teresa Charniga here now for 6 weeks, next is Dr.
Gahler. She cannot cover two 48 hour shifts, so a secnnd Er physician will
be obtained. 3 of our med staff cover ER alternate to locum tenens. Mr.
Salness has coverage until mid-July, then will look to med staff for
direction re/recruitment.
B. Betty Barnes. Mr. Salness gave Board information regarding this issue
so members would have accurate information.
C. Letter from K. Reppond. Discussed letter stating anti -abortion
organization supports hospital philosophy not to do abortions on demand.
Legality of issue discussed. Abortions can be done locally.
D. LHS Annual Meeting in June. John asked for 2 members to go. Gretchen
and Ben may be able to go.
E. DON Office will be relocated in room 15 next week due to very
inadequate office space at nurses station.
F. Management by Objectives. Mr. Salness is working w.iLh all managers on
"MBO's" and will bring finished objectives for the year to the Board.
G. Apartment on Carolyn Street has been leased by KIH for recruited
nurses, etc. this summer.
XI. STAFF REPORTS
A. Kate Fitzgerald, DON. This is on agenda for a regular report to Board.
Staffing: Recruitment always a problem. Sad to see Sharron Reno go -very
hard to replace. Can find RN's, but not experienced managers. January was
very busy, February not as busy, March is becoming busy -admitted 17
patients yesterday! Care Center has 1 empty bed. Approved of management
by objectives - proactive approach vs. crisis management:.
B. Keith Vorachek. March was a good month. Project positive bottom line
for *V tX CA
Mr. Salness gave an update on Eunice Neseth, stating our collections
attorney in Seattle said a court order is out to get this going and
ombudsman in Anchorage will be held in contempt if it's not acted on.
We will received quarterly report on reserve funds.
Ben asked Keith for a report of how much money the KIB directly - not
pass through monies from federal or state sources - has appropriated to
KIH: Since 1986, $13,000 for the carpeting in 1989. All monies for the
new hospital have been state grants.
Mr. Lockwood stated Ross Kenny, director of finance -Kenai hospital,
will be contacting Brice Weeks to inform him of additional available state
monies we are not using.
XII. BOARD COMMENTS
Betty: Commented on concerns of recent visiting surgeon. Recruitment is
still proceeding.
Gretchen: Recommended a mammography month. Asked to have a cholesterol
screening clinic like the health fair. Mr. Salness said this is being
pursued for the Crab Festival Booth. Asked for flower boxes outside the
main entrance - John will follow up. Greenhouse being used - starting
next week. Historical Society - Encouraged to go to auxiliary.
Ben: Re/$17,000. Felt we shouldn't be paying this in total, it should be
shared in thirds by the KIB, LHS, and KIH. It was r.lari..f-ied by Mr. Salness
we are paying half; Ben felt we should pay 1/3. Also did not agree with
Advisory Board, April 11, 1990
4
a
bill being brought forth after the fact. Mr. Lockwood will bring
concerns to Tom.
Issue was referred to Finance Committee.
Ben was also
in
favor of a bonus
system in spite of 3/7.8 Finance Minutes
- discussion
on
non-financial
rewards ("Atta-boy Program"). Whatever is
decided must
be
looked at by
labor attorney and administration very
closely, Mr.
Lockwood
stated,
and could be done in 30 days. Ben also asked
Mr. Salness
to
bring leasing
of apartment to Board before leasing.
XIII. EXECUTIVE SESSION. No session held.
XIV. AUDIENCE COMMENTS. None.
XV. ADJOURNMENT. 10:00 pin. Recorded by Beth Stohl-Reiland.
A""';'e-=1
Bet SPI
p in - ill Chairperson r e White, Secretary