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1991-04-24 Regular MeetingI v 5 u2f -cr2- KODIAK ISLAND HOSPITAL ADVISORY BOARD MEE77NG APRIL 24, 1991 PRESENT: Gil Bane, William Brewer, Gordon Gould, Gretchen Saupe, Wayne Stevens, Lorne White, Ed Myers, Administrator, Keith Vorachek, Finance Manager. ABSENT: Ben Ardinger, Betty Springhill, Jeannie Volker The meeting was called to order at 7:00 P.M. ACCEPTANCE OF AGENDA: Moved and seconded to accept the agenda. Motion carried. APPEARANCES AND COMMUNICATIONS Darnell Anderson and Tamara Jones, students from the high school were pres- ent. MEETING MINUTES Moved and seconded to amend the meeting minutes of April 15, 1991 to reflect that the Advisory Board did not recess to Executive Session. Motion carried. Moved and seconded to approve the meeting minutes of April 15, 1991 as amend- ed. Motion Carried. CONIMITTEE REPORTS Wayne Stevens reported that the Public Relations Committee had met briefly this date. The Committee will be contacting Pat Branson to request a propos- al for developing a publication relations and marketing program. OLD BUSINESS A. Hospital vehicle Ed Myers reported that proposals had been received from three dealer- ships and outlined prices, options and extended warranties. He recom- mended that at this time, the hospital not purchase a new vehicle, but more fully utilize the hospital van. Several options were discussed including using a vehicle from the Borough Pool and purchasing a vehicle from the GSA auction. Moved and seconded to concur with the Administra- tor's recommendation that the proposals for a new vehicle be rejected and that the hospital van be utilized when possible. Motion carried. Advisory Board Meeting April 24, 1991 Page Two B. New Facility Funding Mr. Myers reviewed the status of possible funding of the new facility. Several bills which would amend the funding formulas have been intro- duced and Mr. Myers reviewed those with the Board. Mr. Myers stated that he has been in contact with Representative Davidson's office and the Alaska State Hospital and Nursing Home Association. Both feel it important to make the Governor's office aware of the need to support the funding of new health facilities. Mr. Myers reported that Jerome Selby, KIB Mayor, was in Juneau. He recommended that after his return, that feedback be obtained as to whether further action, i.e., letters to the Governor were necessary. NEW BUSINESS A. Facility Drug & Alcohol Policy Mr. Myers outlined the facility's policy regarding drugs and alcohol. It is KIH's policy to encourage employees to seek help. Counseling done by employee's superior must be performance based. The facility does have a discipline policy in place which is progressive including oral and written warnings, up to termination. Exceptions include probation ary period and when the violation is serious as outlined in th, personnel manual, i.e., drinking on the job. various resources are available to the employee, including EAP programs available through Anchorage and the local mental health center. Several problems exist with the EAP program out of Anchorage, including nonusage by employees and program coverage of only 60% of employees, the percentage who carry the Aetna health insurance. It was requested that the Administrator research the company providing service to the facility and determine if those services could be provided locally. The question as to cost of the program was asked. Mr. Myers noted that there had been no change to the premium costs when the program was added by Aetna. Dr. Brewer asked what procedures were in place regarding professional staff impairment. There are procedures in place in the Medical Staff Bylaws which address this issue. Kate Fitzgerald noted that if a nurse became aware of an physician impairment problem, that the nurse would notify her and she would notify the Chief of Medical Staff. Written report as attached. Mr. Myers reported that he had a meeting scheduled with the U.S.C.G. base commander to discuss the use of the helipad. Advisory Board Meeting April 24, 1991 Page Three Mr. Myers reported that Medicare had disapproved the request that Kodiak Island Hospital & Care Center change its budget year to coincide with that of the Borough. The Finance Director will be determining what implications the decision has on the budget planning process already undertaken. Mr. Myers noted that the Medical Staff is awaiting a proposal from LHS re- garding possible solutions to the malpractice issue. AUDIENCE COMMENTS Kate Fitzgerald reported that Pat Thorne had accepted the position of Direc- tor of Nursing in the ICF and that she was being accepted well by the staff. Ms. Thorne is in the process of correcting some problems and implementing the OBRA regulations. BOARD COMMENTS Gretchen Saupe stated that she had enjoyed the ride in the new ICF bus. She requested that the Administrator investigate the whereabouts and usage of the Pentonometer which had been purchased by the Auxiliary for the hospital. Dr. Brewer stated that he would contact other facilities and determine their policies regarding impaired physicians. Gordon Gould stated that he would be interested in hearing back on the heli - pad and EAP situations. He asked that a financial statement for the first quarter be provided. Wayne Stevens stated that there may be a possibility of facility participa- tion with Dutch Harbor and Unalaska if their new clinic is funded. The population of these areas is growing, but the medical needs of the communi- ties are not being met. There is a population base of 3,000, with an in- crease of up to 9,000 to 10,000 during fishing season. There are approxi- mately 10,000 trauma cases received in the existing clinic. Mr. Stevens and Mr. Myers met with the clinic president and vice president of the board, who indicated an interest in establishing a dialogue with LHS for management of the facility. KIH may be able to offer a support relationship and provide more services, Emergency Room education, and inservices. He noted that if a relationship with the hospital is established, the medical staff might also be able to establish outreach clinics. Lorne White asked the Administrator that if a need was identified for support for the funding bills that the Board be advised. Mr. White asked Mr. Gould if the Assembly was receiving the minutes of the Advisory Board meetings. Mr. Gould stated that the Assembly was receiving the minutes. Meeting adjourned at 8:25 p.m. Recorded by Debra Raper. Jeannie Volker, Secretary/Treasurer ,.'4 1 111VI E R. OPTIONS: These options, presented at the last meeting, were presented to the Medical Staff encouraging their review, comments and other alternative ideas. Issues surrounding the change of E.R. procedures as the result of employed E.R. physicians was discussed. It was decided that the E.R. policies and procedures would be evaluated along with the options available. MEDICAL STAFF MALPRACTICE: The malpractice issue was discussed at the Medical Staff meeting and I requested that the medical staff hold off on any decision regarding recommendations to change the bylaws until such time as the LHS proposal to hire someone to study the issue was received. CASH FLOW PROBLEMS: I received a letter from Karl Short, the Borough Finance Director, pointing out that the hospital has a negative cash flow balance. I have been asked by Mr. Short to present a written plan to reverse this negative cash flow situation. While I will do this, I would point out to the Board that it is my opinion that we need to begin the development of a comprehensive plan to look at this not only in the short term, but over the long term as well. This matter is of significant concern. FACILITY REORGANIZATION: I have reviewed the reorganization plan which has been in process for nearly a year and I believe we have reached a rational organizational plan and it is my intention to begin implementation in the near future. BOROUGH ENGINEER: I met with the Borough Engineer, not only to discuss the status of the construction of the new hospital, but also discuss maintenance in general. I believe I received a very good orientation in this area. CARE CENTER BUS: The new bus, donated by Fern Fuller, has arrived and it is an impressive vehicle. If you have not had an opportunity to see it, I would welcome you to come down to the hospital. The hospital will begin looking at ways the maintenance may be funded from community donations and we will be working on a public relations program toward that end. (RECEIVEL YAY D 8 91 KODIAK ISLAND BOROI: - CLERK'S OFFICE