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1991-01-09 Regular Meetingra3-oma-tea C' KODIAK ISLAND HOSPITAL ADVISORY BOARD MEETING JANUARY 9, 1991 PRESENT: Ben Ardinger, Gil Bane, Gordon Gould, Gretchen Saupe, Betty Springhill, Jeannie Volker, Kate Fitzgerald, Director of Nursing, Keith Vorachek, Accounting Manager, Norm Campeau, Interim Administrator. ABSENT: Jon Hlavinka The meeting was called to order at 7:00 P.M. WELCOME: Betty Springhill welcomed Gil Bane and Lonnie White to the Board. ELECTION OF OFFICERS: The Nominating Committee presented its slate of proposed officers. Gretchen Saupe moved that the following nominees be elected as officers of the Advisory Board: Betty Springhill, Chairperson; Lonnie White, Vice Chairperson; Jeannie Volker, Secretary/Treasurer. Wayne Stevens seconded the motion. Motion Carried. ACCEPTANCE OF AGENDA: The Agenda was amended as follows: Security Contract Update added to Old Business; Open Meeting Law added to New Business. Gordon. Gould moved and Wayne Stevens seconded the motion to accept the amended agenda. Motion Carried. Betty Springhill shared a communication from South Peninsula Hospital inviting members of the Advisory Board to attend a Trustee Orientation Session. Because no member from the Advisory Board would be available to attend, the Recording Secretary was instructed to contact the facility to determine if the meeting would be recorded, and if so, to secure a copy. Advisory Board Meeting January 9, 1991 Page Two MINUTES The minutes of the December 12, 1990 meeting were amended as follows: Noting that Lorne White was not a member at the time of the December 12, 1990 meeting, his name was deleted as being absent from the meeting. The first sentence of the second paragraph of page 2 of the December 12, 1990 meeting was amended to read: "Ms. Saupe reviewed the minutes of the last -Quality Review Committee meeting, noting that the Committee was concerned with the increasing number of home births, which are presented at the Hospital as emergencies." Gretchen saupe moved and Gil Bane seconded the motion that the meeting minutes of December 12, 1990 be adopted and ap- proved as amended. Motion Carried. OLD BUSINESS A. Administrator Recruitment Norm Campeau stated that in discussions with Joe Smith, LHS Management Company, Mr. Smith had indicated the management company anticipates presenting up to three candidates to the Board within sixty days. Mr. Campeau was asked if local candidates would be considered by the management company and he indicated that they would if they would forward their resumes to Joe Smith at the management company. B. Central Treasury Keith Vorachek stated that the Hospital is with the Borough and this week would be the ing in the Central Treasury. Mr. Vorachek other Hospital funds in accounts outside of indicated that there were not. C. Board Retreat Update now depositing its revenue first week of participat- was asked if there were any the Borough. Mr. Vorachek The Board Retreat, scheduled for January 19th at the Buskin River Inn will utilize Nancy McMurtry as facilitator. Invitations have been sent to the Borough Assembly and the Medical Staff. D. Data Processing Update Mr. Vorachek stated that Stacy Heiden of LHS would be here from Janu- ary 15 through the 17th to begin a needs assessment. He indicated that the process of implementation may take up to a year, during which time he and Ms. Heiden will be working to establish the best program for the Hospital. Advisory Board Meeting January 9, 1991 Page Three NEW BUSINESS A. Emergency Room Staff Coverage Mr. Campeau stated that he is working to complete the contractual arrangement with Dr. Mickleson, indicating that dependent on a deter- mination relative to insurance coverage, that Dr. Mickleson may either be a contract or an employed physician. Coverage, costs and revenue associated with the Emergency Room was discussed. Wayne Stevens moved that Mr. Campeau prepare a report for the Advisory Board which pro- vides a comparison of the Emergency Room costs and revenue, with sug- gestions as to how to decrease costs and/or increase revenue. Lonnie White seconded the motion. Motion carried. B. Signature Authorization Cards Mr. Campeau asked if the board wished that he be added as a signatory for the hospital. It was the consensus of the Board that Mr. Campeau not be added as a signatory of the Hospital. C. Open Meeting Law Gordon Gould explained the Open Meeting Law. In order to prevent any misunderstanding in the future, the Recording Secretary was instructed that whenever an unscheduled work session is called, and time is not sufficient to have the meeting published in the newspaper that KMXT be called and a PSA be placed on the air. ADMEWSTRATOR'S REPORT Mr. Campeau gave a brief autobiography and stated that he expects to be here as Interim Administrator for the term of the transition. He reported that Dr. Alvarez will be off the island from January 11 through January 21st and that a locums surgeon had been contracted with for most of that period. Dr. Alvarez is attending training in laproscopic gall bladder surgery. Mr. Campeau indicated that the Board should be aware that Dr. Alvarez would probably be asking the Hospital to provide the necessary surgical equipment to perform this procedure. Mr. Campeau indicated that with regard to the Transition Project Report, he will be providing written status reports to the Board. Advisory Board Meeting January 9, 1991 Page Four Mr. Campeau asked the Board if it wished to renew the Hospital's AHA membership which costs $3,500 annually. It was the consensus of the board that the benefits of such membership did not warrant renewal. He reported that Dr. Mickleson and Keith Vorachek would be reviewing and revamping the Emergency Room billing structure. The Certificate of Need has been determined to be complete. There will be a public hearing at 3:00 p.m. or. January 29th which will be attended by Mike Callahan of LHS Management Company. Noting that new Board members received little orientation, Mr. Campeau sug- gested that he would be happy to meet with each Board member individually and that Board members should arrange to meet with each department in order to understand the history and operation of the facility. He indicated that Board Education should be added as a regular agenda item. He suggested that an orientation packet be provided to each new member which would include the By -Laws of the Board, By -Laws of the Medical Staff, the manage- ment contract and other pertinent data. Mr. Campeau stated that the employees of the facility had selected Juanita Jones as Employee of the Year. The Recording Secretary was instructed to have flowers sent to Ms. Jones with the Board's congratulations on her selection. Mr. Campeau informed the Board that at the Medical Staff meeting held this date, the Medical Staff unanimously decided that they do not support the recruitment of a surgeon. He stated that he had a meeting scheduled with Dr. Hlavinka on January 10th at which time he would present some further documentation and try to determine the cause of the reversal of the Medical Staff's standpoint. Noting that a surgical candidate was scheduled for interview on January 15th, Mr. Campeau asked the Beard's direction. He was directed to contact Jackson & Coker, the recruiting firm, and inform them that the date scheduled for interview was not convenient and that they would be notified when a decision has been reached. AUDIENCE COAMENTS None. Advisory Board Meeting January 9, 1991 Page Five Lonnie White asked about December's financial status. Mr. Vorachek indi- cated that revenue for the month was not quite as bad as that of November. Mr. White asked Mr. Gould his opinion of Governor Hickeys visit to Kodiak. Mr. Gould indicated that Governor Hickel seems to be pro -hospital construc- tion. 'Mr. White asked about the status of the Jones Bill. Mr. Campeau indicated that he had participated in a conference call this past week. Indications are that the bill will be prefiled within the next week. It was suggested that if the bill is introduced, that the Board request that the Assembly formally support the legislation. Mr. Ardinger asked if direction could be provided to Dr. Bob Johnson as to his newspaper articles. Referred to PR Committee. Dr. Bane asked if provisions had been made to update lab facilities in the new hospital plans. Mr. Vorachek indicated that upgrading of the lab facilities had been done in 1990. Mr. Stevens stated that with the oil revenues being up, the groundwork done by the Board and hospital, and Governor Hickel's favorable attitude, he felt positive about the probability of receiving funding. He stated that he strongly felt that a comprehensive Public Relations Plan should be prepared and followed. Gordon Gould stated that as part of negotiations in the next management contract, he would like to see a penalty clause which would be invoked in cases of unapproved and/or unbudgeted expenditures by Administration. Ms. Springhill asked about the status of the Solarium. Mr. Gould indicated that the design and budget had been presented to the Assembly. He indicat- ed that he would ask that it be scheduled for discussion at a work session of the Assembly. Ms. Springhill appointed the following committees: Joint Conference: Administrator, Betty Springhill, Chief of Staff; Finance Committee: Gordon Gould, Lorne White, Ben Ardinger, Chair; Ouality Review Committee: Gretchen Saupe, Gil Bane, Jeannie Volker; PR/Education Committee: Wayne Stevens, Betty Springhill, Dr. Hlavinka. Mr. White asked that in light of the possible upcoming events in the Middle East if the hospital was conducting any blood drives. Administration will follow up on this. Advisory Board Meeting January 9, 1991 Page Six Mr. Ardinger stated that he would not be able to attend the Board Retreat. It was suggested that he provide his ideas, questions, etc. in writing prior to the event. EXECUTIVE SESSION Not called. .ADJOURNMENT Meeting adjourned at 9:30 p.m. Recorded by Debra Raper. Jean Volker, Secretary/Treasurer d� Medical Staff Meeting, January 9, 1991 RE: Medical Staff issues 03 -09 -cQ- Today we discussed the need for specialty clinics in Kodiak, surgeon recruitment and coverage, and the need for a new hospital. Present today were Drs. Alvarez, Withrow, Johnson, Creelman, MicKelson, Juergens and Hlavinka. The meeting was from 8:00 to 9:00 a.m. The medical staff has surveyed the medical specialties that hold clinics in Kodiak. Some of these responses are still outstanding. The ones that have been returned were reviewed. Briefly, we have summarized that the following specialties are represented in Kodiak: 1. Surgery, orthopedics - Dr. Brockman is due to return in Kodiak from May through October. This still, though, is uncertain due to his commitment in the reserves to go to the Persian Gulf. Dr. Withrow is going to be pursuing the Anchorage Fracture and Orthopedic Clinic and seeing on what scheduled basis we can have clinics. Long range, the staff was in favor of recruiting an orthopedist for Kodiak. 2. ENT - Dr. Tschopp is coming monthly. The staff is comfortable with this and questione-4 the possibility of him doing some of the surgery here, however Dr. Tschopp prefers this to be done in Anchorage. 3. OB/GYN - Dr. ErKmann is committed to being here twice this year. We will see if he is willing to come more frequently otherwise the staff would like to see if we could have an Anchorage specialist present for possibly monthly clinics. Dr. Whitefield will be contacted regarding this since he has shown some interest. 4. Podiatry - Dr. Bosenburg holds podiatry clinics every six weeks. He also does some surgery locally. S. Opthalmology - Dr. Crouch and Arnold come monthly, alternating. This appeared to be appropriate. 6. Pediatrics - Dr. Brewer is here locally. Dr. Lyon comes about every third month. Dr. Brauner, a pediatric cardiologist comes twice yearly and this appears to be appropriate. 7. Cardiology - Dr. Sonnaborn comes sporadically and Dr. Bustad comes sporadically. Dr. Juergens is our local internist. No interest was expressed in increasing the frequency of these clinics at this point. 8. Psychiatry - Dr. McGuire and McCarthy hold clinics at Mental Health and alternate on a monthly basis. The medical staff felt that this along with the consulting services through the Mental Health Center is adequate for our needs. Medical Staff Meeting, January 9, 1991 RE: Medical Staff issues 03 -09 -cQ- Today we discussed the need for specialty clinics in Kodiak, surgeon recruitment and coverage, and the need for a new hospital. Present today were Drs. Alvarez, Withrow, Johnson, Creelman, MicKelson, Juergens and Hlavinka. The meeting was from 8:00 to 9:00 a.m. The medical staff has surveyed the medical specialties that hold clinics in Kodiak. Some of these responses are still outstanding. The ones that have been returned were reviewed. Briefly, we have summarized that the following specialties are represented in Kodiak: 1. Surgery, orthopedics - Dr. Brockman is due to return in Kodiak from May through October. This still, though, is uncertain due to his commitment in the reserves to go to the Persian Gulf. Dr. Withrow is going to be pursuing the Anchorage Fracture and Orthopedic Clinic and seeing on what scheduled basis we can have clinics. Long range, the staff was in favor of recruiting an orthopedist for Kodiak. 2. ENT - Dr. Tschopp is coming monthly. The staff is comfortable with this and questione-4 the possibility of him doing some of the surgery here, however Dr. Tschopp prefers this to be done in Anchorage. 3. OB/GYN - Dr. ErKmann is committed to being here twice this year. We will see if he is willing to come more frequently otherwise the staff would like to see if we could have an Anchorage specialist present for possibly monthly clinics. Dr. Whitefield will be contacted regarding this since he has shown some interest. 4. Podiatry - Dr. Bosenburg holds podiatry clinics every six weeks. He also does some surgery locally. S. Opthalmology - Dr. Crouch and Arnold come monthly, alternating. This appeared to be appropriate. 6. Pediatrics - Dr. Brewer is here locally. Dr. Lyon comes about every third month. Dr. Brauner, a pediatric cardiologist comes twice yearly and this appears to be appropriate. 7. Cardiology - Dr. Sonnaborn comes sporadically and Dr. Bustad comes sporadically. Dr. Juergens is our local internist. No interest was expressed in increasing the frequency of these clinics at this point. 8. Psychiatry - Dr. McGuire and McCarthy hold clinics at Mental Health and alternate on a monthly basis. The medical staff felt that this along with the consulting services through the Mental Health Center is adequate for our needs. MEDICAL STAFF NOTES 9. Anesthesia and chronic pain - Dr. Chandler, anesthesiologist from Anchorage, has committed to holding pain clinics in Kodiak monthly. He holds these clinics at the hospital and does give his injections there. IN SUMMARY: We will see about increasing the frequency of orthopedic and GYN clinics in Kodiak. The medical staff was in favor of working towards the recruitment of an orthopedist. This will be formalized at our medical staff meeting. Also, Dr. Alvarez was in support of assisting and following up any surgery that would be done locally (pending prior surgeon approval). Hence, this would be a push for more outpatient or local surgery by specialists coming in to Kodiak. Also, the need for colposcopy which is being addressed would accent the specialists visits. A move for neutralizing and centralizing these specialty clinics was proposed by Dr. Johnson. Perhaps long-term the hospital would have an area designated for outpatient clinics such as these specialists would hold. For now these are being held in local clinics. In the meantime we propose having a central bulletin board which I will address to administration for posting of the specialty clinic visits and to Keep this updated. JH: re Jon HlavinKa, M.D. VU PHYSICIAN MEDICAL STAFF KODIAK ISLAND HOSPITAL & CARE CENTER 1990 SPECIALTY PRIVILEGES LOCATION Rene Alvarez, MD Gen Surg Active Kodiak Bradley Bringgold, MD Fam Prac Active Kodiak William Brewer, MD Fam Prac/Ped Active Kodiak Kevin Creelman, MD Fam Prac Active Kodiak. John Gietzen, DO Fam Prac Active Kodiak Robert Glenney, MD Fam Prac Active Kodiak Loren Halter, DO Fam Prac Active Kodiak Jon Hlavinka, MD Fam Prac Active Kodiak R. Holmes Johnson, MD Fam Prac Active Kodiaki� Carol Juergens, MD Int Med Active Kodiak - William Murdock, DDS Dentist Courtesy Kodiak Logan Porter Crane, MD Int Med Active Kodiak Hans Tschersich, MD Radiology Courtesy Kodiak Timothy Ungs, M.D. Fam Prac Courtesy Kodiak -USCG Mark Withrow, MD Fam Prac Active. Kodiak=` Robert Arnold, MD Ophthal Courtesy Anchorage Karl Boesenberg, DPM Podiatry Courtesy Anchorage Ron Brockman, DO Ortho Courtesy Seattle Leon Chandler, MD Anesth Courtesy Anchorage Edward Crouch, MD Ophthal Courtesy Anchorage John Erkman, MD OB/Gyn Courtesy Anchorage James Faries, MD Radiology Courtesy Anchorage Richard Hill, MD Radiology Courtesy Anchorage Michael James, MD Rehab Med Courtesy Anchorage George Ladyman, MD Radiology Courtesy Anchorage Greg McCarthy, MD Psychiatry Courtesy Anchorage Michael Probst, MD Pathology Courtesy Anchorage Paul Sayer, MD Gen Surg Courtesy Homer David Sonneborn, MD Cardiology Courtesy Anchorage ilk r i 2- MICACorpo„ttIt)itoi*A11Ia. Corporntlun of:llnsku ALELTPLAZA 4000 OLD SE WARD HR'Y., SUITE 203 A.\ CHORAGE, ALASKA 99503 (907)563-3414 December 28, 1990 Rene' Alvarez, M.D. 1811 Mill Valley Road Kodiak, AK 99615 Reference: Non -Renewal of MICA Policy: Rene' Alvarez, M.D. Dear Dr. Alvarez: This will serve to acknowledge receipt of your letter of December 19, 1990 in which you made an appeal for reconsideration of MICA's decision to non -renew your 1990 policy. As I advised you in my letter of December 3, 1990, if the sale of MICA's assets and liabilities to NORCAL is finalized, your appeal will be heard by an advisory panel composed of physicians appointed by NORCAL. If the sal- of MICA to NORCAL is not finalized, the MICA Board of Governors Appeals Committee will hear your appeal as soon as a date can be scheduled. You will be advised shortly after the first of the year which mechanism will be utilized to hear your appeal which obviously will depend on whether or not the sale to NORCAL is finalized. Finally, I feel it necessary to inform you that NORCAL had nothing whatsoever to do with the decision to non -renew your policy and that the authority as well as the responsibility for that action rested solely upon MICA's Underwriting Committee members. Again, you will be advised in the near future as to the date and forum that will be utilized to hear your appeal and you may be assured that your current policy will be extended (either by MICA or NORCAL) until such time as your appea can ear . Very Underwriting ManAger AS/hmc