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2001-09-24 Regular Meeting717 E. Rezanof Drive Kodiak, Alaska 99615 PROVIDENCE KODIAK ISLAND MENTAL HEALTH CENTER ADVISORY BOARD MEETING MINUTES OF REGULAR MEETING OF SEPTEMBER 24, 2001 Meeting Called to Order Tel 907 486 9100 The meeting was called to order by Chairperson Jody Burcham at 5:30 PM in the Providence Mental Health Center Group Room. II Roll Call Members Present Members Absent Jody Burcham Cecil Ranney Pam Foreman Lord Doyle Remegio Marasigan Thia Falcone Steve Honnold Dave Davis Darlene Turner Karen Perkins — KAM" I Rep., ex-officio Staff Present: Guests Present Dr. Welby Jensen Mike Machulsky Chuck Morris Pat Carlson, Borough Manager Jesse Vizcochio Matthew Stutes Karen Bennett Tambi Fields Micky Mummert Crawford Chuck Thompson Frank Peterson Linda Jackson Pam Jackson Don Roberts 4 Minutes of September 24, 2001 Advisory Board Meeting III Acceptance of Agenda Pam requested we add Pat Carlson under "Other Presentations", and made a motion to that effect; Thia seconded said motion, and the motion passed. Darlene moved that the Needs Assessment Committee be added under Old Business; Steve seconded the motion; and the motion passed. Linda Jackson asked if the quality assurance report was going to be addressed. Jody said it was her understanding that it had been signed and e-mailed out to everyone. Jody then asked if everyone had had a chance to look over the minutes of the last meeting. Darlene said she had one change on the July 16, 2001 minutes, that on page 5, second to the last paragraph, it should read Kodiak Youth Services Center, and not Kodiak Village Safety Services. With that change, Pam moved to accept the July 16, 2001 special meeting minutes; Darlene seconded that motion and the motion passed. Pam moved to approve the minutes of the July 23, 2001 meeting; Darlene seconded said motion, and the motion passed. Moving to orange tab #4 of the Board packet, Pam wished to clarify that these are just notes compared to minutes of the "meeting" of September 10, 2001. Pam compared it to a work session as opposed to a meeting. Jody asked if it was too late to move the Public Comments to occur after the Approval of Minutes. Darlene stated that if the Chair would accept the motion, she would move to recommend that Public Comments be moved from number VI to number V in the future, to occur after the Approval of the Minutes. Dave seconded the motion. Discussion followed with Thia reminding the Board that there is still a time limit for public comments of three minutes {per person}, as that is the guideline, and some of the Board members have to leave by 7:00 PM. Motion passed. Steve asked if we were finished reviewing the Notes of the September 10 meeting, and asked for clarification that these were simply for informational purposes. VI Public Comments. Introductions were performed. Don Roberts read a prepared letter, which is now attached as a part of these minutes. He mentioned two concerns: the cancellation of meetings, and Dr. Jensen's refusal to work with Dr. Wiszinckas. He also mentioned that under Robert's Rules of Order the Chair is the person to ascertain whether or not there is a quorum. Minutes of September 24, 2001 Advisory Board Meeting Pg. 2 Linda Jackson submitted a letter also, which is attached to these minutes. She also requested that all pertinent information that is passed out to the Board be made available to the public also. She then read her prepared letter. She asked if indeed her previous letter was attached to the July 23 2001 minutes, and it was confirmed that it was attached to those minutes. Linda also requested the Board answer her question: "Are you........ aware of any reason a consumer should not see Dr. Wiszinckas for psychological services?" Jody thanked Linda for her comments, and asked if there were any more public comments. Frank Peterson stood, and asked what this organization's operating budget is, what the number of personnel is, and if there is any pending litigation. He also asked if that information was readily available and/or if someone could get that information to him. The Board agreed to do that. At that time the public comments portion of the meeting was closed. An organizational chart of personnel was given to Mr. Peterson, along with a copy of the budget. He was also told that according to the Board there was no pending litigation that anyone was aware of. Darlene stated that as far as she knew there was no information on Dr. Wiszinckas, and Jody indicated she had called the State licensing board and there was nothing pending against Dr. Wiszinckas. Pam informed Linda that as far as her letter that was submitted at the July 23, 2001 meeting, there was no discussion of that letter because Linda was not present to discuss same. Dave thought the Board should address Linda's question at the bottom of her letter of September 24, 2001, "Will the Mental Health Center find a way to meet the needs of persons who need the services of a psychiatrist?" His own answer to that was that he had submitted a letter of retraction to his letter of resignation (which is made a part of these minutes and is attached hereto). Pam stated that the Board does support Dr. Jensen's right to choose. She added there could possibly be some other sources to look at, however. Linda said that is all she was asking for at this time. This decision leaves people like herself without psychiatric services, and she is concerned with what could be done to take care of her needs. Jody agreed this is definitely a client -care issue, and is something that needs to be strategized and that the group should search for some options. Dave emphasized that he will stay on the Board to help figure this out. Darlene agreed, and said that perhaps the Needs Assessment Committee could address this. Minutes of September 24, 2001 Advisory Board Meeting Pg. 3 V. Staff / Other Presentations A. Introduction of New Staff. Chuck Morris introduced Jesse Vizcocho as a new Case Manager with the Community Support Program, and everyone welcomed Jesse aboard. Pat Carlson, Borough Manager was introduced. He distributed a copy of the lease agreement between Sisters of Providence and the Borough, and stated that if the Board or the Chair had any questions, he would be available to answer them. The Board duties are laid out on pg. 7 of the lease agreement, and show what the understanding of the two parties is. Issues regarding internal personnel matters of Providence are outside the realm of the Borough. The lease defines a partnership and therefore whatever problems there are need to be addressed to the Borough also, as this facility is a Borough leased entity. Dave asked about the word 'review", noting that the Board has been doing this, but wondering who is actually responsible for creating policies? Pat informed that the actual contract is with what he terms `Providence On High", but as he understands it, they have on staff professionals who set policies based on the advice of advisory Committees and boards. The feds and the state also of course administer these policies, so Providence, which includes both local and Anchorage, will create the policies. Pat went on to say Providence determines who the appropriate parties are to speak on behalf of Providence and their nonprofit corporations, which in the contract are part of Providence. However, without knowing the intimate structure of Providence himself, it could possibly be the local structure of Providence. Darlene asked whom the person in Providence is where the power rests for the approval of the Advisory Board appointments? Does an application go to Providence or to the Borough clerk and then to the Borough Assembly? Or does the Mayor appoint someone and then it goes to Providence for final approval? Pat said he thought the Borough clerk would administer the processing of the applicants and submit those to the Borough, which in turn would be submitted to Providence of Alaska, who would then incorporate the advice and knowledge of the local representatives. Pat said his contact is Susan Humphrey Barnett as far as his issues go. Jody clarified this by saying it looks to her that an applicant would be appointed by the Kodiak Island Borough and then submitted to Providence for approval, and then function as a liaison between the Borough, the Mental Health program and Providence. Would that make a conflict of interest? Minutes of September 24, 2001 Advisory Board Meeting Pg. 4 Pat said that's a possibility, but wanted to emphasize that this board is an Advisory Board, which is different from a board that is actually empowered. Pat said this is one of his projects, to get this clarified. Darlene asked about the organizational chart, which shows in the chain of command, the Advisory Board being in between the Providence Health System Alaska Region Board and Susan Humphrey Barnett. Pat explained that the organization contract says the Board will act in an Advisory capacity reflecting the local community's policies and the relationship to the community. He stated that he looks at it more of a circle than a chain of command; it's more like everyone is in this together and works together. Dave asked for clarification of whom is instructing whom; is the staff asking for advice from the Board, or is the Board instructing the staff on what they should do. Right now if he's handed a policy and asked for changes, he reviews same and submits what revisions he thinks are appropriate. Pat said the way he reads it, it should do both. The Board is supposed to help with the long-range planning, and is supposed to help with the needs assessment, and review and advise on policy changes. However, there is no direct authority in here to require anything. Both activities are compatible with the contract. Dave thought the lack of that clarity is causing a rift, or angst between the Board and the staff. But if there is a rift, the Borough should get involved and repair this rift. Pat stated again, that everything needs to be reviewed by the Board, the policies defined, the level of care, all of those. Clearly if there is a rift, the Borough needs to get involved and repair this rift. And if there is a need for more funds, for instance, maybe the Borough Assembly would be able to help out, with grants or other programs. Don thought there was a problem in that the Advisory Board is simply reviewing policies, who is actually making these policies? Pam made a suggestion, one being that no one had had a real opportunity to read through the packets submitted, and that it is not the Board's position to negotiate this contract, but that is the Borough's position to do so. The only thing the Board can do is to clarify their role within this contract, and that's what needs to be next along with determining the appropriate role of the Board. She thought also it would be helpful to review those roles and sort their way through that. Linda Jackson asked Pat if he could give her clarification on his response to the procedure for appointment to the Mental Health Advisory Board. Pat reiterated that he wasn't really clear, as he was not an attorney, but his interpretation was that the applications were submitted to the Borough clerk and are Minutes of September 24, 2001 Advisory Board Meeting Pg. 5 then appointed by KIB. The Borough appointment process goes to Providence for an up or down. Linda asked again, once the application was submitted, where do they go then? Pat said they go through the Borough's process, which is reviewed typically, and on most of these it's a mayoral appointment with Assembly approval. So if the Mayor has two or three applications, she will interview them and then select one of them and that one is subject to Assembly approval. Linda asked Pat how long he had been working at the Borough, and he responded eight or nine years. Linda stated in her opinion this process was not working. Pat thought this process had been in place at least the past four years. Karen P. stated that she's been on the Board as a non -voting member for about the past 15 years, and when she first came on she had to put in an application, was interviewed by the Assembly, and then was appointed. It had nothing to do with the Center whatsoever. Darlene thought that sometime in the last seven years this process had stopped. Linda said she had applied once in February and again in March perhaps through the Borough clerk, both times. She believed that the Mental Health Center made the selection the first time, but didn't know who did the second. But she was not interviewed by anyone in the Borough either time. She stated she even called Borough Assembly members and asked what had happened to her application. Pat said that process is being done for all Committees now. The application based on the contract would have been sent to Susan Humphrey Barnett as far as he knew. Jody asked we move on from this point, and would entertain further discussion at another meeting. Pat Carlson was thanked for his time. VII New Business A. Resignation(s) Acceptance Darlene moved to accept the resignation of Cecil Ranny; Pam amended that motion to accept with regret; Dave seconded the motion. Motion passed. It was asked the staff write a letter to Cecil thanking him for his service. Micky acquiesced. Thia moved that Dave's resignation not be accepted and Dave reminded the Board that he had rescinded his resignation for the time being. The Board wished to go on record that they were all glad Dave had not resigned. Minutes of September 24, 2001 Advisory Board Meeting Pg. 6 B. Discussion of Meeting / Quorum Policy Darlene recommended we move the meeting place to the Borough conference chambers to have more room, and suggested we change the time of the meeting to 7 or 7:30 PM. Dave asked if we did move to that location if we would have access to the Borough copier and other supplies needed, including conference calls. Pam agreed it should be moved due to so many guests attending, that we simply needed more room. Jody and Thia agreed. Steve made a motion to change the meeting place to the Borough conference room; Darlene seconded; motion passed. Darlene asked that staff contact the Borough staff and arrange for that meeting room on the last Monday of every month at 5:30 PM, and that it be put on the regular schedule for that meeting room. Steve asked for an explanation of what happened to the "meeting" of September 10. He said he was called and reminded of the meeting, and then was called back to be informed there was not going to be a meeting. Pam explained that there was indeed mass confusion surrounding that meeting time. She said it was her decision to show up for that meeting in case there were going to be any public who might show up. She said she was surprised that she was not the only person to show up, and offered to take the onus for all the confusion. She assured all present that there was no intent to not include anyone. It was a matter of being criticized by a member of the public for just the issue that that particular member of the public brought up tonight, which is that we have to have people show up at a scheduled meeting and have a roll call to determine if there is a quorum or not. Linda stated she agreed; Pam corrected herself, noting that it was two members of the public who were concerned about this. Jody said she could also take the blame, that when staff calls and informs her there will not be a quorum, she will agree there shouldn't be a meeting. In the future, we won't do that, realizing that could be creating a lot of problems. Karen P. stated she had always appreciated being called in the past if staff knows there will not be a quorum, since she lives out in Bells Flats and it saves her a long drive into town. She stated she gets quite upset when she does have to drive all the way in, sit around for fifteen minutes, and then drive home — it's a big waste of time for her. She added that she thought it was simple common courtesy to let Board members know beforehand if it's known there will be no quorum and therefore no meeting will occur. Pam agreed it is a great convenience for board members to know beforehand if there will not be a quorum for a scheduled meeting, but there is no way of letting the public know and they might show up for a scheduled meeting. We do in fact make announcements on the radio that the meeting has been cancelled for lack of a quorum. But Pam reiterated that we should get that clarified from the Borough, some sort of requirement that we have to meet to establish whether or not we have a quorum. Minutes of September 24, 2001 Advisory Board Meeting Pg. 7 Darlene thanked the members of the public who called her and were concerned about this issue. She stated that in her opinion, when a time for a meeting has been published, not holding the meeting is wrong. If there is one business day before a meeting is scheduled and that meeting has to be cancelled, that's fine, and you don't have to state why it is cancelled. You just do it. Those things are perfectly legal, but they need to be done by the person who is in charge. The staff can't, and should not. It is supposed to be stated clearly by Jody that it is cancelled, and the reschedule day announced. Jody agreed that was appropriate. Rommy added that he wished to apologize too, since he was the person who had to call late on that Monday when he was unexpectedly taken sick. Rommy asked out of the nine people on the Board, what exactly constitutes a quorum; it was agreed that five of the nine board members must be present. In the packet presented, blue tab #6, Policy # 100.11, item 6, reads: "In the event that staff or Board members determine, prior to a scheduled meeting, that there will not be a quorum, the decision to cancel to hold a meeting for the purpose of determining same shall be deferred to the Chairperson or his/her designee." Jody suggested that in the event of no quorum, the remaining board members could conduct a work session in which no action would be taken. Pam thought though, that whoever did not attend that meeting, doesn't realize it's going to end up being a work session, and sometimes that makes it worse. It was her opinion that we'd be better off just canceling and rescheduling. Thia made a motion to totally delete item #6 of Policy # 100.11. There was no second to this motion. Darlene suggested that the language should just be changed to read: "in the event that staff or Chairperson determines one business day prior to a scheduled meeting, that there will not be a quorum, the decision to cancel or hold a meeting for the purpose of determining same shall be deferred to the Chairperson or his/her designee, and appropriate public notice will be given". With that language being changed, in item # 7 of Policy #100.11, the sentence "Any questions regarding appropriate notice will be deferred to the Clerk" can be taken out. It was then determined that item #7 actually addressed the notice to the public, so the last clause of # 6 would NOT be included, i.e., "and appropriate public notice will be given". Item # 7 will also be amended to read: ......Any notice of cancellation of a meeting will be published one business day prior to that meeting in the Kodiak newspaper and/or broadcast on Kodiak area radio stations as time allows." (i.e., adding the words "one business day prior to that meeting.. ". Minutes of September 24, 2001 Advisory Board Meeting Pg. 8 Steve moved to adopt these changes; Thia seconded; and this motion passed. VIII. Old Business. A. Policy 100.09 Consumer Grievance Moving on to packet green tab #7, the bold items on this policy are the items that were changed. Darlene moved to accept Policy # 100.09, as presented, and Pam seconded. Motion passed. Dr. Jensen wished to bring up that in the absence of Robin, even though he is on vacation, that Robin's intent was to add packet numbers 8 a-h and 9 a-b under old business, i.e., F.: Review of Approved Policies; G., Review of Approved Job Descriptions, and H., Chart QA Plan of Improvement / Action Approval and Signature. Dr. Jensen apologized for not bringing this up sooner. Darlene moved to accept Policy # 400.17 (tab 8-a) as presented with the changes; Pam seconded, and the motion passed. Pam had a question on Policy # 400.18 (tab # 8-b), whereas on the bottom it reads it was approved on July 23, 2001 for Independent Audit, and wondered if this was actually revised on July 23 or approved on July 23. Pam made a motion that the Board holds on Policy # 400.18 until it's clear what should be accomplished, Thia seconded that motion, and the motion passed. Pam moved to accept Policy # 400.19 (tab 8-c) with the change indicated in bold; Steve seconded; motion passed. Moving on to (tab 8-d), Policy # 400.20, Pam asked if the underlined portion was the change; Micky responded she was not aware because Robin had all of those on her computer and Micky had not been working on these. Darlene believed this was the new policy. Thia thought we had to table this policy until the facts were known. Karen Bennett said that according to the old minutes that had been approved. Pam noted that according to the agenda everything that had just been approved had been approved in the past. On that note, Darlene brought back up Policy # 400.18, and made a motion that the Board approve same; Pam seconded, and the motion passed. Jody then moved onto Policy # 400.21 (tab 8-e). Thia then moved that we accept the reviewed policy procedures, what are marked as tabs 8-e, 8-f, 8-g, and 8-h as submitted; Darlene seconded that motion. Motion passed. Minutes of September 24, 2001 Advisory Board Meeting Pg. 9 B. Recruitment Status Dr. Jensen said this is a major issue we have been working on for a few months now. He said he thought we'd gotten someone for the high school, but that didn't work out, and then Sara Bruce quit the Center and went to work full time for the school district (middle school), so we're still vacant in high school and middle school positions. The Clinician II position hopefully will be filled soon; someone is coming for an interview in early October. He said as far as the Clinician I positions, there is another interview set up soon, and one candidate that is probably a go as far as a follow-up interview. Therefore he believed we're looking at October at the earliest for filling the Clinician I positions and November for the Clinician I I position (but it may be November for both). Darlene asked Dr. Jensen what this meant as far as concerns for the high school and middle school. Dr. Jensen said that some of that gets addressed here, and Melanie Nelson is working with the alternative school kids in the high school and with Dave Means in the school system. Jody asked about the administration chart indicating there was a vacancy for a case manager, and wondered about that. She was reminded that Jesse had filled that position. At this time (7:00 PM) Jodi turned the meeting over to Pam and had to leave; Thia also had to leave. Thia stated that although she had talked about being on the Needs Assessment Committee at one point, she now couldn't be on that Committee. It was established we still had a quorum, so the meeting continued. C. Board Vacancies Pam stated we have Cecil's vacancy to fill. Pam asked if we go back to the Borough when there is a vacancy. Darlene stated that we ask the Director to ask the Borough Clerk to publish a vacancy for the Mental Health Advisory Board and to accept applications. Darlene requested that we ask for all old and new applications at that time. She said that then we can try to follow all the guidelines. Pam asked if this vacancy is only until December 31 or if it goes after that. D. Officer Elections Since Cecil was not an officer, this matter is now moot. Minutes of September 24, 2001 Advisory Board Meeting Pg. 10 E. Insurance Coverage Dr. Jensen stated the issue was, did the Advisory Board have insurance coverage through an Errors & Omissions policy, and he stated that yes, the Board does through Providence for a number of dollars in the millions — he did not have the exact amount but knew it was significant. F. Needs Assessment Committee. (This item was added earlier in the meeting.) Pam said the Board had talked earlier about forming some specific Committees, including a Needs Assessment Committee. Pam asks who would be the most logical persons to serve on that Committee. Dave asked if this Committee would be a combination of Board, staff and consumer, or how it should be made up. Pam said it would be up to the Board as to how it would be set up. Darlene asked us to refer to pg. 4 of the July 16 Special Meeting Site Review Minutes, wherein Robin had indicated that in October a Committee should be established, and other criteria time lines set out therein. Pam asked that since Thia had declined to be the Chair of this Committee, who would like to volunteer to hold that position. Pam agreed with Robin's prior comments that we don't really want to change established policies except to add the Committee as part of that policy, and the Board concurred with that statement. Steve asked if there had ever been a Needs Assessment Committee prior to this time, and the Board all agreed this would be a first, so there really are no precedents to follow. Darlene thought we had talked about going to the State and asking for some guidelines. Dave asked if this would include the Villages and schools, and the Board agreed it should include these entities. Pam stated this would probably be a big project to put it all together, come up with some recommendations, and bring it back to the Board for input. Dave asked if we have staff members who now go to the villages, and wondered if it would be a collaborated effort between staff and consumers, and since the staff is already present in the villages if they could do an assessment then. Pam thought it would be up to the Committee to come up with how to do that assessment, but that would be a good idea. Pam thought the Committee could go to several different sources and come up with what services we need, even though we might not necessarily be able to meet each and every service. There may be an opportunity to partner with the Tribal Councils and KANA , etc., for the Village stuff. Dave said if it was just an assessment, he may be willing to join that Committee, but he was not able to chair it. Steve asked how many board members, and how many staff would be sitting on this Committee. He thought maybe a couple of each should be on it, i.e., two Board, two staff, two consumers, and perhaps someone from the school system. Minutes of September 24, 2001 Advisory Board Meeting Pg. 11 Pam reminded us that the next meeting isn't until the end of October; therefore we need to get this information together as soon as we can. Darlene reminded us that since the next meeting isn't until the end of October, the Committee needs to be established now so as to be able to report at the October meeting. Perhaps an e-mail out to all board members and all staff members should go out now to solicit participation in this Committee. Pam said we should also have someone from the school on this Committee. Darlene thought a KANA member should be also included, and someone from Kodiak Alliance on Mental Health also. Karen thought maybe she could participate as a board member and as someone from KAMI. Darlene thought maybe someone from a village too. Pam reminded us that every village's needs are different, and KANA is not all encompassing as far as the villages are concerned. Dr. Jensen commented that the original intent was to have Board members to do that, and then involve other people of the community just to be more efficient. It could just become too huge of a project and/or group and then there will be problems. The Committee could go out to those different people and get that information to bring back for review. He added that perhaps a good way to get this information out was through a mailer. Darlene agreed that was probably the best way to do it, just have board members and staff on the Committee, and Pam concurred. Karen Bennett brought in copies of Policy # 100.04 pertaining to this issue which was reviewed by the Board. Pam suggested again we start out with board members and staff members as the initial Committee, and then after that Committee comes up with a survey instrument, then maybe make the group larger, and then make the decisions. Another suggestion perhaps would be board and staff and KANA. But she agreed with Dr. Jensen's suggestion that if the Committee starts out too large it would be difficult to even develop the instrument. Karen Perkins agreed, and thought that was the original intent, and that to branch out later would be more effective. Pam requested that an e-mail be sent to staff and advisory board members and determine who is interested in serving on this initial Needs Assessment Committee. Dr. Jensen said that he believes the issue is not to look at one or two things, but to look at the community and figure out the instrument. Pam summed up the agreement of the Board, that staff should find two board members and two staff members who are interested in serving on this Committee. Dave said he had a moment of clarity and had to decline serving, as his time just did not allow that. Pam asked that in the e-mail the Policy # 100.04 be attached to show what it is we're asking for. Dr. Jensen thought this was something that should have been done around the state, and wondered what the other mental health centers in Alaska were doing. Darlene thought maybe staff could discover what, if anything, the other centers around the state are actually doing in this regard, and bring that information back to the October Minutes of September 24, 2001 Advisory Board Meeting Pg. 12 meeting. Darlene added that as far as staff members, it should probably be clinical staff compared to administrative, which makes more sense. G. Review of Approved Job Descriptions (tab # 9 a-b) 9-a, Job Description: Clinical Director On pg. 2, # 11, the word "administrative" should be changed to "Assembly" {4th line). 9-b Job Description: Assistant Administrator. On pg. 2, # 11, the word administrative" should be changed to "Assembly' (4" line). Darlene moved to correct those tabbed #'s 9 a-b, and Steve seconded; the motion passed. H. Chart QA Plan of Improvement / Action Approval and Signature (tab #10 in packet, bright orange sticker). This is the chart review. Dr. Jensen said the other one was signed off and submitted. Pam inquired why this was never signed off, as it looked late to her. Dr. Jensen said Robin had signed this on August 30, and was quite certain Robin had also sent it out in a timely manner. Pam asked if the plan of improvement had already been submitted. Dr. Jensen said yes, the previous one had. He stated that this one had not been reviewed, and was worried it was late. Pam read the cover letter stating this was supposed to be returned by September 4 (even though it had not been received until August 20), and two weeks to review it was not enough, especially with no meeting in August. Pam said she was uncomfortable signing it since Dr. Jensen had not had a chance to review it. Steve said he was somewhat confused, and wanted to know if the staff was going to respond to these items. Dr. Jensen said what the signature means is that "I agree to comply". Pam asked where the Plan of Improvement was. The site review is done; that was already reviewed and signed off, and it's gone. But this is not. Dr. Jensen said that Pat Crowe and Robin probably cranked this out. But he said if there was a deadline and it needed to be turned in, he was quite sure it had been done. Pam said that by looking at this review, it was quite good. But what exactly does this Pam Miller ask for. Dr. Jensen's recollection is that it was turned in. Pam said that because of lack of motion and understanding, that this go back to Robin. She also suggested that we call Pam Miller and find out if this is done. Minutes of September 24, 2001 Advisory Board Meeting Pg. 13 Darlene recommends that Dr. Jensen find out if there has been a plan submitted or not. Dr. Jensen again said he believed it had been submitted. Darlene said that if Dr. Jensen did find that it indeed had been done, to please contact Jody and put the worries to rest. Darlene also inquired who it is that takes the place of Robin when Robin is gone, as position of administrative director. Dr. Jensen responded that he does when he isn't on vacation. Dr. Jensen said that Susan H.B. also, and Chuck Morris is acting director right now, and is in charge. IX Director's Report (tab #11) Dr. Jensen wanted to state that we're all pleased to have Jesse, and he's a nice addition to have someone who's been in the community for a long time, and has a good heart and is trainable to become a good case manager. Chuck stated that he agreed with that. Dr. Jensen added that he had dealt with Jesse in the past, and it's just nice to have him at the Center. Dr. Jensen also stated that we had a work shop wherein Susan Humphrey Barnett traveled here and spoke to the Assembly and answered questions to the Assembly. He stated he thought that went well. Some of the issues raised by the Borough involved concerns about finances and who is legally responsible for problems if they arise in the future. Pam interjected with a request that when Robin and Susan H.B. go to the Assembly, it would be great to know that so the Board could attend also and listen to the questions and concerns that the Assembly members might have, and so they can see who their board is. Dave thought that it had been mentioned; but Dr. Jensen said the original date was canceled (twice), so the Board members may not have either been reminded or remembered. Darlene said she did attend that meeting as an Assembly member, and there were in her opinion some really "rotten points" that happened and made her uncomfortable. She said the Assembly was very unhappy with Robin's report, in that the delivery was poor, but the report was great. Because of that delivery, she believed there were some very offended Assembly members. Darlene went on to state that then because Pat Carlson (the Borough manager) had worked with Robin on some of those issues, when Robin came to the Assembly meeting, the Assembly was then incredibly impressed with the delivery, and Robin's humbleness and her apology for the previous delivery. Darlene said that Robin made it clear that she was unaccustomed to public speaking and was new to getting in front of the Borough, and Darlene thought that Robin had recovered beautifully. Darlene added that if that behavior follows through, the Assembly would be very happy with Robin's conduct. Minutes of September 24, 2001 Advisory Board Meeting Pg. 14 Darlene further added that in her opinion Susan Humphrey Barnett had picked up on this issue right away, and it turned out very successful. Darlene stated she thought the Board had a right to know that. Dr. Jensen said that he was at that meeting, and when Robin was going to give that presentation, she had been struck by a couple of the Assembly members' visual appearances and so forth. Dr. Jensen said that Robin said she thought it was just better to turn it over to Susan H.B. Pam wished to make the general statement that she was not comfortable discussing any issues related to personnel without the employee being present. From a content perspective, Dr. Jensen thought that was fine what Susan H.B. had presented. Pam said that she had also had conversations with some of the Assembly members, and that they were very happy with the presentation and the fact that they had some solid numbers to look at. She said they were also happy with Susan H.B.'s willingness to admit that there were some things on the lease agreement that maybe "we should have been doing that we haven't been doing", and we will fix that. She said that not only was the Board struggling, but the Assembly and Providence were also struggling to learn and interpret the lease agreement. Pam stated that as questions come up on the lease agreement, we should fire those back to Pat Carlson as a Board and ask him to clarify. Dr. Jensen said that as far as the financial data, as of August 31 it looks fairly positive. But from a month -to -month thing we really struggle; we have struggled since 1998. The gains made were tremendous. One of the things Providence would like, if we can't break even with the scenario, if people want certain things and we can't provide it, maybe we aren't the ones to do the job. He said he knows the demands are there, and that figure $34,000 is really not accurate, as there are encumbrances in September of about $39,000. We're about "break-even" or even a little bit behind. Pam said that as a Board we have to remember what we're looking at is an income statement. We're not really looking at the balance sheet. Therefore we're not seeing the total picture. Pam asked if this net revenue reflects just eight months, and asked if these first, second and third quarters were actual (unaudited), and should add up to the to the YTD actual. Pam said this kind of tool is actually what she likes to see as a Board member in order to help the Center when there are questions from the community. The more information the Board has, the better. Ultimately if the Center cannot meet its budget, it comes out of Providence Hospital profits, which ultimately comes out of the Borough coffers. That's why the Borough (and the hospital) is so concerned about the financial data. Minutes of September 24, 2001 Advisory Board Meeting pg. 15 Dr. Jensen said that there have been some surprises in that one year there was a profit of approximately $20,000. The Borough does not get 50% of the profit like it does with the hospital. But our agreement is not exactly like the hospital's. The problem is in the last four years, the grant dollars have not increased in about 10 years, salaries are up, costs are up, and keeping people on board, these items have all increased. We do have the building through the Borough, which is only $10 for our rent, and we do the maintenance. Dr. Jensen said that in his opinion the maintenance has been excellent which is also a benefit to all parties. In summary, he said our problems are revenues and expenses and trying to provide what everyone wants or would like to have with limited amounts of money. What else has changed in the community is that we have three private providers now that weren't here in the past, and KANA has two or three providers also. This is good for providing services, but does effect Center revenue. Right now we have only two outpatient clinicians, and they're working really hard, and a lot of hours. Dr. Jensen said that since 1998 the changes in the amounts of paper work have added about $30,000 - $40,000 a year in costs. There is a tremendous strain on us to keep within the budget confines, with less money and more and more demands placed on us. We struggle, and put the clamps on where we can't buy anything. But the bottom line is, mental health is not a moneymaking thing. But it's a good service and provides for the needs of the community, and saves in overall medical cost offset. Darlene said that she agrees with Dr. Jensen, but the Borough's concern is not that money was lost, but that they weren't seeing the financial bottom lines. She believes that once Robin establishes a good working relationship with Pat Carlson, these questions can be answered. She stated the Borough Assembly was not upset that the Center was losing money, only with the fact that the Borough Assembly did not know the Center was losing money. IX. Board Comments. Darlene said she appreciates the work that everyone did at this meeting. Rommy wanted to move to adjourn the meeting! Pam said, no, not yet! The rest of the Board have not made their comments. Darlene said that once a motion to adjourn is made, that's it according to Robert's Rules of Order. Dave just wanted to comment that moving the meetings to a bigger room is a wonderful idea, where the Board members can sit at a bigger table and the guests can sit in the surrounding chairs; everyone will be a lot more comfortable. Dave said he wants to get a good communication link between the staff and the Board, and this will relieve a lot of the confusion and the tension. Karen Perkins said she wished to thank the staff for the packets; she works with children and loves the color coordination. She said it helped to move forward more quickly. Minutes of September 24, 2001 Advisory Board Meeting Pg. 16 Steve said he agrees with everything everyone else just said, and wanted to thank Dr. Jensen for attending the meeting while he is out on vacation. Pam said that she thought it was a really good meeting, and wanted to thank Dave for rescinding his resignation and that he had decided to stick with it. She said that she hoped the staff doesn't feel as though there is any animosity, but the Board is just trying to figure out who is responsible for what, and what we need to do to make it successful. At that, the meeting was officially adjourned. (8:15 PM) Respectfully Submitted, Jody B am ChaiVI of the Board Micky Mummert Crawford Administrative Assistant Minutes of September 24, 2001 Advisory Board Meeting Pg. 17