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2001-10-22 Regular MeetingPROVIDENCE KODIAK ISLAND MENTAL HEALTH CENTER ADVISORY BOARD MEEING MINUTES OF REGULAR MEETING OF OCTOBER 22, 2001 I. Meeting Called to Order 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 Lord Doyle Pam Foreman Steve Honnold Remegio Marasigan Thia Falcone Dave Davis Darlene Turner Karen Perkins — KAM'I Rep, ex-officio Staff Present Guests Present Dr. Welby Jensen Mike Machulsky Robin Gardner Pat Carlson, Borough Manager Susan Humphrey -Barnett Frank Peterson Chuck Morris Linda Jackson Micky Mummert Crawford Don Roberts III. Acceptance of the Agenda: Pam moved to accept the agenda; Thia seconded. Darlene asked to add under VI, Staff/ Other Presentations: Borough Manager Pat Carlson speaking in the general discussion on Advisory Board role. Darlene moved to amend the agenda in that respect; Pam seconded; Motion passed. IV. Approval of Minutes. Pam moved to postpone approval_of _minutes so the Board could have an opportunity to review those minutes; Darlene seconded. Discussion ensued followed by a request that Micky try to summarize the minutes a little more. Motion passed. Providence Kodiak Island Advisory Board Meeting Minutes; October 22, 2001 . pg. 1- V. Public Comments. Don Roberts stated his opinion that if the minutes were not more detailed they sometimes don't quite reflect what each individual said, and maybe the taker of the minutes could check with the person to verify a comment. Linda Jackson introduced herself to Susan Humphrey Barnett. The other guests all introduced themselves. VI. Staff/Other Presentations. A. General Discussion — Advisory Board Role / Responsibilities: Susan Humphrey Barnett and Pat Carlson. Susan began by thanking the Board for their time and effort and noted that there appeared to be some confusion surrounding the location of the meeting. She stated that she felt the need to have this meeting at the Center to eliminate any further confusion. Susan agreed that the Center group room is small and that future meetings could be moved to a larger room. Susan and Pat explained the role of the Board. Pat noted that the Borough has "health powers" but chose to contract with Providence to operate the hospital and mental health center. The decision the Borough had was whether or not to contract with Providence, and since that decision has been made, the Providence governing body is the governing body of the Mental Health Center. All state funded mental health facilities, by state regulation, who have governing bodies must also have an advisory board; so Providence is required to have an advisory board. Pat explained that the Board is structured as a liaison between the staff and Providence through the Providence Service Area Board (which is actually the governing board) and the Borough. The Board is an advisory board with review and advise functions only. Providence may choose to accept or reject any recommendations of the Advisory Board. This advisory board also advises Providence and staff about the needs in the Kodiak Borough. Pat stressed that Providence is in charge of personnel and operations and that the Assembly is not involved in those matters. Dave Davis asked for clarification of the exact role of a board member noting that he has been reviewing policies for the past three years. He also requested clarification on the relationship between this Board, the Hospital Board and Providence in Anchorage. Governing Board member Mike Machulsky clarified this by explaining that, as it pertains to the Mental Health Center, references to "Providence" are references to Providence Health System in Anchorage and not Kodiak's Providence Hospital. This Advisory Board can only review and advise; Providence reviews their recommendations. The Providence governing board has the decision -making authority. Mike also advised that Kodiak has been designated as a service area, and that Alaska is a "region" in the Providence Health system. Darlene stated that there is a fiduciary agreement between Providence and the Borough. Mike noted that Providence does report to the Borough on financial matters related to the mental health center and the hospital even though grant funds are distributed directly to Providence and not through the Borough. Providence Kodiak Island Advisory Board Meeting Minutes; October 22, 2001 . pg. 2- Pat Carlson compared the agreement to the owner of a mall without the authority to directly dictate policy to each and every storeowner about what to sell, etc., that mall owner or mall owner's association does have the right to ask each storeowner to meet certain standards. The agreement between the Borough and Providence is based on that same concept and that is the extent of Borough involvement. The Borough and Providence both have the power to "split the sheets', but the Advisory Board does not have any authority to interfere with the operations of the Center. The Advisory Board's function is to review, advise, and to make the needs of the community known to the Center. Pat noted that the Borough solicits applications to serve on the Advisory Board and that these are reviewed with subsequent appointments made by the Kodiak Island Borough and either approval or rejection by Providence Health System. The Board then went on the review the lease between the Borough and the Center, wherein the duties of the Advisory Board were clearly set out. Dave wished to stress that as a board member, it is not his duty to act as an advocate between staff and consumers, but to review policies, Pam agreed, and added the additional duty of performing a needs assessment to advise the staff and Providence. Darlene clarified that Susan Humphrey -Barnett is the contact for the Providence Governing Board and asked if this Board has a question as to whether or not the Board will have a quorum, is it not up to the chairperson to decide if there will or will not be a meeting, i.e., this is not a staff decision. Susan said she would get back to the Board on that as she did not have the by-laws with her. Jody suggested that since there is a Borough Assembly representative on this Advisory Board, it would make sense to have a representative from Providence Health System also. Susan indicated that she could probably commit to attending every other meeting, or at least six meetings per year either in person or through teleconference arrangements. Discussion ensued regarding moving meetings to the Borough conference room since it has teleconferencing capabilities, copying machine availability, handicapped accessibility, and especially more room. Frank Peterson was late arriving for the meeting and missed the Public Comments section so the Chairperson inquired as to whether he wished to make a comment. Mr. Peterson then reiterated the earlier comments that the Board has no authority other than to review and advise but noted that they could incorporate under state statute as a non-profit and then become a policy making board. Providence Kodiak Island Advisory Board Meeting Minutes; October 22, 2001 . pg. 3- VII. New Business A. 2002 Budget — Susan Humphrey Barnett Susan Humphrey Barnett distributed and reviewed the proposed 2002 budget, which demonstrates actual 2000 operations, 2001 actual operations from January through June, the projected total for 2001, and the proposed budget for 2002. Questions were asked about the 'rental" figure, which was clarified as the income from the apartments. The grant money and the school district monies are combined under "other operating revenue". The outpatient revenue shows the actual monies received from billing, Medicaid, and other sources, including self -pay. The staff apartment shows up in employee benefits. Consulting fees include Dr. McCarthy who does peer review for Dr. Jensen. About 8% in revenue is forgiven in charity (most of which are just uncollectable billings) and "bad debts'. Vill. Old Business A. Establishment of Needs Assessment Committee Dr. Jensen and Robin reported that DMHDD is unaware of any other facility in the state currently doing anything like this. It was originally agreed that two clinical staff and two board members would serve on this committee; however, since the Center is short staffed, only one clinician, Pat Crowe, will serve on the Committee. Thia Falcone, Pam Foreman and Darlene Turner all agreed to serve. The Committee agreed to meet soon and report back to the Board next month with ideas for the process. IX. Director's Report Robin did not distribute a written report but spent time discussing recruitment issues noting specifically that an LCSW from Indiana had been hired as a Clinician II. This position functions as the supervisor of the school program and also provides outpatient and emergency on call services. He will arrive near the end of November. Reference checks are currently underway for the other two vacant positions. Robin noted that there are two strong candidates for these positions: one with a masters in psychology and another with a great deal of adolescent experience. Robin reported that all positions should be filled by the first part of December. Currently, Melanie Nelson is serving as triage with the school program, and Dr. Jensen is acting as clinical supervisor. It was asked if there was a way to get any more funding to allow us to offer more competitive salaries and Susan HB reported that unfortunately grant money very rarely goes up, usually decreases, and that it is very difficult to raise the base funding level. X. Board Comments Romegio had no comments at this time. Pam thanked Susan for coming to the meeting and expressed her hope that in the future Susan would be able to either attend physically or through teleconferencing. She Providence Kodiak Island Advisory Board Meeting Minutes; October 22, 2001 . pg. 4- also clarified that the next meeting would be held November 26, 2001 (i.e., the fourth Monday of the month) at the Borough Conference Room. Thia reiterated Pam's comments, adding that she has hopes for the future of a Board in collaboration and not conflict. She added the less pages in the minutes, the better! Dave Davis stressed that the Board should always allow staff time to research and/or review questions that arise during meetings, either by a Board member or the Public. He also asked for a copy of the by-laws, which he feels are a fundamental part of understanding his role and responsibilities. Dave stated that he was quite content with his position on the Board for the past three years, but became frustrated when he was told by the public that he was "simply rubber-stamping policies". He appreciated the clarification of the "chain of command". Dave asked that the record reflect that "I only review the policies and/or budget, whatever is in front of me and make recommendations. That is my duty." He added that "I am not an advocate for the consumers against the staff, I am a team member with the staff on behalf of our consumers, not to be pitted against either one". Dave also said he feels there's a need for a retreat and to have an open discussion enabling all to work together as a team. Lastly, he stated that according to Roberts Rules of Order, a meeting does need a second to adjourn. Darlene also thanked Susan for coming to the meeting and thanked the staff for putting the meeting together. She stated she thought there was some confusion about the place of this night's meeting, that at the last meeting there was a vote to move the meeting to the Borough conference room, and that she did not understand why the location was changed back to the Center. Darlene stated that on any board she served on, it was the board meeting for the board; not a staff meeting for the staff or a Providence meeting for Providence. She thought that only the chairperson should be able to move the location of a meeting. Darlene added she hoped the Board would continue to keep focused on the mission statement of the Center, and noted that she did not intend to become a grievance arbitrator. Darlene agreed a retreat would be a good idea to help look at the strengths and weaknesses of the Board and expressed hopes to be able to help staff build the program for the next year, and saw a need for identity that is co -equal with the staff and the consumers. Jody said she is in agreement with the Board's statements, and thought that a retreat was an excellent idea. She thanked everyone for attending, including the public. Dave wished to add that there was a motion to move the meeting to the Borough conference room, and wondered why it was moved back to the Center. Robin offered that since there appeared to be some confusion surrounding whether this is a Providence Board or a Borough Board, the Board might want to utilize a neutral location such as the Fish Tech center. Darlene noted that the Borough Conference room is very convenient, and that many agencies in town use that room whether they are affiliated with the Borough or not so it really is in fact considered by most to be a "neutral area". Providence Kodiak Island Advisory Board Meeting Minutes; October 22, 2001 . pg. 5- members do not have the technology to complete the process that was. Jody thought meeting quarterly would be sufficient instead of monthly. Dave Davis felt that an annual review would be an easier process because existing policies that will need amending would be marked with red flags. The Advisory Board was unaware that there are still many policies that have not been presented to the Advisory Board. Jody and Darlene suggested that we begin meeting quarterly in October. This item will remain under Old Business. X. ADVISORY BOARD COMMENTS Steve Honnold welcomed Chuck to the staff and Remegio to the Advisory Board. Stave also thanked staff for their hard work and the Board for being here. Dave Davis welcomed Chuck to the staff and welcomed Remegio to the Advisory Board. Dave asked if we had an answer to a question he posed surrounding whether or not a meeting can continue if a quorum is no longer present. Karen said that she had received the Kodiak Island Borough policy but was still researching Alaska State Statutes. Darlene Turner requested a draft letter to send to employees along with a list of employee names and how each employee participated. Dave Davis clarified that this was the letter that would be placed in the employee's file. Darlene also reported that she had not received her e-mail and requested that we check to see if we had the correct email address, however, she had been off island and her email was full and did not receive others that were sent. Darlene welcomed Chuck to the staff and Remegio to the Advisory Board. She additionally thanked Robin and Dr. Jensen for the fabulous job they were doing and for striving for perfection and not accepting average. Remegio Marasigan said he looked forward to working with the Advisory Board and asked that they remain patient as he learns the ins and outs. He reported that his e-mail address is frllidid@ptiak.net Thia Falcone welcomed Chuck to the staff and welcomed Remegio to the Advisory Board. Jody Burcham welcomed Chuck to the staff and welcomed Remegio to the Advisory Board. XI. ADJOURNMENT The meeting adjourned at 6:35 PM The next regular scheduled meeting is July 23, 2001 at 5:30 PM in the group room of the Providence Kodiak Island Mental Health Center. A work session with a special meeting is scheduled July 16, 2001 at 5:30 PM in the group room of the Providence Kodiak Island Mental Health Center to make recommendations for a Plan of Improvement for the 2001 Site Review. submitted by: trative Assistant Jody -ham, Chairperson P HC Advisory Board It was then agreed that the next meeting would be held at the Borough Conference room on November 26, 2001, at 2001. XI. Adjournment. Pam Foreman moved to adjourn the meeting; Thia Falcone seconded; motion passed, and the meeting was adjourned at 7:30 PM. Respectfully Submitted this day of November 2001. Jody Bu iam Chairpprson of the Board Micky a ford Admini§trative Assistant Providence Kodiak Island Advisory Board Meeting Minutes; October 22, 2001 . pg. 6-