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1991-11-13 Regular Meetingr r KODIAK ISLAND HOSPITAL ADVISORY BOARD MEE77NG NOVEMBER 13, 1991 PRESENT: Ben Ardinger, William Brewer, Gordon Gould, Gretchen Saupe, Betty Springhill, Wayne Stevens, Lorne White, Ed Myers, Administrator, Keith Vorachek, Financial Services Administrator, Corlene Hogg, Director of Ancillary and Patient Information Services, Kate Fitzgerald, Patient Care Administrator. ABSENT: Jeannie Volker With a quorum present, the meeting was called to order at 7:05 p.m. ACCEPTANCE OF AGENDA: Moved, seconded and carried to accept the agenda. APPEARANCES AND COMMUNICATIONS Ms. Springhill acknowledged receipt of a letter from Keith Vorachek, Financial Services Administrator, tendering his resignation. Ms. Springhill reviewed a letter from Joe Smith, VP of operations, LHS Management Company, covering a variety of topics including: * Mr. Myers' evaluation was as discussed at last meeting; * A comparative salary analysis is being done by LHS for all non- union employees to assure salary parity; * The KANA contract has been signed; awaiting final signature from KANA representatives in Anchorage; * New facility project - cost may be lower if a design build ap- proach is used -- Mr. Myers and Borough reviewing options; * FY-92 Budget - LHS believes moderate rate increase necessary; * Surgeon recruitment - feels volume warrants second surgeon; * Bills for legal services impacting trust will now come to Mr. Myers for review before payment is authorized. MEETING MINUTES Moved, seconded and carried to approve the meeting minutes of October 23, 1991. Advisory Board Meeting November 13, 1991 Page Three * Mr. Gould asked why actual figures for 1989 and 1990 were provid- ed, but projected figures were provided for 1991. Mr. Vorachek stated that 1991 figures were based on actual data available through September which were then annualized through the end of the year. He noted that large prepaid items (such as insurance) were expensed out monthly. * Mr. Gould said that he felt "Allowances and Deductions" seemed high. Mr. Myers stated that the figure was actually conservative, noting that current contractuals are running twice what they were last year, in part due to more Medicare surgery patients. * Mr. Gould asked why the "Interest Expense" was higher in this year's budget. Mr. Vorachek explained that the interest shown is based on the CAT Scan capital lease. He stated that under a capital lease, the equipment can be returned to the seller at the end of the lease if it becomes obsolete, but it can also be purchased if the facility de- sires. It was noted that under Medicare reimbursement it was beneficial for the facility to lease the equipment. * Mr. Gould asked about the increase in salaries. Mr. Vorachek explained that under the terms of the union agreement, that non-exempt employees would receive raises based on merit, and that movement from one step to the next in the various classifications was approximately 4%. Mr. Myers noted that there were also some automatic longevity bonuses included in the figure. Ms. Springhill asked if the total expense for wages and benefits was reasonable, noting that over 50% of the budget was for this expense. Mr. Myers stated that hospitals are very labor intensive organizations and that the figure was appropriate. Mr. Gould noted that the schools' appropriations for wages and benefits was much higher. * There was a brief discussion on how FTE figures were established. Mr. Myers noted that security and patient safety was changed from being provided by contract services to in-house staff. There has been a reduction in FTE's of between six to seven during the last six months. Further reduction in FTE's would require a reduction in services. Kate Fitzgerald noted that there has been cross -training of personnel, and a greater sharing and decentralization of job duties. * There was a discussion of what constituted "other expenses". Mr. Gould suggested that a further breakout and backup documentation be provided for "other expenses", including actual year to date figures. Mr. Vorachek said this would be done and the information sent to the Assembly prior to its meeting. Gordon Gould moved to accept the Kodiak Island Hospital & Care Center Budget as proposed. Dr. Brewer seconded the motion. r Advisory Board Meeting November 13, 1991 Page Five Mr. Gould requested that staff be directed to prepare packets for the Assembly which would provide actual year to date figures as well as fiscal year figures which include parity studies. >aa The Chair called a five minute recess. ADNDNNTRATOR'S REPORT Mr. Myers extended his appreciation to the Board for the flowers sent to his wife while she was in the hospital. He reported that she was doing much better and would be released to travel soon. The Administrator reported that regarding unassigned E.R. patients, it was expected that the Medical Staff at their next meeting will amend their bylaws to require that all members of the Medical Staff serve in rotation as backup to the E.R. physicians and accept unassigned E.R. patients. Mr. Myers reviewed the design build concept for a new facility, noting that the original plans are over designed and that he does not feel the state will fund that facility at the amount originally requested. He stated that in talking with various people that a smaller, more effi- cient facility can be built. There was a question as to whether chang- ing plans would affect state funding. Mr. Myers indicated that he did not believe it would. He said that the state had indicated that they felt the original plans were overdesigned for the needs of the facility. Mr. Ardinger stated that he felt some type of drawings or plans should be ready for presentation to the state. Mr. Gould said that he felt that it was important that the mayor and the lobbyist work closely on the wording and intent of the funding request to the legislature. Mr. Myers stated that Dr. Tschersich has submitted his draft of the Radiology agreement and that it has been forwarded to LHS for review. Dr. Mason has been actively recruiting for a second surgeon. Mr. Myers stated that he felt Dr. Mason would be successful. Mr. Myers stated that there are three active malpractice cases against the facility and one defense case. It was the consensus of the Board that LHHS should bear the cost of legal fees in the defense case. Mr. Gould questioned at what point the Borough attorney becomes involved in legal matters, stating that it was important that the Assembly be kept informed on legal issues. Mr. Myers was requested to inform LHHS of the Board's consensus regarding the payment of legal fees in the defense case. Advisory Board Meeting November 13, 1991 Page Seven Noting that the next regular meeting of the Advisory Board was scheduled for Thanksgiving Eve, it was the consensus of the Board to cancel that meeting. 11 611 � ►1 Not called. Moved, seconded and carried to adjourn at 9:40 p.m. Recorded by Debra Raper.