Community Health for the Florida
Keys
June 06
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June 06
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Monday, June 12, 2006, 9AM to 3PM, Executive Board Room, Cheeca Lodge, Islamorada, FL (DRAFT) Agenda
I. Call to Order, Welcome and Introductions Mr. Luse II. Verification of a Quorum Dr. Szurek III. Consent Agenda Members 1. Agenda 2. For the executive director to sign a contract for billing services with East Coast Medical Services. 3. For the executive director to sign a contract for psychiatric services as part of the a HRSA Outreach Grant (1DO4RH06933) with the Guidance Clinic of the Middle Keys. 4. For the executive director to sign a Memo of Agreement with HMA-LFKHC for RHNMC to provide on-site medical services at dePoo Hospital (primary care clinic) on Saturdays, no later than 9/1/06 and until 6/30/07, as funding allows, as also part of the HRSA Outreach grant. IV. Reports. (9:05 to 9:15) Dr. Szurek A. IRS and State Unemployment Determinations , Lawsuit, re: Arthur Doenecke B. HRSA Grant Awards: Outreach (3 yrs) and Network Development (Yr 3 of 3) C. Fishermen’s Hospital Association: “concerns” about our lease V. Program Development Plan, FY 06-07 (9:15 to 9:35) Rev. Todd A. Ideas for Fundraising, Timelines B. Image C. Use of Volunteers VI. Distribution and Review of Revised Policies & Procedures (9:35 to 11:00) Dr. Szurek
Break 11:00 to 11:15
VII. By-Laws Review and Revisions (11:15 to 12:45) Dr. Szurek
VIII. (Working Lunch, 12:00 to 12:45)
Break 12:45 to 1:00
IX. Budget Review (1:00 to 1:45) Mr. Smith, Dr. Szurek A. Pro-active Role of Officers/Board in Local Funding Rev. Todd
Break 1:45 to 2:00
X. Strategic Plan FY 06-07 (2:00 to 2:50) Dr. Szurek A. Service placement, times and locations (primary and dental care) B. Composition of the Board
XI. Community Input Members/Guests
XII. Announcements. The next meeting of the RHNMC Governing & Advisory Boards is scheduled for Monday, July 17, 2006, at 9AM, at 2855 Overseas Highway in Marathon.
XII. Adjournment (3:00) Mr. Luse
RHNMC Annual Retreat of the Executive Committee Cheeca Lodge, MM 80, Islamorada, FL
Meeting Minutes
Governing Board Officers in Attendance: Mr. Robert H. Luse, Chairman (CEO, Mariners Hospital); Dr. Nicki Will, Vice Chair (CEO, LFKHC); Ms. Lori DeNues, Secretary (Consumers – Upper Keys); Ms. Ana Pena, Treasurer (Consumers – Uppers Keys).
Staff Members in Attendance: Dr. Mark L. Szurek, CEO; Mr. John Pascucci, MOT, CAP, COO; Mr. Dan Smith, MBA, CFO; Rev. Chris Todd, PDD
I. Call to Order. The meeting was called to order by Mr. Luse. II. Verification of a Quorum. Dr. Szurek stated all of the Board Officers were present, constituting a quorum. III. Consent Agenda. In a motion made by Dr. Will and seconded by Ms. Pena, the agenda was approved with the additions of “Item IV, Part D: Catholic Charities”, and “Part E: HFSF”. (Please see the agenda for details.) IV. Reports. A. IRS, State Unemployment Determinations, Potential Lawsuit: Re: A. Doenecke. 1. IRS: Dr. Szurek reported that Dr. Art Doenecke was contracted with the organization from 7/29/04 until 4/30/06. Late in his time with RHNMC, he filed a complaint with the IRS that he should be considered an employee, not a contracted worker (3/06). RHNMC was given an opportunity to respond to the IRS and did (5/06). The IRS determination was that he (Doenecke) was an employee, and not a contracted worker, and that RHNMC was liable for unpaid FICA, plus penalties of 20% of FICA due + 1.5% of the gross salary for the period in question (or $10,348; 5/06). Dr. Szurek consulted with our CPA (Buzzi) and was told to appeal the decision. Dr. Szurek stated that he had made the appeal in writing; he then received a call from the IRS agent who again explained their position (6/06). Dr. Szurek asked that the determination be reconsidered, and asked that all taxes due and penalties be waived. He was informed that a reconsideration would be granted but that the regional office of the IRS to which tax payments are made would be the party to which an appeal should be issued for any financial waivers. That request/appeal will be made the week of 6/12/06. Mr. Luse asked if the taxes and penalties or any portion had been paid. Dr. Szurek reported that the entire amount due had been paid to the IRS. 2. Dr. Szurek reported that since Doenecke had been determined by the IRS to be an employee, Doenecke has also petitioned for state unemployment compensation. RHNMC, not considering Doenecke an employee, has not paid any unemployment taxes to cover Doenecke. RHNMC has issued its request that the state not consider Doenecke an employee, and awaits a state determination. 3. Doenecke has also secured an attorney and threatens a lawsuit to be paid for vacation leave, time worked but not compensated for, and for reimbursement for health insurance coverage (6/06). Dr. Szurek stated that Doenecke has signed a witnessed statement that he declined health insurance coverage at contract onset, and that his reimbursement request is for “gap” insurance. Dr. Szurek stated that RHNMC does not provide “gap” insurance to any of its employees nor describes this as an approved benefit. Szurek further stated that there are at least 3 employees that will attest that Doenecke did not work his full hours per day as stipulated on his contract. Szurek asked that the Officers approve that the organization enter into a counter-suit for reimbursement for hours not worked by Doenecke, but paid by the organization. Doenecke’s signed timesheets amount to evidence of fraud, as he declares that he worked 10 hours per day, four days per week, when he did not. By acclamation, the Officers approved pursuit of a counter-suit against Doenecke in this matter. B. HRSA Grant Awards. Dr. Szurek reported that RHNMC has been granted awards in the amount of $200,000 for Yr 3 of 3 for the network development project, and $150,000 for an outreach grant (Yr 1 of 3). Dr. Szurek stated that the network development grant will continue to help with fund-raising endeavors and plans, and that the outreach grant (to be shared with GCMK), will fund one day per week services with HMA at the dePoo clinic on Saturdays, to begin 9/1/06. Dr. Covington has agreed to be the primary practitioner for the (renewed) Key West coverage. RHNMC was the only “outreach grant” recipient awarded by HRSA in the State of FL. C. Fishermen’s Hospital Association (FHA) and Lease Concerns. Dr. Szurek described the history of RHNMC with its new landlords, FHA. FHA has expressed its concern that the site at 2855 O/H in Marathon seems under-utilized and has asked their attorney to discuss ways to reconcile an expectation that more days be devoted to primary care. RHNMC has revealed its plan to increase utilization in Marathon to 5 days per week for primary care no later than 9/1/06. Dr. Szurek awaits the FHA response. D. Catholic Charities/Catholic sites/RHNMC Policy. Dr. Szurek reminded the Officers of policy number Ser 6.09, and RHNMC’s position that it remain neutral for all family planning matters. Dr. Szurek stated that in his judgment and in service to the community, family planning, birth control prescriptions and distribution of condoms should be allowed at all RHNMC service sites not housed at a Catholic Church or property (Key West, Marathon, Islamorada). Out of respect for the Catholic Church’s hospitality and Catholic Charities support, the current policy would remain in effect wherever RHNMC services are offered on Catholic Church property, presently San Pedro in Tavernier and St. Justin in Key Largo. The Officers agreed to this change by unanimous acclamation. E. Health Foundation of So. FL. Dr. Szurek stated his intent to renew a request to HFSF for a new medical mobile van, to be petitioned for in Fall 2006. The strategy to be used will be to solicit the support of the MCHD and AHEC: with a new van, RHNMC will replace its existing one for services in the Upper Keys; the “retiring” van will be given to AHEC to complement their wellness outreach project (funded by HFSF), and to be shared with the MCHD for disaster recovery. By unanimous acclamation, the Officers endorsed the strategy and plan. V. Program Development and Planning. A. Rev. Todd introduced himself as the newly appointed program development director. He proceeded to outline plans for fundraising in the new fiscal year through several projects, and applied these projects to a timeline. The goal of fundraising for 06-07 is placed at $125,000. B. Dr. Szurek and Rev. Todd discussed plans for a revised logo that would not dramatically change in image, but would stress “Rural Health” as a “workable name”. Rev. Todd distributed a sample brochure that he was eager to disseminate into the community and described his plans for increased RHNMC exposure. C. Rev. Todd described methods and needs for increased volunteer usage both for fundraising and service support.
VI.
Review of the Policies & Procedures. In a motion made by Ms. DeNues and
seconded by Ms. Pena, the Officers unanimously approved the following
changes. (Please see corporate files, policies and procedures as of 6/12/06,
with red wording indicating approved changes,
and
VII. Bylaws
Revisions. In a motion made by Dr. Will and seconded by Ms. DeNues, the
following Bylaws revisions were unanimously approved by the Officers, pending
ratification by the Governing Board. (Please see corporate files, Amended
Bylaws as of 6/12/06, with red lettering
indicating approved changes and VIII. The Officers and Staff suspended their work for lunch. IX. Budget Review. Dr. Szurek and Mr. Smith presented the proposed budget for FY 06-07. Dr. Szurek emphasized that an increase in patient volume and patient income was something that would be required but which is possible, to meet financial needs for the next fiscal year. Dr. Szurek asked that the Officers approve revisions to the fee structure: 1. that the “full pay” be calculated as the current Medicare rate x 200% (commonly used by private practices to determine a market rate), and 2. that the sliding fee scale be amended to reflect up to 400% of the FPL. This second change is suggested to provide more equity in the fee schedule. Presently, a household at 201% FPL would pay the same “full pay” as a household making substantially more. Under this suggested change, at 400% FPL, patient households of 4 with an income level of >$76K would be identified as the new full pay threshold, while those making less than $76K down to 100% FPL, would qualify for a discount. Dr. Szurek reminded the Officers that if CHC status is achieved, the organization by law would have to revert back to the 200% FPL policy/threshold. In a motion made by Ms. DeNues and seconded by Ms. Pena, the Officers unanimously approved the proposed budget and fee schedule revisions. X. Strategic Plan. Dr. Szurek introduced the revised/updated strategic plan. A. Service Times, Places in FY 06-07.
By acclamation, the Officers unanimously approved the revised strategic plan. B. Composition of the Board. Dr. Szurek stated that it might be advantageous to expand the Governing Board to its maximum size of 17, soliciting for membership from among those in the community with financial interests and contacts. The Officers voiced their agreement with this strategy. XI. Community Input. There was no community input. XII. Announcements. The next meeting of the Governing Board is scheduled for Monday, July 17, 2006 at 9AM at 2855 Overseas Highway in Marathon. XIII. There being no further business before the group, the meeting was adjourned by unanimous acclamation.
Respectfully recorded,
Mark L. Szurek, Ph.D. President & CEO
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