Community Health for the Florida
Keys
Minutes November
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Minutes November
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RHNMC Meeting of the Governing Board Monday, November 21, 2005, 9AM, Mariners Hospital, 91500 Overseas Highway, Tavernier, FL (with conference call-in arrangements from 1623 Spalding Ct #4, Key West and 2855 Overseas Highway, Marathon) Agenda
I. CALL TO ORDER AND WELCOME. Mr. Luse II. VERIFICATION OF A QUORUM. Dr. Szurek
III. CONSENT AGENDA (Recommended action: Approval) Mr. Luse/Members A. Approval of the Agenda B. Approval of Minutes, 10/17/05 C. Approval of the Composition/Chair of the Membership & Nominating Committee: Ms. Premaza, Chair; Ms. Chris Clark, Dr. Szurek (Members); Approval for the M&N Comm. to nominate officers and directors; approve recipient of the Lignum Vitae Award recommended by staff; approve special community recognitions recommended by staff; approve the “employee of the year” recommended by staff. V. OLD BUSINESS A. Application for funding, Health Foundation of So. FL. Dr. Szurek B. Merger with HMA, Lower Keys Dr. Will C. Dedication of the Marathon Clinic (“name”& signage; approval for Chair to approve sign design and wording.) Dr. Szurek
VI. NEW BUSINESS A. Revisions to the Policies & Procedures Dr. Szurek 1. Emergency Leave (limits) 2. Elimination of Veteran’s Day as an official RHNMC Holiday B. Report: Hurricane Wilma Dr. Szurek 1. Facility status (particularly Big Pine Key) 2. Our Role with Regard to Disaster Recovery C. “Our Kids” Contract, Update Dr. Szurek D. Catholic Charities Request Dr. Szurek E. Performance Review (HRSA) Dr. Szurek VII. COMMUNITY INPUT AND ANNOUNCEMENTS. Members/Guests VIII. RHNMC ANNOUNCEMENTS A. The next joint meeting of the Governing & Advisory Boards is scheduled for Monday, January 23, 2006, at 10AM at, 2855 Overseas Highway, Marathon, FL. This will be the annual meeting of the membership and dedication of the new Marathon facility. B. The next meeting of the Governing Board is scheduled for Monday, December 19, 2005, at 9AM, at Mariners Hospital, with conference call-in arrangements from Key West and Marathon.
IX. ADJOURNMENT. Mr. Luse RHNMC Governing Board Meeting Minutes Monday, November 21, 2005, 9AM Mariners Hospital, Tavernier, FL DRAFT Board Officers in Attendance: Mr. Robert H. Luse, Chairman, (CEO, Mariners Hospital); Ms. Debbie Premaza, RN, Interim Treasurer (Lifelines Home Health Care, Regional Director); Ms. Lori DeNues, Secretary (Consumers – Upper Keys).
Board Members in Attendance: Ms. Ana Pena, Consumers – Upper Keys; Mr. Dirk Smits, Esquire, Community-at-Large.
Advisory Board Member in Attendance: Ms. Chris Clark, RN (Monroe Co. Health Department)
Board Members in Attendance, Marathon, conference call-in: Ms. Kim Bassett, CEO, Fishermen’s Hospital
Board Members in Attendance, Key West conference call-in: Ms. Dorothy Clever, Consumers – Lower Keys; Ms. Marney Brown, Consumers – Middle Keys; Dr. Nicki Will, CEO, LFKHC
Board Member in Attendance, by remote conference call-in: Rev. Michael Hartney
Staff Support, Mariners Hospital: Dr. Mark Szurek, CEO; Mr. John Pascucci, Jr., COO
Staff Support, Marathon: Mr. Keith Douglass, Program Dev. Director
Staff Support, Key West: Mr. Dan Smith, CFO
Guests: None
I. CALL TO ORDER. The meeting was called to order by Mr. Luse. II. VERIFICATION OF A QUORUM. Dr. Szurek reported that 10 Governing Board Members were in attendance, constituting a simple majority and a quorum. III. CONSENT AGENDA. (Please refer to the agenda for details of the consent agenda.) In a motion made by Ms. Denues and seconded by Mr. Smits, the consent agenda was unanimously approved by the Board. The Chairman asked that “Item D, HRSA Application Status”, and “Item E, Good Health Clinic” be added to “V. Old Business”. By unanimous acclamation, these items were added to the agenda. IV. REPORTS. A. Income and Expenses. Mr. Smith reported that a positive balance in the income and expense statement is reflected for the period ending 11/15/05, and that cash flow though marginal, was steady. B. Development Committee Report. Mr. Douglass issued a report that reflected donations, and funds contributed by various sources, with fundraising efforts currently totaling (pledged + actualized) $67,550 (7/1-11/15/05). He also reported that the committee had set a goal of an additional $150,000 in donated funds for the fiscal year. Ms. Premaza, committee chair, renewed her request for donations from the Board itself before (calendar) year’s end, to take advantage of tax benefits. She also stated that the committee would be making a formal report to the Board in December, highlighting plans to complete fundraising efforts for the balance of the year. V. OLD BUSINESS. A. Application for Funding, Health Foundation of S. FL. Dr. Szurek reported that the pre-request for funding to the HFSF for $300,000 to purchase a new mobile medical van ($285,000) and to refurbish “Van 1” ($15,000), was partially approved, with an invitation to submit an application for the $15,000 refurbishing request. Dr. Szurek stated that he would submit the application before the 12/8/05 deadline. B. Merger of Clinics: HMA & RHNMC, Key West. Dr. Will reported that she had met with Dr. Szurek and that the plans for “merging” the Key West site into a 7 day per week, 10 hour per day clinic continues. She stated that Ms. Meylan Lowe-Watler would be the contact person for HMA, and Dr. Szurek stated that Mr. Pascucci will be the planning representative for RHNMC. Still to be worked out is a mutual working agreement. Dr. Szurek asked Mr. Smits if he would be able to offer legal assistance in its preparation. Mr. Smits stated the he would, and was thanked by Chairman Luse. C. Dedication of the Marathon site (2855 Overseas Highway). Dr. Szurek reported that Fishermen’s Hospital Association has asked that the (entire) site NOT be dedicated to the memory of Christine E. Puto; however, an interior portion could be so memorialized. Dr. Szurek reported that Mr. Douglass has been assigned the special task of raising funds for the signage outside of the facility and for working with the landlord regarding approval of the signage design. Dr. Szurek asked that the Board authorize the Chair to approve the final design on behalf of the organization. In a motion made by Ms. DeNues and seconded by Mr. Smits, the Board unanimously authorized the Chairman to approve the design and wording of the proposed signage for the Marathon facility. D. Section 330e (CHC) Application. Dr. Szurek reported that the US Congress has yet to approve a budget for FY 06, and that this will delay the CHC application process. He stated that he would continue to visit the HRSA website daily to ascertain a target date and will apply when indicated. E. Good Health Clinic. Mr. Luse reported that Dr. Sandy Yankow (director, Good Health Clinic) has sent a message to the CEO of the Baptist Health System requesting funds for primary care in the Upper Keys, stating that the Upper Keys are under-served for that purpose. Mr. Luse and Rev. Jim Gustafson (chaplain of Mariners Hospital) have both responded to the email, agreeing that indeed the uninsured are under-served in the Upper Keys, but that RHNMC has sent a grant request to the System to help alleviate the situation through an expansion of services. Both messages (by Luse and Gustafson) reiterated the importance of not duplicating services. Ms. Clark, who sits on the Good Health Clinic Board, stated that she would communicate that message to Good Health, while Ms. Premaza offered to educate that Board about other services that could be offered by Good Health to enhance secondary care. Mr. Luse stated that Dr. Yankow had also offered space to RHNMC for primary care at the Good Health Clinic location. Dr. Szurek stated that he felt that the mobile medical van usage in the Upper Keys was efficient and was now a familiar system for clients. Ms. DeNues agreed. Ms. Bassett suggested that if a site were being offered, similar to the situation with HMA in Key West, that perhaps the organization should take a second look. (It was later learned that the site at Good Health would require a monthly rent. RHNMC is currently not budgeted for rent at any of its locations.) The overall opinion of the Board was to refrain from accepting the Good Health offer at this time. VI. NEW BUSINESS. A. Revisions to the Policies & Procedures (P & P). 1. Emergency Leave (P & P Manual p. 43). Dr. Szurek stated that the present procedure does not cap the amount of emergency leave that could be offered in any (hurricane) season, and that for Hurricane Wilma and since a generous amount of emergency leave had already been given to staff, he had arbitrarily required that all staff use accrued vacation leave time for the “Wilma” closure, pending Board approval. Mr. Smits stated that he felt that no emergency leave time over and above vacation and/or sick leave should be granted to any employee. Mr. Luse concurred and stated that the RHNMC policy was much too liberal. Ms. Premaza stated that she felt there were times when staff should be paid for time off when the facility cannot be open, i.e, through no fault of the employee. Mr. Luse directed Dr. Szurek to reword the policy for Board consideration at the next meeting, with a Board bias that there should be no emergency leave; that employees should be allowed to make up work time lost or deduct it through vacation leave. Dr. Szurek stated that he would reword the policy revision. By acclamation, the Board approved Dr. Szurek’s action in requiring employee vacation leave usage (or make-up time) in lieu of emergency leave authorization for Hurricane Wilma closure. 2. Veteran’s Day Holiday (P & P, p. 40). Dr. Szurek stated that the current policies allow for an employee choice between President’s Day in February or Veteran’s Day in November, each year. He stated that this has become difficult to follow, and causes confusion for new employees who state they will opt for Veteran’s Day if hired after February. He asked that Veteran’s Day be deleted as an official holiday of the organization, with all due respect for veteran employees. In a motion made by Mr. Smits and seconded by Ms. Premaza, the Board unanimously approved the action requested by the CEO. B. The Impact of Hurricane Wilma. 1. Facility Status: Dr. Szurek reported that due to Hurricane Wilma, the Key West office was flooded and a claim in the amount of $15,000 has been made. The St. Clare’s clinic was also flooded but damage was negligible, and the clinic is fully operational. MedVan 2 stationed in Big Pine was a total loss, and a claim has been made with the insurance company. Fr. Mullane in Big Pine has offered the use of classroom space as an alternative for patient care, until a more permanent location can be found. No damage is reported for the Marathon or Upper Keys sites. 2. RHNMC’s role with Regard to Disasters. Dr. Szurek reported that the health department had sought assistance through the MedVan at Big Pine with a group of volunteers, post Hurricane Wilma. Dr. May (health dept. director) and Fr. Mullane (pastor at St. Peter’s Church) were informed that all RHNMC employees had either evacuated according to county directives, or if they had remained during the storm, were now dealing with their own personal damages. In addition, the RHNMC insurance underwriters had stated that RHNMC was prohibited from offering use of facilities as our policies do not include disaster relief as an aspect of coverage. Mr. Pascucci also stated that MedVan 2 had been completely destroyed and was unuseable, and therefore could not assist the volunteers. Finally, Dr. Szurek reported that there was no current agreement with the health department about the RHNMC role concerning disaster recovery. Ms. Clark presented copies of an agreement executed between the health dept. and RHNMC. Dr. Szurek pointed out that the agreement had expired over a year and a half ago (June 2004), and that he had sent a letter to Dr. May in April 2005, asking for a meeting to review respective roles and abilities. He stated that Dr. May has yet to respond, but that he had also sent a personal letter to Dr. May to clarify the current RHNMC situation, and inviting Dr. May to participate in a strategy session to ensure participation where possible. Fr. Hartney questioned why RHNMC should be involved at all in disaster recovery as this seems to be a public health function. Ms. Clark and Mr. Smits suggested that all of the community should participate in disaster recovery, particularly medical personnel. Dr. Szurek reminded the group that he cannot force staff to “volunteer” and that in the current season, all employees had indicated their unwillingness to be part of public relief efforts, stating that their own families and property deserved their attention. Ms. Bassett offered to chair a committee to draft a plan for RHNMC. Mr. Smits asked that any plan include details about “higher ground placement” arrangements to ensure no damage from storm surges to property. Mr. Luse thanked Ms. Bassett for her offer, while Ms. Clark, Mr. Pascucci and Dr. Szurek stated that they would be happy to serve on such a committee. (In an email sent to Ms. Clark after the meeting and copied to Dr. Szurek - by Ms. Clark-, Dr. May also expressed her willingness to participate on this planning committee.) Mr. Luse approved Ms. Bassett’s appointment and the ad hoc committee composition. 3. Continuation of Services at Big Pine Key. Dr. Szurek asked that the group consider primary care services should continue at Big Pine Key. Board Members overwhelmingly stated that services should remain available to residents on Big Pine Key. Ms. Bassett stated that she may have space available at the HMA professional building and would investigate that possibility. Ms. Bassett was thanked by Mr. Luse for her offer. C. Our Kids Contract. Dr. Szurek reported that the Guidance Clinic has elected to terminate its contract with Our Kids, Inc., effective 12/31/05. RHNMC maintains a sub-contract with GCMK for physical exams for Our Kids clients. Dr. Szurek stated that the contract is being terminated due to under-utilization, and that the impact will be negligible. By acclamation, the Board approved the end of this sub-contract agreement. D. Catholic Charities. Dr. Szurek stated that Catholic Charities has asked for use of 2 offices at the 2855 O/H location in Marathon, to start in 12/15/05. He reminded the Board that Catholic Charities has given medical office space in Key West to RHNMC for the past 4 years without rent. Ms. Premaza wondered if this might not set a precedent for other organizations to also ask for space. Dr. Szurek stated that no other organization with the exception of Fishermen’s Hosp. Assn and the county (Ruth Ivins), has ever offered free space to RHNMC. In a motion made by Mr. Smits and seconded by Ms. Pena, the Board unanimously approved the use of 2 offices at 2855 O/H Marathon to Catholic Charities, pending approval by the landlord and on condition that the situation would be annually reviewed by the Board. E. HRSA Performance Review. Dr. Szurek reported that the organization will be reviewed by HRSA for performance in a review of the network development grant in November 2006. Dr. Szurek reported that all of management will participate in the preparation of this review, with Mr. Douglass and himself taking the lead. The Development Committee will play an integral part in a site visit, part of the review process. VII. COMMUNITY INPUT AND ANNOUNCEMENTS. There were no announcements. VIII. RHNMC ANNOUNCEMENTS. A. The next meeting of the Governing and Advisory Board will be the annual meeting of the membership, scheduled for Monday, January 23, 2006, at 10AM, at 2855 Overseas Highway, in Marathon. B. The next meeting of the Governing Board is scheduled for Monday, December 19, 2005 at 9AM at Mariners Hospital in Tavernier. Telephone call-in accommodations will be available at 1623 Spalding CT #4 in Key West, and 2855 Overseas Highway in Marathon. IX. ADJOURNMENT. There being no further business before the Board, the meeting was adjourned by unanimous acclamation.
Respectfully recorded,
Mark L. Szurek, Ph.D. President & CEO
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