The meeting was called to order at 6:01 p.m. by Fred Lau.

Present: Fred Lau      Ingrid Avril

Wendy Lefton      Steve VanWagoner

Ron Alderfer

Excused: Lorna Olson      Kellie Blue

Absent: Rick Eckert

Also Present: Charles Franz, CEO

Charlie Button, CFO

David Green, SAB

Dr. Paul Eneboe, Chief of Staff

Tom Walpole, Director of Human Resources

Larry Dallas, Director of Support Services

Mark Talley, Controller/Purchasing Manager

Peggy Pittman, RN/Acute Care

Robbie Coffey, RN/Acute Care

Donna Anderson

Elizabeth Johnson

Jan Hanenberger, Homer Secretarial Services

The agenda was approved as submitted.

There were no comments of the audience.

Mr. VanWagoner mentioned three typographical errors on page two. In the last sentence of the first paragraph the word "wondering" should be "wandering", in the first sentence in paragraph seven where it read, ".....and wondered into another resident’s room....." should read ".....and wandered into.....", and in the last sentence of the same paragraph where it read ".....residents who wonder.....", should read ".....residents who wander.....".

The members briefly discussed each Finance Policy.

The members then reviewed the Executive Management Performance Policies. Mr. Franz mentioned policy EMP-5, Hiring and Terminating Individuals in Key Positions, is a new policy which will deal with replacement in key positions.

Retreat Planning

Mr. Lau said they received suggestions for agenda items and a draft has been prepared. He suggested having a Retreat that primarily involved both boards, with key management and the Medical Staff attending specific sessions. The draft of the agenda for Saturday contained Medical Staff/Boards/Hospital Staff Relations and Team Building, E ffectiveness of Individual Members, Committees and Board, and Meeting Management. On Sunday it was suggested they cover Quality Improvement, which would include credentialing, peer review, risk management, and how the board can monitor quality.

Ms. Lefton mentioned Dr. Eneboe had suggested covering peer review for the Medical Staff and hoped there would be a time for this topic. She also said one of her main concerns is the financial health of the hospital and hoped there would be an opportunity for the boards and the Medical Staff to discuss this. Dr. Eneboe felt it would be a very good opportunity to communicate with the Medical Staff and cover such issues as credentialing, peer review and risk management. Mr. Franz suggested covering these topics during team building and Medical Staff relations on the first morning. Ms. Lefton said she hoped they could obtain a professional facilitator to assist them. Mr. Lau felt they should revise the agenda to combine some of the sessions. Ms. Avril suggested including board self-evaluation since this is difficult to cover during a regular meeting. Mr. Lau mentioned each board could cover this separately on Sunday afternoon.

Mr. Franz mentioned the dates have been changed to January 16th, 17th, and 18th due to a conflict with availability of meeting facilities at Land’s End. Mr. VanWagoner said these dates were not good for him. The members agreed to see if the facilities would be available for January 23rd, 24th, and 25th.

Board Member Recruitment

Ms. Avril reported Donna Anderson and Pat Hartley have shown interest in becoming a member of the board. Ms. Anderson was present this evening and said that the hospital was very important to her that the choices made today will affect the hospital in the future. Ms. Hartley was out of town and unable to attend this evening. Mr. VanWagoner knew of another individual who may be interested, and Ms. Lefton said she approached Gary Thomas who declined.

Mr. Franz said SPH had applied for a Denali Commission grant, of $250,000.00, and it has been awarded to the hospital. The borough informed him they needed to be the recipient of the grant funds and the Assembly would then appropriated the funds. The SAB forwarded a motion to the Assembly requesting they accept the grant on the hospital’s behalf and appropriate the funds to SPH. Mr. Franz added the grant is a 50-50 match and they will be using the existing construction as part of the match. He then asked for a similar motion from the BOD.

Mr. Franz said after the flooding last fall Larry Dallas worked very hard with FEMA and obtained grant funds, in the amount of $75,000.00, which does not require a match, to improve the drainage on the slope behind the hospital. He said this is a similar situation, as with the Denali Commission grant, and they must recommend the Assembly accept this grant and appropriate the funds to the hospital.

Mr. Franz informed the members that after the special board meeting on October 8th the renewals were placed and bound for the Directors and Officers Insurance, and the Professional Liability Insurance. The premiums did not change this year. The employees’ Long Term Disability Insurance and Life Insurance will be coming up for renewal at the end of October. They have obtained some very competitive bids, which show they will be able to save approximately $46,000.00. Mr. Button added they have chosen Canada Life, which is an A+ rated company.

Revisions to the Personnel Manual for Managers and Confidential Employees

Mr. Lau felt since they have discussed and reviewed the revisions this could be covered in open session unless there were specific issues they would like to discuss in Executive Session. Mr. Franz said some members were concerned about the minimum salary, which has been adjusted downward and is now closer to the Jacobson Betts minimum salary survey numbers. This did not affect the upper end of the range, but did affect the lower end of the range, and brought those to within $2,000.00 of the Jacobson Betts numbers. Mr. Franz felt this would allow for future growth and the salary scale will carry them for two to four years.

Mr. Lau said the committee did not meet and asked Mr. Button to report directly to the board. Mr. Button reported inpatient revenue, year to date, is down $809,000.00. He said during the month of September they were at 22% occupancy and their goal was 40%. Dollar wise, year to date, they had budgeted $2.3 million and they are at $1.5 million. Outpatient revenue is doing very well and they are over the budgeted amount by $197,000.00. LTC has been very close to 100% occupancy. Total patient revenue shows a $708,000.00 increase to the budgeted amount. Total operating revenue is at $5.6 million, which is $533,000.00 below budget. The departments have been doing a good job in trying to control expenses and total operating expenses are under budget by $177,000.00. Mr. Button added that unfortunately, with that much decline in volume, it is very hard to make this up in expenses. Currently there is a loss from operations of $451,000.00, which is $356,000.00 above the budgeted number of $95,000.00. Bad debt has been high due to individual cases that are uncollectible at this point in time, and eventually will be turned over to a collection agency.

Mr. Button said there is a representative from CPSI at the hospital this week working specifically with billing issues. SPH covered the airfare but is not paying them a wage.

President

Mr. Lau had no report.

Chief of Staff

Dr. Eneboe said most of his report would be during Executive Session. He said they have developed a disaster plan and are currently discussing contacting the Fire Department, Police Department, and high school to possibly hold a community wide drill. He then presented a cart containing one month’s generated paperwork, which he considers useless, from the computer system in LTC. CPSI has not been able to address this problem with the system. Dr. Eneboe said each piece of paper must be put into the individual’s chart, later removed when the charts become full, and then stored. He felt this contributes greatly to the workload in LTC when sorting through the un-necessary pages to find vital information. Ms. Lefton felt the hospital should demand free support from CPSI until these issues have been taken care of.

Administrator

Mr. Franz said he also is frustrated with not having the computer system’ s problems repaired as quickly as they would like. Mr. Button, and his staff, have been working very hard with the CPSI staff to correct problems. He said he has also written a letter to David Dye, the CEO of CPSI, regarding the situation. Mr. Dye, as well as his assistant, are working on it and have contacted him regarding their plans. Mr. Franz said he agreed that it is quite a bit of un-necessary paperwork for LTC but the problem they are faced with is that the system is hospital-wide and what is considered burdensome in LTC is needed in AC. He has met with the nurses, and certified nursing assistants, and they agree the system takes longer than the old system but they are now administering the medications in safer manner.

Mr. Franz informed the members an arbitration hearing was held last week, regarding the issue with the union on retro-active pay. They should receive an answer shortly after the first of the year.

Mr. Franz said they received notice from the Denali Commission they will have approximately $50 million available for grants next year for the state, which is twice as much as was available this year. SPH is looking at two possibilities: help with funding for the construction of the ER, which would free up funds to possibly do some of the add alternates, and a MRI and a building to place it in. Mr. Button added they are also considering a third grant to update the boiler system.

Mr. Franz reported they are working on a renovation project for the OB waiting room and they are in the process of moving departments to the Botkin property. He said Larry Dallas has arranged for the asbestos assessment to be done by the borough on the old clinic building. After this has been completed they can proceed with demolition.

Mr. Franz reported Dr. Roger Mason has agreed to return in December and provide a few weeks of coverage. He is very interested in the community and appreciated the time the board spent with him and the interaction with the other physicians during his prior visit. Mr. Franz felt Dr. Mason would be a nice addition to the staff and may help them deal with problem of keeping some of the surgeries from going out of Homer.

Mr. Franz informed the members Mr. Button will be leaving SPH for a position in Lowville, New York. He said he has been a wonderful asset to the hospital and he will be greatly missed.

Mr. Franz reminded the members the Health Fair will be held November 8th and provided them with an alphabetical schedule and information for blood draws at the hospital.

Mr. Franz said there is a class on parliamentary procedure being held at the Kachemak Bay Campus this Saturday from 1:00 p.m. to 5:00 p.m. If they are interested in attending they should contact Jessie Cashman and she will arrange for their registration.

Mr. Franz pointed out the quality posters on the conference room walls, which were from a celebration of Quality Improvement arranged by Christine Anderson, Quality Improvement Manager.

SAB Chairman

Mr. Green reported the ordinance to purchase the Botkin property was introduced at the October 14 th Assembly meeting. Prior to the meeting the borough mayor had contacted Mr. Green saying he did not feel he could support the companion ordinance for a consultant fee for Karen Berg-Forrester. This was due to some controversy that had occurred last year with regard to the volcano center that had been pushed by a realtor in Anchor Point. The mayor said he felt it would be up to our Assembly representatives to present this. Mr. Green said he has met with Chris Moss and Milli Martin, who felt supportive of it, but in looking at the issues they pointed out there was an absence of a written agreement, and with the purchase of the property at fair market price by adding a consultants fee this would make it above fair market price.

Mr. Green said the SAB addressed the ordinance for acceptance of the Denali Commission grant for the bulk oxygen system, and also announced a resolution to recognize Craig Chapman’s contribution in the placement of the bonds for the hospital expansion.

Mr. Green said their Governance Committee is working on board education and agreed with the BOD that it would be appropriate to discuss Effective Evaluation and Effective Meetings at the Retreat. They plan to address other items throughout the calendar year, and those of interest to both boards could be discussed at joint meetings.

Mr. Green reported two SAB members are experiencing health problems and they may be looking for new members in the next couple of months. During their next meeting they will be having election of officers after swearing in the new candidates and re-appointing one of the prior members.

Governance Committee

There was nothing further to discuss.

QI Committee

There was no report. Mr. Franz mentioned no one attended and it would be helpful if a board member would participate. Ms. Lefton volunteered to be the BOD representative. Mr. Franz said he would supply her with a packet of information and the dates and times for the meetings.

Foundation Committee

Mr. Franz said the first annual meeting was held and the existing trustees were re-elected. They are Karen Berg-Forrester, Jackie Dentz, Fred Lau, Bob Plymire, and Tom Walpole. There is approximately $62,000.00 currently in the Foundation’s account and there are 35 members at this point in time. They have received their letter of determination from the IRS that they are classified 501(C)(3 ). Mr. Franz said what is done with the money raised by the Foundation is completely up to the Board of Trustees to determine and they do not have to comply with borough rules on how to handle the funds. There will be a press release next week.

SAB Finance Committee Meeting,     11/03/03 12:00 p.m.,       SPH Conference Room 1

Regular SAB Meeting,     11/06/03 6:00 p.m.,      SPH Conference Rooms

Foundation Committee Meeting,     11/11/03 3:00 p.m.,       SPH Conference Room 2

BOD Finance Committee Meeting,     11/18/03 12:00 p.m.,      SPH Conference Room 2

Regular BOD Meeting,     11/19/03 6:00 p.m.,      SPH Conference Rooms

Mr. Lau mentioned due to Thanksgiving the next BOD meeting date has been changed to November 19th.

Donna Anderson said the Foundation’s certificates are beautiful. She felt it would be a great idea to have a booth at the Health Fair, and offered to set at the booth. She asked what the retention time was on paperwork generated by the computer system. Mr. Franz said it was five years.

Dr. Eneboe thanked Mr. Button for all his hard work and said he will be greatly missed.

Ms. Lefton thanked Mr. Button for his work and professionalism.

Mr. Alderfer also thanked Mr. Button.

Ms. Avril said they real appreciated Mr. Button and will miss him.

Mr. VanWagoner wished the best of luck to Mr. Button and said he will be missed.