The meeting was called to order at 6:01 p.m. by David Green.

Present: David Green   Karen Berg-Forrester

Angelo Hillas   Jay Kennelty

Bettyann Steciw   Valerie Byrd

Doris Cabana

Excused: Jackie Dentz

Also Present: Charles Franz, CEO

Charlie Button, CFO

Julie Woodworth, former SAB member

Mark Talley, Controller/Purchasing Manager

Paul Seaton, State Representative

Sherry Biggs, KPB Deputy Clerk

Donna Anderson

Jan Hanenberger, Homer Secretarial Services

At this time Mr. Green asked for a moment of silence in memory of SAB member, Robert Plymire, who passed away this week.

Mr. Green suggested the oaths of office be given to the new and appointed members after Approval of Agenda. He also requested adding Declaration of Seat C Open after Appointment of Board Member to Seat B. Mr. Green said due to the requirement for giving adequate notice of a vacancy he has asked Ms. Cashman to place an ad in the newspaper announcing Seat C is vacant.

Bettyann Steciw arrived at 6:06 p.m.

Mr. Green also requested adding Election of Officers under New Business.

The agenda was approved as amended.

Jay Kennelty arrived at 6:07 p.m.

Sherry Biggs, KPB Debut Clerk, then swore in the newly elected members, Doris Cabana, Valerie Byrd, and Jay Kennelty. Ms. Biggs asked for all the SAB members to verify that the mailing addresses and telephone numbers the borough currently have for them are correct. She also provided the necessary forms for the appointment to fill Seat C.

There were no comments of the audience.

Mr. Green thanked Representative Paul Seaton for attending this evening.

Ms. Biggs then swore in Ms. Steciw.

The committee did not meet.

Governance

Ms. Steciw said the committee discussed various topics for education and has prepared a schedule. They also discussed the issue regarding compensation for Ms. Berg-Forrester, which will was tabled until next month’s meeting. Borough attorney, Collette Thompson, is planning to speak on open meetings and conflicts of interest in March. The committee meets on the third Tuesday of each month at 4:00 p.m., and is open to anyone interested. Committee meetings will be posted in the newspaper.

Secretary

Mr. Hillas had nothing to report.

Chairperson

Mr. Green felt Donna Anderson would be an excellent candidate to fill Seat C. After the required two week time frame for advertising for possible additional candidates, he anticipated an appointment would be on next month’s agenda.

Mr. Green said he and Mr. Franz have been discussing various methods for controlling change orders to the construction contract, which will allow the hospital some visibility of the size of each change in dollars and the cumulative affect of all the changes.

Mr. Green said the board has quite a bit of work remaining to be done in regard to being efficient in discharging their obligations.

Administrator

Mr. Franz said he just returned from the Alaska State Hospital Association meeting and discussed some of the key issues they would like to accomplish during the next year. One issue is Medicaid reimbursement. Commissioner Gilbertson informed them the state has a Medicaid budget of $1.65 billion, which is 40% funded by the state and 60% funded by the federal government, except for native beneficiaries which are funded 100% by the federal government. Commissioner Gilbertson’s goal is to reduce the Medicaid budget by $20 million next year and $90 million by state fiscal year 2006. Mr. Franz said this will result in some significant reductions in reimbursement, as well as differences in the way the hospital will deliver services. He said the most worrisome part is that in many communities the state is looking at how they can have the local native corporation take ownership of the local health care system. This would then allow for services, provided to native, as well as non-native Medicaid beneficiaries, to be reimbursed to the state at 100% rather than the 60% federal match. Mr. Franz said he plans to meet with Commissioner Gilbertson in the near future.

Mr. Franz said the VA has collected approximately $120,000.00 from the hospital due to some confusion in the way they calculated prior payments going back to 1995. The way the VA regulations are written there are no statues of limitation for overpayment. He added they have also changed their way of reimbursement to all facilities to reduce their reimbursement rate.

Operating Board

No representative present this evening.

SPH Foundation Committee

Ms. Berg-Forrester reported the incumbent trustees were re-elected by the general membership on October 21st. Due to Mr. Plymire’s death they are looking for a member to replace him as Treasurer of the Foundation.

Current Financial

Mr. Button reported during the first three months of the fiscal year the hospital has had a loss from operations of $451,000.00. The budgeted amount was $95,000, making a difference of $356,000.00, which is due primarily to inpatient revenue. Year to date they are $809,000.00 below budget in inpatient revenue. The month of October seems to be doing better. Expenses were under budget in all areas except contract staffing and bad debt. Mr. Button said they are very much concerned with AR days, which have climbed to 89 days, and their goal is 68 days or below. He said a CPSI representative has been brought in to provide special training to the staff, they are currently searching for a manager for patient accounting, and they are giving overtime to the staff. He said he is very optimistic the inpatient volume will come up now that the physicians, who were gone for an extended period of time, have returned and are working very hard.

Mr. Green asked if there might be a problem with re-building trust in the community due to the lack of coverage by the doctors. Mr. Franz said this has been a problem and they hope to address this with the two surgeons. He mentioned Dr. Roger Mason, a surgeon who is very interested in Homer, will return to provide services December 20th through the first part of January. Dr. Mason is dual board certified in vascular and general surgery. Mr. Franz said Dr. Mason has been very active with various school groups and community organizations. He would like to see the doctors become more active in the community, which may help to regain the community’s confidence.

Mr. Franz mentioned the Health Fair will be this coming Saturday from 7:30 a.m. until 1:00 p.m. The fair is always well attended by most of the health care providers in the community. He reminded the members they could receive their free blood test by going to the registration desk and register for the Health Fair blood draw. Donna Anderson volunteered to help with the SPH Foundation booth. Ms. Woodworth mentioned they will be holding a drive for stem cell and bone marrow donors.

Mr. Franz said this should be on the agenda for a final hearing during the November 18th Assembly meeting and he plans to attend. Mr. Green said he may also attend.

Denali Commission Grant for Bulk Oxygen System

Mr. Franz said this is also on the agenda for a final hearing during the November 18th Assembly meeting.

SPH Retreat

Mr. Franz said the date for the Retreat will be January 16th, 17th, and 18th.

Mr. Franz said this is for the flood damage last year and the grant is for remediation work on the hillside behind the hospital to divert water and improve the drainage.

Mr. Franz said the Denali Commission has changed its eligibility criteria and will now open up grants to community hospitals. This year they expect to increase the funding from $20 million to $50 million. SPH will apply for construction funds for the ER, which will then free up the money planned for its construction and apply it towards some of the add alternates. Other grant options would be to replace the hospital’s boilers and to upgrade the MRI to a more powerful magnet that would be placed inside the building.

Mr. Franz mentioned the Assembly approved the award of the contract to RIM/KMD on October 14th, but the firm informed Mr. Franz they have not yet received their notice to proceed.

Resolution #03-05 Commendation for Karen Berg-Forrester

Mr. Franz said this has not been completed and will be on the next meeting’s agenda.

Election of Officers

Ms. Berg-Forrester said she would accepted the position if it was the pleasure of the board. There were no other nominations and Mr. Green declared the nominations for Chairman closed and asked for unanimous consent. There were no objections.

Ms. Steciw accepted and Mr. Green declared nominations for Vice Chairman closed and asked for unanimous consent. There were no objections.

Ms. Byrd declined.

Mr. Hillas accepted and Mr. Green declared nominations for Secretary closed and asked for unanimous consent. There were no objections.

Committees and Committee Participation

Mr. Green said they try to conduct as much business as possible in committee meetings, provide input during board meetings and then take action, which then saves time during the board meetings. Mr. Green volunteered to Chair the Finance Committee, Ms. Byrd said she would like to remain on the Governance Committee, Mr. Hillas will remain on the Governance Committee, Ms. Steciw volunteered to Chair the Governance Committee, and Ms. Cabana will attend the Governance Committee meetings. Mr. Green said he would contact Ms. Dentz and find out her wishes.

BOD Finance Committee Meeting,   11/18/03 12:00 p.m.,    SPH Conference Room 1

Foundation Committee Meeting,   11/18/03 3:00 p.m.,   SPH Conference Room 2

Governance Committee Meeting,   11/18/03 4:00 p.m.,   SPH Conference Room

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

SAB Finance Committee Meeting,   12/01/03 12:00 p.m.,   SPH Conference Room 1

Regular SAB Meeting,   12/04/03 6:00 p.m.,   SPH Conference Rooms

Ms. Berg-Forrester informed the members she will be out of town from December 5th through December 19th.

Representative Paul Seaton said they held a four hour HESS meeting/teleconference and it appears from the testimony received that the reorganization within the department has had positive benefits. He said at this point in time it appears the eligibility for Medicaid will not be changed. Representative Seaton said they are sponsoring a bill giving immunity to health care professionals for providing free care. In light of the problem with C-section coverage this may be something the hospital might consider looking at. Although doctors may not want to provide free service it still would allow the hospitals to charge their regular fees. Mr. Franz said this was discussed at the State Hospital Association meeting and they will support this bill. Representative Seaton said the legislature is currently giving quite a bit of consideration to drug costs, and with a preferred drug list there may be legislation to allow purchase of Canadian drugs. Mr. Franz said the Association would also support this. Medicaid is spending $100 million per year on drugs for their beneficiaries and this would save approximately $10 million. Representative Seaton encouraged individuals to contact him with their concerns.

Mr. Kennelty said due to a shortage of help in the pharmacy where works he has been working six to seven days a week, and has not been able to participate in board activities as much as he would like. Mr. Franz said he may know of a pharmacist who may be interested in a position.

Ms. Byrd said she will miss Mr. Button and welcomed Ms. Cabana.

Ms. Steciw said she will also miss Mr. Button and welcomed Ms. Cabana to the board. She mentioned her father passed away at Providence Hospital. While he was there a nurse came in and played the harp. She asked if anyone had ever offered to do this at SPH. Mr. Franz said they had been approached by an individual who offered to do this for a fee. He said they could approach this again and possibly contact the Homer Council on the Arts. He said there are several volunteers who play for the LTC residents and this would be a great tool to use in AC.

Ms. Berg-Forrester welcomed Ms. Cabana, thanked Representative Seaton for coming this evening, and said she would miss Ms. Woodworth and Mr. Button. She said they had a good group of members and encouraged them to keep on with the good work.

Ms. Woodworth said she was sad to see Mr. Button leave and it was incredible that SPH went through an audit with no findings. She welcomed Ms. Cabana and said she was sorry to leave the board and they might see her back soon. She said she is on the Legislative Committee for the chamber, and as the hospital looks at legislative issues they would be happy to present a resolution at the state level. Mr. Franz added the legislators and the governor need to understand the economic impact of health care in small communities. SPH is the largest employer in Homer and puts $9.5 million in salaries and wages into the community, with those dollars turning over five or six times to businesses in the community.

Mr. Hillas said he would miss Mr. Plymire, Ms. Woodworth and Mr. Button and told a story of how Mr. Plymire had bought his bookkeeping business years ago. He said he will be a great loss to the community.

Ms. Cabana said she appreciated the opportunity to serve on the SAB. She said her mother passed away at the hospital in July and appreciated everything the staff did for her. Mr. Green encouraged her to call him with any questions she might have and will provide her with a packet of information.

Mr. Green thanked Ms. Anderson and Representative Seaton for attending this evening, and mentioned Mark Talley will be the new CFO. He added Mr. Plymire will be greatly missed.