Health and Hospital Corporation of Marion County Board of Trustees Meeting Minutes for April 16, 2002

Minutes of the Board of Trustees Meeting
of the Health and Hospital Corporation
of Marion County, Indiana

April 16, 2002

The meeting of the Board of Trustees ("Board") of The Health and Hospital Corporation of Marion County, Indiana ("HHC"), was held, April 16, 2002, in the Administrative Conference Room "A", Fourth Floor, Ott Building, Wishard Health Services, 1001 West Tenth Street, Indianapolis, Indiana. Members present: Mr. West, Dr. Miner, Mrs. Journey, Ms. Brougher, Mr. Pfeifer, Dr. Bock. Members absent: Mr. Gutwein

In the absence of Matthew R. Gutwein, chairman of the Board, Mrs. Lula Journey, vice chair called the meeting to order and proceeded with roll call.

Mrs. Journey then asked if there were any additions to, corrections to or comments regarding the minutes from the Board meeting of March 19, 2002. There being none she asked for a motion to approve the minutes. Dr. Bock made the motion to approve the minutes. Mr. West seconded the motion. The minutes for the March 19, 2002 annual Board meeting were unanimously approved.

The next agenda item was Resolution No. 3-2002, "Inter-local Cooperation Agreement With the City of Indianapolis For Environmental Code Enforcement Services." Mrs. Journey asked that Ms. Hebenstreit read this resolution. Ms. Hebenstreit requested Resolution No. 3-2002 be tabled due to the fact that it is not ready for Board approval. Resolution No. 3-2002 was tabled.

Mrs. Journey then asked that Dr. Jones present the Bylaws and Policies which include Policy No. 700-17, "Occupational Health Clinic Infection Control Policy," Policy No. 700-20, "Policy for Consent to Human Immunodeficiency Virus (HIV) Diagnostic Testing and Counseling," Policy No. 700-33, "Care of Stillborn/Fetal Death," Policy No. 700-44, "Emergency Authority for Infection Control," Policy No. 700-56, "Obstetrics/Gynecology & Pediatrics," Policy No. 700-93, "Closure of Medical Records by Patient Care Committee," Policy No. 700-107, "Transfusion of Blood/Blood Product Consent" Dr. Jones stated that Dr. Howard would explain the Bylaws and Policies. Dr. Howard began by explaining that the policies have been reviewed in preparation for the Joint Commission survey. The policies include necessary changes and have been submitted to the patient care and/or infection control committees and to the executive council. Seven of the policies contain changes and the eighth Policy No. 700-107, "Transfusion of Blood/Blood Product Consent" is being recommended for deletion. The key components of this policy regarding consent will be incorporated into Administrative Staff Policy No. 950-25. Mrs. Journey asked for approval of Policies No. 700-17, 700-20, 700-33, 700-44, 700-56 and 700-93. Dr. Bock made the motion to approve. Mr. Pfeifer seconded the motion. The policies were unanimously approved. Next, Mrs. Journey asked for approval to delete Policy No. 700-107. Dr. Bock made the motion. Dr. Miner seconded the motion. The Board of Trustees unanimously approved to delete Policy No. 700-107.

Next, Mrs. Journey asked for the Treasurer's Report. Mrs. O'Laughlin began her report with the Budget Revenue and Expenditure Report for February 28, 2002. The Tax Revenues are 2/12th times the sum of the annual budgets for Health and Hospital Corporation property tax, excise tax and financial institutions tax. The Public Health Revenues of $1.7 million are $43,562. (2.5%) over budget. This is attributed to the food license fees that are due by March 1, and collections have been high in January and February. The Headquarters Revenue of $252,678 is over budget by $52.678 (26.3%). Interest income is the main source of this revenue, and is high due to a higher for fund balance available for investing. The Grant Revenues of $1.7 million are under budget by $68,210 (3.8%). Grant reimbursements are dependent on actual expenditures and the timing of claims processing by funding agencies. The Revenue for Public Health and Headquarters is $ 28,035 over budget (.01%). The Expenditures: Personal of $216,865 (4.4%) over budget. In 2002 all employee benefits were moved into the personal services category. Travel, mileage reimbursement and tuition assistance have been included in the contractual services budget. The year to date total of these expenses was $164,500. Supplies of $617,800 are $44,467 (7.8%) over budget. The Clinical Lab encumbered an annual blanket purchase order for chlamydia cultures in January and another annual blanket was encumbered to purchase merchandise for the Babes Store. Other Services and Charges of $23.6 million are over budget by $320,825 (1.31%). This category includes the operating transfer of $21,000,000 made from the Health and Hospital Corporation General Fund to support operations of the Wishard Enterprise Fund. The Health and Hospital Corporation has encumbered purchase orders for the first quarter of the year for several annual contracts. These include legal services, title searches for unsafe building demolitions, programs for prevention of tobacco use, and the school based health initiative. Capital Outlays of $125,193 are under budget by $874,807 (87.5%). Total expenditures for the Health and Hospital Corporation of $29,499,211 are $1.07 million $29.5 million under budget (22.9%). Mrs. O'Laughlin asked for acceptance of the 2002 Revenue and Expenditure Budget Analysis Report for February 28, 2002. Dr. Bock made the motion for acceptance. Mr. Pfeifer seconded the motion. The report was unanimously accepted.

The March Cash Disbursements Report was submitted next. Cash Disbursements at $28.7 million are below the 2001 average of $32.1 million. In April payments for the first quarter PERF and Self Insurance of $ 5 million will be made. Mrs. O'Laughlin requested acceptance of the March Cash Disbursements Report. Dr. Bock moved to accept the report. Mr. West seconded the motion. The March Cash Disbursements Report was unanimously approved.

The next agenda item was Wishard Medical Staff Appointments. Dr. Jones asked for approval. Ms. Brougher made the motion to approve. Mr. Pfeifer seconded the motion. The Wishard Medical Staff Appointments for the month of April 2002 were unanimously approved.

Mrs. Journey then asked for explanation of the "Burn Unit Interior Build-Out " Bid listed on the agenda and included in the Board packet. Dr. Jones stated that the Bid was discussed at the Hospital Committee meeting. He asked that Dr. Bock explain the Bid. Dr. Bock stated that the Hospital Committee recommended that the Bid be accepted. Dr. Bock moved that the Board accept the "Burn Unit Interior Build Out" Bid as presented. Dr. Miner seconded the motion. The Bid was unanimously accepted.

Standing Committee reports began with Dr. Bock reporting on the Quality Committee meeting. Dr. Miner and Dr. Bock along with other members of the committee met on April 15, 2002. JCHO indicators were reviewed. There were six measures submitted in 2000, which indicated that Wishard had more favorable rates than the statewide hospital average and four measures indicated a rate slightly less favorable than the statewide hospital average. The committee discussed the factors that influenced these rates. The Performance Improvement Highlight Report from September through 2002 was also reviewed. In addition, environmental care measures, quantifiable data measures on hazardous waste, equipment, security safety, life safety and utility management were reviewed. Actions taken to address narcotic controls and key activities being undertaken to enhance patient safety was also discussed. The human resources and annual report on competency performance was reviewed and key areas noted are evaluation patterns, use of contracted services personnel, education training, higher turnover, data trends, and drugs screening activities. Improvement has been noticed in the compliance with employee performance reviews which is likely associated with the alignment of merit incentives and reviews and the availability to access computerized evaluation information. The report revealed that participation by employees in annual education has increased. This could have been due to the availability of self-study formats. Overall hospital physician turnover was noted to have a slight decrease from 33% to 31%. There being no questions Mrs. Journey asked for a motion to accept the Quality Report. Ms. Brougher made the motion. Mr. West seconded the motion. The Quality Committee Report was accepted. Dr. Jones stated the Quality Committee deals with issues related to risk management. This committee is composed of the physician members of the Board due to the need for legal peer review protection. The next report was from the Hospital Committee. Dr. Bock stated that the Hospital Committee met on April 16, 2002 and reviewed and discussed the draft of the proposed Wishard Annual Incentive Plan. The plan was recommended for passage by the Board with an amendment that item 7.3 be deleted and item 7.4 replaced item 7.3 and item 7.5 replaced 7.4. In addition, the Burn Unit Bid was discussed and Mrs. Stouffer, director of human resources for Wishard Health Services, gave a presentation on the retention and recognition of employees. Dr. Bock concluded his report by stating that the retention and recognition of employee information is included in the Board packet. Mrs. Journey asked for acceptance of the Hospital Committee Report. Ms. Brougher moved for acceptance. Mr. Pfeifer seconded the motion. The Hospital Committee Report was accepted.

Dr. Jones asked for a separate vote on the incentive plan with the deletion of item 7.3. Dr. Bock moved that the Board accept the Wishard Annual Incentive Plan as amended. Ms. Brougher seconded the motion. The Wishard Annual Incentive Plan was accepted. The Public Health Committee Report was presented next. Mr. West stated that the committee discussed the Pecar Health Clinic. The clinic is scheduled to be complete by Spring 2003. Also, at the Public Health Committee meeting Julie Bishop, administrator, Vital Records, presented information on the renovations of the vital records area and also on the change to optical scanning of records. Dr. Kent Smith gave an oral health assessment update and information on the dental clinics. Mr. West continued the Public Health Committee Report by distributing a draft copy of the minutes from the Public Health Healthy Babies Committee held on March 19, 2002. Mrs. Journey asked for a motion to accept the Public Health Committee Report. Dr. Bock moved for acceptance. Mr. Pfeifer seconded the motion. The Public Health Committee Report was accepted.

Action Items began with Mr. Elwell presenting the Citizens Health Center Budget and explaining that the Health and Hospital Corporation became the 330-status agency for the center as required by the federal government. Mrs. Journey asked if any of the Health and Hospital Board of Trustee members would like to serve on the Citizens Health Center board or would like to recommend individuals to serve on the Citizens board. She then asked for a motion to approve the Citizens Health Center Budget. Dr. Miner made the motion to approve the budget. Mr. West seconded the motion. The Citizens Health Center Budget was approved.

Next, Mr. Elwell introduced a guest, Mary Walker a representative from the Marion County Alliance of Neighborhood Associations, Inc. (McANA) who read two letters of support that were sent to the Board of Trustees regarding the importance of upholding the standards of dedication to neighborhoods and the environmental health community as it pertains to the MCHD environmental health department. There were no questions or comments. Mrs. Journey thanked Mrs. Walker for coming to the meeting and for the support.

Dr. Caine began by reporting that MCHD might possibly raise dental fees for the dental clinics to $10.00 to meet patient care needs. Discussion ensued regarding co-pay and capping cost. Dr. Caine continued her report by referring to the Selected Notifiable Disease Summary for January through March 2002 on the Invasive Streptococcus Pneumoniae Disease for 2001. This report is in the Board packet. MCHD has been effective with immunizations for this disease and hopes to see the decreasing numbers. Dr. Bock complimented the MCHD on the efforts to reduce the occurrence of the syphilis disease in the city.

Mrs. Journey then called for Mrs. Brougher to report on the Midtown Mental Health Advisory Board meeting. Mrs. Brougher stated that the Board met on April 8, 2002. There will be a $354,000 Medicaid charge back to Midtown. Representatives from the board appealed this charge back at an administrative hearing but lost their appeal. They will decide whether it will be worth appealing again. The board reviewed a human resources report that indicated Midtown is having difficulty in filling degreed positions. There was also a presentation from David Wills, president of the Indiana Chapter of the American Mental Health Association, on a program that will train police officers to respond to situations involving profound mentally ill patients. The program hopes to acquire resources from Wishard Health Services, MCHD and other agencies for the training.

Dr. Jones distributed complimentary tickets for the St. Margaret's Guild Decorator's Show House. The tour will be held from April 27, 2002 to May 12, 2002.

The meeting concluded with other business. Collette Duvalle, Director of Communications, Health and Hospital Corporation announced that Public Health Staff Day will be held on Wednesday, April 24, 2002. The speakers will be Dr. Mike Magee, Patricia Russell-McCloud and Deborah Paul. It will be held at the Blue Ribbon Pavilion at the Indiana State Fairgrounds. All Board members are invited to attend. Mr. Elwell also encouraged attendance at the Public Health Awards Dinner. Proceeds from this dinner support the George Rawls Scholarship Fund and will be held on Wednesday, April 17, 2002 at the Indiana Roof. Two scholarships will be awarded this year.

There was no other business and the meeting was adjourned.

The next meeting will be held at 1:30 p.m. on Tuesday, May 21, 2002 in the Administrative Conference Room "A", Fourth Floor, Ott Building, Wishard Health Services, 1001 West Tenth Street, Indianapolis, Indiana.