BOARD OF DIRECTORS June 27, 2012 Bob F. Valliant Center ...

BOARD OF DIRECTORS
June 27, 2012
Bob F. Valliant Center Boardroom
Minutes
CALL TO ORDER
Bob Storer called the meeting to order at 5:15 p.m.
Present
Bob Storer, President
Reed Reynolds, Secretary
Lauree Morton
Nancy Davis
Alex Malter
Linda Thomas, Vice President
Kristen Bomengen
Mary Borthwick
Nathan Peimann
Absent
None
Others Present
John Vowell, Interim CEO
Dennis Stillman, Interim CFO
Toni Petrie, Executive Assistant Kathy Callahan, Director of Physician Services
Norma Adams, HR Director
Dick Monkman, Hospital Attorney
Deven Mitchell, Executive Director Alaska Municipal Bond Bank
Public participation –
Jayne Andreen, Program Manager for Health and Social Services, Matt Felix, NCADD, and Wendy
Hamilton, Juneau Clean Air Coalition –Testified about Rainforest Recovery Center’s “RRC” recent policy
change to allow the patients to leave campus to smoke. CBJ passed an Ordinance in 2007, making BRH
a smoke free campus and they expressed their concerns about patient’s ability to smoke off campus while
still in the program.
Dr. Clark Damon – Testified about his frustration that he is unable to order his own tests at the hospital
without a physician’s referral and that the hospital doesn’t allow referrals from out of state physicians.
Minutes – Linda Thomas made a MOTION to approve the May 22, 2012 minutes as presented. Mary
Borthwick seconded the motion and they were approved.
Kristen Bomengen made a motion to approve the June 18 th minutes as presented. Lauree Morton
seconded the motion and they were approved.
Bond Defeasance – Deven Mitchell, Executive Director of the Alaska Municipal Bond Bank, came to do a
presentation to the Board explaining the process of defeasing bonds. Several questions and comments
Board of Directors
June 27, 2012
Minutes

were asked by Board members and Administration. A copy of the PowerPoint presentation is included in
the record of the Minutes.
Dr. Peimann – what does making this decision now mean? Bob Storer responded - the bond bank meets
periodically, but the amount of debt outstanding is high enough that they could hold a special meeting. It
could be August, September, October, etc.
Mary Borthwick - asked if we decide to do nothing now, could we wait another year? Deven said he
would not recommend waiting a year, but if the Board decides to wait, it should be revisited as often as
needed and the rates should be checked periodically. Dennis said the Assembly authorized the Board to
do this at any time, but it does take about 3 months to process and the rates are not locked in.
Kristen Bomengen – how does this affect our required payments? Deven responded that you could
structure your savings and you could save $120,000 a year if we do this today.
Dennis Stillman – the Assembly authorized the Board to approve this whenever they wanted to do it. The
process is approximately 3 months to complete. The interest rates are not locked in during those 3
months.
Linda Thomas – what risk does the Board have from a fiduciary view point – Deven said the risks he
sees, are interest rates rising and losing the opportunity to make money goes away.
Reed Reynolds – would we use low interest money to pay off a higher interest bond? Deven - Yes.
Bob Storer – the covenants will apply to outstanding bond issues – Deven-the covenants will apply to
outstanding bond issues.
Credentialing report – Dr. McPherson presented the Credentialing report. Dr. Peimann made a
motion to approve it as presented. Kristen Bomengen seconded and it was approved.
CEO report – John went through his report submitted in the meeting packet.
Mary Borthwick – when Joint Commission comes will the Board get a report? John said they do an exit
interview the last day. We will get the information to the Board when that happens so anyone who wishes
to participate may attend.
Kristen Bomengen – encourages Board members to be available for the Joint Commission survey.
Dr. Malter – how did the hospital go about searching for the IT Director candidates? John – we used in
house resources as well as outside resources. Norma Adams - We used a search firm out of Seattle that
we have had good experience with in the past.
Executive Committee– Bob Storer gave the Executive Committee Report included in the packet. Patient
Complaints and Grievance Procedure was discussed and referred back to the Quality Committee for
further discussion.
Reed Reynolds made a MOTION to approve the Juneau Youth Services contract. Kristen
Bomengen seconded and the motion passed.
Kristen Bomengen made a MOTION to approve the Johnson Youth Center contract. Nancy Davis
seconded the motion and it was approved by a roll call vote.
Board of Directors
June 27, 2012
Minutes

Kristen Bomengen made a MOTION to approve the JAMHI contract. Lauree Morton seconded the
motion and it was approved by a roll call vote.
Lynn Canal – Kristen Bomengen made a MOTION to approve the Lynn Canal Counseling Service
Contract. Lauree Morton seconded the motion and it was approved by a roll call vote.
Johnson Youth Center Contract was moved for reconsideration with a roll call vote and was
approved.
Juneau Medical Building – We need to go to the City for approval, but Heather Marlow, CBJ Lands
Manager, has requested a copy of our master plan. We do not have an approved new Master Plan.
Heather indicated through email if we do not have a MFP adopted, it should go to the Lands Committee
instead of the Committee of the Whole. Dick Monkman is working with the City to find out how this
process needs to work.
Dr. Peimann suggested working through Planning to help Administration and the attorney move forward
on this process.
Linda Thomas noted that she doesn’t want to wait for Planning since it seems as if time is of the essence
for approval of the JMC. She recommends following up with the Lands committee chair and Heather
Marlow to see what our options are. If we are not required to submit the MFP, then we shouldn’t have
something submitted that we haven’t fully vetted. We have vetted the need to purchase the Juneau
Medical Building.
Kristen Bomengen – what kind of delay does this create? It might have to wait until the next Lands
Committee meeting.
Finance Committee – Linda Thomas reports;
Financial reports were included in the meeting packet.
The Finance Committee minutes in the packet are in draft form. They will go to the next Finance
Committee for approval and back to the Board if there are any substantive changes. This process will
allow Board members to see the “draft” minutes in a timely manner for awareness, but also give the
Finance Committee members an opportunity to review the minutes at a subsequent meeting and come
back to the Board with any changes at the next meeting.
Linda mentioned that Thursday, June 28 th is the next Finance Committee hearing on 1% sales tax. It’s an
important meeting for vetting the sales tax priorities.
Dennis gave an overview of the May financial statements – Year to date. The bottom line is that we are at
about 1.4 million dollars net income. May was strong, but we did not hit our target. Expenses are right on
budget. We estimated where we would finish the year and it’s been pretty solid so far for the month of
June. This puts us in the range of 1.42% net revenue.
Dennis went through policy discussions; there is a new capital expense form, so when Dept. Managers
are submitting a request for new equipment, they will go through the financial exercise and look at the net
present value and also support it with the intangible benefits, the quality benefits as well as patient
benefits so we will have a complete picture.
Board of Directors
June 27, 2012
Minutes

In reviewing patient billing practices, it was noted that there have been missed billing opportunities for
additional revenues. Administration is currently in the process of reviewing and setting up new standard
operating procedures to help improve this situation. The primary issue is in infusion services, where we
do not have patients “sign in” for each visit. The Finance Department is working on the best way to
improve this with very little impact on the patient.
Linda Thomas noted that the Finance Committee asked for an update on the QHR costs and that was
provided at the Finance Committee meeting.
Joe Wanner informed the Finance Committee that the Medicare cost report submitted for reimbursement
and previously presented to the Finance Committee had been reduced. He had built in a reserve for this,
so no additional costs or reductions to revenue will occur because of this change.
Reed Reynolds wanted to amplify on the capital budget process that he is extremely pleased and feels it’s
an extraordinary step forward.
Mary Borthwick asked if the recruitment expense included QLK. Dennis - Yes its part of the cost.
Linda asked for acceptance of the “draft” finance report. Reed seconded. The report was accepted
as presented.
Planning Committee – Dr. Peimann reports;
There was a presentation by the Fetal Alcohol Team. At the end of the discussion, Administration pointed
out their specific opinion about how we move or not move forward with the FASD team. The Committee
entertained a motion that the finances or any implications for obligation or liability be reported to the
Finance Committee in July.
Management Transition Committee – Kristen Bomengen reports;
Since the last Board meeting, there have been a series of interviews, including an Assessment Center.
There is no final report at this time. Negotiations are ongoing with a candidate and there is hope to have
an answer by the end of the week. Kristen is not able to provide more information in public session due to
personnel matters. She would like to take it up at the end of the meeting in executive session. Bob made
an observation that there were lessons learned with the assessment center, but he really appreciated the
involvement of the Board, staff, medical community and everyone that took the time to come and share
their thoughts with the Board.
CAMHU – Lauree Morton reported that there will be more information at the next Board meeting since the
meeting with the City is tomorrow (Thursday). Bob encouraged the Board members to attend.
BRH Foundation – Mary Borthwick reports;
The Scholarship Committee gave out four scholarships. Two are from Juneau, one from Sitka and one
from Ketchikan. They are;
• Mamie Clare - Sitka
• Carissa Jackson - Juneau
• Mary Keele - Ketchikan
• Elysia Spencer - Juneau
Board of Directors
June 27, 2012
Minutes

RRC – Lauree was unable to attend the meeting but asked if there were any issues that needed to be
reported to the Board and there was nothing to report.
Reed made a motion to ask the Rainforest Recovery Advisory Board “AB” to review their earlier
decision and consider the position we heard tonight regarding the tobacco free campus and RRC
patients being allowed to leave campus to smoke. Kristen seconded for the purpose of
discussion. She would like the AB to be aware of the hospital policy. Our policy should hold some
meaning on how this is handled and to encourage it to be more studied in the future.
Nancy - some people have found the electronic cigarettes to be help with the hand to mouth behavioral
activities.
Dr. Peimann asked to table the motion to a time uncertain since we only heard a one sided
discussion.
Dr. Peimann stated we are a policy setting Board; we aren’t the policy setting board for patient care. It’s a
fine line. He wants to give the medical staff the opportunity to discuss their side. Dr. Peimann would like
the Board’s direction on how they would like to receive the information back to the Board.
Bob Storer stated that we need to revisit the whole issue. He would like to know more about how our
policies work with their abilities to make policies. He would like to know more of the issues and the
complexities. It was discussed how the information would be relayed back to the full Board.
Dr. Malter stated he would be comfortable giving latitude to Bob and/or Lauree to report back to the
Board.
The motion passed to table the motion.
John Vowell spoke to the smoking issue. It came before the Environment of Care Committee. There is a
City ordinance that we are a non-smoking campus and at that time there was confusion how it tied into
this.
Dr. Peimann noted the reason the City made it an ordinance was so that the fines could be enforceable.
Dr. Peimann respects both perspectives on this issue. He respects the work place and what it does for
our profile, but more importantly what it does for our staff and patients. There are staff that leave campus
to smoke. At RRC there is a way you can go out on a pass for a walk about. More and more staff is
requesting these so they can go off campus to smoke.
Nancy would like to hear from RRC about this issue.
Bob would prefer to make a thoughtful decision, rather than a decision in haste. He would like to carve out
time in our next Board meeting to work with staff and review the policy. Dr. Malter reiterated that he is
comfortable giving Bob Storer and Lauree Morton the latitude to report back on this issue in August,
rather than July. Reed Reynolds said this issue was discussed thoroughly in 2007. Dr. Peimann thinks it’s
different and it should be re-addressed.
The July calendar was reviewed and changes were made.
Bob Storer would like to address the Bylaw Committee now, rather than later in the year. He appointed
Nancy Davis as Chair, Mary Borthwick, Dr. Peimann and Kristen Bomengen to be on the committee.
Board of Directors
June 27, 2012
Minutes

Board comments:
Dr. Malter thanked the Transition Committee for all their work.
Nancy will be out of town for the July meeting.
Dr. Peimann cautioned John Vowell and Dennis Stillman that while we implement the new phone system,
there will be communication issues and urged them to do it in sections and to do it in mid-September.
Kristen Bomengen – She wanted to include in her earlier report, the involvement of the medical staff and
hospital staff was astonishing. She felt it made a difference on how things were approached. Their input
was very valuable. She also wanted to thank all the fellow Board members for putting in so much time
and effort during this process. It was a very rewarding process for her to work with everyone. Reed also
wanted to thank Mila Cosgrove and the staff at CBJ.
Linda Thomas – Have we done anything with the evening coverage in the ED waiting area? John Vowell
answered that the desk and computer system are being set up now. The monitoring and after hours
system is being worked on.
Bob Storer – Bob would like to update the ophthalmologists on the progress of the Juneau Medical
Building.
Executive session – Kristen Bomengen made a motion at 7:15 p.m., to go into executive session to
discuss matters which could have an adverse effect on the finances of the hospital and personnel which
requires legal counsel. Dr. Malter seconded and it was approved.
The Board came out of executive session at 7:55 p.m. No action was taken.
The end of the agenda was met and the Board Adjourned at 7:55 p.m.
Board of Directors
June 27, 2012
Minutes