The Hospital Governing Board monthly meeting was held on Thursday May 21, 2009. Chairperson Dottie Ratzlaff conducted the meeting.

Human Resources Director Laurali Noteman stated she sent out a six page proposal to nine different entities that over the past year had expressed interest in becoming the carrier for the employees 457B Retirement Plan.  She said the plan is very similar to a 401(k) but is designed for non-profit organizations that are exempt from federal income taxes such as the hospital.

Several of the entities Noteman contacted are independent companies. She said there is a lot involved once the proposal is acceptable to all concerned and in finalizing the process on a timely basis. Employees have been asked for their input.

Noteman reported on the Hospital Auxiliary Thrift Shop’s new carpeting being installed and how great the remodeling looks great. Auxiliary President Emma Norton said it could not have been done without the help of so many hard working and caring volunteers. The students of the Abundant Life Academy were a big help as well.

Noteman reported she was notified the election for 2009 sign-up starts July 1. Hospital Governing Board members up for re-election are: Debbie Fox, Shayne Ramsay and Ray Clark.

According to Hospital Financial Director Steven Howells the status, revenue-wise, is much like last month; still not quite up to budget, but much better than it had been. Operating expenses are down.

Administrator Panyda stated next month’s record of expenses would go up substantially. The hospital is required to keep anti-venom serum on hand at a cost of $15,000. That is enough for two doses or six shots for two adult patients. A typical snakebite takes 25 doses. Six shots are a loaded dose and a start, then the patient is sent out of the area to complete the care. Howells said the “first Aid” type treatment is not recommended.

Board member Doyle Swallow asked if receiving the sales tax money is consistent. Howells replied generally it is received monthly but it does change through out the year. Lag time is about three months.  The first month the tax money is collected in the store as part of the purchase. The next month the store sends the tax money to the state. The third month the state distributes the monies. The hospital has received January’s. 

Board Member Shayne Ramsay asked when the one percent sales tax “sunsets.” Howells replied it actually ends in June 2015. There was a discussion about the sales tax revenue continuing in support of the hospital. Could it be voted upon at county level or is the decision made at state level? Pandya would try and get clarification.

Shayne Ramsay questioned the issues with the EMT’s qualification and non-qualified training. Panya stated she spoke with the EMS managers in Salt Lake and the state licensing board. A four-day refresher course was conducted and tests given. Testing results have not been received. If they passed the tests, licenses would be issued.

There was a paperwork problem with Orderville and the Valley EMTs recertification. Pandya said the problem has been resolved and the state has approved re-certifications. Dave Owens is a certified trainer and will be conducting classes. Pandya said there has to be a separate certified trainer for a specified number of people.

Providing ambulance service to Jacobs Lake and the Grand Canyon was an issue. Member Ray Clark suggested EMS Supervisor Stewart contact Arizona authorities about reimbursement for services. Pandya stated by law, a request for an ambulance cannot be denied. The hospital’s ambulance in Big Water is covering all that area and since Page is a closer hospital, it is sometimes necessary to utilize their hospital facilities. Pandya said Page emergency services will not cross the state line.

Status of the Critical Access Hospital; Utah Department of Health is waiting for Medicare (CMS) to send the necessary 855 forms; it could take as long as 90 days from the time the paper work went in.

Disproportionate Share Payments (DSH), the final approved version of the contract is ready for signatures and will be sent out.

The Adverse Drug Event audit went well. Teresa Bishoff and the nursing staff were complemented on their involvement, willingness to report and record keeping. There was some concern about the availability and participation of a pharmacist being on call 24-hours a day.

Utah Retirement Systems (URS); they have received and accepted the certified copy of the resolution and will be sending a letter to confirm the hospitals status as non participatory. 

The hospital has purchased 100 doses of Tamiflu (a pill) in response to the “swine flu” through the health department at a reduced price. Ordering medication through regular channels has become impossible since the “swine flu” announcement. The initial distribution from the Strategic National Stockpile was 69 doses; a second shipment was 20 doses. A pandemic will have to be declared to receive any more doses. The first responsibility is to the hospital’s in-patients and the staff.

As a side note, Commissioner Hulet cautioned the over distribution of the medication since it is a controlled substance. If there is not a pandemic event, the medication may be wasted, used incorrectly or flushed down the toilet contaminating the water. 

Electronic Health Records; Kristie McMulin from Cedar City is going to set up a seminar on grant monies available for healthcare IT through the stimulus plan.

Pandya added if a critical access hospital purchased a certified electronic health record system, the time and costs would be greatly reduced. The stimulus plan would pay approximately 70% to 75% of the actual cost to the hospital.

Pandya noted if a system is not “meaningful” implemented by 2015, Medicare payments to the hospital might be reduced. Member Ray Clark was of the opinion once the system is started, it will be important to complete the process in its entirety.

Pandya stated the initial retirement information letter to the employees was sent on April 24, with a follow-up response by the board indicated within 45 days.

 A decision needs to be made on the information contained in that response.

Privileges and credentials were approved for Dr. Joseph W. Nelson. He is a third year resident of St. Mark’s hospital and a licensed physician in the State of Utah. Dr. Nelson has agreed to help in the E.R. one weekend a month as a replacement for Dr. Tamco.