BIRHC Board Meeting Minutes


Board of Directors Approved Minutes

Saturday, January 19, 2008

BIRHC Community Room


Present Board Members – Sandra Birdsall , Ann e Glendon (via speaker phone),

Dr. Brad Grassmick, Pete LoDico , Jean McDonough , (via speaker phone), Barb Murphy, Rick Speck , Connie Wojan

Staff – Donna Kubic , Managing Director

Absent : Don Spencer, Karen Whitecraft

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 2:00 PM, welcoming all board members present; new board member candidates in the audience and on the speakerphone; and guests.

II. Review revisions to agenda

No revisions to the agenda.

III. Review and approval of minutes

Motion to approve minutes of November 17, 2007 as presented (Murphy/Grassmick) approved.

•  Leonor Jacobson presentation

Leonor Jacobson reported on Ray Cole's very generous offer to commission Mary Blocksma to do a painting of someone's home on the island. This prize could then become a valuable silent or live auction item. Ray would pay Mary to come to the island in August and work with the auction winner. It was suggested that Ray's Blocksma painting of the Lodge be displayed at the Health Center during the bidding. Leonor suggested other artists might be approached and asked to donate pieces of art. It was decided the resource development committee would come up with a lead person to organize the event. Connie Wojan then presented Leonor with a plaque expressing thanks for the $15,000 Leonor has raised for the Health Center . This plaque is presented to: Leonor Jacobson , In appreciation for your extraordinary efforts to promote the financial welfare of the Beaver Island Rural Health Center . Your boundless enthusiasm, creativity and countless hours of work have resulted in unprecedented fundraising success. With sincere appreciation, The BIRHC Board of Directors and Staff.

V. Financial & Utilization Reports

•  Financial reports presentation and discussion

Rick Speck reported on the income statement. Most items were in line with budgeting. $10,000 was taken out of the Auxiliary Fund to bridge the gap before millage tax money was received last fall. Connie mentioned the Charlevoix County Community Foundation will make a formal presentation of our $2,500 grant check in the spring, but that the monies could be requested earlier if needed. Motion to accept financial report (Grassmick/LoDico) approved .

•  Reports on Earned revenue for services

Donna Kubic reported that billings were down by $11,601.28 for the first three months of the new fiscal year. There were 75 fewer encounters compared to 2006. Encounters billed for 2007 are down $8,530.

C. Utilization Reports

97 fewer patients were seen in November and 62 fewer patients in December. Sue was called in three times October through December after hours and 7 times during those three months on the weekend. The relief care providers treated 13 patients. Insurance receivables are at $36,064.

VI. Resource Development Report

A. Quarterly Summary Endowment Fund/Special Projects

Ann e Glendon reported that the Special Projects Fund increased $53,554 in the 4 th quarter. However, $27,700 of that was the interest that was transferred from the Endowment Fund. The $157,288 ending balance is the healthiest this fund has ever been. The Endowment Fund took in $31,000 in the fourth quarter. Ann e suggested having a list of donors at the March meeting so board members might thank people in person.

B. Annual Appeal

Ann e stated that the annual appeal was a good letter, for a good cause and people responded. So far over $20,000 has been received in response to the annual appeal letter

C. Truck Raffle.

Pete Lodico reported signing papers for a 2008 Chevy Equinox, the same SUV we raffled last year, except the color is silver. The cost of the Equinox is $18,500. The list price started out at $22,460 but $3,960.00 in various discounts were secured through the help of Ken Slater, Pete, GM and Dave Kring. Many thanks to Pete for doing all the work to get us this great deal. Motion to purchase SUV as recommended by Pete for the 2008 raffle. (Murphy/Grassmick) approved.

VII . Operations Report

A. Summary of Activities, Statistics

Donna Kubic reported on the following:

•  Joyce Runberg wrote a thank you to the board for sponsoring Hospice in their successful $4,000 grant application to the Charlevoix County Community Foundation.

•  There were two Remec Community Telehealth network in services. One was January 10 th. The topic was “Heart Attack and Stroke Awareness.” The next one will be January 22, 1:30 – 2:30 “Stress and Heart Disease, Understanding your Control.” On February 14 th we have “Health for the Community” from 7 – 8:30 PM .

•  We have received the 60 sheets, gowns and towels from Munson hospital towards the supplies needed for the disaster plan thanks to Larry Hansz . Donna received a $5,000.00 check for disaster supplies from Ken Taylor. We will be ordering supplies in the near future.

•  On February 23, the Health Center , along with EMS , will invite island residents 45 years old and older to schedule an appointment to have a baseline EKG performed for their charts. An article will appear in the newspapers about the event.

•  Thanks to EMS for assisting in writing a grant to the Grand Traverse Band of Ottawa and Chippewa Indians for $6,800.00. Gerald LaFreniere was the driving force behind applying and following through. The plan is to put the new computers at the EMS station. EMS could use the computer at their station to fill out patient reports, while waiting for a patient transfer. Having an extra computer could shorten the time in which a run is completed.

•  The exercise program started on January 7. It takes place from 5-6 pm on Monday, Tuesday and Thursday. Also on Monday is a mother daughter exercise program, which was the idea of Brontae Cole, who approached the Health Center , made the flyers and posted them around town.

•  Spencer Glendon, Ann e Glendon 's son donated a much-needed centrifuge in Ann e's name as a Christmas present to Ann e.

•  Blue Cross donated $100.00 as a matching donation, thanks to Arlene Brennan .

•  We received a letter from Janice Wittich donating $1,000.00 in memory of her late husband who visited the island for many years.

B. Goals for 2008

Donna asked if there were any questions regarding the goals for 2008 that included:

•  Hire new NP

•  Orientate relief care providers

•  Performance improvement back on schedule

•  Disaster “stuff” organized

•  Look into Health Savings Plan for employees

•  Digital x ray in place and operational

•  New Telecommunication equipment be familiar with

•  If grant comes through new computers – up and running on network

•  Hospice in place

•  Getting Karmanos to come to the island for mammograms this year

C. Search Plan

Donna Kubic asked if there were any questions about the Search Plan Outline passed out to the board members. Donna passed out a list of desired applicant characteristis and a list of required skills that the applicant we are looking for must have. There are skills required of the BIRHC nurse practtioners that might not be necessay in settings which are not rural health centers.

D. Advertising

Donna Kubic distributed a list of websites and other places that have could be used regarding the hiring of a Nurse Practitioner.

She explained that advertising on the web is expensive and that there is no line item in the budget to pay for advertising.. Donna listed sites she thought would be beneficial with prices.

E. Future Advertising Budget

Motion to spend up to $2,000 for advertising to fill the postion of nurse practitioner. (Speck/Grassmick) approved.

F. Relief Strategy of NP

Donna Kubic informed the board that Penny Kiss was here on the island this weekend doing relief work. Penny will return the end of March for a week and indicated she maybe able to do another week. Chris VanLooy has committed to one weekend a month for relief work. Bev Russell was contacted but could only commit to a two weekends a year. Malpractice insurance must be purchased for each relief provider.

VIII. Old Business:

•  Vacation pay discrepancy.

Sandra Birdsall passed out a list of differences found in the employee handbook and the letter of engagement to the new providers. The board decided the letter would need to be rewritten before the hiring of a new nurse practitioner. Brad Grassmick offered to work with Sandy to draft a revised employment letter. It then would be sent to Webb Martin.

IX. New Business

•  Recognition of Outgoing Board Members

Connie reported that Karen Whitecraft was resigning from the board. Connie thanked Karen for her time spent helping sell tickets for the SUV raffle and all the time she has given to the medical center board. Barb Murphy's term has also expired but she would like to continue to be involved. Connie Wojan appointed Barb as an Ex-officio board member. Barb will be invited to all board meetings, continue to receive board information packets and serve on committees but will not have the privilege of voting. Connie presented Barb with a plaque for her outstanding service over the last 6 years

Election of New Board Members

Larry Hansz , Denny Cook and Sarah McCafferty talked about their backgrounds and why they were interested in serving on the BIRHC board. Conflict of interest policies were given to the new board members. Connie mentioned that both Denny and Sarah have potential conflicts of interest: Sarah McCafferty works in the summer at the clinc and Denny Cook's wife Mary is the Health Center 's accountant. Denny and Sarah confirmed that they understood that they would have to abstain from voting on issues on salary, or issues regarding EMS . Motion was made to approve all three candidates to the board (Birdsall/Grassmick) approved.

•  Election of Board/Staff Liaison

Ann e Glendon and Connie Wojan gave a brief history of the appointment of a board member as board-staff liaison in Mach of 2004. Sandra Birdsall stated that in her experience such a position was very unusual and questioned its necessity. The board discussed whether or not the position should be continued. In view of the staff memo strongly requesting that Don be reappointed, the board concluded that it should be continued. Motion to reappoint Don Spencer as Board Liaison to the Staff for two years. (Cook/Speck) approved .

•  Committee Assignments

Resource Development Committee

Connie Wojan reported that Jeff Traudt has volunteered to serve on the Resource Development Committee. Connie, Ann e and Brad volunteered to serve. A new chair would be elected.

Finance Committee – This committee summits the budget to township in August and would meet in July to work on budget for the following year. Don Spencer, Rick Speck and Sandy Birdsall to serve on the finance committee.

Executive Committee

Elected every two years. This committee remains the same. Connie Wojan , President, Don Spencer, Vice President, Ann e Glendon , Secretary and Rick Speck , Treasurer.

Quality Improvement

Brad Grassmick volunteered to chair the first meeting. Jean McDonough , Sarah McCafferty and Denny Cook also volunteered to be on this committee.


Don Spencer will be leaving the board in two years and offered his expertise with his background on the building committee for the health center. Denny Cook will chair the committee and ask community members with other areas of expertise to join the committee.

Nurse Practitioner Recruitment

Larry Hansz will chair the committee. Jean McDonough , Sandy Birdsall, Donna Kubic and Sarah McCafferty volunteered to serve.

•  Strategic Planning

Connie Wojan has been in touch with Pete Plastrik, who has experience in facilitating a strategic planning session. Pete has graciously offered to facilitate the meeting at no cost to the Health Center . It is desirable to have a non board member facilitate strategic planning. Pete would like to talk to a few of the board members ahead of time. Ann e Glendon , Sandy Birdsall, Connie Wojan , and Brad Grassmick volunteered to meet with Pete beforehand. Jean McDonough offered to be an extra person, if needed. Connie volunteered to call the first meeting.

X. Next Meeting

March 22, 2008

XI. Public Comment

No public comment

XII. Adjournment –

Motion to adjourn at 4:30p.m. (Wojan/Grassmick) approved.

Respectfully submitted,

Connie Wojan , President

Donna Kubic , Managing Director


Board of Directors Approved Minutes

Saturday, November 17, 2007

BIRHC Community Room


Present Board Members – Sandra Birdsall, Ann e Glendon (via speaker phone),

Dr. Brad Grassmick, Pete LoDico , Jean McDonough , Barb Murphy, Rick Speck , Don Spencer, Connie Wojan

Staff – Donna Kubic , Managing Director

Absent : Karen Whitecraft

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 2:00 PM , welcoming all board members present.

II. Review revisions to agenda

No revisions to the agenda.

III. Review and approval of minutes

Motion to approve minutes of September 22, 2007 and September 28, 2007 Special Meeting as presented (Murphy/Spencer) approved. Connie Wojan thanked the Board for getting together on such short notice to attend the September 28 th special meeting.

IV. Financial & Utilization Reports

•  Financial reports presentation and discussion

Rick Speck reported that expenses over all were under budget for last fiscal year. All donations not just the SUV raffle are listed under donations. The October statement shows the first month of the new fiscal year carrying forward $7,800, which was not on the previous budget, also the $15,000 matching funds and surplus income. Expenses are around 8% according to the October income statement. Contract services with relief care are below budget to date. Income from endowment per Mr. Tambellini should be around $41,000. That is higher than expected. Motion to accept financial report (Grassmick/Spencer) approved .

•  Reports on Earned revenue for services

Donna Kubic reported tota l billed January through October 2007 is $194,445, which is $11,392.00 higher than 2006. This is billed and not collected monies. Numbers compared to fiscal 2006 were up by 105 encounters, which means the services being performed are making the difference in the billable amounts. We are now doing more physicals and procedures. Even though the numbers show100 encounters more than 2006, the amount billed is $11,000 higher.

C. Utilization Reports

Encounters in October were up by 84, however, this time last year we didn't have the flu vaccine. Total annual physicals performed to date are 174.

The new billing company has started billing as of November 1 st . Health Services IT person and Steven from Central Solutions have resolved firewalls, etc. Betty and I will receive training soon.

V. Resource Development Report

A. Landscaping Project

Connie Wojan reported on the landscaping project and could not give enough credit to Gary Marvin who donated over $2,000 worth of trees, plants and shrubs plus flew over at his own expense and spent the day digging and designing the layout of the landscaping. BJ and Phil Wyckoff donated four large trees, fertilizer, lilies, daffodils, and the use of their tractor. BJ made lunch for the crew and Phil planted for two days. Leonor Jacobson was instrumental in organizing the landscaping project. She and Bruce Jacobson spent three days digging and planting. Bill Freeze donated wooded planters. Bruce Kingsley, Pam Moxham and Sandy Birdsall also helped plant. Jeff Powers donated hoses and a timer for the sprinklers. Skip McDonough informed the staff she would be donating Christmas lights for 6 of the newly planted trees in memory of John Works, Sr.

B. Quarterly Summary Endowment Fund/Special Projects

Ann e Glendon reported on the amounts as of 9/30/07 in the two separate funds managed by the Charlevoix County Community Foundation. The Endowment Fund with pledges receivable is at $1,102,256.30 and the Special Project stands at $102,353.42.

C. Annual Appeal

A copy of the annual appeal letter was distributed to the board. The letter will be in the mail by Tuesday. It was decided to consolidate the services provided by the Health Center into specific areas instead of incorporating them into the appeal letter. This letter becomes a good tool for board members to be familiar with what the Health Center has to offer.

VI. Operations Report

•  Summary of Activities, Statistic

Donna Kubic reprted on the following:

•  The grant for $2,500 from the Charlevoix County Community Foundation was approved to help defray the $15,000 matching funds portion for the Digital X Ray and telehealth equipment. Hospice Helping Hands also received the $4,000 they requested from CCCF with BIRHC sponsorship.

•  She has received a call from the Department of Veterans in Saginaw . The veterans on the island will be able to get their blood work done at the BIRHC, processed at the Charlevoix Area Hospital and then faxed to the VA doctor. The veterans will need to follow up with the VA Doc.

•  She had a conversation with Margaret Bowers from Northern Michigan Sports Medicine Center about providing physical therapy on Beaver Island when needed. Bowers will discuss traveling to Beaver Island with her staff and get back to Donna to see if it would be feasible. The need for the service is not great, but having an agency willing to come to the island is important.

•  Donna attended a Commission on Aging meeting in Boyne City which was held to help prioritze Senior Services in Charlevoix County . An Ad Hoc Committee for direct care services will be formed and Donna was asked to serve on that committee. Lynda Bockstahler, RN, Director of the Northwest Michigan Community Health Agency and Sue Bergmann will be on that committee. Donna looks forward to promoting a working relationship with Northwest Michigan Community Health Agency.

•  A $200.00 annomous donation was received from one of the organizations which holds regular meetings in the BIRHC Community room.

•  The Beaver Island Boat Company donated the cost of transporting the trailer full of trees, scrubs and plants for the landscaping at the health center which amounted to $257.00.

•  We have not had any additional inquiries regarding the nurse practitioner position. Since the last meeting, the ad has been posted on the Univ of Detroit Mercy, Oakland University Career Services and Michigan Talent bank web sites. The staff has discussed and agreed on desirable applicant characteristics relative to Beaver Island . The candidate should be independent, resourceful, like the outdoors, like 3 seasons, be comfortable with available island resources, school, library, stores, transportation, internet, housing recreation, churches and be comfortable with low key rural/island culture.

•  Update on Distant Learning & Telemedicine Grant

Donna attended a meeting at Charlevoix Area Hospital and Don Spencer participated via speakerphone on October 16 to begin discussion on moving forward with the digital X ray and telemedicine project. A project timeline was presented with a target date of April 30 th to go live with all systems. Joe Schodde, Vice President of Finance at Charlevoix Hospital will be the primary negotiator and project manager.

VII . Old Business:

A Update on Disaster Plan.

Don, Donna and Sue attended the St. James and Peaine Township meetings to present the Health Center 's internal and external diaster plan. The plan was well received by the townships and will be discussed again at their December meetings. Ken Taylor was present at the St. James meeting and following that meeting Donna received an e mail from Ken indicating he would donate $5,000 towards the disaster supplies needed. Ken then spoke with Larry Hansz to see if he might be able to obtain some of the needed items. A phone conversation is set up with Larry, Donna and Munson Hospital on Wednesday to see what supplies might be available from Munson Hospital . Barb Swartzfisher researched the cots and Donna now has a website where the military cots may be purchased. Don Vyse thought the Governmental Building basement could be the storage site for the supplies.

VIII. New Business

•  Board Succession

A spreadsheet prepared by Connie Wojan was passed out (copy attached to minutes). In February 2002 the board members drew lots for staggered terms to comply with the newly revised bylaws. Ann e Glendon spoke about a succession plan for board members whose terms will be expiring.

Jean McDonough commented that she had not yet attended an orientation session. Connie apologized and promised to meet with Jean the next time she can come to the island. A best practices list regarding governance and financial issues was distributed (copy attached). The townships will need to reappoint Pete LoDico and Rick Speck to the BIRHC board as a formality. Barb Murphy's term will be up in January and she will not eligible for reelection. The President could designate her as an ex officio member. Karen Whitecraft, who joined the board as a representative of EMS , will complete her first term in January. Connie will meet with Karen to determine her interest in serving another term and talk to EMS to see whom they want to recommend. Connie Wojan will post an ad for new board members in both papers. Donna will post on the BIRHC website. A board succession task force committee was formed which consists of Don Spencer, Sandra Birdsall, Jean McDonough and Ann e Glendon to come up with job descriptions, and reflect on what the Board has done over the years. Ann e would like the board to be informed about a definite plan for recruiting a care provider.

B Hospice of Little Traverse Bay affiliation

Donna reported on a conversation with Meredith Goodrick, Hospice/Home Health Director and Di Gilroy, Hospice House Manager regarding Munson being the Medicare-certified hospice agency that might have a presence on Beaver Island . As Medicare beneficiaries, patients are entitled to the Medicare Hospice Benefit without additional premiums. For services related to terminal illness, there are virtually no out-of-pocket expenses, even for drugs, equipment and other high cost items that are often needed in the last months of life. No other Medicare benefit offers such financial protection. The family's burden is reduced by the financial relief that the Medicare Hospice Benefit provides, and by volunteers that hospices offer in addition to the hospice staff. After the hospice admission, there is virtually no paperwork, no bills, no claims, and no financial surprises. Having access to the hospice and Medicare Hospice Benefit means that comprehensive care at the end of life does not have to be expensive or burdensome to the family. Patients should be able to die in comfort and with dignity in their own home.

Munson would pay the $1000.00 cost of the training. Donna would need to spend a few days with a Hospice Nurse from Hospice of Little Traverse Bay and whatever other training needed. If these steps are taken, when the need arises on Beaver Island , hospice services could be available.

IX. Next Meeting

•  Set Meeting Dates for 2008

Motion to set meeting dates for 2008 as: January 19, March 22, May 17, July 19, September 20 and November 22 nd at 2 p.m. (Grassmick/Spencer) approved.

•  Set January 2008 as Ann ual Meeting

Motion to set the BIRHC annual meeting for January 19, 2008 at 2:00 p.m.

(LoDico/Grassmick) approved.

•  Public Comment

No public comment

XI. Adjournment –

Motion to adjourn at 3:50p.m. (LoDico/Speck) approved.

Respectfully submitted,

Connie Wojan, President

Donna Kubic , Managing Director