BIRHC Board Meeting Minutes

June 2016 Draft Minutes

Income Statement trhough Feb 2016

Draft Meeting Minutes March 19, 2016

December 2015 Annual Meeting

March 2015 Board Meeting

Board of Directors unapproved  Minutes
Saturday, September 27, 2014
10:00 AM BIRHC Community Room

December 13, 2014 Annual Meeting

Minutes Sept 2014...................Accomplishments 2014.............Budget 2015 report

Income Statement ending Nov 2014....................December 13 2014 Minutes......................Operations Report

Present – Board Members –  Terry Keyes, Pete LoDico, Jeff  Powers, Adam Richards, Connie Wojan
Absent – Rick Speck, Jim Wojan, John Works, Jr.
Staff  – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant
Guest – Don Spencer

  1. Call to Order & Welcome

President Connie Wojan called the meeting to order at 10:00 AM.  

  1. Review, revisions and Approval of Minutes – attached

June 21, 2014 - Motion to approve minutes (Richards/Keyes) unanimously approved.
September 6, 2014 – Motion to approve minutes (Richards/Wojan) unanimously approved.
September 20, 2014 – Motion to approve minutes (Powers/LoDico) unanimously approved.

  1. Financial and Utilization Reports – attached

In Rick Speck’s absence, Connie Wojan presented the draft budget he had prepared, noting that the budget could be amended at a later time.
Motion to approve the draft budget (LoDico/Richards) unanimously approved.
Motion to approve the cash flow report (Richards/Keyes) unanimously approved.
Motion to approve the check register (Richards/LoDico) unanimously approved

  1. Committee Reports
  2. Resource Development – Connie Wojan referred to the fundraising update included in the board packet.
  3. Finance – no meeting.
  4. Building Management – Work on repairing the ice damage should begin in early October.
  5. Medical Services and Quality Assessment – Adam Richards reported on the health fair which had been held the day before. Deb Plastrik said that the QAPI committee had met on July 23.
  6. Audit Committee – Jeff Powers noted the letter from the auditor that was in the board packet.
  1. Operations Report – attached

Donna Kubic spoke about Chris VanLooy’s return as Physician Assistant. She reported on how Mary Cook’s duties as bookkeeper would be covered after Mary’s departure for a new job.
Deb Plastrik asked the board for guidance on fundraising software. She will contact Christie Perdue for advice.

  1. Old Business

Purchase of vehicle for staff use – Motion to authorize Pete LoDico to spend up to $10,000 for a vehicle with all wheel drive or four wheel drive, the choice to be left to his discretion (Powers/Keyes) unanimously approved.                                                         

  1. New Business
  2. Consent Agenda – Connie Wojan asked to postpone the item.
  3. Sign on Road – The board looked at examples of informational signs to be placed on Kings Highway, but agreed to gather more information before a decision.
  4. Bequest Stephens Family – Connie Wojan reported that the Stephens family had donated $29,000 to the BIRHC. There were no stipulations about how the gift should be spent.
  5. Reconsider motion to hire Christie Perdue for additional work – After the special meeting on September 20, Jeff Powers had asked to reconsider the motion hiring Christie for continuing work. Jeff Powers said that he would like to retract the request, based on discussion at this meeting.
  1. Public Comment

Don Spencer had asked earlier in the meeting about the role of an Emeritus Director. Connie Wojan said that she would research the by-laws and report back.
Connie Wojan asked board members to review the survey report and to contact Christie Perdue within two weeks with feedback and questions so that a special meeting work session with her can be scheduled soon. Two items that might be discussed at such a meeting include the Kings Highway sign and the use of the Stephens bequest.

  1. Motion to Adjourn

At 11:45 AM (J. Keyes/Richards) unanimously approved.

Respectfully submitted,
Deb Plastrik, Recording Secretary

Board of Directors Approved Minutes
Saturday, June 21, 2014
10:00 AM BIRHC Community Room

 

Present – Board Members –  Terry Keyes, Pete LoDico, Jeff  Powers, Adam Richards, Rick Speck, Connie Wojan, Jim Wojan
Absent – John Works, Jr.
Staff  – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant
Guests – Jack Gallagher, Eric and Sanomalynn Naranjo, Don Spencer

  1. Call to Order & Welcome

President Connie Wojan called the meeting to order at 10:00 AM.  

  1. Review, revisions and Approval of Minutes – attached

March 15, 2014 - Motion to approve minutes Meeting (Speck/LoDico) unanimously approved.

  1. Financial and Utilization Reports – attached

Rick Speck noted that the reports reflected the $100,000 state funding. While medical services income was down, expenses were tracking okay. The increase in heating costs made looking into a geothermal system and added insulation a good plan, he said.
Motion to approve the financial reports (Keyes/LoDico) unanimously approved.
Motion to approve the check register (Keyes/Richards) unanimously approved.

  1. Committee Reports
  2. Resource Development – Connie Wojan reported that the newsletter had produced $2000 in donations. There were 212 raffle tickets sold by the time of the early bird drawing.
  3. Finance – attached – Rick Speck said that the committee had discussed several needed purchases, including a refrigerator, computers and a used car or van. The committee discussed lowering the collected millage to 1.6 mills which would reduce Health Center income by $20,000.
  4. Building Management – JimWojan said the committee was continuing to work on the problems that created the ice dams the past winter.
  5. Medical Services and Quality Assessment – Adam Richards said the committee was continuing work on the QAPI plan and reported on the health fair set for Sept. 26.
  6. Audit Committee – Jeff Powers reported that the committee and Mary Cook were pleased with Abraham Gaffney as the auditor and recommended continuing with them for the next three years at a cost of about $6000 per year. Motion to contract with Abraham Gaffney for next three years  (J. Wojan/Keyes) unanimously approved.
  1. Operations Report – attached

Donna Kubic asked the board to pay for airfare for a prospective chiropractor who would come on July 12 to meet with prospective patients. Motion to pay for airfare (Keyes/Richards) unanimously approved.

  1. Old Business

None                                                         

  1. New Business
  2. 2014-2015 budget for fiscal year beginning October 1 – Rick Speck said that the finance committee would meet in July to prepare the draft budget for submission to the townships in August. The board could approve the budget in September. Motion to authorize the finance committee to prepare a draft budget with a total not to exceed a 6% increase (J. Wojan/Powers) unanimously approved.
  3. State Money – The board discussed what improvements in equipment might be accomplished with the state funding to demonstrate its impact on the Health Center.
  4. Report on VA Day/VA contract – Connie Wojan and Donna Kubic reported on the turnout of about 40 veterans for the event. A Memorandum of Understanding is in the works.
  5. Consent Agenda – Connie Wojan said she would table this item until the next meeting due to the length of today’s meeting.
  6. Date of next meeting – Terry Keyes asked if the next meeting could be held on September 27 instead of September 20. The board agreed and the change will be posted.
  1. Public Comment

Eric Naranjo reported on his experiences with the recent focus group and said he would like to be involved in an ongoing fashion. Jack Gallagher asked questions about the financial reports and the quality assurance process.

  1. Motion to Adjourn

At 11:50 AM (J. Wojan/Richards) unanimously approved.

Respectfully submitted,
Deb Plastrik, Recording Secretary

 

March 15, 2014

Present – Board Members –  Pete LoDico, Jeff  Powers (on telephone), Rick Speck, Connie Wojan, Jim Wojan, John Works, Jr.
Absent – Terry Keyes, Adam Richards
Staff  – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant
Guest – Don Spencer

  1. Call to Order & Welcome

President Connie Wojan called the meeting to order at 10:01 AM.  

  1. Revisions to the Agenda

Connie Wojan noted that Rick Speck would be presenting the financial reports.

  1. Review, revisions and Approval of Minutes – attached

December 14, 2013 – Motion to approve minutes of Meeting (Works/J. Wojan) unanimously approved.
February 15, 2014 – Motion to approve minutes of Special Meeting (Works/J. Wojan) unanimously approved.

  1. Financial and Utilization Reports – attached

Rick Speck noted that revenue was up and costs were down. Tax dollars were not all received by the end of February. Heating costs are up because of the hard winter. Mary Cook had been off-island so that a cash flow report had not been produced, but Rick Speck said the figures showed the Center “still in good shape on funds on hand.”
Motion to approve the financial reports (J. Wojan/Works) unanimously approved.
Motion to approve the check register (Works/J. Wojan) unanimously approved.

 

  1. Committee Reports
  2. Resource Development (attached) – The board discussed whether to pay hosting fees for the GiftWorks fundraising software. Motion to drop the use of the new Front Stream Payments Inc. hosted software (Speck/Works) unanimously approved.
  3. Finance – no report
  4. Building Management – Don Spencer asked if the board would pursue information about geothermal heating/cooling for the building. Jim Wojan, Pete LoDico and John Works would meet on this. Motion to gather more information on costs, benefits and payback length for geothermal installation (C. Wojan/J. Wojan) unanimously approved.

The ice dams and leaking near the reception desk were discussed. Motion to approve up to $10,000 to hire an engineering firm to come to the island and evaluate the heat loss problem, with Denny Cook and Don Spencer acting as an unofficial subcommittee (Works/J. Wojan) unanimously approved.

  1. Medical Services and Quality Assessment – Jeff Powers reported on that week’s annual evaluation meeting attended by Dr. Edward Newcomb, Sue Solle, Adam Richards, Jeff Powers and Deb Plastrik.
  2. Audit Committee – Jeff Powers reported that the audit was done. The committee will meet before the next board meeting. The committee will need to decide before fall whether to stay with the current auditors or change companies.
  1. Operations Report – attached

Donna reported that VA representatives would be visiting and invited board members to meet them if they desired.

  1. Old Business    
  2. Five Year Plan review – attached: The board reviewed the Five Year Plan and discussed whether goals were being reached. It was decided to wait until the Community Perception Survey was completed to further discuss the plan.
  3. Plan for Long Term Financial Stability update – attached. Don Spencer reported on the proposal from Christie Perdue to conduct a survey in coming months. Motion to accept the proposal for $10,500 and to add as many one-on-one interviews as possible, accepting that extra charges may be incurred (Speck/LoDico) unanimously approved.
  4. Raffle Profit Sharing – attached: Connie Wojan proposed a graduated scale of donation-sharing from the 2014 car raffle with the Beaver Island Community Development Corporation. Motion to approve the donation schedule proposed in Connie Wojan’s email of March 7 (Works/Speck) unanimously approved.
  5. CCCF Endowment Income – Connie Wojan recommended that the board leave the $50,000 interest payment in the CCCF fund. Motion to leave the $50,000 interest in the CCCF fund (Speck/Works) unanimously approved.

                                                                            

  1. New Business
  2. Board Committee Signup

Executive Committee: Connie Wojan, president; Pete LoDico, vice president; John Works, Jr., secretary; Rick Speck, treasurer
Medical Services and Quality Assessment and Professional Development Committee: Adam Richards, Denny Cook, Jeff Powers
Audit Committee: Jeff Powers, Don Spencer, Jim Wojan
Finance Committee: Rick Speck, Don Spencer, Jeff Powers, Connie Wojan
Resource Development and Marketing: Pete LoDico, Terry Keyes, Connie Wojan, Don Spencer
Building Maintenance: Denny Cook, Jim Wojan, John Works, Jr., Pete LoDico
Funding Exploration Committee: Connie Wojan, Don Spencer, KaiLonnie Dunsmore, Donna Kubic

  1. Motion to elect Denny Cook as Board Member Emeritus in honor of his service on the board and as President for two years (LoDico/J. Wojan) unanimously approved.

 

  1. Public Comment

None

  1. Motion to Adjourn

At 12:15 PM  (J. Wojan/C. Wojan) unanimously approved.

Respectfully submitted,
Deb Plastrik, Recording Secretary

 

Saturday, December 14, 2013 Annual Meeting
10:00 AM BIRHC Community Room

Present – Board Members –  Denny Cook, Terry Keyes,  Pete LoDico, Jeff  Powers, Adam Richards, John Works, Jr.

Absent –Rick Speck, Connie Wojan, Jim Wojan

Staff  – Donna Kubic, Managing Director

Guests – Don Spencer

I.          Call to order, welcome, announcements       
            Secretary John Works called the meeting to order at 10:00 AM.

2.         Revisions to the Agenda        
C.  1  Election of officers was added to New Business

3.         Review, revisions & approval of minutes       
Motion to approve October 5, 2013 minutes (LoDico /Keyes) unanimously approved.     

4.         Financial & Utilization Reports - attached
In Rick’s absence, Kubic reported that revenue is ahead of budget for the two month period and employee expenses, contract services, overhead  and total budget are under.  The percentage for two months should be 16.67, Revenue is 20.84  and all of the major Expense categories are under 16.67. Motion to approve the financial reports (Keyes/LoDico) unanimously approved.   Motion to approve Cash Flow Report (Cook/Keyes) unanimously approved.  Motion to approve check register (LoDico/Richards) unanimously approved.

5.         Committee Reports
B.  Medical Services & Quality Assessment
Richards reported on a QAPI meeting last Thursday..   Richards indicated the committee will meet a few more times before the next board meeting.  Sue Solle and Deb Plastrik will join as members.  Cook spoke with John Hess, VA Representative in Charlevoix and Kubic will report on some headway with the Veterans Administration.  Spencer will speak to the BIRHC survey, which was on the top of the QAPI committees list.  Richards spoke with the manager of Forest View to see if there may be ways in which the residents might benefit from interaction with the clinic.  Providers do home visits when residents are unable to come to the clinic and the clinic is providing med management. 

C.  Audit Committee
Powers reported the auditor has visited the clinic and the audit is being worked on.  Nothing to review yet.

6.         Operations Report (attached)
A.  Summary of Activities, Statistics, 2013 Accomplishments
Donna spoke about purchase of I pads.  Recently a patient connected with Dr. Cotter through an Ipad and Dr Cotter’s Iphone.  Kubic indicated there is a recent rural health initiative and hopes to connect with a wound specialist at McLaren in the near future.  Motion for the clinic to purchase three Ipads (Works/Cook) unanimously approved.  Motion to give Donna the authority to rent a new copier.  (Cook/Works) unanimously approved. 

Kubic informed the board about a recent conversation with Sherri DeLoff, a consultant for the Offices of Rural Health VA regarding expansion of health care with veterans at the clinic.  In January, Kubic will have a telephone conversation with the Saginaw VA, and the office of rural health in Washington along with Sherri DeLoff.

7.         Old Business
            A.  Plan for Long Term Financial Stability update
      Spencer reported a phone conversation with NorthSky Nonprofit Network along with C. Wojan and Kubic at an estimated cost is $6800.00.
The following deliverables will be provided by the close of the engagement.

  1. Two community focus groups with year-round  residents
  2. An online community survey focused on year-round  residents
  3. Two community focus groups with seasonal  residents
  4. An online community survey focused on seasonal residents
  5. A 3-hour planning session with BIRHC Leadership
  6. A written work plan for  BIRHC to use in developing/ improving services and programs

Spencer will pursue planning for the island survey for the clinic.

8.         New Business
A. Reducing Size of Board through Attrition  
Motion at the next BIRHC Board Meeting to reduce the size of the board from 9 to 7 members through attrition.  (Cook/LoDico) unanimously approved.

B. Re-election of Board Members                              
Motion to reappoint Keyes to the board (Works/LoDico) unanimously approved.

C. Election of New Board members
Motion to approve the slate of officers (Keyes/Richards) unanimously approved.

C.  1) Officer slate for 2014
Connie Wojan, President, Pete LoDico, Vice President, John Works, Jr., Secretary, Rick Speck, Treasurer.  Motion to approve the slate of officers (Keyes/Richards) unanimously approved.

D. 2014 Car raffle- Select Car to Purchase
Motion to allow LoDico to purchase a car for next year’s car raffle not to exceed $ 19,000 (Cook/Powers) unanimously approved.

E. 2014 Raffle - Discuss Sharing proceeds with BICDC                                 
Motion for BIRHC to keep $19,000 of proceeds above vehicle cost, and the amount above that pending the lawyers approval will be distributed to the BICDC.  The BICDC will assume responsibility of selling the car tickets.  Any advertising will reflect both organizations.  (Works/Powers) unanimously approved.

F. Staff Christmas Bonuses                                                     
Motion to approve, staff Christmas bonuses staff in the amount of $900 total (LoDico/Keyes) unanimously approved.

G. Set 2014 Quarterly Meeting Dates              
March 15, June 21, Sept 20 and December 13 (annual meeting)

H. Recognition of Denny Cook                      
In Wojan’s absence LoDico presented retiring Denny Cook with a plaque and read the following,  (attached).
 
10.       Public Comment
none

11.       Motion to adjourn at 11:40 AM.         

Board of Directors Draft Minutes
Saturday, October 5, 2013
10:00 AM BIRHC Community Room


Present – Board Members –  Denny Cook, Terry Keyes,  Pete LoDico, Jeff  Powers, Connie Wojan, Jim Wojan, John Works, Jr.
Absent – Adam Richards, Rick Speck
Staff  – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant
Guests – KaiLonnie Dunsmore, Don Spencer

  1. Call to Order & Welcome

President Connie Wojan called the meeting to order at 10:04 AM.  

  1. Revisions to the Agenda

Connie Wojan asked to add consideration of the 2013-2014 budget to the Financial and Utilization Reports and to add the creation of a Nominating Committee under New Business. John Works, Jr. asked to add a discussion of visiting professionals under New Business.

  1. Review, revisions and Approval of Minutes – attached

June 25, 2013 – Motion to approve minutes of Special Meeting (Works/Keyes) unanimously approved.

  1. Public Comment - none

 

  1. Plan for Long Term Financial Stability

Island resident KaiLonnie Dunsmore presented her thinking about a strategic plan for the BIRHC based on meeting with Connie Wojan, Donna Kubic and Don Spencer. (attached)
Motion to form a small committee to proceed with planning with a budget of up to $10,000 that Connie Wojan has the authority to spend (Keyes/Cook) unanimously approved.
Motion to appoint a Funding Exploration Committee of Connie Wojan, Donna Kubic, Don Spencer and KaiLonnie Dunsmore to report on progress at the December meeting (Works/Cook) unanimously approved.

  1. Financial and Utilization Reports – attached

Motion to approve the financial reports (Cook/Works) unanimously approved.
Motion to approve the 2014 Budget (Works/J. Wojan) unanimously approved.
Motion to approve the check register (Works/Keyes) unanimously approved.

  1. Committee Reports
  2. Resource Development:  Connie Wojan reported on the car raffle and other summer fundraisers. Pete LoDico asked the board to think about what kind of vehicle should be raffled next summer.
  3. Finance: minutes attached.
  4. Building Maintenance: Denny Cook reported on the maintenance contract for the generator.

Motion to approve three-year maintenance agreement (Works/J. Wojan) unanimously approved.

  1. Medical Services & Quality Assessment: A meeting was held but a written report was not received.
  2. Audit Committee: no report                                                                
  1. Operations Report (attached)

Donna Kubic noted Webb Martin’s response to her question about providing navigation assistance for those signing up for insurance under the Affordable Care Act. She distributed the hand-out from our billing company which could be given to patients.

  1. Old Business
  2. Connie Wojan asked if the board wished to continue to direct the annual appeal contributions to the endowment and special projects fund at the CCCF. Motion to continue the present system for the annual appeal (J. Wojan/Cook) unanimously approved.
  1. New Business
  2. Connie Wojan reported that the St. James millage renewal will be on the November ballot for a maximum of two mills. She suggested a mailing to St. James voters
  3. Connie Wojan noted that John Martin had tendered his resignation from the board. The board will present John with a plaque honoring his service to the board. Motion to accept with regret John Martin’s resignation (J. Wojan/Powers) unanimously approved.
  4. Connie asked  a nominating committee  be appointed to consider candidates. Denny Cook’s term will end at the annual meeting. Denny Cook and Pete LoDico will review board candidates and also suggest a candidate to fill John Martin’s position as vice president.
  5. John Works said that he would like to see more visiting professionals such as chiropractors, ophthalmologists or dermatologists come to the island. The board suggested that this need might be addressed in the work of the Funding Exploration Committee.
  6. The board discussed a fitting thank you to Webb Martin for all the legal work he has done for the BIRHC over the years. Motion to spend up to $1500 for a week’s lodging and round trip transportation for two for a Beaver Island vacation to be arranged with Webb (Cook/Works) unanimously approved.
  1. Motion to adjourn:

At 11:55 a.m. (LoDico/J. Wojan) unanimously approved.

Respectfully submitted,
Deb Plastrik, Recording Secretary

Saturday, March 23, 2013

10:00 AM BIRHC Community Room

Present – Board Members – Denny Cook, Terry Keyes, Pete LoDico, Adam Richards, Connie Wojan, Jim Wojan, John Works; Rick Speck, interim assistant treasurer

Absent – John Martin, Jeff Powers

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant

Guests – Don Spencer

•  Call to Order & Welcome

President Denny Cook called the meeting to order at 10:00 AM.

•  Revisions to the Agenda

Denny Cook asked that items 8A and B of New Business be moved before Old Business.

•  Review, revisions and Approval of Minutes – attached

January 19, 2013 – Motion to approve (Keyes/Works) unanimously approved.

•  Financial and Utilization Reports – attached

Rick Speck noted that the income statement and cash flow reports were about where they should be at this point in the budget year. The search firm fee for the physician assistant is a one-time fee. As the finance committee did not meet, the board reviewed the check register and credit card usage for January and February. Motion to approve the financial reports and check register (Works/Keyes) unanimously approved.

•  Committee Reports

•  Resource Development: Connie Wojan reported that the raffle vehicle had been purchased and thanked Pete LoDico for all his work.

•  Finance: no report.

•  Building Maintenance: no report.

•  Medical Services and Quality Assessment: no report.

•  Audit Committee: Jeff Powers had sent a written report (attached) and Don Spencer asked for approval of the draft audit. Rick noted that he would like comparison figures included in the next audit. Motion to approve the draft audit (Keyes/Works) unanimously approved.

•  Operations Report (attached)

Donna Kubic reported that although the Medical Services and Quality Assessment committee had not met, staff members were working on chart reviews and that she and Deb Plastrik were working on a survey of emergency patients to gauge satisfaction and suggest improvements.

John Works said that he felt Donna Kubic was working too many hours and moved that the board increase the administrative assistant budget line item to $10,000. Donna and Deb Plastrik will report on progress at the next board meeting. Motion to increase administrative assistant budget line item to $10,000 (Works/LoDico) unanimously approved.

•  Old Business

The board considered New Business items 8A and B.

•  Reelection of Board Members: Connie Wojan reported that Carol Gillespie was not running for a second term and that John Works, Jr. had agreed to serve another term. Motion to reelect Works (C. Wojan/J. Wojan) approved with Works abstaining.

•  Election of New Board Member: Denny said that Rick Speck had written a letter of interest in serving on the board. No other letters were received. Motion to elect Rick Speck to the board (Cook/Richards) unanimously approved.

Rick Speck took his position on the board and the board moved on to consider

Old Business.

•  Amend bylaws: The board had discussed at its November 2012 meeting reducing the size of the board through attrition. The board size is now 10 and the proposed amendment (attached) would allow that number to serve until attrition leads to a board size of no more than nine or no fewer than seven members. Motion to approve amendment of bylaw 3.02 Number, Tenure and Qualification (attached) (LoDico/J. Wojan) unanimously approved. Under the bylaws, the amendment will take effect at the board's next meeting.

•  Endowment Fund: Connie noted that the BIRHC Endowment at the Charlevoix County Community Foundation had earned a $50,000 dividend . She recommended that the board request a check from the CCCF to be placed in the BIRHC checking account. A decision about how to spend or invest the dividend will be made later. Motion to request a $50,000 check from the CCCF to be put into the checking account (Speck/Cook) unanimously approved.

•  Action on Money Market Account: The board discussed management of the Special Projects Fund at the CCCF and whether to leave money there or to invest it. It was decided to leave the $120,000 earmarked for maintenance in the Special Projects Fund but to request $180,000 to be sent to the BIRHC. Don Spencer said he would propose at the next meeting that some of that money be used to hire a resource development professional to build the endowment further. Motion to take $180,000 from the CCCF Special Projects Fund (Works/J. Wojan) unanimously approved.

Motion to authorize the Finance Committee and Mary Cook to open a money management account with the $180,000 (Keyes/Works) unanimously approved.

•  New Business (resumption of New Business Items)

•  See above.

•  See above.

•  Nominating committee report: Denny Cook reported that the committee of Cook, Works and Connie Wojan was nominating the following slate of officers: Connie Wojan, President; John Martin, Vice President; John Works, Jr., Secretary; Rick Speck, Treasurer.

•  Election of Officers: There were no nominations from the floor for board offices. Motion to elect the slate of officers as presented (Cook/Richards) unanimously approved.

•  Elect Committees and Committee Chairmen: The following committees were set:

Executive Committee: board officers

Medical Services and Quality Assessment: Adam Richards, chair; Denny Cook, Jeff Powers will be asked to serve.

Audit Committee: Jeff Powers, chair; Jim Wojan, Don Spencer

Finance Committee: Rick Speck, chair; Connie Wojan, Jeff Powers, Don Spencer

Resource Development: John Martin, chair; Terry Keyes, Don Spencer

Building Management: Pete LoDico, Jim Wojan, John Works, Jerry LaFreniere will be asked if he wishes to serve again; chair to be decided later.

•  Public Comment

Denny said that he wanted to recognize Sandy Birdsall for her six years on the board and suggested that a plaque be presented to her at a future date.

Connie said that she wanted to thank Denny Cook for his leadership as president during the paszt two years.

Don Spencer also thanked Denny for his work, especially in building maintenance and in securing the emergency generator for the BIRHC.

•  Motion to adjourn:

Motion to adjourn (Works/Keyes) at 11:45 AM unanimously approved.

Respectfully submitted,

Deb Plastrik, Recording Secretary

Board of Directors draft Annual Meeting Minutes

Saturday, January 19, 2013

10:00 AM BIRHC Community Room

Present – Board Members – Sandy Birdsall, Denny Cook (on phone), Terry Keyes, Pete LoDico, John Martin (on phone), Jeff Powers (joined meeting in progress), Adam Richards, Connie Wojan, John Works

Absent – Carol Gillespie

Staff – Donna Kubic, Managing Director; Gaye Paget, Physician Assistant; Deb Plastrik, Administrative Assistant; Sue Solle, Nurse Practitioner

Guests – Rick Speck, Don Spencer, Jim Wojan, Karen Wojan

•  Call to Order & Welcome

Secretary John Works called the meeting to order at 10:00 AM. Gaye Paget was introduced to the board and guests.

•  Revisions to the Agenda

John Martin asked that a discussion of “Obamacare” be added under new business. Connie Wojan asked that advertising for new board members be added under old business.

•  Review, revisions and Approval of Minutes – attached

November 17, 2012 – Motion to approve (Richards/Works) unanimously approved.

•  Financial and Utilization Reports – attached

Rick Speck noted that tax income was not reflected as it was not deposited until January. He pointed out on the fund balance report that the earmarked maintenance funds are now being listed. The board discussed investigating moving some special projects CCCF money into an account that would earn more interest. Motion to approve the financial reports (Works/Keyes) unanimously approved. The board reviewed the check register and credit card usage. Motion to approve the check register for September and October (Richards/LoDico) unanimously approved.

•  Committee Reports

•  Resource Development: Connie Wojan reviewed the donation report (attached) for 2011 and 2012 newsletters and annual appeals.

•  Finance: Rick Speck presented the draft of a written credit card policy (attached). It was suggested that item (g) be deleted and that this language be substituted: The credit card details will appear on the check register. Motion to approve policy (Wojan/Birdsall) unanimously approved.

•  Building maintenance: Denny noted that the center's emergency generator worked well during the December power outage.

•  Medical Services and Quality Assessment: no report.

•  Audit Committee: Jeff said that the auditors had come but that no report had been received yet.

•  Executive Committee: Rick Speck said that the Executive Committee had approved Webb Martin's language about exempt employees. Donna Kubic said that the language would be added to the employee handbook.

•  Operations Report (attached)

Donna Kubic reported on the new web domain, new telephone system and progress on telemedicine connections with McLaren Northern Michigan Hospital.

•  Old Business

•  The board set the following dates for quarterly board meetings in 2013, all meetings on Saturdays at 10 AM in the community room: March 23, June 22, September 28 and annual meeting December 14. Motion to set meeting dates (Works/Wojan) unanimously approved.

•  The board agreed to advertise for candidates for the board of directors. The board candidate subcommittee was selected at the previous meeting: Works, Wojan, Cook. Motion to post for candidates (Wojan/Works) unanimously approved.

•  New Business

•  Pete LoDico discussed choices for the 2013 raffle vehicle. The choice was a Sonic in victory red for $16,176. Motion to select the Sonic in victory red (Works/Richards) unanimously approved.

•  Donna Kubic explained the confidentiality and conflict of interest policies (attached) to be signed by board members and returned by the next meeting. She also shared Webb Martin's advice (attached) on how board members could report any complaints they might hear to the staff without violating HIPAA requirements. Jeff Powers suggested that the board explore this further at the next meeting, saying he would talk to Carol Gillespie before then.

•  The board asked Pete LoDico to serve as interim treasurer for the board. Motion to select LoDico as interim treasurer (Cook/Birdsall) unanimously approved. Sandy Birdsall said that a non-board member could serve as assistant treasurer under the bylaws. Motion to select Rick Speck to serve as interim assistant treasurer (Birdsall/LoDico) unanimously approved.

•  John Martin explained some of the changes in the national health care system that would be implemented over the next year and suggested that the BIRHC work on a plan to educate its patients

•  Public Comment

Terry Keyes and other board members thanked Sandy Birdsall for her service to the board.

•  Motion to adjourn:

Motion to recess the annual meeting until Saturday, March 23 made at 11:30 AM (Keyes/Works) unanimously approved.

Respectfully submitted,

Deb Plastrik, Recording Secretary

January 19, 2013 Operations Report

Donna Kubic, Managing Director

A revised Credit card policy is included in your packets which will be placed on the agenda for the next board meeting.

The new phone system has been installed and is operational and we have gotten pass the hurdle of using the new system (mostly).

The Health Center has a new Facebook page which I posted Chris's retirement party on.

Our Website is being moved over to our new domain. It is included in the price so hosting it there makes sense. The current website provider has been cancelled. I will have more flexibility on the new site. Our IT person has offered to help with the postings. She is designing the new website from scratch.

The loss of the domain was due to the host sending emails to an old ISP or outdated e mail addresses. They did not forward them here or warn us of the pending expiration. The new domain is locked and protected which will not permit that to happen again. Our original domain should have had the same protection but was not the case. It is now set it up so a few people will receive notices in the event we have a lapse in any service at the new site hosting the domain The original registrar of the birhc domain was contacted and they have confirmed we no longer have possession of that domain nor may we have it back. The pieces are in place as to not allow this to happen again.

The following was posted on Joe's site, the newspapers and the forum

Do you have high blood pressure? There's only one way to know, and that is to have it checked! Stop by the Beaver Island Rural Health Center for a free blood pressure check.
High blood pressure adds to your heart's workload and can damage your arteries and organs over time, according to the American Heart Association. People with high blood pressure are more likely to have a stroke, more likely to develop congestive heart failure and more likely to develop coronary heart disease, which can lead to a heart attack.
High blood pressure has no symptoms, which is why it is called the “silent killer.” High blood pressure can usually be controlled by diet, more exercise and medication.
While you are at the Health Center, check on other diagnostic tests that are available to residents of the Island. Women who are ages 40 through 64 may qualify for free mammograms and Pap tests.
The BIRHC mission is to provide high-quality, low-cost health care to all on the island, regardless of ability to pay. Contact Managing Director Donna Kubic at 448-2275 for more information about our sliding fee scale. Depending on your income and family size, you may qualify for a discount of up to 75% on services provided at the Health Center.
Remember, call us at 448-2275 for a free blood pressure check.

The auditor visited the Health Center on November 28 th .

Dr Molter seen patients on December 5 th , and will return in the spring.

Gaye Paget ‘s first day was January 14 th , she continues to orientate and will begin solo after orientation with Dr Newcomb on January 29 th .

Christie (Health Center IT person) and I have a date on Wednesday January 23 rd to finalize the telemedicine hook up with McLaren Northern Hospital.

 

As of December 31, 2012

2012/2013

Actual

% of Budget

Remaining

Budget

Year to Date

Collected

Budget

Carryover Previous Year

97,377.00

97,377.00

100.00

0.00

Income

Funds from Auxiliary Acct

0.00

0.00

#DIV/0!

0.00

Interest Earned

180.00

40.00

22.22

140.00

Income: Teleme Grant Univ Serv

6,000.00

0.00

0.00

6,000.00

Income: CCCF Special Proj Fund

0.00

0.00

#DIV/0!

0.00

Interest-CCCF Endowment

0.00

0.00

#DIV/0!

0.00

Medicaid Interim Pay't

3,000.00

0.00

0.00

3,000.00

Medicare Contract Adj.

4,000.00

0.00

0.00

4,000.00

Income - Dental Space

3,990.00

740.00

18.55

3,250.00

Income:Millage, St.James

86,816.00

42.00

0.05

86,774.00

Income: Millage, Peaine

128,941.00

0.00

0.00

128,941.00

Donations/Fund Raising

45,000.00

9,933.00

22.07

35,067.00

CCCF/Other Grants

1,500.00

0.00

0.00

0.00

State Funding

100,000.00

0.00

0.00

0.00

Medical Service Income

125,000.00

33,529.00

26.82

91,471.00

 

 

 

Total Income

601,804.00

141,661.00

23.54

358,643.00

Expenses - Employee

Salary:FNP/PA/Relief care

156,709.00

41,974.00

26.78

114,735.00

Salary:Admi/Clerical/Clinical

97,660.00

25,801.00

26.42

71,859.00

Salary:Custodian/Maint

4,970.00

1,196.00

24.06

3,774.00

Insurance-Health Care

22,260.00

4,986.00

22.40

17,274.00

Employers' Portion Simple IRA

7,450.00

2,026.00

27.19

5,424.00

FICA-ER portion

19,840.00

5,007.00

25.24

14,833.00

NP Liability Ins.

0.00

0.00

#DIV/0!

0.00

Insurance-Workman's Comp

3,296.00

0.00

0.00

3,296.00

Education - Prof. Continuing

1,000.00

400.00

40.00

600.00

Education - Clerical Cont

500.00

195.00

39.00

305.00

 

 

 

Total Employee Expenses

313,685.00

81,585.00

26.01

232,100.00

Expenses - Contact Services

Physician's Agreement

24,000.00

6,000.00

25.00

18,000.00

Legal / Accounting

15,330.00

7,906.00

51.57

7,424.00

Contract Services

19,950.00

3,299.00

16.54

16,651.00

 

 

 

Total Contract Services

59,280.00

17,205.00

29.02

42,075.00

Expenses - Overhead

Auto Expenses

2,600.00

279.00

10.73

2,321.00

Internet Project/Service

12,000.00

2,550.00

21.25

9,450.00

Bank Charges/Credit Card Fees

400.00

94.00

23.50

306.00

Computer Software

1,000.00

0.00

0.00

1,000.00

Computer Tech Support

3,000.00

1,525.00

50.83

1,475.00

Dues and Subscriptions Exp

500.00

0.00

0.00

500.00

Electric

9,250.00

1,924.00

20.80

7,326.00

Equip - Purchase

5,000.00

798.00

15.96

4,202.00

Freight /Shipping

1,000.00

224.00

22.40

776.00

Insurance-General

14,000.00

0.00

0.00

14,000.00

Licenses

820.00

198.00

24.15

622.00

Lodging

500.00

0.00

0.00

500.00

Maint.- Building

4,000.00

1,611.00

40.28

2,389.00

Maint. - Equipment (copier, x-

3,500.00

418.00

11.94

3,082.00

Maint. - Grounds

1,500.00

0.00

0.00

1,500.00

Meals and Entertainment

200.00

0.00

0.00

200.00

Pet Gas (Heating)

14,500.00

700.00

4.83

13,800.00

Pet Gas (Emergency Generator)

1,000.00

0.00

0.00

1,000.00

Postage

1,500.00

98.00

6.53

1,402.00

Supplies - Cleaning

750.00

164.00

21.87

586.00

Supplies - Office

3,500.00

2,399.00

68.54

1,101.00

Supplies - Medical

10,800.00

1,963.00

18.18

8,837.00

Supplies -Pharmacy

5,500.00

885.00

16.09

4,615.00

Supplies - Xray

1,000.00

0.00

0.00

1,000.00

Office Publications

200.00

0.00

0.00

200.00

Telephone

4,500.00

887.00

19.71

3,613.00

Travel

4,000.00

1,210.00

30.25

2,790.00

T-One Line

0.00

0.00

#DIV/0!

0.00

Waste Management

450.00

0.00

0.00

450.00

 

 

 

Total Overhead

106,970.00

17,927.00

16.76

89,043.00

Total Budget

479,935.00

116,717.00

24.32

363,218.00

Net Income (Loss)

121,869.00

RaffleTruck Purchase

18,000.00

0.00

Fund Raising Expense

4,000.00

1,371.00

Grant Expenses

7,500.00

487.00

Restricted Fund Expenses

4,000.00

466.00

Miscellaneous U of M Doc's etc

1,500.00

0.00

Budgeted Surplus(Maint/facilities)

50,000.00

0.00

Net Income (Loss)

42,369.00

22,620.00

Board of Directors Meeting unapproved Draft Minutes

Saturday, November 17, 2012

10:00 AM BIRHC Community Room

Present – Board Members – Denny Cook (on phone), Terry Keyes, Pete LoDico, John Martin, Rick Speck, Connie Wojan, John Works

Absent – Sandy Birdsall, Carol Gillespie, Jeff Powers, Adam Richards

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant

•  Call to Order & Welcome

Vice President John Martin called the meeting to order at 10:00 AM.

•  Revisions to the Agenda

Connie Wojan asked to add two items: consideration of the reduction of meeting frequency to quarterly and discussion of a Christmas bonus for staff members. John Works asked addition of consideration of reducing the size of the board. John Martin added the items to new business.

•  Review, revisions and Approval of Minutes – attached

September 15, 2012 – Motion to approve (Works/Keyes) unanimously approved.

•  Financial and Utilization Reports – attached

Rick Speck reviewed the income statements for the fiscal year ending September 30 and for the month of October, as well as the cash flow report . He noted that $100,000 in the special project fund is earmarked for the building and maintenance fund. Motion to designate the building and maintenance funds as restricted funds on future reports (Speck/Wojan) unanimously approved. The board discussed the quarterly fund reports from the Charlevoix County Community Foundation and agreed to consider at a future meeting whether to move funds from the foundation accounts. Motion to approve the financial reports (Works/Wojan) unanimously approved. The board reviewed the check register because the finance committee had not met. The finance committee will review the BIRHC credit card policy before the next meeting. Motion to approve the check register for September and October (Works/LoDico) unanimously approved.

•  Committee Reports

•  Resource Development: Connie Wojan reported that the annual appeal letter would be sent soon. A fundraising update is attached.

•  Finance: no report

•  Building maintenance: no report.

•  Medical Services and Quality Assessment: no report.

•  Audit Committee: no report.

•  Executive Committee: Denny Cook said that the group had just received Webb Martin's explanation of exempt employee status and would review it for the next meeting.

•  Operations Report (attached)

Donna Kubic said that the telephone system and telemed connections with McLaren Northern Hospital were moving along. John Martin added that Dr. Philip Zazove had said that the University of Michigan Hospitals would also be open to telemed discussions.

•  Old Business

Pete LoDico reported that Jeff Powers had provided discounts on materials for construction of the storage shed. A 12 x 12 shed will be constructed on a platform and moved to the site soon. Leftover shingles from Forest View will be used to finish the roof.

•  New Business

•  Connie Wojan proposed scheduling a retirement party for Chris VanLooy. Connie and Terry Keyes will begin planning. Motion to proceed with planning (Keyes/Works) unanimously approved.

•  The board created a board candidate subcommittee of John Works, Denny Cook and Connie Wojan.

•  Donna Kubic reported that the search for another health care provider had not produced a candidate and asked for authorization to hire a search company. Motion to empower Donna Kubic to sign a contract, with Webb Martin's approval, with contingency firms who would charge less than $15,000 and guarantee a six-month stay by the candidate (Cook/Works) unanimously approved.

•  The board set the date of the annual meeting for Saturday, January 19, 2013 at 10:00 AM.

•  Connie Wojan said that in past years Christmas bonuses had been approved for staff members, but that they had been overlooked. Motion to approve, for this year only, bonuses that would also include last year's bonuses for staff in the amount of $1900 total (LoDico/Wojan) unamimously approved.

•  John Works proposed that the board size be reduced. The board discussed by-laws requirements and agreed to reduce the size by attrition. The executive committee will examine the proposal and report back at the annual meeting. Motion to not post a notice advertising for board candidates at this time (Keyes/LoDico) unanimously approved.

•  Connie Wojan proposed that board meetings be held quarterly instead of every other month, saying that a special meeting could always be scheduled if action was required. The board made no decision, but will consider at a future date.

•  A nominating committee for 2013-14 board officers was set: John Martin, Connie Wojan and Denny Cook. The slate will be presented at the January 19 annual meeting.

•  Public Comment None

•  Motion to adjourn: Motion to adjourn at 11:35 AM (Martin/Works) unanimously approved.

Respectfully submitted, Deb Plastrik, Recording Secretary

 

Board of Directors Meeting Draft Minutes

Saturday, September 16, 2012

10:00 AM BIRHC Community Room

Present – Board Members – Sandy Birdsall, Denny Cook, Terry Keyes, Pete LoDico, John Martin, Jeff Powers, Adam Richards, Rick Speck, Connie Wojan, John Works

Absent – Carol Gillespie

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant

Guests – Jerry LaFreniere, Don Spencer, Karen Wojan

•  Call to Order & Welcome

Denny Cook called the meeting to order at 10:00 AM.

•  Revisions to the Agenda

Denny Cook added two items under new business: consideration of a new telephone system and appointment of a representative to the Human Services Commission.

•  Review, revisions and Approval of Minutes – attached

July 21, 2012 – Motion to approve (Works/Richards) unanimously approved.

•  Financial and Utilization Reports – attached

Rick Speck said that the draft budget had been submitted to the two townships. The millage requested would generate about $10,000 less per township for the coming year. After discussion, the board voted to consider the salary line item separately, per the auditors' recommendations. The line reflects a 3% increase after some years of no increases. Motion to approve the salary line item (LoDico/Works) approved with Birdsall and Powers voting no.

Motion to accept the draft budget (Works/LoDico) unanimously approved.

Motion to approve the check register, per the auditors' recommendations.(Powers/Richards) unanimously approved.

•  Committee Reports

•  Resource Development: John Martin summarized the staff reports (attached) regarding the visiting physicians. The board will continue to consider other ways to reach out to the University of Michigan and also perhaps the Michigan State University and Central Michigan University programs. Connie Wojan reported on the car raffle and thanked Pete LoDico for all his work to help raise $18,700 this year.

•  Finance: no report

•  Building maintenance: 1) Pete LoDico reported on the need for a storage unit to hold lawn/snow removal equipment for BIRHC and Forest View. Motion to approve spending up to $2,000 for a shed on BIRHC property (Martin/Cook) unanimously approved.

2) Jerry LaFreniere explained the estimate (attached) for $1,174.85 from Robert's John Service to install timers on exhaust fans which should cut down on energy costs. Motion to approve (Birdsall/Richards) unanimously approved.

•  Medical Services and Quality Assessment: no report

•  Audit Committee: no report.

•  Operations Report (attached)

The board discussed ways to increase community awareness of programs. Motion to investigate cost of digital sign for BIRHC (Speck/Martin) approved with Works voting no.

•  Old Business

None

•  New Business

•  The board considered Webb Martin's letter on exempt employees (attached). Motion to refer the question to the executive committee (Works/Speck) unanimously approved.

•  Motion to appoint Adam Richards as the BIRHC representative to the Human Services Commission (Birdsall/Wojan) unanimously approved.

•  Donna Kubic explained the report on the telephone system (attached). Motion to approve the purchase of a new system with Donna Kubic and Rick Speck authorized to negotiate details (Martin/Birdsall) unanimously approved.

•  Public Comment

Don Spencer asked the board to think about hiring a part-time resource development director in the future.

•  Motion to adjourn:

Motion to adjourn at 12:29 PM (Cook/LoDico) unanimously approved.

Respectfully submitted, Deb Plastrik, Recording Secretary

Board of Directors Meeting unapproved Minutes

Saturday, July 21, 2012

10:00 AM BIRHC Community Room

Present – Board Members – Sandy Birdsall, Denny Cook, Terry Keyes, Pete LoDico, Adam Richards, Rick Speck, Connie Wojan , John Martin

Absent : Carol Gillespie, Jeff Powers, John Works

Staff – Donna Kubic, Managing Director

Guests Karen Wojan, Don Spencer

•  Call to Order & Welcome

Denny Cook called the meeting to order at 10:00 AM.

Bill McDonough informed the Board that Senator Kahn will be visiting the island on August 21 st .

Motion to pay $250.00 for Senator Kahn flight to Beaver Island (Cook/LoDico) unanimously approved .

2. Revisions to the Agenda

No revisions

3. Review, revisions and Approval of Minutes

Motion to approve minutes of the March 17, 2012 Board Meeting (Wojan/Richards) unanimously approved.

4. Financial and Utilization Reports

A. Financial reports presentations & discussion

Rick Speck reported the only two categories that are down are the interest rate, and the other major item is Medical Service income. As far as expenses the major categories are tracking with overhead well below budget. Looking to put $20,000 into the maintenance budget in 2013. Motion to approve income and cash flow reports through June. (Martin/Richards) unanimously approved.

B. Proposed budget for townships

The Finance Committee presented a proposed budget for 2012/2013 to present to the Townships for the August meetings to request millage. Rick Speck will request a rate of 1.8 mills rather than the 2 mills, which was levied. Receiving the state monies this year and next, BIRHC can meet all of the categories, and put $50,000 aside for replacing equipment. Employee salaries will be approved at the September meeting. Motion to approve 2012-2013 budget (Keyes/LoDico) unanimously approved.

C. Cash Flow Report

D. Approve check register

Motion to approve check register on recommendation of the finance committee. (Wojan/Martin) unanimously approved.

5. Committee Reports

A. Resource Development : Connie Wojan reported 186 tickets have been sold on the car. Thanks to Brad, Sally Lounsberry, and Rod Nackerman who are selling tickets once a week. Connie requested additional board help the end of August. The Broder party was a huge success. Connie Wojan thanked everyone who lent a hand. Pete LoDico thanked Wojan for organizing the entire book signing party. To date 200 books have been sold. Thanks to all the merchants who are selling the books. Thank you to the Northern Islander, Beaver Beacon, and the Chamber of Commerce who helped through their publicity. The monies received from the sale of the Broder Books will remain in the general funds for operations. Leonor Jacobson put in countless hours into organizing the garden tour. Sixty people attended the tour. Lunch was served in the Medical Center garden. Donations in Ellie Hohns name will be used to create a path between the Senior Housing and the Medical Center.. Barbara Lucas donated some of her mother's paintings, framing the paintings at her own expense for a silent auction, also to benefit the gardens. The drawing for the car will be September 3 at Stoney Acres; Connie Wojan would like as many board members as possible to be in attendance. John Martin reported discussion regarding the U of M physicians will be reported at the September meeting. The staff will be invited to attend the meeting.

C. Building maintenance

Denny Cook presented a preventative maintenance agreement for the generator with a premium of $463.00 a year . Motion to purchase the agreement (Speck/LoDico) unanimously approved.

D. Medical Services and Quality Assessment :

no report.

E. Audit Committee:

Jeff Powers agreed to remain as Chairman of the Committee, with Sandra Birdsall, Don Spencer and Terry Keyes also agreeing to remain on for 2013.

6. Operations Report

Donna Kubic report that Chris Van Looy has indicated she would like to retire. Donna Kubic has approached McLaren Northern Hospital to assist in the process. Motion to approve $2500 in this budget year and $2500 in the next budget year to advertise for a second care provider. (Speck/Cook) unanimously approved.

7. Old Business

A. Vacation pay

Motion to approve the Vacation policy as presented (Keyes, Richards) unanimously approved.

•  New Business

A. Extra pay for time over 168 hours worked

Rick Speck reported the finance committee discussed a situation where hours not worked were paid over the 168 hours for the care providers. Donna Kubic will refer to Webb Martin to investigate the labor laws of exempt employees on salary. This will then be referred to a committee,. “ Vacation, sick, bereavement, or other compensation will only be paid if a 168 hours within a two week pay period has not been worked.  The compensation will be paid to reach the 168 hours for the pay period if the provider has accrued time.  If the provider does not have accumulated time their salary will be adjusted unless management decides otherwise.” will be the language sent to Webb Martin.

9. Public Comment

None

10. Motion to adjourn:

Motion to adjourn at 11:42 AM (Cook/Richards) unanimously approved.

Respectfully submitted, Donna Kubic

 

Board of Directors Meeting Draft Minutes

Saturday, November 19, 2011

10:00 AM BIRHC Community Room

Present – Board Members – Sandy Birdsall, Denny Cook, Carol Gillespie, Terry Keyes ,Jerry LaFreniere, Pete LoDico, John Martin, Jeff Powers, Adam Richards, Rick Speck, John Works

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant

Guest – Danielle Dedloff, Sarah McCafferty, Webb Martin, Joe Moore, Don Spencer, Angel and Paul Welke, Connie Wojan, Karen Wojan

•  Call to Order & Welcome

Denny Cook called the meeting to order at 10:00 AM. He welcomed and introduced board attorney Webb Martin.

•  Revisions to the Agenda

None

•  Review, Revisions and Approval of Minutes - attached

July 16, 2011 – Motion to approve (Works, Martin) unanimously approved. 

•  BIRHC/EMS Discussion

Donna Kubic presented background information (attached) about the proposed union of the Health Center and EMS. She said that both townships had approved a continuing exploration of the feasibility of the plan. Board members discussed many aspects of how to proceed, Webb Martin recommended that business decisions and legal issues be explored in that order. Motion to create a task force which would proceed with due diligence in exploring the financial, risk management, medical and legal components of a merger (Birdsall/Keyes) unanimously approved.

The board then discussed membership and timeline for the process. Motion to appoint a task force of Sandy Birdsall, Carol Gillespie, Donna Kubic, Jerry LaFreniere, Rick Speck to report back at the January annual meeting (Cook, Keyes) Aye: Birdsall, Cook, Gillespie, Keyes, LaFreniere, LoDico, Martin, Powers, Richards, Speck. No: Works Approved. Carol Gillespie agreed to act as chair.

•  Presentation of Emeritus Awards

On behalf of the board, Denny Cook presented plaques to Emeritus Directors Don Spencer and Connie Wojan, thanking them for their years of service to the health center.

•  Financial and Utilization Reports - attached

Rick Speck said that the center had ended the fiscal year in pretty good financial shape, with revenues over the budgeted amount and expenses slightly under budget. He noted that no interest would be paid on the CCCF endowment fund this year. The October income statement represents the first month of the new fiscal year. Motion to accept income statements (Martin/Works) unanimously approved. Motion to accept cash flow report (Martin/Works) unanimously approved.

•  Committee Reports

•  Resource Development: John Martin noted that a fundraising update report was in the board packet (attached). Connie Wojan said the annual appeal letter had gone in the mail that week.

•  Finance: no report

•  Building maintenance: The windows with faulty seals have been replaced. The committee will look at ways to regulate temperature swings that caused the problem. The generator pad has been poured and the generator should be on the island by the end of the month.

•  Medical Services and Quality Assessment: (attached) Carol Gillespie reported that she had met with staff and that they were addressing improvements in charting. She said they had not yet finished a proposal to divide the Medical Services from the Quality Assessment and Performance Improvement portions of the committee's responsibilities.

•  Audit Committee: Jeff Powers reported that the committee of Sandy Birdsall, Terry Keyes, Don Spencer and himself had selected the firm of Abraham and Gaffney from three proposals, (attached) The auditors will be on the island at the end of the month.

•  Operations Report (attached)

Donna Kubic asked for board approval to withdraw BIRHC from the Health and Wellness Cooperative. Donna indicated the focus of the grant will be Patient Centered Medical Home model. Donna felt Beaver Island Rural Health Center had little to offer the Cooperative. Motion that the BIRHC resign from the cooperative (Works/LaFreniere) unanimously approved.

The board discussed Donna's workload and noted that membership on the task force had been added to her responsibilities. Motion to increase the line item budget for administrative assistant to $7,500.00 (Works/LaFreniere) unanimously approved

•  Old Business

Denny Cook noted that the generator status had been discussed earlier in the meeting. Disposal of the old generator could be accomplished in two ways: trading the generator for the concrete pad installation, or donating it to the Fire Department for use at the fire station in town. Motion to donate the old generator to the Fire Department (Martin/Richards) Aye: Cook, Gillespie, Keyes, LaFreniere, LoDico, Martin, Powers, Richards, Speck, Works. No: Birdsall Approved.

•  New Business

Denny Cook said that the three directors whose terms were ending had expressed an interest in serving again: Jerry LaFreniere, Jeff Powers, Adam Richards. He asked for a nominating committee to interview possible candidates. Motion to appoint Denny Cook and John Works as nominating committee to report at January annual meeting (LaFreniere/LoDico) unanimously approved.

Pete LoDico asked the board to think about the car raffle before the next meeting so the vehicle can be purchased in time. Rick Speck said that $18,000.00 had been budgeted for car costs, including our insurance.

•  Public Comment

None

•  Motion to Adjourn

Motion (LaFreniere/Powers) to adjourn at 12:01 PM Unanimously approved.

Respectfully submitted, Deb Plastrik, Recording Secretary

 

Board of Directors Meeting Draft Minutes

Saturday, September 17, 2011

10:00 AM BIRHC Community Room

 

Present – Board Members – Sandy Birdsall, Carol Gillespie, Terry Keyes, John Martin, Jeff Powers, Adam Richards

Absent – Denny Cook, Jerry LaFreniere, Pete LoDico, Rick Speck, John Works

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant

Guest – Connie Wojan

•  Call to Order & Welcome

John Martin called the meeting to order at 10:09 AM.

•  Revisions to the Agenda

The agenda should say that the minutes of the July 16, 2011 meeting would be reviewed.

John also added under New Business an email from Peaine Supervisor Jack Gallagher.

•  Review, Revisions and Approval of Minutes - attached

July 16, 2011 – Motion to approve (Keyes, Gillespie) unanimously approved.

August 19, 2011, Special Meeting – Motion to approve (Powers, Richards) unanimously approved.

•  Financial and Utilization Reports - attached

Rick Speck was unable to attend.. Donna said that the income statement was pretty straightforward with no surprises. Motion to accept income statement (LaFreniere, Richards) unanimously approved.

Donna said that the finance committee had not been able to meet. Board questions about the cash flow report will be answered at the next meeting .

•  Committee Reports

•  Resource Development: John noted that a copy of the fall newsletter was in the packet. He asked for any volunteers to help write the annual appeal letter.

•  Finance: no report

•  Building maintenance: The windows with faulty seals have not been replaced yet.

•  Medical Services and Quality Assessment: Carol reported that she had met twice with staff and that they were addressing improvements in charting. She suggested that the committee's name be changed and that perhaps Medical Services should be split away from Quality Assessment and Performance Improvement. John asked Carol to write a draft to be considered at the November meeting. He asked that funding for indigent care be kept on the board's future agendas.

•  Audit Committee: Jeff reported that a letter soliciting bids for audits had been sent to CPA firms. He asked if the board would empower the committee to choose a firm before the next board meeting. Motion that audit committee be given the power to select an auditor (Powers, Keyes) unanimously approved.

Jeff asked if another board member could be named to the committee. Motion to appoint Sandy Birdsall to the audit committee (Powers, Gillespie) unanimously approved.

•  Operations Report (attached)

•  Old Business

John said he would like to recognize John Works for his hard work on the golf tourney and thank Connie Wojan for her work on the 2011 car raffle.

•  New Business

•  John referred to the email from Jack Gallagher (attached) asking for information before the Peaine Township Special Board Meeting set for September 28, 2001, at which millage rates will be decided. He asked that as many board members as possible attend the meeting to speak or answer questions about the millage. Motion to designate Connie Wojan as a board representative for the millage meeting (Keyes, Gillespie) unanimously approved.

Jeff Powers had to leave the meeting at 11:35 AM, and the quorum was lost.

•  Nominating committee will be set at the next meeting.. The secretary will advertise for letters from interested candidates.

•  The date of the annual meeting will be set at the next meeting, but is tentatively set for Saturday, January 21, 2012.

•  Public Comment

None

•  Motion to Adjourn

There was no quorum to adjourn.

Respectfully submitted

Deb Plastrik, Recording Secretary

Sept, 2011 Operations Report

Action item Sarah McCafferty will be resigning as director of EMS in January. Sarah and I have discussed EMS becoming part of the Health Center. I would like the board to discuss their thoughts on this issue.

We had a very busy summer. Flu shots are now available.

Fall Newsletter will be mailed out in September.

Ems certified all its volunteers here at the Health Center in CPR.

Coordinated in home care for an island resident who broke her hip until she became stronger.

404 tickets were sold for the car raffle making $23,500 for the Health Center. Thank you Connie Wojan for taking the lead and to Pete LoDico arranging for the purchase of the car and being second in the number of tickets sold. Thank you to all the volunteers who sat out in the hot sun selling tickets. Pete LoDico was the winner of the car this year!

I will begin advertising for free cholesterol screenings this fall.. We will also check B/P and do a baseline EKG at no charge to the patient. The grant from the American Heart Association will pay the cassettes to do the testing.

Requests for proposals have gone out to CPA firms soliciting bids from auditors to do a full audit this year.

Our billing company has indicated that are working towards developing software to provide Electronic Medical records software for rural clinics. I do not have any information at this time other than it will be investigated and I trust their recommendations.

The Golf tournament brought in $4,000 for the Health Center. Thank you to John Works and Jennifer for all their help and all the sponsors and donations received. Also thanks to Dana and Eric for donating the food for the golf tournament.

We have a new phone in the lobby for emergencies, which is programmed to dial 911 or the care provider on call. TDS change the line and I believe this will help with people coming to the Health Center after hours to contact either EMS or the care provider.

Chris, Sue and I stayed at the Health Center the day of the Marathon in case of an emergency. Thank you to Brad Grassmick for again getting the I Stat machine for us to have and for contacting Northern Michigan Hospital for IV solution which we do not stock and for wearing a pager in case we needed to call him.

Board of Directors Meeting Draft Minutes

Saturday, July 16, 2011

10:00 AM BIRHC Community Room

Present – Board Members – Denny Cook, Carol Gillespie, Terry Keyes (at 10:35), Gerry LaFreniere, Pete LoDico, John Martin, Jeff Powers (at 10:10), Adam Richards, Rick Speck

Absent – Sandy Birdsall, John Works

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant

•  Call to Order & Welcome

Denny Cook called the meeting to order at 10:00 AM.

•  Revisions to the Agenda – none

•  Review, Revisions and Approval of Minutes - attached

May 21, 2011 – Motion to approve (Martin/Gillespie) unanimously approved.

•  Financial and Utilization Reports - attached

Rick Speck said that there were no real surprises in the June 30 income statement and that he thought the budget would be very close to projections at the end of the fiscal year. Motion to accept income statement (LaFreniere, Richards) unanimously approved.

Rick presented the budget draft that must be presented to the townships by August 1 along with the millage requests. He noted that the promised $100,000 state funding for next year was reflected in the draft. The board recommended budgeting $15,000 for equipment replacement and $20,000 for maintenance and building replacement. Motion to approve draft budget (Martin/LaFreniere) unanimously approved.

Rick presented the accountant's compilation of financial reports for 2009 and 2010. Acceptance of these reports is needed before the 990 tax form can be filed. Motion to approve compilation (Martin/Richards) unanimously approved.

Rick presented the revised language for the Audit Committee policy, reflecting the requirement that committee members cannot be board officers. The proposed language: 1) The Committee shall be composed of two or more members of the Board who are not officers and could include one outside member. Motion to approve (LaFreniere/Richards) unanimously approved.

Rick nominated Terry Keyes and Jeff Powers as board representatives and Don Spencer as outside member. Motion to appoint audit committee as nominated (Speck/LoDico) unanimously approved.

•  Committee Reports

•  Resource Development: John presented a newsletter review and distributed notes from the July 7 committee meeting. (attached)

•  Finance: previously covered above

•  Building maintenance: Jerry reported that new flooring was installed in the dental office and that baseboard was yet to be installed. He said that he had planned to do the outside water project over two years but had decided to complete the entire job while the equipment was available. An offer to power wash the cedar shakes has been received, but the board decided to decline the offer for now and to see how the weathering process continues for the next couple of years.

•  Medical Services and Quality Assessment: Carol said that had been no formal meeting, but that she had brought the thrombolytic drug with her . A policy will need to be written governing its administration.

•  Operations Report (attached)

•  Old Business

Denny Cook reported that an application for a tribal grant for an emergency generator had been completed and that a decision would be made by the end of the month.

•  New Business

Denny Cook said that he had consulted Webb Martin about the proper way to designate past board members as Emeritus to honor them for their service, but in a way that would not preclude their return to active board membership. Motion (attached) to designate Connie Wojan and Don Spencer as Emeritus Directors (LaFreniere/LoDico) unanimously approved.

John Martin asked if the board could send thank you letters to our legislators who helped with the state funding.

•  Public Comment

Connie Wojan had provided a written report on the garden projects to be distributed (attached).

•  Motion to Adjourn

Motion to adjourn at 11:52 AM (LaFreniere/Martin) unanimously approved.

Respectfully submitted

Deb Plastrik, Recording Secretary

Garden Update

If you have been reading the papers, you know that Leonor Jacobson is spearheading finishing our landscaping in the back of the building.

She has been working on this tirelessly planning fundraisers and doing a lot of physical work herself over the past couple of weeks.

Would urge everyone to take a look around the back to see what has been layed out so far.

Since we have many new board members I would like to give you a quick history about how we got to the current stage of landscaping at the HC.

I think we can all agree that the front of the building looks very nice right now.

When our building was finished we did not have one cent to spend on landscaping. Everything you see out there was donated and placed there with volunteer labor.

The only Health Center money spent on landscaping has been the electricity for our pump to water.

The person most responsible for that is BJ Wyckoff

She organized the project and donated the largest number of tress and bushes, all of the bulbs, all of the lilies, fertilizer, top soil, mulch, the use of their tractor, labor of her employee, lunch for planting crew…you name it.

Others who made major donations were:

Jim Wojan- Boulders

Gary Marvin- came to the island for a day, laid out plan, helped plant and donated over $2000 of trees and bushes.

Volunteer labor from many people.

So that is how we got to where we are today.

So where do we hope to go from here?

Leonor has very ambitious plans.

Three gardening business have been hired to design gardens by Leonor

Also Mary Ann Weaver has volunteered to design and plant a butterfly garden.

We have checked with Jim Wojan about location of drain field and what can and cannot be planted over it.

Fundraisers/ donations

Quilt Donated by Kathy Jones auctioned

Garden Walk on July 13th

Rotating silent auction throughout the summer

Gift already received from Gail Weede family for children's garden

Leonor has made both a financial donations and plant material

Jeff Powers has donated a generous credit on our account at his hardware.

So we continue to look for donations of cash, gardening supplies or plants.

Leonor is also planning silent auction of various prizes. We are looking various donations for prizes. Merchandise/Services

Resource Development Committee met on Thursday July 7 at the Health Center. Attending were Adam Richards, Anne Glendon, Terry Keyes, Donna Kubic, Deb Plastrik, and John Martin.

The committee reviewed the experience of the initial newsletter and found it to be very positive. The newsletter was attractive, informative and well received. It was mailed to all property owners.

We received $1850.00 in returned envelopes from about 20 people. Most of the contributions came from first time donors. Our ‘wish list' of needed items included our need for an updated EKG machine and $3500 was donated enabling us to purchase one. The total revenue from the newsletter mailing was $5,350.00

We spent $511 for envelopes (have sufficient quantity to cover our second Fall mailing), $748 for postage, and $486 for the newsletter design and layout (newsletter design won't need to be changed). We also spent $1300.00 for giftworks software ( a one time expense)

Sarah McCafferty brought students from the school to help with envelope stuffing, taping and applying stamps and mailing labels, saving on our personnel costs and involving students in community service.

Plans were made for the Fall newsletter scheduled to be mailed on September 16. The following members agreed to submit material to Deb by August 15: Frank will be asked to provide pictures, especially of the gardens; Adam will write an article about health care and students; Anne will write about NMRHS and BIRHC; Connie will be asked to write about the gardens; Deb and Donna will write an article from a patients perspective regarding service received as well as prepare the ‘wish list' and a ‘thank you list'

Big thanks to Deb and Donna for the extra work entering data into the new fundraising software and for the special effort involved in putting out the first newsletter.

July, 2011 Operations Report

Leonor Jacobson's Garden tour event was a huge success. I have heard several comments from those who participated on what a well run fun day it was. Lenore had 10 messages when she returned home from the day – before doing all the math – the profit is around $800.00 –

Carol Gillespie has delivered the thrombolytic from Northern Michigan Hospital. We will 60 days prior to expiration send back the drug so Northern so they can use it and we will get another one.

Munson Hospice provided an all day training last week for their members. We had enrolled one patient in the last month and have discussed the service with another patient.

Dr Cotter was here on July 8th and seen 30 patients. That day Dr. Carden was seeing patients and the Health Center saw 25 patients. Overall, about 65 people were seen that day at the Health Center.

Two new patient exam tables have been delivered, bought with the donation from Gail Weede's sister.

I received the grant from the American Heart Assn for $1,000 for cholesterol cassettes. In the fall, we will as we have done in the past, advertise free cholesterol screening. We will also check B/P and do a baseline EKG at no charge to the patient. Also part of the grant was $1,000 for EMS to conduct a community CPR class.

We have receive $1,500 from the Dennis Cady memorial and I will ask Betty Cady what she would like the monies to be spent on.

The floors were waxed by the professional company, giving the Health Center a price break and doing a very nice job. Dr White's floor has also been done. Glass company measured 6 windows that need to be replaced. Does the board want this to be paid for out of the maintenance general operations or out of building maintenance.

The $7500 for building maintenance - is that to be taken out of the general fund building maintenance budget or from the interest from the endowment fund

Will begin to get bids for a new auditor.

Ken Taylor donated $3500 –we bought a new EKG machine which will fax right from the machine to the hospital Emergency Room.

Have distributed notices around town and in the newspapers about turning in prescription and over the counter drugs-to the Health Center and being environmental conscious by not flushing drugs down the toilet..

Dr Hughes, a hematologist oncologist was willing to do visit with a patient who could not get off the island on two separate days for an appointment. It finally worked out where the patient was able to make the appointment in person but the fact that the doctor was willing do to this was a first.

Donations to date from the newsletter mailing is $1800.00. Expenses were $3,050. Of that $1312 was for the Gift works software. Also $250.00 can be subtracted out as the return envelopes were purchased for two mailings. That expense won't be there in the fall. Deb has been inputting to data. It is time consuming, but will be worth the effort when all the data has been entered.

The grant from BCBS continues to move forward. John Martin, Jim Flikema and myself had a phone conference on Tuesday to discuss Sally Davis, the grant writer on retainer at Northern to write the BCBS grant for $3500 which will pay for Sally to to write a larger grant to support telemedicine.

Board of Directors Meeting Draft Minutes

Board of Directors Meeting unapproved Draft Minutes

Saturday, May 21, 2011

10:00 AM BIRHC Community Room

Present – Board Members – Sandy Birdsall, Denny Cook, Gerry LaFreniere, Jeff Powers, Adam Richards, Rick Speck, John Works

Absent – Carol Gillespie, Terry Keyes, Pete LoDico, John Martin

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant

•  Call to Order & Welcome

Denny Cook called the meeting to order at 10:00 AM. He noted that $33,000 in state funding had been approved since the last meeting.

•  Revisions to the Agenda –

None

•  Review, Revisions and Approval of Minutes of March 19, 2011 meeting - attached

Motion to approve (Works, Cook) unanimously approved.

•  Presentation of CCCF Grant Check

In her position as CCCF board member, Connie Wojan presented a check for $2,666 to President Denny Cook and Managing Director Donna Kubic. The grant will benefit the Senior Help Mate program.

•  Financial and Utilization Reports - attached

Rick Speck said that income was a little ahead of budget and that expenses were about as budgeted. Motion to approve the financial report (Works, Cook) unanimously approved.

Rick also presented the cash flow report.

•  Committee Reports

•  Resource Development: Sandy Birdsall said the committee had not met since the March meeting. The newsletter had been produced and had made a great impression. Connie Wojan said that 140 tickets have been sold for the Early Bird Drawing. She distributed tickets and schedule to board members. Connie also updated the board on the garden projects planned, thanking Leonor Jacobson for all her work.

•  Building Maintenance: Gerry LaFreniere said Garrett Cole had done a lot of maintenance and cleaning work since the last meeting. He asked if the board would approve spending to improve the outside water sources to help with the new garden areas. It was agreed to allocate no more than $500 from the grounds budget line for this work. Gerry said that he and Jeff Powers were still considering how to replace the flooring in Wendy White's office. Donna Kubic asked for and received permission to have the tile floors professionally waxed for about $750, charged against the building maintenance budget. The coating should last about three years.

•  Finance Committee: no report

•  Medical Services and Quality Assessment: no report

•  Operations Report (attached)

•  Old Business

Denny Cook asked that board members bring requests for information to him before approaching Donna or the staff.

•  New Business

University of Michigan, Flint NP Program - Denny Cook said that the Health Center had been approached about a clinical placement program for Nurse Practitioner students by the University of Michigan-Flint. Webb Martin has okayed the contract language. Motion to approve the contract (Birdsall, Powers) unanimously approved.

Thrombolytic - Donna said that the Health Center had researched purchasing a clot-busting thrombolytic drug at $3,000 a dose to be used for heart attack or stroke patients. Northern Michigan Regional Hospital will replace it for us before expiration as needed. The board directed her to stock it, charging it against the medical supplies budget.

New policies needed for 990 filing – (attached) Motion to approve the Audit Committee, Records Retention, Conflict of Interest, Board Job Description, Resolution on Availability of Documents, Code of Ethics for Board Members, Position Description – Board Member and Document Destruction and Whistle Blower/Code of Conduct Policies (Birdsall, LaFreniere) unanimously approved.

•  Public Comment

None

•  Motion to Adjourn

Motion to adjourn at 11:17 AM (LaFreniere, Works) unanimously approved.

May 21, 2011 Operations Report

The company that professionally waxes the floors for McDonough's has given me a quote to do all our floors here for $750.00. They will put down 2 coats of wax on the non traffic areas and 3 coats on the higher traffic areas. McDonough's has used them in the past and said they only to their floor every 3 years. If the board approves, they will start after the board meeting today.

I have copies of the resource booklet, a project of the Human Services Commission in case anyone would like one. I have more here if anyone would like one for anyone else. I also have copy of BIRHC newsletter in case anyone hasn't seen it.

The consultant hired by EMS was here a couple of weeks ago. Both airlines spoke with the consultant. Sarah was to get additional information to him and expect a report back on a couple of weeks.

Donations to date from the newsletter mailing is $1,750.00.

Garrett Cole was hired as the maintenance person.

Connie Wojan supervised CMU students who washed windows, raked , picking up branches etc. at the medical center. A thank you was sent to the President of the University.

A grant from Char Em United Way in the amount of $2,400 for the Senior Help Mate Program was awarded .

Drawing for the early bird special is May 29th. 140 tickets have been sold to date

BIRHC and Northern Michigan Regional Hospital have agreed to apply for a grant from BSBC Foundation to support telmed interaction. The Resource Development Committee will be involved in this and we will be scheduling a phone conference next week.

The credit for the $2,667 from Charlevoix county Community Foundation is because of the effort of Connie Wojan. Connie wrote the grant.

The Health Center was named in lieu of flowers from the families of Dennis Cady and Betty VanderLinde which is very much appreciated

We have written pain medication guidelines which have been approved by Dr Mann and Dr Newcomb.

Through Munson Hospice, I offered a Hospice in service “the most difficult conversation” via Remec.

I applied for a Grant from the American Heart Assn to see if they would fund monies for cholesterol cassettes so we can offer more screening. The cost of the cassettes are about $15.00 a piece and the do outdate.

I would like to thank Sarah's Health Occupation Students of America class who helped several afternoon's to help get the newsletter out. This was very time consuming and I want to thank Deb Plastrik who did 90% of the work.

Legislators meet at the Health Center and Don Spencer spoke of the Health Center needs. Angel Welke spoke regarding evacuation of patients off the island. A summary of the meeting was written and e mailed to all of the representatives that were here.-

Larry the physical therapist continues to see 8-10 patients twice a week.

Saturday, March 19, 2011

10:00 AM BIRHC Community Room

January 29, 2011 Operations Report

Brochures are in the mail for the Early Bird Special.

The Char Em Grant has been completed.

Webb Martin received Wendy White's Schedule C and Denny has signed the contract with Webb receiving a copy.

Paperwork has been sent to transfer the $44,300 interest from the Endowment into the Special Projects Fund to the Charlevoix County Community Foundation.

Sarah and I meet with Jack Gallagher and Rick regarding steps to be taken to begin trying to work towards resolving the air transport situation. Sarah and I also met with Paul and Angel. We are getting quotes from 3 insurance carriers which is needed for EMS in the amount of 10 million dollars. Hopefully in the next few weeks we will more answers. This insurance is required for the State of Michigan EMS Air Transport Service.

I do need the Confidentially and Conflict of interest form signed today and returned to me for the 990 being prepared by the auditor.

I offered a Pre hospital trauma conference for Ems through our Polycom unit on Hypovolemic shock.

We are starting to send our old x rays to Charlevoix Area Hospital to destroy for us. They have a company that does this for them. Head of Radiology said we shouldn't have to reinvent the wheel as they were doing this already. We have never done this before so it was a project.

Have had a conversation with Munson Remec employees regarding trying to hook up with Northern Central College to doing paramedic class. There is interest from the college.

Getting a quote on waxing our floors professionally when McDonough's has there's done. They with all their traffic do theirs every 3 years. If it's not a huge amount of money it may be worth it to have it done professionally.

I was able to get our billing software on another computer so hopefully in the summer I will figure something out where Betty can lock herself in an office and do the billing so we can stay on top of it. We didn't incur any expenses like I thought we were going to.

Greg Williams, Director of the Charlevoix Cheboygan Emmet Emergency Management visited the island and met with Denny Cook,, Jim Wojan, John Works, Don Spencer, myself , Sarah McCafferty, Gerry LaFreniere, Tim McDonough and Darrel Butler, to talk about helping with monies to acquire a larger generator for the medical Center. He was thoroughly impressed with the Health Center and indicated this building should be designated as Command Central in case of a disaster. Denny will talk about that later in the agenda.

I am awaiting a phone call regarding being able to receive Thrombolytics from Northern Michigan Hospital. "Thrombolytic" or "clot-busting" therapy is used to stop a heart attack in its tracks. The drugs prevent or limit heart muscle damage by dissolving clots that block an artery. This opens up the artery and restores the blood flow. Clot-busting drugs must be given immediately after heart attack symptoms begin. The sooner they are started, the more good they do-and the greater the chances are of a full recovery. To be most effective, they need to be given within 1 hour of the start of heart attack symptoms.

I had a phone conversation with Jack Messer and Tracey Rupinski from the COA regarding paperwork when working with the COA. Jack presented the contract agreement for BIRHC and COA at the Personnel and Internal Government Committee, March 16.  He explained what we wanted to do and how it will serve the people of Beaver Island.  There were just a few questions, mostly concerning the paperwork and billing.  He explained it would be handled just like our agreement with the North West Community Health Department.  The criteria for clients is the same.  I recommended approval. The Committee agreed and voted to move to the full Board of Commissioners with recommendation for approval.  It should go to the full Board of Commissioners next Wednesday.

Bill McDonough is arranging a visit to Beaver Island on April 15 of 10 senators and representatives.

Senator Howard Walker

Senator Goeff Hansen

Senator Darwin Booher

Senator Tom Casperson

Representative Greg MacMaster

Representative Frank Foster

Representative Wayne Schmidt

Representative Ed McBroom

Representative Matt Huuki

Governor Snyder's Northern Michigan Director Greg Andrews

11 am.  Tour of the Beaver Island Rural Health Clinic and the "under-construction" senior housing building at the same location.  Meet with staff and EMS for a presentation.

 

Present – Board Members – Sandy Birdsall, Denny Cook, Terry Keyes, Gerry LaFreniere, Pete LoDico, Adam Richards, Rick Speck, John Works. On telephone: John Martin, Jeff Powers

Absent – Carol Gillespie

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant

Guest – Don Spencer

•  Call to Order & Welcome

Denny Cook called the meeting to order at 10:00 AM.

•  Revisions to the Agenda – none

•  Review, Revisions and Approval of Minutes - attached

January 18, 2011 – Motion to approve (Works, LaFreniere) unanimously approved.

January 29, 2011 – Motion to approve (Keyes/Richards) Sandy noted that the policies referenced needed to be attached. Motion to approve with revision (Works/Keyes) unanimously approved.

•  Financial and Utilization Reports - attached

Rick said that income was a little ahead of budget because of the receipt of the state funding and nearly all of tax collections. Expenses were running right about at budget or a little behind. He said he did not foresee any budget crunches at this time. Motion to approve the financial report (Works/Richards) unanimously approved.

Rick also presented the cash flow report.

•  Committee Reports

•  Resource Development: John Martin updated the board on plans to send a newsletter to all island property owners in May. Budget is $2,292 including postage, printing, insert of a remittance envelope. A thank you letter will be included to those who contributed to the annual appeal. Motion to approve budget request (Works, Richards) unanimously approved

•  Building Maintenance: Gerry reported he had investigated how to replace the worn tile around Wendy White's dental chair. Gerry and Jeff will select flooring and installer. Motion to approve expenditure of no more than $1,000.00 to replace floor (Works/Cook) unanimously approved.

Gerry discussed the need for a part-time maintenance person. The person would have to be an employee of BIRHC to be covered by the center's insurance. The position description will be posted for an on-call maintenance person at $18.00 an hour. Gerry proposed hiring Garrett Cole for a period of 30 days at $18 an hour to help staff prepare the building for the state legislators' visit. Motion to approve hiring Garrett Cole for 30-day period (Works/Cook) approved unanimously.

Motion to approve allowing the maintenance committee to draft and post a job description and interview candidates (Works/Cook) approved unanimously.

•  Finance: Rick presented a bad debt policy (attached) for consideration, saying that adopting the policy would allow accounts receivable over 150 days old and in collection to be written off. Accounts receivable are considered assets and can skew the financial picture. Terry asked if the policy could be changed to remove the reference to 9/30/2010, replacing it with “annually” and Rick accepted the amendment. Motion to approve bad debt policy as amended (LaFreniere/Works) unanimously accepted.

Motion to approve policy to take effect as of this date (Birdsall/Keyes) unanimously approved.

•  Medical Services and Quality Assessment: Carol was unable to attend the meeting. The board discussed adding a survey about services to a future newsletter.

•  Operations Report

(Attached)

•  Old Business

A . The contract with Dr. Wendy White has been signed.

B . Denny proposed the following framework to stagger director terms: Gerry, Jeff and Adam would serve a one-year term and be eligible for a three-year term next year, ending in 2015; Denny, Terry and John Martin's terms would end in 2014; Sandy, Carol and John Works' terms would end in 2013. Motion to approve this staggering of terms (Works/LaFreniere) unanimously approved.

•  New Business

Denny said that the Memorandum of Understanding with Charlevoix Cheboygan Emergency Management was not yet ready for signature. Greg Williams, the agency's head, had visited the BIRHC and was excited to work with the island. The MOU is needed to allow making the BIRHC a command center for disaster response. Motion to allow Executive Committee to approve MOU when it is ready for signature (Martin/Works) unanimously approved.

•  Public Comment

Don Spencer congratulated the board on dealing with three critical issues: maintenance, accounts receivable and resource development.

•  Motion to Adjourn

Motion to adjourn at 11:50 AM (Keyes/LoDico ) unanimously approved.

Respectfully submitted Deb Plastrik, Recording Secretary

 

Beaver Island Rural Health Center 2011 Board of Director Meetings

Board of Directors Unapproved Meeting Minutes DRAFT, Saturday, January 29, 2011, 9:00 AM BIRHC Community Room

Present – Board Members – Denny Cook, Brad Grassmick, Terry Keyes, Pete LoDico, John Martin, Rick Speck, Don Spencer, Connie Wojan, John Works

Absent- Carol Gillespie, Sandra Birdsall

Staff – Donna Kubic, Managing Director; Deb Plastrik, Administrative Assistant; Sue Solle, FNP

Guests – Bill Cashman, Gerald LaFreniere, Adam Richards, Elaine West

•  Call to Order & Welcome

Connie Wojan called the meeting to order at 9:10 AM.

•  Revisions to the Agenda

The Board moved on to Old Business as the NMRH representatives had not arrived on the island yet.

•  Dr. White Contract Update

Connie Wojan reported that the Board's legal counsel had authorized signing the contract with one change: the 30 days notice clause would be changed to 60 days and upon receipt of Dr White's Schedule C.

•  COA Contract

Donna and Connie Wojan reported that the COA contract was ready for signature. The dollar amounts had been added. Motion to approve the COA contract (attached) (Keyes/Grassmick) unanimously approved. New president will sign.

•  New Business

•  Executive and Finance Committee Recommended Policies

Don Spencer reported that he had drafted two policies for board consideration. Anne Glendon then joined the meeting via speakerphone. Connie and Anne both recommended that all policies be re-evaluated on an annual basis.

Executive Committee Policy: John Martin suggested that all board members be invited to evaluate the Managing Director. Don Spencer said that he has in the past asked the officers for their evaluations and then presented a composite to Donna Kubic in a one-on-one setting.

Finance Committee Policy: Don Spencer read the draft. Connie Wojan said that the board does not approve policies at the meeting at which they are introduced, but that the board could approve them pending legal review. Motion to approve Executive and Finance Committee Policies pending legal review (Martin/LoDico) unanimously approved. 

•  Operations Report

Donna Kubic reported that the administrative assistant job description was in the packet. She said that she, Mary Cook and Deb Plastrik would participate in the Gift works webinar on Feb. 2 or Feb. 3 and that the software would then be ordered. The board urged Donna to purchase the upgrade to include capacity for both island and permanent residence addresses. Donna further reported that she would proceed with a grant application for the Senior Help Mate funds from Char-Em United Way. Connie said that the CCCF had a March 1 deadline for funds that the Senior Help Mate program could also apply for.

•  Appointment of Raffle Chairman

Connie Wojan said that the chairman did not have to be a board member and that she would be willing to serve in that capacity, as the work needs to begin soon. Motion to appoint Connie Wojan as raffle chairman (Keyes/Cook) unanimously approved.

•  Presentation by Northern Michigan Regional Healthcare

Reezie DeVet and Jim Flickema joined the group at 9:40 AM. Jim Flickema noted that the path to the agreement had started in 2009. Reezie DeVet said that the packet included three components: Master Outsourcing Agreement; Business Associate Addendum and Letter of Agreement. Training for staff, IT assistance, grant-writing aid and telemedicine appointments are all possibilities for future collaboration. Motion to approve agreement with Northern Michigan Regional Healthcare (Martin/Spencer) unanimously approved. Anne Glendon recommended that a joint press release be issued and perhaps an event in May or June to celebrate the agreement. Reezie Devet, Donna Kubic and Connie Wojan signed the agreements. Connie thanked Reezie and Jim for coming to the meeting.

•  Charlevoix County Community Foundation Quarterly Fund Reports

The board reviewed the 2010 Endowment Fund and Special Project Fund reports from the CCCF. (attached).

•  Car Raffle Agreement

Agreement attached; no board action required.

•  Recognition of Brad Grassmick and Don Spencer

Connie thanked retiring board members Brad Grassmick and Don Spencer for their work for the BIRHC during the construction of the building. Brad has served the board since 2009 and Don has served longer than Connie herself, she said. Both were presented with plaques honoring their service.

•  Nominating Committee Report

John Works reported that the committee had interviewed three persons for the three positions on the board and nominated: Gerald LaFreniere, Jeff Powers and Adam Richards. Motion to accept the recommendations of the Nominating Committee (Works/Wojan) unanimously approved. 

•  Re-election of Board Members

John Works reported on the recommendations of the nominating committee. Denny Cook, Terry Keyes and John Martin were nominated for re-election to full terms on the board. Motion to accept the recommendations of the Nominating Committee (Works/Martin) unanimously accepted. The board will consider how to stagger the terms of members elected today at a future meeting. Connie Wojan was selected as chairman pro tem until election of officers later in the agenda.

•  Recognition of Connie Wojan

Pete LoDico and Rick Speck honored Connie on behalf of the board, citing her steadfast dedication to the BIRHC and her willingness to do anything, even weeding the gardens. A plaque was presented to her by the board. Connie said that it had been a very rewarding experience.

•  Election of Officers

Connie Wojan said that the Nominating Committee had considered five interested individuals and was making recommendations, but that nominations could also be made from the floor. Recommendations as reported by John Works: Denny Cook, president; Motion to accept recommendation (Works/Keyes) unanimously accepted. John Martin, vice president; Motion to accept recommendation (Works/Keyes) unanimously accepted. Rick Speck, treasurer; Motion to accept recommendation (Works/Keyes) unanimously accepted.

John Works stated that Sandy Birdsall and Gerald LaFreniere had both indicated willingness to serve as secretary. From the floor, Rick Speck nominated John Works, seconded by Denny Cook. unanimously accepted.

•  Set Meeting Dates for the Year

Denny Cook listed meeting dates, third Saturday of every other month, starting at 10 AM

March 19, 2011; May 21, 2011; July 16, 2011; September 17, 2011; November 19, 2011

•  Committee Assignments

Committees may include individuals who are not on the BIRHC board. Denny Cook presiding, the following committees were formed:

Executive Committee: under by bylaws, formed of officers of the board.

Medical Services and Quality Assessment and Performance Improvement Program Committee: Gerald LaFreniere, Carol Gillespie, Brad Grassmick, Adam Richards

Finance Committee: Sandy Birdsall, Denny Cook, Jeff Powers, Rick Speck, Don Spencer

Resource Development and Marketing Committee: Brad Grassmick, Terry Keyes, John Martin, Adam Richards, Connie Wojan, Anne Glendon will also be invited

Building Maintenance Committee: Denny Cook, Gerald LaFreniere, John Works

•  Public Comment

•  Motion to Adjourn

Motion to adjourn at 11:30 AM (Works/Cook) unanimously approved.

Respectfully submitted, Deb Plastrik, Recording Secretary

January 18, 2011—Special Board Meeting

 January 29, 2011—Annual Meeting 

Meetings will be held at 10 AM in the

Beaver Island Rural Health Center

Community Room

Board of Directors Special Meeting unapproved Minutes DRAFT

Tuesday, January 18, 2011

10:00 AM      BIRHC Community Room

 

Present Board Members –Sandra Birdsall, Denny Cook, Brad Grassmick (via speaker phone), Terry Keyes (via speaker phone), Pete LoDico, John Martin, (via speaker phone), Rick Speck, Don Spencer, Connie Wojan, John Works, Jr.

Absent: Carol Gillespie,

Staff Donna Kubic, Managing Director, Sue Solle, Chris VanLooy,

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:00 AM welcoming Jack Messer, Commission on Aging, Executive Director, and guests in the audience, Pam Grassmick, Jeff Powers, and Gerry LaFreniere.

II. Review, revision and approval of minutes

Motion to approve the minutes (Works, Spencer) unanimously approved.

III. Introduction, Jack Messer, Executive Director, Commission on Aging.

Mr. Messer spoke on the focus of the Commission on Aging. The COA has two major focuses: services which allow seniors to remain in their homes and services which provide for socialization for those over age 60. To provide more services on Beaver Island for seniors in their homes, the COA is willing to contract with the BIRHC which would then provide services. A draft contract was distributed and is being reviewed by legal counsels of COA and the BIRHC. COA's legal counsel is looking for 1) the amounts to be charged COA for certified nurse aide services and for med management. The amounts are to be provided by BIRHC and then approved by COA. It was decided foot care could be done at the BIRHC and billed to Medicare for seniors. 2) If the verbiage “on skilled” care was acceptable) 3. If COA is responsible for reimbursing copying, postage and supervision.

IV . Financial & Utilization Reports

A. Financial reports presentation & Discussion

Rick Speck reported on the financial report. Revenue is right where it should be, operating expenses are a little behind. Overhead is at 19%. At this point we are in good shape as far as the budget. $30,000 was taken out of Special Projects. Charlevoix County Community Foundation indicated the Health Center should be getting $44,000 from interest from the Endowment Fund.

B. Cash Flow Report

Don Spencer reported on the Cash flow statement indicating the finance committee met yesterday. Connie Wojan reported to date the annual appeal letter has generated $17,000. In March the $44,000 should be received from the Endowment, and. $30,000 should be put back into Special Projects. It is hopeful that monies from the State for $33,000 will be funded this year and received in October. Accounts receivable from the billing company was looked at by the finance committee. Six months from now the finance committee should make a determination to write off balances or send to collections. It appears we are collecting about 67% of what is billed with insurance write offs. Motion to accept financials (Works/Spencer) unanimously approved.

V. Committee Reports

A. Resource Development

Connie Wojan reported monies collected to date from the annual appeal is $17,000. In the past 90% of the donations were received by the end of the year. Connie indicated contributions seem to be down from last year.

B. Building Maintenance

Denny Cook indicated with the receipt of the $44,000 interest from the Endowment Fund additional monies should be added to the Building Maintenance Fund as provided in the resolution establishing the fund for long term maintenance. To date there is $15,000 in the fund. Motion to put $7,500 into the fund when the Endowment interest is paid by the Community Foundation. (Cook/Works) unanimously approved.

C. Finance Committee

Reported on above under cash flow report.

D. Medical Services & Quality Assessment – x-ray referral

Brad Grassmick reported on speaking with Nighthawk, regarding reading of the x rays at the clinic. At this time Brad stated he sees no reason to change the way x-rays are being read presently. Dr Harlan is providing a great service at minimal cost to the clinic. Brad stated the additional cost of faster service is not worth the benefit. Treatment would not be any different and immediate service is available in the case of serious injury. If a patient is not satisfied with the timing of the reading of x-rays, the patient should be advised that an alternative is choose to leave the island to visit the ER on the mainland.

E. Task Force

Donna Kubic indicated Jim Flikema of Northern Michigan will e mail the current draft of the “Cover Letter, Master Outsourcing Agreement and Business Associate Addendum, which will be forwarded to board members. CEO Reezie DeVet and Jim Flikema will attend the January 29th annual meeting and it is hoped the documents will be ready for approval at that time.

VI. Operations Report

A. Summary of Activities, Statistics

See attached

VII. Old Business

A. Dr. White Contract

Connie Wojan nor any other board members found reason to go into closed session. Dr. White is requesting a month to month contract because Dr White indicated she is unsure of her future plans. Concern was voiced over not receiving her Schedule C which is required by her contract. Motion was made to approve the contract subject to approval by Dr White and her attorney and contingent upon receipt of her schedule and authorizing the next president to execute the contract. (Birdsall/LoDico). Birdsall was appointed to chair a committee to offer to work with Dr. White to discuss ideas on dental office economics on the Island.

B Car Raffle

Pete LoDico will sign the title of the Chevy Cruze over to the medical center to be held in escrow until the raffle. The Health Center attorney will be consulted to provide a disclaimer indicating Pete has no interest in the vehicle. Staff will pick out the color of the car. Motion for Pete to purchase the Chevy Cruze for $16, 121 and the BIRHC staff to pick out the color. (Cook/Martin) unanimously approved.

VIII New Business

A. Staff Letter

Donna referred to the letter written by the BIRHC staff to continue to invite Don Spencer to staff meetings after retiring from the board to provide a transition, and ask Denny Cook to be the Staff Liaison from the current board members. Motion was made to appoint Denny Cook the board liaison with the staff (Speck/LoDico) unanimously approved.

B. Increased clerical support

Motion to allow Donna to hire an assistant for herself not to exceed $5,000 for the year and to draft a job description for what that person has to do (Martin, Birdsall, Grassmick Keyes opposed, Wojan, Works, Cook, LoDico, Speck in favor. Motion carried.

IX. Public Comment

No public comment

Motion to go into closed session for purpose of approving the minutes of the Nov.20 closed session. (Works/Wojan) Role call, Birdsall, yes , Denny Cook, yes

Spencer yes, Speck yes, LoDico yes, Works, yes, Grassmick, yes, Martin yes.

Motion to approve the minutes from the November 20 th , 2010 Closed Session meeting minutes. (Works/Spencer) unanimously approved.

Motion to go into open session Role call, Birdsall, yes , Denny Cook, yes

Spencer yes, Speck yes, LoDico yes, Works, yes, Grassmick, yes, Martin yes.

X . Motion to Adjourn

Motion to adjourn at 12:45 PM (LoDico/Spencer) unanimously approved.

Respectfully submitted,  Donna Kubic, Managing Director Sandra Birdsall, Secretary

 

Board of Directors Meeting unapproved Minutes DRAFT

Saturday, November 20, 2010

8:15 AM      BIRHC Community Room

Present Board Members –Sandra Birdsall, Denny Cook, Carol Gillespie, Brad Grassmick, Terry Keyes, Pete LoDico, John Martin, Rick Speck, Don Spencer, Connie Wojan, John Works, Jr.

Staff Donna Kubic, Managing Director, Sue Solle, FNP

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 8:15 AM.

II. Motion to move into Closed Session to discuss a complaint against an employee

8:18 AM Motion to move into closed session to discuss a personnel matter (Spencer/Grassmick) Role call, Sandy Birdsall, yes , Denny Cook, yes, Carol Gillespie, yes, Brad Grassmick, yes, Terry Keyes, yes, Pete LoDico, yes, John Martin, yes, Rick Speck, yes, Don Spencer, yes, Connie Wojan, yes, John Works, yes

III. Motion to return to open session (Grassmick/LoDico) unanimously approved.

Open session resumed at 8:45 AM

IV. Three Hour Fundraising Strategic Planning

The Board enjoyed a very helpful fundraising presentation by Chris Dundon, Director of Development of NMRH Foundation. The highlights of Chris' recommendations are attached.

V. Review, revisions & approval of minutes

Motion to approve the minutes of the Sept 18, 2010 meeting (Spencer/Works) unanimously approved.

VI. Financial & Utilization Reports

The board was instructed by Rick Speck and Don Spencer to review the cash flow report and financial reports and to call Rick, Don or Donna with questions.

I. Old Business

A. Data base report

Terry Keyes reported on her research into databases for fund raising. Don Spencer indicated he would like someone other than the staff doing the data entry. Donna suggested asking Marianne who is already is on staff to help with data input. Terry will look over the Gift Works software. Donna will oversee the data base project. Motion was made that Terry investigate further and test Gift Works or another computer programs sufficient to merge the 3 sources of data for presentation; that we utilize this data to increase our annual appeal; and that we allocate $2500 for Donna to purchase the software and enter data (Birdsall/Cook) unanimously approved. Connie Wojan wrote the annual appeal letter and indicated she would like to continue on the Resource Development Committee. \

VIII. New Business

A. Appoint committee to interview new Board applicants

Motion to appoint John Works, Connie Wojan and Don Spencer to review new board member applications and survey the board concerning candidates for the officer positions. (Speck/Cook) unanimously approved.

B. Set date for Annual Meeting

Motion was made to set the annual meeting for January 29 th at 10:00 AM. (Cook/Spencer) unanimously approved .

C. Risk assessment and how it applies to BIRHC

Don Spencer and Donna reported on risk factors related to the clinic as well as the care providers. Staff meetings are being held to assess requirements by the state for rural health status/certification. A partial list was provided to the board. A calendar was developed as to when the items need to be done. Brad Grassmick indicated he is willing to stay on the quality improvement committee. Donna asked for Board volunteers to help the staff with maintaining compliance with the many rural health and other regulations.

D. MOU Health & Wellness Cooperative of Northern Michigan

Motion to authorize Donna to participate and sign the MOU with Northern Michigan Regional Hospital, Cheboygan Hospital, Mackinaw Straits and Charlevoix Area Hospital (Works/Birdsall) unanimously approved.

Connie Wojan reported an addition to the agenda that is support for a tentative agreement between the Commission on Aging and BIRHC. Final approved is not needed, but support for the COA to move forward. Jack Messer will attend the January meeting. This contract will enable the COA to contract with the Medical Center for CENA services. Final wording might not be the same. Motion was made to authorize Connie Wojan, or the president in office at the time to sign the contract with our attorney's approval. (Birdsall/Cook) unanimously approved .

E. Availability of the shingles vaccine & exactly who may obtain it. S. Birdsall

Sandy had nothing that made sense to report about the availability of the shingles vaccine at this time.

IX. Public Comment C. Wojan

No public comment

Motion to go into closed session (Spencer/Birdsall) Role call, Sandy Birdsall, yes , Denny Cook, yes, Carol Gillespie, yes, Brad Grassmick, yes, Terry Keyes, yes, Pete LoDico, yes, John Martin, yes, Rick Speck, yes, Don Spencer, yes, Connie Wojan, yes, John Works, yes

Motion to go into open session. (Works/Cook) unanimously approved.

X. Motion to Adjourn

Motion to adjourn at 1:30 PM (Gillespie/LoDico) unanimously approved.

Respectfully submitted,  Connie Wojan, President     Donna Kubic, Managing Director Sandra Birdsall, Secretary

Board of Directors Meeting unapproved Minutes DRAFT

Saturday, September 18, 2010

10:00 AM      BIRHC Community Room

Present Board Members –Sandra Birdsall, Denny Cook, Carol Gillespie, Terry Keyes, Pete LoDico, John Martin, Don Spencer, Connie Wojan, John Works, Jr.

Staff Donna Kubic, Managing Director

Absent : Brad Grassmick, Rick Speck

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:00 AM.

II. Review, revisions to agenda

Under VIII New Business, Don Spencer would like to add: A. Peaine Twp vote to levy two mills for the Health Center.

Sandy Birdsall under Old Business would like to add: B. Estate Planning

III. Review, revisions and approval of minutes

Motion to approval minutes of July 17 th Board Meeting (Spencer/Works) unanimously approved . The Closed Session minutes will be approved at the November meeting.

IV. Financial & Utilization Reports

•  Financial reports presentation and discussion

Donna Kubic reported in Rick's absence. The financial reports were printed out of Quick Books, without Rick Speck's format. Donna reported that patient services were under what was budgeted. Motion to approve financial statement (Works/ Spencer) unanimously approved.

•  Cash Flow Report

Don Spencer reported on the cash flow report. On Tuesday confirmation was received that BIRHC will receive the $33,000 from the State of Michigan by the end of the month. This amount is not reflected in the cash flow chart. At the end of the year, if projections are correct, we will be ahead by $48,000, but in November of last year we borrowed $50,000. If we pay back the $50,000, we will start the fiscal year in the hole by $2,000. The finance committee suggested the $50,000 be paid back as we can borrow again from the Special Projects Fund if needed. At this time there is no guarantee that the state money will be available in the future.

V. Committee Reports

•  Resource Development

Sandy Birdsall informed the Board that Ted Hughes would sponsor a seminar on October 9th at the Community Center on Estate Planning from 10AM -12 noon. Mr. Hughes will cover Trusts, Estate Planning, Charitable Giving, and Power of Attorney for Health Care and Finances. Motion to co sponsor the seminar (Martin/Keyes) unanimously approved.

John Works spoke about the Golf Tournament that raised about $8,000, an increase over last year. Both on and off island individuals and businesses donated many gifts. Thanks to all who were involved. The Shamrock restaurant donated all the food, sponsored a team and sponsored a hole. Island Airways donated many round trip tickets and sponsored a team and the Boat Company donated tickets.

Connie reported on the car raffle where 394 tickets were sold and an extra $400.00 donated. Don Spencer thanked John Works as did all board members for all his hard work organizing the golf tournament. Connie also thanked Sally Lounsberry, Adam Richards, Lenor Jacobson, and Joe Reed for their help. Don applauded Connie for her dedication and commitment to the success of the raffle.

John Martin, Anne Glendon and Donna Kubic met with Krys Lyle. Their recommendations are as follows: to hire Krys as an independent contractor to develop a BIRHC donor data base and supporting material for fund raising after consultation with Northern; and to have Krys pursue a BCBS grant that is available to increase access to care if the MOU with Northern is approved.

John Works suggested that it was premature to hire some one at this time. He stated that the Board might want to go through a more professional process before hiring. Don mentioned the importance of developing an outside resource under contract to do BIRHC's fund development. Terry will find out what donor databases NMRH and the Charlevoix County Community Foundation are using for the November board meeting and the costs of those programs. The board agreed that, before hiring Krys it needs to discuss a comprehensive fundraising plan. John Martin talked about the importance of face-to-face solicitation. John Martin thought the Board should have a special meeting to discuss an over all plan for future fund raising. Motion to proceed with a special Fundraising Development Meeting, November 20th, time to be determined by an outside person who may be attending the meeting (Spencer/Works) unanimously approved. John Martin would like to postpone any recommendations for hiring a contract person until after the meeting.

•  Building Maintenance

Denny Cook reported for the Building Maintenance Committee. Darrel Butler fixed the generator and emptied the septic system donating his time for both jobs. Donna and Denny will be meeting with the new Charlevoix County Chapter 7 Emergency Services Director, Greg Williams, to see if the Health Center may be eligible for grant money for a new generator.

John Works suggested approaching the township to hire Darrel to be the Health Center maintenance person. Pete will approach the townships to see what the cost would be and if this would be allowed.

After discussion regarding the Shingles vaccine, Sandy indicated she would call the Health Department concerning the reasons that the vaccine is not widely available on Beaver Island as it is in other areas of Charlevoix County. John Martin agreed that it was important for Sandy to follow up with the Health Department to try and get services available here.

•  Finance Committee

Addressed earlier in the meeting

•  Medical Services and Quality Assessment

Did not meet

•  Task Force

Donna Kubic reported a copy of a revised Memorandum of Understanding was received this morning from Jim Flikema and will be forwarded to Webb Martin.

VI. Operations Report

•  Summary of Activities, Statistics

See attached report

VII. Old Business

•  Use of Building Maintenance Funds

Defer any decision to the November Board Meeting to see where we stand 

•  Estate Planning

Discussed earlier in the meeting

VIII. New Business

•  Peaine Township vote for maximum of two mills

Don Spencer informed the Board the cash flow chart would be mailed to the Peaine Township officials prior to the Special Meeting on September 22nd . Board members were encouraged to attend the meeting to show support for passing the maximum of two mills. In anticipation Don passed out points for discussion (copy attached). The board agreed that the new specialists' services available at the Health Center should be emphasized at the Peaine meeting. Sandy volunteered to write up arguments for levying the maximum of 2 mills.

IX. Public Comment

There was no public comment

•  Closed session to discuss Personnel Matter

12:25 PM Motion to move into closed session to discuss contract negotiations. (Spencer/Grassmick) Role call, Sandy Birdsall, yes , Denny Cook, yes, Carol Gillespie, yes, Terry Keyes, yes, Pete LoDico, yes, John Martin, yes, Don Spencer, yes, Connie Wojan, yes.

Open session resumed at 12:40 PM

Motion to renew Dr. White's contact beginning March 2011 under the same terms (Keyes/Spencer) unanimously approved.

XI. Adjournment

Motion to adjourn (Keyes/Gillespie) at 12:50 PM.

Respectfully submitted, 

Connie Wojan, President     Donna Kubic, Managing Director

Sandra Birdsall, Secretary

September 18 board meeting Operations Report

Adam e mailed me saying he and his family was off island and he couldn't attend the board meeting today.

According to the charge and encounter comparisons year to date we are down 150 encounters and $13,743 billed out.

Terry Keyes's daughter in law is an x ray technician, and has agreed to spend a long weekend at the Health Center instructing the care providers on more difficult x rays.

Thanks again to Dr. Grassmick for getting the I Stat finger poke machine for the Marathon race and carrying a pager in case we needed additional help at the clinic. Sue and I hung out at the clinic with no patients having to be seen.

The $2,897 which is part of the restricted funds was donated by a unanimous donor and left up to my discretion as to how to use it. I have been saving it for a rainy day and have contacted the person who donated the monies and explained what my plans were. Cathy Garland is currently taking a certified nurse aid class at Grandvue. This money will pay for her class, lodging and air fair. It is a 2 ½ week program which will allow her to take the State of Michigan test and receive her Certified Nursing Assistant certification license. My plans are to use Cathy in the Senior Help Mate program, but also in our Hospice Program which at the present time we do not have a nursing assistant. Yesterday I was informed by CMS that Beaver Island has qualified as a home health shortage area, which makes the clinic eligible for payment for visiting nursing services. The representative I have been dealing with from CMS contacted the State Health Department and the State of Michigan has given their approval. There are no other health shortage areas' in Michigan.

The clinic may be reimbursed for visiting nurse services furnished to Medicare patients if it is located in an area CMS has determined to have a shortage of home health agencies. CMS considers that a shortage of home health agencies exists if an RHC is located in a county, parish or similar geographic area in which:

•  There is no participating home health agency under Medicare; or

•  Adequate home health services are not available to clinic or center patients even though a participating home health agency is in the area;

•  Has patients whose homes are not within the area serviced by a participating home health agency; or

•  Have patients, whose homes are not within a reasonable traveling distance, considering the area's climate and terrain, to a participating home health agency.

An RHC which believes that its area meets these conditions and wishes to offer visiting nurse services must make a written request to the State Agency along with written justification that the area it serves meets one of the above conditions. The State Agency decides whether the clinic qualifies to offer this benefit.

Christine Davidson - Centers for Medicare & Medicaid Services (CMS) did the leg work for me and called yesterday to let me know, CMS and that State approved the designation. So when a person is discharged from a hospital and the discharge planner asks if we have visiting nursing on Beaver Island – the answer now is yes. We now have the designation of a home health shortage area. Cathy would be available to assist with home visits for home health care. The Clinic is now eligible for payment for visiting nursing services. There are currently no designated home health shortage areas in Michigan so the process was somewhat new

I had a meeting with Jack Messer, Executive Director of the Commission on Aging. Jack would like to attend the November Board Meeting. The COA is working on a contract which I will be sending to Webb, I have a copy if anyone would like to see it will be presented to Mr. Jarema for approval. This contract will allow the COA to contract with the Health Center for services provided on the mainland by the Health Department, namely med management and foot care. Also if their recertification nurse is unable to come to the island to recertify a client for COA, Sue, Chris or I would be able to do it.

A writer from the associated press will be visiting the island in October doing an article on how technology has benefited the Health Center. She is also very interested in the Circle of Strength support group and I will demonstrate how the group interacts with Charlevoix's support group via REMEC. She will also be visiting other organizations besides the clinic.

Darrel Butler has repaired the generator and emptied out the septic system, at no charge.

I gave a tour to the Sister's who visited the island in conjunction with the Catholic Church's 150 year celebration. Some of them have not been back to the island for 40 years. I received a very nice thank you from them all. Linda Thiel, is an associate professor at the University of Detroit Mercy, Grand Rapids campus teaches nursing threw around the idea of maybe students doing clinical rotations here. She was impressed with what we do here.

Talk about sue final settlement in closed session

Connie Wojan sold 81 tickets, Pete LoDico 50, McDonough's 29 and Terry 18.

We have received several written thank you letters to staff for services

Yes finally – I spoke with Carol Lutzkannin, Gregg Williams is the new Director and is in the UP.  He will be calling me Monday.  The next Home Land Security grant monies are due by December 15th .and she said it would give us time to work on it.

Jim Flikema indicated Northern's legal counsel reviewed the Memorandum of Understanding document and he had a few concerns. Jim is trying to track down another format that their legal counsel suggested that might meet both of our respective needs.

Board of Directors Meeting Unapproved Minutes DRAFT

Saturday, July 17, 2010

10:00 AM      BIRHC Community Room

Present Board Members – Denny Cook, Carol Gillespie, Brad Grassmick, Terry Keyes, Pete LoDico, John Martin, Rick Speck, Don Spencer, Connie Wojan

Staff Donna Kubic, Managing Director

Absent : Sandra Birdsall, John Works

I. Call to Order & Welcome

Connie Wojan called the meeting to order, welcoming Anne Glendon, Board Member Emeritus.

II. Review, revisions to agenda

Don Spencer added to the agenda under New Business C. Discussion regarding how we deal with part time help, employ or not.

III. Review, revisions and approval of minutes

Approval minutes – Don Spencer changed section five under Resource Development, the third sentence to read, “Northern Michigan Regional Hospital Foundation – Tom Mroczkowski attending one of our Board Meetings indicated that the Foundation could bring us $125,000. He did not stipulate the conditions under which that would occur.” Motion to approve the minutes of the May 15, 2010 meeting with changes (Grassmick/Spencer) approved unanimously.

Motion to approve minutes of the May 15 th 2010 closed session (Spencer/Grassmick). approved unanimously.

IV. Financial & Utilization Reports

•  Financial reports presentation and discussion

Rick Speck informed the board, the office had a computer crash on which the finances are stored. A Sub Committee consisting of Don Spencer, Rick Speck and Donna Kubic met and used Mary Cook's data to prepare a budget for 2011. The draft budget has to be submitted to the Townships per the agreement between the Health Center and the Township, and the millage request by August 1 st . This budget if need be can be amended at a later Board Meeting. One major change is in the third column second page where the projection is that we will have a carry forward of $77,236 but rather than having a carry forward that monies will be put back into the Special Projects Fund. For the next couple years we will need to borrow from the Special Projects. If it is not paid back the fund will be gone in two years. A new line item appears as a loan . Motion to approve the draft budget (Martin/Grassmick) unanimously approved.

Don Spencer reminded the Board that another source of revenue is needed. A program of planned giving needs to be investigated and initiated. Don suggested one Board Member be responsible to research this and come back to the Board at the next meeting. Brad Grassmick volunteered to take the responsibility to research it and report back to the Board. John Martin spoke about no raises for the staff in two years, but putting $10,000 into maintenance and a $7,000 profit. Don Spencer said the maintenance fund is never completely funded.

•  Cash Flow Report

As above

•  2010-2011 Draft Budget

As above

V. Committee Reports

•  Resource Development

Terry Keys suggested a box be place by Betty to make a donation to the Health Center . We are missing a small opportunity. We need something where you check out. Connie suggested the pie chart of expenditures being visible.

Brad Grassmick spoke about the meeting he, Denny Cook and Don Spencer attended at Northern Michigan Regional Hospital at their own expense with Northern's Foundation Chief Development Office, Moon Seagren. Moon spent an hour with them, but made it clear their Foundation can assist BIRHC, but cannot devote their resources. Northern expressed some out reach, but they need to focus on their own fundraising. Moon suggested coming up with a list of major donors and contacts. Northern would be willing to help identify grants that could benefit the Health Center , but not assume the responsibility. Don reported the context was a little different than he had hoped. Don read their mission statement which had two components, money for the hospital and one for outlying activities. Don interpreted outlying activities could be the Health Center 's crutch for our activities. The Health Center needs to come up with a list of people with substantial means and Northern would develop an approach as to how to have a private meeting, and assist in creating a presentation to make a case. NMRH would be willing to do the research when the names have been compiled. This willingness on the part of the Foundation is significant. Their researchers would give BIRHC information on what to expect as far as giving. Connie stated each one of us might know a person of these means. We need to start out with 20 names, then use the skills of Northern's Foundation to target these people.

John Martin spoke about hiring a development person, part time, to organize the material, and accompany a Board Member and Donna on the visit to the potential donor. This could be a two year investment. John suggested if you want to get serious then take some dollars out of the Special Projects Fund to get this up and running. In the long run it would pay for itself. Also, there might be a possibility of getting a grant. Anne Glendon agreed that using Special Projects Funds to initiate something that will have long term affect, is a fine use of the monies, and would be a long term benefit for the Health Center . This will be on the agenda for the September meeting. Don mentioned it is hard for a Board Member to focus on one thing for a long time and it takes a special kind of background. Anne mentioned she had two people in mind who she thinks could do the job. Motion to have Anne Glendon investigate the two local people she knows to become a part time development researcher. (Keyes/Wojan) unanimously approved.

Anne asked for a Board Member to work with her. John Martin will join Anne in the investigation, and to approach Northern about purchased services. Board members will send Donna a list of names to compile and bring to the next Board Meeting.

•  Building Maintenance

Denny Cook reported on a new hot water heater that has been installed. It would have cost more money to fix the damaged water heater than to install and to purchase a smaller unit which was a better fit.

•  Finance Committee

Discussed under Financial reports presentation and discussion

•  Medical Services and Quality Assessment

Did not meet

•  Task Force

Will be discussed under Memorandum of Understanding

•  By law and Policy Review

John Martin reported on the Committee that met on June 24th. John Martin, Anne Glendon, Donna Kubic, and Denny Cook ( via phone) to review the bylaws in comparison to the policy manual regarding eligibility for board membership.

Charge: Recommend changes to Board of Directors Policy Manual regarding eligibility for election to the Board.

Bylaws:

3.06

Sixty days prior to the Annual Meeting, the Secretary shall solicit nominations from the Beaver Island community of individuals to serve on the Board. The deadline for submitting such nominations shall be 30 days prior to the Annual Meeting. The Board may consider other candidates who are permanent or seasonal residents of Beaver Island not nominated by the public.

Members elected to the Board shall, so far as practical, reflect the age, gender, ethnicity, and geographical distribution of the permanent and seasonal residents of Beaver Island .

Board of Directors Policy Manual:

Terms: BIRHC at-large Board members are elected by the-sitting Board to serve three-year terms unless they are elected to fill an unexpired term. Members may be reelected for a second term, but no at-large Board member may serve for more than 8 consecutive years. (Note: The Boards of Peaine and St. James Township each select one representative to the BIRHC Board. Beaver Island EMS is also asked to select one representative.

Eligibility: So long as BIRHC operations are funded by township millage, all voting Board members must be taxpaying owners of property on Beaver Island . At least 2/3 of the BIRHC Board should be permanent residents

Recommendation: Make 2 changes to the Board Policy Manual:

Terms: Delete sentence regarding EMS

Eligibility: Change the Policy Manual language to conform to the by-law language

Eligibility: Members elected to the Board shall, so far as practical, reflect the age, gender, ethnicity, and geographical distribution of the permanent and seasonal residents of Beaver Island .

Committee recommending those two changes to bring in compliance with the bylaws . Motion to accept changes suggested by the Committee (Keyes, Grassmick) unanimously approved.

Connie Wojan brought up the wording of “ethnicity”, which Sandy Birdsall stated might be a concern. The Board did not think this warranted changing. Connie mentioned that in the future Board Members including in the language the number of meetings a Board Member should attend.

VI. Operations Report

•  Summary of Activities, Statistics

See attached report

•  Health Fair Update

There will be several off islands agencies present. Plans are progressing and the next meeting will take place August 6 th .

VII. New Business

•  Memorandum of Understanding

Don reported Webb Martin suggested a confidentiality clause which could become #12.

#13 which would be come “Term of the memorandum of understanding. The effective date of this instrument shall begin when the last signature is executed, and is effective through August 1, 2012 , at which time it will extended unless terminated by mutual agreement.”

Two typos on page four #6 NMRHS and #8 the S is missing in NMRHS.

Changes will be forward to NMRH

•  Shingles Vaccine

Donna will write an article about the Shingles vaccine and put in on Joe's website and the forum and newspapers explaining who is eligible and when we will have the serum

C. Part Time Help

Donna instructed to post maintenance help in the clinic for a contractor with liability insurance.

VIII. Old Business

•  Millage election

Connie encouraged Board Members to vote on August 3 rd . Donna will post the information on Joe's website and the forum closer to the election.

•  Golf Outing

John Works will be contacting Board Members to help.

•  Set Board Goals

Tabled until next meeting;

John Martin spoke about grant dollars from BCBS Foundation to increase access to care from a kind of collaborative relationship. The Board approved exploring the grant of $3,500 which could be available to write a grant with an upward grant of $50,000.

IX. Public Comment

There was no public comment

X. Closed session to discuss Personnel Matter

Open session resumed at 12:40 PM

XI. Adjournment

Motion to adjourn (Spencer/Cook) at 12:50 PM.

Respectfully submitted, 

Connie Wojan, President     Donna Kubic, Managing Director

July 17, 2010 Operations Report

From the Total Charges and Encounter Comparison handout, patients encounters in June we were down 72 patients which resulted in a $4,300 decreased in billing. In May we were up 67 patients and had an increase of $4,100. Between the two months patient visits and billings evened out.

I held a REMEC in-service for the community on “Aging Parents and Legal Issues” learning about Elder Law ,the speaker was Deborah Rysso, Elder Law attorney, who discussed legal issues of aging parents such as estate planning, wills, probate, power of attorney and Medicaid for nursing home residents.

Also through REMEC, I offered a “Hospice and Nutrition at the end of life” for the hospice helping hands and hospice volunteers.

The Open House was well attended with many visitors who had not been in the Health Center before. We were connected to Charlevoix Hospital and were able to demonstrate the telemedicine equipment and our digital x ray.

I was invited to be part of a task force which involves networking with Cheboygan Memorial Hospital, Charlevoix Area Hospital, Northern Michigan Regional Hospital and Mackinac Straits Hospital in St. Ignace. Northern Michigan Regional Hospital received a $84,950 grant to establish a primary care model that creates care solutions in rural and remote areas. A proposed alliance would bring together Northern, Charlevoix, Cheboygan, Mackinac Straits H and Beaver Island Rural Health Center to maximize resources. The funding comes from the U.S. Department of Health and Human Services' Rural Health Network Development Planning Grant Program. The program's goal is to strengthen rural health care delivery systems with funds typically used to acquire staff, contract with technical experts and purchase resources. We had our first meeting this week.

Larry Hudson who is employed by Charlevoix Area Hospital Physical therapy department was here Thursday and beginning July 27 th will offer services on Tuesday and Thursday to island residents at the Health Center. I am waiting for information from Larry on who will be the therapist coming over, so I can place an announcement on the websites and in the papers.

I received a $2,000 grant from Char Em United Way for a Senior Help Mate Program, I partnered with the school to take pictures with the seniors. I hope to find other grants that will compliment this program. The Senior Housing will be started in the fall, so this might fit well with seniors living there. I will begin to work on the program and inform the community of assistance for our seniors. I had four people interested in becoming the Senior Help Mate.

Barb Kenwabikise who helped us with X rays has left the island. Sue spent a few hours training with Barb before she left. Barb would come in whenever we needed her to do the difficult x rays which the providers were not comfortable doing. We will need to send the practitioners over to Charlevoix Area Hospital or pay for Barb to come over and spend time with Sue and Chris, learning the more difficult X rays.

Mary's computer crashed when we had a power surge, which also took out the water heater and the computer. I was able to send the computer to Charlevoix to be repaired. Thus we were behind on getting financial information to the Board Members.

Liz Lanier has generously donated a picnic table which currently we have in the back of the building and the staff has and will enjoyed, eating their lunch outside.

Valerie Newcomb, donated $50.00 worth of toys for the waiting room

Sue Coen, RN, a nurse trained in sexual assault issues from Charlevoix Hospital came to the Health Center and did training with the providers on sexual assault issues. Thank you Carol Gillespie for giving us a head start on a policy for sexual assault victims

Dr Meyerson from the Health Department visited the clinic and will be back in October to do an in-service on vaccines.

Ken Hogarth did insect spraying at no charge.

School children did island clean up here and washed windows for us.

Di Gilroy, the Manager for Munson Hospice who is retiring, brought the new Hospice Manager here to the island to introduce her to Sue and I.

Judy Goodrich, Hospice Volunteer Coordinator did an all day Hospice training with the Hospice Volunteers here in the community room.

Stephen from Central Solutions was here and the T-1line has been switched over to TDS.

Spoke with Bob Hoogendorn about getting names of veterans on the island -

Don, John Martin, Anne Glendon and I met at Northern Michigan Regional Hospital with Barb Berry, Jim Flikema and Reezie DeWitt to discuss the final draft of the Memorandum of Understanding. Webb Martin has reviewed the document and other than the paragraph about Hipaa had no changes. Jim Flikema said that their attorney has been out of touch and has not done a final review yet. But Jim is confident that what we have is close to final.

Respectfully submitted, Donna Kubic

Board of Directors Meeting Unapproved Minutes DRAFT

Saturday, May 15, 2010

10:00 AM      BIRHC Community Room

Present Board Members – Sandra Birdsall, Denny Cook, Carol Gillespie, Terry Keyes, Pete LoDico, John Martin (via speaker phone), Rick Speck, Don Spencer, Connie Wojan, John Works.

Adam Richards, Advisory Board Member

Staff Donna Kubic, Managing Director

Absent : Brad Grassmick

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:00 AM, welcoming all board members and Adam Richards in attendance. 

II. Review, revisions to agenda

No revisions

III. Review, revisions and approval of minutes

Motion to approve the minutes of the March 20, 2010 meeting (Works/Spencer) approved unanimously.

IV. Financial & Utilization Reports

•  Financial reports presentation and discussion

Rick Speck reported on the financial income statement. Taxes have been received earlier this year. Money has been transferred from the Special Projects Fund, so we are financially stable right now. Medical service income shown on statement is not accrued, which gives a more accurate picture. This does not take into consideration account receivables. Cash flow reports are actual. Expenses are running where they should be. Motion to approve the financial statement (Works/Spencer) unanimously approved.

•  Cash Flow Report

Don Spencer reported on the cash flow report. The Finance Committee met on Wednesday and revised this cash flow report. It gives a true picture of expenses and projections. The Kellogg Grant, a one-time grant is recorded in April. If we were to pay back the $50,000, taken out of Special Projects, we would have a deficit of $15.000. Possible golf outing revenue is not included and could be substantial.

Don reported that between now and the end of the year, anything the board can do to provide income is critical. The Finance Committee is suggesting to the Resource Development Committee that $125,000 needs to be raised every year from all sources of fundraising. This is $65,000 more than we currently raise. If we continue to take $50,000 out of Special Projects every year we will exhaust it quickly. Denny Cook and Brad Grassmick are committed to meeting with Northern Michigan Hospital Foundation representatives to see how they might be able to help us with fundraising. Don Spencer mentioned he was not confident the Health Center would receive the money from the state.

•  Audit

Rick Speck reviewed the Financial Statement. A complete audit was not done this year. There was discussion regarding whether the Health Center needed to have an audit done every year. Donna will check the minutes of previous meetings to see if a motion was made to do an audit only every other year. Motion to approve the financial statement (Martin/Works) unanimously approved.

V. Committee Reports

•  Resource Development

Connie Wojan reported on the Resource Development Committee meeting (minutes attached). The golf tournament date will be August 14 with a rain date on August 15 th . Board members will be asked to be greeters and solicit prizes and cash donations. Connie Wojan mentioned she would like whole board there. John Works suggested having the car at the golf course when some of the tournaments are going on. Work assignments will be made at the next meeting. Don Spencer mentioned that the NMRH Foundation indicated they could raise $125,000 for the Health Center. Don emphasized the importance of asking NMRH for their help and offered to facilitate the first meeting.

•  Building Maintenance

Denny Cook reported on the Building Maintenance Committee. - Gerry LaFreniere, Don Spencer and Denny Cook went through different items that should be on hand in case of a malfunction which amount to about $400.00. They met with Bill Inglis, who is a distributor for Wolverine Power Systems, which sells generators. Don Spencer did a study and determined what peak loads would be. The proposed generator will be about $31,000 installed. The USDA will pay 25% of the cost and would offer a loan at 4%. We will try and apply for different grants to help purchase a generator that could run the clinic in an emergency.

•  Finance Committee

Met on May 12, (minutes attached).

•  Medical Services and Quality Assessment

Committee did not meet

•  Task Force

A joint Task Force Meeting took place on March 26 th with Reezie DeVet, the new CEO of Northern Michigan Hospital, and Jim Flikema attending here on the island. The Task Force will be meeting again by conference call the end of May, or beginning of June. The date has not been agreed upon. Jim Flikema agreed to explore additional support on items that were still question marks and to determine how much could be accomplished without a major corporate restructure. Such a move would require substantial legal expenses and could result in negative public reaction over the loss of local control. Reezie was sensitive to the island's concern about losing control of the Health Center. She stated that so long as we have a close and cooperative relationship, there seemed no advantage to creating a complicated and potentially controversial new structure. Northern will draft a Memorandum of Understanding and present it at the next meeting.

•  By law and Policy Review

Denny brought to the board's attention a conflict between the bylaws and the board policy “Board of Directors, Preferred Qualities, Eligibility, Roles and Responsibilities, Orientation.” We have a conflict because the policy puts restrictions on membership, which are not in the bylaws. The board must resolve the conflict before the time comes to elect new members. A committee to look at the policies and how they relate to the bylaws was formed which included Denny Cook, Connie Wojan, Anne Glendon and John Martin. The committee will be assigned to go through policies and review how they relate them to the bylaws.

VI. Operations Report

•  Summary of Activities, Statistics

See attached report

•  Health Fair Update

Discussed under operations report

VII. New Business

A. Millage election

The Health Center's millage renewal is coming up the first Tuesday in August. – The St. James board voted to put the millage request on their ballot for a 3-year renewal. The Peaine board voted to put the item on the ballot for a 4-year renewal. Don Spencer gave a presentation at the Peaine meeting with good financial information to educate the public. Don suggested having a public meeting before the millage election. He suggested a presentation on what happens when you call 911. This might encourage residents to vote for the millage. A good time might be the end of July to be held at the Peaine Township Hall. John Works suggested that information about the millage request be posted on the BIRHC website and an article published in the papers about what happens in a medical emergency on Beaver Island.

•  Good Samaritan Fund

Stoney Acres Grill sponsored a benefit on Saturday, May 1st for Smoke-Free night with .50 cents a drink to benefit the Health Center. The event raised $250.00. Donna Kubic requested that this money and the monies in the Auxiliary account in the amount of $1,100.00 be put into a restrictive fund and renamed the Good Samaritan Fund . Donna will do a thank you to Stoney Acre Grill and an announcement of the new fund for people who might want to donate. Donna will use her judgment in dispensing the money to cover medical treatment for needy patients and will make a report to the board quarterly. The board will review the process in a year to evaluate how it is proceeding. At that time the Board could make a formal policy. For now Donna will gather data and at a future date make a policy. Motion to transfer monies from the Auxiliary Account and rename the account the Good Samaritan Fund (Works/Spencer) unanimously approved. Motion to establish the Good Samaritan Fund and authorize Donna to administer and report back every three months (Works/Speck) unanimously approved.

VIII. Old Business

•  Setting Board Goals for 2010

Connie Wojan mentioned again two important goals for 2010 were: passing the renewal of the millage and successful summer fundraisers

•  Open House

The connection with Charlevoix Area Hospital will be on for the entire two hours. The drawing for the Early Bird Special will be one at 12:00. Connie will ask the deputy to pull the winning ticket. Donna will try and schedule two live demonstrations with the ER and will also demonstrate our digital x ray. Terry Keyes offered to supply refreshments.

IX. Public Comment

There was no public comment

X. Closed session to discuss Personnel Matter

Motion to move into closed session to discuss a personnel matter (Spencer/Works) Role call, Birdsall, yes, Cook, yes, Gillespie, yes, y Keyes, yes, LoDico, yes, Martin (via speaker phone), yes, Speck, yes, Spencer, yes, Wojan, yes.

Open session resumed at 12:50 PM

Motion for the Board to direct Donna to create a policy stating that in legal cases involving an employee facing administrative or other legal action, that the Health Center, except in cases of gross negligence or violation of the law, pay the legal expenses for the employee. (Birdsall/ Speck), m otion approved, unanimous.

XI. Adjournment

Motion to adjourn (Spencer/Cook) at 12:55 PM.

Respectfully submitted, 

Connie Wojan, President     Sandra Birdsall, Secretary    

Donna Kubic, Managing Director

March 2010 Operations report (Donna Kubic)

Included in your package is a flyer for the Jumpstart to wellness program – which has been advertised in the community and will continue indefinitely. The cost will be $25.00 and include Review of Medical History, Height & Weight, Blood pressure check, Cholesterol, anemia, and blood sugar screening by doing a finger poke and an EKG. We will not bill this to insurances. The $25.00 will cover the cost of the supplies we need to do the screening.

I met with Chris Krajewski, Women's Resource Center , who is the Domestic Abuse/Sexual Assault Program Director and obtained rape kits which we have not had at the clinic and I will be writing a policy on how to deal with this situation as we do not have one at the present time.

I heard from TDS about the T-1 being installed and they indicated it would be 608-662-3531, done in about three weeks. They inquired about getting together with our tech support.

I did an interview on Joe Moore's website promoting the open house and several other items.

I received a check from Stoney Acres in the amount of $250.00 from the fund raiser on the night of the “smoke out”. An amount of $1,113.94 is in an auxiliary account which Rick indicated was a fund set up to offset costs of fund raising from several years ago. The auxiliary group no longer is active. At the finance committee meeting, I requested this amount and the $250.00 from Stoney Acres be set aside in an account maybe named the “Good Samaritan” or Guardian Angel Fund” to help community members in need of monetary assistance for various reasons to be used at the board discretion or if the board decides it could be my decision.

The Michigan rural health conference was held in Mt pleasant which I attend. I felt it was worth my while as I made a few contacts..

I offered a Lumbar Stenosis REMEC program and had 6 people in attendance.

I meet with the physical therapist manager at Charlevoix Hospital (Bob Grakowicz) who hasn't forgotten about Beaver Island and said of course it's all about the numbers and would keep me in the loop about possible services here.

The Health Center Website is finished www.birhc.org , please take a look at it and offer any suggestions you may have.

I met with Jack Messer, the new Executive Director of the Commission on Aging. He will be returning to the island and we will get together again.

We had two EMT Specialist spend a couple of days at the clinic to fulfill some of their practical's.

Thank you to Dawn Marsh and Maryanne for stripping and waxing all the floors which was a huge job.

I have switched Insurances (officer and directors, workmen's comp and building insurance with a savings of about $1300.00 (which we can use to pay for the cost of fixing the van)

We have received the Kellogg grant.

I offered a Hospice in service through telemedicine on March 24”living with grief “and end of life care, several of the hospice volunteers attended

Dr Wartinger, urologist from University of Michigan has contact me about having another Men's Prostate Screening day this summer. This is available at no charge to the men of the island who would like to take advantage of this very important examination for prostate cancer. We had a number of men take advantage of this last summer. I will advertise when I get a couple dates from Dr. Wartinger.

Dr Cotter, Dermatologist has begun seeing patients here at the Health Center . On his first visit he saw 29 patients. He brought with him two of his staff members.

A group of cancer survivors have formed a support group which will be meeting the first Wednesday of the month. Through our telemedicine equipment this group met with Charlevoix's Circle of strength support group and interacted with their member's real time. They will continue to meet every month and use the Polycom to meet with the Charlevoix group.

Number of patients seen through April of this year is down 91 patients. Billing compared to 2009 is down $9,000.00.

The Health Fair is moving along. A long list of invitees has been distributed to the steering committee for them to contact. The fair will take place the Christian Fellowship Hall.

Finance Committee Minutes

Wednesday, May 12, 2010

1:300 AM      BIRHC Community Room

Present – Mary Cook, Sandra Birdsall, John Martin (via speaker phone), Rick Speck, Don Spencer, Donna Kubic.

Absent : Carol Gillespie

•  Review current cash flow report

Mary Cook as developed a cumulative cash flow report. With the receipt of the Kellogg grant of $35,000 the end of the fiscal year 2010 will end up with a $19,361.71 positive cash balance.

•  Discussion of allocation of Good Samaritan funds – contributions for specific medical treatment purpose

Donna Kubic reported receiving a check from Stoney Acres in the amount of $250.00 on the night of the “smoke out”. An amount of $1,113.94 is in an auxiliary account which Rick Speck indicated was a fund set up to offset costs of fund raising from several years ago. The auxiliary group no longer is active. Kubic requested this amount and the $250.00 from Stoney Acres be set aside in an account to help community members in need of monetary assistance for various reasons to be used at the board discretion or Kubic. This will be discussed at the Board meeting on May 15 th .

III. Engaging Northern Michigan Hospital Resource Development Dept (Foundation) for assistance toward BIRHC fund raising efforts.

Don Spencer will recommend at the next board meeting that the Resource Development Committee approach Northern Michigan Regional Hospital 's fund raising department

IV. Grant opportunities for operations

Donna reported that her investigations of grants they are for projects and not for operations. The USDA indicated they would allow $7,000 towards a generator with a loan at 4%. Donna indicated she will approach the tribe. Also mentioned was the possibility of looking into FEMA for funds for a larger generator.

Respectfully submitted, 

Donna Kubic, Managing Director

BIRHC Resource Development Committee Meeting

April 26, 2010 4 PM

Present: Connie Wojan, Denny Cook, Terry Keyes, John Works,

Brad Grassmick

Absent: Adam Richards

Connie called the meeting to order at 4 PM. As no one else was interested, Connie agreed to be committee chair. The committee discussed the following topics:

Golf Tournament Fundraiser

John Works confirmed his commitment to take the lead in planning the event. After discussion it was decided to set the date for the tournament for either Saturday August 14 th or Saturday, August 21 st . John suggested that the rain date for the event be set ahead of time for Sunday, the day after the original date.

Connie asked John what help he would need from the board. John said he would need help on the day of the tournament and in soliciting prizes and players. He emphasized the importance of recruiting golfers and business donations from the mainland. He stated his belief that with the boards' help a much larger amount of money could be raised than last year's $6000+.

John will have a date selected by the May board meeting.

Car Raffle

81 tickets have been sold so far. The Early Bird drawing will be May 30th at the open house.

Credit Card Fundraiser

Brad reported on his research into having a deal where 1 % of charges of holders of a special Capital One card would go to the Health Center. He will have specific information for the May meeting that would enable board members, staff and other supporters to benefit the Health Center by applying for and using a Capital One card.

Website

Connie talked about the recent update of the birch.org website initiated by Donna. She asked the committee members to look the site over and contact Donna with suggested changes/improvements to the site.

Open Forum: Suggestions from New Board Members

Connie opened up the meeting to suggestions for improving fundraising.

Terry Keyes - More effort should be made to educate the public about the fact that patient fees cover only about 25% of what is needed to operate the HC. Connie agreed and said this was particularly important this year because of our August millage election.

Terry also suggested that board members approach all island businesses about putting on fundraisers for the HC such as the one Stoney Acre had scheduled for the weekend of April 30-May 1 st .

John Works- emphasized the importance of soliciting new donors to the Endowment Fund. It was suggested that a DVD of Donna Kubic's PowerPoint presentation about the history of the HC would be a good tool to educate and solicit potential major donors.

Brad Grassmick - Suggested that it would be beneficial for members of the committee to meet with Northern Michigan's Foundation Board and/or staff. Denny and Brad will try to set something up when they are in the Petoskey area. Brad will also follow up with Jean McDonough about Ted Hughes' offer to do a free planned giving workshop.

Meeting adjourned 5:20 PM.

Respectfully submitted,

Connie Wojan, Chair

DRAFT

Board of Directors Meeting Unapproved Minutes

Saturday, March 20, 2010

10:00 AM      BIRHC Community Room

Present Board Members – Sandra Birdsall, Denny Cook, Carol Gillespie, Brad Grassmick, Terry Keyes, Pete LoDico. John Martin, Rick Speck, Don Spencer, Connie Wojan, John Works.

Absent :

Staff – Donna Kubic, Managing Director

Guests – Bill Cashman, Adam Richards

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:00 AM, welcoming all board members present, new board members, Bill Cashman and Adam Richards in attendance. 

•  Welcome to new board members

Connie Wojan welcomed Carol Gillespie, Terry Keyes, John Martin and John Works to the meeting.

III. Review, revisions to agenda

No revisions

IV. Review, revisions and approval of minutes

Motion to approve the minutes of the February 20, 2010 meeting. (Grassmick/LoDico) approved unanimously.

V. Financial & Utilization Reports

A. Present budget

Rick Speck reported on the financial statement and stated that expenses are where they should be at five months into the fiscal year . Medical services income is down significantly from what was budgeted. Rick explained line items for the benefit of the new board members. He emphasized that patient revenue would always be insufficient to cover all operating expenses and that the Health Center could not survive without townships' millage, grants, and donations. Motion to approve the financial statement ( Grassmick/Spencer) unanimously approved.

•  Cash Flow Report

Don Spencer explained the cash flow analysis prepared by Mary Cook. We borrowed $50,000 in December 2009 in addition to $20,000, which was withdrawn as previously approved for the matching telemedicine grant funds. These withdrawals are reflected in the $57,000 net loss. The analysis does not include pending State funding or Kellogg grant money. Tax dollars could be down next year. We may avoid a loss this year if the State and Kellogg grant funds come through.

VI. Orientation

•  Power Point )

Donna Kubic will show the power point during lunch.

•  History of the Beaver Island Rural Health Center

Don Spencer reported on the history of the new facility.

•  Linkage

Don Spencer informed the new board members about the affiliations the Health Center has with the neighboring hospitals. (See attached chart.)

•  Emergency Situations

The Health Center has a disaster plan and could be turned into a 22 bed holding area for patients if a disaster struck the island

VII. Task Force Activities

Don Spencer explained the task force activities to the new board members and stated that the task force would be meeting March 26 th with the CEO of Northern Michigan Regional Hospital to further discuss an affiliation.

VIII Operations Report

•  Summary of Activities, Statistics

Donna Kubic reported she attended a House appropriations committee meeting in Traverse City. Bill McDonough introduced Donna to State Representative Gary McDowell. Representative McDowell was chair of the committee. Several other representatives were in attendance. Donna presented a testimony about the importance of the funding of the $100,000 that was allocated to the three islands, and then eliminated from the budget.

IX. New Business

A. Committee Assignments

Were included in board packets.

•  Determine terms of new Board Members

Each new board member drew a slip at random to determine the length of his or her term. Those who drew partial terms are eligible to be reelected to two more 3-year terms. Results were as follows:

Carol Gillespie 3-year term

Terry Keyes 1 year term

John Martin 1 year term

John Works 3 year term

X. Old Business

•  Setting Board Goals for 2010

It was decided the individual committees would set goals at their meetings. All committees will meet before and report at the next full board meeting on May 15 th.

•  Review of Board meeting schedule

Meeting schedule was included in board packets.

XI. Adjournment

Motion to adjourn (Spencer/Cook) at 12:45 PM.

Respectfully submitted, 

Connie Wojan, President     Sandra Birdsall, Secretary    

Donna Kubic, Managing Director

 

Board of Directors Meeting Unapproved Minutes DRAFT

Saturday, January 16, 2010

10:00 AM      BIRHC Community Room

Present Board Members – Sandra Birdsall, Denny Cook, Brad Grassmick, (via speaker phone) Pete LoDico, Jean McDonough, Rick Speck, Don Spencer, Connie Wojan. Staff – Donna Kubic, Managing Director

Guests – Bill Cashman, Gerald LaFreniere

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:00 AM, welcoming all board members present and on speakerphone, and guests.

II. Review, revisions to agenda

No revisions

III. Review, revisions and approval of minutes

Motion to approve the minutes of the November 21, 2009 (Grassmick/Birdsall) approved unanimously.

IV. Financial

A. Financial reports presentation & discussion

Rick Speck reported on the finances. The carryover from last year was slightly higher at $13,081. The report shows a slight profit but we need to put back the $70,000 borrowed from Special Projects. Building maintenance is over budget because of replacing the windows. Connie Wojan reported that she had received a call from Bill McDonough saying that the State monies might be in jeopardy. Rick stated the State money was not included in the budget but could be used to replace some of the $70,000 taken out of Special Projects. Don Spencer said the monies are in jeopardy but not dead. The other two islands will also be in contact with their representatives.

Resolution: To write a common letter in conjunction with the other islands to our state representatives regarding the status of the State money. (McDonough/Spencer) unanimously approved.

Don Spencer talked about returning the $70,000 to Special Projects. He would like to know with some confidence if and when that will be possible. Don said that if we can't repay the fund, we are in trouble. Rick Speck indicated we would know by the end of February when 75% of the tax dollars are received.

Motion to return monies to Special Projects if sufficient tax dollars come in by the end of February. ( Speck/Spencer) approved unanimously .

Motion to approve Financial Report (Spencer/Birdsall ) approved unanimously.

V. Committee Reports

A. Finance

Nothing to report

•  Resource Development & Marketing

Connie Wojan reported the balance shown on the report in Special Projects does not reflect what was taken in from the Annual Appeal. Total contributions to the fund at the end of December were $22,886. In addition, $2,094 was added to the endowment from the Annual Appeal. Ray Murray's bequest went into the Endowment Fund and was just short of $6,000. Connie mentioned that the money collected this year was running about the same as last year. The vast majority of the money received was directed to the Special Projects Fund. The Special Projects Fund money can be spent.

•  Car Raffle 2010

Pete LoDico reported on the differences between the Ford Focus and the Chevy Cobalt Motion to go forward with Dave Kring and the purchase of the burgundy Chevy Cobalt. (Birdsall/Spencer) unanimously approved. Motion to take $15,057.23 out of Special Projects to purchase the Chevy Cobalt (Spencer/Birdsall) unanimously approved.

VI. Operations Report

•  Summary of Activities, Statistics .  Donna Kubic's operational report is attached.

It was decided to demonstrate the new telemedicine equipment to the board at the February meeting. An open house was also discussed to allow the community a chance to see the equipment. Motion to have a community open house Sunday of Memorial Weekend after church. (LoDico/Spencer) unanimously approved.

VII New Business

•  Acceptance of Larry Hansz's resignation

Connie Wojan spoke of Larry Hansz's contributions to the medical center which include: thousands of dollars worth of furnishings and medical equipment and his connection with Eric Mueller who wrote up a comprehensive maintenance plan for the Health Center. Motion to accept with regret Larry Hansz's resignation and to thank him for all his prior contributions. (Wojan/Cook) unanimously approved.

•  Set date to reconvene to hold Board member Elections

Connie suggested February 2 th as the date to reconvene the Annual Meeting, since it has already been published

•  Board Openings

Connie thanked the selection committee, Jean McDonough, Denny Cook and Sandy Birdsall for all their time spent interviewing the 6 potential board members. Jean McDonough will not be seeking reelection to another term because of the number of very qualified candidates. Sandy and Jean reported that all candidates had unique skills sets that could be helpful to the Board. Sandy Birdsall and Jean McDonough suggested changing the bylaws to increase the board to 13. Denny Cook stated he was not in favor of the increase. Don Spencer suggested that the first issue on the February 20th agenda should be a vote on the bylaw change, which if passed, would allow all 6 applicants to join the board. If the bylaws are not changed, four candidates will be chosen. Spencer said the remaining two candidates could be appointed to an advisory committee.

•  Board Goals (Review of Strategic Plan Goals)

Motion to table Board goals until the February 2 th meeting. (Birdsall/Cook) unanimously

•  Steering Committee for “Moon Walk”

Sandy Birdsall talked about board support to get together a steering committee to promote a walking program in the community. Jean McDonough mentioned there is already a similar program in Northern Michigan. Motion for Birdsall to represent the Health Center and encourage the development of this program, and that the Health Center participate. (Cook/Spencer) approved unanimously.

•  Planned Giving Report

Jean McDonough spoke with Lyn Jenks of Charlevoix Area Hospital regarding planned giving. Lyn told her CAH had tried a mailing campaign that was expensive and had not produced any positive results. Lyn would not do a mail campaign again. Sandy Birdsall asked Ted Hughes, a retired estate planner, if he would be willing to conduct a seminar and invite the community at no charge. Connie said this was an excellent idea and should be added to the goals list. Jean McDonough and Sandy Birdsall agreed to be involved and go forward with planning for a seminar in late June.

XI.   Old Business

•  Decision to fully fund the maintenance depreciation budget

After discussion the Board decided a cash flow analysis would be needed to project whether fully funding the maintenance budget would be possible this year. Motion to ask Mary Cook to do a cash flow analysis for the next 6 months and present it at the next meeting (Spencer/Cook) unanimously approved .

•  Motion to accept language for bylaw change

Motion to accept changes in paragraph 4 of section 3.02 of the bylaws concerning extension of terms as recommended by Webb Martin (Birdsall/LoDico). Unanimously approved.

XI.   Public Comment

There was no public comment.

XII.  Adjournment

Motion to adjourn Annual Meeting and reconvene on February 20 th at 10:00 AM, (Birdsall/Spencer) approved unanimously.  Meeting adjourned at 12:55 PM. 

Respectfully submitted Connie Wojan, President;  Sandra Birdsall, Secretary; Donna Kubic, Managing Director

 

Board of Directors Meeting unapproved Minutes DRAFT

Saturday, November 21, 2009

10:00 AM      BIRHC Community Room

Present Board Members – Sandra Birdsall, Brad Grassmick, Pete LoDico, Jean McDonough, Rick Speck, Don Spencer, Connie Wojan.

Larry Hansz and Denny Cook joined the meeting midway by speakerphone as they were stranded in Charlevoix.

Staff – Donna Kubic, Managing Director

Guests – Bill Cashman 

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:00 AM, welcoming all board members present and on speakerphone, and Bill Cashman in attendance. 

II. Review, revisions to agenda

No revisions

III. Review, revisions and approval of minutes

Motion to approve the minutes of the September 19 th minutes with corrections (Spencer/LoDico) approved unanimously. 

IV. Financial

A. Financial reports presentation & discussion

Expenditures for October are within budget. Custodial wage is higher due to a new employee doing extra cleaning that was needed. The bulk of the deep cleaning is now complete and cleaning wages are expected to return to former levels. Motion to approve Financial Report (Wojan/Spencer) approved unanimously.

V. Committee Reports

A. Finance

Don Spencer reported on maintenance items expenses. Eight new windows have been installed and the air conditioning repair work has been completed. We are not aware of any additional building expenses. Because of these unforeseen expenses we were unable to set aside $5,000 into the maintenance reserve budget. The windows will be paid for out of the regular checking account. There was discussion about funding the maintenance reserve budget. Motion to table the decision to fully fund the maintenance depreciation budget until the January meeting. (Birdsall/Spencer) unanimously approved.

Bookkeeper Mary Cook's numbers indicated the need for about $70,000 more than is currently available in unrestricted funds to pay bills and make payroll through the first of January. Motion to authorize Donna to take $80,000 of out Special Projects for budged items only as needed (Speck/Grassmick) unanimously approved. Don Spencer pointed out that the board must be vigilant in making sure this loan from Special Projects is paid back.

Discussion took place regarding what level of audit we should have this year if any. Motion to proceed with a preparation of compiled statement and completion of the 990 review only. If a grant application requires an audit, one can be scheduled at that time. (Speck/Birdsall) unanimously approved.

B. Resource Development & Marketing

Connie Wojan reported the Annual Appeal letter is out. Typically at least $20,000 is received in donations from the Appeal. Sandy Birdsall commented that the letter and attachment were well written. Connie reported that the CCCF has postponed deciding on any endowment interest to be distributed until the end of December.

Brad spoke about planned giving and the need to start investigating. Jean McDonough will meet with Lyn Jenks at Charlevoix Area Hospital to come up with a plan. Connie Wojan reported Dr. Raymond Murray has left his IRA to the Health Center . Pete LoDico reminded the board that a decision will have to be made on a raffle vehicle by February. Board members will individually research vehicles and send the information to Pete, who will report on the findings at the January meeting. It was agreed the early bird special would be done again this year.

•  Building Maintenance

Denny Cook, who was on speaker phone and unable to attend the meeting due to weather asked Don to report on building maintenance. Don reported no big projects were planned for this year.

•  Task Force

On Thursday, Northern Michigan Regional Hospital 's task force was unable to visit the Health Center due to weather. Anne and Brad who were also unable to visit Beaver Island drove to Petoskey and were introduced to Northern's task force. Anne and Brad then joined the Northern Task Force in a conference call with BIRHC task force members. A detailed list of needs of the Health Center was presented to Northern's task force. A second meeting of the joint task force will be set to discuss the best way to structure a partnership for the mutual benefit of both organizations. A date for the meeting has not yet been determined.

VI. Operations Report

A Summary of Activities, Statistics .  Donna Kubic's operational report is attached.

VII New Business

•  Modification of By-laws

There was a discussion about the fact that according to BIRHC by-laws, three board members were term limited out as of January 2010.

Motion to modify the by-laws to allow Don Spencer, Brad Grassmick and Connie Wojan to serve an extended a one-year term to see us through the affiliation with Northern Michigan Regional Hospital. (LoDico/Cook).

Jean McDonough, Larry Hansz and Sandy Birdsall opposed. Motion passed with a 2/3 vote.

•  Thank you letter to Senator Jason Allen

Motion to send Jason Allen a thank you letter for the $38,000 he helped us receive from the State of Michigan . Sandy Birdsall will write the letter to be signed personally by all board members. (LoDico/Grassmick) unanimously approved.

•  Board Openings

Sandy Birdsall agreed to post board openings in the Northern Islander, Beacon, Joe Moore's site and the Forum seeking two new board members. Connie Wojan said the board was not be compelled to add board members at this time because we are not below the minimum of nine specified in the BIRHC by-laws. Motion to approve Sandy Birdsall, Jean McDonough and Larry Hansz to comprise a committee to interview potential candidates for the board. (Grassmick/Birdsall) unanimously approved.

X Next Board Meeting dates

The Board agreed on the following 2010 board meeting dates: January 16th, February 20th, March 20th, May 15th, July 17 , September 18 and Nov 20. January 16 th was set as the annual meeting.

XI. Public Comment

There was no public comment.

XII. Adjournment

Motion to adjourn at 12:30 p.m. (Speck/LoDico) approved unanimously. 

Respectfully submitted,   

Connie Wojan, President     Sandra Birdsall, Secretary    Donna Kubic, Managing Director

 

Saturday, September 19, 2009

10:00 AM      BIRHC Community Room

Present Board Members – Sandra Birdsall, Denny Cook, Brad Grassmick, Larry Hansz, Pete LoDico, Rick Speck, Don Spencer, Connie Wojan

Staff – Donna Kubic, Managing Director

Absent: Jean McDonough, Sarah McCafferty

Guests – Elaine West, Bill Cashman, Angel Welke, Joan Vyse 

 

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:00 AM, welcoming all board members present, and guests in attendance. 

•  Introduction Martha Lancaster, Executive Director, Char Em United Way.

Donna Kubic introduced Martha Lancaster, Executive Director, Char Em United Way . Donna report that 14 island residents have had physicals, EKG's and blood work done with the grant funds. Donna said, thank you again for granting these monies to encourage people who would not have come into the clinic for routine care in these hard times. Martha introduced a video which explained the mission of Char Em United Way .

III. Review, revisions to agenda

No revisions

IV. Review, revisions and approval of minutes

Motion to approve the minutes of the July 18th and August 28 th , 2009 Board Meeting as presented (Grassmick/Hansz) approved unanimously. 

V. Financial

A. Financial reports presentation & discussion

Rick Speck reported on the financial statement.  Overall budget is below by 7% or 8%.in expenditures from what is budgeted for spending. There is a discrepancy in the reporting of patient revenue on the handout. Mary Cook uses the accrual system. Patient income is overstated and is at $114,449 and not $135,000.00 as presented.  Motion to approve Financial Report (Cook/Grassmick) approved unanimously.

VI. Committee Reports

A. Legislative Committee Report

Sandy Birdsall reported the Legislative Committee met once and discussed:

1) What is would take to become a FQHC. 2) EMS ambulance charges,

3) Higher billing at the health center for stabilizing procedures and 4) developing a network of island representatives.

B. Building Maintenance

Denny Cook informed the board that the automatic reset for the electric did not work and Gerry had to reset the controls in the ceiling again. Mike Deuhr came and indicated that this should not happen again. The main air conditioner unit was out for a few months. Roberts John's service repaired the unit. Don Spencer reported that 7 of the 8 windows down the middle of the building have failed. The windows have a 10 year warranty but the labor is not included. An estimate of $1,600.00 to replace the 7 windows has been received. Motion to authorize the Maintence Committee to proceed with replacing all 8 windows. (Hansz/Wojan) approved unanimously. One window in the Community Center Room also will be replaced.

VII. Operations Report

A Summary of Activities, Statistics .  Donna Kubic's operational report is attached.

VIII New Business

•  Sarah McCafferty resignation

Connie Wojan praised Sarah's performance as a board member recognizing her excellent meeting attendance and willingness to volunteer for board projects. Motion to accept letter of resignation from Sarah McCafferty with regret. (Hansz/Grassmick) unanimously approved. Connie mentioned this now puts the board at a nine, its minimum as specified in the by-laws.

•  Officer Nominating Policy

There was a discussion of the Nomination of Officers policy written by Larry Hansz. Motion to adopt the Nomination of Board Officers Policy with Choice A under procedure:" The President of the Board will appoint a nominating committee consisting of at least two current Board members. (LoDico/Hansz) unanimously approved.

•  Explore further affiliation with NMRH

There was a discussion about approving the agreement with NMRH. (copy attached). The board agreed to approve the agreement as presented with the following modifications:

The Parties agree to proceed with the goals of: (A) determining whether the Potential Affiliation should occur, and

Presenting their findings

making recommendations to their respective governing bodies in that regard no later than March 20, 2010 October 31, 2009 ; and ( B) if the Parties determine that the Potential Affiliation should occur, reaching agreement as to the terms of the Potential Affiliation and consummating an arrangement not later than December 31, 2009.

2. Term of Agreement. This Agreement shall remain in effect until March 20, 2010 November 30, 2009 unless extended by mutual written agreement of the Parties; provided, however, that either Party may terminate this Agreement, with or without cause, or such termination shall be effective immediately upon receipt of written notice of termination by the other Party.

Motion to accept Agreement to Explore Potential Affiliation with changes (Grassmick/Hansz) unanimously approved. The board then discussed the membership of the task force committee specified in the agreement. It was decided that it should have a total of seven members as follows: Don Spencer, Larry Hansz, Sandy Birdsall, Brad Grassmick and Donna Kubic as Chair, and two members from the community, Anne Glendon and Angel Welke. Denny Cook and Jean McDonough were appointed as alternates. Denny Cook brought up the issue that three veteran members of the board would be term limited off the board before the agreement was finished. The board decided to consider the issue of modifying the by-laws to allow these board members to stay on the board beyond January 2010 at the November Meeting.

D.  Fund raising Suggestion

Tabled to the next

IX.  Old Business

A. Recruitment of New Board Members

Larry Hansz reminded the board again to solicit new board members.

B. Raffle Update

Connie reported the car raffle made $24,000. 28 less tickets were sold but the car was less costly. Connie mentioned Sally Loundsberry, Joe Reed, Lenore Jacobson and Rod Nackerman helped to sell tickets. Sandy Birdsall and Lenore made phone calls to people at this last minute reminding them that had not purchased a ticket.

C. Update Charity Golf Outing

Sandy Birdsall reported on the Charity Golf Outing. $6,400 was made. Individual thank you letters were mailed out. John Works has indicated he would like to host another charity golf outing next year. Connie thanked Sandy for her work on this successful event.

•  Policy on posting unapproved minutes

Motion to rescind prior action and to send unapproved minutes to Joe Moore for publication on his website on the date the Open Meetings Act requires them to be available electronically by pdf file. (Birdsall/Spencer) unanimously approved.

X.  Next Board Meeting dates

November 21, 2009

XI. Public Comment

There was no public comment.

XII. Adjournment

Motion to adjourn at 12:30 p.m. (Spencer/Cook) approved unanimously. 

Respectfully submitted,   Connie Wojan, President     Sandra Birdsall, Secretary     Donna Kubic, Managing Director

BIRHC Board of Directors Meeting unapproved minutes

Saturday, July 18, 2009 10:00 AM BIRHC Community Room

Present— Board Members — Denny Cook, Brad Grassmick, Larry Hansz, Pete LoDico, Sarah McCafferty, Rick Speck, Don Spencer, Connie Wojan

Staff— Donna Kubic, Managing Director

Absent: Sandra Birdsall, Jean McDonough

Guests — Anne Glendon

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:00 AM, welcoming all board members present,and Anne Glendon.

II. Review, revisions to agenda

Larry Hansz requested under Old Business (E) Recruiting of New Board members to be added.

III. Review, revisions and approval of minutes

Motion to approve the minutes of the May 16, 2009 as presented (Grassmick/Hansz) approved unanimously.

IV. Financial

A. Financial reports presentation & discussion

Rick Speck reported on the financial statement. Overall budget is below by 7% or 8%.in expenditures from what is budgeted for spending. Motion to approve Financial Report (Spencer/Grassmick) approved unanimously.

B. Approve Budget

Rick Speck reported on the 2009/10 Budget which will be distributed to the townships prior to August 1st. Pet gas is being budgeted to come in lower than last year. The finance committee is confident the budget can be balanced without cutting services at this time. $5279 may have to be taken out of the Special Projects Fund. The monies from the State are not included as they may not be available due to the economic status of the State. Because of the decline in the stock market, no monies from the Endowment Fund are included in the 2009-2010 budget. We will not receive the $11,000 Universal Services Grant for the T-One line because of the new contract with Central Solutions. Health insurance cost is down because of the Health Savings Plan and we are suspending continuing education at this time. It is projected that operations will get through the next few years without spending a large amount of monies from the Special Projects.

Don talked about doing an exercise with Donna cutting $15,000, $50,000 and $100,000 from the budget. Don also referred to the Total Charge and Encounter Comparison report that shows that, although we are $24,000 under billing from 2007, we are tracking with 2008. Motion to approve draft budget (Spencer/Grassmick) approved unanimously.

V. Committee Reports

A. Executive Committee Report

Covered above

B. Finance Committee Report

Covered above

C. Resource Development and Marketing Committee Report

Connie Wojan distributed minutes (attached) from the July 16, 2009 meeting of the Resource Development and Marketing Committee. Connie encouraged the board to do their best to promote the golf outing. Sandy, Frank and Buck Ridgeway are looking for door prizes. All board members are encouraged to help August 23rd. Raffle tickets are moving slowly. The last couple of days before the car raffle drawing, Connie needs additional help to call on people who have not purchased tickets. Anne's recognition will be postponed to later in the meeting.

D. Legislative Committee Report

No report, has not met to date

E. Medical Services & Quality Assessment & Performance Improvement Committee Report

No report, has not met to date

F. Building Maintenance Committee

Denny Cook reported that in his absence Don Spencer has talked to Robert Gillespie regarding a cracked window in the Community Room. Thursday Robert will bring the person who installed the glass to see what can be done and also check the windows in the hallway ceiling.

VI. Operations Report

A Summary of Activities, Statistics. Donna Kubic operational report is attached.

VII New Business

A. Sliding Fee Scale

Connie Wojan reported on a comment from a resident regarding lack of community knowledge about the Health Center 's sliding fee scale. Donna Kubic mentioned the information is posted in the waiting room. Anne Glendon suggested that at her doctor's office a hand out is presented to each patient that includes information about all payment options, thus informing patients without embarrassment. Donna will develop a form to be passed out to patients, which includes information on the availability of the sliding fee schedule.

B. Officer Nominating Process

Larry Hansz inquired about the lack of guidelines or a policy regarding the nomination of board officers. Board members agreed this was a helpful suggestion and Larry offered to write a proposed policy for the board to review at the September 19th meeting.

C. Policy on Posting Unapproved Minutes

After much discussion, Motion was made not to post unapproved minutes until the minutes are approved at the next regular board meeting (Hansz/Grassmick) approved unanimously.

D. Update on Charity Golf Tournament, August 23rd

Sandy Birdsall distributed a flyer (attached) for the Charity Golf Outing and Picnic. As mentioned in the Resource Development Committee Report, board members are all encouraged to help that day or recruit a team to play golf.

E. Appointment of representative to BI Human Services Commission

Peaine Township has passed a resolution supporting the BI Human Services Commission to be developed and St. James is to follow. The townships will appoint someone to be a representative from each township. Motion was made that Donna Kubic be the representative to BI Commission from the Health Center . (Grassmick/Hansz) approved unanimously.

VIII. Old Business

A. Status of State Funding

Don mentioned Senator Allen has asked Senator Roger Kahn, Chairman of the Subcommittee on Community Health, for $200,000, for the three islands. Whether or not the appropriation goes through should be known by the August or September.

B. Filling Opening on Board

Denny Cook brought up the point that 11 was a large number of people to be on the board and maybe the board should think about not replacing a board member and down sizing the board. Sandy Birdsall commented that a greater number of members brought in more ideas and expertise. Larry Hansz felt it is each board member's responsibility to seek out new board members and invite them to come to board meetings as part of the public. For the next board meeting it was decided to e-mail Donna a list of possible candidates for the board, or individuals willing to serve on a committee. A selection committee could then be formed to select a new member.

C. Insurance Committee

It was decided that, rather than form another committee, Donna should ask Northern Michigan Regional Hospital 's experts if we have the appropriate policies in place and if the Health Center 's coverage is adequate.

D. Update on Senior Housing

Pete LoDico indicated $77,000 is needed to complete the project. A copy of a solicitation letter was included for the board to read. Suggestions were made to include language in the letter stating that, if the grant monies were not received, donations would be refunded.

E. Recruitment of New Board Member

Addressed under VIII Old Business (B) Filling Opening on Board

Connie Wojan spoke about Anne Glendon's accomplishments:

Anne served on the board for 8 years. She played a key role in drafting many important documents and policies essential to the great progress the Health Center has achieved. Examples include: The Beaver Island Medical Care Assessment, a report which was crucial in securing 1.5 million in state funding for the new Health Center building and the Capital Campaign Policy which outlined the process by which the BIRHC Endowment would grow from $100,000 in 2003 to almost a million today. In partnership with Don Spencer and Bill McDonough Anne has repeatedly lobbied our state legislators to restore operational funding to the Health Center . Those efforts, which included many trip to Lansing at her own expense, resulted in several grants from the Michigan Department of Community Health that totaled $45,000. It was Anne who taught her fellow board members how to polish the content and format of the Health Center 's Annual Appeal letter. In the early days she did most of the work involved in putting out this 1000 piece mailing herself. Under her supervision, the balance in the Special Projects Fund to which most of the Annual Appeal donations rose from $12,500 in 2000 to over $100,000 today. While urging others to support the Health Center , Anne has always set a personal example of generosity has her and husband Paul's membership in the Legacy Tree Society attests. The peak of Anne 's commitment for the BIRHC came during a period of historic transition in 2003-2004. Despite the fact that she lived off island and was working full time as her consulting business, Anne never missed a monthly meeting and constantly did all she could from home to support her fellow board members. During this demanding period of time she proved herself to be a fearless agent of change. New and veteran members alike highly respect Anne's writing skills and knowledge of governance best practices. Most recently she was one of the leaders in the completion of the latest BIRHC strategic plan. In recognition of all these contributions and many more unmentioned, the Board will award a plaque and elect her Board Member Emeritus for life. The entire BIRHC Board looks forward to having continued access to Anne's wisdom as she has agreed to serve on board advisory committees after her retirement. On behalf of everyone at the Health Center , Anne, thank you for leaving it so much better and stronger than you found it.

This plaque is presented to: Anne Glendon

In appreciation for eight years of dedicated service to the Beaver Island Rural Health Center . Thank you for the indispensable role you played in making it financially stronger today than at any time in its fifty-year history. Presented July 18, 2009

After receiving her award Anne made the following statement:

“The past 10 years of working with the Health Center have been personally challenging and rewarding. I've learned a lot about healthcare systems in general, and why our location demands that BIRHC must always be more capable than comparable facilities elsewhere. I also thank the Board and staff for many enduring friendships that were forged by working hand in hand to build the Health Center 's medical and operational capacity to deliver the healthcare services that the community needs. It's been a privilege to be a part of a great team that improved the Health Center 's financial stability, earning respect and support from the community as well as state and regional healthcare agencies. Although my board tenure is over, rest assured that I will always be a staunch supporter. I am more convinced than ever that the Health Center is a community cornerstone without which Beaver Island would be a very different, less desirable place to live. Imagine if families were unsure of the quality and availability of basic healthcare, like check-ups and immunizations for school aged children. How many parents would choose to stay here to work and raise their families? What about older and aging residents who need a variety of medical treatments simply to monitor chronic health conditions or avoid an emergency flight to the mainland? Think of the hard choices all residents would have to make if they couldn't count on care providers and staff to maintain best practices and stay on top of new treatment options. Indeed, without a reliable, well-equipped Health Center and highly trained professionals who do their jobs quickly and well, our island community would be seriously handicapped in attracting the kind of people who will cherish what we have and stay long enough to make it better with their own contributions. As the Board looks ahead, I urge you to resist the temptation of adopting a bunker mentality. Don't be satisfied with mere survival. Don't keep looking through the rearview mirror or ignore what is on the horizon. Instead, be alert to future trends so BIRHC can thrive regardless of economic or political realities. Now is the time to think

and manage strategically; to watch for opportunities that will improve the quality and variety of care; and, to seek out creative, mutually beneficial partnerships like those we've developed with Charlevoix, Munson and Northern Michigan Hospitals that will help us prepare for the future. I also ask that you be steadfast in seeking the very best care providers, administrative staff and board members – people like we have now, who make this a personal priority, who appreciate the values and idiosyncrasies of the island's diverse populations, and who treat everyone with respect and compassion, always mindful of their holistic healthcare needs. Finally, thank you for the beautiful plaque and for designating me as emeritus director for life – the first time I've been an emeritus anything! Please accept my heartfelt gratitude and best wishes for the future."

Don Spencer spoke of a report run by the billing company on what a change in status being owned by Charlevoix Hospital could do for the Health Center financially.

IX. Next Board Meeting dates

September 19, 2009

X. Public Comment

There was no public comment.

XII. Adjournment

Motion to adjourn at 12:45 p.m. (Wojan/Cook) approved unanimously.

Respectfully submitted,

Connie Wojan, President Sandra Birdsall, Secretary Donna Kubic, Managing Director

 

Operations Report:

Items that Require Action

I attended the Char-Em United Fund breakfast June 18 th to receive the first $2000 if tge $6000 grant we were awarded. I will receive another $2000 of the monies in September and the final $2000 in November. Martha Lancaster, the Char Em Executive Director will be doing a Site visit on July 27th at 11:00 AM and would like to met some of the board members. Would any of the board want to come and meet Martha and thank her? She is planning on being at the clinic at 11 on the 27th .

Information was posted in both publications on the island and on both websites about the grant. I sent out 40 individual letters to uninsured individuals. I advertized the $6,000 grant in both newspapers, Joe's website did a video of me talking about the grant and encouraging residents to take advantage of it, and also posted the information on the Beaver Island Forum.

To date we have had 7 women and 6 men take advantage of the free physical, EKG and bloodwork. I expect when things slow down for the working people we will see more residents taking advantage of the offer.

Financial and statistical reports

As of the end of June, we have caught up in amounts billed in 2008. In May we were down $4000 in billing but then in June we were up $5000. Total patient count from last year is about the same at 712 compared to 2008 encounters which were 759.

Report—any new services of diagnostic capabilities

A copy of a letter in your packets from Ken Taylor informing you of a donation of $2500 to be used by management and staff for repairs, supplies, or equipment replacement. After much discussion, the staff decided to replace the PT/INR machine which the printer didn't work and use the old one as a back-up for home visits, and to buy and automatic blood pressure machine for the treatment room, a nebulizer, otoscope head, and LED Headlight.

The Boat Company donated the cost of bringing over the Chevy Cobalt which was $75.

Inform—about operational issues when appropriate

Father Tony Pelak from St. Michael's parish organized several pre-high school students to come to the island and do community work. These volunteers washed all the windows outside and inside at the Health Center . They were a group of well mannered, polite and courteous kids.

The health fair was cancelled due to the passing away of Winnie McDonough as everyone wished to attend the services. We have not rescheduled the fair to date.

Pete LoDico cleaned the carpets for no charge. We haven't had them done since moving in and what a difference. Thank you Pete!

Barb Berry, Pat Seagram and Jim Flikema from Northern Michigan Hospital visited the island June 25th with Don, Brad and Rick meeting with them.

Dr. Dave Wartinger, property owner on the island, who is employed by the University of Michigan did 12 men's screenings for prostate cancer and has indicated to me he is willing to come back in August, as we have 4 more men who couldn't arrange to take advantage of the July 8th screening. Dr. Wartinger is willing to meet with the care providers for in-services on men's health issues. I also received a grant from Great lakes Energy People's Fund Grant for $3,000, which will help pay for the PSA screening blood work we did for the 12 men who saw Dr. Wartinger.

Dr. Frasier, Medical Director for Munson Hospice conducted two pain management in services which I attended as did Hospice Helping Hands on June 16th and June 30.

A representative from the American Physician Assurance Corp. (the new facility insurance policy purchased, visited the Health Center . I spent 4 hours with her and have included the letter we received after her visit. We did very well, the letter reading "your practice appears to be functioning well with respect to your management of risk exposure, and commend you for your efforts to enhance patient safety. Four of the seven advisory recommendations pertain to telephone conversations and documentations. We do not receive any sample medications from drug representatives. I believe it's the 32 miles of water between here and the mainland. We will follow through on all suggestions and implement policies.

I was invited to attend Northern Michigan Regional Hospital 's Practice Forum for Managers Forum meeting on Wednesday. I met Moon Seagren, Northern Michigan Regional Hospital Foundation, Chief Development Officer, the head of Northern's recruitment department. Several new doctors in the area were introduced. The spine center talked about their facility. A new practice of internal medicine doctors talked about discounted prices for patients, not a sliding fee scale but discounted pricing and the practice is accepting new patients and they would act as the patients primary care physician. Northern has a new cardiac observation unit with four beds which will house a patient who has normal cardiac enzymes, and a normal EKG but tells an interesting story. The doctor is not feeling good about sending the patient on his way. They also received a Health Care Most Wired 2009 award.

Working with a doctor of one of our summer residents, I was able to secure medication for the care providers to allow a resident of the island to do a treatment for cancer during her stay here so she didn't have to travel back home.

 

BIRHC is subject to the open meetings act because of its agreement with the Townships.

Summary of Key Provisions of the Michigan Open Meetings Act

As to the health center, the law applies to a meeting composed of a quorum of the HealthCenter Board (6 members). The law does not apply to a social or chance gathering not designed to avoid the law.

Notification of Meetings: Within 10 days of the first meeting in each calendar or fiscal year, post a notice stating times, dates and places of regular meetings for year. (Also, send this notice to the townships and newspapers, radio or tv (if the newspapers, radios ortv request). If the schedule changes, within 3 days of the meeting date, post new notice of time, date and place.

Special Meetings, 18 hours notice posted before the meeting.

Written notice to an individual, organization by 1st class mail must be made to anyone who requests for a yearly fee to include cost of printing an postage.

Closed Meetings: May be called by a roll call vote of the members where 2/3 of the members vote for the closed meeting . (for BIRHC that is 8 members). The purpose of the closed session must be stated in the motion. Those purposes allowed which relate tohealth center include:

1. considering the dismissal, suspension, disciplining of or to hear complaints or charges brought against, an officer, employee, staff member or individual when the person who is subject of the complaint requests a closed hearing.

2. to consider the purchase or lease of real property

3. to consult with the attorney about a trial or settlement strategy in pending litigation, but only when an open meeting would have a detrimental financial effect on the body's position

4. to review the contents of an application for employment when the candidate requests confidentiality. All interviews for employment must be conducted in an open meeting.

Minutes: They must contain:

1. Time, date and place of meeting.

2. Members present and absent

3. a record of any decisions made and a record of all roll call votes

4. for closed session, an explanation of the purpose of the meeting

All minutes are public records and must be available for review and copying at the health center. Draft minutes must be available within 8 days after the meeting. Approved minutes must be available within 5 bsns days after the meeting.

5. Corrections must be available at the next meeting after the correction and must show the original copy and the correction

6. Minutes of closed meetings are not available to the public but must be kept for one year and a day after their approval.

Board of Directors Meeting unapproved Minutes

Saturday, May 16, 2009

10:00 AM BIRHC Community Room

Present Board Members – Sandra Birdsall, Denny Cook, Larry Hansz, Pete LoDico, Sarah McCafferty, Jean McDonough, (via speaker phone), Rick Speck, Don Spencer, Connie Wojan

Staff – Donna Kubic, Managing Director

Guests – Don Vyse, Barb Murphy, Bill Cashman

Absent : Brad Grassmick

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 10:02 AM , welcoming all board members present, and on speaker phone.

II. Review, revisions to agenda

No revisions to agenda

III. Review, revisions and approval of minutes

Motion to approve the minutes of the March 21, 2009 as presented (Spencer/LoDico) approved unanimously.

IV. Financial

A. Financial reports presentation & discussion

Rick Speck reported on the financial statement. Employee expenses are at 49% of the budget. Bottom line is where it should be. Northern Michigan Regional Hospital is unable to lower the cost of insurance for the Health Center due to the insurance company's requirement for a

Financial affiliation between Northern and BIRHC for us to use their coverage. It was

suggested an insurance committee be formed. Patient revenue is behind 10% with July and August coming up being the busiest months. Motion to accept the financial report (Spencer/Hansz) approved unanimously.

V. Resource Development Report

A. Update on Early Bird Special/Schedule

Congratulations to Pete and Denny on 138 tickets being sold for the early bird special. Pete wanted the credit to go to Denny as he came up with the idea . Motion to have car out by Memorial Day beginning at the Shamrock (Cook/Spencer) approved unanimously. Drawing to take place on May 25 th at the Shamrock at 7:00 PM . Connie encouraged board members to attend.

VI. Operations Report

A. Summary of Activities, Statistics. Donna Kubic operational report is attached.

VII New Business

•  Discussion of letter to PABI

Judy Gallagher joined the board meeting and read a letter addressed to Connie Wojan. After much discussion, Motion was made to accept this conversation as helpful and not to pursue fundraising discussion at board level with PABI or even at subcommittee level at this time. (Hansz/Cook) approved with one “No” vote. (Birdsall)

B. Discussion on Long Range financial stability

Don stated he directed Donna Kubic to come up with different scenarios if the budget was short $15,000, $50,000 and $100,000. At the next board meeting these scenarios will be shared with the board. A decision would have to be made by the board if monies would be spent out of the Special Projects Fund.

VIII. Old Business

•  Status of State Funding

Don mentioned Senator Allen has asked Senator Roger Kahn, Chairman of the Subcommittee on Community Health, for $200,000, for the three islands. Whether or not the appropriation goes through should be known by the end of June. Northern Michigan Regional Hospital has also asked for appropriations in a different package. Motion was made to ask the townships to support a formal letter encouraging the funding (Speck/Spencer) unanimously approved. Pete LoDico volunteering to approach Phil Hoffman.

•  Recruitment of new Board members

Larry Hansz voiced his concern about the transition of the board. The board had an opening, posted it and no one applied. He felt it is each board member's responsibility to seek out new board members and invite them to come to board meetings as part of the public.

•  Committee Structure

Sandy Birdsall reported that nothing has been done with committees as chairman have not been appointed. Part of the goal of the committees is to grow new board members, new board members rise out of committees. It was agreed that by the next meeting all committees would meet before the next regular meeting and the chairman to give a report. The following committee appointments were made:

Medical Services and Quality Assessment and Performance Improvement Program Committee

Brad Grassmick, Chairman

Jean McDonough Sarah McCafferty Larry Hansz

Finance

Rick Speck, Co Chairman Don Spencer, Co Chairman

Resource Development and Marketing

Connie Wojan, Chairman

Sandy Birdsall Brad Grassmick Pete LoDico

Building Maintenance

Denny Cook, Chairman

Pete LoDico Don Spencer

Legislative

Sandy Birdsall, Chairman

Jean McDonough Brad Grassmick Sarah McCafferty

D. Correspondence McBride Letter

Connie Wojan reported the board received in their packets two letters, one from Mr. Kirk McBride, and the other from our attorney, Mr. Webb Martin. Kirk has asked that we read Kirk's letter into the minutes, which I will do. minutes.

However the letter you have before for you is not the first communication we have had from Kirk since January nor is it the last. So before I read his letter I will bring you up to date on the time that has been spent by me, Sandy Birdsall and Donna trying to prevent the legal expense of $140 per hour that had to be spent to reply to it.

About ten days after the meeting on January 31 st . We received a communication from Kirk about his concern about OMA allegations committed in connection with our January meeting. As I was just a few days into recovery from surgery at the time, Sandy was kind enough to compose an explanatory letter that I signed and Donna sent to Kirk along with the unapproved minutes of that meeting. Over the winter Donna and I had numerous contacts from Kirk pointing out that we were a month behind in posting our most recent approved minutes on the website and that the BIRHC minute book which is kept at the library for public use was incomplete. Every time Kirk asked for minutes we either emailed them to him or posted then to the website. In response to his point that the minute book at the library was incomplete Donna and I decided to post archived minutes on our website starting with all of 2008 and to date for 2009. Wepay someone from Central Solutions by the hour to post. After doing this I then received a request from Mr. McBride to go back through all of our minutes from January 2006 through the present and send him a list of all of our closed sessions, the dates of those sessions and the purposes of those sessions. Donna reviewed the 2008 minutes and reported to Kirk that we had no closed sessions in 2008. Concerned about burdening Donna further, I politely emailed Kirk that if he wished to research past year's minutes he was welcome to come to the Health Center and review the minute books kept here which are complete.

Shortly after that email I received the letter you have.

Last Wednesday evening I received another email from Kirk indicating that he had contacted Shirley Roloff and County Prosecuting Attorney John Jarema and included a forwarded response from Jarema stating that, from the information he was given, a procedural violation had occurred.

Before I read Kirk's letter I want to state publicly that due to an extremely unusual set of circumstances I did commit a couple of procedural OMA violations in connection with our January meeting. As Kirk points out that meeting was posted to begin at 10:00 AM and we convened at 9:30 . Additional errors were committed in conducting the closed session before 10:00am , in failing to take a roll call vote before entering closed session and include the purpose of the closed session in the minutes. These errors were mine alone as the board counts on me as President to be knowledgeable of and comply with OMA. I take full responsibility for all of them. I regret them because they blemish what was up to this point has been a perfect record of abiding by the Act despite Mr. McBride's many previous accusations to the contrary . As our attorney's letter shows, however, no damages resulted from these errors. In my opinion the letter of the law was violated but not the spirit because no decisions were made outside of the public, open session of our meeting.

Connie Wojan read Kirk's letter and letter from Webb Martin.

Kirk has requested that we acknowledge the violations that have occurred. I have done that. He also asks that we resolve this issue and by that I believe he means that we take steps to make sure violations do not occur again. I am confident that we can avoid making similar errors in the future for the following two reasons:

1) As I stated before a very unusual and unique set of circumstances precipitated the errors made at the January meeting. As you may remember we were finalizing two agreements the week before the meeting: Dr. White's contract and the letter of understanding with NMH. It was unclear until Late Thursday evening if Webb would even is able to finish Dr. White's contract in time to be discussed at the meeting: Hence the indecision about what time to convene. Additionally we had mandatory Annual Meeting business and the arrival of NMH officials at 11 am for a presentation. Finally, we had a party to prepare for at three that afternoon. I sincerely doubt that such a distracting set of circumstances will occur again.

2) The second reason I feel confident we can avoid future OMA errors is that I am recommending that we appoint a different board member to supervise our compliance with that law. I will be leaving the board in 9 months and it makes sense that I start easing out of some of the roles I have been playing.

I therefore suggest that Sandy Birdsall, as Board Secretary, and more importantly an attorney be assigned the role of monitoring the board's future compliance with OMA.

IX. Committee Reports

No committee reports at this time. Pete LoDico stated that John Works offered his golf course for a fund raising golf tournament for the Health Center . Sandy Birdsall volunteered to talk with John Works and to chair the event. It was suggested that we ask Frank Solle to co-chair.

•  Next Meeting Date

July 18, 2009

•  Public Comment

There was no public comment.

XII. Adjournment

Motion to adjourn at 12:35 p.m. (McCafferty/Spencer) approved unanimously.

Respectfully submitted,

Connie Wojan, President Sandra Birdsall, Secretary Donna Kubic, Managing Director

 

Board of Directors Meeting unapproved Minutes

Saturday, March 21, 2009

9:00 AM BIRHC Community Room

Present Board Members – Sandra Birdsall, Denny Cook, Brad Grassmick (via speaker phone), , Pete LoDico, Sarah McCafferty, Jean McDonough, (via speaker phone), Rick Speck, Don Spencer, Connie Wojan

Staff – Donna Kubic, Managing Director

Absent : Larry Hansz

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 9:00 AM, welcoming all board members present, on speaker phone and guest.

II. Review, revisions to agenda

No revisions to agenda

III. Review, revisions and approval of minutes

Motion to approve the minutes of the January 31, 2009 Annual Meeting as presented (Spencer/McDonough) approved unanimously. Motion to approve the minutes of the January 31, 2009 closed session meeting as presented (Spencer/ Birdsall) approved unanimously.

IV. Financial

A. Financial reports presentation & discussion

Rick Speck reported on the financial statement. Insurance is over budget due to payment on the newly acquired facility insurance. Payment of $5100.00 was paid to Ron Harris for the audit. Motion to accept the financial report (Grassmick/Spencer) approved unanimously.

B. Audit

Rick Speck reported on the audit. No discrepancies were found. Cash at the end of the year was down $9,000.00. The trend is down on revenues $415,000 from $432,000 the year before. Expenses were kept in line . Motion to accept the audit as presented (Spencer/Birdsall) Approved unanimously.

V. Resource Development Report

A. Capital Campaign Income

Connie Wojan reported that the BIRHC would not be receiving any monies from the Charlevoix County Community Foundation from the Endowment Fund. Last year $41,000 was made available. Connie remarked we do have the monies in the Special Project Fund which can be used for operations.

VI. Operations Report

(See attached report) Motion was made to accept the non Discrimination policy as presented (Birdsall/Spencer) approved unanimously. Motion was made to execute the signing of the agreement for purchasing by Donna Kubic after receiving in writing from Northern there will be no attached fees (Spencer/Speck) approved unanimously.

VII New Business

•  Website Upgrade

After discussion it was decided to pursue a link with CCCF without updating the BIRHC website. Motion was made to authorize Donna to spend whatever it takes to link to the CCCF website to enable donors to make contributions on line (Spencer/Wojan) approved unanimously.

B. Join Michigan Non Profit Association

It was decided that with our new affiliation with Northern Michigan Regional Hospital the Health Center would not join the Michigan Non Profit Association at this time. Don Spencer reported on a phone conversation he had with Joe Schodde of Charlevoix Hospital informing Joe of the partnering with NMRH and inviting Bill Jackson and Joe to attend a BIRHC board meeting, informing him of the board meeting dates.

C. New Auditor

Don Spencer began the discussion regarding solicitations for proposals for the upcoming 2008/2009 audit. Sandy Birdsall mentioned it was good business practice to change auditors every 3-4 years. Rick Speck indicated because of the need to file a 990 we do need an annual audit and to keep the Health Center 's 501c3 status. Motion was made to authorize Donna and Sandy to send out letters requesting bids for the next audit. (LoDico/Spencer) approved unanimously.

VIII. Old Business

•  Update on Car Raffle

The early bird brochure will be e mailed to Bill Cashman to be printed. Drawing of the winner for the $1,000 early bird winning will be held at the Shamrock on May 25th. Pete LoDico said the car would be over in early May and housed by Joe Reed until displayed at McDonough's.

•  Committees

The 2008 list of committees, were formed by a committee consisting of Sandy Birdsall, Brad Grassmick and Anne Glendon in accordance with the strategic plan. Jean McDonough suggested the Development Committee be combined with the Marketing Committee. Following is a list of committees and committee members. At the next meeting the committees will report back with suggested additional members which should include island residents. Larry Hansz was not present and will be asked to volunteer where his interests lie.

Executive

Serves as resource for staff on minor operational matters between meetings. Advises staff on what matters require a board decision. Is responsible for gathering relevant information for board decisions. As specified in the bylaws, this committee is made up of the officers of the board.

Connie Wojan Don Spencer

Sandy Birdsall Rick Speck

Personnel and Board Development

This committee was discussed and agreed upon as being an ad hoc committee under the Executive Committee. Develop and implement board succession and development plan, training for board members, and recruitment of new board and committee members. Review staff compensation and benefits develop strategies to maintain long term staffing and relationships with providers of professional staff to identify candidates and medical student interns.

Medical Services and Quality Assessment and Performance Improvement Program Committee (QAPI)

Develop and maintain relationships with hospitals and other medical facilities. Increase medical services on the island by specialists Increase wellness options for year round populations. Increase use of telehealth to reduce off-island visits to specialists. Promote awareness of hospital wish list.

Brad Grassmick Jean McDonough Sarah McCafferty

Finance

Prepares budget in consultation with appropriate staff members. As specified in by-laws, board treasurer is a member of this committee. Adopt a five year financial plan, obtain county federal funds, grants, pursue financial support from Charlevoix County , council on again and continue to promote township support.

Rick Speck Don Spencer

Resource Development and Marketing

Develop long term fund raising plan that includes planned giving program, appeals to corporations, utilities banks, coordinate fund raising events, annual appeal and planned giving.

Publicize fund raising, events, health center activities, “Brand” the health center, keeping the health center in the public eye in a positive ways, increase use of the center through promotions.

Connie Wojan Sandy Birdsall

Brad Grassmick Pete LoDico

Building Maintenance

Devise building maintenance plan. Prepare building maintenance budget. Compile a list of competent individuals and /or contractors to serve as resources for managing director when needs arise and who could do routine preventative inspections of building systems.

Denny Cook Pete LoDico Don Spencer

Legislative

Advocate for designation as a special emergency care facility, develop state wide advocacy capacity, deal with insurance issues (like ambulance transport), advocate for funds sought by finance committee. Work with the townships to develop a comprehensive island-wide disaster plan.

Sandy Birdsall Jean McDonough

Brad Grassmick Sarah McCafferty

The board unanimously agreed upon the structure of the committees listed above.

Structure: 2-3 board members per committee with three citizens (with potential to be board members) and former board members willing to stay involved. Committees must consist of less than a quorum of board members. If there are 11 board members this means no committee can consist of more than 5 board members. (Committees can have any number of non board members.) Committees meet to come with ideas / recommendations for action by the full board. Committees do not have decision-making power unless the full board votes to delegate the authority to make a specific decision to that committee .

C. Update on community survey

Sandy Birdsall reported on the results of the community survey. Of the 200 surveys distributed 62 were returned. Age bracket of those responding were 60 and over. Programs that were of interest were nutrition, weight loss and smoking cessation.

IX. Committee Reports

•  Building Maintenance Status

Denny Cook reported Mike Deuhr and Donna got together to test the generator. Within a few seconds the generator came on and the lights in rooms 5 and 6 and the corridors were working. The project of having the handlers reset after a power outage or surge has been completed.

•  Next Meeting Date

May 16, 2009

•  Public Comment

There was no public comment.

XII. Adjournment

Motion to adjourn at 11:20 p.m. (McCafferty/Speck) approved unanimously.

Respectfully submitted,

Connie Wojan, President Sandra Birdsall, Secretary Donna Kubic, Managing Director

Board of Directors Annual Meeting unapproved Minutes

Saturday, January 31, 2009

10:00 AM BIRHC Community Room 

Present Board Members – Sandra Birdsall, Denny Cook, Brad Grassmick (via speaker phone), Larry Hansz (via speaker phone), Pete LoDico, Sarah McCafferty, Jean McDonough, Don Spencer, Connie Wojan

Staff – Donna Kubic, Managing Director

Absent : Anne Glendon, Rick Speck (proxy given to Connie Wojan)

I Call to Order & Welcome

Connie Wojan called the meeting to order at 9:30 AM, welcoming all board members present. Motion to approve the minutes of the November 22, 2008 Board Meeting as presented (Spencer/LoDico) approved unanimously.

II Review, revisions to agenda

It was determined that the meeting time changed to 9:30 AM from 10:00 AM and had not been noticed to the newspapers or public. The Board unanimously agreed to go into closed session at 9:30 AM to discuss renewal of Dr. Wendy White's lease agreement with no action to be taken until the regular meeting and resume the regular Board Meeting at 10:00 AM.

Call to order of regular meeting at 10:00 AM

III Review, revisions and approval of minutes

The board unanimously reaffirmed the earlier motion to approve the minutes of the November 22, 2008 Board Meeting.

IV Old Business

A. Decision on vehicle purchase for next raffle

Connie Wojan thanked Pete LoDico, who was able to get a great price on a Chevy Cobalt. Motion to approve the purchase of the Chevy Cobalt for the raffle (Spencer/McDonough) approved unanimously. Denny Cook and Pete LoDico presented the idea about early sales of tickets for the Chevy cobalt. It was decided to mail out brochures to those who have purchased tickets for the past three years, increase the amount of tickets sold to 600 and set the advance cash price prize at $1,000. Denny Cook will investigate whether two raffle licenses will be needed. Thanks went out to Connie Boyle for creating the brochure to be mailed. Thoughts were to mail the brochures out in March selling advance tickets with a cutoff date the end of May, for the $1,000 early bird prize. Motion was made to authorize Denny Cook to move forward with the early bird special raffle idea (Spencer/McCafferty) approved unanimously. Bill Cashman volunteered to assist with the printing of the brochures.

V New Business

•  Outreach Plan

Larry Hansz reported on a conference call with Kathy Garthe of Munson Hospital . Sandy Birdsall, Don Spencer, Connie Wojan and Donna Kubic spoke with Kathy who along with the CEO of Munson Hospital both agreed to encourage BIRHC to pursue an investigative relationship with NMRH and why it would be an excellent opportunity. Kathy indicated Munson is not in the business of supporting clinics. A relationship with Northern Michigan Regional Hospital would not preclude any request in the future for help from Munson Hospital and would not affect our existing relationship mainly Remec and Hospice. Patients leaving the island for extended care will continue to be transported to the appropriate facility.

VI Approval of Contract with Dr. White

Dr. White agreed to let the Health Center use part of room 125 on the floor plan for storage. In the future a door could be added so the staff of the BIRHC would not have to access Dr. White's part of the space. ( Motion to approve Dr. Wendy White's lease agreement with additions of a two year contract, bi annual window washing and an agreement to allow the use of part of room 125 for storage) Spencer /LoDico approved unanimously.

Jerry LaFreniere came to the meeting to explain the problem of the water softener which has broken a seal for the second time. It was decided to leave the water in by-pass mode to investigate as to whether or not a softener is actually needed. John Robert Service has received quotes from two different companies which were presented. A decision will be made at a later date as to replace the unit or not.

F. Presentation by Northern Michigan Regional Hospital

Tom Mroczkowski, CEO of Northern Michigan Regional Hospital, Jim Flikema, Senior Director of Professional Services and Rod Nelson, CEO of Mackinac Straits Hospital arrived to speak to the Board. Tom Mroczkowski and Jim Flikema together addressed the board about the mission of NMRH and how the proposed Memorandum of Understanding finalized by Webb Martin and NMRH attorney fits into their vision. Rod Nelson sited how Mackinac Straits Hospital and Mackinac Island clinic have prospered because of the help of NMRH. A needs list has been developed by BIRHC and NMRH is eager to assist in providing guidance and support with their expertise. NMRH shared their Regional Strategic Plan and this will be distributed to the board . (Motion was made that we authorize the execution of the Memorandum of Understanding and develop the task force outlined in the memorandum with a due date of May 1 st ) (Spencer/LoDico) approved unanimously .

Don Spencer suggested developing a task force, which would consist of members from BIRHC and NMRH. The two task forces would prioritize the needs list and set out to accomplish them and propose any further affiliation agreements needed. It was decided Donna Kubic, would be the team leader, Sandra Birdsall, Larry Hansz, Jean McDonough, and Don Spencer would serve on the committee. A status report will be given at the March Board Meeting.

Connie Wojan will approach Webb Martin regarding the question of BIRHC liability for injury caused by Jessica Carden and Tamara Graf and any other outside providers utilizing the facility at our request and whether they should be covered under the BIRHC malpractice insurance policy .

C. Election of Officers

Connie Wojan thanked Denny Cook and Pete LoDico for surveying everyone in preparation of the election of officers. Pete and Denny recommended the Executive Committee as follows:

•  Connie Wojan President

•  Don Spencer Vice President

•  Sandra Birdsall Secretary

•  Rick Speck Treasurer

(Motion was made to submit these names in nomination for officers (McCafferty/McDonough) approved unanimously .

Board Committees:

Sandy passed out the suggestions for board committees to be formed by the Committee of Brad Grassmick and Anne Glendon and Sandy. The committees were designed to meet the goals of the BIRHC plan developed in the fall. She mentioned community members should be added to the committees along with the board members. Suggestion was made to add a maintenance committee. The Board was asked to review the committees and send in any comments they have. Committees should be established at the next meeting.

E. Election of Anne Glendon Board Emeritus

Connie Wojan requested a motion to name Anne Glendon as Board Emeritus. Motion to elect Anne Glendon as Board Member Emeritus for life for her tremendous contributions for the last 10 years. (Wojan/McDonough) approved unanimously .

VII Next Meeting

March 21, 2009

VIII Public Comment

No public comment

IX Adjournment –

Motion to adjourn at 12:50 p.m. (Cook/LoDico) approved unanimously .

 

Respectfully submitted,

Connie Wojan, President Sandra Birdsall, Secretary Donna Kubic, Managing Director

 

BEAVER ISLAND RURAL HEALTH CENTER

Board of Directors Approved Minutes

Saturday, November 22, 2008

9 AM BIRHC Community Room

Present Board Members – Sandra Birdsall, Denny Cook, Anne Glendon, Brad Grassmick, Larry Hansz, Pete LoDico, Sarah McCafferty, Jean McDonough (via speaker phone), Rick Speck, Connie Wojan

Staff – Donna Kubic, Managing Director

Absent : Don Spencer

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 9:00 AM, welcoming all board members present and guest.

II. Review revisions to agenda

No revisions to the agenda.

III. Review and approval of minutes

Motion to approve the minutes of the September 20 th , 2008 Regular Board Meeting and the October 8 th Special Meeting as presented (Grassmick/Birdsall) approved.

IV. Financial & Utilization Reports

A. Financial reports presentation and discussion

Rick Speck reported on the financial income statement.

Revenue for fiscal 2008 was less than projected. Expenses were also less than projected. The $15,000 matching funds for the x ray grant has not yet been paid out and will be carried forward. Motion to accept financial report (Grassmick/Glendon) approved .

V. Resource Development Report

A. Annual Appeal Letter

Anne Glendon reported that the annual appeal letter had been sent out. Connie Wojan recently received a check in the amount of $1,000 from an anonymous donor. Bob Tambolini will not be retiring and will continue to work with the Charlevoix County Community Foundation. This is good news as Bob is a champion of the Health Center . Plans can move forward to have Bob help with planned / bequest giving in the future. The Special Projects Fund has not lost money due to market conditions but the Endowment fund was down 15% at the end of September and is expected to be substantially lower on the next statement.

B. Projected Endowment Income for 2009

Connie Wojan indicated that it was likely that no investment income would be available in 2009 from the Endowment Fund. This lack of investment income will leave a sizeable deficit in the budget.

C. Christmas Cards

A list of people who should be sent BIRHC Christmas cards was circulated for suggested additions from board members present. Connie indicated this was an important way of saying thank you to all who have helped in the past.

VI. Operations Report

  1. Summary of Activities, Statistics

•  Donna Kubic reported that total charges and encounter comparisons show that $2,135.62 less was billed out in September 2008 versus September 2007. Almost $1,000 less was billed in October 2008 compared to October of last year. In fiscal year 2007-2008 we billed out a total of $54,612 less in claims than in 2006-2007. Now that we have a second provider things may improve. A breakdown of accounts receivable shows 26% BCBS, 11% Medicare and 27% Medicaid.

•  Our new billing program reflects encounters per provider that Donna will use now that we can obtain the data. Previously, Betty would manually count patients and this number is very inflated because it includes blood draws, B/P checks, flu shots, injections, immunizations that don't reflect true encounters billed. The new software will give us more accurate numbers by provider including Dr. Newcomb and Dr. Mann.

•  Chris VanLooy just finished working a week enabling Sue to take another week of vacation. Chris did 3 physicals while she was here. She will be back Tuesday and plans to be here permanently around Christmas. She will continue to work at the Health Center during December.

•  John Martin and Molly Resnik donated $2,000 back to Health Center from the SUV raffle.

•  42 community surveys have been returned.

•  Joe Schodde, CFO, Charlevoix Area Hospital has been in contact with Donna to plan implementation of the second half of the USDA grant which will be telecommunications. Sue, Chris and Donna are now able to view x rays taken and print out reports on their own computers.

•  Donna reported on the goals she has set for herself for 2009. She stated that she agreed with the Strategic Plan and will do her best to accomplish these goals in 2009.

VII. New Business

  1. Report on Meeting with Northern Michigan Hospital

Connie reported that a meeting between Don Spencer, Connie Wojan, Bill McDonough, Donna Kubic and Thomas Mroczkowski, CEO Northern Michigan Hospital, John Kohler, Treasurer of the Board of Directors of Northern Michigan Hospital, Dr. Kal Attie, ER Physician Northern Michigan Hospital, Rod Nelson, Mackinac Island Ron Mitchell, Mackinac Island , and Jim Haveman took place on November 14 th . Rod Nelson of Mackinac Island has developed a close relationship with Northern Michigan Hospital and the purpose of the meeting was to discuss what relationship could be cultivated between NMH and the Beaver Island Rural Health Center .

No commitments were made at the meeting. Examples of possible opportunities might be electronic medical records, IT help, training opportunities, purchasing, and maintenance. Several board members expressed the strong opinion that in the future, all board members should be informed in advance of meetings of this importance.

B. Report on Meeting with Senators

Connie Wojan reported on a meeting with Senator Jason Allen, Richard Richardson, and Jim Barcia, Don Spencer Connie Wojan and Donna Kubic. At the meeting Don Spencer presented the concerns and needs of the Health Center . The Senators seemed genuinely surprised about the lack of funds from the state during the past few years. The Senators seemed hopeful about the passage of a yearly $33,000 fund appropriation.

C Advertize for replacement for Ann Glendon on Board

Anne Glendon's term expires in January. All officers will be up for reelection at that time. Sandy Birdsall will place an article in the newspapers soliciting a new board member with expertise similar to Anne's.

VIII. Old Business

A. Liability Insurance

Motion to go forward to purchase 1 million/4 million-facility insurance for a yearly premium of $11,434.00 (Cook/Glendon) approved.

•  Community Survey

42 surveys have been collected to date. Results will be tabulated later when more surveys are received. At January's meeting a preliminary report will be given.

•  Strategic Plan Update

It was decided to send a specific thank you letter to plan facilitator Pete Plastrik, something he could use in marketing his business. Brad Grassmick volunteered to compose a draft letter. It was suggested that an abbreviated form of the newly adopted strategic be placed in the newspapers. Motion was made to accept the Strategic Plan as presented as a work in progress (Grassmick/Birdsall) approved.

•  Physical Plant Sinking Fund Policy

There was discussion concerning the Physical Plant Sinking Fund Policy composed by Larry Hansz. The board agreed that the fund should be held in a separate account such as a money market account or CD. It would be a restricted fund. Motion to accept the Physical Plant Sinking Fund Policy as written by Larry Hansz with amendments (Cook/LoDico) approved.

•  Decision on vehicle purchase for next raffle

The Board tabled the topic until the January meeting because more attractive pricing may be available at a later date due to the automaker crisis. Selling tickets ahead of time might be an option for people who are not residents of the island and who may not be on Beaver Island during the summer. Printing 600 tickets next year instead of 500 was also discussed.

•  Welcome Party for Chris

Larry Hansz has spoken with Ray Cole about hosting the welcome party for Chris VanLooy at the Beaver Lodge. Ray indicated appetizers could be brought in or catered and a cash bar could be available. December 20th is the tentative date if Chris is available.

IX. Committee Reports

A. Building Maintenance

Denny Cook reported Mike Duehr should have the parts by November 5 or 6 th and is still waiting to correct the problem of fans not resetting when there is a power surge.

X. Meeting Dates for 2009 Motion to set January 31 st as the Annual Meeting and set other 2009 regular meetings for January 31, March 21, May 16, July 18, September 19 and November21 to begin

10:00 AM (LoDico/Hansz) approved.

XI. Public Comment

No public comment

XII. Adjournment –Motion to adjourn at 11:35 a.m. (Glendon/LoDico) approved.

Respectfully submitted, Connie Wojan, President Anne Glendon, Secretary Donna Kubic, Managing Director

 

BEAVER ISLAND RURAL HEALTH CENTER

Board of Directors Approved Minutes

Saturday, September 20, 2008 9 AM BIRHC Community Room

 

Present Board Members – Sandra Birdsall, Denny Cook, Anne Glendon via speaker phone, Brad Grassmick, Larry Hansz, Pete LoDico, Sarah McCafferty, Jean McDonough, Don Spencer, Connie Wojan

Staff – Donna Kubic, Managing Director Absent : Rick Speck

I. Call to Order & Welcome

Connie Wojan called the meeting to order at 9:00 AM, welcoming all board members present and guest.

II. Review revisions to agenda

No revisions to the agenda.

III. Review and approval of minutes

Minutes of the Special Meeting held on August 4 th were corrected to read, “Larry Hansz rejoined the meeting “under V. Community Survey section” and not VI. Strategic Planning Goals section as stated. Motion to approve minutes of August 4 th special meeting with corrections and regular board meeting of July 19th, 2008 as presented (Grassmick/Spencer) approved.

IV. Financial & Utilization Reports

A. Financial reports presentation and discussion

Don Spencer and Donna Kubic reported on the financial income statement. There was nothing out of the ordinary to report. Don mentioned that a $1000 control needed to be ordered for the boiler. Donna drew attention to the fact that patient revenues were down and will report on that in the operations report. Motion to accept financial report (Spencer/Grassmick) approved .

  1. Reports on Earned revenue for services

reported under utilization reports

  1. Utilization Reports
    • Donna reported on items that need attention on the computer network: the backup system; network printing and server update. Larry Hansz mentioned there is money in the budget to accomplish this.
    • Donna distributed a fact sheet about a Priority Health Savings Plan that she is recommending to the board for the 3 staff members. Donna asked the board to consider putting $1100 into the staff's Health Savings Plan. The saving to the Health Center would be $8,086.00 a year with the $3300.00 into the employee's health savings plan. Motion to authorize Donna to change insurance carriers and to authorize the $1100 contribution to each employee's health savings plan (Grassmick/Hansz) approved.
    • Donna drew attention to patient encounters in August: Encounters were down by 81 patients or 21%. Billing in August was down substantially. In August 2007 $32,289.00 was billed and this year $13,653.00 was billed.
    • The Beaver Island Fire Department is required to do mandatory training by the State. Brian Tort and Stephen Charles have accomplished the necessary connection with Charlevoix at the Health Center so that the B.I. Fire Department can do the training remotely. Beaver Island is the only site doing the training remotely.
    • The digital x-ray is up and running. We have sent over around 10 x-rays to Charlevoix to date. Donna reported on a conference call with Don Spencer and Brian Tort regarding the Health Center taking over the T-1 line that Central Solutions is using at the end of September. The board instructed Donna to investigate other vendors and to obtain quotes.
    • Dr. Carden saw 10 patients on her first visit. She has decided to come every two weeks through the fall and possibly the winter. Dr. Carden would like to teach yoga while she is here, if there is enough interest in the community.
    • Two candidates have been interviewed recently for the NP/PA position: Jane Campbell traveled from Alabama and Chris VanLooy who left the island 5 years ago and is interested in returning. We will make a decision very soon.

V. Resource Development Report

A. Art Auction Update

A high bid of $1100.00 was made on the Mary Blocksma commission. Ray Cole paid Mary Blocksma $1200.00 for the service.

B. Dinner at Nina's

The dinner at Nina's was well promoted by Anne, Brad and Leonor Jacobson. A check for $3,388 was received from the Lodge, in addition, $2,000 in checks made out directly to the Health Center were received, which resulted in about a $5,000 profit to the Health Center . Connie Wojan and Donna mailed thank you letters to all those who contributed to the dinner. Connie Wojan stated we are using summer fundraiser monies to pay bills.

C. SUV Update

415 SUV raffle tickets were sold this year, plus $200.00 in donations compared to 475 last year. Connie thanked all who helped make the raffle a success, especially Pete Lo Dico. Pete deserves a tremendous amount of credit. There was discussion about which type of vehicle would be purchased for next year's raffle. Suggestions were a hybrid or an electric car.

D. Income from Endowment Fund

Anne and Connie are working on the Special Projects letter to be mailed the end of October.

Motion was made to take $41,030 interest from the Endowment Fund and place it into the Special Projects Fund (Glendon/Grassmick) approved.

VI. Operations Report

A. Summary of Activities, Statistics

Reported under C. Utilization Reports

B. NP update

Reported under C. Utilization Reports

VII. New Business

No new business reported.

VIII. Old Business

A. Budget for Building Maintenance

It was agreed to set aside $10,000 a year, possibly in April when the cash flow is good, into a separate money market account for major building repairs. Larry Hansz offered to write a Building Maintenance Fund permissible spending policy. Motion to place $10,000 in a money market account with the CCCF in March or April 2009 (Hansz/Cook)) approved.

B . Community Survey

Sandy Birdsall stated the community survey would go out in the Northern Islander's November issue. Motion to go ahead with sending out the Community Survey (LoDico/Grassmick) approved . Sandy also offered to do some marketing publicity advising residents of flu shots and services of the Health Center .

•  Strategic Plan Update

Draft three of the Strategic Plan to be discussed at the November 22, 2008 board meeting.

IX. Committee Reports

A. Building Maintenance

Denny Cook reported Mike Duehr should have the part to correct the problem of fans not resetting when there is a power surge early next month and the work should be completed.

X. Next Meeting

The next meeting will begin at 9:00 AM on November 22, 2008

XI. Public Comment

No public comment

XII. Adjournment –

Motion to adjourn at 9:50 a.m. (Glendon/Spencer) approved.

Respectfully submitted,

Connie Wojan, President Anne Glendon, Secretary Donna Kubic, Managing Director