Special Meeting July 10, 2015, 12:30 p.m.
Conference Rooms A&B



A special meeting of the Klickitat Valley Health (KVH) Board of Commissioners was held on Friday, July 10, 2015 at 12:30 p.m. in the KVH Conference Rooms A&B. Commissioner Connie Pond was the presiding officer. A quorum was present including: Commissioners John Quinn, Jim Daniel, Mark Sigfrinius and Dennis Carver. Leslie Hiebert, CEO; Jeff Teal, Ph.D., Director of Quality and Risk; Charis Weis, Director of HR; Gwen Cox, Director of Quality and Risk; Kasey Schneider, DNS; Gail Garcia, Clinic Director; Dean Basse, Plant Manager; Bob Hill, PT and Barbara Bostick (Recorder).


President Connie Pond called the meeting to order at 12:39 p.m. President Pond requested disclosure from the Commissioners of any conflict of interest items on the Agenda. Each Commissioner indicated that there were no conflicts of interest.




President Connie Pond noted that the Board would go into Executive Session at 12:43 for approximately 10 minutes for the purpose of reviewing strategies and proposals made during Collective Bargaining Negotiations as allowed per RCW.42.30.140 (4) (b).


The Board returned from Executive Session and President Connie Pond noted that the meeting was again in open public session at 12:55 p.m. Upon coming out of Executive Session, Commissioner Quinn asked that it be noted that he is not in agreement with the method that the Union took to reach the final agreement by taking a portion of the increase from employees that were under market and giving it to employees that were over market. He went on to say that he was extremely disappointed with how SEIU handled negotiations in general. Commissioners Pond, Daniel, Carver and Sigfrinius all noted that they strongly concurred with Commissioner Quinn's statement. Commissioner Sigfrinius made a motion to authorize Leslie Hiebert to approve the SEIU Collective Bargaining Agreement pending ratification. The motion was seconded by Commissioner Carver. The motion carried unanimously.



Jody Carona of Health Facilities Planning and Development provided data to the Board for use in the development of a Master Facilities Plan. (See power point presentation in Board Book).

Jody noted that the primary focus is out-patient services and primary care. Additionally she noted that virtual care/telemedicine has become very popular in urban areas and is becoming more popular in rural areas as it is a way to address shortages. She stated that reports show that patient satisfaction is just as good or better than face-to-face encounters. Some of the issues related to telehealth are HIPAA and risk and that there are sophisticated protocols being developed to address them. She noted that Dermatology is one of the highest uses of telemedicine. Jeff Teal inquired as to the best way to prepare for adding telemedicine services. Jody suggested that site visits to larger facilities that have developed successful programs would be a good place to start.


Discussion regarding some unexpected numbers; lower than expected in MRI and Mammography and surprisingly high in PT; Jody will do some additional research to determine if the numbers are accurate. There is an opportunity to gain market share in out-patient surgery and in endoscopy. KVH does have 65% of the primary care market. Jody commented that is consistent with rural communities. Leslie asked for information on wound care, which Jody agreed to provide.


Gwen Cox noted that the areas of most referrals are ENT, Ortho and Neurology services. There was a great deal of discussion regarding the high use of the ED for dental issues. Jeff Teal noted there is a county collaborative for dental services, but the primary focus is on children. He went on to note that it would not require a special room, but would require specialized equipment if dental issues were to be addressed at KVH. Leslie Hiebert noted that it is Rural Health Clinic reimbursable. Leslie also noted that Pain Management has been brought up several times at clinic meetings. Jody noted that there is some interest for telehealth to be used by EMTs/Ambulances and are used to see if the patient needs to be transported to the hospital or if they can make an appointment to be seen the next day. She also noted that there are USDA grants that assist with purchasing telehealth services and that they are usually available yearly.


Commissioner Quinn inquired as to whether a separate space is required for telehealth services, Jody replied that it depends on the model that you use. She noted that Robots can go from room to room, and that some can actually take themselves to different locations within the facility. She noted that some behavioral services may need to have a dedicated room for telehealth. There was discussion regarding Davita obtaining a license, as well as some opportunity for growth within the swing bed program because of the agreement with Allevant. Leslie Hiebert asked what the process is going forward regarding the data and the Master Facilities Planning. Jody noted that she can meet again at KVH, potentially a joint meeting with the architect so she can hand it off to them. Leslie asked about the financial impact aspect of Master Facilities Planning and whether or not it would be best to continue with DZA for that. Jody noted that she doesn't do the financial piece, but agreed our cost report preparer would be a good choice.



Commissioner Quinn moved that the meeting be adjourned at 3:03 p.m. Commissioner Carver seconded the motion.The motion carried unanimously.


Minutes Approved and Signed by Vice-President Dennis Carver and Secretary John Quinn.

Note: Printed copies are available at a charge of $.15 per page.