North Dakota Veterans Home Board Minutes

July 16, 2004

PRESENT: Daryl Beard - Chairman, Norris Braaten, Larry Dakken, Orletta Kilen, Darrol Schroeder, Neal Asper, Administrator-NDVH

ABSENT: Alex Schweitzer, Robert Volk

GUESTS: Rudy Jenson, Chairman, Administrative Committee, Kelly Noack, Representative, North Dakota Public Employees Association, Jake Reuter, NDVH Social Service Director, Jan Neameyer, NDVH Social Service, Liz King, NDVH Admissions /Case Manager, Randy Bowman, Representative of Energy and Building Management, Bob Nelson, NDVH Maintenance Supervisor, Kristin Lunneborg, NDVH Accounting Manager, Margie Ourenhagen, NDVH Executive Secretary

Meeting called to order by Chairman, Daryl Beard. The Pledge of Allegiance was recited, followed by a moment of silence for the POW/MIA's.

MINUTES: Larry Dakken made a motion, seconded by Norris Braaten to accept the June 11, 2004 minutes as mailed. Motion carried.

SOCIAL SERVICES REPORT: Jake Reuter, Director

ADDICTION/SOCIAL WORKER POSITION: This position has been re-advertised as a full time position.

SKILLED CARE SURVEY RESULTS: (Handout) Jake Reuter discussed the NDVH Skilled Care Survey Results which was conducted with the residents and their families.

Comparison of the last three surveys shows the response from the residents and families has been very consistent. These surveys will be presented to each department and the department will be requested to address any areas of concern expressed by the residents.

THE STADTER CENTER: (Handout) The operational plan committee recommended focusing on the area of resident behavior management. Jake Reuter presented the letter received from Thomas Petersen, MD, Clinic Director of the Center for Psychiatric Care, concerning the list of areas to be addressed.

Currently a Psychiatrist visits our facility one time per month. Within the next week we will be signing a contract with the Center for Psychiatric Care that will utilize the $1,000 presently being spent on mental health to cover a Psychiatrist visit twice a month, 24 hour consultation for mental health needs, assistance with emergency placement and transportation. Staff education seminars will be provided at $75.00 per hour. The August 9th & 16th scheduled trainings will cover Nonviolent Crisis Intervention. (Letter handout)

The Stadter Center also has completed an onsite safety environment evaluation. (Handout) Some of the areas of concern to be considered are:

Using walkie-talkies, screamers, or a whistle to distract a potential attacker particularly in the basement area.
Using double locks or dead bolt locks to keep areas securely locked.
Hall mirrors/video surveillance.

These areas will also be addressed with respect to the HIPPA Security rules. Also discussed was what type of security will be needed with the addition of the pharmacy at the Veterans Home.

HIPPA PRIVACY AGREEMENT REVIEW: (Handout) Jake Reuter reviewed the HIPPA privacy rules with the board and had them sign the confidentiality and Security Agreement form.

The Administrative Committee on Veterans Affairs will also be asked to sign the confidentiality and Security Agreement.

CRISIS TEAM: (Handout) Jan Neameyer reviewed the plans for developing a Crisis Team to be called in should additional staffing be needed when a crisis develops. The on duty staff at the time of the crisis will decide if they need to call in additional staff members. This crisis team is not intended to be called should the scheduled CNA's be working challenged.

A list of the volunteer Crisis Team members will be at each of the Nurses' stations. The team members will be paid for the hours they are working - minimum of 1 hour of pay.

RESIDENT ELIGIBITY: (Handout) Liz King, NDVH Admissions, reviewed the Admissions Eligibility Requirements for a Veteran to be admitted to the veterans' home.

Discussion was held on the Administrative Code requirement under section 86-01-01-02 which states "No applicant shall be considered eligible for residency whose last period of service in the armed forces was terminated under dishonorable conditions". One of the current residents was discharged from the service under conditions other than honorable; however it did not state dishonorable discharge so this veteran is still eligible for rooming at the veteran's home.

A veteran may also be discharged from the service under dishonorable conditions and go back to the service to fill a term and receive an honorable discharged. This veteran would now be eligible at the veteran's home. This will be discussed further at the Administrative Committee Meeting. It was recommended to have Gene Kouba, Acting Commissioner notify the Veterans Service Officers of how this is to be interpreted.

MAINTENANCE REPORT: Bob Nelson, Maintenance Supervisor

ENERGY AUDIT: (Handout) Randy Bowman, Representative of Energy and Building Management, who sub-contracted with Obermiller-Nelson Engineering, gave an Energy Audit Report of where the energy is being used at the Veterans Home. This report is a comprehensive facility analysis report which identifies the current condition and needs of the mechanical, electrical, ventilation, and temperature control systems for the North Dakota Veterans Home. Discussion was held on the eighteen Energy Conservation Measures.

LIFE SAFETY CODE: (Handout) Bob Nelson, NDVH Maintenance Supervisor gave a demonstration and report on the Life Safety Code. Discussion was held on the need for fire rated chairs in the smoking areas, the need to replace the deadbolt locks in the entire facility, and to properly seal all the identified unsealed space between smoke barriers.

ADMINISTRATOR'S REPORT: Neal Asper, Administrator

DIGITAL CAMERA: Neal Asper acknowledged the Fargo V.F.W. Post 762 for the Olympus 3.2 pixel digital camera they donated to the North Dakota Veterans Home.

MEDICATION/PHARMACY UPDATE: Neal Asper gave an update of the progress being made preparing for the providing of medications for our domiciliary residents by January 1, 2005. In the past these medications were dispensed by the Fargo VA at no charge to the resident.

EMERGENCY COMMISSION MEETING: Kristin Lunneborg, Daryl Beard and Rudy Jenson attended the Emergency Commission meeting June 16, 2004 in Bismarck, requesting appropriations of $208,000 to support the pharmacy and medication changes.

BUDGET COMMITTEE MEETING: Neal Asper, Kristin Lunneborg, Daryl Beard, and Rod Backman attended the Budget Committee Meeting June 29, 2004. The appropriations request for $208,000 from the Emergency Contingency Fund was approved at this meeting. Sheila Peterson, O.M.B., gave an outstanding presentation on behalf of the Veterans Home.

PHARMACY PROGRESS: Neal Asper briefed the Governing Board on all the avenues he explored on the options for a pharmacy. Building a pharmacy within the facility is the most feasible option. The available 3rd floor room, which has 250 square feet, will be submitted for approval to the Board of Pharmacy. We will have to build and stock the pharmacy, hire a pharmacist for 20 hours a week and hire a full time pharmacist tech.

The possibility of placing visual surveillance cameras for security to the pharmacy was discussed.

WAGE DISPARITIES: Neal Asper discussed some of the areas of wage disparities. One problem area is the starting employee wage has been increased, but existing wages for State Employees has not been increased to stay ahead of the starting wage increase. Therefore an individual being hired may received more salary than someone who has been working here for three or more years. Neal and Kristin are investigating how these areas can be corrected. Also discussed were the wage disparities between the Veterans Home and ND nursing homes.

NORTH DAKOTA PUBLIC EMPLOYEES ASSOCIATION: (Handout) Neal Asper introduced Kelly Noack, representative of NDPEA, who had submitted the enclosed letter to him. Kelly Noack's stated that other City, State and County entities provide a scheduled worksite area available for her to visit with the employees on a regular basis, preferably over the lunch hour. The request for the meeting over the lunch hour is because this is not a paid time for the employees. She also explained in the Labor Law it states that a facility cannot discriminate against any organizations coming into the facility.

Discussion was held on the last meeting NDPEA held at the Veterans Home. They were sponsoring a card drive to inform and educate the employees of the Administrative Rules Changes that were proposed by State Central Personal Office.

RESIDENT CELL PHONE: Neal Asper discussed the cell phone access to the residents after 8:00 p.m. evenings and on the week-ends. Daryl Beard recommended Neal check with the Attorney General on allowing the residents the use of State phones which are indirectly provided by taxpayers' dollars. Also discussed was the phone calls made by Social Services to a resident's family.

RESIDENT DSL ACCESS: Neal Asper reported this service will soon be available on the 2nd floor TV Lounge and 2nd floor Library. The resident who made an issue of needing faster service with the Governing Board has discharged from the Veterans Home.

ATTORNEY GENERAL: Any legal service required for any questions presented to the Attorney General's Office is billed backed to the Veterans Home.

MEETINGS/COMMITMENTS: The North Dakota Legislative Council Budget Review Committee will be visiting the Veterans Home August 25th. (Handout) Also that same day, a group from the Bismarck V.F.W. will be visiting the Veterans Home.

Neal stated he did make an appearance at all the Veterans Conventions this year.

CHAIRMAN'S REPORT: Daryl Beard, Chairman

PERFORMANCE EVALUATION: (Handout) Daryl Beard discussed the performance evaluation to be conducted on Administrator, Neal Asper. The Governing Board Members will form in groups of three after this Governing Board meeting to interview staff members concerning the accomplishments and goals of the Administrator.

Neal stated his main goal at the Veterans Home was to develop team work and a positive attitude with the employees.

ADMINISTRATIVE CODE CHANGES 86-03: This is on the agenda for the Administrative Committee to discuss at the July 23-24th meeting. If approved at this meeting the changes will be forwarded to the Attorney General Office.

GOVERNING BOARD VACANCY: The Administrative Committee will discuss the term lengths for the Governing Board Members at the July 23-34th meeting.

In a prior Governing Board meeting the terms of the members had been informally set as follows:

1 year term Brad Maasjo - 2004
1 year term Joe Novak - 2004
2 year term Darrol Schroeder - 2005
2 year term Alex Schweitzer - 2005
3 year term Daryl Beard - 2006
3 year term Larry Dakken - 2006
3 year term Robert Volk - 2006

The following members were appointed at the April 16 & 17, 2004 Administrative Meeting:

Orletta Kilen
Norris Braaten
Daryl Beard

Also Alex Schweitzer has submitted his resignation to the Governing Board. The Chairman and Secretary of the Administrative Committee will have to fill this position.

FINANCIAL UPDATE: Kristin Lunneborg, Accounting Manager

HUMAN RESOURCE POLICY: (Handouts) Kristin Lunneborg, Accounting Manager, submitted a recommendation from the North Dakota Veterans Home Management Team to update the Annual Leave and Holiday Pay.

Two new forms were drafted for employees to fill out when requesting annual leave or donated leave. The employee would have to state, if taking sick leave, if the request is for family sick leave or personal sick leave. On the donated leave form, the employee would document why he/she is requesting donated leave. The Employee, Supervisor, and Administrator would sign these forms. On the backside of the form, payroll personal will document who donated hours to this employee.

Discussion was held on how holiday pay for State employees working Monday thru Friday is a different situation from the Veterans Home, operating twenty-four hours a day, seven days a week. An amendment will be drafted to clarify holiday pay to employees. Those who work Monday thru Friday will be paid for the day the State recognizes as the holiday. Those departments who work the seven day/week shifts will be paid for the day of the holiday.

Also discussed was looking at the option of offering paid time off instead of vacation and sick-time.

Discussion was held on the proposed holiday pay for employees who are not full time FTE's.

Action on these policies was tabled at this time. A drafted amendment will be sent out to the Governing Board prior to the next meeting.

ACCOUNTS RECEIVEABLE: (Handout) Recently the NDVH policy has been changed to put into effect that once a resident becomes 30 days past due they are given a discharge notice. The NDVH Social Service Department is notified of the past due account with a penalty attached for follow-up procedure. The resident has a few days to pay the past due account or he/she receives the thirty day notice to pay the account in full or be discharged.

Discussion was held on the skilled unit rent charges. Kristin is checking how far back she can file claims to Medicaid for payment. Also discussed was the fact the previous employee did not list all the past due accounts on the Skilled Accounts Receivable report.

Discussion was held on the action process Neal and Kristin have developed to try to collect past due accounts. The Attorney General's Office will also be notified on how to pursue any unpaid accounts receivable. In the past no procedure of action was completed on these accounts except sometimes they were written off the records.

CENSUS: (Handout) Discussion was held on the open bed on the skilled unit. The basic care unit is down a few beds which is customary in the summer months.

2005-2007 PROPOSED BUDGET: (Handout) Kristin presented the preliminary proposed budget. O.M.B. granted a one month extension to complete the budget by August 15th.

A copy of the proposed final budget will be mailed out to the Governing Board prior to Aug. 6th.

MEETING DATES:

The Governing Board will have a conference call Friday, August 6th at 7:00 p.m.
Admin. Comm. on Veterans Affairs: Bismarck, Fri., July 23 at 1:00 p.m. & July 24th
Admin. Comm. on Veterans Affairs: Tentative-Fargo VA, October 15 & 16th

Motion was made by Orletta Kilen, seconded by Norris Braaten to adjourn this meeting.

Meeting adjourned.

Neal Asper
Administrator