Lake County Community Health Center Governing Council met May 10

By Kristine Gonzales-Abella

Sep 21, 2022

Lake County Community Health Center Governing Council met May 10.

Here are the minutes provided by the council:

1. Call to Order

Chair Smith-Taylor called the meeting to order at 5:50 p.m. The delay was due to technical difficulties with the Board Room system.

Present 5 - Chair Smith-Taylor, Member Bejster, Member Lara, Member Ross Cunningham and Member Tarter

Absent 4 - Vice Chair Fornero, Secretary Argueta, Member Chuc and Member Washington 2. Pledge of Allegiance

This matter was presented

3. Approval of Minutes

3.1 April 12, 2022 Meeting Minutes

A motion was made by Member Ross Cunningham, seconded by Member Tarter, to approve the minutes of the April 12, 2022, meeting. Voice vote, all in favor, motion carried.

Aye: 5 - Chair Smith-Taylor, Member Bejster, Member Lara, Member Ross Cunningham and Member Tarter

Absent: 4 - Vice Chair Fornero, Secretary Argueta, Member Chuc and Member Washington 4. Public Comment to the Council

None

5. Executive Director's Report

Executive Director Mark Pfister reported on the following:

1) Lake County Board of Health President Tim Sashko will first provide an update on my 2021 performance appraisal performed jointly with the Governing Council Executive Committee members.

• President Sashko reported that the Board of Health Executive Committee and the Governing Council Executive Committee, a total of 10, completed Mark’s evaluation at the beginning of April. Mark was rated on 14 internal competencies and on goals and objectives established the previous year. Mark’s overall score on a scale of 6 was 5.502. On April 7, 2022, he and Chair Smith-Taylor co-authored and signed a letter that was submitted to Human Resources identifying the change in Mark’s compensation package based on the compensation policy. A handout of Mark’s goals and objectives for calendar year 2022 will be shared with the Governing Council at their next regular meeting. Mark has done an exceptional job with both governing boards and the hard work that goes into the leadership of this organization is greatly appreciated.

2) HMA Consultant has completed interviews with all FQHC managers, both virtually and in-person. The assessment will be completed by June 2022 and the findings to-date have confirmed known issues and have identified additional ones that will need to be addressed. We are currently not prepared to move into a value-based care model. Additional consulting will be necessary to continue moving us forward for which we will use the HRSA ARPA grant to fund.

3) Gallagher Consultant continues to review HR staffing, processes and policies for recruiting, on-boarding, training and off-boarding.

4) Lake County COVID-19 cases have increased and are now averaging 300 cases per day for the last week. It is probably higher than that as many people are now using home tests and they are not required to be reported. The good news is that COVID-19 vaccinations and natural immunity from previous COVID-19 infection are preventing increased hospitalizations and death. We are still actively attempting to get all our patients fully vaccinated and boosted and our COVID-19 call center is calling all.

5) Now that we are back in person, Governing Council member expense reimbursement is available to you if you wish to claim it. Council members that desire expense reimbursement (per the HRSA Health Center Program Compliance Manual) may receive $25 per meeting attended to cover mileage costs, etc., as a result of Council meeting attendance. Lisa Kroeger has a packet of information and forms for each of you if you would like to be reimbursed.

Chair Smith-Taylor asked if the COVID-19 cases being seen is one variant or multiple. Mark stated that the majority of the current cases are the omicron variant with the predominant subvariant being BA.1, and we are seeing an uptick in BA.2. There are other BA's (3, 4, 5) coming forward but they are not in the United States yet. BA.4 and 5 are definitely growing in South Africa and it is currently winter there so they are surging like we do in the colder weather.

This matter was presented

6. Action items

6.1 Recommendation to Approve New Governing Council Member - Tarter

Nominating Committee Chair Tarter informed the Council that the Nominating Committee met on Thursday, April 28, to meet with Manuel "Manny" Hernandez, a prospective new member. They found Manny to be very highly qualified as he knows a lot about the health centers and the operations of health care and they highly recommend that the Council approve his membership.

Mark added that he is very excited to have Manny join the Governing Council. He trains the Health Department's Community Health Workers (CHWs) as well as other CHWs across Lake County which fits in well with the discussion we've been having on how we are going to start using CHWs more. A pilot is currently being done at the Midlakes Health Center where we are adding more CHWs to our care teams as we know they can be very effective in improving patient outcomes. He and Manny will be having an orientation meeting in the very near future.

Manny thanked the Council for their approval of his membership and stated that he is very excited and honored for the opportunity he has been given. He has been blessed to be working at the community level to provide health education to not only treat the illnesses people already suffer with but to prevent them, and to connect them with services. Now, as a member of the Council, he can also provide input to assist the Health Department in understanding the needs and cultural differences of the community.

A motion was made by Member Bejster, seconded by Member Tarter, to approve the membership of Manuel "Manny" Hernandez. Voice vote, all in favor, motion carried.

Aye: 5 - Chair Smith-Taylor, Member Bejster, Member Lara, Member Ross Cunningham and Member Tarter

Absent: 4 - Vice Chair Fornero, Secretary Argueta, Member Chuc and Member Washington 6.2

Change in FQHC Hours of Operation - Burke

Kim Burke, Director of Healthcare Operations, reviewed the information provided in the agenda packet. Member Tarter asked what the utilization is during the summer hours at the School-Based Health Center (SBHC). Kim stated that it isn't as strong as during the school year, however, with the current access issues at Midlakes the plan is to shift some of those urgent appointment eligible patients to the SBHC.

A motion was made by Member Ross Cunningham, seconded by Member Bejster, to approve the change in FQHC hours of operation. Voice vote, all in favor, motion carried.

*Newly approved member Manuel Hernandez entered an Aye vote for a total of 6.

Aye: 5 - Chair Smith-Taylor, Member Bejster, Member Lara, Member Ross Cunningham and Member Tarter

Absent: 4 - Vice Chair Fornero, Secretary Argueta, Member Chuc and Member Washington 6.3

FY2023 Proposed Budget Timetable - Riley

Attachments: FY23 Proposed Budget Timetable

Pam Riley, Director of Finance, reviewed the information provided in the agenda packet.

A motion was made by Member Tarter, seconded by Member Ross Cunningham, to approve the FY2023 proposed budget timetable. Voice vote, all in favor, motion carried.

*Newly approved member Manuel Hernandez entered an Aye vote for a total of 6.

Aye: 5 - Chair Smith-Taylor, Member Bejster, Member Lara, Member Ross Cunningham and Member Tarter

Absent: 4 - Vice Chair Fornero, Secretary Argueta, Member Chuc and Member Washington

7. Presentations

None

8. Discussion Items

8.1 CQI Update - Hayes

Christina Hayes, CQI Coordinator, reviewed the information provided in the agenda packet. She noted that performance is stable across the metrics. One highlight is that we are excited for upcoming partnerships that will help us to implement strategies to improve colorectal cancer screening rates in our patients. This is important because screening can be lifesaving. More to come as we progress through these efforts.

9. Medical Director Report

9.1 Medical Director Report - Dr. Zun

Dr. Zun reviewed the highlights of his report as provided in the agenda packet. Chair Smith-Taylor asked how long the Behavioral Health Medical Director position has been posted. Mark stated that the current vacancy has been posted for two years. He noted that historically it has been an extremely difficult position to hire. It took three years of posting before the previous BH Medical Director was hired and that was pre-pandemic. And, the position does require the candidate to be a psychiatrist and, generally, psychiatrists don't have the desire to be a manager/supervisor/leader, which poses an even greater challenge. Dr. Daram Reddy has been our interim BH Medical Director but he does not want to apply for the position full-time.

10. Director of Healthcare Operations Report

10.1 Director of Healthcare Operations Report - Burke

Kim Burke reviewed the highlights of her report as provided in the agenda packet. Member Tarter asked if there is any sense of optimism that the work of the HR consultant is going to result in increased hiring. Mark explained that Gallagher is going to be making some best practice recommendations on things we can be doing concurrently that we're doing in a sequential fashion. The new applicant population is looking to be interviewed and hired faster as they want to know, in a more timely manner, that they will be able to start work. Having a candidate recommended for a position but having to wait another month to go through the whole process is something that we are looking at and we are going to need the County's assistance to ensure we can speed up that process. We also need to ensure we retain after we train. He added that the State is going to be providing a loan repayment program for counselors and therapists, like it currently offers for medical providers (MD, APRN), which means more people going in to those fields that we can recruit. We also hope that those who left the workforce due to child care issues related to the pandemic rejoin the workforce as daycares reopen.

11. Director of Finance Report

11.1 Director of Finance Report - Riley

Pam Riley reviewed the information provided in the agenda packet.

12. Added to Agenda

None

13. Old Business

None

14. New Business

None

15. Executive Session

None

16. Adjournment