MINUTES OF MEETING
BOARD OF DIRECTORS
SEQUOIA HEALTHCARE DISTRICT
February 11, 2002
Present: Mr. Faro, President Also present:
Mr. Gibson, CEO - Ms. Kane - Ms. Johnson (recorder)
Mr. MacNaughton - Dr. Shefren
Absent: Mr. Smith
CALL TO ORDER:
President Faro called the meeting to order at 1630 hours in the Board Room at Sequoia Hospital.
PUBLIC COMMENT:
There was no public comment.
CONSENT CALENDAR:
On a motion offered by Director Shefren and seconded by Director Kane, the Consent Calendar was approved as presented.
NEW BUSINESS:
Resignation of Michael Smith -- Post Vacancy Notice:
Director Faro announced that Michael Smith moved to New York City as the result of a company transfer and has resigned from the Board. Director Kane moved to accept Mr. Smith’s resignation, with regret. The motion was seconded by Director Shefren and unanimously passed. A Notice of Vacancy on the Board of Directors will be duly posted.
Resolution 02-1, Sequoia Hospital District Pension Plan:
After review, Director Shefren moved to waive reading of the resolution which, if adopted, will amend the Pension Plan to comply with a series of recent tax laws known by the acronym "GUST". Director MacNaughton seconded the motion which unanimously passed. The amendments are being requested by counsel for the Pension Plan and authorized by Sequoia Health Services and Catholic Healthcare West. Director Shefren offered a motion to approve the resolution as presented. Director MacNaughton seconded the motion which passed by roll call vote as follows:
Ayes: Director Faro, Director Kane, Director MacNaughton,
Director Shefren.
Noes: None
Absent: Director Smith
Consider Board Members Attendance at Governance Institute and Estes Park Conferences:
Both President Faro and Director Kane have attended past seminars and found them to be very informative, providing valuable learning tools related to the fiduciary responsibilities of District directors. Director MacNaughton offered a motion to approve the attendance for any director interested in one of the conferences. The motion was duly seconded and unanimously passed.
Investment Report:
Last week, President Faro and Mr. Gibson met with Alan Sneider and Eric Reynolds of Fiduciary Trust International (FTI), the District's investment portfolio managers. The market value of the corpus totaled $34,545,348 as of December 31, 2001 and the performance for the fourth quarter of 2001 reflected an increase in value of 4.5%, compared to the benchmark (Lehman Government Intermediate Index) of 5.0% and 6.8% versus 6.6% since 1990. For the calendar year ending December 31, 2001 the portfolio generated nearly $2.1 million in investment income. The portfolio is in compliance with hospital guidelines and State regulations.
Mr. Gibson reported that the Bank of New York currently acts as custodian of documents and funds for the District. FTI has requested they be retained as the District's custodian of documents and funds as well as the investment advisor. The District pays the Bank of New York approximately $6,000 a year as a custody fee. FTI would not charge for this service. Director MacNaughton stated that as long as there are no problems with Bank of New York, he preferred keeping the custodial and investment functions separate and considered it an additional security measure.
Director Kane offered a motion to accept the investment report as of 12/31/01. The motion was seconded by Director MacNaughton and unanimously passed. (A copy of FTI's written report is included with the original of these minutes.) No action was taken to retain Fiduciary Trust as the District's custodian.
Strategic Planning Presentation:
As part of the Hospital's Strategic Planning Process, Gerri Berg of Cattaneo & Stroud has been working with Ms. Vaskelis to prepare an environmental overview and a service line assessment of the Hospital's market and operating performance. The market area designated for the study ranges from San Bruno to East Palo Alto and Santa Clara.
Findings from the study reflect an aging population with a declining adult-to-child ratio. A major current and long-term issue for healthcare providers is the labor shortage for nursing and other skilled professionals. The nursing shortage is expected to be further impacted with the implementation of the new nurse-to-patient ratios. The Bay Area also continues to be challenged in recruitment and retention of physicians due to the high cost of living and lower reimbursement levels than in other states. This is exacerbated by the fact that many members of Sequoia's medical staff are approaching retirement age. The number of HMOs is decreasing within San Mateo County as are the number of Sequoia physicians/groups participating in HMOs. Managing profitability under HMO contracts remains a major challenge for Sequoia and other CHW hospitals. Medical costs have risen more rapidly than all consumer prices leading employers to seek new health plan coverage options to reduce their healthcare benefit expenses.
Ms. Vaskelis reported that a physician/hospital task force was formed to address physician recruitment and retention and hospital management is working with the medical staff to identify physician needs for fiscal years 2003 to 2005. Progress is being made and a new primary care physician from Washington state has joined Dr. Marchison's group. A new OBGYN physician is coming to Sequoia from Mills; one new orthopedic surgeon and a new urologist have recently joined the medical staff with a second ortho joining in June. Contracts with these new physicians require that they take HMO patients.
In reviewing Sequoia's market and operating performance, Sequoia has experienced declining market share but improved financial performance. Sequoia achieved its highest market position in cardiac, rehabilitation and surgical specialty services. Outpatient services contribute more to profitability than inpatient services.
Aside from cardiology other services have declined either because we don’t have physicians willing to take HMO contracts or physicians to perform the required procedure. Sequoia's market share of orthopedic patients has declined from 15.9% in 1998 to 12.9% in year 2000. While the hospital has achieved increased share in back services, market share levels have fallen in general orthopedics, joint and hand cases. Cardiac and surgical specialty patients contribute the largest share of net income on the acute care services and also provide the largest component of the contribution margin. Within cardiac services, HMO/PPO patients generated the largest share of profits and the second largest share of patients. Within acute level surgical specialty services, the largest share of profits were generated by HMO/PPO patients followed by the large Medicare component. Cardiovascular services reflect the best overall performance in terms of market share, regional draw and profitability. While rehabilitation services display strong market performance, their operating performance is weak.
Is Sequoia destined to become a specialty hospital? Hospital management and the medical staff must figure out how to increase market share and profitability of other departments--as well as convince physicians that they need to be more willing to expand and welcome other new physicians.
Director Shefren stated that the insurance payment mechanism within the next 5-10 years will have the potential to either drive business to Sequoia or away from Sequoia.
Retain a Strategic Planning Consultant for the District:
Mr. Gibson noted that one reason for asking Ms. Vaskelis to have this presentation is to identify where Sequoia Hospital stands today. It is part of the District Board’s fiduciary responsibility to find out where the healthcare market is headed and what healthcare issues may occur within the District. Director Kane offered a motion to authorize the CEO and President to retain a strategic planning consultant to begin the process of addressing the issues raised by Ms. Berg's presentation. Director MacNaughton seconded the motion which unanimously passed.
ADJOURN:
At 1830 hours, President Faro adjourned the meeting. The next Regular Meeting of the Board of Directors is scheduled for 1630 hours, Monday, April 1, 2002 in the Administration Board Room at the Hospital.
Respectfully submitted,
Gerald Shefren, M.D. Secretary
MINUTES OF MEETINGApril 1, 2002
Present: Mr. Faro, President Also present:
Mr. Gibson, CEO - Ms. Kane - Ms. Johnson (recorder) - Dr. Shefren
Absent: Mr. MacNaughton
CALL TO ORDER:
President Faro called the meeting to order at 1640 hours in the Board Room at Sequoia Hospital.
PUBLIC COMMENT:
There was no public comment.
CONSENT CALENDAR:
On a motion offered by Director Shefren and seconded by Director Kane, the Consent Calendar was approved as presented.
NEW BUSINESS:
Resolution 02-2, Authorizing Establishing a Banking Relationship with Bay Area Bank:
After review, Director Kane moved to waive reading the resolution which, if adopted, will authorize the Board to open an account at Bay Area Bank in Redwood City. Director Shefren seconded the motion which unanimously passed. Bay Area Bank has been a long time supporter of the Hospital and the Foundation. A proposal to provide services was presented by Bay Area Bank reflecting that the District will save approximately $20,000 a year compared to the charges incurred with Wells Fargo Bank. Director Kane offered a motion to approve the resolution as presented. Director Shefren seconded the motion which passed by roll call vote as follows:
Ayes: Director Faro, Director Kane, Director Shefren.
Noes: None
Absent: Director MacNaughton
Cycle V Grants:
Diana Haigwood joined the meeting along with members of the Review Panel--Gail Anderson, certified nurse midwife and Roy Deffebach, MD. The review panel presented their recommendations for Cycle V funding and provided detailed information to the Directors. The Board previously had set the focus for this grant cycle and agreed to consider five proposals for single year grants and three for multi-year grants. Initially the Board had considered 34 letters of intent.
Mr. Gibson said the Board agreed to consider multi-year grants to allow community agencies an opportunity to provide a program or service which would make a significant and sustainable impact on the health of District residents. However, he expressed disappointment with all of the multi-year proposals for their lack of innovation and they did not significantly differ from single year proposals.
The proposal from the Community Breast Health Project (CBHP) for the continuation and expansion of the their program to provide mammograms to uninsured women under age 40 was discussed thoroughly with the consensus of the Directors not to fund this proposal. Several physicians indicated that the return to the community for this program is limited and several other agencies are able to provide this type of screening. Also, such services to those under 40 years of age has not been proven to have a high level of efficacy.
The proposal from the Center for Domestic Violence Prevention (DVP) was discussed. A letter outlining internal problems the organization is experiencing, which are largely due to their rapid growth and expansion of services was included. DVP has assessed its strengths and weaknesses and has initiated changes which include discontinuing several ancillary services. Susan Mooney, Interim Executive Director of DVP expressed hope that the District will continue its support for the agency as it works through its expansion problems to insure the continuation of the Center's core services.
The Jewish Family and Children's Services proposal for a multi-year grant was discussed. The Seniors-At-Home program will allow approximately 100 low-income, frail Peninsula seniors to remain in their homes, and volunteers to support the elders will be recruited and trained to assist them. Directors agreed that there is certainly a need for such a worthy program.
Director Shefren offered a motion, which was duly seconded and unanimously passed to approve single year Cycle V grants as follows:
El Concilio of San Mateo County - $75,000 for its Youth Promotore Program;
Mid-Peninsula Housing Services Corp. - $48,000 for its Teen Health Initiative for low income families;
Planned Parenthood Golden Gate - $100,000 for its Outreach Program for Latina women and youth;
Service League of San Mateo County - $52,600 for Comprehensive Ancillary Health Services for formerly incarcerated women and men;
St. Vincent de Paul Society - $45,000 for emergency medical funds to be used for the poor residents of San Mateo County.
Although proposals were submitted for multi-year grants, Director Shefren offered a motion to approve single year Cycle V grants to:
The Center for Domestic Violence Prevention - $100,000 for its emergency outreach program contingent upon the Center providing periodic progress reports;
Jewish Family & Children's Services - $125,000 for its senior-at-home elder care management
program. If JFCS cannot start their program without a commitment for a multi-year grant the
Board will reconsider their request.
The motion was seconded by Director Kane and unanimously passed. Cycle V Grants totaled $545,600.
Consider Three-Year Membership in Health Technology Inc. President Faro introduced Molly Coye, MD and CEO of the Health Technology Center. Dr. Coye explained that HealthTech is a nonprofit research organization based in San Francisco that provides in-depth forecasts of the impact of new and emerging technologies related to health care delivery. Current members include Premier Health, Kaiser Permanente, Sutter Health, Wellpoint Health Networks and others. HealthTech's intent is to provide objective information about emerging technologies that are expected to have a significant impact on healthcare delivery in the future, support development of new public and private policies to propel the broad-scale adoption of beneficial and cost-effective technologies that improve heath, and works to close the technology gap that exists for underserved populations and safety net providers. Services include a web service to provide strategic information about the development and probably impact of new technologies on healthcare delivery; an interactive strategic planning modeling tool to analyze and predict the impact of technology choices on each organization; a database of new technology based produces under development, policy analyses of reimbursement and coverage issues; consumer product analyses to assess new technologies that support the management of chronic diseases and ten reports each year on key categories of new and emerging technologies. The center also staffs a Hospital for the Future Task Force that has been very useful for those institutions which are planning on building or retrofitting their physical plants.
Mr. Gibson reported that he attended a HealthTech planning session and was very impressed with the caliber of the participants. Director Kane added that she just returned from a Governance Institute conference which discussed the importance of healthcare technology and the need to access same. Director Shefren questioned if it would not be more appropriate for CHW to join HealthTech instead. Dr. Coye indicated that CHW had been approached and expressed a desire to join but did not have the funds at the time. Director Faro indicated that the District Board has a responsibility to the residents to insure that Sequoia Hospital is providing appropriate services and technology. A membership in HealthTech will provide the District with more information thereby allowing the Directors, both as Hospital and District members, to make more enlightened decisions. Director Kane offered a motion to approve a three-year membership at the cost of $50,000 per year in the Health Technology Center. Director Shefren seconded the motion which was unanimously passed.
Resolution 02-3, Appointing Cecilia C. Montalvo to the Board of Directors:
This resolution acknowledges the vacancy on the Board of Directors resulting from Michael Smith's recent resignation. On a motion offered by Director Kane and duly seconded, the Directors unanimously waived reading Resolution 02-3. President Faro reported that Ms. Montalvo was interviewed by the CEO and himself and that several of the Board members know or have worked with her in the past. Ms. Montalvo has extensive managerial experience with healthcare providers and corporations. Ms. Montalvo worked for the Sequoia Hospital District from 1994-1996 and was instrumental in negotiating the affiliation with Catholic Healthcare West. Ms. Montalvo has agreed to fill the existing vacancy on the Board with the term ending December 2002. Director Kane offered a motion to adopt the Resolution appointing Cecilia Montalvo to the Board of Directors of Sequoia Healthcare District. The motion was seconded by Director Shefren and was adopted by the following roll call vote:
Ayes: Director Faro, Director Kane, Director Shefren.
Noes: None
Absent: Director MacNaughton
President Faro reported that Director MacNaughton, who was unable to attend tonight's meeting, had indicated that he is in favor of Ms. Montalvo's appointment to the Board.
Strategic Planning Presentation:
As part of the Hospital's Strategic Planning Process, Gerri Berg of Cattaneo & Stroud has been working with Ms. Vaskelis to prepare an environmental overview and a service line assessment of the Hospital's market and operating performance. The market area designated for the study ranges from San Bruno to East Palo Alto and Santa Clara.
Findings from the study reflect an aging population with a declining adult-to-child ratio. A major current and long-term issue for healthcare providers is the labor shortage for nursing and other skilled professionals. The nursing shortage is expected to be further impacted with the implementation of the new nurse-to-patient ratios. The Bay Area also continues to be challenged in recruitment and retention of physicians due to the high cost of living and lower reimbursement levels than in other states. This is exacerbated by the fact that many members of Sequoia's medical staff are approaching retirement age. The number of HMOs is decreasing within San Mateo County as are the number of Sequoia physicians/groups participating in HMOs at the same time the number of people joining HMO's (Kaiser) is on the rise. Managing profitability under HMO contracts remains a major challenge for Sequoia and other CHW hospitals. Medical costs have risen more rapidly than all consumer prices leading employers to seek new health plan coverage options to reduce their healthcare benefit expenses, which generally mean less scope of coverage and/or increased co-pay requirements.
Ms. Vaskelis reported that a physician/hospital task force was formed to address physician recruitment and retention and hospital management is working with the medical staff to identify physician needs for fiscal years 2003 to 2005. Progress is being made and a new primary care physician from Washington state has joined Dr. Marchison's group. A new OBGYN physician is coming to Sequoia from Mills; one new orthopedic surgeon and a new urologist have recently joined the medical staff with a second ortho hopefully joining in June. Contracts with these new physicians require that they take HMO patients.
In reviewing Sequoia's market and operating performance, Sequoia has experienced declining market share but improved financial performance. Sequoia achieved its highest market position in cardiac, rehabilitation and surgical specialty services. Outpatient services contribute more to profitability than inpatient services.
Aside from cardiology other services have declined either because we don’t have physicians willing to take HMO contracts or physicians to perform the required procedure. Sequoia's market share of orthopedic patients has declined from 15.9% in 1998 to 12.9% in year 2000. While the hospital has achieved increased share in back services, market share levels have fallen in general orthopedics, joint and hand cases. Cardiac and surgical specialty patients contribute the largest share of net income on the acute care services and also provide the largest component of the contribution margin. Within cardiac services, HMO/PPO patients generated the largest share of profits and the second largest share of patients. Within acute level surgical specialty services, the largest share of profits were generated by HMO/PPO patients followed by the large Medicare component. Cardiovascular services reflect the best overall performance in terms of market share, regional draw and profitability. While rehabilitation services display strong market performance, their operating performance is weak.
Is Sequoia destined to become a specialty hospital? The hospital's management, medical staff and governing board must figure out how to increase market share and profitability of other departments--as well as convince physicians that they need to be more willing to expand and welcome other new physicians.
Director Shefren stated that the insurance payment mechanism within the next 5-10 years will have the potential to either drive business to Sequoia or away from Sequoia and unless the hospital and its medical staff are organized and willing to participate in HMO products, we will not have access to these patients.
Retain a Strategic Planning Consultant for the District:
Mr. Gibson noted that one reason for asking Ms. Vaskelis and Ms. Berg to have this presentation is to identify the environment that Sequoia Hospital operates in today. Part of the District Board’s fiduciary responsibilities is to find out where the healthcare market is headed and what healthcare issues may be needed within the District in the future. Therefore, Mr. Gibson was seeking authorization to retain a strategic planning consultant. Director Kane offered a motion to authorize the CEO and President to interview and retain a strategic planning consultant to begin the process of addressing the issues raised by Ms. Berg's presentation. Director Shefren seconded the motion which unanimously passed.
Change Regular Meeting Date: Mr. Gibson reported that the meeting date was changed to accommodate Director Smith's schedule. Mr. Gibson asked if the Board would prefer to change the meeting day back to the first Wednesday of every even numbered month. The time and meeting place will remain the same. Director Kane moved to change the District's Board meetings to the first Wednesday of every other month beginning at 4:30 PM. Director Shefren seconded the motion which unanimously passed.
ADJOURN:
At 1930 hours, President Faro adjourned the meeting. The next Regular Meeting of the Board of Directors is scheduled for 1630 hours, Wednesday, June 5, 2002 in the Administration Board Room at the Hospital.
Respectfully submitted,
Gerald Shefren, M.D. Secretary
MINUTES OF A SPECIAL MEETING
May 15, 2002
Present: Mr. Faro, President Also present:
Mr. Gibson, CEO - Ms. Kane - Dennis Strum***
Mr. MacNaughton - Ms. Montalvo - Dr. Shefren
Absent: None
Follow the District money!
2410 |
05/01/2002 |
Dennis Strum, Ph.D |
$20,000.00 |
2422 |
05/14/2002 |
The Strum Group |
$417.89 |
|
2460 |
06/17/2002 |
The Strum Group |
$4,459.94 |
|
1014 |
08/06/2002 |
The Strum Group |
$9,885.81 |
CALL TO ORDER:
President Faro called the meeting to order at 12:30 PM in the Board Room at Bay Area Bank, 900 Veterans Boulevard, Redwood City.
PUBLIC COMMENT:
There was no public comment.
NEW BUSINESS:
President Faro reported that this meeting was being conducted as a workshop to develop a vision and objectives for the District's strategic plan; therefore, no action was taken by the Board. Additional workshops will be held prior to submitting a strategic plan to the Board for consideration.
ADJOURN:
At 5:30 PM President Faro adjourned the meeting.
Respectfully submitted,
Gerald Shefren, M.D. Secretary
May 16, 2002 San Mateo County
Civil Grand Jury Report
May 23, 2002
Country Almanac - Marion Sofkey
May 24, 2002 Daily
News Editorial - Dave Price
MINUTES OF A SPECIAL
MEETING
BOARD OF DIRECTORS
SEQUOIA HEALTHCARE DISTRICT
May 30, 2002
Present: Mr. Faro, President Also present:
Mr. Gibson, CEO - Ms. Kane - Ms. Johnson, Recorder
Mr. MacNaughton - Penny Greenberg, Counsel - Ms. Montalvo
Dr. George Koenig - Dr. Shefren - Brent
Britschgi
Adrienne Tissier, BayRelations - Michael Pacelli, BayRelations***
Absent: None
Aug 2, 1996 SEQUOIA HOSPITAL: Election to decide hospital's future
Follow the District money!
2475 |
07/02/2002 |
Bay Relations |
$5,000.00 |
|
1016 |
08/06/2002 |
Bay Relations Inc. |
$5,000.00 |
|
1084 |
10/31/2002 |
Bay Relations, Inc. |
$1,071.68 |
|
1038 |
09/03/2002 |
Bay Relations, Inc. |
$5,000.00 |
CALL TO ORDER:
President Faro called the meeting to order at 4:45 PM in the Administrative Board Room at Sequoia Hospital.
PUBLIC COMMENT:
There was no public comment.
NEW BUSINESS:
President Faro thanked the directors for changing their schedules in order to attend this special meeting. The purpose of the meeting is to discuss ways the Board can improve its communication with the public, non-profit agencies and the press in addressing the issues raised in the 2002 Grand Jury Report. Penny Greenberg, the District's legal counsel, has been asked to assist with the District's response which is due August 5.
Mr. Gibson introduced Adrienne Tissier and Michael Pacelli of BayRelations and indicated they were available to assist the District in preparing a communication and public education plan. BayRelations, established in 1972, has extensive experience in public awareness and community outreach. Ms. Tissier acknowledged that it is important to promote the many beneficial actions taken by the District in financially assisting non-profit agencies as well as educating the public about the District.
Dr. Koenig stated that the physicians at Sequoia are concerned about the Grand Jury Report and are interested in the District's response. Director MacNaughton agreed that the District's response should be a priority. It needs to address each of the statements made by the Grand Jury and if the Foreman, Bruce Hasenkamp is incorrect in his statements, that fact should be publicly noted. Once our response is submitted, the Board can turn its focus to public awareness and communications.
Mr. Gibson indicated that this year's Grand Jury interviewed both Mr. Faro and himself. They were very interested in the language contained in the 1946 District Hospital Act. This Act has been amended more than 163 times and today is very broad in terms of what healthcare districts can do. The Grand Jury was also interested in why the Board has not stopped the annual collection of taxes as well as the Board's decision to provide grants to community agencies. Mr. Gibson pointed out that the County Controller's office has indicated that on average each parcel of property is assessed roughly at $53 each per year. Unfortunately since Proposition 13, the actual amount is not indicated on the property owners tax bill.
Director Shefren suggested that priority also be given to finalizing the District's Strategic Plan. Once that is done, the Board can focus on a public awareness/education plan, meet with community residents at Town Hall meetings, etc. The District's Strategic Plan would then become the platform from which the three directors running for re-election could be judged.
Mr. Gibson informed the Board that he may need the services of BayRelations and legal counsel in drafting the response to the Grand Jury and in preparing the next newsletter to the community.
For insight on Bay Relations, see: SMCCCD PR or Felony
Mr. Gibson suggested that a compensation analysis be performed to insure that the Board is comfortable with the compensation being paid for the CEO position. After discussion, it was the consensus of the Board to proceed with this analysis, stating, however, that they do not consider Mr. Gibson's compensation to be out of line for his level of expertise and work performance.
ADJOURN:
At 7:00 PM President Faro adjourned the meeting.
Respectfully submitted,
Gerald Shefren, M.D. Secretary
MINUTES OF A SPECIAL
MEETING
BOARD OF DIRECTORS
SEQUOIA HEALTHCARE DISTRICT
June 3, 2002
Present: Mr. Faro, President Also present:
Mr. Gibson, CEO - Ms. Kane - Dennis Strum
Mr. MacNaughton - Ms. Montalvo - Dr. Shefren
Absent: None
CALL TO ORDER:
President Faro called the meeting to order at 12:30 PM in the Board Room at Bay Area Bank, 900 Veterans Boulevard, Redwood City.
PUBLIC COMMENT:
There was no public comment.
OLD BUSINESS:
The workshop continued on the development of a vision and objectives for the District's strategic plan. President Faro reported that no action was taken by the Board.
ADJOURN:
At 5:00 PM President Faro adjourned the meeting.
Respectfully submitted,
Gerald Shefren, M.D. Secretary
MINUTES OF A SPECIAL MEETING
June 27, 2002
Present: Mr. Faro, President Also present:
Mr. Gibson, CEO - Ms. Kane - Dennis Strum - Mr. MacNaughton
Glenna Vaskelis - Ms. Montalvo - Dr. Shefren
Absent: None
CALL TO ORDER:
President Faro called the meeting to order at 12:30 PM in the Board Room at Bay Area Bank, 900 Veterans Boulevard, Redwood City.
PUBLIC COMMENT:
There was no public comment.
OLD BUSINESS:
Discussion continued in this workshop on the development of the District's strategic plan. President Faro reported that no action was taken by the Board.
ADJOURN:
At 5:00 PM President Faro adjourned the meeting.
Respectfully submitted,
Gerald Shefren, M.D. Secretary
Daily
News Editorial July 19, 2002
Sequoia Healthcare District August 5, 2002
Response to the 2002 Civil Grand Jury
MINUTES OF A SPECIAL
MEETING
BOARD OF DIRECTORS
SEQUOIA HEALTHCARE DISTRICT
August 7, 2002
Present: Mr. Faro, President Also present:
Mr. Gibson, CEO - Ms. Kane - Dr. Shefren - Ms. Johnson, recorder
Mr. MacNaughton - El Don A. Corl, resident - Melanie Carroll, reporter
Absent: None
CALL TO ORDER:
President Faro called the meeting to order at 4:45 PM in the Board Room at Sequoia Hospital.
PUBLIC COMMENT:
There was no public comment.
CONSENT CALENDAR:
On a motion offered by Director Shefren and seconded by Director MacNaughton, the Consent Calendar was approved as presented.
NEW BUSINESS:
Resignation of Cecilia Montalvo:
Director Faro announced that Cecilia Montalvo has resigned from the Board effective immediately. Ms. Montalvo's letter of resignation cited the time commitment to fully serve on the Board coupled by her role as a full-time working mother of four. Director Faro reported that the Elections Department has been officially notified. Director Kane moved to accept Ms. Montalvo's resignation. The motion was seconded by Director MacNaughton and unanimously passed.
Options to Fill Vacancy on the Board of Directors:
Mr. Gibson reported on various options open to the Board for the filling the vacancy created by Ms. Montalvo's resignation. The Board could post the vacancy and interview interested candidates. The candidate then duly appointed by the Board would run in the November election as an "appointed incumbent." An alternative is to leave the position vacant, allowing it to be filled by the election process. After consideration, Director MacNaughton moved to leave the seat vacant and thereby filled by the election process. Director Kane seconded the motion which unanimously passed.
Investment Report:
Mr. Alan Seidner and Mr. Eric Reynolds of Fiduciary Trust International (FTI), the District's investment portfolio managers, were in attendance to report on the performance for the second quarter of 2002. Mr. Seidner stated that the District's investments are in adherence with State guidelines and regulations.
Mr. Reynolds reported that the portfolio increased in value by 3.9%, compared to the benchmark, the Lehman Government Intermediate Index, of 3.6%. As of June 30, 2002, the portfolio's asset allocation was 6.36% cash, 33.25% government treasury notes, 13.57% government agencies, 19.89% mortgage-backed, 7.00% asset-backed and 19.84% corporate bonds. The portfolio's average weighted maturity is 4.5 years and duration of 3.10 years. Mr. Reynolds noted that the asset allocation and length of maturity comply with the District' investment guidelines adopted by the Board on August 7, 2000.
Director Shefren offered a motion to approve the investment report as presented. The motion was seconded by Director MacNaughton and unanimously passed. (A copy of FTI's written report is included with the original of these minutes.)
Fiscal 2001/2002 Annual Audit:
After review of the proposed engagement letter from Pearson Del Prete to provide audit services for the annual audit, Director Shefren moved to authorize Mr. Gibson to execute the engagement letter as presented at a cost not to exceed $11,250. Director MacNaughton seconded the motion which passed by unanimous vote. Mr. Gibson noted that the fee has increased by 4% over last year.
Biannual Review of Conflict of Interest Code:
Mr. Gibson reported that the State code requires government entities to review their conflict of interest code and acknowledge that it is in accordance with State regulations. Directors reviewed the current code, which has been in effect since 1998, and found it to be in order. Director Kane offered a motion to ratify the existing Code as presented. Director MacNaughton seconded the motion which unanimously passed.
OLD BUSINESS:
Sequoia Hospital Foundation Request for Matching Grant for FY 02-03:
Mr. Gibson reported that at the last meeting, the Board approved a matching grant to the Foundation for up to $1 million contingent upon review of the Foundation's work plans for those funds. Ms. Key's letter included in the Board packet specifies that the District's matching funds would be used toward the Cardiac Catheterization Laboratory, purchase of a dual head camera for the Nuclear Medicine Department, and a patient monitoring system for the ICU. Director Kane offered a motion to reaffirm the Board's approval of the $1 million matching grant to the Foundation. Director Shefren seconded the motion which unanimously passed.
ADJOURN:
At 5:10 PM, President Faro adjourned the meeting.
Respectfully submitted,
Gerald Shefren, M.D. Secretary
MINUTES OF A SPECIAL MEETING
August 28, 2001
Present: Mr. Faro, President*
Also present: Mr. Gibson, CEO Ms. Kane
Ms. Johnson (recorder) Mr. MacNaughton
Ms. Greenberg (counsel) Dr. Shefren
Excused: None
*Participated by teleconference
CALL TO ORDER:
Vice Chair MacNaughton called the meeting to order at 4:45 PM in the Administration Board Room at Sequoia Hospital.
PUBLIC COMMENT:
There was no public comment.
CHILDREN'S HEALTH INITIATIVE:
(At this time Margaret Taylor, the County's Director of Health, and Toby Douglas joined meeting.) The Board had been provided with information outlining the County's request that the District commit $1.35 million annually for five years to help support San Mateo County's Children's Health Initiative. Ms. Taylor stated that the initiative would:
Santa Clara and San Francisco counties have implemented such a plan for all low income children.
The Board of Supervisors has agreed to match up to $2.7 million to cover kids from 6-18 throughout the County.
The District's $1.35 million would cover kids within the District.
Board questions concerned:
How would the ever-increasing costs of health insurance premiums be addressed in the coming years? Ms. Taylor replied that many of the uninsured children qualify for Medi-Cal and they project that a reserve can be built up in the first few years that will help offset rising insurance premiums.
How would the plan's administration and management be handled? Ms. Taylor reported that the administration of the uninsured program would be moved out of the County and into the Health Plan of San Mateo. Mr. Gibson indicated that the Health Plan may be going out of business. Ms. Taylor responded that if that occurred, they would contract with the Santa Clara County network.
Who would provide the care? Ms. Taylor answered that many of the children who would be covered by this new program are now being provided care through hospital emergency rooms. Under the new program, some of the costs for their care would be covered, and hospitals, clinics and physicians would receive payment based on the MediCal fee schedule.
Referencing the lack of funding participation from Stanford and Kaiser, the Board noted that under the new program, both hospitals would receive payment for services that they had previously provided through charity care. Ms. Taylor indicated that Kaiser has been approached for funding and Stanford will be also.
The San Mateo County Children and Families First Commission has committed $2.3 million annually for the next 10 years to insure that every child in the county from birth until their sixth birthday receives health insurance.
Director Shefren reminded the board he works for Stanford Hospital and that some of these children may be seen at one or more of Stanford's clinics. He stated that he receives no compensation or financial gain from the existing or proposed services. It was suggested that District counsel meet with Director Shefren and advise the Board if there are any conflict of interest issues.
After discussion of the merits of this program, Director Faro stated that the vision to make available access to healthcare to every child within the District fits the philosophy of this Board and he offered a motion to grant $1.35 million for 5 years to help fund the Children's Health Initiative with the following terms and conditions:
Director Kane seconded the motion which passed by roll call vote as follows:
Ayes: Director Faro, Director Kane, Director MacNaughton, Director Shefren
Noes: None
Abstain: None
Ms. Taylor thanked the Board and stated that she will provide the additional information they requested.
RE-ROOF PROJECT AT 2900 WHIPPLE MOB:
Mr. Gibson introduced John Friel who has been conducting the bid process for the re-roofing project at 2900 Whipple Avenue. Mr. Gibson indicated that this project could not move forward earlier due to litigation which has now been settled. Three bids for a poly-foam roof with a 15 year warranty and which will leave the existing roof in place were received. The bids submitted ranged from $218,327 to $123,570. Mr. Gibson and Mr. Friel recommended the lowest bid, which was presented by Best Roofing at $123,570. Mr. Friel has run a Dunn and Bradstreet report on the company and checked their references, which are excellent. Mr. Gibson reported that Best Roofing did indicate that in their bid they overlooked the requirement to remove and replace the existing wood blocks under one of the noise barriers with stainless steel supports. (One of the barriers has steel supports and the other does not.) Best Roofing said they could do the work but asked to increase their bid by $7,000, to which Mr. Gibson responded that they could not adjust their bid amount. Best Roofing then suggested wrapping the existing wood in sheets of metal and applying the foam over the metal wrap. Mr. Gibson and Ms. Greenberg discussed this situation at length and Ms. Greenberg determined that that Board could accept this contractor as the low bidder and accept the modification of work as inconsequential to the overall project, if the Board approved. It was pointed out that the second place bidder was $64,000 more than Best Roofing's bid.
Director Shefren offered a motion to accept the bid presented by Best Roofing deeming the work modification to the bid as inconsequential. Director MacNaughton seconded the motion which passed by roll call vote as follows:
Ayes: Director Faro, Director MacNaughton, Director Shefren
Noes: Director Kane
Abstain: None
The next step in this process is to have a contract drawn and the contract and warranty reviewed by legal counsel. It is imperative this project is completed before the rainy season begins.
CLOSED SESSION:
At 6:20 PM, Director Shefren offered a motion to recess to a Closed Session for the purpose of discussing a personnel matter, pursuant to Government Code §54957.6. Director Kane seconded the motion which passed by roll call vote as follows:
Ayes: Director Faro, Director Kane, Director MacNaughton,
Director Shefren
Noes: None
Abstain: None
RECONVENE:
At 6:45 PM, the meeting was reconvened in Open Session. Vice Chair MacNaughton announced that the Board reviewed the terms, provisions and performance of the management contract with Frank E. Gibson Associates and approved the agreement to extend the term until August 31, 2006.
Director Faro offered a motion to ratify the amendments to Mr. Gibson's contract as approved in the Closed Session. Counsel was requested to draft the language necessary to amend the contract. Director Kane seconded the motion which passed by roll call vote as follows:
Ayes: Director Faro, Director Kane, Director MacNaughton,
Director Shefren
Noes: None
Abstain: None
CONSIDER RESCHEDULING OCTOBER MEETING:
Mr. Gibson reported that the ACHD Annual Meeting falls on the same date as the District's next regular meeting on October 2nd and conflicts with schedules of two board members. After discussion, it was the consensus of the Board to reschedule the October 2nd meeting as soon as practical. The next regular meeting of the Board of Directors is scheduled for December 4th.
ADJOURN:
At 7:00 PM, Vice Chair MacNaughton adjourned the meeting.
Respectfully submitted,
Gerald Shefren, M.D., Secretary
Minutes of Meeting
Board of Directors
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