Los Medanos Community Healthcare District

6. Financial Report Ð Action #071002

Director Reyes reported that the Finance Committee met last week, and he asked the Accountant, Arlene Mose, to report.

Ms. Mose explained that what the Board has before them is a Balance Sheet, which is a new concept with respect to the Financial Report presented at the Board Meeting. She will be working on adjusting the numbers that appear in this Balance Sheet. Also included is a Profit and Loss Statement for July, August and September. Also included is the Budget Profit and Loss to Actual. This tool provides a method for tracking how much money has been expended to date for each program budgeted.

Ms. Mose pointed out that the Audit Report for June 30, 2006 was completed, and this will appear on your next Board Meeting agenda for approval, and the Cost Report which will be filed with the State of California this month.

Based on discussions at the Finance Committee meeting, the Board agreed to review/revise the Budget on a mid-year and annual basis. Also, a revised Balance Sheet will be adjusted and presented at the next regular Board Meeting. The Finance Committee will meet on Friday, November 2, at 12:30 p.m., to review these issues.

It was the consensus of the Board to continue action regarding the Financial Report to the November 12, Board Meeting.

á Paid Invoice from Contra Costa Health Services Ð Director Reyes noted that the invoice for the Dental Program in the amount of $187,000, which was previously approved, has been paid.

á District Credit Card Ð Ms. Mose stated that the District is going to submit an application for a card with a company used by another Special District with a cap of $2,000 to $3,000.

Director Reyes moved, and Director Vera seconded to approve application for a District credit card, not to exceed $3,000 per purchase. The motion was approved by the following vote:

Ayes: Directors Vera, Condit, Reyes, Cromartie

Noes: None

Absent: Director Rubi

Abstain: None

7. Continued Support for Los Medanos College Nursing Program for Fiscal Year 2007-08 Ð Sandra Castillo Ð Action #070804

Sandra Castillo addressed the Board on behalf of the Los Medanos College Nursing Program. Ms. Castillo reviewed her background, including her service as Director of the RN Program at Los Medanos College for the past three years. She explained that the nursing program is a two-year program that is accredited by the Board of Registered Nursing, and prepares students to pass the exam for RN. The BRN is an accredited program, and there is considerable criteria which the college is required to abide by. Part of the criteria is the ratio of students per instructor, and this governs the number of students they can accept. Historically, the program has taken in 33 students annually, and with the funds received from the Los Medanos Community Healthcare District, they have been able to take in an additional 11 students annually. This has also helped to support instructors from many specialty areas.

A survey was sent out to students who graduated this spring, and the comments were positive. Also, salaries they are receiving is in the range of $60,000 to $80,000 after completion of the two-year program, resulting in a better quality of life for these graduate and providing a service to our community. One of the struggles nursing programs are currently experiencing is that there is not enough clinical placement to staff the number of employment opportunities; therefore, many of the community colleges and nursing programs have been asked to increase the number of students they can take in. The Board of Registered Nurses has recognized this problem, and one of the current movements is to offer simulation-type experience, and Los Medanos would like to incorporate this into the experience of the students and to offer a state-of-the-art kind of program.

Ms. Castillo responded by questions by Director Reyes concerning the retention rate and the cost for students who donÕt follow through. Mr. Reyes inquired about the idea of granting funds to students for scholarships. Ms. Castillo replied that there is only an emergency fund to help students with financial needs

Director Cromartie commented that he is convinced through personal experience that the college is doing a good job in providing nursing staff to our community.

Members of the Board acknowledged and welcomed Peter Garcia, President of Los Medanos College. Mr. Garcia thanked the Board for its support, and that he believes this is an excellent return for the investment

A motion was made by Director Vera, seconded by Director Condit to continue support for the Los Medanos College Nursing Program for Fiscal Year 2007-08. The motion was approved by the following vote:

Ayes: Directors Vera, Condit

Noes: None

Absent: Director Rubi

Abstain: Directors Reyes, Cromartie

8. Review of Mid-Year Activity Report for John Muir Partnership Ð Lyn Baskett

Lyn Baskett addressed the Board and expressed appreciation for investing in John Muir Health programs, and this has made a huge difference in her departmentÕs ability to connect with the Latino and African-American populations. In addition to the one FTE that the Los Medanos Health Care District is providing, the program is able to provide many more hours for clinical expertise.

Director Reyes commented that what he expected was a more data-rich or tabulated report, and on how the $94,000 was used. For instance, he would prefer to see more data on actual activities and how many people participated.

Ms. Baskett stated that in the future, they would reformat the report. What they attempted to do was to outline various issues and then discuss what they did in each area. For example, in the area of diabetes, they met with the health conductors, which is a part of the Bay Point Community Health Center (community outreach), which has access to many people to provide education. The health conductors also ran a ten-week support group for African-American women which covers various subjects. They are unable to provide, however, the number of people contacted on the subject of diabetes as a statistic.

Director Cromartie inquired as to what kind of direct services are provided in terms of heart disease, cancer and stroke, and also, what this organization is doing about prevention. Also, he would like to see included in the report a better measurement for what has been done.

Ms. Baskett clarified that their contract does not call for direct services in patient care. She explained that a key part to prevention is education and awareness, and what this report describes is education and promotion of available services. She pointed out that when talking about health education, it is very difficult to measure knowledge change over time.

She reported that for part of last year, a U.C. Berkeley grad student helped them lay the ground work on some of the mobile health and dental clinics which were more established, and this was to be used as the model. There will be a replacement student in the near future to resume the evaluation focus.

Director Cromartie requested that the next activity report focus more on the Pittsburg and Bay Point areas specifically.

In response to Director ReyesÕ inquiry about a survey of findings, Ms. Baskett replied that they didnÕt do a survey, but used a community assessment in cooperation with the community hospitals. Therefore, what was included in the report was not anything they did specifically, but an excerpt from the larger report to say it is worth doing the education and prevention for asthma, diabetes, hearth disease, cancer and stroke.

President Condit commented that John Muir is going to offer a workshop on October 25 in the Board Room in which several schools will be represented, and they will be given materials on how to access health care.

Ms. Baskett mentioned that one of the things they were also charged with was to pull together partners for other areas, such as access and how to get appropriate utilization of services by the communities that are most at risk. They would like to present a proposal for the District to review in December.

9. Review and Approve Extension of New Kids Program for Fiscal Year 2007-08 Ð Charlotte Dickson Ð Action #071005

Charlotte Dickson addressed the Board. She stated that her role is to manage the Obesity and Diabetes program. She introduced Susan Nairn, one of the nurse managers with Public

Health Clinic Services, who is involved with the day-to-day workings of the Kids-Shape component of the New Kids program.

Ms. Dickson pointed out that they have had some great successes this year with the Kids-Shape program, which is a series of workshops for parents of children who are at risk of being overweight. They served approximately 100 family members this year, and 37 children graduated from the program, of which approximately 70% were Latino, 10% were African-American, and 20% were White.

They have started an after-school program in which all after-school staff members were trained as role models in conducting physical activities and encouraging nutrition. Also, they did some work at Bay Point to increase opportunities for families to walk safely along the canal trail over to the commercial district on near BART. As a result of the New Kids program and the partnership in serving families in Pittsburg and Bay Point, Kaiser has approached them and offered to make their curriculum available at no cost.

Ms. Dickson stated that they are very interested in continuing their partnership with LMCHD and would like to do some community-based prevention programs, i.e., working more closely with Ambrose Recreation District in enhancing the trail along Bailey Road and offering cooking programs for young people.

Director Reyes inquired what kind of data is being run to determine the success of the program.

Ms. Dickson stated they do pre- and post-evaluations, as well as follow up by calling parents to see if students have continued with their intended change. She reported that approximately 50% of the families stay in the program. They are looking at ways to more accurately measure success of the program participants.

Director Cromartie inquired regarding the KP Kids curriculum and research data provided in Kaiser study using the Kid-Shape model. Ms. Dickson stated that she would provide a copy of this study to the Board as this might prove to be a good benchmark for measuring the program success.

Ms. Dickson stated she would be holding a meeting with partners in which Board members would be invited, and some of the Kaiser research can be shared at that time. Also, some discussion could involve what benchmarks might be built into the program.

A motion was made by Director Reyes, seconded by Director Cromartie, to approve extension of the New Kids Program for Fiscal Year 2007-08. The motion was approved by the following vote:

Ayes: Directors Reyes, Cromartie

Noes: None

Absent: Director Rubi

Abstain: Directors Condit, Vera

10. Review of LMCH Bylaws, Article V, Sections 1 and 2 Ð Colin Coffey

Attorney Colin Coffey presented information to the Board, based on a discussion at the September Board Meeting relative to committees. He presented provisions reflecting what the Board currently does, as well as proposed revisions that also define various types of committees. He requested that the Board review the sections addressed and provide feedback prior to the next Board meeting. He would then incorporate any suggestions into the Bylaws for consideration by the Board at its November meeting.

He additionally pointed out that most organizations commensurate with the election of its officers, appoint committees for the upcoming year; therefore, the Board may wish to determine if it would like to include this in its Bylaws.

Mike Lengyel, member of the public, addressed the Board and presented a written proposed amendment that Òeach standing committee shall include at least two members of the Board of Directors and may include non-Board members.Ó

Members of the Board discussed the idea of including non-Board members to serve on a Standing Committee. Also discussed was the number of Board members permitted to serve and vote on a Standing Committee. The Attorney recommended that Standing Committees consisting of more than two Board members be designated as a Committee of the Whole, and noticed as a Board Study Session.

Director Cromartie questioned if the BoardÕs action to appoint a Fit-Fest Events Coordinator would violate a suggested Bylaws provision that Òall contracts, agreements and personnel actions be submitted to the Board of Directors for Board action prior to implementation.Ó Attorney Coffey stated that it would not be in violation in that the Board previously delegated authority to a committee to hire an Events Coordinator and established a budget for this position. He further clarified that the role of the Board is to delegate specific authority and a budget to hire personnel.

11. Ad hoc Committee Recommendations Re: CEO/Executive Director Position and Process for Recruitment Ð Action #070906

Mr. Cromartie stated that he would like to set up a meeting with the attorney to review the previous Executive DirectorÕs contract, and would report at the next Board Meeting.

12. Approving Hiring of Webmaster Ð Action #071007

Director Reyes asked that the Board review the proposed Webmaster contract, dated October 30, 2006, for any modifications. Director Reyes proposed that the Board amend the pay schedule to designate that Mr. Akeson be paid on a monthly basis to allow better monitoring. This was agreeable to other members of the Board.

Mr. Lengyel addressed the Board and endorsed hiring Mr. Akeson, and also offered the name and background information of an alternate individual for the BoardÕs consideration.

It was moved by Director Vera, seconded by Director Reyes, to accept Akeson DesignÕs proposal, dated October 30, 2006. The motion was approved by the following vote:

Ayes: Directors Reyes, Vera, Condit, Cromartie

Noes: None

Absent: Director Rubi

Abstain: None

13. Reconsideration of Board Action Re: Purchase of Death Certificates by LMCHD Ð Action #070808 Ð Cromartie

Director Cromartie requested that due to the time, this item be tabled to the next regular Board meeting. This was agreeable to all members of the Board.

14. Board Comments

á Grants Parameters Ð Mid-Term and Final Report Benchmarks Ð Director Reyes

Director Reyes suggested that the issue of benchmarks be addressed by the Grants Committee. This was agreeable to all members of the Board.

á President Condit announced that she would propose a $200 gift card to Ramekins Cooking School in Sonoma be presented to former Executive Director Frank Puglisi. This was agreeable to all members of the Board.

15. Adjournment

There being no further business to come before the Board, the meeting was adjourned at 9:10 p.m.

Respectfully submitted,