Washington Parish Council
Regular Meeting
Washington Parish Courthouse
Council Chambers
March 14, 2016
Monday – 6:00 PM
Item No. 1 - Call to order – Chairman Thomas called the meeting to order.
Item No. 2 - Invocation – Councilman Lewis gave the invocation.
Item No. 3 - Pledge of Allegiance – Councilman Workman led the Pledge of Allegiance.
Item No. 4 - Roll Call – Council Clerk Sarah Cook called the roll. Present were Perry Talley, Michael Fussell, Chris Workman, Levi Lewis, Pete Thomas, Reginald McMasters and David Anthony.
Chairman Thomas: “We had an Introduction of Ordinance No. 16-607 on February 22, 2016 We will be calling for a special meeting to set up a day to have a public hearing. We will take a 5 minute recess to determine a date and time for the special meeting before the council’s discussion. This was an ordinance accepting the lowest qualified bid for the construction of the new cell No. 6 at the Choctaw Road Landfill Project No. 26504 and to authorize the Parish President to execute the contract, any and all other contracts other documents related thereto on behalf of the Washington Parish Government.
Item No. 5- Approval of Minutes – Approval of Minutes dated February 22, 2016.
Councilman Talley offered a motion, seconded by Councilman Workman to approve the minutes of the regular meeting of February 22, 2016.
Roll call of vote as follows:
YEAS: (7) Talley, Fussell, Workman, Lewis, Thomas, McMasters and Anthony
NAYS: (0)
ABSENT: (0)
ABSTAIN: (0)
Item No. 6. – Riverside Medical Center- Brent King – “First of all I appreciate the opportunity to address the council. I have three things that I want to talk to you about. I know that one of the questions on your mind is the resignation of Dr. Kyle Magee. I received Dr. Kyle Magee’s resignation this pass Monday on March 7, 2016. We then called for a special meeting on Thursday, March 10, 2016. We formed a search committee at Thursday’s meeting that consists of Dr. Alvarado, Dr. Voelker, Mr. Wayne Knight, Barry Kennedy, Laverne Jenkins and I. Our plans are to advertise for the next thirty days then review the applications that we receive. We have received a couple of applications because I signed a couple of thank you letters today. Dr. Magee’s last day will be April 15, 2016. It will probably be necessary to us to appoint an interim CEO following that day. I don’t anticipate that we will have a CEO in place by April 15. When that date gets here we will appoint someone to fill that position as interim CEO. We have people that we feel like are in place that can do that. We haven’t decided or named an interim as of this point, we will probably wait until that time comes as to what we are looking at. The second thing I would like to talk to you about is some of the progress that we made at the hospital. I had several things that I have noted and I will be glad to answer any questions you may have when we are through. One of the things that we are very proud of is that we have leased radiology equipment which makes our radiology all digital and is the first one on the North Shore. In leasing the equipment we have saved about $50,000 a year and we are also able to provide state of the art services. Most of you are aware that we now have cardiology services 24/7. The Cath Lab opened in October of 2014 and we are currently still doing some diagnostic work and some renal stints with some peripheral stints as well. We are on schedule this summer to begin interventions as far as cardiac. One of the things I wanted to tell you about the Cath Lab as I know that when we were talking about it a couple of years ago, there were a lot of questions about the profitability of the Cath Lab. The first year the Cath Lab showed a profit of over $20,000. Another thing that we have done that I would like for all of you to be aware of is that we converted all of the clinics to rural health clinics. This improves access to care and also helps us with reimbursements. In August of 2013 there was no provider in Washington Parish that provided care for Medicaid patients, now that has changed. We are not only providing care for Medicaid patients in all our clinics but we are also doing something that I’m very proud and thankful for is inbound patients. These patients are not able to drive or travel so they have to use the ambulance service and Medicaid does not pay for the ambulance. These patients would get billed somewhere to $500.00 and $700.00. What we are doing now is sending some of the nurse practitioners, basically to make house calls. This saves the patient from having to get to the hospital, being billed by the ambulance company and we get paid for it as well. We are able to do that because of our Rural Health status and it has been something that has really helped us. When Family Medical left October of last year, we began to recruit physicians and nurse practitioners. I wanted to report to you that we now have a full time Surgeon on staff, 4 Cardiologist, 2 Family Nurse Practitioners, 2 Pediatric Nurse Practitioners, 1 part time OBGYN Physician, 2 Internal Medicine Physicians and 1 Family Practice Physician. We have more access to providers in Washington Parish then we ever had. We are able to employee all of those through Riverside Medical Center. Another thing I think we are going to see the results of especially this summer, some time ago we started a 340B Drug Program, as you know we are self insured and through this government program we were able to save $150,000 a year just on employee prescription medicines. We are now going to go public with that starting April 1, 2016. Our projections are that this is going to gain us anywhere from $750,000 to $1.5 Million a year based upon a number of prescriptions filled through our providers. Also, we are very proud of a stroke program that we started some time ago. We have the most successful stroke program in the State of Louisiana. We have been asked to attend a conference in Las Vegas later this year in regards to our program. In the past year we have bought a fully intergraded electronic health record keeping system and we are able to pay for almost 80% of that through a federal program. When we were here before we were talking about added Thomas Clinic to the program and we were able to do that. We are at a level 7 and as my understanding level 7 is a top ranking. We are the only rural hospital in the nation that has that ranking. We are in the process of converting Thomas Clinic into a Rural Health Clinic and that means Dr. Thomas will be able to see the Medicaid patients in Thomas. We plan to add a Cardiologist and other specialty services in the Thomas Clinic. We are in discussions with Our Lady of Angels in Bogalusa, talking about sharing services with them to benefit both hospitals. We will try and get all the help in Washington Parish that we can through a combined effort with both hospitals. We have been working with Larry Kinlaw on a capital outlay project and we were approved for $100,000 to replace generators and boilers to bring them up to speed. We didn’t take that money because it wasn’t enough to pay for the entire project and we are hoping that this coming year we can get more to complete the project. The hospital continues to see a record of emergency room visits with about $16,000 a year. In billing and coding our collections have went from $80,000 a week to approximately $350,000 a week. We have been able to claim more on the cost report where we were getting 2 million dollars from the state and now we are getting 3.5 million per year. We are continuing to work very closely to capture swing bed patients for our hospital with other hospitals to make sure they get those patients back. We are now being able to provide more coverage for people in Washington Parish simply because of the rural health designation and able to provide for Medicaid patients as well. The third thing that I want to mention is our financial state of the hospital. I have some reports with me and I will be glad to provide you with a report. What we did was took the first quarter cash analysis and compared the first quarter of this year to the first quarter of the years 2013, 2014 and 2015. We haven’t figured what the rest of March would be. The results of the cash analysis is first quarter of 2013 we received $5.4 million, 2014 we received $5.9 million, in 2015 we received $6.4 million and today we have received $7.8 million. This is a 44% increase in our cash flow since 2013 to today. A lot of that is due to outpatient. Our cash flow continues to increase and we are maintaining an average of 8 to 10 days of cash on hand. Keep in mind we haven’t started receiving any money from Thomas Clinic up to this point. We have been paying all the employees and expenses at the Thomas clinic and still able to maintain our cash flow. We will start next month, receiving money for the care that Dr. Thomas gave his patients in January. We will run 90 days behind with him just like we do with the rest of our clinics. I wanted you all to be aware that there are some good things happened as well and I will be happy to answer any questions you may have about any of the things that I have discussed.”
Councilman McMasters: “How many Rural Clinics do we have and where are they at?
Brent King: “We have 3 in Franklinton and Thomas Clinic being number 4.”
Councilman Talley: “It seems like there is a whole lot of turnover at the Hospital, is this a normal type of turnover for a Hospital?”
Brent King: “We haven’t experienced a lot of turnover with our nurses and staff. We have in the last month a turnover with a CFO and he has been replaced. Mike got another job with another hospital and turned in his resignation.”
Councilman Workman: “Can you talk a little bit about the position that was eliminated of Ben Lot?”
Brent King: “The COO position was something that was created recently and we came to the decision that we were top heavy in upper management. That was one of the positions that were eliminated as a result to that. We are looking at somewhere around $130,000 a year job.”
Councilman Workman: “Could you elaborate a little bit more about Riverside partnering up with Our Lady of the Angels, which I am thrilled to hear?”
Brent King: “We have had a couple meetings with them and intend to meet with them later this week. We have a lot to offer them through the cardiology department. They have a contract with the same cardiology group that we do and so we have an interventionist coming on in July. Our Lady of Angels treats a lot of free patient care and we are not designated to do that and they fill the gap of the charity. What we are trying to do is partner with them because they don’t have a Cath Lab. If they have a person who needs this done they are sending them to Baton Rouge and New Orleans. Washington Parish families have to travel long distance. We are trying to work out where these patients can be treated at Riverside when a Cath procedure can be done. Government can pay for it and then send them back to Bogalusa. That is one of the things we are working with. They also have services that we don’t have: a maternity ward and psychiatric care. These are just a few things but we are excited about this.”
Councilman Lewis: “Thanks for the report, very detailed. You indicated that there was an increase of revenues. Is that a reflection of total patient flow increasing or better collection procedures?”
Brent King: “It is both, we have a lot of outpatient and the other is being able to contract with Pioneer which is a company out of Magee Mississippi who does all of our collecting now. The turnaround once they receive a bill for us is so much better. It has helped increase from $80,000 to $100,000 a week and we are now collecting $350,000 per week. Another reason for the increase is it cost more to do a hard cath than it does other procedures. We have higher dollar procedures going on now and not only with the caths we are doing pace makers and surgeries. Here is the thing guy’s, when we got our own providers they are sending the patients to us. We were just not getting what Washington Parish needed to get to survive and now it’s all starting to pay off.”
Councilman Lewis: “The council approved a line of credit for the hospital. Have we used any of that line of credit?”
Brent King: “No.”
Councilman Lewis: “What would you say the hospitals greatest challenge is in this season?”
Brent King: “The greatest challenge we face right now is inpatient care and swing bed.”
Brent King: “One of the things I wanted to mention to you all was Mr. David Anthony came to our board meeting and I don’t know if he was speaking on behalf of all of you when he asked to remove Dr. Kyle Magee from his position. We are not going to do that and we are not able to do that. There are agreements with our Nurse Practitioners that we have to have worked out which we spent time working that out. We spent a lot of time in trying to get Rural Health access and approval and you have to have a supervisor in position to do that and Dr. Magee is our Supervisor, that would have to change. If we were to fire him immediately or ask him to leave, it is not something we are in a position to do or a something we desire to do. We have some things that we need to have finished before he leaves.”
Chairman Thomas: “Thank you Mr. King”
Item No. 7. DA Warren Montgomery – “Thank you for giving me the opportunity to speak. I would like to thank the President and staff for your help in putting in some security measures in our office. I appreciate you all in helping with that, thank you very much. If there is anything we can do to help you, legal advice we can render, legal service we can render considering what has happened this past weekend. We are available to do that and we want to do what we can using our expertise to help the community. The main reason I am here tonight is to ask for your support on a millage proposition regarding the Florida Parishes Juvenile Detention Center. That is a facility that is near Robert Louisiana and it handles juveniles in a 5 parish area; Washington, St. Tammany, Tangaphoia, Livingston and St. Helena Parish. This facility is very helpful to all of us in the law enforcement community and ultimately to Washington Parish. Those individuals who are juveniles under state law after their arrest cannot be housed in a prison facility. Those individuals have been charged with armed robbery, murder, rape and very serious crimes are arrested and they can’t be brought to the jail here in Washington Parish. They can’t be housed in the jail under the law, then they can be released back into the community and this is a recipe for disaster. We had a foresight to build this building and fund this facility near Robert Louisiana where these people are taken, treated and kept in a safe environment for them and safe for the public. One of the advantages particularly with regards to Washington Parish is that the millage is principally paid for by St. Tammany and to a lesser extent by Tangaphoia Parish. Really Washington Parish has more of a benefit so that maybe you spend 10% of the funding comes from Washington Parish and 20% to 25% of the young people who are housed their come from Washington Parish. It is a great bang for the buck in terms of what Washington Parish contributes to operate this facility and how much Washington Parish benefits from this facility. I want to encourage you to support and to vote positively on that millage when it appears on the ballot in the next few weeks. I’m also here to answer any questions you may have at this time. Thank you very much.”