Current Happenings

Beyond Voting: Making Your Voice Count

On Thursday January 18th at 7pm at St. John’s Lutheran Church, we have organized a presentation called Beyond Voting: Making Your Voice Count.

This is caucus training that seeks to answer the questions of why and how to caucus. At the event, Kevin Dahl, our former DFL legislator will address why to caucus, while Jennifer DeJournett, the Director for Minnesota of the American Majority, a conservative training organization will present on how to caucus. We will also provide examples of resolutions and recommendations for writing them. As the League is a non-partisan organization, we aim to provide multiple perspectives to our members and information to enable all of us to take action and participate in our communities.

While that night we will all learn far more, we want to share a few teasers in this invitation:

Why caucus?

  • Because among other activities, we will be involved in nominating the party’s candidate for governor in each of the parties at our precinct caucuses
  • Because caucuses provide the opportunity to enact grassroots democracy where you can bring the resolutions about issues that you care about to your party and try to move them up the party platform. It is the most grassroots democratic moment in the upcoming year to help shape political party plans.

How to caucus?

  • Caucuses will be held on February 6th. Please hold that date to be an active citizen. We will provide you with more information as to where you caucus as well.

Come learn more on January 18th. If you need transportation, please let me know and we will seek to provide it for you. If you have questions, please feel free to send those my way as well.

Looking forward to seeing you January 18th!

Adrienne Falcon

president@lwvnorthfieldmn.org

League Caucus training poster

 

 

 

 

Northfield Hospital Board Meeting Report

Opening

  1. Chair, Charlie Mandile, called the meeting to order at 6:30 p.m. The Agenda was approved.
  2. The Consent Agenda was approved. The Consent Agenda included: Minutes for a Joint City Council/Hospital Board meeting; Minutes for the November Board Meeting; Minutes for a Community Relations Committee meeting; Minutes for a Special Budget and Finance Committee meeting; Revision to the Medical Staff Manual.

 

Reports

  1. Hospital Chief of Staff. The applications for Medical Staff Membership/Privileges were approved.
  2. Chief Medical Officer—Jeff Meland. No report.

 

Presentations/Discussions/Action Items

  1. Accountable Care Organization (ACO) Launch—Stacie Rice. ACO’s “are groups of doctors, hospitals, and other health care providers, who come together to coordinate care for their Medicare fee-for-service patients. “ ACO’s are required to serve a minimum of 5000 Medicare beneficiaries. NH&C currently serves only 1400 so it has partnered with other communities through Caravan Health for a 3-year trial. The purposes of the trial are to provide a better patient experience and to prepare for the industry shift to reimbursement models based on wellness and health. Four of the ACO partners are located in Idaho, and 6 are in MN. The ACO and Medicare will share any cost savings achieved in 2018. New practices developed in the ACO will apply to all patients served by NH&C. NH&C will add a “Population Health RN” and Dr. Felland from the Lakeville Clinic will serve as the “ACO Provider Champion”.   An ACO Launch Meeting is scheduled for Tuesday, Jan. 23, 2018 in the hospital Conference Center.
  2. Home Care Quality—Tammy Hayes. Quality and patient satisfaction measures have improved in 2017, but some care quality measures remain below the National Reference Standards. Progress will continue.
  3. Approval of Nurse Call/Code Blue System—Tammy Hayes. The need and the system details were presented at the Nov. Board meeting. The Board approved an expenditure of $515,000 to purchase a Rauland 5 nurse call system for the Northfield facility.
  4. Foundation Funding—Charlie Mandile. Charlie requested a small, one-time donation of $5000 to the Northfield Hospital Foundation to create an account with Northfield Shares. Northfield Shares will provide administrative services to the foundation for a fee. The donation was approved.
  5. Annual Donations Pool—Charlie Kyte. The Budget and Finance Committee recommended a community donation pool of $70,000 to be dispensed in 2018 to communities served by NH&C. The B&F Committee also recommended $115,900 pass through to the Northfield Park and Recreation Program for 2018. (This is year 2 of a 3-year agreement.) Motion passed. There was no increase in the 2018 funding due to a very tight operating budget for 2018. It was noted that Health Finders Collaborative will receive subsidies for lab fees of approximately $80,000, and lease costs of $16,000 from NH&C in 2018.
  6. Recommendation on Investment Advisor—Charlie Kyte/Scott Edin. The Budget and Finance Committee recommended the investment firm of Cleary Gull from Milwaukee to supervise equity investments. The current fixed income advisor will be retained. Cleary Gull will survey all Board members to determine the best risk-tolerance level for the equity portfolio. Motion passed. The Budget and Finance Committee will meet with Cleary Gull in January.
  7. Operating Budget for 2018—Scott Edin. The Operating Budget for 2018 basically assumes 2018 service and revenue levels will be constant (changes less than +/- 1%) with the exception of ambulance runs (+6%) and clinic visits (+12%). Expense items projected to increase in 2018 are salary expenses (+4.4%), Drugs (+3 – 4%), and medical supplies (+2.1%). Budgeted revenue for 2018 is $108.3 million; budgeted expense is $107.5. Projected Net operating income for 2018 is positive, but less than the figure for recent years, not including whatever accounting costs may be dictated by PERA adjustments. 2018 is projected to be a tight fiscal year. The Board approved the budget.
  8. Capital Budget for 2018—Scott Edin. Capital expenditures are projected at $10.9 million for 2018, including $3.6 million for remodeling of the Northfield Clinic and $2.4 million for an ambulatory surgery center. It is anticipated that $4.5 million of the amount would come from reserves.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) The City Council is considering a change to the lease agreement with St. Olaf College to permit construction of the senior care facility. b) NH&C and Olmstead Medical Center are still negotiating over implementation of an electronic health records system. It appears that the cost to NH&C may be significantly higher than expected. c) The telemedicine project with Mayo and Stanford Univ. is proceeding.   If successful, it will allow NH&C to keep sicker patients. d) a market survey is planned for 2018, but changes in communication technology (cell phones) has made land-line surveys less reliable. Alternatives are being considered. e) The Advanced Care Planning project is proceeding. f) The billing and coding processes are back on track. g) The 4th quarter patient and revenue surge experienced in recent years has not materialized in 2017. This may require some rethinking of expenses. h) The repeal of the insurance mandate in the ACA is projected to lead to a major decline in enrollment. This is not fair to insurers as the more healthy people are most likely to opt out. A series of meetings with state and national politicians is anticipated.

A request was made that any material sent to the City Council also be sent to Board members.

  1. November Financial Report—Scott Edin. Services were over budget, including Home Health Visits (+21.9%), CCIC (+19.4%), Births (15.4%), etc. Net Operating Revenue and Operating Expenses were both over budget. The result was a Net Operating Income for Nov. of $301 thousand. Net Income was reduced as a result of the increase in government (Medicare and Medicaid) payers that receive a larger discount than the private payers. As a result the cumulative Net Income is below that of recent years at this date. The days-cash-on-hand is 224 days.
  2. Quality Committee Report—Charlie Mandile. Patient ratings are improving. Staff is being added as new problems are encountered (e.g. increasing workplace violence).
  3. Budget and Finance Committee—Charlie Kyte. No report. Steve Underdahl thanked the committee for all the work they have done in recent work on the 2018 budget, the investment advisor, and other tasks.

 

Roundtable

Charlie Mandile reported many positive comments on the recent retreat.

 

Meeting adjourned at 8:54 p.m.

Next meeting: January 25, 2018

Northfield Hospital Board Report

Opening

Chair, Charlie Mandile, called the meeting to order at 6:30 p.m. The Agenda was approved.

The Consent Agenda was approved. The Consent Agenda included Minutes for the October Board Meeting; Minutes for a Governance and Planning Committee meeting; Revision to the Emergency Medicine Privilege Request Form; Medical Staff Polices; and Compliance Policies.

Reports

  1. Hospital Chief of Staff. The applications for Medical Staff Membership/Privileges were approved.
  2. Chief Medical Officer—Jeff Meland. Recruiting medical providers is becoming increasingly difficult, but providers appear to be interested in working with NH&C.
  3. NH&C Report—Ben Flannery. The remodeling and expansion of the Northfield facility is underway. NH&C has hired a neo-natal/pediatric practitioner who is upgrading the care provided in the system.
  4. Allina Medical Clinic Report—Keith Olson. The clinic is adding a physician assistant in March. Allina is working with ICSI on the opioid crisis and is willing to share the results. Allina is also working on reducing readmissions at District One Hospital and would share the results.

 Presentations/Discussions/Action Items

  1. Hospice Quality—Tammy Hayes. The problems that led to lower satisfaction and quality ratings in the hospice program for 2016 have been resolved. Patient satisfaction is over 90% on 2017 surveys and the HIS quality-of-care measures were 100% achieved in 2017. CEO Underdahl praised Tammy Hayes’ work on this project.
  2. Nurse Call/Code Blue System—Tammy Hayes. The internal communication system/nurse call system/Code Blue System is at the end of its useful life. The proposal is to replace the current system with the Responder 5 system at a cost of $515,035. The Responder 5 system offers many more communication options for both patients and staff and will reduce the noise level in patient rooms. The Responder 5 system is already deployed in the recently remodeled sections of the hospital. Given the need to connect to the Responder 5 system already in place, this is a no-bid purchase.   The Board will vote at the Dec. meeting.
  3. Foundation Board Nominations—Charlie Mandile. Charlie asked for 3 Hospital Board members to serve on the Board of the new hospital foundation. The new Board’s task in 2018 will be to organize and establish procedures for the foundation. Four additional foundation Board members, including 2 community members, will be added in 2019. It is likely that the hospital will provide $5,000-$10,000 of initial funding to launch the foundation and establish financial ties.
  4. December Board Retreat—Charlie Mandile. The Board has hired Heather Durenburger to facilitate the retreat and she has talked individually with all Board members. An agenda for the retreat was shared along with a reading for the retreat, “Three Phases of a Board’s Evolution.” In response to a question, Charlie stated his hope that a document describing board procedures and expectations would emerge from the Retreat. Any such document would require periodic/annual updates.
  5. EHR (Electronic Health Records) Update—Steve Underdahl. NH&C is exploring the potential for partnering with Olmstead Medical Center (OMC) in Rochester to share an EPIC electronic medical records system. This would be an expensive project, perhaps $20 million over 10 years for NH&C, but it would allow NH&C to be with the same software vendor as the Mayo and Allina systems. Northfield and OMC would run the standard/non-customized system, unlike Mayo and Allina, but the standard system can be continuously upgraded, a plus. Work is going forward on three fronts: establishing a financial model for the arrangement, drafting contractual/legal documents, and exploring EPIC compatibility with the operation of NH&C. Teams from NH&C are currently working with OMC and EPIC personnel to determine compatibility. A decision on the OMC/EPIC option is expected early in 2018.

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) The City Council and the Hospital Board held a joint work session on Tuesday evening 11/28/17 to discuss the proposed Senior Services project. Steve reported NH&C is working to support the City staff as they consider the project. b) NH&C has contracted with a firm to help with “enterprise risk management,” i.e., how can we best deal with the multitude of threats in our environment? The contract will provide software and consulting time. c) NH&C’s participation in an ACO (Accountable Care Organization) will go live in January. The purpose of participation is to gain experience with what many perceive as the evolving Medicare payment system featuring financial rewards and penalties depending on how the hospital delivers care. There are no financial penalties in the system for 2018. d) Strategic partnerships with HCMC and OMC are being explored. e) The Medicare Low-Volume Program that ended in October will reduce NH&C revenues by $300,000 in 2017 and by $1 million in 2018. f) The self-funded employee health insurance program operated by NH&C will not run a surplus in 2017. It was commented that recent studies show that individuals with high- deducible health insurance coverage behave similar to persons who are uninsured. The uninsured avoid using the health care system until they turn up in the emergency room. g) A cultural sea change is underway, and NH&C is reviewing policies and procedures with respect to sexual harassment.
  2. Financial Report—Scott Edin. October was busy but the proportion of payments by Medicare and Medicaid was higher than budgeted, so the discount was higher than budgeted. The Net Operating Income was positive but almost $300,000 under budget.
  3. Community Relations Committee—Steve O’Neill. The committee received community requests for donations totaling $125,000. The budget is $70,000. The committee will bring a list of awards to the Dec. meeting. Should the budgeted amount be increased for 2018?

Roundtable

The Budget and Finance Committee received and reviewed proposals from 10 investment firms. The Committee will interview 3 – 4 firms and will recommend an investment adviser at the December Board meeting. Recent changes in state law now allow NH&C to invest in a wider variety of financial instruments.

Meeting adjourned at 8:25 p.m.

Next meeting: December 21, 2017

Northfield Hospital Board Report

 Opening

  1. Vice Chair, Virginia Kaczmarek, called the meeting to order at 6:30 p.m. The Agenda was approved.

The Consent Agenda was approved. The Consent Agenda included Minutes for the August Board Meeting; Minutes for the Community Relations Committee meeting; approval of Quality & Performance Improvement Policy and Program; and Clinical Privilege Request forms.

 

Reports

  1. Hospital Chief of Staff. The applications for Medical Staff Membership/Privileges were approved.
  2. Chief Medical Officer. No report.
  3. NH&C. No report.
  4. Allina Medical Clinic Report. No report.
  5. City Business—Brad Ness. Ness reported that the Council returned a proposal to the Charter Commission without passing it. A $3.5 million project for the Fire Department is likely to begin in 2018. A lease agreement for the hospital and clinics was approved. A 2018 tax levy increase of 8.5% was proposed by the City. Most of the increase will go to increase staff salaries that lag those in other municipalities.

 

Presentations/Discussions/Action Items

  1. Board Portal—Vern Lougheed. NH&C has been working on a communication network that would provide simple, secure internal communication between Board members and administration. The IT staff reviewed the software available and is recommending the Board Effect package. A local firm is also developing suitable software, but is only in Beta testing stage at this time. The cost will be $5400 per year, and the contract would run for 1 year at a time.
  2. Foundation Recommendation—Laura Peterson. Peterson brought a series of questions regarding the foundation to the Board. Q–If the Bylaws of the foundation specify 3 members from the Hospital Board, how should they be selected? A—The Hospital Board will appoint the three. Q—Should the Foundation report to the Hospital Board on a regular basis? A—Yes, the Foundation should appear semi-annually at Board meetings to report. Q—should NH&C provide initial funding for the Foundation? A—this is still under study. The Hospital Board will set the initial Bylaws for the Foundation, but after that the Foundation Board is responsible for the Bylaws. A Board member proposed that the Articles of Incorporation be changed to read that a super-majority of Foundation Board members be required to remove an At-Large Board member from the Foundation. Several steps remain to be completed but the foundation should be operational in early 2018.
  3. LTCC Nursing Patient Care Update—Tammy Hayes. The Long Term Care Center receives 5 out of 5 stars on broad quality measures and equals or exceeds the MN average on the Quality of Life Survey of residents. The Family Satisfaction Survey scores were below the state average in 2016, but the problems have been addressed. The LTCC meets or exceeds state averages for a variety of other quality measures. There were no penalties or payment denials by Medicare in 2015 and 2016.
  4. Senior Care Development Agreement Update—Jerry Ehn. Several discussions have been held between Yanik (the developer), St. Olaf College, and the City regarding the location of the proposed project. The City would prefer that the project be located on the east side—toward Cedar Ave. in the hope that it would spur residential development of that area. Yanik argued that such a move would delay the project (Stages 1 & 2) considerably, so the project will likely be in the west location. If further development is undertaken (Stage 3) it could be located across the road and a mirror image of this project. Steve Underdahl pointed out that NH&C is only a facilitator for this project, and not involved in the actual negotiations between the 3 other parties. The project continues to move forward.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. Dr. Fulco will be recognized in MN Monthly as one of the “top Docs” in Minnesota. Underdahl reported on the progress for a variety of initiatives.   The EHR assessment continues. The Faribault orthopedic site is completed. More orthopedic space is needed in Northfield. NH&C staff made a site visit to Ivinson Memorial Hospital in Laramie WY, to learn about their Process Improvement Project. The hope is that the visit will give employees insight into the Process Improvement and a new set of “peers.”   The Advanced Care Planning program continues to make progress. Steve has been “following the patient” at the Lakeville Clinic to better understand clinic operations. September volume at the hospital was good.
  2. Financial Report—Scott Edin. August was busy and revenues and expenses were both above budget, and Net Operating Income was substantially above budget. Services were above budget in most departments. Government paid revenue was higher than projected so the discount on revenue was also above budget.
  3. Budget and Finance Committee Report—Charlie Kyte. Recent changes in state law have expanded the investment options open to NH&C, and the Committee is developing new investment policies and guidelines for the $55 million in its portfolio. The Committee will come to the Board to determine its risk tolerance and a set of goals for the investment plan at the December meeting. A Request for Proposals will be issued to financial planners in this area.

 

Roundtable

Board members commented on a recent article in the paper describing the efforts of St. Gabriel’s Hospital to combat the opioid epidemic. Could the health care providers in Northfield be doing more? Could NH&C be a leader in this area?

A retreat on “Governance” is scheduled for Friday, Nov. 3

Meeting adjourned at 8:20 p.m.

Next meeting: October 27, 2017

School Levy Referendum Presentation November 2nd – Bridgewater Township hall

Come here Matt Hillman give a presentation on the upcoming school levy referendum on Thursday, November 2nd, 2017 @ 7PM Bridgewater Town Hall 500 Railway Street, Dundas

On November 7, 2017, Northfield Public Schools residents will be asked to vote on two important potential changes: increasing the operating levy and authorizing the District to sell $109 million in bonds for the purpose of implementing the Master Facilities Plan.

Come to the presentation for more details!

 

Fall 2017 Local League Election Events

We invite you to two upcoming events:

Monday October 23, 7pm

At-Large City Council Member Candidate Forum –

The Northfield City Council Chambers

801 Washington Street.

 

On November 7, there will be an election for the 4th ward seat on the Northfield City Council, with three candidates vying for the position. The incumbent, Greg Colby, was appointed to fill the vacancy created in November 2016 when Rhonda Pownell was elected Mayor. The three candidates are: Greg Colby, Jon Denison and Don McGee. Allene Moesler of Cannon Falls will moderate the forum. There will be opportunities for the public to submit questions to the candidates following their formal presentations.

For more information, contact: Stephanie Ennis, Voter Service, schwartz.ennis@gmail.com

 

Thursday, November 2, 7 pm

School Levy Presentation – Matt Hillman Superintendant

Bridgewater Town Hall

500 Railway Street, Dundas.

 

On November 7, there will also be a vote for a school levy. The school levy ballot has two requests, the first is an operating levy, the second a building levy. The second depends upon the first passing, Superintendant Hillman has done a series of presentations on the levy in Northfield. We have organized this presentation specifically to be outside of Northfield to offer information to constituencies throughout the district. There will be opportunities for the public to hear Superintendant’s presentation and to ask questions following that presentation.

For more information, contact: Kathleen Doran Norton, Vice-President of the League, kdorannorton@gmail.com

We are also looking for a few volunteer time keepers and others who could help with logistics the day of the event. If you are able, please let us know.

Please feel free to share these events with your friends and invite them to join you.