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03/23/2015 MINUTESParis - -Lamar County Health District 400 West Sherman treet, Paris, Texas 75460 -5646 C erman Health District: (903) 785 -4561 ' a� Women, Infant and Children (WIC): (903) 784 -1411 WAM Fax: (903) 737 -0978 www.parislamarhealth.com Minutes of SPECIAL Meeting Paris - Lamar County Board of Health The Paris - Lamar County Board of Health held a SPECIAL meeting at 5:30 p.m. on Monday, March 23rd, 2015. In attendance were Dr. Mark Gibbons, Mr. Bill Collins, Dr. Lance Wyche, Dr. William George, Dr. Rick Erickson and Mrs. Kristi Graham. Dr. Keith House was not in attendance. Others in attendance were Mrs. Gina Prestridge, Ms. Cheryl Johnson. Mrs. Emily Neeley, Mrs. Elda Francis and Dr. Amanda Green. Dr. Gibbons called the meeting to order in open session at 5:32 p.m. Dr. Erickson made the motion and was seconded by Mr. Collins to approve the minutes from the meetings on January 26th and February 16th, 2015. All approved. Mrs. Francis addressed the board members and stated that she thought they had been misled from their last meeting about her practice and the method that she did her practice was discussed and she wanted to address the members and answer any questions they may have. Mrs. Francis advised that she did not do the referral forms, that she delegated this responsibility to her nurses. Mrs. Francis also stated that the number of patients being seen is out of her control and if a patient walks in then she tries to see them but she does want the nurse to advise her of any add -ons or walk -ins. Mrs. Francis had the RN and LVN write down the duties that they do for the FNP. Mrs. Francis advised that we have a high rate of no- shows and reschedules, but most of the time her patients are double- booked. Mrs. Francis advised that there is a lot of paperwork that the nurses have to do to comply with the grants and this reduces the number of patients that can be seen. Mrs. Francis advised that the Paris -Lamar County Health District has a huge absenteeism, so therefore she is working short- staffed a lot of the time. Mrs. Francis advised that the type of patients that she sees also takes a lot of time, such as bi- polar, depression, and lack of medical treatment for long periods of time. Also, Mrs. Francis advised that her numbers could be down during the month of March, due to weather days and the office being closed and well as spring break. Mrs. Francis also presented the board with a complaint on Mrs. Gina Prestridge, Paris -Lamar County Health District Executive Director. Mrs. Francis advised that Mrs. Prestridge had given her a letter dated March 12, 2015 and the letter stated that Mrs. Francis' weekly hours had been reduced from 35 hours per week to 20 hours per week. Mrs. Francis thinks the letter is very disrespectful and did not appreciate this conduct since she feels she has contributed a lot to the clinic. Mrs. Francis would like for the board members to consider adjusting her hours back to 35 or 40 hours per week and she would like their feedback. Dr. Gibbons asked how Mrs. Francis handles walk -ins. Mrs. Francis advised that she does them if at all possible, but advises the patient that they may have to wait. Also, Mrs. Francis advised that a lot of the time she does not know about walk -ins because the receptionist may have told them that we do not have any openings for that day, but if they are there and Mrs. Francis can work them in then she will. Mrs. Francis advised that if we have patients that are late, then she tells them that we will see them but she will see the patients that arrived at their appointed time and then she will work you in. Dr. Gibbons asked Mrs. Francis if she refused walk -in patients or patients that are late for their appointments if they are an hour late for their appointment. Mrs. Francis advised that she will not refuse to see them even if they are 30 -45 minutes late, then they are told to wait and she will work them in and will be seen, and the receptionist also tell the patients. This is Mrs. Francis policy, and always has been her policy since day one. Mr. Collins asked why Mrs. Francis had help 11 different positions since July 1990. Mrs. Francis advised that she was a Registered Nurse and in 1999 became a Family Nurse Practitioner, then worked at the next job for 5 years, then another 5 years at the next job, then 1 year and left for family obligations and cut back on hours worked and then came to Paris -Lamar County Health District after Dr. Amanda Green and Mrs. Gina Prestridge called Mrs. Francis multiple times during the summer asking her to consider a job at the Health District. Mr. Collins asked Mrs. Francis why she quit in November and then returned to the Health District in December. Mrs. Francis advised for a dumb reason. Dr. Atoria asked her to come work for him and she quit and then she started missing her patients so she came back and the Health District had been trying to replace Mrs. Francis and hadn't replaced her or been able to replace her so Mrs. Francis returned. Dr. Gibbons asked Mrs. Francis how many patients does she see in a day and how often or patients scheduled. Mrs. Francis advised that she does not have any control over the scheduling, the receptionist book the appointments, but she sees them however they are booked whether single booked or double booked, but paps take longer, so the receptionist know how long to book different types of appointments. Dr. Gibbons asked Mrs. Francis how the electronic medical records documentation is working. Mrs. Francis advised that the free version is not the greatest in the world but it is user friendly and she has built several templates and is using them. Mrs. Francis advised that she is an old IC Nurse and is used to documenting a lot and she is having to tone down with the EMR. Dr. Gibbons asked if anyone else had any questions for Mrs. Francis. All responded with no. Dr. Gibbons made the motion and was seconded by Dr. Wyche to go into executive session at 5:47 p.m. on Monday, March 23,d, 2015. In attendance were Dr. Mark Gibbons, Mr. Bill Collins, Dr. Lance Wyche, Dr. William George, Dr. Rick Erickson, Mrs. Kristi Graham, Mrs. Gina Prestridge and Dr. Amanda Green. Dr. Gibbons made the motion and was seconded by Dr. Wyche to convene into open session at 6:22 p.m. with no formal action being taken or needed. All approved. Mrs. Prestridge advised that Dr. Gibbons will need to sign the New Hope lease payoff document and the annual evaluation form on Dr. Amanda Green, Medical Director. Mr. Collins made the motion and was seconded by Dr. Wyche to change the by -laws to state that the regular monthly meeting will be held on the third Monday of each month instead of the third Tuesday. All approved. Mrs. Prestridge advised that we are currently operating on a temporary co fire alarm system, but we are in the process of getting a fire alarm system installed. Mrs. Prestridge advised that we have been awarded a new breastfeeding grant, Texas Healthy Community Grant, Legacy, Lennox, from Dr. Green and LDCSM, and the Medical Reserve Corp. Mrs. Prestridge advised that she attended a meeting in Tyler to discuss the E -PHC fee -for- service portion of the grant. Mrs. Prestridge presented the monthly figures for the clinic at 396, WIC close to 1,500, 26 restaurants, and 1 septic. Mrs. Prestridge advised that she had hired Mrs. Donna Callicoat to work 20 hours per week as a FNP in the clinic and Ms. Kristi Carter to work as a clinical LVN. Mrs. Prestridge advised that Sally Boswell with the Paris News will have a write up in the Valley Vision about the Paris -Lamar County Health District in April or May. Also, advertising on the radio and Dr. Amanda Green advertised for the Paris -Lamar County Health District inside the Marti Gras booklet. Mrs. Prestridge advised that Dr. Gibbons and Dr. George terms will expire on June 30th and we will start advertising for their positions as board members. The next meeting will be April 20th, 2015 at 5:30 p.m. at the Paris - Lamar County Health District. Dr. Gibbons made the motion and was seconded by Dr. Erickson for the meeting to be adjourned at 6:21 p.m. Respectfully submitted by: GhetylTJ. Johnson Approval motion made by Dr. Wyche and seconded by Dr. George at the April 20th, 2015 meeting.