July 2019 MSH Meet and Confer

AFSCME Labor Management MSH

June 20 2019 1230PM

Administration Building


Attendance: Adam Castle, Marvin Sullivan, Crystal Kreklow, Emilio Florez, Matt Stenger, Steve Wilking, Ryan Cates, Kurt Crosby, Lisa Vanderveen, Alli Kuhlman, Scott Melby, Roxanne Portner, Carol Olsen, Michelle Chalin


Reflection/Celebration: Carol-Admin renamed to Peterson building. Reception went very well. Thanks to ground, maintenance, and kitchen for the hard work.

Standing Agenda Items:

  1. OSHA Information-Handouts from Alli.
  2. 2.      Overtime Information-Handouts from Alli.

Old Business:




  1. 1.      LPN and RN Mutuals: Cates-Meeting with MNA next week and we can get back to you after that.

New Business:




  1. 1.      Organization Restructuring/Changes to LPNs Work Location: CATES-move Frazier to Birch? Roxanne-yes. The PowerPoint showed this as well. Cates-reason why nurses that worked Frazier can’t anymore? Roxanne-no. It’s just that now the nursing team covering the grove now doesn’t have LPNs. Cates-not because the patients, just because the grove changed? Roxanne-that is correct. Carol-we heard interest for people to stay where they bid. There are a lot of things that will happen but keeping people where they bid. Roxane-you are not bidding to a unit as a nurse. Where they cover will change. They don’t align directly with number of beds. Carol-when everything is done, there will be opportunity to look at it differently. So we wanted to keep people working with the same coworkers. Cates-just want to say that LPNs worked for years with high acuity. Carol-part of it was amount of restraints and need RN to give that permission. Also because we had difficulty filling positions. How do we organize units to still have flex with vacation and meet needs of patients? So it made more sense to fill high acuity with RNs because we had good hiring. Roxanne-we would love to have more LPNs but it’s tough to fill them right now. We don’t have the applicants.
  2. 2.      FMLA Problems/Member’s Paperwork from Doctor Gets Denied: Cates-a lot of issues not being told they don’t have the right info, then they get them the info and told they need more. Crystal-is there a new leadership there in St. Paul? We asked for higher level meeting and can’t get it. Alli-Mary Rudolph was but left last September. Shaun Tolfry deals with that now. We have had conversation to better assist staff here. We have been getting a lot of calls. If staff are having trouble let us know and we can escalate it. Kurt-we all agree it’s not us. I have had good luck with the local HR here. I haven’t heard complaints with this HR. Alli-a lot of confusion with new fiscal year. We can get more info out. I can take it to Mel as well to communicate to Shaun. Crystal-it’s throughout the state. They are denying everything.
  3. 3.      New Policy on one to ones? Cates-Weekly 1 to 1s being required? Carol-I wasn’t sure what the question was. Lisa-part of it was they have to define a week. That Thursday to Wednesday is the timeframe. I will do follow up to confirm and see if there is some flexibility. Cates-I would do it every Friday. Now you can’t do them the same day. Marvin-mixed messages. If it’s possible to go back to doing the same day every week. Carol-we will clarify. Kurt-we aren’t like everyone else and sometimes we have to do things different than other places.
  4. 4.      Patient Being Placed on 1:1 for Being Assaultive: Cates-in CRP. Patient always assaultive and making staff stay within 5 feet. What good does that do the staff? One staff won’t be able to intervene in a 2 patient fight due to training. Matt-the staff feels obligated to help. This could cause harm to the staff sitting there. I know of 3 instances when patient blows passed the 1 to 1. Scott-we know that presence around patients enhances the peace on the unit. Staff presence can stop that. The 1 to 1 gives opportunity to be there to watch for triggers and get help. We don’t expect any staff to intervene when by themselves. If you feel uneasy with patient, call for help. ICS, call a staff, etc. this needs to go back to that treatment team. Lisa-I can look into that. Steve-if someone is assaultive, they would potentially be in crisis mode, wouldn’t they be in crisis unit? That says potential OSHA reportable incident. Matt-I have asked clients what can we do to stop this and he says “move me to another unit” Scott-we need to go to treatment team. They can look at a different placement. Staff need to intervene but I don’t want to move someone else that can activate other guys we don’t know about. Kurt-5 foot barrier is a big thing. What is determination for 5 feet? If within 5 feet, chances of acting without thinking is increased when trying to help. Emilio-you can maintain a safe view of patients in most places here. We don’t even do windows alone. This also triggers other patients because they don’t like staff being around so much. It’s just as good as a 1 to 1 with line of sight. You aren’t intervening with one staff anyway. Don’t need to be that close. Scott-patients are complicated. Treatment team can review this stuff.
  5. 5.      Structure of Groves/OT, Inversing and Coverage: Carol-we have moved into groves last week officially. Roxanne-we are making no changes. Carol-staff schedule will remain the same in the grove as it has been in the past. Grove E and A are separate from B, C, D. Cates-so still separate. Any plan on combining? Roxanne-it could but for right now it is the same. Carol-never say never. Scott-FSSS has groves and we get into OT it will be offered program wide with inversing. We will evaluate it. Carol-we are going to combine FMH program. If there is a need, it’s by seniority and inversing by the whole. Everything forensic wide. Scott-no implementation date yet. Roxanne-has to be filtered through atlas before we can start. Scott-we will let you know. Carol-HSSS need
  6. 6.      Willow after Restructuring: Scott-2 bed units. No physical plant changes. Right now, I don’t know if we can say what patients. Where a patient goes, is a treatment decisions. It has been discussed with this patient could possibly go there but nothing has been determined. It is a fluid thing. Carol-we said that in our forums. Scott-encourage people to talk to supervisors. Carol-have staff make recommendations also.


Add Ons:

  1. 1.      Hospital Coverage with 2 staff: Cates-we were told you would try to have 2 covering in hospital. Steve-up at Abbott and HCMC. Cates-covering for FNH for sure. Steve-that’s where hospital won’t cover breaks. Scott-do we have a current issue? Cates-recent with FNH one staff last week. Carol-nursing home patient is possibly dying. Is 2 for help with breaks and bathroom? Cates-yes. Mankato won’t cover the breaks due to policy. Kurt-some will. Cates-I had a patient that wasn’t mobile and they stayed for me but if something were to happen. Scott-I appreciate it but if I tell you to work with hospital staff to cover and you try.  We have learned more with our practices. I need to learn more and get back to you.
  2. 2.      Forensic Nursing Home inversing and vacation on weekends: Cates-one vacation slot for 50 staff. Michelle-one slot on days and evening and one on nights. 45 between all shifts. Maybe 30 on days. Carol-we will take a look at it. Roxanne-it’s consistent with our practices. Cates-inversed every weekend they work? Michelle-not all of them, I will have to look. Scott-we have had a couple of weekends that have been tough but it’s not every weekend. It’s been tough with hospital coverages. Carol-looking at data from nursing home. Looks like inversing is 41.5 hours for the pay period. Scott-that shows overtime totals spike on July 6, Saturday. Carol-July 4, 5, 6 a lot of inversing. But something to pay attention to.
  3. 3.      Band Practice Back Filling: Not backfilling for the staff who went to band practice. We contacted OD and said he was supposed to be back at 5. We ask that when he leaves, backfill. Scott-we call the OD and make it explicit as well. Ill follow up as well. Scott-we made a commitment that band practice is important but we also need to make sure to fill in.
  4. 4.      Parking and Speed Bumps: Cates-across the road. In lane which you already hit a speedbump and stop in the middle again. Scott-so people slow down. Roxanne-people were going around. Cates-as long as they already stopped. I went over 12 times. Kurt-if someone could record and show why. Carol-we warned people. We saw some stopping and others going around the bump and pass the person who stopped. Scott-I know it’s an irritant but I want it to be safe.
  5. 5.      Scheduling in nursing home: Cates-HSSS new scheduling patterns done without rotation? Is this the practice? Michelle-I am not aware that is happening. Kurt-look into it and see if it’s happening. Michelle-yes, I will look into it.
  6. 6.      Bartlett 2 north and 2 south signing ancillary: Cates-someone told them this. Do they have to sign both books no matter where they are scheduled? Marvin-on 2 south I sign 2 north. Lisa-we can check on that. Cates-not sure who made the call? Lisa-maybe just evolved from regular staff. Marvin-are staff supposed sign them when they come back? Carol-Licensing questioned it. There has been a message that if you don’t sign on first day back you can get reprimanded. On first day back you can’t really get an ancillary. Matt-is it possible to explain to them that you don’t always have someone available. Carol-we started a conversation with licensing about a variance and this was part of it. They wanted to wait until the review. We have interest with that direction but don’t know where it will land. They own it, we don’t. It’s all on the table. Carol-I’m not sure where the message came about reprimanding if you don’t do the ancillary. Licensing had flexibility, they wanted to know why. Cates-even if we sign late, we have shift change meeting where we go through all of this information. Steve-is there disciplinary action if you don’t sign first day? Carol-that is not a message we have given.
  7. 7.      Findings for incident February 2nd: Kurt-findings were that imminent risk wasn’t met. It’s in the eyes of the staff member. You must accurately describe it. We have been told no one has been fired for this. Why did they get away with saying it wasn’t met but management doesn’t come back? It does have to be justified but reading the snippet. There are a lot of thigs that contradict what we are taught. Carol-that is correct I can’t judge imminent risk. Staff need to always document to best of ability what occurred to define imminent risk. We are doing critical reviews. Licensing comes in and does more. We provide what we know and what we did. In the end, they are going to determine what they determine. We got a fine, we will pay it. One thing we have to do is go back over what we did and how we can improve. Slow down, document well. If there is an opportunity to deescalate. We do that well and we document that. Kurt-people are doing a good job of waiting and we did wait, then got dinged. These people come in not knowing what it’s like here. It’s better to hear it from you. Scott-I can understand and glad the staff care. The fine is facility. Looking at our system. If there is something we can do we will. Carol-message we try to get through at forum. More critically we look at ourselves critically, the better we look to licensing. They see that and sometimes close investigations. Staff may not like all of the tough questions but internally it looks good to licensing which helps everyone. Roxanne-ultimately then decide. Carol-under DHS is licensing and there is us. If you want to appeal, I go to my commissioner to appeal their decision.


Adjourned at 135pm