September 2021 CBHH/CARE Meeting Minutes

CBHH/Care Meet and Confer

September 23, 2021


Attendees: Ryan Cates, Eric Hesse, Steve Wilking, Judy Ehrman, Jim P, Heather T, Christina A, Fred Bettner, Bill, Elizabeth Trandem


Labor Questions and Updates

Old Business


Care St Peter

FT Positions (See Sheet)

Management Updates-

Christina – The GMW responsibilities -

Ryan - Mainly a GMW out there he has multiple responsibilities.... Doesn’t this align with the BSL instead of the GMW?

Christa- she spoke with Liz and Fred, look at doing a job audit... look at reclassify it into another position.  Will look into it


Christian- full time position for CBHH - got granted funding... new positions, (2) FTE

(CARE st peter logged out) Christina had another obligation


New Business


Care St Peter

GMW Responsibilities


CBHH Rochester


The Schedule continues to be posted with open shifts: Ryan- create conflict where schedule has open shifts?

Is this where the conflict comes from?

Heather - night shift got hit the most, LPN and RN onboarding for nights and should help with some of the open spots. 

Liz-Is it possible staff being out could cause some of the problems? 

Judy - The question was... will the positions being filled.... will they be filling the gaps?  The schedule won't have gaps

Jim- when the schedule is posted.... it’s filled.  It’s not until call-ins and such that there are gaps.

Judy - no... there have been 2 instances where the schedule is posted and its short.  it’s not until a couple days after that the call outs happen.  We aren't talking about leave or sick calls. we are talking about not having enough staff when the schedule is posted. 

Heather - yes you are also correct when the gaps are filled its going to help more.

Judy - is the staffing on nights going to be 4 or 3 staff?

Heather - based on the acuity,

Jim we don't think the standard will be 3.... we want it more than 3.  If we had to run at 3 it’s because we had an issue we don't mind answering the schedule.  I guess we would like more information so we can get it narrowed down. There is not a loss of overtime being offered

Ryan - how is it being offered?  When the need is known?

Heather - it’s called out based on seniority.  

Ryan - is there a list of shifts that can be filed?  Or is it called out when you see them or how does that work

Heather - we aren't putting a list out. 

Ryan - if a part timer wants to pick up a shift.... how are they to pick that up.  Intermittents we just call it out, you just call it out though. Emails were sent to ask for people to volunteer and change their shifts to eight hours and they are asking for people to roster adjust

Ryan - I suppose roster adjustment is the same as a voluntary shift change? Ryan-with how that works, are you asking them to work part of the shift or changing the shift?

Heather - it’s mostly RN or licensing staff

Ryan - are you doing it with LPN or HST... if it benefits them or staffing needs?

We currently have a patient on a 1:1 and there are 6-night shifts which are short for the next two weeks.  By short I mean only 3 people scheduled.  With censes running between 12 and 14, this is not enough


High numbers of incidents on the unit and short staffing: Jim-The incidents happening on the unit... they are relating to patient behaviors... can't say it is acting out because of the staffing pattern or mix.  we have had some difficult patients.  one of them we transferred 3 weeks ago and 1 last week they were creating an unsafe situation for our staff. we asked to get them transferred

Ryan-do you know what’s causing more aggressive pts to come here

Jim - you may get a referral it may look good on paper.  when you get them here... sometimes they aren't as good as they may appear on paper.  if we can't get the behavior to change.... then we are actively advocating to get them gone

Jim - we are aware we have staffing challenges.  If i were to show you my list... I’ll show it to ya.  in addition to trying to get positions filled.  we are trying to lower our cap so we can maintain the staffing.  through most of the spring... our census was 13, its going to fluctuate.  July, we went and asked the cap lowered to 12. staffing was tight.  we did have some resignations in July. We have been staying at the cap for 12 at now.  the daily census...we are seeing the numbers go down.  we are running really between 10-11 and we are trying to work onboard with that. 


HUC Update: Jim - we have an approved budget and staffing plan.  we have a plan to convert an HST position to an OASI.  it will be similar with amrtc has on their units.  I talked to finance and its feasible to do it.  working with Fred... waiting on decision on proceed.

Judy - why would we need to lose a floor person. 

Jim - we have to use a position we have vacant to create the function. We have vacant HST for the huc.  the easiest way to get it accomplished is to turn it into an oasi. 

Ryan - follow up question... converting the oasi... will it create any staffing issues as an HST. 

Jim - awaiting on green light and will create the 1768 and get it created.  Budget it may be a 2nd quarter higher...

Liz it would have to go to a job audit and create a delay.



Wrap up and miscellaneous

Next meeting scheduled: Liz - next meeting will be in October...