4/8/10 MSH Meeting Minutes

Present: Chuck Carlson, John Knobbe, Molly Kennedy, Connie Anderson, John Collins, Ann Sullivan (Recorder), Larry TeBrake, Nancy Draves, Jasmine Bohnert, Denise Gardner, Becky Kern, Jo Blaschko, Tom Christensen, Colleen Ryan

Old Business:
1. Work Rules Review
a. Rescinding vacation:
1. Tudy Fowler and Scott Grefe will need to meet and get on the same page regarding this issue. Both the union and management are seeing this as an expansion of language. Nancy Draves will contact Tudy and have her contact Scott.
b. Overtime work Rule:
1. Electronic overtime sign up is ready to go. There is a CBT available on Pathlore. Lynn Butcher will be monitoring the training. TC and Lynn have set Monday April, 19th beginning with the 6:00am shift as a roll out date for this. The CBT is not mandatory. The union and management agreed that if people want to know how to sign up (and the sheets are gone) they will either figure it out or complete the CBT. OD’s will use both the electronic sign up and the sheets until the sheets are gone.
2. Denise will update the work rule and send it to Chuck. A link to the work rule will also be sent out.
2. CRP: Joint SPRTC/AMRTC staffing up – possible bumps from Crisis Center Mkto
1. Chuck received a list of the hires from Tudy. Chuck asked about the timeline. Colleen Ryan does not have an exact timeline and stated that she hopes to have people begin in June. Larry Tebrake said the hope is to not lay people off and re-hire them a month later. If the timing doesn’t match up the hope is to have them work in the FNH until June. This depends on if they are a HSSS or CNA. Colleen and Larry are no longer attending the planning meetings as the facility will no longer be forensics. Beck Kern is now taking over. Management is unsure of the layoff numbers but stated that Crisis Center LPN’s should have opportunities locally.
The Department of Health will be here April 29th to survey the Nursing Home building for licensure. Anoka and Bartlett 1S patients will reside there. The nursing home will not be a secure facility and will require review board hearings to change commitment status.

3. Safety
a. Follow-up on Focus groups and safety meetings
1. The notes that were taken by Pete Thomsen during the meetings with Dr. Sulik are being compiled and we can expect a follow up SOFS email next week. No new information was brought forward, but he heard what was being said and will be working on solutions.
2. A non-violence message/plan will be presented to the patients. Larry asked for input on what should be said to the patients and who should say it. Chuck suggested that the message be delivered by an appointing authority that does not work on the unit. John Collins spoke about the urgency of this message getting out to the patients, the importance of the message being at their level, and the impact that this message will have in reassuring staff. Talking to the patients about the use of restraint and seclusion was mentioned as a way of getting patients back on track. It was estimated that Larry would deliver this message to both patients and staff on Tuesday 4/13/10.
3. Mixed messages regarding restraint and seclusion were discussed.
a. Nursing is to be the last step in authorizing seclusion, but what is to be done when there is not a nurse on the unit? Authorization can be done over the phone or the radio in this situation. TC and Jo suggested the use of radios more, not just for ICS. We have the opportunity to get people there fast with the use of radios (instead of paging). Jo Blaschko wants to know about situations in MSH where we have to wait more than 10 minutes for a nurse. Nursing should be communicating with staff when leaving the building and a backup RN should be identified.
b. The goal for everyone involved is to reduce violence! When we start with the least restrictive measure and end with seclusion, documentation will show progressive discipline. When there is a pattern and we know the next step is violence we absolutely should intervene.
c. De-escalation plans, specific patient release criteria, and patient responsibility for non-violence were all discussed. We need to be in line with other facilities and JCHO standards are being looked into.
4. Supervisors are going to be expected to have monthly meetings and to communicate with staff on a regular basis not only to discuss negative/bad things but also to talk about talk about positive things. Leadership wants to know this information also.
5. Chain of command/organizational charts need to be worked on. Staff no longer feels they are working for one team. With each member reporting to a different supervisor the team feeling is no longer there and it is unclear where the lines of authority are drawn. The treatment director, operations director and clinical lead roles are very unclear.
6. The union feels that investigations are a part of the morale problem. Many members feel that they are being interrogated as opposed to investigated. It is understood that VA investigations still need to be done, but it was asked that the process for them be looked at as well.
b. SC Injury rate/Staffing Levels/Unit Minimums/Building extra:
1. Melissa Jensen is looking for volunteers for the Peer Support Program to provide support to staff post injury.
2. A supervisory follow up list is being worked on for staff support after being injured.
3. See Current Business #4 regarding building extras.
4. SOFS Budget numbers - plans
1. Larry said the first area that is being looked at is non-salary issues; blackberries, cell phones, laptops, and personally assigned vehicles for example. Some changes have already been made such as blackberries changing to cell phones and management vehicles being unassigned. They are looking at copiers and scanners going to multifunction machines in order to reduce the cost of toner (an estimated savings of $150,000-$200,000).
2. Another are that is being looked at is Pharmacy- reducing Rx cost. They are estimating a 1 million dollar savings in adult mental health and .2 million dollar savings in forensics.
3. Out of state travel/training has already been eliminated. There is also talk about other training and tuition reimbursement being cut.
Salary numbers were not talked about in this meeting due to time constraints.

Current Business:

1. Cameras in staff areas- deleted from agenda due to lack of information.
2. Shantz AED/ Med room->count coordinator
1. The Shantz building is owned by Forensics and MSOP is renting the second floor, the basement, and the Control Center. John Knobbe asked about MSOP taking over additional space in the Shantz nursing core. The omnicell and AED were supposed to remain there, but now this area has become the count coordinator area. The omnicell is still there but the AED was moved and unable to be found one night. John K. stressed the importance of the AED being easily accessible for Shantz 1W. Larry wants to know about any problems that arise and he will meet with Mary Kreykes, Jaime Fromm, and Bonnie Wold to help resolve them.
3. Six-month Probation Periods
1. The union asked why anyone should have a probation period when transferring between MSOP and MSH. Larry stated that this is a decision made at a higher level than us- it is a DHS/SOS Human Resources decision. Currently staff transferring from MSH to MSOP is required to go to 7 day training on Moose Lake and staff transferring from MSOP to MSH is required to attend 2 day SOS training in Anoka. Larry is working with Pete Thomsen to eliminate confusion. John K. asked about written time lines. Denise and Larry said there is written SOS information that was updated within the last couple months. Some staff has started on their new units before completing the training because the SOS training is only offered once per month. Management wants people to have time to complete CBT’s and feel ready and safe on their new units before they are assigned A-team and additional duties.

4. 3 person discussion
1. In the past we had 3 building extras scheduled even if this meant overtime. This was done to assist with outer yard, visits, staff going home sick, etc. and was useful so that units did not have to run short in these situations. Management suggested that this staffing come from eliminating campus security or reducing unit minimums to account for these extras. The benefits of having Campus Security and the politics of eliminating them were discussed. The union was asked to come up with ideas about adding 3 additional staff in the evenings without additional cost. There is currently one building extra scheduled on both the early and the late shift. The union suggested that the building extra be pulled from the early shift and the units could enlist the help of BA’s, Social Workers, and RT’s if needed. This extra could then be added to the late shift and the need would then be only for 1 additional security counselor each evening.
5. Sick Call Reporting-
a. It is a MMB directive that specific information be asked regarding sick calls. TC and Kim Bakker will come up with a script for the OD’s. Information such as; infectious/non-infectious, self/family member will be asked.

Step 3 Grievances :
3 step 3 grievances filed.