4/21/16 MSH Meeting Minutes

Present: Stacey Mueller, Tom Keck, Kurt Crosby, Chris Hanson, Matt Stenger, Tim Headlee, Molly Kennedy, James Hemshrot, Amanda Castle, Ryan Cates, Colleen Ryan, Cindy Jungers, Michelle Chalin, Tom Christenson, Carol Olson, Lisa Vanderveen-Nagel, Katie Gleason, Scott Melby, Tom Kolstad

Follow up Items:
1. Private Security Company Usage
a. There were 26 – 1 way AMV Trips.
b. 111.25 hours overtime, 66.75 hours the Nursing Home had for the contracted company. CRP did not use the contracted company at all. The FNH was inversing staff to cover two separate residents until the contracted company could cover. It was only at the point of inverse that management engaged them.
2. HSSS title to SC/SCL’s
a. Carol Olson stated that she had talk to Melissa Gresczyk about this and right now we are waiting to see what happens with the funding request. Carol stated that we will have to go down numbers if we do not get more money because SC/SCL is a higher salary. Until we find out funding for 2017 there is not an answer. If there is additional funding and the title is switched that would mean less FTE’s.
b. AFSCME asked if when Anoka comes down if they will still be HSSS or SC’s. Management stated that that detail has not been discussed. Anoka moving is being considered in the budget legislative session.
c. AFSCME asked if there would be a hay study if we do do this and receive funding.  Management stated that they thought there would be an audit done to make the comparison and that they shouldn’t have to go through a hay study. Matt Stenger stated that Melissa Gresczyk had told him it would be done internally.
3. Intermittent employees (unit coverage/capable and qualified).
a. What kind of coverage do intermittent employees receive if injured on duty? Management stated that they are covered and that it is a worker’s comp issue. AFSCME asked how hours are factored. Management stated that they are not sure how worker’s comp would go about doing that.
b. Last month AFSCME mentioned that staff were having to cover outside of their bid position to accommodate where some intermittent staff were agreeing to work. Tom Christensen stated that this was when we were struggling with a lot of overtime and inversing. Intermittent’s can go onto Schedule Anywhere and indicate where they would like to work and management will try to accommodate as much as possible. Now OD’s are offering the spots that they know are available only. Carol stated that they did listen to what was said at last month’s meeting. Now Intermittent’s are told that they can’t guarantee where they want to work. They do have the option to say no. That has not happened more frequently since this change.
4. MSH OT distribution (call list).
a. Management stated that they have not offered MAPE overtime for a long time with an exception in Transition because they are down a few RN’s. AFSCME stated that they know of 1 MAPE staff being offered overtime a couple of times this last week. In this instance there were 5 AFSCME staff signed up out of the building. The MAPE staff was in the building.  Tom Christensen stated he would assume we should offer overtime within AFSCME first but this was at the point of inverse. He asked if we should call people who are currently working and inverse them instead of calling MAPE. We will need to look at how this should be looked at. Tim Headlee stated that he thinks it is being done correct but would like an improvement. Would like to see the OT sign up being used first. There is the factor that a person outside the facility may not answer. Management stated that the reason why non AFSCME staff were looked at was at the request of AFSCME.  If an AFSCME staff is inversed can they ask a MAPE staff to take it?
b. There will be a smaller committee formed to meet about this issue and get some clear answers.
5. Admissions Unit /staffing levels (weekends).
a. Has this been resolved? Scott Melby stated that to the best of his knowledge it has. He talked to Dan Seaquist about this and he stated that he has not been approached about this issue. He checked in with staff twice on that unit and has not heard of any concerns. Management asked if AFSCME has heard different. Molly Kennedy stated that she had heard the door with the courtyard was a concern. That there is a nurse and a staff. The unit staff ask the nurse to stay while they go out to the courtyard. Management stated that if there is no personal available, there should not be a courtyard. Scott stated that people should talk to Dan or Brian Wills or himself to try to solve this.
6. Current MSH vacancies (SC/SCL & LPNs).
a. There are 13 LPN’s across campus and 12 SC positions total 2 of which are dead bids that will move to the new hire pool. There are 6 SC’s starting in May. Management stated that the hiring pool has been working well for us but is a lot of work.
7. Budget Proposal Request
a. If we don’t get the funding we are seeking we are looking at a reduction of 50 staff. Currently at Forensics we have 48 employees that are unfunded. These positions have not been budgeted for. This is what Scott Melby was referring to in his testimony. We have positions that aren’t funded but know that with the current funding that includes cost of living increases. If we do not get additional dollars and do have to work with the current budget it equates to a 48 position deduction. Management stated that they are hoping and pushing the issue to get additional funding. AFSCME is helping with this.
b. AFSCME asked why we filled the positions and management stated that they were filled last year. Management stated that they are trying to do something similar to MSOP to get a better handle on the budget. 
c. In 2014 and 2015 we over spent 10 – 11 million dollars because of filling extra positions that were approved to meet licensing. Last session gave us 12 million for a 2 year span, so 6 million per year.  We started the year spending 10 million more but got 6 million.  The Governor decided that 12 million was what he was going to request. 
d. This year through the whole BMS process we are determining what the need is on this campus. Carol stated that she believes the Commissioner and the Governor will put together a budget that fits this campus. We are at a 3.8 million dollar deficit right now. If we get no further funding we will have to figure out how to manage this campus with the current amount. Carol stated that she does not know what that will look like. We will use the BMS process to help sort this out. We have to run the campus at budget neutral. Management is trying to drive the need for additional dollars home when meeting with any legislator for us to cut down on injuries and for them to stop hearing from this campus.
e. We are once again revamping the program to figure into our philosophy. Tom Keck asked why buy these programs if we are not going to run them. Management stated that that is a very clinical question.  There is not a person evaluating that. If you have questions on that ask for a full team meeting. Fulton folks were talked to and they stated that they evolved since this started.  They have changed what they are doing as well. We will continue to change going forward. There were a lot of things learned in regards to safety. They took a lot of recommendations. The social learning program is evolving as well. AFSCME asked if we ever got a specific number simply around SC staff to patient ratios. Management stated that they haven’t heard back yet but that it might be in the detailed staffing proposal. Overall staff in forensics are 2 to 1. SC ratios are different and very hard to compare like facilities. Not everyone has the same positions. Overall numbers are something we can compare.
1. Union Meetings & Requests for Time off
a. It is appreciated when advanced notice is given and hope to continue that moving forward with the realization that they have to go through with what we have contractually. If it creates a need for overtime management will have to look at as an organization.
b. Molly Kennedy stated that we get a calendar together for the upcoming year along with who would be attending each meeting. There are meetings every 2nd and 3rd Thursday. Tim Headlee should be sending scheduling a very comprehensive email. Matt Stenger stated that his schedule was given in advance but he was never scheduled off. TC stated that he will look into this. When this is noticed please bring it to management’s attention.
c. Scheduling needs to know what the meeting is and what it is for. Sometimes requests come through with only “union meeting” with no times or what it is about. Scheduling needs that to see what can be granted and what cannot.
d. Those on the overnight shift will collaborate on a plan for their schedule and get it to Jodi Culver. TC stated that he will work with scheduling to see if they have the information.
2. Day off changes for job postings
a. This was talked about amongst a smaller group. We have units where a vacancy was moved to the Utility Pool and what’s left behind is a unit where days off are getting out of balance. We will need to assess that and probably change people’s days off. Management stated that they will be looking into how many days’ notice is needed. A 14 day requirement has to be met but it is nice to give 28. This will be done by people’s preferences by seniority.  AFSCME asked what this will do to weekends. Management stated that it could potentially affect the amount of weekend days off. They are trying to cover holes in the schedule. We are short on weekends. To be fiscally responsible UP is being scheduled to work weekends.
b. AFSCME asked if the job posting can state the previous incumbents days off at the bottom.  It would say “Initial days off.”  Management will ask the Scheduling Dept. to do this. The 1768 will not need to be changed.
3. Construction Moves
a. AFSCME stated that they have heard from members on South Unit that they received notice regarding them moving to Bartlett 1 North. Management stated that that is not a notice. They put out a proposed movement of units when the new building opens up. This is just tentative. Management wanted to get people’s reactions to it. If they do move to B1N North and South will become CRP. This information has been shared with Unit Directors who then will share with their staff. North and South will not be filled because CRP is budgeted for 38 beds
b. Some units will be available in the fall. The Security Hospital needs to start planning now. The Admissions Unit will stay where it is right now. The initial plan is for Phase 2 of construction will last roughly 2 years before we can move into the final phase.
c. There will be an additional co-ed unit for those not in crisis. Women in crisis will be the Stabilization Unit. This is probably the biggest change.
d. The swing ability will make Unit 200 a lot larger and will reduce Unit 300 just by changing the direction of the swing.
e. Evaluations is a 2 – 2 bed unit. Stabilization will be 2 – 6 bed units. Men and women both in crisis will not be living in the same environment. This is the size of a space we do not currently have so now we will have more options. We are going to have a period of time to try some of these spaces out. New units will look the same. Some of this is confusing if you do not have the maps in front of you that you can find by going into 424.
f. Staff will have a lot of questions. There is not a lot of detail at this point but this is a rough idea of the intent. Management stated that the UD’s should be communicating regularly with their teams and field questions. We will be learning and making adjustments going into fall. There will be staff forums in May to field questions.
4. Meeting Minutes
a. There will be a new format for the meeting minutes. There will be a standard minute template with specific communication pieces. This is coming out of the BMS process. There should be a discussion about the communication and how it is broadcasted on campus. It could possibly be on the SharePoint site?
1. MSH manual restraints (length of time)
a. Tom Keck stated that he had heard a lot from members who were involved with a restraint on Unit 200 that lasted almost an hour. Medical staff were concerned and wanted to move toward a more safe intervention but it felt like they were not getting the authorization to do so. Tom asked if we don’t have to go hands on avoiding injury once we are why are we allowed to retrain for that long. Can a nurse make that call? There are two individuals who can give the order to go beyond. Staff do need approval at a Medical Director level due to the Jensen Settlement and Positive Support Rule. Both clients creating major problems fall under this. A Committed DD ties our hands. They may not be a settlement case but they fall under the Positive Support Rule. There is a list of the patients who fall under the rule or the settlement that require a Medical Director.
b. Management stated that in a situation like this staff should make sure they are using the equipment provided (i.e. knee pads) and are switching out with each other. Carol stated that it has been approved before to go to mechanical restraints. AFSCME asked what the threshold is. Management stated that there is not a set threshold and that there are a lot of factors considered by the Medical Director. It depends on the individual. Management stated that this is a tough situation and if it is not done right this will just put the facility in trouble. Carol stated that they are thinking of the staff there too. Staff struggling need to switch out more. Once the patient is on the ground they are under control. Moving a patient to a chair also involves risk. Kurt Crosby stated that if staff know it will be a 40-50 minute restraint they will be less likely to go hands on when this should happen.  Management stated that they are thinking about this. That they are not doing what we do. It’s difficult and is tough. We are under court order and there are statute requirements that we have to follow. Dr. Stevens is saying restraint chair or cuffs to get into a chair. We are always weighing that out because we are scrutinized so heavily. It’s a balance. Management stated that we are not trying to put staff safety at a lower level and are always trying to balance.
c. One of the patients creating a lot of assaults will be placed in a house soon. They are going through the process of hiring staff. Our campus will be assisting as much as possible with training these staff in who will be working with the said patient. Management stated that staff have done a phenomenal job with the patient on Unit 100. Those working for the house have contacted state employees for their input. Management stated that the house is a MSOCS home. They said that staff should be directed to work with their leader who will then contact our leader. Carol will bring this forward to Dr. Stevens.
2. FNH (break Schedule)
a. Molly Kennedy stated that she had heard from staff that they were being expected to finish their breaks by 5:45 pm if working the evening shift. Michelle Chalin stated that they try not to schedule breaks between 5 pm and 5:30 pm because of meal time. They are trying to schedule breaks around meal times and heavy care times. This change is being piloted. There were adjustments made last week after suggestions were given to Becky Kern. Michelle stated that they continue to look at this and tweak when needed. This is a work in progress. AFSCME stated that by contract breaks need to be mid shift. Michelle gave the break times they are following currently and they are mid shift.
3. Joint Labor M&C (404 attendees), MSH M&C
a. A list was provided for the BMS Labor Management Meeting of who would be attending from Local 404. It was a long list but AFSCME stated that it is what they felt they needed being a larger union and expected vacancies. Management stated that they are looking at a charter for the committee. It will be the whole committee that makes recommendations for what is the right proportion. Janet will help lead that. Carol stated that it does seem like 404 is coming with a lot of people and a reminder that people are coming with a 1 year and 2 year rotation. Carol stated that she will let Janet drive this. She will help us get this started in the right direction. The first meeting is May 24th. Joint labor meetings are for Forensics. This is not a meet & confer, which is around AFSCME. This is a carrying on of the BMS process.
b. MSH Meet & Confer attendees – will keep updated and move forward
4. Utility Pool vacation, days off vacation
a. AFSCME stated that there is a grievance for Unit 600 dealing with eliminating vacation. It was brought to AFSCME’s attention that an employee’s scheduled day off if included in their vacation request is being held as a taken vacation spot. Matt Stenger stated that this is eliminating vacation which goes against contract language. This is being done program wide. An employee did put in for vacation stating that one employee on the calendar for that date was their scheduled day off and the request was approved. Tom Christensen stated that that was done incorrectly.
b. TC stated that that spot is held because the employee’s days off can change. He stated that the employee should rescind the day 14 days out when they know it will be their scheduled day off. AFSCME stated that at that time the scheduling department will go by known needs and most likely deny any request coming in. AFSCME asked that the spot become open earlier within the time before the bid movement day. It would become open in the timeframe where no one’s scheduled days off are changing. TC stated that he will work with Cindy Jungers on this.
5. 7.5 hours between shifts
a. There is an MOU draft in progress addressing the 24 in 48 rule. Basically this will be drafted to read that you are not eligible for an inverse if you work 3 shifts in a 48hr period. There are some questions on the current draft. AFSCME and Human Resources are working on a meeting time for this.
6. Injured on Duty – Light Duty
a. Molly Kennedy stated that she is working with a member who was IOD and approved for light duty but given part time hours while others are working full time who were injured outside.  Management asked if this employee’s restrictions were in line with what other people are doing on campus who were not injured on duty. Molly stated yes. Molly stated that she understands that it is nice to let people come back light duty who were not injured on duty but those who were should take priority. Management agreed with this and thought that that is the current practice. Management would like specifics on the specific situation. Molly will follow up with this.
b. The Worker’s Comp group facilitates light duty. There are always a number of factors. Management stated that they would never deny someone who was IOD because of someone injured outside. An example of a situation where there’s a possibility of someone injured on the outside would take precedence is if the light duty task had to be done by a licensed staff. For example: someone who was doing specific nursing tasks that needed to be done by an RN would not be able to be replaced with a SC IOD.
c. There was an instance where an employee’s injury did not show up as a reportable even though the person did report. There were 2 employee’s involved with the same incident. One received workers comp and the other did not. The difference stated was that one person took a day off where that person came back that night then could not work the next morning and was sent home. The employee ended up taking sick time for 2 days instead of going back to their doctor. Cindy Jungers stated that everything goes through Workers Comp so they cannot give an answer. There will be one Workers Comp representative starting in May who will be on campus.
d. Page 85 under Return to Work, Section A it states “Each Appointing Authority and Local Union shall establish a joint committee to discuss ways to facilitate the return to work of employees on Workers’ Compensation.  This Committee may be an existing Labor/Management Committee or a new committee.”
e. ESAP is in our budget proposal. In order to roll out that program it requires specific training. It is a formal training process. There is a purple packet given to those IOD. This is currently not part of new employee orientation. Cindy Jungers will ask about that.