Medical Review CommitteeJanuary 25, 20071
MEDICAL REVIEW COMMITTEE MINUTES
January 25, 2007
9:00 A.M.
Department of Correction
MRC: / CIVIGENICS:Joyce Talley, Chair
Tom Carroll, Warden-DCC
Raphael Williams, Warden-HRYCI
Mike Deloy, Deputy Warden-SCI
Ed Synoski, Deputy Bureau Chief
Jim Welch, Health Services Director-DOC / Mary Rose Worthington
Jim Elder, State Director
George Vose, Exec. VP of Operations
Linda Riddagh, Controller
LEGAL COUNSEL:
Aaron Goldstein
ABSENT: / CMS
Ken Parker, Regional Manager
Dr. Jay Conlon
Scott Altman
Susan Lynch, Mental Health Director
Jim Friedel, Corporate Office
Phil Morgan, Warden-Plummer
GUESTS
Steve Martin, University of DE
Maureen Querey, Office of Management & Budget
Jeremy McEntire, DOC Medical
Imad Jarwan, DOC Medical
IThe meeting was called to order at 9:00 A.M.
- Roll call was taken
A motion was made to go into Executive Session pursuant to 29 Del. C.§ 1004(b) 4 and 9.
All committee members voted in favor of the motion.
A motion was made to exit Executive Session at 9:27 A.M.
All committee members voted in favor of the motion.
- Review and acceptance of Substance Abuse/Treatment Minutes:
The December Minutes were accepted as presented.
- Changes or deletions to Agenda: Month of October is replaced with December under Item III.
V.Substance Abuse:
- Old Business – None
- New Business
- State Director’s Report – Jim Elder provided the committee with the
January 22, 2007 State Director’s Report regarding staffing issues.
New Horizons-at time of report two candidates were waiting for clearance,
however, (1) has cleared.
- DSAMH Licensure – There has been a good series of DSAMH audits.
Civigenics state office continues to monitor and support the 6 for 1
Corrective Action Plan.
- Green Tree South Program – December Management Report was distributed
to the MRC. Deputy Warden Deloy reported that they have completed one
grant and are starting another and should be good through September.
- Bureau Chief Talley asked Jim Elder if there were any problems with getting
background clearance from IA – Jim reported things are going well.
- (Welch) Reported that the meeting with Civigenics on 1/24/07 was to introduce
Imad to the staff. Jim Elder and Imad are meeting on 1/30/07 and will be
visiting Key South.
- (Vose) Thanked the MRC for their continued support of recruitment and
retention. This has been a major issue and the incentives for recruitment
have had a tremendous impact.
- (Worthington) Civigenics will continue to work on recruitment.
- (Deloy) Talked to Rita, Director of Key South regarding providing shirts
for the employees, and asked for Civigenics’ thoughts on the issue.
(Worthington) The shirts were part of a recognition event and were not
intended as uniforms. Uniforms are not included in the budget and it is
something they would have to do statewide. (Vose) Civigenics will put
together some numbers for the next MRC meeting.
A motion was made to go into Executive Session pursuant to 29 Del. C.§ 1004(b)9
at 9:45 A.M. All committee members voted in favor of the motion.
A motion was made to exit Executive Session at 9:57 A.M. All committee members
voted in favor of the motion.
- Issues for the Commissioner – Just to wish Commissioner Taylor
luck on his retirement and Civigenics is looking forward to working
with Commissioner Danberg and will assist with the transition in any way
they can.
- (Vose) Civigenics is also developing new ideas with regards
to some basic training for CO’s and/or special training for Civigenics
employees and DOC staff (i.e. brining in experts on issues from around
the country) with no cost to DOC. Civigenics would like to expand
their involvement and is “putting it on the table”.
(Welch) That is appreciated and DOC will probably take you up on it.
A motion was made to adjourn at 10:01 A.M. All committee members voted in favor of the motion.
- BREAK
Health Care Services Meeting called to order at 10:16 A.M.
- Review and acceptance of Health Services Minutes from December, 2006
The December Minutes were accepted as presented.
- Changes or deletions to Agenda: Month of October is replaced with December
under Item VII. CMS would like to add the following items under new business:
(1) Recruitment Report – Current spreadsheet
(2) Delaware Staffing Charts
(3) Dental Scope of Services
(4)Organizational Charts
(5)Archiving Update
(6)MAC Meeting Minutes to DOC
(7)Training on M&M documentation
(8)Equipment-Requests/monitoring/invoicing
- Health Services
(a)Old Business
- Staffing Updates-recruitment/hiring/vacancies – Ken Parker distributed
the CMS Recruitment Report and a summary of hours worked by site.
Recruitment Report-Nursing areas still the highest.
Old Business (Con’t)
- Summary of hours worked-The total hours worked column is the
number of hours actually worked. At some institutions the amount
is higher than scheduled hours because more hrs. worked than scheduled
due to NCCHC. At 103.5% for month of December also due to the
holidays. In future reports the agency percentage will go down.
The percentage of CMS staff was 88.72%.
- (Welch) What’s the difference between scheduled hours and CMS
regular worked hours? (Parker) The scheduled hours are based off
of CMS documents (they don’t change for CMS during the year).
CMS goes by calendar year, January 01 through December 31.
- (Welch) Asked Scott to make sure the hours in the Third Amendment
are included in scheduled hours.
- (Synoski) With this chart being presented, the scheduled hours column is
an arbitrary number and when presented at a % they are over inflated. A year
ago, the document Scott first submitted was correct. Every report since the
first one the numbers are over inflated.
- (Parker) Will get the report previously done by Scott and will give to Ed and
Jim for review and will use for future reporting. (Synoski) The information
on the current reports are useful to the MRC but not accurate.
- (Welch) Any specific vacancies? (Parker) Admin. Assistant at HRYCI is
being vacated in mid February. CMS is in the process of looking for a
replacement. In the interim, have people from outside of the system. Also
recruiting for Director of Nursing.
- (Lynch) At DCC for Mental Health Supervisor-has 3 internal and 3 external
interviews scheduled. (1) candidate is from Delaware, (1) Maryland and
another from Florida. Also looking at these applicants for Mental Health
Supervisor position at BWCI and SCI.
- (Parker) Also recruiting a local dentist for BWCI – has a teleconference
scheduled for 5:00 P.M. today. The dentist contacted CMS and is seeking
a full time position in Northern DE. However, he cannot take the
test until June.
- Discussion in progress regarding additional hours for psychiatry
at several locations (DCC, CVOP, Morris) Increasing hours at
HRYCI also.
- DCC is down one provider.
- PRN with CMS – continuing to use his services P/T
- Major concern at HRYCI-A plan for coverage and assistance
to stabilize situation.
- (Welch) Need to work on leadership on all shifts. (Conlon) CMS
has made progress in that direction. Conlon on the phone at
midnight a few nights ago making sure the sick slips were getting
picked up.
- (Welch) Need to make sure that if there are security issues, CMS
brings these to the warden’s attention ASAP.
- (Parker) Supervision on different shifts-As CMS brings people on
they are looking at hours overlapping especially the evening and
early morning shifts.
- (Welch) CMS needs to work with the Wardens on this issue and
make sure the warden knows potential staff and when they are scheduled.
- With regards to the Dental Guidelines, since Warden Williams did not
receive the information from last meeting, Jim Welch will review them
with him and contact Ken.
- (Deloy) Would like to receive Monthly CMS book prior to the MRC
meeting. (CMS) The monthly books were put in the mail slots at the
Admin. Bldg. and the mailbags for HRYCI and DCC. The MRC requested
that the books be given to the receptionist and she will make sure they
get sent appropriately.
- (Parker) The HSAs get with the wardens regarding the numbers in the monthly
book. (Deloy) The numbers from Scott, Jill and the CMS book he has the
numbers are always different. (Welch) The numbers Warden Carroll
received from the HSA are different from the ones in the book also.
(Parker) Site level is giving the numbers. (Deloy) When he receives
the CMS Book he will meet with Jill to determine why the numbers are
different. (Welch) At MAC Meetings the numbers are looked at.
(Parker) The MRC should have the ability to review the monthly books
before the meeting.
(b) New Business
- Dental Scope of Services – (Williams) If a person comes in and brings
dentures in from the outside, the dentist says to accept them. This however,
is not acceptable.
- Organizational Charts-Will provide within the next week. CMS will give
Jim one and give the warden’s a master copy.
- Archiving Update- (Scott) Spoke with staff and DCC will be ready by
January 31, 2007. HRYCI-files have been moved to the Regional Office
in Dover and staff will be working weekends to get them complete. Baylor
and CVOP records are complete and have been picked up.
- (Synoski) Thanked CMS for their effort with regards to the archiving
asked if it was ok to have the records stored at the Regional Office.
(Scott) They are stored in a secure area. (Welch) How soon will it
be before the files are out of the regional office (Scott) should be
completed by the end of February. SCI has 75 boxes that need to
be archived which Sue Chappell is working on. The forms are not
complete yet.
- MAC Meeting Minutes – All meeting minutes have been transmitted
to Andy. There was no meeting in December for SCI. There is a document
that states this.
- M & M Training – (Parker) Streamlining best they can will be glad to change
and coordinate with site at DCC.
- Equipment Requests – The fiscal year for CMS is different than DOC.
CMS will provide DOC with equipment requests. (Welch) SCI looking
at broader changes. (Conlon) Requested equipment that can be attached
to the wall i.e. BP cuffs, etc.
- Additional Item – (Parker) Physical Therapy – Meeting with a PT group
Who will do physical therapy on site. They are willing
to perform basic PT. They will be giving CMS a list of what they
can and cannot do. CMS will work out a contract for February.
(Williams) HRYCI has 2 fitness centers available-just need to work
out schedules. (Welch) It’s important to work as quickly as possible
CMS will have to work with the HSA on this.
- (Welch) Another problem with scheduling appointments with urologist
appointments are scheduled for the same site, but all different times of
the day (i.e. 10:00, 1:00, 3:30)
- (Conlon) With regards to inmates with chest pains, CMS would rather
send to the ER in case there is a more serious problem going on that
need special cardiac tests performed. Dr. Binyan is a Cardiologist so
this will help when he comes on board. (Deloy) If it is found that an
inmate is “abusing the system”, it needs to be brought to the warden’s
attention. (Welch) It would be more cost effective for CMS and DOC
and more secure if done in-house.
- (Parker) MRI-Will be starting by first of March. Will not be done every
week. DCC first then ½ day basis at SCI, HRYCI will be a little more
difficult but it is possible they can be done there too.
- Nephrology – CMS in the process of contacting a doctor interested
in this position. (Welch) Status on Activity Aid? (Parker) not sure.
There is greater recruiting difficult than anticipated with getting
a psychiatric RN (Welch) CMS may want to contact Wesley College’s
nursing department.
(b)Issues for the Commissioner – None
A motion was made at 11:24 A.M. to go into Executive Session pursuant to
29 Del. C.§ 1004(b)9. All committee members voted in favor of the motion.
A motion was made to exit Executive Session at 11:43 A.M. All committee members
voted in favor of the motion.
A motion was made to adjourn at 11:44 A.M. All committee members voted in favor
of the motion.
REMINDER: The next MRC meeting is scheduled for Thursday, February 22 at 9:00 A.M.
in Conference Room 300.
/bdl 1/31/07