10/31/09 - Dr. Paul Mann reported to the Block Island Health Services board Monday that the Medical Center would follow the protocol established by the state regarding administration of the H1N1 vaccine. The state follows guidelines set down by the Centers for Disease Control and Prevention.

Those priorities dictate that pregnant women and young children should be the first to be inoculated because these are considered to be the most vulnerable populations. Mann said that while the local center currently has sufficient doses of seasonal flu vaccines, at this time there is a limited supply of the H1N1 available, “which means we need to prioritize.”

As more of the vaccine is made available to the island center, Mann said, the staff would be “doing school kids in two sessions.” The Rhode Island Health Department has reminded the public that the H1N1 vaccine does not replace seasonal flu vaccine, but rather “it is intended to be used alongside” it.

After the first priority group, the state has set up the following order of populations to receive the vaccine: school-aged children (kindergarten through 12th grade); young adults between the ages of 19 and 24; household caregivers; health workers in direct patient care; elderly over 65; and healthy adults (25 to 64).

Executive Director Monty Stover pointed out the center received regular updates from the state.

Mann also reported that Dr. Peter Krause had spent a day at the medical center conducting Lyme disease testing, which has been part of his research on the disease for over a 20-year period. Krause, who is on the faculty at Yale University in their Division of Epidemiology of Microbial Diseases, saw more than 90 people while here.

Planning a retreat

The board discussed setting up a one-day retreat in order to define the medical center’s role in serving a shifting patient population.

As Kay Lewis described it, in addition to the year-round community, “We serve long-term and short-term visitors.” She added, “We need to evaluate our size and many of the assumptions operating out there in the public.” Visitors have expressed surprise that there is no medical lab at the center. Even a recent survey of year-round residents indicated many residents were not aware of the services provided by the center.

In addition, Lewis said, “We need to look at ourselves and what reasonable aspirations we should set for ourselves given our size, the size of the community, the money we can raise, etc. The first step is for us to be clear among ourselves.”

Recently, Lewis explained, she and two other board members had attended a meeting of the Rhode Island Health Centers Association (RIHCA). The group is an umbrella agency for 10 medical centers within the state — including the island — serving a total of 112,000 people.

Part of RIHCA’s charge is to update community health centers about policies and policy changes affecting patients. The group also serves as a resource for legislators, and works with the state to improve programs affecting health care, especially of uninsured and underserved patients.

Lewis said she had returned with recommendations from RIHCA and thought it would be useful to examine them at the retreat, “to ask ourselves are we doing these things?”

As one of her goals for the retreat, Lewis said, “I think it would be important to take a look at everything, e.g., our committee structure, and see whether we are covering all the bases and try to come to a better understanding of our responsibilities.”

Lewis said she was arranging for a medical sociologist at the University of Connecticut Medical School to come out to address the group.

Lewis said, “Hopefully, she can help clarify what’s reasonable for us.” Among other things on the agenda is “whether we want to pursue being designated a rural practice.” This issue has come up again and again at board meetings, but as Lewis pointed out, “There’s never enough time to discuss it. The retreat will give us time.”

A date for the retreat has not yet been announced.

Sliding scale alternative and budget status

On another matter, Stover said he had been in contact with Health Access Rhode Island (HARI), with a view to becoming a participating provider. According to Stover, HARI is “used as an alternative to a sliding scale, increasing access to primary care services for people who otherwise can’t afford it.” He added, “It will be interesting to explore this.”

Regarding the capital budget for 2010, Stover said he was working on three projects: improvements on the Davidson house, placing solar panels on the center building, and the development of the property. On the latter, he noted, the center is considering adding another house.

Summarizing and comparing current patient visits and receipts with those of last year, Stover indicated that visits were up for September at 461 visits, 80 over last year’s figure of 381. Services charges were up for September approximately $7,000, but down for the year around $15,000. Cash receipts were up $7,000 for September and up at $16,000 for the year-to date. Accounts receivable came in at $81,000 for 2008 to 2009 dates of service compared to close to $99,000 for 2007 to 2008 dates of service.

Stover added that though wages were running approximately $14,000 higher this year they were not entirely responsible for the $14,000 deficit the center is looking at. Rather, the deficit also reflected a downturn in investment income and that grants had not yet been received.

Noting the recent receipt of two grants, Stover said: $7,000 came in from the Roosa Family Foundation and $5,000 from the Rhode Island Legislative Grant for Public Health Nurses’ Offices. The Roosa monies were the last installment of a $21,000 grant spread over three years.

Fund-raisers

Reporting on the most recent fund-raiser, President Millie McGinnes said, “The ‘Heat it Up!” event was great! There were lots of people and lots of food and we did very well!”

The goal of the event was to bring in enough to pay for a new furnace for the center.

Stover said, “We took in well over $9,000, with money still coming in. We have enough to cover the boiler.” He noted he had been working to obtain the boiler at cost for the center.

The next big fund-raiser, the “Lights of Love” campaign is “coming together,” said Stover.

Exploring a zoning change

McGinnes reported that she had been working with the town planner about drafting an ordinance creating a medical zone. The re-zoning would allow the Medical Center to develop its property as it saw fit. As Judith Cyronak explained, “We’re in a residential zone now and we must get special use permits for any changes we need to make. This change would facilitate making those changes as needed.”