Name of Observer:  Judy Hucka 
Observed Meeting:   Whidbey Health Board of Commissioners
Date of Meeting:  June 20, 2024
Members present: James Golder, president; Ron Wallin, Gregory Richardson, Marion Jouas (virtual), Kate Rose
Members absent: none 
Others present (staff, media, public): CEO Nathan Staggs, Dr. David Lemme, chief of medical staff (virtual), Dominic Symes. HealthTech EVP/Staffing Solutions & Chief Revenue Officer; Shanna Harney-Bates, Quality; Paul Rogers, CFO; John Gleason, administrative chief of staff. 
Others present (staff, media, public):  Vicki McFarland (spelling not confirmed), Whidbey Island resident.


Summarize the main issues discussed at the meeting:
The meeting consisted solely of regular staff and status reports. Of particular interest is always the Finance Report, given the financial problems the hospital district experienced a few years ago. The financial trends are mostly improving, though this warrants careful monitoring by our Observer Corps. 


According to CFO Paul Rogers:
Patient volumes are up significantly, which is good. Of particular note are increases in newborns, indicating WI residents are using the hospital to deliver their babies, and outpatient visits, “our strong suit” according to Rogers.


Gross patient revenues are up (“a record”) and May ended with a total revenue surplus of $768,000 (the first time in the black this year), long-term debt is down (though still high compared to industry benchmarks), accounts receivable are down (meaning the hospital is collecting money owed to it faster), cash on hand is improved. The overall Financial Strength Index rating is still negative and rated “poor,” “but is moving in the right direction.”


Related to this, Moody’s recently downgraded the district’s bond ratings, but Rogers noted that the district may be able to improve its rating in 4-6 months.


CEO Nathan Staggs noted that the hospital has added a net of 27 providers since Jan. 2023 and hopes to expand hours at pharmacies and walk-in clinics soon. He noted that wages are competitive, but lack of affordable housing is a challenge. Temporary “traveler” nurses are still required in some areas of the operation. 


List any issues on the agenda relevant to any LWV state or local positions or programs: 
(League positions can be found here:  - LWV Whidbey Island)

Do you recommend local League action or study on any of these issues?      N/A
If ‘yes’ what action do you recommend?


Was the meeting conducted in an open, business-like, and civil manner?  Yes


Consider the following questions and respond if relevant:


Was the agenda made available prior to and at the meeting? Yes
Did members adhere to the provided agenda? Yes
Were any non-agenda items discussed?  No
Was there adequate discussion of issues?  Yes
Were any “Executive Sessions” called? No
Was there adequate opportunity for public input? Yes
Was background material available to the public? Yes, upon request
Did any member recuse themselves during the meeting? No
If yes, for what reason?


List any other concerns or observations:


Observer E-mail: Judy Hucka                                            Date submitted:  6/25/2024

Name of Observer:   Judy Hucka 
Observed Meeting:   WhidbeyHealth Board of Commissioners 
Date of Meeting:  3/21/2024 
Members present: James Golder, president; Ron Wallin, Gregory Richardson, Marion Jouas, Kate Rose 
Members absent: none  
Others present (staff, media, public): CEO Nathan Staggs, Dr. David Lemme, chief of medical staff (virtual), Dr. Garth Miller, Shanna Harney-Bates, Quality; Paul Rogers, CFO; Tim Waldner, Ancillary Services; Chris Tumblin, WhidbeyHealth EMS; ; John Gleason, administrative chief of staff; . Dominic Symes, HealthTech EVP/Staffing Solutions & Chief Revenue Officer; Patrick Banks, HealthTech AVP/Regional Finance Officer.    
 
Summarize the main issues discussed at the meeting: 
 
--Approved resolutions to place EMS (emergency medical services) tax levy proposal on August primary election ballot. Six-year levy would be a renewal of current six-year levy. Tax rate would remain the same -- $0.50 per $1,000 of assessed property value. However, property owners’ tax bills are expected to go up because property values have increased. This levy provides major portion of operating revenue for WhidbeyHealth EMS.  
--Approved lease of replacement telemetry system. Purchase price is $1 million, and WH is hoping Whidbey Health Foundation will raise money for this at its annual fundraising gala. In the meantime, they will lease the system. Current system is at end of life and at risk for failing. Expected life of new system is 10 years plus. 
--Cyber security. Dominic Symes of HealthTech, discussed the threat of cyber attacks, the need for training to prevent them and preparation in case they happen, and the large potential costs if they happen. Patrick Banks noted that WhidbeyHealth intends to be prepared and is going to make this a focus, including staff training about password security and the danger of clicking on phishing links in emails. 
--Dr. Garth Miller gave a detailed presentation on Accountable Care Organizations, a part of the Affordable Care Act that all hospitals that have traditional Medicare patients must implement. The goal is to reduce costs and improve care quality for Medicare patients. Hospitals must meet certain financial and quality targets, and if they do, they are eligible for a share of the cost savings.  
--After executive session, the board returned to regular session, and approved the purchase of a building at 101 NE Birch St. to house the hospice and palliative care departments. The purchase price is $725,000 and WhidbeyHealth Foundation will provide around $700,000 of that. 
List any issues on the agenda relevant to any LWV state or local positions or programs: EMS levy 
(League positions can be found here: Positions - LWV Whidbey Island) 
 
Do you recommend local League action or study on any of these issues?  Yes 
If ‘yes’ what action do you recommend? 
 
WhidbeyHealth EMS has sent us (LWVWI) an email offering to provide us a presentation in the next several months to learn more about WhidbeyHealth Emergency Medical Services  and the levy proposal.  While we cannot include the EMS levy as part of our candidates forums, we might want to consider a member and/or public program on WH-EMS and the levy proposal. 
Was the meeting conducted in an open, business-like, and civil manner?  Yes 
 
Consider the following questions and respond if relevant: 
 
Was the agenda made available prior to and at the meeting? yes 
Did members adhere to the provided agenda? yes 
Were any non-agenda items discussed?  no 
Was there adequate discussion of issues?  yes 
Were any “Executive Sessions” called? yes 
Was there adequate opportunity for public input? yes 
Was background material available to the public? yes 
Did any member recuse themselves during the meeting? no 
If yes, for what reason? 
 
List any other concerns or observations: 
 
Observer E-mail: [email protected]                                           Date submitted:  3/22/2024 
Please submit your report to the Observer Corp Committee at [email protected] within one week of meeting date.   
 
Last revised: May 13, 2023 
 ​

​Name of Observer: Judy Hucka
Observed Meeting:   WhidbeyHealth Board of Commissioners
Date of Meeting: September 21, 2023
Members present: Members present: All five commissioners were present: President Ron Wallin,
Gregory Richardson, James Golder, Morgan Cooper, Eric Anderson. Commissioner Anderson attended remotely via Zoom
Members absent: 0
Others present (staff, media, public):  Staff members present: CEO Nathan Staggs, chief of staff, Dr David Lemme (attending remotely), John Freeman (Associate Vice President of HealthTech Management Services), Shanna Harney-Bates (Quality), Paul Rogers (Finance), needs updating from recording.

Summarize the main issues discussed at the meeting:
I was unable to attend the first half-hour of the meeting. Recordings of meetings are generally not available until 30 days after the meeting. I will update this report when I can view the recording.
The meeting was primarily devoted to routine reports. There was good news from a “patient experience survey” with a score of 1.04. Anything above 1.0 is considered “better than average.”
There was discussion of a new walk-in clinic in Coupeville that is in the works. The commissioners regularly say WhidbeyHealth needs to do more to promote its growing services and improving financial and management situation to the public. A new marketing manager is now on staff. Her first task is upgrading the district’s website.

Financial news was mixed, with some good news and some cases of not meeting budget projections. However, the consensus is that the financial situation is consistently improving. In the recent past, the district had to pay back Medicare overpayments. However, the situation has changed and now Medicare has underpaid the district and owes the district money. The district continues to make progress in hiring medical staff, reducing the need to hire expensive traveling and temporary staff.

List any issues on the agenda relevant to any LWV state or local positions or programs: 
(League positions can be found here.
None

Do you recommend local League action or study on any of these issues? No    
If ‘yes’ what action do you recommend?

Was the meeting conducted in an open, business-like, and civil manner?  Yes

Consider the following questions and respond if relevant:
Was the agenda made available prior to and at the meeting? Yes
Did members adhere to the provided agenda? Yes
Were any non-agenda items discussed?  No
Was there adequate discussion of issues?  Yes
Were any “Executive Sessions” called? Yes
Was there adequate opportunity for public input? Yes
Was background material available to the public? Yes, I assume so.
Did any member recuse themselves during the meeting? No
If yes, for what reason?
List any other concerns or observations: None

Observer E-mail: [email protected]                                            Date submitted:  9/26/2023

​Name of Observer: Judy Hucka
Observed Meeting:   WhidbeyHealth Board of Commissioners
Date of Meeting: August 17, 2023
Members present: Members present: All five commissioners were present: President Ron Wallin, Gregory Richardson, James Golder, Morgan Cooper, Eric Anderson.
Members absent: 0
Others present (staff, media, public):  Staff members present: CEO Nathan Staggs, Dr. Robert Wagner, (former chief of staff, filling in for Dr David Lemme), John Freeman (Associate Vice President of HealthTech Management Services), Shanna Harney-Bates (Quality), Paul Rogers (Finance), Tim Waldner (IT/Ancillary Services), Samar Arny (Director, WhidbeyHealth Foundation).\

Summarize the main issues discussed at the meeting:
The meeting was primarily devoted to routine reports. One recurring topic was progress being made in attracting new providers (doctors, nurses, etc.) to WhidbeyHealth, reducing the need to hire temporary locums, which are expensive. This is a reflection of the improving reputation of WhidbeyHealth and the positive turnaround in management, finances and staff morale. Another recurring topic was the nationwide problem of long wait times to see primary care providers, which WhidbeyHealth is also experiencing. Financial results for July were somewhat mixed, due to a variety of factors. Still a sense that financial situation is gradually improving.

A new women’s clinic is opening soon near the hospital in Coupeville. A new CT unit is being built.

Continuing discussion on the need to market WH’s services and tell the community about the marked improvement in management, finances and health care services. A new marketing director has been hired and will be on board soon.

List any issues on the agenda relevant to any LWV state or local positions or programs: 
(League positions can be found here.
None

Do you recommend local League action or study on any of these issues? No    
If ‘yes’ what action do you recommend?

Was the meeting conducted in an open, business-like, and civil manner?  Yes

Consider the following questions and respond if relevant:
Was the agenda made available prior to and at the meeting? Yes
Did members adhere to the provided agenda? Yes
Were any non-agenda items discussed?  No
Was there adequate discussion of issues?  Yes
Were any “Executive Sessions” called? No
Was there adequate opportunity for public input? Yes
Was background material available to the public? Yes, I assume so.
Did any member recuse themselves during the meeting? No
If yes, for what reason?
List any other concerns or observations: None

Observer E-mail: [email protected]                                            Date submitted:  8/17/2023

​Name of Observer: Judy Hucka
Observed Meeting:   WbidbeyHealth Board of Commissioners
Date of Meeting: 04/20/2023
Members present: All five commissioners were present: President Ron Wallin, Gregory Richardson, James Golder, Morgan Cooper, Eric Anderson.
Members absent: 0
Others present (staff, media, public):  Staff members present: Dr. David Lemme (Chief of Staff), John Freeman (Associate Vice President of HealthTech Management Services), Shanna Harney-Bates (Quality), Dr. Garth Miller (COO), Paul Rogers (Finance), Tim Waldner (IT/Ancillary Services), Curtis Shumate (Nursing), LaJolla Peters (HR). New CEO Nathan Staggs attended remotely via Zoom but had a poor connection.
Member of the public: Vicki McFarland.

Summarize the main issues discussed at the meeting:
Electronic health records consulting contract. This is a $2.455 million 16-month contract with the consulting firm Tegria to provide consulting for the implementation of a new electronic health records system. The hospital district is migrating from two disparate EHR systems to a single integrated platform (Meditech) and upgrading from Meditech 6.08 to Meditech Expanse. 

Commissioner Gregory Richardson raised concerns that he had not been given adequate time to review the proposed contract, which had been reviewed and recommended by the Finance Committee. He noted that he did not intend to be a “rubber stamp” for staff recommendations and that the commissioners’ job is governance and oversight. He asked that in the future commissioners be given at least two days before a meeting to review complicated and high-cost contracts and other proposals before being asked to vote on them.
CEO Staggs agreed that information should be provided earlier. However, he said that multiple people with multiple areas of expertise were involved in recommending the contract. After some
discussion, Richardson said he supported the contract and it was approved unanimously.

Medical staffing. Both Chief Operating Officer Dr. Garth Miller and Executive Director of Nursing Curtis Shumate noted some progress in hiring doctors, physician’s assistants and nurses to address what is a nationwide shortage of medical providers. Shumate noted that he is continuing to work to reduce the need to use expensive traveling nurses. There was mention of increased workplace violence and behavioral problems; staff is monitoring this situation and implementing training to deal with it.

Financial status. John Freeman and Paul Rogers noted continuing improvement in financial status, with several key indicators favorable over the same time last year. A report from state auditors is to be given tomorrow (April 21) and the commissioners plan to attend. It was determined this was not a public meeting.

Commissioners Comments: Commissioners noted that it has been one year since the hospital contracted with HealthTech to provide management services. They agreed this has brought the hospital to a much better position, but they would like a report on the total costs of this arrangement.

Several times during the meeting, commissioners noted that the hospital is in much better shape than a year ago and that most of the serious problems (financial, management,
staffing) are behind it.

Executive Session. The Board clearly advertised an executive session for “education” with legal adviser Brad Berg. No more specific topic for the executive session was stated. When the board came out of executive session, Board President Wallin stated that no votes had been taken or decisions made.

List any issues on the agenda relevant to any LWV state or local positions or programs: NONE

Do you recommend local League action or study on any of these issues? NO  

Was the meeting conducted in an open, business-like, and civil manner?  YES

Consider the following questions and respond if relevant:

Was the agenda made available prior to and at the meeting? Yes, but no supporting documentation.

Did members adhere to the provided agenda? Were any non-agenda
items discussed?  
Tegria contract was not listed on the agenda.

Was there adequate discussion of issues?   Yes, there was a bit more discussion than the previous
meeting I attended.

Were any “Executive Sessions” called? Yes. For “education” with legal adviser Brad Berg.

Was there adequate opportunity for public input? Yes
Was background material available to the public? Not that I could find.
Did any member recuse themselves during the meeting? No

List any other concerns or observations:
The Board of Commissioners, with leadership team and staff, meets in person at WH’s Health
Education Center. I attended online via Zoom. Because of the way the camera was set up, it was
difficult to see who was speaking and was also difficult to hear at times. Members of the Board
of Commissioners were not introduced and did not appear to have nameplates so it is difficult to
identify who was who. It would probably be better to attend these meetings in person.

The most important item discussed at the meeting, the $2.4 million contract with Tegria, was not
listed on the agenda made available to the public.
I intend to follow up to get a copy of the state auditors’ report.
Board President Ron Wallin made it clear that public input was welcome and appreciated.
Several other commissioners also mentioned they valued public comment.
Several staff members gave reports and shared various documents on the screen, but copies of
reports were not readily provided on the website, so it was difficult to see the details. Most likely
I could ask for copies of these reports.
​
Observer E-mail: [email protected]                                     Date submitted: 04/21/2023

Name of Observer: Judy Hucka
Observed Meeting:   WbidbeyHealth Board of Commissioners
Date of Meeting: 01/19/2023
Members present: All five board members appeared to be present: President Ron Wallin, Gregory Richardson, James Golder, Grethe Cammermeyer, Eric Anderson. They were not introduced and did not appear to have nameplates, so I could not easily identify them or tell who was speaking.
Members absent: 0
Others present (staff, media, public):  Multiple staff members present: Dr. David Lemme, Neil Todhunter, Shanna Harney-Bates, Dr. Miller, Paul Rogers, Tim Waldner, Curtis Shumate, LaJolla Peters, Mike Layfield.

Summarize the main issues discussed at the meeting:
--Unmet demand for healthcare services. This was a recurring topic during the meeting–large demand for medical care on Whidbey Island, but challenges to recruit and hire enough care providers of all kinds – doctors, nurses, etc. Freeland primary care clinic reopened on Dec. 1, 2022, and there is a waiting list of 700 people wanting to see a doctor.

In last 1 ½ years, WH has had a net gain of 12 providers, which Dr. Miller said speaks to the positive cultural change that has been happening at WH. Currently 8-10 open positions for providers; hardest to fill are positions for provider care providers.

--Expansion of telehealth/virtual care. WH is actively discussing telehealth services with four companies, as a way to meet customer demand for healthcare and also to increase business. Telehealth would be offered 24/7 and would help reduce wait times at clinics. Particular interest in using it for behavioral health services. It was noted that telehealth is where healthcare is going and that WH is well behind in providing it. If it isn’t offered, WH will lose patients off island and other healthcare organizations that offer telehealth.

--Financial status. Some improvements in financial status. Net loss for November was $106,000 and 2022 year to date was $1,069,432. These numbers are seen as good news because the level of losses is declining. Financial Strength Index is 0.81 (poor), but much improved from recent number of negative 3.1. WH has been making progress on CMS settlement payments, which within the next 30-60 days will improve the cash flow situation.

--Nursing staffing. WH is making some progress in recruiting nursing staff, though it is still needing to use expensive traveling nurses to maintain adequate staffing. Currently they have 138 RNs and 7 LPNs. Last year had a net loss of 14 RNs. Seeing turnaround in nursing staff morale.

--Staffing - recruitment, gains and losses. Currently they have 657 active employees.

--Interim CEO Mike Layfield report: Briefly discussed strategic plan and “Seven Pillars of Excellence.” Overall goal is to “delight the customer.” This was the last meeting for Commissioner Grethe Cammermeyer, who is resigning. She was praised and applauded for 11 years of service.

--Executive Session. The Board clearly advertised several executive sessions held on Jan. 18 and
19 to discuss candidates for the vacant permanent CEO position. When the board came out of executive session, they announced that they had asked HealthTech (current hospital management
team) to set up interviews with several CEO candidates. No votes were taken.

List any issues on the agenda relevant to any LWV state or local positions or programs:
Possibly access to affordable healthcare.

Do you recommend local League action or study on any of these issues?        NO  

Was the meeting conducted in an open, business-like, and civil manner? YES

Consider the following questions and respond if relevant.  

FEATURE EVALUATED COMMENTS
Was the agenda made available prior to and at the meeting? Yes, but no supporting documentation

Did members adhere to the provided agenda? Were any non-agenda items discussed? Yes, stuck to
agenda.

Was there adequate discussion of issues?   Yes. Little discussion, but some questions, and praise for leadership team and staff.

Were any “Executive Sessions” called? Yes. To discuss candidates for permanent CEO position, currently held by interim CEO.

Was there adequate opportunity for public input? Yes

Was background material available to the public? Not that I could find.

Did any member recuse themselves during the meeting? For what reason? No

List any other concerns or observations:
The Board of Commissioners, with leadership team and staff, met in person at WH’s Health Education Center. I attended online via Zoom. Because of the way the camera was set up, it was difficult to see who was speaking. It was also difficult to hear at times, particularly the commissioners. It was easier to hear staff. Members of the Board of Commissioners were not introduced and did not appear to have nameplates so I could not identify who was who. It would probably be better to attend these meetings in person.

Board President Ron Wallin made it clear that public input was welcome, and he asked at several times during the meeting whether there was anyone who wanted to comment. Near the top of the agenda was discussion of a letter to U.S. Rep. Rick Larsen. However, there was no mention of what the letter was about.
Several staff members gave reports and shared various documents on the screen, but copies of reports were not readily provided on the website, so it was difficult to see the details of the reports.

Observer E-mail: [email protected]                                     Date submitted: 01/19/2023