2013 Board Members: President – Randy Cassingham (arcie@thisistrue.com), Vice President – Christen
Williams (christenwilliams@reagan.com), Secretary – Linda Ingo (fisherranch@ridgwayco.net), Harvey
Hudson (harvey.hudson@q.com), Dick Gingery (dgingery@q.com); Medical Provider – Dr. Joel Gates
(reception@ridgwaymountainmedical.com), Administrator – Diedra Silbert, ouraycountyrsa@gmail.com
____________
July 16, 2013
Ouray County Regional Service Authority
REGULAR BOARD MEETING
MINUTES
________________
1. Call to order: Christen called the meeting to order at 12:40 PM. In attendance:
Board Members: Linda Ingo, Christen Williams, Dick Gingery, Harvey Hudson; Public:
None; Other: Joel Gates, Diedra Silbert. A quorum was declared.
2. Review of Agenda: No additions to the agenda.
3. Approval of Minutes: Linda moved to approve the 6/25/13 minutes as written.
Harvey seconded the motion, and the minutes were approved unanimously.
4. Public Input: None.
5. Discussions with Medical Provider:
a. Allscripts: The VPN access for the QHN-Allscripts interface is moving forward.
b. Tree Removal: Dr. Gates asked Michael Kriegshauser about removing the tree,
plus doing the bark, the gutters, and parking lot clean up for $250. He seemed
amenable but hadn’t returned with a proposal yet.
c. File Cabinets: Dr. Gates spoke with Joey Huddleston from the Ouray County
Historical Society about the vertical file cabinets. They had just bought other
cabinets, but he thought they might still need more space. Unclear timing on this.
d. Cyber Insurance: MMC did receive another bid on cyber insurance on the day
the current policy was due. The new bid would have required significant review
due to differences from the old and an application process. MMC is keeping the
same policy for this year and will begin researching possible changes in January to
leave time for review before next year’s policy is due.
e. Conversation with Public Health: Dr. Gates spoke with Cheryl Roberts,
outgoing County Public Health Director, and the incoming director about their
interest in moving the public health office into a building in Ridgway. Further
discussion about details would certainly be necessary, but Dr. Gates communicated
that MMC would like to be more connected with the Public Health office and
could see benefits for both parties.
6. Old Business:
a. Building Maintenance: Dr. Gates noted that there have been no new water leaks
since the change in the recirculating pump. The Board asked that Diedra and
Susie Blakney of MMC move forward with scheduling K2 Restoration to mitigate
the mold issues, have Alan Senter re-test for mold, and then patch the walls.
b. Needs Assessment/Survey Update: Dick reported on his interviews with
physicians, though he still plans to interview Gates and Degenhardt. He
summarized that he has so far heard interest in a freestanding, RSA-controlled
radiology clinic, but not much interest in a lab or specialty clinics. Dick estimated
that he could finish with his surveys in the next two weeks. The Board discussed
whether having a freestanding radiology clinic would actually save patients a trip
to Montrose. Dr. Gates thought the majority of cases could be handled locally
with digital x-rays and orthopedist input, saving an emergency room visit.
Follow-up would be needed but even that could be local.
c. Building Lighting: Discussed out of sequence, after 6e.
d. Parking Lot: Harvey reported on a conversation he had with Phil Blackford
about the southeastern side of the parking lot where the fire hydrant and culvert
are. Phil suggested strategically placing rocks to keep people from hitting the
culvert. Harvey requested a bid from him for placing rocks and for putting up a
railing, but he hadn’t received one yet. The Board discussed various ideas,
including placing a few more posts with reflectors in that area, painting a no
parking area with a line near the culvert (assuming the area near the hydrant gets
paved), removing the bent fencepost (Linda could take care of this), and not
messing with the culvert itself since that could increase the problems. The Board
would like to have bids on dealing with this issue. A bid is in process for paving
and striping the whole parking lot, with potential joint timing of the paving
project with Citizens Bank.
e. Rainbow Accounting Response: Diedra listed the contents of what was returned
to Linda and Harvey after the last meeting. A spreadsheet listing the inventory
and the software appear to be missing. Diedra will make contact with Denise
from Rainbow to see if she can get additional information. Dr. Gates suggested
that Joey Huddleston could potentially pick up where Rainbow left off, if the
spreadsheet and software can be obtained.
6c. Building Lighting: Ken Haynes from SMPA presented information to the Board
about options for replacing the current fluorescent bulbs in the building, which
will soon no longer be manufactured. Two options are possible: 1) slowly
replace the T12 bulbs with T8’s, as they stop functioning, or 2) replace all the
bulbs at once with T8’s or with LED bulbs. At some point in the future, T8’s will
also likely stop being manufactured. Per Ken, LEDs will be much more efficient
and reduce electric bills with rebates from SMPA. Ken presented data on
payback point using his estimates for costs to replace the bulbs. The initial
estimated cost to switch all bulbs to LED bulbs, including labor, would be
$17,500. The initial estimated cost to switch all bulbs to T8’s would be $4,200.
The LED bulbs would reach the payback point at 11 years, sooner than the T8’s at
19 years. Questions asked included how well LED bulbs withstand power
outages and surges, warranty (LEDs have better warranty, per Ken), labor needed
(25-30 minutes per bulb initially, then less time), number of contractors available
to do the work (around 6, but could be done by a maintenance person instead).
Ken also indicated that there are possible grant options through the Colorado
Energy Office, USDA, or maybe the Colorado Health Foundation to offset some
of these costs. Ken offered to return to discuss this further with the Board and
then left the meeting. Harvey noted his preference for LEDs because costs are
expected to decrease on them and the light quality is good. If funding is sought,
including motion sensors in each room might be useful. Christen thought there
was no need to rush this project. The only disadvantage to this might be not
receiving a rebate for the change. Diedra will explore grant possibilities.
7. Report from Administrator:
a. Invoice Review: Diedra provided a QuickBooks list in the Board packet of this
month’s checks to be signed. Dick moved, and Harvey seconded, to approve the
invoices detailed on the list for payment. The motion was approved unanimously.
Checks were signed.
b. Correspondence: Diedra summarized a letter from Club 20 which the Town
Manager had passed along to her inviting participation in a regional forum about
health care issues, one of which will be in Ridgway on August 1. Dick agreed to
attend this forum. There will also be a meeting in the fall in Grand Junction on
September 7. None at this meeting offered to attend this.
c. Financial Statements: The Board reviewed the Balance Sheet and Profit and
Loss Budget Performance Statement.
8. New Business:
a. County Multi-Hazard Mitigation Plan 2013: This item was tabled again for
discussion when Randy is present.
b. Grantwriting Related to Radiology Plans: Diedra reviewed some of the
requirements for writing a grant to fund upgrading the radiology equipment
and/or remodeling the facility to create a freestanding radiology clinic. The
Board and Dr. Gates discussed at length ideas for upgrading the radiology
equipment, possible remodeling of building to create a freestanding radiology
clinic, concerns about the personnel expenses to run the clinic, follow-ups and
referrals and the medical liabilities involved, and the need for data. Dr. Gates has
not kept records of the number of patients who go to Montrose to get their x-rays.
Dick believes that usage of the machine will increase even more than anticipated,
when it’s upgraded. Dr. Gates would want to invest in training other staff to get
certified to take x-rays on the upgraded machine and would want this included in
a grant proposal. The need to upgrade the equipment is high, and it needs to
happen or radiology capability is lost for the county. The costs of maintaining the
machine as it is are high and with less than optimal results. Dr. Gates will get 90or 180-day bids on upgrading the machine, with details. He will also talk with his
lawyer about models that could possibly work if this was done more
collaboratively with other physicians, as it has been done elsewhere. The group
mentioned that a vote would very possibly be needed from the public before
proceeding with remodeling for this purpose. A dialogue (roundtable meeting?)
with other doctors would also be important. Christen would want to see longer
term budgets for the RSA and how this project would impact them.
c. New Business from Floor: None.
9. Other/Next Meeting: The next scheduled meeting is Tuesday, August 20, at 12:30
P.M. at Ridgway Town Hall.
10. Adjourn: Dick moved to adjourn, Harvey seconded it, and the Board approved the
motion unanimously. The meeting concluded at 2:52 PM.