VTH Board Minutes 4/22/2021

Updates: Info Only

Personnel Updates

• Faculty Searches – update provided by Dr. French
  • Dermatology - Dr. Braeme has accepted position
  • Spay/Neuter Community Outreach – Dr. Becky Morrow has accepted position
  • Clin Path – Dr. Rosser has accepted position
  • Offers to Dr. Griffin (onc surgeon, scheduled to visit in May), Dr. Trenholme (anesthesia), Dr. Heng (diagnostic imaging)
  • Other searches – surgery candidates interviewing and dentistry candidate interview next week (vKling).
• Technicians – Close to filling neuro and derm positions with internal transfers, primary care search has one internal candidate interested, ECC interviewing for 2 openings, shelter med opening, urgent/convenient care opening (no internal interest) sent for external candidate listing
• Client Services Staff model – Service specific CSR model for onco/IM/neuro/surgery has been met with favor by clients (pleased with consistency). Will begin exploring opportunities to implement further. 

Facilities

• Water outage SAC May 2, 8 hours

Programs

• Student On-Call SA ECC – discontinued for VM Class of 2022
• ECC Busines Manager (part of ECC re-org) starting next week (Angela). 
• New SOP for patient sedation in imaging – imaging techs to administer additional sedation when needed.
• HIS update – significant progress thus far is not forward-facing to all end-users. Developed a timeline & looking at faculty testing on SANDI in the near-future. Next site visit with ATC scheduled for 6/7/21.

Other

• New Section – CUPAWS (Community Outreach, Urgent Care, Primary Care, Wildlife, Shelter); Drew Sullivan Section Head
• Tisha Harper – SAND Section Head

3:00 
Dean Constable

Professional Development funds for house officers

Main objective is to ensure that we are supporting residents equally (ie boarding is different across services so some may get the opportunity based on timing of exam while others may not). 
Ensure we are not offering state funds once the resident is no longer employed with the university – this is included in ProDev702 policy approved by board on 2/25/21, which will go into effect 7/1/21.

Specialty LA interns – do they need to be an exception from our current policy by being allowed to earn ER fees?

Considerations for S. Camp to evaluate:

• Paying an increased salary to cover these expenses? 
  Assumption: under this scenario VTH would no longer pay out
  ER fee/no annual department/hospital contribution
• Consistency across resident ER fee rates. Is it equitable when some are called in for longer periods of time?

Strategic plan and VTH Implications

• Funding for research – Recommendation from P. Constable is to use affiliate funding for VTH share since self-supporting funds cannot be used (VCM/VTH/Dept share $100K funding for clinical oriented research projects)
  • Make clinical trials more available to clients of VTH/engage HOs in research projects key to their career progression/encourage student participation 
• Foster continued growth and excellence in veterinary clinical and diagnostic services
  • Explore alternative business organization models for clinical services to facilitate cost control and enhanced operational efficiency 
  • Explore alternative employment models for clinicians to facilitate the recruitment and retention of exceptional personnel in areas critical to long-term growth of caseload and revenue across the portfolio of clinical services 
  • Develop improved communication and data exchange between the Veterinary Teaching Hospital and the Veterinary Diagnostic Laboratory to benefit our clients and referring veterinarians
• Develop a comprehensive college-wide marketing and communications plan to support strategic goals/improve national perception/rankings

Budget Report Review & Strategic Priorities

Veterinary Teaching Hospital
Review of financial statements – March 2021

Overall:

• The VTH had expenses in excess of revenue of $248,906.47 for clinical operations (fund 301732) in March. 

Revenue:

• Revenue for the month of March was $1,528,458.32 for VTH operations. There was overall favorability in revenue for month of $19,972. YTD revenue (including storeroom figures) is favorable compared to budget by $640K. 
• Please see attached for a breakdown of revenue/admissions per service. Due to COVID, a comparison to prior year is not provided, as results would be skewed due to reduced service. Compared to FY21 budgets provided per service, there is favorability in revenue (8%) and registrations (15%).

Expenses: 

• Expenses were unfavorable by $474K for the month and $971K YTD compared to budget.
  • Wages are unfavorable by $24.5K compared to budget due $5300 locum coverage (offset by state funding) & $27K front desk wages. Overall personnel expenses are favorable for the month and YTD due to position vacancies.
  • Supply expense is favorable by $60.5K this month due to $94K in transfers to COGS. Alternatively, COGS expense is unfavorable by $145K, which includes $30K of surgical device expenses. YTD net of these expenses appear reasonable compared to positive variance in clinical sales.
  • Service expense is unfavorable compared to budget by $36K due to a $6350 in rabies titers and $33K client gift funding adjustments.
  • There is significant favorability in credit card fees due to changes with the credit card processor near month-end. We should see a significant increase in related expenses next month as a catch-up.
  • Utilities – annual $174K payment to campus.
  • Facilities repairs and maintenance costs are favorable compared to budget due to $3.5K COVID related expenses for SAC lobby (air purifiers/plexiglass) & $4500 LA icemaker W2-32.
  • Office and computer supplies expense was unfavorable for the month due to annual contract with tech services for the VTH of $63K (skype, zoom, wifi, etc).
  • Equipment expense was slightly unfavorable due to an invoice catch-up for cubex (paid 3 months of expense @ $4K/month).
  • Equipment/software maintenance expense was unfavorable compared to budget by $164K due to RT service agreement $145K and the echo agreement of $14,750.
  • Other/misc expense is unfavorable compared to budget due to internal financing payments (RT/VMSC).

Other:

• Other self-supporting revenue is higher than budgeted due to affiliate funding of $293K.

Preliminary FY22 Budget Numbers – will present FY22 budget next meeting 5/27/21

Update from COVID task force RE: pods/VTH clients

•  Modified Client receiving – Issues involve communication rooms returning to use as exam rooms, services requiring more than one exam room, diligence in moving clients.
  • Reason for modified receiving plan: clients currently questioning value of information received (more faceto-face interaction is wanted) since most information is relayed by phone.
  • Current: Phase 4 in Region 6
    • masks, screenings, social distancing/hygiene, 50% capacity/50 max gatherings, ventilation, vaccination (recommended, not required)
  • Air purifiers have been purchased to move forward with clients re-entering the exam rooms/plexiglass for CSR.
  • SAC: One client/1-2 VTH personnel per exam room –client enters exam room for clinician discussions & return to vehicles (opposite for discharge)
    • With warmer weather – could some of these conversations happen outside? Keep in mind patient transfer happening outside can be difficult.
    • Who will clean between uses? The responsibility will fall on the person using the room and/or the service.
  • LAC: equine/therio – may pose issues, faculty agreed to keep current receiving model.
  • VMSC: 5 exam rooms – concerned about # of rooms/size to accommodate social distancing.
  • Timeline – If we choose to move forward, VTH will need to implement in approximately one month.
• Student engagement in rounds rooms –
  • 108 add’l pod locations needed if we take ward 4 back for clinical operations. 
  • Open pod space (not assigned)
  • Learning commons/CLCS – may make students feel further disengaged from clinics.
  • LA pods do not seem to be utilized by many students currently.
  • Timeline - Hold until phase 2 & 3 are completed (August)
    
    

Recruiting/Retention

Technician shortage – Missouri has 30 open positions. VTH is appreciative of the Parkland program as the resource for staffing.

On-boarding is crucial for faculty retention 

• assigning mentors/set-up in their offices/dissemination of info/follow-up with candidates that we didn’t extend offers to/welcome basket or flowers)
  • Each section to think about retention improvement.

Illegal /Noncompliant Activities in VTH

Dispensing medication to go home from automated dispensing machine.

Technicians dispensing medication without DVM orders

Illinois Veterinary Practice Act (225 ILCS 115/17 from Ch. 111, par. 7017)

• Any person licensed under this Act who dispenses any drug or medicine shall dispense such drug or medicine in good faith and shall affix to the container containing the same a label indicating: (a) the date on which such drug or medicine is dispensed, (b) the name of the owner, (c) the last name of the person dispensing such drug or medicine, (d) directions for use thereof, including dosage and quantity, and (e) the proprietary or generic name of the drug or medicine, except as otherwise authorized by rules of the Department.
  • (c) Each person who provides veterinary medical services shall maintain appropriate patient records as defined by rule. The patient records are the property of the practice and the practice owner. Patient records shall, if applicable, include the following:
    
    • (7) all medicines dispensed or prescribed must be recorded, including directions for use and quantity;
      
      

Patients being seen for services not offered by VTH

Charges not entered for services provided

No record generated for service

Illinois Compiled Statues 720 ILCS 5/16-3

• (a) A person commits theft when he or she knowingly obtains the temporary use of property, labor or services of another which are available only for hire, by means of threat or deception or knowing that such use is without the consent of the person providing the property, labor or services.
  
  

Hospitalization Fees

• Combine the hospitalization/hospital services fee, so only one charge rolls in each day (proposed at $77.50). Revenue would be recognized by the service. Finance to offset the current caretaker expense on back side.
• Transfer Exams/exam fees, consults, resident ER – S. Camp & N. Lamphier to evaluate/recommend consistency in pricing. 
  • MDVC’s current practice is to for a transfer exam to be charged at the full exam cost.