VTH Board Minutes 01/26/23

Updates: Info Only

Personnel Update

Faculty

• Anatomic Pathology Search: Offer declined, search re-opened
• Anesthesia: Offer Extended
• Cardiology: Candidates invited to campus (February and March)
• Clinical Pathology at Veterinary Specialty Center: Search on-going
• Dentistry: Search open, candidate invited to interview
• Diagnostic Imaging: Candidate interview in February
• ECC: One candidate interviewed, one candidate being scheduled
• Medical Oncology: Ready to extend offer, waiting for LOR
  Orthopedic Surgery: Candidates interviewed, waiting for search committee report and LOR
• Primary Care: Opening Search
• Radiation Oncology: Candidate invited to interview
• Shelter Medicine: Opening Search
• Small Animal Internal Medicine: Offer Extended
• Wildlife Director: Candidates scheduled to come to campus this week and next

MWE – staffing evaluation, looking at 2.4 FTE vet model

Rad Onc – physicist being sought who is local, hope to provide more consistent training/support

Staff

• Daniel Restenberger, Accounting Associate hired in VTH BO
• Search underway for Hospital Service Coordinator – Vice Duncan
• Search concluding for HR Service Center at CVM
• Joy Hinrichsen – Technician Recruiting Coordinator (interim), leading team of volunteer technicians (Misty Croy, Rachel Dorney, Kim Knap, Mikayla Wrasse, Jenny Byrd, Ang Hintz, Jill Sackville, Joy Hinrichsen, Jessica Risley, Paige Demblon, Caitlin Cordell)

Facilities

• Equine Surgery – Renovation underway (see images)

• Oncology Expansion - Concept Design phase complete, selected location south of current SAIM/ER wing. Schematic Design phase underway, to be concluded early Feb. Design Development phase to commence shortly after. Cost of project exceeds allocated funding; VTH will evaluate feasibility of loan.

•  Surgery hallway alcove – Small group/study seating (options) being explored

• Emergency call boxes – being installed at every reception desk, SAC 80 commons, LAC T-intersecting hallway

• Ward 2/Ward 4 Resurfacing – mid-February

• Possible $2M staged gift for VMSC – need to develop proposal/plan

Programs

• Technician Recruitment/ Externship program – Externs (vet tech students) hired as extra help Vet Assistants, placed in VTH services based on needs/wants of student. Service need not considered. Duration 4-12 weeks. Joy Hinrichsen coordinating extern student engagement.

• VTH Townhall – Tuesday January 31^st LAC 100 – discussion regarding positive culture promoting activities and culture committee – looking for input and ideas for future initiatives.

• Student Job Board – On-line job posting format for VTH/College student employment opportunities. In development.

Other

• Thank you, Dr. Stephanie Keating, for your service on the VTH Board. The election of the next faculty elected member will be held, with the next member starting the term for the Feb. meeting.
• Request received for additional 2 SA rotating interns in match – see attached document for detail.
• Incinerator operational at VDL – N. Lamphier working to coordinate general cremations to be done in-house.
• OSCE sign up – According to the College Administration – 43% of all OSCE station manpower should be filled by VTH personnel. Please encourage those who can sign up to assist with the OSCE evaluation to do so. Hourly personnel working during their time off would be overtime eligible.

Financials

VTH Report – Sara Kennedy

Veterinary Teaching Hospital

Review of financial statements –Dec 22

Overall:

• On a YTD basis, VTH revenue over expenses is $(313,233) (fund 301732).  This is unfavorable to last year by $(829.2k).
• There will likely be some savings to VTH related to reallocation of resident salary expenses in FY23.  However, that amount will not resolve the full deficit.
• Total revenue over expenses for Q2 all funds = $455,394.  That compares to last year of $596,297.  FY23 does include the excess of the $1M donation for the SAC lobby (current YTD excess includes $1M gift funds less expenses).

Revenue:

• YTD revenue in VTH operations (fund 301732) is higher than prior year by $817k, or 8.7%.
• Please see attached for a breakdown of revenue/admissions per service.
  • There is overall unfavourability compared to budget for revenue of -1% (by service).
  • There is overall favorability YTD compared to prior year for admissions of -10% and revenue of 9% (including storeroom).  Services with lower admissions than prior year (100 cases or more):
    • Oncology -8%
    • Ophthalmology -72%
    • Zoo Med -38%
    • ER/ICU/Critical Care -15%
    • Shelter Medicine -72%
    • Equine Medicine -25%

Expenses:

• YTD expenses on VTH operations (301732) are $1.6M (18%) higher than YTD prior year.

Personnel

• Academic salaries are higher than prior year by $317.9k.  This includes additional intern salaries, allocation of clinical faculty, and instructors (Shores, Walker).

Services

• Supplies are higher than prior year by $218.7k.  This is somewhat due to timing of the payment of invoices in Q1 FY23 that relate to prior year.  When comparing supplies as a % of revenue, this year is 12% while last year was 11% of revenue.

• Travel is higher than prior year by $48k due to increase in professional development.
• It appears there are several expense categories that are higher than last year under services.
  • Vet Tech salaries are $655.7k higher than prior year. 
  • VetCT is higher than prior year.  Average invoices at the beginning of last year were around $25k per month.  This year, they average $60k per month.  That includes an average of $6.5k/mo this year related to locums.

AR – N. Lamphier
An Accounts Receivable worklist has been developed in SANDI – gives ability to view client balances exceeding 30 days. In progress: real-time view of account balances at GAR

Budget Planning and Meetings. Future budget reports will include tools to view service expenses and balances. Budget meetings will be scheduled for late February/early March.

Client Funding Accounts – The VTH is working with the Office of Advancement to develop and maintain client support funds.

Friends of/Gift Accounts – Service Heads will need to review all service discretionary funds to ensure appropriate spending. Accounts not used will be scrutinized when audited.

Other Accounts – curricular accounts should be reviewed to ensure supplies used for teaching are restocked for the services from curricular funds.

Grief Counseling

A discussion around scope of services offered through the VTH by the Grief Counselor was had. Consensus is that efforts be focused around immediate in-the-moment needs of clients suffering loss/duress. Resources for after-event support should be developed/available. Training of veterinary students and house officers in the management of difficult situations should also be prioritized so that services can be maintained with Grief Counselor is unavailable.

Pharmaceutical Pricing - Large Animal

Concerns that with inflation VTH prices have increased, and large animal caseload has noticeably declined. New fees associated with medication dispensing are an additional burden on already strained system. Discussion regarding exempting LAC patients from $8 dispensing fee and/or $1 Cubex fee.

Action Item: VTH Admin will look at financials, dispensary stats and caseload numbers after 1^st quarter (end of March) to determine degree of impact and will reevaluate fees at that time.

Xylazine Regulation 

Reasons for concern: the increased potential of xylazine as an adulterant in illicit use but is currently a non-controlled substance.
Recommendations: Xylazine should be moved to a more restricted status within the VTH and associated areas (MWE and Zoos) to decrease the opportunity for diversion. There was serious concern regarding the removal of xylazine from cage side/stall side access due to safety concerns.

Action Item: Dr. Austin will discuss concerns/solutions with EQMS Section. Consider limiting ward stock supply and storing with keycode access, with additional product available in Cubex.

VetCT Partnership 

VetCT has provided us with a proposed annual partnership package. Will review services and prices. Package includes some virtual teleradiology and in person radiology locums, rounds instruction, and resident training. Other opportunities include instruction modules for VM1-3 students, teleradiology services for US.

Other Discussion 

VTH Board Structure – section heads, diagnostic services? – Discussion regarding board structure, specifically the need to include the Diagnostic Services Section Head on the board. The consensus was to invite as a courtesy when relevant topics are on the agenda, Dr. Barger provides insight/information in most cases.

Service/Section issues – None brought forward.