VTH Board Minutes 8/21/2019

Updates: Info Only

Personnel:

Facilities: Virtual tour of VMSC

Programs: Go-live date for StringSoft that was shared at the VCM faculty meeting by J. Fox is not realistic.  Steering Committee is working to address Board Member concerns and move implementation forward.

3:00 Budget Report 

Documents Placed in Box

Fiscal year 2019 Results Compared to FY18 – The year ended favorably compared to previous year with $1.23 million more revenue.  However personnel costs, especially academic salaries and benefits, went up.  This was the result of successfully recruiting faculty into open positions.  Non-personnel expenses rose as would be expected with caseload growth and increases in supply costs. A transfer of $190,820 is related to financing for the linear accelerator.  Overall, the VTH revenue was $2.1 million over expenses which is $47K better than FY18.

Cash Reserves – The VTH has cash reserves.  The VTH cumulative cash balance is $5.36 million. It is recommended that the VTH keep the equivalent of 1 month of expenses ($1.5 million) on hand as cash.  The VTH has committed $5.75 million to the SA expansion project, of which $3.0 million has already been paid out to Facilities and Services for the project.  We are taking another $492,600 out of FY19 revenue to pay for furnishing, fixtures, and equipment (FFE) for the Expansion Project, with the remaining balance coming out of FY20 for a total investment of $700K.  We have already paid for 2 lift tables out of FY19 cash and are going to use FY19 revenue to pay for the camera security system in the pharmacy, the cattle chute in ward I, and rebuilding the fenced dog area on the SAC east side.  The available cash balance, after accounting for the reserve and purchases, is ~$1.25 million.  Each year the VTH receives money for providing clinical instruction for Affiliate Year students.  This is estimated to be ~$500K.  We were able to bring forward a balance from the FY19 fund totaling $129,778.  This also is available cash.  However, there are a number of projects that do not have funding sources assigned yet and the cash balance will be used to support those projects. Other VTH expenses that do not having funding sources identified include additional VTH remodeling (SAC lobby, LAC lobby, Dentistry), start-up equipment, wage increases, HIS expenses, etc.

VTH Capital Projects – Funding Plans – The VTH has multiple Capital Projects:

• Replacing the one large ward door in all four LAC wards (campus funding)
• Installation of a 128 CT
• Developing a location for equine lameness assessment pending a clinical center for rehabilitation and performance
• Pharmacy clean room construction
• Revision of equine orthopedic OR
• QA equipment for Lin Acc
• Interventional Radiography equipment
• Expansion project FF&E
• Vet Med South Clinic FF&E

The funding sources are a combination of VTH revenue, Affiliate Year funds, College funds and Gift funds.

VTH FY20 Capital Requests – These are the proposed expenses that will be applied to FY20 Affiliate Year funds.  These include the pharmacy clean room renovation, the equine performance space, replacement of SA and LA ventilators, a LA anesthesia machine, replacement of the equine therio truck, a power injector for the new CT, an operating microscope for ophtho, a table and surgery light to outfit the remodeled equine ortho OR, SA arthroscopy equipment, and the remaining Expansion project FFE.  The total requests exceed the $500K so purchases will have to be balanced against fund availability and FY20 performance.

VTH performance remains critical to the success of our plans and goals for projects.

VMSC Personnel Review – The working business plan for Vet Med South Clinic is 1.6-1.8 FTE Primary Care Clinicians and 2.0 FTE Zoo Med Clinicians, 4 veterinary technicians, 2 veterinary assistants, and 2 client services staff.

VMSC financial projections – The business plan is showing a first year deficit estimated to be ~120K but projections are difficult due to limited date regarding expanded scope.

VTH Board Members asked for Service visit/revenue data.

Research Fee Policy Review 

Revised research policy (Research Adjustment-Clinical Research Policy #Bill306a) as reviewed and edited.  Action Item: Policy will be updated and sent out.

Imaging Concerns

Imaging is experiencing increased demands for service and have had significant technician turnover so several of their techs are new.  Additionally, one technician is on medical leave.  With the additions of the new CT and SA imaging room, there is concern about staffing.  A request was presented for an additional technician.  Following discussion, the VTH Board members asked for the service to evaluate student engagement to determine if processes could change to support service activities. 

There is an increasing number of weekend and afterhours Urgent and Priority imaging requests, including both radiographs and CT.  A request has been made to be mindful when using CT as a modality, especially when requesting stat reads, as the modality is overused and time consuming to read.  A discussion with imaging and ER faculty led to a plan for training with house officers.  After hours requests for CT will need to be approved by the requesting house officer’s faculty.  The Board Members were in support of charging for priority reports.

Intern and Resident Requests 

Board members were provided service requests for interns and residents.  The VTH Director and VCM Dept Head will review and determine if the requests will be honored.  The requests are for a net change of 0 for interns and 4.16 residents.  This would result in ~$70 cost to VTH in FY21 budget.

Report Completion Concerns 

The VTH is having an increasingly greater problem with discharge reports being finalized in a timely manner and provided to the client +/- RDVM. 

There is a systemic problem of test results not being shared with clients +/- RDVM.

Discussion about the roadblocks that are impacting these issues was had.  It was recommended that a working group (Possibly the Hospital Services Group) be charged with identifying solutions.  First step is to fact find and determine what should be included in the information sent out.