NOTICE - Kaweah Delta Medical Center · Hsueh, M.D. William. 08/19. American Board of Internal...

400 West Mineral King Avenue · Visalia, CA · (559) 624 2000 · www.kaweahdelta.org

October 26, 2018

NOTICE The Kaweah Delta Health Care District Board of Directors will meet in a Human Resources Committee meeting at 11:00AM on Monday, October 29th in the Kaweah Delta Medical Center – Acequia Wing - Executive Office Conference Room {400 W. Mineral King, Visalia}.

All Kaweah Delta Health Care District regular board meeting and committee meeting notices and agendas are posted 72 hours prior to meetings in the Kaweah Delta Medical Center, Mineral King Wing entry corridor between the Mineral King lobby and the Emergency Department waiting room.

The disclosable public records related to agendas are available for public inspection at the Kaweah Delta Medical Center – Acequia Wing, Executive Offices (Administration Department) {1st floor}, 400 West Mineral King Avenue, Visalia, CA and on the Kaweah Delta Health Care District web page http://www.kaweahdelta.org. KAWEAH DELTA HEALTH CARE DISTRICT Nevin House, Secretary/Treasurer

Cindy Moccio Board Clerk & Executive Assistant to CEO DISTRIBUTION: Governing Board Legal Counsel Executive Team Chief of Staff http://www.kaweahdelta.org

http://www.kaweahdelta.org/

http://www.kaweahdelta.org/

KAWEAH DELTA HEALTH CARE DISTRICT BOARD OF DIRECTORS

HUMAN RESOURCES COMMITTEE

Monday, October 29, 2018

Kaweah Delta Medical Center / 400 West Mineral King Executive Office Conference Room (1st floor Acequia Wing)

ATTENDING: Directors; Nevin House (Chair) & John Hipskind, MD; Gary Herbst, CEO; Dianne Cox, VP Human Resources; Regina Sawyer, CNO; Linda Hansen, Director; Jeannie Born, Director; Gloria Simonetti, Employee Health Manager; Brittany Taylor, Sr. Physician Recruiter; Blanca Bedolla, Recording

OPEN MEETING – 11:00AM

Call to order – Nevin House, Human Resources Committee Chair

Public / Medical Staff participation – Members of the public wishing to address the Committee concerning items not on the agenda and within the subject matter jurisdiction of the Committee may step forward and are requested to identify themselves at this time. Members of the public or the medical staff may comment on agenda items after the item has been discussed by the Committee but before a Committee recommendation is decided. In either case, each speaker will be allowed five minutes.

1) Physician Recruitment Update – Medical staff recruitment efforts update- Brittany Taylor, Sr. Physician Recruiter

2) Employee Health and Welfare Benefits – Update on 2019 Employee Benefits – Jeannie Born, Director

3) Compensation Program – Update on current compensation program restructure – Linda Hansen, Director

4) Policies- Discuss changes to current policies – Gloria Simonetti, Employee Health Manager a. EH.11 Immunization Requirements for Health Care Workers {NEW}

5) Kaweah Delta Health Care District Human Resources Direction, Evolution, and Future Programs- Discussion on potential improvements and advancements relating to Kaweah Delta employees

Adjourn – Nevin House, Human Resources Committee Chair

In compliance with the Americans with Disabilities Act, if you need special assistance to participate at this meeting, please contact the Board Clerk (559) 624-2330. Notification 48 hours prior to the meeting will enable the District to make reasonable arrangements to ensure accessibility to the Kaweah Delta Health Care District Board of Directors meeting.

Cardiac & Thoracic Surgery 1 Adult Primary Care 3OB/Gyn 1Pediatrics 1

Intensivist 3Hospitalist 6

Cardiology - Non-Invasive 2

GI Hospitalist 3Radiation Oncologist 1

Adult Primary Care 3Adult Primary Care - APP 1 Maternal Fetal Medicine 2Dermatology 2 Neonatology 1Endocrinology 1ENT 1Gastroenterology 2 Family Medicine Core Faculty 1OB/GYN 3Orthopedic Surgery 1Podiatry 1Psychiatry 2Radiology 1Rheumatology 1Urology (1- physician; 1-APP) 2Palliative Medicine 2

Golden State Cardiac & Thoracic Surgery

Vituity - Family Medicine Clinic

Central Valley Critical Care Medicine

IQ Surgical Associates

Kaweah Delta Physician Recruitment

Prepared by: Brittany Taylor, Senior Physician Recruiter [email protected] - (559)624-2899Date prepared: 10/9/2018

Kaweah Delta Medical Foundation

Kaweah Exeter Medical Group

Open Position Snapshot - October 2018

Sequoia Cardiology Medical Group

Sequoia Radiation Oncology Medical Associates

Valley Children's Health Care

1

Specialty Group Last Name First Name Availability Board Certification Miscellaneous Current Status

Cardiothoracic SurgeryGolden State Cardiac & Thoracic Surgery

Carrizo, M.D. Gonzalo 08/19American Board of Thoracic Surgery, Certified

No CA license; Currently completing additional training with Cleveland Clinic. Bilingual in Spanish; Responded directly through Cleveland Clinic Foundation posting on 7/27/18.

Site Visit: 9/27/18; References in progress

Family MedicineKaweah Delta Medical Foundation

Martinez, M.D. Rafael 07/19American Board of Family Medicine, Eligible

CA Licensed; Currently completing training at UCSF Fresno; Applied directly through referral from VMC Pediatrician.

Site visit pending dates

Family MedicineKaweah Exeter Medical Group

Amari, M.D. Ahmed 07/18American Board of Family Medicine, Eligible

No CA license; Candidate applied directly upon recommendation from Dr. Swehli, KEMG.

Currently under review

Gastroenterology IQ Surgical Associates Dang, M.D. Duyen 07/19

American Board of Internal Medicine, Certified; American Board of Internal Medicine - Gastroenterology, Certified

CA Licensed; Candidate was presented by Fidelis Partners on 9/12/18.


GastroenterologyKaweah Delta Medical Foundation

Greenberg, M.D. Adam 08/19American Board of Internal Medicine, Certified

CA Licensed; Candidate reached out directly on 7/15/18.

Site visit: 9/10/18; Offer extended

Gastroenterology IQ Surgical Associates Servin-Abad, M.D. Luis TBD

American Board of Internal Medicine, Certified; American Board of Internal Medicine - Gastroenterology, Certified; American Board of Internal Medicine - Transplant Hepatology, Certified

No CA license; Currently practicing Advanced GI in Lakeland, FL. Met at specialty conference 6/4/18.

Site visit: 7/2/18; pending CA License and 2nd visit.

Candidate Activity

2



Suchniak-Mussari, M.D.

Kristen 08/19American Board of Internal Medicine, Certified

No CA License; Candidate reached out directly on 7/6/18.

Site visit: 9/14/18; Offer extended.


Hsueh, M.D. William 08/19American Board of Internal Medicine, Certified

No CA license; Presented by Fidelis Partners on 7/25/17.

Site visit: 11/10/17; Offer accepted.

HospitalistValley Hospitalist Group

Tedaldi, M.D. Michael 07/19American Board of Internal Medicine, Eligible

CA Licensed; Spouse is currently PGY 1 with KDHCD General Surgery program; Candidate reached out directly on 11/10/17.

Site visit: 11/14/17; Offer accepted

Hospitalist - Critical CareCentral Valley Critical Care Medicine

Lawler, M.D. Scott 08/19American Board of Internal Medicine, Eligible

No CA License; Presented by Medical Puzzle Piece Solutions on 8/16/18.

Site visit pending

Hospitalist - Critical CareCentral Valley Critical Care Medicine

Villaflor, M.D. Janjenali 08/19American Board of Internal Medicine, Eligible


Site visit: 10/19/18

IntensivistCentral Valley Critical Care Medicine

Sagar, M.D. Ala Eddin 08/19

American Board of Internal Medicine, Certified; Pulmonary Medicine, Certified


Site visit pending, November 2018


Sharma, M.D. Bikram TBD

American Board of Internal Medicine, Eligible; Critical Care Medicine, Eligible

CA License; Presented by Medical Puzzle Piece Solutions on 7/24/18.

Site Visit: 8/2/18


Wilson, M.D. Lawrence TBD

American Board of Internal Medicine, Eligible; Critical Care Medicine, Certified

No CA License Site Visit: 10/11/18

Maternal Fetal MedicineValley Children's Hospital

Hasan, M.D. Abida 08/19American Board of Obstetrics and Gynecology, Eligible

No CA License; Presented by VCH on 8/27/18.

Site visit: 9/4/18; Offer extended

Maternal Fetal MedicineValley Children's Hospital

Sperling, M.D. Jeffrey 08/19American Board of Obstetrics and Gynecology, Certified

CA Licensed; Presented by VCH on 7/18/18.

Site visit: 8/10/18; Offer extended, will respond in October.

NeonatologyValley Children's Hospital

Okafor, M.D. Ebuka 06/19American Board of Pediatrics, Certified

No CA license; Presented by VCH on 9/12/18.

Site Visit: 9/28/18; Offer pending

3


Orthopedic Surgery - Adult Reconstruction

Orthopaedic Associates

Kim, D.O. Jun 08/19American Board of Orthopedic Surgery, Eligible

No CA license; Direct candidate referred by Dr. Bruce Le on 12/11/17.

Site visit: 3/1/18; offer accepted

OtolaryngologyKaweah Delta Medical Foundation

Patsias, M.D. Alexis 08/19American Board of Otolaryngology, Eligible

No CA License; Candidate presented by Physician Empire on 9/17/18.


Pediatric HospitalistValley Children's Hospital

Valladares, M.D. Enrique 07/19American Board of Pediatrics, Eligible

No CA license; Spouse is Internal Medicine physician considering FHCN; Presented by VCH on 8/15/18.

Site Visit: 8/24/18; Offer accepted

PodiatryKaweah Delta Medical Foundation

Daniel, D.P.M. Matthew 08/19American Board of Podiatric Medicine, Eligible

No CA License; Bilingual in Spanish; Candidate applied directly on 7/2018.

Site visit: 10/8/18

PodiatryKaweah Delta Medical Foundation

Ghai, D.P.M. Ajay 08/19American Board of Podiatric Medicine, Eligible

No CA License; Candidate applied directly on 8/1/2018.

Site visit: 9/27/18

Radiation Oncology Sequoia Radiation Oncology Medical Associates

Beydoun, M.D. Hassan 08/19American Board of Radiology - Radiology Oncology, Eligible

No CA License; Candidate applied directly.



Harris, M.D. Jeremy 08/19American Board of Radiology - Radiology Oncology, Eligible

CA License; Spouse is Palliative Medicine physician; Candidate applied directly.



Lee, M.D. Jennifer 08/19American Board of Radiology - Radiology Oncology, Eligible




Lee, M.D. Joon 08/19American Board of Radiology - Radiology Oncology, Eligible



Vascular Surgery South Valley Vascular Nye, D.O. David 08/19American Osteopathic Board of Surgery - General Surgery, Eligible

No CA License; Candidate applied directly with group.

Site Visit: 8/8/18; Offer accepted

Date: October 22, 2018 To: Human Resources Committee From: Dianne Cox Subject: Employee Health and Welfare Benefits – Calendar Year 2019 Employee health and welfare benefits include medical, dental and vision insurance, as well as life, accidental death and dismemberment, and disability insurances. The following information is a summary of the changes and additions to these benefits for Calendar Year 2019. Medical Benefits (Health Insurance) When reviewing medical benefit options for the New Year, consideration was given to compliance with Federal Government Affordable Care Act (ACA) provisions, the competitive market affecting recruitment and retention, and the impact on employees from a benefits design and cost perspective. Compliance with the ACA includes remaining in a Grandfathered Status and avoiding the Cadillac Tax in 2022 (a four year delay from the original date of 2018). To remain in a Grandfathered Status, benefits design (deductibles, copays, coinsurance, out of pocket maximums) cannot change by more than the sum of medical inflation and 15 percentage points measured from March 23, 2010. Milliman estimates that if we were to forfeit Grandfathered Status, claims costs would increase by approximately 2% ($583,000 in a single year of projected claims). Thus, the Grandfathered Status continues to provide for lower overall costs to KDHCD than if not Grandfathered. The purpose of the Cadillac Tax under the ACA is to slow the growth of health costs nationally and be a revenue generator that helps offset the cost of the ACA at the federal level. For purposes of calculating the value of coverage, the law indicates a methodology to be used which provides for a threshold of costs at $10,200 for individual coverage and $27,500 for family coverage. Any excess costs above these amounts would be taxed at 40% to the employer. It is critical to position the District in 2019 to again remain under the Cadillac Tax for 2022; the government has been and is continuing to collect medical insurance costs from employers and will be looking at plans that have wide swings in costs between now and 2022. As a result of our desire to stay Grandfathered and our need to avoid the Cadillac Tax, we once again engaged Milliman to value our expenses, considering the actual cost of care for our employees and dependents utilizing KDHCD services. Based on a monthly review of claims experience and expense, Milliman proposes a 0.6% increase, or $285,000, for 2019 to cover cost of claims as well as an increase in the cost of Stop Loss insurance for 2019. There were several exceptionally large claims in 2017 that surpassed our Stop Loss deductible and some were ongoing for 2018. The California Hospital Association (CHA) produces an annual benefits survey. The results of this survey show the average percentage of cost share for employees is: PPO EPO CHA 20% 12% Milliman Max 17% 14% CY 2018 15% 11% CY 2019 17% 13%

Interoffice Memorandum

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The chart below indicates the current and proposed share of cost of the total premium for employees for the EPO only (90% of our employees enroll in this plan). No Wellness Wellness CY 2018 EPO $60.00 $20.00 CY 2019 EPO $70.00 $30.00 Milliman Max $71.06 We are implementing an increase of $10.00 per month at all tiers in the EPO and PPO. This will result in a return to Kaweah Delta of $426,000 in employee contributions, maintains grandfather status, and is competitive in our market. Employees who participated in the wellness program by having a biometric screening at their primary care physician will pay $30.00 per month (a savings of $40.00). For 2019, copays will again be waived for preventive visits for biometric screenings at the Primary Care Physician for consideration of a premium discount in 2020. We will require more of a commitment from part time employees by increasing the hours to be eligible for benefits from 36 to 48 (most common eligibility status). This will impact 133 employees, who may have the opportunity to increase their weekly hours by six. We believe most will work more hours, with the intent to reduce overtime and contract labor. Dental Benefits Analysis provided by Milliman indicates that there could be a 13.3% decrease in cost. We will be able to hold employee share of dental costs flat again this year. Vision Benefits We currently offer a fully insured Vision Plan with VSP. The proposal in 2016 lowered overall costs of the benefits by approximately one-half and included a sliding 10% increase over 4 years. The cost to the District to cover benefit eligible employees will be an additional $24,000 for Calendar Year 2019. Employee cost share will not change. Life Insurance and AD&D KDHCD provides our term life insurance at one time annual salary up to $150,000 with a buy up option to five times to a maximum of $300,000 and AD&D benefits with a buy up option to $500,000. We will move this benefit to Voya with a $66,377 savings and a 3% savings off the medical plan stop loss coverage which is currently written by Voya. We will also be able to offer this benefit to part time benefit eligible employees with the eligibility requirement of 48 hours per pay period. STD Benefit The Short Term Disability benefit is a voluntary benefit (fully paid by the employee). The current plan with CIGNA will be moved to Voya and will be less expensive for employees. This benefit does not pay until EIB hours are exhausted. LTD Benefit The Long Term Disability benefit is an employer-paid benefit as a default to all benefit eligible employees (full time and part time). This benefit provides two years of coverage at 60% up to $10,000 taxable income per month with a four-month waiting period. These benefit eligible employees may purchase a buy-up to the two-year benefit that will provide income protection to age 65. This default LTD benefit coordinates with the Leaves of Absence Policies (maximum of 4 months), minimizes risk with American’s with Disabilities Act compliance, and provides income protection to eligible employees. This plan will also be moved to Voya and will provide a potential savings of $19,174. The cost of the buy-up option will be a flat rate (rather than age rated) and will provide a savings to employees.

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Additional Voluntary Benefits (Paid by Employee)

• Accident Insurance provides a benefit to an employee or covered dependent if they suffer an injury as the result of an accident. Coverage is provided through Voya. In addition to a participate receiving cash benefits for qualified accidents, this Plan will pay an additional 25% of the benefit ($1,000 maximum) if the services for the covered accident are provided by Kaweah Delta.

• Critical Illness Insurance provides a benefit up to $15,000 to an employee or covered dependent if they are diagnosed with one of seven critical illnesses. Coverage is provided through Voya. This Plan also offers a $100 Wellness Benefit for participation in annual physical examinations and screenings.

• Legal advice, support services and identity theft provided through LegalZoom. Voya was chosen as the carrier for the Life, AD&D, Disability and Voluntary benefits not only because of the new lower rates for coverage overall, but they also differentiated themselves from other carriers reviewed by offering a performance guarantee of 2% of the annual premium and a 3% savings off our Stop Loss coverage for 2019, or $76,000. In addition, Voya was the only carrier who offered Accident coverage with an additional benefit that will steer employees to services at Kaweah Delta. The total projected savings with Voya will be $162,000 for Calendar Year 2019.

Policy Submission Summary

Manual Name: Human Resources Date: 10/22/18

Support Staff Name: Blanca Bedolla

Policy/Procedure Title

#

Status (New, Revised,

Reviewed, Deleted)

Name and Phone # of person who wrote

the new policy or revised an existing

policy

Immunization Requirements for Health Care Workers

EH.11 NEW Gloria Simonetti, Employee Health Manager 624-2795

Employee Health

Policy Number: EHS 11 Date Created: No Date Set Document Owner: Sarah Amend (RN-Employee Health Nurse)

Date Approved: Not Approved Yet

Approvers: Board of Directors (Employee Health), Dianne Cox (VP Human Resources)

Immunization Requirements for Health Care Workers

Printed copies are for reference only. Please refer to the electronic copy for the latest version. Policy: Health Care Workers (HCWs) are at risk for exposure to and possible transmission of vaccine-preventable diseases because of their contact with patients or infective material from patients. The Centers for Disease Control (CDC) and Advisory Committee on Immunization Practices (ACIP) recommend the following requirements for all Health Care Worker Immunizations. Procedure: Hepatitis B (HBV) : Documented evidence of complete Hep B series plus a positive HBSAB titer, or positive HBSAB titer alone. Vaccination of Hep B includes a series of three vaccinations: dose 1, dose 2 one month later, dose 3 six months from first dose. If the HCW has had the complete series already but does not have evidence of a positive/ reactive HBSAB (Hep B titre), draw an HBSAB. If the HBSAB is Non-Reactive, meaning no or low immunity to the HBV, give one Hep B booster, then recheck HBSAB in one month. If the Employee is still non-reactive, continue the full series of Hep B vaccine. Retest HBSAB one month following competed series. Influenza Vaccine: One dose of Influenza Vaccine annually. See Policy EHS 05: Influenza Prevention. MMR (Measles, Mumps, Rubella): Proof of two MMR doses given, or a positive titer. If no evidence of vaccination or positive titer, draw titer. If results negative, give two doses of MMR one month apart. No follow up titer is necessary. Varicella (Chicken Pox): Proof of two doses of Varicella vaccine or a positive titer. If no evidence of vaccination or positive titer, draw titer. If results negative, give two doses of Varicella one month apart. No follow up titer is necessary. Tdap (Tetanus, Diphtheria, Pertussis): One time dose of Tdap for high risk areas. See Policy EHS 07: Tdap Policy for Health Care Workers. TB testing (Tuberculosis) - A two-step TB test is required for all new hire employees, and then an annual TB test thereafter. If the HCW has had a previous positive TB test, they will need a chest x-ray and annual TB questionnaire.

Immunization Requirements for Health Care Workers 2 References: Immunization of Health Care Personnel: Recommendations of the Advisory Committee in Immunization Practices (ACIP) November 25, 2011 / 60(RR07); 1-45 https://www.cdc.gov/vaccines/adults/rec-vac/hcw.html "These guidelines, procedures, or policies herein do not represent the only medically or legally acceptable approach, but rather are presented with the recognition that acceptable approaches exist. Deviations under appropriate circumstances do not represent a breach of a medical standard of care. New knowledge, new techniques, clinical or research data, clinical experience, or clinical or bio-ethical circumstances may provide sound reasons for alternative approaches, even though they are not described in the document."

NOTICE - Kaweah Delta Medical Center · Hsueh, M.D. William. 08/19. American Board of Internal...

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