Alberni-Clayoquot Regional Hospital District

Alberni-Clayoquot Regional Hospital District BOARD OF DIRECTORS MEETING WEDNESDAY, JULY 25, 2018 Regional District Board Room, 3008 Fifth Avenue, Port Alberni, BC AGENDA 1. CALL TO ORDER (immediately following the ACRD Board Meeting) PAGE # Recognition of Traditional Territories. 2. APPROVAL OF AGENDA (motion to approve, including late items requires 2/3 majority vote) 3. ADOPTION OF MINUTES a. Board of Directors Meeting June 13, 2018 3-5 THAT the minutes of the Alberni-Clayoquot Regional Hospital District Board of Directors held on June 13, 2018 be adopted. 4. PETITIONS, DELEGATIONS & PRESENTATIONS (10-minute maximum) 5. CORRESPONDENCE FOR ACTION 6. CORRESPONDENCE FOR INFORMATION a. ISLAND HEALTH and VANCOUVER ISLAND REGIONAL HOSPITAL DISTRICTS Special Topic Meeting Minutes Recruitment of Physician and Other Hard to Fill Health Professionals 6-25 THAT this correspondence be received for information. 7. REQUEST FOR DECISIONS & BYLAWS a. Request for Decision Finance Warrant No. 512 26-28 THAT the Alberni-Clayoquot Regional Hospital District Board of Directors approve Finance Warrant Number 512 in the amount of $335,472.23 dated June 30, 2018. 8. REPORTS 1

ACRD Hospital District Board Agenda July 25/18 Page 2 a. Bamfield Health Centre K. Wyton b. Alberni-Clayoquot Continuing Care Society J. McNabb c. Island Health Capital Planning Committee P. Cote/J. Osborne d. West Coast Native Health Care Society P. Cote e. Tofino General Hospital J. Osborne/D. St. Jacques f. Alberni-Clayoquot Health Network P. Cote/J. Osborne g. Other Reports THAT the Regional Hospital Board of Directors receives reports a-g. 9. UNFINISHED BUSINESS 10. LATE BUSINESS 11. QUESTION PERIOD 12. ADJOURN 2

Alberni-Clayoquot Regional Hospital District MINUTES OF THE BOARD OF DIRECTORS MEETING HELD ON WEDNESDAY, WEDNESDAY, JUNE 13, 2018 Regional District Board Room, 3008 Fifth Avenue, Port Alberni, BC DIRECTORS PRESENT: REGRETS: STAFF PRESENT: Josie Osborne, Chairperson, Mayor, District of Tofino John Jack, Vice-Chairperson, Councillor, Huu-ay-aht First Nation Keith Wyton, Director, Electoral Area A (Bamfield) Mike Kokura, Director, Electoral Area B (Beaufort) Tony Bennett, Director, Electoral Area C (Long Beach) Penny Cote, Director, Electoral Area D (Sproat Lake) John McNabb, Director, Electoral Area E (Beaver Creek) Lucas Banton, Director, Electoral Area F (Cherry Creek) Jack McLeman, Councillor, City of Port Alberni Mike Ruttan, Mayor, City of Port Alberni Dianne St. Jacques, Mayor, District of Ucluelet Kirsten Johnsen, Councillor, Toquaht Nation Alan McCarthy, Member of Legislature, Yuułuʔiłʔatḥ Government Wilfred Cootes, Councillor, Uchucklesaht Tribe Government Douglas Holmes, Chief Administrative Officer Teri Fong, Manager of Finance Mike Irg, Manager of Planning and Development Wendy Thomson, Manager of Administrative Services 1. CALL TO ORDER The Chairperson called the meeting to order at 4:08 pm. The Chairperson recognized the meeting this afternoon is being held in the Tseshaht First Nation and the Hupacasath First Nation Traditional Territories. 2. APPROVAL OF AGENDA MOVED: SECONDED: Director St. Jacques Director Johnsen THAT the agenda be approved as circulated. CARRIED 3. ADOPTION OF MINUTES a. Board of Directors Meeting May 9, 2018 3

Alberni-Clayoquot Regional Hospital District Board Meeting Minutes June 13/18 Page 2 MOVED: SECONDED: Director Kokura Director Cote THAT the minutes of the Alberni-Clayoquot Regional Hospital District meeting held on May 9, 2018 be adopted. CARRIED 4. PETITIONS, DELEGATIONS & PRESENTATIONS 5. CORRESPONDENCE FOR ACTION 6. CORRESPONDENCE FOR INFORMATION a. ISLAND HEALTH News Release Island Health Invests in Improvements at West Coast General Hospital. MOVED: SECONDED: Director St. Jacques Director Bennett THAT this correspondence be received for information. CARRIED 7. REQUEST FOR DECISIONS & BYLAWS a. Request for Decision regarding Finance Warrant No. 511. MOVED: SECONDED: Director Kokura Director Bennett THAT the Alberni-Clayoquot Regional Hospital District Board of Directors approve Finance Warrant Number 511 in the amount of $75,738.42 dated May 31, 2018. CARRIED 8. REPORTS a. Bamfield Health Centre K. Wyton No Report b. Alberni-Clayoquot Continuing Care Society J. McNabb Director McNabb provide an update on the Society. They will be discussing the 2018/19 budget at their next meeting. 4 c. IH Capital Planning Committee P. Cote/J. Osborne No Report

Alberni-Clayoquot Regional Hospital District Board Meeting Minutes June 13/18 Page 3 d. West Coast Native Health Care Society P. Cote No Report e. Tofino General Hospital J. Osborne/D. St. Jacques No Report f. Alberni-Clayoquot Health Network P. Cote/J. Osborne Director Cote reported on the regional housing gathering tomorrow at the Regional District Office from 12 to 3 pm. g. Other Reports MOVED: SECONDED: Director Cote Director Jack THAT the Regional Hospital Board of Directors receives reports a-g. CARRIED 9. UNFINISHED BUSINESS 10. LATE BUSINESS 11. QUESTION PERIOD 12. ADJOURN MOVED: SECONDED: Director Ruttan Director Jack THAT this meeting be adjourned at 4:12 pm CARRIED Certified Correct: Josie Osborne, Chairperson Wendy Thomson, Manager of Administrative Services 5

In attendance from Island Health: Island Health and Vancouver Island Regional Hospital Districts Special Topic Meeting Nanaimo, BC June 29, 2018 Minutes of Meeting Kim Kerrone Rod O Connell Brenda Warren Eva Vincent Jamie Braman Matthew O Rae Chris Sullivan Catherine Claiter-Larsen In attendance from the Regional Hospital Districts (RHDs): Greg Fletcher, Mt. Waddington Kevin Douville, Comox-Strathcona Teri Fong, Alberni-Clayoquot Phyllis Carlyle, Nanaimo Barb Mohan, Cowichan Valley Charlie Cornfield, Comox-Strathcona James Warren, Comox-Strathcona Bill Veenhof, Nanaimo Brian Carruthers, Cowichan Valley Michael Barnes, Capital 1. Introductions Roundtable introductions were made by Kim Kerrone. 2. Recruitment of physician and other hard to fill health professionals Brenda Warren, Director, Medical Staff Support Eva Vincent, Manager, Medical Staff Recruitment, Credentialing & Privileging Rod O Connell, Strategist, Talent Acquisition & Retention There was a presentation on the recruitment challenges faced by Island Health This presentation included: Current workforce challenges in different communities; Current strategies and successes; System challenges and barriers; and Strategies for considerations In addition to the above items, there was a discussion on the role of RHDs and how Island Health can provide more information to RHDs related to the challenges Island Health faces. 6 Page 1 of 6

Island Health and Vancouver Island Regional Hospital Districts Minutes of Special Topics Meeting June 29, 2018 Action Item: Develop a working group to further explore how local communities can help with recruitment. This working group will include representatives from Island Health, RHDs and possibly other community representatives. 3. Evolution of the health system and the expanding capital needs required to adequately support it Matt O Rae, Corporate Director, Capital Management & Finance Projects Kim Kerrone, Vice President, Chief Financial Officer, Legal Services & Risk Catherine Claiter-Larsen, Vice-President, Innovation, Analytics & Chief Information Officer There was a presentation on opportunities to continue broadening the scope of cost sharing and partnering with RHDs as the system transforms. This presentation included: A review of Island Health s 2018/19 priorities; Highlights of how we have been evolving the partnership to date; and Opportunities such as residential care, integrated primary care, mental health and substance use services and investment needed in new digital solutions to enable the quality and safety of care, and future sustainability of the health system. There was a discussion and agreement that Information Management/Information Technology projects and equipment should be treated no differently than other capital expenditures for cost sharing purposes. There was also a further discussion on communication with RHDs with respect to challenges and strategies. Action Item: Island Health to discuss with each RHD how best to communicate with each RHD on challenges and strategies. This could include participating in the Regional District post election orientation in December or January. 4. Closing Remarks Meeting participants felt this meeting was useful. Clarity is needed for the next similar meeting on whether only staff should participate. Kim Kerrone thanked everyone for their participation. Page 2 of 2 7

Island Health - Regional Hospital District Special Topic Meeting Nanaimo June 29, 2018 Excellent 8 health and care for everyone, everywhere, every time

Agenda 1. Recruitment of physician and other hard to fill health professionals Opportunities for RHD s and communities to play a crucial role Presenters: Eva Vincent, Brenda Warren and Rod O Connell 2. Evolution of the health system and the expanding capital needs required to adequately support it Opportunities to continue broadening the scope of cost sharing and partnering with RHD s as the system transforms Presenters: Kim Kerrone, Cheryl Damstetter and Catherine Claiter-Larsen Excellent health and care for everyone, everywhere, every time 9

Update on Island Health Recruitment Challenges Rod O Connell, Strategist Talent Acquisition & Retention & Brenda Warren, Director Medical Staff Support Eva Vincent, Manager Medical Staff Recruitment, Credentialing & Privileging 10

Staff Current Workforce Challenges Community Mt Waddington Campbell River Comox Valley West Coast Port Alberni Nanaimo Cowichan Gulf Islands Victoria Professions Nurses, Ultrasound, Physio, HCA, NP, Community Support Workers Specialty Nurses, HCA, LPN, Pharm Techs, Physio Specialty Nurses, HCA, Pharm Techs, Community Support Workers, Food Service Supervisors Lab Tech Specialty Nurses, Physio Specialty Nurses, Pharm Techs, Food Service Supervisors, MRI Techs, Lab Tech Specialty Nurses, Pharm Techs, MRI Tech, Ultrasound Nurses, LPN, Specialty Nurses, Pharm Techs, MRI Techs, Ultrasound, Lab Tech, Rehab Assistant, IM/IT, Power Engineers 11

Medical Staff Current Workforce Challenges Community Mt Waddington Campbell River Comox Valley Port Alberni Nanaimo Cowichan Gulf Islands Victoria Specialty Family Practice Family Practice, Anesthesiology Family Practice, Internal Medicine, Psychiatry Internal Medicine, Pediatrics Family Practice, Psychiatry, Neurology, Dermatology Family Practice, Pediatrics, Psychiatry, Anesthesiology, Dermatology Family Practice (Quadra) Psychiatry (SSI) Family Practice, Neurology, Dermatology 12

Current Strategies/Successes Rural Remote Recruitment/Retention Incentives for return of service (ROS) Relocation Assistance for ROS Staff Medical Staff Internal training for ROS PRA- BC and UBC IMG for ROS Creation of Advanced Hire positions Float Pools Employee Referral Program Temporary Housing Support Aboriginal Employment Program Providing support to obtain work permit and permanent residency for International Recruitment Collaboration with Divisions of FP Collaboration with Health Match BC Sponsored Site Visits 13

System Challenge/Barriers Housing availability Spousal Employment Insufficient local training seats All jurisdictions face similar or worse challenges Salary differentials with other provinces and/or private sector Staff Status of vacancies: Regular Full time - 100 Regular Part time - 49 Temporary Full Time 93 Temporary Part Time - 60 Casual - 400 Total = ~700 external postings No local training programs for key professions Collective Agreement language 14 Medical Staff Status of vacancies: Permanent Family Practice - 68 Permanent Medical Specialty 38 Locum Family Practice - 24 Locum Medical Specialty - 11 Total = ~141 external postings Highest percentage of FP vacancies is in Victoria (40% of total perm.)

Strategies for Consideration Development of community recruitment marketing materials (videos, websites, brochures) Community Ambassador Program to support site visits of candidates and integration of new recruits and families within the community Community Welcome Kit : (e.g. rec center passes, gift certificates to local businesses, etc.) Promoting health careers to Island youth Development of Housing Strategy Other Recruitment Incentives Increased Island based training seats (e.g. LPN, HCA) Staff recruitment Creation of island based training programs (e.g. Ultrasonography, Food Service Supervisors, Rehab Assistant, Pharmacy Tech) Staff recruitment 15

3) Catherine Claiter- Larsen VP Innovation, Analytics and Information *Presentation / Discussion Areas* 1) Kim Kerrone VP, CFO, Legal Services and Risk 2) Cheryl Damstetter Chief Community Health and Care, Portfolio M 16

Highlights of how we have been evolving the partnership to date? 1. Summit 2. UDMD 3. Cowichan Integration 4. Patient Portal Seniors Health Quality and Innovation MHSU / Primary & Community Care Quality and Innovation Excellent health and care for everyone, everywhere, every time 17

Seniors Health The Summit At Quadra Village Excellent 18 health and care for everyone, everywhere, every time

Island Health Challenges / Opportunities Community focused service model Rising demand for services Priority Populations: Mental Health and Substance Use At-risk Children, Youth and Families Indigenous Seniors Excellent health and care for everyone, everywhere, every time 19

Strategies to Address Integrated Primary Care Strategy: Primary Care Networks Urgent Primary Care Centres 2 under development Mental Health and Substance Use Services Pandora Supervised Consumption Site Pembroke Mental Health/Substance Use Hub 20 Excellent health and care for everyone, everywhere, every time

Quality and Innovation Digitally-Enabled Health and Care Excellent health and care for everyone, everywhere, every time 21

Quality and Innovation Island Health currently has one of the most comprehensive digitally-enabled health care systems in Canada Medication Records Results Distribution Front-End Voice Recognition Disease and Process Alerts Registration/ Scheduling Patient Demographics Health Information Management Encounter Specific Documents e.g. Consult Notes Laboratory Graphic Monitoring Multidisciplinary Documentation Orders Provider Communication Tools Vital Sign and Image Integration All Laboratory, Diagnostic Results Community and Inpatient Medication Profiles Cross- Encounter Documents e.g. Allergies Pharmacy Diagnostic Imaging and Heart Health AND, our health care system is still drowning in paper, with only 30% of the health record digitized to-date Infection Prevention and Control Emergency Services and Urgent Care Paper-based Patient Information Electronic Patient Data Electronic Modules/Capabilities 22 Excellent health and care for everyone, everywhere, every time

Quality and Innovation Access and use of the digital environment is pervasive and growing across Island Health >2,500 physicians and 11,000 clinical staff have active EHR accounts At any given time, over 3,500 clinicians are using the EHR > 1.9M EHR transactions per day Average Daily Peak Concurrent EHR Users 2700 3850 The infrastructure required to enable the digital environment is significant >$46M in technology assets, on average requiring $11.5M/year to sustain >75,000 networked devices, including : 2,000 phones, 1,500 switches, 300 routers 3,500 wireless access points, 14,000 computers, 295 physical servers, 1,205 virtual servers 2,000 printers, 2,100 label printers 480 2005 2014 2018 Excellent health and care for everyone, everywhere, every time 23

Quality and Innovation Investment in new digital solutions is required to enable the quality and safety of care, and future sustainability of the health system Continuous investment in sustainability of the digital infrastructure is also required to ensure reliable access to existing tools, and maintain confidence of end users 24 Excellent health and care for everyone, everywhere, every time

Future Meetings Staff to Staff Meeting September October Semi-Annual Meeting December Excellent health and care for everyone, everywhere, every time 25

ALBERNI-CLAYOQUOT REGIONAL DISTRICT 3008 Fifth Avenue, Port Alberni, B.C. CANADA V9Y 2E3 Telephone (250) 720-2700 FAX: (250) 723-1327 REQUEST FOR DECISION To: From: Hospital District Board of Directors Teri Fong, CPA, CGA, Manager of Finance Meeting Date: July 25, 2018 Subject: Finance Warrant No. 512 Recommendation: That the Alberni-Clayoquot Regional Hospital District Board of Directors approve Finance Warrant Number 512 in the amount of $335,472.23 dated June 30, 2018. Desired Outcome: To provide transparency of the Regional Hospital District s financial affairs. Summary: The Regional Hospital District Board of Directors reviews the details of the expenditures made in the previous month and when satisfied, approves the finance warrant. Time Requirements Staff & Elected Officials: Minimal. Submitted by: Teri Fong, CPA, CGA, Manager of Finance 26 Members: City of Port Alberni, District of Ucluelet, District of Tofino Yuułuʔiłʔatḥ Government, Huu-ay-aht First Nations, Uchucklesaht Tribe and Toquaht Nation Electoral Areas A (Bamfield). B (Beaufort), C (Long Beach), D (Sproat Lake), E (Beaver Creek) and F (Cherry Creek)

Alberni-Clayoquot Regional Hospital Cheque Register - Detail - Supp. AP5100 Date : Jul 03, 2018 Page : 1 Time : 9:52 am Supplier : 0050 To 912 Bank : 1 To 1 Trans. Date : 01-Jun-2018 To 30-Jun-2018 Status : All Cheque Date : 01-Jun-2018 To 30-Jun-2018 Medium : Cheque No. : Batch No. : Supplier All All Supplier Name M=Manual C=Computer R=Credit E=EFT-PAP T=EFT-File Chq/Ref # Cheque Date Status Batch Medium Amount Invoice No. Account No. Account Description Debit Credit 1125 MUNICIPAL FINANCE AUTHORITY EFT-2 01-Jun-2018 Issued 16 E 13060.64 71-1/2018 01-4-6030-000 ACCOUNTS PAYABLE 13060.64 Invoice Description --> DEBENTURE DEBT Total : 13060.64 0.00 13060.64 EFT-3 01-Jun-2018 Issued 16 E 39515.28 75-1/2018 01-4-6030-000 ACCOUNTS PAYABLE 39515.28 Invoice Description --> DEBENTURE DEBT Total : 39515.28 0.00 39515.28 EFT-4 01-Jun-2018 Issued 16 E 43442.75 73-1/2018 01-4-6030-000 ACCOUNTS PAYABLE 43442.75 Invoice Description --> DEBENTURE DEBT Total : 43442.75 0.00 43442.75 EFT-5 01-Jun-2018 Issued 16 E 62830.28 77-1/2018 01-4-6030-000 ACCOUNTS PAYABLE 62830.28 Invoice Description --> DEBENTURE DEBT Total : 62830.28 0.00 62830.28 EFT-6 01-Jun-2018 Issued 16 E 133058.26 72-1/2018 01-4-6030-000 ACCOUNTS PAYABLE 133058.26 Invoice Description --> DEBENTURE DEBT Total : 133058.26 0.00 133058.26 EFT-7 03-Jun-2018 Issued 16 E 4938.37 78-1/2018 01-4-6030-000 ACCOUNTS PAYABLE 4938.37 Invoice Description --> DEBENTURE DEBT Total : 4938.37 0.00 4938.37 EFT-8 03-Jun-2018 Issued 16 E 13663.47 79-1/2018 01-4-6030-000 ACCOUNTS PAYABLE 13663.47 Invoice Description --> DEBENTURE DEBT Total : 13663.47 0.00 13663.47 Supplier Total : 310509.05 0.00 310509.05 1850 VANCOUVER ISLAND HEALTH AUTHORITY 1063 27-Jun-2018 Issued 14 C 24963.18 JUN27/18 01-4-6030-000 ACCOUNTS PAYABLE 24963.18 Invoice Description --> P-086, P-087, P-088, P-089, P-090, P-091 Total : 24963.18 0.00 24963.18 27

Alberni-Clayoquot Regional Hospital Cheque Register - Detail - Supp. AP5100 Date : Jul 03, 2018 Page : 2 Time : 9:52 am Supplier : 0050 To 912 Bank : 1 To 1 Trans. Date : 01-Jun-2018 To 30-Jun-2018 Status : All Cheque Date : 01-Jun-2018 To 30-Jun-2018 Medium : Cheque No. : Batch No. : Supplier All All Supplier Name M=Manual C=Computer R=Credit E=EFT-PAP T=EFT-File Chq/Ref # Cheque Date Status Batch Medium Amount Invoice No. Account No. Account Description Debit Credit Supplier Total : 24963.18 0.00 24963.18 Total Computer Paid : 24,963.18 Total EFT PAP : 310,509.05 Total Paid : 335,472.23 Total Manually Paid : 0.00 Total EFT File Transfer : 0.00 28