AFSCME Labor/FMHP Management Meeting

April 15, 2021 1230PM

Administration Building

Attendance: Adam Castle, Ryan Cates, Steve Wilking, Scott Melby, Roxanne Portner, Carol Olsen, Michelle Chalin, Marvin Sullivan, Alli Kuhlman, Annie Jakacki, Becky Robinson, Kristen Hiner, Ryne Latem, Sharon Huntley

Reflection/Celebration: Scott-Linden is no longer on quarantine. Great work by the staff on the unit.

Standing Agenda Items:

1. Osha Information: Handouts from Alli.
2. 2.      Overtime Information: Handouts from Alli.
3. 3.      Budgeted Position Review: Carol-We continue to fill all vacant positions. HSSS and LPNs. We are not getting a lot of candidates. Also seeing it with food services recently. Ryne has shared a lot of what he has done with recruitment. I am willing to spend money on recruitment next fiscal year. If labor has ideas on recruitment, let us know. Cates-Pay them better is our idea but we know that is contractual. Carol-CNAs is very competitive. Ryne-Our CNAs are the highest in the area. The average is 12.50 to 13 an hour state wide. Carol-our benefits are our advantage. It’s a tough job in the kitchen as well. Our FSSS positions get plenty of interviews every month and they are in person. Becky-We are adding more to the mix to help offset the needs we have observed with frequent 1 to 1s on day/evening shifts or others that need more. Carol-we got supported to fill extra HSSS in grove a with move to north campus.

Old Business

Management

1. 1.      Update on Quarantine/COVID/Point Prevalence Testing: Carol-We were able to end quarantine on linden yesterday. PPT with no positive patients. No one else on precautions. Last week we had 72 staff participate and no positives. We had 50 participate this week and still awaiting results. If we have no positives, we will end the point prevalence testing. In the public, there are many places to be tested. Nicollet county extended invite for staff to get vaccinated. The number is on SharePoint.
2. 2.      Update on Construction Move from 5 to 4 Groves: Becky-We are working to decrease census in north campus. We were at 12. Clinical staff has moved to new locations. Continuing nursing and base staffing as it decreases. We hope to have the majority of clients located at other placements. Some may have to come to the main building. When that is cleared out, we can relocate staff. Cedar isn’t going to be ready when it closes. Jesse Miller will be the supervisor for that unit. It was announced to supervisors that we anticipate the linden GS departure and we will take a look at our compliment. Looking to take the GS position and place it on aspen. We will then move forward with the RNS to help lead linden due to med psych needs. Give it a try with a nursing lead. Roxanne is looking into anyone who may be interested. Cates-What is the timeline for cedar, birch and aspen? Carol-The hope is to open before the first of July. Hopeful for the middle of June. We sent a letter to licensing asking if they are still needing to do a tour. The Fire Marshall and Department of Health is scheduled to visit. Furniture is in there now and working on the punch list. Cates-What about the Pine and Redwood switch? Becky-We will wait until we are close to the end of sequencing. When Bartlett separates, they will fill to half capacity so we will look at other places. Some from pine and redwood may be able to move. We will sequence later on. Cates-Will there be level of care changes? Becky-We will have a team-based discussion on that. Considerations are environmental and if it’s necessary before they institute a level of care. Trying to balance when will be cleanest in regards to teams. The soft date is the 15th.

AFSCME

1. 1.      COVID Issues: Carol-No increase in patients or staff. The total is 108 for staff. Roxanne-We had 5 patients and one that wouldn’t participate that we treated the patient as positive.
2. 2.      Hazard Pay: Denise-There has been no movement on hazard pay.
3. 3.      LPNs Working Across Groves: Roxanne-Put on hold until quarantine is resolved. We will move forward for those who want to cross train. Steve-Was there a communication put out for all grove A? Roxanne-It’s ready to go but was put on pause.
4. 4.      Radios Unable to Transmit: Cates-There were a couple of reports on NOCS. People couldn’t transmit and got the busy tone. Scott-We had two instances where 2 people tried and got the bonk. Its designed this way. If you get the bonk, it notifies you. In one instance, the staff tried until they were able to transmit. On another occasion, the staff thought there was something not right, so they shut it off and turned it back on which created delay and confusion. I was not aware that it didn’t work properly. There is testing going on in security services. Steve-I didn’t get the results. I was doing additional testing for the man down. Some are very concerning. Scott-If they forget about the function, I am not aware of malfunction. There are discussions on training but having discussions on how the system works is helpful. Cates-when they got the bonk, were there other transmissions? Scott-That’s what I had heard. Marvin-that is what we need to focus on. If we aren’t 100 percent sure. When you don’t have signal, you get the bonk also. Steve-we had some dead spots but then replaced equipment. Nothing since. There were some issues where an ICS was called and couldn’t get incoming calls within the system. Scott-I can share what I know. I can never say anything is 100 percent. At least you know it didn’t transmit. Not aware of any dead spots. If staff reach out to you, please do those security reports. Nothing is definitive. Roxanne-if there is a bonk, does the man down work? Steve-that was a test we did; I don’t remember the result. Within my test, I did it with my radio only. I did get a bonk when keying and pushing a man down button. Carol-safety committee talked about radio training again. Keep testing and testing.
5. 5.      OT Increase: Cates-Overtime is still high. Carol-I noted we are comparable to last year. We want to reduce it. We have more units now. Cates-The concern is coming into the summer. Scott-we have the same concern. Carol-we want to get the positions filled. The process takes a lot of time, which is contractual. Hoping to bring in a lot in the next few months. We have positions but it takes time to hire. Steve-Will the budget allocate this? Carol-We have them covered this year. If we don’t get more funding, we will have a hard time. We don’t want to lay off people. We are hoping for funding. Becky-We need to point out different phases of approval from start to finish. It was helpful to me. We put forward a 6.5 vacancy rate in addition to the relief ratio. The budget is considered. From start to finish, this process has been eye opening. Carol-Have you heard from your leadership how receptive the politicians are? Cates-The house is, but the senate is the problem.
6. 6.      Vacation Shifts Used Daily: Cates-Have you been looking at not just the allotted 21 slots but how many are taken? Carol-Jodi said you all have access on atlas. You can look to see how many. Cates-There is no way to look at the data as a whole? Scott-if you go to the calendar you can see how many spots were utilized. Cates-We don’t know how many are used. The issue is rescinding inside of the posting. Scott-Atlas would be adjusted, I believe. Carol-check in with Jodi to see if it gives you what you need. Marvin-It’s not an accurate review on our end.
7. 7.      Hospital Coverage: Steve-Sending 2 staff to hospital for coverage. Patient had dialysis catheter and we were to observe him. With one person at appointment, they can’t maintain that observation and take a break because if they step away and it gets removed….we will always go back to safety, we need to maintain 2 staff. Cates-We went through problem solving with this. When patients that shouldn’t have one staff, it creates problems. Becky-Let’s look into that more. Transport was looking into a proposal with that so I want to process through that first. Steve-I will let you know who said to keep an eye on the patient. Michelle-There needs to be clarification with the duty of the counselor in that situation as well. This is something that has to be clarified as well. Carol-The role of the staff is not to take care of medical issues. The reason is security and safety of the public. Get us more information on that. Carol-Always have staff check in with the supervisor as well. Steve-We are always going to challenge the not having two staff issue.
8. 8.      Not Backfilling Units When Staff Leave: Cates-There have been many examples of this. Staff going home sick. Staff having the last 2 hours vacation. Not backfilling the units on many occasions. Carol-I didn’t understand what this was so I didn’t know how to prepare. We have shifts where staff were injured as well so I thought it was related. Scott-I will do some follow up. Cates-some with staff going home sick but most is staff on vacation on late shift. Marvin-The early shift also.

New Business

Management

1. 1.      Engagement Discussion: Carol-I want us to have a discussion on the threshold for engagement style. So many instances when staff go home crying for how they are treated here. We hold people accountable but what is the threshold? Interested in your thoughts and having discussion. I don’t want to start looking at it all. People need to be nice to each other. We aren’t here to take a side; we want good treatment of patients and each other. I am hearing it weekly. Becky-Due to the nature of the work, we become tolerant of mal-adaptive behavior. There is a level of what we are able to develop as a norm. When we do this with each other, we need to check it. I hear from others about non-professional behavior. What we tolerate is described as passionate. I appreciate that but we know where the line is crossed. How do we start shifting that to what Is acceptable? It’s a culture shift. It needs to come from multiple places. Not feeling retaliation, or saying that is not cool. I hear routinely so and so is mean. They make comments and people don’t want to say what happened or who it was. What steps can we take? Cates-a few different angles. Dark humor in a stressful environment. But being mean is where it’s a problem. I don’t know how to address it. Carol-people who have started working here and soon after say it’s a very toxic environment. Then they leave, that’s sad. Becky-Blatant discrimination is also more prevalent. Homophobia and disdain for trans is common as well. I have heard disclination of race as well. We can’t ignore it anymore as a whole. How do we partner? That could be an entire session. Carol-we can bring all of our labor partners together jointly. Not inclusive of one bargaining unit. Cates-we can definitely do that. Scott-be willing to have that conversation. If I see something, and I don’t say anything as a leader, that becomes accepted behavior. As leaders, we can address this. I may follow up later instead of in the moment. I want people to come to work and have a good day. If we can have a commitment to address things when we see it. Peer to peer interaction that this is not okay. Becky-Just calling it out and having awareness.

AFSCME

1. 1.      Coachings. Criticizing Management Decisions/Being Tagged on Social Media Post: Cates-supposed to improve performance. One was for being negative and disagreeing with management. This isn’t a coaching issue, its being open minded and thinking differently. It appears as you are saying to not disagree or else. I have seen two of them. Becky-Due to criticizing management? Cates-just as negative and an example is criticizing management decisions. Steve-to tie in the previous engagement issue, this is a good example. Becky-Saying you disagree can be done professionally. Framing it the right way is important. Carol-we all need to be held to the code of conduct. We want to encourage people to bring ideas forward and this is why…In the end the decisions is made, maybe not in the way you want but it is in the presentation. Becky-going back to the culture. Its not uncommon to hear negative things about people. If you go outside of here, that wouldn’t be acceptable. Steve-Being professional and how you deliver it opposed to you not liking what I’m saying, then you are suppressing me. Becky-being able to honor both of those. Cates-Tagging in social media. If someone is tagged in a post, they did nothing wrong. That person shouldn’t be responsible for being tagged. Becky-educating the person. If they suspect a privacy violation, they should report it. if there is potential you are observing something illegal that should be reported. Steve-I can’t control what you put on social media. You can use that to the tagger. If an investigation happens, they have no issue putting that coaching in an investigation that I may be reprimanded. If you are saying lock down your settings. I can’t control I was tagged but at the end of the day, you will hold me accountable. Becky-not if you report it. Ask the person to remove you from it. Roxanne-you can untag yourself. Becky-It goes beyond this with protected information. There is more to this as far as awareness with violations. This was part of the conversation. Through legal review it was found to be illegal. Steve-you can have a conversation but don’t need a coaching for it. Becky-now we go back to debate about the line between coachings and not having to listen to it. Cates-because they are on social media citing an article. What makes it a legal issue? Becky-hypothetically, if someone identifies themselves as employed here and worked with this person, you have inside information about the issue. Content isn’t the concern. Roxanne-keep social networks separate from work.
2. 2.      Meeting Patient Families Outside of Perimeter for Property: Cates-Unit staff required to go to guard shack for patients? Carol-for COVID-19 we looked at exceptions. It’s a conversation if they are comfortable doing that. I don’t know if anyone was asked that didn’t want to. Cates-asking them to go outside to meet with patient relatives, you don’t know who they are. Carol-It was always by a staff in the gate. Cates-You also have boundary issues and what could come in. Becky-we don’t want people coming into the parking lot.
3. 3.      Mask Confusion about Tie Behind Masks: Carol-Yes, they are allowed, we hand them out. cates-someone in management isn’t on the same page. It was at a committee meeting. Scott-let me know who it was and I can follow up and set expectations.
4. 4.      Single Person Transports Inside and Outside the Perimeter: Cates-Med trips and going outside the perimeter with one staff. This opens up staff to all types of things while driving, can’t take breaks, etc. The contract states a staff can take a break within 4 hours. There is a DOC lawsuit where an officer was accused of sexual misconduct with a prisoner. DOC was liable because they only sent one officer instead of two. Sued based on only sending one officer instead of two. Steve-even for patient safety. Staff could put a stop to that if it was happening as well. Becky-typically wouldn’t have one staff unless they were on liberty level blue or green. Scott-we did work to clean this up. Was it recent? Cates-yes. They are a blue in the main building. Marvin-still goes back to having one staff liability. You don’t want me going on the unit by myself but still doing a trip with one. Becky-it also isn’t therapeutic for that patient who is doing good work and allowing them the opportunity to gain trust and further their treatment. Marvin-there are a lot of allegations that occur. Carol-there are risks with any actions you take. It has been evaluated which is why we allow that patient to be out on their own on campus.
5. 5.      Requests Not to Work Earlies on Fridays Being Emailed To Supervisors: Cates-Is it a performance issue if staff ask to not have earlies on their Friday. Carol-Jodi has asked the supervisors if this does or doesn’t work for the unit. She says she can stop but she wants to look into it with the supervisor first.
6. 6.      Parking Issues: Cates-Parking is terrible. Carol-we will look into it. We did the math when we factored in the parking spots.
7. 7.      New Staff Being Told in Training They Will Only Be Inversed 1 Time a Pay Period: Cates-when staff are told they are inversed for a second time; they are very confused and upset when it happens. I don’t know who is telling them this. Scott-I wonder if it’s a misunderstanding with the float process. Scott-find out where the leak is and let us know.
8. 8.      TSS Instructors Telling Staff They are Required to Run to All ICS and Drills: Cates-They are being told by some instructors, not all. Carol-I did some follow up and they are saying you need to respond quickly and safely. I can reach out to Nate also. Scott-for drills we still need to respond quickly. Cates-but if they get hurt, they won’t get IOD. Scott-yeah, respond within their own capabilities. A criticism could also be we aren’t performing effective drills. Steve-ICS refresher courses would be good. Cates-I hear staging and I will walk quickly but others are running. Carol-I heard they were doing ICS training today.
9. 9.      Supervisors Changing Time Books Without Notifying Staff: Cates-Notify staff if you change it so they can learn from it. Its not a coaching if they are sent an email. Becky-Yes, we encourage people to send a snippet also to show how to do it correctly. Cates-There isn’t a class on timebooks, so there shouldn’t be discipline. Steve-I want to put forward training on time books so people know what to use. Becky-We are looking into starting an overview on this. One portion is dedicated to time entry with pointers and guides about when to use them. It’s a step to progress. Scott-staff should be specific in their notes if they are not sure of how to code it. this really helps us match the codes.
10. 10.  Request Not to Cover and Then Placed There the Next Day: Cates-There is an issue with staff requesting not to cover linden.  The staff talked to AODS on Friday to not cover the weekend. Came in the next day and was covering linden. Appeared as though it was purposeful. Scott-we wouldn’t intentionally put someone where they didn’t want to be. We do place staff related to coverage needs.
11. 11.  Rescinding Vacation: Cates-Is there a process for rescinding vacation in and outside of posting of less than a week? Is it consistent? Carol-Jodi follows the contract. Denise-I don’t know the answer to that, we can check with Jodi. I will say it depends on business needs. The contract is silent on this, so its discretionary. Cates-everyone has to be treated fairly. By doing it how you want, there is discrimination. Denise-I don’t want to use the word discrimination because that isn’t what is going on. Scott-there isn’t language but we need to find a balance. It can impact many people on both ends of this. We should look at the needs. Its not discriminatory. If it saves overtime, its beneficial. If someone takes vacation, it stops someone else from getting it. Cates-If you say one person can rescind but another one can’t. Scott-I’m saying there is a reason for it. Cates-there is a lot of rescinding happening right now. If you aren’t offering enough vacation, is there enough being offered compared to what they accrue? Carol-we can find out what their process is. You can look into the other information as well.

Add Ons:

1. 1.      Wellness Rounds: Steve-The integrity of rounds with a person in the shower or the bathroom. Are we expected to see the person on all wellness rounds? If it is to be done this way and issue is with one patient, should we approach that in the individuals plans? Becky-The wellness policy is in review. There are a variety of issues coming up. It is the expectation following the 2 events we have had in two years. Incidents happened on different levels of care related to people who had extended periods of time in the shower. There weren’t any vulnerabilities identified around those. There are a lot of ways to help navigate. Most rounds are every hour. When you start a round, start with that location and announce you will be back in 10 minutes to check which allows the person to finish. Then if you need to enter, employees are backed up. It is a facility safety need. Communicate that with the patient that you are required to do this. You are always going to have outliers that don’t demonstrate blatant precursors. We need to update the policy if it is confusing. Steve-That is why we need to two staff on all med trips because we don’t have precursors. Becky-I am coming up with more clear language. It really is if someone is in the bathroom. So, you aren’t barging in on them. During waking hours, all levels of care. Cates-so there is a potential every 15 minutes? Becky-There is potential. Marvin-when you say visual contact, I can have eyes on patients without opening a door, is that enough if I can see him and talk to him? Carol-The key is to make sure there is no harm and they are breathing. Becky-policy is if you can see their face, it is sufficient. We have variation with hour round are being completed on NOCS shift. On level care they require door is open and monitor them every round. We don’t do that on our highly acute areas. But it begs the question why our least restrictive is doing it in a way that is more intrusive than our high acuity units. We need to identify what is practical and get everyone on the same page. There is confusing language in the policy right now.

Meeting Adjourned at 208pm