CBHH/ CARE Labor/Management Meeting

September 24, 2020 130PM

CBHH/CARE-Virtual Meeting

Attendance: Adam Castle, Jim Pierce, Heather Tucky, Rn Sup, Ashley Samora, Tiffany Brown, Christina Anderly, Steve Wilking, Frederick Bettner, Alex Flores

CBHH/CARE Agenda Items

1. 1.      HUC Position: Pierce-no update with covid and budget, there is a freeze. Until that straightens out, on hold. Alex-temporary? Peirce-It is collateral duty that people volunteer for until they have to take a break to follow contract. Steve-The last conversation was about plans to convert it to a permanent position, then couldn’t. Is that the plan? Pierce-yes, still intend to, but timing is bad right now.

New Items

1. 2.      Overtime: Alex-conversation about the shift being posted. Can we go over the process of filling? Samora-Before its posted, I call intermittents to see if they want it. For the most part, there are no open positions when I post. If I do see one, I ask for adjustments. We have call ins and then goes to the call out process. Alex-You operate using subsequent? Samora-Yes, they have a list.
2. 3.      Night Shift Staffing: Alex-There are concerns over safety numbers at night. Is it adequate for 1 to 1s, meds, breaks, etc. Samora-alone on units? Alex-only one person at the desk, no other staff. 1 to 1 shouldn’t be able to assist then if something happens. Samora-Asking what are our numbers for staffing on NOCs. How does it break down? 1 to 1, etc. availability of staff assisting. Steve-that is accurate. Samora-if we have a 1 to 1, we look at staffing and do call outs and inverse to help at night. Heather-standard staffing is 1 licensed in house. 1 RN for sure, and it varies from 4 to 5 staff. Jim-based on acuity and capacity. Addressing nights by reducing capacity. We aren’t running at 16 so that affects the numbers. Alex-The concern was injectable meds. Is 2 licensed on site required?  Heather-they have enough staff to administer if needed. There is usually always an RN and LPN. If no LPN, there are 2 RNs. Alex-Injectables given when only 1 was present at 215 am. At the window where technically they couldn’t do injectables if necessary. That was a night concern into an early. One incident April 10. Only had 3 staff on. Minimum supposed to be 5. Patient in crisis, one needed to be transferred in 4-point restraints. June 19th  I mean. Jim-okay that makes sense. Alex-2 sick calls for AM shift. Heather-I was on that morning at 3am to help cover the floor for nights. Incident didn’t happen until 814am. When I came in, there were 4 of us.
3. 4.      Staffing: Alex-Any reported injures in last 6 months? Jim-We have reported injuries for staff, but injuries didn’t occur on night shift. Occurred when there were more staff on. Alex-we would like the first report of injury forms from this year now, and then bimonthly. Heather-I will ask about that. I am not sure about the specific sheet, if we can provide without being redacted. I will ask about that for you. Steve-Typically what happens is that the report is redacted for names. We are just looking at who was injured, and the 300 logs are self-explanatory. Not asking for identifiable person. Alex-do you use acuity for staffing levels? Jim-we don’t have an actual staffing program that does but we look at the acuity of unit to determine to add staff or not. It may require 1 to 1s. We may add staff to do that. Alex-how does that work? Samora-I take into account what is going on. Staff will come in and say, “this is why.” Not a lot but when they do, we look and call out. Alex-So, relying on staff to talk to you or is it formal? Samora-if something happens where we have 1 to 1, usually charge nurse will come and say to look at the staffing and do call outs if needed. Alex-if 1 patient is amping up and another amps up in crisis state. Do you have an emergency meeting or what? Samora-so far, the charge nurse does a good job asking for what is needed. Heather-we have a morning meeting every day where we discuss staffing needs.
4. 5.      Filling Job Vacancies: Alex-any available currently? Jim-AFSCME side there are 4 LPN open. And a couple MPAs. Struggling to find suitable recruits for LPNs. Heather-the interviewees have turned them down. One has been out there since May. Jim-Conversation that the LPN will be eliminated for .8 has not happened. We have started talking about converting LPN to RN to find more. Haven’t done that yet. Alex-that would be a conversation we would have together or be informed if that happens? Heather-yes, we would let you know. We are being asked to put new hires through a review process right now. That comes from executive leadership. On a secondary approval for hiring. Steve-what does the budget shortage look like for you? Tiffany-we have not been directly told there is an impact at care of CBHH. We want to fill needed positions. End goal is to serve clients. None have been cut or eliminated. Trying to avoid additional costs. Jim-struggling with nursing staffing related to vacancies and staff being out for a variety of issues. We haven’t had discussions about changing staffing model. Priority is to fill licensed staff positions first because then I can get capacity raised that allows us to serve more patients.

Rochester

1. 6.      CDPA Full Time: Steve-last time we talked about CDPA becoming full time and mashing together to create full time. Heather-we haven’t made any progress. We furloughed staff and found that the permanent staff were happier. Haven’t had new requests for that. As of now, it makes more sense to remain at the .8.
2. 7.      Staff Assault in June: Alex-how was that handled? Heather-RN supervisor and LNDD came in to help staff. I don’t know that we pulled anyone aside. We offered to listen to staff that wanted to meet. We met as a group and had further discussions. There were 3 staff involved. It was determined that a staff had been more direct in his approach that may have had an impact on the escalation. The other 2 thought maybe they could talk about better ways to approach the de-escalation. We offered additional training for that. Alex-Was any information gathered during those talks used in those investigations? Heather-there were not any investigations that came out of it. Alex-any further investigation? Heather-The critical incident review was done. We reviewed video and no personnel investigation was completed.
3. 8.      Overtime: Alex-issues with overtime being given out appropriately? You guys use the same model as CBHH I assume. Heather-Yes
4. 9.      Staffing Levels: Alex-do you feel it is appropriate currently? Heather-we were fortunate to have addition of the furlough staff, so we were able to add staffing. Levels are perfectly adequate now. With an Increase in clients needing additional time, we do call for overtime to increase when needed.  Alex-Fully staffed? Heather-4 CDPAs are open. 3 are .8 and 1 is .5. waiting for offers to be approved. We also have 2 unfilled overnight LPNs potentially but unable to fill those right now. We had a contract nurse that had been offered overtime. We don’t need 2 full time on overnights. Only need a .6 but looking to rearrange those.
5. 10.  Safety committee meetings: Alex-we would like to attend the safety meetings. Have there been AFSCME members in those? Heather-we have had 2 people at the regional’s meetings and they are AFSCME voting members in those. Casey Bartlyzal and Ryan Link. Regional meeting is monthly, and the safety focus is quarterly. We will send you the minutes when Casey returns.
6. 11.  Steve-Are you allowing visits or HR other than staff that work there? Heather-no, not at this time. We can do a meeting but would need to do it virtually. Conflict management, training, HR is all done virtually at this time. That was put out in March by HR requesting this. Steve-are you in discussion as far as de mobilization? Opening visits, lawyers, social workers are resuming. Heather-I don’t know of a plan for Rochester, we had our meetings with AFSCME today and HR weekly. Anoka area talked about plans but not aware of committee for Rochester. Christina-we have not opened. They are meeting about it and it is being reviewed to see if it’s feasible. Fred-we had plans, but visitation is put on hold. Recommendations from CDC is to put on hold. We have plans but not able to implement at this point. Steve-Tiffany, forward me the email about the virtual meetings. Tiffany- I will send it to you.

Adjourned at 226pm