BOARD MEETING: Regular Meeting DATE: October 25, 2016 MEMBERS PRESENT: Helen Adger, Kenneth Clay, Robert T. Green, Jr., Mary Irvin, David Norman, Brenda D. Smith, Helen Godfrey-Smith, Bruce Walker, Patricia White MEMBERS ABSENT:None OTHERS PRESENT:David Jones, CEO, Pam Hughes, COO, Allyson Allums, CFO, Lanell Audirsch, Human Resources Director, Doug White, Hospital Attorney, Mary Coil, Foundation Director/Marketing Director, Dr. John H. Haynes, Jr., Dr. John Woods, Chief of Staff, Dr. Jody Chance, Dr. Walker May, Dr. Eiel Ragsdale BOARD CHAIRMAN: Robert Green SECRETARY: David Jones TIME CALLED TO ORDER: 5:30 p.m. LOCATION: NCMC Events Center I. Called to Order Robert T. Green, Jr – Chairperson, called the meeting to order. II. Invocation and Pledge of Allegiance Robert T. Green, Jr. offered the Invocation and Brenda Smith led the group in the Pledge of Allegiance.III. Approval /Amend Agenda: Robert Green noted that there was one new item to add under New Business. David Jones requested to strike #3 – Approval of Resolution #5 to Approve a Capital Lease for the Purchase of Steris SSI 6 Inch AD 208 V Prevacuum Sterilizer. We are going to replace the electrical power unit in the equipment which will put the cost within his spending limit. This item will be replaced with “Approval of Purchase of Allscripts Interface for the 340B Program”. We need this to get our special pricing for our pharmaceuticals through the clinic piece. Pat White made a motion to approve the request to amend the agenda as recommended. Brenda Smith seconded the motion. The vote: yeas: Robert T. Green, Jr., Pat White, David Norman, Brenda Smith, Helen Adger, Mary Irvin, Bruce Walker; Nays: None; Absent: Kenneth Clay, Helen Godfrey-Smith, Abstained: None The motion passed. IV. Community Comments:No community comments. Robert Green stated that Dr. Haynes is present tonight and requested to address the Board. He requested to speak at the time of the passing of the Medical Staff By-Laws. Robert Green asked if anyone had an objection to him speaking at that time. There were no objections. V. Minutes – Regular Meeting September 27, 2016:The minutes of the September 27, 2016 regular Board meeting were mailed prior to today’s meeting for review. Bruce Walker made a motion to approve the minutes as mailed. Pat White seconded the motion. The vote: yeas: Robert T. Green, Jr., Pat White, David Norman, Brenda Smith, Helen Adger, Mary Irvin, Bruce Walker; Nays: None; Absent: Kenneth Clay, Helen Godfrey-Smith, Abstained: None The motion passed. VI. Old Business – 1) Construction Update:David Jones stated that at the latest update meeting the date of December 22nd was given for the final completion of Part D – the front entrance, the chapel, the remainder of the lobby, the gift shop and the parking lot. It has not rained in the last four weeks so they have been able to do a lot of dirt work with a lot to be done. He feels that date will be moving backwards. This is the date given. The old hospital has been completely demolished and removed. We were able to save some bricks for Board members and community members that want a brick from the old building. It was a good building and served the community well for many years and certainly want to keep some mementos of it. David Jones stated they are running a drainage line now. Once that is done they will begin work on the parking lot and working on the structure. The hospital is much more functional now that Part B is open. It is extremely nice. There are still some things inside the building that need to be completed – some hardware on some of the automatic doors that are not complete. Pam is keeping a running tic list of everything that we are aware of and some things that have not been worked on. It is coming along. We are closing in on the final stretch. Mr. Jones noted that it is dinner and a show in the cafeteria with all that is going on with the demolition and now the dirt work. 2) Renewal of Ambulance Tax:Mr. Jones reported, that along with the help of the Marketing Director/Foundation Director, Mary Coil, we have a plan to do some low key group meetings in the next month or so then be more vocal right before the election commences. This passed rather easily last time. We are not going to take for granted that it is going to pass easily again. Our Ambulance Service is a huge benefit for the community. It is certainly something that we want to continue and we need the tax renewal to help fund it. We are the only small rural hospital in the state that has its own ambulance service. The hospital service is a large area as far as square mileage. It would be a massive disservice to the community if we didn’t have the ambulance service. We must stress that this is a “tax renewal”. We may have some assignments for a few of the Board members if we could enlist some help with this. There will probably be some voter burn out after the Presidential election. Board chair, Robert Green, noted that he injured his knee. He received excellent care by the doctors and staff. He extended this thanks and appreciation and how proud he is of the hospital and Board. VII. 1) Review September 2016 Statistics – Allyson Allums: Allyson Allums presented the September Statistical Report. There were 70 Admissions and 72 Discharges with Total Days Stayed –237. The Average Length of Stay – 3.3 Days. Total In-patient Days – 226. The average Daily Census – 7.5 Our Total Occupancy Rate was 50.20%. Total Surgeries for September (In-patient – 2 / Outpatient – 3). Endoscopies performed in September –33. The total Emergency Room patients seen – 515. Swing Bed Admission – 16. There were 152 Total E.M.S. runs in September. Observation Patients for September – 34. There were 4 Newborns in September. The total Patient Visits for the Medical & Surgical Clinic is 2245. The Plain Dealing Clinic saw 637. Benton Medical saw 103. There were 30 Mammograms for September. 2) Review September 2016 Financials – Allyson Allums:Allyson Allums presented the Financials. She reported Bad debt was 4.7% Days cash on hand 31.0. Hospital Revenue over Expense. Revenue –$3,163,806 Expense – $1,720,211 with a loss of $179,975. AR Days 46.3 days. The AR Days for all three facilities – 51. Plain Dealing Clinic – Revenue over Expense. Revenue –$111,201 Expense – $80,004 with a profit $11,638. Medical and Surgical Clinic – Revenue over Expense. Revenue – $450,405 Expense – $307,405 with a profit of $356. Benton Clinic – Revenue over Expense. Revenue –$21,645 Expense – $18,464 with a loss of $9,419.63. Self-Funded Insurance – Total Net Insurance Expense – $91,271. We have had a couple of months with large claims. David Jones noted that this does not reflect the increase we would have incurred had we gone with BlueCross Blue Shield. The first year was pretty much break even. We have enacted some initiatives and will probably come to the Board with more. Tobacco users will pay a higher premium opposed to a non-tobacco user. The financial liability, based on certain criteria, will come into play. Pat White made a motion to accept the Statistical and Financial Reports as presented pending the audit. Brenda Smith seconded the motion. The vote: yeas: Pat White, David Norman, Brenda Smith, Helen Adger, Mary Irvin, Bruce Walker; Helen-Godfrey Smith; Robert T. Green, Jr., Nays: None; Absent: Kenneth Clay, Abstained: None The motion passed. VIII. New Business 1) Approval of Medical Staff By-Laws: Robert T. Green, Jr. noted that a copy of the Medical Staff By-Laws were sent to the Board members for review prior to tonight’s meeting. He stated that Dr. Haynes has requested to speak to a portion of the by-laws. The specific section is 4-A4, page 22. Dr. Haynes requested that portion be read aloud. Pat White read the section aloud. Upon reaching the age of 75, a Medical Staff member or Allied Health Practitioner credentialed through the medical staff process shall no longer be granted privileges. Dr. Haynes stated that apparently that applied to him – he is 79 years old. He expressed his appreciation for the nice parties for his retirement. He appreciates Administration and the Board for doing that. Upon hearing from Dr. Taylor about the age limit being in the by-laws – he started thinking about it. That applied to him. Why are we putting a restriction like that in the by-laws? If he decided he wanted to come back after retirement for partial retirement – he would not be able to because of this age restriction. Why do you decide that at a particular age that you are no longer capable? He stated that he asked the staff members at the table if they thought he was not capable of practicing good medicine? He stated that every one of them said he was. Dr. May and Dr. Chance spoke up and said that they disagreed with him at that time when Dr. Haynes asked them. They did not say that. Both stated they felt Dr. Haynes was unsafe practicing medicine. Dr. Haynes said he has practice medicine for a long time. He stated that he has received many awards and he has written several published papers. He stated he has never had a patient that has complained he is not capable of practicing medicine. He performed surgery up to the time he retired. He did cholecystectomies, which the other doctors don’t do. Most of these doctors are very good. He has trained them and they are very capable of practicing medicine. We cannot, by age, determine if someone is not capable of doing what they have always done. He has taken care of people in this community and he does not think that there has been very many negative things said about the way he practices medicine. If he did decide to come back, which he has not decided to do, he would certainly like to be able to do it not because of age but because of ability. He has never judged patients by their color or their ability to pay. He did not mean to be critical about the staff. He has been up front about what was on his mind. He noted that when he hears about something that is questionable he looks into it. He thought everything was set up with the Rural Family Practice Program that we had. We are supposed to have OB. We trained doctors extra and we have Dr. Taylor. He is still on staff at LSU Medical School and on staff at Willis Knighton. We have some good doctors here. He is sorry that maybe one or two have changed their mind that he is not capable. It does not hurt his feelings for someone to tell him the truth. He is worried about the program that he started about 17 years ago. He did criticize the way this was going. If he does not like something he does not mind saying something about it. He does feel that without the program he started 17 years ago that the hospital would not be here today. He has worked hard for the community. He has been on the School Board, he has reared his children in the community. His heart is in the community and in this hospital. One of the doctors told him he was trying to destroy this hospital – why would he try to destroy something he has worked so hard for all these years. It is unfortunate that grown people don’t get along as well as we should – he is very capable of practicing medicine if he did want to come back. Just because you are greater than 75 you are not capable anymore. How many doctors that are 79 will be applying for a position at this hospital – none. Helen Godfrey Smith stated that she personally would like to take the opportunity to say that she knows that there is nothing personal from her stand point or any other Board member. Sometime appearances can play a role. Because you are above that age it could seem that it was pointed. The actuality was that is not uncommon for hospitals across the country, because our country has shifted. The morals and values have changed – people are so litigious now. They look for ways to sue and most hospitals are risk mitigating is all it is. She is not a rubber stamper. She is getting older. In her profession, if she misses a beat it does not put someone’s life in jeopardy. In the medical field it becomes highly risky. She would not be sitting on the Board if she felt the group had values so shallow that they would use a pin and paper to make his career and all that he has given to the community less than the value it holds. She has known of his work since she was a young girl. This is the Boards fiduciary responsibility to protect the hospital and the legacy that he has built for the future. Dr. Haynes stated that every individual should be evaluated by their ability – not by their age. Helen Godfrey Smith stated that sometimes the young doctors are often times placed in the position of having to negatively access the ability of an older doctor and that would be uncomfortable. Most of the time the team has been trained by the older individual. To put them at the table and asked them to judge the competency of their mentor – they would not be able to do this. Rather than use a subjective method of judgement – this method is a way of moving forward. Dr. Haynes stated that he has never had a malpractice case. He hopes all the young doctors here can go fifty years and be able to say this. Robert Green, Board Chair, stated we would hear from Dr. John Woods, Chief of Staff, then from Bruce Walker. Dr. Woods stated that Dr. Haynes approached him a couple of weeks ago regarding his concern about the age stipulation in the by-laws. Dr. Woods told Dr. Haynes he would objectively look into matter and do the best he could. He told him he did not know about the laws – this is very new territory to him. He researched it the best he could and he has to take all emotion out of it and present exactly what he sees and has found. The hospital by-laws have not been updated for almost 30 years. Our outside auditor at some point was asked to address the age issue at an annual retreat because of the liability. Dr. Taylor, Chief of Staff at the time, appointed Dr. Chance to research and append the outdated by-laws. It was a hard task to undertake. Dr. Chance modeled, as close as he could, to the Willis-Knighton by-laws. The new by-laws were then approved and sent to the Hospital Board for final approval. This is where we are and how we got here. It did not have anything to do with any other reasons that he can see besides the factual steps. There are Medical Staffs that look the other way because the common perception is that they have been a good doctor and were are not going to betray them. That kind of kindness can backfire subjecting patients to potentially dangerous consequences such as serious injury or death and or faltering malpractice suit or loss of medical license. Competence is a highly individual matter and incompetence can be found in every age in difference situations. For older physicians deciding when to leave practice is about more than just clinical competency also comes with an emotional internal struggle. Dr. Haynes came back after officially retiring and wanted to continue to be a part of the hospital. He was given 2 – 3hour slots for teaching and worked with Dr. Woods in the ER and maintained an office space. The hospital must ultimately look out for patient safety. Dr. Woods looked at the ultimate responsibility so he asked the hospital attorney about this. Dr. Woods distributed a copy of the Louisiana Statutes regarding Utilization reviews; relief from liability and discovery; standards compliance. There is a responsibility with the hospital and everyone dealing with the hospital must take all measures to protect the patients. As long as these measures are held in compliance we are not held liable. The hospital is held to a standard that we must keep up or everyone involved is held liable. Requiring doctors to undergo periodic physical and cognitive exams as conditions of renewing their privileges. It is a very emotional topic and very touchy. It does not have anything to do with you not knowing what you are doing. The hospital must put this in place they are leaving a huge open door for anyone to step in and basically shut the doors. The legacy and everything then goes. Robert Green asked if Bruce Walker wanted to speak. He said yes. He reviewed the by-laws last night. He noted that he personally is opposed to an age limit. Just because a man is 75 years does not mean he is not capable of doing the job. He is just opposed to anyone putting an age limit on a person’s capabilities. If we see there is a problem, there are steps to take. Robert T. Green asked if there were other comments on this matter. Bruce Walker asked if there could be a vote on that one section. Brenda Smith asked if by-laws can be amended. The answer was yes. Because of the time frame that we need to approve the by-laws. Is this something that we can pass the by-laws and give them a chance to do some research and thinking and have some more conversation about his section. David Jones noted, procedurally that these are the Medical Staff’s by-laws. The Board should request the Medical Staff to review those things and whatever adjustments they make, they would bring back to the Board for final approval or disapproval. Robert Green stated we are at the point of approving the Medical Staff by-laws after comments. Pat White noted that the by-laws have not been updated for years and many things have changed. Bylaws are always subject to change and it does not take an act of Congress to change bylaws. We need to go ahead and put some bylaws in effect so they can have something to be guided by and they can always be changed and there can be more reviews and discussions about it down the road. Pat White made a motion to approve the Medical Staff bylaws as presented. Brenda Smith seconded the motion. The vote: yeas: Helen Adger, Kenneth Clay, Robert T. Green, Jr., Mary Irvin, David Norman, Brenda Smith, Helen Godfrey Smith, Bruce Walker, Pat White, Nays: None; Abstained: None The motion passed. Mary Irvin inquired if we are voting that way on the notion that we, as a Board, are going to take the responsibility to look into the possibility of changing the age restriction. Robert Green stated the bylaws stand as approved. We have the opportunity to request the Medical Staff to review the age clause and to look into each individual cases. Dr. Haynes asked that as the bylaws stand that means that he cannot come back to practice. The age limit, as it stands, he would not be eligible. Robert Green stated yes, as of right now. Dr. Haynes asked how it would change. Robert Green responded that as a Board they would look at it further. Brenda Smith wanted to know if we can make a request from the Board to the Medial Staff that they revisit as a Medical Staff and talk about it among themselves and get back to the Board. Dr. Woods said yes. Helen Godfrey Smith stated she would like for the Board to make a formal request. Clarification for the record. After a brief discussion Helen Godfrey Smith made a motion to formally request the Medical Staff to re-visit the age limit clause and come back to the Board with the their recommendations regarding the age stipulation. Dr. Haynes wanted to know where it stands with him continuing to teach. Dr. May stated that he respects him and he is his mentor and he has learned a lot from him. He thinks Dr. Haynes has a wealth of knowledge from his years of experience. He thinks the Residents benefit from his knowledge. It is a teaching hospital and we train Residents. Dr. May stated that medicine changes – there is new ways to treat diabetes and common illnesses that involve a lot of new medicines. Being updated is involved with passing the boards. Dr. May said Dr. Haynes has a lot to teach from past experience but there are a lot of new things that he is not familiar because Dr. Haynes is not up to date on his boards. Coming in and teaching two days a week is beneficial to the Residents. He hopes he will continue to do that. Dr. Haynes thanked the Board for their time and left the meeting. After further discussion the motion was seconded by Bruce Walker. The vote: yeas: Helen Adger, Kenneth Clay, Robert T. Green, Jr., Mary Irvin, David Norman, Brenda Smith, Helen Godfrey Smith, Bruce Walker, Pat White, Nays: None; Abstained: None. The vote was unanimous in favor. Mary Irvin noted that if a doctor does not pass their boards the board has previously discussed the concerns about that. It was not an age bracket put on it. If the boards are not passed, we as a Board are not willing to take on the liability of anyone practicing that does not pass the boards. Robert Green said it is evident with the vote that it is a concern. We are doing what we feel is best for the hospital and community. That is the Board’s job. David Jones stated that when this was first brought up, it was in an executive committee of the Medical Staff which was at that time – Chief Staff Steven Taylor, Vice-Chief John Woods and CEO, David Jones. Dr. Haynes was never considered nor brought up in any of those meetings – only the soon to be 70 year old Dr. Taylor was brought up. He was the one they were more concerned with age. Dr. Haynes had recently retired. Dr. Haynes requested to come back to teach – that was all he requested to do. They assumed Dr. Haynes was happy in his current role doing what he was doing. All thought and consideration was given to Dr. Taylor – never to Dr. Haynes. Dr. Taylor was in total agreement that something needed to be put in place. Dr. Taylor did not know what the magic number was. A physician is different to other professions. There has to be rules and regulations. 2) Approval of Revised Board By-Laws: Robert Green noted that Board has reviewed the revised Board Bylaws and we are at the point of approval. Brenda Smith made a motion to approve the Board Bylaws as presented. Helen Godfrey Smith seconded the motion. The vote: yeas: Helen Adger, Kenneth Clay, Robert T. Green, Jr., Mary Irvin, David Norman, Brenda Smith, Helen Godfrey Smith, Bruce Walker, Pat White, Nays: None; Abstained: None The motion passed. 3) Approval of Purchase of Allscripts Interface for the 340B Program:Mr. Jones said he would like Board approval to purchase an Allscripts Interface for the 340B Drug Program. This, he believes, we will realize several hundred thousands of dollars in savings and case recoupment. Willis Knighton saves and recoups millions with the 340B Drug Program. It is a very complex program. It is an interface and support software to do this from the clinic standpoint. Dr. Woods spoke to the Board about this program previously. Mr. Jones plans to have Dakota Robinson, Hospital Controller, to come to the meeting with graphs and do a presentation for the Board to show exactly what we will realize going forward with this. The cost is $11,100. Brenda Smith made a motion to approve the Allscripts Interface for the 340B Drug Program. Mary Irvin seconded the motion. The vote: yeas: Helen Adger, Kenneth Clay, Robert T. Green, Jr., Mary Irvin, David Norman, Brenda Smith, Helen Godfrey Smith, Bruce Walker, Pat White, Nays: None; Abstained: None The motion passed. X. Administrative Report – 1) NCMC – Current Activity: Mr. Jones stated that lately our construction has dominated everything but he would like to get a Board and Medical Staff dinner set up. We have tried to do this in the past. It helps to develop a relationship between the Board, the providers and Administration, along with their spouses. We could get Mrs. Billie Goodson to put a dinner together for us or pick a restaurant. We have the November and December Board meeting to finish out the year and holidays. He thinks it’s a good time of the year to do something like this to spring forward with the new building that he is hoping will happen in January of 2017. 2) ADP Payroll System Update: Mr. Jones stated that he hoping there are no issues the next payroll period. If not, this will come off the agenda. We are still smoothing out a few bugs and bumps with the ADP system. 90% have been handled. As long as we keep a certain member of their staff out of our system he thinks it will be fine. 3) Dialysis Clinic Partnership:Mr. Jones noted that the Board members should have received a handout along with the Medical Staff recommendations. There is a brief synopsis. We have received an offer from Citizens Bank. We have an actual lease/contract offered by Fresenius for 15 years. That is the rental rate of $109,488 for a year. There are three lease terms – if we do 15, 18 or 20 years – that dollar figure
Will cover all three – whichever we do. So basically, Fresenius will pay for the building that we build. The benefit, of course, from dialysis is massive in the community, but ancillary wise will be massive for the hospital in testing and visits, etc. It is a huge service that we can provide and should provide. He would like, pending Board approval, to go forward – have some paperwork drawn up by Citizens Bank and present to the Board at the next meeting to go forward with the project. We have all of the bids in for the demolition of the house and asbestos removal for the house. We will start doing that because it will need to be done whether we do the project or not. He would like send this out prior to the board packets so that the Board can review it and break it down so we can get final approval to start the borrowing process to get this project started. Fresenius is ready to start now. Once the campus is completed it will be a beautiful addition on the property. Brenda Smith inquired – the lease term is for 15 years – what then? Mr. Jones said it depends – if the clinic is running well and profitable, they will want another 5 to 10 year term tacked on to it. Which would then be all profit from that standpoint. It’s not about profit – it’s about keeping patients here for the lab work, radiologic work. These are some of the sickest of the sick. There are stats about the damage done to these patients when they miss their dialysis appointments. There are patients in this area that miss appointments due to the distance. The number of patients that are in need of dialysis is only going to go up over the years. Brenda Smith was looking at the figures favoring the 15 year lease /contract. Mr. Jones wanted the Financial Committee to look at this as well. 4) Foundation: Mary Coil, Foundation Executive Director, noted that the holidays are coming and we are looking at the end of year giving. If you know of anyone that has expressed an interest in the Hospital Foundation, please let her know. She reported that $20,000 has been received over the last month from two different donors. One donor gave in memory of a family member that was cared for at our facility. She told the staff and department heads that this is a reflection of the care that is given here at North Caddo. Mary said she has not met these family members. They have not lived in our district for a very long time but have ties to us and sent a $10,000 check. We appreciate what our Foundation is able to do because of our doctors and staff. Mary noted the $10 donation ornaments will be available this year in honor or memory of someone. We will be able to display our tree in our new facility. Many donate in their doctor’s name or nurses’ name. Several donate in their grandchildren’s name. We look forward to this every year and for our community members to walk by and see what is going on with the Foundation. Brenda Smith noted in the September 13, 2016 Foundation minutes that Bernie Loftin requested replacement of treadmills. It seems it had not been long since we bought treadmills. Mr. Jones stated it was the ellipticals that were last purchased and that the life of the treadmills is about four years. The wear out quickly. They are in poor shape. X. Medical Staff Report – 1) Recommendations – Allyson Allums:Allyson Allums presented the Medical Staff recommendations for the Governing Board approval: MEDICAL STAFF APPOINTMENTS: 1)William Wise, M. D. -Requests Provisional Privileges in the field of Emergency Medicine for the period of October 1, 2016 thru October 31, 2017. MEDICAL STAFF REAPPOINTMENTS: 1) David Remedios, M. D. -Requests Courtesy Privileges in the field of General Surgery and Wound Care for the period of September 1, 2016 through November 30, 2018. 2) John Chandler, M. D. -Requests Active Staff Privileges in the field of Emergency Medicine for the period of November 1, 2016 through November 30, 2018. 3) Jeffrey Holt, M.D. – Requests Courtesy Privileges in the field of Cardiology for the period of September 1, 2016 through September 30, 2018. ADVANCE PRACTICE PROFESSIONALSAPPOINTMENTS/RE-APPOINTMENTS 1) Michael “Jeff ‘ Lewis, CRNA- Requests Courtesy Privileges in the field of Certified Registered Nurse Anesthetist for the period of September 1, 2016 through September 30, 2018. EXTENSION REQUESTS: 1) James Thomson, CRNA–Request extension for Privileges in the field of Certified Registered Nurse Anesthetist due to incompletion of application at time of reappointment date. VOLUNTARY RESIGNATIONS: 1) John Thomas Mays, M.D. – Voluntary resigns Privileges in Orthopedics due to primary practice volume effective October 11, 2016. 2) John H. Haynes Jr., M. D. – Voluntary resigns Active Privileges in Family Practice due to retirement effective August 1, 2016. Kenneth Clay made a motion to accept the medical staff recommendations for medical staff appointments, reappointments, advance practice professionals appointments/reappointments, extension requests and voluntary resignations. Pat White seconded the motion. The vote: yeas: Helen Adger, Kenneth Clay, Robert T. Green, Jr., Mary Irvin, David Norman, Brenda Smith, Helen Godfrey Smith, Bruce Walker, Pat White, Nays: None; Abstained: None The motion passed. 2) Chief of Staff Comments: Dr. Woods stated that we really tried to do their best to accommodate Dr. Haynes. David Jones noted that in the eleven plus years that Dr. Woods is the best Chief of Staff because he does not do things on emotion; he tries to do what is right for all the doctors. That is extremely unique. Dr. Woods stated that he does not take compliments well but he does appreciate it. XI. Executive Session: None XII. Adjourn: There being no further business Helen Godfrey Smith made a motion to adjourn. Pat White seconded the motion. The vote: yeas: Helen Adger, Kenneth Clay, Robert T. Green, Jr., Mary Irvin, David Norman, Brenda Smith, Helen Godfrey Smith, Bruce Walker, Pat White, Nays: None; Abstained: None The motion passed.