BOARD MEETING: Regular Meeting DATE: October 23, 2017 MEMBERS PRESENT: Robert T. Green, Jr., Patricia White, Kenneth Clay, Mary Irvin, David Norman, Helen Godfrey-Smith MEMBERS ABSENT: Helen Adger, Brenda Smith, Bruce Walker TIME CALLED TO ORDER: 5:30 p.m. OTHERS PRESENT: David Jones, CEO, Pam Hughes, COO, Dakota Robinson, Controller, Lanell Audirsch, Admin. Asst., Walter D. (Doug) White, Hospital Attorney, Allison A. Jones, Attorney, Dr. John Woods, Chief of Staff, Mike Gray, Security LOCATION: NCMC Events Center BOARD CHAIR: Robert T. Green, Jr. SECRETARY: David Jones I. Called to Order – Robert T. Green, Jr., Chairperson, called the meeting to order. II. Invocation and Pledge of Allegiance – Robert Green offered the Invocation and David Jones led the group in the Pledge of Allegiance. III. Approval /Amend Agenda – Robert T Green, Jr. stated it is time for approval or amendment of the agenda. No amendments noted. Pat White made a motion to approve the agenda as presented. David Norman seconded the motion. Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Helen Godfrey-Smith. Nays: None; Absent: Helen Adger, Kenneth Clay, Brenda Smith, Bruce Walker. Abstained: None. The motion passed. IV. Community Comments – Robert T. Green, Jr., Chairperson, noted there were no signed Visitor Recognition Cards requesting to address the Board. V. Minutes – Special Meeting September 20, 2017 – The minutes of the September 20, 2017 Special Board meeting were mailed prior to today’s meeting for review. Robert Green inquired if there are any corrections to be noted. If not, he would entertain a motion to approve the minutes. David Norman made a motion to approve the minutes of the Special Meeting, held on September 20, 2017, as mailed. Helen Godfrey-Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Helen Godfrey-Smith, Nays: None; Absent: Helen Adger, Kenneth Clay, Brenda Smith, Bruce Walker. Abstained: None. The motion passed. VI. Minutes – Regular Meeting September 26, 2017 – The minutes of the September 26, 2017 Regular Board meeting were mailed prior to today’s meeting for review. Robert Green inquired if there are any corrections to be noted. If not, he would entertain a motion to approve the minutes. Pat White made a motion to approve the minutes of the Regular Meeting, held on September 26, 2017, as mailed. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Helen Godfrey-Smith, Nays: None; Absent: Helen Adger, Kenneth Clay, Brenda Smith, Bruce Walker. Abstained: None. The motion passed. VII. Old Business – 1) Radiology and ER Expansion Update: David Jones stated the waiver that we initially applied for, for the removal for the anti-room, was denied. We now have to include that square footage into the plan. Their latest revision kind of took away one of the emergency rooms that we had planned to expand and that kind of defeated the purpose for what we are doing so they are back to the drawing board trying to figure out how to include that square footage without taking away any of the emergency room space. Basically, they are talking about not expanding outside the back wall but including some of the space on the east side of the emergency room along the side of the clinic where it is concreted. He does not have the exact figure, but we came in under budget for the hospital, so that is the amount that we will try to come in under budget for the ER/Radiology Expansion. It is still on the drawing board. VIII. 1) Review August 2017 Statistics – Allyson Allums: Allyson Allums presented the September 2017 Statistical Report. There were 66 Admissions and 62 Discharges with Total Days Stayed –213. The Average Length of Stay – 3.4 Days. Total In-patient Days – 235; The average Daily Census – 7.8. Our Total Occupancy Rate was 52.20%. Total Surgeries for September (In-patient – 4 / Outpatient – 3). Endoscopies performed in September – 12. The total Emergency Room patients seen – 537. Swing Bed Admission –10. There were 158 Total E.M.S. runs in September. Observation Patients for September- 39. There were 4 Newborns in September. The total Patient Visits for the clinics – Medical & Surgical Clinic is 1712. The Plain Dealing Clinic saw 654. Benton Medical saw 286. There were 30 Mammograms for September. 2) Review September 2017 Financials – Allyson Allums: Allyson Allums presented the Financials. Hospital Revenue over Expense. Revenue –$3.6 million Expense – $1.8 million with a profit of $177,000. If you look at the year to date financials, they are healthy compared to this time last year. The AR Days for all three facilities –57 days; for the hospital we are at 38 days. Plain Dealing Clinic – Revenue over Expense. Revenue –$140,000 Expense – $100,000 with a loss of $7,100.00. Medical and Surgical Clinic – Revenue over Expense. Revenue – $476,000 Expense – $269,000 with a profit of $1,700. Benton Clinic – Revenue over Expense. Revenue –$64,000.00; Expense – $26,000. They had a loss of $2,100. The Bad Debt Expense is right at 3%. Days cash on hand is steadily and slowly coming up – 14.4 days. Self-Funded Insurance is at $148,000 in claims. The specific reimbursement, for any claim over $50,000, we received $667.00. Compared to last year’s self-funded to self-funded, we are a little bit higher. We were at $1.4 million last year and we are at $1.6, but we have had a lot of large claims this year. In review of the 340B program – the claims are broken it out by Walmart, Benzer and Kelly. Those are our three pharmacies that we are getting these from. We have just added Walker Brothers in Plain Dealing. This won’t go live until January 1. We did 130 at Walmart, 170 at Benzer and 62 at Kelly. The revenue that those claims generated – Walmart – $38,000, Benzer, $30,000 and Kelly – $17,000 – a total of $87,000 generated this month. Allyson stated that she wanted to point out that on the financial statements – Exhibit B on page 3 – our expenses have gone down. If you look at the changes that we have made to try to adjust depleting cash from the facility – our salaries are down with the benefits down about $45,000. All of our other expenses, medical supplies, etc., we are working very hard to bring those down. Right now we are sitting in three months – a profit of $209,000; which is a difference of $909,000 from last year. We are sitting a lot better than we were last year. If you look at our budget page on page 7; we are sitting at a $78,000 profit right now. We are under budget for our expenses. We are about as close to our budget as you can get. That is operating pretty much at what was predicted. This is good. She just wanted to point these areas out. David Jones stated he is piggy backing on what Allyson stated. We are budgeted right now for $121,000 increase in unrestricted net assets. We are at $199, now – we are still down probably $240 from Grant Revenue, which he is pretty sure that is UCC which is money we have coming in. The amount calculated for UCC this fiscal year was $1.9 million, which is the largest that we have ever received. We used to get that in one check in October. Those were the good old days, before the State was broke. Now we get payments in increments. That is for services that we have already given, some upwards of two years prior. That is cash coming in and collectable to some degree – depending on State coffers. Also, for the month of October, he thinks we are up to 7 surgeries so far with our new surgeon, Dr. Mike Banda. Last Thursday we did three surgeries and delivered a baby and did an EGD colon; which would mark the busiest, procedure wise, since he has been here, for one particular day. Dr. Banda is as fine a surgeon that you will find in Shreveport/Bossier. He is excited about being here. He likes the freedom of it, he likes that we basically cater to him and right now he is the only game in town. He has a very good relationship with several of our doctors. Actually, David Jones said he has to give a lot of credit to both of the ER doctors. Dr. Chandler is very good friends with Dr. Banda. Through Dr. Woods’ vision and help we are pushing that forward as much as humanly possible. It is off to a very good start. We need to, of course, nurture it and mature it and keep it going down the road. We think that will be a fairly solid revenue stream for us in the future. Also, to key on the Benton Clinic, actually, if not for some missed time drugs, we probably would have turned a profit for the month for the first time since it has been open. That being said, they are already working on the busiest month they have ever had since we’ve opened, hopefully, we will push the 300 to 350 mark, depending on how busy it is for the rest of the month for the month of October. Once we get the Rural Health Clinic status at that clinic, he really foresees about a $9,000 a month swing in cash, not revenue, for the hospital from that clinic. That is not if a single patient comes here from that clinic. That is just money that we will make at that clinic. We have things inching in the right direction. It is a Rural Hospital. There were some rumors going around; somebody from outside the organization, was basically saying that we have one payroll period of cash left and then we are going to shut the place down. He kind of laughed, thinking that well, we are a Rural Hospital; we are always one payroll period away from shutting down. We are used to operating in that realm. We plan on being here for a lot longer than one payroll period. Robert Green asked if there was any discussion or comments. If not he would entertain a motion to accept the Statistical and Financial Reports. Pat White made a motion to accept the Statistical and Financial Reports as presented subject to audit. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Helen Godfrey-Smith, Nays: None; Absent: Helen Adger, Kenneth Clay, Brenda Smith; Bruce Walker. Abstained: None. The motion passed. IX. New Business – 1) Resolution #2 – 2017 – Adoption of Millage Rate of 4.770 Mills for 2017: David Jones noted the reason for the meeting being held a day early, we have Resolution #2 for 2017 – the Adoption of Millage Rate of 4.770 Mills for 2017. Of course we need to get that in this week to the Tax Collector in Baton Rouge. That is why we gave us one more day to get it all in. There was a little mix up at the Caddo Parish Commission, because this was our renewal period, because we got the election passed last December. We have that straightened out. This needs to be approved tonight so we can collect the millage for 2018. David Norman made a motion to approve Resolution #2 – 2017 – Adoption of Millage Rate of 4.770 for 2017. Helen Godfrey-Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Helen Godfrey-Smith, Nays: None; Absent: Helen Adger, Kenneth Clay, Brenda Smith; Bruce Walker. Abstained: None. The motion passed. 2) Formation of Nominating Committee for Board of Trustees: Robert Green noted that we will eventually need to fill a couple of spots on the Board. We need to form a nominating committee that would work along with one member from the Caddo Commission. That would be in the process of filling a vacant spot on the Board as we did in the past. He needs to form a committee tonight to be in charge of that. First of all, he would like to hear any volunteers that would like to serve on that committee, prior to appointing someone. Mary Irvin volunteered. Helen Godfrey-Smith noted that her term is to expire in 2018. Does that mean that she should not serve on the nominating committee? It was noted that she could abstain when it is related to her. She volunteered to be on the committee. Mary Irvin noted that she was not at the last meeting, but has it not been discussed about that this committee having a pool of potential candidates where if we were in need we would already be in a position to have the screening already completed. Robert Green stated that would be the committee’s responsibility. Robert Green also stated that anyone that would have a candidate they would like to be considered, there is a form to be filled out. Pat White stated that if anyone had a potential candidate they can submit that information to the committee for consideration. Doug Dominick will be the person from the Commission to work with the committee. Robert Green asked if two was all that should be on the committee. It was suggested there be three Board members to serve. Brenda Smith was suggested along with Mary Irvin and Helen Godfrey-Smith. Robert Green stated the Nominating Committee will consist of Mary Irvin, Helen Godfrey-Smith, and Brenda Smith along with Doug Dominick. Mary Irvin inquired how soon the Board would like to hear back from the committee. Robert Green stated he would like to hear back from the committee at the next meeting. Pat White made a motion to approve Mary Irvin, Brenda Smith, Helen Godfrey-Smith and Doug Dominick as the members of the Nominating Committee for Board Trustees. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Helen Godfrey-Smith, Nays: None; Absent: Helen Adger, Kenneth Clay, Brenda Smith; Bruce Walker. Abstained: None. The motion passed. X. Administrative Report – 1) NCMC – Current Activities: David Jones stated they are settling in the building. The maintenance really began about a year and a half ago. David Jones said they should stress out Robbie or Chad or both of them and invite them to come to the Board to go over the HVAC system that runs that building. It is impressive. We have been having some issues and some meetings with the engineer that designed it and the people that put it together. He wants to keep the Board abreast of that. There was a meeting last week and a meeting again Thursday about it. We are going to get to the bottom of it. The people that put it together are the people who are actually part of the ones who are maintenancing it. We are meeting on all that and trying to get all that straightened out. Mary Irvin asked if Mr. Jones would tell them what system that is. He said it is the air conditioning, heating, water system that runs through the hot water heater and the chillers. The air handlers are on top of the building. It is not like your house cooling and heating system for sure. They are struggling to kind of keep up with the technology and they are doing a pretty good job from that stand point, but sometimes it is more than they can handle as far as what is going on and why it is down and that kind of thing. They have a computer system that basically monitors it. Anytime an air handler or chiller or boiler goes down, it sends out warnings to Pam and the Maintenance guys that this is going on. Or if the water temperature gets beyond a certain temperature, alarms will start going off. We are in some infantile phases of getting our Christmas decorations ready to roll. We have a big front lobby to make beautiful and ready for Christmas. If at all possible, the Finance Committee will be reviewing to see if there is a possibility of a low key Christmas party of some sort. This will be for the staff and the Board members and a few key community members to come and celebrate Jesus’ birthday and give thanks and have a good time. 2) Finance Committee Report: Helen Godfrey-Smith stated that just dovetails right into the Finance Committee report. It would be interesting to hear how the Board would feel about this activity if the committee could find the funds. Would the Board be in support of this? She asked Pat White how she felt about this. Pat White said it would be alright with her. Helen Godfrey-Smith asked Mr. Jones when he would want to do this? He replied a couple of weeks prior to Christmas; sometime during the week. That would give them some time. She said they had a really interesting Finance Committee meeting. Allyson Allums, David Jones has gone over what we discussed prior to this Board meeting. Our in depth analysis of our Finances, as you can tell, was very encouraging and we are looking forward to having even more positive reports as we get further into our plan to reducing expenses and increasing revenues. Of the 340B Program, we see as a real bottom line booster as it continues to flow. $90,000 a month is nothing to sneeze at. Great job Dakota! We do acknowledge the wonderful creativity in the staff as it relates to that program. We sent a letter out to Willis Knighton and our letter was almost intuitive and the timing was just amazing. Mr. Daigle is no longer the Chief Operating Officer there. Willis Knighton is for the near future going to transition to a new CEO over not a given time period but over the near future, whatever that is. In the interim, the acting CFO, Tim Borst with Cole, Evans & Peterson, contacted David Jones. Tim Borst was going over some of the documentation that was on Chuck Daigle’s desk. He came across our letter and did call David Jones and said that Willis Knighton would very much appreciate a little more time to be able to respond. They are definitely wanting to respond and to sit down and meet with us to see if they can meet our needs and those kind of things. They are in a little bit of a flux right now, managerial wise. They asked for a little more time which David Jones said would not be an issue. That is where we are with that. He waited another week and a half to send out anything to Christus or to University Health seeing that the magnitude for somebody outside the organization versus somebody inside Willis Knighton Health System, the turmoil that they are experiencing right now is probably the first in fifty to sixty years for them. There’s are a lot of issues and lot of things on their plate that they are dealing with that typically they don’t have to deal with or that those individuals didn’t have to deal with. He hates that anybody has to go through that. He has a lot of friends and there are a lot of good people at Willis Knighton, but they will come out fine on the back side. Helen Godfrey-Smith will say that we are playing this by ear. She asked that Mr. Jones keep them all informed. He stated yes he will. She asked if it would be o.k. to say at least until the first week in November. David Jones said yes; if they have not contacted him, he will contact them back. We will not send out any letters to Christus until he hears back or he makes that phone call. Mary Irvin inquired how long Tim Borst had been in the acting CFO position. David Jones stated he had been in that position for about 2 years now. There is a very strong relationship with Cole, Evans and Peterson and has been forever. When Robert Huie passed they were kind of in a flux for that position. Ramona Fryer stood in for a little bit, but Tim was helping support some of that from a financial end anyway. He took over a lot of those roles. David Jones does not know if Tim Borst has an official title. Helen Godfrey-Smith added to the financial report that it was encouraging that we reduced overtime and our salaries are very much in line with budget as a result of the reduction of overtime. Allyson said you can see that on the budget as you look at the salaries and look at the benefits underneath it you can see. It was about $45 – $46,000 between the two. David Jones stated that expenses wise, as far as budget goes, it is probably the best we have done in expenses in about a decade to be totally honest. To be a quarter into the fiscal year and be under budget wise for expenses is a testament to everybody, including department heads. There are several people that are doing above and beyond to kind of keep those as low as possible. Helen Godfrey-Smith stated that the committee agreed to meet Wednesday at 4:00 o’clock prior to our regular monthly Board meeting so if anyone is interested in stopping by, please do. 3) Foundation: David Jones noted that Mary Coil had an emergency in the family so she was unable to attend the meeting tonight. He noted that the Foundation is in the beginning stages of planning a Gala or party type event. Also, the Christmas giving programs are being prepared such as tree ornaments. Pam has a large tree set up for decoration and we will have a donor tree as well. XI. Medical Staff Report – 1) Recommendations – Allyson Allums: Allyson Allums presented the Medical Staff recommendations for the Governing Board approval: MEDICAL STAFF APPOINTMENTS: 1. Stephanie D. Runyan, D.O. – Requests Provisional Privileges in the field of Radiology for the period of October 24, 2017 through October 31, 2018. 2. Tal Baruch Delman, M.D. – Requests Provisional Privileges in the field of Radiology for the period of October 24, 2017 through October 31, 2018. 3. Robert Morley, D.O. – Requests Provisional Privileges in the field of Radiology for the period of October 24, 2017 through October 31, 2018. 4. Matthew H. Smith, M.D. – Requests Provisional Privileges in the field of Radiology for the period of October 24, 2017 through October 31, 2018. MEDICAL STAFF REAPPOINTMENT: 1. Yulia Bronstein, M. D. – Requests Courtesy Privileges in the field of Pathology for the period of November 01, 2017 through August 31, 2019. 2. George Kenneth Harrison, M.D.-Requests Courtesy Privileges in the field of Pathology for the period of October 24, 2017 through October 31, 2018. 3. Steven J. Lengle, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of November 1, 2017 through March 31, 2019. 4. Steven W. Davis, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of November 1, 2017 through July 31, 2019. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: NONE. EXTENSION REQUEST: NONE. VOLUNTARY RESIGNATIONS: NONE. Pat White made a motion to accept the Medical Staff Recommendations for Medical Staff Appointments and Medical Staff Reappointments. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Helen-Godfrey-Smith. Nays: None. Absent: Helen Adger, Kenneth Clay, Brenda Smith, Bruce Walker. Abstained: None. The motion carried. 2) Chief of Staff Comments: Dr. John Woods, Chief of Staff, said David Jones had covered most of what he was going to mention. He stole his glory. Since we moved to a more expanded version of our previous hospital, it was really a good, smart move to compartmentalize our departments. We use to be all meshed together. It was too much and there was no real one person in charge. Compartmentalizing the ER and the clinic and the floor has allowed everybody to gain a lot of control over the finances and the way things run. He thinks it was a very good move. We have had a lot of good, positive things to come about with that. Dr. Banda is a great addition. Dr. Woods sees that as a walking advertisement. He is a very good potential for huge income stream. He will be an asset to this hospital. He likes to teach, he likes to teach the Residents. He is a very well versed surgeon. He thinks he is going to be a great asset to this hospital. Anything we can do to accommodate him, he thinks would definitely benefit this hospital. Mary Irvin inquired if he has everything he needs to do everything he wanting to do. David Jones replied so far. Dr. Woods said he is very happy here and he is enjoying basically being able to be a surgeon here. Pam stated he loves our OR. He said the OR is way better set up and better organized than Willis Knighton’s ever thought about being. Dr. Woods stated that he likes the staff and the staff likes him. He does not whine and complain. He innovates and tries to come up with ways we can do things better. Whatever we can do to hold on to him we need to do. Pam stated that his assistant that comes with him is great, too. Helen Godfrey-Smith questioned are these surgeries that are within our system that he is coming here to perform. Dr. Woods stated that these are surgeries that normally we would be sending out to another hospital. Helen Godfrey-Smith stated that is what she was asking. That is great. Dr. Woods said we are basically capturing in the community things that we were normally subletting out somewhere else. Helen Godfrey-Smith asked if he had a specialty. Dr. Woods stated that he is a general surgeon which basically covers all. He trained under Dr. John C McDonald. Dr. McDonald was there when Dr. Woods was there. This was before they had cardiothoracic, vascular, ENT. They operated in all areas. Dr. Banda is not afraid to step in any areas. He has a proven track record. We are very lucky to have a man of his caliber up here. He is interested and motivated. Pam stated he is a very nice person. Dr. Woods stated that he is easy to work with. He has come in handy multiple times. There are things that he sees in the ER – gallbladders, appendixes, hernias – things of that nature that normally he would be trying to ship them out. He calls Dr. Banda and it makes it so much easier for the patient. Helen Godfrey-Smith asked if Dr. Woods referred patients to an outside source did he have to go to the other facility to see the patient. David Jones replied no – they would be released to another doctor; one they were not use to. Dr. Woods stated that the surgery patients that we do send to other hospitals, he has seen them sit and wait 12 to 18 hours. They end up getting upset with our hospital. He had them accepted 18 hours ago, but the transport had not arrived to pick them up. All around it is better for the patient, the hospital and all involved. He has heard chatter amongst patients, “we have really taken off; we have a top notch surgeon”. You hear a little bit of chatter – we don’t really have to advertise. The best advertisement is word of mouth. Oddly enough, he was a little late because he had a received a patient from Oil City. They may have a surgical issue. David Jones, is going to piggy back on the Chief of Staff comments, because the Chief of Staff was there when this happened and did comment on it. David Jones asked Mike Gray, Security Officer, to join the meeting. David Jones just wanted the Board to know and recognize that there was a pretty serious incident that occurred by one of Mike’s personnel and the Vivian police department had a gentleman that was suspected of breaking into some cars. There was a pretty bad fight that happened. One of our own staff members in the room, Dakota Robinson, actually assisted; he was asked to assist – he didn’t just see it and run to it. This in all honesty, could have been an extremely serious situation. Dakota assisting the other two men, they finally got this one, 5’4” person, subdued. He had enough drugs in his system he was very difficult to subdue. He could have gotten a weapon away from one of these gentlemen – it could have been a tragic situation. Thanks to Dakota and Mike’s staff and the other officer, they did an unbelievable job. It could have ended with someone’s life being lost and due to their diligence and their unbelievable training they handled the situation and got the guy in. There were some pretty bad bite marks and scuff marks, but they got the man and got him arrested and got him out of here. David Jones wanted to thank our security personnel and thank Dakota for stopping that situation from getting any worse than it was. Helen Godfrey-Smith stated we were going to get Dakota some hats for all that Dakota does – MMA fighter, CPA, Rifleman. David Jones asked Mike to tell his officer involved that we appreciate everything he did with that. Mike Gray stated that Dakota’s assistance probably saved someone’s life. When an officer is in that kind of battle – the individual was attempting to disarm one of the officers and they were fighting, trying not to escalate but it was pretty much at that point, if they had not had additional help. It brought a conversation up, if you ever see an officer in a life and death struggle, call 911, because in this situation it escalated so quickly that they were not able to call and ask for addition resources. They were fighting for their life within just a few moments. Anytime you see that, don’t assume that you can just stand by or create some distance; call 911. Someone may have been attacked and there may not be someone coming to help. David Jones said you here about all stuff happening in the news and all the bad tragedy stuff; if you really listen to the details of this situation, why anyone would want to be a police officer, is beyond him. This man was trying to kill both police officers. To him they would have been extremely justifiable in putting this man down – they didn’t – they did everything possible to not do that. Thank God the situation worked out the way it did. Pat White asked what time of day did this happen. Dr. Woods stated it was 6:00 in the morning. Mike Gray said it was just a few moments before Clint got off work. Vivian police wear their vest on the outside of the uniform. The suspect ripped his vest off – was on top of him on the ground and was trying to disarm the officer. Pat White stated drugs make them think they are superhuman. Dr. Woods stated not even a week prior, they brought in someone handcuffed and face down – about 240 pounds – biting and spitting, they had the masks on. He had already busted out of one side of the handcuffs already with his hands behind his back. Mike stated that is the third time this month that it has taken several to subdue them because they were on drugs and were completely out of control. Helen Godfrey-Smith asked is there a particular kind of drug that seems to give them this supernatural powers. Mike Gray and Dr. Woods both said methamphetamine. Dr. Woods said cocaine wears on and wears off, but the methamphetamine keeps them on for days then they go crazy. From what we have learned about the incidents here around Vivian and Hosston, it’s been methamphetamine. Dr. Woods stated they had changed their protocols with EMS – we have what we call excited delirium. They are a danger to themselves and well as other people. The main thing is you have to get them subdued and quickly. Pat White said she has had an incident at her house twice in the last two weeks. The last one was Friday. The first time she heard it she thought it was an armadillo hitting the house. There is a woman there who is evidently drunk out of her mind. She was banging on the house. She is not going outside or open the door. They called Whit the other night and Whit found her and brought her over here. Now if it happens again, she will be the first one on the phone calling the police. David Jones said he just wanted to say thank you to the security and to Dakota as well. It could have been a tragic situation they prevented. XII. Executive Session – Robert T. Green stated we are at the point to enter into Executive Session. He will need a motion to enter in to Executive Session for the purpose of strategic planning. Helen Godfrey-Smith made a motion to enter into Executive Session for the purpose of strategic planning. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Helen-Godfrey-Smith. Nays: None. Absent: Helen Adger, Kenneth Clay, Brenda Smith, Bruce Walker. Abstained: None. The motion carried. The Executive Session was entered into. No action was taken during the Executive Session. Mary Irvin made a motion to enter back into regular session. Pat White seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Mary Irvin, David Norman, Helen-Godfrey-Smith. Nays: None. Absent: Helen Adger, Brenda Smith, Bruce Walker. Abstained: None. The motion carried. XII. Adjourn – There being no further business Kenneth Clay made a motion to adjourn. David Norman seconded the motion. The vote: Yeas: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Mary Irvin, David Norman, Helen-Godfrey-Smith. Nays: None. Absent: Helen Adger, Brenda Smith, Bruce Walker. Abstained: None. The motion carried. Meeting adjourned at 6:59 p.m.

NORTH CADDO HOSPITAL SERVICE DISTRICT
North Caddo Medical Center
Vivian, Louisiana