At the Sept. 18 meeting of the Ellsworth County Medical Center board of directors, discussion took place on whether to allow an open agenda during open board meetings.

ECMC Chief Executive Officer Jim Kirkbride said a patron made the request.

“Right now, they have to ask to be put on the agenda,” Kirkbride said. “The board approves that, then there is some discussion during the agenda.”

He said with an open agenda in place, no request to be put on the agenda would be needed.

“They basically could come to the open meeting and then, when there is a section in the agenda for open discussion, then they would be able to openly discuss any topic they would like,” Kirkbride said.

“I am not for an open session in the meeting,” said Board President Clint Rogers, who was attending via Zoom. “This has been this way since the board was started in the early 1990s,” he said, “and it’s always been that way. The county commissioners created the rules, and they have the power to change the rules if they want to.”

Rogers said he has a hard time having just an open slot “where the conversation really has the ability to go places where we would have employees, providers and staff with an open target, with no way to reply to any of that.

“And especially at the provider level, having open access,” he said. “It would be extremely hard to recruit; it would be potentially detrimental to their practice. And to have no ability to control whether things are being said truthfully or emotionally or anything like that.”

Rogers said the board has a responsibility to protect the employees, staff and providers from situations like that.

“I cannot think of one time where we have had a constituent from the county that has came to a board member where we have not listened, that we have not taken it under advisement,” he said. “Including CEO, anyone.”

Rogers said there have been concerns about the potential of how something was handled.

“I think the way the hospital came together, had a conversation with a patient or a patient’s family, has always been very proactive and responsive with a lot of thought and a lot of care,” Rogers said. “I’m very leery about just having it kind of as a freefor- all.”

Kirkbride clarified that the commissioners were approached and he believed their answer was that the hospital board makes the bylaws and the commissioners approve the bylaws.

“Changes to our meeting structure would have to be approved by this board and then the commissioners would approve the bylaws,” he said. “They (the commissioners) don’t have the power to change our bylaws.”

“Thank you for that clarification,” Rogers said.

Board Vice President Stacie Schmidt said the current mechanism for somebody who wants to be on a hospital board meeting agenda is they have to call and request to be put on the agenda.

“So, there is still an avenue for them if we choose to accept it, is that correct,” she asked Kirkbride.

“Yes,” he said. “It always has been.”

Kirkbride said when the individual making the recent request was asked what the topic of the conversation before the board would be, the answer was “there’s really no topic, I just want to address the board.”

“That’s exactly where I’m reluctant,” Rogers said. “If an individual cannot place the agenda item, I really have a hard time adopting it in changing the bylaws. We have not been given a good example where we failed to listen.”

“I have taken several phone calls or in-person concerns,” Schmidt said.

She asked Kirkbride if all of the board members’ names and contact information (email would be preferred rather than a telephone number) are all accessible somewhere on the hospital website.

“And if not, could they be,” Schmidt asked.

“That would be you all giving me permission to do that,” Kirkbride said. “Because right now, it’s not listed on the website, which is our choice.”

Kirkbride said Kate Schiermeyer, ECMC’s public information officer, is allowed to give that information out when requested.

“And then she validates with whichever of you is being requested,” he said. “So, we’ve been kind of protective of your information.”

“Is that a consensus that we could agree to make, though,” Schmidt asked. “It’s an element of transparency to access us.”

“It’s fairly common to have board member listed on a website,” Kirkbride said. “Contact information that is not personal, but at least an indirect route to the board members.”

“I would agree to that as an intermediary,” Schmidt said.

“Another thing I can offer for you is to have an ECMC email address,” Kirkbride said, “so it’s not your personal email, but you can still check it from your iPad and correspond through an ECMC email if you’d rather not give out your personal email.”

“I think using an ECMC email would be good,” Rogers said.

“I agree with what Stacie is saying about transparency and people having an easier access if there is a problem,” Board Member Sandy Robinson said.

“I would be in favor of keeping the current poli- cy, but adding a layer where we would each have published email addresses for the ECMC mechanism,” Schmidt said. “So I guess that’s a motion.”

Rogers seconded the motion and the board approved it.

In other business:

• Kirkbride said he got a telephone call that there is COVID in the community, and the hospital is kind of on hold presently.

• Kirkbride said last month, the hospital had one employee leave. He said he has made an offer to an applicant for the hospital’s open executive director of human resources job.

“I don’t know what the results of that were,” he said. “We interviewed four (applicants) total, and we think we have a very good applicant. As soon as we know more, we will announce that.”

• Melissa Fry presented the quality dashboard for the board to review, as well as the quality report and policy review. Both were approved.

Kirkbride congratulated Fry for accepting the position of executive director of nursing at ECMC.

• During a review of the August financial report, Kirkbride said ECMC had another $3 million in gross revenue for the month.

“I think $2.7 million or $2.8 million was our biggest month up until six months ago,” he said. “Now, we’ve been averaging about $3 million. There’s changes we’ve made in our wound care charges and a few other departments that really paid off.”

Kirkbride said the hospital had a significant drop in inpatient days during August (28 days) compared to July (54 days).

Swing bed days in August were worse (two days compared to 51 in July).

Observation days were also down from 22 in July to 17 in August, as were emergency room visits (218 in August compared to 233 in July).

“Our ER for the last couple of years has been about 215, so we got back to basically where we were,” Kirkbride said.

He said the number of outpatient visits at 1,074 for August was strangely low, when clinic encounters for the month (1,410) was “off the charts.”

“1,410 was right up there close to the highest monthly clinic encounters we’ve had in years,” Kirkbride said, “and it’s proportionate to outpatient visits.”

Kirkbride said what this tells him is the high-end services at ECMC are being used more.

“There’s a difference between having 10 lab tests at $100 apiece, or 10 wound care visits at $8,000 apiece,” he said. “So our high-end services, even though our stats are low, our highend services continue to be strong.”

The next meeting of the Ellsworth County Medical Center board of directors will be at 5:30 p.m. Wednesday, Oct. 16, in the hospital conference room.