Advisory Council Meeting April 20, 2023  HOLLIDAYSBURG VETERANS HOME (HVH) ADVISORY COUNCIL MEETING MINUTES  THURSDAV, April 20, 2023 10:00 A.M.  ADVISORY COUNCIL MEMBERS PRESENT: Raymond Lenz, American Legion Department of PA Henry Gaunt, AMVETS Joe Rodkey, Blinded Veterans Association Goose Marin, Catholic War Vets Brian Querry, Centre County, Director of VA Ron Dawson, MacArthur Hall, Resident Representative Thomas Williams, VFW Department ofPA Tim Susengill, Vietnam Veterans Association  Duffy Hines (Council Present), Marine Corps League Department of PA  David Wagner, DAV VIPs PRESENT: Senator. Judy' Ward DMVA PRESENT  State Representative Louis Schmitt Jr.  Maureen Weigl, Deputy Adjutant General- Veterans Affairs Travis Davis, Executive Director of Long-Term Care Barb Raymond, Director, Bureau of Veterans Homes Craig Swineford, Veterans' Service Specialist, Central PA Region Samantha Cossman, Regional Program Outreach Coordinator, Central PAI Region Jennifer Hagaman, Veteran Services Specialist, Central PAI Region  Samuel Estrada, Executive Policy Specialist Josh Spigner, Regional Compliance Officer Barry Lowen, Interim Commandant Chrissy Dambeck, Deputy Commandant John Reinhardt, Doctor Kelly Smith, Director of Nursing Joe Patterson, Admissions & Marketing Sheena Mickel, Social Services Krista Hooper, Revenue Rita DeCarlo, Revenue Jim McConnell, Chief Pharmacist  HVHPRESENT  Tia Williams, Assistant to the Commandant and Recorder  OTHERS PRESENT:  Michael "Mick" Hoover, MOPH Guest Mrs. Anna Marie Rodkey, Spouse of Joe Rodkey  1    Advisory Council Meeting April 20, 2023  Constance Stransky, Guest of Council Member Ray Lenz Amanda Walker, District Director - Office of Senator Judy' Ward  Rich Schnar, Guest of Council Member VACANT POSITIONS: Military Order of the Purple Heart (MOPH) Jewish War' Veterans, Vacant ADVISORY COUNCIL MEMBERS ABSENT:  Robert "Hank" Sembower, Military Officers Association of America  Called to Order/ Roll Call  Duffy Hines called the meeting to order at 1000hrs and asked everyone in attendance to introduce themselves  and to provide their title and or Service Organization. Moment of Silence and Pledge of Allegiance  Duffy asked everyone to stand and to take a Moment of Silence and then asked for everyone to stand and join-in  reciting the Pledge of Allegiance toi the United States of America. REVIEW OF MINUTES FROM PREVIOUS MEETING  Duffy asked every member ift they had any question, comments, or concerns regarding the Minutes from the previous meeting held on Thursday, January 19, 2023, N no comments were received. Duffy said the Minutes for  January are accepted as posted. Swearing-In New Members  None  Duffy asked about Mick Hoover, Barb stated things have slowed down with the change of admin, but will keep us  notified of when things make progress.  Dr.John Reinhardt  Dr. Reinhardt stated we've made al lot of progress with Barry and Chrissy over the past few months, especially with grievances. He thanked them for letting people know when grievances are, or are not, substantiated. He spoke about how grievances will change how doctors practice. He spoke about how iti is his mission to resuce polypharmacy, and how he is concerned about some people using grievnaces as "weapons". He then went on to  talk about how great the new building will be once it is completed. Questions, Comments or Concerns (QCC) for Dr. John Reinhardt  Tim Susengill stated he is familiar with the grievance process from Department of Correctons and that it can be abused but having a well-run, thorough review process is vital. Grievances can be helpful. Dr. Reinhardt replied with saying howi important it is to "close the loop" and inform individuals if grievances are founded or unfounded.  He stated multiple grievance can affect how one practices and affect good care.  Final QCC for Dr.. John Reinhardt None received.  2    Advisory Council Meeting April 20,2023  Maureen Weigl, Deputy Adjutant General-Veterans Affairs  General Weigl thanked everyone in attendance fori their support from the large turnout. She said we were close ton not recievinh money fori the new building. Governor: Shapiro was in Philadelphia with President Biden; we were one of two states to receive waiveri to be able to build only one day before the expiration. Groundbreaking Ceremony will be held here on May 2, 2023 frin 10:00. AM -1 1:00 PM. Governor Shapiro planning to attend along with Secretary of DGS and TAG. Announced HVH is now upi to a 4-star from previously being a 3-star rating. Spoke ofTown Hall Meetings and about PACT Act changes presumptives for Vietnam Veterans and Post Gulf Veterans. She encouraged Veterans to have VSO look at claims. State AG - National Association AG's looking for poaching, such as lawyers wanting money for helping Veterans get money. Female Veteran's Dayl looking to get approved for a dayi in. June - Women's Military Day. General Weigl recognized Memorial Day since we have no meeting in  May. She updated that Mac Hall renovation monies were approved.  Final QCC for General Weigl  Tim Susengill stated VSO - since PACT Act, activity level has gone up almost 100%- come. July 1st budged to support VSO to increase. Thanked legislators for supporting what they do. - General Weigl Stated last year, there  was funding for 6 additional VSO, next year there will be more.  Travis Davis, Executive Director  Travis thanked Advisory Council for their support and said it is ai testimony to our community. We are off to a busy start in the first quarter with 12 inspections, 3 internal audits. He said grievances are in the spotlight and are one oft the first things that surveyors look at. He agreed that "closing the loop" on them is very important. 0 COVID residents in hospital. SVH has highest admission since the pandemic at 1,009 total residents - started at 950. Total beds is 1500+ - not enough. staff to have all beds full. 23% wait list across all 6 State Veterans' Homes Staffing ratios strong across all 6SVH - relying on some OT and agency. Recruitment and retention is the biggest challenge now - we need to be better at letting people at other facilities know about us and our job openings. April is Volunteer Month. Our volunteer numbers were high before the pandemic. The pandemic forced us to limit interactions and now we are struggling to get our volunteer numbers back up. DMVA to push on social media to May 2-groundbreaking, May 6-12-nurses week, May 24-SWVC Anniversary, June 11-17-State Veterans'  (SVH) and continues to decrease.  recruit volunteers. Homes week Star Ratings 5-Star-D DVVC, GMVC, PSSH 4-Star-HVH 3-Star-SEVC  3    Advisory Council Meeting April 20, 2023  Questions, Comments or Concerns (QCC) for Travis Davis  Senator. Judy Ward asked about the open Commandant position. Barb Raymond replied that a notification went out to the board via email. Senator Ward stated she received no notification. Duffy Hines added he received an email stating that Sam Dunkle was on leave, and Travis said it is our process to notify of change in leadership. Senator Ward asked how the process works and when will there be a new Commandant? Travis said first it has to be decided howi it will be posted and it isn't up to DMVA. Barb said an update came in as we: speak and the position will be posted April 24th thru May 5th, internally and externally. After the posting comes down, we should have al list within a week, then will conduct interviews. Ifthe chosen candidate isi internal, it will move quicker. If external, the individual will have to provide a 30-day notice to their current employer. A new Commandant will be in by early. June at the absolute earliest. Senator Ward commented this is our 3rd Commandant in three years and that is al heavy turnover. Barb said this decision was not taken lightly. Travis added that CMS is looking at turnover as part oft the 5-star as a new initiative. Senator Ward asked what support is given to those in critical roles? Barb replied that they are looking at a training program for newi individuals ini those roles. Internal would need less internal process training than someone coming from the private sector who would need heavy training on internal processes. Any candidate fort the Commandant position needs NHA with up to six years of experience. Ray Lenz commented on how Sam Dunkle brought up morale and did a good job. Travis replied that they asked Sam to work on morale and that he was here on weekends and days off. He also stated that personnel issues are Duffy Hines stated he feels as though there is SO much support due to when Sam became Commandant, a lot of tension was gone. He stated the current administration has done well at keeping everyone informed.  Can'tgive ai timeframe for when this newi training would begin.  one ofthe most difficult things to deal with but their priority is to protect residents.  Ray Lenz asked why Sam had to leave?  Representative Louis Schmitt said no matter what happened, Sam Dunkle was devoted to HVH and Veterans. With him leaving, we risk losing morale and historical knowledge. He is concerned this decision made on Sam is Goose Marin stated he worked at HVH for 17 years and when he went to Labor Management meetings with the former Commandant before Sam, it was always an argument. When Sam came, there was a big change. Staff was Senator Ward explained that with the former Commandant, she had numerous complaints to her office constantly from families, residents and employees, but when Sam came there was not one complaint t-t this Dave Wagner said cambria and Somerset have a lot of interest ini the Commandant. He: said. Joe Patterson did a great job at the VVA meeting and said there were a lot of questions regarding Sam at the meeting and that the Veteran community has their ears and eyes open and they want answers. He said the same for DAV and stated they feel they have to fight for themselves and things don't look great and they want answers. General Weigl state she appreciates the comments. She explained that Human Resources and Labor Relations has processes they follow for these things and she is available to talk to those who have questions, even if she cannot  not right.  happier and residents could pick up on that.  speaks to his character.  answer those questions.  4    Advisory Council Meeting April20,2023  Ray Lenz stated he appreciates General Weigl being here to talk about thei issues with Sam leaving. Anna Rodkey stated that she was disappointed at the lack oft transparency and said it clouds the issue when you can't say anything. General Weigl replied she wouldn't want to leave al bad impression or tarnish Sam's  reputation.  Duffy Hines states we need to have some trust in leadership to do what is right. We need to have some degree of  confidence in the leadership that exists.  Barbara Raymond, Director  Hiring/training process discussed previously with no questions. Upcoming events - Senior Leadership Conference in May which will include DON, Commandant and Deputy Commandant's from all 6 Veterans' Homes. Barb explained that our regulations mirror thel Federal Government and there are some new stipulations and training requirements, long-term care specific training, financial disclosures out of homes and now to DOH. Nurses week is cokming up in May and all 6 homes are having events, although they are limited due to procurement. Public Health Emergency is ending May 11, 2023. Barb said she is unsure about any mask and testing changes for COVID report-7residents COVID+ between SWVC and SEVC and all are stable. 7 staff across all SVH except DVVH Very littlei influenza across 6homes - will wait for DOH recommendations for masking with flu season. Glf flu/illness at SWVC- all stable, likely norovirus which generally isn't tested for - Barb reminded everyone  PA at this time. Some states have already dropped the mask mandate, but PAI has not.  who has 0 staff COVID+ at this time.  about the importance ofl handwasningeducation.  QCC for Barb Raymond, Director  Senator. Judy Ward asked about PCU and whati is the drug/alcohol policy? Barb answered that from a regulation standpoint, we can have house rules saying that residents cant have it, but regulations say we are not permitted to search rooms without consent. Senator Ward commented that the Federal VA does not permit medicnal use of marijuana and recreational use is still illegal here. Senator' Ward asked what our policy is for residents breaking rules? Barb answered that if we can show a resident is breaking rules without searching, we can give them a notice oft the violations. Senator Ward asked if a resident is intoxicated and there is fear with staff and others, how do we handle this? Barb replied if is escalated that much, we contact police or crisis if they are a harm to self or others. They will determine 302. 201 is voluntary. Senator Ward said ifar resident is escalated and staff and others are fearful, we call the police, but what do we doi if it keeps happening? Barb replied that guidance is we can find a safe discharge and do a 30 day notice if the resident is agreeable. Immediate discharge is a little tougher; we can immediate discharge for a criminal act. Travis Davis added that for a safe discharge of someone who requires care, it can be difficult to transfer especially due to having to send records. Senator Ward asked how do we keep residents and staff safe? Travis replied acknowledging that Veterans with behaviors can be challenging and sometimes 1 on 1 staffing is needed, which in turn can hurt the waitlist due to staffing needs.  5    Advisory Councill Meeting April20,2023  General Weigl added that there is an increase in PA residents needing more assistance and regrettably we are having to deny more than ever. An office is being created at the Federal VA to help figure out solutions and what to do with veterans in these situations. Travis stated that if DMVA doesn't take someone then nobody is which could lead tol homelessness and is a real issue. General Weigl added that HVH has most open beds, sO many times, residents comehere then go elsewhere. Barb stated that DHS regulations for PCU are different than DOH for safe discharge. Sometimes safe discharge for PCU is utilizing HUDVASH, homeless for a day then HUDVASH can Brian Querry stated grievances can take al life of their own - what ist the exact process? Travis replied the Individual has a complaint, we will investigate using camera footage, witnesses, interview random others Regarding issue -1 the purpose is toi find out what is going on, not to "get someone in trouble". General Weigl Stated that grievances are for all reasons, and there is a fine line on if we would think: something is acceptable or Not. We have to put ourself ini the Veterans' shoes in a situation. Brian Querry asked does the grievant receive Feedback on the outcome? Barb said yes and that every single grievance is looked at no matter what.  support. Limited by county.  Josh Spigner, Compliance  Trying to use Justifacts for employees SO background checks can be done automatically- currently being done by  hand. Two compliance continued reviews - Benchmark Therapies and Vistamed- - psych.  QCC for. Josh Spigner N/A  Joe Patterson, Admissions & Marketing  Upon admission, residents and families are made aware that grievances are their right. Encouraged to follow "chain of command" - start with Joe then he will direct it toward the department or the Commandant Passed out chart -J January - 4 gains, 2 losses; February- - 8 gains, 21 transfers, 6 losses; March-S 9 gains, 1t transfer,  7k losses; total - 21 gain, 3 transfer, 15 losses  53 in the pipeline at this time, reminded that this is from application to admission.  Marketing - visiting DESA, group in Martinsburg on May 18th at noon. Group was reminded that if there are any  events they would like. Joe to attend tol let him know.  QCC for. Joe Patterson goes to the committee.  Brian Querry asked what advocates can do to try to speed up the admission process?. Joe replied that having all paperwork and documentation from doctors is vital. Once all needed documentation is received, application Tim Susengill stated he will send form 212680 to. Joe - Veterans can get form done by team at VA, same as MA  51.  6    Advisory Council Meeting April 20, 2023  Barry Lowen, Interim Commandant  Barryi is a 28 year Air Force Veteran, 10 years working for the Commonwealth, SWVC/SEVCI leadership history. Not Taking thet transition lightly, will continue to support residents, staff and families. Staff at HVH are excellent,  and really care for residents and their families.  Over $68,000.00 in the holiday fund; giving $75.00 per resident for Christmas and the remainder will go into the welfare fund. See pictures from events in Commandant's Report packet  100th birthday party for Russell Stiffler a huge success. It included a surprise visit from his daughter he hadn'ts seen Active Shooter Training will be held on April 29th, working with VZMC, police, EMS - will run through the scenario, No residents will be involved. Will take place on South 1in Eisenhower Hall which is a closed unit. The event will Be closed to the media and viewers but the facility will be open to visitors as normal. Can talk offline with any MacArthur Hall replacing roof, windows, 80% of brick/mortar, new dining room and kitchen area. Once skilled Residents are moved to new building, MacArthur Hall residents will be moved to either Arnold Hall or Eisenhower  iny years.  Questions and we will report on how the event goes at the next meeting.  Hall SO complete indoor renovation can take place. Spring C outdoor activities in full swing QCC for Barry Lowen, Commandant  Brian Querry asked if there is a percentage of non-Veteran resident limit - 25% Federal, 12% internal unless DAG Notified. General Weigl stated a non-Vet can be PA National Guard -I marked as non-Vet but will still accept at  State Veterans' Homes Duffy Hines- = Report of Status: 2 members need recommendations  Barb Raymond will follow up about Duffy Hines, Ray Lenz and Mick Hoover  Old Business: N/A  New Business:  Ray Lenz - Lightner Hall name for CLCdiscussed, discussed different floors to be designated for heroes. Ray sent a letter regarding Ralph Fabbri name recommendation also recommended Martin Hamlin, Paul Rokus Representative Schmitt = Recommended John Gority. He spent most of his life sacrificing and was part of the  Advisory Council  7    Advisory Council Meeting April 20, 2023  General Weigl - Ribbon cutting ceremony for new facility is where naming will happen  Recommendations sitting with TAG fori final facility name Joe Patterson - Took photo of Advisory Council  Barb Raymond - Talked about changing the Advisory Council meeting to a different day because in coincides with another standing meeting - suggested changing to second Wednesday, quarterly. It was noted this would not work for Senator Ward and Representative Schmitt. Duffy Hines suggested 3rd Wednesday. Senator Ward asked to avoid Wednesdays. Members are to check calendars and we will discuss this issue at the next Advisory Council  meeting on July 20th.  Announcements Good or the Council:  N/A Adjournment  Duffy reminded everyone the next Advisory Council Meeting will be on Thursday, July 20, 2023, at 1000hrs.  Meeting was adjourned at 1157hrs.  Tial  Recorder  SE  8