Advisory Council Meeting  July 20, 2023  HOLLIDAYSBURG VETERANS' HOME (HVH) ADVISORY COUNCIL MEETING MINUTES  THURSDAY,July 20, 2023 10:00. A.M.  ADVISORY COUNCIL MEMBERS PRESENT: R. Raymond Lenz, American Legion Department ofPA Henry Gaunt, AMVETS Joe Rodkey, Blinded Veterans Association Goose Marin, Catholic War Vets Brian Querry, Centre County, Director of VA Thomas Williams, VFW Department ofPA Tim Susengill, Vietnam Veterans Association David Wagner, DAV Michael "Mick"Hoover, MOPH  Ildephonse "Duffy" Hines (Council President), Marine Corps League Department ofPA  VIPs PRESENT:  State Representative Louis Schmitt Jr.  DMVA PRESENT  Brigadier General (Ret.) Maureen Weigl, Deputy Adjutant General for Veterans' Affairs - via telephone  Travis Davis, Executive Director ofLong-Term Care Barb Raymond, Director, Bureau of Veterans Homes Craig Swineford, Veterans' Service Specialist, Central PA Region  HVH PRESENT Chrissy Dambeck, Commandant John Reinhardt, Doctor Kelly Smith, Director of Nursing Joe Patterson, Admissions & Marketing Tyler Daugherty, Maintenance  Melissa Meade, Assistant to the Deputy Commandant Tia Williams, Assistant to the Commandant and Recorder  OTHERS PRESENT:  Mrs. Anna Marie Rodkey, Spouse of Joe Rodkey Constance Stransky, Guest of Council Member Ray Lenz Rick Orlowski, MacArthur Hall Resident Nancy Hoover, Spouse ofl Mick Hoover  VACANT POSITIONS: Jewish War Veterans, Vacant  1    Advisory Council Meeting  July20,2023  ADVISORY COUNCIL MEMBERS ABSENT:  Robert "Hank" Sembower, Military Officers Association of America  HVH Resident Representative Called to Order/ Roll Call  Duffy Hines called the meeting to order at 1000hrs and asked everyone in attendance to introduce themselves and  toj 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 to the United States of America. Duffy asked Henry Gaunt to lead the Pledge of  Allegiance.  REVIEW OF MINUTES FROM PREVIOUS MEETING  Duffy asked every memberifthey had any question, comments, or concerns regarding the Minutes from the previous meeting held on Thursday, April 20, 2023, - Brian Querry asked for verification ofj percentage ofnon- Vets as printed on page 7 in the packet handout - Barb Raymond stated it is correct as typed. She explained we keep the percentage lower due to fluctuation of admisions/lischarges With no other questions, comments or  concerns, Duffy said the minutes for April are accepted as posted. General Weigl swore in the following members via telephone- - Duffy Hines (Council Present), Marine Corps League Department ofPA Raymond Lenz, American Legion Department ofPA Joel Rodkey, Blinded Veterans Association Brian Querry, Centre County, Director ofVA Tim Susengill, Vietnam Veterans Association David Wagner, DAV Michael "Mick" Hoover, MOPH Dr.. John Reinhardt  Swearing-In New Members  Henry Gaunt, AMVETS  Dr. Reinhardt commented on new residents and how he enjoys seeing them, especially when they recognize him. Last Monday, received ai message about the power outage and DOH being in. Came in on Tuesday and it was wonderful. The staff were smiling, happy, the first resident he saw had al lantern and was in good spirits. Could not have been more happy to be somewhere that "rolled with the punches". Temporary resident moves during the outage to VZMC went smoothly; VA staff very cooperative and helpful. HVH staff was absolutely wonderful. Lou Schmitt - COVID seems tol have receded, is there any consensus in the medical community/cdc about vaccines?- Dr. Reinhardt stated, unfortunately boosters have not worked thus far hopeful this will change with an annual booster - compared to flu vax that has now moved to two per year - problem with covid was get new variant, create new vax and boostera and by then variant was likely gone. Virulent has dropped = essentially a cold. Colds can be significant iff frail/elderly. Looking at what can make booster/annual vax more effective. CDC on hold  Questions, Comments or Concerns for Dr. John Reinhardt  probably get some type of guidance in August. In works and testing boosters now.  2    Advisory Council Meeting  July 20,2023  Tim Susengill - variant strain is producing less of aj problem? - Dr. Reinhardt stated the biggest problem with boosteri isi its late - by the time produced and put out, strain is mostly gone. Even within a season, viruses can  change. COVID - people have not been getting as sick which is great to hear.  Travis Davis, Executive Director  Announced General Weigl is speaking at event in North Carolina now, will present certificates at next meeting. Welcomed group and congratulated new Commandant, Chrissy Dambeck. Chrissy has 27 years experience in long- term care and started in the private sector. Came to DMVA as a nursing administrator, then came to HVH as Deputy and now Commandant. Wanted to echo some oft the statements from Dr. Reinhardt Contractors hit main power source: for Arnold Hall and Eisenhower Hall. Power went to backup generators, but they only support general life safety measures. Haven't updated generators due to new building being built. Temperatures in Arnold Hall building were entering an unsafe range. No residents were complaining because oft the heat, but still an unsafe temperature was being reached in some rooms. Staffused emergency preparedness plan. Looked at VZMC and sister Veterans' homes throughout the state. Ultimately, we only had to move 19 residents to VZMC along with staff, meds, etc. In order to get power back up to the buildings, it took working around the clock, nobody was injured and all residents were safe. It tested us to see how we would respond. Lessons learned to pass on to all other New procedure in packets for how we handle Advisory Council meetings and minutes. Outlines how we let public know about the meetingsa and DMVA uses social media to get the word out as well. Forminutes, we want to increase transparency to public sO we will post on website. Will get a draft posted until approved, then once signed, State budget still not passed, moving on with business as usual. Waiting to see ifthere is there going to be an increase to Medicaid. Last year we saw 17% increase, one oft the largest which is used for staffing ratio increase. Unsure what is going to happen to support the year two staffing increase; hearing 1%. Ifthis is true, there are concerns about how this staffing increase regulation will be funded for industry as a whole. Will be hard for  veterans homes. Team did an excellent job.  will move to official.  nursing homes tol hit these numbers without support from Medicaid. Questions, Comments or Concerns for Travis Davis  Duffy said to the council to think about who wants to be secretary for council to sign minutes, per the handout in the packet. Duffy asked ifanyone would volunteer. Raymond Lenz volunteered. Joe Rodkey gave a motion to appoint Raymond Lenz as Secretary of the Advisory Council and Goose Marin seconded. Raymond Lenz elected  Secretary for Advisory Council. Barbara Raymond, Director  It's been a busy last three months. We were still in the public health emergency when we last met in April and were still in masks. Currently, no residents with COVID across all six homes. Out of masks except SWVC, one staff positive last week. The staff! has no symptoms and little exposure, SO only a few people are inj masks. Last several weeks have been okay from a COVID perspective. As far as vaccine, monitoring closely to get further guidance. Moderna and Pfizer to go commercial - no longer emergency use. This will likely be when we get guidance, anticipating September. Amount ofillness we see is very low. There is a variant that has been getting news recently - in the United States - variant of Omicron. This variant has been in the states since fall oflast year and is not the most common variant. Not sure why it is getting press, but we are. keeping a close eye on it. This variant is taking herd immunity and vaccinated and pushing through those. Not seeing al lot of changes but nursing teams keeping a  close eye on. Public health emergency ended on May 11th.  3    Advisory Council Meeting  July 20, 2023  New DOH regulations went into effect. July 1st. Very similar to CMS regulations, however, this is the state matching those regs. All six homes are well aware of regulations, had to update policies and procedures and no HVH fairly good with staffing. Across six homes, social workers and nurses is what we are struggling with. Doing Nurses week/nursing asst week. Had celebrations across homes. Leadership paid for a lot out of piocket. State veterans homes week in June. A lot of fun activities, Barb was at HVH. Some events scaled back here because of From survey perspective - HVH and SEVC are in window for Department of Health annual inspection. We go through various surveys a year. DHS in three buildings, DOH in all buildings, VA comes in, in addition to internal  major changes from that perspective other than staffing. various things from the state end for retention.  construction but staff and residents had a great time.  facility assessments. Star ratings  Two homes increased; SEVC, SWVC bumped to five star. Questions, Comments or Concerns for Barb Raymond  HVH working to bump up star rating. Staffing numbers great, quality measures great, health inspections are issue.  N/A  Chrissy Dambeck, Commandant  Duffy stated this is Chrissy's first report as Commandant - Chrissy thanked everyone for their support. Stated she is daughter ofa Veteran, aunt ofa Veteran, has a God daughter serving in Africa, member of American Legion Auxiliary and Legion Riders. Here to improve lives oft those who served our country. Resident advocate. Believes leading by example. Its been a rocky start - was congratulated on first day and then DOH walked in for annual survey. Then power was out. Everything went as well as it could with the power outage. With DOH, because they had no wifi connection, they left. We are anticipating they will be back any day. Life Safety came in this week and exited already. HVH received 61 tags, but other than that it was a good inspection. Groundbreaking ceremony for new CLC was. held on May 2nd Pictures can be seen inj packet handout. We still have multiple residents talk about the ceremony on a regular basis. Pictures from the ceremony are scrolling on the screens in residential buildings forall to see. Annual VA survey was conducted beginning June 6', received several deficiencies. Working on corrective action plan and staff education. Submitting plan for approval within the next few days. June 15",DOH came in on complaint of care and services. Multiple concerns voiced by individual. Complaints were unsubstantiated and no deficiencies were: received from this visit, Carnival was held on June 15th. We had to scale back because of construction but it was still a good time for all. Oktoberfest will be happening September 2151, but also will be scaled back. June 2151 meeting with VZMC, tour of facility and discussed admissions. Working very closely with them and maintaining positive relationship. Patriotic contest was held with various prizes given. Continuing to do contest on quarterly basis. Morale committee meetings happening on monthly basis. Having first annual softball marathon competing with VZMC, tentatively planned for August. Open to all staff, families and Vacancies - 3 open social worker positions, Accountant 3 and Dietician openings as well. Having difficulty  in  friends. Will let everyone know when date and time is officially decided.  recruiting Dieticians.  4    Advisory Council Meeting  July 20, 2023  Questions, Comments or Concerns for Chrissy Dambeck  Brian querry - on the census, it says "total non-Vet". Could wej provide al breakdown with spouses and national guard? National Guard does not like to be called "non-Vet".- Barb asked if we could add line for National Guard - Are there people on standby ifthere are open beds? - Joe will go into detail on this in his Admissions report.  Joe Patterson, Admissions & Marketing  Admissions report quick at a glance, April thru June admissions, discharge and deceased. For April 4 new admissions, 4 deceased, 2 discharged (1 toj public, 1 hospitalized then passed). For May 9 new admissions, 2 discharge (1 within SVH, 1 to public). For. June 7 new admissions, 2 discharge (1 in SVH, 1 hospital), 2 deceased. Marketing - two senior expos coming up, every Tuesday Veteran coffee social, Rotary Club went well this week - al loto ofnetworking inl Huntingdon, Blair, Mifflin, many counties. Little things - phone calls, special forces chapter  Admissions by county provided in handout.  67 wants to present beret to one of veterans here, interacting with community.  Questions, Comments or Concerns for Joe Patterson  Brian Querry- asked for population by county. When he talks to people, would like to tell them amount of Veterans in HVH from certain counties- - makes more personable. Joe said this could be done. Barb likes this idea. - Brian asked ifa anyone is on standby? - Joe asked for him to explain - Brian stated anyone with full package in but because of non-Vet standing, waiting? Joe said there is only waiting list on secure unit. Processing list - turn in all revenue paperwork to revenue, they talk directly to POA - total of9.Ofthis 9 some are: non-vet, service members and spouses, some not ready to come in. Brian asked him to verify number ofVeterans on wait list because no bed available because they are non-Vet - Joe stated there are two = Brian asked what is hold up on these two? - service members - Barb said need to look at percentage; we will figure out how many discharges we would need to put us close to 25%. We check risk before admit in. Brian asked when first came to. Advisory Council, Joe gave a handout showing where people were inj process, it hasn't been included the last two times. Joe said he thought that handout might be confusing to some. Brian stated he didn'tt think was confusing. It provided a lot ofc questions and thinks it should be put back in. When people come to. him, it is an issue, don't know where they can go, don't have money, can't wait 30-40 days. Feels that his responsibility is to push group - how can admission process be sped up? Barb will work with team on this. Brian said Joe works well with him, but finds that when looks at process, surprised at why we don't ask for medical records at the beginning. Joe stated we: need authorization first. Brian said what if Veteran would provide? Joe explained the admissions processs -pre-committee review = next week 3 veterans, awaiting medical doc once received sent tol FIG to see ifDD-214 is good/background check, when we get back, getting last 90 days ofclinical, vaccine records, whole picture then take to committee, post-committee awaiting cost ofcare, the more information we are provided by the Veteran, the quicker we can go, ifthey want to be full cost of care we can bring in sooner, cost of care given and accepted, revisits (ifcommittee needs more documentation ori if site visit needed). Brian said some have been done quickly. Barb will work with Chrissy on how process can be Chrissy- did recently have two admissions turned over rather quickly. Asked Joe to talk about when met with Joe - did go talk to leadership and social services at VZMC. Every situation is different. Ifthere is a situation out of Joes hands, Commandant and Barb decide ifemergency. In month of April, turned an admission in three days. One was a Veteran from aj personal care. home that decided to close, another was when house was being sold.  done quicker.  VZMC HUD-VASH.  5    Advisory Council Meeting  July 20,2023  Barb - some are from literally on the streets. Joe said some come straight from being incarcerated to temporarily Brian- - thought someone couldn't be accepted ifthey are a convicted felon? Barb said different legal opinion on good behavior for 5 years. Some say even though ifi in prison, some want not incarcerated in 5 years. Most recent legal guidance say it is okay ifthe Veteran had no problems/issues in legal system. Not sure what current chief counsels interpretation of what "good behavior" will be. Most recent scenario, individual timed out and would have  with VZMC, denied because not evicted, came to us and took appropriate action.  been on the streets.  Duffy Hines - Report ofs Status:  Mick Hoover officially a member, Goose Marin waiting for reappointment  Jewish War Vets position still open - Duffy started working on Jewish War Vet opening years ago. Called Pittsburgh and was told this person wasn't in charge ofit anymore. Got to Commandant for Jewish War Vets in PA - lives in New Jersey. Jewish War Council from Blair county back in 1950's died out, did not have enough people to keep going. Commandant had no Solutions, but was going back to headquarters to ask ifmember not associated with particular unit might live in the area and willing to serve. As oftwo weeks ago thought he had someone who would be willing to serve here, waiting for call back on who this person is. Ifthis doesn't work out, only one alternative. Ifcant find someone from Jewish War Vets, need to come up with another military group to supply member; unsure who that would be. We have a good representation now of who is available and operating in the area. Hoping this works out with Jewish War Vets - be thinking what organization we can go to if we need to. Tim Susengill -] Does it have to be nationally chartered organization? Through VA sponsored meetings for women veterans - a few groups getting bigger but not formal service organization. Would be nice to have woman vet on Duffy - War council has to make recommendation to Governor - not sure how it would go ifnot. Barb looked up Title 51 Establishment of Advisory Council - 12 members shall be appointed by Governor from list of nominations. Duffy knows some organizations are getting started - one in particular a take on Vietnam Veterans. Believes there are people who would be viable candidates - has toj present to war council. Tim - IAVA nationaly chartered but no local chapter - local members. Not part ofc council yet. Younger group. Duffy said one issue is we don'thave local representation we get back in to a situation where people have to travel far. Some younger members of  committee. Barb looking into.  organizations don't want to serve, have to work, sO they don'thave the time.  Travis - reached out to war council last week, issue with Scranton filling their. Jewish War Vet position as well. Barb looked up PA War Council - theirs is specific. Are they thinking our Advisory Council has to be as specific? Brian Querry - Barb brings up good point - even if we work out with Jewish War Vets, could we add a womens Veteran representative? Feels as ifv we are missing this as a group. Barb said it seems as though we could. Duffy Ray Lenz- - a few years ago we. had a woman on this committee. Inl honor guard, have about six active women helping with military funerals. Feels as though one would be happy to do it. Duffy said we need a volunteer, male Tom Williams - Does Jewish War council have member? Duffy called local Synagogue and left message to ask for  said we could submit info and see where it goes.  or female. Should try to satisfy Jewish War Veteran vacancy then go from there.  assistance.  6    Advisory Council Meeting  July 20,2023  Old Business: N/A  New Business:  Chrissy apologizes as far as employee recognition, invited Tyler as Maintenance representative. Tyler worked straight through and didn'tleave until Tuesday. Joe Patterson really stepped up and took charge. Kelly Smith, Melissa Meade, Tia Williams, Adrienne Bilek and everyone really pulled together. Teamwork at its best. Lou Schmitt briefon budget - involved extensively over the years = reassured the group that PA will get a budget, have to pass, but when and what cant say at this point. State budget is passed like any other law. Senate can amend and this year was amended bill and sent back to house. Was hopeful when was sent home that budget would be worked on - yesterday Allegheny county resigned. Left us with 101 Democrats and 101 Republicans. In order to implement budget, have toj pass code bills, say where money is spent, etc. Probably nothing until September. Ray - Ifbudget hasn'tp passed within in a certain period of time, does state allocate funds? Lou - There will be a point where state agencies run out of money. Have been funded on emergency basis in past. First people to make noise is usually human services, then law enforcement then state employees. Doesn'tanticipate dragging into next year. Reminded the group that everyone in this budget process is new to positions. A little learning  curve/negotiation.  Wagner- - finance chairman for DAV- - two grants - grants come from DMVA - unsure what can be given until budgets passed. Lou said school districts don't know what theyre getting either. Everybody is in limbo waiting for  state budget tol happen.  Announcements/ Good or the Council:  N/A  Adjournment  Duffy reminded everyone the next. Advisory Council Meeting will be on Thursday, October 19, 2023, at 1000hrs.  An motion to adjourn was made by Tim Susengill and seconded by Mick Hoover  Meeting was adjourned at 1200hrs.  <.  hy Secretary  Rhm  7