WV Rural Health Education Partnerships

School Committee

Meeting Minutes

September 20, 2004

Members in Attendance: Sonnie Strader, Rosie Cannarella, Barry Linger, Marilyn Fox, Sandra Morra, Richard Meckstroth, Sarah Miller, Patty Crawford, Henry Taylor, Kathleen Bors, April Vestal, Imogene Foster, Norman Ferrari, Robert Foster, Brenda Michael, Carla See, Ralph Utzman, Hilda Heady, David Brown, Haylee Heinsberg. Recording Secretary: Rhonda Carpenter

Imogene Foster called the meeting to order at 11:30am. Those in attendance introduced themselves.

Review of Minutes from May 17, 2004.

Minutes are not currently posted so approval of the May 17, 2004 minutes will be postponed until the minutes are available to the committee.

OLD BUSINESS

Needlestick Policy

When this proposed policy was last discussed it was suggested that the policy be made broader and to include exposure to bodily fluids and to somehow incorporate a plan to have a prophylaxis kit available throughout the state. A draft that included these changes was presented. Dr. Meckstroth mentioned that billing procedures needed to be addressed. Billing for treatment after exposure is handled differently at each location. At Ruby Memorial and CAMC the student is sent to Employee Health and the bill is written off. At other sites the student, or the students insurance, is billed. Dr. Ferarri expressed the opinion that the facility where the student is training should be aware that if they want to have students they need to understand that there is going to be some risk of exposure. If it happens on their site they have some liability. That’s part of the risk of having students. Dr. Cannarella asked if all students in RHEP are required to have health insurance. Most disciplines recommend that their students carry health insurance but not all require it. Most of the student policies have huge deductibles and very little coverage. Some policies do not cover things at certain hospitals (non-participating hospitals). B. Linger expressed the opinion that since RHEP is a required element of the students’ training the student should not be held responsible for the bills nor should their insurance. It was then asked where is the line drawn-they are required to drive but should RHEP be responsible if they are in an automobile accident? Dr. Cannarella noted that the other issue is the students are not assigned to a hospital - they are assigned to a physician. The hospital would argue that the student is the responsibility of the preceptor not the facility. Discussion turned to immediate procedure for handling the incident. The telephone number for MARS is listed within the proposed policy and it is suggested that the student call to contact an Infectious Disease Specialist for recommendations on treatment and for the location of a drug- storage site for post exposure prophylaxis. At this time the drug-storage locations are not up to date. A survey would need to be completed and the storage site list updated. It is agreed that each incident must be handled following the facility’s guidelines.

Returning to the discussion of billing procedures, H. Heady suggested that the panel send a letter to the West Virginia Hospital Association requesting that they appeal to their membership that if they are taking students to please consider the cost of the initial screening and first treatment of exposure as a perk of the program. She asked for a report from each site that has had an exposure be sent to April Vestal. It is essential to collect data of past incidents to present to the WVHA before they could consider our request. All sites (Site Coordinators, Field Faculty, Schools) should send information about any incidents that they are aware of to April Vestal. Dates of the incidents should be included so that information will not be duplicated. If you know what happened with the billing of the screening/treatment, and/or how much it cost, send that information also.

It was determined that the drug kits are kept on hand at all hospitals. Every training site is within a two-hour drive of a hospital so students could be referred to the nearest hospital.

P. Crawford suggested that the policy needed to include specific guidelines for testing of the index person/source. Motion was made and seconded to approve the proposed policy excluding the Billing Procedures section and with an amendment to add a bullet under Section 4 of the proposed policy that states that the preceptor will help facilitate consent of the index person/source. (Meckstroth/Linger) Motion carried.

Student Advisory Committee

A. Vestal reported that the next Student Advisory Committee meeting will be held in Charleston in conjunction with the Legislative Day activities.

NEW BUSINESS

Educational value of community service activities at RHEP sites

H. Heady requested that the School Committee develop a sounder theoretical base that relates learning objectives to community service. The students need to see the relevance of community service to their training. She requested that this committee work with the Joint Community Outreach and Curriculum Committee to address the RHEP Community Service policy. She asked that this review and changes to the policy be completed by July 1, 2005. (A. Vestal distributed the Final Report of the Schools Sub-Committee on the Parameters of Community Service that was developed in 2001.) H. Heady asked the committee not to change the goals and objectives that have already been developed. A sub-committee was formed to begin the process. Committee members will include: R. Meckstroth, C. See, H. Taylor, P. Crawford, R. Cannarella, B. Linger, J. Jackson, S. Tenant, J. Cochran, I. Foster, S. Bell and M. Fox. The committee will also include a couple of students. A. Vestal will check for available meeting dates and e-mail committee members.

Preceptor Honorarium Payments

A. Vestal introduced a plan to make an umbrella policy (for sites that pay preceptor honorariums) that would allow sites that pay honorariums to make those payments based on the Level I, II, or III classifications. At this point, she asked the School Committee to review the current policy and provide feedback. The committee felt that introduction of this policy could create controversy among preceptors who were receiving payments and those preceptors who are not being paid honorariums.

ADJOURN

Due to the amount of time spent on the Needlestick Policy discussion of the other agenda items will be postponed until the next Committee meeting. The Committee adjourned at 1:25pm.