Norman Regional Hospital Authority Meeting

NORMAN REGIONAL HOSPITAL AUTHORITY Board Meeting May 29, 2018 MINUTES The Norman Regional Hospital Authority met in monthly session Tuesday, May 29, 2018, at 5:30 p.m., in the Norman Regional Hospital Board Room. The meeting Agenda was posted May 24, 2018, on the NRHS and Norman websites and at the entrance to Norman Regional Hospital. Members Present: Doug Cubberley, Vice Chair/Secretary Joan Greenleaf Muhammad Anwar, MD James (Jeff) Kimpel, Ph.D. Tom Sherman Jerome (Jerry) Weber, Ph.D. Kevin Pipes Member Absent: Tom Clote, Chair Diane Chambers, MD Others Present: Robin Mantooth, MD, Chief of Staff Farhan Jawed, MD, Chief of Staff-Elect Richie Splitt, President and CEO Meegan Carter, VP Population Health & Wellness Paula Price, VP Strategy & Growth Brittni McGill, CNO John Manfredo, COO John Sweatt, Director Finance Karen Rieger, Crowe & Dunlevy Jenny Anderson, Director QPI & Medical Staff Services Lisa White, Manager PI & Medical Staff Services Molly McCool-Hare, Business Planning/Operations Specialist Cindy Gilmore, LEAN Specialist Brian Loftus, Business Planning/LEAN Specialist Courtney Blau, Admin. Dir. Risk Management & Compliance Kelly Wells, Director Health Promotion & Community Relations Joy Hampton, Journalist Norman Transcript Shane Cohea, Director Safety & Security Mike Nabors, Manager Security Services Neal Risenhoover, Media Services Supervisor Shannon Largent, Director of Oncology Services & Clinical Education Cassie Chaffin, Clinical Educator, Nurse Residency Program Coordinator LeAnn Richardson, Director Case Management/Care Transitions Jennifer Minnis, Manager Case Management, CDI and MSMES Alicia Stromberg, Case Management Wayne Cook, Manager, Transition of Care  NRHA Board Minutes 2 May 29, 2018 Recorder: Doris Gonzalez, Executive Assistant Agenda Item I. Meeting Called to Order In the absence of Mr. Clote, Mr. Cubberley, Vice Chair/Secretary called the May 29, 2018, Norman Regional Hospital Authority meeting to order at 5:31 p.m. Agenda Item II. Introduction and Recognition of Outstanding Healers A. June 2018 Healer of the Month, Alicia Stromberg, Case Management – Jennifer Minnis, Manager Case Management, CDI & MSMES Mr. Cubberley introduced Ms. Minnis who presented Ms. Stromberg as the Outstanding Healer for June 2018. Ms. Minnis noted that Ms. Stromberg is the Case Manager on the Cardiovascular ICU. She shared the employee’s accomplishments, outstanding teamwork, work ethic, vast knowledge base, positive attitude, and her compassion toward patients, families and co-workers. She is truly an asset to the Case Management Department and Norman Regional Health System. She is the “Norman Way” and well deserving of this honor. Ms. Stromberg stated she was honored to be recognized as the Healer of the month. She stated she was grateful for her co-workers and that Norman Regional Health System is a great organization for which to work. Mr. Cubberley congratulated and thanked Ms. Stromberg on behalf of the Board for her outstanding dedication, professionalism and positive attitude that continues to make Norman Regional Health System a caring, high quality system. Ms. Stromberg, Ms. Richardson, Mr. Cook, and Ms. Minnis left the meeting at 5:35 p.m. The minutes will reflect the order of discussion. Agenda Item III. Board Education – Nurse Residency Program Update – Ms. Largent and Ms. Chaffin Ms. McGill introduced Ms. Largent, Director of Palliative Care Unit and Ms. Chaffin, Nurse Residency Coordinator. The program began August 2017 with 24 residents and will graduate its first class in July 2018. The second cohort started March 2018 with 20 residents and in the fall will begin our third with a goal to apply for accreditation next spring. This is a year review of where we are and where we want to be with this program. Ms. Chaffin stated Norman Regional Health System partnered with Vizient/AACN Nurse Residency Program in 2017. The program is to support new nurses transitioning from nursing school graduate to professional nurse, ensuring the best outcomes. Vizient started the program in 2006 based on evident-based curriculum to build on the knowledge gained during nursing school and unit orientation and based on professionalism, leadership and quality. It contains a series of classroom work once a month for four-hours, emphasizes the development of clinical leadership, and drills the need to continue looking for learning opportunities. The Institute of Medicine in 2010  NRHA Board Minutes 3 May 29, 2018 recommended that all nursing programs look at a transition of practice program along with growing its BSM base. It is mandatory for all nurses with less than six months of experience to go through the program and the nurses that have been on the unit for longer than six months it is up to the individual managers as to who they want in the program. We provide surveys to the residents at zero month, six months and 12 months. We have access to that feedback and the availability to compare to the Vizient database. The Vizient/AACN Nurse Residency Program:  Is in 40 States, D.C., and two foreign countries  17,671 residents participated in 2017  Vizient programs have 92.7% retention rate – national average for new graduate retention is about 74% Norman Regional Health System is the only hospital in Oklahoma that has the Vizient/AACN Nurse Residency Program within the hospital. Successes:  Competitive with market  Increased amount of new graduate applicants  Reduced new graduate turnover (baseline FY17 74% -- Current 92.5%) Opportunities for Improvement  Policy revisions o Refined the Policy regarding the inclusion criteria o Visibly defining expectations of resident  Involvement of unit leadership o To have an understanding of the program and its benefits o Involving leaders in presentations  Continued cultivation of speakers and revision of content based on evaluations Next Steps  Vizient will do a touch point visit June 2018  First cohort graduation July 2018  Third and Fourth cohorts to start late summer and early fall 2018  Prepare for accreditation application (Commission on Collegiate Nursing Education (CCNE) or American Association of College of Nursing (AACN)  CCNE accreditation requires that we partner with an academic partner and we have selected Kramer School of Nursing. They will offer their RN to BSN program at NRHS starting in August and there are already 24 RNs registered (not all are from NRHS) for this program. They are considering having a second session at NRHS. Mr. Splitt complimented both Ms. Largent and Ms. Chaffin for their leadership in this program. The need for this was based on physician feedback. We are recruiting talented nurses and we need to provide them a safety net to build confidence and trust between teammates and physicians. This program is showing its success and retention is just an added bonus. Ms. Chaffin and Ms. Largent left the meeting at this time.  NRHA Board Minutes 4 May 29, 2018 Agenda Item IV. Approval of the April 7 Board Study Session Minutes and the April 23, 2018 Board Meeting Minutes Mr. Cubberley asked for approval of the April 7 Board Study Session and the April 23, 2018 Board Meeting Minutes ACTION TAKEN: Dr. Weber made the motion to approve the April 7 Board Study Session and the April 23, 2018 Board Meeting Minutes as submitted. Mr. Sherman seconded the motion, and the motion was approved unanimously with aye votes from Dr. Anwar, Mr. Cubberley, Dr. Kimpel, Mr. Pipes, Ms. Greenleaf, Mr. Sherman, and Dr. Weber. Agenda Item V. Performance Updates Ms. Anderson provided a Quality & Patient Safety Update highlighting the following:  Patient Safety o C-difficile has increased. We will continue to educate all providers, and thoroughly review cases with Infectious Disease. We are looking at a new lab test to determine colonization vs. active infection. o Central Line Associated Bloodstream Infection (CLABSI) – Decreased with only one case since inception of the Vascular Access Specialist Team (VAST). They are monitoring and teaching insertion techniques for reducing infections, performing dressing changes and serving as a liaison to nursing units. We collaborated with Medical Staff and through MEC received approval for a line removal protocol, putting emphasis on removing the lines earlier. We have seen a dramatic drop in our line days at both campuses. o Surgical Site Infections – The two Center for Medicare and Medicaid Services (CMS) Reportable Infections are the abdominal hysterectomies and colons and we report those that are complex. We have had no complex abdominal hysterectomies and no complex colons through March 2018.  Quality and Performance Improvement o Sepsis – First public reporting in July 2018. We are ahead of the curve at 59%. Our Sepsis sub-group meets monthly reviewing cases and order-sets and talking to nursing and physicians about what is not working. We send all outliers to all care providers and nursing/physician leadership. We are trying to keep it mindful that we are working on this and the goal is 70%.  Patient Experience o Inpatient Real-Time Surveys  Currently making weekly calls with NRC  Implementation for all of our inpatient and outpatient areas that are not currently on Real-Time Surveys July 9, 2018 (will survey back to July 1)  Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) paper surveys will be reduced to the 400 required by CMS annually. All data will be coming from the Real-Time Surveys. o Provided an overview of the Current HCAHPS NEWs Walls o Porter Nurse Forum June 6, 2018 will focus on HCAHPS and as time allows any other Nursing Quality Metrics.  NRHA Board Minutes 5 May 29, 2018 Agenda Item VI. Approval of the April 2018 Norman Regional Health System Financial Statements In Mr. Hopkins’ absence, Mr. Sweatt presented the April 2018 Norman Regional Health System Financial report. He highlighted the following from the April 2018 NRHS Financial Statement:  April Hospital Inpatient Volumes – Admissions were stronger than budget. Discharges were 7% above budget with a favorable Average-Length-of-Stay and a strong Cath Lab component.  April Hospital Outpatient Registrations – Hospital Outpatient volumes were very strong. Overall Outpatient visits were 5.5% higher than budget and included a strong Cath Lab component. Clinics registrations were on budget. April 2018 Financial Performance  Gross Revenues .................................. (Budget $153,216,917)............ $159,622,131  Net Patient Revenue .............................. (Budget $33,940,397).............. $33,423,551  Total Operating Expenses ..................... (Budget $33,040,449).............. $32,641,776  Total Operating Revenues ...................... (Budget $34,362,465).............. $33,812,846  Operating Income .................................... (Budget $1,322,016)................ $1,171,070  Non-Operating Revenues (Expenses) ........ (Budget $526,918)................ $1,038,495  Excess Revenues over Expenses ............ (Budget $1,848,934)................ $2,209,565 Year-to-Date  Operating Income .................................. (Budget $13,901,333).............. $13,505,600  Non-Operating Revenues (Expenses) ..... (Budget $5,635,180).............. $10,919,102  Excess Revenues over Expenses .......... (Budget $19,536,513).............. $24,424,702  Accounts Receivable Days ............................ (Budget 46 Days).................. 43.7 Days  Days Cash on Hand .................................................................. ................ 226.0 Days ACTION TAKEN: Mr. Sherman motioned to approve the April 2018 NRHS Financial Statements. Dr. Weber seconded and the motion was approved unanimously with aye votes from Dr. Anwar, Mr. Cubberley, Dr. Kimpel, Mr. Pipes, Ms. Greenleaf, Mr. Sherman, and Dr. Weber. Agenda Item VII. Medical Staff A. Report from the May 9, 2018, Medical Executive Committee (MEC) Dr. Mantooth reported that MEC met May 9, 2018, and highlighted the following:  Mr. Hopkins presented an in-depth second quarter financial report.  Discussed the confusion of ordering blood products and the transfusion of those products. The correct way to order a blood product transfusion is to utilize the “Blood Product Transfusion Order Set.” In this order set the physician can chose the blood product to be transfused and specify when it is to be transfused. It was noted that pop-ups are being created and added in Meditech to assist in the ordering and transfusion of blood products.  Discussed the Board Certification section of the Bylaws and after a brief discussion they decided that all physicians must become Board Certified and remain Board Certified.  NRHA Board Minutes 6 May 29, 2018  Department/Committee Reports o OR Committee/Surgery Department – Dr. McCurdy reported the following:  They are tightening the practice of scrub techs assisting with surgeries. Scrub techs will be under the direct supervision of the surgeon with whom they are working.  Discussed 1st case delays and robotics.  Reviewed and discussed the “Stop the Bleed” program. o Pathology Department – Dr. Littlejohn reported the following:  Lab is preparing for their Department Inspection to take place between mid- June and Mid-September. The inspectors will want to meet with the Chief of Staff and a member of Administration. o Pediatric Department –  Discussed they will begin hearing screens on all babies. If any baby fails their hearing screen, they will begin screening for Cytomegalovirus (CMV). o Pediatric Hospitalist Update – Dr. Cook reported since she and Dr. Laughey joined NRHS their admissions have doubled. Bronchiolitis was the most common admission diagnosis; however on the downward trend. They are going out into the community and the Moore Clinics informing every one of all the specialties NRHS offers and that they have Pediatric Hospitalists on-call 24/7. They will be rebranding with the name “Norman Regional Kids. o Emergency Medicine Department – Dr. Hoos-Reinke reported the following:  Updated their STEMI order set  Talked about doing Morbidity and Mortality cases for education.  Reviewed and voted to keep their current department indicators, but may add evaluating “Left Without Being Seen” to their indicator list.  Dr. Zimmerman is starting Quality Pearls, which will be used to evaluate simple topics in the ED and ensure they are being done well. The first topic evaluated will be CPR.  Dr. Porter will be retraining all Attendings on the ultrasound in June  Discussed the oversight of mid-levels and how to meet their Code Stroke times  Sepsis numbers are looking better o Infection Committee – Dr. Ahmed reported the following:  Announced that CLABSIs have been declining and the line days are trending down.  They started performing Penicillin testing on patients with a stated allergy to Penicillin.  Started a trial for external female catheters in an effort to see a decrease in catheter related infections.  Talked about C-diff – He noted that if a patient is admitted at 11 pm; that 11pm to 12 am is considered the first day of admission.  Discussed the PCR testing, the positive C-diff test and toxin level o Residency Update – Dr. Cody addressed concerns from members, and provided his card encouraging them to call or email him with any concerns regarding the residents. Discussion included the M&M project.  Reports from the Vice President – o Infection Prevention was moved to be under nursing. o ED is working on ordering the correct bed for patient initially. In an effort to improve throughput, 4-North will be trialing coming to the ED to move their  NRHA Board Minutes 7 May 29, 2018 patients from the ED to 4-N. oDiscussed the first graduating group of nursing residents oPerformed their first system-wide teach week in April oHad our first Code Black on May 3, 2018, which went well. oRecognized Dr. Zimmerman specifically for picking up an intoxicated man from outside, carrying him into a room to safety, checking on him throughout the duration of the Code Black and then personally getting him food once the Code Black was over.  Reports from the Vice President o Announced that Ms. Brittni McGill is our new CNO. o Talked about the “Stop the Bleed” training exercise May 14 at 6:30 a.m. at the HealthPlex. This was brought about from the recent school shootings. Dr. Mantooth stated that she appreciates the NRHS Administrative Team support. The physicians really feel that Administration wants to know what the physicians want and acts on that. We have a very good Administrative Team at NRHS. Agenda Item IX Strategic Planning Committee Dr. Weber reported the Patient Quality and Safety Committee met Monday, May 7, and highlighted the following:  Mr. Hopkins provided an update on two research studies conducted by the University of Oklahoma Health Sciences graduate students in the Masters Health Administration program. The two projects provided a review of business opportunities in Behavioral Health and Long-Term Acute Care Hospital (LTACH) programs. The information provided the necessary requirements and regulations that must be in place to pursue business opportunities in these two areas of healthcare.  Mr. Hopkins reported that our BHAG consultant, Navigant, has begun the process of gathering health system data for review and analysis. The next step will be a kick- off meeting to clarify the timeline and other needed materials and information for review.  Strategic Planning Updates highlighted: o Norman Regional Clinics growth in patient visits and new patients o The strategic planning process for the Oncology Clinic and Oncology service line o The ongoing development of the Health System’s Lung Health program, coordinated by NRHS pulmonologists, Drs. Sergio Garcia and Christopher Parker o Ms. Gilmore, Strategy and Growth team member, reported on the recent Strategic Teams fiscal year planning sessions. These teams are comprised of members from leadership and front-line staff who develop system-wide tactics and activities that support the strategic focus areas of Service, Operations, Clinical and Team. o The planning session focused on:  Enhance the value of patient care provided  Close the gap between the patient’s expectation of service and the service provided  Utilize health system data to quantify, measure, and trend patient and healer engagement  NRHA Board Minutes 8 May 29, 2018  Ms. McGill reported on process improvement initiatives in the Health System’s three emergency departments. The focus of the initiatives is the standardization of processes, protocols and service among the three campuses. In order to ensure standardization, the ED leadership was restructured to include an Emergency Department System Manager and Clinical Supervisors at each location.  The meeting ended with a GEMBA walk to the NEWs Walls in the Porter Emergency Department. Agenda Item X. Finance Committee A. Report from the May 21, 2018, Finance Committee Mr. Sherman reported the Finance Committee met May 21, 2018, and highlighted the following:  Mr. Hopkins provided an in-depth April 2018 Financial Report and a brief overview for Medical Park West, LLC  Charity Care for April was $666,918 and YTD the System provided $7,964,270  Bad Debt for April was $1,663,567 and YTD was $15,422,811  Community Contributions for April was $111,516 and YTD was 1,068,476  The Health Explorers Post 901 completed its first year of service to Norman and South Oklahoma City students. It was very successful.  BKD will be coming in June to start the Audit  Five capital requests were presented for approvals totaling $1,123,918: o HealthPlex Endoscopy Construction - $267,059 – This would prevent transferring a patient to the Porter campus for emergency procedures. o HealthPlex Intra-aortic Balloon Pumps X 4 -- $236,200 – Current models are no longer reliable to be used on critical patient population o HealthPlex Fetal Monitors X 25 - $306,577 – Current fetal monitors are more than 10 years old and parts are no longer available for repairs. o Ambulance Remount X 2 - $226,814 – This request is for a new chassis with refurbished box with remount and refurbish of a current box on new chassis. o Clinical Peripheral Enhancement - $87,268 – Upgrade of worn out devices, system upgrades and device refresh B. Recommend Approval of Capital Equipment Purchase Requests ACTION TAKEN: Mr. Sherman made a motion to approve the Capital Equipment Requests totaling $1,123,918 as recommended by the Finance Committee. Mr. Pipes seconded and the motion was approved unanimously with aye votes from Dr. Anwar, Mr. Cubberley, Dr. Kimpel, Mr. Pipes, Ms. Greenleaf, Mr. Sherman, and Dr. Weber. Agenda Item XI. Old Business Mr. Splitt reported that the Oncology Clinic construction project was delayed due to some unexpected design structural issues. Those issues have been addressed and we anticipate the new Oncology Clinic to open the first of September. The Norman Regional Moore Mammography space is complete and cared for about 24 patients last month.  NRHA Board Minutes 9 May 29, 2018 Agenda Item XII. New Business Mr. Manfredo congratulated Ms. Jenny Anderson for being accepted into the John Hopkins Bloomberg School of Public Health’s Master Program, which is the top rated school in the country. We are looking forward to her successes and what she brings to our organization through this program. Mr. Cubberley announced that Mr. Tom Clote is resigning from the NRHA Board June 25, 2018. He asked the members to make every effort to attend the June 25 meeting to celebrate his retirement from the Board. He will be missed. Agenda Item XIII. Administrative Report Mr. Splitt provided an update on the following:  As follow-up to a previous presentation of “Project Search.” Project Search was a partnership with the Moore Public Schools for special needs students that were finishing high school and needed some on-the-job training. Five students in the program graduated last week. It was a wonderful experience to see those five young men and their achievements and accomplishments. A nice video was created and we want to share that with the Board next month. A student was recognized in the Emergency Department meeting as Employee of the Month. He is enrolled in a Certified Nursing Assistant (CNA) program so that he can one day get a job in an Emergency Room. It changed their lives and changed our lives as well. Working with them was a joy. We have eight students requesting acceptance in next year’s program.  The Navigant data request is well underway. We expect a phone call May 31 to find out “next steps.” We will keep the Board apprised.  Mr. Hopkins has a family issue that would not allow him to attend the meeting tonight, but wanted the Board to know the FY 19 Budget is being finalized. It will be growth oriented and look at our expenses, how we can better control them.  We are looking forward to the finalization of our Strategic Planning and our ability to achieve not only goals for this year but also the goals for next year and beyond and how that relates to our Big Hairy Audacious Goal. Agenda Item XIV Proposed Executive Session A. Proposed Vote to Convene an Executive Session Pursuant to 25 Okla. Stat. Section 307 B.4. to Discuss with Legal Counsel Pending Internal Peer Review/Credentialing Investigation Regarding the Medical Staff Members/Applicants Listed Below and to Discuss Real Property/Appraisal Pursuant to 25 Okla. Stat. Section 307 B.3. ACTION TAKEN: Mr. Pipes made a motion to adjourn into Executive Session. Dr. Kimpel seconded and the motion was approved unanimously with aye votes from Ms. Greenleaf, Dr. Anwar, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Ms. Anderson, Mr. Risenhoover, Mr. Sweatt, Ms. White, Ms. Gilmore, Ms. McCool-Hare, Ms. Blau, Mr. Loftus, Ms. Wells, Mr. Nabors, Mr. Cohea, and Ms. Hampton, left the meeting at 6:40 p.m.  NRHA Board Minutes 10 May 29, 2018 B. Medical Staff Recommendations Regarding the Medical Staff Members/ Applicants as Listed in XIV.B 1-4 Below. 1. Recommend New Provisional Medical Staff Appointments: a) Smaranda Galis, MD, Active Staff – Medicine Department b) Hey Le, MD, Privilege Only-Teleradiology Staff – Radiology Dept. 2. Recommend Advancement of Medical Staff from Provisional Status: a) Larhonda Sims, MD, Active Affiliate Staff – Medicine Department b) Sean Mills, APRN-CNP, Allied Health – Emergency Medicine Dept. c) Sean Olsen, PA, Allied Health – Emergency Medicine Department d) Brittney Osborn, PA, Allied Health – Emergency Medicine Dept. 3. Recommend Medical Staff Reappointments: a) Muhammad Anwar, MD, Active Staff – Cardiovascular Medicine b) Philip Bird, MD, Active Staff – Medicine Department c) Charles Lackey, MD, Active Staff – Medicine Department d) Lubna Mirza, MD Active Staff – Medicine Department e) M. Dianne Chambers, MD, Active Staff – OB/GYN Department f) Jessica Hinojosa, DO, Active Staff – OB/GYN Department g) Thomas Whalen, DO, Active Staff – Hospital Medicine Department h) Reba Beard, MD, Active Staff – Pediatrics Department i) Kathryn Cook, MD, Active Staff – Pediatrics Department j) James Seay, Jr, MD, Active Staff – Pathology Department k) Jonathan Bryan, DO, Active-Affiliate Staff – Medicine Department l) John Krodel, MD, Active-Affiliate Staff – Medicine Department m) John Christiansen, MD, Active–Affiliate Staff – Medicine Dept. m) Joel Holloway, MD, Consulting Staff – Medicine Department n) Robert McArthur, MD, Consulting Staff – Medicine Department o) Ginger Thibault, APRN-CNP, Allied Health Staff – Pediatrics Dept. 4. Recommend Request for Additional Clinical Privileges a) Tony Tran, MD is requesting to add Endoscopic Retrograde Cholangiopancreatography (ERCP) Privilege C. Request to Adjourn Out of Any Such Executive Session and Return to Regular Session ACTION TAKEN: Mr. Pipes made a motion to adjourn out of Executive Session and return to regular session. Ms. Greenleaf seconded, and the motion was approved with aye votes from Dr. Anwar, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Ms. Greenleaf, Mr. Pipes, and Dr. Weber. Mr. Cubberley noted the Board returned to regular session. There were no decisions or votes taken except to return to regular session and any information shared during the Executive Session is privileged and needs to remain in Executive Session.  NRHA Board Minutes 11 May 29, 2018 D. Proposed Vote to Approve or Disapprove the Medical Executive Committee Recommendations Regarding Credentialing of the Referenced Medical Staff Members as Listed in XIV B 1-4 ACTION TAKEN: Dr. Kimpel motioned to approve credentialing items as recommended by Medical Executive Committee and Credentials Committee of all referenced Medical Staff members listed in XIV B 1-4. Dr. Weber seconded, and the motion was approved with aye votes from Ms. Greenleaf, Mr. Cubberley, Dr. Kimpel, Mr. Sherman, Mr. Pipes, and Dr. Weber. Dr. Anwar abstained from voting. Agenda Item XV Board Open Discussion Mr. Splitt thanked and noted appreciation to the Board, Physicians and Executive Team for their time, talents and efforts. Agenda Item XVI. Adjournment ACTION TAKEN: Mr. Sherman made a motion to adjourn at 7:00 p.m. Ms. Greenleaf seconded, and the motion passed unanimously with aye votes from Ms. Greenleaf, Dr. Anwar, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Respectfully Submitted, Doug Cubberley, Vice-Chair/Secretary