Ketchikan: Healthcare Advisory Committee Quarterly Meeting of Oct. 22, 2026

The chair. You ready?

Yeah. Thank you.

All right, welcome. Hope everybody hear me okay. All right, I'll call the October 22nd Healthcare Advisory Committee meeting to order. Taylor, if you could call the roll, please. Cynna Smith.

Here. Robinson. Here. Bob Sivertsen. Present.

Park. Present. Hoag. Here. And Cook.

Here.

All right, thank you. I don't have any communications unless anybody else on the committee does, which will move us— if not, that'll move us into persons to be heard. You have the list. And are we doing 3 minutes then? Yes.

So the city clerk will act as our timekeeper and we'll ask speakers to limit their comments to 3 minutes, please.

Good evening. Good evening. Last night at the town hall for the Community Health Board, PeaceHealth responded to previous public outcry regarding noticeable malignancy of silence. In multiple settings, patients, caregivers recounted story after story of instances where concerns about care, concerns that range from a disregard for their specific needs at a vulnerable time, to dangerous misdiagnosis, mistreatment, and missed life-saving medications that in some instances even resulted in death.

PeaceHealth presented a grand outline for their renewed efforts at quality improvement and safety, no doubt aimed at trying to help the community feel heard.

But what they said next indicated that they were just giving lip service. The promises of improvement were accompanied by way too much defensiveness. This defensiveness took the form of different versions of the following statement.

I was looking how hard we're trying, but cut us some slack because we all know that the medical system is broken and it sucks. This was accompanied by a complete abdication on the board's part of any responsibility for or oversight of the quality improvement efforts that they were outlining. It was very disheartening to me.

You here on this board have accepted responsibility for the oversight of the hospital as far as the lease goes, but how will you require the explanations when patients and caregivers have been unable to obtain them about problems with quality and safety? Last night I advocated for passing an ordinance that creates a new position an ombuds person paid for by the hospital to act as someone who could field safety concerns and assure that those concerns are receiving adequate follow-up. I'm repeating this suggestion here to you. This board should welcome the advocacy an ombuds person would bring. Advocacy for the patient, advocacy for caregivers, advocacy even for you, and advocacy for the community.

Thank you.

Thank you. Mr. Weaver's next.

Thank you. Um, a little bit different tact. Accountability starts with each one of us. With you all. Of course, you accepted the challenge, but it relies also on the accountability of the citizens.

We had about a 17 to 23% voter turnout last election for city council and for other voter-delict officials in the, in the borough.

Mandate is you don't have to do anything at all. 80% Of people just didn't care enough to vote. I've often said Ketchikan will get the healthcare that it fights for. That's true. But tonight, with respect to the lease, Ketchikan will get the healthcare that it's voted for, or in our case, not voted for.

So this is the required annual open, well, widely open public HAC meeting before the Gateway Review. The Gateway Review is not a lease renewal process.

It is not necessarily to discuss renewals, to discuss the lease and how it's been implemented and how it's been— what we've learned over 5 years. There's been a lot of learning, both sides, no question. It was developed in a joint conference, 3 and 3, not a very effective community to have 3 and 3, but that's the way the structure of the AJC was committed. And it's an advisory committee to the City Council, so the ultimate responsibility for interpretation comes down to the City Council. We'll be asking or at least a forehand vote to proceed with a pretty clear delineated structured review of the lease financially.

There's a lot of red ink, millions of dollars in transfers. Kendall Sal was here. Thank you for attending, Kendall. But healthcare financing is complex. I think everybody will recognize that.

I don't pretend to be an expert, but $44 million was actually transferred up from PeaceHealth to cover something, but they also have $40 million in shared services coverage on roughly $100 million to $110 million in total revenues. Seems like a lot. They have some positive patient operating margins, and yet total margins are negative. More red ink on Saving Rural Hospitals website than any other hospital, basically any other hospital in Alaska. PeaceHealth could learn quite a lot from talking to perhaps a hospital as close as Bartlett that has better financial performance.

Our caregivers are good. They're operating under extreme duress, and that's under our leadership, local leadership. The culture we've gone into, we don't have to go into it again. So tonight, I want the HAC board to remember Ketchikan citizens will be watching. We're hoping that you recall the feelings you had when you were kicked out of the Residents Meeting Elder Care.

I hope you recall the intent that you had when you formed this on behalf of the citizens of Ketchikan. But you can also remember 80% of them didn't vote. Thank you.

Thank you.

Good evening. My name is Greg McCormick. I'm an emergency medicine physician, works in the ER here in Ketchikan through Apollo MD, who's the group that staffs our ER. I'm also the medical director of the ER. Just a little background about me, I have been living here and working here for the past 2.5 years.

I'm really happy to call this place home. It's been a wonderful experience. In the past 2.5 years, I've also been through some transitions with staffing. There's kind of been a lot of changes, but I would say working with Apollo MD in alliance with PeaceHealth has been pretty refreshing. We have a good core staff now.

I also want to make a comment about the, one of the wonderful things about working at the hospital has been the staff who I work with, my colleagues, the physicians, the nurses, the ancillary staff. I've worked in 3 other states over the past 2.5 years and since residency, 7 different ERs, and I think there's something really special to be said about working in a community where people are serving their neighbors, their family members, their friends, and there's just there's a sense of genuine caring that comes with that, which makes this place really special. And I'm happy to be working in a place like this. I also feel that even though we're staffed by Apollo MD, we work closely with PeaceHealth and they've been very supportive to us. One recent example and a victory for our ER is Sarah Cook has been helpful working to get some grant funding.

We have a new state-of-the-art ultrasound machine coming to our ER, which we're all looking forward to having there. It's been great, so I look forward to continue working in this community and working with PeaceHealth and Apollo and just working to make sure we're delivering the best care we can for our patients. Thank you. Thank you.

Yeah, thanks for allowing me to speak. Richard Benson, I'm also a practicing emergency physician. Glad to be here tonight. Just really quickly, I wanted to say thank you to Everybody, I have been a practicing emergency medicine physician for over the past 10 years. I work with the Apollo Group where we see over 4 million patient visits over the year, and we oversee about 3,500 practicing clinicians across 18 states.

In addition, I'm accompanied by two of my colleagues, Dr. McCormick, who you saw, Dr. Pathan. I think between the three of us are credentialed in over 50 different hospital systems, have worked in large places like Atlanta, New York City, Chicago, but then also very rural cities as well. As an early director, kind of one of the things I was very passionate about is standing up a critical access hospital in a rural part of North Carolina. And so I believe that we do know that population very intimately. And what I will say is that working with PeaceHealth has been great.

I think when you look at the hospital here, the amount of specialty coverage that we have with ortho, peds, surgery is just really not something that you typically see. So obviously kudos to the hospital for that. In addition, the administration has been great. So very engaging conversations around kind of increasing the physical space of the emergency department, matching the seasonal surges in terms of staffing. So it's been a great opportunity to work with everybody here.

So thank you. Thank you.

Is there anybody else here tonight that would like to address the committee?

All right. Well, we will close the public comment period then and move on to approving our July 23rd, 2026 meeting minutes. Mr. Chair, I move that we approve the minutes as presented. I just had a couple of minor changes on page 3 in the paragraph under PeaceHealth updates.

Second line where it says fusion, it should just say infusion, just to be clear. Sorry. That's right.

I move to approve as amended.

We have a second. I second that. Thank you. All right, it's been moved and seconded. Taylor, can you please call—.

Sorry, I'm trying to speak a little bit louder. Yeah, okay. Um, okay, calling for, um Smith has amended. Smith?

Yes. Robinson?

Yes. Cook? Yes. Bob Sivertsen? Yes.

Park? Yes. Oh, yes.

Right, let's pass. Um, moving to standing business, uh, I did make a, make a note on the agenda that, uh, the, the items under A will be covered under our PeaceHealth report card. So if there are no objections, we'll move to the report card. And just for the committee, if you can please keep those 3 items under A in mind as we look through those, and if there are any questions, we can certainly circle back to those 3 if there's any questions about those. So we'll—.

So, priority care to answer. Sure, sure. Yeah, so we are going to address some numbers related to item A.1.

In the report card, we'll go over the whole fiscal year, but Mayor, at the last session, you were asking about priority care and the volumes in the summer.

And so I pulled the— we pulled the volumes from May through September. We saw 1,372 patients in the priority care clinic. We were able to see that 939 were from Metlakatla, Craig, Ward Cove, Thorn Bay, Klawock, and Ketchikan, leaving 433 visits were from outside addresses. So that could be cruise ships, seasonal workers, Um, so just wanted to follow up on that ask of last meeting.

Thank you. You're welcome. All right, I got one. So now we, we will move, uh, to Item B, the PeaceHealth report card.

Have that?

Yeah, work out some paper. Yeah, I'll work out paper. Yeah.

All right. So the first page is the executive summary.

Um, do you want me to read line by line, or just—. Well, we can certainly ask the committee. The packet was included on the city website as well as to the committee prior to. So, um, I guess I'll ask the opinion of the committee whether or not we really want to go through this line by line. We can, uh, or if You'd prefer a high-level summary as we go through these slides?

I think that providing information to the public is important. This is one of the forums that we can do that, so I don't mind doing a little deeper detail than just the title, so.

Okay, so we can dive into it a little deeper. Any other opinions or objections to that approach?

From my end, could you put it up on the screen? I'm on my iPad and I can't toggle back and forth very easily.

I do have it on the screen. I don't know how else to do this. I'm sorry. Oh, sorry. I can— all I see is your is your folder, because this executive summary—.

Yeah, but further in depth. So I don't think we need to read this. We're going to go through. That's fine. It is part of the requirement.

Okay, to read this. Sure. Okay, I'll read.

Can you see it now?

Yes. Okay. Yes. Thank you. Thank you both.

Okay. All right. So, I'm going to go ahead and read the executive summary. I'll try to make sure it's a brisk pace, but understandable pace. Please tell me to slow down if you'd like me to.

So, the executive summary, fiscal year 2026 at PeaceHealth Ketchikan Medical Center was a year of stabilization and continued commitment to the health of Southeast Alaska. Through strong fiscal stewardship and disciplined resource management, KMC maintained all core service lines throughout the year while providing access to a broad continuum of care. We completed Phase 1 of the facility remodel, bringing on a new CT scanner, and are underway with Phase 2 to improve and relocate our laboratory. Access to care. PeaceHealth sustained access to specialty services through visiting physician clinics, providing more than 3,500 specialty visits in cardiology, oncology, urology, pediatric neurology, and other disciplines.

These services reduce the need for patients to travel outside the region for routine specialty care and expanded access to essential healthcare close to home. We had a year of successful recruitment of 2 additional primary primary care clinicians who recently joined the practice. Quality and patient experience. KMC saw strong performance in both quality and patient experience measures. Annual targets were exceeded for overall patient rating, physician communication, and patient willingness to recommend the hospital.

Clinical quality outcomes remain strong with zero early elective deliveries, zero central line-associated bloodstream infections, zero hospital-acquired pressure injuries, and no falls resulting in serious harm during FY26. Community commitment. As a mission-driven nonprofit healthcare provider, PeaceHealth continued to invest in community well-being. The organization provided more than $5.1 million in charity care and approved 793 financial assistance applications, helping ensure access to care regardless of ability to pay. In addition, $100,000 was invested in local community organizations addressing needs— sorry, priorities identified through community health needs assessment.

Looking ahead, as PeaceHealth Ketchikan Medical Center enters FY '27, KMC remains focused on strengthening access to care, maintaining high-quality clinical outcomes, enhancing the patient experience, and building partnerships that improve community health. PeaceHealth is well positioned to meet the evolving needs of the region. So, if we go to the next—. Uh, oh, sorry, go ahead. Um, so the next one is the core services that PeaceHealth Ketchikan Medical Center maintained.

All core services through fiscal year 26, supporting a broad continuum of care for inpatient, long-term care, diagnostic, surgical, rehab, and home-based services. Definitions are below, and then the list of services that we provide and how many visits or deliveries, meals, procedures, and such to the right.

Any questions? No. Okay. All right. So, uh, visiting physician services.

Uh, these clinics expand access to specialized healthcare services within the community, reducing the need for patients to travel for routine specialty care. During FY '26, visiting specialists provided 3,520 patient visits with the highest volumes in oncology, uh, 805 visits, urology, 671 visits, and cardiology, 449 visits.

Additional services include dermatology, otolaryngology or ENT, gastroenterology, pediatric psychiatry, pediatric neurology, pulmonology, and neurology, supporting comprehensive specialty access, specialty care access to Southeast Alaskans throughout the year. You'll see the numbers below.

Okay, next. Ketchikan. Yeah, go ahead. This is Abner. Can we go back to that previous page for a second?

I noticed that the written content in the paragraph above the table, those numbers don't match what's in the table.

I agree with you. Yeah, right.

What's that? I just saw that and wanted to bring it up. Um, is that, uh, just something—. The table is accurate. The table is accurate.

The numbers in the, uh, in the paragraph are inaccurate. It's the table that's accurate. My apologies. Okay, can we— sorry, I missed raising my hand on the previous page. Can we go back to that for just a second as well?

Under the— let me look at my note here. One of these looked like it was off, and I'm just wondering which as well.

Under the general inpatient, if I understand the methodology correct for determining the ADC, you would take the inpatient days and divide that by 365. And if that's correct, that should be 8, I think, instead of 10.3.

So, the average daily census is calculated in different ways. So, this says inpatient admits. Some patients are admitted under what's called an outpatient status, and so those won't necessarily be included in the inpatient admits number, but could be included in the average daily census. Like our swing bed. Okay.

Yeah. I appreciate that clarification.

Very good eye. Thank you very much. And for Abner and Amanda, we've got our back to the monitor. So if you guys have comments or questions, please speak up so we can make sure that we get your questions answered or comments heard. Okay?

Will do. Thank you.

For our final report, we'll make the amendments to the paragraph to make sure that the numbers correspond. So, thank you again for that.

I'm going to go ahead and proceed with recruitment and retention, if that's okay.

All right. Recruitment and retention are top priority to continue to strengthen physician and clinician coverage across key service lines.

Recent successes include addition of new primary care clinicians, expanded hospice coverage, new per diem support in OB and GYN and general surgeon, and the engagement of two highly qualified locum oncologists with interest in long-term opportunities. Several candidates have also expressed interest in transitioning to more permanent roles. Retention efforts remain a priority and are producing positive results. Regular rounding on a medical staff team and a high level of community support have contributed to the highest level of participation ever recorded in the provider survey with 18 responses and two 26 compared with fewer than 5 in prior years. Together, recruitment momentum and retention initiatives are helping strengthen access to care.

So, you'll see below some highlights. Primary care recruited and onboarded 2 family medicine practitioners, included 1 family medicine MD. Hospice, we recruited 1 permanent physician and onboarded 7 per diem hospice. OB/GYN recruited 2 per diem OB/GYN physicians. General surgery recruited 2 per diem general surgeons, and oncology recruit— currently recruiting for oncology coverage with 2 strong candidates interested.

So, one of the things I'll just mention also in passing that we've had a— one of the successes we have is that when people come in, they really enjoy practicing at the hospital, and it's a major recruitment driver. Per diem surgeon who's working today, I saw him and he said, this is probably the most efficient OR I've ever worked in, and surgeons tend to like that. So that's a good recruiting tool because he definitely wants to do more work here coming in FY '27.

So. Through the chair, I appreciate the fact that we're, we're getting the better off end-pounder of per diem surgeons. What's it take to get full-time employment to stay in Ketchikan and provide these services? Well, full-time employment in Ketchikan means that somebody wants to come to Ketchikan and live full-time in Ketchikan. So I think that's the main thing.

And, you know, as I think you know, it's not something that some people are ready for. I'd say that our family medicine, uh, physician, um, you know, has two young kids and was living in Anchorage and wanted to change and wanted to come to Ketchikan. So for her, uh, being in a town like Ketchikan was a big driver. So finding people like that is kind of what we're, what we're working on. And that's, I think, what the community's looking for.

They want to make sure that when they go to the doctor, they see familiar faces. You like that. You don't have to go through everything again, right? So, um, in your recruitment and your retention program, what are you hearing, I guess, is What would it take to keep more nurses? Yeah, I can speak to this.

You know, right now we're really concerned. We have a lot of caregivers that are really worried about staying here because of the school system. So it's a very scary time. I almost— when I round every day, I see moms like ready to be in tears because of the experience their kids are having in the school system right now. Some of the other things that we've seen is when we're recruiting, we get a lot of questions on the volumes that they're going to see, and sometimes our volumes aren't as high as what they would like.

So that can be a reason why they may not choose to be here. We have a wonderful general surgeon that grew up here that we would like to recruit to come here, but his request was to have a robot. So, so excited with the Rural Health Transformation Funds that we will be able to have that robot and hopefully be able to get him to come here because he was raised here. So those are just a couple of the ones that I've heard. Housing is another.

Thank you. Mm-hmm. Mr. Chair? Yes.

On this page, there used to be a table that talked about the number of days that a position was open. I found that really helpful. I like the paragraph as well, but I would like to see both the table and the paragraph in the future.

We're taking notes. I think one of the challenges with that particular metric is that there wasn't really a national benchmark, so you were— but if we still find value in it, we certainly can revisit that, revisit that number. That was one of the reasons that that particular piece of information wasn't presented.

Okay.

For patient financial services, PeaceHealth remains committed to ensuring access to care regardless of patient's ability to pay. So during the year, fiscal year '26, We had 793 financial assistance plan applications that were approved, resulting in more than $4.1 million in adjusted patient balances. PeaceHealth also maintained a strong focus on patient experience and issue resolutions, with no billing concerns remaining unresolved after the initial point of contact. In total, PeaceHealth Ketchikan Medical Center, accompanying the clinics, home health, and hospice care, provided more than $5.9 million in charity care during fiscal year '26, reflecting its ongoing commitment to serving the healthcare needs of the community. Any comments?

Sarah? Yes. Sarah, could, could we maybe get the number of applicants total versus number approved?

Yes. For financial assistance. Thank you.

I have a question on this one as well. I think some of the past versions had a calendar year table versus a fiscal year, and I'm just not sure. Are you guys on a fiscal year that matches the calendar year, or is your fiscal year different? Our fiscal year is July 1st through June 30th. So I'm not sure that it matters which way that it is, but as long as we do it the same way from year to year, it makes it easier to compare.

Or from a report to report.

Make notes on that.

All right, moving on to community benefit. PeaceHealth is focused not just on individual patient outcomes, but also maximizing community health benefits and ensuring access to high-quality, affordable care. We are proud of our healing mission and are committed to giving back to the communities we serve. As a mission-driven nonprofit health system, we reinvest our profits into our communities by enhancing the healthcare services we provide or through supporting community health initiatives. Through community partners, PeaceHealth makes direct investments that improve wellness, access, quality, and health justice.

The community health needs define our priorities for investment with partners. Every 3 years, we conduct a community health needs assessment and work with communities community-based partners to address critical social determinants of health. Our most recent, um, CHNA was completed in 2025 and identified 4 focus areas outlined below. And so we've got Home, Hope, Care, and Nourish. With the guidance of the Community Health Needs Assessment and the governance of the Community Collaboration Committee, PeaceHealth Ketchikan Medical Center contributed $100,000 to community organizations in fiscal year '26.

$44,000 Went to home and housing for the warming shelter for KIC, the PATH shelter furnace, Love in Action for emergency utilities and rental assistance. For hope, behavioral health and substance use was $23,000, the youth health and wellness, Craig Parks and Rec, and the Ketchikan after-school program. For care, community caregiving, $20,000 for the Ketchikan 123 Navigation Program. Nourish Nutrition Health and Wellness, $13,000, The Giving Table, and Sunny's Lunch. Total funding distributed was $100,000.

Any questions or comments?

All right, uh, what you have before you is the— our patient experience metrics. So patient experience results in FY26 demonstration demonstrates strong performance in several key areas of care. The hospital exceeded its annual targets for both overall hospital rating and physician communication. Performance for recommending the hospital also exceeded the FY26 target of 72.65%. Nurse communication remained strong at 79.36%, narrowly missing the target of 80.17%.

FY27 first quarter results reflect continued strength in nurse communication at 88.89%, while opportunities remain to improve overall hospital ratings, physician communication, and patient willingness to recommend the hospital. Ongoing efforts are focused on enhancing the patient experience and maintaining high-quality, patient-centered care across all services.

I'll just leave this here for a second in case there's any questions regarding the numbers here.

These are through the survey feedback that you gave? That's correct.

All right, moving on to clinical quality and safety. Clinical quality outcomes in FY '26 reflect a strong commitment to patient safety and high-quality care. PeaceHealth Ketchikan met or exceeded targets in 4 of 5 quality indicators, reporting zero early elective deliveries prior to 39 weeks gestation, zero central line-associated bloodstream infections, zero hospital-acquired pressure injuries, and zero catheter-associated urinary tract infections during FY26. Falls with serious harm remain below the annual target with no incidents reported for the year. FY first quarter performances continue to demonstrate strong quality outcomes with no falls resulting in serious harm, no elective early deliveries, no CLABSIs, no HAPIs reported.

One CAUTI event occurred during the first quarter, and corrective measures continue to support ongoing patient safety and quality improvement efforts. And so again, you see the numbers there. Happy to explain more about what the actual measures are measuring if that would be of use.

My audio cut out for just a second there, and I missed like the very last part you just said after the CAUTI discussion. Yeah, I just said I'm happy to explain more about each one of what those numbers actually mean or what those measures are about. Okay, I did have one question on the— and I'm wondering if again the paragraph just isn't matching. It says falls with serious harm remain below the annual target with no incidents. Why is Q4 say 2.56 then?

So, yeah, it's fiscal year versus calendar year.

Okay, got it.

All right, next— oh, and then the next page has the definitions.

So would you like me to go through the definitions of each one of those measures? I don't need you to. I really appreciated the fact that you put those in there. I don't think that those were always in there before, or at least not the denominator wasn't there. And so it makes it much easier to understand how those are calculated.

So thank you.

And just so, you know, for future reference, I think it sounds like Abner, you know, this CLABSI and HAPI and CAUTI are the way we say those things. Sometimes you'll hear us say that, and that means C-A-U-T-I. DI. So always ask questions if it doesn't make sense. So appreciate that.

Moving on to operating. PeaceHealth Ketchikan Medical Center concluded fiscal year '26 with a strong financial performance, generating $112.6 million in total operating revenue while managing $108.7 million in operating expenses and capital investments. This resulted in a total operating gain of $3.9 million for the fiscal year. Despite fluctuations throughout the year, operating expenses and capital expenditures remained relatively consistent, demonstrating effective financial management and cost control. Revenue exceeded expenses during most reporting periods, supporting sustained positive operating performance.

The favorable year-end result reflects continued operational discipline and the organization's ability to align expenses with revenue trends while maintaining investment and capital needs. Needs. Overall fiscal year '26 results demonstrates the financial stability of Ketchikan Medical Center and provides a solid foundation for ongoing investments in patient care, workforce support, and strategic priorities.

Any comments? Yes, it's me again. Operating expenses and capital, do we have a definition of that somewhere?

We can go ahead and add that next time. The reason that I asked just for clarity is that the numbers that are on the slide in the past and now don't always match what we see in the audited report. It seems like they're two different calculations and it's a little bit confusing not having an explanation of what it is. I think I've got it figured out and I'll— we can talk offline, Sarah, so I can share with you what I figured out because it's complicated, but I don't know how a citizen who sees this and looks at it from our meeting packet would understand that.

Okay. Yeah, and I'll just make a comment too, Abner, for the memo that you sent us. I think if the citizens can interpret it differently, so can, so can committee members and future committee members. So I do think there's value in sitting down and creating much more specific definitions about what the committee would like to see and what those different reporting metrics look like moving forward. So I appreciate you calling that out.

Thank you. And I just wanted to mention, a good time to mention, I really thank both you and Sarah for all the information you provided back to me over these past couple months. So that's allowed me to ask these questions.

Yep. We appreciate you pointing it out. We want it to be clear. That's our goal.

Great. And that concludes the presentation. Yep. Great. Okay.

Well, we'll need a motion from the committee in order to move that report card forward and present the executive summary, move that to the council. Mr. Chair? Yes. In, uh, in light of the various corrections that need to be made, I would make a motion that we postpone accepting the, uh, report that we just received to the January meeting with the corrections added by then.

Okay, corrections to the 2026 report card. Correct.

Okay, I guess it would also be appropriate in my interpretation to approve it as amended, but if that's the will of the committee, then we can postpone it.

Did we have, um, did we have questions that we needed to get more information on in order to clarify this report card? I don't remember any.

Well, there's a motion on the table. My apologies. Do we have a second? Second. Okay, discussion.

Uh, I'll just speak to it very briefly. Um, we talked about a couple corrections. I think that I don't think that the report is significantly wrong. I just would like to see the corrections before we accept/adopt it as presented.

We did, we did ask for a little bit more information on a couple slides as well.

Okay. Any more discussion? Well, I, so I guess I want to make sure that we're clear because on some of the slides I think you asked asked for something different, and it sounded like for next, next report, but then there's also corrections. So I think it'd be helpful to understand, are we talking about the corrections? So for example, the, the numbers on the one slide, the numbers in the paragraph didn't match the numbers in the graph.

So that's a correction versus an addition or a different way to present the information, which it sounded to me like—. The intent of my motion is just to bring it back with the corrections. And then we can work offline to clean up the other components together for the next report. So the corrections is really what we're looking for for the next one. Okay.

That's what I'm interested in. Thank you.

There's not any more discussion. I guess we'll call the roll. Yes.

Bob Sivertsen? Yeah. Robinson? Yes. Park?

Yes. Hov?

Abner?

Abner, can you hear us? I can hear you now, yes. Okay, abstaining on his own motion.

I have a headphone case, but I opened it and it It took over the sound, so I just threw it across the room so I don't do it again. Okay, so just for clarification, the next time that we will meet will be in January. So, um, um, just for city council notice that normally that report would come to you this month and it won't until January.

Do we need a short, short technology recess here? We could take a short break if you want. Okay, we'll take a 5-minute break, uh, back here at 6:49.

Yeah, we're not crunching. Oh yeah, yeah, the camera snapped. Oh no, no, we got that sorted. Gonna be back to this, maybe. I'm all over the place.

Yeah, I know. All those, all those. Yeah, I know. I'm like, oh, 1, 3, 4. Next year we need to maybe get a second monitor.

It's hard having your back track down. Yeah, it feel like you're everything, you're looking down, the rest of the audience.

Okay. Scott, I think you said 6:49. Yeah, 6:49, yeah.

All right, sounds like we're ready to call the meeting back to order.

Moving into item B2, local purchasing.

This one will be a fairly quick report, but a follow-up question for the committee as well. We did no changes to this policy in the last year. We did take a look at the local spending here in Ketchikan. And that number for FY26 was $3.2 million with about another $72,000 on Prince of Wales Island.

One of the items in the lease also kind of asked the question or asked us to consider, you know, any other potential opportunities for local opportunities to purchase locally. So I did want to make sure and open that up to the committee for any comments if folks had thoughts or ideas or had heard anything out there in the community that we might want to consider.

You know, I know that in their capital project staff, they're using a lot of local contractors. And the contractors are using their materials from, you know, a lot of, lot of local stores and stuff. And of course, there's some things that you can't get in Ketchikan that have to be ordered in. But I certainly appreciate the effort to buy as much as we can and do as much as we can that's reasonable. I think that especially in this time when we have a downturn, we have schools closing and different things going on, I think it's huge.

So thank you. Thank you for your comments.

Anything from those online?

All right. We'll move on to B3, Title 47 Mental Health Holds Policy Revisions. We have not had any revisions since the last time that this reported, but you can see that the next review is due next month, and so if any revisions are made after that review, we will report those back to the committee.

Mr. Chair? Yes, please. I was hoping you'd—. Yes, the Title 47 policy is one of the documents that I had asked for, and again, I appreciate you guys getting that over to us.

The Police Department has been meeting with the hospital staff. I talked with them and shared your policy with the police department. So I know they've been meeting with your staff and they tell me that cooperation is, is very good and they're pleased with the current relationship. So they haven't reported any major issues and I just wanted to share that. So thanks.

Thank you. Thanks for that feedback. That's been our experience as well. It's been very helpful over the last 6 months or so. Yeah, we have the police department, the, um, state troopers, the jail, and, um, a judge that comes and meets with us to talk about our Title 47s and what we can do differently or improve on.

So it's great, it's a great collaborative.

Yeah, and I know, I know the community sees, sees that trend, um, as well as we do. It's certainly not an issue that's, that's going anywhere soon. So we continue to think this is an important one for us to continue to track and, and, uh, have collaborative discussions around. So thank you. Any other comments or questions about that item?

Okay, moving on to, uh, the rent payments. I think this one might be quick too. Abner, would you mind, uh, addressing that, please? Absolutely. So Section 1D sets the rent— Section 1D of the lease sets the rent amount.

It was at $100,000 per year for the first 5 years, and then it goes up to $113,000 per year for years 6 through 10. I did check with Finance, and all 5 of the completed years have been paid in full, and the invoice for year 6 went out on September 24th and is due October 24th.

And the funds from those payments go into our hospital sales tax fund.

Okay, any comments?

We'll move on to the emergency department renovation then.

Um, you have the floor plan.

The middle one, the window.

Try and look both directions here.

Can you— there we go. Good. All right. So what, what you're looking at there is just kind of a high-level overview of what we call the infill area, or of the first floor. And the dotted line around on the left-hand side of the monitor indicates the future space of the lab that represents the second phase of our ED remodel, creating the space we need.

You know, really kind of a twofold issue. One, we got to create space for our ER expansion, but, but we also have to keep those services open to our community as well. So if you move on to the next slide, the dotted line you saw on the previous slide is then expanded to a more detailed floor plan for the, for the future lab. This current design represent is taken out of our, our full design development set of drawings. Those are, are now bid-ready documents, and all structural, mechanical, and electrical is all, all completed and ready, ready for bid.

We—. Next step really is to, is to continue to work on this, on the certificate of need, and we're working with a team of people to help get that accomplished. The Timeline that we were given to get that completed and off to the state was about 30 to 45 days, so we'll be starting getting, getting rolling on that shortly.

Making sure I've got all my notes here. Oh, we are— the other note I had made, Bob, you guys had requested the conceptual drawings of the ER itself, and we do have those. And I didn't catch that in my notes until I was prepping for the meeting yesterday. So we can get those to you. Those have been developed for a couple of years, but they're— that's how we got the original ROM pricing on the ER moving forward, and which helped direct us in phasing these, the construction plan as we have.

So thank you. Yep. Any questions about that project or its progress? So again, you know, with the added concerns in regards to the impacts on our ER in the extremely busy times that we have in summer when we have high passenger count and those individuals coming in that, um, are in conflict with the, the, the local needs also. And, um, I know that there's been days when we had people waiting in the hallway.

I'm hoping when we're doing all this redesign work that we're really trying to think about how we mitigate some of that. I don't know what to what what level we build it to. But, uh, it, it's really tough, and I, I understand that that place gets very busy. And, uh, I think for the, the care of those individuals that we really need to take a real good close look and get this right the first time. We appreciate any input that you have.

Uh, your ER doctors and staff probably know more about that operation than anybody else, so hope we're consulting with them and see what, what may be needed. I appreciate it. I totally, totally agree. Um, you know, and the lease does call for, um, this, the city's final approval of those drawings. But, um, we have been keeping your Public Works Department, um, in step, uh, really every step of the way.

We—. Amanda and Seth have seen, seen the, the, um, different iterations of these drawings as they've been developed and changed and trying to make sure that, I mean, they're hearing things too. They've got feedback, certainly some expertise that we'll lean on as well. So I'm trying to keep them, and hopefully they're relaying that they feel like they're getting the information they need.

Thank you. Yep. Any other questions?

Thank you. Sorry. Yeah, we've had all the information we need.

And Seth just was telling me the other day that he's met with, with your folks a couple of different times, and he's been very pleased with those discussions as well.

Yeah, that's good to hear.

All right, we'll move on to Item 7 then, review of the shared capital improvements to this facility from the lease. Abner, I'd like to hear you, hear your thoughts on this. You had some thoughts in the memo. I will, in reference to the comment you just made, Seth was, came over to the hospital. We had a great conversation, talked quite a bit about priorities, both from the city's perspective and from PeaceHealth's perspective, recognized how much work needs to be done on that document.

We were also able to take him on a tour, which I don't think he's had in quite a while, but we went and saw some of the mechanical spaces that are aging. He was able to walk the shell space that will be the future location of our laboratory, and I think gave him some perspective, and I think he was able to kind of wrap his head around the— I don't want to put words in his mouth, but wrap his head around the kind of the phasing plan and why it was phased the way it was. So yeah, I'll just add, you know, my thoughts on that joint repair plan is that it was created 5 years ago. Some things have been already done, some things were done maybe even before it was signed. Costs and estimates, cost estimates specifically, are probably way off in that.

If it holds true to anything I've seen with our projects, you know, costs from 5 years ago have doubled or tripled, if not more. I think that it doesn't in the least do a very good job of outlining who pays for what on shared projects or shared responsibility. I think that the engineer team can kind of work together to, to re-scope that plan. I think it needs a significant update, and I think the place to do that is to bring it to us in January prior to the Gateway review, and then we can, we can update that document.

Thank you for those comments. Any others?

Um, my term is up in January, and I'd like to, you know, work with you, Scott, on, on those— that list a little bit more, but before I'm done. So if you're willing. Yeah, that'd be great. We could, uh, yeah, and, um, The 3 of us in our facilities department as well can certainly— you'd be more than welcome and would bring value to that discussion. So thank you for offering.

Doesn't sound like we have any more comments on the capital plan. So I'll just kind of open the floor to committee for any future agenda items. I have a couple, but I'll I'll let you guys offer anything that you have.

I have just the things we've talked about tonight. We know that the annual lease review is supposed to be on our January meeting.

We'd like to have that Exhibit G brought back as a rebased line exhibit updated based on current costs and any needs that have changed. The corrected report card. And an update on where we stand at the— on the Gateway review status in the January meeting as well.

I think I got all that. I can email them to you. That'd be great. Thank you.

Anything else?

Okay, so that, uh, you brought up one of the things I was going to bring up. So the only other item that we need to start thinking about a little bit for January are our committee members. We do have a few that their terms are coming. Mayor Sivertsen, thanks for stepping in and So October of this year, that one expires, and I know you guys are having conversations already, it sounds like, with what that'll look like for that chair. And then we've got a couple that are also, as Amanda just mentioned, a couple more and myself that are also terming in January.

So we'll have to have a discussion as well at the next meeting.

On, on any new or renewing committee members, as well as the rotation of officers. So the lease spells out that the chair and vice chair rotate annually, so the city will appoint a chair from their side, and at the January meeting, uh, pass the gavel to the city representative at that point, and the PSO folks will decide who's going to vice.

All right, well, thank you. Committee member comments. Let's start with the folks online. Amanda, do you have any comments, closing comments?

I appreciate the in-depth presentation this time, and I look forward to working on the capital projects. That's about it.

Excellent, thank you. Abner? Yes, the, uh, the report card was, was very good despite the couple things that need to be corrected. I appreciate the effort that went into that. Um, and just for the record, I did send, and as you know, a letter to PeaceHealth notifying you of the city's desire to begin the Gateway review process.

And we'll be meeting next month to scope that and then scheduling it in late January, early February.

Thank you. Anything else?

That's all for me. Mayor. Thank you. I certainly appreciate all the collaboration been passing back and forth the documents in regards to, um, the report card and, and the capital projects that we have going. I think that's some very important stuff going on.

Um, and again, the, the community of Ketchikan is very, um, fortunate to have the services that we do. Uh, there's always a concern in regards to cost and quality of care that we want to make sure that we we have our public listening sessions, we get that information and process it in a manner that helps us improve, right? And we do that in the spirit of cooperation. But I'd like to thank the members of the committee. It's been a good experience.

Thank you.

Sarah. I just want to— Governor, thank you so much for your responsiveness back and forth as we collect all these documents. Really appreciate the partnership, and I'm excited to see that, like, everything start— all the boxes are getting checked. So thank you.

Dr. Park? I appreciate the collaboration, love boxes getting checked, and thanks for having me.

Okay, well, I'll just close with thanking all the committee members for their time. Thank you to the public for for your attendance today, and thank you for your comments. With that— oh, I got one more item here. I'm sorry. So our next meeting will be January 21st at 9:00 AM.

On the agenda, it does say City Council Chambers, but I was notified that that will not be the case because they're in the middle of a move. So we will try to get that information out to the public as soon as we know. There's probably not too many options, but Yeah, we'll, we'll make sure everybody's aware of where that meeting's at. At that point, I'd move that we adjourn. So moved.

Yep. All right, second. It's got to be second. Okay, it has been seconded. We adjourn.

Thank you. Thank you.