Thursday –
Aegis Corporate Office
Recorded By: Sharon Fuentes
PARTICIPATING MEMBERS:
Stephen
Day...................
Starvel
Junios.................
Bill
Lidikay......................
Adrian F.
Zavala.............
Ramiro
Romero.............
Ruben
Ornales...............
INVITEES:
Harland
Austin................ Manager in
training
Udi Barkai....................... President and
CEO
Russ
Spencer.................
The following matters were
presented, discussed and concluded:
1) Expansion of PAAG Membership: Starvel Junios was introduced and welcomed by all
board members. Starvel’s appointment is consistent with the recommendation made
in the previous meeting to have a fair representation in PAAG for all
geographical regions and to expand the number of board members.
Udi took it upon himself to ask Aegis Department and
Regional Directors as well as Clinic Managers for their support of PAAG. Special attention will be given to large
clinics such as
The board members have taken it upon themselves to
involve their clinic managers and counselors in PAAG activities and seek
support for PAAG from other nearby clinics.
It was agreed that:
a.
b.
Bill -
c.
Starvel –
d.
Steve –
e.
Ramiro –
f.
Ruben –
Udi proposed on behalf of Aegis Institute to reimburse
the previously mentioned members for their time and travel expenses.
Bill and Steve stated that the board members should
act with mature discretion and humility and follow the PAAG Code of
Ethics. They should not present
themselves to be staff members or have any authority over the staff members or
patients.
2)
Billboard
w/ Resolutions and Suggestion Box: The board members inspected
and reviewed the billboard, new suggestion box and comment cards prepared by
Loanne in the Department of Logistics.
This display included a billboard with recent resolutions from the board
and membership announcements. The
members approved the billboard and suggestion box. However, Bill raised a
concern regarding the possibility that some patients may have a problem leaving
a complaint card in a clinic’s suggestion box. Udi proposed that Aegis would
provide pre-paid envelopes that could be mailed from an outside mailbox
directly to the PAAG without the involvement of a clinic staff member. These envelopes and cards would be provided
in addition to regular envelopes. The
board accepted the proposal (enclosed is a copy of the approved comment card
and envelopes). The members agreed and
the billboard with resolutions and suggestion box will be distributed through
the months of November and December 2003.
3)
Follow-up
to Previous Meeting: Udi apologized to the board for the delay in the
distribution of the previous meeting minutes and reviewed the implementation of
the previous meeting minutes, including the following:
a.
The board was
provided with the names and contact information of Aegis key personnel (see
enclosure).
b.
Additional PAAG
Policies, Protocols and Procedures (“P,P,&Ps”)
manuals were printed by the department of logistics and provided to the PAAG
members by the end of this meeting.
c.
The PAAG
Billboard, which will be posted in the clinics through the month of November
2003, will include PAAG resolutions and opinion letters as well as naming who
the PAAG board member is for that clinic, if any.
d.
The board
members contact list was generated and provided with the following information:
i.
Starvel M.
Junious – (916) 721-6111 home (916)
289-0475 cell
ii.
Adrian Zavala –
(805) 986-3711
iii.
Ruben Ornales –
(661) 366-4877
iv.
Bill Lidikay –
(909) 203-4215 lidikay-b-j@msn.org
v.
Ramiro Romero –
(626) 443-1393
e.
Udi confirmed
Aegis Institute’s (“A.I.”) previous commitment to provide PAAG board members
with computers, e-mail address (e.g. johndoe@aegispaag.com) and internet
access. Udi instructed Tushar to provide
computers to Ramiro, Ruben, and Starvel through Aegis Institute.
4)
Assembly
Bill 1308: Robert
Harris’ progress report on AB1308 (provision of treatment in jails and prisons
as well as prohibition of judges, parole, and probation officers from
practicing medicine) was distributed to the members (see enclosure).
a.
The board
acknowledged with great pride the approval of the bill by following forums:
i.
The Assembly
Health Committee by a vote of nineteen (19) to zero (0) on
ii.
The Assembly
Public Safety Committee by a vote of six (6) to zero (0) on
iii.
The Assembly
House by a bi-partisan vote of forty-two (42) to fifteen (15) on
iv.
The Senate
Public Safety Committee by a vote of four (4) to one (1) on
v.
The Assembly
House by a bi-partisan vote of forty-eight (48) to thirty (30) on
vi.
A final vote by
the Senate approved the bill with an impressive majority vote of twenty-five
(25) to twelve (12)
Unfortunately, this bill was
vetoed by Governor Gray Davis. The members agreed to present the bill to the
newly elected Governor.
b.
Starvel Junios
briefed the board members on his involvement with AB1308. This included his
presentation and testimonials before the Assembly Health and Public Safety
Committee prior to their votes in April 2003.
c.
Ruben Ornales
provided a copy (see enclosed) of the letter that he received from Nicole M.
Parra, 30th District Assembly Woman, dated
5)
Take-Home
Bottles Policy: Discussion was conducted by the board members to
finalize a recommended Take-home Bottle Policy, the following notes were made:
a.
Steve Day’s
recommendation to prohibit re-using/refilling of take-home bottles was
discussed and approved. Udi, on behalf
of Aegis, has accepted the recommendation and has taken it upon himself to
issue the recommendation to Department Directors and clinic managers.
b.
The board
reaffirmed their previous opinion letter that requested patients to return their
take-home bottles to the clinic and to erase their names (a marker will be
provided by the clinic) prior to receipt of the their
subsequent take-home bottles. Patients
who neglect to return their used take-home bottles will be provided with same
day medication only. No new take-home
medication will be provided until the patient returns his previous take-home
bottles.
c.
Udi explained
the delay in the issuance of the policy due to higher prioritized tasks in the
clinics. However, he promised to institute the policy on the first available
opportunity.
6) The Ombudsman: Steve initiated a short discussion on the need to involve the Ombudsman
with complaints and incident reports, such as the reuse of take-home
bottles. Udi repeated his position that
each patient has the right to pursue a complaint and/or concern through the
clinic staff members, Department of Quality Assurance (Pete), the General
Counsel (Karl), and/or the ombudsman (Prof. Bill Shilley) per the patient’s
sole discretion. Udi explained that the
purpose of the alternative communication channels was to increase customer
service, as well as customer satisfaction.
7) The NAMA “Watch Dog” Website: Upon Steve’s proposal, the board members have
further discussed his suggestion to get in touch with the NAMA “Watch Dog”
Website and to involve them with the PAAG activities and opinion letters. It was agreed that PAAG is setting a new
standard for the addiction treatment industry and that such “exposure” to the
PAAG may affect other organizations and patient groups encouraging them to do
the same.
Udi proposed
the subscription to the following printed and/or electronic newsletters for
PAAG board members:
a.
“Join Together”
on-line
b.
“Addiction
Weekly” by CD Publications
c.
“NIDA Notes”
8)
Counselors’
Qualifications: Udi has presented AMS’s intention to enhance
counseling services through the incorporation of a specialized second tier of
counselors addressing special needs of patients through individual and group
counseling for the following topics:
§
Relapse Prevention
§
Anger Management
§
Domestic
Violence
§
Family
Preservation
§
Vocational
Rehabilitation
§
Nutritional
Counseling
§
Eligibility
Counseling
Starvel has recommended that Aegis consider hiring
counselors with personal addiction experience, Bill and Steve have objected on
the grounds that such qualification may raise other difficulties and that
recovering addicts are not necessarily better counselors. Bill further
suggested that Aegis would seek to hire counselors with higher credentials and
licensure. The board decided to schedule
additional time in the one of the upcoming meetings for further discussion of
this matter.
9)
Administrative
(15-Day) Fee Detox: Steve discussed the present protocol of the 15-Day
Fee Detox and asked the other board members for their opinion on whether this
period is appropriate for “relapse prevention.” He shared his own opinion that
a longer period will allow patients, their physicians, and counselors a longer
period to resolve their relapse problems.
Ramiro confirmed Steve’s suspicion that 15 days
is too short a period - his experience being that patients are not willing to
face the withdrawal effects and therefore are likely to abuse heroin the same
day that they are administrated into a 15 Day Fee Detox Program.
By Steve’s recommendation, the board has agreed to
issue the following opinion letter:
“To
All Aegis Staff Members,
We,
the Board Members of PAAG could not conclude what would be the best clinical
protocol for administrative detoxification of non-complying patients (fee
detox), we highly recommend that Aegis will launch a study to explore alternative
protocols for longer periods of detox (i.e., 21 days, 30 days).
We
hope that the study will be able to prove successful results with a longer
period of fee detox, mainly because if will allow the patients, their
physicians and counselors to have additional time for dealing with the cause of
the relapse.
Entered this 29th day of October 2003 by the undersigned, Board Members of PAAG.”
10)
“Keys To
Recovery” Support Groups: The board
members continued their discussion on the matter of support groups, and have
agreed as follows:
a.
The new approved
name is “Keys To Recovery” instead of “Methadone
Anonymous” and/or “Steps To Recovery.”
Udi instructed the General Counsel (Karl) to register “Keys To Recovery” as a registered trade name under Aegis
Institute and Tushar to register “Keys To Recovery” as a website and intranet
name.
b.
The following
changes will be made to the P,P,&Ps:
i.
Paragraph VIII,
sub-paragraph (4) was amended from 80% to a 75% vote majority requirement to
expel a member
ii.
Paragraph IX,
page 6 “Member’s Duties and Responsibilities” will have a new provision
allowing KTR members to volunteer their name and contact information for a
“Member’s Only Outreach List” upon their sole discretion.
iii.
Each chapter is
entitled to appoint and/or elect a secretary and treasurer in addition to the
chairperson. Paragraph VIII,
sub-paragraphs (2), (3) Page 5; and Paragraph XIII (now XIV), page 9,
sub-paragraph (11) will be amended accordingly.
iv.
Paragraph XII,
page 7, “Contributions and Donations” will have a new a provision to
sub-paragraph (2), allowing Aegis Medical Systems and/or Aegis Institute to
practice their discretion in supporting KTR chapters through reimbursement for
bus passes, phone cards, and other travel expenses necessary for chapters to
conduct their meetings.
v.
A new paragraph
XIII was added, “Handling of Funds” will have additional provision for handling
of funds and bank accounts on behalf of KTR.
These provisions allowing a chapter to open a bank account for funds
exceeding $100 dollars. At least two members (preferably the chairperson and
treasurer or secretary) will have to jointly sign for each check. No credit and/or debit cards will be
permitted. The new language will also
prohibit acceptance of donations over $2000 dollars to any individual chapter,
any donations over the amount of $50 dollars will be announced and made public
to all members.
vi.
Paragraph XIII
(now XIV), sub-paragraphs (2), (11), and pages 9 and 11, “Schedule of Meetings”
and “Recommended Schedule and Meeting Format” will be amended to expand meeting
lengths to “60 to 120 minutes.”
vii.
Paragraph XIII
(now XIV), sub-paragraph (7), page 9, “Appearance and Attire,” will be amended
to restrict members carrying infectious diseases from participating in a KTR
meeting. However, special accommodations
will be made for other individuals who carry no infectious disease, but are
homeless and/or handicapped.
viii.
Paragraph XIII
(now XIV), sub-paragraph (10), page 9, “Conduct of Meetings” will be amended to
require meetings to be completed within 15 minutes of the scheduled time.
ix.
Paragraph XIII
(now XIV), sub-paragraph (11), page 10, the responsibility for handling
donations, funds, bank accounts and the issuance of receipts was amended to
become primarily the treasurer’s responsibility together with another member,
preferably the chairman or the secretary.
The secretary will be in charge of issuance of Proof of Participation
and handling of all other paper work, including attendance sheets, receipts books,
stamps, etc. (see page 11).
x.
Paragraph XIII
(now XIV), sub-paragraph (11), “Recommended Schedule and Meeting Format” will
be amended by the new provision whereby new members will not be requested to
make the pledge, but instead recitation will become voluntary. It was also agreed that such members be asked
to make the pledge only within the first 90 days of their participation in the
KTR chapter. However, no sanctions will
be held against any members who refrain from reciting the KTR pledge.
xi.
Paragraph XIV
(now XV), sub-paragraph (1), the word “inability” was replaced with
“difficulty”; sub-paragraph (3) text was amended to read “…seeking direction
from either spirituality, science and others in recovery…”;
sub-paragraph (10) the word “timely” was
replaced with “promptly”; and sub-paragraph (15) was rewritten to read “…a key
at a time, a day at a time.”
Enclosed you will find the final draft version of the
“Keys to Recovery” P,P,&Ps.
The PAAG members agreed that upon the completion of
the proposed changes, they will be reviewed and approved through a
teleconference meeting scheduled for
11)
PAAG
Operations: Udi announced his
intention to reduce his future involvement in the PAAG meetings through the
year 2004 as long as it will not be detrimental for the PAAG future activities.
Both Steve and Bill have endorsed his statement and agreed to volunteer to head
the group in the future, if they are elected.
12)
Meeting
Adjourned:
Recorded by: _________________________________
Sharon
Fuentes, Administrative Assistant
Department
of Operations