At the first and most recent All Hands meeting, Michelle stated that she will be meeting one-on-one with all CHS staff. Is this still happening?
Absolutely! Michelle met with over 300 employees before COVID. Since then, she has met with another ten or so, at their request. If you wish to meet with Michelle one-on-one, please email her or Nicole Peterson to set up a meeting. In addition to Michelle, our executive leadership team is making every attempt to meet with all employees at all locations on a very frequent basis. It just takes time to get around! 

It seems that CHS is moving in the direction of unity, which is good. However, it also seems like more attention is drawn to the Sioux Falls side and feels pretty lopsided. We have a lot of good things happening in the Hills, but we have also had some very traumatic things happen that seem forgotten. Is it possible for Executive Leadership to be more available at each location, and be present and available to all employees?
Executive leadership has renewed our commitment to ensuring time is spent at each location and open communication with staff takes place. This might take place through casual visits, staff meeting attendance, or appointments made by staff. Without question, staff are encouraged to request time with a leader if they have an issue to discuss.

Why does the CEO, COO, CFO, CPO, etc. make so much more money than those handling cases? And the direct staff that don’t ever interact with our clients?
Each leadership position comes with different expectations for accountability, fiscal responsibility, community engagement, supervision, compliance oversight, and state/government public relations and advocacy. We compete with the corporate world for these leadership skills, which are also needed by CHS.

The CHS overall pay structure is not unlike any other business or organization. Within the organizational chart, there are various rates of compensation for every position and the related responsibilities. At CHS, we are consistently reviewing our pay structure to ensure fairness and market competitiveness. CHS is also working diligently to establish its overall compensation philosophy and will determine what impact this will have on CHS as it progresses into the future. 

How much money does the top leadership typically make?
Executive wage bands are determined by the Board of Directors. As a nonprofit organization, this is public information and is reported on our tax Form990's. These forms are accessible online for anyone to view. 

In the eyes of each CHS leader, what is more important for the children at CHS?
To effectively provide necessary services for both children and their families.
To provide hope and a better life for those in crisis.
To be seen as a community leader in our field of service delivery.

Have you ever considered a daycare program for staff who have kids in daycare?
This is certainly a benefit that can be reviewed and could be considered based upon need, benefit, and cost.

Will student loan payments be eligible to staff who are not direct care?
The pilot program is still under evaluation through the end of calendar year 2020. We will continue to evaluate and determine potential changes to the plan.

Could there be incentives offered to reward and encourage staff longevity?
At the end of the last fiscal year, CHS provided a year-end bonus based on years of service.  This is one recent example of responding to and recognizing the commitment of long-time staff members.

Since many of our jobs take physical strength/endurance, does CHS have a gym affiliation? If not, could we make a connection somewhere that staff could use?
There are current wellness services and fitness center discounts that are available through our current Sanford health plan. To view a list of participating fitness centers, visit https://nihca.org.

When will therapists become eligible for student loan help and car payment help?
We continue to evaluate and determine potential changes/additions to the student loan assistance program. We have promised to evaluate the success of the program at the end of 2020 and are hoping that we will be able to offer the program to all employees. A car payment plan would be much like all CHS benefits, it is something that could be reviewed and if feasible, potentially considered.  

Could you consider ending pay caps on some salaries? Doesn’t seem right/fair. With no cost of living adjustment and insurance increases, you make less and less each year. And it doesn’t promote longevity when we’re trying to retain employees.
Market analysis drives the changing of roles, wages, and wage bands, and shows what the market is willing to bear related to pay levels for each role. It is very important that wages are reviewed on an annual basis. 

Wage increases and tuition reimbursement do not seem to have impacted staff retention on the residential units.
Through the first five full months of the student loan repayment and tuition assistance pilot programs, those employees who are eligible and have elected to participate in this program have demonstrated a 100% retention rate.

Is there a provision in our FMLA policy for COVID? Can this be explained to us?
As of today, FMLA has an additional component—the Families First Coronavirus Response Act (FFCRA) which requires certain employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to COVID 19 from April 1, 2020 through December 31, 2020.

Will the process for how the Employee of the Month be changed along with how people are nominated?
The Employee of the Month nomination form has recently transitioned to an online form which is accessible on the Good Works employee portal. This was done to create nomination consistency across programs and focus on our agency’s core values. Selection of Employee of the Month is currently a random selection among all the entries at each program area: Black Hills campuses, Bright Start and Children’s Inn campuses, and Sioux Falls Children’s Home campus. 

We have also recently decided to create a small subcommittee to determine the best way to nominate and award Employee of the Month. 

Thank you for changing the way Employee of the Year is selected. It has never been a fair system when just one person decides.   
The reason for the change to the awards format, is to create a culture of unity, focusing on the collective organization instead of a specific location, department, or function.    

Why was the flu shot made mandatory? You are taking away our right to choose!
The intent is to protect ourselves, the people we work with, and the clients we serve. We need to keep one another safe and healthy. It is a requirement of employment.

Why does all CHS news have to be on Good Works or Bamboo? Can’t we just get regular emails like we used to? It’s frustrating to have to keep logging in with our password.
The Good Works Employee Portal makes CHS information a one-stop shop because it is accessible from anywhere at any time, day or night, and you can read it on any device: cell phone, home computer, iPad, or work computer. This allows all staff to get the information they need at a time that is convenient for their personal schedule.

The Portal was also created in response to earlier surveys where staff said that they are tired of getting so many emails, that they possibly deleted information they might have needed, and that they just didn’t have time to read every single email. With the Good Works employee portal, you can access all news, past and present, anytime you wish.

If you are not on a shared computer or are using a personal device, you can check the “Remember me” box and/or opt to save your password through your web browser when logging in to avoid having to retype your log in information each time you visit the portal. Then you will have one-click shopping (reading)!

Are there still plans for added security around unit/school doors?
Yes. Both projects are in the starting stage. Cameras are going to start first week of October. 

Can the IT department have regular meetings for anyone to attend so they can get training or have questions answered?
Yes. We will be working on a plan to start in mid-October.

When will we switch to a different Microsoft program? Quite frankly, this one is awful! 
If referencing Office365, there will be no changes. If training is needed, please let IT know. We can provide some great training videos to show you everything you need to know about Office365.

It would be helpful if direct-care staff could know when CHS kids are sick. Maybe by sending an email about the child/diagnosis with the day it occurs.
Black Hills: Communication is provided directly to the staff working with the child and informs them of the diagnoses that day. That staff then relays the information to the oncoming shift. Information is sent out via email if there are any recommendations by a physician, so it is clear, if needed.
Sioux Falls: Nursing staff will start sending an email to all direct care staff when children have a diagnosed illness.

When kids are sick, why are they allowed to come to school? When kids are brought into a clinic due to being ill or contagious, why is staff not aware of this until days later?
Black Hills: If kids are sick, there is a bed in Sabrina's office for the ill child's use. Nursing staff will care for them, but sometimes nursing staff may not be available (doctor visits, appointments, etc.), and there is no one else to watch them. 
Sioux Falls: Illness is more complex with CHS kids due to their psychiatric diagnoses and, sometimes inaccurate reporting by children. Criteria for children not attending school:

• Fever >100.4
• Vomiting — must be witnessed and be more than phlegm 
• Diarrhea — must be heard or seen and not related to Miralax

Nursing staff needs to be more supportive towards staff and children.
Black Hills: Let us know how we can be more supportive. If there is something we need to change, we're all for it.
Sioux Falls: In light of direct care staff spending so many hours with children, nursing staff will make every effort to consider any input regarding children’s health.

Why are kids who are throwing up and have diarrhea sent to school to expose other kids and staff? If staff have these symptoms, we have to stay home. It seems to be a double standard. The kids should be in the sick bay with nursing just like in any other school.
Answered above.

When one of our kids gets sick or is diagnosed with an illness, would it be possible to notify staff that previously cared for that child about the situation? (i.e. strep throat)
Answered above.

Can nursing staff bring kids’ meds to them in the classrooms? Among other issues, it takes away from our student/teacher ratios. It would sure be helpful if the nursing staff came to the classrooms to give meds.
Black Hills: If kids need meds during the day, it is generally around noon or 3 PM. The noon meds are generally administered at lunch time by nursing staff, following agency policy. Staff don’t have to bring kids to us. If there are other medical issues that need to be done in the nursing office, nursing staff gets the child and brings them back to school.
Sioux Falls: CHS has a policy in place for administering medications. This includes having a child come to the med room, using two client identifiers, triple-checking the bottle/card against the medication sheet, and finally administering the medication. This policy is in place to prevent medication errors.

Can nurses administer kids’ tests for strep, etc.?
Black Hills: Given our distance from a clinic, Dr. Franz has ordered strep screens for us to use and we then notify his office of the results.
Sioux Falls: No. Tests such as for strep require a physician’s order and need to be done at a clinic that has a lab.

Why do teaching staff have to take care of kids who are sick? When kids are sick in school, it can spread to other kids and teaching staff. It takes away from learning. Plus, staff can get sick from kids and are then expected to stay home and use their PTO time.
Answered above.

It makes me uncomfortable to have to share when I have been out sick, and for what I am sick with (not related to COVID 19), especially via e-mail. That seems like very personal information to me. I think that should be between myself, medical staff, and the people I want to share that with.
Black Hills: Staff often do not share with us if they’ve been sick, although we do request that information for our QI report. It is not mandatory.
Sioux Falls: Joint Commission requires CHS to have an Infection Control Plan. Infection surveillance is the key. Daily monitoring and reporting of infectious disease potential is the responsibility of all staff. Although nursing staff requests this information, it is appreciated but not mandatory.

Is it possible for all nurses to share duties like morning meds especially during schedule changes or when people are gone?
Black Hills: Nursing staff administers meds in the morning along with one night staff. Sabrina helps cover, if needed, but is not scheduled because both our medical doctor and psychiatrist start early, around 7:30 am. Sabrina also helps to cover evening shifts, when needed.
Sioux Falls: The volume of administrative duties prevents the nursing supervisor from administering medications. The nursing supervisor works varied hours and spends several evenings a month training staff to administer medication.

There are days when nursing staff are gone. Is there a way they can plan so that there are less days without any nursing staff?
Black Hills: Every effort is made that nursing staff will not be off at the same time. However, very rarely, it cannot be avoided. Sabrina is always available by phone.
Sioux Falls: Every effort is made to assure that one of the medical staff is available during school hours.

Will school staff still have to use PTO during Christmas break?  Would it be possible to have the opportunity to work in the classrooms and not use PTO? 
For Christmas 2020, school staff in Sioux Falls will continue to follow the same procedures as in previous years. On December 28, 29, and 30, Sioux Falls school staff will utilize PTO or work on residential units. On these days, Black Hills school staff will be present with students. Moving forward, a consistent plan between Sioux Falls and the Black Hills will be developed.

Could we change the title of Teacher Assistant?
I am only familiar with titles of ‘Education Assistant’ and/or ‘Teacher Assistant’. I am uncertain what an equivalent title would be or the need/purpose for changing the title. If you are interested, please share an alternative title and your reasons for the title change.

Could you consider increasing compensation for TAs when we are the acting teacher? And not put a cap on TA wages?
Evaluation and review of wages will be considered for all positions on annual basis.

Educational assistants in many of the public school systems receive higher hourly wages than the TAs at CHS. Will there be an increase in the TA salary in the near future?
Present Teacher Assistant data, as well as public school comparisons are being studied and considered in order to ensure our Teacher Assistant staff is adequately compensated for the duties they perform.

Could pay increases and tuition reimbursement occur in the school setting to reward staff who remain at CHS?
The pilot program is still under evaluation through the end of calendar year 2020. We will continue to evaluate and determine potential changes to the plan.

Why don’t therapists have to do wakeups? 
Therapists in Sioux Falls did wakeups several years ago but increases in workload volume changed their ability to do that. In addition to individual, group, and family therapy, the complexity of the casework, multiple family issues, and increased documentation requirements by DSS and Medicaid have added an enormous amount of time to each therapist’s workload.

I keep hearing about kids being discharged or not admitted because they are “too sophisticated.” What does that mean? Can we adjust to fit their needs? 
In our case, the term “too sophisticated” means children who have conduct disorders and more delinquent behavior. These children, we believe, would be too dangerous to mix with our younger population. So, decisions to either discharge or not admit these children are made with the consideration and safety of our entire population in mind. As long as we serve 4, 5, 6, and 7-year-olds, we will be cautious about the behaviors they are exposed to.

With current client counts, has the re-organization of our residential units been considered?
Reorganization of units is something that is a possibility should census continue to stay low. Currently, we are trying to minimize disruption as much as possible to staff and children’s schedules and routines and to be ready if our census bounces back in the weeks ahead. Our hope is that referral numbers will begin to increase with school back in session. In fact, we have had several admissions at BHCH in the past few weeks, and three more admissions at SFCH planned for the next few weeks. 

Throughout the years, various clients have been termed “not appropriate” for our programs due to IQ, adaptive behavior, sophistication, significant aggression, age, etc. It often seems like these clients may not have other options available to them either due to lack of service for that type of group. Perhaps now would be a good opportunity for change and re-organization of units to be able to meet some of these clients’ needs when they might otherwise fall through the cracks. It could provide much-needed services in our area.
This is a good question and the timing of it is perfect. CHS is motivated to provide relevant and valuable services to children, women, and families and has a history of adding and changing programming to do so. We, along with the other Psychiatric Residential Treatment Facilities in South Dakota, are participating in a workgroup along with DSS, DOC, and three major hospitals to look at gaps in services and ways to meet the increasing and evolving needs of the children we all serve. This workgroup begins later this week (September 25). The results of the workgroup will help advise our decisions, along with our own evaluation of the financial impact of any changes within CHS. An internal reorganization of any of our programs would obviously have a significant impact on our staff, so would be evaluated carefully.

We continue to admit clients when we are understaffed. If keeping kids safe is our main priority, why do we continue to admit students when we know we are not adequately staffed?
This is a challenge that we have been working through as a leadership team for many months. Program leadership in Sioux Falls did intentionally limit admissions this spring and summer to allow for staff to be hired and trained. At the same time, we have to balance that with decreased revenue each day we have an open bed and an open desk at school. Our HR department and our unit directors are working constantly to hire and train staff so that we can fill our beds and desks.

Please, no “riffs” during All Hands. It feels like it takes away from the importance of the meeting and uses unnecessary time that could be better spent discussing concerns, issues, praises, etc.
We are hoping that various kinds of music/entertainment make for a more engaging experience.