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					Johnnie B. Byrd, Sr. Alzheimer’s Center and Research Institute
               And University of South Florida



        Joint Affiliation Board Meeting

        Transition / Affiliation Update


                      September 12, 2008

                                                                 1
          Transition / Affiliation Update

• CEO Report………………………..………………………Steve Klasko

• Update on Research………….…..………………………Abdul Rao

• Update on Clinical.………...……………………………..Cliff Gooch

• Update on Financial Management……………………..Joann Strobbe

• Update on Administration and Management………….Pat Haynie
                                              John Ekarius

• Summary of Immediate Next Steps.…………………..Steve Klasko




                                                             2
CEO Report




             3
              Our Objectives Today

• Inform the Joint Affiliation Board of the progress made
  in the last three weeks

• Identify “issues and concerns” that are the focus of our
  attention

• Inform the Joint Affiliation Board about the planned
  action – “no surprises”

• Confirm that the direction we are taking is supported by
  the Joint Affiliation Board


                                                             4
         Summary of Most Important Messages

          Past                          Present                             Future
• No Longer a Topic              • Today’s Focus                      • October 20


As of Today
•   The financial assets have been secured
•   The Transition Team is in place and making significant progress
•   A new Organization Structure is under development
•   The climate is expectedly “nervous, but positive”
•   Significant progress in multiple areas – more details to follow
•   Developing plans for improvement in many other areas – more details to follow
•   Developing Blueprint for Strategic Action – will share on October 20




                                                                                     5
    A Few More Comments About the Present

Overall, the Transition is Moving Very Smoothly

A Few Pleasant Surprises
   • Spirit of cooperation among institutions and individuals with a long history of
     competition
   • Opportunity to integrate and optimize a very unique Multi-Disciplinary Clinic
      • USF Memory Disorder Clinics
      • Byrd
      • Suncoast
   • Facility well suited to support expanding research agenda

A Few Lingering Concerns
   • Roles/responsibilities of Governance vs. Management
   • Expenditure levels exceed approved budget
   • Moving VERY quickly

Speed Really Matters! We’re moving VERY strategically and quickly…some
  believe too quickly… (and even some too slowly!)….but…we need to stop the
  hemorrhage and get the financial and operating performance of the Center
  under control in the shortest possible time with an understanding of the second
  and third order consequences of our decisions                                6
 Examples of Significant Accomplishments in the Last 3 Weeks

        Research                        Clinical                  Financial Mgmt.
• Asset Maps: Byrd, USF,       • Suncoast Relocation Plan      • Control of Assets, e.g.,
  USF Health                   • Centralize All Alzheimer’s      Checkbooks, Credit
• “Town Hall” for Scientists     Disease Clinical Research       Cards, Property, etc.
• Byrd Investigators USF         and Services at Byrd          • Review of “Internal
  COM Faculty                  • Plan for Multi-Disciplinary     Controls”
• 4 Investigators Co-            team care for AD              • Budget Review
  Locating                     • Leadership of Suncoast,       • Grant Management
• New Recruits: USF Health       Byrd and USF MDC agree          Accounting Analysis
• Grad Student Support           on framework                  • Bank Account Review
• Vivarium Renovation          • Recruitment Underway for      • Cash and Cash
• Vivarium Facility Manager      Chief Clinical Officer          Management Review
• Lab and Space Plan           • Strategy re ADRC              • Review of Policies,
• Dr. Dickey (+9) to Byrd        designation                     Procedures,
• Planning 3 new Cores                                           Accountability

                                   Administration                       Strategic
                               • Centralized Coordination       • Initiated “Blueprint for
                                 of Affiliation Activity          Strategic Action”
                               • “Tactical Plan”                • Plan for Unique
                               • Financial Support for Byrd       Comprehensive Multi-
                                 Facilities                       Disciplinary Clinic
                               • Facility/Space Plan
                               • Info Services Plan
                               • Organization Plan in
                                                                                             7
                                 Process
                               • Personnel Plan in Process
              Next on the Agenda

Updates from Members of the Transition Team

  • Abdul Rao - Research

  • Cliff Gooch - Clinical

  • Joann Strobbe - Financial Management

  • Pat Haynie and John Ekarius - Administration
    and Management


                                               8
Research




           9
                        Research

                    Important Considerations



       People                               Place

• Faculty                          • Laboratory
• Staff                            • Vivarium
• Students                         • Office Space



    Infrastructure                        Services

• Equipment                        •   Compliance
• Core Facilities                  •   DSR
• Information Systems              •   DCM
• Human Resource                   •   RFM
  Management
• Financial
  Management                                         10
                                     Research

Accomplishments to Date

• Asset Maps for Byrd and USF / USF Health

• Basic and Translational Research
  •   Investigators working in the area of Alzheimer’s disease
  •   Staff and students
  •   Equipment
  •   Laboratory and office space
  •   Vivarium
  •   Infrastructure

• Clinical Research
  •   Physicians and physician-scientists working in this area
  •   Staff
  •   Space
  •   Infrastructure



                                                                 11
                                   Research

Accomplishments to Date (continued)

• Completed Laboratory and Office Space Assignments

• All Investigators at Byrd Became USF Faculty Effective September 2

• Research Staff at Byrd Retained by the Faculty will Become USF
  Employees

• Graduate Students will Continue to Retain their Existing
  Compensation/Tuition Package for AY 2008-09
  • In AY 2009-10, the stipend and tuition benefits will revert to their peers in the
    College of Medicine
  • All new incoming students will have stipend and tuition benefits comparable to their
    peers in the College of Medicine



                                                                                      12
                                   Research

Accomplishments to Date (continued)
 • A team of four investigators with NIH-funded research in the
   area of Alzheimer’s will co-locate from the COM to Byrd

     • The four investigators include:
        • Dr. Dave Morgan
        • Dr. Marcia Gordon
        • Dr. Edwin Weeber
        • Dr. Chad Dickey

     • Collectively, they bring ~$5 million of existing (mostly NIH)
       funding and ~29 faculty, staff, and students to Byrd

     • They have ~$5 million of potential funding in the pipeline
       (predominantly NIH) with tremendous promise for growth and
       collaboration

     • Co-location will begin immediately and concluded by December
       15, 2008
                                                                       13
                                  Research

Accomplishments to Date (continued)

• Started the Process of Creating a Functional Vivarium
  •   Ensured that Byrd vivarium is part of USF AAALAC accreditation
  •   Appointed Facility Manager – August 27, 2008
  •   Initiated the process of undertaking minor renovations
  •   Transfer of animals will be phased with PI co-location
  •   Fully functional: October 15, 2008

• Effective August 27, 2008, All New Recruits (Faculty, Staff, and
  Students) at Byrd will be Employees of USF/USF Health

• Reached Out to Key Leaders in AD Across US to Seek their Advice
  and Counsel



                                                                       14
                                                Research

    Accomplishments to Date (continued)
     • Completed Occupancy Analysis for Research/Clinical Space

                                        RESEARCH-RELATED OCCUPANCY (%)
             FLOORS
                                                CURRENT                      DECEMBER 15, 2008

          VIVARIUM*                                    0                           100
           FLOOR I                                 15-20                           100
            FLOOR II                               30-40                          10-15
            FLOOR III                                0                              50
            FLOOR IV                               40-45                           100
             FLOOR V                                            Shelled Space
                                                       for future growth & expansion
            FLOOR VI
                                                                                                 15
*Built out space only; shell space available for future growth & expansion
                      Research: Next Steps


• Three NEW Research Cores will be Established at Byrd
    •   Viral Vector Core (Floor Level IV)
    •   Electrophysiology Core (Floor Level III)
    •   Behavioral Core (Vivarium)
    •   Completion date: On or before December 15, 2008

• All Existing Grants/Contracts for Sponsored Research at Byrd Will
  Transition to USF in Faculty’s Respective Departments
    • Completion date: On or before September 30, 2008

• Eric Pfeiffer Suncoast Alzheimer's & Gerontology Center will Co-
  Locate to Byrd
    • Completion date: On October 10, 2008

• Full Integration of ALL Clinical Research Activity at Byrd
    • Completion date: On October 10, 2008


                                                                      16
            Research: Next Steps                   (Continued)



• Recruit New NIH-Funded Investigators

• Assess Research Support Personnel at Byrd
  • Completion date: On or before September 30, 2008


• Transition Research Support Services to USF
  • Completion date: On or before September 30, 2008


• Build-Out Vivarium and Research Laboratory Space

• Town Hall Meeting Scheduled for Monday, September
  15, 2008, to Discuss Clinical Research and Clinical
  Care


                                                                 17
Clinical




           18
          Clinical Research and Clinical Care
Three Historically Separate and Independent Units

   • Suncoast Alzheimer’s and Gerontology Center
      • Renowned Alzheimer’s clinical trials center
      • Special focus on Alzheimer’s Education
      • Alzheimer’s Clinical Evaluation and Management


   • Byrd Institute Clinical Unit
      • Alzheimer’s Clinic in early Start-Up Phase
      • Limited Clinical Trial Activity


   • USF Memory Disorders Center (MDC)
      • Comprehensive, multidisciplinary Alzheimer’s clinic
      • Only full multidisciplinary care clinic among these units
      • Part of the FL Department of Elder Affairs Network


                                                                    19
Clinical Research and Clinical Care: Integration Progress

Suncoast-Byrd-USF Alzheimer’s Clinical Trials
  •   Suncoast core faculty and staff will function as the AD Clinical Research Center
  •   Suncoast Faculty and Staff Co-Locating to Byrd, First Floor in October
  •   Suncoast will co-brand with Byrd-USF, and maintain identity within the Byrd
  •   Suncoast/Byrd will publically re-launch after co-location complete
  •   Byrd Clinical trials will revert to the new Clinical Research Center (CRC)
  •   Clinical Trials at the MDC will utilize new CRC
  •   Suncoast/Byrd will spearhead AD Education and Community Outreach

Alzheimer’s Clinical Care
  • The USF MDC will provide multidisciplinary team care for AD
  • The USF MDC will transition its clinics to the Byrd within the next few months
  • Traditional clinical E&M services, outside of MDC team care, will be offered by the
    Suncoast/Byrd faculty for patients who do not wish MDC team care

Leadership of Suncoast, Byrd and the USF MDC have agreed on this framework

Recruitment of a Chief Clinical Officer Underway
  • Will coordinate and oversee the above operations
  • Will be a major figure in AD nationwide
  • Advanced negotiations are in progress with a prime candidate
                                                                                          20
Alzheimer’s Disease Research Center (ADRC)

              ADRC Designation is an Academic Badge of Honor

Byrd Institute--USF ADRC (“Florida ADRC”)
  •   Only ADRC currently in Florida
  •   Multiple Required Cores: Clinical, Research, Education, Database, etc.
  •   ADRC Review for recertification in first half of 2009
  •   Florida ADRC has complex structure spanning the state

Current Strategy
  •   Retain major elements of Florida ADRC to maximize chances of renewal
  •   Huntington Potter remains Director of the ADRC
  •   Maintain current clinical network, database, education core, etc.
  •   Solicit new projects for inclusion in the application

Future Plans
  • Assess and build on best elements of ADRC
  • Analyze fiscal structure and plan for future support
  • Explore mutually beneficial collaborations with other academic institutions in FL -
    identify new Cores/Projects for inclusion in the renewal application (such as
    genetics, imaging, neuropathology, etc.)
                                                                                          21
                   Clinical: Next Steps


• Continue to Map Clinical Operations and Office Space

• Develop Business Management and Support Staff Structure

• Complete Suncoast Relocation

• Recruit Chief Clinical Officer

• Alzheimer’s Disease Research Center
   • Secure continued collaboration from existing and new Florida ADRC
     partners
   • Develop a competitive renewal application – submission date: May
     1, 2009
   • Finalize ADRC Budget (current and future years)              22
Financial Management




                       23
                          Financial Management
                       Summary Observations and Action to Date
• First Priority: Secure the Assets
   • Bank Accounts
   • Credit Cards
   • Property, Plant & Equipment (in process)

• Current Financial Model is Not Sustainable
   • Sources of Revenue
      • Inadequate to Support Programs
   • Magnitude of Expenses
      • Administrative Structure and Infrastructure more Costly than Budgeted
   • Significant Changes Necessary
      • Expand and Diversify Sources of Revenue
      • Opportunities for Efficiencies and Synergy with USF
      • Cash and Investment Management

• Assessment of Internal Control Procedures
   • Separation of Financial Duties
   • Security of Financial Data
   • Fixed Asset Inventory and Fixed Assed Management
   • Adherence to Established Policies and Procedures
   • Inconsistency with USF Policies and Procedures

• Major Work-in-Process
   • Cash and Cash Management – Current State and Projections
   • Budget and Budget Management – Recast                                      24
   • Align Financial Policies and Procedures
                            Financial Management

    Budget and Budget Management                               Observations and Comments
                                                           • Present Budget does not represent the current
                                    2008-09                  reality
                                    Original
                                   Approved                • Previously proposed budget reductions are
                                                             incorporated into the Original Approved Budget, but
                                    Budget           %       have not been executed
Revenue:
  Research Mission                          $428     43%   • Nearly 40% of expenses are budgeted for
                                                             Administration – up from 28% last year and 24% the
  Clinical Mission                          $125     13%
                                                             prior year
  Administration                            $447     45%
Total Revenue                              $1,000   100%   • Need “Mission Based” process for approval of
                                                             expenditures
Expenses:                                                  • “Mission” leaders need monthly reporting of budget
  Research Mission                         $4,468    59%     vs. actual expenditures – and should be held
  Clinical Mission                          $224      3%     accountable to CEO for results
  Administration                           $2,926    38%
                                                           • Board should receive “corporate level” reporting of
Total Expenses                             $7,617   100%     budget vs. actual expenditures

Net Gain/(Loss)                        ($6,617)            • Need to recast the budget and present to Board for
                                                             review/approval by October 20

                  (Dollars in thousands)                   • USF will provide Byrd appropriate accounting
                                                             documentation related to Support Services and
                                                             other agreements                              25
                                 Financial Management
                                                                     Observations and Comments
       Cash and Cash Management
                                                                 • Cash balances in five accounts (in $000’s)
                                                                    • Operating Account………………..$6,915
                                                  Year to Date      • Building…………………………….$6,640
                                                 July & August      • Other Income…………………..……$925
                                                                    • Donation…………………………...…$251
                                                                    • Grant……………………………….…..$12
Beginning Cash Balance                                $17,763
                                                                 • Significant cash outlays continue for prior
Revenues                                                 $102
                                                                   commitments
Expenses                                                         • Revenue is comprised of interest earnings, grants
  Payroll                                                 $782     and donations
  Temporary Services                                       $77
  Academic Grants                                       $1,007   • Additional sources of revenue are required;
  Construction & Related Professional Services            $434     additional interest earnings are possible with
  Professional/Legal Services                              $83     enhanced investment policy
  Building Maintenance                                    $222
  Seperation Payments                                      $20   • Spending levels are not sustainable – would deplete
  Lab Supplies/Animal Charges                             $179     cash in 12 to 18 months
  Advertising                                              $22
  Insurance                                                $11   • Academic Grants includes two “one time” outlays of
  Other                                                   $285     cash
    Total Expenses                                      $3,122
                                                                 • Construction & Related Professional Services are
Ending Cash Balance                                   $14,743      essentially complete

                     (Dollars in thousands)                      • Most significant area for expense reduction is in
                                                                   Payroll (Currently $300 to $350 thousand per
                                                                   month)                                            26
        Financial Management: Next Steps
• Current accounting software has limited capabilities. Will transition to USF’s
  PeopleSoft for funds that move to USF – will provide enhanced reporting and
  accountability

• Revamp “Data Security” procedures

• Draft new cash management policy for Board approval, particularly as regards:
    • Investment policy
    • FDIC insurance limits
    • Five separate accounts

• Draft “authority” process for management of expenses, authority to spend,
  accountability, cash management, and the like.

• Revamp Payroll Management process

• Review Board policies re expense management, e.g. use of outside counsel vs.
  using internal USF associate general counsel for routine matters

• Develop recommendations for improved financial management

• Re-cast Budget for FY 2009
                                                                                   27
• Prepare Cash Flow Projection for FY 2009
Administration and
  Management




                     28
            Administration and Management
Summary of Action to Date

• Finalized and Implemented Plan for Information Services

• Confidentiality Agreement Signed

• Byrd Facility Added to USF Inventory for Plant, Operations & Maintenance
     • State Funding ~ $1.625 beginning July 2009

• Completed Review of Dr. Potter’s Intellectual Property

• Currently Drafting Three Agreements – All “Time Limited”
     • Administrative Support
     • Staff Funding
     • Space Use

• Work-in-Process Includes:
     • Proposed Organization Chart for “Functional Responsibilities”
     • Staffing Plan for All Current Byrd Employees




                                                                             29
  Administration and Management: Next Steps

• Finalize Legal Agreements

• Finalize Organization Chart

• Finalize Staffing Plan

• Begin Implementation of Staffing Plan




Target Completion for Next Steps Listed Above: On or Before October 20, 2008

                                                                          30
               Administration and Management
                          Draft Chart for “Functional Responsibilities”

 Byrd “Advocacy” Board                                         USF Board of Trustees




                                     Joint Affiliation Board



                                              CEO


                                                                       Finance, Admin &
       Research                              Clinical
                                                                         Management
• Basic Translational                • Patient Care                  • Financial Management
  Research                           • Community Outreach            • Information Services
• Vivarium                           • Education                     • Facilities/Space
• Compliance                         • Compliance                      Management &
• Intellectual Property              • Clinical Trials                 Maintenance
• Grants Management                  • Other?                        • External Affairs /
• Other?                                                               Development          31
                                                                     • Other?
Summary of Immediate
    Next Steps




                       32
             Summary of Immediate Next Steps
                       Key Activities                        Target Dates

• Review and Approve Proposed Policy Letter                Today

• Complete “Immediate Next Steps” as Already Discussed     As Presented
   • Research
   • Clinical
   • Finance
   • Administration and Management

• Individual Meetings with Independent Consultant          Next 2 – 3 Weeks
   • Blueprint for Strategic Action
   • Organization and Management

• Board of Governor’s Meeting on USF Campus                September 25, 2008
   • Ann Duncan will report on USF-Byrd Status

• Next Board Meeting: Combined – Joint Affiliation Board   October 20, 2008
  and Byrd “Advocacy” Board


                                                                                33

				
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