Minutes Archive

Board of Health Minutes

CALHOUN COUNTY BOARD OF HEALTH MEETING MINUTES

DATE: April 15, 2002

Battle Creek, Michigan

PRESENT:

Board of Health Larry Anderson, Chairperson

L.J. McKeown, Vice Chairperson

Byron McDonald

Charles Seifert, M.D.

Ben Miller, County Commissioner

Jean Cook-Hughes

Health Department Heidi Oberlin, Health Officer

Ted Havens, Environmental Health

Jerry Dean, Environmental Health

Carmen Sweezy, Assurance/Prevention Team Mgr.

Ginger Hentz, Assessment Team Mgr.

Judy Hoelscher, Access/Promotion Team Mgr.

Dianna Morand, Adm. Asst.

JoDee Marsh, Senior Health Coordinator

Kathy Hanson, Community Assessing

Dr. Greg Harrington, Medical Officer

Calhoun County Greg Purcell, County Administrator

Nancy Mullett, Legal Counsel

Jim Latham, County Finance Director

Kevin Siefke, GIS Coordinator

Guest Ron Hackworth, Coldwell Banker Real Estate

Mr. Anderson called the meeting to order at 8:05 a.m. in the Health Department Conference Room, George W. Toeller Building, 190 E. Michigan Avenue, Battle Creek, Michigan. Introductions were made.

II. Approval of the Agenda with the addition of the Administrative Report was moved by Byron McDonald, seconded and approved unanimously.

III. Public comment.

Ron Hackworth of Coldwell Banker in Marshall was present regarding an appeal on a site evaluation for the property at 19525 L Drive North. He suggested that this be tabled, however, since there is a new owner of the property and it was felt that the new owner should speak on his own behalf.

Nancy Mullett indicated to Mr. Hackworth that it is important that the new owner understand the time-line for the appeal. Ted Havens stated that he could contact the new owner by letter explaining that he would have to appear at the next BOH meeting to continue his appeal. Mr. Hackworth indicated that the new owner was aware of the sight evaluation problem when he purchased the property. A motion was made to table the matter until next month when the new owner of the property will be able to handle his own appeal. The motion was unanimously approved.

IV. Medical Report.

V. The Consent Agenda was moved by Charles Seifert. Seconded and approved unanimously.

VI. Resolutions:

-Res. 10-2002 Grant Contract with Southwest Michigan Affiliate of the Susan G. Komen Breast Cancer Foundation.

Moved by Byron McDonald, seconded by Charles Seifert, and approved.

-Res. 11-2002 Contract with Region IIIB Area Agency on Aging for providing dietician services to Area Agency on Aging.

Moved by L. J. McKeown, seconded by Charles Seifert, and approved.

-Res. 12-2002 Contract with Region IIIB Area Agency on Aging for providing mobile health screening and health education/ disease prevention services to the Area Agency on Aging.

Moved by Byron McDonald, seconded by L.J. McKeown, and approved.

-Res. 14-2002 Contract with Regional Health Alliance to assist CCHD in providing health education presentations to seniors.

Moved by Charles Seifert, seconded by L.J. McKeown, and approved.

VII. Finance Report

Jim Latham went over the Finance Report, stating that if expenditures are incurred at a rate of 50% for half the fiscal year, which is not always a valid assumption, the Health Department is 50% complete on the expenditure side. The Department has incurred 43.6% of the total budget for the fiscal year so the Department is under on the spending level, however, the expenditures exceed revenues by $137,000 approximately. Since it is only halfway through the year, this is not a concern at this time until we approach the end of the fiscal year.

It was agreed that there are pending grants and cigarette tax money that will probably help balance the revenues to expenses, as well as up-front expenditures and a variety of other factors that could be resulting in this imbalance.

Heidi will be furnishing a report next month showing where revenues might be down.

Administrative Report

Heidi Oberlin informed the BOH that John Robertson has resigned. If any Board members would like information on this, they can contact Heidi. The position is being looked at and the County Finance Department is assisting in the meantime.

Also Michigan' s Bio-Terrorism money plan has come in and it is anticipated that Calhoun County will receive approximately $34,000 within the next couple of months to reimburse for any expenses which have occurred since 09/11, related to that or to the anthrax scares which we have had to deal with since then. This one-time money will allow the Department to do some of the things that will help in meeting accreditation requirements in both communicable disease and environmental health areas where there are significant needs in the area of computer equipment. However we don' t have the guidelines yet for the use of this money.

Also, indications are that there will be an epidemiologist for a region which will follow State Police emergency borders, as well as some infrastructure building, ensuring that every health department has a T-1 internet connection, enough computers, text pagers, and one broadcast fax machine per county. There would also be software provided as well as training. This was supposed to be decided upon on Friday, April 12, and the results are not available yet.

Greg Purcell was asked if the County Emergency Services Coordinator has retired. He responded that John Townsend has retired and the Sheriff is filling that spot on an interim basis. The job description is being reviewed and the County intends to fill the position but at this time, there is discussion as to whether or not the position should be filled by a sworn sheriff' s deputy or a civilian as has been the case in the past.

Heidi was then asked for an update on the Nursing Clinic. She indicated that there is a report in the packet which shows the thinking of the group as they are discussing the pros and the cons of the different options. Steve Laslo, who is the Region V program director, will be coming at the end of this month to provide information. It is clear that there is an obligation (Federal) to bill Medicaid/Medicare, but the sticking point seems to be the 20-hour-per-week physician as required by the State of Michigan.

A motion was made by Byron McDonald that the Board of Health run the Nursing Clinic program and use their expertise to keep it funded. The motion was seconded by Ben Miller.

Dr. Seifert expressed his opinion that the requirement for a 20-hour physician so that there is more continuous care is possibly a step forward for the clinic. However, financing for this would be a difficult thing to accomplish.

Ben Miller commented that it is his understanding that there are two entities whose requirements must be met. The Federal Government is requiring that their billing standards be met to get the $66,000 funding from them. In addition, the Federal Government is requiring that State guidelines be met to have a doctor to bill for Medicaid. The billing system must be in place to meet the federal requirement. A 20-hour-per-week physician is required to meet the state requirement.

Heidi stated that all options are being looked at - what can be done and what cannot. The fund-raising committee meets once a month and that could be an opportunity for BOH members to become more involved in the process.

Ben Miller inquired as to the complexity of getting a billing system in place. He was told that training of staff, a software billing package (costing $20,000 to $40,000), and computers would be required. Heidi stated that one of the options might be to have Family Health Center do the billing for the clinic.

Physician recruitment through the federal loan repayment program is being looked at. There are other options being looked at regarding physicians with visas.

Byron McDonald inquired as to why the Federal Government is suddenly telling us we have to do these things. Are the requirements new or were the requirements in place before? Heidi explained to the Board that the requirements were in place before and had reportedly been brought up at a previous audit. However, the Health Department did not come into compliance at that time, which is why the Federal Government is more insistent now that the requirements be met. It was requested that a copy of the previous audit be obtained for the Board.

Judy Hoelscher advised the Board of the Clinic Advisory Board meeting at 3:00

on April 15th. She also stated that currently the goal is to raise $120,000 just to meet budget this year. The overall budget for the Nursing Clinic is about $500,000. At six months into the year, $68,000 is all that has been raised. There is a huge commitment just to reach the $120,000 goal. She expressed the concern that when you look at adding a doctor, a billing clerk, a billing system, and take away the federal money, it would be very difficult to maintain the level of service we now have. The Health Department is not working in isolation. What is best for the community has to be looked at. What is the best use of resources?

She also stated that the Board has to be involved in strategic planning to decide what the Health Department is going to be doing. Decisions need to be made regarding the mandated programs as well as what other programs will be continued and added.

Greg Purcell indicated that he felt that it was premature to make a motion to take over the running of the Clinic at this time without consideration of the facts as presented in this matter as well as consideration of more urgent matters such as accreditation issues. At this time, Byron McDonald withdrew his motion. Ben Miller concurred.

Dr. Seifert expressed his feeling that a major part of the concerns regarding the Nurse' s Clinic are that the Family Health Center will be taking over the running of the Clinic. Since this is a collaboration, if it is structured so that the major player is the Health Department and some of the other necessary things are contracted for, some of these concerns could be alleviated. He also said that the billing aspect of the federal requirement is not just costly, but billing clerks are at a premium.

Byron McDonald requested information as to how much would be billed if the Clinic were billing.
Medical Director' s Report

Dr. Harrington stated that gonorrhea rates are going up this year - he does not know why.

There is a problem with nursing homes not reporting outbreaks of upper respiratory illness and GI illness. A plan of action needs to be discussed regarding the nursing homes.

At this time, Heidi Oberlin pointed out that because of staff shortages in a core public health area, communicable disease, we have ended up being reactive rather than proactive. The Centers for Disease Control have a standard of one communicable disease nurse per 50,000 so Calhoun County should have closer to three and we have only one communicable disease nurse.

X. Other Business:

GIS presentation of teen pregnancies in Calhoun County, presented by Ginger Henz and Kevin Siefke.

Great Choices presentation by JoDee Marsh.

XI. Adjournment: Chairman Anderson adjourned the meeting at 10:00 a.m.

Calhoun County
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Marshall, MI 49068
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