Board of Health Minutes

II. Charles Seifert moved to approve the Agenda. It was seconded by Jean Cook-Hughes and approved unanimously.

Kathy Lunardini, representing the nurses of the Calhoun County Health Department, presented a letter to the Board of Health. She expressed the concerns of the nurses over the possibility of losing the only Team Manager who is a nurse. The nurses feel that they are in need of a nurse manager.

IV. The Consent Agenda was moved by Jean Cook-Hughes and seconded by Charles Seifert and approved unanimously.

V. Resolutions:

Moved by Charles Seifert, seconded by Jean Cook-Hughes, and approved unanimously.

There was some discussion about the difference between Aventis and Wyeth in price paid per vial of vaccine. Judy explained that the order is split between Wyeth and Aventis. Aventis charges much more but delivers on time and is an excellent provider. Unfortunately, although Wyeth is considerably less expensive, they cannot be depended upon to deliver timely.

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

It was explained by Ted Havens that the DEQ agreement consists of program activities that have been conducted for ten years or more. The Health Department is reimbursed for most of these by the State; for some there are charges.

Ted indicated that the Department generally breaks even on these programs although it does depend somewhat on the economy.

This contract is for $8,000. The money goes to the WIC program for the services of a nutritionist in reviewing menus. It would not be reasonable for the CAA to hire a full-time nutritionist for the assistance they need. This works out well for both parties in that the money helps pay for the salary of a nutritionist for the Health Department.

Moved by George Perrett, seconded by Jean Cook-Hughes, and approved unanimously.

This is an agreement with Barry-Eaton that provides for computer support for Environmental Health' s computer program activities. It is very cost-effective.

Moved by Jean Cook-Hughes, seconded by Ben Miller, and approved unanimously.

It was explained by Heidi Oberlin that this is the boiler-plate language for the agreement with the Michigan Department of Community Health and the Department of Agriculture.

Greg Purcell asked at this time if the Board would be interested in seeing copies of contracts, particularly the CPBC contract, put in the packets. Larry Anderson responded that the contracts are always available if anyone wants to review them and since Nancy Mullett reviews all contracts, the Board does not really feel the need to see the contracts in the packets.

Dr. Harrington indicated that there has been considerable confusion among health care providers about West Nile Virus. He said that a memo was sent out to try to clarify the case definition as it is known today; however, the definition is going to change as the virus evolves. It has been around since 1937 and there have been four major outbreaks since 1996. Something has changed in the virus. He said that so far, he has not seen as many cases of aseptic meningitis as last year. He indicated that an education program should be planned for next Spring. He stated that he would be working in concert with the Environmental Health staff.

He also stated that he has seen some active cases of tuberculosis. All of the cases that he has seen in the past two years have come from other countries.

He said that they are gearing up for influenza season and he is waiting for the vaccine to come in. The immunity lasts only six months after a person receives the immunization. It is not a potent vaccine and since the virus is constantly mutating, surveillance must be done.

He indicated that there are no confirmed cases of West Nile Virus in Calhoun County at this time. However, it is inevitable that it is going to happen. It is important to get the word out about DEET. Eventually, Dr. Harrington feels that a vaccine will be developed.

Ted Havens added that nationally there have been 1,438 cases of West Nile. There have been 673 just since the first of the month. There have been 64 deaths nationally and 32 in September. There have been 135 cases confirmed in Michigan. There have been nine deaths in Michigan. There has been one case in Eaton County and one case in Van Buren County.

Kathy Ferguson said that there was a question asked last month regarding water samples, in that the actual revenue received was much higher than the amount budgeted. It was found that there was a typographical error of $36,000 in the current year' s budget. In addition, it was found that the operating transfer of Calhoun County funds was budgeted as $765,307 instead of the $779,260 that is actually expected. The difference of about $14,000, added to the $36,000 error, results in anticipated current year revenues exceeding expenses by $50,000.

Kathy stated that the finance report is a sort of snapshot of where the budget was at the end of August. These reports are interim statements; bills not received are not shown and estimates for receivables not yet collected don' t show.

VIII. OTHER BUSINESS

Greg Purcell indicated that Kathy and Jim Latham and he had met to work on the details of the budget. He wanted to have a review opportunity for the Board to go over those details prior to passing the budget.

There will be a Special Meeting of the Board of Health on Monday, September 30, at 8:00 a.m. to act on the budget. The budget will then go to the Board of Commissioners on October 8. They will review the recommendation and it will have to be at the State by November 1.

It was determined that the Budget Committee would be made up of George Perrett, Byron McDonald and Larry Anderson and they will plan to meet prior to the September 30^th meeting so that they can offer their recommendations.

Ben Miller inquired as to the breakdown of the $433,000 that the Health Department will not be getting. Kathy responded that about $130,000 of it was the net effect of State funding. Some of the money was foundations giving money one time only, approximately $80,000. The School Nursing Program has been reduced and so has the funding on that basis. There was also Senior Millage money lost.

Kathy indicated that part of the problem is due to revenue decreases but there are other factors. The budget is also assuming a 1% COLA which depends on union negotiations. It costs about $23,000 to $24,000 for each additional percent of increase. There is additional cost of health insurance, which was figured at a 20% increase which could actually be quite low. That is a cost of

$80,000 taken away from the bottom line. Since this doesn' t happen until January 1, Kathy only calculated it at $60,000.

Greg Purcell said that they are working on a cafeteria plan to be introduced to County employees. Health Department employees are paying 5% of their health insurance now and it does not appear that there will be any reduction in that amount.

Ted Havens pointed out that the Health Department has been at the same Maintenance of Effort level for well over ten years. Greg Purcell indicated that although it is true that the Health Department has not seen an increase, he does not see this as a good time to expect one. Ted also pointed out that it has been noted by members of the Strategic Planning team that the Health Department has been underfunded and understaffed for some time.

Judy Hoelscher said that she understands the need to cut a Team Manager position; however she would hate to see two Team Managers cut. She urged that the Health Department seek additional funding from the County and she suggested that the Board start the budget process much earlier so problems can be seen and possibly remedied.

George Perrett inquired as to the status of the jail health contract. He suggested it as a revenue possibility for the Health Department. Greg Purcell stated that the Health Department would have to bid on this on the same competitive footing as the private sector. He said that the liability would be a concern.

Heidi indicated that for the Health Department to seek the contract to do the jail health would really be chasing the dollar rather than following the Health Department' s mission.

IX ADJOURNMENT