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 Minutes Archive |
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Board of Health
Minutes
CALHOUN COUNTY BOARD OF HEALTH MEETING MINUTES
190 East Michigan Avenue, Suite A100, Battle Creek, MI 49014
Date: September 15, 2003
PRESENT
| Board of Health |
Larry Anderson, Chairperson |
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Jean Cook-Hughes, Vice Chairperson |
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Ben Miller, County Commissioner |
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George Perrett, Attorney-at-Law |
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Dr. Jeffrey Mitchell |
| Health Department |
Heidi Oberlin, Health Officer |
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Kathy Ferguson, Finance Officer |
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Ted Havens, Environmental Health |
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Paul Makoski, Environmental Health |
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Brigette Reichenbaugh, Administrative Assistant |
| Calhoun County |
Greg Purcell, County Administrator |
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Nancy Mullett, Legal Counsel |
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Jim Latham, County Finance Director |
| Guests |
Barbara Fredericks |
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Kate Segal |
- Call to order and introductions
Time: Larry called the meeting to order at 8:05 a.m.
- Approval of Agenda
Larry Anderson has one announcement to make.
Ben moved for approval. Jeff seconded.
- Public Comment
Commissioner Barbara Fredericks expressed her concerns about the
Environmental Health (EH) fees for small restaurants. She has received
several comments from a small caterer and several small restaurants in
the Albion area. The fee increase, which for some, particularly small
restaurants (15 – 25 seat restaurants) is $250, is quite high. Her
concern is that the increase may force some of the small business
owners out of business, particularly due to the tough economic times
in Albion. Barbara had a conversation with Ted and suggested looking
at a new fee avenue for the smaller restaurants. Possibly consider a
third level to Simple and Complex. Owners of those small restaurants
have contacted Barbara and stated that the increases are high and
steep. Barbara also asked if, during conversation today, Ted could
also explain the Lead Test fee increase.
Commissioner Kate Segal joined the meeting. Once introducing Kate,
Larry asked for introductions.
Larry stated that some of those concerns were expressed at previous
meetings, and asked Barbara for suggestions.
Barbara suggested that if the proposed fees need to remain as they
are, we should consider developing a fee for small restaurants
considering the calls she received. Seating capacity may be a good
way.
Larry: The proposed fees do not reflect the size of the
restaurant, but how we inspect restaurants.
Barbara feels that restaurants that have health problems should be
inspected more than those that don’t. A $450 fee is large for everyone
but for others, it is extremely large.
Ted Havens stated that he fully recognizes that this is a new
approach, and can be controversial. The risk is what we are looking
at. The risk is the same for a small establishment as it is for the
large. A small establishment doesn’t have as large of volume, however,
the risk is the same. Our new approach addresses the risk.
Greg Purcell: Are there any numbers indicating how many
restaurants have 25 or less seats that are in the Complex category?
Ted: There are 83 restaurants in the 0 – 50 seating
category. Approximately 50% of these are restaurant chains. The
remaining restaurants are the smaller/mom-and-pop. Of these
“mom-and-pop” restaurants, they are 50-50 for Simple and Complex.
Barb: Why didn’t we base our fees on the type of rate
schedule we currently have in place rather than increase all
restaurants to $450, increasing smaller restaurants fees by $250?
Larry: Fees are based on the time it takes to inspect a
restaurant. We have to be fair to everyone.
Ted: The reason that we didn’t pursue a similar fee schedule
is due to the risk involved in food handling as opposed to seating,
which was based on sanitation. Sanitation is a factor, however, not as
high of risk as food preparation.
Greg clarified Barbara’s question -- if the Complex category can be
two-tiered for both large and small restaurants, does the restaurant
size have any impact on the revenues and the completion time of an
inspection.
Ted: Are you suggesting a two-tier Complex and Simple. What
would the difference be between the one-tier and two-tier?
Greg: Does it take you more time to do a large restaurant
than a small restaurant?
Larry: Pose the question back, we would have to go back and
have another public hearing, present to the Board of Commissioners,
does the county have the revenue to support this?
Nancy: Would not have to go back to modifications to reduce
one level. Several restaurants do not understand fees. This Health
Department has undercharged restaurants in past years. It’s only been
in the last few years that we have taken a realistic view. We have to
be able to take a look at the fee we are suggesting, compared to what
they would have paid all along with the gradual increases, the fees
are similar and, in many cases, less than. Our proposed fees will
begin to bring the fees closer to what we should have been charging
all along.
George: Our proposal is not revenue driven, it’s cost
recovery driven. Second, we estimate that we are below Jackson and
Kalamazoo Counties. We are below our actual cost for the service. We
don’t do a good job of allocating fixed cost to these overheads. We
underestimate our variable cost and haven’t included fringe benefits
to the FTEs, transportation, etc. that consists of variable overhead.
The fixed overhead of county allocation. For example, when the
Commissioners’ pay was decreased, we cut salaries below and light
years from where other counties are. When their pay was increased, we
increased tremendously, but lower than many surrounding counties. This
is not covering our cost, but we are getting closer to recovering our
costs. Does the increase place a burden on the smaller restaurant, but
cover our cost? I do not think we should approach a two-tier system.
We will have to look at the Commissioners to cover cost.
Ben: We are recovering the cost of the inspection that was
handed down from the State. If we want to lower standards, our
representative should be contacted. Cost: 300 days, 16 seats, 1,800
people, only served one item at one time, penny increase for each
item, $480. Unfortunate but it’s reasonable.
George: The fact is those costs are not ultimately going to
be absorbed by the patron. This is the least objectionable of the
options.
Ted: These fees are based on the 02/03 budget. Not having
the 03/04 budget in place, these fees will not cover all expenses.
Fees also include training that we will provide at no additional cost
to the operator if they send their employees to the Health Department.
A company called Maximus evaluates revenue fees for several counties
to recommend reasonable fees for their EH fees – that’s always an
option.
George: Maximus should be explored. We are dealing with a
cost recovery issue, but Barb’s point should be well taken -- why not
go after repeat violators? He and Larry have discussed. What are the
actual costs associated with enforcement of the health code. A recent
example included an establishment that was shut down several weeks ago
(dedicated FTEs/staff to close, research, assess situation, corrected,
complete process, etc.). Activities associated with the enforcement
are not being recognized. The costs far exceed our fees.
Larry: Thanked Barbara for her comments.
Barbara felt that if we keep the proposed fees as they are, we are
sending a bad message to the public. She suggested that we send a
message to the public via newspaper, letter, etc. stating how our
costs compare to surrounding counties. She suggested allowing clients
to pay their annual fee on a quarterly or payment plan.
- Consent Agenda
Consent Agenda. Ben moved, Jean seconded.
Jeff Mitchell stated that the Health Department can make a career
out of violators. Regarding the August 19th meeting minutes, Jeff
referred to page 6. Jeff also asked about page 9 in the minutes --
two–year 0% lease, then further along in the minutes, we state that we
purchase the equipment. Is it a purchase or lease?
Kathy: Capital lease. Lease for two-year at the end of the
lease, we own.
With those corrections, Ben moved. Jeff seconded. Approved.
- Resolution 30-2003
Nancy made a correction to the food code changes items 3.1 and
3.6—change from employee to supervisor.
George: former 3.5 and 3.6 are now combined. The concern was
having someone certified 24/7 at these operations, particularly the
smaller operations that Barb was referring to earlier. Someone will be
available for technical assistance at all times, but not on-duty at
all times.
Jeff: What does regularly available mean?
George: Regularly means they are available at all times, but
they “can take a vacation.” The can answer questions via telephone.
Jeff: Does the definition need to be included?
Ted: The certified individual has accessibility at all
times.
Heidi: Several restaurant owners felt that we were stepping
into the operations of their establishment. After further discussion,
it was decided that it wasn’t up to the HD to tell a restaurant how to
run their business. It is to the restaurant owner’s benefit to have at
least one certified individual accessible.
George: The risk of loss, for lack of better words, has to
be shifted to the restaurant. Ultimately, they will have to comply
with the existing health code, they will have to determine how they
will do that. Our role is on the enforcement side, the risk of
loss/burden shifts to them. The word “regularly” was suggested by the
owners.
Greg: Refer to the last sentence in 3.5. What if a
restaurant has two facilities/franchises? Are they required to have
two separate certified individuals?
George: Each restaurant will have someone available at each
of those franchises. We are forcing restaurants to have one person per
facility. If one person is the owner of two units, they can not be
available for both locations.
Jeff: If phone consultation is the minimal standard?
George: Phone consultation is only OK in certain situations.
For example, what does the grill temp need to be versus is this meat
OK to save or toss it?
Jeff: The purpose of this individual is consultation or
interpretation. Who will ask/answer the question if this person is on
vacation.
Ted: If a restaurant receives a shipment of food that is
only partially frozen, who do they call. They can call us or their
certified individual. It is up to the certified individual to train
their staff.
George: The burden has to be shifted to the operator.
Minimum standards we can uniformly spread across all restaurants. The
restaurants have to make the determination as to how many individuals
should be certified.
Larry: Motioned to approve resolution 30-2003 with the
modifications.
Ben moved. George supported.
George: Can we develop some administrative guidelines to
determine “regularly”? An internal discussion was suggested to resolve
this issue.
Jeff: First, as a minimal standard, would be fine with an
internal definition. Second, as a public health issue, this is a
transition to a higher standard.
No one disagrees with Jeff.
Approved.
Resolution 31-2003
Heidi was unable to resolve the issues around this amendment.
Nancy: What they are proposing for 03/04 is an amendment of
a contract that does not exist. The other issue is we can’t get
commercial insurance. Addressed the layoff issue. Nancy is not
concerned that timeliness is an issue, and layoffs should not occur.
Greg: According to Nancy we need a new contract. Message to
the Board, we will not be lying off staff because of the contract
language and contract non-approval.
George provided an example (we would lease to them for
approximately six months because we could not get through to the FIA
to resolve lease agreements. They almost put legal hurdles in place in
order to resolve agreements).
No action needed.
Resolution 32-2003 -- Heidi stated that the BOH approved the
contract with the Department of Environmental Quality. This is our
standard contract for water, radon, etc. George moved. Ben seconded.
Nancy: Is this part of the contract plus the amendments.
Nancy has not reviewed amendments yet.
Heidi confirmed that amendments were just received last week
separate from the contract.
George: Approved based on legal review.
Approved.
- Finance report:
Kathy Ferguson: County tax dollars subsidize Environmental
Health $300K/$400K per year. Kathy explained that at this time, we are
showing an excess of revenue over expenses of $28K. Several positions
have remained unfilled longer than expected. We expect to have about
$70K to carryover for the NCBC.
Jean Cook-Hughes: About our training budget, why has it
increased so much from previous years?
Kathy: We received money for Bioterrorism that mandates that
we spend the funds on training.
- Other Business
Heidi summarized the Public Health Trends handout.
Other highlights of our programs are as follows. At the Nursing
Clinic of Battle Creek (NCBC), we are looking at the pharmaceutical
issues and programs. Distribution – people will look at the easiest
way to get free medications. Heidi also noted that we are sponsoring a
visit from the Michigan Surgeon General to discuss Lead.
The NCBC is once again picking up the plans that were put in place,
previously put on hold due to talks of the NCBC merging with the
Family Health Center. Also, the consultant, Lena Hackett, has been
approved for another 12 days.
George: Regarding the NCBC and the pharmaceutical costs, he
knows that there are a number of individuals within the community
interested in supporting the NCBC. How is it that we ensure the NCBC’s
existence? There is a political tie to the Health Department that
needs to be recognized, public health concern with the NCBC. Need to
preserve that tie.
Heidi: We are looking at what the best relationship is.
George: To be able to garner outside revenue sources (due to
Federal dollars).
Jean: What are the revenue sources to the NCBC.
Heidi/Kathy: Approximately one-half comes from the Federal
Government, substantial amounts come from outside sources, BCHS,
Senior Millage, donations, etc.
George: The excitement is real positive.
- Board Business
Larry: We are about to join the policy governance network.
Training opportunities offered on September 22nd at Noon for board
members and executives. Will also discuss Ends policies. $5 for lunch.
Approximately $250 membership fee. Provides interaction between other
Boards that use Ends policies.
Ben: Last Board meeting we discussed an article relating to
teen pregnancy preventative measures. This led to the discussion of
individual Board of Health members speaking on behalf of the Board.
Ben thought it was inappropriate for a member to make a decision on
behalf of the Board.
Larry: A Board should bring as many opinions as possible to
a Board meeting. The Board should speak with one voice. Majority of
the voice agrees.
George: Issue does need resolution. We can reach a point
were Ben is comfortable with the policy. The difference between this
Board and other Boards is that this Board serves as a representative
for the public. We carry a different role than a Corporate Board. We
voice as a representative for the public. Vote in favor of a partial
resolution. Dissent is desired, but at the same time, we are going to
take a public position, we can’t have Board members dissenting from
that public decision. There’s a balance between our policy and where
Ben is at. We need substantial discussion. Think on it for another
month. Need to discuss in extent at further meetings.
Ben: Feels that we shouldn’t have a Board where we all have
to think one way or the other. Should not be denied to serve on the
Board or speak on behalf of the Board because of the policy.
Larry: Makes it difficult for the Board. Larry has
background for Heidi to distribute to others.
Jean: Why does an individual feel they have to acknowledge
their presence on the BOH and/or BOC?
Ben: Prevented by this by not identifying Board status.
Larry: Discuss and develop framework for next meeting. Draft
some thoughts to distribute to the Board in advance of the meeting.
George: Provision 3B…If I write a letter saying that I
disagree with the Board and I am not speaking for the Board. Not
speaking for the Board but you are speaking on behalf of yourself.
Jean: Reach a consensus then go out and speak individually,
not on behalf of the Board.
Larry: Will bring back for discussion.
Meeting adjourned at 9:55 a.m.
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Several photos included in this 
