Resolution 33-2003 Mutual Aid Agreement: Heidi Oberlin
summarized the need for the mutual aid agreement (e.g., Hep B outbreak
several years ago). Amy Latham summarized that two health departments
have passed this agreement, Van Buren and Berrien, to assist each
other when the need arises. All Emergency Preparedness Coordinators
are in favor and will move forward on this.
Greg Purcell asked about the details and clarified that this is
formalization to the process already in place.
Mac: Asked if this is any way regionalizing Health Departments.
Heidi answered no.
Mac moved to approve; Jean supported. Approved unanimously.
Resolution 34-2003 - Acceptance of HCAP Grant: Heidi
summarized: This grant was awarded to look at county-wide access to
care issues. There are many partners identifying the gaps and the
approaches to the gaps. Approximately 1/3 of the $923,000 is allocated
to the Health Department whereas the other 2/3 will be given to the
partners. Heidi is presenting to the Board of Health due to additional
staffing requirements (e.g., team manager, program coordinator). Funds
from this grant will also pay for a portion of the NCBC salaries and
NCBC program. Freeing up these funds will allow for hiring of a
part-time nurse at the Clinic.
Mac supported, Ben seconded.
Comment: Mac stated that this looks very similar to the
Kellogg Foundation program, CHIPS, whereas approximately $5,000,000
was spent with no outcome. He hopes the HCAP grant will have better
outcomes.
Larry stated that this is not a CHIPS program. This focuses on the
un/underinsured citizens and was adapted by 12 different agencies in
coordination with the RHA and the Access to Care taskforce, not
consultant driven.
Ben commented that we just trimmed our Team Manager role. Is there
anyway that we can operate this under the current structure.
Heidi stated that the person hired will know up front that this is
a three-year term. The HCAP program needs somebody with authority and
direction since we are the fiduciary. The individuals noted as
partners were part of the initial application process. There will be
official contracts for each partner agency that will be approved by
the Board of Health. For example, there were three entities in Albion
that were identified. It will be the decision of those three agencies
who will receive funds from the HCAP grant, one of those three
agencies will be allocated to receive and designate those monies.
Greg congratulated everyone for their time and effort. Greg had
three questions: 1) Is there a local match required and if so, where
is it coming from? 2) Since this will require a staffing change, will
require BOC approval also. 3) Albion issues.
Heidi answered that there is a fully equipped dental operatory
proposed in this grant proposal. This will continue after the grant
has ended. Another focus will be potentially working with the school
wellness program identifying school nurses in the school for
students/families that are under/uninsured. Utilizing existing
resources (FHC in Albion has not been used to its fullest capacity).
Greg asked what the exit dollars are. Grants are great; however,
they are not forever. What is the 3-5 year plan for the project once
the dollars have diminished/ended? He also commented that we are happy
today, at the end of the three years, where will we be and will we
sustain this?
Larry: 1) the HCAP grant team will look at existing health plans
within the community and tag-on to what already exists (exploring the
possibilities). There were definitely lessons learned from the failed
CHIPS program.
Mac: Is there anyway to guarantee that the Team Manager and
Coordinator are Calhoun County residents? How will they be hired?
Heidi: We will go through the typical county hiring procedures.
Greg: Feels that if the County is good enough to work in, it should
be good enough to live in, however, the law does not allow us to hire
specifically within Calhoun County.
All in favor. Approved the HCAP grant.
Resolution 35-2003 – Affiliation Agreement with Tenet Health
System ID, Inc. Heidi summarized that we were approached by a
nurse that would like to obtain her Public Health experience through
Calhoun County. The contract was sent to Nancy Mullett for legal
review. Nancy had several comments and suggested that Deaconess
revise. Heidi has contacted Deaconess who indicated that they will
make the suggested changes.
Mac approved. Ben seconded.
Discussion: Jean asked how long this contract would be for.
Heidi: Deaconess would like this agreement to be for three years;
however, we could make shorter or hire at our discretion.
All in favor.
Health Officer Report
Ginger Hentz, Planning and Development Director
• Grant update
Ginger summarized her report stating that most of the monies
received were continuation funds. We have about $40K pending in
outstanding grants. We have about $1M in grant requests not funded.
Approximately $130K of requested funds were continuation programs,
e.g., lead program with CDBG. The remaining $870K requested was for
new programs and new monies. Competition is greater now and we are
more proactive in seeking funds. In the past we only sought grants
that we were sure we could get.
Jean asked what the Bureau of Primary Health Care is.
Ginger explained that it is the Bureau under the Federal Government
supporting health care programs such as the NCBC, HCAP, etc.
Larry asked about the Nurse Family Partnership.
Ginger stated that it was not awarded to us. We are looking at new
ways of packaging our programs (e.g., we applying with surrounding
communities (i.e., Kalamazoo County) to serve additional numbers of
citizens and that several counties are working together for the good).
Ted Havens, EH Director
• Environmental Health report
Ted asked Paul to brief the Board on the West Nile Virus.
Paul indicated that this was a very good year for Calhoun County.
The mosquito numbers were down. Calhoun County is squeezed between two
counties in Red (high rates of WNV tested in birds and mosquitoes). We
credited this success to trapping, basins, etc. This year we only
found approximately 10 mosquitoes with West Nile Virus whereas in the
past, numbers were quite high. No individuals, pets, etc. tested
positive in Calhoun County. Next year we will copy this year’s
procedures.
Larry noted this within the State of Michigan; there were only two
positive cases.
Paul stated that their theory is: 1) Mosquitoes acquired immunity
2) The statistics for West Nile Virus in crows in Ohio are down by
90%. Mosquitoes have shifted to another quadrant within the U.S., west
of the Mississippi River. The mosquitoes that we are working to
control carry several other diseases, such as St. Louis Ensephylitis,
Eastern Equine Esephylitis, etc.).
There have been no reported cases of other diseases in Michigan
either.
Nursing Clinic of Battle Creek: Heidi passed out Lena’s
(consultant) recommendations including clinic hour reduction, staffing
changes, etc. These were presented at a meeting with Larry Anderson,
Chris Christ, Angela Graham (BCCF), Heidi, and Lena Hackett on
Wednesday, October 1st. At that meeting they discussed the PECR
(federal audit) and the primary pieces required. The understanding
after the meeting was for Chris Christ to inform Drs. Ptacin and
Collins of the recommendations and decision.
Heidi summarized the suggested NCBC governing board resolution
presented at the Thursday, October 16th NCBC Advisory Board meeting.
Heidi clearly stated that she can’t say what is behind this.
Ben: “I’m stunned.” He has the up most respect for Drs. Collins and
Ptacin; we have bent over backwards for funding, billing, etc.
although not always successful. Ben feels that they are out of line.
If a consultant is requested for assistance, then it is possible that
one may not know how operate the NCBC.
Larry: The comments by Dr. Ptacin were off-base. He had been
informed by Chris Christ following the meeting on Wednesday, October
1st. They were informed.
Mac stated that he has the highest regard for Drs. Ptacin and
Collins for what they started and have done for the community. He
feels that we have done everything we could do. Drs. Ptacin and
Collins clearly want to run the NCBC by themselves. Mac feels that we
should let them go out and be on their own per their quote “…the
future of the clinic is certain with or without federal funding.” Let
them run the Clinic if they are that deeply involved.
Jean had a similar reaction. Her feeling is that somehow this is a
problem through the Enquirer. The Enquirer has the story wrong and may
have misquoted individuals. Perhaps this issue needs clarification in
a follow-up article. Didn’t like hearing about all of this through the
paper. Jean suggested that the Health Department inform BOH members
before similar articles are published.
Heidi: The Health Department was blindsided by this. Heidi believes
that they were upset that they were not a part of the
decision/recommendations. What is most unfortunate, the consultant has
indicated that the NCBC will pass the PCER. The staff read that
article as a vote of no confidence. We are recruiting staff to come
work in this program and this article deflates the true meaning. Heidi
feels that the article was demoralizing for the staff. Due to
non-billing, the federal government does not want to pay for the care
we are providing. Per a discussion between Lena and Heidi, Lena was
unhappy with the article. As a result, Lena may consider not
contracting or be able to contract with the NCBC Board.
Larry feels that they may have a difficult time keeping the NCBC
alive without federal dollars and a billing system, which currently is
close to being put in place. Family Health Center has indicated that
they are not in a position to take on billing at the NCBC. Battle
Creek Health System indicated that they would not take-on the
responsibility of the NCBC, however, may provide some funds.
Ben: The NCBC employees are Health Department employees receiving
county benefits. How would this be implemented and how is this
feasible?
Jean: What is the NCBC Board asking us to do with this resolution?
Larry: The NCBC Advisory Board has no legal stance. They are an
advisory board that they developed. There is no legal status, we are
the responsible Board.
Heidi: They are asking us to approve the request to transfer the
authority.
Larry: Transfer of authority/approval of recommended governance
structure cannot be completed until BOH and the BOC approve the
recommended governance structure.
Greg: They are proposing to use the consultant that made the
recommendations attached. Appears that they want to operate the clinic
how they want to operate it, excluding the “strings” attached (e.g.,
federal dollars, union contract, billing, etc.).
Larry: The consultant recommendations requiring change are proposed
because the NCBC hasn’t met the Federal standards of care.
Mac: Is there a way for us to give them what they want for them to
find out how good they have it with us.
Greg: Mac’s proposal is intriguing; however, this is what you are
asking: They would be required to find health insurance, life
insurance, dental insurance, telephone system, computer system, etc.
without federal funds.
Heidi: We are looking at this as a jewel to the community not to
the Health Department.
Greg: Lena’s recommendation is giving them some of what they want.
Use Lena as a facilitator to bridge this issue. We have recognized
their concern that they would like to have some voice/say in the
matter.
Ben: The Board of Health has never received a communication
regarding suggestions, concerns, etc. from the NCBC Advisory Board.
Mac: Suggested that Heidi and Kathy provide the NCBC Advisory Board
a detailed list of the clinic operations (e.g., insurance, computers,
telephone, etc.).
Larry: Dr. Ptacin would like a “Heidi” and a “Kathy” full-time in
the NCBC. It appears that he does not understand there are funds
allocated to these positions.
Heidi: Due to staff requirements preparing for the audit, Heidi
requests a letter of confidence that the BOH is behind the NCBC staff.
Would the BOH agree to meet with the NCBC Advisory Board?
Mac moved that Larry meet with the staff at the NCBC after today’s
meeting and speak on behalf of the BOH that we are behind them. Be
honest with them and tell them that we will consider the Governing
Board but the Clinic will not end.
Greg: One of their recommendations is to continue meeting with Lena
Hacket, Larry should send a letter for the BOH proposing that the BOH
meet with the NCBC Advisory Board and discuss further options.
Jean asked if the Health Department staff were aware of this
article before it was published.
Heidi stated yes. John VanderMeer attended the NCBC meeting
Thursday, October 16th. After the NCBC meeting she met with the NCBC
staff and informed them of the article.
Kathy: The Medicaid/Medicare billing requires cooperation of the
doctors in order to bill (physicians need to code, complete paperwork,
etc.).
Heidi: Heidi spoke with Dr. Ptacin who indicated that he felt that
there was misquoting in the article on Friday.
Heidi and Larry will visit with the NCBC staff after the BOH
meeting today to boast their moral.
Greg: the BOH needs to respond to the governing issues.
Larry: The BOH will write a letter to the NCBC Advisory Board
stating that they have received their concerns/recommendations. We
will not take any action until the PCER is completed. We will work
together to resolve these issues. These issues will be handled
carefully.
Jean: Be careful what we would/would not consider.
Mac: Do not put “list of operations” in letter, just in “back
pocket” for future reference.
Kathy: Federal money is $243K and no state dollars. They raised
$130K. Motion to follow up with the Advisory Board and that Larry meet
with the NCBC staff and develop a letter to the NCBC Board.
Jean supported. All in favor.
Board Business
Ends Policies
Will be put on hold for next meeting.
Minutes Archive
Several photos included in this 
