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 Minutes Archive |
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Board of Health
Minutes
CALHOUN COUNTY BOARD OF HEALTH MEETING
190 East Michigan Avenue, Suite A-100, Battle Creek, MI 49014
July 19, 2004
MEETING MINUTES
| ATTENDEES |
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| Board of Health |
Health Department |
| Larry Anderson |
Heidi Oberlin |
| Jean Cook-Hughes |
William Burton |
| Ben Miller |
Kathy Ferguson |
| Jeff Mitchell |
Brigette Reichenbaugh |
| George Perrett |
Michele Thomas |
| Ken Ponds |
Dr. Harrington |
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| Calhoun County |
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| Greg Purcell |
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| Jim Latham |
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| Nancy Mullett |
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Larry called the meeting was called to order at 8:02 a.m. beginning
with approval of the agenda. All in favor, passed.
Larry asked for approval of the June 2004 meeting minutes. All in favor.
Passed
RESOLUTIONS
- Resolution 19-2004 Approval of Agreement with Joyce Brown,
Ph.D. (Organizational Development Solutions) to Conduct an Ongoing
Evaluation of CareSource; George moved. Jeff supported. Jean asked
William about the focus group stipends. William clarified that small
stipends could be meals or small fees, for example. Resolution passed,
6-0.
- Resolution 20-2004 Approve Vaccine Fees for PPV23 (pneumonia)
and Meningococcal Vaccines; Ben moved. Jeff seconded. Jean asked
how often the vaccines should be given. Michele answered that the
pneumonia vaccine is issued to individuals over 65 once in a lifetime.
If the individual is younger than 65 when they receive their first
vaccine, they will get it then and again at age 65. The majority of
individuals who receive this vaccine are age 50 and over with chronic
conditions. George asked about the minimal impact on the budget,
specifically the $10 administrative fee. Kathy answered that it covers
the staff and administration costs. Nancy answered that according to
the law, the $10 fee must be equal or less than cost + labor.
Therefore, we can’t provide vaccine for a profit. George suggested
that anytime we administer these vaccines, we need to do a great job
of analyzing our labor costs. He feels that in the past we have
undercharged our labor costs. We can’t afford to do this any longer.
Let’s look closely at whether or not we are covering our costs. Kathy
indicated that we are not the only organization offering this vaccine
in the county. George stated if Lifespan is also offering the vaccine,
and are costs are lower than ours, we need to be careful to not make a
profit but at the same time, cover our costs and charge a competitive
price. Larry asked if this vaccine covers all forms. Michele answered
that it does not cover all forms of pneumonia, but the majority.
Resolution passed, 6-0.
- Resolution 21-2004 Approve Vaccine Fees for the Student Health
Center at Battle Creek Central High School. Heidi stated that this
resolution is related to the need to provide these vaccines to all
families if they are willing and able to pay for it. Typically we
provided to only lower income students at no charge for the vaccine
through the Vaccine for Children (VFC) program. George asked if we
have a demand for this. Does our data suggest that the product we
purchase is all going to be used? Is anyone else providing this
besides the HD? Yes, in the private sector and Family Health Center.
George is concerned about the demand for this service. Although we are
ensuring that our marginal costs are covered, he is concerned that if
we don’t sell all the vaccine we will lose money. Heidi stated that
previously we referred students who could pay to private providers;
however, the funder stated that this is a required service during the
recent SHC audit. In order to provide primary care, as required by the
funding, we can’t parcel out specific services. Michele stated that
varicella vaccine will only be ordered one at a time when in need. For
the PPV23 there is no threat of going over. Resolution passed, 6-0.
- Resolution 22-2004 Approve TB Test Fee Increase. Kathy
stated that, again, our administrative fee is $10, and as we compared
fees with surrounding counties, they also charge $10. Jeff stated that
if we are testing individuals for private corporations (profit), can
we charge those individuals what our actual costs are? George stated
that we have a public health concern to provide services for those who
can’t afford it, however, for those who can afford to pay, profit
corporations, they should pay. The HD should not make a profit,
however, we should not lose money on our services. We should not be
charging substantially below our costs when those individuals can
afford it, e.g., for profit companies. When calculating administrative
fees, we include all direct and indirect costs. Heidi stated that when
a person is a contact to the disease, the tests are free, through the
Communicable Disease program. Resolution passed, 6-0.
MEDICAL DIRECTOR’S REPORT
Dr. Harrington reported on the jail. It was determined that things
are in order as to Health Department procedures, summarizing that the
jail’s physician is more conservative in the approach to TB treatment,
but that it’s within acceptable limits.
The West Nile Virus (WNV) remains a health concern. EH is doing a
wonderful job monitoring for WNV. There are no active cases at this
time.
George asked about those individuals that are testing positive for
TB. The majority of those cases are expatriates. When an active case is
found, if the person can’t afford the medication, we intervene. If they
have insurance, they will seek care from their individual physician. The
Health Department monitors cases that are not seen directly here. If the
INS patients are at the jail, costs are recovered. The jail bed and CMS
contracts do cover the majority of our costs for positive TB cases and
their treatment.
FINANCE REPORT
Kathy updated and reviewed the Board on the June financial
statements. There may be additional small adjustments (e.g., dental and
health insurance); however, everything is as expected. Ben asked about
the revenues, such as water tests, and influenza, how are we bringing in
so many dollars? In terms of influenza, is there a net increase in
revenue, when considering the increase in the expense line? Kathy
responded that as far as water tests re concerned, when we changed how
we charge EH fees this also changed where we account for fees. In other
words, we did not have any history on how these amounts were going to
show up in the books, so some accounts now appear to be over and some
under-budget but EH is overall coming out as expected. As far as
influenza is concerned, we have not yet received all the revenue so we
can’t tell, but we set our prices so as to break even. George asked
about our overtime costs. Heidi answered that yes, overtime has stopped.
Brigette provides updates by staff as to Compensatory Time accruals,
which were the root cause of overtime when the limits were exceeded.
OTHER BUSINESS
Health Officer’s Report:
- Minority Health Partnership (MHP) – We received a notice from the
State of Michigan that the State is not renewing our funds for MHP.
They notified us that they are not automatically renewing the current
Minority Health grants. The letter stated that a state level Health
Disparities Workgroup will be developing a strategic plan over the
next several months. Once that plan is complete, an RFP will be
developed and distributed. If the State doesn’t use the Federal MHP
monies, they lose it. According to Brenda Hunt, the Battle Creek
Community Foundation (BCCF) plans to move forward to their commitment
to move MHP here and not financially impact the County. Jeff asked if
at this point we know how long the delay will be. Heidi’s concern is
talking about the health disparities group; the track record of the
state developing a workgroup of only state employees, the plan could
be the same for all counties. This could cause difficulties because of
each county’s individual needs. Jeff stated that BCCF excess funds for
MHP would last how long? Heidi answered that we will meet with BCCF
again, but that their commitment was for 4 years. Greg asked if there
is any timeframe. Heidi answered that the indication was very vague.
There are about 10 other counties in a similar situation. George asked
when the funds are ultimately distributed, will these funds be
directed specifically to STD/HIV/teen pregnancy? If so, we may have to
direct our MHP focus to specific causes rather than the overall
mission. Nancy stated that it appears that they are placing a focus on
specific issues rather than overall Minority Health, as they did
several years ago. George asked if this changes our views at all on
MHP. Ben stated that the question would be to the BCCF, would this
impact the future commitment? Would it make more sense to commit with
the BCCF not only for our costs in the near future and protecting them
to any unnecessary costs long-term? This process is implemented
statewide, affecting the 10 counties that receive funding. Heidi will
look into specifically which 10 counties are impacted and provide the
county names to the Board. George suggested that we contact Sen. Mark
Schauer to become directly involved. Make a call to Mark Schauer to
tell him what we are facing and that we need help. This program is
critical. Have the representatives obtain some temporary resolution to
this issue.
BOARD BUSINESS
- Update on Nursing Clinic of Battle Creek (NCBC) Advisory Council
(NCAC) – Larry updated the Board on the NCAC meeting. We are moving in
the right direction. The NCAC recognizes itself an advisory council as
opposed to a governing board. The NCAC will provide advice to this
board in terms of policy and to the Health Officer in terms of
operations. The BOH’s bylaws will be revised to reflect the Board’s
relationship to both the NCBC and the Minority Health Partnership.
John Harper is the chair of the NCAC that is moving forward
positively. There is active fundraising for the NCBC and donations
would be greatly appreciated. Jean stated that grantees often look at
how much a Board gives is reflective on their giving.
- BOH Governance Update – Next month you will be receiving a
calendar with a schedule of review of our policies related to the
governance process.
Reminder to all Board members that the budget committee meeting
follows this meeting at 10:00.
Meeting adjourned at 9:20 a.m.
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Several photos included in this 
