MINUTES ** NOT APPROVED **
COMMITTEE/PROJECT/MEETING: Board of Health			RECORDED BY: Lynne Roeske, Secretary to Public Health Director
DATE: February 4, 2008	Called to session: 7:05pm Adjourned: 8:00pm		LOCATION: 7 Court St., Belmont Health Dept. Conf. Room		CC: Karen Wida, NYSNA Alice Alsworth, County Admin. Dr. Christopher Depner
BOH MEMBERS PRESENT: Ronald Truax, Dr. Willard Simons, Timothy LaFever, Dr. Leo Cusumano, Cathy Richmond, Medical Director Dr. Christopher Depner ABSENT: Dr. David Brubaker OTHERS PRESENT: Loreen Ballengee, Public Health Director; Thomas Hull, Deputy PHD; , Lynne Roeske, Secretary to PHD; Jean Heady, Interim DPS
NEXT MEETING: March 3, 2008
AGENDA /TOPICS		DISCUSSION		ACTION/NEXT STEPS
Ron Truax, President		Approval of Minutes		A motion was made to approve the Board of Health Minutes dated December 10, 2007 and January 7, 2008 by Tim LaFever, seconded by Dr. Cusumano, Motion Carried.
Lori M. Ballengee, MS, PHD		Over 200 Request for Proposal letters were sent to WNY Agencies who may be interested in purchasing our CHHA and LT Home Care Programs. Thirteen Agencies have requested and received the complete packet including cost reports. Some of these agencies are in the northern part of WNY and have discussed possibly putting a satellite office in Allegany County. As part of the proposal, it was requested that they address their willingness to take on staff from the Health Dept.		The deadline for returning proposals to John Margeson, County Administrator is March 1, 2008. Ron will discuss with John reviewing with a committee from the Board of Health the proposals and completing a compliance audit for each received. We will be down to seven nurses on staff by the end of February; however, per Marge Jordan from NYSDOH, we must stay open and continue to services as many clients as possible (4 visits/day per staff member).
		Lori presented the Medication Administration Policy in which there was a minor change in length of time allowed to set up medications – changed from 8 days to 15 days.		Cathy Richmond made a motion to to approve the change, Dr. Simons Seconded, Motion Carried.
AGENDA /TOPICS		DISCUSSION		ACTION/NEXT STEPS
Lori M. Ballengee, MS		Nursing Acuity Audits were done with a goal of 4 visits per nurse per day. For the week of 1/7/08, average visits/day was 2.34, with 39 hours of overtime; on 1/20/08, average visits/day was 2.78, with 48 hours of overtime.		Lori has issued a new policy that nurses can only have a maximum of two hours of overtime per day and only if their acuity is at 4 visits per day. All overtime must be preapproved. A grievance has been filed from the NYSNA union regarding this. Sixty-eight percent of the Health Dept. overtime for 2007 is from Nursing.
Jean Heady, Interim DPS		Jean distributed and reviewed the Start of Care and Comprehensive Audits, stating that these audits have improved dramatically. One of the biggest issues is the reconciliation of medications, part of the problem stems from what meds are on a referral and what meds are found in the home once a patient is discharged from a facility. Nurses are working with Primary physicians to ensure proper medications are listed and being used.		Although there are still issues on some key areas of the audits, Jean stated there has been improvement and she hopes that what the nurse have learned will be taken with them to their new jobs. We have received the Satisfaction Surveys from homecare for Oct., Nov., and Dec. and only received one that the person did not like their PCW. All others were favorable & positive.
		2006 S^2AY Policies and Procedures have been revised and were approved at the PAC meeting in January.		Ron made a motion to approve the 2006 S^2AY Policies and Procedures, Dr. Christopher Depner seconded, Motion carried.
Lori M. Ballengee, MS		A request to accept the ATUPA Grant has been approved by both the Human Services and Ways & Means Committee. Human Services Comm. wanted to ensure that the Grant did not include policing area establishments for smoking, but instead only required pursuing complaints of smoking.		Lori spoke with someone at the State and we will not be expected to police establishments for smoking taking place, however, we will be expected to follow-up on complaints. This Grant will also require us to do compliance checks for facilities that sell tobacco; so far, seven checks have been completed.
		Family Planning Grant for next year has been sent to the State. The State is pleased with the program. They have asked us to pursue getting a Nurse Practitioner on Staff. Visits are down & teen pregnancy rates are up.		We have placed an ad in the paper for a Part-time Nurse Practitioner and do have one person possibly interested. Visits may be down because college students going to family doctors instead of clinics.
AGENDA /TOPICS		DISCUSSION		ACTION/NEXT STEPS
Lori M. Ballengee, MS Board of Health Replacement		We need a replacement for Dr. Kassas’s Board position. It must be a physician.		Cathy has a person in mind and she will contact him.
Dr. Simons Cost Savings from Sale of Home Care		The Board of Legislators wanted to know how much money we will save by selling our Home Care. Lori was asked if she had these numbers yet.		Lori does not have these numbers, but will obtain them and get that information to the Board of Legislators; she did state however, that the county cost is approximately $600,000 per year.
Dr. Depner, Medical Director		Dr. Depner has requested his contract be increased from $1,000/month to $1,500/month due to the increased need at the jail.		Lori and Ron will discuss with John Margeson and Sheriff Tompkins.
Tom Hull, Deputy PHD Violation		There was a tobacco sale violation at the Alfred Uni-Mart on December 26, 2007.		The Uni-Mart has paid its fine, no further action needed.
Article 28		The Plan of Correction for Article 28 has been accepted and most of the compliances have been completed. The biggest problem was that Policy and Procedures were being followed, but they were not down on paper (i.e. who can and cannot chart in medical files), these are now in a Policy & Procedure Manual which is about 90% complete. We also have a Consulting Pharmacist who has been playing a bigger part in his role and helping us review and approve the required Drug Formulary.		The Article 28 Policy and Procedure Manual will be brought to the Board of Health next month for approval.
Loreen M. Ballengee, MS Public Health Director		Lori requested to go into Executive Session to discuss the medical, financial, credit or employment history of a particular person or corporation, or matters leading to the appointment, employment, promotion, demotion, discipline, suspension, dismissal or removal of a particular person or corporation.
		There being no further business, the Meeting was adjourned at 8:00pm