Board of Health

Meeting Minutes from 08/03/2009

** NOT APPROVED **

Board Members attending:  Dr. Cusumano, Sherry Herdman, Dr. Gulati, and Ron Truax. 

 

Board Members absent:  Dr. Simons and Timothy Lafever.

 

Others present:  Dr.  Depner, Medical Director, Lori Ballengee, Tom Hull, Laurie Hennessy.

 

The meeting was called to order at 7:05pm by Ron Truax.

 

Approval of Minutes

Minutes were approved by a motion made by Sherry Herdman and seconded by Dr. Cusumano .  Motion carried.

 

Immunization State Review

Our immunization program has recently undergone some changes.  The Health Department takes patients by appointment only for immunizations.  At the time a patient schedules an appointment for an immunization, we also ask for their shot record and date of birth.  Before the patient arrives for their appointment, we are able to check the NYSIIS program and see what immunizations are needed for that patient.  These new changes for the immunization program are working well.  We had an AFIX review which was conducted by the State which awarded us an excellent review.  Our immunization program has increased in immunizations since last year.  Last year at this time we had given 127 immunizations and currently for 2009 we have given 155 immunizations.  During our review by the State which followed ACIP guidelines our medication refrigerator was checked for appropriate temperature.  The State was so impressed by our immunization program and the changes that we have implemented that they are telling other counties about our changes in our immunization program. 

We utilize the VFC vaccine which is given to uninsured or underinsured patients under the age of 19.  Lori Ballengee and Laurie Hennessy applied for a $20,000.00 grant to for the immunization program.  This grant money can be used to purchase additional vaccine such as Tdap and Zostavax (Shingles) for adults.  Laurie Hennessy presented the sliding fee scale to be used in the immunization program.  Many adults come to the clinic in need of vaccinations for a new job or enrollment in college.  The public will be asked to bring in a month’s worth of paystubs and the total will be used to determine where the patient would fall on the sliding fee scale.  Adults would be encouraged to apply for Medicaid if eligible. 

A conditional approval was given for the immunization sliding fee scale, policies and procedures with a motion made by Dr. Gulati and seconded by Dr. Cusumano .  Motion carried.

Laurie Hennessy reported that she is working hard to promote the Gardasil vaccine on the local college campuses. 

 

Mercy Flight Donation

The Health Department has donated monies to Mercy Flight for the past several years.  Lori Ballengee received a copy of the report from Mercy Flight which indicated Allegany County doesn’t utilize Mercy Flight.  So Lori called Mercy Flight and they reported 188 calls from Allegany County in 2009.  A representative from Mercy Flight will contact Lori Ballengee with more accurate figures.  It was stated by Lori she just wants to justify the donation to Mercy Flight.  Dr Depner indicated it would be money well spent. 

 

Estelle Clark Retirement

Estelle Clark, Public Health Nurse, retired from the Allegany County Health Department in June.  Interviews are being conducted to find a suitable replacement.  The person who will hold this position will work 95% of his/her time in Family Planning and the other 5% will be dedicated to Flu Clinics.

 

Home Care Update

There is very little billing left to do for the Certified Home Care program since its sale to WillCare.

The balance will be sold to Willcare so that they may do follow-up on collection of fees due. 

 

Lead Update

The Health Department is currently managing 3 cases of elevated blood lead levels.  One case is an elevated blood lead level in a pregnant patient’s umbilical cord with a level of 14 and the baby at 1 year old had an elevated blood lead level of 22.  A home visit was made giving the new mother nutrition and educational guidance to assist in lowering the blood lead levels.  Laurie Hennessy presented a sliding fee scale for Lead testing which will be used at all clinic sites.  All blood tests for lead are entered into ECLARS and also recorded on a card and given to the patient for their records.  A blood lead level of 8 in the Lead Care 2 program will require a follow-up venipuncture for the patient.  Steve Chaffee has been busy testing patients in Cattaraugus County for elevated blood lead levels.  The budget is set for $3,000.00 for Cattaraugus County and he will soon reach that amount.  Cattaraugus County will use up their budget for the Lead program soon.  A motion was made by Dr. Gulati and seconded by Dr. Cusumano to give conditional approval for the sliding fee scale and policies and procedures for the Lead Care 2 program.  Motion carried.

 

LHCSA Update

Several newborn referrals have been made.  Chart audits were done on these charts.  It was determined that new forms need to be added after the chart audit was performed.  Nutrition teaching should have an assessment audit.  The staff is improving service and informing physicians of their findings.

 

Blood Pressure clinics have been conducted at all of the Senior Luncheon sites.  At the end of May 108 seniors had their blood pressure checked.  In June 2009, 89 seniors had their blood pressure checked.

10% of the clients who had their blood pressure checked were referred to their physician for follow-up.

 

Laurie Hennessy indicated requests have been made by the public to the Health Department to purchase pneumovax vaccine. 

 

Swine Flu (H1N1) Update

Allegany County has confirmed one case of Swine Flu (H1N1) in Allegany County.  This patient has fully recovered from this illness.  There are currently 2 pending cases in Allegany County.  In the fall, clinics will be scheduled for the public to receive (regular) flu shots as well as a series of two Swine flu shots.

 

Accident/Incident Reports, Satisfaction Surveys

Laurie Hennessy reported seven children had been given an additional Tdap vaccination due to a physician’s office delaying the entry of immunizations given to these children into the NYSIIS program.  The physician’s office has remedied this situation. 

 

Satisfaction survey reports were distributed to members from patients who received care through the Health Departments Home Care program for the months of February, March, April and May.  Lori Ballengee reported Altreya recommends the Health Department uses surveys at all of our public health programs to help us review our programs and make any necessary improvements.

 

Board of Health Meeting Frequency

Lori reported other boards throughout the state meet less often.  Since we no longer have the homecare division there is less business to discuss at Board of Health meetings.  A special meeting can be called between regularly scheduled meetings if the need arises.  A motion was made to change the meeting frequency from every month to every other month by Dr. Gulati and seconded by Sherry Herdman.  Motion carried.

 

Environmental Health Updates

Tom Hull reported Erie and Niagara Counties have seen an increase in rabies so far this year, and the number of people going through post exposure treatment has been higher than expected.  To date, for Allegany County, the incidence of rabies has been average with no unusual increase in the number of people going through rabies post-exposure treatment. 

 

Tom Hull reviewed the situation at the Country Estates Mobile Home Park.  The foreclosure attorney is actively working on the case.  The grounds are being kept up.  Jamie Herman from the New York Rural Water Association has agreed to serve as the required Certified Water Operator for the park, to resolve this outstanding problem.

 

Tom reported there are 6 sites in Patton’s Mobile Home Park, which is also part of a pending foreclosure action.  Of the six park sites, only 3 are active at this time and as a result the Health Department has no real regulatory responsibility under the State Sanitary Code.  Five Star Bank is involved in the foreclosure action and it appears they may simply walk-away from their losses and let the park go up for taxes.

 

Simon Halliday, who was the proposed “builder” with respect to the development of the Six S/Waterways resort, has left the area and is no longer involved in this project.  Roy Sawyers (CEO) and Richard Patton (CFO) of the Sawyer group are now the primary points of contact to the Health Department and NYSDEC in development of the resort.  Currently permits are being issued for this project.  Senator Catherine Young is apparently getting involved in this project to help the Sawyers Group and NYSDEC have a better working relationship to hopefully facilitate the development of the project.

 

The current Bioterrorism grant will expire on the 9th of August 2009.  There is supposedly $47,000.00 in grant money  to fund this program for the 2009-2010 Grant Year but nothing definitive on this issue has been forthcoming to date. The issue at hand is whether there will be funding available to keep a Cornell Cooperative Extension contract employee working in this program, in both the near and far terms. 

 

Tom asked the Board of Health for guidance in relation to the “Hume-Sanford Water Supply.”  There are 37 property owners and they each own 1/37th interest in the deed on the water system.  The Public Service Commission considers this to be a “Homeowner’s Association” owned and operated public water supply, although they have/know little direct information on how the system operates, and there is no rate structure in place. 

 

There is also no formal Homeowner’s Association (no officers, no board of directors, etc. so other than a non-responsive Certified Water Operator, the question of importance to the Health Department is who to send violation notices to for corrective action, for a system that has multiple violations that have gone unaddressed.  The State DOH indicated we should send out violation notices to all 37 property owners.  Ron Truax asked if it could be condemned.  Tom Hull replied there are avenues to take to attempt to bring about compliance with violations, but that this would seem to be a long, arduous process given the ownership situation with the water system. Ron Truax suggested Tom consult with the County Attorney as to what direction to follow to address these concerns.

 

Condom distribution in Bars in Allegany County

The public health educator would like to offer condoms placed in a basket in the bathrooms of Allegany County bars.  Several voiced concern about having baskets of condoms which could be tampered with.  It was determined that this was not a good idea unless they were placed in some type of machine.

 

A motion was made to adjourn the meeting at 8:10pm by Dr. Gulati and seconded by Sherry Herdman Motion carried.

 

The next Board of Health meeting is scheduled for October 5, 2009 at 7:00pm.

 

 

Respectfully submitted,

Janet Norris