Board of Health

Meeting Minutes from April 5, 2010

** NOT APPROVED **


The following Board Members were in attendance:  Timothy Lafever, Dr. Rajan Gulati, Dr. Leo Cusumano, and Douglas Burdick.

Medical Advisor Dr. Christopher Depner was in attendance.

Others in attendance were Lori Ballengee, Tom Hull, Laurie Hennessy and Madelyn Thornton.

Absent were Dr. Willard Simons, and Sherry Herdman.

 

Madelyn Thornton, Case Manager for Cancer Services of Allegany and Cattaraugus Counties and the Quality Assurance Coordinator for the Allegany County Department of Health was introduced to the Board of Health. 

 

The meeting was called to order by Board President Dr. Cusumano at 6:58PM.

 

A motion was made by Tim LaFever to approve the minutes from the February 5, 2010 meeting and seconded by Dr. Gulati.  Motion Carried.

 

Lori Ballengee indicated Wellsville and Scio currently have fluoridated water supplies.  It was noted this practice is really outdated.  Wellsville and Scio may be encouraged to discontinue this practice by the Board of Health.  There has been a long time debate about whether fluoridation has any real impact on improving dental health.  It was noted that fluoridation is really expensive to maintain.  The Board of Health decided to have the Allegany County Department of Health send out a survey letter to all of Dentists in Allegany County to see what their opinion is on fluoride in the water system.  Mrs. Ballengee will report on the results of this survey at the next scheduled Board of Health Meeting in June  for further discussion.

 

A copy of the Health Department’s 2009 Annual Report was given to the Board members for their review several weeks ahead of the meeting.   Lori noted over 7000 H1N1 vaccinations were given to the public last year.  Health Department staff was able to vaccinate more than double the patients with zero dollars extra paid to staff.  The public health educators played a very important role in this outcome by educating the public of the need to receive this vaccination and with public service announcements on the radio and in the newspapers regarding clinic times, sites etc.

 

 The final 2009 budget figures for the Health Department showed it as being $161,052 over budgeted revenues and $950,287 under budgeted expenses.

 

Doug Burdick questioned the difference in the figures from 2008 and 2009 in regard to the expenses for the preschool program.  Lori noted B.O.C.E.S. has been more current with their payments and submitting their rates as one possible explanation for some of these differences.

 

Lori mentioned Dr. Richard Daines, the Commissioner of Health for New York State, will be visiting the Health Department on April 8, 2010 to see if there are any questions or concerns by staff or by the Board of Health which he could address. 

 

He also will be giving our Health Department an award for administering H1N1 Influenza vaccine to county residents.  He is making a tour of all the County Health Departments in New York State.

 

Dr. Cusumano agreed to continue on as a Board of Health member for another term.  His current term expires on July 7, 2010.  Lori will present this information to the Board of Legislators for their approval.

 

Tom Hull presented information to the Board of Health on the new Tanning Regulations.  The Human Services committee chose to “opt-in” to this program during its meeting on March 3, 2010, meaning the Health Department will manage and administer this new State Sanitary Code requirement within Allegany County.  State DOH provided training for owners of facilities with tanning units will begin sometime in May or June.  There will be training for sanitarians in how to check the tanning units in accordance with code requirements, prior to full implementation of this program which is tentatively scheduled for November 2010.  Every two years the Health Department will conduct an inspection of the tanning units at a fee of $50 per unit, and a $30 facility permitting fee.  There are approximately 19 to 20 facilities in the county with tanning units, so this could mean an additional $2,500to $3000 in revenue for the Health Department every two years.    A motion was made by Tim LaFever to approve the Health Department to carry out this new program responsibility instead of State DOH.  This motion was seconded by Dr. Gulati and the motion was carried.

 

Tom Hull informed the Board of Health about the Clean Indoor Air Enforcement Action with The Herbert W. Delong Post 808 American Legion located in Belmont.  The Health Department imposed a $200.00 fine due to a complaint filed with the Health Department.  An informal hearing was held with the President and Financial Officer of the Legion to educate them on their responsibilities under the law to prevent smoking from occurring within the facility. 

 

A discussion was held in regards to the proposal of putting a water supply at the Landfill site.  A proposal has been made to move the Public Works offices located in the County Office Building to near the county landfill on county road 48, and a well would be needed to provide water for the employees. Due to fear of potential contamination of such a well by leachate from the landfill, creating possible health concerns among the county employees using this water, the sensibility of a well at this site was discussed.  Board members felt a water well in this area would not be a good idea.

 

Tom noted in a recent Human Services meeting a complaint had been made by an employee about cigarette smoke entering the building from smokers outside entranceways to the County Courthouse Building, and that this smoke was aggravating this persons allergies.   There were also 4 or 5 additional complaints received from other county employees about this same issue.  Tom asked if the Board of Health would like to set a policy on smoking by employees on the County Office Building campus.  He indicated the State of New York does not have a policy regarding smoking outside State Office Buildings that is managed by the NYS Office of Government Services.  Dr.  Depner made a motion to make the Allegany County Office Building a smoke-free campus.  This motion was seconded by Dr. Cusumano and the motion was carried.

 

Laurie Hennessy asked the Board of Health if they would approve a standing order for Allegany ARC to obtain Tubersol and syringes from the Health Department for PPD Testing at their facility.  This is a standing order that has been approved annually by the Board of Health for several years.  A motion was made by Dr. Cusumano to approve the standing order.  Dr. Gulati seconded the motion.  Motion carried.

 

Laurie reported the nurses were making baby visits from referrals by hospitals and from birth certificates.  Laurie also reported we have one TB patient who no longer is under directly observed therapy for home visits but the patient is called on a nearly (M-F) basis.  The patient’s sputum test came back negative. The patient is back to work.

 

Laurie Hennessy indicated she would like to be able to do Qauntaferon Blood Tests on TB patients.  Monroe County currently uses these tests on college students.  Generally college students from foreign countries who attend school in the United States are urged by their families to refuse treatment for TB.  By administering a Quantaferon Blood test this tells us if the patient has been exposed to TB.  Laurie will get more information from Cattaraugus County, MaryAnn Powers, whose lab performs the Quantaferon testing.

 

Laurie presented the sliding fee scale for Lead Testing.  NYS law indicates we cannot charge for patients who are at the 200% poverty level.  A motion was made by Dr. Depner to approve the sliding fee scale for Lead Testing.  The motion was seconded by Dr. Gulati and motion was carried.  Laurie has updated the policy and procedure guide for the year.  The Health Department will begin using the Lead Care II machine for testing in half day clinics.  If a reading of 8 or above then a follow-up venipuncture is recommended.  We are currently testing 50% of the eligible children in the county.  The Health Department’s goal is to reach 70% to 80% of all eligible children.  Physicians in Allegany County are doing more lead testing and WIC is also doing more Lead Testing in their clinics as well.

 

Laurie reported the Health Department can administer Hepatitis A and B at no charge for adults.  (Insurance is not a factor).  The Health Department is promoting the administration of these vaccinations and would like to give these vaccinations to restaurant workers and school employees. Laurie noted if a group of 10 or more at a site would like the vaccine, the Health department would go to the site.   Under an ARRA grant, Zostavax, TDap, HPV and Pneumovax will soon be available and can also be administered at no cost.  (Insurance is not a factor).  HPV can now be given to males.  The administration of HPV is currently being given to males and females in the Health Department’s Family Planning Clinics and immunization clinic.

 

Laurie presented to the Board of Health a contract for the Health Department to become an in-network provider with Today’s Options.  Many seniors who receive their influenza shots through the Health Department carry this insurance and this would benefit these patients as well as the Health Department.

Laurie also presented a contract from United Health Care to become an in-network provider with them.  Many of our Early Intervention children would benefit from our contracting with United Health Care.  A motion was made by Dr. Cusumano to sign the contracts with Today’s Options and United Health Care to become in-network providers with these insurance carriers.  Tim LaFever seconded the motion.  Motion carried.

 

Laurie asked the Board of Health for their approval of a policy for the receptionist to be able to hand out dental dams and condoms to patients who request them.  A motion was made by Dr. Gulati to approve the policy and have the receptionist hand out the dental dams and condoms to patients who request them.  This motion was seconded by Tim LaFever.  Motion carried.

 

Madelyn Thornton presented information on Komen Kares and indicated the Health Department just received a grant for $39,000.00. Komen Kares program assists women with breast cancer.  This program is able to assist with things such as gas cards for their trips to chemotherapy, for the purchase of prosthetic devices and wigs and assisting with co-pays.  Madelyn indicated they would be starting a support group this year. 

 

Madelyn also spoke about Cancer Services of Allegany and Cattaraugus Counties.  This program provides services for the underinsured and the uninsured.  If a patient has a positive result on a cancer screening, Cancer Services will pay for follow-up services for the patient.  Cancer Services has a recruiter who goes out and makes the public aware of services, such as health fairs etc.  Cancer Services employs a Case Manager who works with patients who have received positive screenings and helps them through the process of seeking follow-up care.  Madelyn gave each of the Board of Health Members a wooden note pad holder with the Cancer Services Program logo etched on it. 

 

Madelyn reported on what she has been working on in regards to Quality Assurance for the Health Department.  An occurrence screen was created which has a list of events.  When one of these events occurs, such as an incorrect procedure or a policy was not followed,  these events are tracked and if necessary a corrective action plan will be developed to prevent reoccurrence in the future.  She is in the process of developing a checklist for documentation of well baby/mother visits.  Madelyn is looking at standardizing packets to give to these new mothers.  Madelyn is working with Janet Norris to develop a spreadsheet for credentialing and proper documentation of physicals, PPD’s etc.

 

Laurie Hennessy stated she is adding H1N1 and Seasonal Influenza vaccinations in the NYSIIS program.  She reported a child less than 2 years of age was given the nasal influenza vaccine in error.  Patient’s parent or guardian put down the wrong date of birth on the paperwork.  All the H1N1 and seasonal flu vaccines that were uploaded to CDMS have not been put into NYSIIS by NYS.  This is now being done manually but may take several months.  There may be more errors found as these are put into NYSIIS.  Laurie reported a Medicaid billing problem.  The employee did not enter correct information which is technically considered fraud.  In six different instances this employee billed incorrectly.  Billing tasks have been relieved of this employee.  The Board fully understands the liability involved with this activity, and Dr. Cusumano recommended we use Medent for billing and will refer his representative to the Health Department.

 

With no further business to discuss, the meeting was adjourned at 8:35pm.

 

The next Board of Health Meeting is scheduled for June 7, 2010.

 

Respectfully Submitted

Janet E. Norris