Board of Health Minutes – 2/1/2010

** NOT APPROVED **

Board of Health

Meeting Minutes from

February 1, 2010

 

The following members of the Board of Health were present:

Timothy LaFever, Dr. Willard Simons, Sherry Herdman, Dr. Leo Cusumano, and Douglas Burdick. Allegany County Department of Health Medical Director Dr. Christopher Depner was present.

Others present were Lori Ballengee, Public Health Director, Thomas Hull, Deputy Public Health Director and Laurie Hennessy, Director of Patient Services.

 

The meeting was brought to order at 7:03pm by Lori Ballengee.  Lori announced to the Board Members since Ron Truax did not run again for reelection as a legislator we needed to fill his position as Board of Health President until July.  A motion was made by Sherry Herdman to nominate Dr. Cusumano as President of the Board of Health and this motion was seconded by Tim LaFever.  Motion was carried.  Dr. Cusumano will fill seat of Ron Truax as President of the Board of Health until July 2010.

 

A motion was made by Tim LaFever to nominate Sherry Herdman as Vice President of the Board of Health.  This motion was seconded by Willard Simons.  Motion Carried.  Sherry Herdman was elected as Vice President until July 2010. 

 

The minutes from the October 5, 2009 meeting were approved with a motion from Tim LaFever and seconded by Willard Simons.  Motion Carried.

 

Lori Ballengee commented on the staffing changes recommended by Altreya.  They recommended the Health Department capitalize on skills of the employees.  All the program staff and managers of the Health Department are being offered classes in Excel, Word, Power Point and Publisher.  Employees are encouraged to think more about how money is spent in the department, how to be more economical in their spending and how to maximize efficiency.

 

Lori reported the Health Department has been given the OK by Human Services to create a Public Health Technician Position and the Environmental Secretary position has been abolished.  This will only cost the Health Department $100.00 more per year.  The newly created position will be of great help to the Sanitarians since the person who will hold the Public Health Technician position will be able to go out and do some of the testing which is required of the Environmental Division; it will also generate some revenue.

 

The Public Health Educator position still needs to go to Ways and Means for approval. 

 

The Health Department is moving forward with the recommendations made by Altreya and moving ahead with more programming staff versus clerical staff.  The 2009 budget was projected to be about $550,000 under budget as of October, 2009.  The Health Department is generating more revenue than is budgeted and the services have not decreased with fewer staff meeting the program expectations.

 

The Annual Report was not ready for presentation to the Board of Health so discussion was tabled until the April Board of Health meeting.  The Annual Report will be emailed to Board of Health members for their review before the next Board of Health Meeting scheduled for April 5, 2010. 

 

Thomas Hull gave an update to the Board of Health on the Country Estates Mobile Home Park and Patton’s Mobile Home Park.  Both properties are in foreclosure with minimum involvement from the Health Department. First Citizen’s Bank (Mansfield, PA & Wellsville, NY branches) is involved the foreclosure for Patton’s MHP.   Only 3 Trailers are occupied at the current time so there is not much jurisdictionally the Health Department is responsible for.  However, the Health Department is continuing to take water samples required under Subpart 5-1 of the New York State Sanitary Code (NYSSC), and any problems that come to the Health Department’s attention concerning that MHP are referred to the bank for action, as needed.   Bayview Loan Servicing of Coral Gables, FL, is involved in the foreclosure on Country Estates MHP.  The Health Department has ensured that a certified water operator (Dan Gardner from Wellsville) is overseeing the operation and maintenance of the water system serving that MHP.  The Health Department also continues to take water samples required under NYSSC Subpart 5-1, still inspects the MHP for compliance with NYSSC Part 17 regulations, and reports problems needing correction to the “Receiver” in the foreclosure action, an attorney (Susan Duke) with an office in Lakeville, NY.  General maintenance of the park has been adequate since Ms. Duke was named “Receiver”; however, continued maintenance will likely depend on how much money Bayview Loan Servicing is willing to put into the MHP to sustain its financial interest prior to the time an acceptable offer for the MHP is brought to them.  It would not be surprising if either or both lending institutions walk away from the parks at some point to cut their losses, at which point the parks would likely fall into county possession pending a tax sale.   It may become necessary at some point for the Board of Health to intervene and order closure of the MHP and removal of the tenants if their safety becomes compromised due to deterioration of the parks due to lack of oversight and maintenance. 

 

Laurie Hennessy reported to the Board of Health she revised both of the Policy and Procedure manuals for LHCSA (Licensed Health Care Services Agency) and Immunization.

 

The Allegany County Department of Health has given and/or distributed over 10,000 doses of H1N1 and seasonal flu vaccine.  The Health Department continues to hold nearly daily clinics.  The Health Department has held 3 large P.O.D.’S (Point of Distribution) which were very well attended.  Residents are still making appointments at our immunization clinics.  Laurie reported our November POD vaccinated over 1400 people that were given 1600 vaccinations for H1N1 and Seasonal Flu.  35 to 40 volunteers assisted 5 Health Department employees in the delivery of the vaccine to residents.  Genesee Valley Central School generously donated their site for the P.O.D.  Holding this P.O.D. helped us keep up with the demand for the H1N1 and Seasonal Flu vaccine.  The H1N1 and seasonal flu vaccine is still being offered at our Walk-in-Clinics and at the Senior Luncheon Blood Pressure Clinics.  The Health Department is currently using Family Planning work sites for Walk-in-Clinics to offer H1N1 and Seasonal Flu Vaccine to the residents of Allegany County.  WIC Clinic sites are also offering H1N1 and Seasonal Flu Vaccine to residents.

 

Laurie Hennessy gave updates on LHCSA.  LHCSA will officially be 1 year old in March.  The Health Department has removed Medical Social Worker and Nutritionist from our LHCSA due to the fact that we are unable to be paid for these services and we are able to refer anyone who needs them elsewhere.

 

Statistics on Well-baby visits have improved dramatically.  87% is the lowest result on the last audit collation upon chart review.   If more than one visit is needed, the Health Department will refer them on to a Home Care agency.  Referrals for well-baby visits are received from doctors and hospitals who want the Health Department to follow-up with new parents.  Laurie indicated there is a policy change to well-baby visits, attempt to contact the family will be made within 7 days of referral receipt and visit made upon the convenience of the family 

 

Currently the Health Department has one D.O.T. (Directly Observed Therapy) patient.  The patient is to be seen for 8 weeks everyday Monday through Friday.  This patient wants to be off therapy.  The nurse who goes out to see this patient makes sure the patient takes his/her medications and answers any questions they may have.  Patient was seen Monday through Friday for the first 4 weeks then returned to work.  Patient is called daily to see if he/she is working or home and if a visit is accepted.  New York State representative is aware as is MD.

 

The Health Department currently has three Latent TB patients.  Each one is seen 1 time a month.

Laurie reported on the Lead program.  The Health Department is currently sending out information to daycares and parents for education about Lead Poisoning Prevention.  The Public Health Nurse is going out to the Day Care Centers in Allegany County and providing education to children and caregivers about Lead Poisoning Prevention.  The Health Department currently has 3 cases they are following with the highest BLL (Blood Lead Level) being 22.  In one of these cases the parents feel they have done sufficient remodeling to lower the risk of lead poisoning.  The Health Department has a Lead Care II machine to test children for Lead Poisoning.  The CLIA waiver came back with lead testing on it, but the Health Department has not received word that the policies and procedures are approved for testing as yet.

 

The policy and procedures have been reviewed for the Immunization Program.  The payment procedure was adopted.  The payment procedure makes the program a bit less cumbersome.  Fees for immunizations were reviewed and changed as necessary.  The immunization program bills any insurance with the exception of Medicaid. Medicaid is not being billed at this time as there are issues with the billing.  A motion was made to approve the immunization payment procedure as presented by Dr. Simons and seconded by Dr. Depner. Motion carried. Both LHCSA and Immunization policy and procedure changes were adopted and approved changes/amendments to written policies by a motion by Dr. Simons and seconded by Dr. Depner.  Motion carried.

 

The Family Planning Sliding Fee Scale was presented to the Board of Health.  A motion was made by Dr. Simons to approve the Family Planning Sliding Fee Scale and Dr. Depner seconded that motion.  Motion Carried.  Laurie stressed the importance of maximizing revenue in the Family Planning Program.  The Health Department does bill Medicaid in the Family Planning Program.  The medication pricing was reviewed and changed to reflect current costs.  If the patient who comes to a family planning clinic does not have insurance, they are referred to facilitated enrollment. Patients are encouraged to receive adult immunizations at the Family Planning Clinics.

 

Laurie mentioned she had spoken to Craig Braack about the shredding of documents by the company in Elmira.  The individual date must be written on the box to be destroyed.  The company in Elmira gave the county a less expensive bid than a local company which is located in between Allentown and Bolivar.

Laurie gave the annual report on the individually identifying health information storage and disposal.  Craig Braack, County’s Records Management Officer, verified storage is in a secure area, password protected, only available to authorized Health Department staff.  The disposal procedure is shredding and a record of Health information will be developed and retained indefinitely. 

 

Laurie reported our immunization rate is very high compared with other counties.  Clinics are being held until 5:30pm and for the most part nurses are flexing their day to work these clinics.  Laurie noted that 4000 doses of seasonal flu vaccine have been ordered for next year.

 

Laurie reviewed the 2009 accident incident log with the Board of Health members.  She indicated 3 medication errors occurred at Genesee Valley Central School during the clinic.  One incident in a regular clinic occurred where a man ran into a door and fell down.  VARS report indicates both H1N1 and Seasonal Flu vaccine (both inactivated vaccine) were administered to a patient with the patient waking up the next morning unable to move their limbs and incontinent.  The patient is now reported to be just fine.  The one patient at a POD had numbness and was sent to the emergency room via ambulance.  Laurie submitted a VARS report.  In a regular clinic a child was given Adult Hepatitis A instead of Pediatric Hepatitis A.  Child is fine.  Both primary care physician and mother were informed.

The next meeting has been scheduled for April 5, 2010 at 7:00pm.

 

Being no further business to come before the board, a motion was made by Tim LaFever to adjourn the meeting and seconded by Doug Burdick.  The meeting was adjourned at 8:13pm.

 

Respectfully submitted,

Janet Norris

Confidential Secretary