Van Buren/Cass County
District Board of Health
Minutes
10/8/08
Board Members Present: Chairperson Carl Higley Sr., Robert Morris, Don Hanson, Richard Freestone, Dwight Dyes and Cathy Goodenough.
Board Members Absent: John Tapper Sr.
Health Department Employees Present: Jeff Elliott, Dr. Rick Johansen, Chantal Wojcik, Mike Laufer, Emily Diederich, George Kilts, Mona Hale, Sue Bailey and Tina Cox.
Others: Judith & Ron Schincariol
Corrections to September minutes. Estimated expenditures were $432,919.04. Actual expenditures were $444,517.15. Difference of $11,598.11. Difference due to: Utilities, Dentist Productivity, consulting, Electrical work on the Dowagiac Building, Substance Abuse Certifications, Waste Removal, telephone charges and payroll. Motion by Freestone, 2nd by Goodenough to accept the minutes as corrected. All voting yes, motion carried.
Jeff asked for the board permission to change the agenda to allow Emily to give a brief review of the health department’s web site. Permission granted. Emily handed out postcards to all board members with the web address, she then briefly reviewed how to access and maneuver through the site. She informed the board that the site is updated regularly.
Chairperson Higley and Vice-Chairperson Morris acknowledged Judith Schincariol for her 30 plus years of service as a member to the Board of Health by giving her a certificate of appreciation and a gift card. Pictures were taken to be sent to the local newspaper.
Cash flow analysis for both counties was discussed and reviewed. Jeff reminded the board that this is the beginning of a new fiscal year. AGENCY SUPPORT: Jeff explained that appropriations from Cass are received annually and appropriations from Van Buren are quarterly. Jeff informed the board that the health department received recognition for the Director’s Award, 3rd time in a row! This time for the New Directions Program. A presentation will be held in Kalamazoo on Wednesday, October 15th from 5-6:30 pm at the Radisson. Jeff requested that the Commissioners that sit on the Board of Health accompany him for the award presentation. A certificate will be awarded with a check for $3,000 which can be used however the board wants. DENTAL: Jeff reported that Medicaid money is being received on a more regular basis than before.
Expenditure report for both counties was reviewed. Jeff informed the board that the Workers Compensation Premium is a quarterly payment. Also discussed dental lab fees and how building our own dental lab will cut costs considerably. Jeff explained that dental laboratories do not have to be certified in the State of Michigan. Other expenses reviewed were; Global Solutions, food licenses, Special Needs/Women’s and families program for Substance Abuse, Dowagiac building lease. Motion by Morris, 2nd by Dyes to accept vouchers 1 and 2 in the estimated amount of $537,246.60 for payment. All voting yes, motion carried.
Administrative Report: Each board member was given a copy of a response letter to Gloria Hynes indicating that no wrong doing had taken place.
Nursing Activities Report for September for Van Buren. COMMUNICABLE DISEASE: 31 animal bites were reported. There was 1 Camphylobacter, 2 Hepatitis B, 3 Chronic Hepatitis C and 1 Shigellosis. IMMUNIZATION CLINIC: Hartford: There were 23 new clinic clients and 18 revisits. Paw Paw: There were 2 new clinic clients and 5 revisits. CSHCS: Four (4) care plans were done in person. Seven (7) nursing family assessments were done in the client’s home. Five (5) diagnostics were issued. There are 318 active cases with 67 pending. STD/HIV: There were 32 total STD clinic visits and 32 received STD testing and/or treatment. 25 STD/HIV partner notification interviews were conducted. There were 4 Gonorrhea and 11 Chlamydia reported by private clinics. There were 2 Gonorrhea and 13 Chlamydia reported by the health department. There were 20 for HIV/AIDS counseling and/or testing. There were 18 for HIV/AIDS post test counseling. 117 received education on an individual basis. HIV CASE MANAGEMENT: There are currently 91 individuals with HIV/AIDS.
Nursing Activities for September for Cass. COMMUNICABLE DISEASES: There was 1 Chicken Pox, 1 Hepatitis, 3 Chronic Hepatitis C, 2 Aseptic Meningitis and 1 Salmonellosis. IMMUNIZATION CLINIC: Dowagiac: There were 8 new clients and 8 revisits. Cassopolis: There were 12 new clients and 18 revisits. CSHCS: Six (6) care plans were completed in person. There are 274 active cases with 3 pending. STD/HIV: There were 32 total STD clinic visits and 32 received testing and/or treatment. 13 STD/HIV partner notification interviews were conducted. There were 5 Chlamydia reported by the health department. There were 2 gonorrhea and 7 Chlamydia reported by private clinics. There were 30 for HIV/AIDS counseling and/or testing. There were 30 for HIV/AIDS post test counseling. 78 received HIV/AIDS education individually. HIV CASE MANAGEMENT: There are currently 26 individuals with HIV/AIDS.
These statistics were discussed and reviewed with Susie informing the board on a positive rabid bat in Van Buren County.
Sue reported that flu clinic schedules have been sent to the media and staff busy making appointments. A copy of the flu clinics for both counties was distributed to the board to use in case constituents contacted them. Sue also gave each board member a copy of the 2008 master flu clinic schedule which indicated the number of private clinics held throughout both counties at various agencies, as well as those clinics that still need to be scheduled.
Sue updated the board on a recent MRSA rumor in Gobles involving the football team. She stated there has been no confirmed MRSA case. The school had contacted the health department requesting direction and sent a letter home to parents. The health department has provided Gobles schools with educational material, and Bronson plans to have their Infection Disease Director to address parents, school staff and students at an upcoming meeting.
Jeff requested the board to adjust Susan Oosterwal, STD/HIV Supervisor’s salary. He explained that the health department has not been able to fine someone to fill a vacancy in the STD/HIV department and Susan has been working nights and weekends to assure required activities are completed. Jeff stated that it has been difficult finding qualified individuals to fill other vacancies. This was discussed and reviewed. Motion by Morris, 2nd by Freestone to adjust Susan’s salary as requested, to be effective October 16, 2008. All voting yes, motion carried.
Medical Director’s Report: Dr. Johansen informed the board that no new cases from the national Salmonella outbreak that involved peppers and cilantro have been reported. He did however report on a recent outbreak of E-Coli 157 in Michigan that involved Aunt Mid’s shredded lettuce that affected over 60 people, including some people in Ohio.
Dr. Johansen reported that the strain of flu in the flu vaccine has been a good match to the strains that are currently being reported.
A copy of an employee newsletter was also distributed to each board member.
Reproductive Health Statistical Report for September. FAMILY PLANNING: Hartford: 67 clients were seen; 14 for refills, 19 for medical revisits, 20 for annuals and 14 for initials. 67 clients received education. Paw Paw: 32 clients were seen; 6 for refills, 5 for medical revisits, 11 for annuals and 10 for initials. 32 clients received education. Cassopolis: 36 clients were seen, 10 for refills, 15 for medical revisits, 6 for annuals and 5 for initials. 36 clients received education. Dowagiac: 34 clients were seen, 3 for refills, 16 for medical revisits, 14 for annuals and 1 for initials. 35 clients received education. 30% of all new clients seen were teens, ages 14 through 17 and 19. Others seen were between 20-46 years of age. TEEN PREGNANCY: Van Buren: 25 clients received a UCG (pregnancy) test and 3 tested positive. None of the positives were teens. There is a 0% positive teen pregnancy rate. Cass: 19 clients received a UCG test and 8 tested positive, one of those testing positive was a teen, age 18. There is a 13% positive teen pregnancy rate. All other positives were between 21-30 years of age. SEXUALLY TRANSMITTED DISEASES: Van Buren: 1 Gonorrhea and 17 Chlamydia tests were given. Zero tested positive for Gonorrhea or Chlamydia. There is a 0% positive Gonorrhea & Chlamydia rate. Cass: 2 Gonorrhea and 14 Chlamydia tests were given. Zero tested positive for Gonorrhea and one (1) tested positive for Chlamydia. None of the positives were teens. There is a 0% positive Gonorrhea rate and 7% positive Chlamydia rate. CLINICS SCHEDULED: 20 clinics were scheduled, 18 medical and 2 non-medical. There were 251 possible appointments, 209 appointments were scheduled and 168 appointments were kept. There was a 83% scheduling rate and 80% show rate. CONTRACT COMPLIANCE: Total projected users are 1100 and 1445 have been seen to date, at 131% compliance. Projected Title X is 800 and 1167 have been seen to date, at 146% compliance. Projected Plan First is 300 and 278 have been seen to date, at 93% in compliance. REFERRALS PROGRAM: 4 clients were referred to the STD-HIV Program and 1 to Immunizations. REFERRALS SERVICES: 10 referrals were made to PNC, 9 to MSSP, 10 to WIC, 9 to DHS (FIA), 1 for medical, 8 BCCP-RFC, 7 for Mammograms, 3 for sterilizations and 1 for Breast follow-up.
These statistics were discussed and reviewed with Mona reporting that they have already met their compliance level but will continue to provide services. Currently working on their report for 2009, will present at the November board meeting for their approval. She also thanked Judy for her many years of service on the board.
Dental Report: An YTD (year to date) Practice Analysis report was distributed to the board for their review. Number of active clients to date is 9,084. Over $1 million has been billed year to date. Jeff reported that another dentist has been hired and will be working Fridays only until he is able to sell his practice. He also informed the board that an open house directed to new dental graduates will be held in Novi and a representative from Patterson has agreed to take our information there to distribute instead of going himself. Jeff also reported that Dr. Chung plans to leave sometime in November to open his own practice and another dentist will need to be hired to fill this vacancy.
Environmental Health Report: Statistics were discussed and reviewed with Mike reported that they are currently finished with long term ground water monitoring and septic haulers.
Mike informed the board on a recent problem involving a subdivision in Cass County called “Sunset Gardens”. It appears that over 3 years ago a previous sanitarian had approved this area for septic and wells based on the approval from the owner’s consultant instead of doing a soil sample himself. Recently, Bill Singler, Sanitarian from Cass went to this site and found the area to be unacceptable due to a high water table and has denied their permits. As a result, someone from DEQ has been contacted and requested to look at the site to see what can be done. DEQ will be visiting this site on October 28th. Jeff requested Mike and Chairperson Higley also be at the site on October 28th. This was discussed and reviewed.
Substance Abuse Report for September: REFERRALS: 43 referrals were received; 22 from court, 2 from New Directions, 2 from SARF, 5 from DHS, 2 from Community Mental Health, 7 self referred and 1 from another source. OUTPATIENT INDIVIDUAL APPOINTMENTS: 272 total individual sessions were scheduled; 185 in Paw Paw and 85 in Hartford. There were 154 individual sessions held; 109 in Paw Paw and 45 in Hartford. 17 sessions cancelled by staff; 15 in Paw Paw and 2 in Hartford. 41 sessions cancelled by the client; 21 in Paw Paw and 20 in Hartford. There were 60 no shows; 40 in Paw Paw and 20 in Hartford. GROUP SESSIONS: 57 units of services were produced. SARF: Screenings: 19 sessions were scheduled, 12 attended sessions, 2 sessions were cancelled and 5 no shows. DLAD: 6 sessions were scheduled, 3 sessions were attended, 1 session was cancelled and 2 no shows. Show rate is 60%.
August statistics were also available for the board’s review.
The status of the Van Buren County Drug Court was discussed and reviewed with Jeff stating he believed this program to be a duplicate program of New Directions. Jeff explained that the drug court has been in existence for 9 months and only has 3 individuals, which are also enrolled in the New Directions and is now requesting over $450,000. This was discussed and reviewed. Jeff stated that Van Buren’s Drug Court keeps referring to Kalamazoo’s successful drug court but neglects to remember that Kalamazoo has more foundation money and does not ask the county for funds; Van Buren does not have that luxury. Jeff was adamant about not being the service provider and will inform the commissioners of this at tomorrow’s meeting.
Other Business: A letter from Van Buren County Sheriff Gribler and Alain Svilpe, Director of Van Buren County's Office of Domestic Preparedness, was distributed to the board for their review. This letter thanks Sue Bailey and her staff for participating in the Palisades exercise drill for 2008. The Federal Emergency Management Agency/Homeland Security Doctorate gave the health department top marks after completing all necessary objectives. A news article regarding this was also distributed.
Morris also thanked Mike for his recent correspondence regarding an appeal. He stated that the letter was well written and showed the professionalism of the environmental office.
Motion by Morris, 2nd by Goodenough to adjourn. The next District Board of Health meeting is scheduled for Wednesday, November 12th at 4:00 p.m. at the public health department facility in Cassopolis.
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District Board of Health