DRAFT

Michigan Association of Local Public Health

Nurse Administrators Forum

NURSE ADMINISTRATOR’S FORUM

Meeting Minutes

Tuesday, June 11, 2013

9:30 am - 12:30 pm

Location: MPHI, Okemos, MI

1. Call to Order: The meeting was called to order by Bobby Peacock at9:33 am.

2. Roll Call: Angelique Joynes, June Gillespie, Kathleen Janer, Debbie Aldridge, Jo Ann Wilczynski, Michelle Thorne, Renee Crays, Debbie Poquette, Joyce Zigler, Ann Marie Young, Mitzi Koroleski, Regina Traylor, Sarah Bryant, JoAnne Eakins, Mary Ricciardello, Lynne Norman, Bobby Peacock (Chair),JoAnn Hoganson, Joyce Baron, Elaine Brown,Pat Fralick,Lynn McDaniels (Secretary), Lisa Hahn,Sue Schryber, Courtney Herrick (Guest), Catherine Oliver, Mary Roman (Guest).

Lori Barnes, supervisor at CadillacMercyHospital and baccalaureate student at DavenportUniversity, attended as a guest of Ann Marie Young.

3. Administrative Items

A. Approval of the Agenda: Motion by Mary Ricciardello, support by JoAnne Eakinsto accept the agenda as proposed.

B. Approval of the Minutes: Motion byAnn Marie Young, support by Joanne Eakins, to approve the May 14, 2013 minutes. Motion approved.

C. Treasurer’s Report: Report submitted by Ann Hepfer by email. Motion to receive the May report made by Joanne Eakins and supported by Ann Marie Young.

D. Chair’s Report:

  1. May 13, 2013 MALPH Board Items - MDCH has embarked on a process to look at issues involving getting credit in Michigan’s accreditation process for undergoing the national voluntary accreditation process. The Environmental Health director’s forum will provide recommendations to MAPH, LARA and DEQ regarding issues concerning water supply and sewer systems in mobile home parks. Legislation is being proposed to allow restaurant patrons to bring their dogs into the patio seating area; PH issues include animals defecating and urinating, people with asthma, dog bites, impact on LHDs. The Board will take a formal position on this at the June meeting. MDARD has offered to provide customer service training for LHDs. A House Health Policy committee meeting for testimony on expedited partner therapy legislation is scheduled for May 21, 2013. The Michigan Consumers for Healthcare is applying for navigator dollars and does not see Public Health as a logical partner, M. Swain will follow up. Hearings are being held on Medicaid expansion legislation. The MDCH Office of Public Health Preparedness has invited all Health officers to participate in the May 20, 2013 state/local workgroup meeting to talk about funding formulas.The Governance Committee has been working on updating the operations manual, revised manual is being presented to the board for review and will be voted on at the June meeting. Mark Miller introduced Dr. Davis as the state’s new chief medical executive; he will work with MDCH on a part-time basis. Dr. Davis understands the importance of educating legislators on the value of public health. His priorities are the infant mortality plan, integrating public health and primary care and promoting access to high-quality care. MDARD is developing a training curriculum for restaurants that do specialized processing, working on issues involving the dogs on patios legislation, and revamping the onsite water and wastewater request review form. DEQ – A pilot program for medical waste facility inspections is being developed; nine agencies to be funded. MDCH – Lynda Zeller is the Deputy Director of Behavioral Health and Developmental Disabilities Administration. By October 1, 2014 all coordinating agencies need to have a plan forintegrating substance abuse and mentalhealth funding and management streams. Joel Strasz was introduced as the BayCounty interim health officer.
  2. June 10 2013 MALPH Board Meeting Items – Strategic planning session scheduled for Fall. Adam London introduced as new health officer for KentCounty. Steve Fitton will be invited to a future board meeting to discuss Medicaid expansion and how it might affect cost-based reimbursement. MALPH received MDCH funding to award mini-grants to LHDs for promoting county health rankings among businesses. Legislation for expedited partner therapy has passed the House Health Policy Committee. Legislation has been introduced to change the immunization schedule from 6th to 7th grade. Community Linkages/State Innovation Update – The State Innovation Model (SIM) project will develop future service delivery models with accountability, person, family and community-centeredness,a focus on prevention, wellness and development, systemwide linkages, community integration, evidence based and payment for value. The SIM team has developed six goals regarding strengthening the primary care infrastructure, coordinated care, improving population health, improving systems of care, reducing administrative complexity, and healthcare costs. The team membership is broad based, includes all facets of the health care delivery system. The project is beginning to look at the role of public health. Health officers are invited to participate in the workgroups. Operations Manual – no additional comments received; approved revised operations manual. MDCH Office of Public Health Preparedness was not able to come to consensus regarding funding formula for next cycle during conference call with health officers; MALPH will submit a statement to MDCH that the state should absorb the cut effective October 1, 2010. MPHI PHAB and Dual Accreditation Concept Paper – Motion passed to request the state form a workgroup to look at Michigan’s accreditation program to identify efficiencies and how we can align with the PHAB process. DEQ – The well construction stakeholder workgroup is underway, are developing a MOU with LARA regarding handling complaints at manufactured housing parks and a committee is being formed to look at newly released federal total coliform rules slated to go into affect April 2016. MDCH – Health officers have received notice from the Tobacco Section that funding is being reduced. Mark Miller distributed PHAB technical assistance request information. OPHP has decided on which funding formula to use and will notify health officers.
  3. Correspondence: Contact received from Sandy Walls, MPHA/PHN Section, who is looking for LHD nursing representatives (rural & urban) to speak to how the Affordable Care Act will affect public health services. Members felt that it was premature to determine the effects at this point and suggested alternate speakers.

4. Old Business

A. PHN Display- Send any ideas or comments to Angelique Joynes and Bonnie Havelick.

B. PH Code Definitions-the Executive Committee plans to meet and develop a response for Mark Miller.

5. New Business

6.Speakers

A.Rosemary Asman, MDCH/: See attached report.

Bobby Peacock agreed to represent NAF in developing the perinatal oral health guidelines.

Lynn McDaniels asked for an update on the MDCH Infant Mortality goal regarding adoption of the progesterone protocol for high risk women (to delay preterm labor). Progesterone cream has not been approved for use in this way by the FDA. Rosemary started that she would direct that a status update be sent out to LHDs and providers.

7. Reports

A. NAF Committee Reports

1. Awards- Angelique will send out requests for award nominations.

2. Bylaws-Mary Ricciardello and Ann Marie Young have preparedtwo drafts of suggested revisions for review by the Executive Committee this afternoon. The draft will be sent to the Member Agencies for review and approval. Approval is required of two thirds of the Member Agencies.

3. Data-No report.

4. Education & Orientation: The NAFHigginsLake conference, titled “I.N.F.L.U.E.N.T.I.A.L. Leadership”was held on May 13-14.

Regarding NAF orientation: Lynn McDaniels has offered to mentor Regina Traylor and Sarah Bryant from InghamCounty.

5.2013/14 Nominating-No report

6. Strategic Planning: Angelique Joynes reports that we have encountered a roadblock in using the MALPH website to centralize our strategic planning work and continue the development momentum. Many of the action steps have been identified. Bobby has a meeting with Meghan Swain scheduled and will also ask her about facilitating access to the website.

B. NAF Representative Reports

1. COMON: No report.

2. MPHA: No report.

3. MPHA PHN/NAF Task Force on Clinical Experiences:No report.

C. MALPH Committee Reports:

1. Governance-The next meeting is 6-27-13.

2. Premier Conference-Janine Chittenden reports 2013 Premier Public Health Conference will take place October 17-18 (Thu-Fri), 2013 at the Double Tree Resort in Bay City. Pre-conference day is Wednesday, October 16. The deadline for presentations has been extended.

D. MDCH Committee Reports:

1.CSHCS Advisory:No report.

2. Family Planning-No report.

3. Local Maternal Child Health-No report

4. MACI - Sue Schryber reports that we still do not know how Sequestration will affect the Immunization Program – from the federal (CDC) or MDCH perspective.Prevention funding (grants) are being used to make up for the loss in 317 funding; in 2013, possible nationwide reductions may be $73 million – mostly 317 vaccine and in 2014, possibly $62 million reduction (nationwide).

MDCH thinks that CDC is counting on the Affordable Care Act to eliminate the need for 317 vaccine as the underinsured will now be insured and will be able to be given private stock vaccine.

62% of the births in MI are covered by Medicaid. Bill to move the 6th grade assessment to 7th grade has passed the full Senate (5/9/13) and is now in the House Health Policy subcommittee. There is opposition from MI Association of Health Plans because they feel that it will affect their HEDIS rates.

HL7 real time went live (immunizations go to MCIR as soon as they are entered into EMR) on 4/10/13. Tdap assessment for MCIR Profile reports is now available (need to put “0” in DTaP line so that Tdap becomes unshadowed and can be chosen).Revisions to the MCIR Official Immunization Record have been finalized and are now in the hands of the tech team.

VFC Pentacel is on allocation (again) starting in June and will be through Aug or Sept.

VFC Pediarix in on allocation. Hope to be back to full supply in Sept. Vaccine rep says that MenHibrix will most likely be on the market/available to order in late fall.

MDCH has made it official (printed in FluBytes): flu vaccine should start to be given as soon as a provider has flu vaccine and it should continue to be given until the vaccine expires (most flu vaccines expire on 6/30 each year).

5. Michigan Education Nursing Council– no report.

6. MIHP-Pat Fralick reported on concerns that MIHP clients will be required to be in a MHP. Discussion is continuing.

8. Free Forum (Open Discussion):

  • Lisa Hahn requested information on the Expedited Partner Therapy proposal. Bobby states that the legislature has passed the proposal but it still requires legal review.
  • JacksonCounty has a new Health Officer, Richard Thoune, effective 7-15-13.
  • The IoniaCountyHD has resigned.
  • In KentCounty, Adam London has been appointed Health Officer.

Please note that the next NAF meeting is scheduled for August 13, 2013. There is no JULY meeting.

The meeting wasadjourned at 11:23 am.

Submitted by Lynn McDaniels, Secretary

Nurse Administrators’ Forum Report

Rose Mary Asman

June 11, 2013

ADOLESCENT HEALTH

  • The latest Child and AdolescentHealthCenter dashboard has been released. MDCH is very excited about this document and it reflects a lot of effort on the part of the centers to collect important data. This is the first year that contains much of the data we will use to monitor the program over the years (second to last page). A copy of the document is attached.
  • Registration is now open for the 6th Annual Moving Toward Solutions: Addressing Teen Pregnancy Prevention in Michigan Conference. MTS will be held August 11-13 at the Dearborn Inn in Dearborn. Registration website is

EARLY HEARING AND DETECTION

  • The EHDI Online Hearing Screener Course is available for 2.0 FREE Nursing Contact Hours, but the server was changed on April 28th and there are new instructions (attached).
  • Also, anyone who took the course previously no longer has access to their certificates of completion and Nursing Contact hours through the old site, but we got a list of everyone who has completed the course with 80% score or higher. They can contact EHDI for this information if needed.
  • The course is still available for two free contact hours until August, when it will be recertified.It is expected to remain the same, but it could change, so MDCH is encouraging any nurses who are interested to take it now.

FAMILY PLANNING

  • The Family Planning Coordinator Meeting Webinar was held on June 12,

FETAL ALCOHOL SPECTRUM DISORDERS (FASD)

  • The focus of the FASD Taskforce strategic plan is Youth in Transition and Adults with FASD and they are planning a Fall 40 year Anniversary Conference on September 12, 2013, in Ann Arbor to commemorate the first article written about FAS/Fetal Alcohol Syndrome. Rob Wybrecht is 40 years old this year and he was the first case diagnosed in the US in Ann Arbor, MI. The keynote speaker for the conference is co-author of the publication, Dr. Kenneth Jones, MD, from the University of California, San Diego. The conference will also include speakers from Michigan as well as a presentation featuring the FASD Community-Based Projects. Save The Date flyer is available online at:

The registration will be available during the first week of July.

  • The Lac Vieux Desert Native American community-based project located in the Upper Peninsula has produced a DVD featuring a family story about FASD that will be featured at the conference.

HEARING AND VISION

  • The Annual Hearing and Vision Coordinator’s meetings were held on:

June 11, 2013: FetzerCenter, WMU, Kalamazoo, MI

June 13, 2013: Ojibway Hotel, Sault Ste. Marie, MI

  • The meetings provided State and program updates and facilitating round table discussions of issues affecting H/V at the local, State and national levels.

LOCAL MATERNAL CHILD HEALTH (LMCH)

  • The deadline for FINAL amendments is approaching. If you need a budget/plan amendment, they are due by June 19 to the department.

MATERNAL INFANT HEALTH PROGRAM (MIHP)

  • Glitches in the MIHP application of SSO are being addressed as they are discovered. There are still a few outstanding issues that have required some investigation, including why some MRIs seem to be "disappearing" in the system and why IE8 allows some functions and not others.
  • The rewrite of the MRI is complete and testing will begin mid -June. A POC2 committee has been convened to review and revise the current POC2s to match the new MRI. There work will be done by the end of July
  • A state wide workgroup is developing recommendations for the NICU follow up committee regarding how to assure that all birth hospitals support and refer all eligible newborns to MIHP and CSHCS. That committee is working through October and will present recommendations in November.
  • There are currently 6 new providers who will be attending the August new provider orientation. 4 more applications are being processed. The application process is under revision to assure that new agencies coming on board have both the business acumen and clinical expertise to successfully administer a MIHP.
  • Cycle 4 began May 1st. The new review process was designed to be clear and concise with no surprises regarding what is required.
  • A committee has been formed at DCH to develop a logo specific to MIHP.
  • RAC audits have begun. Several MIHP agencies had claims suspended during the initial part of the process which is where "the system' examines whether a pattern of claims is expected or unusual. There have not yet been reports from agencies that files have been required for verification. Suspended claims were paid within 2 weeks.
  • The summary report from the quasi-experimental study has been widely circulated and has generated interest in MIHP from a variety of stakeholders. There have been inquiries from other states.
  • MIHP Coordinator training Will take place:

Grand Rapids, September 9, 2013

Detroit, September 12, 2013

Bellaire, Shanty Creek, September 17, 2013

Marquette, September 19, 2013

  • MIHP Website redesign is in development. There will be a password protected portal for MIHP providers.
  • Home visitation conference to be held August 12-14. MIHP will have training on the first day for all providers on the new MRI and POCs.

MICHGIAN MATERNAL MORTALITY Surveillance (MMMS)

  • National Maternal Mortality Initiative (NMMI) is a two-year joint initiative between AMCHP and CDC. Guidelines are being written to strengthen existing maternal mortality review committees and provide guidance to states with new emerging maternal death reviews. Michigan has a lead role with the Preventability and Case Ascertainment Chapters and will be providing first draft review for 4 of 7 chapters. AMCHP issued a NMMI Learning Collaborative RFP on May 28, 2013 due June 28, 2013.

ORAL HEALTH

  • The MichiganCenter for Rural Health is hosting an Oral Health Grand Round on June 14th titled “Breastfeeding and Oral Health: What’s New.” Please see the attached flier for more information. You may register for this program online using the following link:
  • The Oral Health Program is having a consensus conference (by invitation only) on August 7-8 to discuss Perinatal Oral Health guidelines and development for Michigan. We are looking for a 2-3 representatives from LHDs to attend.
  • The SEAL! Michigan sealant program completed its new competitive grant cycle. MDCH is in the process of notifying the awardees. In addition, MDCH has requested additional funding from Delta Dental to help fund 3-4 additional sites. The Department should know more by August.
  • A new Burden of Disease document was published and copies will be mailed to each Health Officer. If any NAF member would like one sent to them, please contact Chris Farrell at

PERINATAL REGIONALIZATION

  • The first strategy in Michigan’s Infant Mortality Reduction Plan, released 8/1/12, and is to implement a regional perinatal system. The attached schematic is a visual of the work being done under the statewide perinatal coordinated system. The following is a brief overview of active committee work. If you have an interest in serving on a workgroup or committee, or would like further information, please contact Trudy Esch at
  • Level of Care Guideline Committee – Made recommendations to endorse the national Level of Care guidelines released in 2012. Dr. Matt Davis, Chief Medical Executive signed the endorsement on May 20, 2013. For more information and a copy of the signed endorsement see:
  • NICU Follow-up Committee – This committee met in April and May. The committee recommended the formation of 5 workgroups under the NICU follow-up committee and a Perinatal System Data workgroup that will be housed under the Perinatal Service System. Three workgroups are being formed with their first meetings in June.

1. MIHP/CSHCS Linkage Workgroup