INGHAM COUNTY BOARD OF COMMISSIONERS P.O. Box 319. Mason, Michigan Telephone (517) Fax (517)

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1 CHAIRPERSON CALVIN LYNCH VICE-CHAIRPERSON CURTISHERTEL,JR. VICE-CHAIRPERSON PRO-TEM THOMAS L. MINTER COUNTY SERVICES COMMITTEE VICTOR CELENTINO, CHAIR DIANNE HOLMAN DEBBIE DE LEON ANDY SCHOR MICHAEL SEVERINO JOHN NEVIN INGHAM COUNTY BOARD OF COMMISSIONERS P.O. Box 319. Mason, Michigan Telephone (517) Fax (517) THE COUNTY SERVICES COMMITTEE WILL MEET ON TUESDAY, NOVEMBER 4, 2003 AT 6:00 P.M. IN THE PERSONNEL CONFERENCE ROOM, (D & E) OF THE HUMAN SERVICES BUILDING, 5303 S. CEDAR, LANSING. NOTE CHANGE IN TIME Agenda Call to Order Approval of the October 21, 2003 Minutes Additions to the Agenda Limited Public Comment 1. Discussion with the Ingham County Road Commission 2. Parks Board - Resolution Honoring the Volunteers Who Comprised the We Can Hear Music Committee Which Was Responsible for Building the Band Shell at Lake Lansing Park-South 3. Circuit Court/ Family Division - Resolution Authorizing a Contract with the Lansing School District and Amendments to the Circuit Court/ Family Division 2003/04 Child Care Fund Budget 4. Health Department a. Resolution to Authorize a Plan to Improve Dental Program Efficiency and Expand Dental Services b. Resolution to Authorize an Amendment to the CPBC and Accept Federal Public Health Preparedness and Response for Bioterrorism Grant Funds 5. Discussion - Project Labor Agreements 6. Board of Commissioners a. Resolution Supporting the USA Patriot Act b. Resolution Appropriating Funds for Changes to the Board of Commissioners Video Recording System c. Resolution Honoring Alfreda Schmidt d. Resolution Supporting the Nomination of Oakland County Commissioner Eric Coleman for the Office of Second Vice-President of the National Association of Counties 7. Controller s Office - Resolution Authorizing a Tax Sharing Agreement with the Delhi Charter Township DDA

2 8. Board Referrals - Letter from Clarice Sperry, Former Ogemaw County Commissioner, Regarding a Lawsuit Filed Against County Commissioners Announcements Public Comment Adjournment PLEASE TURN OFF CELL PHONES OR OTHER ELECTRONIC DEVICES OR SET TO MUTE OR VIBRATE TO AVOID DISRUPTION DURING THE MEETING The County of Ingham will provide necessary reasonable auxiliary aids and services, such as interpreters for the hearing impaired and audio tapes of printed materials being considered at the meeting for the visually impaired, for individuals with disabilities at the meeting upon five (5) working days notice to the County of Ingham. Individuals with disabilities requiring auxiliary aids or services should contact the County of Ingham in writing or by calling the following: Ingham County Board of Commissioners, P.O. Box 319, Mason, MI Phone: (517) A quorum of the Board of Commissioners may be in attendance at this meeting.

3 COUNTY SERVICES October 21, 2003 Minutes Members Present: Members Absent: Others Present: Victor Celentino, Dianne Holman, Debbie DeLeon, Andy Schor, Mike Severino and Board Chairperson Lynch John Nevin Jerry Ambrose, Harold Hailey, Eric Schertzing, Len Stuttman, Gene Hayhoe, Pat Lamison, Bob Glandon, Stacy Hickock, Andrew Banya, Morgan Quinney, Johnhenry Milbourne, Craig Whitford, Scott Shattuck and Loren Shattuck The meeting was called to order by Chairperson Celentino at 7:08 p.m. in the Personnel Conference Room of the Human Services Building, 5303 S. Cedar, Lansing. Approval of the October 7, 2003 Minutes MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. HOLMAN, TO APPROVE THE OCTOBER 7 MINUTES AS AMENDED. MOTION CARRIED UNANIMOUSLY. Absent: Comms. DeLeon, Schor and Nevin Additions to the Agenda 7. Resolution pulled from the agenda at the request of the Parks Board. J. Resolution pulled from the agenda at the request of the Corporate Attorney. 12. Late - Resolution Amending the Ingham County Living Wage Policy Limited Public Comment Mr. Hayhoe addressed the Committee regarding the Patriot Act. He also thanked the County for its support of the Capital Area District Library. Mr. Hayhoe explained in great detail his non-support of the Patriot Act. He urged this Committee to pass a resolution indicating its non-support of the Patriot Act. (Comm. DeLeon arrived at approximately 7:10 p.m.) Ms. Hickock addressed the Committee regarding the Patriot Act. She stated small portions of the Act are legal. However, other parts are very scary. The Act endorses government searches of personal property without probable cause. The County should not support the Patriot Act in its current form. (Comm. Schor arrived at approximately 7:12 p.m.) Mr. Banya spoke regarding his perspective of the Patriot Act. Basically, students at the law school he attends have extremely negative comments relating to the Act. 2. Ingham County Youth Commission - Interviews The Committee interviewed Morgan Quinney and Johnhenry Milbourne for the vacancies on the Ingham County Youth Commission.

4 MOVED BY COMM. DELEON, SUPPORTED BY COMM. SCHOR, TO RECOMMEND THE APPOINTMENTS OF MORGAN QUINNEY AND JOHNHENRY MILBOURNE TO THE INGHAM COUNTY YOUTH COMMISSION. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Nevin Chairperson Lynch stated the County should make an extra effort to recruit youths who are not already active in school activities. 1. Presentation - Leonard Stuttman - Resolution Supporting the Kirtland s Warbler Initiative Replacing the Robin with the Kirtland s Warbler as Michigan s State Bird Mr. Stuttman encouraged the Committee to un-table the Resolution Supporting the Kirtland s Warbler Initiative Replacing the Robin with the Kirtland s Warbler as Michigan s State Bird. He explained the Robin was promoted as Michigan s state bird in 1931 by the Audubon Society. It was discovered in 1934 that the Kirtland s Warbler nests exclusively in Michigan. The Kirtland s Warbler is one of the world s rarest warblers. Mr. Stuttman further stated it appears Michigan s Jack Pine Barrens are essentially the only known nesting grounds of the warbler. The Endangered Species Act provides funding to the State and Federal agencies to maintain and manage the Jack Pine Ecosystems to benefit the warbler. Michigan s forest industry participates and profits from the Jack Pine Forest Management Program. Mr. Stuttman presented a twelve-minute segment of a video tape regarding the importance and uniqueness of the warbler. Chairperson Celentino asked if a phase-in plan would be implemented to make the necessary changes in school classroom materials should the state bird be changed to the warbler. Mr. Stuttman stated the costs associated with the implementation are included in the Kirtland s Warbler Initiative. He further explained that when classroom textbooks are due for replacement, the new books would have the warbler information. Comm. Schor asked if any groups are opposed to this initiative. Mr. Stuttman stated there are some groups that would challenge this initiative. In response to Chairperson Celentino, Mr. Stuttman stated the Robin is the state bird of a few other states. It is also commonplace in other states. Chairperson Celentino thanked Mr. Stuttman for his presentation. The Committee will consider this information for a few weeks before making a decision on the resolution. MOVED BY COMM. SCHOR, TO REMOVE THE RESOLUTION SUPPORTING THE KIRTLAND S WARBLER INITIATIVE REPLACING THE ROBIN WITH THE KIRTLAND S WARBLER AS MICHIGAN S STATE BIRD. MOTION DIED due to lack of support. Absent: Comm. Nevin Comm. Severino asked if the initiative would consider naming the warbler as a northern Michigan county bird. Chairperson Celentino stated this Committee could encourage northern counties to 2

5 accept the warbler as their county bird. Chairperson Celentino also stated he does realize this is an important issue to Mr. Stuttman. MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. SCHOR, TO APPROVE A CONSENT AGENDA FOR THE FOLLOWING ITEMS: 8. Financial Services - Resolution Extending an Agreement with the Accident Fund for Administration of the Self-Funded Workers Compensation Program. 12. Resolution Amending the Ingham County Living Wage Policy MOTION CARRIED UNANIMOUSLY. Absent: Comm. Nevin MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. SCHOR, TO APPROVE THE ITEMS ON THE CONSENT AGENDA. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Nevin 3. Presentation - Ingham County Historical Commission Mr. Whitford stated 2005 marks the centennial of the Ingham County Courthouse. The Historical Commission wishes to mark this important anniversary with a Courthouse Centennial Celebration. At present, the recommended dates are May 6-8, This event will include various county departments and their staff, County Commissioners, school and civic groups as well as both local and county businesses. Prior to May 6, local merchants can have window displays of items and photographs from the turn of the century. The Commission is encouraging as many businesses as possible to participate in this event. The Centennial weekend festivities will include, weather permitting, living history demonstrations of arts, crafts, etc. Additionally, collectors, county historians, museums and other county historical societies could provide displays within the Courthouse. Guided and self-guided tours of the Courthouse could also be arranged. Outside activities will include various mini-concerts by church groups, schools, barber shop quartets, gospel, folk and fiddlers. Mr. Whitford further stated the Centennial Rededication will be held on May 7. The re-creation of the dedication speech will be provided by Historian Lawton T. Hemans, who resided in Mason at the time. With the permission of the County and responsible department heads, the cornerstone would be opened. The cornerstone would have been sealed for nearly a century in either the later part of 2004 or the early part of This opening will be done prior to the celebration weekend. Any surviving artifacts will be placed on display. A new time-capsule will be placed within the Courthouse for the next generations to open in Mr. Whitford asked for this Committee s support with this event. The Historical Commission realizes there are many details to be worked out, including a budget and the finalization of the plans. 3

6 The role of the Historical Commission will be to act as the hub of the wheel and to coordinate activities. Comm. Schor expressed his support for this event. He then stated the Commission should submit a wish list with associated costs to this Committee for review. Mr. Ambrose stated the Commission will submit a proposal for this event in the 2005 budget cycle. MOVED BY COMM. HOLMAN, SUPPORTED BY COM. SCHOR, TO SUPPORT THE INGHAM COUNTY HISTORICAL COMMISSION S PLANS FOR A COURTHOUSE CENTENNIAL CELEBRATION; AND TO SUPPORT THEIR CONTINUED PLANNING EFFORTS. Chairperson Celentino commended the Historical Commission for their Centennial Celebration plans. He also suggested the Commission include the Ingham County Youth Commission in its planning efforts. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Nevin 4. Treasurer s Office - Update on the Status of the Accommodation Tax Audit/Williamston Inn Mr. Schertzing stated this Tax Audit process has provided him a good opportunity to inform the businesses of the ordinance and related issues. The cost of the first audit was approximately $3,700. The Village Inn is now collecting an accommodation tax. The Williamston Inn has retained an attorney to handle this matter. They have not yet paid their accommodation tax. The position of the Inn is that since the owner of the facility lives on the site, it is exempt from the accommodation tax. It believes it falls within the Bed & Breakfast exemption. Mr. Schertzing stated he will continue to follow up with the Williamston Inn. In response to Comm. Schor, Mr. Schertzing explained his office is requesting payment of the accommodation tax from this point on. Retroactive taxes are not being requested. In response to Mr. Ambrose, Mr. Schertzing stated he believes the Williamston Inn does not fall within the Bed & Breakfast exemption. Mr. Ambrose stated the County should modify its current ordinance to avoid any future misunderstandings. Comm. Schor suggested the Controller review the meeting minutes from 1991 which included a discussion of the Bed & Breakfast exemption. However, he will now follow the determination of the Treasurer. He also stated he would support the elimination of the Bed & Breakfast exemption. Comm. Severino stated this Committee should accept the Treasurer s interpretation of the ordinance. Mr. Schertzing stated his interpretation is that the Williamston Inn does not qualify for the Bed & Breakfast exemption. He will continue to follow the ordinance as it is written until it is changed by the Board of Commissioners. Comm. Holman expressed her support for Mr. Schertzing s efforts regarding the Williamston Inn. She also suggested this Committee should review the language of the current policy. 4

7 5. Health Department a. Resolution to Authorize Administrative Service and Medical Services Agreements with the Ingham Health Plan Corporation MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. SCHOR, TO APPROVE THE RESOLUTION TO AUTHORIZE ADMINISTRATIVE SERVICE AND MEDICAL SERVICES AGREEMENTS WITH THE INGHAM HEALTH PLAN CORPORATION. In response to Comm. Schor, Mr. Bragg stated he would clarify the costs associated with this matter. Mr. Ambrose also explained this is a revenue-neutral agreement. It was not included in the 2004 budget process because this issue could not be anticipated. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Nevin b. Resolution to Appoint Dennis Jurczak, M.D. as Deputy Medical Director and Chief Deputy Medical Examiner and to Authorize an Employment Contract MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. SCHOR, TO APPROVE THE RESOLUTION TO APPOINT DENNIS JURCZAK, M.D. AS DEPUTY MEDICAL DIRECTOR AND CHIEF DEPUTY MEDICAL EXAMINER AND TO AUTHORIZE AN EMPLOYMENT CONTRACT. The Committee held a general discussion regarding this item. Mr. Godbold explained Dr. Jurczak has served as a Deputy Medical Director for the Ingham County Health Department since July He was appointed Acting Medical Director and Chief Deputy Medical Examiner effective March 1, 2003 to replace Dr. Sienko. Dr. Sienko has been serving on active duty status with the U.S. Army. Dr. Jurczak will receive direction from the Medical Director/Medical Examiner, and in the absence of the Medical Director/Medical Examiner, from the Health Department Director. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Nevin th District Court - Resolution to Authorize Budget Amendments within 55 th District Court MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. HOLMAN, TO APPROVE THE RESOLUTION TO AUTHORIZE BUDGET AMENDMENTS WITHIN 55 TH DISTRICT COURT. In response to Comm. Severino, Mr. Ambrose explained the proposed budget amendments addresses the increase in court fees which were effective October 1, MOTION CARRIED UNANIMOUSLY. Absent: Comm. Nevin 7. Parks Board - Resolution to Authorize an Appropriation to be Used for the Construction of the Proposed City of Lansing Dog Park This item was pulled at the direction of the Parks Board. 5

8 9. Human Resources Department - Review of County Compensation Structure Mr. Hailey distributed information to the Committee regarding the County s compensation structure. This information was requested in a previous meeting. The Committee reviewed this information. Mr. Hailey explained that positions are ranked according to a Job Evaluation Plan which was developed by Mr. William Rye. Mr. Ambrose stated the compensation structure involves a very complicated process. After further discussion, Mr. Ambrose stated positions within the court are not funded with Juvenile Justice Millage funds. Comm. Holman stated the information was very helpful. She just needed to see the full picture to have a total understanding of the compensation structure. Mr. Hailey stated he was happy to provide this information to the Committee. He also stated he is willing to address any further questions from the Commissioners on this issue. In response to Comm. Schor, Mr. Hailey stated his recommendations do not always match the requests of the departments. When a position is vacant, this provides the department an opportunity re-evaluate the needs of the department. Mr. Hailey stated specific departments were not included in the Job Evaluation Plan. Comm. Holman expressed her appreciation to Mr. Hailey for providing this information. 10. Board of Commissioners - Resolution Supporting the Lansing School District Bond Proposals on the November 4, 2003 General Election Ballot This item was pulled from the agenda at the request of the County s Attorney. 11. Board Referral - Letter of Transmittal from the Michigan Department of Consumer and Industry Services, Forwarding the Sixth Legislative Report for the State Survey and Remonumentation Section The Board Referral was received and placed on file. Announcements Chairperson Celentino informed the Committee the November 4 meeting will be held at 6:00 p.m. instead of 7:00 p.m. The Road Commission is scheduled to appear at the November 4 meeting. Public Comment: None The meeting adjourned at 9:17 p.m. Respectfully submitted, Debra Neff 6

9 Agenda Item 2 Introduced by the County Services Committee of the: INGHAM COUNTY BOARD OF COMMISSIONERS RESOLUTION HONORING THE VOLUNTEERS WHO COMPRISED THE WE CAN HEAR MUSIC COMMITTEE WHICH WAS RESPONSIBLE FOR BUILDING THE BAND SHELL AT LAKE LANSING PARK-SOUTH WHEREAS, the members of the We Can Hear Music committee have shown a remarkable level of devotion to the idea of community involvement by actively seeking out ways to benefit the community in which they live; and WHEREAS, 24 members of the committee have worked tirelessly since 1999 to raise $164,000 in private donations for the Band Shell; and WHEREAS, the Band Shell was designed as a multi-use facility, capable of accommodating performances, plays, concerts, and other family-oriented cultural and social events; and WHEREAS, the Band Shell was successfully completed and the first concert and Grand Opening were held on June 6, 2003; and WHEREAS, the Committee will continue to be involved with the Band Shell by planning and supervising at least one family-oriented performance/event each week during the summer. THEREFORE BE IT RESOLVED, that the Ingham County Board of Commissioners hereby commends the following dedicated individuals who went above and beyond the call of duty for the Band Shell Project. Malinda Barr Pat Hagen Karen Saunders Cathy Claypool Ruth Hall Alfreda Schmidt Sam Cryderman Richelle McFate Bob Vandervoort June Cryderman Karen Meis Robert Vince Chris Eberhart Maggie Milz John Webb Susan Geshel Doug Nordhous Bob Weisflog Laura Giles Steve Osborn Gail Wickham Ed Gillespie Barry Roney Virginia White BE IT FURTHER RESOLVED, that the Ingham County Board of Commissioners extends its sincere appreciation to the above-mentioned individuals, as well as those individuals who donated directly to the project or who provided in-kind donations, thereby providing another wholesome recreation environment for the community at Lake Lansing Park-South and improving the quality of life in Ingham County.

10 Agenda Item 3 RESOLUTION STAFF REVIEW DATE: October 22, 2003 Agenda Item Title: Resolution Authorizing a Contract with the Lansing School District and Amendments to the Circuit Court/ Family Division 2003/04 Child Care Fund Budget Submitted by: Circuit Court/ Family Division Committees: LE, JD *, H.S., CS *, Finance * Summary of Proposed Action: This Circuit Court/Family Division Proposal has been unanimously adopted by the Family Division Judges and is being submitted for your consideration and approval by the Honorable Richard J. Garcia, Presiding Judge Family Division. (See attached Truancy Court Program description, correspondence from Lansing School District Superintendent, Dr. Banks, Position Duties Budget and background information.) This resolution would authorize: - Amendments to the Circuit Court/Family Division 2003/04 Child Care Fund Budget by authorizing additional expenditure of Child Care Funds; - Create a new grant/contract-funded position within the Circuit Court/Family Division as noted; - Authorize a two (2) year contract with the Lansing School District and the Ingham County Circuit Court/Family Division to be reviewed at the end of each year during the contractual period. As part of the contract, Lansing School District will be responsible for all office space, furniture, computers, and office supplies. Financial Implications: Total request for Child Care Fund dollars (50%) $23, to be matched with Lansing School District money (50%) $23,842.50, total cost is $47,685, for 2003/04 FY. There is no County General Fund or Juvenile Justice Millage Funds associated with this position estimate is $51,688 $25,844 Child Care Fund dollars (50%) $25,844 Lansing School District money (50%) Other Implications: Due to the reduction of one (1) Lansing School District staff person assigned to the Truancy Court, the program is not able to provide student documentation in a timely manner. The Casework Assistant will coordinate this function now. The Lansing School District Board of Education has agreed in principle to the proposal for a two year jointly funded contract between the school district and the Court in support of the Truancy Court program.

11 Agenda Item 3 Staff Recommendation: JA JN * HH The University of Cincinnati s final report on the Court programs will be presented November 13, Because this position is subject to the availability of grant/contract funds, the County/Court have the flexibility to review and terminate the contract with the Lansing School District on an annual basis for the two-year duration of this proposed contract.

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19 Agenda Item 3 Introduced by the Judiciary, County Services and Finance Committees of the: INGHAM COUNTY BOARD OF COMMISSIONERS RESOLUTION AUTHORIZING A CONTRACT WITH THE LANSING SCHOOL DISTRICT AND AMENDMENTS TO THE CIRCUIT COURT/FAMILY DIVISION 2003/04 CHILD CARE FUND BUDGET WHEREAS, the 30 th Circuit Court/Family Division has developed a Truancy Court Program to address truancy within Ingham County as preventive and intervention strategies to delinquency and WHEREAS, 30 th Circuit Court/Family Division will continue to work with the Lansing School District in a collaborative spirit essential to fully support this community-based program. THEREFORE BE IT RESOLVED, that the Ingham County Board of Commissioners hereby approves the 30 th Circuit Court/Family Division Request and authorizes a contract with the Lansing School District to reimburse Ingham County for half of the personnel costs of a Casework Aide position for the time period of January 1, 2004 through December 31, BE IT FURTHER RESOLVED, that the Ingham County Board of Commissioners authorizes the creation of one new Child Care Fund/Contract Casework Aide position effective January 1, 2004 through December 31, 2005, subject to the availability of contract/grant funds. BE IT FURTHER RESOLVED, that the Ingham County Board of Commissioners authorizes the Controller to make the necessary budget adjustments and Position Allocation List amendment in the Circuit Court 2003/04 Child Care Fund Budget. BE IT FURTHER RESOLVED, that the Chairperson of the Ingham County Board of Commissioners and the County Clerk are authorized to sign any necessary contract documents consistent with this resolution and approved as to form by the County Attorney.

20 Agenda Item 4a RESOLUTION STAFF REVIEW DATE: October 24, 2003 Agenda Item Title: Submitted by: Resolution to Authorize a Plan to Improve Dental Program Efficiency and Expand Dental Services Health Department Committees: LE, JD, H.S *, CS *, Finance * Summary of Proposed Action: (see attached letter of explanation) This resolution will authorize implementation of a Dental Plan to add to the following: 1) an additional half time dentist in the adult dental clinic; 2) an additional support staff person to be shared between the two clinics; 3) a small amount of equipment that will help providers become more productive; 4) a contract with Ms. Wheeler to provide ongoing support to Dr. Norris and the dental staff in implementing the plan. Every element of the plan can be supported by increased revenue. Financial Implications: The cost of implementing the plan is $111,832. The anticipated, additional revenue from implementation of the plan is $190,575, resulting in nearly $80,000 of uncommitted revenue. Other Implications: None Staff Recommendation: JA JN * HH This resolution should be approved.

21 Agenda Item 4a MEMORANDUM To: From: Human Services Committee County Services Committee Finance Committee Bruce Bragg Date: October 29, 2003 Subject: Recommendation to Implement a Plan to Improve Productivity and Expand Services in the County s Dental Clinics This is a recommendation to implement a plan to improve the productivity and expand services at the County s dental clinics. The plan will recognize additional revenues and use them to expand services. The Health Department operates two dental clinics - one focused on serving low-income, uninsured adults and one focuses on services low-income and Medicaid eligible children. The adult dental clinic served 1,364 unduplicated users in 2002; the users made 4,386 visits. The children's dental clinic served 1,956 children in 2002; the children made 4306 visits. Both clinics get requests for services that cannot be met under the current operating methods, so there is an immediate opportunity to expand services to the target population if additional resources can be found. An outside review of our dental clinics undertaken last month has produced a set of recommendation that, if implemented, can improve the operation of both dental clinics. Specifically, the plan can result in improved access for patients, more patients being seen, more procedures being rendered, improvement of billing and cash collection, the generation of additional revenue, and the establishment of a system to better support the Dental Director who functions as a dentist and is responsible for administering two busy dental clinics. The outside review was performed by a dental consultant named Annette Wheeler. Ms. Wheeler was recommended to the administration by the Mid Michigan District Health Department. Ms. Wheeler has had a consulting relationship with Mid Michigan s Stanton Dental Clinic with the following results: provider productivity has improved, additional revenue is being generated and provider, staff and patient satisfaction are all at higher levels. The review found many of the same issues, problems and possibilities that were discovered in the assessment of the Mid Michigan Dental program. As in the Mid Michigan s dental clinic, Ingham County has a patient no show rate at both dental clinics that if reduced, would provide additional capacity and revenue. The plan that she developed addresses the no show problem. The plan also recognizes that we have a basic problem in the adult dental area: far too many patients and too few appointments. Her plan addresses the capacity issue in the adult dental

22 clinic, though the hope for additional revenue in adult dental is slight. Most of the additional revenue generated comes from the children's dental clinic. The plan also provides a way for us to support Dr. Norris, who has administrative responsibility for two clinic sites while maintaining an active practice four days per week. The plan calls for: 1) an additional half time dentist in the adult dental clinic; 2) an additional support staff person to be shared between the two clinics; 3) a small amount of equipment that will help providers become more productive; 4) a contract with Ms. Wheeler to provide ongoing support to Dr. Norris and the dental staff in implementing the plan. Every element of the plan is important to the overall success of the plan. All of the costs of the plan can be supported by increased revenue. The cost of implementing the plan is $111,832. The anticipated, additional revenue from implementation of the plan is $190,575. The increase in revenue will result from: 1) The Department will implement a schedule and plan to see 20 additional patients per day (about ten at each location). Roughly half of the patients will have Medicaid coverage. The average reimbursement for a Medicaid visit is between $50-$75. Most of the patient revenue will come from the children's dental clinic but a small amount will come from the adult dental clinic. 2) Dr. Norris is providing dental services to children who are best treated under anesthesia in the hospital. These children are seen in the hospital because they have so many cavities that performing one or two procedures at a time is less cost effective than performing many fillings at once with the patient under an anesthetic. When Dr. Norris performs the services in the hospital the Department is able to bill for many procedures. The revenue generated is turning out to be about $615 a week. 3) The Department will add a CHR III to the staffing of the dental clinic. The CHR III will: a) assure that each location becomes and remains current in billing; b) assure that scheduling and cash collection procedures are followed; c) perform functions consistent with the role of "lead clerk; d) assist Dr. Norris with a variety of administrative tasks. The cost of the position will be $47,000. 4) The Department will have a contract with Annette Wheeler. Annette will work with Dr. Norris, Bruce Miller, Lynn Schaeffer, the new CHR III and the dental staff to implement and monitor the changes in the dental clinics that are intended to result in the increase in patients and revenue. I recommend that the Board of Commissioners adopt the attached resolution to authorize the implementation of the plan to increase efficiency and to expand services of the dental clinics. The plan is to increase revenue and expense by $111,832. With the proposed work plan, nearly $80,000 of uncommitted revenue will result. Attachment

23 Agenda Item 4a Introduced by the Human Services, County Services and Finance Committees of the: INGHAM COUNTY BOARD OF COMMISSIONERS RESOLUTION TO AUTHORIZE A PLAN TO IMPROVE DENTAL PROGRAM EFFICIENCY AND EXPAND DENTAL SERVICES WHEREAS, Ingham County operates two dental clinics, one focused on services to low income, uninsured adults and one focused on Medicaid eligible children; and WHEREAS, Michigan Medicaid has eliminated all but emergency dental services for Medicaid eligible adults; and WHEREAS, an outside dental consultant has conducted a study of the two dental clinics and has made recommendations which can improve the efficiency of services and expand services without any additional investment by Ingham County; and WHEREAS, the Health Officer has recommended that the Board of Commissioners authorize the implementation of the plan to improve and expand services in the dental clinics. THEREFORE BE IT RESOLVED, that the Board of Commissioners authorizes implementation of the Health Officer recommended plan to improve the efficiency of operation of the two dental clinics and to expand dental services. BE IT FURTHER RESOLVED, that a contract for services be authorized with a dentist to work approximately 20 hours per week at the rate of $40.57 per hour for the period January 1, 2004 through December 31, BE IT FURTHER RESOLVED, that a Community Health Representative III (UAW TOPS E) be established to work in the two dental clinics. BE IT FURTHER RESOLVED, that the purchase of a nitrous oxide unit is authorized for the Children s Dental Clinic; and BE IT FURTHER RESOLVED, that a dental clinic management consultant contract be authorized with Annette Wheeler at the rate of $1,574 per month, on a month to month basis. BE IT FURTHER RESOLVED, that the Controller is authorized to amend the Health Department s 2004 budget to recognize an additional $111,832 in dental clinic revenue and to authorize expenditure increases of the same amount. BE IT FURTHER RESOLVED, that the Board Chairperson is authorized to sign the consultant agreement after review by the County Attorney.

24 Agenda Item 4b RESOLUTION STAFF REVIEW DATE October 24, 2003 Agenda Item Title: Resolution to Authorize an Amendment to the Comprehensive Plan Budget and Contract (CPBC) and Accept Federal Public Health Preparedness and Response for Bioterrorism Grant Funds Submitted by: Health Department Committees: LE, JD, H.S. *, CS *, Finance * Summary of Proposed Action: (see attached letter of explanation) This resolution will authorize an amendment to the Comprehensive Plan Budget and Contract (CPBC) with the Michigan Department of Community Health (MDCH). The purpose of the amendment is to recognize the additional Public Health Preparedness and Response for Bioterrorism grant funding that has been allocated to Ingham County. The Federal grant funding allocated to Ingham County has increased by $218,014 over the allocation. The additional funding requires the additional responsibilities as outlined in the attached summary of the work plan for Additional positions and equipment are also authorized. Financial Implications: This will increase the allocation by an additional $218,014 over the budget. The funds are for: Pro 07 Two New grant funded Positions: Public Health Emergency Preparedness System Analyst at ICEA Pro 09 Public Health (Emergency Preparedness) Risk Communication Specialist at ICEA $33,000 for a contract with Home Access Health Corporation for the establishment of an Outbreak Communication and Disease Response System. $20,000 to purchase computer and communication equipment and software. Other Implications: None Staff Recommendation: JA JN * HH This resolution should be approved.

25 Agenda Item 4b MEMORANDUM To: From: Human Services Committee County Services Committee Finance Committee Bruce Bragg Date: October 29, 2003 Subject: Recommendation to Authorize an Amendment to the CPBC Agreement to Implement the Public Health Preparedness and Response for Bioterrorism Grant Program This is a recommendation to authorize an amendment to the Comprehensive Plan Budget and Contract (CPBC) with the Michigan Department of Community Health (MDCH). The purpose of the amendment is to recognize the additional Public Health Preparedness and Response for Bioterrorism grant funding that has been allocated to Ingham County. The Federal grant funding allocated to Ingham County has increased by $218,014 over the allocation. With the additional funding comes additional responsibilities. A summary of the work plan for is attached. The Department will need to add additional resources and relationships in order to implement the work plan. The attached resolution will authorize two new positions, a contract for services and the purchase of communication and computer equipment and software. The Human Resources Department has reviewed the proposed job descriptions of the two new positions and has recommended establishing the positions as follows: Public Health Emergency Preparedness System Analyst at ICEA Pro 09 Public Health (Emergency Preparedness) Risk Communication Specialist at ICEA Pro 07 The resolution also authorizes a service contract, for up to $33,000 (the amount included in the grant budget) with Home Access Health Corporation to implement an Outbreak Communication and Disease Response System, which is part of the work plan. The resolution also authorizes the County MIS Director to expend up to $20,000 to purchase communication and computer equipment and software to implement the work plan. The specific items will either be specifically identified in the grant budget or approved by the MDCH Office of Public Health Preparedness. All items will be purchased using the standard County procedures. I recommend that the Board adopt the resolution, authorize the amendment to the CPBC Agreement, establish the positions, authorize the service contract and the equipment purchases. Attachment

26 Agenda Item 4b The Health Department to implement the following Public Health Preparedness and Response to Bioterrorism work plan for : FOCUS AREA A: Preparedness Planning and Readiness Assessment Critical Capacity #1: To establish a process for strategic leadership, direction, coordination, and assessment of activities to ensure state and local readiness, interagency collaboration, and preparedness for bioterrorism, other outbreaks of infectious disease, and other public threats and emergencies. Activity 1: Identify a senior public health official to serve as the Executive Director of the department s Terrorism Preparedness and Response Program. Identify and maintain a full-time Emergency Preparedness Coordinator to plan and implement activities related to public health emergency preparedness, response. Activity 2: Establish or enhance a coordinated and integrated process for setting goals and objectives, implementing work plans with timelines, monitoring progress, and allocating resources related to the agreement Activity 3: Utilize and maintain a financial accounting system capable of tracking costs by work plan focus area. Activity 4: Identify a Point of Contact for smallpox initiatives. Critical Capacity #2: To conduct integrated assessments of public health system capacities related to bioterrorism, other infectious disease outbreaks, and other public health threats and emergencies to aid and improve planning, coordination and implementation. Activity 5: Conduct a comprehensive analysis of all information and data contained in the LHD Assessment Inventory Report of January 2003 to determine a baseline emergency preparedness and response capacity related to bioterrorism, other infectious disease outbreaks and other public health threats and emergencies. Document the findings and corrective actions taken and establish timelines, goals and objectives for achieving and refining the critical capacity requirements. Activity 6: Review the Statute Review and Recommendations Report (Summer 2003) developed by the Public Health Code Committee of the Michigan Association for Local Public Health, incorporate those recommendations in local health department emergency preparedness plans, as applicable, and report this activity in the progress reports.

27 Critical Capacity #4: To respond to emergencies caused by bioterrorism, other infectious disease outbreaks, and other public health threats and emergencies through development, exercise and evaluation of a comprehensive public health preparedness and response plan. Activity 7: Activity 8: Activity 9: Activity 10: Activity 11: In coordination with State and Federal response plans, develop or enhance scalable plans for local and regional response to incidents of bioterrorism, catastrophic infectious disease such as pandemic influenza, other infectious disease outbreaks and other public health threats and emergencies through the development, exercise and evaluation of a comprehensive public health emergency preparedness and response plan. Demonstrate how local public health preparedness and response planning is coordinated within existing emergency management infrastructure that is facilitated and supported by all appropriate state and regional response plans. Maintain a system for 24/7 notification or activation of the local public health emergency response system. Exercise all plans, including at least one tabletop, on an annual basis to demonstrate proficiency in responding to bioterrorism, other infectious disease outbreaks and other public health threats and emergencies. Work with hospitals, the medical community, tribal health centers and others to plan coordinated delivery of critical health services and effective medical management emergencies. Establish timelines, goals and objectives for achieving and refining the critical capacity requirements. Critical Capacity #4: To effectively manage the CDC Strategic National Stockpile (SNS) should it be deployed - translating SNS plans into firm preparations, periodic testing of SNS preparedness, and periodic training for entities and individuals that are part of SNS preparedness. Activity 12: Collaborate with regional and local partners to carry out SNS planning, training and exercises consistent with the requirements and recommendations outlined in the OPHP SNS Planning Guidance. Activity 13: Collaborate with Focus Area F (Risk Communication) initiatives to prepare public communication campaigns that, in a bioterrorism event, would (a) inform the public ow where to obtain prophylaxis; (b) encourage adherence to oral prophylaxis regimens; (c) advise on various antibiotics to be prescribed; (d) explain the threat agent and its transmissibility; and (e) address local issues.

28 Activity 14: Activity 15: Develop and maintain communications between SNS Regional Planners and other regional preparedness partners. (Smallpox) Describe the procedure that will be used to monitor, store, and manage smallpox vaccine within the local health department smallpox clinics, consistent with State Smallpox and SNS Plans. FOCUS AREA B: Surveillance and Epidemiology Capacity Critical Capacity #5: To rapidly detect a terrorist event through a highly functioning, mandatory reportable disease surveillance system, as evidenced by ongoing timely and complete reporting by local jurisdictions, especially of illnesses and conditions possibly resulting from bioterrorism, other infectious disease outbreaks and other public health threats and emergencies. Activity 1: Support the use of a system to receive and evaluate urgent disease reports and to communicate with and respond to clinical or laboratory reports on a 24-hour-per-day, 7-dayper-week basis. Activity 2: Assist the MDCH Bureau of Epidemiology with assessing the timeliness and completeness of the State s reportable disease surveillance (MDSS) system. Activity 3: Ensure capacity to manage the reportable disease system at the local level for epidemiology, surveillance and interpretation of clinical and laboratory information. Activity 4: (Smallpox) Improve the adequacy fo local public health surveillance and report capacities related to smallpox, such as active surveillance for rash illness, case contract, and monitoring for adverse events following vaccination. Critical Capacity #6: To rapidly and effectively investigate and respond to a potential terrorist event as evidenced by a comprehensive and exercised epidemiologic response plan that addresses surge capacity, delivery of mass prophylaxis and immunizations, and pre-event development of specific epidemiologic investigation and response needs. Activity 5: Participate in specialized epidemiology investigation and response training for local public health staff, who would respond to a bioterrorism event or public health emergency. FOCUS AREA E: Health Alert Network/Communications and Information Technology Critical Capacity #11: To ensure effective communication connectivity among public health departments, healthcare organizations, law enforcement organizations, public officials, and others.

29 Activity 1: Implement a plan for Internet connectivity according to guidelines distributed by OPHP Focus E Coordinator. Activity 2: Document at least 90 percent of the key local public/private stakeholders involved in a public health emergency response can receive and send information including alerts, critical event data and other public health events. Activity 3: (Smallpox) Continue to support a system to enhance public health capacity for recruitment and tracing of participants, data collection, storage, and management, reporting and evaluation activities related to the National Smallpox Vaccination Program. Critical Capacity #12: To ensure a method of emergency communication for participants in public health emergency response that is fully redundant with standard telecommunications (telephone, , Internet, etc.). Activity 4: Implement MIHAN and become proficient in its use. Activity 5: Assess the capacity for redundant local communications systems/devices (two-way radios, cell phones, voice mail boxes, satellite phones, amateur radio groups, hand radio or wireless messaging), the capacity of existing systems at the local level to broadcast and/or autodial to automatically distribute alerts and messages to these systems/devices, and the capacity to link to the emergency communication systems. If necessary, make improvements during this budget cycle. Activity 6: Implement a back-up process or method to MICHAN for receiving critical alerts such as pagers, cell phones, voice mailboxes, to receive alerts in full redundancy with . Activity 7: Collaborate with local emergency management, other local/regional partners and the MDCH to evaluate and assess national standards from which to develop an effective emergency communication system. Activity 8: Provide for technological and staffing redundancy of critical information and communication systems to support these functions. Activity 9: Routinely assess the timeliness and completeness of the redundant method of alerting. Critical Capacity #13: To ensure the ongoing protection of critical data information systems and capabilities for continuity of operations. Activity 10: Assess the existing capacity in your jurisdiction regarding policies and procedures for protecting and granting access to secure systems for management of secure information, system backups, and systems redundancy.

30 Activity 11: Activity 12: Activity 13: Activity 14: Perform regular local validation and verification of Internet security, vulnerability assessment, and security and continuity of operations practices and rapidly implement recommended remedial activities. Establish a firewall for the protection of critical information resources from the Internet based on guidelines provided by MDCH/OPHP MIHAN Coordinator. Use and update anti-virus software to protect technological equipment and essential communication systems. Implement software systems and/or servers to support the activities of the Critical Capacities elsewhere in this guidance. FOCUS AREA F: Communicating Health Risks and Health Information Dissemination Critical Capacity #15: To provide needed health/risk information to the public and key partners during a terrorism event by establishing critical baseline information about the current communication needs and barriers within individual communities, and identifying effective channels of communication for reaching the general public and special populations during public health threats and emergencies. Activity 1: Complete a plan for crisis and emergency risk communication (CERC) and information dissemination, using the MICERC template to educate the media, public, partners and stakeholders regarding risks associated with the real or apparent threat and an effective public response. Activity 2: Use and evaluate communication systems during exercises and training to ensure channels of communications to inform the public, partners and stakeholders about recommendations during public health emergencies. Activity 3: Complete a plan for activities that will be implemented to meet the specific needs of special populations that include but not limited to people with disabilities, minority groups, the non-english speaking, children and the elderly. Consider all operational and infrastructure issues as well as public information/risk communications strategies. Such activities must be integrated with hospital communities. Activity 4: Using the MICERC template, assess local public information needs and identify communication resources needed for the public distribution of supplies through the SNS Program. Activity 5: Evaluate current capabilities to provide hotline services during a public health emergency. Where no capacity exists, establish a hotline for emergency preparedness and response.

31 Activity 6: Activity 7: Activity 8: Activity 9: Activity 10: Train key local public health staff who may be involved in crisis and emergency risk communication principles and standards. (Smallpox) Enumerate participants in a public information system, including call-down lists fo public health and clinical contacts that can be activated to address communications and information dissemination issues regarding smallpox. Adapt CDC and/or MDCH/OPHP smallpox training and education communication materials for dissemination to local stakeholders and the general public. Coordinate public information and crisis communication with adjacent counties, jurisdictions, tribal health centers, regions, states and countries. Establish mechanisms to adapt emergency messages into priority languages spoken within the local jurisdiction. Enhanced Capacity #11: To identify, develop and improve crisis and emergency-risk communication planning with respect to the needs of specific populations, cultural and psychological aspects of crisis communication, and communication barriers to effective public health response during public health emergencies including terrorism, infectious disease outbreaks and other public health threats and emergencies. Activity 11: Activity 12: Incorporate local resources and activities related to crisis and emergency risk communication into LHD websites with links to other federal, state, regional and local websites. With other stakeholders, establish the capacity to conduct public outreach campaigns which may include town-hall meetings and presentations to civic organizations, schools, businesses, faith-based institutions and special ethnic and cultural groups. FOCUS AREA G: Education and Training Critical Capacity #16: To ensure the delivery of appropriate education and training to key public health professionals, infectious disease specialists, emergency department personnel and other healthcare providers in preparedness for and response to bioterrorism, other infectious disease outbreaks and other public health threats and emergencies. Activity 1: Identify a Point of Contract (POC) for Focus G Training activities. Activity 2: Develop a plan for institutionalizing MI-TRAIN as the