ST. LAWRENCE COUNTY BOARD OF HEALTH MINUTES For July 17, 2012 The St. Lawrence County Board of Health (hereafter typed SLCBOH) met on Tuesday, July 19, 2012 in the 2 nd floor conference room of the Human Services Center, Canton, New York. MEMBERS PRESENT: Timothy Monroe Benjamin Gruda, Gregory Healey, Robert Kimmes, and MEETING TO ORDER President Benjamin Gruda called the meeting to order at 6:03 pm. MINUTES OF THE JUNE 19, 2012 MEETING Mr. Gruda asked if there were any corrections or additions to the July 19, 2012 minutes. There were none. He made a motion to accept the minutes as written and all were in favor. COMMUNICATION There were no new communications to discuss. PUBLIC COMMENT There were no public comments. REPORTS Ticks, Lyme Disease, and EEE Myrna Barney Ms. Barney told the members of the Board that if they would like she would email them a copy of the Power Point she was going to present and with Ms. Hathaway s permission, the information would be put on the county website. Ms. Barney expressed to the Board that ticks, Lyme Disease and EEE are high priority this summer. The public needs to be made aware of the dangers of these diseases. Ms. Barney distributed a number of items that were purchased and provided to St. Lawrence County to help with the spread of these diseases and to educate the public. The mosquito dunks distributed are for small areas of standing water that have been there for a prolonged period of time such as pools and ditches.
Ms. Barney presented a Power Point presentation regarding Lyme Disease and EEE. She explained that Lyme Disease is caused by a bacterium that is transmitted to humans through ticks. Symptoms can range from a red, expanding rash at the bite area, to additional lesions in other areas of the body, to intermittent bouts of arthritis, or severe joint pain. Symptoms differ depending on how long the disease is undiagnosed and untreated. Patients are usually treated with antibiotics in early stages and normally recover rapidly and completely. Patients diagnosed in a later stage following antibiotic treatment may have persistent or recurrent symptoms and are considered to have post-treatment Lyme disease syndrome. The presentation included tips for protecting yourself from ticks and how to keep them out of your yard. The Eastern Equine Encephalitis Virus (EEEV) is transmitted to humans by the bite of an infected mosquito. EEE is one of the most severe mosquitotransmitted diseases in the United States with a 33% mortality rate and significant brain damage in most survivors. There is no specific treatment for EEE. The presentation offered tips for protecting yourself from mosquitoes and how to keep mosquitoes out of your yard. There was also information regarding countywide mosquito control and the spraying of mosquitoes and the use of mosquito dunks. OLD BUSINESS Election of Officers President Gruda asked for nominations for the office of President of the SLCBOH. Mr. Monroe nominated Mr. Gruda for a second term. Dr. Healey seconded the nomination. There were no other nominations for President. President Gruda agreed to a second term and all present were in favor of the nomination. President Gruda asked for nominations for the office of Vice-President of the SLCBOH. Dr. Healey nominated Mr. Monroe for the position and Mr. Gruda seconded the nomination. There were no other nominations for Vice-President. Mr. Monroe agreed to accept the nomination and all present were in favor of the nomination. Board Meeting Dates for 2012-2013 After discussion it was decided to keep the same meeting schedule, time, and location as last year. Following are the dates for next year s meetings: September 18, 2012
November 20, 2012 March 19, 2013 April 16, 2013 June 18, 2013 These meetings will continue to be held at 6:00 pm in the large conference room on the Human Services Center. Respite Care and Medicaid Overpayment Ms. Hathaway Ms. Hathaway reported the internal audit of overpayment by Medicaid for respite care has been completed. The process took almost three months to complete. When Medicaid didn t pay us for billed care, this was taken as a credit toward the overpayment. The final overpayment amount was $299,709.11. This money will have to be paid back to Medicaid. The disclosure and submitted and we re waiting for Medicaid to get back with us regarding the method of repayment. We expect they will withhold our Medicaid payments in lieu of future payments until the repayment is complete. We don t expect to hear back from Medicaid before next week. Mr. Kimmes stated that the department could request Medicaid withhold a percentage of the department s payments. Tobacco Law - Ms. Maki Ms. Maki explained to the SLCBOH that she had distributed a new version of the tobacco law just before the meeting began. She explained that she had been on a telephone conference with Mr. Crowe, SLC Attorney, regarding the law and he had suggested some changes. One change requested was to add a description of tobacco usage. This has been added under Section 2 of the law. Also Mr. Crowe asked that the word charter be changed to local law throughout the law and this has been completed. Another issue raised with Section 6F was the wording regarding penalties. The wording has been changed to better describe the penalty for noncompliance when asked to leave the premises for violating the no-tobacco ban. Mr. Crowe suggested the law be voted on for its context and if passed he would review it for legal aspects/language which would change only wording and not the context of the law. Board members decided they would like to take the law to the Board of Legislators in August. They requested that Mr. Crowe revise the language and the final law be sent to them electronically for their final approval so it could be added to the agenda in August. Mr. Gruda made a suggestion that Draft 4-A of the tobacco law be passed in concept. Mr. Monroe made the motion and Mr. Kimmes seconded the motion. All were in favor.
Letter to Town Supervisors Re DCOs The letter written by Ms. Hathaway was sent electronically to the Board members for their review. Mr. Gruda asked if anyone had any additions or corrections to the letter. The only suggestion was to send a copy to police stations as well. With this suggestion agreed upon, Mr. Kimmes made a motion to accept the letter with suggested changes and Mr. Monroe seconded the motion. All were in favor. Mr. Gruda will sign the letters as they are sent from the Board of Health. NEW BUSINESS Public Health Infrastructure Ms. Hathaway explained to the Board that staffing has become a challenge for the department. One of the problems is an aging workforce. We have had one nurse out for six weeks with a broken ankle, a long-term employee is retiring and we have had resignations. Prevent has also been effected. We have lost four nurses there and another one is out on extended sick leave. To provide relief to the Prevent staff, we have decided to discontinue all blood pressure clinics. They will be stopped on August 1 st. Many people now have home blood pressure units, pharmacies to provide the service, and their own physicians. We are also looking at travel clinics and considering reducing the number or hours provided. We need to relieve some of the pressure on our staff. We originally had three nurses in the Cancer Services Program. We took one of the nurses and made her 50% Cancer Services and 50% Prevent. She will be trained for clinics and Maternal Child Health. Maternal Child Health is not a mandated program but it is necessary, especially in St. Lawrence County. The choice between taking care of sick babies and providing blood pressure clinics was clear. We have also asked one of our Community Health Nurses to do Maternal Child Health home visits as she has experience. By moving people around we ll be able to handle the necessary programs. Mr. Gruda asked for more information on the travel clinics. Ms. Hathaway told him that people who use the travel clinics pay cash up front for the immunizations. There is no cost to the department accept staffing. Most doctors don t stock these less common vaccines. This is still under review. Mr. Monroe expressed that what the department has done to alleviate the number of rabies clinics we provide by asking the towns to do their own has worked out very well.
Dr. Healey expressed an interest in providing free annual checkups for clients. He felt that this should be promoted. Another idea was to develop some sort of parenting classes. New parents need to be told how to wash a baby, how often, etc. We deal with a lot of teen Moms. What can we do to encourage mothers to participate in parenting classes? Mr. Monroe told the Board that there are a couple of Moms groups in Gouverneur. Ms. Hathaway told the Board that Karen St. Hilaire has asked that Public Health cut an additional $400,000 from it 2013 budget. We are looking at ways to accomplish this. Staff reduction is not an option. PERSONNEL Ms. Hathaway asked that the remaining issues be taken into executive session. Dr. Healey made the motion to go to executive session and Mr. Monroe seconded it. The Board went into executive session at 7:05 pm. At 7:26 Mr. Monroe made a motion to adjourn the executive session and adjourn. Mr. Kimmes seconded. The executive session and meeting were adjourned. Respectfully Submitted, Rosemary A. Brown Administrative Assistant