CHIPPEWA COUNTY BOARD OF HEALTH MEETING January 28, 2011 PRESENT: James Moore, Don Cooper, Maryanne Shannon, Kathy Cairns, Aaron Hopper (arrived at 10:20 am) ALSO PRESENT: David Martin, Christine Lundquist, Heidi Bailey, Renee Crays, Jesse Knoll, and Lana Forrest CALL TO ORDER Mr. Moore called the meeting to order at 10:01 a.m. REVIEW OF AGENDA Mr. Moore called for review of the agenda. It moved by Mr. Cooper, supported by Ms. Cairns, to accept the agenda. On the call of the question there were three ayes. Motion REVIEW OF THE MINUTES Mr. Moore called for review of the minutes. It was moved by Ms. Cairns, supported by Mr. Cooper, to accept the December 23, 2010 and January 14, 2011 minutes. On the call of the question there were three ayes. Motion PUBLIC COMMENT Mr. Knoll expressed concern about a friend who is receiving home care. Mr. Knoll stated that he took his friend to Cheboygan and when he returned from Cheboygan, the home health nurse explained to the friend that he could lose Medicare benefits since an individual must be homebound in order to received Medicare covered home health. Ms. Lundquist explained the Medicare rules do not allow a homebound individual to continue to receive home care services if the individual is able to leave the home. Ms. Bailey explained a homebound client may leave the home to attend church, get his/her hair done, or see the physician. Mr. Knoll asked who he should see about getting the Medicare rules changed. Mr. Cooper explained that Medicare would withdraw the individual s eligibility which would affect the client s ability to obtain services. COMMITTEE REPORTS Finance Committee Mr. Cooper reviewed the Finance Committee report. Page 1
Claims and Accounts Mr. Cooper reviewed the January claims and accounts. It was noted that Dr. Garlinghouse s medical malpractice was included in this month s claims. It was moved by Mr. Cooper, supported by Ms. Cairns, to accept the January Claims and Accounts in the amount of $662,389.68. On the call of the question, there were three ayes. Motion Financial Statements The December financial statements were reviewed. There is a $186,000 loss year to date. It was moved by Mr. Cooper, supported by Mrs. Shannon to accept the December Financial Statements. On the call of the question there were three ayes. Motion Purchase Orders over $1,000 Netsmart upgrade New software package to replace the CMHC financial system. The cost is $261,226 and is completely grant funded. Mr. Cooper requested that letters of appreciation be placed in Mr. Carpentier s, Ms. Lundquist s, and Mr. Pietrangelo s personnel files for their proactive measures in determining the need for a new system and finding grant funding for the project. It was moved by Mr. Cooper, supported by Mrs. Shannon, to accept the Netsmart contract in the amount of $261,262. On the call of the question there were three ayes. Motion DSTech File Servers for the new software upgrade. The cost is $27,869 with 50% due up front. These costs are grant funded. It was moved by Mr. Cooper, supported by Ms. Cairns, to accept the DSTech file server purchase in the amount of $27,869. On the call of the question there were three ayes. Motion H1N1 Carryover grant We received the additional H1N1 funding. The Finance committee asked that the purchases be checked for local pricing. Ms. Cairns questioned if the radios could be found locally. It will be reviewed and the County purchasing policy will be followed. It was moved by Mr. Cooper, supported by Mrs. Shannon, to authorize the purchase of 2 generators, 10 radios, and a portable sign, with prices not to exceed those noted. On the call of the question there were three ayes. Motion EH computers Three computers are being requested. They would be purchased from three grant funding sources. Page 2
It was moved by Mr. Cooper, supported by Ms. Cairns, to purchase three laptops from grant funding in the amount of $5,014.89. On the call of the question there were three ayes. Motion Medicaid Cost Settlement We have received notice the 2009 cost settlement is $223, 919. It will be posted in January s financial statements. $100,000 will be placed against the receivables and $123,919 will be placed in income. Mr. Cooper suggested being less conservative for future cost settlement projections. Well Child Physicals The fee increase will be brought in July. Ramsey Badre will be here on Tuesday. We may need to increase the Home Health fees based on his recommendations. They are not a rate which can be brought in July. MERS Hybrid Plan The plan will be revised by MERS so individuals transferring between positions maintain their defined benefit plan. The resolution will be brought to the Board. Western UP grant The U.P. lab closed, leaving designated funding unused. To assist with potential problems involved with the closing, each U.P. health department will receive funding. The requirements for utilizing the funding are not well defined. Any purchases over $1,000 will be brought to the Board. Receivables/payables report and cash position It was noted the days of cash are down slightly. Furlough Days It was noted the furlough days will continue at least through the end of the fiscal year. A report will be provided to the Board after two months showing how the furlough days are working. It was moved by Mr. Cooper, supported by Mrs. Shannon, to accept the January 27, 2011 Finance Committee minutes. On the call of the question there were four ayes. Motion Community Health Services Committee Mr. Moore reviewed the Community Health Services Committee report. Home health 60 admissions for this month and are comparable to 2009. A report may be created to show skilled versus non skilled services. Policy Review 4.11.010 Refrigeration/freezer alarm The policy will be revised to include the SHACC procedures. Page 3
Emergency Preparedness supplies There should be a login/logout procedure for providing PPE. The expired PPE could be used as practice equipment for emergency responders. WIC Renee will inquire with the State requiring Walmart s vendor status. BCCCP A new poster was presented. The goal by 2012 is to reach 25% of women ages 40 49. Home Health Sliding fee scale Ms. Bailey is preparing a policy for the use of a sliding fee scale. Client s rejected by Medicaid will be required to show the reason for the rejection. Home Health and Hospice Face to Face physician requirements The forms are being revised. Dr. Garlinghouse will be making home hospice visit to clients. A nurse practitioner can provide the face to face visit but the nurse practitioner must already be an employee. The hospice face to face is at the third recertification. The home health requirements are much stricter. Mrs. Shannon believes this will be a costly endeavor and would like the department to review all options. Critical Stress Management February 16 and 17. Ms. Senkus will review what CEUs are offered. Community Family Night Will be held at the Middle School G codes Effective for episodes beginning on or after January 1, 2011, 32 G codes are required. Home Health is looking at using a superbill. Furlough days Teamster s union rejected the furlough days and a nurse was laid off. Public health is adjusting clinics according to staffing. WIC funding increase Ms. Crays noted that we received notice this morning indicating a rate increase of $4.00 per WIC participant as well as additional funding based on clients who meet certain criteria. It was moved by Mrs. Shannon, supported by Ms. Cairns, to accept the January 19, 2011 Community Health Services Committee minutes. On the call of the question there were four ayes. Motion Environmental Health Committee Mr. Moore reviewed the Environmental Health Committee report. Albany Bar The owner is upset there is a fee for any service. The owner is bringing the matter to the County Commission. MDA/Smoking room The State visited a local bar to check the smoke levels within the bar. The bar owner refused them entry into the bar. Mr. Martin noted the prosecutor is interpreting the law as the health department does and will not pursue prosecution until Page 4
clarification is received from the State. Mr. Cooper noted CCHD is following the regulation and there is no further discussion needed unless the State wants to address the matter further. Accreditation To prepare for May 2012 s accreditation, a complete self assessment is due one year before accreditation. The frequency of low risk establishments will be discussed. A fee structure proposal will be presented at the March meeting. Water programs CCHD passed its State evaluation. WUPDHD Lab grant A plan is being developed on how to use the funding. Septic Installers Conference The conference will be ½ day. It was moved by Mrs. Shannon, supported by Mr. Cooper, to accept the January 27, 2011 Environmental Health Committee minutes. On the call of the question there were four ayes. Motion Personnel Committee Mr. Moore reviewed the Personnel Committee report. Furlough days Mr. Moore clarified he meant the furlough days should end when a permanent financial turnaround has occurred. Medical Director degree requirements The State of Michigan requires medical directors to have a Master s in Public Health degree. Dr. Garlinghouse is working towards his degree. This requirement places a burden on the physicians and local health departments. It was moved by Mr. Cooper, supported by Mrs. Shannon, to accept the January 19, 2011 Personnel Committee minutes. On the call of the question there were four ayes. Motion OLD BUSINESS There was no old business. NEW BUSIENSS Annual Policy review It is required to have the agency policies reviewed and approved by the Board of Health annually. It was moved by Mrs. Shannon, supported by Ms. Cairns, to accept the agency policies. On the call of the question there were four ayes. Motion Home Health Annual Report The report was provided at last month s meeting. Page 5
It was moved by Mrs. Shannon, supported by Mr. Cooper, to accept the Home Health Annual report. On the call of the question there were four ayes. Motion HEALTH OFFICER S REPORT Prescription drug meeting Several meetings have been held to address the prescription drug problems which are occurring in the community. They have had great participation. The meetings times will be rotated to accommodate more individuals. Ms. Senkus is writing for grant funding. Mr. Knoll asked if we could send a mass email so the community could be more involved. Ms. Lundquist suggested placing an article in the paper. Ms. Cairns explained the MAPs program. She noted the State compiles a list of prescriptions acquired from all pharmacies around the state. There is a two week delay in getting the information entered. Smoke Free Law Mr. Martin noted that medical marihuana is being distributed in Oakland county food establishments since it is not covered by the smoke free law. Third hand smoke is defined as residuals from smoking (i.e., smell on the clothes, ashes). Mrs. Shannon noted that smoking is a large health issue but there are not enough resources to cover all areas. We have so many other critical issues which need immediate attention. Mrs. Shannon suggested placing an article in the paper noting the department is concerned about smoking. ESSAR Steel The company continues to make progress on reducing atmospheric conditions. ESSAR Steel was fined and must be meet certain strict requirements. A meeting is being scheduled for May for the public. Other: Smoke Free advertising The coalition would like to place a billboard sign. The sample was distributed to the Board. The Board does not agree with the sample presented. Mrs. Shannon believes the coalition should be included on the billboard. It was noted Chippewa County Health Department s name should be removed from the billboard if the one presented is used. It was moved by Mr. Hopper, supported by Ms. Cairns, to accept the Health Officer s report. On the call of the question there were four ayes. Motion REVIEW OF MEETING SCHEDULE CHS and Personnel Committees will move to February 22 at 1pm. Mrs. Shannon questioned if the County has a hiring policy for rehiring retired staff. Mr. Moore indicated the County does not have a policy but MERS has certain rules which will affect the process. Mr. Cooper believes the County should be proactive. Mrs. Shannon noted it could help with recruiting new staff to have a policy. Page 6
ADJOURNMENT It was moved by Mr. Cooper, supported by Mrs. Shannon, to adjourn the meeting. On the call of the call of the question there were four ayes. Motion Adjourned 11:19 a.m. Respectfully submitted, Lana Forrest Executive Assistant James Moore Board of Health Chairman Page 7