PRIMARY CARE/PUBLIC HEALTH COMMITTEE There was a meeting of the Primary Care/Public Health Committee on Thursday, June 24, 2004 at 10:00 a.m. in First Floor Conference Room A, of the County Administration Building, 1840 25 th Street, Vero Beach, Florida. Present were Chairman Michele Kiesel, Director of Nursing, Health Department; and Joyce Johnston-Carlson, Director of Human Services, Indian River County (IRC); D. Scott Joseph, Executive Director, Healthy Start Coalition; Beverly O'Neill, Community Health Network (CHN); Karen Lampert-Riley, RN, Visiting Nurse Association (VNA); Barbara Horne, Vice President and Chief Nursing Officer, Indian River Memorial Hospital (IRMH); G. Leigh Lupton, Fellsmere Community Health Coalition; Karen Deigl, and Lalita Janke, Indian River Memorial Hospital District; Brian Burkeen, Chief, Emergency Medical Services (EMS); and Victor Hart, Sr., Gifford Community Representative. Also present were Liaison Commissioner Caroline Ginn; Kristine Sarkauskas, Executive Director, Mental Health Association; William DeBraal, Assistant County Attorney, IRC; Tina Zayas, Indian River Memorial Hospital District, Indian River County; Mark Mucher, Taxpayer s Association; Bill Brunner, Sheriff s Department, IRC; and Victoria Phillips, Staff Assistant IV, IRC. Absent was Carol Molloy, Acquired Immune Deficiency Syndrome (AIDS) Support Group of IRC (excused). Call to Order Chairman Kiesel called the meeting to order and welcomed everyone in attendance. Additions/Deletions to the Agenda Chairman Kiesel asked if anyone had any objection to changing the order of the agenda so that after Kristine Sarkauskas, Barbara Horne would present her update, and move Public Health down to the bottom. There were no objections. Approval of Minutes Chairman Kiesel said on page 2, paragraph 3 of the April 29, 2004 minutes it might be much clearer to state draw down dollars as a collaborative effort and end the sentence, and to correct Mr. Loupton s name to Lupton wherever it appeared. 1
ON MOTION by Ms. Sarkauskas, SECONDED by Ms. Horne, the Board voted unanimously (10-0) to approve the minutes of April 29, 2004 as amended. Discussion re Primary Care Resolution Chairman Kiesel referred to the resolution distributed to the members, a copy of which is on file in the County Commission office. She then reviewed the item pertaining to membership. Ms. Deigl felt the objective of this committee should be better defined, because if the update format continued on a regular basis, meetings would probably last five hours; therefore, the purpose would identify who the participants should be. A discussion ensued as to the powers and duties of the committee, and it was determined items 4.a, 4.e and 4.f would be amended, as follows: 4.a. 4.e. 4.f. Consider and study the entire field of primary and public health care services within Indian River County. Vote to support grant application or other types of assistance from private and public groups to further the goals of the committee. Collaborate, coordinate and cooperate among the various entities represented by the committee. No changes to items 4.b., 4.c., and 4.d. ON MOTION by Ms. Janke, SECONDED by Mr. Hart, the Board voted unanimously (10-0) to approve the powers and duties of the committee as outlined. A discussion ensued concerning future changes, and Chairman Kiesel suggested approval be delayed in case the next few pages of the resolution generated some more ideas. Ms. Janke withdrew her motion. A conversation followed concerning item 5, and it was decided the definition would stay as is, except that the word Commission should be changed to committee. 2
ON MOTION by Ms. Janke, SECONDED by Mr. Hart, the Board voted unanimously (10-0) to approve item #5 and substitute the word Commission with committee. Chairman Kiesel brought up the issue of membership, and Mr. Joseph requested Indian River County be added in front of Healthy Start Coalition to distinguish it from the other 33 Healthy Start Coalitions in the State of Florida. Chairman Kiesel read the proposed membership, and after a brief discussion, it was agreed the Primary Care Committee would consist of the following members: 1. Community Health Network 2. Council on Aging 3. Department of Children and Families 4. Fellsmere Medical Center 5. Gifford Health Center 6. Indian River County Emergency Medical Service 7. Indian River County Health Department 8. Indian River County Healthy Start Coalition 9. Indian River County Hospital District 10. Indian River County Human Services 11. Indian River County Ministerial Association 12. Indian River County School District 13. Indian River County Sheriff s Department 14. Indian River Memorial Hospital 15. Member of the public 16. Mental Health Association 17. New Horizons of the Treasure Coast 18. Sebastian River Medical Center 19. Taxpayer s Association 20. Treasure Coast Homeless Services Council 21. Visiting Nurses Association Assistant County Attorney DeBraal mentioned since there were many members, it might be a good idea to consider setting up a quorum for a specific number in order to avoid attendance problems. Commissioner Ginn remarked she would not want to see it reduced to the point where there would only be a few people making decisions; however, this could be considered if it became a problem at a later date. Mr. Lupton stated he would be the dissenting vote in approving the resolution. He felt the committee would be too large to conduct business in an 3
expeditious manner, particularly with updates. Mr. Joseph stated the big question was if CHN would eventually merge into this group and if everyone would be willing to go through this process all over again if that occurred. Ms. O'Neill said she had extended an invitation to all the membership of CHN, and some were present, because she did not see a need for all these bodies to take care of health; however, CHN had not voted to disband, and she needed to give the members the opportunity to do so. Ms. Horne stated a large number of people attended both meetings, and there was a huge amount of redundancy, and it was difficult to allocate time to do the same thing in two different places. She said it did not matter to her which committee it would be, but she would like to attend one, and she did not see the need to provide an update at every meeting. Mr. Burkeen remarked he did not think it was important to give updates every quarter, but those people who wanted to give updates should request to be put on the agenda. He suggested the discussion insofar as the rest of the membership was concerned should be tabled until CHN was dissolved. Chairman Kiesel emphasized this conversation had been going on for some time and she expected today would be the culmination of this group welcoming CHN, acknowledging CHN s fabulous accomplishments, and continuing from that point on. Assistant County Attorney DeBraal noted when taking a look at the membership, there was only one member from each area, except for Ms. Deigl and Ms. Janke, who were both under the Hospital District. A discussion ensued concerning various membership alternatives, and Chairman Kiesel suggested a disclaimer be added to the resolution so that if more than one person from an agency was represented, only one would be entitled to vote. ON MOTION by Ms. Johnston-Carlson, SECONDED by Mr. Hart, the Board voted unanimously (10-0) to approve the resolution as amended with a disclaimer stating if more than one agency was represented, only one vote would be recognized. 4
Updates Mental Health - Kristine Sarkauskas Ms. Sarkauskas distributed a Mental Health Newsletter and a pamphlet from the Mental Health Association of Central Florida, a copy of which is on file in the County Commission office. Ms. Sarkauskas explained the Medical Security Program was a means of identification for people suffering from mental illness or other types of disabilities, causing them to become disoriented and not be able to communicate with law enforcement as to who they were, and where they needed to go. Mr. Brunner remarked representatives from the Mental Health Association of Central Florida spoke at the Sheriff s Office, and all law enforcement officers in the County would be trained as to what to look for when confronting these individuals. Indian River Memorial Hospital - Barbara Horne Ms. Horne spoke about the renovations which would take place to fully accommodate the open heart surgery unit, which was scheduled to start in January 2006. Ms. Horne said the Emergency Department project was on schedule for January 2005, and the existing empty space would be renovated to accommodate IRMH s outpatient entrance. Chairman Kiesel interjected the Health Department, the physicians and some other clinicians met with the hospitalists and smoothed out the referral process, doctor-to-doctor and nurse-to-nurse. Ms. Horne commented there were a lot of doctors who were not taking emergency calls, and as a result, IRMH was conducting physician recruitment and primary care. AIDS Support Group - Carol Molloy Chairman Kiesel mentioned she had a conversation with Ms. Molloy who told her while she had not been able to attend these meetings lately, she fully intended attending them in the future. 5
Community Health Network (CHN) - Beverly O Neill Ms. O'Neill stated she had nothing new to report at this time. Emergency Services - Brian Burkeen Mr. Burkeen reported he had been talking to the IRMH Emergency Room (ER) doctors about alleviating some of the seasonal crush occurring in the ER because a lot of the abusers of the system resided in local assisted living facilities and nursing homes. Fellsmere Community Health Coalition - Graylan Lupton Mr. Lupton said by next month, he would no longer have a pediatrician on staff and would be trying different ways to obtain a pediatrician using different funding mechanisms. Mr. Lupton advised beginning July 1, 2004, the minimum fee for lab and physician fees would change from $10.00 to $15.00. Gifford Health Center - Victor Hart, Sr. Mr. Hart related the Gifford Health Center had been receiving very good support from the surrounding areas, and his goal was to let people know there was health care available, so no one could say they had no place to go. Healthy Start Coalition - D. Scott Joseph Mr. Joseph stated one of the big efforts of the Healthy Start Coalition involved looking into more long-term sustainable funding for the Tender Loving Care Newborn Program. Hospice Health Services: Visiting Nurses Association (VNA) Karen Lampert-Riley Ms. Lampert-Riley distributed information concerning Health Care on Wheels, a copy of which is on file in the County Commission office. She said there would be an open house for the public and those dates would be published in the paper. 6
Hospital District - Karen Deigl Ms. Deigl stated the chairman s meeting would be taking place on Wednesday, July 14, 2004, and the millage rate would be set at the regular meeting of the trustees on July 15, 2004. She said the Hospital District had been funding five agencies, and since the funding methodology had not been reviewed for a number of years, some of the trustees had asked the issue be discussed at the chairman s meeting. Human Services - Joyce Johnson-Carlson Ms. Joyce Johnston-Carlson said she had nothing new to report. Public Health - Michele Kiesel Chairman Kiesel stated the Health Department was in the throes of working on its long-term plan. Old Business None New Business None Adjournment ON MOTION by Ms. Janke, SECONDED by Ms. Horne, the Board voted unanimously (10-0) to adjourn the meeting at 11:45 a.m. 7