TB Board & Board of Health Minutes

LIVINGSTON COUNTY BOARD OF HEALTH

MEETING MINUTES

June 12, 2006

PRESENT:

Board of Health:

James Day, D.D.S.

Armin Groom (Buzz)

Steven Norris, M.D.

Pat Platz, R.N.

Fred Strufe, J.D.

ABSENT:

Board of Health

Jeanne Elliott, R.N.

Helen Holz, Co. Bd

PRESENT:

Health Department

MaLinda Hillman, Adm.

Jackie Dever, Director of Nursing

Donnie Simmons, Director of Environmental Health

PRESENT:

Public Health Committee

Frank Deninger

David Heath

Harold Lyons

ABSENT:

Public Health Committee

Stan Weber

I. Call to Order

The meeting was called to order by President Jim Day at 7 PM. with the following change in the agenda accepted: V. New Business, C. Policy and Procedure Review, 8. Lipid panel.

II. Approval of March 13, 2006 Meeting Minutes

Fred Strufe made a motion, seconded by Buzz Groom to approve the March 13, 2006 meeting minutes. Motion carried.

III. Reports

A. Administrative Report by MaLinda Hillman, Administrator

Once again the health department certification has been extended another six months. The Illinois Department of Public Health hasn’t had the resources to review the IPLAN submitted early in 2005. We continue to implement IPLAN as feasible and as if it was approved.

The Livingston County Health Department was selected as a host site for one AmeriCorp member for the 2006-2007 service year. Members are recruited through June and then host sites have the opportunity to interview prospective candidates. The focus will be on health education projects. Service begins in September.

State budget update: After approximately 7 – 8 years, an increase in the local health protection grant line item was successfully negotiated for a $3 million increase. Representative Tom Cross did reply to the Jim Day’s and MaLinda Hillman’s letters in regard to this matter. This grant is utilized for mandated core public health programs and funds approximately 30% of their total cost. The allocation of these funds is still under discussion but every health department in the state will receive an increase. The current formula is based on a minimum award, population and poverty. WIC received an increase in caseload of 12 individuals per month, so had an increase in the contract. Healthy Families Illinois is budgeted to receive a 3% cost of doing business increase. The majority of grants will remain at the same level of funding as last year. Most of the contracts haven’t arrived yet. For the tobacco prevention grant we will be applying for additional funds. The bioterrorism preparedness and pandemic flu planning grants funding levels are undetermined at this time. Current discussion on the preparedness grants is to have funding correlate with grant deliverables, with input from each county and be based on a risk assessment. The Illinois Breast & Cervical Cancer program has increased eligibility for the program to 250% of poverty since additional funds were included in the state’s budget. Heart Smart for Teens from the Office of Women’s Health, IDPH received an increase to $30,000.

An agreement has been signed with the Illinois Department of Public Health to gain access to vital record statistics earlier than when the published report is available. We should receive the 2000 – 2004 birth and death data online and be able to utilize it for surveillance activities.

Staffing has been challenging and will continue until next quarter. One professional support and one RN will be off approximately 2 weeks with surgery. One bookkeeper is off on FMLA (Family Medical Leave Act) due to her health for 4 weeks. One professional support has been off and worked sporadically due to the serious illness of a spouse. One professional support staff member is scheduled for major surgery in July and will be off 6 weeks. One homemaker has injured an ankle and is receiving treatment under workers compensation. Two staff members will decrease their hours over the summer due to family issues with the grants able to absorb this. Animal Control has not hired a PRN worker to work on the weekends yet.

B. Nursing Report by Jackie Dever, Director of Nursing

Public Health:

Annual program review by the State was done for the HFI and TPS programs in March. Both had excellent reviews. WIC audit was held in May and we have not received the results yet.

Immunization clinics were offered in April to all schools in the county. This year we were able to offer the new TDaP vaccine. Of those that participated, most chose to get the new Pertussis vaccine. Unfortunately, we had very low numbers this year at all schools. We will be evaluating this program to determine if it is financially feasible to continue to offer the clinics in the schools.

Dawn Thorson and Valerie Knapp held CPR and AED trainings for school personnel in April. LCHD staff will be trained in June.

Communicable disease department has been working closely with the State regarding the mumps outbreak. We have had 2 confirmed cases, both in their 50s. We are also getting reports on chickenpox, with half of the cases being in children who have previously received the vaccine. Pertussis cases continue to be reported in pockets throughout the county.

HEALTH EDUCATION:

Arthritis: Linda Rhodes participated in the State Arthritis Partnership meeting and Legislative Action Day in Springfield. Lori Lake conducted the third Arthritis Self Help Course for the fiscal year with 12 participants. On May 25^th, the LCHD arthritis partnership conducted an arthritis workshop for the general public, to recognize Arthritis Awareness Month. Seventeen people participated. Due to restructuring of the CDC grant funding provided to IDPH, at this time IDPH will not be seeking proposals for grant funding from local health departments in FY07.

Women’s Health: The final Heart Smart for Teens programs were conducted at Dwight and Pontiac Junior High Schools this quarter. Two hundred thirty four students completed the program this fiscal year. A grant application has been submitted to IDPH to expand this program to more schools in FY07. LCHD contracted with Illinois State University to conduct a pilot ‘Comprehensive Women’s Health’ program. If approved, the pilot program will become one of the model programs offered through IDPH-Office of Women’s Health grant program in FY08. Flanagan School District served as the pilot site and 16 school staff participated in the program. LCHD contracted with the LaSalle County Health Department to provide Osteoporosis Screening at a women’s health fair in Ottawa. Fifty women participated in the screening. Forty-five women participated in the two May worksite wellness clinics conducted at Vactor Guzzler Mfg in Streator.

Men’s Health: Prostate and Testicular Cancer Education and Awareness grant activities:

1) One Prostate Cancer Education program was conducted in Pontiac.

2) Monthly No-cost PSA/DRE clinics for under and uninsured eligible men were conducted.

March of Dimes: 1) HIV prevention education classes were conducted in 11 junior high and high school classes; 2) two special educational sessions for family planning clients; and 3) The “Its Your Future – Its Your Choice” teen pregnancy and STD prevention program was conducted at Prairie Central, Dwight, and Pontiac Junior High Schools, with a total of 479 students in attendance. Programs funded by this grant will be continued during the 2006-2007 Fall semester.

Tobacco: 535 4^th grade students attended Livingston’s Body Walk. The 479 junior high students who attended Its Your Future – Its Your Choice were provided education regarding tobacco’s effect on the unborn child. LCHD has received the tobacco grant RFP for FY07. IDPH is making changes in program requirements.

Special Events: In collaboration with Bro-Menn Wellness Center, U of I Extension and Illinois Heart and Lung, LCHD is conducting a Community Walking Program.

C. CLIA Report by Jackie Dever, RN, Director of Nursing

Monthly audits were done to assure that appropriate documentation of all labs and procedures were done by staff. Results were within normal limits and no remedial actions were required. Proficiency testing was done by the FNP, with no problems found.

D. Environmental Health Report by Donnie Simmons, LEHP, Director of Environmental Health

A proposed chicken processing plant site that is north of Fairbury has been approved by Livingston County Zoning. This plant will not have public water or public wastewater disposal available to it. An existing water well located on the property will be used to provide water to the plant. Illinois Department of Agriculture will monitor the water to assure it is safe to use in the processing and will inspect the operation of the plant. Wastewater disposal will be handled through the design and installation of a private sewage disposal system. The current goal is to design a system that will not have a surface discharge. The challenges in designing this system is the high strength wastewater that will result in the chicken processing. A meeting with the Farnsworth Group to discuss concerns and ideas that should be incorporated into the design has taken place. No design proposal has been received to date.

With the start of summer, also begins the appearance of mosquitos and West Nile Virus (WNV). This year the Illinois Department of Public Health has expanded the list of birds accepted for testing from Blue Jay’s and Crows to all perching birds (over thirty species). We are still limited to having a total of ten birds tested.

Mosquito collection sites are being operated once per week in the communities of Flanagan, Fairbury and Pontiac. Collected mosquitos are then tested for WNV.

The Illinois Department of Public Health has purchased a quantity of larvicide that they are making available to local health departments. We have requested the maximum amount available to each health department which is four cases. Once we receive the larvicide, communities will be notified of this. They are to notify this department if they have an interest in receiving this product in a limited quantity.

E. Advisory Board Reports by MaLinda Hillman, Adm.

1. Case Coordination Unit

The minutes of the January 26, 2006 meeting were reviewed.

2. Healthy Families Illinois

The minutes of the May 4, 2006 meeting were reviewed.

F. Annual Financial Report by MaLinda Hillman, Adm.

The balance on hand as of March 1, 2006: $700,973.79. Quarterly receipts: $372,947.20. Quarterly disbursements: $459,491.25. This leaves a balance on hand of $614,429.74 as of May 31, 2006. An itemized listing of the receipts and disbursements was distributed. Grant funds have been on target for payment. EPSDT (Public Aid) is behind with $43,700 still being owed thru April of this year. Buzz Groom made a motion, seconded by Fred Strufe, to approve the financial report as submitted. Motion carried.

G. Quarterly Wellness Financial Report by MaLinda Hillman, Adm.

The balance on hand as of March 1, 2006: $30,890.19. Receipts for the quarter: $3,065.00. Expenses for the quarter: $8,115.41. This leaves a balance on hand of $25,839.78 as of May 31, 2006. Fred Strufe made a motion, seconded by Pat Platz, to approve the Wellness Financial Report. Motion carried.

H. Gladys Kohrt Memorial Fund by MaLinda Hillman, Adm.

The balance in the fund as of May 31, 2006 was $7,179.82 with little activity this past quarter. Fred Strufe made a motion, seconded by Dr. Norris, to approve the Memorial Fund report. Motion carried.

I. Donation/Cancer Fund by MaLinda Hillman, Adm.

The balance on hand of the donation fund (without the cancer fund included) as of February 28, 2006 was $37,419.43. The expenses for the quarter: $738.20. The donation fund balance as of May 31, 2006: $37,090.79. The cancer fund had a balance of $30,816.31 as of February 28, 2006. Income for the quarter: $236.50. Expenses for the quarter: $933.38. The balance of the cancer fund as of May 31, 2006: $30,119.43. Buzz Groom made a motion, seconded by Pat Platz, to approve the donation/cancer fund report. Motion carried.

IV. Old Business

None.

V. New Business

A. Grants/Contracts/Agreements

1. Agreement between Livingston County Tuberculosis Care and Treatment Board and Livingston County Board of Health

MaLinda Hillman reviewed the agreement which outlines the responsibilities of both boards and the administrative fee. The TB Board had passed the agreement. Buzz Groom made a motion, seconded by Fred Strufe, to approve the agreement. Motion carried.

2. Pandemic Flu

The Illinois Department of Public Health has awarded a contract to the health department for $14,250 for May - August 31, 2006 to conduct an assessment of pandemic flu preparedness in the county, develop a county plan, and attend a regional exercise with our partners. Fred Strufe made a motion, seconded by Buzz Groom, to authorize acceptance of the contract. Motion carried.

B. Health Insurance Rates

The county participates in the Local Government Health Plan for employees. The rates increased significantly (HMO increased 16.5% and Cigna increased 19.8%). The county appealed the rate increase and was successful, which will translate into a savings of $7,000 for the health department and please the employees. The increase will be approximately 10%. This will increase our line item for health insurance by $22,000 for the next year. Two employees added the coverage for a total of 25 employees participating from the health department. This benefit is worth $5,290 per employee.

C. Policy and Procedure Review

1. Affirmative Action Policy, 2006/2007 Goals and Workforce Analysis

MaLinda Hillman reviewed the policy, goals and analysis which is comparable to the county’s population characteristics. Fred Strufe made a motion, seconded by Pat Platz, to approve the policy, goals and analysis. Motion carried. The report will be submitted to the state to fulfill grant requirements.

2. School Based Health Clinic - School and & Athletic Physical Exam Policy

MaLinda Hillman reviewed the policy for the SBHC which had not changed.

3. Personnel Pilot Project - LCHD Voluntary Flexible Hour Work Week Policy

MaLinda Hillman reviewed the proposed policy with the pilot anticipating to last 1 year. 17 employees (47%) have expressed interest in participating. All services will remain the same and program statistics will be monitored to insure that clients aren’t negatively impacted. Fred Strufe made a motion, seconded by Buzz Groom, to approve the pilot project. Motion carried.

4. WIC, CLIA, Hearing & Vision Policies

Staff will continue with the same policies for the next year.

5. Family Planning Manual

All the family planning policies have been reviewed/revised to reflect the federal/state requirements.

6. Fee - Lipid Panel

Clients have requested to have their lipids rechecked through the Wellness Clinic in conjunction with medical management of the case. Many of the clients have limited resources to have it rechecked. There was a discussion. Fred Strufe made a motion, seconded by Buzz Groom, to approve the following fees: Lipid Panel: $15, Liver Function: $15. Motion carried.

D. Emergency Generator

When the health department had coordinated a full scale BT drill last February, one item that came up was that the health department did not have a back up generator. The Livingston County jail facility has an old generator to dispose of. The cost to move the generator would be $6,000 with additional costs of $800 to change a breaker box and $5,900 to run a natural gas line. There was discussion. It was decided that it was cost prohibitive to move the generator to the building, so it will be declined. Homeland Security funds for McLean and Livingston had been authorized to purchase a small generator as a back up for the vaccine refrigerator. MaLinda Hillman has requested Chuck Schopp, ESDA Director to check and see where the generator is.

E. Pandemic Flu

MaLinda Hillman distributed a handout on Pandemic flu with estimates on the impact of Livingston County that she had developed from participating in various state exercises and receiving updates from the government. The prioritization groups for vaccine and anti-viral medications were included with the problems noted that medical supplies will be inadequate. There was discussion.

F. Appointments

1. Board of Health Physician

Dr. James McKinney has resigned as a Board of Health member and Medical Director alternate as he has moved out of the county. MaLinda Hillman and Dr. Norris will continue to look for another physician to fill this role.

2. Finance Committee

Dr. James Day appointed Fred Strufe, Helen Holz, Buzz Groom and himself to work with MaLinda on the health department’s budget for next fiscal year with the consent of the board.

3. Family Planning Information and Education Advisory Committee

Fred Strufe made a motion, seconded by Pat Platz, to appoint the following to the Information and Advisory Committee for the Family Planning program at the health department: Linda Rhodes, Desiree Eden, Esmeralda Pina, Tim Dever, Shekedra Woods, Sabrina Oxarart, Patty Habercorn, Sue Shifflitt and Jeanne Elliott. Motion carried.

4. Certification of Physicians

Fred Strufe made a motion, seconded by Buzz Groom to have Dr. Steve Norris continue to serve as the health department medical advisor. Motion carried.

G. Election of Officers

Buzz Groom made a motion, seconded by Pat Platz, to elect Dr. James Day President of the Board of Health and Fred Strufe as Secretary of the Board of Health. Motion carried.

H. Other

None.

VI. Adjourn until September 11, 2006

Fred Strufe made a motion, seconded by Buzz Groom, to adjourn the meeting until September 11, 2006. Motion carried.

Respectfully submitted,

Fred Strufe, J.D., Board of Health Secretary

Call to Order

The meeting was called to order by President Jim Day at 7 PM.

II. Approval of September 12, 2005 Meeting Minutes

Fred Strufe made a motion, seconded by Dr. McKinney to approve the September 12, 2005 meeting minutes. Motion carried.

III. Reports

A. Administrative Report by MaLinda Hillman, Administrator

The TB and Board of Health agendas and minutes (after being approved) will be posted routinely on the health department’s web site starting this December. The Open Meetings Act was amended to include this mandate for any public body that has a website that is maintained by their staff. Our website is www.lchd.us.

For our bioterrorism preparedness grant, a full scale dispensing exercise for oral medication will be conducted on Friday, February 10. Clinics will be cancelled so that all staff will be available. Several of our community partners will be participating. Objectives are to train our staff, assess our plan, and have baseline data on the time it takes to implement activities. Planning meetings are underway. A drop site exercise was conducted in October which provided a valuable learning experience. ESDA, Highway and the Sheriff’s department coordinated well with us for this exercise. There are concerns with the different state agencies’ performances. A tabletop exercise was conducted with community partners in November and then repeated at the staff meeting. The bioterrorism preparedness grant deliverables are very ambitious and will require local support for implementation. CDC requires that the plan demonstrates that the entire population be able to receive prophylactic medication within 48 hours. There was a discussion on preparedness plan.

The state has completed the pandemic flu plan for Illinois and is in the process of furnishing guidelines to health departments on what will be required in a local plan. This plan should be coordinated with our SNS plan. Unfortunately there are two different state level departments involved, which complicates the process. A handout was available on pandemic flu.

In January of 2006, Illinois will begin name reporting for HIV/Aids testing. This is being required by CDC and is tied to funding. We currently do not receive any grant funding for this and do the tests in our STD clinics. Further training will be done for staff.

MaLinda Hillman continues to work on the Family Case Management (FCM) funding issue on the state level. This is being done as a coalition with Chicago, Northern Illinois Public Health Consortium, Illinois Public Health Association and Illinois Association of Public Health Administrators participating. FCM has not received any increase in funding for over ten years. Funding has been reallocated the past several years based on the number of Medicaid eligible pregnant women and infants in the county and the number of those who were served. Due to an increase statewide in eligible participants, Livingston County has received a decrease in funding, even though the numbers served haven’t decreased. Medicaid matching funds has helped but it is becoming more challenging. FCM and WIC have been proven to provide significant Medicaid savings. I’ve attached the latest fact sheet utilized in our discussions with the Bureau of the Budget. FCM, WIC, immunizations and EPSDT services are fully integrated here. The allocation formula for the next state fiscal year has not been determined.

Staffing: Nancy Nylander plans to retire March 31, 2006 after 22 years at the health department. The rehiring process will be started in January.

B. Nursing Report by Jackie Dever, Director of Nursing

PUBLIC HEALTH:

Three programs were audited this quarter, including family planning, SBHC, and immunization clinic. All went very well and had several commendations. Family planning had only minor requirements that needed addressed.

Family planning will be following a new policy that addresses services for new teens. The no-show rate for teens has been high, so to address this issue, staff will assure that teens are given an appointment for clinic within 2 weeks of calling for services. Procedures for notifying clients and follow-up for missed appointments will also be addressed in this policy. The FP nursing supervisor will track the no-show rates for improvement.

IBCCP has received $3,500 additional funding that will allow us to serve approximately 10 more women. The Komen grant has been applied for again this year.

As part of the Bio-terrorism grant, meetings have been scheduled with the Red Cross to work on volunteer recruitment to assist LCHD staff during a dispensing exercise.

Flu clinics have been held through-out the county this year. Clinics will continue to be held at the Health Department, as long as vaccine is available. We received a total of 3500 adult doses this year.

HEALTH EDUCATION:

Arthritis: Health Educator Lori Lake conducted the Arthritis Foundation’s Self Help Course in Pontiac. One more course series will be conducted before the end of the grant period in June, 2006. Health Education Program Coordinator Linda Rhodes has been working with the Illinois Arthritis Initiative to write a new Illinois Arthritis Action Plan for the next five year period.

Osteoporosis: A full day of screening was conducted in conjunction with the health fair at Kankakee Natural Foods in Bradley.

Tobacco: Partnered with Odell Public and Prairie Central Junior High schools, Pour Richard’s and China Inn restaurants, IHR, and American Cancer Society, to conduct youth tobacco prevention and smoke-free restaurant recognition project, in conjunction with the Great American Smoke-out. Partnered with IHR to conduct youth tobacco prevention, and second-hand smoke education, at the Snow Flurry project offered to all 4^th and 5^th grade students in the county. Sixty 4^th and 5^th grade students participated and fifty high school Snowball members assisted with activities for the day.

Women’s Health: Heart Smart for Teens, heart disease prevention programs, are being conducted at Dwight and Pontiac Junior High Schools. Seventy students completed the program this quarter.

Men’s Health: Prostate and Testicular Cancer Education and Awareness grant activities – 1) Prostate Cancer Education programs were conducted in Fairbury and Cornell. 2) No-cost PSA/DRE clinics for under and uninsured eligible men were conducted in September, October, and November; 3) a survey was sent to all local high schools to help determine if they are providing, or need LCHD to provide, Testicular Cancer Education programs.

COMMUNITY HEALTH:

Visits for the quarter were 6 for Private Pay Nurse, 204 for Homemaker and there were no Public Health Nurse visits.

C. CLIA Report by Jackie Dever, Director of Nursing

Monthly audits were done to assure that appropriate documentation of all labs are done by all staff. Results were within limits for all months and no remedial actions were required. Proficiency testing was done by the FNP with 100% accuracy.

D. Environmental Health Report by Donnie Simmons Director of Environmental Health

Earlier this year new federal legislation was passed that requires schools to be inspected a minimum of twice a year, develop a Hazard Analysis Critical Control Program (HACCP) and implement the HACCP Plan by the end of the 2006 school year. The HACCP Plan is required to be reviewed by some entity that was not named and conduct reviews to assure the HACCP Plan is followed. It is unclear how all this will share out. We are trying to take an active role in participating with area schools. We currently inspect school kitchens twice a year. Some health departments inspect schools once per year.

Mosquito collection for West Nile Virus ended October 15, 2005. No mosquitos were found to be infected with West Nile Virus. Letters were sent to the mayors of the communities where the collections took place explaining that surveillance is occurring and the results.

The Children’s Demonstration Kitchen was on display at Kids Fest Chicago held in St. Charles, Illinois. One of the organizers had visited the booth at the Illinois State Fair and thought it would be a nice addition to their event.

A food refresher and certified food manager course are being planned for this spring. Due to lack of participation in the last two certified food manager courses in the fall, there are no plans to schedule one for 2006 at this time. A fall food refresher course will still be held in the fall.

E. Advisory Board Reports

1. Case Coordination Unit

MaLinda Hillman reported that the CCU Advisory Board meets quarterly with the last meeting on October 27, 2005. The Medicare Prescription Drug plan was discussed with agencies providing program updates. The respite program conducted through the health department was renewed starting October 1, 2005. This allows up to $500 per person per fiscal year for respite care.

2. Healthy Families Illinois

MaLinda Hillman reviewed the minutes of the November 3, 2005 advisory board meeting. The acceptance and retention rates for the program were covered with ideas for improvement discussed. Seven participants graduated from the program in August.

3. School Based Health Center

The minutes of the School Based Health Center Advisory Board which met on August 31, 2005 were reviewed. The state fiscal year statistics were covered.

F. Annual Financial Report by MaLinda Hillman, Administrator

The balance on hand as of December 1, 2005: $659,016.87. Annual receipts: $1,768,775.38. Annual disbursements: $1,779,846.52. This leaves a balance on hand of $647,945.73 as of November 30, 2005. An itemized listing of the receipts and disbursements was distributed. Fred Strufe made a motion, seconded by Dr. McKinney, to approve the financial report as submitted. Motion carried.

G. Quarterly Wellness Financial Report by MaLinda Hillman, Adm.

The balance on hand as of September 1, 2005: $30,509.64. Receipts for the quarter: $2,105.00. Expenses for the quarter: $4,766.02. This leaves a balance on hand of $27,848.62 as of November 30, 2005. Fred Strufe made a motion, seconded by Helen Holz, to approve the Wellness Financial Report. Motion carried.

H. Gladys Kohrt Memorial Fund by MaLinda Hillman, Administrator

The balance in the fund as of August 31, 2005 was $7,350.27. Income for the quarter: $25. Expenses for the quarter were $48.45. The balance on hand as of November 30, 2005: $7,326.82. Fred Strufe made a motion, seconded by Buzz Groom, to approve the Memorial Fund report. Motion carried.

I. Donation/Cancer Fund by MaLinda Hillman, Administrator

The donation fund (which doesn’t include the cancer fund) has a balance of $36,786.25 as of August 31, 2005. Income for the quarter: $6,087.36 with a specific donation from the Byrne Trust to purchase a pharmacy refrigerator. Expenses for the quarter were: $610.71. This leaves a balance on hand of $42,262.90. The cancer fund which includes the funds recently received from the Hoerner estate has a balance of $31,421.47 as of August 31, 2005. Receipts for the quarter: $210. Expenses for the quarter: $407.00. The balance on hand as of November 30, 2005: $31,224.47. Dr. McKinney made a motion, seconded by Buzz Groom, to approve the report. Motion carried.

J. 2004 Audited Financial Statements

The public health section of the Livingston County Basic Financial Statements and Supplemental Information, November 30, 2004 was provided to the board. This audit is performed by Clifton Gunderson, LLP and shows the financial picture of the health department on an accrual basis.

IV. Old Business

A. Vision Screening

MaLinda Hillman reviewed the request of Dr. Bryan Stoller to mandate eye exams for certain grades of school children. MaLinda researched the proposal and found that the optometrist organization was the only professional association to recommend the mandate. Schools are happy with the current screening services provided by the health department. The board decided to not recommend mandatory vision exams. Dr. Stoller requested that the health department look into providing a centralized ordering and dispensing sight for the Illinois Department of Public Aid funded eye glasses. His office would be willing to train personnel to fit individuals for glasses. Administrative expenses for this program is a concern. It was decided that if Dr. Stoller could obtain a funding source to cover all expenses, the health department could look into providing the service.

B. IPLAN - Health Department Certification

The Illinois Department of Public Health is requiring additional time to complete the review of our IPLAN submission due to a lack of staff. IPLAN was submitted in April of 2005 and contains a county needs assessment and a five year county health plan. Thus our certification was extended by six months to May 1, 2006. MaLinda has been in contact with IDPH and the Illinois Association of Public Health Administrators has submitted a proposal to streamline the review process.

V. New Business

A. Vaccine Refrigerator

The current refrigerator that is utilized as a pharmacy refrigerator for vaccines has had difficulty maintaining a constant temperature. The Helmer company is a supplier of pharmacy refrigerators and has the contract with the CDC to provide each health department in Missouri with a vaccine refrigerator. Vermillion County has purchased a pharmacy refrigerator from the Helmer Company and is extremely pleased with it. The bid for a 25.2 cubic feet single door pharmacy refrigerator installed at the health department is $5,503.90. Humiston Trust was approached for a donation to purchase the refrigerator. The Alta Byrne Trust awarded the health department $5,500 to purchase the refrigerator. Pat Platz made a motion, seconded by Jeanne Elliott, to authorize the purchase and accept the donation for the pharmacy refrigerator. Motion carried.

B. Operational Definition of a Local Health Department and Standards

NACCHO (National Association of City and County Health Officials) has recently adopted an operational definition of a local health department which sets the standards for all local health departments to strive for, recognizing the variety within health departments across the nation. These standards incorporate the ten essential services of public health and is the direction the public health field has been moving towards. An informative handout was distributed. The IPLAN for Livingston County took into account these standards when the assessment was completed.

C. Grant Approval

Dr. McKinney made a motion, seconded by Buzz Groom, to authorize grant submission and acceptance (if awarded) for a mosquito testing grant and vector prevention grant. Motion carried.

D. Policy Review

1. Family Case Management, Fiscal, and HIPAA did not make any changes in their policy and will continue as before.

2. MaLinda Hillman reviewed the proposed Retention of Record policy with some changes and the records disposal certificate for submission. Fred Strufe made a motion, seconded by Dr. McKinney, to approve the changes for submission to destroy the records listed. Motion carried.

3. Fee Schedule

Proposed fee changes are to increase the food establishment category fees across board by $10 each, effective January 1, 2006. Food fees haven’t been increased since 1999. Dr. McKinney made a motion, seconded by Pat Platz, to approve the increases. Motion carried.

4. SBHC Scope of Care Policy

The scope of care for the PTHS School Based Health Center policy was reviewed. Fred Strufe made a motion, seconded by Dr. McKinney to approve the policy. Motion carried.

E. SBHC Advisory Board Members

The Livingston County Ministerial Association had agreed to nominate members to serve on the Advisory Board. Dr. McKinney made a motion, seconded by Helen Holz, to appoint Pastor Punt of the First Lutheran Church and Pastor Routien of the Pontiac Church of God to serve on the SBHC Advisory Board. Motion carried.

F. Allocation for FY06

MaLinda Hillman reviewed the allocation plan for indirect costs for general expenses that serve the good of all programs. This is utilized for the copier, phone, postage meter and general office expenses. Fred Strufe made a motion, seconded by Buzz Groom, to approve the allocation plan. Motion carried.

G. School Based Health Center Funding

Deferred to March board meeting.

H. Private Sewage Code Revisions

Donnie Simmons reviewed what currently is being proposed as changes to the Illinois Private Sewage Licensing Act & Code. There was a discussion on the changes.

I. Budget

1. Raises

Helen Holz made a motion, seconded by Buzz Groom, to authorize across the board 3% raises to all health department staff members effective January 1, 2006. Motion carried. The IRS mileage reimbursement rate will decrease to 44½ cents per mile effective 1/1/06.

2. Holiday Schedule

The holiday schedule adopted by the county board for employees for 2006 was furnished. There are 12 paid holidays, which is the same as in 2005.

J. FY2006 Board of Health Meeting Dates

The Board of Health will continue to meet quarterly on the second Monday of March, June, September and December in 2006 with the meeting to start at 7 PM at the health department conference room.

VI. Other

None.

VII. Adjourn until March 13, 2006

Helen Holz made a motion, seconded by Pat Platz, to adjourn the meeting. Motion carried.

Respectfully submitted,

Fred Strufe, J.D.

Board of Health Secretary

LIVINGSTON COUNTY TB BOARD

MEETING MINUTES

June 12, 2006

PRESENT: TB Board James Day, D.D.S.

Fred Strufe, J.D.

ABSENT: TB Board Muhammad Zafar, M.D.

PRESENT: Health Department MaLinda Hillman, Adm

PRESENT: Public Health Committee Frank Deninger

David Heath

Harold Lyons

ABSENT: Public Health Committee Helen Holz

Stan Weber

I. Call to Order

The meeting was called to order at 6:45 PM by Fred Strufe.

II. Approval of March 13, 2006 Meeting Minutes

Jim Day made a motion, seconded by Fred Strufe, to approve the minutes as submitted. Motion carried.

III. Reports

a. Statistical

There were 96 clients served during the second quarter of 2006. Two chest x-rays were authorized, 73 skin tests and 2 positive reactors were placed on medication. No active cases of TB was reported.

b. Financial

The beginning balance 3/1/06: $7,842.32. Quarterly receipts: $448.00. Quarterly disbursements: $5,916.66. This leaves a balance on hand as of 5/31/06 of $2,373.66. Next quarter the administrative payment might have to be delayed until the tax receipts are distributed. A detailed financial statement was also available. Jim Day made a motion, seconded by Fred Strufe, to approve the financial report as submitted. Motion carried.

IV. Old Business

None.

A. Agreement between Livingston County Tuberculosis Care and Treatment Board and Livingston County Board of Health

MaLinda Hillman reviewed the agreement, which is effective 7/1/06, outlining the responsibilities of both boards and the administrative fee. Fred Strufe made a motion, seconded by Jim Day to approve the agreement.

Jim Day made a motion, seconded by Fred Strufe, to retain the same officers. Motion carried.

Jim Day made a motion, seconded by Fred Strufe, to adjourn the meeting until September 11, 2006. Motion carried.

Jim Day made a motion, seconded by Fred Strufe, to approve the minutes as submitted. Motion carried.

There were 393 skin tests, 7 X-rays, 4 positive reactors placed on medication and 1 active case of TB for the county fiscal year.

The balance on hand as of December 1, 2004was $13,832.67. The annual receipts were: $24,948.05. Annual disbursements were: $26,274.75. This leaves a balance on hand as of November 30, 2005 of $12,505.97. A detailed financial statement was available. Jim Day made a motion, seconded by Fred Strufe, to approve the financial report as submitted. Motion carried.

The budget request for the next fiscal year was passed by the county board with an increase in the tax levy included.

MaLinda Hillman briefly reviewed the agreement between the Board and Dr. John Rinker. Jim Day made a motion, seconded by Fred Strufe to authorize the agreement. Motion carried.

MaLinda Hillman reviewed the Provision of Services policy which has only minor changes from the previous year. Jim Day made a motion, seconded by Fred Strufe, to approve the policy. Motion carried.

Jim Day made a motion, seconded by Fred Strufe, to adjourn the meeting until March 13, 2006. Motion carried.

Jim Day made a motion, seconded by Fred Strufe, to approve the minutes as submitted. Motion carried.

There weren’t any cases of TB identified or any positive reactors placed on medication this past quarter. 177 clients were served, with 2 chest x-rays authorized and 154 skin test performed.

The balance on hand as of June 1, 2005 was $3,351.29. The quarterly receipts were: $10,709.21 with approximately half of the tax levy received. Quarterly disbursements were: $6,263.27. This leaves a balance on hand as of August 31, 2005 of $7,797.23. Jim Day made a motion, seconded by Fred Strufe, to approve the financial report as submitted. Motion carried.

An update was provider on a TB patient. The medication had been decreased down to two medications and the patient is evaluated and managed by his physician in Kankakee every month. The three month follow-up skin tests on his contacts have been negative so far.

MaLinda Hillman provided an overview of the proposed FY2006 budget for TB. An increase in the tax levy to approximately $25,500 is proposed for a break even budget. Jim Day made a motion, seconded by Fred Strufe, to approve the proposed budget. Motion carried.

Jim Day made a motion, seconded by Fred Strufe, to adjourn the meeting until December 12, 2005. Motion carried.

The meeting was called to order by President Jim Day at 7 PM. The IRS mileage reimbursement rate was added to the agenda as V. H.

Fred Strufe made a motion, seconded by Buzz Groom to approve the June 13, 2005 meeting minutes. Motion carried.

The number of doses for influenza vaccine for the United States is still undetermined, but is starting to look better. Sanofi Pasteur and MedImmune are producing the same number of doses as last year, which was the entire supply. The vaccine the health department utilizes is from Sanofi Pasteur. Chiron is awaiting FDA approval for their vaccine with their FDA inspection in July being listed as “generally acceptable.” Chiron will still have to successfully complete production and final testing of vaccine before it may be released. GlaxoSmithKline has received license approval for their influenza vaccine, Fluarix as ofAugust 31, 2005. Our first shipment of vaccine has been confirmed, but is for only 20% of our order, with the remaining to be confirmed in 3 to 4 shipments. There could be a problem with nursing homes receiving enough vaccine for their residents. These individuals are categorized as the highest priority for receiving the vaccine, so they will be served first with our supply. Clinics will not be set up until official notification is received on the number of doses with the shipment dates. The VFC (Vaccine for Children) program should also be distributing influenza vaccine to providers for eligible children. If our vaccine supply is decreased, the CDC priority system will be utilized and recipients will be limited to county residents. Our order is for 3500 doses of the adult vaccine, which is what we gave last year.

A protest was registered over not being funded for the pregnancy prevention grant. The protest was denied due to the lack of resources to fund all programs. Funds were given to “communities identifying the highest need based on the teen pregnancy rates.” A proposal will be submitted to March of Dimes to continue with our “It’s Your Future, It’s Your Choice” program.

The Offices of Family Health and Community Health/Prevention in the Illinois Department of Human Services are undergoing a reorganization to build a more coherent system. One of the goals is to have adequate funding based for all the programs, as all programs did not receive a COLA. DHS will select 10 to 12 indicators as priorities for all programs to address. Program integration and partnerships would be stressed. The MCH block grant to the state is anticipated to have a $300,000 cut. Presently, none of our grants have been identified for the MAX initiative in fiscal year 07.

The Livingston County Community Needs Assessment/Health Plan for 2005 – 2010 was submitted to the Illinois Department of Public Health the beginning of April. This is the IPLAN component required for health department certification. Our certification expires November 1, 2005. I’m still waiting on notification on the status of our IPLAN.

MaLinda Hillman participated in the National Public Health Performance Standards Retreat for Illinois. The purpose of the meeting was to review Illinois’ assessment results and set priorities that are to be utilized for the State Health Improvement Plan. The performance standards are based on the ten essential public health services and focus on a system approach for public health.

The bioterrorism preparedness grant deliverables for the new fiscal year starts Sept. 1 and focuses on exercises. The state has planned an exercise for October 14 that will test the “drop” system for each county’s Strategic National Stockpile (SNS) plan. The highway department will be assisting us with this exercise. A full scale exercise for our plan will be done early next year, utilizing all our staff and working with our partners. A tabletop exercise dealing with a smallpox response must be completed. There will also be a phone drill for a 24/7/365 contact with a knowledgeable public health professional to answer a disease report. Staff training and the use of I-NEDSS are large components of the contract. The required deliverables will be a challenge for the funding furnished. It is doubtful whether supplemental BT funding will be available this time.

Staffing: Betty Potts will retire September 30 after 28 years with the health department. Teresa Arduini has been hired to replace her. Lori Lake’s position has changed to a part-time health educator, part-time office manager from a full time health educator. Tallulah Scott has been terminated from employment as a cost-saving measure.

Wellness clinic staff will be focusing on metabolic syndrome and educating clients on this issue. Metabolic syndrome is a collection of health risks that increase the chance of developing heart disease, stroke, and diabetes. Staff will be evaluating the risk factors of waist circumference, blood pressure, triglycerides, fasting blood glucose, and high density lipoprotein and educating the client on preventive measures they can take to reduce their risks.

School nurses have agreements with 6 schools to do their immunization surveys. Two schools contracted with LCHD to provide ongoing nursing services through-out the year. Immunizations will be provided to all schools. Other services may be done during the year, upon request.

PSA clinics have been set for September. Clinics will be held at the LCHD for those interested in receiving free PSA/DRE exams. Dawn Thorson will be providing these services. Other clinics will be scheduled through-out the year.

Local medical providers are now reporting on I-NEDSS. To date, the hospital has not been reporting directly, but continues to send reports. Jackie Dever and Valerie Knapp have completed training on the I-NEDSS report section.

ISU Mennonite students are back for the coming semester. They will be here every Wednesday, under the direction of Teresa Saxton.

Arthritis: One Arthritis Self Help Course was implemented this quarter, in South Streator, with eight people participating. The next course, which will be offered in Pontiac, will begin in September.

Osteoporosis: Screened 76 women this quarter. Thirty-three (43%) found to be at high risk for a fracture.

Tobacco: In accordance with FY06 grant objectives and time-line, Illinois Tobacco Toll Free Quitline cards have been distributed to health care providers and schools. We are waiting for direction from the IDPH Tobacco Division as to how to best approach local government entities regarding the new law that will become effective in January, regarding local ordinances for making restaurants smoke-free.

Women’s Health: Heart Smart for Teens, a heart disease prevention program, is being implemented in Pontiac and Dwight Junior High School eighth grade health education classes.

Men’s Health: Prostate and Testicular Cancer Education and Awareness grant activities – 1) information was distributed at the Livingston County 4-H fair and the Relay for Life; 2) information regarding the health department’s availability to provide prostate cancer prevention programs has been sent to grant partners and several men’s groups. Programs will begin in September. 3) the first free PSA/DRE clinic for under and uninsured eligible men has been scheduled for September 15^th; 4) the American Cancer Society has provided LCHD with Power Point presentations that can be used with both Prostate and Testicular Cancer Education programs.

A total of 271 nursing and homemaker community health visits were provided to those clients who do not qualify for billable services. Three new admits and two discharges took place in the community health program this quarter. A total of 19 unduplicated individuals were served. The quarterly statistics are listed as follows.

Monthly audits were done to assure that appropriate documentation of all labs are done by all staff. Results were within limits for all months and no remedial actions were required.

D. Environmental Health Report by Donnie Simmons Director of Environmental Health

The presence of West Nile Virus (WNV) has been found in humans, birds, and mosquitoes primarily in the northeastern part of the state. The combination of hot weather and lack of rainfall contributes to the proliferation of the virus through concentrating breeding pools of the specific mosquito species that transmits WNV. There have been no positive human cases or positive tests in either mosquitoes or birds in Livingston County. Testing of birds has been expanded to include robins in addition to crows and bluejays. We continue to collect and test mosquitoes weekly and submit birds for testing when appropriate as part of our surveillance for WNV.

Revisions to the Illinois Private Sewage Disposal Licensing Act and Code are currently being drafted by the Illinois Department of Public Health. These revisions will include some form of maintenance requirement for all septic system types, surface discharge reduction practices and possibly expanded permitting requirements by local health departments. These draft rule changes are being proposed for comment late September to early October. A discussion was held on what is currently known about the draft revisions to the Sewage Code.

Food activities this quarter include setting up the Children’s Demonstration Kitchen at the Illinois State Fair, a food refresher course in August, and a certified food manager’s course currently ongoing.

A well sealing demonstration was held in conjunction with the Livingston County Soil and Water Conservation District at the Terry Bachtold farm south of Forrest. Two wells were properly sealed during this demonstration.

The proposed coffee shop in Dwight was granted a variance by the Village of Dwight to allow a private sewage disposal system to be installed since sanitary sewer is not feasible for either the business or the village to extend. A proposal to install a private sewage disposal system for the coffee shop has been received and approved by this Department. We are currently waiting for further information on the operation of the coffee shop. A restaurant in Forrest was temporarily closed due to the lack of hot water. It has since reopened and is in compliance with the regulations.

MaLinda Hillman reviewed the minutes of the July 28, 2005 meeting along with the results from the client survey conducted by the health department on CCU clients. Survey results were very positive.

MaLinda Hillman reviewed the minutes of the August 4, 2005 advisory board meeting along with the results of the survey of Livingston County Healthy Families’ clients. Survey results were positive. Jean Kleen, program supervisor, received Direct Service Supervisor Certification from the Ounce of Prevention Fund.

Jackie Dever reviewed the meeting which was conducted on August 10, 2005. Clinic brochures, clinic flow and the new depression screening tool were discussed.

The balance on hand as of June 1, 2005: $550,253.74. Quarterly receipts: $491,334.68 which includes approximately half of the public health tax levy. Quarterly disbursements: $404,623.28. This leaves a balance on hand of $636,965.14 as of August 31, 2005. For the fiscal year, it is running approximately at the break even point. An itemized listing of the receipts and disbursements was distributed. Fred Strufe made a motion, seconded by Dr. Norris, to approve the financial report as submitted. Motion carried.

The balance on hand as of June 1, 2005: $26,054.51. Receipts for the quarter: $17,345.10 which includes the semi-annual interest income. Expenses for the quarter: $12,889.97. This leaves a balance on hand of $30,509.64 as of August 31, 2005. Helen Holz made a motion, seconded by Buzz Groom, to approve the Wellness Financial Report. Motion carried.

The balance in the fund as of May 31, 2005 was $7,355.27. Income for the quarter: $20. Expenses for the quarter: $25. The balance on hand as of August 31, 2005: $7,350.27. Helen Holz made a motion, seconded by Buzz Groom, to approve the Memorial Fund report. Motion carried.

The cancer donation fund maintained at the health department for Livingston County has a total of $13,878 in it. This includes $2,385 from the Randy Spires memorial. Funds have been utilized to pay for transportation and diagnostic tests such as mammograms, Pap smears and PSA blood tests.

The Illinois Department of Human Services requires that the Provider certifies that employees assigned to work on the premises do not have a felony conviction. The personnel policy will be changed to have new employees submit to these background checks, with all current employees completing one by 1/1/2007.

The low census policy would be changed to allow the employee to take a low census day, with supervisor approval, and not utilize their benefit time first. If low census days are utilized repeatedly, benefit time will be adjusted. Fred Strufe made a motion, seconded by Buzz Groom, to approve the personnel policy changes as outlined. Motion carried.

MaLinda Hillman reviewed the proposed budget for the next fiscal year. Grants were estimated on their contract year and a comparison to last year grant funding was furnished. Grant funding is down for FY 2006. The CPI is projected for 3.3%. Animal control funds remain in the budget since it is subsidized by the public health levy. Staff raises were projected at 3% with 34 FTEs for a total of 39 employees. Health insurance costs cover approximately 23 employees and cost $4,800 per year for each employee (current rate). The public health levy is proposed to increase from approximately $259,300 (rate of .05186) to $306,000 (rate of .06000). The proposed increase in the public health levy was presented to the county board finance committee on September 7. The public health levy primarily supports animal control, environmental health, building rent, school services and communicable disease control. There was discussion on the budget.

Buzz Groom made a motion, seconded by Fred Strufe, to approve the proposed budget. Motion carried.

Helen Holz made a motion, seconded by Fred Strufe, to continue with the School Based Health Center, MDR, Environmental Health and Illinois Breast and Cervical Cancer program policies. Motion carried.

MaLinda Hillman reviewed proposed fee increases for Sanitarian consultations for real estate transactions, private well sample tests, and clinic fees. Fred Strufe made a motion, seconded by Dr. Norris, to approve the fee increases. Motion carried.

Fred Strufe made a motion, seconded by Buzz Groom to appoint the following individuals to the Advisory Board for the School Based Health Center for 05/06 school year: MaLinda Hillman, Dawn Thorson, Butch Cotter, Jim Drengwitz, Dr. Jim Day, Mary Heath, Robert McCarty, Betty Murphy, Jack Vietti, Rita Allen, Denise Graves, Dr. Angelito Fernandez, Norm Francis, Dawn Conway, Jackie Dever, Joe Ronaldson, Dr. Adena Myers, Kathy Kelly, Angela Thomas, Vicky Applegate, Brad Follmer and Katie Bressner. Motion carried.

MaLinda Hillman reviewed the proposed change to the Bylaws made by the Advisory Board. Fred Strufe made a motion, seconded by Buzz Groom, to approve the proposed bylaw change. Motion carried.

MaLinda Hillman reported the Livingston County Health Department received $19,928.42 as their percent of the sale of specific farm real estate named in her will. This donation must be utilized for cancer prevention/services. A report will be furnished to the board on how these funds are expended.

Dr. Bryan Stoller has requested the support of the Livingston County Board of Health to mandate eye exams for certain grade levels. He intends to discuss this with county superintendents. There is language in the school administration code that allows a local school board to mandate eye exams. There was a discussion. This matter was tabled until the next board meeting with MaLinda to bring back more information on this request.

The IRS increased the mileage reimbursement rate to 48.5 cents per mile for all business miles driven between September 1, 2005 and December 31, 2005. The county reimburses at the IRS rate, so this will increase retroactive to Sept. 1.

Fred Strufe made a motion, seconded by Buzz Groom, to adjourn the meeting. Motion carried.