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WC CWF Health District Board Minutes - 10/24/2003WICHITA FALLS - WICHITA COUNTY PUBLIC HEALTH BOARD PLACE: Wichita Falls- Wichita County Public Health District TIME: 12.15 p.m. DATE: October 24, 2003 BOARD MEMBERS PRESENT: Susan Strate, M.D. Kathy Sultemeier, D.V.M. Diane Stewart, R.N. Larry Rains, D.D.S. BOARD MEMBERS ABSENT: Gregory Stockton Tom Delizio, M.D. Beverly Stiles, Ph.D. HEALTH DISTRICT Barbara J. Clements. Director of Health REPRESENTATIVES: Reuben A. Warren, Jr., Assistant Director of Health WICHITA CO. REPRESENTATIVE: WICHITA FALLS CITY COUNCIL: Joseph Miller, County Commissioner Mike Norrie, Councilor WICHITA FALLS CITY MANAGER'S OFFICE:Matt Benoit, Assistant City Manager MINUTES: I. Call to order Dr. Susan Strate called the meeting to order at 12:20 p.m. II. Approval of Minutes: Moved by Diane Stewart, seconded by Larry Rains and carried by voice vote that the August 22, 2003 minutes be approved. III. Update on Humane Society Susan Morris, R.S. Mr. Roy Ressel, R.S. not being in attendance today, Ms. Susan Morris, R.S., Supervisor for Vector Control and the On -Site Sewage Facilities (OSSF) program, presented the update. Ms. Morris is conducting follow -up inspections at the Humane Society and Animal Reclaim Center (ARC) at the request of the Texas Department of Health Regional Office in Arlington. Ms. Morris stated that she has been doing weekly inspections at the ARC and communicating with the staff there to effect needed improvements. She stated that she found that rats had been nesting in the crawl space in cinder blocks in the ceiling and air vents. CITY CLERK'S OFFICE Date 62 �� _ Page 1 of 7 BY Time S a She recommended that the existing ceiling material be removed and replaced along with the air vents and ductwork. Wood along the edges of the cinder blocks is being replaced with sheet metal. She added that they also might pour cement in some of the cinder blocks. Ms. Morris reported that there are three septic systems located on the property and all three need to be replaced. She stated that she has now received plans from an installer to replace all systems. The expected completion date is early November. Ms. Morris stated that she felt progress was being made in correcting existing problems. They have recently hired an exterminator. Ms. Morris said that on her initial inspection fleas were a significant problem. On her last inspection, there was a marked decrease in these vermin. The reduction of the flea infestation is an indication that the rat problem is abating as well. Dr. Sultemeier asked on a scale of 1 -10 with 1 being as bad as it was when the investigation started and 10 being great, where does Ms. Morris feel they are? Ms. Morris replied she felt there were at a 5. She felt this applied not only to the rat infestation but to the condition of the quarantine area as well. Specifically, they have improved the cage area and are adhering to state required practices in the quarantine area such as keeping the animals segregated by size, type and sex. Ms. Morris stated that she has met with the Humane Society Board and discussed the situation and that she has received positive feedback from the Board. Dr. Strate asked if the inspections would continue. Ms. Morris replied that until the facility is cleared by Texas Department of Health, she will continue to visit weekly and monitor the work being done. Dr. Strate stated that the Board would continue monitoring progress through these reports until the matter was resolved with the Texas Department of Health. Review Draft Animal Control Ordinance Susan Morris, R.S. Ms. Morris stated that Mr. Ressel presented a first draft of the ordinance to the Board at the August 22 meeting. At that time, Dr. Strate appointed a sub - committee consisting of Dr. Sultemeier, Dr. Rains and Mr. Matt Benoit to meet with staff to review the draft Ordinance and make recommendations for any changes. Dr. Stiles, who was appointed to the sub - committee to review the Humane Society issue, also met with the group in discussion of the ordinance. Ms. Morris commented that Dr. Sultemeier was unable to attend the last meeting of the sub - committee, however, she called with some suggestions for recommended changes. Ms. Morris proceeded to review the revised draft for Board members stating that other stakeholders had not yet reviewed the revisions. Dr. Sultemeier expressed concern that area veterinarians need to see the draft and have discussion on the proposed ordinance, particularly the sections impacting their practice. Ms. Morris stated that it is the practice of the Department to seek input from stakeholders on all ordinance revisions prior to presenting to the City Council. Page 2 of 7 Section 14.70: Certificate tag and fee. The main change in this section is the proposed issuance of the license tag by the veterinarian at the time of rabies vaccination. Dr. Sultemeier stated that she has two reservations about the revised draft. She stated that in its present form it has some requirements related to issuing the license that the veterinarians may not be totally aware of and they may not wish to participate. The issuance of the tags by the veterinarians would be done as a service to the City of Wichita Falls to collect more fees and Dr. Sultemeier states the meeting with the veterinarians should take place prior to the Board taking any action on the proposed revisions. Ms. Clements stated that in February an evening meeting was held at the Health District with approximately 18 veterinarians in attendance. The concept of the issuance of tags by the veterinarians at time of rabies vaccination was presented to the vets with favorable response; however, the information presented did not include detailed language in the current draft. Dr. Sultemeier stated that there are problematic issues with the issuance of the tags by the veterinarians such as persons living outside Wichita County not needing them, and people that have never paid for a City tag may not want to do so. She said that she did not feel the veterinarians should be a regulatory resource. Further, she commented that while most of the veterinarians are willing to do the licensing, some requirements in the draft ordinance might make it unacceptable to the veterinarians and raises questions about conflict with the state veterinarian licensing board. Ms. Morris said that she had met with the Legal Department who had researched the changes and their opinion was there are not any concerns. They commented that this has been done in other cities. Dr. Sultemeier asked if Legal had contacted the Texas State Veterinary Board as to whether the vets could release all the requested information. Ms. Morris offered to check with Legal again on this matter. Ms. Clements offered to make the recommended language changes and mail them to the members for review and comment. She stated that it would be preferable to have the ordinance in a final draft form prior to convening a meeting with veterinarians and other stakeholders. Dr. Strate stated that she felt after hearing the discussion that instead of mailing revisions to members more face -to -face meetings are needed to develop a draft that would be acceptable to everyone. The second reservation expressed by Dr. Sultemeier was on the issue of at -large cats. The ordinance would allow cats to be treated similarly to dogs in the matter of being at- large. She stated that in its current form, she would have to recommend the Board not approve the Ordinance. Ms. Clements stated that in the discussions to date, the subcommittee might not be in full agreement on the recommendation for dealing with the cat issue. She stated that staff is not asking for a vote on the ordinance today and the item was placed on the agenda to allow more time for discussion and suggestions for revisions. She stated that the staff is looking for ways to address the large number of complaints from citizens regarding cats at- large. Page 3 of 7 At this point Ms. Morris proceeded to discuss Section 14 -236: Running at- large. She stated that the Animal Control (AC) office receives many calls from residents complaining about cats running loose. They complain that "a cat is tearing up my yard ", or that "a cat is in the street and I almost hit it," etc. She commented that a significant number of at -large cats are feral cats. Under the current ordinance if a resident complains of a cat on their property they are offered a rental trap from Animal Control. If they catch the cat in the trap, Animal Control will respond to pick it up; however, if the cat is wearing a tag & license the cat cannot be impounded and is released. As revised, the ordinance would allow the cat to be impounded; the owner contacted and allowed to reclaim the cat. The owner would be issued a citation, as dog owners now are when their animals are picked up at- large. The cats would be picked up only on a complaint basis. Dr. Sultemeier pointed out that this is a simplified explanation. Basically, under the new ordinance, a cat would be restrained to the owner's property or inside the house. If they stray over to the neighbor's yard, it would be considered 'at- large'. That it would be no longer legal to have an outside cat in the City of Wichita Falls. Ms. Morris stated that the cats would be picked up on a complaint basis. Residents have become very angry after having rented a trap, catching the offending cat and it being turned loose because it is wearing a tag. Under the new Ordinance, we would be able to ticket the owner and tell them to control their animal. Ms. Clements stated that the reclaim rate on at -large animals is only about 8 - 13% for dogs and about 2% on cats. Animal Control picks up high numbers of at -large animals, including cats, but very few are reclaimed. Dr. Sultemeier then suggested that if the problem is having to release cats with tags, we should establish a policy whereby if a cat with a tag is taken to Reclaim three times in a twelve month period, it can be labeled a nuisance and something done at that time. She stated that there are a lot of responsible people taking care of outdoor cats and vaccinating, neutering etc. She also stated that limiting cats to indoors will most likely result in a rat problem throughout the City such as the Animal Reclaim Center now has. Ms. Morris pointed out that there are a lot of feral cats around the ARC and they are still over run with rats. Ms. Clements said that this item had been researched on the Texas Department of Health Zoonosis Control web site where there is a listing of cities that have "at- large" ordinances. Many cities no longer make a distinction between cats and dogs in the issue of at- large. Ms. Clements offered to provide the Board with a listing of cities with such ordinances. Dr. Strate suggested that the sub - committee of Dr. Rains, Dr. Sultemeier, Mr. Benoit and Dr. Stiles meet to work out some of these questions. She also suggested that Ms. Clements gather existing information for their consideration and bring their findings to the Board at a later date. Ms. Morris proceeded to Section 14 -272 Destruction of Vicious Dogs. This section provides for due process for the owner to have a hearing after receiving written notice of intent to destroy. If no request for hearing is received the animal will be destroyed. Page 4 of 7 Section 14 -381: Food, water and shelter. Ms. Morris stated that "reasonable veterinary care" has been added to this section. She said that the former draft stated 'veterinary care' but someone pointed out that there is a difference between 'veterinary care' and 'reasonable veterinary care' depending on the cost involved. V. Administrative Report Barbara J. Clements FY04 Budget: Ms. Clements presented the Health District's approved budget for fiscal year 2003 and 2004. Overall, the Budget increase for 2004 was less than 1%; however, due to various terms for the grant programs, the revised budget will likely increase prior to the end of the fiscal year. It was noted that the exact amount of funding for the Immunization grant is not known at this time and a projected amount was used based on the request submitted. Mr. Benoit asked if the Department received additional employees in the budget for 2004. Ms. Clements replied that an additional Animal Control Officer and one Public Health Inspector I was added. Ms. Clements explained some fluctuations in revenue accounts including a slight increase in Laboratory fees due to the new grease trap ordinance, and a small increase in Vital Registrar's fees, which are set by the state legislature. Some third party revenue from Medicaid may be reduced due to reduced reimbursement as set by the 78th Legislature. She also stated that the arrangement with the Family Practice Residency Program would result in a decrease in Medicaid revenue for maternity patients. Previously this Medicaid revenue was billed by the District then returned to the Residency, they will now bill Medicaid directly through their office. Ms. Clements explained that all of the revenues from Tarrant County are in the Early Intervention /HIV Program. The District has signed contracts with TDH on all grants except two and those are projected in within the next few weeks. The Board will receive the annual expenditure report for 2003 at the February meeting. Initially, the District was advised that the Children's Health Insurance Program grant would not be renewed; however, in the end, it was reduced, but not eliminated. The full -time employee in that program was reduced to part-time at 28 hours per week to match funding. The Innovation grant for Vector Control ended 31 August resulting in the loss of one Vector Control worker. However, this was offset when the Division gained two employees as mentioned in the budget report. Page 5 of 7 Ln Family Practice Residency Contract: The Contract was approved on October 7 by the City Council. The new Oaths of Office have been administered and all the necessary paperwork has been forwarded to the TDH Regional Office in Arlington and to the state office in Austin. Dr. Dale Moquist will serve as Medical Director with Dr. Roy Carr as Associate and Dr. Carr will serve as Health Authority with Dr. Moquist as Associate. PH Emergency Planning Update: Ms. Clements reported that the Health District is continuing with the Smallpox vaccination effort. The focus is on vaccinators. The goal of TDH and the Centers for Disease Control and Prevention (CDC) is to get more vaccinators trained. Our initial round of recruitment was somewhat hampered by concerns about cardiac complications after receiving smallpox vaccination. In recent weeks, CDC has issued statements saying that after researching the cases for possible links between cardiac events and smallpox vaccination; they found no evidence to associate the two. This report may result in more volunteers for the vaccine. The District plans to attend a meeting in November in Abilene with CDC and TDH concerning the Strategic National Stockpile (SNS). We continue to research where we could deploy the SNS shipment. We would need a facility that has a loading dock and 12,000 square feet of open space to unload it and the facility would have to be climatically controlled. Ms. Clements distributed information on The Wichita County Emergency Management CERT (Community Emergency Response Team) Program to the board members. CERT is a training program for citizen volunteers trained to meet emergency needs while awaiting professional help on the scene. The program provides training for volunteers on what to do in an emergency such as a house fire, a tornado or some other event. Volunteers are not intended to replace the fire department or an ambulance crew. Ms. Clements commented that Board Member Diane Stewart had earlier inquired about making the information available to Midwestern State University nursing students. Classes are planned through December with approximately 60 people in the most recent class. FLU Vaccinations The Health District moved up the beginning of the annual flu vaccination campaign this year due to recent alerts from TDH advising that several areas are reporting significant cases of flu earlier than usual. Physicians in Wichita Falls have already reported more than a dozen cases of Type A influenza. We have several surveillance sites around the city that have reported seeing a high number of patients with flu -like symptoms. It was reported on the news that Houston hospitals have been overrun with hundreds of people exhibiting flu -like symptoms. Page 6 of 7 M Epidemiology The Health District has received 20 reports of Salmonella. Wichita County usually has about 3 -5 cases each year. To date, there seems to be no common source in any of the cases. Delayed reporting from area healthcare providers has hampered the investigation. Although reports of Salmonella are required to be submitted weekly, several reports received last week were cases from August. This delay makes it impossible to conduct a valid investigation. One aspect of the investigation is to ask the patient where they ate recently and what foods were eaten. It is impossible to elicit this information if the investigation is not timely. The District recently forwarded a reminder to area providers to please be prompt in reporting these cases to facilitate follow -up VI. Other Business Dr. Stiles, Greg Stockton and Dr. Delizio were formally excused for the meeting. VII. Adjourn It was moved by Diane Stewart and seconded by Dr. Rains that the meeting be adjourned. The motion carried and the meeting was adjourned at 1:45 p.m. ;ier, Secretary Board Page 7 of 7