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