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WC CWF Health District Board Minutes - 06/27/2003WICHITA FALLS - WICHITA COUNTY PUBLIC HEALTH BOARD PLACE: Wichita Falls- Wichita County Public Health Di TIME: 12.15 p.m. DATE: June 27, 2003 BOARD MEMBERS PRESENT: BOARD MEMBERS ABSENT: Susan Strate, M.D. Kathy Sultemeier, D.V.M. Diane Stewart, R.N. Gregory Stockton Beverly Stiles, Ph.D. Tom Delizio, M.D. Larry Rains, D.D.S. t HEULIVEU IN CITY CLERK'S OFFICE V Date ,i By _. Time HEALTH DISTRICT Barbara J. Clements. Director of Health REPRESENTATIVES: Reuben A. Warren, Jr., Assistant Director of Health Arthur J. Szczerba, M.D., Interim Medical Director WICHITA CO. REPRESENTATIVE: WICHITA FALLS CITY COUNCIL: WICHITA FALLS CITY MANAGER'S OFFICE: MINUTES: I. Call to order Dr. Susan Strate called the meeting to order at 12:15 p.m. II. Approval of Minutes: Moved by Diane Stewart, seconded by Dr. Stiles and carried by voice vote that the April 25, 2003 minutes be approved with the correction of the spelling of Cone. III. Vital Records Update — Gwen McWhorter, City Registrar Ms. Clements introduced Mrs. McWhorter to the Board. In 1869 the Texas constitution called for all births, deaths and marriages in each organized county to be registered. In 1873 an additional mandate required parents to report a child's birth to a State District Court within 6 months and pay 10¢ registration fee. The County Clerks records begin around 1875 — 1876. In 1903 the Bureau of Vital Statistics was created and given the responsibility for maintaining a statewide system of vital records. The State Registrar was established in 1908 and registration was at about 40% complete compared to 1989 at 99% complete. Page 1 of 4 Vital Records serves two purposes today: that of statistical data and proof of identity. The statistical data is used for planning and evaluating health care programs, medical research, estimating the state's population, traveling, employment, school enrollment, drivers license, insurance, social security benefits, transfer titles, etc. In Wichita Falls, we file an average of 2200 births, 1400 deaths and 15 fetal deaths per year. To purchase a birth certificate costs $11 and death certificates are $9 for the first copy and $3 for each additional copy of the same record ordered at the same time. Birth and death records have specific exemption under the Public Information Act. Birth records are closed and confidential until 50 years after the file date. Death records are closed and confidential until 25 years after the file date. The paper used today is bonded paper but we no longer use the `raised seal' that so many people expect. If this paper is copied, the word "void" comes up in the background so that it cannot be illegally duplicated. The hospital certificate with the gold seal in the corner is a personal copy and not a legal document. It is not the original certificate, as some people believe. If a persons' birth record was not recorded, we assist with the delayed record process. Any record not recorded within 1 year is considered a delayed record. We can provide forms and addresses of various Vital Records offices to apply for a certificate if someone was born in another state. If a record has an error on it, we can assist with the amendment process to make corrections on certificates. If the parents of a child are not married they may sign an Acknowledgement of Paternity (AOP) to have the father's name added to the birth certificate. They may complete the AOP process at the time of birth at the hospital or they may come to the Vital Records Office and we will assist with the process. If the mother is married to someone other than the biological father, her husband has to either sign a Denial of Paternity or have a court order stating who the father is before the father's name can be added to the certificate. The mother may give the child whatever first, middle and last name she chooses when the child is born. Each year, the Attorney Generals Office must certify anyone who assists with the AOP process. IV. Update on Contract with Family Practice Residency — Dr. Moquist Dr. Moquist presented a proposal to the Board concerning the maternity care if provided by Family Residency Program. The object is to provide continuity of care to the pregnant women who do not have adequate resources. It has been discussed that the Health District will continue to provide pregnancy testing, initial intake appointment, case management and prenatal vitamins for these patients and prenatal care will be provided at the Residency building. Dr. Moquist stated that, being aware of the patients who fall through the cracks that do not qualify for Medicaid or Title V, the Residency is willing to accept all clients and will look to sources such as the County Indigent Health Program or a foundation that might assist with Page 2 of 4 providing funding for this care. There is an average of between 1800 and 2000 deliveries per year in this county. Approximately 5% of those patients receive no prenatal care. The other services of the Health District such as HIV, TB, and Child Health would not be affected by this change. Dr. Sultemeier asked what means of publicity would be used to notify the public of the change. Dr. Moquist replied that word of mouth is the best notification. People calling the Health District for care would be referred. Notification would be posted in the appropriate locations such as public schools, Salvation Army, Faith Mission, churches etc. Dr. Moquist said that a contract with the scope of services would be written and submitted in the near future that would clarify the responsibilities of the Health District and the Residency. Referring to the Health Authority position, Dr. Moquist stated that while Dr. Szczerba has done an excellent job as Health Authority and Medical Director, his duties at the Residency have become such that he would like to withdraw his name. Dr. Carr would like to continue and Dr. Moquist will work with him jointly. Kathy Sultemeier made the motion and Greg Stockton seconded that Dr. Roy Carr and Dr. Dale Moquist would serve as Medical Director and Health Authority. Voice vote taken and passed unanimously. Ms. Clements thanked the Board for the recommendation and said their appointments would be contingent on approval of City Administration and elected officials and a signed contract agreement. V. Legislative Impact on Public Health Mrs. Clements discussed that through the enactment of House Bill 2292, the Governor and the Legislature have directed Texas health and human services agencies to consolidate organizational structures and functions, eliminate duplicative administrative systems, and streamline processes and procedures that guide the delivery of health and human services to Texans. The operations of the existing 12 Health and Human Services Agencies will be re- aligned by consolidating similar functions within 5 agencies. Texas Department of Health will be directly affected by this consolidation. An executive commissioner appointed by the Governor for a two -year term and confirmed by the Senate will oversee the operations of the Health and Human Services Commission. The commissioners of the individual agencies will assist in the development of rules for their respective agencies, although the authority to adopt rules for each HHS agency is delegated to the executive commissioner of HHSC. The final plan must be submitted to the Governor and Legislative Budget Board no later than December 1, 2003. Mrs. Clements reviewed a handout that listed the Medicaid policy changes established by the 78th Legislature. One of the changes that will impact the local maternity program is that it discontinues coverage for adult pregnant women above 158% of the federal poverty level. There were also CHIP policy changes that will affect our program. Eligibility is restricted for families at or above 150% of Federal Poverty level to those with assets within allowable levels. It also limits the benefit package to coverage of basic health care services. Such vital benefits as dental, durable medical equipment, vision care, eyeglasses and speech and physical therapy have been excluded. The District is awaiting full explanation of additional changes to Medicaid and CHIP eligibility guidelines. Page 3 of 4 One of the major concerns is language contained in House Bill 2292 that allows exceptions to the requirements for immunizations to enter public school or institutions of higher education if an affidavit states the parent, family or the guardian declines for reasons of conscience. The potential impact on immunization rates from this related requirement is unknown. It is especially troublesome for a state with very low immunization rates under current requirements. Ms. Clements commented concerning tattooing and body piercing, the Legislature did outlaw the practice of tongue splitting. Ms. Clements also commented that the Health District is now looking at what our community can do to prevent an occurrence such as SARS and West Nile. There will be more information forthcoming. VI. Adjourn It was moved by Dr. Sultemeier and seconded by Greg Stockton that the meeting be adjourned. The motion carried and the meeting was adjourned at 1:30 p.m. Page 4 of 4