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
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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.
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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
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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.
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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.
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