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WC CWF Health District Board Minutes - 06/28/2002WICHITA FALLS - WICHITA COUNTY PUBLIC HEALTH BOARD PLACE: Wichita Falls- Wichita County Public Health 'nrCEIVED IN TIME: 12:15 p.m. CITY Date CLERK'S 08 ''O--��FFFI__CE d� -01 DATE: June 28, 2002 By AC _Time BOARD MEMBERS PRESENT: BOARD MEMBERS ABSENT: C.J. Lippard, Chairman Larry Rains, D.D.S. Beverly Stiles, Ph.D. Susan Strate, MD Kathy Sultemeier, D.V.M. Diane Stewart, R.N. Gregory Stockton HEALTH DISTRICT Barbara J. Clements. Director of Health; REPRESENTATIVES: Reuben A. Warren, Jr., Assistant Director of Health Elia C. Dimitri, M.D., Associate Medical Director WICHITA CO. REPRESENTATIVE: WICHITA FALLS CITY COUNCIL: Mike Norrie, Councilor WICHITA FALLS CITY MANAGER'S OFFICE: MINUTES: I. Call to order C.J. Lippard, Chairman, called the meeting to order at 12:15 p.m. II. Approval of Minutes Dr. Dimitri states that a correction should be made to the last word in the TB portion of the minutes. The word should read `consultation'. He also noted that he was listed as attending the last meeting when in fact he was not here. Dr. Dimitri wanted to go on record stating what excellent staff work in the TB program and what an outstanding job they do. With those corrections, it was moved by Kathy Sultemeier, seconded by Beverly Stiles and carried that the April 26, 2002 minutes be approved. III. Next Meeting Date The next meeting date will be Friday, August 23, 2002 Page 1 of 5 { . IV. Director's Report — Barbara I Clements, Director of Health Mrs. Clements presented the following: 1). General Funding: With the exception of the new Emergency Preparedness funding, the FY03 grant awards for the District are projected to be near the current amount. However, some individual programs will see some variance, with HIV /AIDS receiving the greatest increase. 2). Bioterrorism Grant: We have received confirmation that the Bioterrorism Grant has been approved. This funding will include an upgrade for the District laboratory to a BioSafety Level II and provide for two generators for emergency power. The project also includes plans to remodel our immunization room and provide better access for the public as well as providing staff more accessible workstations. The goal of the remodeling project is to double the rate at which clients may be processed through the area. This funding of $214,863 was awarded by a formula of $20,000 as the base amount plus $1.48 per capita for Wichita County. The grant is intended to strengthen public health infrastructure, improving the District's capacity to respond to any public health emergency, including a bioterrorism event. The Board will be kept advised of all future happenings with the grant. 3). Medicaid Administration Claiming Fund - MAC The Nursing staff has been involved in this time study program for approximately six years. The time study requires each employee posts their work activities in 15- minute increments. The study lasts for about 2 weeks quarterly. Claims are filed and monies are received for Medicaid patient activities. Monies have to be dedicated strictly to the Medicaid Program. Formulating the claim and checking the time sheets is very involved and takes a considerable amount of time. Statewide there are only five (5) agencies participating in this study. No others want to take the time to work with it. We have almost perfected the tabulation process and are processing claims much faster with a more substantial return. We want to continue the program but TDH wants to drop it and they intend to do so. This is revenue that we have used to purchase various items of clinical equipment, some dental equipment and to pay a dental hygienist for clinics. There are other agencies in the State that also want to continue but at this point, we are not sure which way it will go. 4). Legislature: (handouts provided). • There may be a request to the Legislature to fund an upgrade for Vital Statistics services. The current program, at the state and local level, is antiquated and in need of upgrading and modernizing. • There are several items related to the emergency powers of state and local health departments and officials that are under review and possible consideration for revision. • Several areas related to the powers of the local Health Authority to control communicable disease and abate public health nuisances are also under consideration for change. Page 2 of 5 • Animal Control: Rabies vaccination is recommended annually locally. You must show proof of vaccination when you purchase a license. When an unvaccinated animal is picked up, the animal is released from the facility and a voucher is provided to take back to your vet to obtain the rabies shot. 5). National Public Health Performance Standards: CDC has developed questionnaires so that once completed locally, health departments and agencies can compare themselves to other similar agencies. Texas is in the pilot program. We have had several meetings on the project and have Texas-ized, if you will, the original questionnaire. It aims at two different types of groups; public health systems and local health agencies. They would monitor local health issues in the community such as obesity, high blood pressure causes, and what can be done. Peer Review is a program that would ask people in similar type /size agencies to review others to evaluate their programs and needs. When the Bioterrorism grant came into effect, the focus areas were more comprehensive than those we had in the NPHPS so they superseded them. We are in the initial planning stages of the grant. 6). TNRCC - Reuben explained to the board that the federal government sets standards concerning certain pollutants that can be discharged into the sewer system. Industries that discharge those pollutants must be permitted, inspected, and have their waste - streams monitored routinely. Based on our Publicly Owned Treatment Works (POTW) ability to remove certain pollutants from our environment, we have to set local limits. When the dynamics of our POTW's change, we have to go back and recalculate those local limits. It is recommended that this be done every five years. We performed our most recent recalculation about four years ago. We have some local industries that would not be subject to the fines they are now paying under the new limits. The new revised standards should be approved by September 1, 2002. 7). Pools & Classes: - Roy Ressel, Environmental Health Coordinator: Swimming pool program: We monitor approximately 107 -110 pools in the county. These are commercial pools, hotels, motels, everything but home pools. One of the biggest problems we encounter is the high closure rate due to no chlorine, high chlorine and water turbidity where you can't see the bottom drain. There have been a number of health departments in Texas sued for negligent liability after inspecting pools. We have closed some of the pools because of inadequate closing or latching gates close to a public school, and inadequate Ph of water that must be between 7.2 and 7.6. We have 3 -4 pool schools each year. Each pool is required to have a manager of operations in Wichita Falls and they have to be certified thru the Health District. It is an all day course and they are required to take a test at the close of the day. It is an open book test and the Board of Health years ago decided that since it is an open book test, 60 or above is a passing grade. We do not back off closures standards. There are no exceptions made. 8) West Nile Virus -Roy Ressel: First case diagnosed in Houston. The virus is carried by Blue Jays, crows and hawks. With the irrigation systems in Wichita County, we have an abundance of mosquitoes. This is the second year that we have had sentinel chicken flocks. The baseline blood screen drawn from the chickens is back and it is negative. Page 3 of 5 We draw blood every other week. We spend approximately $25,000 a year on larvicide's, and about $30,000 on spraying for adult mosquitoes. Several years ago, we switched chemicals and have had excellent results meaning we get effective results in about 3 % days with 6 to 7 trucks spraying every night. We also have mosquito traps throughout the county that we can examine the mosquito under the microscope and detect various species. Dr. Dimitri discussed the vaccine for horses. Roy Ressel stated that letters were sent to veterinarians in Wichita County. The problem with that is that the vaccine has to be administered 60 days prior to mosquito season and it is a two shot dose. Dr. Sultemeier said that perhaps the Health District could be instrumental getting the word out prior to mosquito season. 9). Mr. Ressel invited the Board to attend a presentation at 1:30 PM Monday 7/1/02, to become acquainted with the Environmental Health Programs. 10). Health Authority Contract Health Authority Contract. The Health District currently has a contract with the Family Practice Residency for Medical Director and Health Authority services. It is a single contract including both services. Dr. Burross serves as primary for each item with Dr. Dimitri designated as the Associate in each case. They have served in this capacity since 1988. The term of office for both Dr Burross and Dr Dimitri will expire August 31 and the District has received notice that they will not renew the Oath of Office September 1. The Health District plans to meet with Dr. Strate and others in coming weeks to discuss a proposal for continuing the contractual arrangement with the Residency Program. Talks regarding continuance have been complicated and delayed due to the uncertainty surrounding the possible change in the structure of the Residency Program. State statute provides authority for the Regional Public Health Director, Dr. James Zoretic, to serve as interim Health Authority should there be a lapse in service due to continuing negotiations. Ms. Clements expressed appreciation to the Family Practice Residency for their services, especially recognizing the contributions to the Health District from Dr. Dimitri. Dr. Dimitri discussed what an excellent relationship the Residency has had with the Health District. He has been involved with the HD since before 1988 and expressed what `a marvelous educational opportunity for the residents' is provided here. He sincerely hopes that even though he is retiring, the relationship with the Health District and the Residency will continue as it has. 11). Weather Vane — Ms. Clements provided an update on situation concerning the weather vane atop the former health department (CAC building). Although the District received approval to bring the weather vane back to the District for historical display, someone removed the weather vane before it could be secured and its current location is unknown. The Board discussed possible methods to locate the item and expressed the hope that it will eventually be located. Page 4 of 5 V. Other Business The Board excused Diane Stewart who had notified the Director prior to the meeting that she would not be able to attend. VIII. Adjournment It was moved by Dr. Strate and seconded by Dr. Sultemeier that the meeting be adjourned. The motion carried and the meeting was adjourned at 1:30 p.m. I C- Diane tewart, Secretary Public Health Board Page 5 of 5