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
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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
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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.
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• 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.
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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.
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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
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