WC CWF Health District Board Notice - 01/09/2026 (2) WICHITA FALLS-WICHITA COUNTY PUBLIC HEALTH BOARD MINUTES
,,"C0UN1Ypoe�, January 9, 2026
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x Wichita Falls-Wichita County Public Health District
1700 Third Street— Clements Conference Room
'` Wichita Falls, Texas
Public Health
BOARD MEMBERS PRESENT:
Keith Williamson, M.D., Chair Physician — City Appointment
Terri Farabee, RN Registered Nurse —City Appointment
Morgen Gardner, DDS Dentist—County Appointment
Ray Forsythe Citizen At-Large—County Appointment
BOARD MEMBERS EXCUSED ABSENCE:
Melissa Plowman Restaurant Association—City Appointment
Rachel Reitan, DNP, FNP-c Citizen At-Large — City Appointment
OTHERS PRESENT:
Amy K. Fagan, M.P.A. Director of Health
Brandi Smith, BS, RN Assistant Director of Health
Judge Jim Johnson County Judge
Mark Beauchamp County Commissioner
I. CALL TO ORDER
Dr. Williamson, Chair, called the meeting to order at 12:04 pm after a quorum of members was
attained.
II. Approval of Minutes &Absences
Dr. Williamson called for a review and approval of the November 14, 2025 minutes.
Dr. Williamson asked for a motion to approve the minutes. Ray made a motion to approve and Dr.
Gardner seconded. The minutes were approved unanimously.
Dr. Williamson stated that Rachel Reitan and Melissa Plowman are excused from the meeting.
III. TB Program Overview
Dr. Williamson introduced Maddison Goodwin, RN. She spoke about TB and went over her
presentation, as follows:
TB is often thought of as a disease of the past or a disease that only exists in far off countries. In
reality, approximately 13 million people in the United States have latent infection (LTBI). Of those
people 5-10% will progress to the active disease if left untreated.
LTBI is a sleeping infection only kept in check by a healthy immune system. LTBI is diagnosed by a
positive skin test (TST) or blood test (IGRA) and a negative (or normal) chest x-ray. Active disease is
diagnosed by an abnormal chest x-ray and presence of M. tuberculosis in a specimen culture.
Judge Johnson asked a question about a false positive result. Maddison said we do see more false
positives with the Quantiferon test than the T-Spot test as it is slightly less specific and a compromised
immune system can skew the results. If the positive is considered a "low positive" she would think it
could be a false positive result but if the results are high, she would consider those a positive regardless
if follow up testing was negative or indeterminate to be safe.
Judge Johnson asked about how to confirm if the Quantiferon tests were truly positive or a skin test to
confirm. Maddison said "Per the DSHS guidelines, they do not recommend performing both skin test
and IGRA's together. The IGRA can be repeated if a physician finds it necessary, but we prefer the T-
spot IGRA tests at the Health Department as they are less likely to have false positives. Regardless,
every positive IGRA and skin tests requires a 2-view chest x-ray to rule out active TB disease. In the
presence of symptoms of TB disease, DSHS also recommends 3 consecutive negative sputum
samples to rule out active disease."
Most common symptoms are:
cough > 3 weeks/
weight loss/no appetite
fatigue
night sweats
fever/chills
Shortness of breath/chest pain
Joint/musculoskeletal pain
Swollen lymph nodes
Treatment for active disease can take 6 months to 2 years to complete. The regimens consist of
multiple strong antibiotics that can cause a range of adverse reactions. Patients have to be closely
monitored during treatment for signs of toxicity.
Early identification and treatment of LTBI are critical to TB elimination. However, reductions in federal
funding have limited the availability of free LTBI treatment. Under current Texas DSHS guidance, our
health department is only able to provide LTBI services to high-risk individuals referred through
immigration processes or to uninsured patients who are unable to access care through a Federally
Qualified Health Center.
Ensuring access to LTBI care requires a community-wide approach. Treatment capacity cannot be
managed by specialty providers alone. Strengthening partnerships with local primary care providers
is essential to meeting the needs for LTBI treatment within our community. The health department
supports these efforts by offering consultation and case-by-case clinical guidance to help ensure
individuals with LTBI can access appropriate care.
TB does not always follow a predictable path or presentation. Effective TB control depends on
education, access to care, and coordinated systems working together.
Amy spoke about TB and how dangerous it can be. The Health District had our first death last year.
Mark asked about cases in jail. Amy said they will need to be in isolation. Terri Farabee asked how
they would pay for the medication? Maddison said the state will help with medication while they are in
jail and we can help when they are released.
Ray asked how many cases do we see. Maddison said we see about 1 or 2 cases a year.
Dr. Gardner asked about people that didn't know they were positive. Maddison said they will begin to
have symptoms
IV. Immunizations Program Overview
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Bethany Buscher, RN, introduced herself as the Immunization nurse. She said Immunizations offers
many services:
Childhood Immunizations
Adult Immunizations
Travel Vaccines
Pregnancy confirmation testing
TB skin testing
Titer testing
She said our Immunizations clinic has transitioned into offering appointments as well as walk ins. All
clinical services are merged into one clinic offering all services in one convenient location. Same hours
— Faster service.
We are called You're Public Health Clinic.
Programs offered are Texas Vaccines for Children (TVFC), Adult Safety Net (ASN), Private Pay
immunizations as well as STI Clinic. We accept BCBS-PPO Plans, Aetna, Cigna and
Medicaid/Medicare.
Bethany went over the qualifications for the programs.
Bethany mentioned that there are some changes coming in the vaccines.
Amy talked about some changes.
V. Clinic Tour
Amy took the Board of Health and others present on a tour of the new Immunization/STD/TB clinic
area.
VI. Next Meeting Date
March 13, 2026
VII. Adjourn
Dr. Williamson adjourned the meeting at 12:46 pm.
Signature
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Keith W iamson, MD, Chair, Rachel Reitan, DNP, FNP-c, Vice-Chair,
Melissa Plowman, Secretary
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