WC CWF Health District Board Minutes - 02/20/2015WICHITA FALLS- WICHITA COUNTY PUBLIC HEALTH BOARD MINUTES
February 20, 2015
Wichita Falls- Wichita County Public Health District
1700 Third Street - Parker Conference Room
Wichita Falls, Texas
MEMBERS PRESENT:
Scott Plowman, Chair
David Carlston, Ph.D.
Robin Moreno, MHA -HAS, ACHE
Larry Rains, D.D.S.
Diane Stewart, R.N.
Keith Williamson, M.D.
MEMBERS ABSENCE EXCUSED:
Julie Gibson, D.V.M, Vice -Chair
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Lou Kreidler, R.N., B.S.N.
Amy Fagan, M.P.A.
Ray Gonzalez
Board Members
s
Director of Health
Assistant Director of Health
County Commissioner
I. CALL TO ORDER
Scott Plowman called the Health Board meeting to order at 12:00 pm after a quorum of members was
attained.
II. NEW MEMBER INDUCTION
The appointment of new Health Board member Diane Stewart, RN into the City appointed Registered
Nurse vacancy left by Dr. Jane Leach was conducted by Janice Flores, Notary.
lll. ELECTION OF OFFICERS
Dr. David Carlston introduced a motion to nominate Scott Plowman to continue as Chair and Dr.
Williamson seconded the motion. The motion passed unanimously.
Dr. David Carlston introduced a motion to nominate Dr. Julie Gibson to continue as Vice -Chair and
Robin Moreno seconded the motion. The motion passed unanimously.
Dr. Keith Williamson introduced a motion to nominate Diane Stewart as Secretary and Dr. David
Carlston seconded the motion. The motion passed unanimously.
IV. APPROVAL OF MINUTES AND ABSENCES
Scott Plowman called for the review and approval of minutes from the meeting held on Friday December
19, 2014. Robin Moreno introduced a motion to approve the minutes as presented and Dr. Keith
Williamson seconded the motion. The motion passed unanimously.
At this time it was noted the excused absence of Dr. Julie Gibson.
V. HEALTH DEPARTMENT OVERVIEW
Lou Kreidler, Director presented the Health District VISION, MISSION, CORES VALUES with an
overview of the Department and Divisions.
VISION: Health People, Healthy Community
MISSION: Preventing Illness and Injury, Promoting a Healthy and Safe Community, Protecting
all Members of Our Community
CORE VALUES: Professional Staff, Progressive Programs, Focus on Our Community
The Health District operates on a 5.6 million dollar budget within that about 2.2 million are from grants.
Employed are 78 full time employees with a Local, Regional, State, and National service area being
unique in the State of Texas as the only Health District that is a City Department. As a District it not only
allows us to serve the City of Wichita Falls but Wichita County and eleven counties with various grants.
An Organizational Diagram of the Health District depicts Lou Kreidler as the Director, Amy Fagan as the
Assistant Director, Dr. Mattar as the Local Health Authority Medical Director, and the 5 Divisions
(Environmental Health, Lab, Nursing, WIC and Animal Services ). The Health District contracts with the
Residency program for the Local Health Authority and physicians for onsite clinic services.
Our Wichita Falls Health facts based on the County Health rankings last year are not in a good place
compared to Texas as per the few listed below.
2094 Ranking
Wichita Falls
Texas
Adult Smoking
21%
17%
Adult Obesity
33%
29%
Physical & Activity
29%
24%
Excessive Drinking
16%
16%
Amy Fagan remarked that in the Wichita County Health Facts hand out are more detailed rankings.
Lou Kreidler stated the Health District was in the Accreditation process which is recognition of
achievement focused on improvement and quality assurance issued by the Accreditation Health Board.
The Statement of Intent was submitted 3 weeks ago with the stipulation of a six month wait but no more
than a year to apply for the Accreditation. The final requirements are in process to apply at the end of
the six month wait. In the State of Texas the only Health Department accredited was Houston but
several other Health Departments are in the process.
The Health Coalition formed three years ago with over 40 members in 6 sub - groups with 3 focused on
prevention and 3 on system issues. The initiative of the comprehensive Smoke Free ordinance was the
most important thing the Health District and Health Coalition had done in the past year. The Coalition
was instrumental in the passage of the Smoking ordinance. In the upcoming months work will be toward
passage of the Smoking ordinance in the communities of Burkburnett, Electra and Iowa Park. The
partnership with the Health Coalition has been monumental for the Health District and community it was
the first time in the community history that peers from all the large health care organizations gathered put
politics aside to work for improvement of health in our community.
Amy Fagan is the Administration supervisor of Vital Statistics, Public Health Preparedness, the Billing
Clerk and Accreditation Specialist. Vital Statistics handles Birth and Death records within the City of
Wichita Falls. Public Health Preparedness conducts the planning and preparedness activities to help the
community be ready for public health emergencies. The Billing Clerk currently handles the
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Medicaid /Medicare billing but when credentialed can bill private insurance. The Accreditation Specialist
works on the process to become accredited by the Accreditation Health Board.
Susan Morris is the Administrator of Environmental Health the Division conducts inspections of the
following; Ambulances, Schools, Day Cares, Foster Homes, Tattoo /Body Piercing Studios,
Hotels /Motels, Public Swimming Pools, and Food Control. Services include regulation of the Smoking
Ordinance, On -Site Sewage Facilities, Soft serve Ice Cream and Food Safety. Educational programs for
food handlers, pool operators, and soft serve certification. Vector Control monitors the mosquito
population for different species and controls epidemics of mosquito borne diseases. Swimming pools
had been a challenge with the Stage 5 restriction of not able to use water to fill pools we had to examine
the safety of well water use in public pools. Establishment of standards for the well water to meet gave
us the ability to inform the community it was safe to swim in.
Katrena Mitchell is the Administrator of the Animal Services Center (ASC) located at 1207 Hatton Road
that opened on February 1, 2011. At the last Council Meeting an Adoption Wing was approved for an
additional 18 kennels at the back of the current building to hold more dogs for adoption. Adoptions
began in April 2014 with 100 adoptions done as of January 31, 2015.
Jennifer Chewens is the Administrator of the Laboratory that provides the following services; Clinical,
Food & Environmental, Potable and Non - Potable Water, and Water Well Testing.
Janna Kaelin is the Administrator of the Women, Infants, and Children (WIC) program that is 100%
federal funded received this year right at $900,000. Those eligible for the supplemental food and
nutrition program are: pregnant women, postpartum and nursing mothers, and infants and children up to
age 5. The program supports the big push of breastfeeding with an active program where the WIC Peer
Counselors go into the hospitals to work with new moms.
Lynette Williams is the Administrator of the Nursing Division that in the last year was reorganized into
Preventive Services and Communicable Diseases clinical service the HIV Prevention goes out to test
individuals for HIV and Health Educators are in the program now. The Texas Healthy Communities are
working on the Por Vida program and the Active Living Plan for our community. The Tobacco Prevention
and Control Coalition has been important in support of the grant activity with formation of the Adult and
Youth Coalition. The Say What! Conference at the Woman's Forum for those 12 to 18 years old had 60
children attend the youth conference for education. In the afternoon the group went to MSU which is
ironically a smoke free campus and they picked up over a 1,000 butts and placed flags in the place of the
butts. A couple of the youth did interviews with the news it has been a great program they go out to the
Boys & Girls Club, Teens against Tobacco Use (TATU) also a successful program. The Health District
conducts Tuberculosis, Sexually Transmitted Infection, Epidemiology, and Immunization Clinics.
The Health District was one of the 15 communities chosen across the Nation for a new Community
Partnerships grant from the National WIC Program. The District is to contract directly with WIC to work
with not only WIC clients but all community members to help improve nutrition.
For the new members and previous members back on the Board ordinances will be presented to the
Board for a recommendation or not to council. If there are no regulatory items for the Boards advice and
input the different programs will present and discuss the program.
Vll. PHIMS
Lou Kreidler asked Amy Fagan, Assistant Director of Health to discuss the electronic records project
called Public Health Information Management System (PHIMS) we have worked on for over a year and a
half and now with the Staff.
Amy Fagan stated for all 5 Divisions we used a highly ad equated process. In the last few years we went
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about on how to improve and better utilize our staff time because in the fiscal year 2009 was asked to
reduce our budget by 8% which would be about six million less as a good steward we tried to do as
much as we could. One of the ways was to improve our knowledge to better enhance customer
experiences. Over the years we started to offer an online food handler class not orchestrated by the
Health Department but as another option to customers to opt out of the food handler classes taught at
the Department.
We offer ChexOut as part of a STI clinical visit so the client can get their negative result online the
younger clients prefer the method. The CDD Lab system is used so clients can come here get their labs
drawn when needed or physician ordered. Several years have used a web portal for the community to
view online food inspections.
One thing we saw coming especially with the formation of the Health Coalition was the forces of change
which was discussed with the Health Coalition. Part of that process discussed was the things to come in
the future with requirements to report certain scenarios to Public Health but we were so antiquated in the
past. It was known there would be challenges because of the process no matter what vendor whether it
was the hardware, software, staffs time, or operating cost it was going to be expensive. The Department
offers a lot of services there are 78 active employees which includes; Breastfeeding Peer Counselors,
Vector Control, and Staff Clinics. In 2013 our bid was put into the City government process and made
sure to follow the appropriate process to incorporate the Advanced Business System (ABS) some
features from the general process was to customize drop down menus. Our Health Department and the
other 63 Texas Health Departments are all different in what is offered in vaccines and services, those
features are requirements for us within the system also with our records retention we had to be HIPPA
compliant. The Laboratory receives internal specimens from Environmental Health some can be done in
house and others sent to the State for results. We wanted Environmental to be able to do permits for
restaurants and grease traps that are posted for the public view. The Inspectors needed some field
functionality with the SWEEPS system time was spend in the morning to determine where they needed
to go then out to inspect to come back at the end of the day to enter all the information into SWEEPS the
system consumed the beginning and end of each day. The STI Clinic goes out to the jail and jail annex
to provide STI services also to offer some immunization clinics off site. The web based system chosen is
great for our access all we do is login because our IT planned the network it would not allow us to any
record, document or information that has (PHI) Protected Health Information. We operate with a
combination of desk tops, tablets, and the inspectors in the field at restaurants, etc. work on tough pads
that are expensive but long term functional they can go out to different point sites more so than [pads.
Wireless access points was installed a big deal because not very many City buildings have wireless.
Environmental Health converted in June then in July imported the SWEEPS data with some challenges
but now fully functional that includes the staff have the tough pad to go out to the restaurants work with
management through the questionnaire process for entry the individual signs the report that can be
emailed or with the thermal printer print the report they and issue to the individual. The front desk
converted in August now Nursing Services in the thick of conversion with the STI clinic challenge
remains with the jail and jail annex technology to allow us for use of their WiFi a confirmation we are in
compliance with all their requirements. The County staff is to offer a special training for our staff to
include the appropriate conduct with the use of technological devices because often times it is not
thought about what should not be done. Immunization Clinic is in the process of converting which is
similar to the Electronic Health Records (HER) when the state provided us with our compact data that
made the Immunization clinics final modification. Dr. Mattar as Lou mentioned functions as our Local
Health Authority and manages the Residency Physicians will have their own log with the ability to remote
from their location at the Family Health Center which will be nice because they do records review and be
able to view chest x -rays that are ordered and done at United Regional. Our Laboratory converted with
ability to access Lab reports. Eventually billing Private Insurance as Lou mentioned that is so much
easier to integrate with ICD10 the pay scale. Another thing looked at what would be a first was a Quality
Improvement Plan as a Department wide project to preplan with strategic
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thinking to get out of it long term as a evaluator mechanism at the end. Quality Improvement would give
us a thought process to help as we get to the end project to approach another simflar big project.
Robin Moreno questioned if it has the ability to grow and change when you needed.
Amy Fagan answered it is hopeful that was one of the things needed was to have some customization
options in the system the vendor merchant called them add -on modules with additional costs through
time a challenge.
Lou Kriedler stated the Public Health Inspectors now have the ability to email the inspection report to the
local establishments Manager and their Corporate office to notify them of any issues that may not be
corrected locally. Where it use to take at least a week for the inspections to be posted once the
inspection is entered as done it is automatically posted to the web.
Dr. Carlston asked had it been noticeable of any cutting down time on the process of entry, ability to do
more inspections to the level you want or more frequent inspections done than before.
Amy Fagan replied the data would need to be looked at on how many inspections were done over a
period of time and by how many inspectors a challenging part of the QIP measure. The only feedback
we have other than to do the comparison of inspections /inspectors is the inspectors have given positive
feedback as to be out in the field more and ability to do more than in the past.
Scott Plowman adjourned the meeting.
VII. NEXT MEETING
April 24, 2015
VIII. ADJOURN
The meeting adjourned at 1:00 pm.
Signature
r ct �A
Print Name
Scott Plowman,_ Chair, Julie Gibson. D; V. M.. Vice- Chair. or Diane Stewart, R.N., Secretary
Wichita Falls- Wichita County Public Health Board
City- County Board