AGENDA. CALL TO ORDER 11:30 am Sue Warren. Action Items:

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BOARD of HEALTH MEETING December 3, 2014 City-County Health Department Lge. Conference Rm - Meeting Starts @ 11:30 a.m. 115 4 th Street South, Great Falls AGENDA CALL TO ORDER 11:30 am Sue Warren Roll Call: Sue Warren Action Items: 1. Approve Minutes from November 5, 2014 Meeting Sue Warren 2. Report from Nominating Committee Ryan Burke 3. Environmental Health Report Sandy Johnson a. 2015 DPHHS & BOH Coop Agreement b. Adoption of changes to ARM 17.36, Subchapter 9 Septic Regulations c. PHEP Deliverable Authority of the Sanitarian Sandy Johnson/Janelle Olberding 4. Prevention Services Report Trixie Smith/Jill Boettcher a. Communicable Disease Report 5. Finance Report Casey Mohler 6. Health Officer s Report Tanya Houston a. Ebola Readiness b. Legislative Forum 7. Public comment on any public matter that is within the Board of Health s jurisdiction MCA 50-2-116. MEMBER COMMENTS ADJOURNMENT

Members Present: Bill Bronson, Acting Chair Ray Geyer, DO Matt Martin, DDS Tammy Lacey Tanya Houston, Secretary Ryan Burke Board of Health Meeting Wednesday, December 3, 2014 MINUTES Staff/Visitors Present: Sandy Johnson Trixie Smith Marcella Weingarten Casey Mohler Jill Boettcher Janelle Olberding Mr. Bronson called the meeting to order at 11:30 a.m. and stated a quorum was present. ACTION ITEMS: 1. Approve Minutes from November 5, 2014 BOH meeting: Mr. Bronson Ms. Lacey moved to approve the minutes as provided; Dr. Martin seconded the motion, and with all in favor the motion passed. 2. Report from Nominating Committee: Mr. Burke Mr. Burke shared an email correspondence between him and Ms. Weber regarding Board of Health (BOH) Chair positions. Ms. Warren is willing to chair the Board of Health next year and Mr. Bronson is willing to serve as the Vice Chair. All other board members respectfully declined to run for either position. Mr. Burke moved that the Nominating Committee Report be accepted as presented. Mr. Bronson asked three times if there were any other nominations from the floor. No nominations given. With all those in favor, the motion was passed. 3. Environmental Health Report: Sandy Johnson a. 2015 DPHHS & BOH Coop Agreement Ms. Johnson summarized the agreement for board members. Environmental Health (EH) is required to inspect most establishments at least once a year, with the exception of indoor pools (twice a year) and tourist homes (inspected upon opening and then only on a complaint basis). Cascade County also conducts the swimming pools and body art inspections which are optional for counties. 1 P a g e

Ms. Lacey moved that the board approve and sign the Cooperative Agreement with DPHHS to allow disbursement of funds to the BOH for inspections of licensed establishments completed in Cascade County. Mr. Burke seconded the motion, and with all in favor the motion passed. b. Adoption of changes to ARM 17.36, Subchapter 9 Septic Regulations Ms. Johnson presented the recent DEQ changes to the ARM s for on-site subsurface wastewater treatment systems (title 17, chapter 36, subchapter9) that became effective in August 2014 after the BOH had adopted the Cascade County septic regulations in July 2014. The Board of Health is now adopting these revisions. This information had also been briefly discussed at the November board meeting. Dr. Geyer arrived at 11:38 a.m. Mr. Burke moved that the board adopt the recent changes to the Administrative Rules of MT, Title 17, Chapter 36, Subchapter 9 for Onsite Subsurface Wastewater Treatment Systems as part of the Cascade County Regulations for Subsurface Wastewater Treatment Systems. Dr. Martin seconded the motion, and with all in favor the motion passed. c. PHEP Deliverable Authority of the Sanitarian: Janelle Olberding/Sandy Johnson Ms. Olberding presented a handout, Authority of the Sanitarian, a Public Health Emergency Preparedness (PHEP) grant deliverable. The approval of this document would grant the Lead Sanitarian of Cascade County the authority to act on behalf of the Health Officer and the BOH when time sensitive issues of public health importance arise, and immediate convening of the Board is not possible. Appendix A of the handout provides the legal references. The handout does not encompass all job duties, but only items the Lead Sanitarian may need to convene the board to address. This authority also does not mean that the Board will not be asked to convene for appropriate issues, but it allows the Sanitarian to stop activities that threaten the public s health in the interim. Ms. Lacey moved that the BOH approve and sign the Authority of the Cascade County Lead Sanitarian. Mr. Burke seconded the motion, and with all in favor the motion passed. 4. Prevention Services Report: Trixie Smith/Jill Boettcher a. Communicable Disease Report Ms. Boettcher shared the Communicable Disease Report. There was an increase in Shigella cases; Prevention Services is continuing to identify contacts and provide testing and/or treatment Influenza had one to two cases within the past couple of weeks One pertussis case was found in a six month old; all contacts were tested and treated, including follow-up in 21 days Ms. Houston stated new information has come to light regarding a Communicable Disease and due to the sensitive nature of the additional details she requests the board 2 P a g e

go into closed session. Ms. Lacey moved that the BOH go into closed session as the individual rights to privacy outweigh the public s right to know. Dr. Geyer seconded the motion, and with all in favor the motion carried. The BOH went into closed session at 11:46 a.m. At 12:00 p.m. the BOH reconvened with no action being taken during closed session. 5. Finance Report: Casey Mohler Ms. Mohler shared the Finance Report. The county finance system is still working through a few issues, but the report given at the BOH meetings is accurate due to internal budget tracking. Ms. Mohler stated that programs with quarterly invoices or payments may be posted in the beginning of November. HD (Health Department) revenue (2270-216) is being monitored closely. Last FY (Fiscal Year) the HD was at 24 percent received at the end of October; this year is at 22 percent. o Beginning of October the CHCC (Community Health Care Center) was contracted to do billing for the Immunizations Department; the clinic is currently going through a change in the billing software that they use which has caused some delay in the billing process. This is currently being resolved and it is anticipated that within the next two or three month that revenue will be collected and posted. o Ms. Houston stated the HD will save an estimated $12,000 a year with outsourcing the billing to CHCC. BUMT (Buckle Up Montana) (Fund #2960-442) contract has been approved by the county commission. The HD is awaiting the fully executed contract prior to sending the appropriation forward to Finance MIECHV Expansion and MIECHV SafeCare both are low on expenditures due to the majority of funds are set aside for the sub-recipient payments. Ms. Mohler, Ms. Houston, and the program manager will be monitoring the expenses closely. Ms. Houston shared that PHEP (Public Health Emergency Preparedness) funding stream 2963-328 has a balance for response funds. Under encouragement from the State, the HD is working on lowering the balance. Funds have been used to purchase a trailer for storing and moving flu shot clinic supplies and CCHD is ensuring that the use of funding is appropriate and will benefit the Department for the long term. Currently they are exploring other purchasing options but will continue to sustain a smaller reserve amount in the future. Ms. Houston shared that at the county level, they (Ms. Houston later identified that the Audit is being completed by Joseph Eve & Company) are auditing for FY (Fiscal Year) 2012 and 2013. 3 P a g e

The auditors have asked that every department pull specific documentation and place it on the county shared network. 6. Health Officer s Report: Tanya Houston The CCHD (City-County Health Department) and CCHC are working together to raise money for United Way and the Great Falls Rescue Mission this year by holding a Jeans Day, Silent Auction, and Bake Sale. a. Ebola Readiness Ms. Houston stated the readiness group has continued holding the Ebola readiness meetings but are now meeting bi-weekly or as needed. They will continue to meet after the Ebola topic has died down to further strengthen partnerships. The State has finished their plan and will be a great resource on a local level to aide in developing protocols Ms. Houston presented at the last Rural Fire Council meeting and also provided handouts to attendees. The QRU s (Quick Response Units) were invited to attend a training that covered PPE (Personal Protective Equipment) and basic Ebola training; due to the small attendance, packets will be provided to Vince Kolar for mailing and email CCHD participated in the MAFB (Malmstrom Air Force Base) exercise/debrief and found it very useful; she invited a MAFB representative to participate in the HD s smaller readiness group to help streamline communication and mitigate potential issues Future plans consist of working on the airport response to any infectious disease; meeting in the next month or so with applicable partners b. Legislative Forum Ms. Houston shared the turnout from across the community was good and topics such as Medicaid Expansion, Early childhood education, and tobacco cessation were covered. Ms. Houston travelled to Helena to attend the Lead Local Health Official DPHHS Overview and found it useful. DPHHS offered to present information to Board of Health members at a local level; Mr. Bronson asked Ms. Houston to send an email to the board stating the orientation opportunity had been offered and ask the BOH members what is their willingness to participate. Ms. Houston stated the HD has been involved in the selection and demos of a mass notification system that the county has purchased. The Health Officer is an administrator of the system and would be able to create messages and utilize the system in the event of a public health emergency. Ms. Houston added that DES (Disaster and Emergency Services) has the lead on this but CCHD will support and assist with the public information component. 7. Comment: Public 4 P a g e

Mr. Bronson mentioned the City has an Emergency Medical Services Panel in place but dispatch has data that is dated. o An advisory committee voted on developing and following their own resources and contacts list; allowing the city to address issues on a local level. Dr. Geyer moved to adjourn the meeting at 12:27 p.m. Ms. Lacey seconded the motion, and with all in favor, the meeting was adjourned. Respectfully Submitted, Bill Bronson, Acting Chair Date 5 P a g e