MID-MICHIGAN DISTRICT HEALTH DEPARTMENT An Accredited Local Public Health Department

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MID-MICHIGAN DISTRICT HEALTH DEPARTMENT An Accredited Local Public Health Department www.mmdhd.org CLINTON Branch Office 1307 E. Townsend Rd. St. Johns, MI 48879-9036 (989) 224-2195 GRATIOT Branch Office 151 Commerce Drive Ithaca, MI 48847-1627 (989) 875-3681 MONTCALM Branch Office 615 N. State St., Ste. 1 Stanton, MI 48888-9702 (989) 831-5237 ADMINISTRATIVE OFFICES 615 N. State St. Ste. 2 Stanton, MI 48888-9702 (989) 831-5237 MARK W. (MARCUS) CHEATHAM Health Officer ROBERT GRAHAM, DO, MPH, FAAFP Medical Director BOARD OF HEALTH Bruce Delong Jack A. Enderle Betty Kellenberger Jane Keon Tom Lindeman Laura McCollum BOARD OF HEALTH REGULAR MEETING at Mid-Michigan District Health Department Gratiot County Branch Office Ithaca, Michigan Conference Room A Wednesday, September 24, 2014, 10:00 a.m. MINUTES We take action to assure the health and well being of our community and the environment by responding to public health needs and providing a broad spectrum of prevention and educational services. Members Present: Members Absent: Staff Present: Staff Absent: Guests: Laura McCollum, Chairperson; Bruce Delong; Jack A. Enderle; Jane Keon; and Tom Lindeman Betty Kellenberger Mark W. (Marcus) Cheatham, Ph.D., Health Officer; Melissa Bowerman, Director of Administrative Services; Cynthia M. Partlo, Board Secretary; Robert Graham, DO, MPH, FAAFP, Medical Director; and Bob Gouin, Director of Environmental Services None None L. McCollum, Chairperson called the regular meeting of the Mid-Michigan District Board of Health to order at 10:11 a.m., on Wednesday, September 24, 2014, at the Gratiot County Branch Office of the Mid-Michigan District Health Department, Ithaca, Michigan. Pledge of Allegiance was led by L. McCollum. A. AGENDA NOTES, REVIEW, AND REVISIONS: M. Cheatham requested to add Grant Update under Health Officer s Report, item G. 4. Your Public Health Team, Connecting with our Communities to Achieve Healthier Outcomes

Motion made by J. Enderle and seconded by T. Lindeman to approve the Agenda as revised. Motion carried. B. CONSENT ITEMS: 1. Meeting Minutes a. Mid-Michigan Health Plan Advisory Board Meeting held August 21, 2014 b. Mid-Michigan District Board of Health Regular Meeting held August 27, 2014 c. Mid-Michigan District Board of Health Closed Session held August 27, 2014 d. Mid-Michigan District Board of Health Personnel Committee Closed Session Meeting held September 17, 2014 e. Mid-Michigan District Board of Health Personnel Committee Meeting held September17, 2014 2. Communications None C. Partlo distributed the Closed Session Meeting Minutes for August 27 and September 17, 2014. After the Board read them, C. Partlo collected them. Motion made by J. Enderle to accept and place on file meeting minutes B. 1. a. through e. Motion seconded by J. Keon. Motion carried. C. PUBLIC COMMENTS: None. D. BRANCH OFFICE EMPLOYEES: None. E. COMMITTEE REPORTS: 1. Finance Committee Tom Lindeman, Chair a. Mid-Michigan District Health Department s Monthly Balance Sheet, Revenue and Expenditure Report for August 2014 Motion made by T. Lindeman to approve and place on file the Mid-Michigan District Health Department s Monthly Balance Sheet, Revenue and Expenditure Report for August 2014. Motion seconded by B. Delong. Motion carried. b. Mid-Michigan District Health Department's Expenses for August 23 September 19, 2014 J. Enderle stated that the agency pays $4,000 per month for a copier lease and expressed concern over the annual cost. M. Bowerman indicated that the lease would be expiring in one to two years and stated she would explore other options to see if the expense for copiers could be reduced. Page 2 of 7

Motion made by T. Lindeman to pay the Mid-Michigan District Health Department s Expenses for August 23 September 20, 2014, totaling $310,375.86. Motion seconded by J. Keon. Motion carried. c. FY 13/14 Proposed Amended Budget Motion made by T. Lindeman and seconded by J. Enderle to approve the FY 13/14 Amended Budget as proposed. Motion carried. d. FY 14/15 Fee Changes T. Lindeman indicated that the Finance Committee recommended approval of three new fees: Irrigation Well Permit Applications $333; Paraguard IUD $485; and Mirena IUS $670. Motion made by T. Lindeman and seconded by J. Keon to approve the fee changes as proposed: Irrigation Well Permit Application Fee $333; Paraguard IUD $485; and Mirena IUS - $670. Motion carried. e. Epidemiologist Contract M. Cheatham explained that the Associated Agreement for Epidemiologist Services is a 50% split of services between the CMDHD and the MMDHD. He requested authorization to have L. McCollum sign the Agreement on behalf of the Board. Motion made by T. Lindeman and seconded by J. Enderle to authorize L. McCollum, Chairperson to sign the Associated Agreement for Epidemiology Services as proposed. Motion carried. 2. Personnel Committee Betty Kellenberger, Chair (B. Delong reported for B. Kellenberger) 1. Consider Acceptance of Teamsters Local 214 Ratified Contract C. Partlo distributed a memo outlining the changes to the Teamsters Local 214 Contract and the Ratification Summary. M. Cheatham reviewed the documents and requested Board acceptance of the Contract. Motion made by B. Delong and seconded by J. Keon to accept the Teamsters Local 214 ratified Contract as proposed and authorize L. McCollum to sign the completed Contract once received. Motion carried. 2. Health Officer s Contract M. Cheatham explained two changes to the Health Officer s Contract that the Personnel Committee recommended noting that his wages increased by 2%, consistent with the Teamsters Local 214 and non-union employees. He explained the second change was to section 5. h) requiring Board approval for payment of out-of-state travel. Language was removed requiring Board approval for out-of-state travel. He requested the full Board of Health to approve the revised contract. Page 3 of 7

Motion made by B. Delong and seconded by J. Keon to approve the Health Officer s Contract as revised. Motion carried. 3. Program Committee B. Delong, Chair No report. 4. Mid-Central Coordinating Committee T. Lindeman, Vice Chair No report. F. MEDICAL DIRECTOR S REPORT: Robert Graham, DO, MPH, FAAFP 1. Infectious Disease Soup Dr. Graham stated that a five-year-old child died recently from the CMDHD district during the time that Enterovirus 68 was announced. He stated that due to the ease of communication through social media, rumors were being circulated that the child died from Enterovirus, when in fact, the child died from other causes. He described Enterovirus and its symptoms. Additionally, he emphasized the importance of relying on factual information rather than sensationalism and controversy. Dr. Graham also stated that cases of Pertussis/Whooping Cough have been seen within all of the 19 counties he serves. He emphasized the importance of prevention for all those in the family. No cases of Middle East Respiratory Syndrome or Ebola Virus have been seen in our district. He outlined the precautions that have been taken within the district in case these infectious diseases make their way into Michigan. He added that West Nile Virus (WNV) was still present, although there were fewer cases this year compared to last year s increased number of cases. In summary Dr. Graham stressed the importance of preventing infectious diseases and preparedness. Dr. Graham offered the following as the Recommendation of the Board of Health for the month of October: Everyone over the age of six months should get a flu shot. Everyone two months of age and older should begin vaccination against whooping cough or have a completed series against whooping cough. J. Enderle asked if anything was being done to change the ability of residents to sign a waiver for receiving immunizations. Dr. Graham replied that the State was considering a proposal requiring residents to come to the health department to receive education regarding vaccine-preventable diseases before obtaining a waiver. He stated that he was aware of two health departments in the State of Michigan that do not allow waivers for immunizations without first consulting with the health department staff. The Board discussed the immunization waiver process. M. Cheatham reported that the State was working on changes to the waiver process. Motion made by J. Enderle and seconded by J. Keon to adopt the BOH Monthly Healthy Living Recommendation for October as proposed. Motion carried. G. HEALTH OFFICER'S REPORT: Mark W. (Marcus) Cheatham, Health Officer, Ph.D. 1. Travel Request M. Cheatham requested approval from the Board to travel to the Joint Public Health Informatics Task Force (JPHIT) meeting in Washington, DC, October 29-30, 2014. Although the memo stated he requested that Melissa Bowerman, Director of Administrative Services be appointed as Page 4 of 7

Acting Health Officer in his absence, he would not be out of touch and felt it not necessary. No action was taken by the Board. M. Cheatham provided an update regarding JPHIT. 2. Health Officer Vacation Request M. Cheatham stated that he will be on vacation out-of-state September 27 through October 5, 2014. He requested that M. Bowerman be appointed as the Person in Charge during his absence. Motion made by J. Keon and seconded by T. Lindeman to approve the Health officer s vacation September 27 through October 5, 2014 and appoint M. Bowerman as Person in Charge during his absence. Motion carried. 3. FY 14/15 MMDHD Organizational Charts M. Cheatham stated that the agency s Organizational Charts needed to be approved on an annual basis; and he reviewed the changes with the Board. Motion made by B. Delong and seconded by T. Lindeman to approve the agency s FY 14/15 Organizational Charts as presented. Motion carried. 4. Grant Update H. OLD BUSINESS: C. Partlo distributed the Grant Update. M. Cheatham stated that the agency has had success with recent grant applications. He outlined the grant funds received stating that $21,000 had been received for the expansion of the Montcalm Area Dental Clinic; $5,000 for the fluoride varnish program; and $73,669 from the Substance Abuse and Mental Health Services Administration (SAMHSA) for the first year of a five year grant to support the work of the Clinton Substance Abuse Coalition. Additionally, M. Cheatham mentioned he forgot to add to the Grant Update the $5,000 from the Central Montcalm Community Foundation for the expansion of the Montcalm Area Dental Clinic (although it was included in the amount above). He added that he planned to partner with the Greenville Area Community Foundation to assist with requesting the remainder of the funding. The Board expressed concern regarding the growing use of heroin within the district. 1. Additional Members to the Board of Health M. Cheatham explained that any changes to the Intergovernmental Agreement to add at-large Board members would need to be approved by County Commissioners. The Board members discussed how the process might be structured and indicated that the details would need to be worked out, such as: must have two County Commissioners; each county may appoint one alternate; each county can only have two votes; Commissioners have the vote unless not present, then alternate votes on behalf of Commissioner; consider per diem/mileage expense because alternates need to attend every meeting. L. McCollum suggested that the county appointing the alternate could be responsible for paying the per diem to the alternate. M. Cheatham stated that he would consider the feedback provided and develop language for consideration. Page 5 of 7

I. NEW BUSINESS: J. Keon asked M. Cheatham to see examples of what other counties are doing regarding alternate members and the language in their agreements. M. Cheatham agreed to provide information at a future meeting. 1. Board of Health Actions and Outcomes M. Cheatham explained that the document was created to serve a need for national accreditation. He reviewed the document and stated that it was very helpful to provide a history of Board of Health actions. He proposed that this document be reviewed by the Board of Health every December at the regular Board meeting. He requested the Board accept and place the document on file. Motion made by B. Delong and seconded by J. Keon to accept and place the Board of Health Actions and Outcomes, August 2013 through August 2014 on file. Motion carried. 3. Emerging Issues 1. B. Delong reported that Steve Willis Clinton County Republican Party Chairperson obtained a copy of the Well and Septic Stakeholder s Committee final report and recommendations; sending emails to the community requesting them to attend tomorrow s Commissioner Forum. B. Delong also received a complaint from a constituent regarding the final report and recommendations, stating that the health department doesn t have the right to go into a person s home to inspect their water or do soil borings without just cause, and charging the homeowner for the costs. M. Cheatham stated that those are not the topics that are being discussed tomorrow. He provided an overview of the final report and recommendations, stating that the Commissioner Forum was held to obtain feedback from Commissioners on whether to proceed forward with the recommendations. B. Gouin explained what he thought was the concerns of the constituent. After discussion regarding the format of the Commissioner Forum, L. McCollum stated that she would be willing to moderate the event. J. LEGISLATIVE ACTION: 1. Legislative Update M. Cheatham reviewed the Legislative Update stating that the document was prepared to bring awareness to bills that could become law and how they affect public health. After discussion, the Board of Health expressed interest in receiving the legislative update periodically. K. INFORMATIONAL ITEMS: 1. Mid-Michigan District Board of Health Action Items, August 2014 2. Staffing Report Page 6 of 7

L. RELATED NEWS ARTICLES AND LINKS: 1. "Michigan Hospitals Placed on Alert for Enterovirus", Gannett Michigan, September 9, 2014; http://www.lansingstatejournal.com/story/news/local/michigan/2014/09/08/enteroviru s-may-already-michigan/15304037/ 2. "Air is Still Contaminated 40 Years After the Michigan Chemical Plant Disaster in St. Louis, Michigan", Environmental Science & Technology, September 11, 2014 M. AGENCY NEWSLETTERS: 1. Inside MMDHD, Health Enhancement Committee (HEC), September 2014 There being no further business to come before the Board, the meeting adjourned at 12:05 p.m. Respectfully Submitted, Cynthia M. Partlo, Board Secretary For Laura McCollum, Chairperson Mid-Michigan District Board of Health Page 7 of 7