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LUCAS COUNTY REGIONAL HEALTH DISTRICT Board of Health Meeting Department of Operations Center (DOC) #254 July 24, 2014 8:30 A.M. Roll Call A roll call was taken of Board members for attendance. Present: Barbara Conover, Mary Duncan, Perlean Griffin, Matthew Heyrman, Donald Murray, Barbara Sarantou, Hans Schmalzried, Dr. Donna Woodson Absent: Darlene Chaplin, Reynald Debroas, A. Debra Nicotra, Robert Reinbolt, Dr. Christopher Sherman (all excused) Guests: Kathy Holmes, ONA Representative; Jason Fries, Union Steward, AFSCME; Kevin Pituch, Assistant Prosecutor; Stacy (DeBruyne) Weber, PIO; Tiffany Akeman, MPH Student; Nancy Benedetto, Public Health Nurse Staff: Mary Frank, David Grossman, M.D., Barbara Gunning, Joanne Melamed, Larry Vasko, Eric Zgodzinski Dr. Donna Woodson, President, called the meeting to order. Introduction of Guests Larry Vasko introduced Kathy Holmes, Jason Fries, Kevin Pituch and Nancy Benedetto. Minutes of June 26, 2014 The minutes of the June 26, 2014 meeting were reviewed. The following change was made: On page 8, last sentence. Change wording to read: the Council for Science and Public Health for recommendations. There was agreement. Mary Duncan made a motion to approve the minutes as corrected. Donald Murray seconded the motion. A vote was taken of those present. Motion carried. Agenda Dr. Donna Woodson requested an executive session to discuss pending contract negotiations. There was agreement. Vouchers Mary Duncan presented for Dr. Christopher Sherman. The Audit/Finance Committee met on July 22, 2014 and reviewed the July vouchers. The committee found the Bill Schedule to be satisfactory and recommended approval. Donald Murray made a motion to approve the payment of the July vouchers. Barbara Conover seconded the motion. A vote was taken: 8 yeas, 0 nays. Motion carried. Old Business 1

Follow-Up Items Dr. Woodson inquired about the CASPER program. Dr. David Grossman said that this program would likely start sometime in August. Eric Zgodzinski added that this item is in the planning phase and the survey will start in August. Prosecutor s Update Kevin Pituch reported as follows: Road House Case The Road House case is still in litigation. The owner was instructed to remove concrete from his property. The case in now in appeal stage. Mr. Pituch noted that the court usually takes from two to four months to render a decision on these types of cases. We anticipate a decision soon. Ad-Hoc Committee Report (WLCC) Dr. Grossman noted that our health department is moving forward with FQHC and FQHC updates would likely be needed at the committee meetings. New Business Executive Session Donald Murray made a motion that the board go into executive session to discuss upcoming contract negotiations. Mary Duncan seconded the motion. A roll call was taken: 8 yeas, 0 nays. Motion carried. The Board went into executive session at 8:40 a.m. and returned at 9:02 a.m. The following employees were asked to stay: Dr. David Grossman, Larry Vasko, Joanne Melamed, Barbara Gunning, Eric Zgodzinski and Kevin Pituch. Federally Qualified Health Center (FQHC) Dr. David Grossman reported. The Board approved going forward with FQHC status on June 17, 2014. Dr. Grossman reported that he and Barbara Gunning had met with Doni Miller, CEO, Neighborhood Health Association, regarding the Neighborhood Health Association FQHC. Many federal grants require the involvement of a Federal Center. Ms. Miller indicated her support and cooperation with our agency if we become an FQHC. The health department has done an incredible amount of work, and we anticipate becoming an FQHC look-alike sometime this year. We have been working with a consultant on this issue. Barbara Gunning reported on current activities including meetings with Michael Mucci, consultant; working with templates; co-applicant agreements; Law Department involvement; development of Bylaws; marketing contract; marketing person; and other items. Currently, we are working on developing policies for both the health center and the health department. The budget will be a regular budget. We have also been working with an architect regarding the Western Lucas County Clinic. Formal floor plans and signage will be addressed at this location. A major area of concern is transportation as our patients must have access to our centers. Matt Heyrman suggested contacting the TARTA director to obtain good, quantifiable numbers as well as Tim Harrington from the Ability Center regarding transportation. 2

Dr. Woodson inquired about the actual target date for FQHC. Barbara Gunning replied that there is a two-part application process. The first part of the application for the large grant is due August 20, and we will also apply for the FQHC look-alike status simultaneously. The policies are due either October 7 or 14. Confirmation of New/Separated Employees Larry Vasko reported that two new employees were hired and there were no separations. Mahjida Steffin was hired as a Clerk 1 on June 24, 2014 at a rate of $10.05. She will be working in the Community and Environmental Health Division. Sarah Milliron, M.D., was hired as a physician on July 7, 2014 at a rate of $76.923. Barbara Conover made a motion to approve the report. Donald Murray seconded the motion. A vote was taken: 8 yeas, 0 nays. Motion carried. Environmental Health Issues Committee Donald Murray said that there was no report this past month. Personnel Committee There was no report this month. Audit/Finance Committee Mary Duncan reported for Dr. Christopher Sherman. The committee met on July 22, 2014 and reviewed the following items: June 2014 Financial Status, July Bill Schedule, Grant Funded Programs, Contracts, and Other Items--Transfers of Appropriations and Parking. Update Grant Funded Programs Total submitted applications in the amount of $4,549,773 for 2014 fiscal year, and during this same time period we were awarded $4,381,721 in funding. Total applications in the amount of $3,801,685 for 2015 fiscal year, and during this same time period we were awarded $3,693,490 in funding. Contracts There were 6 contracts in the months of June/July: 1. Angela Webber, FNP-C Standard Care Arrangement No economic impact. 2. University of Toledo Education Affiliation Agreement No economic impact. 3. Lucas County Children Services. 4. Sylvania Schools - $167,740. 5. Feldesman, Tucker, Leifer, Fidell, LLP (FQHC) - $7,500. 6. T. Parker & Co. (marketing) - $2,500. Dr. Grossman reported that the contract with Feldesman, Tucker, Leifer, Fidell, LLP will provide legal advice regarding FQHC. Other Items Transfers of Appropriations A transfer reallocates funds from one cost object to another. Board of Health Resolution is required to approve Transfers of Appropriations performed in the month of June 2014 in the 3

ordinary course of business. Total of transfers was for $25,736.91, consisting of changes in various expense categories. Board of Health Resolution is required to approve changes in Revenue Estimates and Expense Appropriations. In the month of June 2014 revenue estimates and expense appropriations are $773,865.65, representing new program dollars for Case Western Reserve University Delivery and Cost Study, Personal Responsibility Education Program, Public Health Emergency Preparedness, Electronic Health Records Incentives and CDBG Rodent Program, and reduction in budget for prior year programs for WIC and MRC. Matt Heyrman made a motion to approve the resolutions as read. Donald Murray seconded the motion. A vote was taken: 8 yeas, 0 nays. Motion carried. Other Items Parking The committee discussed expansion of the parking lot to accommodate visitors to the Health Department. Barbara made a motion to approve the report. Matt Heyrman seconded the motion. A vote was taken: 8 yeas, 0 nays. Motion carried. Contracts None DIVISION REPORTS Community and Environmental Health Services Strategic Planning Eric Zgodzinski reported. The Strategic Planning Committee met on July 8 and focused on Strategic Plan Priorities for July 2014. The committee worked on specific Domains for our strategic plan and things are going well. Mr. Zgodzinski reported on several items including interns, CASPER, Health Space, and other items. The CDC has asked our department to participate in a study regarding water. The study is called CASPER (Community Assessment for Public Health Emergency Response). As reported last month, the study will examine items such as exposure to problems, symptoms, and other issues. It is a scientific study that is being partnered with the Ohio Department of Health. This will start the process of conducting public health applied research for our community. It is anticipated that the project will start sometime in August. Health Space is a computer program that the Ohio Department of Health selected for health department use. It will give our inspectors a great tool, e.g., it will allow them to conduct inspection reports more expeditiously. Health Services Barbara Gunning reported. Two employees were recently interviewed by the newspapers. Michael Stubblefield, DDS, was interviewed by The Free Press. Dennis Hicks, Minority 4

Health Coordinator, was interviewed by Sojourner s Truth magazine. Mr. Hick s real focus was on infant mortality. This is the second part of a three part series. Child Fatality Review Nancy Benedetto, Public Health Nurse, presented on the Child Fatality Review Board. This is a program that is mandated by the State of Ohio. A powerpoint was presented. In 2012, there were 77 child deaths from birth to age 18. Causes of deaths broken down by categories were provided. One of the reasons the committee meets is to come up with ways to prevent child deaths. The CFR Board makes recommendations as part of its reporting requirements. Dr. David Grossman said that he serves as chairman of the CFR Board. When the state mandated the program, the responsibility for manning this program went to local health departments. Dr. James Patrick, Coroner, also attends these meetings. These meetings are closed to the general public. The committee has the authority to subpoena physicians and others in court cases. The only restriction deals with cases that are in litigation. Administrative Services Joanne Melamed reported on certified copies of birth and death certificates and on FQHC. The cost of a birth/death certificate is $25.00. The Health Department is allowed to keep $11.64 of this amount. An Activities Report for 2012 2014 was provided for the Bureau of Vital Statistics (attachment). It showed sales by month. Clients were offered the ability to purchase a birth/death certificate using a credit card. This helped our sales. Agency effort is being put forth to becoming an FQHC. Administrative Services is providing all HR, Financial, and Bill Department policies. Barbara Gunning, Health Services, has been instrumental in this project. One essential document has been shared with the Prosecutor s Office. They have been very helpful and instrumental in offering their assistance to our agency. We are currently working with Pete Kanios and Jim Walter. We are also working with a law firm from Washington D.C. whose expertise deals with assisting public entities in becoming FQHC qualified. We had a recent conversation with Jim Walter about how our employees will work for the health department but yet work with the FQHC. Pete Kanios, Lucas County Assistant Prosecuting Attorney, will be working on the co-op agreement. Health Commissioner s Comments Dr. David Grossman commented on FQHC, a thank you letter, Summer Fairs, and the 5K Get the Lead Out Event. Dr. Grossman announced that he received a nice thank you letter from McKinley Elementary School. The letter recognized Michael Stubblefield, D.D.S., and the mobile Dental Team for providing dental services to the school. Dr. Grossman noted that if the FQHC status is successful, it will help address some budget concerns. The 5K Get the Lead Out event is scheduled for Friday, August 1, 2014 at Ottawa Park. He reminded everyone that the next Board of Health meeting would be held at the Western Lucas County Clinic, 330 Oak Terrace Blvd., Holland. Ohio Public Health in the News Dr. Donna Woodson provided some articles on public health in the news: The measles outbreak in Ohio seems to be ending, although mumps is still spreading. As of last 5

Wednesday, there were 461 cases of measles, which surpassed all of the nationwide total of 438 cases for 2013. Most cases are from the Amish community. The Amish community has shown great cooperation in the immunization effort. Dr. Grossman noted that the mumps outbreak appeared mainly at the Ohio State University campus. There was news that China had reported that one of its plants had repackaged old beef and chicken and put new stickers on them. However, this has a global outreach. Dr. Woodson inquired about attendance at opiate conferences. Dr. Grossman provided an update and said that the Opiate Task Force is evolving. He has attended meetings locally. Larry Vasko and Barbara Gunning recently attended a meeting in Columbus. Also, Dr. Grossman and Barbara Gunning are involved with SASI and other local communities in dealing with this issue in a comprehensive way. Matt Heyrman and the Sheriff s Department are also involved. One reason for our involvement is because heroin and opiates and the effects on people s lives is a public health issue, Dr. Woodson voiced her concern with the lack of rehab efforts, instead of putting people in jail. Larry Vasko replied that one of our goals is decreasing the number of people getting involved with the use of heroin. He noted that the only way out is to stop using heroin. It is estimated that 48% of people who use heroin end up dying from it before their time. Without drug assisted therapy, the chances of getting out is only 18% on their first quit attempt. When people receive drug assisted therapy, the chances of getting out is 30+% on the first attempt. Donald Murray inquired about any discussions in our area about people coming across the Texas border and moving into different parts of the United States. Dr. Grossman replied that Northwest Ohio has always had a large migrant population. He was unaware if anyone has plans to track Central American people as there are different people coming from various countries. There are no known plans about what authorities will do regarding children who are being dropped off in the U.S. unattended. Mr. Murray voiced his concern if they come into our communities, then it would likely become an item that we will be involved with. Next Meeting The next regular Board of Health meeting will be held on Thursday, August 28, 2014 at 8:30 a.m. at the Western Lucas County Clinic, Cafeteria area, 330 Oak Terrace Blvd., Holland, Ohio. Adjournment Donald Murray made a motion to adjourn the meeting. Barbara Conover seconded the motion. The motion passed unanimously. The meeting adjourned at approximately 10:40 a.m. 6

Signed: Dr. Donna A. Woodson, President Lucas County Regional Health District Attested By: David Grossman, M.D. Secretary to the Board 7