ST. LAWRENCE COUNTY BOARD OF HEALTH. MINUTES For April 16, 2013

Transcription

1 ST. LAWRENCE COUNTY BOARD OF HEALTH MINUTES For April 16, 2013 The St. Lawrence County Board of Health (hereafter typed SLCBOH met on Tuesday, April 16, 2013 in the 2 nd floor conference room of the Human Services Center, Canton, New York. MEMBERS PRESENT: Jim Bunstone, Benjamin Gruda, Victor Pisani, Dr. Scott Spicer, and Dr. Anthony Tramontano PUBLIC HEALTH STAFF PRESENT: Susan J. Hathaway, PH Director; Laura Duval, Director of Patient Services; Kindra Cousineau, Communicable Disease Nurse; and Laurie Maki, Prevent Supervisor CALL TO ORDER President Benjamin Gruda called the meeting to order at 6:08 pm. INTRODUCTIONS Mr. Gruda welcomed our new members, Victor Pisani, former Director of the District office of the New York State Department of Health and Dr. Scott Spicer, pediatrician. Jessica Scillieri Smith, veterinarian, could not attend due to a prior commitment. Mr. Gruda asked everyone present to introduce themselves to the new members and asked the members to tell the board about themselves APPROVAL OF DECEMBER 4, 2012 AND MARCH 19, 2013 MINUTES Mr. Gruda asked if there were any corrections or omissions in the minutes. He asked for a motion to accept the minutes as written. Mr. Bunstone made the motion and Dr. Tramontano seconded the motion. The minutes were accepted as written. COMMUNICATION There was no communication to present.

2 PUBLIC COMMENT There was no public comment. REPORTS Communicable Disease Kindra Cousineau Ms. Cousineau presented a case study regarding an active case of tuberculosis involving a student at a local university. This case was a particularly difficult one due to an early misdiagnosis and out of state status. The reporting agency did not want to identify the student. After much investigation and negotiation, the student was identified and 42 contacts were identified and 41 of those were evaluated. During the evaluations, another 5 contacts were identified. Forty people tested negative and 1 tested positive for latent tuberculosis. The patient was very compliant and proper treatment was administered. Tuberculosis (TB) is one of the world s deadliest diseases. A total of 9,951 TB cases were reported in the United States in Most cases are among foreign born persons. In 2012 New York State ranked third in number of TB cases, and its case rate continues to be one of the highest in the country. Syphilis is a communicable disease that is easy to cure in its early stages. In 2008, 63% of the reported primary and secondary (P&S) syphilis cases were among men who have sex with men. During , rates of P & S syphilis increased the most among year old men and women. The department doesn t see many syphilis cases but has just successfully handled one. The Influenza season started in October 2012 and continues to the present. Flu A was prevalent in the winter months (90%) and Flu B in the spring months (88%) There have been 13 pediatric deaths in New York State and 113 nationwide. Seventy percent (70%) of Flu B was covered by this year s vaccine. A new flu vaccine that will be available for 2013 has two As and 2 Bs but only one company is making it so it will not be readily available. We have ordered this vaccine. There is a new requirement for surgical or procedural masks to be worn by health care personnel who are not vaccinated for influenza while in areas where they may come into contact with patients or residents during the flu season. This new

3 regulation will affect all health care facilities under Article 28 and all nursing homes. We as a health care facility will be developing a policy to cover the new requirement. Rabies Positive rabies cases started very early this year. We have had five positive reports since January (4 raccoons and 1 skunk). Last year our first positive was in June. Rabies seems to be further east than in the past. Aerial bait drops are still being done but the federal government decides where and how much bait is given. In the past few years they have baited less of the county. We treated four people in January and have submitted ten animals for testing with two being positive. Last year the Board of Health sent a letter to towns regarding the lack of compliance by dog control officers but it didn t effect change. Mr. Gruda asked if another letter could be developed with stronger language to be sent to the Board members for approval. This will be worked on. After the letter is approved, it will be sent to Town Clerks. There is a shortage of rabies vaccine. Anytime post exposure vaccine is needed, the company has to be called and they will ship the vaccine overnight. Our local hospitals have always stored post exposure rabies vaccine at their facility to be given upon the department s approval of the treatment. We re unable to treat anyone for pre-exposure. If an exposed person does not have insurance or money, the department is responsible for providing the vaccine. Immunizations Laurie Maki We are due for a new five-year Immunization Action Program grant. The State is beginning to benchmark outcomes. The first two years of benchmarking will be used as a baseline. After three years, funding will be correlated to our immunization compliance rate. The compliance rate will be based on children s vaccinations being current at two years of age and between four and five when they begin school. Due to new state regulations in order to receive free vaccine from the Vaccine for Children Program (VFC) a child must meet certain requirements. We no longer can provide vaccine to every child as in the past. We have recently had to begin

4 to purchase much more pediatric vaccine due to the change in requirements for the use of free VFC vaccine. Another change in the VFC Program is that all vaccine has to be ordered through the NYSIIS program and at the time of the order, we have to give them our usage rate and refrigerator temperatures. They are also now tracking our waste rate. Bonnie Hayden who worked in the Cancer Services Program has taken over recording refrigerator temperatures and inputting records into NYSIIS. We are going to be tracking usage so we will have stats in graph form. Another change with immunization is that our clinics are now by appointment only. OLD BUSINESS Tobacco Law The new tobacco law will go into effect on May 4 th. A tour of county property was done to enable us to come up with a plan for placement of the new Tobacco Free signage. On the county website, we will have our sign as a link that will take users to available information. We had our first free smoking cessation class last week but there were no attendees. Next week the second class will be presented and a reminder will be sent out to county employees. Board Openings The St. Lawrence County Board of Health is fully staffed at the present time due to our recent appointments. NEW BUSINESS Review of Draft Strategic Plan The Strategic Plan was completed during our last meeting with CITEC. The Board is the first to see the final version. We have worked since January and revised our Mission and Vision Statements. We also decided upon five primary goals and strategies that will enable us to reach them. Staff has been impacted by the loss of six programs in the last two years so this is the ideal time to

5 recreate our department. We ll be working to pull the team together, reenergize, and let the community know we are still here. One of our goals is to ensure we make available critical health services to the residents of St. Lawrence County. We also want to ensure we have a qualified staff. This is a concern due to the loss of many of our younger staff. Our department has an aging work force with many senior staff preparing to retire in the next five years. Laurie Maki is a new supervisor for the prevent staff. Janine Giglio, who is presently a CHHA/LTHHCP supervisor, will become a new supervisor for our children s programs when CHHA is completely closed. Laurie Maki was the Public Health Educator for many years but that position was eliminated and she has assumed a supervisory position for the prevent staff. We re in the process of training staff for their new positions. We have CHHA nurses who are now working in Prevent positions and they re doing jobs they haven t done before. Mr. Pisani asked if there were any specific service areas we would like to target. Ms. Hathaway explained that one of our focuses will be Maternal Child Health due to the number of babies being born to parents with addiction problems. Also our Early Intervention and Preschool children from ages 3 4 will continue to be another of our focuses. We currently have a waiting list for special services in the Early Intervention Program. If we can reach these children and help them in the early years, it will save money in the future. Another area where we are looking to increase our focus is chronic diseases such as COPD and CHF. Another issue is the loss of our surge capacity with the loss of many of our staff. During The Ice Storm of 1998 we had everyone participating including the county attorney. The Emergency Preparedness Program is now a core Public Health program and the State has just extended our grant for another five years. Dr. Tramontano asked if we had access to other Public Health departments and their programs and assessments which could assist our department in developing new programs and new avenues of approach. Ms. Hathaway stated that all Public Health Directors meet at the NYSACHO meetings on a monthly basis to discuss matters and try to assist one another.

6 Mr. Pisani stated that the department needed to get a message to the public that the Public Health Department is alive and well and is needed. He stressed that the message needed to be designed to provide an impact. We need to begin a campaign identifying our department s goals and services. We plan to coordinate with local universities and hospitals to help spread the word. A press conference has also been discussed as another option. Mr. Bunstone stated that the educational aspect of the department is very important. He suggested that we utilize school board meetings as a resource. He felt that issues within the county are not always brought to the forefront and this may be a way to do that. Communicable diseases, drug abuse and alcohol problems are widespread in the county. Other suggested avenues for getting the message out would be broadcast free radio Health Minutes and Canton Potsdam Hospital s media. Ms. Hathaway stated that there were many issues we would like to address such as tobacco, obesity, etc. She asked the Board to look the plan over and provide us with feedback. Also we would like some Board members to attend the Board of Legislators meeting when this is presented to them. We have begun to work toward accreditation as a Public Health department. The first eleven departments in the United Stated have just achieved accreditation. The Strategic Plan is the first step in this process. It s about a three-year process and we re in the beginning stage. We re also looking at funding sources to help with accreditation costs. Ms. Hathaway has appointed our QA Coordinator as Accreditation Coordinator to form a team that will work on this over the next three years. The Coordinator is going to an accreditation conference in Atlanta next week thanks to the NACCHO grant we were awarded. The cost of accreditation is approximately $26,000 and we hope she ll be able to make contacts for more sources of funding. We want to use the Strategic Plan to generate interest and enthusiasm in staff. PERSONNEL None.

7 OTHER The Board of Health has expressed an interest in establishing a local sanitary code. We are only partial service at this time and it would be a challenge to develop a local code. Mr. Pisani stated that the NYSDOH would like nothing more than for the department to become full service and take on sanitary and environmental issues. The sanitary code would be used to take on issues not addressed through the State. The Board may want to take on a specific issue such as nuisances. Thirty years ago a decision was made to work with the State sanitary code and to hire a public health sanitarian to fill in the gaps. The NYSDOH District office supervised that individual. It was felt that our sanitarian, Public Health nurses, and an environmental investigator would work hand-in-hand. The sanitarian would also work with code enforcement officers and dog control officers. If it s decided to pursue the local sanitary code, there would be expense for the county and an increased work load for Public Health. Environmental issues are a big responsibility and income is not great. The State would provide reimbursement for minimum services. Mr. Pisani felt this is something for the Board to discuss. The CHHA patients have now been completely transitioned to Health Services of Northern New York. The last patient was transitioned on March 31, We do have 47 patients in the Long Term Home Health Care Program (LTHHCP). We will continue this transition to HSNNY. They received approval from the Public Health and Health Planning Council on April 11 for their Certificate of Need to operate a LTHHCP. At this point all they re waiting for approval of their policies and procedures and to receive their Medicaid rate for the program. We will have regular calls/meetings with Matt O Bryan and Molly Ward to ensure the transition of the LTHHCP goes as smoothly as the CHHA transition. A question was also asked regarding the staff lost with the closure of the CHHA program. How many employees left with attrition and how many were layed off. Ms. Hathaway explained that eight or nine staff retired to avoid being layed off. Some resigned and went to other positions to avoid being layed off. There were really 35 positions and there are still 4 more staff members that will go when everything is complete.

8 At 8:05 pm Mr. Gruda asked for a motion to adjourn the meeting. A motion was made by Victor Pisani to adjourn the meeting and the motion was seconded by Mr. Bunsotne. The meeting was adjourned. Respectfully Submitted, Rosemary A. Brown Administrative Assistant