Marion County Board of Health Meeting Minutes March 24, 2015 7:00 P.M. Board Members Present: Richard Haney, Tom Turner, Michael Morton, and Keith Kessler, and Paula Strother. Others Present: Lori Ryan, Administrator; Melissa Mallow, Environmental Health Director; Shelley Yoder, Director of Clinical Services; Dena Kemp, Director of Family Services; Cathy Hays, Administrative Secretary. I. CALL TO ORDER The Marion County Board of Health met on March 24, 2015 at the Marion County Health Department, Centralia office. Keith Kessler called the meeting to order at 7:00 p.m. II. QUORUM A quorum of five board members were present. III. MINUTES Richard Haney made a motion to accept the December Quarterly Board of Health meeting minutes as presented; Tom Turner seconded the motion. All were in favor; none opposed. The minutes were approved. IV. FINCANCIAL REPORT Keith Kessler called for a review of the financial report. Lori Ryan reported the cash flow balance at the end of the 1st Quarter is $825,018.02. Building Fund is $7,283.89. The revenue for the end of the 1st Quarter is $315,763.97, or 25.95% of the total budget. The variance of $11,599.97. Total revenues are $1,228,303.45. Expenditures for the end of the 1st Quarter is $286,765.09, or 23.56% of the budget. Total expenditures are $1,241,104.76. Expenditures over Revenues were $12,801.31. Accounts Receivable are $197,152.01. Mike Morton made a motion to accept the financial report; Paula Strother seconded the motion. All were in favor; none opposed. The financial report was approved. Page 1 of 7
VI. OLD BUSINESS a. 2015 Medical Insurance The County Board approved a Coventry Insurance Plan for county employees at the March County Board Meeting. The plan was supposed to go in effect April 1, 2015. The health department chose the plan that was most comparable to the health departments current plan. --$1,500 Deductable --100% Co-Insurance after deductable --$25 Office Visits --10/35/60 RX Card --Cost: Per Employee $452.67; Health Department pays 90% ($407.40), --Employee pays 10% ($45.27). The County is only paying $300.00 on each of their employees insurance or giving $300.00 stipend if they do not take insurance. As of March 24, 2015; the Laboror s of the county are not signing the insurance papers and there will be a meeting on March 30, 2015. Mr. Haney made a motion to authorize Ms. Ryan and Tom Turner to move into the new health insurance when the approval is made by the county. Mike Morton seconded the motion. All were in favor; none opposed. The authorization of new insurance plan was approved upon the county s resolution. VII. NEW BUSINESS a. Activities: 1. Environmental Health: Melissa Mallow, Director of Environmental Health Ms. Mallow performed a fire inspection on January 13, 2015, at The 101 Club in Central City. The bar was a total loss, the owner plans to eventually reopen. During a routine inspection on February 4, 2015 at the Sandoval Petro, it was discovered the facility had no running water, spoiled food in the coolers and the entire facility was filthy. On February 5, 2015, the health department along with the city of Sandoval closed Sandoval Petro. On February 10, the facility was allowed to re-open. Ms. Mallow gave a presentation on March 13, at the Marion County Extension Office about the new IDPH rules concerning farmer s markets that will start in 2015. The new rules deal with food sampling, product origin labeling and cottage food registration. Starting in July, the health department will start publishing routine food inspections on our website. Page 2 of 7
Dan Tahtinen, the health departments new Health Inspector, will be attending IDPH s New Sanitarian training in April. This training is required by IDPH and must be completed during first year of employment. 2. Nursing: a. Shelley Yoder, Director of Clinical Services STD Testing Information: This quarter 4 HIV tests, 9 GC/ Chlamydia tests, and 8 syphilis tests were done with 1 positive Chlamydia result. 5 clients were started on Hepatitis A vaccine and 3 clients were started on Hepatitis B vaccine IDPH STD Testing data report showed from January 1 st through December 31 st 2014, we completed a total of 69 Chlamydia and GC tests. 10 or 14.5% were positive for Chlamydia and none were positive for GC. Lead Poisoning Prevention: 145 lead tests were completed. 9 children are currently being followed for lead poisoning case management services. 5 cases were closed due to closure criteria met and 3 lead nursing home visits were conducted this quarter. Communicable Diseases: 63 communicable disease reports were investigated. Out of those reports 56 met the criteria to be counted as either a suspect, probable or confirmed case. TB Monitoring: 4 clients were reported to health department this quarter due to a positive TB test result or positive AFB culture. All clients were screened to routine potential TB. No active cases of TB disease were reported. 1 client elected to start treatment for Latent TB infection. Risk assessment review of TB case numbers: Since 2005 the TB case numbers for the state of Illinois have decreased every year. Over the past nine years the case numbers have decreased by 46.3%. In 2005-596 cases were reported and in 2014-320 cases were reported. Marion County numbers tend to fluctuate with the highest number of cases that was reported annually since 1996 were 2 cases. 2 cases were reported in 1996, 1998, 2000 and 2009. Since Ms. Yoder has been employed in 2005, we have had 5 active TB cases, with the last case reported in 2011. Page 3 of 7
Lab Services: This quarter 217 clients had labs drawn through the health department and 52 clients had labs drawn through our Quest Lab Card agreement. This generated $4,964 dollars in revenue for the health department. Ms. Yoder was able to negotiate a new reimbursement rate with Quest diagnostics. As of April 1 st, the new reimbursement rate will be $15.00 per collection. The old rate was $12.00. Immunization Clinics: This quarter 23 immunization clinics were held. During those clinics 118 adult vaccines and 471 pediatric vaccines were administered. A total of 174 adult clients and 279 pediatric clients were served through those clinics. Flu Vaccine: As of March 24 approximately 1,270 doses of quadrivalent, 277 doses of high dose and approximately 40 doses of trivalent flu vaccine have been administered this season. 130 doses of quadrivalent, 180 doses of high dose and 30 doses of trivalent flu vaccine were returned to the manufacturer for a full credit. We currently have high dose and trivalent vaccine that can still be used this season. Vaccine For Children Program: Our enrollment process for the Vaccines For Children (VFC) program was delayed this year, in late December we were notified that the thermometers we previously were using were deemed to be unacceptable for use in the VFC program. We had to purchase 6 new electronic data logger thermometers at a cost of $1,027 due to VFC requirements. The new calibration certificates for the data loggers were faxed to the VFC program on January 14, 2015 to complete enrollment. The VFC program did not act promptly and delayed enrollment of both offices. We were finally enrolled on February 11, 2015. Adult Vaccine Program: IDPH sent out a memo in February that the state is implementing a new Adult immunization program for uninsured and underinsured adults. An administration fee up to $23.87 can be charged, but the vaccine will be free to the qualifying adult. A special screening form will need to be completed by the client verifying uninsured or under-insured status to qualify. Currently clients enrolled in Medicaid will not qualify for the program. Medicare recipients would be eligible if they didn t have Part D coverage or other insurance that covers vaccines. The first regional meeting in this area to learn more about the details of this program is tentatively scheduled for May 5 th in Mt. Vernon. Page 4 of 7
Temperature Excursion: On January 27 th we discovered a VFC refrigerator in Centralia that underwent a temperature excursion in the evening and early morning hours of January 20-21 st (the temperatures became too cold). The excursion was discovered on January 27, 2015 and immediately we followed protocol by contacting all of vaccine manufacturers for vaccine viability and revaccination information. All of the vaccine was deemed non-viable except for Rotarix, Prevnar 13, MMR and Hib vaccine per the manufacturer s instruction. 6 children were identified as receiving vaccine that underwent the temperature excursion. In response to this the parents or/guardians of those 6 children were mailed notifications that the vaccine their child received was recommended to be re-administered. A copy of the letter is provided. As of today, March 24, one parent had their child revaccinated. One parent called and talked with us and elected not to revaccinate their two children. Three parents/guardians have not contacted the health department regarding the letter. b. Dena Kemp; Director of Family Services 1st Quarter WIC caseload averaged at 78%. Walk-In WIC Clinics: Salem Office served 70 walk-in clients and Centralia office served 247 walk-in clients this quarter Family Case Management Program Genetics Family Health History Screenings were 57 total this quarter. Averaging a total of 109 infant/child developmental screening a month and of those about 8% are referred for early intervention follow up. APORS (High Risk Infants/Children) currently 25 active cases. Averaging a total of 73 a month perinatal depression screenings. Averaging 36 fluoride varnishes a month within the ages of 6 months to 35. Ms. Kemp and Terri Adams, a maternal Child Helath Nurse, applied for and received a Perinatal Education Scholarship for free tuition to a two day March of Dimes 40 th Anniversary Conference in Lombard, Illinois in early March. Page 5 of 7
3. Administration: Lori Ryan IPLAN 2016 County health needs assessment is due in 2016. The health department will be bringing committee members together in which the committee members will consist of representatives from county schools, hospitals and doctors offices. There will be three meetings where compiling of health data and where the committee will choose three health priortites to work together on and to implement strategies to address the health priorites. Any board member who would like to attend the meetings is welcome to do so. The meeting dates are as follows: April 20, May 4, and May 18, at the Salem office. 2016 Local Health Protection Grant was written and submitted for $84,542.00. 2013 Liability Insurance was not billed to the health department, our Auditor noticed this and the health department will make payments of $1,500.00 to the county until the bill is paid. Workman s Comp. Claim. Debbie Spencer fell off a foot stool on February 10, 2015 while filing, she twisted and fractured her ankle. Ms. Spencer has continued to work. b. 2014 Annual Report Ms. Ryan stated this year was the 21 st year of providing services for Marion County. c. Department of Labor Review January 20, 2015 the health department had a site visit from the Deparment of Labor. The Department s findings were; Salem office, latch on a breaker box was broken and an outside circuit breaker not labeled. Centralia office, one emergency light needed a battery. Corrective actions were taken; all items/nvoices, and photos were submitted to the Department of Labor. No fines were given. VII. CLOSED SESSION Closed Session was not needed at this time. Page 6 of 7
VIII. ADJOURNMENT Tom Turner made a motion for adjournment at 7:35 p.m.; Richard Haney seconded the motion. The next meeting is scheduled for June 16, 2015, 7 pm, at the Salem office. March 26, 2015 Cathy Hays, Administrative Secretary Date Page 7 of 7