Tompkins County Board of Health

Meeting Minutes
January 8, 2008

12:00 Noon
Rice Conference Room

Present:	Dr. Francis Fox; Mr. Brooke Greenhouse; Mr. Frank Proto; Dr. Jeffrey Snedeker, President (arrived at 12:10 PM); Mr. Greg Stevenson; and Dr. William Tyler
Staff:	Mrs. Sylvia Allinger, Director of CSCN; Mrs. Liz Cameron, Director of Environmental Health; Mrs. Alice Cole, Public Health Director; Mrs. Sigrid Connors, Director of Patient Services; Mrs. Brenda Grinnell Crosby, Public Health Administrator; Dr. William Klepack, Medical Director; Jonathan Wood, County Attorney (arrived at 12:12 PM); and Mrs. Patty Stamm, Administrative Assistant.
Absent:	Dr. James Macmillan and Mr. David Raimon
Guests:	Mr. Steven Kern, Sr. Public Health Sanitarian; Mrs. Carol Chase, Sr. Public Health Sanitarian; Sheng Wu Dong and Guest; Cornell Pre-Med student who was a guest of Dr. Snedeker

 

Since Dr. Snedeker was running late, Mr. Proto called the regular meeting of the Board of Health to order at 12:10 P.M. Dr. Snedeker arrived simultaneously and took over the meeting following approval of the minutes.

Approval of Minutes:

Mr. Stevenson moved to accept the minutes of the December 11, 2007 meeting, seconded by Dr. Tyler, and carried by a unanimous voice vote.

Financial Summary:

Mrs. Grinnell Crosby reported she had no written financial summary. She added it is the end of the year and currently they are busy closing the books and filing claims.

Administration Report:

In addition to her written report, Mrs. Cole:

• Passed around leaflets, which are part of the Health Promotion Program’s new initiative promoting the NYS Smokers’ Quitline. These leaflets are being distributed throughout the community and will be available in doctors’ offices, as well as local agencies.
• Stated the November BOH meeting was inadvertently scheduled for Veteran’s Day, so a new date needed to be selected. Tuesday, November 18th, will be the new date for the November BOH meeting.

Mr. Stevenson expressed his concern that the new generator Mrs. Cole made reference to in her written report is not fully secured. Mrs. Cole stated she would confer with Mr. LeMaro to see what security measures have been taken to prevent the generator from being stolen.

Medical Director’s Report:

Dr. Klepack stated in his written report, there was a mistake on the forth bullet. It should read as follows:

• Discussed uses of out patient cases involving an area practitioner with staff in order to formulate a plan of communication.

Dr. Klepack also commented on some nice aspects of public health:

• The fact that Cayuga Lake water does not contain lots of contaminates (including lead);
• The announcement of Wegman’s stand on tobacco.

Mr. Greenhouse congratulated Dr. Klepack on his recent guest column article in the Ithaca Journal regarding “Family physicians advocate single-payer system.”

Division for Community Health:

In addition to her written report, Mrs. Connors reported:

• 2007 was a record year for Home Care; 599 patients were served.
• Visiting Nurse Service is still not taking new referrals. They are now looking for a new Director of Patient Services, as well as a Director of Nursing. In addition, Cayuga Medical Center has been assisting VNS with some education and training formats; VNS is also working on a new quality improvement plan. Mrs. Connors added Home Care staff is now fully staffed and they continue to use additional per diem staff to help carry the extra load. She added that she hired another per diem employee in December, and continues to recruit additional per diem staff members. Mrs. Connors is hopeful this will provide enough flexibility to keep up with the extra load.
• 2,500 doses of flu vaccine have been ordered for the 2008 season. Part of this order will cover the County’s new initiative, spearheaded by Mrs. Cole, for all County staff to be eligible for free flu vaccine in 2008. Also, a pilot will be started to determine if non-profit organizations would be interested in the Health Department providing the flu vaccination for their staff at risk with direct patient contact. The flu vaccine would not be provided free of charge, however an on-site clinic would be provided for these organizations.
• She is working on new diagnostic and treatment center regulations which will require TCHD to expand the number of trained staff to assure any staff working in one of the clinics will have the required basic training, i.e. identification and reporting of child abuse, domestic violence, TB education and prevention. Also, documentation will be needed in staff files for Rubella and Rubeola. This means more training this year to catch staff up who might not have had all of the required training, as well as providing more MMR vaccinations and titers for staff to determine if they have immunity.

Children with Special Care Needs:

Mrs. Allinger reported she was pleased to announce that Joanne Horton, the Family Outreach Worker/Social Worker in the Children with Special Health Care Needs Program, as of January 1, 2008, is now the first Public Health Social Worker. This program, which serves families of children in the birth through 21 age range in terms of crisis intervention within the home and connecting families with resources in the community, has grown over the past four years, as well as the job duties involved. Mrs. Allinger added Ms. Horton has taken and passed the NYS certification, as well as being a licensed, certified social worker, and has now taken the testing to be a registered, licensed, and certified social worker which is the highest level of designation in NYS that a social worker can have.

County Attorney’s Report:

Mr. Wood stated that he had nothing to report.

Environmental Health Report:

In addition to her written report, Mrs. Cameron stated:

• She, along with several staff members, met with the new Owasco Lake Watershed Inspector, Jessica Miles, in December to discuss coordination on the portions of the Owasco Lake Watershed that fall in Tompkins County. Cayuga County was under the impression the Watershed regulations applied within the portions of Tompkins County that are within the Watershed (parts of Groton). Mr. Wood has reviewed these regulations and stated that these regulations do not apply in Tompkins County. Mrs. Cameron will address this issue with Cayuga County.
• Article VII changes are moving forward. Mrs. Cameron stated she would like to set up a hearing in early February.
• There was an alleged ATUPA violation at the P&C on December 31, 2007. This was the only ATUPA violation for the year.

Nominating Committee:

(one term expiring – consumer member): Mr. Proto stated Mr. Raimon’s seat on the Board expired December 31, 2007. He added he left several messages for Mr. Raimon to see if he was interested in being reappointed, however Mr. Proto received no call back. Mr. Proto stated a letter went out from the Legislature some time in October advising Mr. Raimon his term would be expiring, however because the position is a city-influenced seat it was sent to the City of Ithaca. No response was received.

Mrs. Cole stated she received an e-mail from the Mayor with a suggestion for the position if there was a vacancy. The name is Leslie Moskowitz. Ms. Moskowitz is the Manager of Organizational Development for the City of Ithaca. She has an educational background in nutrition.

Mr. Proto stated that normally this particular seat on the Board is filled by a restaurateur with an establishment within the city. Mrs. Cole added she had pointed this out in the letter she sent to the Mayor. She said the Mayor had called to ask if the Board would consider Ms. Moskowitz since she had a background in nutrition, however did not have food service experience. Mrs. Cole had said the Board would consider Ms. Moskowitz’s name. Mrs. Cole will send Ms. Moskowitz a resume to complete and return to the Board for their consideration. A recommendation was then made to extend the search. Mrs. Cole will consult with Mrs. Chase for some suggested names. She will also go back to the Mayor and see if the Mayor has any additional names in the food service arena to submit. Mrs. Cole will recommend that the Mayor contact the Restaurant and Tavern Association for potential candidates. In the meantime, Mrs. Cole was directed to send a letter to Mr. Raimon thanking him for his years of service on the Board of Health.

Change November meeting date:

Due to the Veterans Day holiday, Tuesday, November 18th, will be the new date for the November BOH meeting.

Approval for revisions to the procedure:

Catheter Management and Principles of IV Therapy:

Mrs. Connors discussed the reasons for the suggested changes to the procedure. Following a lengthy discussion between Board members and staff regarding IV antibiotic therapy, the procedure was withdrawn for further clarification of revisions.

Imperial Kitchen Buffet, Sheng Wu Dong, Owner/Operator, V-Lansing;

New York State Sanitary Code Violation (Food Service Violations):

This resolution was on the December BOH agenda and was passed by the Board of Health prior to the arrival of Sheng Wu Dong. The resolution as adopted was brought back before the Board for potential modification.

Dr. Tyler moved to reconsider the initial resolution, which was adopted December 11, 2007, seconded by Mr. Greenhouse, and carried.

Sheng Wu Dong addressed the Board (see attached narrative), explaining what actions have been taken to resolve the violations of October 12th and October 30th.

Mr. Proto moved the $400 fine be waived, seconded by Dr. Fox, and carried by a unanimous voice vote. The initial resolution still requires a temperature monitoring log be established and maintained to record potentially hazardous food temperatures twice a day during cold and hot holding.

Mr. Richard Maxim, Fraternal Order of Eagles #1253, C-Ithaca,

Clean Indoor Air Act Waiver Request:

Mr. Greenhouse moved to approve renewal of the Clean Indoor Air Act Waiver Request as written, seconded by Mr. Proto, and carried by a unanimous voice vote.

Note: Mrs. Connors mentioned Wegman’s welcomes comments, either positive or negative. She added these comments are being tracked regarding their decision to withdraw all tobacco products from their stores.

Dr. Tyler suggested the Board of Health send a letter to the Ithaca Journal in support of Wegmans decision to withdraw all tobacco products from their stores. Mrs. Cole stated she had asked Ted Schiele from the Health Promotion Program to do a “Laurel” to Wegman’s in the Ithaca Journal. She also added she would be responding to a letter sent to her from Wegmans regarding withdrawal of tobacco products from their stores. Mrs. Cole stated if the Board would like to send a letter to the Ithaca Journal regarding Wegmans’ decision that would be fine.

Revision of 2008 Public Water System fees:

Mrs. Cole stated due to the publicity this issue had been receiving, she decided to put it on today’s agenda for further discussion, pending continued discussion in February.

Mrs. Cameron summarized recent happenings regarding the public water system fees including:

• Legislature adopted flat fee of $130 for all community water systems for the year 2007; this bill was sent out December 21, 2007.
• 2008 bills will be sent out in June 2008.
• Editorial in Ithaca Journal on December 24th submitted by Bolton Point; their primary point being they won the lawsuit and they shouldn’t have to pay water system fees for 2004 and 2005.
• Tim Joseph submitted a response pointing out Bolton Point customers would end up paying more if this is spread out through the property tax.

Mr. Proto suggested the Board of Health set up a committee to work with Mrs. Cameron regarding the 2008 and the 2009 fees. He also suggested due to the substantial loss of income, the Health Department be prepared to make a Contingency Fund request during the year. Mrs. Cole stated the County Administrator would want to see the Health Department’s deficit for the year 2007. If there was no deficit, she stated the County Administrator would not support a Contingency Fund request.

Following a brief discussion amongst staff and Board members regarding the State law and the setting of community water system fees, it was determined the best policy regarding the issue would be to set a single fee which would be tolerable by the smaller water systems and then absorb the balance. Mrs. Cameron will present suggested fees at the February meeting for approval by the Board. One suggestion was made to revert back to the old formula used for formulating fees; Mr. Wood indicated that this was not acceptable.

Adjournment:

Meeting adjourned at 1:28 P.M.