Tompkins County Board of Health

Meeting Minutes
February 12, 2008

12:00 Noon
Rice Conference Room

Present:	Dr. Francis Fox; Mr. Brooke Greenhouse (12:18 PM); Dr. James Macmillan (12:10 PM); Dr. Jeffrey Snedeker, President (12:14 PM); 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; and Mrs. Patty Stamm, Administrative Assistant
Excused:	Mr. Frank Proto and Mr. Greg Stevenson
Guests:	Mr. Steven Kern, Sr. Public Health Sanitarian, and Mrs. Carol Chase, Sr. Public Health Sanitarian

 

Dr. Snedeker called the regular meeting of the Board of Health to order at 12:18 P.M.

Approval of Minutes:

Mrs. Connors requested that two corrections be made on Page 1 of the Director of Patient Services Report:

1. Under “For Your Information” – the last sentence should read as follows: “Although the brochure was written specifically for consumers, the payment system and its less than simple description continues to perplex consumers and challenge providers.”
2. Under “Kudos’” – item #1 should read as follows: “To CHN Supervisor Melissa Gatch and her Home Health Care team for their continued peak level of work serving the community’s home care needs.”

There being no additions or corrections to the minutes of the January 08, 2008 meeting, they were unanimously approved as written.

Financial Summary:

Mrs. Grinnell Crosby reported she had no written financial summary due to difficulties with the financial system.

She stated the 4th Quarter State Aid Claim has been filed, as well as adding that the ’07 application has been amended since they exceeded what they originally requested for State Aid. They are currently working on the ’08 application.

Mrs. Crosby reviewed a summary of the 2008 Governor’s proposed budget impact, which was included in the Board of Health packets. She pointed out currently there is not a lot of information available and added they are waiting for further guidance from NYSACHO and various other groups to help figure out the total impact.

Administration Report:

In addition to her written report, Mrs. Cole:

• Thanked Board members for their support during her performance review.
• Reported she received a very nice letter from Dr. Rob Mackenzie of Cayuga Medical Center, thanking the Home Health Care team for all of their help during the Visiting Nurse crisis.
• Passed around the Statewide Influenza Surveillance Report, adding currently all counties in the State have flu activity.
• Passed out a handout, which was a summary of e-mail inquiries to “Bob”. Mrs. Cole explained that she, or in her absence Mrs. Grinnell Crosby, is “Bob.” When anyone writes to the Health Department website, they write to “Bob” so that no identifying information will be given out.
• Passed around the application and resume from Leslie Moskowitz, whom the Mayor had proposed for the vacant seat on the Board of Health. Mrs. Cole stated she has had additional conversations with the Mayor’s office regarding the Mayor contacting the Restaurant and Tavern Association for potential candidates, however she has heard nothing back from the Mayor regarding this. Mrs. Cole stated Mrs. Chase from Environmental Health gave her the names of three gentlemen in the restaurant business that might be potential candidates. Mrs. Cole stated she contacted them, however has only heard back from one at this point and he is still considering whether he is interested in the position. The decision was made to wait a while longer since there are still two other potential candidates from the restaurant business still to be heard from.

Medical Director’s Report:

Dr. Klepack stated he had nothing to add to his written report.

Division for Community Health:

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

• Regarding the Visiting Nurse Service (VNS), the State completed their final survey this past week and VNS now has the “green light” to continue service. The Health Department’s Home Care Management staff met with the current director, Barbara Campbell, who is acting as Interim DPS for VNS for six to eight weeks. Jeanne Henderson, Assistant DPS, will then likely take over the role of DPS when Ms. Campbell leaves. Currently, VNS is taking three referrals per week. They will continue with limited services until they are fully staffed again.
• There was an increase of 73 reports in the 2007 Communicable Disease Report over the 2006 report. This increase was seen primarily in the Hepatitis C, Chronic infection reporting (10 cases), Hepatitis B, Chronic infection reporting (10 cases), 13 additional rabies cases, and the biggest area was in Sexually Transmitted Diseases with 55 more Chlamydia infections, 13 Gonorrhea, and six Syphilis cases (as opposed to one case last year). She added there was a significant reduction in the vaccine preventable diseases with only five cases of Pertussis in 2007 as opposed to 39 cases in 2006.

Children with Special Care Needs:

Mrs. Allinger reported they welcomed a new nurse, Cindy LaLonde, to their program in January. Ms. LaLonde will be working as a Service Coordinator in the Early Intervention Program.

County Attorney’s Report:

Mr. Wood stated he had nothing to report.

Environmental Health Report:

In addition to her written report:

• Mrs. Cameron thanked Mr. Greenhouse for acting as Hearing Officer at the February 11, 2008 Public Hearing on proposed changes to Article VII of the Tompkins County Sanitary Code. She added she hopes to present Mr. Greenhouse’s report at the March BOH meeting for approval.
• Regarding Lao Village: Mrs. Cameron requested input from the Board regarding Lao Village’s fulfillment of its most recent Board of Health order. Mr. Sisombath has taken, but not passed a Serv-Safe course. Mr. Sisombath’s attorney has been working with him and is concerned that language difficulties continue to make it very difficult for Mr. Sisombath to pass the course. Lao Village passed their inspection at the Apple Festival, and Mr. Sisombath has demonstrated knowledge of safe food concepts to Environmental Health staff. Environmental Health staff recommended these factors be considered as fulfilling the Board Order requirement for successful completion of a Serv-Safe course. Dr. Macmillan moved, that in consideration of the language difficulties with passing the Serv-Safe course and that Mr. Sisombath has demonstrated competency in the practical performance of safe food service concepts, the Board of Health considers this as fulfillment of the intent of the resolution pertaining to completion of the Serv-Safe course, seconded by Dr. Tyler, and carried by a unanimous voice vote.
• Mrs. Cameron distributed a report she received from Robert Howarth, Ph.D. Apparently Dr. Howarth has taken considerable interest in how the Health Department made the GWUDI determination at Taughannock Falls State Park. He is also interested in the proposed Water District #5 and the GWUDI determination for Taughannock Falls State Park as a factor in funding for the proposed water district. Dr. Howarth expressed a number of concerns in his report, including:
• Taughannock Falls State Park being ordered to join the new water district #5.
• Whether there is a true public health threat from Cryptosporidium in the lake or in the park’s water system.
• The risks to other households that might be using the lake and to recreational swimmers.
• That Bolton Point also poses a small but acceptable risk.
• Procedures and documentation of the Environmental Health Division due to the fact there were not many phone logs, e-mails, meeting minutes, etc. in the files.
• The potential ethanol production at the Seneca Army Depot.
• The new water district would make water available so there would be the potential for large animal facilities in the Ulysses Water District.

Mrs. Cameron went on to say Dr. Howarth said there is not a threat from Cryptosporidium to the general population. If there is a threat, it will only affect those with compromised immune systems, which is true and is what the regulations are based on. Mrs. Cameron also reported that Dr. Howarth contacted Michael P. Wilson, Ph.D., a consultant from SUNY Fredonia. Dr. Wilson’s response is included in the report. Mrs. Cameron noted that Dr. Wilson does support the GWUDI determination.

Following a lengthy discussion on this issue, Mrs. Cameron stated she would be preparing a response for Dr. Howarth with a copy to the Town of Ulysses. She added that her main concern was the Ulysses Town Board is again considering the water district and the deadline for any activity to be taken is approaching. She stated since the Town Board has been supportive of the water district and since a copy of Dr. Howarth’s letter was sent to the Town Board, she would like to clarify any points that might be misinterpreted by the general public.

Presentation - Overview of Governor’s Task Force Recommendations:

Per Mr. Proto’s request, Mrs. Allinger gave a presentation on the conclusions and recommendations from the Temporary Task Force on Preschool Special Education (see handout distributed at BOH meeting).

In conclusion, Mrs. Allinger reported the Governor is recommending many of the above referenced recommendations. She stated they anticipate the preschool program will move from County-based to school district-based over a five to six year period. She also stated, although it needs to happen, there are a lot of challenges with regard to how this is going to flow from one entity to the other.

Mr. Doug Moore, Operator, P&C Food Market #119;

NYS Public Health Law Violation (ATUPA Violation):

Mr. Greenhouse moved to accept the resolution as written, seconded by Dr. Macmillan, and carried by a unanimous voice vote.

Environmental Health Community Water Supply Fees for 2008:

Mrs. Cameron stated she was proposing a $130 flat fee for community water system operating fees for 2008 for the following reasons:

• Recent law suit
• Most water systems did not receive a bill for operating fees for 2006
• 2007 operating fees were not submitted to the community water systems until the end of 2007
• New requirements for radiological sampling this year that will cost the water systems about $250 (new cost to water systems this year)

She added that using a flat fee of $130 per water system would generate $13,520 in revenue, which will leave an estimated 2008 budget shortfall of $31,230.

Dr. Tyler moved to accept Mrs. Cameron’s proposed Community Water System Operating Fee for 2008 of $130 per water system, seconded by Dr. Macmillan.

Following a short discussion regarding the determination of community water systems, the proposed Community Water System Operating Fee of $130 per water system for 2008 was carried unanimously.

Executive Session:

Dr. Macmillan moved to go into Executive Session at 1:33 P.M. for the purpose of discussing contract negotiations, seconded by Dr. Tyler. Carried.

Out of Executive Session:

Dr. Macmillan moved to go out of Executive Session at 1:45 P.M., seconded by Dr. Tyler. Carried.

Adjournment:

Meeting adjourned at 1:45 P.M.