Board of Health

In Dr. Macmillan’s absence, Mr. Stevenson moved that Dr. Snedeker be appointed temporary President of the April 14, 2009 Board of Health meeting, seconded by Dr. Fox, and carried by a unanimous voice vote. Dr. Snedeker called the regular meeting of the Board of Health to order at 12:03 P.M.

Approval of Minutes:

Ms. Morgan moved to approve the minutes March 10, 2009 Board of Health meeting as written.  Carried unanimously.

Financial Summary:

Mrs. Grinnell Crosby distributed the Health Department Financial Summary for March 2009, adding the First Quarter grant claims and State Aid were not posted to this summary since they do not get filed until sometime in late April/first week of May.  Revenues for State and Federal Aid will look low at this point.

Mrs. Grinnell Crosby pointed out under the Division for Community Health account, “Other Revenues” are exceeding the 25% mark, which is good news.  She added she didn’t have anything else to comment on; they are still assessing the State budget language to determine what the final impacts will be.  The biggest impact at this point they are aware of is the Preparedness Grant, which did not make the last iteration of the State budget.  Mrs. Grinnell Crosby added they are still working through some of the other items that affect the Home Care Program.  Article VI changes with the Medical Examiner Program, Emergency Medical Services, and Preschool Administration is being retained in the current budget proposal.  She also stated they have heard from numerous organizations they expect the budget to be reopened again at a later date and additional cuts are anticipated at that time.    

Administration Report:

Mrs. Cole stated Dr. Daines, the State Health Commissioner, came to Ithaca and presented an award to the Health Department’s Tobacco Control Program.  This event was held on the Ithaca Commons since part of the Tobacco Program’s newest initiative is working with the City of Ithaca to make portions of the Commons smoke-free.  Mrs. Cole added this was the first time a State Health Commissioner has visited Tompkins County in many years.

Mrs. Cole reported the WIC Request for Proposal was submitted at the end of March, per the deadline.  She added it will likely be months before the Health Department hears back from the State regarding a decision. 

Mrs. Cole reiterated that the Bioterrorism Preparedness Grant was eliminated from the State Budget.  As of August 9th, Carol Hill and Janis Mehall will lose their jobs.  Mrs. Cole added this is a real tragedy since we have come so far since 9/11 in all of the planning and preparedness activities.  There will still be deliverables which will be passed on to existing staff since there will be no dedicated staff to carry out this work.  Mrs. Cole added originally the County Administrator had said the County would continue funding the grant, at least through the end of the year, but now there are no plans for funding beyond August 9th.

Mrs. Cole passed around a birthday card for Dr. Macmillan who is celebrating his birthday today!

Medical Director’s Report:

Mrs. Cole reported that Dr. Klepack is out of the country on vacation, but offered to answer any questions Board members might have.

Division for Community Health:

Mrs. Connors reported she had a phone call from Ed Gottlieb of the Ithaca Wastewater Treatment Plant who has been talking with other people involved in sanitation and wastewater issues about developing a community drug disposal day where community members could bring their drugs to dispose of them safely as opposed to putting them into the water or garbage where they could be retrieved.  Mrs. Connors stated she also talked to him about the problem of disposal of household “Sharps” within the community and suggested combining the two efforts.  Mr. Gottlieb is coordinating a fact finding meeting in early May and invited key staff at Tompkins County Solid Waste, Tompkins County Environmental Health, and the Ithaca Wastewater Treatment Plant.

Mrs. Cameron stated unused medications are typically being flushed down, which they are trying to get away from and having them disposed of in solid waste.  Unused/expired medications in doctors’ offices are generally returned and incinerated.  Otherwise unused/expired medications usually end up in landfills or treatment plants.  

Children with Special Care Needs:

Mrs. Cole stated she would be glad to answer any questions Board members may have regarding Mrs. Allinger’s report for this month.

County Attorney’s Report:

Mr. Wood stated he had nothing to report.

Environmental Health Report:

Mrs. Cameron reported John Strepelis, Regional Engineer with NYSDOH, just finished a three-day comprehensive review of their Public Water Supply program.  She added overall things went very well.

Mrs. Cameron also reported staff has been looking at the Environmental Health website and some of the different program areas have added a lot of different materials in advance of the busy season, i.e. all of the forms for children’s camps are available on the web.  The plan is to offer more information on the website, as well as making it more user friendly.

 
Approvals and Actions
 

Nomination/Selection of Vice President of the Board of Health: 

Mr. Stevenson put forth a motion that Dr. Tyler be nominated as Vice President of the Board of Health for 2009, seconded by Dr. Fox, and carried by a unanimous voice vote.

Approval of Revised Policy: Universal Precautions Policy & Procedure:

Mrs. Connors discussed revisions to and reviewed the purpose of the Universal Precautions Policy & Procedure.

Dr. Snedeker had comments regarding the hand washing procedure, Item A. Section III.  He recommended a statement be inserted in Section I – Purpose regarding the acceptance of alcohol disinfectants.

Ms. Morgan recommended the deletion of the word “diluted” on page. 3, Item F – Bathrooms.  Sentence should read, “If unavailable, clean with an approved disinfectant or 1:10 bleach solution.” 

Mrs. Morgan moved to approve the Universal Precautions Revised Policy & Procedure as modified, seconded by Mr. McLaughlin, carried unanimously.

Approval of Revised Policy: Client Satisfaction Survey Procedure for Community Health Services:

Mrs. Connors discussed revisions and reviewed the purpose and process for the Client Satisfaction Survey Procedure.

Dr. Snedeker raised a question regarding the deletion of expletives.  He asked if a notation was made in the final version that an expletive was deleted or if they were just eliminated.  Mrs. Connors said she bracketed any words she inserted if the grammar wasn’t correct to indicate that it wasn’t part of the original statement.  She stated she would add that any expletives, etc. are deleted, but noted in brackets as an expletive.

Mr. Stevenson moved to accept the Revised Policy: Client Satisfaction Survey Procedure for Community Health Services as modified seconded by Mr. McLaughlin.

Ms. Morgan offered to send Mrs. Connors some suggestions to help clarify the contents of the Client Satisfaction Questionnaire.  Board members were acceptable of modifications offered by Ms. Morgan.  Carried. 

Kevin Jacobs, Owner, Collegeview North Mobile Home Park, T-Enfield; NYS Sanitary Code Part 17 Violation and Tompkins County Sanitary Code Articles III and VI Violations (Sewage System):

Mrs. Cameron stated one of her staff visited Collegeview North Mobile Home Park and found that a sewage system had been installed which was not approved, as well as the expansion of the mobile home park without approval.  Plans had been submitted in 2007 and reviewed by the Division, but no revised plans were submitted.  During the field visit to the mobile home park, the owner said the Engineer gave approval to install the sewage system.  The Engineer has said the owner reported he had received approval to install the system.  Mrs. Cameron stated her Division does not have the authority to take action against the Engineer; however they are pursuing enforcement action against the owner.  She stated the owner met with staff; he and the Engineer have taken steps to correct the violations, and they have submitted as-built plans for the system.  Mrs. Cameron stated her Division is pleased with the efforts of the owner and Engineer in complying.  Mrs. Cameron added part of the reason for the $2,000 penalty was due to previous water violations for an unapproved system.  Mrs. Cameron reported they submitted a letter to the Department of Education concerning the Engineer’s actions.

Mr. McLaughlin moved to accept the resolution as written, seconded by Mr. Stevenson. 

Mr. McLaughlin asked what message would need to be sent to mobile home park owners to let them know if they are not going to provide the right environment, that it will be unprofitable to them.  Mrs. Cameron stated it’s difficult to address mobile home parks from an enforcement perspective because as the fines increase, the owner has reduced resources to address the problems.  She added that if fines are not paid, closing a mobile home park is very difficult.  Board members expressed their thoughts regarding fines/penalties to mobile home parks and how it affects the residents.

Resolution carried unanimously.    

Ellen Weinstein, Owner, Meadowbrook Mobile Home Park, T-Newfield; NYS Sanitary Code Parts 5 and 17 Violations and Tompkins County Sanitary Code Articles III and VII Violations (Public Water Supply):

Mrs. Cameron reviewed the situation at the Meadowbrook Mobile Home Park.  There is a poor water system at the MHP.  Deficiencies with the existing system were not addressed because Meadowbrook MHP was supposed to connect to the new water district in Newfield.  There have been delays connecting and costs to install the system were much higher than estimated by the Engineer.  At one point the owner stated she wasn’t going to connect to the new water district, which meant she had to improve the existing system.  Ms. Weinstein came to the Health Department for an office meeting on March 27, 2009, at which time she stated she planned to connect by the deadline.  Staff worked with her on ways to decrease the cost of the connection. 

Mr. Stevenson moved to accept the resolution as written, seconded by Mr. McLaughlin, and carried by a unanimous voice vote.

For Discussion: Workers’ Comp/Disability Insurance and Temporary Permit Discussion: 

Mrs. Cameron stated in February 2009, NYSDOH issued new guidance regarding requirements for Workers’ Compensation/Disability Insurance.  She stated they are required to obtain documentation of Workers’ Comp/Disability Insurance with any permit they issue.  She also added they worked through a new process for their permanent facilities to make sure they have the proper forms and comply with the Worker’s Comp requirements in order to get their permit.

Mrs. Cameron stated temporary permits are for food service establishments and that is where they have more of an issue with compliance.  She stated a lot of the temporary event applicants are non-profit individuals or volunteer groups raising monies for youth groups, etc. that are generally not aware of the Workers’ Comp/Disability Insurance requirements.  Mrs. Cameron stated if the applicant for a temporary event was willing to check the box on the application that says they have the Workers’ Comp/Disability Insurance or that they are exempt from it, the Division would recommend they issue a permit.  If they don’t have the forms that are actually required, the permit would have a condition on it stating they have 10 days to submit the actual forms.  She added that her Division intends to use this as an educational tool this year.

Another issue to consider is whether Environmental Health staff should check an applicant that doesn’t get a permit, which makes a staff workload issue. 

Mrs. Cameron asked Board members for their opinions on the temporary permit situation and whether they would be agreeable to Environmental Health issuing temporary permits with a lenient enforcement policy.  When asked if the County would get in trouble, Mr. Wood stated if the applicant would sign a sworn statement stating that they are exempt, this would take the responsibility away from the Health Department.  He stated otherwise it would mean denying the permits since there was little chance temporary permit applicants would get the forms submitted in time.  The choice would be to not have temporary events or to accept some certification that they are exempt.  Mrs. Cameron pointed out it would be unfortunate to deny temporary events since in most cases they are non-profit people trying to raise money for good causes. 

Mrs. Chase announced they had just completed a mailing to 300 temporary facilities and/or volunteer groups (gleaned from a list of 1,500 that had served food over the last 2-3 years).  She stated they are hopeful that this educational effort will help people understand what they need to do.  She added they also have updated the Environmental Health website with the new Workers Comp information and the new application.

A lively discussion regarding Workers’ Comp/Disability Insurance and Temporary Permits ensued.  Board members offered no objections to Mrs. Cameron’s plan of action.    

Adjournment:

Dr. Fox moved to adjourn the meeting at 1:05 P.M.  Carried.

Minutes Revised: 05/12/09