Board of Health

Meeting Minutes
August 11, 2009

12:00 Noon
Rice Conference Room

Present:	Dr. Francis Fox; Mr. Brooke Greenhouse; Dr. James Macmillan, President; Michael McLaughlin, Jr.; Ms. Janet Morgan; Dr. Jeffrey Snedeker; and Dr. William Tyler;
Staff:	Mrs. Sylvia Allinger, Director of CSCN; Mrs. Alice Cole, Public Health Director; Mrs. Sigrid Connors, Director of Patient Services; Steven Kern, Sr. Public Health Sanitarian; Dr. William Klepack, Medical Director; Mr. Jonathan Wood, County Attorney; and Mrs. Patty Stamm, Administrative Assistant
Excused:	Mr. Greg Stevenson; Mrs. Liz Cameron, Director of Environmental Health; and Mrs. Brenda Grinnell Crosby, Public Health Administrator
Guests:	Carol Chase, Sr. Public Health Sanitarian and Richard Holgate, Owner/Operator, Pinecreek Campground

 

Dr. Macmillan, President, called the regular meeting of the Board of Health to order at 12:05 P.M.

Approval of Minutes:

Dr. Tyler moved to approve the minutes of the June 09, 2009 Board of Health meeting as written, seconded by Mr. McLaughlin, and carried unanimously.

Financial Summary:

In Mrs. Grinnell Crosby’s absence, Mrs. Cole reported there was no financial summary for this month.

Administration Report: 

Mrs. Cole:

• Reported that she attended a memorial service for Clara Goodman.  Clara Goodman, RN, worked for the Health Department for 42 years and was instrumental in instituting the Home Care Program.  Mrs. Cole presented the family with a resolution that will name one of the conference rooms in the new Health Department facility the Clara Goodman Conference Room. 
• Reported that she and Karen Bishop went to Albany on Friday, August 7th, for a mandatory Commissioner’s Call Meeting.  The theme of this year’s meeting was “H1N1” or “Swine Flu.”  Mrs. Cole stated the crux of the meeting was learning how to plan for the upcoming vaccination clinics which the Health Department will be required to coordinate this fall.  She added that the seasonal flu clinics are being moved up to mid-September to mid-October.  The State reports the local Health Department will be receiving their Swine Flu vaccine sometime towards the end of October and then will be required to immunize the target groups with two doses of vaccine 30 days apart.  Mrs. Cole stated this will present a great challenge for the Health Department, as it will triple the workload, as well as trying to explain to the public/target groups as to why they may or may not be able to get a shot in the first wave of the campaign. 
• Reported that there are several Board members whose terms will be expiring this year: Dr. Fox and Dr. Snedeker; also Mr. Stevenson’s slot will need to be filled for next year as he is not seeking reelection to the County Legislature.  The Chairperson of the Legislature will be responsible for appointing a new representative from the Legislature to serve on the Board of Health.

Medical Director’s Report:

In addition to his July and August written reports, Dr. Klepack discussed vaccine delivery.  He pointed out that in the case of the H1N1 vaccine - as it is being produced, it will be released.  This means there will not be a large stockpile of vaccine being released at one time; it will be trickling over time.  He added the challenge to Health Department staff will be explaining this dynamic to patients/families/communities so that they understand why they are being asked to be flexible and to help them understand why targeting is so important.

Dr. Klepack also spoke about vaccine delivery from the private practice point of view.  He stated there are still issues that need to be resolved such as whether and to what extent administration fees will be honored by third-party payors and, if not, making sure patients can be billed for administration fees.  He stated that, otherwise, it would be doubtful if the private sector would pick up on vaccine delivery since it costs the private sector money to deliver the vaccine even if they get it for free. 

Another issue is that the State is requiring, at this point, reporting of all vaccine doses to them through an electronic system with demographics so they can identify whether the targeting is being done by the private sector and others so that they can help to insure compliance.  Dr. Klepack stated it is very difficult for the delivers of vaccine to report all vaccine doses.  He stated he is hopeful the State backs off on this issue since it could potentially be a roadblock to bringing online an important source of vaccine deliverance. 

Dr. Klepack added that the current status of H1N1 Swine Flu in this area is a relatively low incidence of cases.

Division for Community Health:

Mrs. Connors stated she had nothing to add to her written report.

Mrs. Connors noted that on the June 2009 Summary of DC103s by Disease without Name list, the information for the disease, Babesiosis, was missing from the summary, making the total disease count incorrect.  She stated this will be corrected in the July summary.

Children with Special Care Needs:

Mrs. Allinger stated that contract season was now behind them, which also included the transportation contract.  She added they recently learned that the company developing the NYS database system (the NYEIS system) has declared bankruptcy in Federal Court.  This means that this program, which has been under development for three years, will not be coming out this fall, but rather sometime within the next year.  Mrs. Allinger also added they have been busy working on the 2010 budget.

County Attorney’s Report:

Mr. Wood commented that there have not been any hearings in quite a long time.  These hearings are usually a result of issues that can not be resolved, particularly in Environmental Health.  Mr. Wood then becomes involved at that point.  He added that there used to be quite a few hearings and now there are hardly any, which is good.

Environmental Health Report:

Mr. Kern commented one of the reasons for the decline in hearings is that the hearings were mostly related to the ATUPA (Adolescent Tobacco Use and Prevention Act) Program.  He stated that retailers are checking ID’s and so there have been very few sales of tobacco to minors, as well as those who objected to the process and went to hearing.

Other than that comment, Mr. Kern stated there was nothing to add to the Environmental Health report for this month.

 
Approvals and Actions
 

Approval of Revised Procedure: Rabies Post-Exposure Vaccination: Authorization, Billing, & Documentation Procedure: 

Mrs. Connors reported they have just received news that, in most cases, instead of a five-dose series of rabies post-exposure vaccine, clients will now only need four doses.  She added this will save the Health Department a great deal of expense, as well as a lot of time and effort for the nurses.  Mrs. Connors stated she could withdraw this current policy and come back in September with the amended policy or the policy could be approved as presented at today’s meeting and then bring the revisions back in September for approval.  She added that either choice will not hold up putting the new measures into practice; and either way the revised procedure will need to come back before the Board in September. 

Board members were in agreement the revised procedure should be tabled for today’s meeting and be brought back for approval in September.

Approval of Revised Immune Globulin Policy:

Mrs. Connors requested permission to withdraw the revised policy today and bring it back in September after it has been reviewed appropriately.  She stated that Karen Bishop, Community Health Services Supervisor, advised her that Dr. Klepack had some questions regarding Section A. – Eligibility.  Mrs. Bishop has given Mrs. Connors additional information regarding eligibility, but Mrs. Connors would like Dr, Klepack to have an opportunity to review it to make sure the language in the policy is correct prior to presenting it to Board members. 

Richard Holgate, Owner/Operator, Pinecreek Campground, T-Enfield; Violation of Tompkins County Sanitary Code (Sewage):  

Mr. Kern reviewed the Pinecreek Campground Sewage System Enforcement Chronology which was included in the BOH packets.  In 2008, a resolution was adopted that if schedules for construction deadlines were not compiled with for the three separate sewage systems there would be a $500 penalty each.  Plans have all been submitted on time; however construction of one of the sewage systems was not completed by the deadline.  Since this system has since been installed and certification has been received from the Engineer, Environmental Health staff is asking that Mr. Holgate pay a $250 penalty for failure to meet the deadline for this system rather than the $500 that was initially asked. 

Mr. Holgate stated that, due to the weather, it was impossible to install anything earlier this year.  He stated that it was completed the first week in June, which was the earliest possible time to do it without sinking the equipment.  He further stated he did not feel any penalty was appropriate at this time and asked that the penalty be waived. 

Mr. Kern added that the last sewage system has been installed and was certified on July 9th by the contracted engineer and Pinecreek Campground is now in full compliance.

Dr. Snedeker moved that the recommended $250 fine be waived, seconded by Dr. Fox, and carried by a unanimous voice vote.

Charles B. Park, Owner/Operator, Greene Café, C-Ithaca; Violation of Part 14-1 of the NYS Sanitary Code (Food Service):

Mr. Kern reviewed the history of the Green Café as it relates to current consecutive inspections.  He stated that staff is asking that  Green Café establish and maintain a temperature monitoring log as explained in the resolution and to pay a penalty of $400 for the violation of April 30th.

Mrs. Chase reported that Mr. Park had planned to come to the July 14th BOH meeting prior to being advised that the meeting had been cancelled.  However, there was no one present from Greene Café at today’s meeting. 

Dr. Tyler moved the resolution as written, seconded by Dr. Snedeker, and carried by a unanimous voice vote.

Penny Kinsman, Owner/Operator, P.D.R.’s Catering; Violation of Part 14-1 of the NYS Sanitary Code (Food Service):

Mr. Kern reviewed the history of P.D.R.’s Catering as it relates to current consecutive inspections.  He stated that staff is asking that P.D.R.’s Catering establish and maintain a temperature monitoring log as explained in the resolution and pay a penalty of $400 for the May 30th violation.

Dr. Snedeker moved to accept the resolution as written, seconded by Mrs. Morgan, and carried by a unanimous voice vote.

NYSDEC Supplemental Environmental Impact Statement (SEIS) for Natural Gas Drilling – Resolution requesting an expanded public comment period:

Mr. Kern stated that since the time the draft Gas Drilling Resolution was sent to Board members regarding an extended public comment period for review of the Draft Supplemental Impact Statement concerning horizontal gas drilling, Senator Seward’s office sent out an endorsement of extending the review period as well.

Mr. Greenhouse moved that the draft resolution be accepted as written, seconded by Dr. Snedeker.  It was pointed out that names were missing from the Board of Health resolution that were copied on Resolution No. 84 of the Tompkins County Legislature.  Mrs. Cole assured Mr. Greenhouse that all of the appropriate individuals would receive a copy of the Health Department Resolution.

Carried unanimously.      

Adjourn to Executive Session:

Dr. Snedeker moved to adjourn to Executive Session to discuss the proposed 2010 Budget and resulting personnel impacts at 12:50 P.M., seconded by Dr. Tyler, and carried unanimously.

Adjourn from Executive Session:

Dr. Snedeker moved to adjourn from Executive Session at 1:20 P.M., seconded by Dr. Tyler, and carried unanimously.

Approval to submit draft 2010 Budget:

Dr. Tyler moved to approve the 2010 draft budget as written, seconded by Mrs. Morgan, and carried by a unanimous voice vote.

Adjournment:

Dr. Snedeker moved to adjourn from today’s meeting at 1:21 P.M., seconded by Dr. Tyler; carried.