Board of Health

Meeting Minutes
January 12, 2010

12:00 Noon
Rice Conference Room

Present:	Mr. Brooke Greenhouse; Dr. James Macmillan, President; Mr. Michael McLaughlin, Jr.; Ms. Janet Morgan; Mr. Frank Proto; 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 Service; Mrs. Brenda Grinnell Crosby, Public Health Administrator; Dr. William Klepack, Medical Director; Mr. Jonathan Wood, County Attorney; and Mrs. Patty Stamm, Administrative Assistant
Guests:	Joe Mareane, County Administrator; Anita Fitzpatrick, Commissioner of Personnel; Steven Kern, Sr. Public Health Sanitarian; and Rick Ewald, Sr. Public Health Sanitarian
Privilage of the Floor:	Mr. Ernest Bury

 

Dr. Macmillan called the regular meeting of the Board of Health to order at 12:10 P.M.

Privilege of the Floor: 

Mr. Ernest Bury spoke under Privilege of the Floor requesting permission to build an affordable housing duplex on a quarter-acre lot on Shelter Valley Road in the Town of Newfield.  He displayed an Engineering Report from Hunt Engineering with an on-site wastewater treatment and disposal system for the quarter acre property which he felt made him eligible for a waiver.

Mrs. Cameron stated her Division did approve plans from Mr. Bury for a half-acre lot; however they had comments on the plans they received from Mr. Bury for the quarter-acre which were returned to Mr. Bury.  She added her Division has not received anything additional from Mr. Bury.  She also added that she spoke with the Planning Department.  The Planning Department supports high density affordable housing where there is supporting infrastructure for water and sewer on the property.  Mr. Bury commented that the property is on community water supply and he would always have the 100’ radius included in any lot he would consider.

Mrs. Cameron stated Mr. Bury needed to submit a revised report from Hunt Engineering that addresses our comments so that her Division could review it.  She added that her Division did not officially turn down Mr. Bury’s application; however with the information previously submitted by Mr. Bury, they did state they did not intend to approve his application for a unit on a quarter acre lot.  To date, they have not received any response from Mr. Bury or his Engineer.  Mr. Bury requested a copy of the response the Environmental Health Division sent to him.

Public Health Director Search Committee:

Mr. Wood read the section from the Charter pertaining to the role the Board of Health takes in the selection of a Public Health Director.  Basically, the Public Health Director is appointed by the County Administrator, upon recommendation of the Board of Health, subject to confirmation by the Tompkins County Legislature, the Board of Health, and the NYS Commissioner of Health.

Mr. Wood then introduced Joe Mareane, County Administrator, and Anita Fitzpatrick, Director of Personnel, who were at today’s meeting to propose how the hiring process will take place, as well as looking for input from Board members on the composition of the Search Committee and the general course of the process.

Mr. Mareane recognized the skills and attributes possessed by Mrs. Cole and stated through the search process they hope to find someone who possesses the multiple dimensions they are seeking in Mrs. Cole’s successor.  He added to do that it was important they have the right balance of individuals to make up the Search Committee. After collaborating with Mrs. Cole, Ms. Fitzpatrick, the leadership of the Legislature, as well as his own staff over the past few weeks, Mr. Mareane developed a proposal for the composition of the Search Committee.  Mr. Mareane circulated and reviewed a memo regarding the makeup of a Search Committee for the new Public Health Director and requested input from Board members.  Mr. Mareane also circulated copies of an advertisement for the position including the job description for Public Health Director, as well as a recruitment plan which listed the publications which will be used to advertise the position.
            Ms. Fitzpatrick also addressed the Board and staff, outlining experiences from other searches that were well-received whereby the Search Committee went from the initial process through to a recommendation to the County Administrator and the Board of three or four finalists and then focus meetings were scheduled with stakeholders which could consist of internal staff from a department, as well as community members.  She added even though these individuals would not have a vote in the final selection, it would give them an opportunity to provide input to the Search Committee and the County Administrator and, this case, the Board of Health on two or three finalists.  She stated this method has been quite productive in other searches.  Ms. Fitzpatrick also discussed the time-line and procedure for the recruitment process.

Following a short discussion among Board members and staff regarding the composition of the Search Committee, it was determined that Board members would like some additional time to discuss the issue.  Mr. Mareane asked them to communicate their suggestions to him within a week.  Ms. Fitzpatrick also requested Board members review the documents that were distributed and let her know of any recommended language changes within the next two weeks.

Approval of Minutes:

Dr. Tyler moved to approve the minutes of the December 08, 2009 Board of Health meeting as written, seconded by Mr. Greenhouse; carried unanimously.

Financial Summary: 

Mrs. Grinnell Crosby stated there was no financial summary for this month.  She added they were in the midst of closing their 2009 books and preparing for 2010.  Mrs. Grinnell Crosby stated the County still has not been paid for the 2nd and 3rd quarters for 2009, amounting to nearly $800,000.00 in Article VI funding.  She also stated there are a number of grants from the State of New York with payments outstanding. 

Administration Report: 

Mrs. Cole

• Welcomed Mr. Proto back to the Board of Health.  She added Mr. Proto has been appointed to the Board on an interim basis until the official appointment is made to the Board of Health by the new Chair of the Legislature.
• Passed around a thank you note that had been received from Dr. Myers, Superintendent of the Groton Central School System, expressing thanks to the staff for sponsoring the school-based H1N1 vaccination clinic.
• Reported that H1N1 clinics are now open to anyone over the age of 6 months.

Medical Director’s Report:

Dr. Klepack stated he didn’t have anything to add to his written report.  He did comment briefly where he had read that Governor Patterson might propose raising tobacco taxes.  He stated he felt the cost of purchasing tobacco does have a significant impact on usage. 

Division for Community Health:

Mrs. Connors:

• Reported she has been serving on a volunteer coalition for safe medication disposal.  On Saturday, March 6th, from 10:00 A.M. to 3:00 P.M. at the TCAT building, a drive-through collection will be held for household medications and sharps.  Mrs. Connors expressed her appreciation to Cornell University for taking care of picking up and incinerating the household sharps and lancets, gratis. 
• The number of individuals vaccinated for H1N1 has passed 6,600.  She added that last week, which was the first full week of opening up the clinics to the general public, they vaccinated over 1,200 individuals.  During the remainder of the month of January, there will be six clinic days by appointment at the Health Department, as well as two outreach clinics; one at Lifelong on January 21st, from 9:00 A.M. to 12:00 Noon and another clinic at The Shops at Ithaca Mall from 3:00 to 6:00 P.M., date to be determined.  Mrs. Connors added they are focusing on getting communication out to school nurses, the Day Care Council, and other places that work with children to encourage them to contact their physician or to make an appointment with the Health Department for children under ten who need a second dose of vaccine.
•  Reported on an unexpected visit by the State Health Department on December 22nd for a surprise survey of the Home Care Program.  Mrs. Cole phoned the State and suggested this was not a good time for a survey taking into account that this was close to a holiday and all staff was expected to be present for the survey.  The State finished on December 22nd and then returned again on January 4th.  Mrs. Connors stated two surveyors visited on site for a total of six days.  During this time they made five home visits, reviewed 15 client charts, reviewed many personnel records, as well as contract files.  They also reviewed policies and procedures, the QA Program, and the Emergency Response Plan.  As a result of all of this, based on their findings in the client charts, there will be four to five deficiencies cited.  Mrs. Connors stated they felt the deficiencies were minor; none of them were as a result of a bad outcome for any patient.  Instead, they were a potential for what might prove to be a negative outcome for a patient.  She cited examples of the types of deficiencies which were cited.  Mrs. Connors added that the results will be sent to them within 10 working days and then a Plan of Action and Correction needs to be returned back to the State within 10 calendar days.    Mrs. Connors stated the State found no problems with any files, contracts, policies and procedures, QA Program, or the Emergency Plan.  She expressed disappointment over the deficiencies, adding they had gone for nine years without a deficiency, but stated there are always things that can be improved on and they will plan to work harder.  Dr. Macmillan suggested it be looked at as “opportunities for improvement” rather than deficiencies.  Board members offered congratulations to the Home Care team that the State had to work hard to come up with the deficiencies that they did. 

Children with Special Care Needs:

Mrs. Allinger reported that currently IPRO, which is the evaluating agency for the Department of Health and Early Intervention, are auditing contract service providers and agencies.  Mrs. Allinger stated she meets with each provider individually to review all of their policies, procedures, and processes prior to the audit, which she herself also attends.  She added all of the last four providers that were audited had perfect reviews.  She felt this was due to the level of work and planning that is collaboratively done.

Mrs. Allinger stated they are struggling to find additional Speech Therapists.  They have been at capacity for service provision for nearly two months and now they are nearing capacity in Occupational and Physical Therapists.  Mrs. Allinger stated it is a struggle to meet the regulatory requirements of having enough therapists to go around.

County Attorney’s Report:

Mr. Wood stated he had nothing to report. 

Environmental Health Report:

Mrs. Cameron:

• Highlighted that her Division received the news that they did receive the Healthy Neighborhoods Program (HNP) grant.  This will help them address fire safety, asthma, smoke-free homes, and exposure to indoor air pollutants.  This program targets residents in the Village of Groton, mobile home parks in the Town of Dryden, and the Northside and Southside communities in the City of Ithaca. 
• Reported that her Division received notification that their NYSDOH Drinking Water Grant needed to be cut by 12.5% ($19,000) retroactively.  This is a difficult cut to absorb, considering that the grant year is already 75% over and most funds have been expended.  She added they will be unable to do public water supply inspections from now until the start of their new grant on April 1st.  Field work for individual water supplies is also curtailed. 
• Reported that Cornell Cooperative Extension and Shale Shock will be holding a community forum on the health effects of gas drilling at TC3 on Tuesday, February 23rd, in the evening. 

Election of Officers for 2010:

Mr. Greenhouse nominated the following Slate of Officers for 2010: Dr. Macmillan for President and Dr. Tyler for Vice President. 

Mr. Greenhouse moved to accept the Slate of Officers as presented, seconded by Mr. McLaughlin. 

Carried.

Report from Nominating Committee on two vacancies: 

Mr. Greenhouse reported he and Mr. McLaughlin have narrowed their list to a few candidates with only one applicant for the Physician seat.  Dr. Macmillan stated he had an interested physician who would be submitting an application as soon as they return from vacation.  With this in mind, Mr. Greenhouse suggested they proceed with the interview process for the consumer position.

Following a short discussion regarding the best plan of action, it was decided to move forward with interviewing physician applicants. Following the interviews, the committee will make their recommendations to the Board and, if needed, the deadline for accepting applications for a physician will be extended.

Approval of revisions of Board of Health Bylaws:

Dr. Tyler moved to accept the Board of Health Bylaws as revised, seconded by Mr. Proto, carried unanimously.

The suggestion was made that on page 6, Section 11.02, (a) be changed to read as follows: “The Board shall appoint a group of professional personnel known as the Professional Advisory Committee, ……  This friendly amendment was agreeable to both Dr. Tyler and Mr. Proto.  Mrs. Crosby will include a final revised copy of the Board of Health Bylaws in the February Board of Health packet.

Approval to reappoint William Klepack, MD, to a two-year position as Tompkins County Health Department Medical Director:

After reviewing the credentialing document from Cayuga Medical Center, Mr. Greenhouse moved to reappoint Dr. William Klepack, MD, to a two-year position as Tompkins County Health Department Medical Director, seconded by Ms. Morgan, and carried by a unanimous voice vote.

Approval for revisions to the Professional Advisory Committee Bylaws: 

Dr. Tyler moved to accept the revisions to the Professional Advisory Committee Bylaws as submitted, seconded by Mr. Proto.

Following a lively discussion regarding membership for the Professional Advisory Committee, it was agreed that Mrs. Connors would make the recommended edits and include a final revised copy of the Professional Advisory Committee Bylaws in the February Board of Health packet.

Carried unanimously.

Approval for revisions to the Accident and Incident Report Policy & Procedure:

Mr. Greenhouse moved to accept the revisions as written, seconded by Ms. Morgan.

Ms. Morgan made the recommendation that where the word “should” is used within the document, it be replaced with the word “will.” 

Dr. Macmillan recommended that on pg. 11, #2 – be changed to read as follows: “Report time frame is measured by the Date of Awareness.”

The revised Accident and Incident Report Policy & Procedure was unanimously accepted as amended.

Approval for revisions to the Client Complaint Policy & Procedure:

Mr. Greenhouse moved to accept the revisions as written, seconded by Ms. Morgan.

Ms. Morgan made the recommendation that on page 2, III-E, the word “should” in the sentence be changed to “will.”  Also, page 2, III-F, the word “is” in the sentence is changed to “are.”

The revised Client Complaint Policy & Procedure was unanimously accepted as amended. 

Mr. Kenneth P. Fiero, Fraternal Order of Eagles #1253, C-Ithaca – Request to renew Clean Indoor Air Act Waiver:

Mr. Proto moved to accept the resolution as written, seconded by Dr. Tyler.  Carried with 4 votes for (Greenhouse, Macmillan, McLaughlin, and Proto) and 1 vote against (Morgan).  

Board of Health Representatives for the Public Health Director Search Committee:

Dr. Macmillan expressed an interest, with the approval of the Board, in representing the Board on the Search Committee.  Ms. Morgan also offered to represent the Board on the Search Committee. 

A lengthy discussion ensued regarding the composition of the Search Committee and it was determined that Board members would take this month to consider the issue and then make a final decision at the February meeting and pass this information on to Mr. Mareane.  In the meantime, it was determined that if anyone had any comments regarding the Public Health Director job description, they would pass them on to Anita Fitzpatrick, Commissioner of Personnel.

Staff also expressed an interest in seeing Division Managers included in the Search Committee.  Dr. Macmillan will communicate with Anita Fitzpatrick the sense of the Board regarding the need for additional staff representation to serve on the Search Committee.    

Adjournment: 

Mr. Proto moved to adjourn the meeting at 2:20 P.M.; carried unanimously.

 
Reminder:

The 55 Brown Road facility still isn’t ready for occupancy, so Board members should plan on coming to the current location for the February BOH meeting.