Board of Health

Meeting Minutes
March 09, 2010

12:00 Noon
Rice Conference Room

Present:	Mr. Will Burbank; Mr. Patrick McKee; Mr. Michael McLaughlin, Jr.; Ms. Janet Morgan; 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; Mr. Jonathan Wood, County Attorney; and Mrs. Patty Stamm, Administrative Assistant
Guests:	Rick Darfler, Franziska Racker Center; Allan Tallman, Dryden Central Schools; Rita Rosenberg and Don Barber, Sunrise Barn Apartments; Steven Kern, Sr. Public Health Sanitarian; and Carol Chase, Sr. Public Health Sanitarian
Excused:	Mr. Brooke Greenhouse; Dr. James Macmillan, President; and Dr. William Klepack, Medical Director

 

Call to order

In Dr. Macmillan’s absence, Dr. Tyler called the regular meeting of the Board of Health to order at 12:05 P.M.

Dr. Tyler welcomed Mr. Burbank and Mr. McKee to the Board of Health.  Introductions were made around the room.

Privilege of the Floor: 

No one was present to speak for Privilege of the Floor.
 
Approval of Minutes:

Ms. Morgan moved to approve the minutes of the February 09, 2010 Board of Health meeting as written; seconded by Mr. McLaughlin; carried unanimously.

Financial Summary:

Mrs. Grinnell Crosby reported the period of statement for the financial summary she passed out was Supplemental 2009 which is pretty close to the final for 2009.  She added the county will continue to make adjustments to expenses for a while longer, particularly in the mandated accounts, as well as additional phone expenses.  She briefly reviewed the financial summary, stating she felt the department did fairly well for the 2009 year. 

Mrs. Grinnell Crosby gave an update on the Article VI funding stating they were expecting $1,429,098.99 to come in.  A payment was received on March 2nd for the 2nd quarter (which was filed on August 25, 2008).  Currently, the State of New York owes the Health Department $655,353.83. 

Mrs. Grinnell Crosby also reported on March 5th they started receiving their grant COLA awards.  These awards were to be spent between April 1, 2009 and March 31, 2010.  She stated the lateness of this notification of funds makes it very difficult to spend the money in a three-week period, particularly with the county purchasing rules and claiming requirements; as well as restrictions as to how the funds can be spent.   So far only three awards have been received.  Mrs. Grinnell Crosby stated she is expecting at least three more awards, one of them being the largest award for WIC.  She did add the WIC Program is a bit more flexible in how the funds are used.

Administration Report: 

Mrs. Cole:

• Discussed the County Health Rankings report funded by the Robert Wood Johnson Foundation and conducted by the University of Wisconsin.  She stated this report ranked all county health departments across the United States according to several factors, adding that Tompkins County came in 3rd in New York State.  Mrs. Cole added that lower ranking counties are protesting that this report was done poorly, however she felt the whole intent of the report was to help county health departments highlight what they do and to get their community partners together.
• Reported concerns were raised by members of the Legislature over the Board of Health Bylaws.  The Health Committee will discuss these concerns on March 10th at their monthly meeting and then the Bylaws will come back to the Board of Health in April.
• Shared a letter of “Kudos” for Jane Daum from Jerry Dietz who organizes and runs the “Taste of the Nation” event. 
• Shared a picture of Mrs. Connors working at the Household Pharmaceutical Collect Event on Saturday, March 6th. 

Medical Director’s Report:

Since Dr. Klepack was out of town today, there was nothing to add to his written report.

Division for Community Health:

Mrs. Connors:

• Reported they were currently undergoing a review of the Lead Program by the State Health Department which is done every three years.  She added the survey seems to be going well.
• Reported the State Regional Representatives for the WIC Program will be arriving to do their site review on March 22nd. 
• Reported last fall they were notified of funds available through the American Recovery and Reinvestment Act of 2009 for immunizations.  Through these stimulus funds there were immunizations they would be able to get for free.  Mrs. Connors submitted a request for immunizations that were offered.  She was unsure of how much they would receive; however they did ask for 1,000 doses of Zostavax for shingles, 900 doses of Human Papilloma Virus, 300 doses of Tdap, and 200 doses of Pneumovax. 
• Reported a very successful Household Pharmaceutical Collect Event was held on Saturday, March 6th.  This was organized by a coalition of community organizations of which the Health Department is a member.  There were 509 vehicles that drove through in a six hour period.  She reported they collected ~1,800 pounds of drugs.  Three pharmacists from Tops, Wegman’s, and Cornell Gannett Clinic donated their time.  An inventory was done of all the drugs collected to help get an idea of what drugs were coming in and how much was being used.  Mrs. Connors added that 632 pounds of IV bags were collected, including 25 cases of dialysis fluids.  She stated they would like to see this type of event held several times a year.  Mr. Burbank thanked Mrs. Connors and the committee for all of the hard work that went into organizing this event, adding he felt that it was “good community outreach.”    

Children with Special Care Needs Report:

Mrs. Allinger:

• Reported the Autism Resource Fair held at TC3 in February went very well.  Over 1,100 people attended the presentation by Temple Grandin.  The Children with Special Care Needs Division had a booth and were kept very busy answering a lot of questions for parents, grandparents, day care providers, and pre-school teachers. 
• Reported she is still going over the multiple proposed regulatory changes for the Early Intervention program, which seem to be changing weekly.  Mrs. Allinger also reported they are starting to hear of changes for the Preschool Special Education Program as well. 
• Reported they definitely are experiencing a shortage in contract providers currently in the areas of Speech Pathology and Special Education.  Close behind are Occupational and Physical Therapists.

County Attorney’s Report:

Mr. Wood stated he had nothing to report.

Mr. Wood stated he has been enlisted to help with the floor problem in the new Health Department at 55 Brown Road.  It now appears that the move will not take place until June at the earliest.

Environmental Health Report: 

Mrs. Cameron:  

• Reported that through Tompkins County Area Development (TCAD), T.G. Miller has been doing a water and sewage system evaluation of municipal systems to assess current municipal water and sewage and what future development could be supported.  The draft report was presented to the public last week at a meeting held at the Tompkins County Library.
• Reported her Division has two vacancies posted for Public Health Sanitarians.

Report from Nominating Committee on Physician vacancy:

Mr. McLaughlin reported the final interview was conducted for the physician vacancy.  He added he and Mr. Greenhouse would like to recommend the name of Dr. Erin Hall-Rhoades for this seat on the Board.

Ms. Morgan made a motion to approve the recommendation of Dr. Erin Hall-Rhoades for the vacant physician seat on the Board of Health, seconded by Mr. McLaughlin; carried by a unanimous voice vote.

Mrs. Cole added this recommendation will go to the full Legislature for their approval, and if accepted, Dr. Hall-Rhoades would be able to come to the April meeting.   

Approval for new Zostavax Vaccine Policy:

Mrs. Connors stated currently the Health Department does not have any of the Zostavax vaccine on hand, however they anticipate receiving some of this vaccine which is being supplied free of charge through federal stimulus funds.  She added this vaccine is for anyone 60 years of age and older and indicated for the prevention of herpes zoster (shingles) disease.  She added it is a very expensive vaccine and not always covered by insurance.  Mrs. Connors stated there have been a lot of senior citizens calling the Health Department looking for this vaccine.

Mr. Burbank moved to approve the Zostavax Vaccine Policy as written, seconded by Ms. Morgan; carried unanimously.  

Yan Fei Huang, Owner/Operator; Cajun Café, T-Ithaca; Violation of Part 14-1 of the NYS Sanitary Code – food out of temperature:

Mr. McLaughlin moved to accept the resolution as written.

It was pointed out that item #2 of the draft resolution stated, “Pay a penalty not to exceed $400.00….; Mrs. Cameron stated this should read, “Pay a penalty of $400…

Motion seconded by Ms. Morgan; carried unanimously.

Background information on Public Water Supply Violations: 

Mrs. Cameron stated that annual nitrate and coliform sampling is required at the larger water systems.  In 2008, her Division was notified by NYSDOH that the smaller, state-regulated community water systems also needed to start this sampling.  These systems were notified in 2008 when sampling schedules were sent out.  They were also reminded of the new requirements during their annual sanitary survey/inspection.  In addition, coliform sampling reminder notices were sent, and in early December, those systems that had not submitted their nitrate results were called to remind them to sample for nitrate.  In consultation with NYSDOH, no enforcement action was taken in 2008 for those systems who failed to comply.

In 2009, the same procedure was repeated; however people were advised they would be subject to enforcement action if they did not comply.

The actions below are the people who did not comply either with the nitrate or coliform sampling for 2009.  Mrs. Cameron added these are all businesses where their main priority is not providing water to the public; however she felt it was important that people perform this activity with diligence and awareness.  Safe water is not something to be taken for granted and, especially when serving the public, needs to be monitored.

Resolutions Regarding Violations of Subpart 5-1.51(b) of the NYS Sanitary Code – failure to submit annual nitrate sampling results for:

Don Barber and Rita Rosenberg, Owners/Operators; Sunrise Barn Apartments, T-Caroline:   

Rita Rosenberg reported she is totally responsible for the water sampling and takes this activity very seriously.  She stated in November of ’09 she took a coliform sample to Cornell and submitted a copy of the report for that quarter to the Health Department.  In December of ’09 she went to Linear Lab, picked up a bottle and application and did a water sampling for nitrate and sent that report in.  She stated she was informed by a staff member of the Environmental Health (EH) Division that the nitrate sample was not received.  Ms. Rosenberg stated she copied the report and sent it once again.  She added she was unaware that she was actually sending the coliform report instead of the nitrate report.  She stated she received notification from the Health Department she was in violation for not doing the nitrate sampling.  It was suggested she send her report to the attention of the staff member she was working with, which she stated she did.  She then received a phone call on a Friday that the report still had not been received.  She then hand- delivered the report on Monday, only to find out she had completed the wrong application and did not do the nitrate sample.  She stated she signed the stipulation agreement; however she felt very uncomfortable with the conversation she had with the EH staff member she had been working with, adding she felt coerced into signing it.  She called this particular person and requested a meeting to discuss the situation further.  She was advised if she was not happy with the stipulation agreement, she should tear it up, and then proceed to a formal hearing.  She stated she did tear up the stipulation agreement.  She added that the communication was not positive; she felt she was being lectured and spoken to in a derogatory way instead of being supported.  She felt that person should have taken the time to get back to her and let her know she was sending the wrong report.  She added this was an innocent mistake and felt the violation did not match the offense.  She also stated this has gone on for several months and has taken a lot of energy on everyone’s part and again stated if staff had taken the time to help her be successful in this new process, it could have been readily resolved.  Ms. Rosenberg stated she wanted the Board to be aware of this occurrence and also that she felt a $200 penalty is totally inappropriate.

Mr. Barber stated that if the staff member working with his wife had taken the time to call them after receiving a report from a different lab in December for exactly the same test that was submitted in November and advised them of the situation, then they could have submitted the correct test and been in compliance.  They did not find out until January that Ms. Rosenberg was running the wrong test and then they were in violation.  He felt the fine was misdirected; he and his wife should not be fined, rather the EH Division should consider this a learning experience.  He added people do make innocent mistakes and should be treated as such. 

Mrs. Cameron reported that systems have 12 months to collect nitrate samples and that her Division encourages that these samples be taken earlier in the year which allows more time to resolve any discrepancies or mistakes.  Unfortunately, a number of systems do put this off until December and then, if there is a mistake, there is not a lot of time to resolve it.  She added the standard process for a bacteriological sample is that it goes to EH support staff and then is entered in a state mandated data base.  They do receive multiple samples from some facilities, so this is not an uncommon occurrence.  Mrs. Cameron also reviewed the proposed fine schedule.    

Mrs. Cameron stated she was not familiar with the forms at the lab; however she stated the forms do indicate either nitrate or coliform.  If the operator reviews the results, they should be aware of what they tested for.  Ms. Rosenberg stated it was her understanding she was to do the nitrate sampling at Linear Lab and the coliform sampling at Cornell Lab.  She stated she did not realize she could do both samplings at Linear.  She stated she hastily filled out the form, not realizing there were two different forms, and wrapped it around the sample bottle.  She stated, again, she was just trying to comply with the regulations. 

Following further discussion regarding nitrate and coliform sampling regulations, Mr. McLaughlin moved to accept the resolution as written, seconded by Ms. Morgan. 

Mr. Burbank offered a friendly amendment to reduce the fine to $50.  This friendly amendment was acceptable to both Mr. McLaughlin and Ms. Morgan.  Carried unanimously.

Ms. Rosenberg thanked everyone for taking the time to listen and for all of their hard work. 

Ishka Alpern, Owner/Operator; Thorpe Apartments, T-Dryden:

Mr. McLaughlin moved to accept the resolution as written, seconded by Mr. Burbank; carried unanimously.

Wayne Woodward, Owner/Operator; Deerfield Apartments, T-Dryden:

Mr. McLaughlin moved to accept the resolution as written, seconded by Mr. Burbank; carried unanimously.

Joshua Adams, Owner/Operator; Banner Apartments, T-Caroline:

Mr. McLaughlin moved to accept the resolution as written, seconded by Mr. Burbank; carried unanimously.

John and Elizabeth Hamilton, Owners/Operators; John Joseph Inn, T-Lansing:

Mr. McLaughlin moved to accept the resolution as written, seconded by Mr. Burbank; carried unanimously. 

Resolutions Regarding Violations of Subpart 5-1.51(b) of the NYS Sanitary Code – failure to submit coliform sampling results for: 

Allan Tallman, Operator; Dryden Central Schools (Freeville Elementary and Cassavant Elementary), T-Dryden:

Mrs. Cameron reported that Dryden Central Schools operates Freeville Elementary and Cassavant Elementary and the fourth quarter coliform sample was missed at each location, which resulted in two missed samples for the operator.

Mr. Tallman addressed the Board, stating he holds the water license for both of the schools; however, this is the first year he has had to do the coliform sampling.  He apologized for this, stating the Maintenance Department does everything at school, i.e. cleaning and snow removal, and it was just an oversight, but assured Board members this would not happen again.

Mr. Tallman reported on a couple of occasions they have faxed reports to the Health Department and when they have called to check that the reports were received, they have found that they weren’t. 

Mr. Tallman stated he came before the Board today in hopes of getting the penalty reduced since it was their first offense.  He stated they did comply, however agreed that it was late. 

Mr. Kern reported that up until this past year, the Environmental Health Division had done all of the water sampling for all of the schools, including the Franziska Racker Center.  Due to the decrease in the water grant, they were told they had to cut back on this sampling, which is why the schools are now doing this procedure.  Mr. Kern also pointed out that in the stipulation agreement it lists the penalty at $300 for three missing samples and in the final draft resolution it was listed as $200 for two missing samples.  This is due to one of the missing samples being found and the results being sent on to the Health Department.  Mr. Tallman added they asked the lab to fax the report to the Health Department, however this didn’t happen.  He stated he followed-up with the lab and had the sample results picked up so that he could send them on to the Health Department.  Mr. Tallman stated now he makes sure that he or a member of his staff goes to the lab and picks up the sample results and then passes this on to the Health Department instead of relying on the lab to do this.  Mr. Tallman also described the procedure that is now in place for taking quarterly microbiological samples at both of the schools.

Mrs. Morgan moved to approve the draft resolution with one amendment that the penalty be reduced to $50, seconded by Mr. McLaughlin; carried unanimously.

Rick Darfler, Operator; Franziska Racker Center, Inc., T-Ulysses:

Mrs. Cameron stated there was no microbiological sample submission for both the third and fourth quarters for 2009 for the Franziska Racker Center. 

Mr. Darfler addressed the Board, stating that this was a new process for his staff.  He accepted responsibility for the violation, stating he did not make sure that the water operator understood the new sampling duties.  He added all of their work requests for preventive maintenance go through an automated computer-based system.  Mr. Darfler reported the operator did do the first two quarters of 2009.  Before they received a letter from Mr. Kern regarding the third and fourth quarter violations, they had successfully taken samples for the first quarter of this year.  Mr. Darfler stated in order to make sure this doesn’t happen again there is a brightly colored checklist posted on the water tank which outlines everything that needs to happen each month.  He also outlined other steps he has taken with the work requests to alleviate any further violations.

Mr. Darfler asked for the Board’s consideration in reducing the penalty, adding they try to be diligent in all of their water testing.  He apologized for the reports getting lost for the last two quarters and assured Board members this testing will not fall though the cracks again this year or any subsequent year.

Mrs. Cameron stated the systems are notified when they fail to submit a sample report.

Mr. McKee moved to accept the resolution as written, seconded by Ms. Morgan.

Mr. Burbank offered a friendly amendment that the penalty be reduced to $100; Mr. McKee was not accepting of this amendment.  Amendment fails for lack of a second.

A voice vote on the resolution resulted as follows: Ayes – 4; Noes – 1 (Burbank).  Resolution adopted.

Richard Holgate, Owner/Operator; Pinecreek Campground, T-Newfield:

Mrs. Cameron read a letter submitted by Mr. Holgate of Pinecreek Campground which was received on March 2nd.  The letter was requesting leniency in the monetary penalty due to the untimely death of their maintenance manager in March of 2009 which possibly led to the lack in their reporting.  Mr. Holgate wrote they have spent hundreds of thousands of dollars rebuilding the campground, as well as paying nearly $80,000 in property and school taxes, leaving no extra money for them as yet.  Mrs. Cameron added Mr. Holgate made no mention of the above during the office conference when he signed the Stipulation Agreement.  She also added Mr. Holgate would have received notification from the Health Department that they had not received any microbiological sample reports for the second and third quarters for 2009. 

Mr. McLaughlin moved to accept the resolution as written, seconded by Ms. Morgan; carried unanimously.

George Michelis, Owner/Operator; A-1 Pizzeria, T-Dryden:

Mr. McLaughlin moved to accept the resolution as written, seconded by Mr. Burbank; carried unanimously. 

Mrs. Cameron reported an oversight; one of the missing sample results for the third quarter of 2009 had been found.  Staff was recommending the penalty be reduced from $300 to $200.

Mr. Burbank moved to accept this recommendation and reduce the penalty to $200, seconded by Ms. Morgan; carried unanimously. 

Resolutions Regarding Timetables of Compliance for Part 5-1 of the NYS Sanitary Code – Ground Water Under the Direct Influence of Surface Water (GWUDI):

Mrs. Cameron reported these are systems which have been under a timetable of compliance schedule to bring their systems into compliance with the specific requirements for GWUDI systems.  Both Brookton’s Market and Glenwood Pines have requested an extension.  She noted staff supports both requests for an extension of time due to unforeseen circumstances for both establishments.

Debby Halpern, Owner/Operator; Brookton’s Market, T-Caroline:

Ms. Morgan moved to approve the resolution as written, seconded by Mr. Burbank; carried unanimously.

Cory Hohwald, Owner/Operator, Glenwood Pines, T-Ulysses:

Ms. Morgan moved to approve the resolution as written, seconded by Mr. Burbank; carried unanimously.

Discussion:

Mrs. Cole expressed her discomfort with Rita Rosenberg’s comments to Board members regarding staff.  She felt it was inappropriate and expressed the hope that disgruntled people would go up the chain of command looking for some sort of satisfaction before going into a public meeting and start discussing specific individuals. 

Mr. McLaughlin suggested in the future the Board should move to Executive Session for discussions regarding an incident involving specific Health Department personnel.

Mr. McLaughlin then moved that individuals planning to speak before the Board to discuss draft resolutions do this under Privilege of the Floor.  He added he felt this would make it easier for Board members to discuss these actions later in the meeting without setting a precedent regarding fines, etc. starting with the first agenda item. 

This motion was seconded by Mr. Burbank and carried unanimously. 

The new format will start in May since Notice of Violation letters have already gone out for the April meeting.  Mr. Wood suggested the Agenda be arranged so that the Environmental Health violations are acted on first.

Adjournment:

Mr. Burbank moved to adjourn the meeting at 1:46 P.M.; carried unanimously.