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Approval of revisions to the Home Health Aide Flow Sheet Procedure:

Ms. Morgan moved to accept the revisions to the Home Health Aide Flow Sheet Procedure as written, seconded by Mr. McKee.

Mrs. Connors reviewed the procedure that guides Health Department nurses/ therapists on developing a care plan for Home Health Aides.  She stated when the State did their survey in January, they cited the Home Health Care Unit for lack of specific frequency for shampoos or nail care.  Mrs. Connors stated when they went to make modifications to the procedure, they took a good look at the language, terminology, and formatting and decided to update the whole document.

Dr. Tyler requested a list of approved medical abbreviations.  Mrs. Connors stated she was working on updating this list and would bring it forth at a future meeting.

Carried unanimously.

Approval of revisions to the Nutritional Assessment Policy and Procedure:

Mrs. Connors stated they completely revised the Nutritional Assessment Policy and Procedure. She stated this policy/procedure describes the method the nurses/therapists use to do a general nutrition assessment when they admit a patient.  If there are any red flags that come up in the general assessment, they would go on to do a more detailed assessment and also communicate with the physician to see if there should be a change in the patient’s plan of care.  Mrs. Connors added that this was also cited by the State because they felt the Home Health Care Unit was not using a consistent method of assuring that the Nutritional Care Plan was updated for every patient.  She stated this revised policy/procedure does walk staff through the process and helps assure they won’t miss someone who might otherwise need some help.

Mr. Greenhouse moved to accept the revisions to the Nutritional Assessment Policy and Procedure as written, seconded by Mr. McKee.

Dr. Tyler had some questions/concerns regarding the scales that were used to weigh the patient and the consistency/accuracy of the same scale being used. Mrs. Connors suggested under section VII. Documentation Guidelines, D. Document, #1. “Height and weight on admission, and weight on revisits per physician’s orders.  Note whether measured or self reported,” a statement could be added, “Note which scale was used.” 

Dr. Tyler had additional questions regarding section V. Procedure, B, #2 – Height and the accuracy of the patient’s response to this question.  Mrs. Connors suggested it might be helpful to verify the height given for the patient against the height on record in the physician’s office.  She stated this could be used as a guideline.  It was determined that it might be a good to do a height assessment on patient entry.  Mrs. Connors stated she would change item #2. (Section V. Procedure, B.) Height: to “Measure client height as able; otherwise ask client/caregiver height and record.”

Dr. Hall-Rhoades stated that pediatric patients do not use BMI’s; they use the height and weight curve.  Mrs. Connors stated the Health Department does not serve many children, however they would use this assessment on all patients.  She added that a standard should be set for what age a BMI is used.  She also stated whatever information was obtained regarding the patient, it would be reported to the physician. 

Revisions to the Nutritional Assessment Policy and Procedure, as amended, carried unanimously.

Approval of new Zoll Life Vest External Defibrillator Policy:  

Mrs. Connors stated on the State survey, although it was noted that the patient had an external defibrillator and that the patient expressed understanding, the Health Department did not have a procedure on the Zoll Life Vest Defibrillator and did not specifically know how the vest worked.  She added even though Home Care nurses were not doing patient training on the vest, it was important that they understood how it worked and subsequent steps if the patient were to use it. 

Mr. Greenhouse moved to accept the Policy as written, seconded by Dr. Tyler.

Ms. Morgan suggested a change on pg. 1 under II. Other Information, B. so that it reads as follows: “The Zoll Life Vest is the only external wearable defibrillator presently on the market.”

Mr. Greenhouse also suggested a change on pg. 2, B. Types of Alarm, 3. Gong Alarm – the last two sentences should be combined to read as follows: “Client may need to refer to the manual to find the message on the chart, determine what the message means and what to do.

Approval of policy, as amended, carried unanimously.

Yan Fie Huang, Owner/Operator; Cajun Café & Grill, Village-Lansing; Violation of Part 14-1 of the NYS Sanitary Code (Food): 

Mrs. Cameron reviewed the history of the Cajun Café, stating there is a relatively new owner.  The initial inspection, as well as their re-inspection, was unsatisfactory due the chicken being out of temperature.  At a re-inspection following adoption of BOH orders on March 9, 2010, chicken pieces were again observed to be out of temperature, as well as food temperature monitoring logs not being maintained.  The Environmental Health Division is proposing a penalty of $1,000 for these violations, as well as being required to maintain their food temperature monitoring logs.  Mrs. Cameron noted that on the Draft Resolution, item #2 under THEREFORE, BE IT RESOLVED…should be modified to read as follows “Pay a penalty of $1000 for these violations… 

Mr. McLaughlin moved to accept the resolution with the proposed modification, seconded by Ms. Morgan.

Dai Qi, from the Cajun Café & Grill, was present at the meeting, but choose not to address the Board.

Resolution, as modified, carried unanimously.

Ronald Beck, Owner/Operator; On A Roll, T-Dryden; Violation of Part 5-1 of the New York State Sanitary Code (Water – microbiological sampling):

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

Todd Fox, Owner/Operator; Quiznos Sub #8294, C-Ithaca; Violation of Part 14-1 of the NYS Sanitary Code (Food):

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

Mrs. Chase explained that Mr. Fox was under the impression that he was going to be selling his business, however she had subsequently spoken with him three or four times reminding him that if he did not sell his business before the permit expired, he needed to renew it.

Mr. Burbank questioned the disparity between the proposed fines for Quiznos Sub and Dryden Pizza.  Mrs. Cameron stated that Quiznos Sub was informed ahead of time that they needed a permit.  The Health Department was unaware Dryden Pizza was in business under new ownership and operating without a permit.  Once Dryden Pizza became aware of the need for a new permit, they submitted their application.  This was the reasoning between the differences in fines.  A short discussion ensued regarding the guidelines used for establishing fines.  

Resolution carried by a unanimous voice vote.

Terry Utter, Owner/Operator; Dryden Pizza, V-Dryden; Violation of Part 14-1 of the NYS Sanitary Code (Food):

Dr. Tyler moved to accept the resolution as written, seconded by Dr. Hall-Rhoades, and carried by a unanimous voice vote.

Richard and Blodwen Monclova, Owners/Operators, C-Ithaca, Violation of Part 14-1 of the NYS Sanitary Code (Food):

Dr. Tyler moved to add Orange Blossom Pancake House to today’s BOH agenda for discussion, seconded by Mr. McKee.

A discussion was held amongst staff and Board members regarding setting a precedent of revisiting agenda items from previous meetings and, perhaps, bringing forth a conundrum.  In this particular case, Mr. Monclova was given sufficient notice to appear at the BOH meeting last month; however, he did not show up.  It was pointed out there could be extenuating circumstances under which someone could not show up for the meeting, however, it does not want to become routine to revisit agenda items.  Mr. Wood suggested setting some sort of criteria for when motions that were voted on should be revisited.  It was suggested that anyone wishing to speak be given the message that they can speak at Privilege of the Floor; however it’s up to Board members whether something gets put back on the agenda. 

Motion to add Orange Blossom Pancake House to the agenda carried unanimously.  Board members felt that Mr. Monclova provided an adequate explanation for having missed the April BOH meeting.

Following further discussion regarding the violations at the Orange Blossom Pancake House, Mr. McLaughlin moved that the resolution stand as passed, seconded by Dr. Tyler.  Vote:  7 - Ayes; 1 - No (Tyler).  Resolution stands as adopted.      

Executive Session:

At 1:16 P.M. Mr. Greenhouse moved to adjourn to Executive Session for the purpose of further discussion regarding the move to 55 Brown Road, seconded by Mr. McLaughlin.  Carried.

Out of Executive Session:

At 1:29 P.M., Mr. Greenhouse moved to adjourn from Executive Session, seconded by Mr. Burbank.  Carried.

Adjournment:

Mr. McLaughlin moved to adjourn the meeting at 1:30 P.M., seconded by Ms. Morgan and carried unanimously.