Board of Health

Meeting Minutes
August 10, 2010

12:00 Noon
Rice Conference Room

Present:	Mr. Brooke Greenhouse; Dr. James Macmillan, President; Mr. Patrick McKee; Mr. Michael McLaughlin, Jr.; Ms. Janet Morgan; and Dr. William Tyler
Staff:	Mrs. Sylvia Allinger, Director of CSCN; Mrs. Sigrid Connors, Director of Patient Services; Mrs. Brenda Grinnell Crosby, Public Health Administrator; Dr. William Klepack, Medical Director; Mr. Jonathan Wood, County Attorney; and Mrs. Patty Stamm, Administrative Assistant
Excused:	Mr. Will Burbank; Dr. Erin Hall-Rhoades; and Mrs. Liz Cameron, Director of Environmental Health
Guests:	Steven Kern, Sr. Public Health Sanitarian; Carol Chase, Sr. Public Health Sanitarian; Skip Parr, Public Health Sanitarian; Joe Mareane, County Administrator; Anita Fitzpatrick, Commissioner of Personnel;
Privilege of the Floor:	John Comereski, Island Health & Fitness; Jobe Zulu & Maria Barr, Feel Good Foods; Yeshi Tsondu, Potala Café; and Christopher Holmes, Orange Blossom Pancake House

 

Call to Order

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

Privilege of the Floor

(1) John Comereski of Island Health & Fitness addressed the Board regarding the incident in their pool on May 24th.  The lifeguard was in the pump room for about 10-12 seconds adjusting a chemical level for the pool when the event occurred.  Mr. Comereski happily reported the pool patron is alive today due to the swift action of his staff.  He stated the ambulance crew reported the CPR administered by his staff is what kept this individual alive since he was in ventricular fibrillation.  Mr. Comereski added that now the manager on duty goes to the pump room to make chemical adjustments as advised by the life guard.  He stated he was not looking for any leniency on the fine; he just wanted the Board to know the outcome of the situation.

(2) Maria Barr, mother of Lamin Zulu of Feel Good Foods, addressed the Board regarding two critical violations for failure to store potentially hazardous foods at an appropriate temperature.  She discussed corrective actions they are taking to avoid a reoccurrence of violations, including a fully loaded concession truck with a permanent location to park it which should be in place by the end of the month.  She said the truck holds a refrigerator, stove, and a hot water heater which should remedy their temperature issues.  She added since this is a new enterprise and they are trying to build up their vending business within the community, they would appreciate some leniency on the fine. 
            When asked if anyone at the business had had the opportunity to take a Serv-Safe course, Maria Barr said she was interested and was sure other members of the business would be interested and willing to take it as well.  It was pointed out that as a new business it might be well-worth having someone on the staff Serv-Safe certified.  Maria Barr stated they are currently storing their items at the Women’s Community Building and then they transfer these items to a place they cook on weekends.  She stated that they won’t expand their catering until their concession truck is ready to go.  She also added that they are currently keeping temperature logs.

(3) Yeshi Tsondu of Potala Café addressed Board members regarding the fine imposed at last month’s Board of Health meeting for critical violation(s) in both May and June of 2010 for foods not being stored under refrigeration and the fact he feels that he cannot serve sushi because it will be ruined if it is taken to the temperature required by the Health Department. 

(4) Christopher Holmes of the Orange Blossom Pancake House introduced himself to Board members and briefly outlined his work background experience, the latest as Head Chef of the Orange Blossom Pancake House.  He discussed previous chefs for the restaurant, stating that the last chef had a different approach to serving food from his own, despite the fact that the former chef had taken a Serv-Safe course.  Mr. Holmes stated that he had never taken a food course, but would be happy to take one.  He added that he felt if you had a “passion for food, you are pretty much going to ensure that you have a safe product.”  Mr. Holmes discussed his reputation as a chef, stating that he’s trying to reverse all the unfortunate violations at the Orange Blossom and offer the public something nice.  He explained the sequence of events on the day of the most recent inspection by the Health Department.  He stated that there were potatoes out of temperature which he had not planned to use; however, he was involved in another task at the time.  He expressed his frustration over the fact that the Monclovas feel that $1,200 of the fine for the recent violation is his responsibility due to the inadequacy of the potatoes and the lack of paperwork.  Mr. Holmes stated that he can keep appropriate food temperature logs; however, did not write them down that particular morning.  Mr. Holmes explained his philosophy towards food, stating that in the end the food will be safe.

Approval of Minutes:

Dr. Tyler moved to approve the minutes of the July 13, 2010 Board of Health meeting as written, seconded by Mr. Greenhouse.  Mr. Greenhouse asked for a correction at the bottom of pg. 3, last sentence; change “would” to “should.”  The sentence should now read: He added since there are no fees involved, there is no reason why an individual or a contractor should not contact the department…..  Minutes, as amended, carried unanimously.

Financial Summary

Mrs. Grinnell Crosby stated she had no report this month.

Administration Report: 

Mrs. Grinnell Crosby reported Health Department staff finally moved into 55 Brown Road on July 19th.  She reported the move has consumed the entire staff for the last several weeks getting ready for the move, and then trying to get things put away and get settled, in addition to carrying out our regular daily work.

Medical Director’s Report:

Dr. Klepack followed-up on last month’s report regarding his visit to Planned Parenthood and vaccine delivery at the point of care.  He reported that Karen Bishop, Supervisor of the Community Health Services program, has advised him they receive Gardasil (HPV vaccine) through the stimulus package monies and of those doses, they can allocate some of them to Planned Parenthood for use for HPV vaccination.  Although this doesn’t address Hepatitis B and Hepatitis A, those vaccinations are available through a special program of the State for high-risk populations, of which Planned Parenthood caters to.  In addition, Dr. Klepack stated Planned Parenthood is registered as a Vaccine for Children provider and, hopefully, they might be encouraged to use some of the vaccine materials that are available through that safety net program which cover people up to the age of 19.  This would cover Gardasil, as well as Hepatitis A & B, and Rubella/Rubeola vaccinations.  He added that he and Mrs. Bishop will have more dialogues in the coming month about helping to close the gap in point of care vaccine delivery and seeing what they can do in terms of facilitating this.

Dr. Klepack also spoke briefly of the Whooping Cough epidemic in California that led to the death of six infants.  He stated this was largely a vaccine delivery issue.  He added fortunately in New York State the VFC (Vaccine for Children) program and whooping cough vaccine is available to any practitioner signing up for that program.     

Direct or of Patient Services Report:

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

Children with Special Care Needs Report:

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

County Attorney’s Report:

Mr. Wood stated he had nothing to report.  He stated he would like to request an Executive Session at the end of the meeting for the purpose of discussing personnel issues.

Environmental Health Report:

Mr. Kern stated he had nothing to add to Mrs. Cameron’s written report.

Mr. Greenhouse commented on the helpfulness of the history of the establishment inspections which are included in enforcement actions for restaurants and stated a history along with the resolution, when appropriate, for other actions would be really helpful. 

Mr. Greenhouse also discussed the possible message that was being sent to consumers regarding establishments being referred for collection for not paying their fines.  He asked if there was some sort of mechanism by which a permit renewal could be denied or an existing permit revoked other than referring the establishment for collection.  Mr. Wood stated most fines are actually collected, adding that if action is commenced to collect a penalty, in addition to interest as well as other costs, judgments can be attached to the owner’s properties.  Mr. Wood also stated the biggest issues in collections occur when companies are formed to run a business and then they disappear.  If there are no properties attached to the entity, then you cannot attach a judgment to the property.  He did state that they do have other ways of handling collections.  Mr. Wood further stated he did not believe permits could be denied or revoked since the penalties for violations are set forth in the law.  Mrs. Chase stated that if consistent, persistent violations occurred and an establishment was a threat to public health, staff would come before the Board and ask for a permit to be revoked or not issue a renewal.

Approval of revisions of BOH Bylaws:

Mr. McLaughlin moved to accept the revisions to the Board of Health Bylaws as written, seconded by Mr. Greenhouse.

Mrs. Grinnell Crosby stated that Board of Health members acted on revisions to the Board of Health Bylaws back at the January 12, 2010 Board of Health meeting.  The bylaws then went to Health Committee where Legislator Kiefer suggested additional revisions.  The bylaws with suggested clarifications from Mrs. Kiefer have been edited to show where language needs to come out and new language needs to go in, as well as raising questions.  Mrs. Grinnell Crosby stated that she, Mrs. Cole, and Mrs. Connors had done a review of the bylaws at the end of June and added or agreed to certain things, so their comments are included with the exception of one change she and Dr. Klepack have recently been discussing. 

A lengthy discussion ensued regarding Section VIII. Medical Director and the policy question regarding the jail medical oversight.  Dr. Klepack reported that he and Brenda have been corresponding with regard to this question and they both agree that it would be best to leave that service to the jail as a courtesy service that the Health Department provides.  Dr. Klepack added that this is not necessarily part of the Medical Director’s position, however explained the situation in which the Health Department was asked to help out, which they did, and it has remained as a courtesy service to the jail ever since. 

Regarding Section IX. Medical Examiner, Mrs. Grinnell Crosby stated that she and Dr. Klepack have discussed the question raised regarding the policies.  She stated that they believe the language “for the implementation of policies established by the County Legislature” is old language, adding that the County Legislature doesn’t write policy for the Medical Examiner.  She stated they recommend deleting that language. 

Ms. Morgan had questions regarding Section VII. Public Health Director, Section 7.00.  “The County Administrator shall appoint a Public Health Director, upon recommendation of the Board of Health,”…  Ms. Morgan stated she did not feel this has been the process that has been used in the selection of a candidate for the Public Health Director. 

Mr. Wood stated the method of selecting the Public Health Director is in the County Charter and this language basically reiterates some of which is in the County Charter.  He added this cannot be changed just by changing the bylaws.  He also stated the bylaws need to be consistent with the County Charter. 

Mr. Mareane, County Administrator, stated the search and appointment of a new Public Health Director has been handled in the appropriate way and does respect the responsibilities and powers of the Board of Health.  He described the four entities involved in this processes: (1) County Administrator has to appoint; (2) Legislature has to confirm; (3) Board of Health has to recommend; and (4) confirmation by the NYS Commissioner of Health.  He added the Search Committee includes representatives from three of those four entities.  Mr. Mareane also stated it is done in this way so that when a candidate has been chosen, there is an opportunity to come to the Board of Health and ask for its recommendation based on the outcome of the Search Committee process through its representatives.  He stated that when the appointment process begins to proceed, it would require the recommendation of the Board of Health. 

Regarding Section X. Committees, Mr. Greenhouse had a question regarding Section 10.00 Executive Committee.  He felt that the suggestion of {Better practice: Chosen at the annual organizational meeting.} was not a necessary change.  In the second paragraph, he felt the recommended change {Suggested insert: shall be called by the President and} was reasonable.  In Section 10.01 Special Committees: Ms. Morgan thought that {Suggested change: “Chair” is more appropriate for a Committee head title.} was a reasonable change.

Regarding Section 10.02 Professional Advisory Committee (PAC): (a) The Board shall appoint a group of {at least…5? 7 Department supports 7 to help meet quorum? 9?...}  Mrs. Grinnell Crosby stated she and Mrs. Connors recommend using a group of 7, which was acceptable to Board members.  Mrs. Connors added the Professional Advisory Committee is not a requirement of the Diagnostic and Treatment Center regulations.  They require an advisory group to oversee the clinic activities, but they do not specifically require the PAC which the CHHA does.  She stated she felt all {insert: “and the Clinic”?} were not necessary since it is not required by regulation.  It was determined that (b) should read as follows: “This group of professional personnel shall participate in the annual evaluation of the Agency and shall meet at least quarterly to:” 

It was also determined that on pg. 6, XI. Home Health Agency and XII. Diagnostic & Treatment Center were redundant (they were referenced on pg. 1, II. Board of Health Powers and Duties, Section 2.00, item b); so could be eliminated.  Also on pg. 6, XIII. Amendment of the Bylaws, {Does the ten calendar day requirement apply to the Board of Health?}.  It was determined that the suggested language in that section was fine. 

The Bylaws of the Tompkins County Board of Health, as amended, were carried unanimously. 

EPA Hearings:

Mrs. Grinnell Crosby reported that Frank Proto had called her earlier today in reference to the EPA hearings on fracking and gas drilling scheduled for this week.  The hearings have been moved to the Onondaga County On-Center due to the anticipated large number of people who will be in attendance.  Mr. Proto asked if the Board of Health would consider submitting written comments as it pertains to drinking water since generally written comments will be accepted up to two weeks after the hearing.  Mrs. Grinnell Crosby stated she had spoken briefly with Mr. Kern this morning and he felt that comments previously submitted to the State DEC could also be used for this hearing. 

Mr. Greenhouse moved that staff use the information from the previous document submitted as an appropriate form to send to the EPA, seconded by Ms. Morgan.  Dr. Macmillan requested that the final form for the letter be brought to the September BOH meeting as a FYI.  Motion carried unanimously.

Executive Session: 

At 1:50 P.M. Ms. Morgan moved to adjourn to Executive Session for the purpose of discussing personnel issues, seconded by Mr. McLaughlin; carried unanimously.

Out of Executive Session & Adjournment:

At 2:25 P.M. Mr. Greenhouse moved to adjourn from Executive Session and Adjourn the meeting, seconded by Mr. McLaughlin; carried unanimously.