LARIMER COUNTY BOARD OF HEALTH – January 22, 2009
The Larimer County Board of Health convened its regular meeting at 7:00 PM at the Larimer County Department of Health and Environment, 1525 Blue Spruce Drive, Fort Collins, CO.
MEMBERS PRESENT: Lee Thielen, M.P.A.
Dr. Mark Richards, M.D., M.P.H.
Blair Trautwein, J.D.
Adrienne LeBailly, M.D., M.P.H. – Exec. Secretary
Commissioner Steve Johnson – BCC Liaison
OTHERS PRESENT: Marie Macpherson, Avie Strand, Gerald Blehm, and Amy Smith
1. Call to order
The Board of Health meeting was called to order at 7:04 P.M.
2. Approval of minutes of the December 11, 2008 Board of Health meeting
The minutes of the December 11, 2008 meeting were unanimously approved.
3. Proposed goals for 2009 – Dr. LeBailly, Division Directors, and Board members
Dr. Richards expressed the importance of the proposed goals being reasonably feasible if they are going to be used for evaluating the director’s accomplishments each year.
Department goals: Dr. LeBailly reviewed the goals of participating in the statewide Public Health Improvement Plan, replacing our cashiering/clinic information system, and updating our department video.
Administrative goals: Marie Macpherson, Director of Administrative Services, confirmed that the department/division goals carried forward from 2008 were feasible and should be completed, barring unexpected emergencies. She told the Board the Department is moving forward with the goals to evaluate the option of teleworking, both as a back-up for critical functions and as appropriate for routine duties, in conjunction with a county-wide review of teleworking policies and procedures. Ms. Macpherson also described the goal of clarifying and improving our system for billing Medicaid, and developing clear expectations of staff responsibilities and procedures to be used.
CHS goals: Averil Strand, Community Health Services Director, discussed several efforts to secure funds to help maintain our Maternal Health Services, including a grant proposal from the Colorado Department of Human Services State Strategic Use Fund, as well as through collaborative efforts with PVH’s Community Partnerships program and Larimer County’s Human Services Department. Ms. Strand also described the goal of developing communicable disease policies and procedures relating to state and local responsibilities for STD treatment and partner follow-up, as well as policies regarding employee TB screening for our department. Ms. Strand also described the goal of using new state funds from an anonymous donor to make additional contraceptive methods, especially long-acting methods, more available to our Family Planning clients
EH goals: Gerald Blehm, Director of Environmental Health, expressed confidence that the EH division would be able to meet their goals for 2009. He described the Department’s continuing efforts to monitor the proposed in-situ uranium mining proposal. He updated the BOH on the proposed bill to increase food license fees in the 2009 legislative session. Mr. Blehm also reviewed the goal relating to the construction and start-up of Glacier View Meadows wastewater treatment plant, and the prospects for the Hidden View Estates project.
Board of Health goals: The Board discussed wording for additional Board of Health goals, and came up with the following three items for consideration.
Continue to evaluate the role and performance of the Board of Health
Identify the most significant population health deficits and consider approaches to improve them.
Periodically review priorities of the department based on community need and available resources
**Two motions were made: first, to accept the goals for the Department and Divisions, second, to accept the proposed goals for the Board.
**Both motions were unanimously approved.
Ms. Thielen encouraged department managers, during this recession, to continue their support for staff training and development through free or low-cost instruction available on-line and through other organizations.
4. Follow-up discussion of BOH use of indicators – BOH and Dr. LeBailly
Dr. LeBailly distributed a handout from the November BOH meeting’s discussion of possible health indicators and how they can be used. She and Dr. Richards had talked before tonight’s meeting, and agreed that we needed the direction from the Board about what they wanted to use the indicators for, and with that direction, the department could suggest appropriate indicators to be followed. Much discussion ensued about what the Board wanted to do with the indicators and how they should be used, as well as whether outside experts should be invited to present to the Board periodically about other health measures (such as the Health District survey of Larimer County residents, done most recently in 2007), and whether the BOH might work with other Boards (such as the Board of Education) to bring forward health concerns. Mr. Trautwein suggested that Dr. Richards send out to other Board members two to four ideas about health measures he would like to see the BOH track, and let the rest of the Board provide feedback by email. Ms. Thielen asked that we keep this as a issue for ongoing discussion in the future.
5. Review of evaluation tools for Director – Lee Thielen
Ms. Thielen distributed a copy of the draft for the evaluation tool, and suggested the draft document should be reviewed, modified as needed, and approved at this meeting. She shared a suggestion from Teri Olson that “delegation” be added to the evaluation criteria. This modification was added to the “Teamwork” criterion as: “Provides direction and delegates appropriately.” This new tool would be used on a test basis to evaluate Dr. LeBailly’s 2008 performance, but 2009 salary decisions would be based on the prior precedent of completing BOH goals and complying with BOH governing policies. Dr. LeBailly distributed a “Supervisor Evaluation Tool” form that is being used in 2009 for Department Supervisors, if the Board would like to consider using it now or for the 2009 evaluation. Ms. Thielen stated that there should be written documentation of the Director’s evaluation to be fair to the director. The Director and the Board can consider ways of getting feedback from others for evaluations in the future.
**Motion was made to use the form with two modifications which will be attached to the minutes.
**Motion was unanimously approved.
6. Health Director’s Report – Dr. LeBailly
Dr. LeBailly updated the members of the Board of the peanut butter outbreak impact; Larimer County had two confirmed E. coli cases, and one suspect case [now confirmed], with ages ranging from age 2 to age 56. She also stated the CDC’s advice was to avoid peanut butter-containing products, except for retail peanut butter in jars made by large companies (such as Skippy, Jiff, Peter Pan).
Dr LeBailly discussed the state health department cuts anticipated for the current state fiscal year (July 2008 – June 2009)
Dr. LeBailly, Board members, and staff discussed proposed state legislation, such as new bills relating to tobacco, cell phones, and hospital fees that may be used to help draw down more Medicaid dollars.
7. Discussion of Salaries of appointed officials – Decision on Director’s salary – Marie Macpherson, BOH members
Ms. Macpherson distributed two handouts related to a recent survey of 2009 salaries for physician Public Health Director positions. One handout showed the trends of salaries over the past several years. One contained information related to 2009 salary data and showed that according to that survey Larimer’s salary is approximately 18% behind the 50% percentile for other local health agencies/departments. She informed the Board of Larimer County’s merit increase amount (3.5%) for regular staff who are not yet at the top of their position range.
The inconsistency of wage levels for the Public Health Directors was discussed and it was pointed out that Larimer’s level is still far below comparable departments/agencies.
**Motion was moved to increase the Directors salary by $10,000/yr, which is approximately a 6% increase.
**Motion was unanimously approved
Dr. LeBailly also shared the handouts relating to the salaries for the other appointed official and their ranges. When their performance evaluations are completed, they will most likely receive the 3.5% increase that the county allows within their ranges. Some issues on the salary range still need to be resolved with Human Resources regarding the Director of Administration’s position.
8. Additional Discussion
In response to a request from Teri Olson that the Board of Health hear more of the industry’s perspective on In-Situ Uranium Mining, Dr. LeBailly distributed DVD’s of the County’s public hearing on uranium mining from early 2008, which includes testimony from a broad spectrum of positions on this issue, including those from Powertech.
Ms. Thielen expressed the Board’s interest in meeting with our two new commissioners to become better acquainted and discuss some public health issues. Commissioner Johnson will be coming to an orientation at the Health Department on Jan 28, what Board members could attend. [Commissioner Donnelly also attended this orientation on the 28th.] Commissioner Johnson suggested that Ms. Thielen and other available Board members get together with the new Commissioners for lunch sometime in the near future.
9. Next meeting – February 12, 2009 at 7:00 PM
10. Meeting was adjourned at 9:02 P.M.
Amy Smith, Recording Secretary Adrienne LeBailly, MD, Executive Secretary