Cirque Meadows by Adam Johnson




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:                                 Teri Olson, R.N., M.S.N.

                                                                                    N. Mark Richards, M.D., M.P.H.                   

                                                                                    Steve Yurash

                                                                                    Lee Thielen, M.P.A. via telephone


      Executive Secretary                                        Adrienne LeBailly, M.D., M.P.H.

OTHERS PRESENT:                                       Marie Macpherson, Gerald Blehm,                                       Averil Strand, and Amy Smith


     1.   Call to order


            The Board of Health meeting was called to order at 7:06 P.M.



    2.     Approval of minutes of the August 20, 2009 Board of Health Meeting.


The minutes of the August 20, 2009 meeting were unanimously approved.



3.   Update on the September Budget Hearing/Review meeting – Marie Macpherson and Dr. Richards.


Dr. Richards, the Board vice president, who represented the Board at the department’s budget hearing, reported positive feedback from the County Budget Hearing regarding the Department’s proposed budget and the work the Board of Health does with the Department before the budget is submitted.  Marie Macpherson, the Director of Administration, explained that there were some questions regarding fund balance usage projected for the Department in 2010.  She explained that the reserve use is on target and that 2010 is not the time to be reducing staff as we continue to respond to H1N1.  We need the ability to reassign core services staff to responsibilities that are most needed.  Ms. Macpherson distributed handouts of the budget and updated the Board of an additional $17,000 for the county retirement plan funding that will be added to the 2010 budget.  She also explained that the County Manager has accepted our budget proposal; it will then to the Commissioners  for review, and their proposed budget be open for public comment.


Ms. Macpherson informed the Board that the Department has received up to $ 860,000 of H1N1 grant funding to help cover the costs of mass vaccination clinics and other H1N1 response activities. These are federal dollars passed through to us by the State.  These grant dollars will help us not use as much of our fund balance as anticipated in 2010.



4.   Update on “Uniting Public Health” Conference– Lee Thielen and Averil Strand.


Averil Strand, the Community Health Services Director, distributed a handout from the “Uniting Public Health” conference, which summarized the state’s planning efforts and recommendations to meet the requirements of the 2008 Public Health Act.  She explained this is part of a 5-year process, which also includes adopting our own county health improvement plan in the next few years.  She described the concerns and different operational structures in different counties around the State, and the process to gather feedback on the recommendations before they go to the State Board of Health.  Ms. Strand described the anticipated timelines and shared the web address  where the report can be downloaded and where the public can make comments about the recommendations. (


Lee Thielen informed the Board that some of the feedback coming out of the breakout groups indicated that some participants wanted more detail in the draft plans, while others wanted the recommendations to be left more general. They also stated that the role of the local health agencies was more clearly articulated than the role of the state health department, and that it would be better to state goals in terms of the “public health system,” with both a local and a state component.  She explained a draft of the plan would be submitted to the State Board of Health early in November, which must create the process for the State Improvement Plan by December 31, but would not vote on it at that meeting. 


Ms. Thielen informed the Board that a meeting for County Commissioners and County Board of Health members will be held on November 30, 2009 at 1:00 pm (the day before the CCI [Colorado Counties, Inc – the state organization of County governments] meeting in Colorado Springs), and all the Board of Health members were invited. Dr. Richards asked if there were a system for training or mentoring counties that want to move forward with this effort but don’t know how, and allow them to learn from more experienced practitioners. Avie indicated that the meeting on the 30th might a good place to make such a suggestion. Ms. Macpherson informed the Board that the Department would reimburse the travel expenses to the members if they wanted to attend the meeting.


5.   Update on H1N1 Pandemic Flu 2009 – Dr. LeBailly


Dr. LeBailly distributed handouts of the Incident Command System structure to respond to the H1N1 Pandemic Flu outbreak. She described the complicated risk communication issues and the public’s confusion about the priority groups for H1N1 vaccine, seasonal flu vaccine, and antiviral medications, all of which are somewhat different.  She provided a handout explaining the priority groups for each.  She mentioned that current updates on vaccination clinics and other H1N1 information can be found on the website, which we maintain with the assistance of the Health District of Northern Larimer County.


Our department also has the responsibility to track the progress of the outbreak.  Dr. LeBailly distributed a handout with graphs and epidemiological statistics showing the marked recent increase in flu hospitalizations.  She explained that the hospitalized cases almost certainly represent an undercount of actual cases, because the rapid flu test does a poor job at detecting H1N1.  Dr. LeBailly explained that the department will be receiving data from the five sentinel provider practices as well as all three school systems. 


The department has distributed antiviral medicines to the four hospitals in the county as well as to the “safety-net” clinics to make sure that low-income persons who are at high risk can get treatment if they can’t afford to fill a commercial prescription. We’re also trying to enter into agreements with with local pharmacies to distribute antivirals on our behalf, because we can’t get the medicines to every provider office who may see a patient who can’t afford to fill a commercial prescription. We have a couple of small pharmacies who have signed our agreement, but we’re trying to get the area Wal-Marts to participate, too.  This will involve working on an agreement with Wal-Mart corporate headquarters, which is taking a lot of time to work out.


Dr. LeBailly updated the Board on the role of the Department in allocating H1N1 vaccine on a weekly basis to about 90 local health care providers in the county, as well as on the mass vaccination clinics to be offered through a joint effort of the Department and the Health District.  She also described our efforts to develop of an on-line registration system for vaccination clinic time slots to screen persons for eligibility, spread people out over time, and speed up the intake process of the clinic. The Health District has also created an online website to register volunteers for the mass vaccination clinics.


To facilitate communication among key agencies, a flow chart for distributing information to Public Information Officers of partner organizations was developed, which Ms. Macpherson distributed to the Board.


6.   Director’s Report


·  We learned that our Tobacco Education and  Prevention Grant would be cut from $325,000 to $160,000; these funds from tobacco tax revenues are being taken away to deal with the state fiscal crisis.  The losses are temporarily being picked up by the H1N1 grant dollars, as these professional health educators are needed to help with pandemic response efforts.


·  Using some economic stimulus money and some H1N1 money, a part-time nurse will be hired to provide vaccinations to household members of newborns to prevent the transmission of pertussis (whooping cough) and H1N1


·  The Colorado Association of Local Public Health Officials (CALPHO) received a grant from the Robert Wood Johnson Foundation to look at  how laws and policies work for or against the sharing of regional public health services.  CALPHO was one of 20 recipients out of 235 applicants.


·  Dr. LeBailly informed the Board the Policy Governance Report would be submitted to them at the December meeting since a November meeting would not be held due to the H1N1 activities.  Discussion of the Director’s evaluation process will also be discussed but the actual evaluation is unlikely to occur before January.  No salary increase will occur.


   7.    Next meeting – December 17, 2009

Due to the demands on staff time with H1N1 clinic in November and early December, there will not be a Board of Health meeting in November, and the Dec 10th meeting will be moved to December 17.


   8.     Adjourn

           Meeting was adjourned at 8:23 P.M.




_______________________________                       ____________________________________

Amy Smith, Recording Secretary                               Adrienne LeBailly, MD, Executive Secretary

Background Image: Cirque Meadows by Adam Johnson. All rights reserved.