LARIMER COUNTY BOARD OF HEALTH – December 11, 2008
The Larimer County Board of Health convened its regular meeting at the Larimer County Department of Health and Environment, 1525 Blue Spruce Drive, Fort Collins, CO.
MEMBERS PRESENT: Lee Thielen, M.P.A.
Judy Robinson, B.S.N., M.P.H.
N. Mark Richards, M.D., M.P.H., via telephone
Adrienne LeBailly, M.D., M.P.H.
OTHERS PRESENT: Marie Macpherson, Avie Strand, Gerald Blehm, Dave McCloskey, and Amy Smith
1. Individual Sewage Disposal System (ISDS)
Variance Hearing for 38 Misty
An ISDS regulation variance hearing was held at 6:30 P.M. with Board of Health members Lee Thielen and Judy Robinson present, and Dr. Mark Richards participated via telephone. Also present was Mr. Ali who requested the variances.
Dave McCloskey, Water Quality Supervisor for the Department, distributed handouts of regarding the four requested variances and presented the situation of Mr. Ali's property. Mr. McCloskey recommended the variance requests be approved with specific conditions:
1. Mr. Ali will have the relevant easement agreements signed by the property owners and recorded with the Larimer County Clerk and Recorder before applying for the vault permit.
2. Permit application for a vault must include model, size, contractor’s name, etc.
3. Install an audio and visual alarm when the vault reaches 75% of capacity to signal the need for pumping.
4. Install a switch in the vault to cut off operation of the well pump if the vault fills to the 90% of capacity level.
5. Mandate the electrical operator controlling the switch be kept locked or inaccessible to prevent tampering.
6. Grade the subdivision road to prevent overflow on to the neighbor’s property in the event of malfunction of the unit.
7. Stake off neighbor’s vault to make sure it is not damaged during the construction, installation or grading for this vault.
Mr. McCloskey informed the Board that all of Mr. Ali’s neighbors have been notified by certified mail soliciting any comments regarding the variances requested, and one neighbor did express his concerns about potential overflow issues. The department feels that the conditions above provide adequate protection to prevent any adverse impact on the neighbor’s property.
Mr. McCloskey recommended that the Board set a deadline for the process of completing the recording of the signed easements and securing a permit. With Mr. Ali's input, the Board set a deadline of 45 days. Gerald Blehm, Director of Environmental Health, said that the vault permit is good for 120 days, and assured Mr. Ali that weather conditions would be taken into consideration if there were issues with having an installation completed during the cold weather. The neighbor also wishes to be present when the work is being done, so Mr. Ali will try to schedule it with him as well, since all the residences in this subdivision are seasonal rather than occupied year-round.
*Motion was made to approve the requested variances requested, with the conditions above.
*Motion was unanimously approved.
The variance hearing was adjourned at 6:50 P.M.
2. Call to order
The regular Board of Health meeting was called to order at 7:16 P.M.
3. Approval of minutes
The minutes of the November 13, 2008 meeting were unanimously approved.
4. Review of evaluation tools for the Director – Lee Thielen and Board
of Health members.
Ms. Thielen distributed several different evaluation instruments/ tools, to the BOH members, as well as a list of criteria gleaned from all the instruments. She requested they choose their top six criteria choices and e-mail them to her within a couple days. Ms. Thielen agreed to e-mail the members of the Board the finalized tool with instructions to complete and return the evaluation to her. She stated the results would be available to discuss, in Executive Session, at the next BOH meeting.
5. Review of status of goals for 2008 – Dr. LeBailly, Division Directors, and BOH members.
Dr. LeBailly distributed a draft of the “Goals Draft Report for 2008.” She reviewed the report with the members of the Board and requested their comments on their section of the goals report. The Board all accepted the written draft of that section.
Dr. LeBailly discussed the 40th anniversary of the Department and reminded the members they were invited to the employee breakfast to be held January 7, 2009. She shared the progress/outcome of the Pan Flu exercise, reported that the Department implemented measures to reduce use of fund balance, completed the goal of adding to the previous prioritization tool, and balanced resources among core services priorities. Dr. LeBailly informed the Board the Department had convened an employee task force to develop suggestions for employee recognition. The Department will be discussing the feasibility of the suggestions with Human Resources, as well as gathering more information about how other departments recognize employees. We were also able to obtain vital statistics data broken out by specific community (Fort Collins, Loveland, etc). However only events (births, deaths, etc.) could be counted, rather than rates, since we don’t have the denominator data for each city’s population in non-census years.
Marie Macpherson, Director of Administrative Services, informed the Board that the Health Managers are in the process of creating a policy related to handling customer complaints which can be used Department-wide. She stated the Department does have a procedure that staff and supervisors use, but there is not a written policy in place at this time. Ms. Macpherson spoke of the progress made on documentation of the administrative functions and tasks of each position, as well as the cross-training of administrative employees and planned rotation of duties for appropriate task completion and back up.
Ms. Macpherson shared that she is evaluating and will be implementing the use of teleworking with some admin staff/functions, as appropriate, including testing to make sure that critical functions can be completed by employees at home or off-site. Ms. Thielen said this process would have good preparedness benefits.
Avie Strand, Community Health Services Director, shared with the Board the process of moving forward with providing post-partum visits after the decision by Medicaid to cut-off reimbursement for these services, and the slow process of getting Medicaid to find a way for us to bill for these services again in the future. Ms. Strand discussed the partnership and support of the Larimer County Human Services Department, which is also helping us to fund a new program, Nurturing II, which will provide care to high-risk women that do not qualify for other prenatal risk reduction programs.
Ms. Strand described the work the Community Health Services Division has done on strategic planning and indicated that most of needs identified have been in the area of communications, both internal and external. Ms. Strand shared information related to the County’s teen fertility rate and informed the Board that the Department has received additional dollars for the Family Planning program for supplies, paid for by donated funds. She also discussed the percentage of children receiving the recommended immunizations and work done to educate physician office staff about missed opportunities for giving vaccines.
Mr. Blehm updated the BOH members on what is being done in the area of information on uranium mining. The Department monitors the progress of this proposal through several websites, as well as through contact with the State Department. The BOH will be kept informed of any developments in this area. Mr. Blehm updated the status of monitoring for West Nile Virus by the department, as well as the work done with the city of Fort Collins over the past year to develop a process for responding to Health Department recommendations to do mosquito spraying. No spraying was recommended in 2008 due to the relatively low risk this past summer. He reported on the joint meeting of elected officials and staff from Larimer, Weld, and Boulder counties to explore the potential of working more closely together on this issue. Mr. Blehm offered to send to any interested Board members a CD containing the Powerpoint presentations from the regional meeting on West Nile Virus control options.
Mr. Blehm briefly reviewed the participation of the Environmental Health staff in the County’s Go Green Committee, and the progress of various sewer projects involving State Revolving fund money, including the lack of progress at Carter Lake Heights.
6. Brief reports from Health Care Summit on Dec 5, and Public Health Summit, Dec 1-2 – Lee Thielen and LCDHE managers
Ms. Thielen gave a brief report on the recent Health Care Summit sponsored by Senator Ken Salazar, with the keynote speech given by Tom Daschle, the nominated director of Health and Human Services under the new Obama administration. Dr. LeBailly provided a handout with web links to written and video recordings of the presentations. Lee Thielen expressed the need for public health organizations to help Mr. Daschle understand the mission and services of public health agencies. While he emphasized preventive services in his talk, he seemed to not clearly distinguish between healthcare and public health. She suggested that public health leaders participate in the www.change.gov internet site, which the Obama administration will be using to get input from people dealing with health care reform.
Ms. Thielen and LCDHE managers who attended the statewide Public Health Summit also informed the Board of the enthusiastic attendance at the meeting to look at implementing changes required by the passage of the Public Health Reorganization bill in the past legislative session. A handout with links to the presentations was given to the Board members. A report on outcomes of the meeting and next steps is planned soon for the State Board of Health, who are very enthusiastic about the process. She discussed the possibility holding regional meetings to discuss these issues. Dr. LeBailly commented on the potential usefulness of web tools to continue the discussion with statewide participation of anyone interested who can participate on-line.
7. Health Director’s Report – Dr. LeBailly
Dr. LeBailly distributed a summary handout about the 2008 West Nile Virus season.
Dr. LeBailly informed the members on the potential legislative bill to be introduced in 2009 that would increase the Food License Fees. The State is taking the lead on this, and after program cost information was gathered, came back with a proposed fee increase that covers much less than our costs. However it represents about a 60% increase in fees for restaurants, and a 50% increase for grocery stores in 2010 compared to current fees.
Dr. LeBailly updated the BOH members about revisions made to the draft Tobacco Policy after the BOH Resolution was presented the Commissioners. Commissioner Eubanks will bring the Policy to the Admin Matters meeting to be held on December 16, 2008.
Dr. LeBailly discussed the need for a new cashiering and clinic/EH transaction software system. After looking at systems available for purchase, how well they might meet our needs, and the ongoing costs, we feel it would be more cost-effective and efficient to develop our own through the open source system, which could be shared and adopted by other local health agencies. The goal is to have this completed by the end of 2009; this is a very ambitious schedule for development and implementation.
Dr. LeBailly informed the Board that the Commissioners have granted all employees two extra holidays this year, the day after Christmas and the day after New Years.
8. Next meeting January 22, 2009
9. Meeting was adjourned at 8:47 P.M.
Amy Smith, Recording Secretary Adrienne LeBailly, MD, Executive Secretary