LARIMER COUNTY BOARD OF HEALTH – December 17, 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: Teri Olson, R.N., M.S.N.
Dr. Mark Richards, M.D., M.P.H.
Lee Thielen, M.P.H.
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 7:08 P.M.
2. Approval of minutes of the October 8, 2009 Board of Health Meeting.
The minutes of the October 8, 2009 meeting were unanimously approved.
3. Update on H1N1 Pandemic Flu 2009 – Dr. LeBailly
Teri Olson and Dr. Mark Richards described their positive impressions of the Department’s performance at the H1N1 clinics, especially the organization, careful planning, and highly successful collaboration with the Health District.
Dr. LeBailly distributed some epidemiologic graphs showing the course of the outbreak over time, and the distribution of cases by age, gender, and location. The H1N1 pandemic has so far been much less severe than what communities were planning for in the event the H5N1 flu had developed the ability to spread easily between people. However it has been more severe than seasonal flu outbreaks for people under the age of 65, with higher rates of hospitalization than in recent seasonal flu outbreaks for those between the ages of 5 and 64 (about 4-5 times higher). Three deaths have occurred in Larimer County, all in persons in their 50’s.
Dr. LeBailly informed the Board that there are very few positive H1N1 cases right now, and the peak of the fall wave of the flu was in October. However, there may be a winter-spring wave, so this is the perfect time to get vaccinated. She gave the Board members a newspaper insert developed locally which contained information about H1N1 disease, prevention, priority groups for antiviral medicines and vaccine, and home care, in addition to clinics. She reported success, after months of effort, in implementing a contract with Wal-Mart pharmacies to distribute antiviral medicines to the low income population to be in effect the first week of January 2010.
Dr. LeBailly also mentioned that the department had submitted an abstract to the National Immunization conference in November to describe the various information system tools we cobbled together to make possible both the successful planning and the implementation of our “no-wait” mass vaccination clinics.
4. Update on the Nov. 30 meeting for Commissioners and BOH members on the State Public Health Plan and Public Health Reorganization Law – Lee Thielen
Lee Thielen distributed a handout from the meeting, which was attended by commissioners, local Board of Health members, administrators and staff. After a general introduction explaining the new law and the process of the State Plan, people broke out into regional areas to discuss core public health services, based on a list of activities that are generally either required by law or part of the 10 essential public health services. To the surprise of many, there was opposition to the core services list from a couple of regions during the small-group discussions, with a few people wanting to repeal the law passed in 2008 and insisting the state slow down in this process. While the state plan will be implemented, the process of the state Board of Health putting the core services into regulation will be slowed down to try to address the concerns from the areas that expressed objections.
Ms. Thielen also shared a timetable for the various pieces of the implementation, and suggested that we pay attention to the “Funding and Finance” discussions, as the state will be taking four funding streams, each with a different funding formula, and combining them into one formula. The local public health improvement plans will probably receive some funding support from the Preventive Health Services Block grant, assisting about 10 counties per year in this effort. The requirements of the new Colorado state law and proposed core services closely approximates what will be required for national public health accreditation, which will likely become obligatory for local health agencies within the next 10 years, so this law will help position Colorado’s public health agencies to be ready for that process.
5. Policy Governance Report to the Board of Health for 2009 – Dr. LeBailly
Dr. LeBailly distributed and reviewed a copy of the Governance Policy report for 2009, and reported compliance with Board of Health and county policies with a couple minor exceptions. A statement about the BCC’s approval, at the department’s suggestion, of a policy to advance sick leave during the H1N1 flu pandemic will be added to the document.
During the review of the section on financial management, Lee mentioned some efforts that might help make up for the loss of tobacco funding. The Colorado Health Foundation has been asked if they would consider funding projects that tried to integrate chronic disease prevention efforts at the local level, which could include tobacco, but also included obesity, cardiovascular disease, etc. There will be a follow-up meeting tomorrow.
During the review of the section on compliance with county policies, Dr. LeBailly mentioned a draft BCC policy to have the meeting minutes of all county Boards posted on the web within 30 days of the meeting; the policy is not finalized but this will be quite difficult to do since the minutes can’t be approved until the next meeting, which isn’t always within 30 days of the prior meeting. We suggested that agendas are at least as important to the public interested in an issue as minutes, and may in fact be more important if someone wants to give input before a Board decision is made. It’s likely that posting agendas will also be required when the new policy is finalized. We do post our agendas and minutes on the web, but our minutes are not always posted within the proposed time limit.
6. Process for Director’s Evaluation – Dr. LeBailly
Last year, the evaluation form was e-mailed to all Board members, who completed it and sent them by email to the President, who combined all the scores for the review. It was suggested that that occur again this year, and folks e-mail the evaluation form to Teri Olson. The members of the Board agreed on the same evaluation process for the Director’s evaluation should take place as last year: scale range will be 1-5: 5=best. Information will be sent to the members of the Board who were not present at this evening’s meeting. The feedback will be sent back to Ms. Olson by January 11, 2010 so she can compile the results to share at the meeting on January 14.
7. Director’s Report
· Dr. LeBailly distributed handouts listing the indicators to be used in a Robert Wood Johnson foundation report to be released soon [ Feb 2010] giving the County Health rankings within each state, for all counties in the US. Ms. Thielen suggested this to be a topic for the yearly Public Health summer meeting: “How Healthy is my County”.
· Dr. LeBailly informed the members of a potential funding opportunity known as the “Beacon Community Cooperative Agreement” funded with ARRA (Recovery) funds to increase the adoption of Electronic Health Records and facilitate the creation of electronic health information exchange systems to improve quality of care, reduce costs, and improve population health. It’s a 3-yr grant that could bring $10-20 million of health information system improvements to our counties, and would probably be a joint proposal including Larimer and Weld Counties if it moves forward. A meeting to discuss the possibility was held earlier this week and included the Health District and director of the Northern Colorado Health Alliance. She said that a decision has not been made yet, and we have concerns about the staff time available to write a proposal and to implement such a project.
· Averil Strand updated the Board on the Cocooning Project grant we have received, to provide pertussis vaccinations to family members in households with newborns. We’re combining this effort with similar work to get these household members immunized against H1N1 as well, funded through our H1N1 grant.
8. Next meeting – January 14, 2010
Meeting was adjourned at 8:48 P.M.
Amy Smith, Recording Secretary Adrienne LeBailly, MD, Executive Secretary