Cirque Meadows by Adam Johnson




The Larimer County Board of Health (BOH) convened its regular meeting at 7:00 PM at the Larimer County Department of Health and Environment (LCDHE), 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. (by phone)

                                                                                    Judy R. Robinson, B.S.N., M. P.H.

                                                                                    Steve Yurash


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


Staff:                                                                Gerald Blehm, Brenda Graves, Amy Smith, and Amanda Mozer


                                                                      Guests:                                                              Victoria Herazo


     1.   Call to order


            The Board of Health meeting was called to order at 7:02 PM.


    2.     Approval of the January 14, 2010, Board of Health meeting minutes


            The minutes of the January 14, 2010 meeting were unanimously approved.


3.   Update on the Nurse Family Partnership (NFP) Program – Brenda Graves, RN


Ø Brenda Graves, Nursing Supervisor, presented the NFP program and distributed NFP pamphlets to Board Members


Ø NFP program

·  A nationwide nurse home-visitation program that serves first time moms who are low income

o Client is followed throughout pregnancy and until the child is 2 years old

o Nurse follows a prescribed visit schedule (maximum number of home visiting hours a client can have over the course of the program is 64)

·  Goals: improved pregnancy outcome, improved child health and development and helping the mother develop her own self-sufficiency

·  In addition to the health outcomes, NFP has been shown to be an effective, evidence-based program for preventing crime in a community and keeping both parents and children from correctional facilities, based on long-term follow-up of these families.


Ø Larimer County has been a contracted NFP site for 10 years; began in year 2000

·  Annual budget approximately $950,000-$988,000; funded through tobacco settlement money and approximately $108,000 is Medicaid revenue

·  200 family contracted site; approximately 156 clients are currently enrolled

·  230 clients have graduated from program

·  Staff consists of nine BSN-prepared nurses and one Spanish interpreter

·  Statistics of clients as of December 2009

o Median age is 19

o 91% of babies were born full term

o 89% of mothers initiate breastfeeding; by 12 months 20% of moms are still breastfeeding

o 91% of babies are born at a healthy weight (above 5.5 pounds)

o Upon entry to the program, 50% of moms do not have a high school diploma; by completion of program, 25% of moms get a GED or a high school diploma and 19% of moms go on to higher education

o 84% are unmarried

o 71% are on Medicaid

o Ethnic composition: 25% Hispanic, 1% African-American, 63% Non-Hispanic/White, 7.5% Multiracial, 1.1% Asian, 1.1% Native American, 5% monolingual Spanish

·  Receives referrals from: LCDHE’s Presumptive Eligibility class and WIC program, community healthcare providers, Teen Parent Program, social services and word-of-mouth

o If NFP is unable to see a client they refer client over to other LCDHE Maternal Services Programs (MSP)


Ø Unfortunately some pregnant women who are of high-risk do not meet the eligibility requirements for NFP.  They are referred to other maternal service programs in the department, but these programs can’t provide the same length and intensity of services to the family.


Ø If Board Members are interested in participating in a NFP home visit, please contact Ms. Graves


4.   Discussion and Approval of 2010 BOH and Dept. Goals – Board Members


Ø Dr. LeBailly distributed “Draft 2010 Goals to be reviewed and approved by Board Members


Ø Revisions made to Board of Health Goals:

·  On second bullet, changed “Continue to do a self-evaluation…” to “Complete a 2010 self-evaluation…”

·  In accordance with the third bullet, suggestion made for Board Members to complete an education session and review responsibilities at one of the BOH meetings


Ø Revisions made to Department Goals:

·  On last bullet, changed “…public health improving planning process.” to “…public health improvement planning process.”


Ø Revisions made to Community Health Services Goals:

·  On first bullet, changed “Miramar” to “Myanmar”


Ø The “Draft 2010 Goals” were unanimously approved and re-named to “Final 2010 Goals”


Ø Self-evaluation tool discussion

·  Agreement to use the same anonymous evaluation tool as used in the past

·  Agreement to solicit feedback from senior LCDHE managers

·  Dr. LeBailly will send an email to senior LCDHE managers and BOH members reminding them to complete the evaluation tool; the email will include the evaluation tool

·  Completed evaluation will be returned to Teri by March 1st via email or mail


5.   Update of County Health Rankings to be release on February 17, 2010 – Dr. LeBailly


Ø Dr. LeBailly presented part of the County Health Rankings results and distributed “2010 County Health Rankings: Measures, Data Sources and Years of Data”, “2008 County Health Snapshot Milwaukee City” and “The 2009 Colorado Health Report Card” handouts to Board Members


Ø County Health Rankings  

·  Funded by the Robert Wood Johnson Foundation, which has done a similar project in Wisconsin with the University of Wisconsin Population Health Institute for past 7 years.

·  Provides a measure of overall health in each US county, a snapshot of county’s overall health, health factors and health status and evaluates how your county’s health compares to other counties in your own state

·  County’s are ranked on health outcomes (based on an equal weighting of mortality and morbidity) and health factors (based on weighted scores of health behaviors, clinical care, socioeconomic factors and physical environment)

o Different components are measured within each health factor

o Health behaviors focus areas are: tobacco, diet and exercise, alcohol use and high risk sexual behavior

o Clinical care focus areas are: access to care and quality of care

o Socioeconomic factors focus areas are: education, employment, income, family and social support and community safety

o Physical environment focus areas are: air quality and built environment

·  Data sources used: Vital statistics data, STD rates, Behavior Risk Factor Surveillance Survey (BRFSS) data, Dartmouth Atlas of Healthcare, Medicaid claims data, Census 2000 and the American Community Survey (ACS) 2005-2007, among others.


Ø Larimer County’s rankings out of 56 counties included in the Colorado report.

·  Ranked 8th overall in health outcomes  (6th in mortality and 13th in morbidity)

·  Ranked 8th overall in health factors (8th in health behaviors, 7th in clinical care, 10th in socioeconomic factors and 47th in physical environment)

·  Rankings likely reflect the income and educational level of the residents of the counties

·  Worth looking at as we develop our county health improvement plan.


6.   Early returns of H1N1 clinic survey of participants – Dr. LeBailly


Ø Dr. LeBailly presented H1N1 clinic survey results and distributed “Summarized Data Report - Survey 2009/2010 H1N1 Flu Clinics Client Survey” and participant’s narrative responses to “issues/problems”, “what worked well” and “global open-ended comments” to Board Members


Ø As of now, 1,854 participants responded to survey out of 6,300

·  Survey solicited feedback on registration, location, wait time, if staff and nurses were friendly and knowledgeable, if their children under 10 were reminded of second H1N1 dose, etc.  

·  60% of those surveyed reported they were vaccinated in 10 minutes or less and 94% of were vaccinated in 20 minutes or less

·  Almost 80% of those surveyed who had children under 10 received their second H1N1 dose, much higher than national figures

·   Some survey responders are unaware that their children under 10 who need a second H1N1 dose can attend LCDHE’s walk-in clinic; some also have a misconception that after 28 days, it’s too late for children under 10 to receive their second H1N1 dose


7.   Director’s Report – Dr. LeBailly


Ø Dr. LeBailly encouraged Board Members to read the PowerPoint presentation on Colorado ballot initiatives she sent via email


Ø Agreement made to serve Subway sandwiches and/or salads for BOH meetings

·  Fruit and water is also favored by Board Members


8.   Next meeting –  March 11, 2010


Ø Agenda items:

·  Elections


9.   Adjourn

The Board of Health Meeting was adjourned at 8:40 PM.













_______________________________                 ____________________________________

Amanda Mozer, Recording Secretary                    Adrienne LeBailly, MD, Executive Secretary


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