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.                  

                                                                                    Judy Robinson, R.N., M.P.H. (by phone)



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


Staff:                                                                Avie Strand, Gerald Blehm, Marie Macpherson, Darlene Huang and Amanda Mozer


                                                                      Guests:                                                              Deirdre Sullivan


     1.   Call to order


            The Board of Health meeting was called to order at 7:15 PM.


    2.     Approval of the February 11, 2010, Board of Health meeting minutes


            The minutes of the February 11, 2010 meeting were unanimously approved.


3.   Coalition for Activity and Nutrition to Defeat Obesity (CanDO) Presentation  – Deirdre Sullivan and Darlene Huang


Ø Darlene Huang, Health Educator, and Deirdre Sullivan, Health Educator, presented CanDO and distributed to the Board some LiveWell Colorado packets containing CanDO overview and strategic plans, Center for Disease Control Morbidity and Mortality Weekly Report, “Recommended Community Strategies and Measurements to Prevent Obesity in the United States”, Robert Wood Johnson Foundation Active Living Research Brief, “The Surgeon General’s Vision for a Healthy and Fit Nation Fact Sheet” and “Physical Education in Schools, A Statement from the American Cancer Society, the American Diabetes Association, and the American Heart Association.”



·  Initiated by Poudre Valley Hospital (PVH) Foundation in 2004 as a community coalition

·  Received a LiveWell Fort Collins grant in 2007

o Over 60% of funding is committed to working in the school system

·  Expanded into Loveland during Fiscal Year 2008/2009

·  Mission : improve the health of the community by increasing physical activity and healthy eating to reduce and prevent obesity

·  Community systems that CanDO works in: childcare, schools, community gardens, worksites, active environments, breastfeeding, media and public awareness, healthy food purchases, older adults life and healthcare

·  CanDO committees in Fort Collins and Loveland: Youth Committee, Adult Committee (also known as Well City Task Force), Nutrition Network, and Steering Committee


Ø Obesity data from the Behavioral Risk Factor and Surveillance Survey (BRFSS)

·  Colorado

o Has one of the lowest but fastest growing obesity rates (17%) in the nation

o If obesity trends continue to rise at the level at which Colorado has risen, by 2020 76% of Coloradoans will be overweight or obese

·  Larimer County

o Obesity rates doubled between 1990 and 2000; raised from 7% to 14%

o Over half of adults and one in four kids are overweight or obese

o 1 in 5 adults eats 5 servings of fruits and vegetables a day


Ø CanDO’s efforts in Larimer County:

·  Worksite Wellness Programs - offering technical assistance to employers on providing access to physical activity and healthy eating in the workplace and in the home

o Fort Collins Well City initiative has more than 25 businesses participating

·  Community Gardens – providing mini-grants and technical assistance to community gardens

o Loveland High Plains Environmental Center and Fort Collins Spring Creek Garden have large community gardens; produce goes to support the Food Bank for distribution

·  Enhance Wellness - working with older adults on behavior change and lifestyle choices; involves interventions such as nutrition, fitness, social support and medication management

o CanDO will no longer fund this program as PVH is absorbing the program internally

·  Healthcare - working on interventions with patients, healthcare system changes and including motivational interviewing and weight management strategies in electronic health records

·   Active Communities - designing a community to support healthy eating and active living

o Loveland will be assembling a bike and pedestrian plan, piloting a downtown farmers market and updating their master plan to include health language

o Working with the City of Fort Collins on the North Fort Collins redevelopment plan

·  Faith Communities - developing a state-wide wellness resource kit for faith-based communities

·  Breastfeeding - started a breastfeeding peer counseling program at PVH

·  Community Engagement – maintaining and building community partnerships

·  Healthy Snacks for Kids - improving the kind of snacks the Food Bank provides

o Piloting a fresh fruits and vegetables distribution at two after-school sites this year

·  School Successes  

o Created a Physical Fitness and Nutrition Advisory Council and 22 Wellness Teams in Poudre School District (PSD) and hired an internal Wellness Coordinator within PSD and Thompson School District (TSD)


Ø Physical Education “PE for Me” Campaign

·  In 2009 CanDO decided to put efforts toward improving PE across PSD as: 1) they were continually hearing from schools and councils that PE is the area of most needed improvement and 2) research supports PE as it is foundational to physical activity in children


Ø National recommendations for the amount of PE kids should be getting is 150 minutes per week

·  PSD students are receiving about one third of this amount

o Due to funding and the misperception that more PE time decreases academic performance

·  Colorado is 1 out of 14 states without PE requirements for elementary students, 1 out of 17 states without them for middle school and 1 out of 8 states without them for high school


Ø Reasons to offer better and more PE in PSD

·  Reduce overweight and obesity and decrease their associated costs

o Colorado ’s Medicaid and Medicare expenditures to treat adult obesity were $870 million per year in 2003

o Colorado hospital costs from childhood obesity tripled between 1980 and 2000

o By 2018 Colorado’s annual expenditures will be $3.2 billion per year

·  Improve students’ academic performance and close the achievement and health gaps


Ø CanDO’s efforts in PSD and the community

·  Educating that the research shows PE maintains academic performance, can improve it and helps with health and disciplinary issues

·  Working on securing funding on the 2010 Mill Bond

o 10-year mark for PSD to ask voters to consider a levy on property taxes to support schools

o Board of Education is the final decision maker on what’s included on the 2010 Mill Bond

o CanDO is going to advocate for maintaining the current level of PE and if possible improving and increasing PE

o Examples of what the funding could be used for: PE teachers, PE equipment, extracurricular activities/intramurals, physical activity programs, PE coordinator for district

·  Learning from model communities such as Naperville, IL who has implemented daily PE and tied it to academic outcomes

·  Distributing postcards and having community members write on them why PE is important and mailing them to the Board of Education

o Ms. Huang distributed postcards to Board

·  Getting endorsements forms signed at community events

·  Giving community presentations to spread the word of the campaign

·  Working with organizations and boards to formally endorse the campaign

o Endorsers: Health District of Northern Larimer County, Family Medicine Center, Salud Family Center, Associates in Family Medicine, Children and Nature Network, among others

o CanDO would be honored to have the BOH formally endorse the “PE for Me” campaign and support their effort to get funding for PE on the Mill Bond in 2010


Ø Board offered to consider a CanDO PE campaign resolution from Ms. Huang and Mrs. Sullivan

·  Board will review CanDO resolution at April BOH meeting  


4.   Board of Health Election of Officials for 2010-2011 – Board Members


Ø Agreement made on a slate of nominees for elections

·  Dr. Mark Richards was nominated for President

·  Judy Robinson was nominated for Vice President

·  Board is open for other nominations

·  Elections will be formalized at April BOH meeting and elected President will take over meeting


5.   Board of Health Self-Evaluation – Board and staff members


Ø Teri Olson distributed and explained BOH self-evaluation results completed by Board Members and LCDHE Managers

·  Evaluation scale: 1 = very ineffective, 2 = somewhat ineffective, 3 = somewhat effective and 4 = very effective

·  Majority of scores were between 3 and 4


Ø LCDHE Mangers scored BOH lowest (3.25) in:

·  Board assumes responsibility to communicate with other community leaders about LCDHE   

·  Board provides a self evaluation

o Agreement made to conduct a self-evaluation annually


Ø Disparities and outliers

·  In the “Director/Board Communications” section, Board Members scored BOH an average of 4; LCDHE Managers scored BOH with an average of 3.85

·  In the “Education and Planning” section, Board Members scored BOH an average of 3.35; LCDHE Managers scored BOH an average of 3.75

·  In the “Goals” section, specifically, “Board reviews community health assessments to set priorities”, Board Members scored BOH an average of 2.8; LCDHE Managers scored BOH an average of 3.625


Ø Board requested clarification of their role in relation to a couple of questions on the self-evaluation tool


Ø Board’s next steps for self-evaluation tool:

·  Receive more training on Board governance and revisit evaluation tool  

·  Define the Boards’ appropriate responsibilities

·  Board is encouraged to visit for questions on mission, by-laws, county board policies, etc.

·  Discussion will be re-visited at May BOH meeting


6.   Legislative update


Ø Dr LeBailly provided an update on some legislative bills to the Board


Ø Bill to make birth and death certificates free for people who are of low income

·  There is no limit for how many certificates a department would have to give

·  LCDHE is concerned the bill will: 1) differentially effect different departments from a financial standpoint and 2) potentially lead to smaller counties not providing vital records services


Ø Bill that part of which says putting marijuana into any product does not constitute adulteration 

·  Would be regulated by the Department of Revenue

·  LCDHE does not support retail vendors putting medical marijuana in food because: 1) it is adulteration of food, 2) food used as a drug delivery device needs FDA licensing, and 3) it is more likely it will accidently be ingested by young children.


Ø Bill by Representative John Kefalas for a bicycle helmet law for children

·  Public Health Directors of Colorado (PHDOC) support the bill

·  Currently there is no disincentive to not comply with the law (no penalties or fines)


Ø Primary seat belt law

·  Bill has been changed to the extent that it no longer applies to primary seat belt use enforcement but it does strengthen some child restraint requirements

·  PHDC is still supporting bill


Ø Bill that would allow counties to do a permissive needle exchange program, if they wanted to

·  Would be regulated by BOH

·  Has to be offered by or contracted by the Health Department to another community agency


Ø Dr. LeBailly will check on any other bills that Board Members are interested in


7.   Director’s Report – Dr. LeBailly


Ø  Board recognized their Director, Dr. LeBailly, for being the recipient of the McKee Community Health Award and for her department’s and partner’s response to the H1N1 flu outbreak

·  Newspaper articles, editorial and soapbox published in Coloradoan, Loveland Connection, and Loveland Reporter Herald on H1N1 response were distributed to Board

·  LCDHE has a poster session at the National Immunizations Conference and submitted an abstract for the American Public Health Association Meeting on Larimer County H1N1 clinics


Ø  Dr. LeBailly presented LCDHE new grant projects to Board

·  $60,000 for WIC breastfeeding peer counseling

o Hiring two hourly peer counselors and some lactation specialist consultation time

·  $4000 from two sources to improve outreach to Latino/a youth to prevent teenage pregnancy

o Hiring bilingual department specialists for interpretation and purchasing materials

·  $5000 partnership for LCDHE and CSU to reduce obesity and diabetes among Hispanic adults

·  Remaining H1N1 money will be used for H1N1 communications assessment and H1N1 IT system conversions

o Assessing how well LCDHE communicated to the Latino population during H1N1 efforts

o Rewriting LCDHE’s clinic registration system so that any local health department can use it as an open source application


Ø  Dr. LeBailly distributed a summary of some 2010 Ballot Initiatives to Board

·  There are several initiatives to reduce certain taxes and fees, which would have a significant effect on district, local, and State governments

·  Board Members are encouraged to review summary for possible future discussion


Ø  Dr. LeBailly distributed “2009 December Larimer County Employee Survey Executive Summary” and presented survey results to Board

·  Larimer County surveyed employees to asses how they felt about where they work

o Survey had an 80% response rate

·  LCDHE scored better than average on 75% of the issues surveyed

·  LCDHE scored low on: 1) “My department has the tools and equipment we need to provide the services our customers expect from us” and 2) “My department finds new ways of delivering old services better or provides new services, rather than doing things ‘just because we’ve always done them that way

·  Majority of employees thought working for Larimer County was a positive experience   

·  Survey will be a future LCDHE Health Managers meeting discussion


Ø  Dr. LeBailly presented Department H1N1 Celebration and distributed “Big Pig Gig” flyers to Board

·  Scheduled for March 27th from 4 - 8 PM at the Drake Center

·  Board Members are invited and welcomed to bring family members

o Please RSVP at


Ø  LCDHE has solicitations out for the Joseph Jabaily Award (closes March 19th)

·  Will be an agenda item for April BOH meeting because award is presented in May or June

·  Dr. LeBailly will email the nominations to Board Members prior to the April BOH meeting


Ø  Marie Macpherson, Administrative Services Director, distributed “International Travel Services and Immunizations” document and “Yellow Fever Vaccine Providers” chart and presented fee increase starting April 1st to Board

·  LCDHE calculates immunization fees by looking at actual cost of the vaccine and adding $20 (covers nurses time, supplies and cost of handling, storing and ordering vaccine)

·  Counseling visits have been raised from $40 to $55

·  These increases are being enacted because travel fees are not fully covering our clinic costs this year


8.   Next meeting –  April 8, 2010

Ø  Agenda:

·  Elections

·  CanDO PE campaign resolution

·  Joseph Jabaily Award

·  ISDS (septic permits) fee increase



The Board of Health Meeting was adjourned at 9:10 PM.













_______________________________                 ____________________________________

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

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