LARIMER COUNTY BOARD OF HEALTH – April 10, 2008
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: Lee Thielen, M.P.A
Teri Olson, R.N., M.S.N.
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, Bruce Peters, Ed Schemm,
Averil Strand, Warrenetta Underwood, and Amy
Commissioner Kathay Rennels via telephone
1. Call to order
Meeting was called to order at 7:08 PM
2. Approval of the Minutes of March 13, 2008
Minutes of March 13, 2008 were unanimously approved
3. Reproductive Health Program update – Nettie Underwood
Dr. LeBailly introduced Nettie Underwood, the Assistant Director of Community Health services. Ms. Underwood described the Family Planning (Title X) program, which offers a broad range of contraceptive methods and services, as well as natural family planning and fertility services. She informed them that teens under 18 can receive services according to the Colorado Statutes, though the Health Department does encourage parental involvement. Ms. Underwood shared with the BOH members that over 4,400 clients were served in our family planning clinic, out of 51,000 clients served throughout the state of Colorado in 2007.
Ms. Underwood reported on the success of our partnership with the Larimer County Human Services department, which supports us in a project to reduce out-of-wedlock pregnancies. Their funding has helped us cover some very large increases in contraceptives costs. It has also helped up cover the cost of outreach to low-income women and high-risk teens.
Ms. Underwood explained that the Health Department receives federal Title X funds through the State of Colorado and that we have been asked to participate in the federal audit that will be done this fall. The feedback from the state consultants has been very positive concerning our family planning program.
Ms. Underwood explained that in addition to Family Planning clients, we also treat patients with sexually transmitted diseases (STDs) in the Reproductive Clinic. Our Department is required to report all STD patients that we see to the State Health Department, but we do not receive reports from the state on STD patients seen by private providers in Larimer County. The state currently follows up on some STD cases—those with HIV, syphilis, and rectal/oral gonorrhea—but not on cases of chlamydia or genital gonorrhea. This has led to some patients or their partners falling through the cracks, and has impaired our ability to monitor increases in STD rates in the county. Ms. Underwood also explained the STD disease control specialist who used to perform these services for the northeastern area of the state was reassigned to the Denver-metro area, which has resulted in fewer resources to be available for prevention and follow-up in Weld and Larimer Counties.
Dr LeBailly reported that recent statistics on Larimer STDs show gonorrhea, syphilis, and chlamydia are on the rise. The state has integrated their STD and HIV programs and, because of this, their data system requires a very high level of security, and they have not allowed our local Health Department to gain access to it. The state does not do follow-up or partner notification for numerous patients, nor do they give us the information that would allow us to do the follow-up. Since we have not performed this function in over a decade, we would have to discuss whether we would take on this responsibility, as we have no additional resources to do so. Dr. Richards expressed his serious concern that we cannot let the critical function of STD follow-up and partner notification remain undone, both to find unrecognized cases and prevent new infections.
Dr. LeBailly will be meeting with the head of the head of the State STD program on May 9, 2008 to discuss the situation and try to come up with options to improve the situation and will keep the board informed about the outcome.
4. Increase in Septic Permit Fees – Marie Macpherson
Marie Macpherson distributed a spreadsheet (attached on last page) showing Health Department costs for issuing septic permits with two options for the BOH to consider for increasing revenues to come closer to cost recovery for the program. Ms. Macpherson reviewed the minutes from the Board of Health meeting held on January 18, 2007, which stated the motion had been unanimously approved to increase the fees for new residential septic permits to current levels, with the understanding that Septic Permit Fees would be revisited in one year with the goal of full cost recovery over a short time period.
Bruce Peters explained the two options for potential increases included in the spreadsheet based on changes made in the program over the past year. Ed Schemm explained that the total costs include a review of the design of the septic, a field visit, issuance of the permit, at least one final inspection (sometimes two, depending on the system), plus additional overhead expenses such as administrative costs. Mr. Peters also distributed a comparison of septic permit fees for 2007/ 2008 for some other Front Range counties.
Discussion ensued about the amount of septic permitting activity expected in the upcoming year, the cost per unit for permits, the reorganization of the program done in 2007 to deal with reduced demand for permits, and the reason that repair permits are not recommended to increase.
Commissioner Rennels shared her concerns about the higher fee increase option (Option B) because of the good support from the septic installers with the increase implemented last year.
There was discussion of which option would be the most feasible in view of the need to decrease fund balance usage, the county budget situation, the economy, and the effects on the community.
Motion was made to implement Option A for 2008’s septic permit fees.
Motion was unanimously approved.
The BOH members suggested to set the goal for the effective date to be May 1, 2008; with the knowledge of the permits that are already in process will be honored.
5. Review of Board of Health Evaluation Tools – Lee Thielen
Ms. Thielen shared several examples of a tool for evaluating Board functions that the Board of Health might want to consider using. The members selected two forms to try to combine into a single tool. Ms. Thielen agreed to create a draft form to bring back to the board for further review.
6. Discussion of 2008 Jabaily Award nominations
The BOH members reviewed the nominations presented. After discussing the merits of each nominee, the Board members were ready to make their decision.
Motion was made and unanimously accepted to present the award to Dr. Jane Higgins.
Dr. Higgins will be invited to the next BOH meeting to receive the Joe Jabaily award.
7. Director’s Report – Adrienne LeBailly, MD
Dr. LeBailly asked Ms. Thielen if she would review the latest legislation as she may have more recent knowledge of the current bills. Ms. Thielen shared information about Senate bill 194, the Public Health Reorganization bill. Some industry lobbyists are concerned that local agencies would have more authority than they do now. But she stated the bill is not about authority, it’s actually about changing structure and planning. She added that this bill would go to the floor of the Senate soon.
There was discussion of a bill making
adolescent possession of tobacco a crime. Many public health advocates tend
not to support the idea that such behavior should be criminalized. The bill
was added on to another bill after it went through all the
committees. There may be expectations that Public Health agencies will be the enforcers of this bill.
Dr. LeBailly distributed a report from the Trust for America’s Health which contained information about how federal health dollars are allocated in Colorado.
Dr. LeBailly informed the BOH that the Pandemic Flu tabletop exercise will take place on May 2, 2008; approximately 60 have confirmed. Commissioner Rennels offered to attend if there is space available.
Dr. LeBailly distributed the new brochures of Larimer County Health and Environment.
8. The next Board of Health meeting will be held on May 8, 2008 [subsequently moved to June 12.]
9. The meeting was adjourned at 9:05 PM.
Amy Smith, Recording Secretary Adrienne LeBailly, MD, Executive Secretary