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LARIMER COUNTY BOARD OF HEALTH – August 25, 2010
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: Dr. Mark Richards, M.D., M.P.H.
Lee Thielen, M.P.A.
Judy Robinson, RN, MPH
Steve Yurash (by phone)
C.J. McKinney, M.A.
Executive Secretary: Adrienne LeBailly, M.D., M.P.H.
Staff: Avie Strand, Jerry Blehm, Ed Schemm, Jim Devore, Marie Macpherson, Bruce Peters, and Amanda Mozer
1. Call to order
The Board of Health meeting was called to order at 7:09 PM.
2. Approval of the June 10, 2010, Board of Health meeting minutes
The minutes of the June 10, 2010 meeting were unanimously approved.
3. Individual Sewage Disposal System Variance Request – Staff and Board Members
Ř Ed Schemm, Assistant Director of Environmental Health, distributed photos and presented information about a variance request on a vaulted privy to Board
· In August 2008 the BOH approved several variances for a cabin owner on Thompson River to put in a new vault to replace an old vault privy next to the Big Thompson River.
· Owner is now requesting the empty concrete be left in place as it protects river bank and the cabin when the river is running high
· Department recommends approving owner’s request providing the outhouse building be removed and the empty concrete vault be filled with dirt
· An inspection will be made to ensure outhouse is removed and the vault has been filled; cabin owner is agreeable to inspection
*MOTION was made to approve the requested variances, with the conditions above.
*MOTION was unanimously approved.
4. Draft Budget Proposal for 2011 – Macpherson, LeBailly, Board members
Ř Dr. LeBailly distributed and explained Health and Well-Being Strategy Map to Board
· All of LCDHE’s services were placed into one of 5 service areas and their administrative costs were spread across those 5 service areas
· Board of County Commissioners (BCC) ranked 4 of LCDHE’s service areas as high priority (received a 2% reduction) and ranked the Maternal and Child Health services [now more accurately called “Protecting the Health of High-Risk Women, Infants, and Children] as low priority (received a 6% reduction)
· BCC understands the BOH has the ability to make different allocation decisions for LCDHE within the overall base budget allocated to the department.
Ř Marie Macpherson, Director of Administrative Services, provided a synopsis of LCDHE’s 2009 and 2010 budget to Board
· LCDHE anticipated using $97,000 of fund balance in 2009 but with the help of H1N1 and Immunization money and savings from H1N1, LCDHE was able to add $70,365 to fund balance and entered 2010 without using any fund balance
· LCDHE originally anticipated using $405,000 of fund balance in 2010; however in our revised 2010 budget, LCDHE will use only $187,000 of fund balance.
· LCDHE’s total expenses for 2010 will be approximately $9 million dollars
· LCDHE’s fund balance for 2010 is approximately $1.9 million dollars
· The department is required, by BCC and BOH policy, to maintain at least 10% of budget in reserves, and we are within those guidelines.
Ř Ms. Macpherson distributed "Draft Budget Proposal for 2011” and presented Budget A to Board
· LCDHE’s reduction in county tax allocation for the base budget in 2011 is $86,112
· BCC, County Budget Director and County Manager understand the BOH determines how LCDHE manages their tax dollar reductions
· LCDHE’s total expenses for 2011 are approximately $8.7 million dollars
· Due to funding reductions caused by the state fiscal crisis, in 2010 LCDHE lost several grants and projects: a Health Disparities grant, two tobacco project grants, and two projects supported by federal Temporary Aid to Needy Families (TANF) dollars—an immunization project and a pregnancy prevention project.
· LCDHE’s proposed 2011 budget includes a use of approximately $510,000 in fund balance; although it’s likely we will not use this much fund balance. Even if the budget fund balance amount were expended, LCDHE would still have the required reserves
· The Department will be holding planning sessions with LCDHE staff over the next 6 months to strategically look at necessary changes to increase department revenues and decrease expenses, in order to reduce use of fund balance in coming years. These recommendations will be presented to the Board by May 2011; the Board agreed to this arrangement
· Ms. Macpherson will send BOH finalized budget
*MOTION was made to approve the proposed budget A in concept.
*MOTION was unanimously approved.
Ř Ms. Macpherson presented Budget B to Board
· County is requiring departments complete a second budget that reflects the effects of passing amendments 60, 61 and proposition 101 (i.e. reduces LCDHE’s tax dollars by $392,000) and show how the reductions in funding translate into services lost
· Budget B’s reductions are based on how the County prioritized service areas (highest priority receives a 10% reduction, middle priority receives a 20% reduction and lowest priority receives a 25% reduction)
· Dr. LeBailly distributed “Potential Impacts on LCDHE Budget” handout, “Estimated Larimer County Impact” PowerPoint, “How Proposition 101 Would Affect Larimer County” handout. She asked if the board was interested in passing a resolution regarding amendments 60,61 and proposition 101
· BOH reviewed a composite of other similar resolutions and approved a revised resolution and will submit a soapbox to local newspapers opposing amendments 60, 61 and proposition 101
· Dr. LeBailly will send BOH final version resolution with the changes they made
5. Communicable Disease Update
Ř Dr. LeBailly distributed Colorado Department of Public Health and Environment (CDPHE) raw milk fact sheet and Food Safety article to Board
· At Statewide Local Health Directors meeting LCDHE learned it’s unclear whether that a raw milk bill will be introduced in this coming legislative session.
Ř Larimer County had another meningococcal disease case
· Child of one of hockey players had meningococcal infection, but was not severely ill, and was hospitalized primarily to administer intravenous antibiotics. Child went home and is doing well.
· State confirmed it was the same strain that caused the Larimer County meningococcal outbreak
· LCDHE will offer meningococcal vaccine to children of FCTA hockey players in C League, aged 2-10 years old at no cost (older children have already been offered vaccine)
Ř Vaccination/Flu season for 2010-2011 has begun
· CDC is recommending anyone over 6 months old be vaccinated
· An extra-strength flu vaccine will be available for people over 65 years old, however not all providers will carry it. (LCDHE will not, but RVNA plans to offer it)
Ř West Nile Virus cases have been less than anticipated so far this year
· Positive traps have been found in Fort Collins and Loveland
· Larimer County has had two West Nile fevers reported; no neuroinvasive cases reported yet
6. Directors report - Dr. LeBailly
Ř Dr. LeBailly presented the Model Practice Award LCDHE received from National Association of City and County Health Officials (NACCHO) for their H1N1 vaccination registration system
Ř Dr. LeBailly distributed National Association of Local Boards of Health (NALBOH) Newsbrief magazines to Board
· NALBOH’s election has two people running for President Elect; submissions are due 10/18/10
· BOH would like Dr. LeBailly to vote on the Board Members behalf
Ř Under Colorado law, every July Health Departments have to update their BOH on the status of their Emergency Operations Plan
· Dr. LeBailly distributed state regulation and updated parts of LCDHE’s Emergency Operations Plan to Board
· LCDHE is submitting their Project Public Health Ready plan in August, and the plan will reviewed by NACCHO in March
Ř Poudre Valley Health System (PVHS), Banner Health and other big practices including LCDHE met with Colorado Regional Health Information Organization (CO-RHIO)
· CO-RHIO is trying to facilitate electronic health record systems by local providers, which can feed data into a state health information exchange
· Colorado Springs, Boulder, Denver and possibly Larimer/Weld area will be pilot communities
· There might be some initial upfront cost for pilot agencies to participate in a state Health Information Exchange; some of those initial start-up costs could be covered by grant funds from the Colorado Health Foundation
· LCDHE Family Planning services may be able to qualify under the “meaningful use” rules for an electronic health record and be eligible for Medicaid incentives through the Federal government in coming years
7. Next meeting September/October dates to be reviewed
Ř Dr. Mark Richards will attend the Larimer County budget hearing on September 30th from 2-3 PM
Ř Next BOH meeting will be on October 14; The BOH will not meet in September.
The Board of Health meeting was adjourned at 9:14 PM.
Amanda Mozer, Recording Secretary Adrienne LeBailly, MD, Executive Secretary