LARIMER COUNTY BOARD OF HEALTH – July 18, 2013

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:                     C.J. McKinney, Ph.D.

                                                Steve Yurash

                                                Jana West Kowalski

 

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

Staff:                                         Marie Macpherson, Averil Strand

 

Public:                                       Lorie Daigle and Craig Chapin from Northern CO AIDS Project

                                     

1.   Call to order – CJ McKinney, Board president - The Board of Health meeting was called to order at 7:00 PM. 

2.   Introduction of new Board of Health Member -  Janna West Kowalski was introduced and welcomed as a new Board of Health member.   Ms. Kowalski currently is employed at the Center for Public Health Practice at the School of Public Health.  Ms. Kowalski said that she is excited to serve on the Board.

 

3.   Approval of minutes of June 13, 2013 meeting – Minutes of the June 13, 2013 meeting were unanimously approved.

4.   NCAP report and discussion of Syringe Exchange program for 2013-2014 – Lori Daigle, and Craig Chapin from the  Northern Colorado Health Network (NCAP) presented the 2013 second quarter report of the Syringe Exchange Program (SEP) and reviewed the data with the BOH.  The ratio of returned syringes compared to the number given out was  at 66% for the 2nd quarter.  However, it rose to 77% since the recent implementation of  Senate Bill 208 on May 10, 2013.  This new law exempts current SEP participants from drug paraphernalia possession charges.  Research has indicated that SEPs in jurisdictions that have had a paraphernalia law in place can reach a rate of syringe return around 92%.  This is the level that NCAP hopes to achieve once they have made their clients aware of the new law.  Ms. Daigle is working to create a card to show that a person is an active participant in the SEP should they be stopped by police.  To date, there have been no complaints about the operation of the SEP from neighbors, businesses, law enforcement, or anyone else.  Mr. Chapin reported that the number of bleach kits distributed has been reduced because clients are able to get clean needles.  The number of syringes participants request per visit has also decreased, likely because they are referring others to get involved in the SEP.  There were about 200 SEP visits this past quarter. 


There was discussion among the BOH members that they would like NCAP to gather data and report both on the number of  visits and of unduplicated clients, as well as demographics of participants based on zip codes.  Dr. LeBailly asked if the BOH would like to see anything added to the contract that will be renewed in August.  Mr. Yurash said he would like the number of syringes per visit limited to twenty.  Dr. LeBailly asked the BOH if it was acceptable for the ID cards be given to a participant


annually.  Based on the BOH discussion, a 20-syringe limit per vist and a card given annually, printed on secure paper, will be added to the SEP agreement.   Dr. LeBailly said that she will contact community partners to see if the SEP has had any impact on their business or neighborhood.  NCAP will collect data based on zip code to have a better idea of where participants reside.  Dr. LeBailly asked Ms. Daigle and Mr. Chapin to communicate to NCAP clients, especially those with impaired immune function, that West Nile virus is on the rise in Larimer County and to protect themselves as best they can.

         

5.   Annual update on department Emergency Preparedness Plans – Dr. LeBailly presented updates to the BOH on Larimer County’s Public Health Emergency Operations Plan Submittal.  Changes and updates are reflected on the Submittal document as well as to the documents saved by the depart­ment’s Emergency Preparedness Program. 

 

6.   Update on the Community Health Improvement Planning (CHIP) Process and the County Strategic PlanCHIP update: Dr. LeBailly reminded the Board that task forces are working on the top two priorities: Mental and Emotional Well-being, and Raising Healthy Children.  The projected timeline for finishing the plan that the two task forces are working on is October 2013.
County Strategic Plan update: The County selected five teams of eight people to come up with objectives related to each of the seven County goals.  The Health Department had two representatives on a team of eight. Doug Ryan and Jane Viste were the two representatives from the Health Department.  The suggested objectives that came out of the meeting will be winnowed down to a smaller number for community feedback and commissioner review and approval.

 

7.   Director’s report
Dr. LeBailly reported to the BOH on the Fort Collins City Council decision to allow backyard goats in Fort Collins, despite Health Department concerns about exposure of neighbors to “Q Fever” bacteria shed by goats that can be blown by the wind over long distances and cause disease in high-risk persons (pregnant women, immunosuppressed persons, those with heart valve problems or arterial grafts, older adults).  Dr. LeBailly indicated the department will try to get information about Q Fever to HOAs in the city, whose covenants take precedence over city ordinances.   The Health Department will also communicate information regarding Q Fever to health care providers who treat such patients, such as cardiologists and obstetricians.  Dr. LeBailly had suggested that the ordinance include a requirement to test the goats after a miscarriage or birth, but no such requirement was included in the ordinance.  CSU has offered to do a study of infection levels in these goats, if goat owners choose to participate and the study is approved by their institutional review board, but there is no requirement to participate.

Public Health Associate Program  - The Health Department and the Health District made a joint application to this program.   We will be getting the associate the second year.  The associate will be working with the Health District the first year.  CDC pays the salary of this associate for two years.  This associate will be part of the Communicable Disease team the first year to gain exposure to communicable disease.  With the Health District she will primarily be working with the Community Health Survey. 
 

West Nile virus update – We are having some very high counts this week in the traps.  Over 600 Culex were collected in a single trap in one night on the west side of Fossil Creek reservoir.  Dr. LeBailly is concerned that the city of Fort Collins’ current plan does not support adult mosquito control (spraying) until numerous human cases have been reported, and these reports lag 3-4 weeks behind the time people are infected by mosquito bites.  HOA’s do not have to get consent from the city to spray their neighborhoods. Dr. LeBailly distributed handouts regarding West Nile virus.  It generally takes about a week to get things organized and the public notified once the decision to spray has been made. 

 

 

Mr. Yurash made a motion that the BOH approve Dr. LeBailly recommending to the City Council of Fort Collins, spraying for mosquitoes because of the high incidence of West Nile virus.  The motion passed unanimously. 

 

Other -  Dr. LeBailly told the BOH that the resolution that was created by the BOH regarding edible marijuana has been sent to all municipalities that are entirely in Larimer County.   The City of Fort
Collins will be having their first discussion regarding the sale of marijuana on July 30th.  Dr. LeBailly received a response from Darryl Klassen, a Loveland City Councilman, and said he would support not having edible retail sales in the city.  She also received a response from the Estes Park Town Manager, Frank Lancaster, saying he has been directed by the Board of Trustees to draft a resolution banning all marijuana growth, sales, cultivation, processing etc. in Estes Park, for their consideration on August 13th.  Berthoud, Timnath and Wellington have banned sales, cultivation, etc.  The Board of County Commissioners have received the resolution, and Dr. LeBailly is unsure how they will move forward.  Mr. McKinney  said that he is still working on a draft of a letter to the editor regarding the BOH’s stance on edible marijuana and should be able to send it to members next week for input. 

 

Budget – Ms. Macpherson received an email from the County’s budget director, Bob Keister, reporting that nearly all funds (including the Public Health fund) will receive a 2% increase in County support.   This is outlined in an email Ms. Macpherson shared with the BOH.  Ms. Macpherson will have the preliminary budget for the BOH’s review at the meeting in August.

 

Ambulance services – Dr. LeBailly reported that the Health Department is required to license and inspect ambulances in Larimer County.   We inspect the ambulances’ equipment, insurance and make sure the people that work on the ambulance have the proper licenses.  We do not review, approve, or enforce their clinical care protocols.  This is done by the medical advisor of the ambulance service.  A complaint was received by us about an ambulance service that we have a responsibility to investigate.  We will proceed with the investigation of this complaint and report our findings.  Dr. LeBailly wanted the BOH to be aware that this is happening.

 

Dr. LeBailly reported to the BOH that our Assistant Director of Community Health is on an extended medical leave for a serious medical problem. 

 

8.   Next meeting: – Budget meeting

9.   Adjourn – The meeting was adjourned at 9:15 pm.

 

 

 

_____________________________    _____________________________________________

Paula Lady, Recording Secretary         Adrienne LeBailly, MD, MPH, Executive Secretary