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:                  N. Mark Richards, M.D., M.P.H.

Lee Thielen, M.P. A.

Steve Yurash

C.J. McKinney, Ph.D.

Debby Healy, RN, BHS


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

                                                        Via conference phone


Commissioner Liaison:             Steve Johnson


Staff:                                         Marie Macpherson, Jerry Blehm, Paula Lady



1.   Call to order The Board of Health meeting was called to order at 7:00 PM.


2.   Approval of October 13, 2011 meeting minutes - minutes of the October 13, 2011 meeting were unanimously approved.


Next meeting date:  it was decided that due to a conflict in schedules to meet on Thursday, December 15th at 7:00 pm.  Ms. Healy will be unable to attend that evening. [Update  Debby Healy has made arrangements to attend the meeting]  It was also decided to change the meeting date in January from the 12th to the 19th at 7:00 pm due to a conflict in schedules.


3.   NACCHO 2010 Profile of Local Health Departments – Dr. LeBailly presented a PowerPoint  presentation with information from this report.  The data was collected in 2010 with financial data from 2009. This profile is done every three years.  It gives us a good snapshot of our department as well as about 2800 local public health agencies across the United States. The survey is about 40 pages long.  There was an 82% response rate in completing this survey.  2565 local public health agencies participated in completing the survey. Colorado’s response rate is 93% or 50 out of 54 responded to this survey.  Dr. LeBailly has highlighted Larimer County’s data with red outline on the PowerPoint slides.


Dr. LeBailly took the group slide-by-slide through the core section of the report, indicating how our Health Department compares to other local health departments.   Dr. Richards asked if there was an issue of particular concern.  Dr. LeBailly indicated that budgets are shrinking and public health forces all across the country are getting smaller.   The Congressional super-committee is supposed to propose a federal budget next week or there will be across the board cuts. 

Dr. LeBailly will email a PDF copy of the NACCHO report and the PowerPoint to the BOH members.


Mr. Yurash inquired about the number of FTE’s in our department.  He asked how the lower number of administrative / clerical personnel impacts our department.  Dr. LeBailly clarified where some of the positions (clerical vs. paraprofessionals) are reflected in the report.  Ms. Thielen said that in public health there has been a shift of what personnel do including more administrative / clerical duties and in areas related to technology etc. There was some acknowledgement that this area for the Department is barely able to get everything that is needed done.


Dr. LeBailly informed the group that all historical NACCHO profiles of local health agencies are available on the web back to the late 1980’s  [at ]



  1. Policy Governance Report for 2011- Marie took the group through the Policy Governance Report for the Department for  2011 noting compliance with expectations in most all areas with notations of variance and/or special interest added into the report.   This Report is similar in format to the one completed by the County Manager and reported to the County Commissioners. 


Related to questions from Mr. Yurash concerning the section that included a personnel issue, Dr. LeBailly clarified for the Board that the Department follows the County’s Human Resource Personnel policies and in this instance, the Department’s clinical policies, as well as appropriate notification of the Colorado Board of Nursing should an action involve a nurse.


In the area of Customer Satisfaction, Ms. Thielen asked what the Department’s next steps are with measures of customer satisfaction.  Dr. LeBailly said that employees were asked during the Department’s recent process to develop performance measures in five areas one of which included specific measures of customer service. The other measures were: inputs, outputs, outcomes and efficiencies.   The Department plans review all of the measures and develop a prioritized list from which to implement.  The next steps for this have not yet been finalized. 


In the area of Financial Condition and Activities, Ms. Healy asked if there was a cost associated with the accounting system changes to meet the Department’s needs.  Ms. Macpherson was hoping to utilize the one-time monies that had been set aside in the budget hire a consultant to help with this project but has not had the time to get the information completed to do the purchasing/hire process.  Therefore she and Bruce Peters will be working on the project themselves to design and implement a system to put most of this information on the County’s general ledger system. 


Mr. Yurash asked if the single audit report for 2010 was presented to the BOH.  Ms. Macpherson replied that it is a report attached (a separate document that is referred to) to the County’s Financial report (CAFR) and has not been presented to the BOH.  Dr. LeBailly will forward an electronic version of this document to the BOH.


Related to the section on Fees, Dr. Richards asked if the restaurant fees are out of line with the costs.  Dr. LeBailly indicated that fees cover approximately 35% of our costs.  Ms. Macpherson indicated that personnel are the bulk of our costs.  Since staff will be getting small increases in 2012 we will see a slight increase in costs.  Fees for restaurant inspections are set by State Statute.  Dr. Richards asked if this is the only one out of line with our costs.  Ms. Macpherson replied that our Prenatal Plus program also does not recover enough money from Medicaid to cover our costs  and to her recollection it covers about 40%.


In the section on the Emergency Public Health Director Replacement and Back Up, Ms. Thielen asked about the procedure of back-up in case of emergency replacement and continuity of operations.  Dr. LeBailly indicated we have a document that spells out the delegation should there be a need. We will bring this document to the next BOH meeting with a review.  Dr. Richards asked about IT back-up.  Dr. LeBailly replied that the IT department has worked on a plan but she has not had time to review this.  In a related matter, we have submitted an application  to host an Applied Public Health Informatics Fellow  for a one year position sponsored by and paid by the CDC.  We submitted this application at no cost to the county.  We should hear within the next month or so if this will be awarded to us. 


Under Communication and Support to the Board, Dr. Richards indicated the ease of getting in touch with Dr. LeBailly. Ms. Thielen indicated the education that is provided to the BOH should be added to the document and that the education is ongoing.


Mr. McKinney commented that the governing policy language seems negative in how it is written/presented as each statement reflects what the Public Health Director “should not” do.  He suggested that it  be rewritten in a more positive light.  Ms. Macpherson indicated we would review and see where we could rewrite this document with that in mind for next year.


  1. Public Health Director Evaluation Forms – Ms. Macpherson distributed the evaluation form that was used last year and asked board members if they would like to make any changes for this year. Following some discussion Ms. Thielen incorporated the following changes on the draft written form: added language related to assessment and planning to an existing category, the order of two of the categories was switched and it was recommended to change the scale to a 10 point scale as this broader scale would allow for a greater range of movement.  A column to write the numerical score and separate comment section was also incorporated.  Ms. Macpherson will revise the electronic version of the form and sent it out to all BOH members.  Each Board member should complete it and e-mail it to Dr. Richards by December 8th to compile the responses before the next BOH meeting. 

  2. Salary survey of CO physician Public Health Directors – Ms. Macpherson presented the County’s recommendation’s for employee compensation changes for 2012 (up to 2.5% increase for regular employees) and indicated as the appointing authority for the three Division Directors (CHS Director, EH Director and Admin Director) in the Health Department, that Dr. LeBailly is recommending that those positions receive those same increases as applicable as well.  Salaries for all positions have not increased in the last two years.  Ms. Macpherson then distributed a copy of a salary survey of Colorado physician Public Health Directors that was just completed and recommended that Dr. LeBailly’s salary be considered for at least the same % increase as the rest of the staff, as well as the officials she appoints (2.5% increase) in 2012.  Dr. Richards asked if Dr. LeBailly receives a car allowance.  Ms. Macpherson replied that she does not; she is eligible for mileage reimbursement.  Ms. Thielen indicated that this matter seems to be out of order, that the evaluation should come before the BOH makes a recommendation for a salary increase.  It was proposed that the salary increase recommendation along with the performance review be presented at the next meeting. 


7.   Director's Report –  Ms. Macpherson announced that Christine Bush was offered and accepted the temporary hourly Project Manager position d for Community Health Assessment/Public Health Improvement Planning efforts.  This is an hourly temporary position; a little under half-time through September 2012.  Ms. Bush has a bachelor’s degree from CSU in psychology and a master’s degree in public health from John Hopkins University.  She is currently a public health data analyst with Science Applications International Corporation, working as a consultant to the US Health Resources and Services Administration.  She has a lot of the skills and strengths we feel will be helpful to us for this project.  There are some specific expectations that must be met for this project.  This position is funded by the Colorado Department of Health and Environment with federal pass through grant monies for $25,000.  It was identified that the information about this project needs to be sent to Board members who missed that presentation.


Dr. LeBailly asked if the BOH would be interested in a presentation from the Health District at the February 2012 BOH meeting on the results from the 2010 Community Survey . The Board indicated their interest and would also like to ask that they discuss their agency’s cuts and what will things look like going forward.


Dr. Richards asked what next steps might be for the Syringe Exchange Program (SEP).  Dr. LeBailly recommended that this topic be moved to the January meeting.  This would give more time to get a feel for interest from law agencies and other stakeholders.  The BOH needs to make a decision on whether a formal or informal process should take place before any decision is made to move forward with the SEP.  It was decided that next steps for the SEP be discussed at the January BOH meeting.


Mr. Yurash shared with the BOH a visit he had with a client going through the WIC program.


8.   Next meeting – The next meeting will be Thursday, Jan 18, 2012 .  


9.   Adjourn - meeting was adjourned at 8:55 pm.  




_______________________________           _______________________________________________

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


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