Minutes Archive

Board of Health Minutes

Calhoun County Board of Health
Meeting Minutes
May 15, 2006

ATTENDANCE

Board of Health	Health Department
Larry Anderson	Dottie-Kay Bowersox
Kathy Foerster	Amy Latham
Byron McDonald	Brigette Reichenbaugh
Ben Miller	Mike Waite
Dr. Jeffrey Mitchell
Ken Ponds
Rick Tsoumas

Calhoun County	Other
Jim Latham	Bill Schroer
Nancy Mullett
Greg Purcell

Anderson called the meeting to order at 8:00 a.m. Motioned for approval of the agenda. McDonald moved. Ponds supported. All in favor.

CONSENT AGENDA
Motion for approval. McDonald moved. Tsoumas approved. All in favor.

HEALTH OFFICER’S REPORT

Breast and Cervical Cancer Control Program
Mullet presented the Breast and Cervical Cancer Control Program (BCCCP) agreement. Mullet stated there is not a contract available today. Per conversations with Kalamazoo, a contract is not mandatory; however, the Health Department (HD) requires Board approval for the program transfer. Mullet presented the operation of the BCCCP program for further understanding by the BOH. No local dollars follow the program, CCPHD will have no hands on after the transfer, but CCPHD will assist in the transition of the program (calls and clients).

Foerster asked if in 2009 we want the program back, can we get it back. Mullet answered yes, it is possible but the existence of the program depends solely on State funding continuation. Foerster also asked about the Komen Foundation allocated dollars. The Komen Foundation requires that Komen dollars must be used in SW Michigan (includes Calhoun County).

McDonald asked if we spoke to members of the community (Battle Creek Community Foundation (BCCF), partners, etc.). Waite stated that Bowersox spoke to the BCCF and guaranteed the Board that the services to the women will not change, only the location.

Miller questioned the budget/staffing impact statement in resolution 8-2006. Waite clarified the budget and staff time associated with the dollars. In order to see additional clients, more staff is needed. If you choose not to transfer the program, then the BOH requires BOC involvement -- program requires additional funds to operate. We are not transferring any employees or dollars. This is a programming decision for the HD. We can revisit at a future time but the plan is to relinquish the program permanently. Bowersox stated that community partners (BCCF, etc.) do not want to fund a program that can be transferred and clients will continue to receive the same service at a much lower cost.

Tsoumas stated that he serves on many of those boards and funders will not pay for something that will continue if transferred.

Mullet stated that if we want to review the quality of the program after transfer, it can be mutually agreed upon that Calhoun County review. But Mullet states that she feels it will not take a long time and Kalamazoo’s reputation, within the different counties currently administered, is very positive.

Bowersox stated that there are State program mandates and the State indicated that there are no quality issues with Kalamazoo. She also stated that she spoke with the BCCCF and they are very supportive of the transfer of the program to Kalamazoo as long as the Komen foundation dollars are kept.

Miller stated that we collaborate when needed. But at some time we have to decide the quality and manner a program is provided. Miller also stated that we find a way to maintain the program here in Calhoun County and that he will not support here or at the commissioner level. Ponds stated that the program or clients are not leaving Calhoun County.

Bowersox stated that the nurse practitioner (NP) who serves in this program is retiring in January. Again, a NP is required for operation of this program. Past part-time NP hiring attempts have proved unsuccessful. Tsoumas motioned approval of resolution 8-2006. Miller requested roll call: Anderson: Yes; Mitchell, Yes; Tsoumas, Yes; Ponds, Yes; McDonald No; Foerster, Yes; Miller, No. Motioned approved of transfer of the BCCCP program to Kalamazoo County Human Services Department. 5-2.

Mullet stated that this transfer does not involve any local money in the transfer and does not require BOC approval. Mullet clarified that there is no pass through, no connection with the HD, there are no local dollars, no reporting requirements, no switching employee relationship, and the State will mandate the program with Kalamazoo. Kalamazoo will “do there thing” with the providers and Family Health Center (FHC). The original discussions included CCPHD performing case management. That has been rectified. There are no contracts with the other Kalamazoo administered counties.

Purcell clarified the resolution that states approving an agreement with Kalamazoo County. Bowersox stated that we were hoping to transfer the program June 1st. Tsoumas asked if it is possible to approach the State if we would consider running the program in its entirety here again. Bowersox stated yes, we could approach the State if we wanted the program back.

Tsoumas asked again for FHC to present to the Board and that we have a bigger issue if we can’t entrust FHC to provide the same services we do. Miller and McDonald feel that there is no need for FHC to present.

Ponds motioned that Mullet develop a written agreement/letter of understanding for BOC for approval. This agreement will contain a checks and balance statement for FHC. Mullet stated that checks and balance points will completed at the end of September and at the end of each fiscal year. Or if there is a noncompliance report, the report will trigger immediate discussion.

All in favor of the motion to have the letter of understanding presented to the BOC. The agreement will be sent to BOH members but the BOC will have final say. All in favor. Approved unanimously.

Tobacco Resolution
The students that were present at the BOH will present to the BOC either June 1st or June 15th.

FINANCIAL OFFICER’S REPORT
McDonald asked that the asterisks be placed alongside the mandated programs. He also asked about the Nurse Manager position. Bowersox stated that upon review of the 2006-2007 budget and after further discussion with Marshall Administration, the Nurse Manager position will remain vacant.

Latham clarified the emergency facility use agreement. Tsoumas asked if we have these facilities in place. Latham stated that we have five dispensing sites in Calhoun County. Tsoumas asked for clarification of the action today. Latham stated that this agreement allows us to go forth when speaking to other organizations about becoming a dispensing site. Anderson asked who are the sites and to see the master agreement.

Tsoumas asked if there is a subcommittee. Latham answered there is a county initiative that focuses on county emergency preparedness, although not health specific. Present the agreement at the next meeting for approval.

Purcell stated that we are approving a template not the individual agreements with providers. Dispensing sites are designated (three in Battle Creek, one in Marshall, and one in Albion). Tsoumas asked Latham to present the overall emergency preparedness plan summary at the next meeting.

Agreement discussion
Purcell feels that the BOH should have a copy of all agreements that are presented to the BOH for approval, excluding State and Federal contracts. Mitchell stated that if he’s being asked to approve a concept a summary memo is fine. But if a contract is presented for BOH approval, the BOH would like to have the entire contract. Tsoumas clarified again that all agreements and contracts be summarized, but that all non-State and non-Federal contracts be provided to the BOH.

BOARD EDUCATION AND DISCUSSION

Health Officer Evaluation Committee Appointment
In conjunction with the BOC, Ponds, Foerster, and Mitchell expressed interest in evaluation Bowersox, Health Officer.

Board Governance and Strategic Planning Retreat Report (Schroer)
Schroer stated that according to the governance model, all contracts that are presented to the leadership go through a screen test (mission, etc.) and the Board will hold the leadership accountable. If the Board approves the contracts, yes, the Board should review them. But the Board should not be approving contracts.

The feeling during the retreat was many community members and partners have no idea of what the HD does or is supposed to be doing. From a funder perspective there is a compliance/accountability issue. Mitchell suggested that we combine Long Range Objectives (LRO) 1 and 2. He feels that LRO 4 is an outcome. Schroer stated that typically, LROs do not have verbs (e.g., LRO 4: Have a rapid, flexible response force).

The next step is establishing task forces for each objective on a one-year basis. Task forces are experts that are responsible for each task. Miller asked for clarification (e.g., LRO 1: includes both direct service and health education). Tsoumas stated that these objectives will allow us to meet all services (direct service, health education, and serve as public health leader in the County). Mitchell stated that most individuals in the retreat felt that we are doing a good job at the micro level but not at the macro level. Mitchell asked for clarification of LRO 3. Schroer clarified that the intention of this comment was to have more diversity of staff (Health Department, RHA, etc.).

Set a portion of the agenda to strategic planning. Bowersox and Schroer will begin working on task force assignments.

Mitchell asked about program compliance. Mitchell feels that we have too many programs to oversee. He would like to know how we got out of compliance and what we are doing to fix. Approximate number of county residents served for each non-mandated program.

McDonald asked about the Health Partnership update. Bowersox stated that Nicole Boyd, Council of Advisors Chair, and Bowersox interviewed two more candidates, one of which was an African-American candidate. Boyd and Bowersox determined that to-date their original candidate is best suited for this position.

McDonald motioned for adjournment. All in favor. Meeting adjourned 10:00 a.m.

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