BOARD MEMBERS PRESENT: Steve Wolf, R.N., President; Russell Bishop, Psy.D., Vice President; Jean Gastiger, R.N., F.N.P.; Linda Liston, M.D.; John Olson, D.D.S.; Stephen Slack; Scott Starkweather

BOARD MEMBERS ABSENT: Mike Groark, J.D.; Jesus Romero; Deborah Schelkopf, D.V.M.; Mary Beth Shear, M.D.

Mrs. Grush asked that an item, Executive Session, be added to the agenda. 

MINUTES

On a motion by Dr. Bishop, seconded by Dr. Olson, the minutes of the Board of Health meeting of May 23, 2006, were approved.  Motion carried.

DIVISION REPORTS

Mrs. Grush reported that the FY2007 Budget would be submitted to the County on the 4^th of August.  Following approval of the Health Department budget by the Board of Health at this meeting, recommendations for funding from the County will be forwarded to them.

Mrs. Grush reported that three bills relating to animal control issues were recently signed by the Governor.  HB 4238 increases the criminal penalty in the Animal Control Act for the owner of a vicious dog that fails to keep the animal in an enclosure or fails to spay or neuter it.  HB 2496 prohibits felons convicted of Class 3 felonies, under a number of Acts, to have custody of or reside in a residence with a dog over 12 weeks of age that has not been spayed or neutered or has been declared vicious or dangerous.  HB 4711 increases penalties for dog fighting.  She reported that, during the past year, there have been several piecemeal legislations passed while the entire Animal Control Act needs revision.  Legislation to appoint a task force to do this was also passed, but appointments have not yet been made.

Progress is being made on the proposed building that will house the Home Care Program.  A number of buildings have been visited.  Last week, Mrs. Grush, Gary Hanson (DeKalb County Deputy Director) and Bob Hutcheson (Public Building Commission (PBC) chair) traveled to Iowa to look at a few geothermal heating systems.  Mrs. Grush reported that these systems are impressive; however, they would initially be more costly with future savings in utility costs expected.  These systems require the drilling of a number of wells, resulting in the increased cost, with the water used to heat and cool the building.  It is reported that this is also a more balanced system, with fewer complaints of the room temperature by staff.  Mrs. Gastiger felt that the Health Department should consider it if the systems are environmentally sound.  Dr. Olson indicated that he was aware of a building erected about ten years ago, and that the geothermal system did not work there.  Mrs. Grush stated it is her understanding that these systems have improved a great deal in the past ten years.  Dr. Olson asked if any consideration was being given to including a tornado shelter in the new building.  Mrs. Grush responded that this has been discussed, and while a basement has not been planned for the building, reinforced areas are being considered.

Mr. Slack asked how the legislation recently signed by the Governor to regulate tattoo parlors would affect the Health Department.  Mrs. Grush responded that she just received a copy of this legislation this week, and has not yet had a chance to review it.  The law goes into effect on July 1, 2007.  She explained that the current law does not allow the individual receiving the tattoo to give blood for a one-year period.  Under the new law, there would be no wait for these individuals to give blood as the facilities would be licensed and regulated.  Mrs. Grush added that the State typically writes the rules and regulations for the program and local health departments conduct the investigations and collect the fee.  Mr. Slack asked if the Board of Health would authorize the fee, and Mrs. Grush reported that the State typically sets the fee.  She stated that she would provide more information at a future meeting.  Facility owners will send the license fee to the State, and the State will forward it to our agency after the inspection is done. 

Mr. Drake, Director of Environmental Health, reported that not as much oil was collected this year as in the past since these collections have been conducted every year.  He added that there have not been very many mosquitoes this year because the ground dries up, followed by the rain coming and flushing the larva out of the catch basins.

Mr. Wolf asked if any determination had been made in regards to the bird head found in a can of beans earlier this year.  Mr. Drake responded that he does call from time to time, but has not heard anything as of yet.  The Food and Drug Administration (FDA) reports that they do still have the can and head in their possession.

Mrs. Grush pointed out the article from the Daily Chronicle in the “Ear to Ear” section regarding the use of recyclable bins at festivals.  She reported that Habitat for Humanity has used recycling bins, but people throw everything in them and it is difficult then to separate the garbage from the cans.  She reported that the Solid Waste Management Program is purchasing mobile containers that use clear plastic bags that discourage garbage from being put in them.  These containers will be loaned to organizations for recycling at county events.

Mrs. Lux, Director of Personal Health Services, stated that ads have been running for a nurse in the Communicable Disease Program for four to five weeks, with only one viable applicant to interview.  The previous nurse resigned in July to begin work on her masters’ degree.  Mrs. Carroll, Communicable Disease Program Coordinator, reported that our county was lucky with the mumps outbreak as it fell at the end of the school year. 

Mrs. Gastiger asked about the human papillomavirus vaccine (HPV), Gardasil.  Mrs. Lux reported that this is a three-dose series for pre-adolescents.  She added that it is available through the Vaccines for Children (VFC) Program, but Illinois is still working on the state contract.  The vaccine will also eventually be available through the adult immunization program.  Mrs. Carroll reported that she has received several calls for the new shingles vaccine.

Dr. Liston asked if the HPV vaccine would be available through the Family Planning (FP) clinic.  Mrs. Lux stated it would be available through the VFC Program if the client is under the age of 19 years, and is also being promoted through the Well Child Clinic for eligible FP clients.  Dr. Liston asked if there was criteria at the State level for a woman over the age of 18 years.  Mrs. Lux responded that the vaccine would routinely be given to adolescents, age 11 to 18 years, but can be given to women up to the age of 26.  It is ideal to receive the vaccine before one becomes sexually active.  Mrs. Gastiger pointed out that CDC has an excellent web site that answers a lot of questions regarding HPV.

Mr. Wolf asked why the active T.B. client declined to continue treatment.  Mrs. Carroll responded that the client does not believe she has active T.B.   She added that this individual has several diagnoses, which has made treatment physically difficult for her.  Mrs. Carroll was advised to stop directly observed therapy (DOT) at this time and monitor her closely.

Mr. Slack asked if a program, such as VFC, would be available to college-age individuals.  Dr. Liston indicated that was her main reason for asking.  Mrs. Grush added that she has never been aware of the government sponsoring any vaccine programs for college-age students as they do for children 18 years of age and under.  Mrs. Lux reported that medications are available at the University Health Service, but students do have to pay.  Mrs. Gastiger reported that this has not yet been decided at NIU because of the cost.  Dr. Liston added that she believes women that know about the vaccine would be willing to pay the $360 charge.  Mrs. Gastiger pointed out that this does not include the administrative cost, and Mrs. Grush indicated that most “preventive” medications are not covered by health insurance.

Mr. Wolf asked who the 17 rabies vaccines were given to in the past two months.  Mrs. Carroll responded that there were pre-exposure requests.  A family from Ogle County was exposed to a bat that tested positive for rabies and were advised against receiving the rabies post-exposure vaccine, but the family insisted on  receiving it.  Ogle County does not carry the vaccine, so the family came to our agency.  Mr. Slack asked about the Cub Scout group that was exposed to a bat at a forest preserve and had to receive the vaccine.  Mrs. Grush responded that 16 scouts received the vaccine because of bats in a county shelter even though none of the scouts were actually bitten by a bat.  She explained that the recommendation for treatment is if one sleeps in an area where there are bats, they are considered to be exposed.  Since the individuals were from Boone County, our agency dealt with the forest preserve and Boone County Health Department dealt with the treatment of the individuals. 

Mr. Wolf asked if there were requests for Japanese Encephalitis vaccine in the travel clinic.  Mrs. Carroll responded that requests are generally received in the months of May and June when students will be studying abroad and will be in the outer areas of countries doing research and study, which puts them at risk. 

Mrs. Baj, Director of Home Care, reported that a nurse, Gayle Cox, has been hired full-time and started on the 5^th of July.  The other good news is that a nurse was interviewed that lives in the southern part of DeKalb County.  She pointed out that hiring a nurse from this area saves the agency on mileage and travel time.  She thanked Mr. Wolf for his visit to their building, at which time he also met several of the staff.

Mr. Wolf commented that staffing and computer issues seem to be the biggest problems at Home Care.  Mrs. Baj agreed, but stated the program staffing-wise is doing okay this year even with summer vacations.  Mr. Wolf stated that it is difficult to refuse referrals of patients since our agency is the only provider in the area, and asked if other agencies picked up those declined referrals.  Mrs. Baj added that a referral can sometimes be postponed for a day or so and then the agency is able to accept them.  However, at such times, IV and pediatric patients are referred to another agency.

Mrs. Grush reported that Mrs. Zanellato, Director of Health Education, now spends the majority of her time on emergency preparedness, with her staff working on the other grants.  Staff are gearing up for the start of school.  We were told to re-write the Tobacco Grant for the “ideal program” as there would be additional money available.  Mrs. Zanellato and her staff contributed a great deal of time to this as did many other Health Department staff.  However, additional money was not available and everyone received level funding.  Needless to say, health departments were not pleased with this; not that additional money was not available, but the extra time that went into grant development when the State was aware what the end result would be.

Mr. Wolf announced that he signed two more certificates this evening for restaurants that are smoke-free: Captain Vic’s and Sycamore Café.

Mr. Wolf asked if there has been further discussion on a smoking ban in Sycamore or other communities.  Mrs. Grush responded that she has not heard anything about such activity, but thinks the DeKalb group will target Sycamore next.  The Governor recently signed a new law that any municipality can become smoke-free.  Mr. Wolf asked if there was any discussion by the County Board on going smoke-free county-wide.  Mr. Slack indicated that there has not been any such discussion yet. 

FINANCIAL DATA            

Mrs. Grush reported that the tax levy and General Fund payments are received at this time of year, which helps boost agency revenue.  No IPA payments have been received for any Public Health services for this budget year, starting 12/1/05, and that minimal IPA payments for Home Care have been received.  Dr. Olson asked if this was the same payments as for KidCare and All Kids.  Mrs. Grush explained that everybody that was in KidCare is now in All Kids, and it is still considered Medicaid (IPA).  Mrs. Lux reported that there are expanded rates for pregnant women and infants, but this does not apply at our agency.  Mrs. Grush pointed out that our accounts receivable with IPA is reaching one year, and the potential for this, most likely, will increase as more children statewide are added to the program. 

On a motion by Dr. Bishop, seconded by Mrs. Gastiger, the Financial Statements for the months of May and June 2006 and the Claims for the months of June and July 2006 were approved.  Motion carried. 

NEW BUSINESS

FY 2007 Health Department Budget

Mrs. Grush presented the proposed FY 2007 Health Department Budget.  She explained that the assessed valuation in DeKalb County is $1.9 billion, with the maximum levy for the Health Department at .0232¢ per $100, resulting in anticipated revenue of $440,800.  She is recommending the full levy be requested.  Mrs. Grush is asking for the payment of IMRF and SS for Public Health salaries in the amount of $309,500, while the Home Care Program pays their own IMRF and SS.  SS is currently 7.65%, and IMRF will be 7.5%.  She explained that IMRF is expected to increase .5% every year to 8% or 8.5%.  A request is being made from the PBC for utilities (in the amount of $100,000), building maintenance ($55,000) and janitorial/supplies ($28,000) for a total request of $183,000. 

A request of $2,600 is being made for Animal Control from the General Fund to offset the cost of the program that fees do not generate.  Expenses and revenue for this program were detailed.

Proposed FY 2007 program fees were reviewed.  Increases of 3% to 4% are being recommended in Food Sanitation programs: Class A from $360 to $375; Class B from $230 to $240; Class C from $120 to $125; Class D from $95 to $100.  Mrs. Grush is recommending that the structure for Class E Temporary Food Permits be changed.  This permit is for food booths in operation less than 14 days.  Concerns by vendors have been voiced that the $70 permit fee is the same whether they are in operation 1 day or 14 days, and the cost for one day can make it cost-prohibitive to some.  Mrs. Grush recommends that the one-day fee be $40, two to four day $75 and five plus days at $100.  The five plus days are booths that set up for the Sandwich Fair.

The administrative fee for a well permit inspection/sample will increase from $100 per permit to $115.  A recommendation for an increase in Sewage Permits is: Septic Installer License from $120 to $125; Septic Permit – Established from $185 to $190; Septic Permit – New from $255 to $265; and, Septic Inspection from $105 to $110.  Family Planning charges are based on a sliding scale formula provided by the State and calculated using our costs.  

In reviewing revenues for FY2007, Mrs. Grush is projecting an increase in the Property Tax line item, with Animal Control revenue remaining the same.  Some Environmental Health fees will generate additional revenue, but she pointed out that Septic Permits and Licenses appear to be decreasing due to the county not authorizing the construction of subdivisions that allow septic systems.

Grant revenue for FY2007 overall is projected at being down about 3% because of one-time funds received this year in both  Family Planning and WIC.  The Illinois Breast and Cervical Cancer Program is currently in the process of being transitioned to Winnebago County Health Department, so will no longer be available to DeKalb County.  Additional money was received for emergency preparedness; however, we have been told that the expectation is a decrease for FY 2007.

Mrs. Grush indicated that Home Care revenue would not be what was projected for FY2006.  This includes Medicare, State Aid, Private Pay and Contributions from Senior Services.  She assumes that the program will be fully staffed next year, with all referrals accepted, so is projecting a 5% increase for FY2007.

Mrs. Grush pointed out that Line Item 4212 – Flu Shots, if all goes as anticipated, will generate more revenue than in the past.  This is because Medicare has raised the reimbursement rate significantly, and the contract the agency has with the State of Illinois to provide vaccine to State workers this year will reimburse Medicare rates as well.  

Mrs. Grush explained that Personal Services is always the agency’s largest expenditure.  In FY2006, $3.2 million was budgeted for these line items, and it is estimated that only $3 million will actually be spent because of a significant number of staff vacancies.  In addition, Health Insurance was projected to increase by 25%; however, there was no increase in FY 2006 as changes to the pharmaceutical benefit offset increased costs.  Departments have been advised to budget a 15% increase for FY 2007, which is $90,000 more than FY 2006.  Actual rates will not be announced until January 2007.

Mrs. Grush reported that a 4% salary increase was built into the Salary line item.  Historically, a COLA is given in December with a mid-year raise in June.  It is unknown if an AFCSME contract will be signed by December 1, 2006, and if the contract will maintain the historical compensation structure.

The Public Building Commission (PBC) is requesting $200,000 this year towards the new building, and this payment will be made by November 30, 2006.  $1,300,000 is budgeted to be transferred to the PBC in 2007.  Mrs. Grush reported that the Health Department’s commitment for the new building is $2 million; consequently, $500,000 will remain as debt.

Less will be spent in Professional Services because of the decrease in physical therapy visits.  An unanticipated expense for 2006, and in the new budget, is the retainer for the attorney representing the Health Department in the development of the AFCSME contract.

In summary, Mrs. Grush reported that FY 2007 Revenue is expected to be $5,734,800, with Public Health being $3,260,800 and Home Care $2,474,000.  Expenditures are expected to be $5,798,800 with $4,394,800 allocated to Public Health and $3,704,000 to Home Care.  She explained that this does present a deficit budget but, historically, the agency has always been able to make up that deficit.  An additional $1,300,000 is budgeted for transfer to the PBC for the new building from the agency’s Fund Balance.  This will result in the Fund Balance being reduced to approximately $1.7 million, with actual Fund Balance cash being approximately $900,000 to $1,000,000, approximately two and one-half month operational costs.  She indicated that four months is recommended.  Mrs. Grush added that, at any given time, approximately $500,000 to $700,000 is used for cash flow and outstanding accounts receivable.

FY 2007 Solid Waste Budget

The Health Department is the administering agency for the Solid Waste Management Program.  Revenue for this program is received through tipping fees at $1.10 per ton of garbage.  Mrs. Grush reported that Professional Services, Commercial Services and Contributions to Agencies consume 65% of the revenue.  This year, $30,000 was budgeted for mini-grants to be offered to businesses for recycling grants in the amounts from $50 to $5,000.  Included in the FY2007 budget is $15,000 for recycling efforts in apartment buildings. 

Mr. Slack asked what the maximum tipping fee was, and Mrs. Grush responded that she believed it to be $1.29 per ton.  She will confirm this amount.  Mr. Slack suggested that the full fee be considered as an additional 19¢ per ton would generate approximately $10,000 in additional revenue that could be put into community programming. 

Dr. Olson asked about the possibility of losing this revenue to the town of Cortland.  Mr. Slack responded that a County Solid Waste Committee is being considered to review the future of the landfill.

Mrs. Grush reported that $25,000 is being budgeted for local support to the Environmental Protection Agency (EPA) to conduct a Hazardous Waste Collection in DeKalb County in 2007.  Experience has shown that there is a greater chance the EPA will host an event in the county if local funds are contributed. 

Mrs. Grush is proposing a Solid Waste Budget with revenue at $110,500 and expenditures at $125,000, with an anticipated Fund Balance of $22,881.

Mr. Stakweather made a motion to approve the Health Department and Solid Waste budgets, as presented, seconded by Dr. Bishop.  On a roll call vote, those voting yes included Dr. Bishop, Mrs. Gastiger, Dr. Liston, Dr. Olson, Mr. Slack, Mr. Starkweather and Mr. Wolf.  Motion carried.

Mr. Slack made a motion that a recommendation be made to the Planning and Zoning Committee to increase the tipping fee to the maximum amount of $1.29 per ton, seconded by Dr. Olson.  Motion carried.

Dr. Bishop congratulated Mrs. Grush for her good work on putting the budgets together.  He added that it speaks to her hard work and continuing diligence in providing the Board with positives with which to work.

Executive Session

Union Update

At 8:55 p.m., Mr. Starkweather made a motion to enter into executive session for the purpose of an update on the AFCSME union, seconded by Dr. Olson.   On a roll call vote, those voting yes included Dr. Bishop, Mrs. Gastiger, Dr. Liston, Dr. Olson, Mr. Slack, Mr. Starkweather and Mr. Wolf.  Motion carried.

At 9:10 p.m., Dr. Olson made a motion to reconvene to regular session, seconded by Dr. Bishop.  On a roll call vote, those voting yes included Dr. Bishop, Mrs. Gastiger, Dr. Liston, Dr. Olson, Mr. Slack, Mr. Starkweather and Mr. Wolf.  Motion carried.

CORRESPONDENCE AND ANNOUNCEMENTS

Mrs. Grush reported the death of Mary Uscian who began her early career at the Health Department, starting many of our programs.  A couple years ago, Mrs. Uscian addressed the board regarding the dental program.  Other news articles reported on receipt of 4-C’s Champion of Children award by DeKalb, Whiteside and McHenry Public Health Departments, national testing day for HIV on June 27, mumps reported in two DeKalb schools, success of the electronics recycling collection, and WIC coupons to be used at the Farmer’s Market.  An e-mail was sent to Bette Chilton, FCM/WIC Coordinator, from Jennifer Groce, executive director of Main Street DeKalb, Inc., regarding participation at the Farmer’s Market by WIC clients.  Other news articles reported on the growing number of coyote sightings in DeKalb County.  An e-mail was received by Mrs. Grush from Julia Fauci, DeKalb County Forest Preserve Committee chair, for her proactive response to the recent rabies problem.

ADJOURNMENT

On a motion by Dr. Bishop, seconded by Dr. Olson, the Board of Health adjourned at 9:13 p.m.  Motion carried.

Deborah Schelkopf, D.V.M., Secretary

DeKalb County Board of Health

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