BOARD MEMBERS PRESENT: Russell Bishop, Psy.D., President; Steve Wolf, R.N., Vice President; Kevin Buick, J.D.; Julia Fauci; Jesus Romero; Mary Beth Shear, M.D.; Scott Starkweather

BOARD MEMBERS ABSENT: Jean Gastiger, R.N., N.P.; Linda Liston, M.D.; John Olson, D.D.S.; Deborah Schelkopf, D.V.M.

MINUTES

On a motion by Ms. Fauci, seconded by Mr. Buick, the minutes of the Board of Health meeting of March 27, 2007, were approved.  Motion carried.

On a motion by Mr. Starkweather, seconded by Dr. Shear, the minutes of the Executive Session of March 27, 2007, were approved.  Motion carried.

DIVISION REPORTS

Mrs. Grush reported that the architectural drawings with final approval for the Community Outreach Building have been completed.  She presented pictures of the building, which is designed to blend with the other two buildings in the health complex.  The building has two entrances and includes a training center with auditorium seating.  There will also be temperature-controlled storage in addition to an area designated for maintenance for the Health Facility Complex.  Groundbreaking is projected for sometime this summer.

Mrs. Grush reported that Jane Lux, Assistant Administrator, has completed the data gathering of Phase I of the IPLAN  certification process.  The Organizational Capacity Assessment was completed with the priority item selected for the Action Plan, which will be presented to the Board of Health at a later date.  The first meeting of the IPLAN Community Committee will be held in June, with additional meetings monthly for four months.  Mr. Wolf asked if there was a representative from the southern part of the county.  Mrs. Lux responded that there is an individual representing Kishwaukee Community Hospital and Valley West Community Hospital.  She encouraged additional recommendations as committee members. 

Mr. Drake, Director of Environmental Health, reported that summer temporary food inspections have begun.  He added that the rain has helped, from a public health standpoint, in controlling the West Nile virus.

Ms. Fauci asked if a model ordinance for recycling at apartment buildings had been investigated.  Mr. Drake responded that he did receive Kane County’s.  He is working on getting a couple more, adding that there are not many such ordinances currently available.  Ms. Fauci stated that implementation is the key, and she feels people would participate. 

Mrs. Chilton, Director of Personal Health Services, added some explanation on how the new bill signed by the Governor, Illinois HealthConnect, will impact Health Department services.  She pointed out that this is confusing for agency staff and also for our clients.  In this HealthConnect model, clients will be asked to select a primary care physician.  If they do not choose one, one will be auto-assigned.  Bette added that there are not a lot of providers in our area taking new Medicaid patients.  There are quite a few steps to the system and she foresees a number of calls from our Medicaid clients after the letters go out with questions on how to proceed.  Mr. Wolf asked how many physicians from our area are taking Illinois HealthConnect clients.  Bette responded that it is difficult to tell because she knows many of the providers that are listed are not accepting new Medicaid patients. 

Mr. Starkweather reported that he had checked with the bank about advancing a portion of reimbursement for local medical providers, but the underwriters will not fund Illinois Medicaid.  Mrs. Chilton stated that low and timely reimbursement is the biggest part of the problem.  She added that such a program may work in an urban area where there are a lot of providers, and cited the goal of the program as decreasing the use of emergency rooms, but her feeling is that this will instead increase demand. 

Mr. Starkweather asked how the Federally Qualified Health Clinics (FQHC) are different.  Mrs. Grush responded that they receive an encounter rate and the reimbursement is much greater and receive it in a timely manner.  The federal government also provides the liability coverage.  She does not believe DeKalb County would qualify for a FQHC, but could perhaps become a satellite for an existing clinic.  Ms. Fauci confirmed that FQHCs are designed for a larger urban area that is more economically stressed.  Mrs. Grush stated the local task force on access to care is looking at various options.

Mrs. Zanellato, Director of Health Education, reported on SB500, which prohibits smoking in all Illinois public and work spaces, that passed both houses as of May 1, 2007, and is awaiting the Governor’s signature.  She pointed out that the Bill has been held up because casinos want an exemption. 

The Comprehensive School Health Education and Services Grant, which was to be a three-year grant, received a fourth year extension.  Notification was recently received that a fifth year extension was received.  Mrs. Zanellato reported that this project with DeKalb High School keeps growing, with 60 girls participating last year and more expected this year.  The 10-session project, Future Is Ours, gathers Hispanic teen girls together as a group for career teaching, social support and self-esteem training.  She reported that the project, which started as a prevention program, has grown far beyond that.  Because of legal issues and confidentiality, the participants cannot be surveyed in terms of pregnancies, but information has been received from the school district reporting on stories of girls that have turned their lives around.  Marcy hopes to work with a consultant to do evaluations of programs like this to obtain impact information. 

Ms. Fauci stated that she recently served on an NIU regional planning task force where they discussed the increases in Hispanic students at NIU.  She wondered if the Health Department could work with these students at NIU.  Mrs. Zanellato responded that the Health Department has been partnering with the Latino sorority, who spends time with the teens and attends the workshops sponsored through the program.  The mentoring by these sorority students is one of their community services.  The Health Department has also worked with Latina organizations on career building for Hispanic high school students.  Mr. Romero wondered if such a program could be expanded.  Mrs. Zanellato stated that they are hoping to expand the program into the eighth grade.  A session is currently being done for sixth and seventh graders.  Because student numbers have increased so substantially, the goal is to split each grade level into two groups.  She pointed out that students new to this country are under a lot of pressure and wanting to fit in, so this group is trying to build social support and help them make good choices.  Dr. Bishop stated that he finds it encouraging to hear because it is about instilling hope and opportunity for these young women.

Dr. Shear asked if the Health Department still had the Illinois Breast and Cervical Cancer Grant.  Mrs. Lux reported that the grant that serves DeKalb County women is now administered by Winnebago County Health Department.  Clients can still go to local providers, but they will talk to someone at Winnebago CHD.  Mr. Wolf stated that he thought it was a requirement that every local health department have this program.  Mrs. Grush responded that this has always been a Winnebago CHD grant, and that for a period of time, we were a sub-contractor, but now it is administered solely by Winnebago CHD.  She pointed out that many other areas of the state also operate in a regional manner as well.  The program is available to residents in every county. 

Dr. Bishop stated that the level of detail of reports is very well done and much appreciated.  Mr. Wolf thanked staff for everything they have done to get the Illinois Smoke-Free Bill passed. 

FINANCIAL DATA                                                         

Mrs. Grush reported that payments for 2007 for the new Home Care building have started, with the first payment of $500,00 being made in May.  Another $400,000 will be given next month and then $400,000 in September.  The final payment of $200,000 will be made in 2008.  This will result in a spenddown of the agency’s fund balance.

Ms. Fauci stated that she was pleased to hear about the storing of records electronically.  She hopes that the rest of the county follows our lead with this project.  Mrs. Hills responded that progress is being made, and it should make a difference in future space needs. 

On a motion by Mr. Wolf, seconded by Mr. Starkweather, the Financial Statements for the months of March and April 2007 and the Claims for the months of April and May 2007 were approved.  Motion carried. 

NEW BUSINESS

Animal Control

HB 315 Animal Control Act Amendments

Mrs. Grush provided a synopsis of the amendments made to the Animal Control Act in 2005, which detailed requirements of the Act.  The Amendment to the Animal Control Act was introduced by the American Society for the Prevention of Cruelty to Animals (ASPCA), with virtually no input from animal control programs. 

Mrs. Grush stated that she did speak with staff in Springfield today because the Act has been signed, and the fees indicated in the Act were to be collected beginning in January 2007; however, the rules and regulations of how to implement the Act have not yet been published; consequently, many counties have not implemented the collection of the fees.  The Act involves a number of fines, which are to be collected by our staff and forwarded to the state.  Mrs. Grush reviewed some of the amendments to the Act. 

One of the requirements of the Act is the establishment of a $10 differential for unaltered dogs in the registration fee.  The $10 differential fee would be placed in a county animal population control fund or sent to the State’s Pet Population Control Fund.  Funds from this would be used to pay for the spay or neuter of pets belonging to Illinois residents that are eligible for the Food Stamp Program or the Social Security Disabilities Program.  The individual completing the application and requesting the assistance would pay $15 towards the cost of the spay or neuter at a local veterinarian of their choice.  She predicts that the administration of this program by the State could result in veterinarians not being paid in a timely manner or simply not being paid.

Mrs. Grush explained that registration fees for DeKalb County currently are $12 for one-year registrations and $30 for a three-year.  The veterinarian receives 75¢ from these registration fees for processing.  Registration and pickup fees pay for most of the cost of our Animal Control Program. 

30 agencies responded to a survey conducted by another county in 2006 regarding differentials for altered/unaltered dogs.  One-third of them had no differential.  Thirty percent (30%) had the $10 differential and four of the 30 responders had a $2 or $3 differential.  Eight programs had a $30 to $40 differential.  Mrs. Grush feels the fee would need to be more than $10 if the intent is to encourage alteration. 

Some county animal control programs have changed their local ordinance from a registration fee to calling it a tag fee because then they are not in violation of the new amendments.  Mrs. Grush pointed out that getting a pet altered is costly and may cause some pet owners to not get them vaccinated either. 

Mrs. Grush feels the County should support a spay-neuter program, but it should not be financed by dog owners as they are already paying for the majority of the program, as well as it should not be available only to individuals on food stamps or Social Security disability.  Another concern is that if the funding for a program is tied to the registration fee, it is one more thing the veterinarian must report, and she does not know what the response of the veterinarian community would be to that.  She has been told that one cannot always tell visually if a dog has been altered with the new surgery techniques, so confirmation may need to be provided as proof.

Mrs. Grush stated that there are a number of animal control issues and perhaps the best route to go is with the establishment of a task force with representatives from Animal Control, TAILS, local veterinarians, the animal shelter staff and law enforcement.  They could define what the issues are and the Board of Health could determine if there was something that could be done to address them.  Dr. Bishop agreed that it would be helpful to develop such a task force, and then the Board of Health could address appropriate issues.  At this time, Mrs. Grush is recommending the following: (1) not establishing a $10 differential fee from dog owners; (2) recommend an ordinance change requiring a tag fee instead of a registration fee; (3) give consideration to requesting a County General Fund increase to support a spay-neuter program in the 2008 Budget; and, (4) establish a task force composed of local veterinarians, TAILS staff, animal shelter staff, Animal Control staff and law enforcement to study the county animal control issues and report back to the Board of Health.  Ms. Fauci noted that a tag fee increase might be warranted, and Mrs. Grush responded that this fee is due to increase in 2008. 

Consideration of TAILS for Cremation of Dogs

Mrs. Grush pointed out that Ms. Fauci, at the last Board meeting, raised the issue of TAILS doing cremations of county dogs, rather than sending them out of the area.  She did follow up on this and found that very few dogs are cremated, with only 10 to 15% of dogs euthanized; thus, this would not generate much money for the TAILS program.  Mrs. Grush suggested that this be kept on hold for now and become one of the issues studied by the task force. 

Establishment of Task Force

Mr. Starkweather made a motion that a community task force be developed to study county animal control issues, seconded by Mr. Romero.  Motion carried.

Personnel

LEHP/Sanitarian Class Specification Revision

Mrs. Grush announced that one of the sanitarians from the Division of Environmental Health has submitted her resignation.  She pointed out that our job classifications have become outdated and sanitarians are not hired any more, and have been replaced by Licensed Environmental Health Practitioners (LEHP) or LEHP in Training.  The in-training position requires successful completion of the LEHP licensing examination designated by IDPH within three years of employment. 

Public Health Nurse Position – Increase from Part-time to Full-time

Mrs. Grush is requesting an increase in hours for a Public Health Nurse position because of a $10,000 increase in the WIC Grant and increase in the WIC caseload, in addition to an increase in Well Child Clinic services. 

Dr. Shear moved to approve the change in the Sanitarian job classification to Licensed Environmental Health Practitioner in Training/Sanitarian, and an increase in one Public Health Nurse position from part-time to full-time, seconded by Mr. Romero.  Motion carried. 

Executive Session

Mr. Starkweather moved to enter into executive session at 8:50 p.m. for the purpose of discussing a personnel issue, to be provided a Union update and annual evaluation of the Public Health Administrator.  Mr. Romero seconded.  On a roll call vote, those voting yes included Dr. Bishop, Mr. Buick, Ms. Fauci, Dr. Shear, Mr. Romero, Mr. Starkweather and Mr. Wolf.  Motion carried.

Mr. Wolf made a motion, seconded by Ms. Fauci, to reconvene to regular session at 9:06 p.m.  On a roll call vote, those voting yes included Dr. Bishop, Mr. Buick, Ms. Fauci, Dr. Shear, Mr. Romero, Mr. Starkweather and Mr. Wolf.  Motion carried.

Dr. Bishop recognized Mrs. Grush’s incredible contributions to the agency and the community in her position as Health Department administrator.  He recognized the additional responsibilities assumed over the past year, and the fact that no aspects of programs have declined or suffered in any significant way because of this. 

Mr. Wolf made a motion to increase the administrator’s salary by 2%, effective May 27, 2007, seconded by Mr. Buick.  Motion carried.

CORRESPONDENCE AND ANNOUNCEMENTS

Newspaper articles for the months of March and April covered Union negotiations, a request by health department administrators for more funding for additional work performed, the receipt of a $6,000 grant from the DeKalb County Community Foundation to conduct the Community Health Needs Assessment, preparation of families for an emergency, proper hand washing, Household Hazardous Waste Collection Day on May 5, and an Electronics Collection on April 21.  Correspondence included a thank you from YMCA staff for the Health Department’s contribution to YMCA Healthy Kids Day on April 13.

ADJOURNMENT

On a motion by Mr. Buick, seconded by Ms. Fauci, the Board of Health adjourned at 9:11 p.m.  Motion carried.

Jean Gastiger, R.N., F.N.P., Secretary

DeKalb County Board of Health

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