BOARD MEMBERS PRESENT:  Fred Peltz, D.D.S., President; Glenda Pecka, R.N., M.S., Vice President; Steve Kuhn, P.A., Secretary; Russell Bishop, Psy.D.; Carl Heinisch; Steve Wolf, R.N.

BOARD MEMBERS ABSENT:  James Cole, M.D.; Sonja Conway, Ph.D.; Mike Groark, J.D.; Debra Schelkopf, D.V.M.; Darrell Wiley, M.D. 

MINUTES

On a motion by Mr. Heinisch, seconded by Mrs. Pecka, the minutes of the Board of Health meeting of July 23, 2002, were approved.  Motion carried. 

DIVISION REPORTS

Mrs. Grush stated that the Health Department Budget was submitted to the County in August.  Recommendations included: reducing the tax levy request from $324,800 to $317,421; eliminating the County chargeback; reducing the Public Building Commission request for building maintenance by $18,000 and eliminating the $18,000 assessment for the County Information Management Office staff; increasing the Renewal and Replacement funding for the Health Department/County Multipurpose Room from $50,000 to $100,000; and supporting the proposed late fee increases in the Food Sanitation and Animal Control programs.  The County Budget also calls for consideration of a per capita share payment from each department to cover the current $600,000 medical insurance fund debt payable over the next five years.  As the Health Department is the second largest county department, this will be a substantial amount due by the agency.

A requirement of the Bioterrorism Grant is the implementation of a County Terrorism Committee.  The first meeting was held July 17 and the agenda included determining what each department has done since October 2001, what needs to be done to be better prepared should an event occur, and who else should be added to the committee to ensure county-wide coverage.  Approval is being requested from Northern Illinois University to use the Convocation Center as a distribution site for the county, should that be necessary, as it is the perfect facility for such an event.  Mrs. Grush did ask other county health departments about the cooperation of state universities located in their counties, and all expressed complete cooperation with each other. 

A lot of time and effort have been put into mosquito control since the first big rain on August 22, 2002.  Briquettes for larviciding of the entire county were ordered on that day.  Our agency was fortunate to have a staff person from the State come to the facility to conduct training for 35 representatives from municipalities to become licensed operators to distribute briquettes in catch basins.  An emergency law was passed to allow two hours of training to become a licensed operator until October 31, 2002.  Ten days after the rain, the county’s first human case of West Nile Virus was confirmed.  At that point, the agency became eligible for funding for the purchase of larvicide.  A grant was written and enough funding was received for two more applications.  We were fortunate to receive all the briquettes that were ordered as many other agencies were reporting long backorder delays.  These were distributed and municipalities have been larvicided twice, with the rest being saved for next year.  Unfortunately, State Health Director, Dr. John Lumpkin, was told there was no new money available for mosquito abatement.  Consequently, Dr. Lumpkin took the money from local health departments’ Local Health Protection Grants.  As a result, at this time, there is no money for third and fourth quarter grant payments. 

Mrs. Grush stated that calls have decreased and she feels the agency is nearing the end of dealing with the West Nile Virus situation for this year.  A horse did die, as well as a flock of chickens and some swans.  The second human case was reported this week.  She reported that the average age of contracting the West Nile fever is 56.  Deaths from the virus have all been individuals at least 70 years of age, many of them with chronic conditions.  She added that it has recently been determined that it can be contracted through blood transfusions and transplants. 

Dr. Peltz asked if refrigeration for the vaccine was available at the Convocation Center.  Mrs. Grush affirmed that there was some refrigeration available but that is still a point of discussion.  Mr. Drake added that the agency does have a list of refrigerated semis that could be available.  Mr. Wolf asked if the agency had needles available for an event, and Mrs. Grush responded that they would be available through the National Pharmaceutical stockpile.

Mr. Drake, Director of Environmental Health, announced that violation notices would soon be sent out to owners of dogs that are past due for registration for the past 18 months. 

Mrs. Grush pointed out a map included in the packet that plotted calls on where dead crows were found, with the majority being in DeKalb.  The purpose of this map was for surveillance, and should several cases of the virus be reported in an area, adult spraying could be warranted.

Mrs. Lux, Director of Personal Health Services, reported a new initiative that has been implemented to assure prompt appointment availability for clients by increasing intake appointment slots, as well as offering preliminary appointments prior to the complete intake being conducted.  The second initiative is to encourage pregnant women to call earlier for an appointment and a mechanism is being developed where pregnant women can call directly from the Department of Human Services (Public Aid) office to make an appointment at the Health Department.    Mrs. Lux distributed examples of outreach posters that have been developed for the community focusing on the importance of early prenatal care.   These posters are also available in Spanish.  Mr. Kuhn stated that the Hispanic population needs to be targeted with more teen pregnancies and the need for those clients to receive prenatal care sooner.  Mrs. Lux pointed out that our community health worker is Spanish and bilingual, as well as an MCH nurse, and they both have close connections with Hispanic ministry and have done a great deal of informal outreach.  The Division of Health Education is also working through the Teen Pregnancy Prevention Grant in targeting Hispanic youth.

Immunization compliance has been a priority objective since FY2002.  The goal is for 90% of all children to have a complete set of immunizations at 12 months and 2 years of age.  A recall and reminder system has been used within the agency for a number of years for children that receive their immunizations here.  This effort is being expanded to include children for any program, regardless of where they receive their immunizations.  Colored charts were presented for the fourth quarter of the last fiscal year that shows our agency’s compliance rate for children 2 years of age going from 67% to 89% from 2001 to 2002.  Compliance for 1 year olds was over 90%.  She stated that this has been an effective strategy on a statewide level. 

Mrs. Baj, Director of Home Care, reported that staffing is currently right where it needs to be, and with the nursing shortage, feels very fortunate to have adequate staffing.  At the end of last week, the router on the Internet connection (ISDN) began experiencing problems and several days have been spent working to regain that connection.  Many options have been explored, and it was learned today that the agency could hook into the hospital’s T-1.  Kishwaukee Community Hospital currently has a wireless connection to the Health Care building and this should increase the speed of the computers.  Mrs. Baj distributed a new colored brochure to provide the community with information regarding the Home Health Program. 

Mrs. Zanellato, Director of Health Education, reiterated Mrs. Grush’s comments on the complications with the grant through the state-funded Illinois Tobacco-Free Communities Program.  Staff are working on and close to completing web pages for the Health Department, which will have a County site and Health Department site, with each program having its own page.  A trainer has been obtained from LifeLink to develop and provide a one-day Hispanic culture training for Health Department staff and area school personnel on December 2, 2002.   

FINANCIAL DATA 

Mrs. Grush reported that revenue was down somewhat in a few areas, but Home Care Medicare revenue was up by $148,000 over the same time last year and Home Care insurance up by $120,000.  She attributes this increase to the new secretary that was hired to follow-up on payments and also getting the bills out earlier because of the additional help.  Grants are down slightly and interest revenue is down as compared to 2001 because of low interest rates.  She stated that the agency is doing well in light of the current economy. 

Dr. Bishop asked how actual receipts compared with projections for this time of year.  Mrs. Grush stated that it is close or a little higher as compared to projections.  She added that summer is typically the time of year when more money is received because of license renewals and increases in clinic usage due to school physicals and immunizations.  Grants tend to be down at this time of year because it is the end of the grant year and new fiscal year payments have not yet been received.

On a motion by Mr.Heinisch, seconded by Mr. Kuhn, the Financial Statements for the months of July and August 2002 and the Claims for the months of August and September 2002 were approved.  Motion carried. 

NEW BUSINESS

IDPH Grant Funding

Tobacco Grant

The Health Department- was awarded $30,671 in tobacco dollars for FY2003.  Mrs. Grush reported that all these payments have been suspended and will be suspended until such time sufficient cash flow exists to fund local health departments.  The State legislature appropriated $547.4 million from the Tobacco Settlement Fund when only $300 million will be received.  Public Health may not get their money as many other departments receive funding from this fund also.  The State has indicated that no money will be received until April 2003 and no commitment will be made that 100% of the funding or any money will be received.  The Health Department has been requested to indicate whether the agency will continue the program as proposed and “front” the money until April 2003, reduce the program and send in a revised budget, or eliminate the program. 

Mrs. Grush stated that her recommendation is to continue the program as proposed and front the money until April 2003.  She pointed out that it is not unusual for the agency to front money for grants.  It has been her experience that those who ride out the tough times benefit in the end.  If the agency does carry the program, it would be the first to get paid.  Also, when additional monies become available, those who continued generally receive the first increases. 

Local Health Protection Grant  

The Local Health Protection Grant has been used to fund West Nile mosquito abatement efforts in Illinois, with the majority of the money going to the City of Chicago and Cook County.  The Health Department’s FY2003 grant award is $127,423.  The agency has been advised that it will receive the first two quarterly payments, the third payment is uncertain, and there is no potential at this time for the fourth quarter.  It is hoped that some federal dollars will come into the State to replenish this fund. 

Delayed Payments

Currently, Department of Human Services (DHS) grants are running about 30 days late, but have been told these can be expected to be longer during September and October because the State continues to be behind in its collection.  This is due to the fact that not as much money is being received from the federal government, as well as a decrease in sales tax.  She added that all contracts have been signed and the State will receive funding contingent on the funding being allocated and being available.

Dr. Bishop asked where the money would come from to “front” the Tobacco Program until April 2003.  Mrs. Grush responded that she hopes to have enough cash coming into the agency to pay for it and, if not, adequate funding is in the fund balance.  Mr. Wolf asked if it would be the full $30,000 that was budgeted.  Mrs. Grush responded that there is a little bit of overhead, as well as salaries and benefits.  The position of a three-day per week health educator could be carried.  She added that an extra year of the Comprehensive Health Grant money was received that was not anticipated. 

Mr. Kuhn questioned the value of education to young teens when the largest group of smokers is teenage girls.  Mrs. Zanellato added that Mrs. Grush did ask her division to work through NIU in obtaining a more formal evaluation of smoking programs to determine impact.  Nationally, a prevention effort can be tracked to determine the impact of education.  She added that there is usually a delay, but the decrease is there.  A number of studies have been conducted across the state and there will be a stronger body of evidence available in a year or two.  Mrs. Zanellato pointed out that the State has been very strong in looking at evidence-based outcomes to see where the money is being spent and where it does the most good.  Mr. Wolf added that there is nothing in our society that affects our population more than tobacco, and it is hard to match money up with results. 

Mrs. Pecka asked about smoking statistics in DeKalb County.  Mrs. Zanellato responded that 24.9% of the population in the county smokes.  The high school statistics have been very similar to that of the national numbers.  There has been a significant decrease of 5 to 6% over the last three years nationally in teenage smoking.  She added that there was a peak and then preventive efforts started, but unfortunately the college level students were the ones that were already addicted.

Mr. Wolf moved to continue the Tobacco Grant program until April 2003, seconded by Mrs. Pecka.  Motion carried.

FY2003 Employee Raises

Mrs. Grush reported that the County’s Pay Plan has historically given the cost-of-living (COLA) in December and 0 to 3% in June.  This year, the County Budget is recommending giving non-union employees a 1.6% COLA and a 1.4% merit, which is the full 3%, effective December 1, 2002.  This is the result of a difficult budget year and financial need.  Individuals at the top of their range will receive a 1.6% COLA and a 1.6% merit bonus on December 1.  She added that a large insurance increase is anticipated in January, and this will provide more money up-front for employees to help offset the anticipated significant increases.   Mrs. Grush recommends following the County’s recommendation in giving the entire 3% on December 1 instead of a COLA then and a merit increase in June.  Mrs. Grush presented the other options which included a 1.6% COLA in December 2002 and a 3% merit in June 2003 and a 1.6% COLA in December 2002 and 2% merit in June 2003. 

Mr. Wolf asked if this recommendation was consistent with other county departments.  Mrs. Grush stated that it is consistent with the other non-union employees, adding that union departments may adopt a different plan. 

Mr. Heinisch asked if this sets a precedent for future years.  Mrs. Grush stated she hopes the economy changes and allows for instituting the established compensation plan next year. 

Mr. Wolf asked if the Health Department has the option of going against the County’s recommendation in regards to salary increases.  Mrs. Grush stated that the agency did not follow the county’s recommendation last year giving 1% more because of a good year financially for the agency.  She stated that there had been previous years when the Health Department did not give as much as the county.  However, historically, the Health Department follows the County recommendation.  She added that the economy is different this year and 3 percent was budgeted, but she does not feel that more should be given based on the current economy. 

Mr. Wolf moved to approve a 1.6% cost-of-living increase and 1.4% merit in December 2002, seconded by Mr. Kuhn.  Motion carried.

Resignation of Dr. Chet Palmer, Animal Control Administrator

Mrs. Grush announced that Dr. Palmer, Animal Control Administrator, is resigning at the end of September or beginning of October because of his retirement from Malta Veterinary Hospital.  A new administrator is needed, and Dr. Augustine, a partner of Dr. Palmer’s for many years and backup to him, is willing to assume the position.  This position requires that the individual be a licensed veterinarian in the State of Illinois.  Mrs. Grush stated that she brought the resignation to the Board of Health to determine the need to advertise or pass the position on to Dr. Augustine.  She pointed out that much support has been received from Malta Veterinary Hospital over the years as they board the dogs picked up by the wardens.  She stated it would be very difficult to have dogs boarded at one facility and have the administrator at another clinic.  No other local veterinarian clinics have shown interest in boarding the county’s strays.  Mrs. Grush recommended the position be offered to Dr. Augustine. 

Mr. Heinisch suggested asking Dr. Shelkopf her opinion, as a Board member, as she is also a veterinarian but was unable to attend this meeting.  Since Dr. Palmer is resigning before the next Board meeting, Mrs. Grush stated this should be decided before the next meeting.  Mr. Heinisch asked what functions the position performs.  Mrs. Grush responded that they serve as consultant to the Animal Control wardens, physicians, and public health staff in regards to rabies, livestock kills and vicious dogs.  Their name also appears on the certificate as administrator.  She stated she would like to receive authorization to offer the position to Dr. Augustine should Dr. Schelkopf approve.  Mrs. Grush added that this is not always an easy job, especially when dogs are boarded because owners are not always pleasant and happy in this situation and some disruption can occur.  She feels that other veterinarian offices may not want such activity occurring in their offices. 

Mr. Wolf asked if the administrator received reimbursement.  Mrs. Grush responded that they receive approximately $650 per month to perform their duties. Dr. Bishop stated that there are liabilities and some risk factors involved, and their name does appear on the certificate.  Mrs. Grush pointed out that Malta Veterinary Hospital did build additional kennels when the second warden was hired and declined assistance in paying for them when offered.  Mr. Drake stated that the system would never work if the administrator were not located at the kennel where stray or vicious dogs were located. 

Mr. Heinisch moved to offer the position of Animal Control Administrator to Dr. Augustine, pending the approval of Dr. Schelkopf, seconded by Mr. Wolf.  Motion carried.

Nominating Committee – Board of Health Memberships

Mrs. Grush reported that Mr. Heinisch, Mr. Kuhn and Dr. Wiley are due for reappointment to the Board of Health.  Mrs. Conway, County Board representative, is not running for reelection so will not remain a member of the Board.  Mr. Heinisch has offered to serve on the Board of Health again, but is also running for the County Board.  Should he win the election, he could be the County Board representative in place of Mrs. Conway, with his current position replaced by a consumer from the community.  Mrs. Grush stated she would check with Dr. Wiley to determine his interest in remaining on the Board.  She indicated that the Nominating Committee would present a slate of officers at the November meeting.

CORRESPONDENCE AND ANNOUNCEMENTS

Newspaper articles for the months of July and August 2002 included West Nile virus, mosquito abatement, back-to-school information, National Five-a-Day Week, the increase of temperatures in closed up cars, and the requirement of dogs to have rabies shots and tags.

Correspondence included three thank you notes from the families of Home Care patients.

ADJOURNMENT

On a motion by Mr. Wolf, seconded by Mr. Kuhn, the Board of Health meeting adjourned at 8:45 p.m.  Motion carried.