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DeKalb County, Illinois |
Minutes of the
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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.; James Cole, M.D.; Sonja Conway, Ph.D.; Carl
Heinisch; Mike Groark, J.D.; Debra Schelkopf, D.V.M.; Darrell Wiley, M.D.; Steve
Wolf, R.N.
On
a motion by Carl Heinisch, seconded by Mrs. Pecka, the minutes of the Board of
Health meeting of May 28, 2002, were approved.
Motion carried.
Mrs.
Grush reported that the FY2003 budget process has begun for both the State and
the County. In terms of the State
budget, the Health Department survived many of the cuts, however did experience
a significant reduction in tobacco funding with the grant reduced from $90,000
in FY2002 to $30,000 in FY2003. The
State Department of Public Health received nearly a $57 million cut in general
revenue, tobacco settlement and other state funds. In addition, a state hiring freeze has been implemented and a
package offered to encourage early retirements. Mrs. Grush stated it will be unfortunate to lose experienced
personnel in light of the many challenges facing public health today.
The
FY2000 Medicare Cost Report has finally been completed and submitted.
It is estimated that approximately $50,000 will be received in
unreimbursed payments. Mrs. Grush
reported that this was good news as the accounts receivables for FY2002 were
over-estimated by approximately that amount.
The
State surveyors visited the Home Care Program on the 3rd of June to
complete the licensure recertification for the Home Care Program.
They praised the care provided by staff, both during observed home visits
and chart reviews. Paperwork documentation issues were pointed out that needed a
plan of correction and this was sent to the state within the required time
period.
The
Family Case Management Program had its annual medical chart review on May 16 and
17. This includes a detailed review
of records utilizing a 15-page audit tool.
The final report indicated that the agency continues to provide high
quality services to the residents of the county.
Mr.
Heinisch asked about the inservice provided to DeKalb Park District employees.
Mr. Drake responded that training was provided to the Park District as
they operate several concession stands, with many young people hired.
The importance of hand washing is emphasized at these trainings.
Mrs.
Grush reported that many calls have been received on dead birds.
One bird was found in DeKalb that tested positive for West Nile Virus.
He stated not all dead birds are being picked up.
She added that the agency is only allowed to send in eight birds for the
year for testing, so the only birds that will be sent in now would be from areas
outside the City of DeKalb. Dr.
Peltz asked if the virus affected all birds.
Mr. Drake responded that only crows and blue jays are affected.
He added that many other birds are dying this year, but he does not know
the reason for that. He felt the articles in the newspaper were excellent and
covered the issue very well.
Mr.
Heinisch expressed his appreciation for the Hazardous Waste Day held in April in
collaboration with the DeKalb County Farm Bureau. He feels fortunate that the citizens of DeKalb County were
able to benefit from this event.
Jane
Lux, Director of Personal Health Services, stated that the agency had their
first client, a 38 year old, diagnosed with breast cancer. Dr. Cole performed the surgery and chemotherapy has been
started. The patient is very
appreciative of the compassionate care received.
Mr.
Wolf noted the report of three positive HIV cases and wondered if they were
related. Mrs. Carroll, Communicable
Disease coordinator, responded that they were not related and the only
commonality is that they were a minority population. One was a college student and the other two are community
individuals. She pointed out that
three cases is usually the total for the whole year and she is watching the
situation very closely.
Lisa
Baj, Director of Home Care, reported that she had hoped to hire an additional
nurse in May or June but received no applications. Since then, however, a nurse has been hired to begin working
part-time on August 5. Lisa
reported that Lori Swedberg, the new secretary hired to assist with billing and
accounts receivables, has been doing a great job in contacting insurance
companies and receiving payments, reducing our accounts receivable.
Marcy
Zanellato, Director of Health Education, stated that Lisa Yaklich, health
educator, has done a wonderful job with the tobacco countermarketing campaign at
Genoa-Kingston High School. Photos
were taken and posters developed depicting the positive influences that keep
students from using tobacco products. These
posters were chosen by the Illinois Department of Public Health to be displayed
as a part of the World No Tobacco Day events held at the State Capitol building
in Springfield on May 31. Post-tests
were completed by 286 Genoa-Kingston High School students, with 25% of the
students stating they would like to participate in this year’s program and
want to be actively involved, which is a positive indicator.
It is planned that anti-smoking campaigns will be expanded next year to
junior high students.
Mrs.
Pecka asked if ongoing research is being done to determine outcomes.
Mrs. Zanellato responded that NIU has been contracted with to assist in
this aspect, but it is still too early to tell much.
She pointed out that 61% of the pre-tests indicated the student lived in
a home where someone smoked, and national research states that this makes the
child much more likely to smoke. NIU
has helped set up an evaluation process and this will be continued, as well as
looking at other types of impact. Mrs.
Pecka stated that she is proud of this campaign and what the Division of Health
Education has done in the county.
On
a motion by Mr. Groark, seconded by Mr. Kuhn, the Financial Statements for the
months of May and June 2002 and the Claims for the months of June and July 2002
were approved. Motion carried.
The
Department of Human Services contracts with Ahler’s Associates to process
family planning grant payments and collect data from submitted client visit
records. We are one of six
organizations in the State of Illinois who still submit data manually to Ahlers
Associates, who in turn, enters the information into their database.
Effective with the FY2003 grant, these agencies are required to implement
the Ahler’s software by December 1, 2002.
To do this, the Family Planning computer and printer need to be updated
to support this Windows-based software. The
cost of the computer and printer will be approximately $2,700, and the cost of
the software is $7,200 for the billing and client visit modules.
Support is $360 per year. The
Department of Human Services provided $1,800 towards this effort.
Mrs. Grush pointed out that this has been built into the anticipated
expenditures for FY2002 since the agency does not have a choice in this
computerization.
Mrs.
Grush reported that the Bioterrorism Grant requires that local health
departments have someone on-call 24 hours a day seven days a week.
An on-call schedule has been established and beepers acquired for seven
staff members who will take call one week at a time.
She is recommending that on-call staff be reimbursed $80 per week for
providing this service.
Dr.
Cole asked what the responsibilities are of the individual on-call.
Mrs. Grush responded that it is that person’s responsibility to either
handle the call themselves, if possible, or locate a staff person to do so.
If it were to report an act of terrorism, the State would be calling the
Health Department to activate staff.
Mr.
Heinisch moved to approve the purchase of software and hardware for the Family
Planning Program and compensation in the amount of $80 per week for Public
Health on-call staff, seconded by Mrs. Pecka.
Motion carried.
Mrs.
Grush indicated that this budget would be voted on at this meeting by the Board
of Health and then submitted to the county by August 7 before being submitted to
the County Board. The new budget
becomes effective on December 1, 2002. She
reported that the Finance Committee of the Board of Health met yesterday and
reviewed the proposed budget with no recommendations for changes.
Mrs.
Grush reviewed her three revenue goals: (1) not requesting from taxpayers more
than what was requested for FY2002, yet maintaining or increasing services; (2)
recommending minimal user fee increases of late registration fees in Animal
Control increasing from $5 to $10 and late fees for food permits not paid by
July 1 from $15 to 25% of the current license fee; and, (3) maintaining
financial stability of the Department during uncertain economic times.
Mrs.
Grush stated that, of 400 county restaurants, approximately 75 do not return
their permit fees in a timely manner and staff spend a great deal of time
following up on them. If the
payment is not received by July 1, the current late fee is $15. Environmental Health staff recommended increasing the late
fee to 50% of the cost of the license, but Mrs. Grush is recommending 25%.
Mrs.
Grush stated that she generally increases Animal Control fees every other year
and this would typically be the year for the increase.
Since it was determined from a survey conducted about five years ago that
DeKalb County’s fees are at the higher end, she recommends passing the
increase on to dog owners who are non-compliant in purchasing their tags and
registering their dogs on time, increasing the late fee from $5 to $10.
Mrs.
Grush presented the Revenue line items for the FY2003 Budget, with estimates
broken out for Public Health and Home Care.
Under Medicare Home Nursing, she is projecting receipts at $1.7 million.
This line item was maintained at the same level for next year as a 15%
cut is projected due to Medicare legislation.
The Bioterrorism Grant line item shows revenue in the amount of $100,000,
with matching expenditures for upgrading of the computer system and connection
with Springfield and the administration building in Sycamore.
Expected grant revenue is down only $8,300 as compared to FY2002 in spite
of a number of cuts. Family Case
Management/Federal Match is a new revenue source for the agency and helps with
that program’s costs. As of July
1, 2002, the agency will experience a 2.5% decrease in Public Aid reimbursement.
The Interest line item is down from $45,000 to $30,000 due to low
interest rates. Funding from the
Department’s Fund Balance shows revenue in FY2003 of $146,000 to balance the
budget.
The
Health Department anticipated revenue for FY2003 is $4,450,100, a 4% increase
over FY2002’s projected revenue and 9% more than budgeted for FY2002.
Mrs.
Grush presented the General Fund request for Animal Control, with direct costs
at $134,000 plus $11,200 for IMRF/SS paid by the County and $21,300
administrative allocation paid for by the Health Department for a total program
cost of $166,500. Fees will
generate approximately $120,000. $10,000
is being requested from the General Fund to subsidize the program.
The Public Building Commission request includes $68,000 for utilities,
$18,000 for maintenance, $25,000 for building maintenance and $26,000 for
janitorial and supplies, for a total of $137,000.
Mrs. Grush pointed out that these are expenses that the Public Building
Commission pays for all county buildings.
Mrs.
Grush presented Expenditures for the FY2003 Budget, with the largest expense
being salaries, with an overall increase of 6.3% over projected FY2002.
3.5% is for projected salary increases and 2.8% is for new staff hired
this year and employed for a full 12 months in 2003.
The salary increase is in line with County policy, that being the
cost-of-living projected at 1.6% on December 1 and a merit of 0-3% in June 2003.
Mrs.
Grush pointed out the large increase in health insurance.
A letter from Ray Bockman, County Administrator, to all insured county
employees was presented which addressed the problem and explained why an
increase will be needed. Mr. Groark
asked if the county had talked to private companies regarding coverage.
Mrs. Grush responded that private companies were approached last year but
none bid. Mr. Heinisch added that
private companies will bid, with the lowest bidder being granted the award, but
then they will raise their rates the following year to compensate.
Mrs. Grush explained that the county went to self-insurance because of
such increases in costs in the past. The
County did do well under this system for a number of years, but is now
experiencing large deficits with dramatic premium increases projected if the
program is not restructured. She
added that another reason for the increase is in the area of pharmaceuticals.
Expenditures
for FY2003 are projected at $4,450,100, a 9.2% increase over projected FY2002
expenditures. With the $100,000
additional in health insurance taken out, there is a 6.8% overall increase over
last year’s budget, which is very good in light of current 20 to 25% increases
in health care environments.
The
FY2001 fund balance was $2,062,036 and it is projected this year’s balance
will be $2,284,558. Mrs. Grush
indicated that it would be necessary to use some of this fund balance for
operating expenses. She anticipates
a fund balance in FY2003 of $2,137,658. The
average cash available for the period of December 31, 2001, through June 30,
2002, was $1,641,379.
Mrs.
Grush presented the Solid Waste Program budget. Revenue earned is from a $1.10 tipping fee on every ton of
garbage deposited in the DeKalb County Landfill. In 2002, an increase in expenditures was experienced because
of the Hazardous Waste Day and the $25,000 contribution toward that event.
The Solid Waste Program will have a fund balance of approximately $9,000
at the end of the year.
Dr.
Bishop asked if there was a dollar amount on the cost of recouping late fees
from restaurants, adding that the proposed 25% of permit fee late charge is
probably not enough to cover the administrative costs of collecting the fees.
Mr. Heinisch pointed out that there is an 18% penalty on real estate
taxes not paid by the due date.
Mr.
Groark moved to approve adoption of the FY2003 Health Department and Solid Waste
Budgets, including the increase in fees in the Animal Control Program and a 50%
of permit fee late charge rather than the 25% presented, seconded by Dr. Bishop.
Motion carried, with Mr. Heinisch voting no.
Mrs.
Pecka pointed out the issue of foodborne illnesses coming to the forefront more
and becoming a major problem and no reimbursement received by the Communicable
Disease Program for their handling of these cases.
Dr.
Cole asked for the definitions of the different food licenses classes and Mr.
Drake provided an explanation. Mr.
Groark asked if a large restaurant or a grocery store required more inspections
or more intensive inspections than other facilities. Mr. Drake responded that grocery stores do require more
inspecting because they often include delis and meat cutting departments, which
requires a lot of work on the part of Environmental Health staff.
Mrs.
Conway asked if the license fees in DeKalb County were comparable with other
communities. Mrs. Grush stated that
fees are cheaper to the west and generally higher to the east.
Newspaper articles for May and June focused on West Nile Virus, recycling by DeKalb County residents, warning by the Health Department of threat of food borne illness, safety on the Fourth of July holiday, Hiawatha High School’s activities with the tobacco grant, the increase of poverty in DeKalb County and the collection and recycling of used motor oil. Correspondence included a thank you note from the daughter of a Home Care patient.
On
a motion by Mr. Heinisch, seconded by Mr. Groark, the Board of Health meeting
adjourned at 8:34 p.m. Motion
carried.
Steve Kuhn, P.A., Secretary
DeKalb County Board of Health
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