DEKALB COUNTY HEALTH DEPARTMENT
MINUTES OF THE MEETING
December 1, 2009

 

BOARD OF HEALTH MEMBERS PRESENT

 

Scott Starkweather – President

Jean Gastiger, R.N., N.P. – Vice President

Linda Liston, M.D. – Secretary

Kevin Buick, J.D.

Dennis Diemer, D.V.M.

Paul Stoddard

Todd Latham

John Olson, D.D.S.

David Phillips, M.D.

Jesus Romero

BOARD OF HEALTH MEMBERS ABSENT

E. Sue Thompson, R.N.

Staff Members Present

Karen Grush, DeKalb County Health Department, Administrator

Jane Lux, DeKalb County Health Department, Assistant Administrator

Bette Chilton, DeKalb County Health Department, Director of Personal Health Services

Brenda Courtney, Director of Fiscal Operations

Ruth Patton, DeKalb County Health Department, Director of Office Support

Deb Rolf, DeKalb County Health Department, Director of Home Care

Marcy Zanellato, Director of Health Education

STAFF MEMBERS ABSENT

Bob Drake, DeKalb County Health Department, Director of Environmental Health

 

CALL TO ORDER

The DeKalb County Board of Health meeting of December 1, 2009, was called to order at 7:38 p.m. by Mr. Scott Starkweather, President.

 

AGENDA

Mrs. Grush added H1N1 Compensation for Salaried Employees and Personal Cell Phone Reimbursement for Work Related Use for Home Care Management Staff to the agenda under New Business. 

MINUTES
On a motion by Dr. Phillips, seconded by Mr. Romero, the Board of Health Minutes of the Meeting for September 29, 2009, were approved.  Motion carried. 

DIVISION REPORTS
Public Health Administrator
Mrs. Grush reported that the Health Department’s budget had passed and we received the level of funding we requested.  There was some debate among the County board members regarding the County’s 2010 Budget over using monies in reserve in order to maintain services as they are.  Some board members didn’t want to use reserve funds but instead wanted to reduce expenditures.  However, County administrators maintained the reserve is there to sustain services.  Services may need to be cut next year if the economy remains the same.  Mrs. Grush reported that the Health Department has started the process of closing the financial books for FY2009. 

 

Mrs. Grush reported we were one of four agencies named as beneficiaries of the Gordon Walters estate.  Our portion was to be paid out over eight years, however, the family wanted to close the account and make a lump sum payment.  We have received a check in the amount of $71,715.00 which will go into our fund balance and be a reserve for the Home Care division. 

 

Environmental Health

Mrs. Grush spoke on behalf of Mr. Drake who was unable to attend tonight’s meeting.  Environmental Health is winding down for their year in terms of special events, fall festivals, etc.  The electronic waste event on October 17, 2009, was very successful. 

 

Personal Health Services

Mrs. Chilton reported that the H1N1 pandemic has made a huge impact on division.  Administration of the seasonal flu vaccine was started earlier than usual in anticipation of H1N1.  However, we weren’t expecting shipments of the seasonal flu vaccine to be delayed.  This made it very difficult to maintain the clinics already scheduled.  At the same time, eighteen new nurses were interviewed and hired to help administer the H1N1 vaccine. 

 

During this time, there was a pertussis outbreak in an area homeless shelter.  Fortunately, Dave Wester, P.A., of the Community Cares Clinic stepped in to help Lorna Schmidt, Community Disease Coordinator, and Mrs. Chilton treat the homeless residing there at the time. 

 

Dr. Olson stated that he noticed that there was a lot more lead testing during the month of September than in October.  Mrs. Chilton reported that this was due to the beginning of the school year and children receiving a lead test during their physical exams. 

 

Home Care

Mrs. Rolf reported that Home Care is in the process of implementing OASIS education in anticipation of the changes coming January 1, 2010.  Four sessions have been completed so far and there are four left to go.

 

Health Education

Mrs. Zanellato reported they are finalizing the last CATCH grant in Sycamore.  Should future funding become available, the long range goal is to branch out to the Sandwich, Somonauk, and Genoa areas.

FINANCIAL DATA
Mrs. Grush reported that outstanding grant payments due will eventually be received. 

Mr. Starkweather stated that it looked like no money had been collected for animal control licenses.  Mrs. Grush replied that those monies go into a county fund which is transferred at the end of the year to the Health Department Animal Control line item.  

 

Mr. Starkweather also asked about the income of the Medicare home nursing which seemed like it was lagging behind what had been budgeted.  Mrs. Grush replied that there’s always a two to three month lag in payments.  Also, she is estimating revenue to be down about $50,000 to $100,000 at the end of the year in Home Care. 

 

Dr. Olson asked if the County penalizes us for receiving the $72,000 from the Walters estate.  Mrs. Grush replied it the policy that Home Care sustains itself financially without County financial support.  Had the money been given to Public Health, the County might have reduced the health levy, but she did not believe this would reduce County support for Public Health.

 

Mr. Latham moved to approve the Financial Statements for the months of September and October 2009, and Claims for the months of October and November, 2009.  The motion was seconded by Dr. Olson.  Motion carried.

NEW BUSINESS
H1N1 Report

Mrs. Grush presented to the Board of Health a Summary Report of the H1N1 activities completed by the Health Department to date. 

She reported many variables came together to challenge our planning assumptions contributing to a difficult H1N1 Flu planning and response. Vaccine production delay, widespread illness, and media saturation leading to public panic and fear resulted in a high demand for vaccine with very low supply.

 

She stated the Health Department had a solid plan to initially focus vaccination efforts on children in county school districts. However, the plan was based on the assumptions we would have ample supplies of vaccine, and other health care providers would have their vaccine shortly thereafter to reach medically high-risk individuals and adults in the CDC target group.  Neither of those two key factors occurred. Planning meetings were held with the Regional Superintendent of Schools, county superintendents and later with countywide school principals and school nurses to discuss our distribution plan. Consequently, the plan had to be revised many times in accordance with vaccine supply considerations.

 

At the same time the Health Department was planning vaccine distribution, notification of a death of a sixteen-year-old county student from H1N1 was received.  Response efforts were directed to communicable disease investigation regarding underlying medical conditions of the teenager, handling of the media and assisting the affected school district with their response. 

 

The Health Department received an initial 5,000 doses of vaccine on October 15^th and a second shipment of 4,000 doses on November 4^th.  Eighteen part-time temporary nurses were hired to assist with our vaccination efforts.  Clinics began October 22, 2009, first vaccinating employees and household members, emergency medical services personnel and first responders. Because ample supplies of vaccine never came in to implement our school plan in each district throughout the county, the decision was made to hold a clinic at the Health Department, a clinic in the north at the Genoa Kingston High School, and a clinic in the south at the Sandwich High School for any individual in the CDC target group. Over the course of the next month, the Health Department administered 4,820 doses of vaccine. Clinics were primarily held during evening and weekend hours; consequently, our other services were largely unaffected.

 

Because local health care providers never received any of their pre-ordered vaccine, the Health Department transferred some of its shipment to Kishwaukee Hospital and private providers for their highest risk patients. Approximately 2,000 doses were transferred. 

 

School and community surveillance were conducted to recognize illness above the norm in the community.  Investigations were completed on fifteen confirmed cases.

 

The Illinois Department of Public Health broadened its scope of the SNS Antiviral distribution.  Antivirals received by the Health Department from the federal stockpile were offered twice to local healthcare providers for uninsured and underinsured patients that had difficulty affording them.  As part of our prevention efforts, each school district was provided a supply of surgical masks for their ill students.

 

The Illinois Department of Public Health held weekly Conference Call Updates. The Health Department Flu Team met following these conference calls to discuss surveillance, vaccine supplies, distribution strategy, and the logistics of the community clinics.   Meetings were held with local partners including local Fire/EMS/Law Enforcement prior to our community clinics. Frequent phone conferences were held with Kishwaukee Hospital and local health care providers. 

 

Collaboration with Elder Care Services to develop an email distribution network to communicate public health information to the social service community and their clientele was completed. 

 

Much was done in the arena of Public Information.  Trittenhaus Design was contracted with to develop the content and organization of the Health Department H1N1 Website, which would become our primary source for keeping the public informed.  Twelve thousand copies of CDC H1N1 public information brochure were distributed and printed throughout the county. There was intense media interest, especially in light of the teen death

 

All Health Departments in the State received funding under the Public Health Emergency Response Act to implement required services related to the pandemic influenza.  Two grants have been received.  PHER I and II received are planning grants and funding in the amount of $122,297 has been received.  This funding is to be used to plan clinics and vaccination venues, engage private sector partners to provide vaccination, provide vaccine monitoring, handling and storage guidance to providers, inform providers regarding the Vaccine Adverse Events Reporting System, disseminate information related to H1N1 and vaccine availability, implement community mitigation strategies to reduce exposure, improve monitoring and reporting of influenza like illness and hospitalizations for respiratory infection and investigate reports of confirmed influenza.  PHER III funding in the amount of $194,231 was received to implement public distribution of vaccination, implement communication strategies to reach the public, distribute and assure dispensing of stockpile supplies of antiviral drugs, implement community mitigation  activities and measures, assure adequate security at central receiving sites, develop IT infrastructure for tracking personnel, contracts, inventory, funding, purchase protective equipment for vaccination work force, assure public health surge capacity, investigate adverse events as the result of vaccination and investigate confirmed H1N1 cases and deaths.

 

Mrs. Grush reported this has been the most challenging public health event of her career because of all the variables, primarily vaccine unavailability.  She commended the Management Staff for the incredible amount of planning and implementation work that has been done and the entire Health Department staff for their dedication and professionalism at the clinic sites in distributing vaccine.  

 

H1N1 Compensation for Salaried Employees

Mrs. Grush reported that all hourly staff working H1N1 activities receive their hourly rate, and if it is over 40 hours, receive their hourly pay at time-and-a-half.  Management/salaried staff receive pay for 37.5 hours regardless of the hours worked. Mrs. Grush requested approval to pay management/salaried employees for working over the normal workweek for H1N1 activities.  Mrs. Grush reported that the Board of Health had authorized previously for additional pay for management staff for extraordinary situations warranting above and beyond time worked. This situation meets that criteria.  Mrs. Grush informed the Board that the extra compensation had to be in the form of a bonus and not hourly pay.  The lump sum bonus would be calculated on the H1N1 time worked beyond the normal work week times the employee’s straight hourly rate. Mrs. Grush stated this would be paid for from the funding provided from the Public Health Emergency Response Grants received. 

 

Mr. Stoddard moved to approve H1N1 compensation for salaried employees.  The motion was seconded by Mr. Romero, the Board of Health approved H1N1 compensation for salaried employees.  Motion carried. 

 

Cell Phones for Home Care Management

Mrs. Grush reported that Home Care management uses their personal cell phones for business calls.  In the FY2010 budget, it has been budgeted to reimburse them $50.00 per month.  Mrs. Grush requested that they be reimbursed $50.00 per month for FY2009.  After a brief discussion regarding cost, Dr. Olson moved to approve compensating Home Care managers for use of their personal cell phones for business purposes.  The motion was seconded by Mr. Buick.  Motion carried.

 

Nominating Committee

Mr. Latham passed out the Nominating Committee report to all Board Members and staff.  Kevin Buick was recommended for a second term from January 1, 2010 through December 31, 2012.  Paul Stoddard was recommended for a second term from January 1, 2010 through December 31, 2010.  Recommended for a first term were Tim Duez, D.D.S, replacing John Olson, D.D.S, and Karen Hagen, R.N., M.S., Executive Director, DeKalb County Hospice, replacing Jean Gastiger, R.N., N.P.  The nomination for the 2010 Board of Health Officers were Linda Liston, M.D., President, Jesus Romero, Vice President, and Kevin Buick, J.D., Secretary

 

On a motion by Mrs. Gastiger, seconded by Mr. Latham, the 2010 Board of Health recommendations for the Board of Health Officers were approved.  Motion carried.  Board recommendations will be forwarded to the County Board.

 

Recognition of Retiring Board of Health Members

Mrs. Grush recognized outgoing Board of Health member Jean Gastiger, R.N., N.P., with a plaque noting her dates of service on the Board of Health.  Mrs. Gastiger stated she was proud of Health Department and enjoyed coming to the meetings.  Mrs. Gastiger commended Mrs. Grush on her organization and making the job of Board of Health members easy.

 

Mrs. Grush also recognized outgoing Board of Health member John Olson. D.D.S., with plaque noting his dates of service on the Board of Health. 

 

Mr. Starkweather was presented with a card of thanks for his term as Board of Health President for the past two years.

 

CORRESPONDENCE AND ANNOUNCEMENTS

Highlights noted.

ADJOURNMENT

On a motion by Mr. Latham, seconded by Mr. Romero, the Board of Health adjourned at 8:57 p.m.  Motion carried.

 

________________________________________________

Kevin Buick, J.D., Secretary

DeKalb County Board of Health