DEKALB COUNTY BOARD OF HEALTH

MINUTES OF THE MEETING

July 28, 2009

 

 

BOARD OF HEALTH MEMBERS PRESENT

Scott Starkweather – President
Jean Gastiger, R.N., N.P. – Vice President
Todd Latham
John Olson, D.D.S.
Jesus Romero
E. Sue Thompson, R.N.

BOARD OF HEALTH MEMBERS ABSENT
Linda K. Liston, M.D. – Secretary
Kevin Buick, J.D.
Dennis Diemer, D.V.M.
David Phillips, M.D.
Paul Stoddard

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
Bob Drake, DeKalb County Health Department, Director of Environmental Health
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
None

 

CALL TO ORDER
Mr. Starkweather, President, called to order the DeKalb County Board of Health meeting of July 28, 2009, and started at 7:34 p.m. without a quorum.    

 

AGENDA
Mrs. Grush added the Vision and Hearing Screening Grant to the agenda. 

 

MINUTES
Because there were not enough Board members to meet quorum requirements at the start of this meeting, the meeting minutes of the DeKalb County Board of Health for May 26, 2009, were not be approved at that time.  However, Mr. Romero arrived at 7:39 p.m., producing a quorum.  Therefore, on a motion by Mr. Latham, seconded by Mr. Romero, the meeting minutes of the May 26, 2009, were approved.  Motion carried.

Dr. Olson noted that on the meeting minutes of May 26, 2009, a second motion to approve the salary increase of Mrs. Grush was missing.  The minutes will be corrected by Ruth Patton, Recording Secretary, reflecting the second motion.

The Executive Session minutes of May 26, 2009, were approved with a motion from Dr. Olson, seconded by Mrs. Thompson.  Motion carried.

 

DIVISION REPORTS

Public Health Administrator
Mrs. Grush reported that State funding and other reduced income is the biggest concern at this time.  The Health Department is preparing for the seasonal flu season and H1N1 (swine flu).  Recruitment of 35 additional county workers to help with vaccine dispensing sites has been completed.  The Emergency Preparedness team will be touring the NIU Convocation Center on Wednesday, August 5, 2009, in order to revise the flow in which the public will be processed throughout an emergency event.  The Health Department has been working closely with NIU on this process.  CDC has encouraged large employers to assume dispensing for their employees and that had been our focus last year with NIU.  However, because of limited resources, recent thinking is to have one central dispensing site with the Health Department dispensing to the public and NIU dispensing to NIU.

New information is coming in every day regarding the H1N1 virus. 

Mrs. Jane Lux, Assistant Administrator, and Mrs. Bette Chilton, Director of Personal Health Services, will be meeting with school nurses to discuss the H1N1 virus.  Plans to meet with County superintendents are being coordinated through the Regional Office of Education.

Mrs. Grush mentioned an article from the Wall Street Journal which states that by the time a school closes, it’s too late; the virus has already been spread and infected the entire school.  The article read that in order for a school closing to be effective, it needs to occur sooner.  Mrs. Grush stated this finding may change the school closure recommendations.

Mr. Latham asked if the Governor Quinn had responded to her letter regarding State cuts.  Mrs. Grush stated he had not nor did she expect one due to the number of letters the Governor is receiving regarding this issue. 

Mr. Starkweather inquired as to the supply of H1N1 vaccine.  Mrs. Grush stated that there is not enough for everyone initially but CDC is prioritizing target and priority groups such as pregnant women and children.

Mrs. Gastiger stated that she heard that the seasonal flu vaccine being manufactured is not going to be the right one. 

Dr. Olson stated that the Health Department allocated $17,000.00 for the Natural Resource Center to teach school-age children about recycling and wondered if we could ask Waste Management to help fund recycling education.  Mrs. Grush responded the funding comes from the tipping fee from Waste Management.  If the landfill expands, additional money will be received for additional educational opportunities from Waste Management. 

Environmental Health
In addition to his Environmental Health report, Mr. Drake reported that Animal Control picked up a rat snake in a house in DeKalb that had been abandoned.

Mr. Romero reported that during the car show held in Sycamore over the weekend, he noticed some vendors who were not prepared for food inspections and asked if there was a way vendors could be penalized for this.  Mr. Romero stated he felt there should be some sort of fine for these vendors since they know what is needed before they can open.  Mrs. Grush replied stating there is no mechanism for fines in the current ordinance, but the vendors would not be allowed to open if there were serious violations.  Mrs. Grush stated this issue is something that could be addressed.

Personal Health Services
Mrs. Chilton reported on the changes in the WIC food packaging starting August 1, 2009.  The food packaging hasn’t changed since 1980.  When WIC was established, it was because women were underweight and not getting enough to eat.  The changes now are dealing with obesity.  Baby juices have been deleted and food packages are more culturally sensitive, adding more whole grains, fruits and vegetables in an effort to assist in combating the obesity epidemic.     

Mrs. Chilton met with Shelly Johnson of Kishwaukee Hospital regarding the community clinic joint venture the hospital and NIU have been working on.  This group will be opening the Partners Health Care Clinic in the old Monsanto Building in August.  Mrs. Chilton was able to spend time with Ms. Johnson, who will be acting as the director of the program, and some of her staff.  Mrs. Chilton added that this project will be a huge asset to the community and the problem of access to affordable healthcare. 

Mrs. Chilton reported on the pertussis outbreak DeKalb County is facing at this time.  She and her staff are keeping local providers informed on the situation on a daily basis and the response from the provider community has been good.  Mrs. Chilton added that we are fortunate that school isn’t in session or the outbreak could be much worse.  The age range of cases has been one month to 59 years.  While she doesn’t have an exact number of cases to report yet, it seems the outbreak started in late May and started to increase in early July. 

Home Care
Mrs. Rolf reported that one full-time nurse and part-time nurse have been hired and will start August 17, 2009.

Health Education
Mrs. Zanellato reported that she is in process of finishing year end reports and grants, and working on emergency planning.  The emergency plan is being reviewed and refined to be applied towards the H1N1 epidemic. 

Mrs. Grush commended Mrs. Zanellato and the Emergency Preparedness team on the Site Visit Executive Summary and the progress that’s been made since last year.  As a Cities Readiness Initiative county, a score of 80 was required to maintain funding.  Our score increased from 77 in 2008 to 94 in 2009.  Mrs. Grush reported the two areas needing additional work are recruiting additional workers to be able to complete dispensing in 48 hours and security.   

 

FINANCIAL
Mr. Latham moved to approve the Financial Statements for the months of May and June 2009, and Claims for the months of June and July, 2009, seconded by Mrs. Thompson.  Motion carried.
 

NEW BUSINESS

Identity Theft Policies Proposal
Mrs. Grush reported on the Identity Theft Policy that goes into effect August 1, 2009.  This policy is required in order to implement the “Red Flag Rule” in which organizations are required to look for red flags that someone may have stolen another person’s identity.  Mrs. Grush presented two policies, both for Identity Theft Protection – the first a general fiscal management policy and the other specific to Home Care.

Mr. Latham asked if there was a procedure in place if someone was committing identity theft.  Mrs. Courtney stated that if identity theft was suspected, she would contact Global Payments and the local police department. 
 
Mrs. Thompson moved to approve the Identity Theft policies, seconded by Dr. Olson.  Motion carried.

2010 Health Department Budget
Mrs. Grush presented the proposed FY2010 Budget.  She indicated County revenues have begun to decline and are expected to continue declining through at least 2010.  Investment losses from pension funds will place an additional burden on county expenses.  State allocations are uncertain.  Because of these factors, departments were instructed to not plan for any increases in property tax revenue.

Mrs. Grush presented proposed program fees for 2010, which included increases for animal control, food establishments, sewage, water, childhood immunizations, flu shots, TB tests, and certified birth and death certificates.  

The Health Department requests funding from the County to support the agency.  This funding comes from the health tax levy (maximum of .0232¢ per $100,000 of assessed valuation), which based on this year’s assessed valuation could generate $514,000. However, based on budget guidelines, the same tax dollar amount received in 2009, that being $495,000, is being requested. The County has provided funding for Social Security and IMRF for Public Health employees, while Home Care generates their own funding to pay the cost.   The General Fund provides funding for building utilities, maintenance and janitorial for the Health Department and the Multi-Purpose Room. Funding is also being requested for janitorial for the Community Outreach Building. Mrs. Grush recommended the funding request to the County in the amount of in the amount of $602,700 for the stated purposes.  

The Animal Control budget was presented. Tag registrations, Health Department administrative in-kind support, and County subsidy of Social Security and IMRF will fund Animal Control.  No General Fund request for Animal Control is being requested.   

Mrs. Grush reported that the Finance Committee of the Board of Health, consisting of Mrs. Gastiger, Jesus Romero, Paul Stoddard, and President Starkweather met on the 24th of July.  She reported that 2009 Environmental Health revenue is expected to be down about 2% but proposed fee increases should generate approximately $30,900 for 2010.  Home Care revenue at this time compared to last year is up slightly and the current revenue is used to project revenue for 2010. Mrs. Grush reported the State Budget is still not approved, and this is the first time she can recall not having received grant awards by this time.  Most vulnerable is $485,000 the Department receives in State General Fund monies that could be funded at 0% to 90% funding.  At the moment the Basic Health Services Grant, that as been the backbone of many Health Departments, is funded at $0.  The 2010 Budget is based on the assumption that grant funding from the State will be approximately the same as 2009.  However, this year State grants will be down about $80,000 due to one-time supplemental funds received in 2008 that will not be received this year. It is expected that the Federal Match for Family Case Management will increase approximately $32,500.   Mrs. Grush reported that Stimulus money coming into the State of Illinois got Medicaid payments fairly caught up, but that is not expected to continue in the future. Approximately $20,000 in additional Medicaid funding is expected for 2010.  Fees for service are down approximately $45,000 due primarily to fewer immunizations administered in both children and adults even though the number of clients receiving service has remained the same.   Interest on investments is down significantly and not expected to increase in 2010.  It is expected that the areas of revenue decreases expected will be offset by the proposed fee increases and the expected increase in the Family Case Management Federal Match funding.  
 
Projected revenue for 2009 is expected to be $6,224,000 and for 2010 is expected to be $6,294,600, a 1.5% increase.   
 
The largest expense category is Personnel, with the FY2010 Budget based on a 4% annual salary increase for Bargaining Unit and non-union staff.  Mrs. Grush reported that IMRF is going from 8.5% to 9.0%.  County health insurance is expected to increase 10% in 2010; however, Health Department health insurance is expected to increase approximately 17.5% in 2010 due to some anticipated changes by employees from single to family coverage.  Overall it is expected that Personnel Services will increase approximately 7.5%. 

Dr. Olson asked if the Health Department salary increases were in line with what others in the area were giving.  Mrs. Grush stated the Bargaining Agreement calls for a 3% January 1 and a
2 % July 1 and this is higher than what others in the community appear to be giving. County budget guidance for non-union is recommending non-union employees receive 2%. At this
time NIU has not reported if raises will be given to the NIU community.   

In the Capital expenditure line items, the Health Department will be reviewing capital items closely and only replacing if absolutely necessary. Contractual and Commodities Services line items are budgeted to increase approximately 3%. The only new item added to the budget is to reimburse Home Care Management positions $50 per month to compensate for work related use of personal cell phones.

The Asset Replacement Fund for Health Department Technology is new this year and will increase in 2010 to set aside money for future upgrades.  Fund Balance revenue will be used to pay for this expense. 

Projected expenses for 2009 are $6,103,200.  Expenses budgeted for 2010 are expected to be $6,446,200, a 5.6% increase.   

The fund balance for FY2009 is anticipated to be $2,150,449 and $1,998,849 for FY2010.  Mrs. Grush pointed out that this is not cash on hand as about $600,000 at any given time is accounts receivable and revenue used for cash flow when monthly expenditures exceed monthly revenue received. 

Mrs. Grush indicated in addition to the $31,000 Asset Replacement expense from the Fund Balance an additional $120,600 will be needed to balance the budget. 

Mrs. Grush also indicated that because of the uncertainty of revenue and state funding, it will be necessary to monitor the budget every six months and make necessary adjustments as warranted.
Mrs. Grush did voice concern about being able to sustain the current level of the Personnel Services cost in the current economy.

Mrs. Grush recommended the budget as presented be adopted.   

On a motion by Mrs. Gastiger, seconded by Mr. Latham, the proposed 2010 Health Department Budget was approved.  Motion carried.

2010 Solid Waste Budget
Mrs. Grush presented the proposed FY 2010 Solid Waste Budget. Revenue is expected to be $113,800.  Revenue is generated from the tipping fee.  Expenses for 2009 are expected to be $133,200.  Expenses for 2010 are expected to be $164,000.  The increase primarily due to an anticipated sharing of cost with Waste Management for three rural recycling sites and a financial commitment to EPA to host a Hazardous Waste collection in DeKalb.  A fund balance of $40,474 is anticipated at the end of 2010. 

On a motion by Mr. Latham, seconded by Mrs. Gastiger, the proposed 2010 Solid Waste Budget was approved.  Motion carried.

Vision and Hearing Screening Grant
Mrs. Grush reported that the Vision and Hearing Screening Grant has the potential of being cut completely or significantly reduced by the State.  Mrs. Grush requested that she be allowed to use the Executive Committee of Board to determine the scope of the program should funding be reduced or eliminated.  If no grant funding is available she would recommend eliminating the program as other options for screening are available to children.  Vision and hearing screenings are to begin at the end of August or early September.  The Health Department will need to contact day care centers if the program is cut. 

Mrs. Thompson suggested that if reduced funds were offered, perhaps we could then offer services to those daycare centers that serve the highest number of low income children. 

 

EXECUTIVE SESSION

At 8:40 p.m., Mrs. Thompson moved to enter into Executive Session for the purpose of biannual review of Executive Session minutes and the destruction of verbatim Executive Session recordings, seconded by Mr. Latham.  On a roll call vote, those voting yes were Mrs. Gastiger, Dr. Olson, Mrs. Thompson, Mr. Latham, Mr. Romero, and Mr. Starkweather.

At 8:50 p.m., Mr. Latham moved to reconvene to regular session, seconded by Mrs. Thompson.  On a roll call vote, those voting yes were Mrs. Gastiger, Dr. Olson, Mrs. Thompson, Mr. Latham, Mr. Romero, and Mr. Starkweather.

Mr. Latham made a motion to not make public past Executive Session minutes, seconded by Mrs. Gastiger.  Motion carried. 

Mrs. Thompson made a motion to accept the written resolution authorizing the destruction of the verbatim recordings of Executive Session minutes of January 23, 2007, March 27, 2007, May 22, 2007, July 24, 2007, September 25, 2007, November 27, 2007, and January 22, 2008.  Motion seconded by Dr. Olson.

 

CORRESPONDENCE AND ANNOUNCEMENTS

Highlights noted.

 

ADJOURNMENT

On a motion by Dr. Olson, seconded by Mr. Romero, the Board of Health adjourned at 8:53 p.m.  Motion carried.

 

________________________________________________
Linda K. Liston, M.D., Secretary
DeKalb County Board of Health