DEKALB COUNTY BOARD OF HEALTH

MINUTES OF THE MEETING

MAY 24, 2011

 

BOARD OF HEALTH MEMBERS PRESENT

Linda Liston, MD – President
Kevin Buick, JD - Secretary
Dennis Diemer, DVM
Tim Duez – DDS
Karen Hagen, RN, MS
Todd Latham
David Phillips, MD
Scott Starkweather

BOARD OF HEALTH MEMBERS ABSENT
Jesus Romero – Vice President
Paul Stoddard
E. Sue Thompson, RN, MS

Staff Members Present

Karen Grush, Administrator
Jane Lux, Assistant Administrator
Bette Chilton, Director of Personal Health Services
Brenda Courtney, Director of Administrative Services
Marcy Zanellato, Director of Health Education
Greg Maurice, Director of Environmental Health
Lisa Hardcastle, Director of Home Care

CALL TO ORDER

The DeKalb County Board of Health meeting of May 24, 2011, was called to order at 7:42 PM by Dr. Linda Liston, President.

Karen introduced Lisa Hardcastle, Director of Home Care, and Greg Maurice, Director of Environmental Health.

MINUTES

FULL BOARD
On a motion by Scott Starkweather, seconded by Dennis Diemer, the Board of Health Minutes of the Meeting for March 22, 2011, were approved. Motion carried. 

On a motion by Tim Duez, seconded by Scott Starkweather, the Executive Board of Health Minutes of the Meeting for March 22, 2011, were approved. Motion carried. 

PERSONNEL COMMITTEE
On a motion by Scott Starkweather, seconded by Karen Hagen, the Personnel Committee Minutes of the Meeting for May 3, 2011, were approved. Motion carried. 

On a motion by Scott Starkweather, seconded by Todd Latham, the Personnel Committee Executive Minutes of the Meeting for May 3, 2011, were approved. Motion carried. 
Division Reports

Public Health Administrator – Karen Grush
Mrs. Grush demonstrated the new DeKalb County Health Department website for the Board highlighting the various links. She reported the new website illustrates our commitment to continually improve our ability to communicate with residents regarding our services and important public health news. She commended Marcy Zanellato and Jane Lux who directed the development of the site.

Mrs. Grush reported on late grant payments, additional funding received for HIV Case Management, and a reduction in our Senior Services award for 2011/2012.  

Mrs. Grush reported this is the last administrator’s report she would be submitting as her official retirement date is June 30, 2011. She thanked the Board for their support of her and the health department.

Environmental Health
Our former Director of Environmental Health, Bob Drake, has officially retired. His last day was Friday, May 20, 2011.

Personal Health Services
Mrs. Chilton reported on the table in her report. As of January 1st, the Well Child Program was discontinued. However we are still providing the Childhood Immunizations Program. In the Childhood Immunizations Program, we have administered vaccines to 582 children as compared to 558 children this time last year. Mrs. Chilton stated she thought we might lose some immunization clients after discontinuing Well Child Clinics, but Immunization Clinic numbers (children getting immunizations without exams) have not decreased. We continue to refine and evaluate the Personal Health Services Division.

Dr. Liston asked if the WIC caseload was assigned by the state. Mrs. Chilton said yes and it is based on the number of clients served from year to year. This past year WIC caseloads have been down both nationally and statewide. It is believed the decrease is due to stimulus money increasing food stamp funding. This resulted in more individuals being eligible for food stamps. As a result, some individuals have not signed up for WIC.  We have been told the same caseload will be assigned for 2012, as the state anticipates with the end of stimulus money for food stamps, WIC caseloads will rebound (increase).

Home Care
Mrs. Hardcastle reported she has completed approximately eight weeks as Director of Home Care. She has been spending most of her time observing and analyzing home care office and clinical processes. She has identified many strengths in the program, as well as some processes that could make the program more efficient. She reported new therapy regulations and physician face to face regulations became effective April 1, 2011.

Health Education
Mrs. Zanellato reported the Break the Habit program, a requirement of the Illinois Tobacco Free Grant, has been very successful, with 42 individuals signing up to participate.

She also reported that we had our Local Technical Assistance Review (LTAR) of our Emergency Preparedness program on April 22, 2011, conducted by Illinois Department Emergency Response Coordinator, Masood Athar, MD, and Carla Little, SNS Coordinator. We are required to score 69 on this review to assure continued funding. We have not yet received our score.

Financial Data

Mrs. Grush commented that we still have $110,000 in accounts receivables from 2010 which are grant payments that the state has not paid for the period July through December 2010. Some grant payments for 2011 that are funded by state general revenue are also behind or have not been paid at all.  

Dr. Diemer asked if the state paid interest on money they owe to us. Mrs. Grush said that they are supposed to.

Dr. Duez moved to approve the Financial Statements for March and April 2011, seconded by Dr. Phillips.  Motion carried.

Scott Scottweather moved to approve the Claims for March and April 2011, seconded by Todd Latham.  Motion carried.

NEW BUSINESS

ANNUAL ADMINISTRATIVE REVIEW OF HOME CARE DIVISION
Mrs. Grush presented the 2010 Annual Home Care Review to the Board. The cost per visit for skilled nursing visits increased by 6.4%. The cost for all other disciplines decreased slightly. In 2010, revenue decreased approximately $155,000 (6.3%) and expenses decreased approximately 4.6%. Medicare reimbursement is based on episodes, and they decreased by 74 (8.7%) in 2010. The non-adjusted reimbursement rate of the decreased 74 episodes calculates to approximately $200,000 for 2010. It is believed this decrease is due to local competition that we did not have before, reducing our patients by a few per month. An additional 6 episodes (patients) per month would help offset this deficit. We have experienced competition before and historically it has resolved itself over time.

Scott Starkweather asked if the trend appears to be holding the first four months of this fiscal year. Mrs. Grush stated yes. Revenue is down because of the 5% cut in reimbursement.  

Dr. Diemer asked if the private sector competition could take care of the county’s Home Care needs. Mrs. Grush said, no, in that local competition is not large enough to assume our caseload, and they are selective of their payor sources and do not accept all payor sources as we do.

Karen Hagen asked if the competition takes Medicaid. Mrs. Grush said no they do not and one of the competitors she is aware of does not accept insurance patients, just Medicare patients. Generally, negotiated insurance reimbursement does not cover the cost, and providers are selective regarding acceptance of patients covered by insurance, and sometimes they do not accept any patients covered by insurance.  

Our agency’s quality data and patient satisfaction data compares favorably to the national and state overall ratings. Karen Hagen asked if this data comes from OASIS. Mrs. Hardcastle responded that it does, and is collected when a nurse admits a patient and at different points throughout the patient’s care. This data determines how much we will be paid. This is a challenge for all agencies, as the assessment is subjective by individual nurses. A priority is for the Home Care program is to focus on standardizing this process, which will positively impact revenue.  

Mrs. Grush reported Home Care policies were reviewed and revised in 2010 to reflect internal as well as regulatory changes.

Todd Latham moved to approve the Home Care Administrative Review as submitted for Fiscal Year 2010, seconded by Dr. Duez.  Motion carried.

PERSONNEL COMMITTEE UPDATE

Todd Latham, chair of the Personnel Committee, provided a review of the activity and process of the committee for the selection of the new Public Health Administrator. The position was advertised extensively through various media throughout Illinois. Fifteen individuals applied for the position. The committee held five meetings to consider the applicants. Four individuals were selected to be interviewed by the committee and the Division Directors. Two individuals were selected for second interviews. The Committee will recommend the individual chosen by them to the full Board in Executive Session.

EXECUTIVE SESSION

At  8:15 PM, Dr. Phillips moved to enter into Executive Session for the purpose of discussing Personnel under Subsection Number 1, 2, and 3 of Section 2 (c) of the Open Meeting Act, seconded by Dr. Duez.                                        

On a roll call vote, those voting yes were Dr. Linda Liston, Mr. Kevin Buick, Dr. Dennis Deimer, Dr. Tim Duez, Mrs. Karen Hagen, Dr. David Phillips, and Mr. Scott Starkweather.

At 8:28 PM, Kevin Buick moved to reconvene to Open Session, seconded by Scott Starkweather.                            Motion carried.

On a motion by Scott Scottweather, seconded by Kevin Buick, the Board of Health appointed Jane Lux as the Public Health Administrator at a salary as discussed in Executive Session effective July 1, 2011.   Motion carried. 

On a motion by Dr. Duez, seconded by Kevin Buick, the Board of Health employed Karen Grush in accordance with the rules for employment under the Illinois Municipal Retirement Fund for up to one year post retirement at a salary discussed in Executive Session. Motion carried. 

REQUEST TO CHANGE JULY MEETING DATE

Mrs. Grush reported that the YMCA and Kishwaukee Community Hospital have received a Pioneering Healthier Community three year grant from the federal government to address chronic diseases and risk factors for over weight, unhealthy eating and physical inactivity. Mrs. Grush had written a letter of support for this grant as the goals are consistent with our IPLAN findings and goals. Only 19 entities in the nation were chosen for grant awards. The YMCA and Kishwaukee Hopsital have selected their core team to lead the grant. It will be composed of executive officer(s) of the YMCA, Kishwaukee Hospital, DeKalb County Health Department, Sycamore and DeKalb Park Districts, Sycamore and DeKalb School Districts. There is a three day conference being held July 25, 26, and 27 in Washington, DC. The grant will pay all expenses for the executive team members to attend the conference. Jane would be attending this conference on behalf of the Health Department. Therefore, a request to change the Board of Health meeting from July 26, 2011 to August 2, 2011 was made. All members present, except Kevin Buick, indicated they could attend the August 2, 2011 meeting. Mr. Buick, chair of the Finance Committee, indicated he would be available for a Finance Committee meeting the week of July 18th. The Board of Health meeting was changed to August 2, 2011 at 7:30 PM.

Correspondence and Announcements

Mr. Latham asked who was shooting the geese in the retention pond by Lowes. Mrs. Grush stated that apparently the police have a lead, but she is unaware if any charges have been made.   

Adjournment

On a motion by Todd Latham, seconded by Dr. Duez, the Board of Health adjourned at 8:43 PM.  Motion carried.

 

 

________________________________________________
Kevin Buick, JD, Secretary
DeKalb County Board of Heath

 

 

DEKALB COUNTY BOARD OF HEALTH

FINANCE COMMITTEE MEETING

July 21, 2011

 

 

 

Finance Committee Members Present:

 

Kevin Buick, Chair

Dennis Diemer, DDS

Jesus Romero

Paul Stoddard

Linda Liston, MD, Board of Health President

 

Finance Committee Members absent:

None

 

Staff Present:

 

Jane Lux, Public Health Administrator

Brenda Courtney, Director of Administrative Services

 

The meeting was called to order by Kevin Buick, Chairman, at 5:09 PM.

 

NEW BUISNESS

 

FY 2012 Health Department Budget

 

Mrs. Lux presented the proposed FY 2012 Health Department budget.  She explained that proposed fee increases and the salary adjustments, in accordance with the Collective Bargaining Agreement, for all employees, were assumed in the proposed budget.

 

There was discussion about fee increases, how to fairly assess fees, and the role of fees in the agency revenue. Mrs. Lux stated that the Environmental Health Program will study the revenue to cover the costs of the Animal Control Program over the next year, and will return to the Board of Health with data and a proposal.

 

Mr. Romero brought up the issue of temporary food permit vendors that do not comply with applications on a timely basis, and require additional staff time to inspect. He discussed the possibility of charging these vendors more than those in compliance. Mrs. Lux will further investigate this issue and bring it back to the full Board.

 

Mrs. Lux reviewed anticipated revenues and expenditures for FY2011. She explained that while we substantially reduced expenditures with the staff reductions in December 2010, revenues are projected to be lower than anticipated. Fortunately, the Department also saved additional cost to the agency as well.

Mrs. Lux reviewed projected revenue for 2012, most of which is trending down once again. She acknowledged it continues to be a very challenging economic environment.  The proposed Budget has a $159,000 deficit, and Mrs. Lux presented her proposal to address the deficit by going into the Fund Balance on a one-time-only basis to give the agency a year to work on increasing revenue. 

 

There was discussion about the need to continue to reduce the growth in expenditures while working on increasing revenue.

 

Mr. Buick made a motion to recommend the FY 2012 Health Department Budget as presented to the full Board of Health.  Mr. Stoddard seconded.  Motion passed.

 

FY 2012 Solid Waste Program Budget

 

Mrs. Lux explained the revenue and expenditures in the proposed FY 2012 Solid Waste Program Budget. Plans are to hold the same recycling events next year, and to work on adding an additional rural recycling site in the southern part of the County.

 

Mr. Stoddard made a motion to recommend the FY 2012 Solid Waste Program Budget as presented to the full Board of Health.  Dr. Diemer seconded.  Motion passed.

 

Mr. Buick moved to adjourn the meeting at 6:25 PM, and Mr. Romero seconded. The motion passed.