Health Committee

June 11, 2008 – 7:30 a.m.

DRAFT Minutes- Corrected

 

Present:                   Carol Tytler, Chairman; Sandy Price, Vice Chairman; Larry Cornell; John Steger; Kathie Wilcox

Others Present:       Scott Schrader, County Administrator; Ann Homer, Secretary II; Jackie Gailor, Public Health Director; Mike Kilmer, Administrative Services Director, Mental Health; Mark Suben, County Attorney; John Troy, Legislator, LD 1; Elaine Lambert, JCRH Director; Mike McKee, Legislator, LD 16; Evan Geibel, Cortland Standard

Excused:                  Dan Tagliente

Absent:                    Steve Dafoe

Mrs. Tytler called the meeting to order at 7:31 a.m.

Mrs. Price moved adoption of the May 7, 2008, minutes as printed. Seconded by Mr. Cornell. All members voting in favor, none opposed; minutes approved as printed.

Resolutions

Health

 

1.         Authorize Agreement/Accept Funds – Health Department/Nursing (Immunization Action Plan Grant). Mr. Cornell moved adoption; seconded by Mr. Steger. Mrs. Gailor explained that this is a routine, annual grant. She believes based on her visit to Albany that this will be reduced by 2% and the Health Department is planning for that in the budget. Mrs. Tytler asked about the content of the immunization that has been alleged to cause autism. Mrs. Gailor believes the vaccines are free of that product. All members voting in favor, none opposed; resolution approved.

2.         Amend 2008 Budget Health Department/Administration/Health Education (State Farm Insurance Donation). Mr. Cornell moved adoption; seconded by Mrs. Price. Mrs. Gailor indicated that this was put in to place at the Kids Day that was held at the Cortlandville Fire Department last week. This was utilized for many programs, including car seats. Mrs. Gailor explained that if individuals attend an event such as the Kids Day, they receive a free car seat if theirs is inappropriate or if they do not have one. There is a program here at the COB and individuals receive car seats on a sliding scale basis. All members voting in favor; none opposed; resolution approved.

3.         Award Proposal/Authorize Agreement – Health Department/Nursing Division (Clinical Software-Certified Home Health Agency). Mr. Cornell moved adoption; seconded by Mr. Steger. Mrs. Gailor explained that the Health Department has been looking at the CHHA software for a couple of years. Last year we began looking at a software system that is fairly new and is being utilized in only one NY Public Health Agency. However, it is being utilized in other agencies throughout the country. We went out to bid and we took the two lowest bids – one that we were already looking at and one that is being utilized by a few public and private health agencies throughout the State. We have looked at the second software at two sites – St. Camillus and Jefferson County . This software does not provide everything we are looking for, particularly utilization by staff. HealthWyse, the system we are recommending, is much easier for staff to use. When MYSIS was installed in Jefferson County , new computers needed to be purchased for implementation. MYSIS is also an installation date of a year away. Nurses are scarce, and we need to ensure that they are not spending half of their time looking at a computer doing documentation. Mrs. Gailor indicated that we have money in the budget to purchase it. Mrs. Gailor acknowledged that Mr. Schrader had a concern about purchasing software being utilized in only one small county in the State. Mr. Schrader acknowledged that it is in use in the smallest county in the State. Mr. Cornell inquired about training and Mrs. Gailor indicated that training will be included in the purchase price. Mrs. Wilcox asked if this is compatible with our computers and Mrs. Gailor indicated that it is and that it can be installed on palm computers as well. Mr. Steger asked about increase in productivity. Mrs. Gailor indicated that we currently average a little over 3 visits per day, we are shooting for 4 visits per day, and with the implementation of this system we believe that goal is reachable. Mrs. Wilcox asked about what is covered in the monthly maintenance and Mrs. Gailor explained what was covered. All members voting in favor, none opposed; resolution approved.

Discussion

1.         Mrs. Tytler explained that Mr. Kilmer requested permission to bring forth the MOU for the Community Services Board for discussion, not vote, today. Mr. Kilmer explained that we started this project approximately two years ago to develop an MOU outlining the relationship between the County and the CSB. Mr. Schrader attended a meeting and this document was developed. The CSB then made some adjustments, and now Mr. Kilmer has been asked to present this MOU to move forward. Mr. Schrader explained that under New York State Law, the Community Services Director is under the direction of the Community Services Board. This has been problematic. This MOU brings the appointment of the Community Services Director under the guise of the Legislature and it also explains all the policies and responsibilities of the CSB in relation to the County. Much of this are spelled out in New York State Law, so it is a repeat of that law. This does, however, provide for the County Administrator to supervise the Community Services Director and memorializes how the Community Services Director and Administrative Manager are appointed. Under current law and without this MOU, when a vacancy occurs in the Community Services Director, that position is appointed without input from the Legislature or County Administrator . When a vacancy occurs in Director of Administrative Services, that position is appointed by the County Administrator and County Legislature without input from the CSB. He does not feel this is the most effective manner of operating. Mr. Schrader further explained that there is some urgency in this as there will be a vacancy in the Director of Community Services in the next week. Mrs. Tytler explained that she served on the CSB for four years. One of their concerns was that they were expected to perform the Community Services Director’s performance evaluation and they did not work with him on a daily basis. Mrs. Tytler explained that both the CSB and the County Legislature are relinquishing a bit of authority through this MOU. Mrs. Tytler explained that the section with the largest amount of changes is under the duties of the County Administrator . Mrs. Tytler asked that every member receive a copy of this MOU. Mrs. Wilcox asked Mr. Suben if he had reviewed the document. Mr. Suben indicated that he just received it this morning. Mr. Suben indicated that he needed to review it. He needs to research whether or not the shift in the law can be accomplished. However, he understands the need to get it done. He cannot advise the committee today whether the law allows this to be done, but he does not intend to stand in the way of this. Mr. Cornell moved to accept the MOU, contingent upon Mr. Suben’s approval; seconded by Mrs. Wilcox. All members voting in favor; none opposed; motion adopted.

2.         Mrs. Price gave an update on the event recognizing Dr. Charles Capanzano’s retirement. The event will be June 12, 2008, at the Country Club, commencing at 6:00 p.m. Speeches are planned for approximately 7:00 p.m. and the event will run through 8:00 p.m. Speakers are asked to limit remarks to 3 minutes; there are approximately 11 speakers. Mrs. Price will serve as the MC and she will ensure that the program moves along.  Mrs. Morgan has prepared a certificate on behalf of the Legislature, and tomorrow, Mrs. Tytler will pick up the gift from the Legislature. Mr. Kilmer indicated that a luncheon was hosted for Charlie and he was presented a watch on behalf of the department. Mrs. Tytler encouraged all members to attend if possible. Mr. Troy expressed his regret at being unable to attend due to his commitment to a meeting at TC3. Mrs. Tytler thanked Mrs. Price and Mr. Kilmer for their work in preparing this event. Mrs. Price thanked Mr. Kilmer for all of his work on the invitations.

Presentation

1.         Mrs. Gailor introduced Ms. Elaine Lambert, Director of the Jacobus Center for Reproductive Health. Mrs. Tytler asked all members to introduce themselves to Elaine. Ms. Lambert thanked the committee for the opportunity to speak to them. She provided some materials to the committee, including an organization chart and an overview of the program. Ms. Lambert explained that JCRH is a division of the Health Department, over which she is the Director. Ms. Lambert briefly explained, via the organizational chart, the functions of the division. Ms. Lambert indicated that they have excellent staff, who are creative and committed to serving the patients who seek their services. Ms. Lambert indicated that family planning services are the largest portion of the services provided. They also provide rapid HIV testing, which has increased the number of testing they are doing. Title X funding allows the JCRH to provide sliding scale fee services. JCRH also provided facilitated enrollment for the Family Planning Benefit Program, which is funded 90% by federal funds and 10% by state share, so there is no local cost for this excellent service. The JCRH also provides the mandated Sexually Transmitted Disease (STD) diagnosis and treatment for our residents. Ms. Lambert indicated that the number of patients and visits have decreased since 2004, which is reflective of a state-wide trend. Ms. Lambert indicated that we are part of a Title X team, which looks at various issues, including decrease in patients and how to increase patient satisfaction. The patient satisfaction surveys are excellent, however, we do not know what the remainder of the community thinks of the service and they are working on a community survey to gather that information. Ms. Lambert explained our community education and training programs, which are spearheaded by Mary Dykeman, the JCRH Health Educator. Ms. Dykeman is very well respected in the community and works with a broad range of program participants. The education programs have had a positive impact on our community. Ms. Lambert spoke about the Zero Adolescent Pregnancy (ZAP) program. She spoke about the success of the program, and indicated that we are working on an Advisory Council this summer to work on future goals for the program. Mrs. Gailor indicated that not only were we trying to reduce the rate of teen pregnancies in Cortland County when the program was implemented in 1990, but we were also trying to reduce the rate of repeat teen pregnancies. In 1990, we had the highest rate of repeat teen pregnancies in the state; that number had reduced and it appears we are having success with that goal as well. Ms. Lambert also gave a brief overview of the revenue stream and expenditures for the JCRH. Ms. Lambert explained that she has been exposed to the JCRH in her career outside the Health Department, and she found the JCRH patients to be much better educated that the typical OB-GYN patient. Ms. Lambert extended an invitation to all members to visit the JCRH for a tour so they can see firsthand what services are being provided.

            Ms. Lambert spoke about the “Sexual Health A to Z” campaign that is underway. She shared with the committee the variety of promotional materials that the JCRH utilizes. She also spoke about the logo that is on one of the Cortland Transit buses. Ms. Lambert spoke about “Teen Tuesday”, which is an opportunity for teens to come to the JCRH when there are not “adults” around that will intimate them. Ms. Dykeman provides education in the clinic on “Teen Tuesday” as well. Mrs. Price indicated that she has been present when Ms. Dykeman presented a program and found that Ms. Dykeman provides wonderful information with humor and sensitivity and her presentation is well received. Ms. Lambert explained that Ms. Dykeman will present a program wherever she is requested. Mrs. Gailor indicated that Ms. Dykeman will also provide workplace programs to talk with parents. Sessions have been hosted here at the COB. Mrs. Gailor indicated that the mother-daughter retreat has been extremely successful; unfortunately, the father-son or parent-son retreat has not been as successful.

            Mrs. Tytler indicated that the Legislature is looking at space for departments. She asked Ms. Lambert is the space layout of the JCRH impacts services. Ms. Lambert indicated that the clinic is laid out backwards – you must pass everything to get to the reception area. There are only two exam rooms available for the NPs, so you cannot have another person getting ready. The coordinator also has office space with other nurses, so it is difficult to get work done. She also indicated that in doing facilitated enrollment, there is not a private place for the Medical Services Clerk to speak to the patients, which means some of the interviews are being conducted at the window. Mrs. Tytler inquired if JCRH is still leaving the small conference space near the Maintenance. Mrs. Gailor indicated that space was being utilized for the MOMS program. It is not being utilized for the MOMS program now, we have an office in the Health Department, however, the MOMS patients have to walk through two Health Department areas to reach the interview room. Ms. Lambert indicated that the Health Educator and ZAP Coordinator share office space.

            Mr. John Troy indicated that the ZAP program has been very effective, particularly recently. He was around at the schools when the program was first implemented. In the beginning, it wasn’t as well received as it is now. He complemented the work of the ZAP Peers and indicated he felt it was a very effective and well-received program.

            Mrs. Tytler thanked Mrs. Gailor and Ms. Lambert.

Mrs. Wilcox moved for adjournment at 8:20 a.m.; seconded by Mr. Cornell. Meeting adjourned at 8:20 a.m.

Minutes prepared by Ann Homer, Secretary