Marion County Board of Health Meeting Minutes September 16, 2008 7:00 P.M.

Board Members Present: Dr. Elizabeth Franczyk, Dr. Stanley Morrison, Michael Morton, Dr. Matt Stedelin, Paula Strothers, and Thomas Turner Others Present: Lori Ryan, Administrator; Melissa Mallow, Environmental Health Director; Shelly Yoder, Director of Nursing; Tara DeWitt, Health Educator; Crystal Russell, Administrative Secretary I. CALL TO ORDER The Marion County Board of Health met on September 16, 2008, at the Marion County Health Department, Centralia office. President Tom Turner called the meeting to order at 7:00 pm.

II. QUORUM A quorum of six board members was present.

III. MINUTES The minutes of the June 17, 2008, quarterly Board of Health meeting were approved and were accepted as presented.

IV. SPECIAL ORDERS Lori Ryan welcomed Paula Strothers, Registered Nurse at Salem Elementary to the Board of Health. a. Board Appointment: A letter was received from the Marion County Board, appointing the following members to the Board of Health: Pam Hawkins, Representative of the County Board, 11/30/2008–11/30/2009; Mike Morton, Dr. Elizabeth Franczyk, Dick Haney, and Dr. Aziz Rahman terms being 11/30/2008–11/30/2011. b. Selection of Board Members: Dr. Morrison nominated Dr. Stedelin for President. All were in favor, none opposed. Dr. Franczyk nominated Mike Morton as Secretary; Dr. Morrison, Paula Strothers, and Dr. Franczyk were appointed to be on the finance committee. These terms become effective December 1, 2008. Dr. Stedelin will be the Board of Health Medical Director through 11/30/2010.

V. FINANCIAL REPORT Turner called for a review of the financial report. Lori Ryan reported that the cash flow balance at the end of the third quarter for Fiscal Year 2008 is $481,029.76. Total revenue for the third quarter was $895,748.91, which is 81.24% of our total budget; which gives the Health Department a positive variance of $68,845.56. Expenditures were $850,792.82, which is 69.22% of our total budget. Dr. Stedelin made a motion to accept the financial report; Mike Morton seconded the motion. All were in favor; none opposed. The financial report was approved. Marion County Board of Health: September 16, 2008

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VI. OLD BUSINESS a. Bonus for No Call-In: If an employee had no call-ins from December 1–November 30, a $250 pro-rated bonus would be given to the employee at the end of the time period; bonuses would range from $50-$250 for part- and full-time employees. Dr. Franczyk made a motion for a one year trial period, then re-evaluate. Dr. Morrison seconded the motion. All were in favor; none opposed.

VII. NEW BUSINESS a. Activities: Health Education: Tara DeWitt, Health Educator Through the Illinois Tobacco Free Communities Grant, DeWitt started the Truth or Consequences / Social Norm Marketing Campaign. The overview and requirements have been mailed to the five Marion County High Schools. DeWitt is presently setting up times to meet with the school sponsors and deliver posters. DeWitt distributed poster examples, which were school specific. Franklin Park Middle School has also agreed to display the posters for Salem Community High School; even though they are not part of the Truth or Consequences program. Great American Smoke Out (GASO): the Health Department should have 11 elementary and middle schools involved. This year, South Central Elementary and Middle School have agreed to participate. For the grade schools, the main emphasis is through the four handouts, one per week, with the last one concluding the week of GASO, November 20. Each handout has Kindergarten thru 3rd or 4th thru 8th student side and a parent side of tobacco information. Through the GASO at the grade school level, the education portrays: youth and adults on the dangers of tobacco; challenges the students and parents to stop using tobacco for one day; all of these while raising awareness of the effective ways to quit for good. At the high school level, the students will make a pledge wall; make tobacco announcements; direct activities; and challenge students to say “no” to tobacco products or go to smoke-free for a healthier lifestyle. Turner stated all South Central Community schools, including the high school, are considered Marion County since the unit office is in Marion County. DeWitt was appreciative to learn this information.

Environmental Health: Melissa Mallow, Director of Environmental Health West Nile Virus: On July 1, the Environmental Health Division started collecting Culex mosquito samples with CDC gravid traps at two locations, behind both health department offices. So far there have been no positive samples. As of today, there have been no positive human cases, birds or horses in Marion County. There are only five human cases in the state, which are in Cook, DuPage, Kane, Macon and Montgomery counties. Smoke Free Illinois Act: As of today, September 16, the Health Department has received 39 complaints for 24 businesses from the IDPH Complaint Line. Eleven facilities were restaurants / bars and 13 were offices / workplaces. Mallow plans to mail a copy of all the complaints to Matt Wilzbach, Marion County State Attorney, so Wilzbach can see that the public wants the Act enforced. New Septic Regulation: On August 29, the Centralia Sentinel ran an article on the front page Marion County Board of Health: September 16, 2008

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about an amendment to the Illinois Private Sewage Act. The article read that homeowner maintenance was now required and the homeowner had to provide verification to the local government once every three years. The reporter was completely wrong. Mallow talked to a different reporter about the story being wrong and how the Sentinel needed to correct their mistake. A new article was run on September 6. The amendment is to Section 10 of the Illinois Private Sewage Code. This amendment gives local health department, who have a septic ordinance, the authority to require homeowners to have maintenance on their septic systems by a licensed contractor, if that county wants to. Marion County does not have a septic ordinance; therefore homeowners do not have to worry about this regulation.

Nursing: Shelley Yoder, Director of Nursing Women, Infant & Children (WIC) Caseload: The state goal for the Marion County Health Department is to have 1,418 participants. The Health Department’s statics are as follows: June – 1,361 participants, 96% of the caseload; July – 1,367 participants, 96% of the caseload; and August – 1,412 participants, 100% of the caseload. Flu Clinics: 30 off-site clinics have been scheduled and confirmed, beginning October 2, 2008. October 7, 2008, from 2:00-3:30 at Evergreen Christian Church in Salem, the Health Department will hold a drive-up flu clinic to accommodate clients that have difficulty ambulating. Anyone that has mobility problems is encouraged to attend this flu clinic. Yoder will contact WJBD. On-site clinics have been scheduled for the month of October. Walk-in clinics will be held every Monday in Salem from 8-4 pm, and every Wednesday in Centralia from 8-4 pm, excluding Monday, October 13, which the offices will be closed in observance of Columbus Day. On September 9, 2008, all 3,000 doses of the adult influenza vaccine, Novartis Fluvirin vaccine, were received. The vaccine contains strains: A/Brisbane H1N1; A/Uruguay, a Brisbane-like strain; and B/Florida. Off-Site TB Clinics: The Health Department held a tuberculosis Clinic for the Health Educator students at Sandoval High School on August 26, 2008; 13 students were tested. A TB clinic is also scheduled for the Health Educator students at Centralia High School on September 17; 54 students are scheduled to be tested. Zostavax: On July 10, 2008, the Marion County Health Department sent a memo to all pharmacies in Marion County giving information on proper storage and handling of the Zostavax vaccine, due to reports of clients picking up the vaccine themselves and transporting it to their physicians, or other health care provider for administration. A copy of the memo was provided. Immunizations: An immunization site review was conducted by the Illinois Department of Public Health on September 9. The review went well, and no corrective actions were indicated. Hepatitis B Contact Testing: On July 16, 2008, the Health Department initiated Hepatitis b contact testing. All household or close contacts to Hepatitis B cases can now be tested via lab draw for Hepatitis B Surface Antigen and Hepatitis B Surface Antibody through the health department at no charge, prior to vaccine administration in susceptible household contacts. Dr. Aziz signed the order, and a policy and procedure was written. If the lab tests return negative, the Health Department will complete the series of 3 Hepatitis B vaccinations for the contacts at no charge. If the Hepatitis B Surface Antigen tests returns positive, the client will be referred to their physician for an evaluation, and the Hepatitis B vaccination will be discontinued. The vaccine is supplied free from the State, and the lab testing is done free at the Chicago State Lab.

Marion County Board of Health: September 16, 2008

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School Physicals: On July 31, the Health Department provided school physicals in the Salem office and on August 5 at the Centralia office. Thirty-nine school physicals were completed; 16 private pay and 23 Medicaid. The total gross income was $1,379.45. Cindy Lord, a Nurse Practitioner from Bluford, Illinois, completed the physical assessment STD Testing: This quarter, 6 urine tests for gonorrhea and Chlamydia were completed. Four of the 6 tests were positive; no positive results for gonorrhea. All positive clients were referred to Dr. Asghar for treatment. Other Testing: This quarter, 9 HIV tests with no positive results; 10 standing order lab tests; and 15 cholesterol screenings were completed. Lead Services: This quarter, 298 blood lead capillary tests, 4 new lead investigations and home visits were completed. Eighteen children are currently being followed under Lead Case Management Services through the Health Department. Client Surveys: The semi-annual surveys were distributed in July. One hundred twenty-five general surveys were completed. The following had “Very Satisfied” responses to the survey: 87% with the convenience of location; 71%^ with length of time spent waiting; 86% with among of privacy; 91% with Courtesy and Respect; and 92% with staff skills and knowledge. One hundred forty-five WIC participant surveys were completed: 99% responded that staff was helpful; 98% responded that staff was respectful; 84% responded that the time they spent at the clinic was what they expected; and 82% responded that appointment times were very good.

Administration: Lori Ryan Upcoming Events: Pandemic Flu Exercise will be held September 18 at Rend Lake. Several counties will be in attendance. The Health Department will meet with the Marion County ESDA, Sheriff, Police Chief to perform an exercise on strategies. ◘ Open House will be held September 23 from 1:00-3:00 at the Centralia Office, celebrating the remodel completion and 15 Year Anniversary as a Public Health Department. ◘ Education Day will be held September 25; both offices will be closed to the public. All staff will review OSHA, safety issues, the Fire Department will attend, along with other speakers. FY’09 Grants: Grants for the next fiscal year are not looking good. New contracts have been received with 3% reserve taken out that the governor has mandated. ◘ Heart Smart for Teens grant was denied to the Health Department for funding. The Health Department will write for that grant again next year. Accounts Receivable: The Health Department is owed $104,000; Frank Watson said the state money will probably not be released until after December. The Health Department has a reserve to cover this issue. Change in Positions: Tara DeWitt will now be splitting her time as Health Educator and Emergency Preparedness Coordinator. Pam Snyder was the Emergency Preparedness Coordinator and is now actins as a WIC Nurse. Remodeling: The remodeling at the Centralia office is complete. The attic area of the back third new remodeling has trusses strong enough for additional offices or storage area. Amount spent on remodeling totaled $101,000; this includes $19,000 for the extra trusses and lobby insulation. Marion County Board of Health: September 16, 2008

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Dr. Franczyk inquired if the WIC classes included discipline strategies; parents are bringing their children in the office requesting prescriptions to treat ADHD. The children do not have structure at home. Ryan stated she would talk with the WIC Coordinator to possibly enhance the classes. Ryan then added that 12,000 books are to be picked up next week to disburse to low income clients for parents to read to their children. Franczyk suggested high school students read in the lobby as a community service project.

b. FY’09 Budget / Raises The Board of Health decided to discuss these subjects in closed session.

c. FY’07 Audit The Fiscal Year 2007 Audit was completed the end of August. Excess of revenues over expenditures for 2007 were $122,713. Changes in Net Assets were $106,508 (page 7); compared to 2006, this was a 14% increase, which brings the Net Assets to $853,709 (page 6). The Findings were the same as previous years: inadequate segregation of duties at the court house. The Audit Report was sent to the State, DHS, and all other required agencies. Dr. Morrison made a motion to accept the FY’07 Audit; Dr. Stedelin seconded the motion. All were in favor; none opposed. The FY’07 Audit was approved.

d. FY’09 Meetings The Board Members in attendance agreed to alternate meeting locations between the Salem and Centralia offices. A calendar was distributed with the meeting dates highlighted as follows: December 16, 2008 ........... Salem Office March 17, 2009 ................. Centralia Office June 16, 2009.................... Salem Office September 15, 2009 .......... Centralia Office Dr. Stedelin made a motion to accept the FY’09 Meeting Dates; Paula Strothers seconded the motion. All were in favor; none opposed. The FY’09 Meeting Dates were approved.

VIII. CLOSED SESSION Mike Morton made a motion to proceed in closed session; Dr. Stedelin seconded the motion. All were in favor; none opposed. The public board meeting came to a close and the then proceeded in closed session. Dr. Morrison made a motion to come out of closed session; Dr. Stedelin seconded the motion. All were in favor; none opposed. The board meeting came out of close session.

FY’09 Salary Revisions Dr. Franczyk made a motion to approve raises for the nurses of $1.50 per hour; Paula Strothers seconded the motion. All were in favor; none opposed. The nurse’s hourly raise was approved. Dr. Franczyk made a motion to approve raises of 4% for the remaining staff; Dr. Stedelin seconded the motion. All were in favor; none opposed. The 4% remaining staff raise was approved. Marion County Board of Health: September 16, 2008

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Dr. Morrison made a motion to raise the Administrator annual salary by $3,000; Dr. Franczyk seconded the motion. All were in favor; none opposed. The Administrator salary increase was approved. Dr. Morrison made a motion to approve the budget as amended; Dr. Franczyk seconded the motion. All were in favor; none opposed. The amended budget was approved.

IX. ADJOURNMENT Mike Morton made a motion for adjournment; Dr. Stedelin seconded the motion. The next meeting is scheduled for December 16, 2008, at the Salem office.

___Crystal Russell / signature / Crystal Russell, Administrative Secretary Marion County Board of Health: September 16, 2008

September 17, 2008

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